December 1, 2023

Healthy Choice

Healthy Choice The Only Solution

Opinion: ‘Personal choice’ on masks will put immunocompromised at risk

I hope Quebecers will consider continuing to use masks in places where immunocompromised people still need to go, such as public transport.

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“The feeling of being disposable … is knitted into my bones and sinews. It lives in my cells and the parasites in my gut.”

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These are the words of Elliot Kukla, a disabled rabbi, writing in the New York Times in March 2020.

These words ring even truer to me today. When I was 15, a sudden illness turned into months of dialysis and, eventually, a kidney transplant. Despite this, much of my life was normal. I studied, travelled, have a job I enjoy. But, lately, listening to politicians and the media has made me feel as if those of us who oftentimes fought hardest to be here are seen as less alive, our deaths less tragic.

The political motives behind Premier François Legault’s recent response to the pandemic have seemed clear. Two months ago, the Coalition Avenir Québec government was pushing an ill-advised tax on the unvaccinated and a curfew opposed by Montreal public health authorities. Its about-face is not the result of any end of the pandemic. BA.2 is already surging globally. Pandemic fatigue and a bleeding of CAQ voters to the Conservative Party of Quebec are probably stronger influences.

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Across the aisle, Québec solidaire has spoken out on behalf of groups like the unhoused during the pandemic while showing little concern for those with immune deficiencies.

Quebec Public Health Director Dr. Luc Boileau has emphasized the “personal choice” of one-way masking for the immunocompromised once current requirements are dropped. Most masks won’t fit well enough to provide adequate protection with a variant that spreads in seconds. Omicron has more asymptomatic carriers and a lack of testing makes “assessing personal risk” impossible. He has also spoken about a fourth dose and medications. However, many can’t mount a response to vaccination and Omicron evades most monoclonal antibodies. The antiviral Paxlovid is contraindicated with many other medications. Evusheld, the antibody with the best prospects, has yet to be approved by Health Canada, despite being used in the United States.

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Immunocompromised people understand that others are willing to take more risks to get back to their lives. I will continue to see few people and avoid places like restaurants and gyms. But our lives will be rendered extremely difficult when masks are removed in grocery stores, pharmacies or public transportation. When the government decided that it was in the interest of the majority to require vaccine passports, they ensured that essential services remained available to the unvaccinated. It has de facto declared that immunocompromised people do not share this same right.

Meanwhile, despite media showcasing Quebecers overjoyed at the end of measures, data from the Quebec Institute of Public Health show that only 45 per cent are in favour of removing masks, with 51 per cent opposed.

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It is not only the immunocompromised whose well-being is at risk when the public is lulled into a false sense of “normalcy.” Many now healthy individuals will suffer from long COVID. There is mounting evidence of long-term impact on vital organs including the brain and the possibility for vascular conditions and reactivating Epstein-Barr virus, linked to lymphomas. All of this within a health-care system unable to handle its current caseload of chronically ill patients and where there are long waits for surgery.

So, while returning to “normal,” I hope Quebecers will consider continuing to use masks in places where immunocompromised people still need to go, such as crowded public transport. With COVID, transplant patients have a 50-50 chance of being hospitalized and one in 10 will die.

But we also need to ask for more from our government in terms of paid leave, flexible work, ventilation and a public-health system that tracks the virus as it evolves. I, like many, hope that rather than a return to normal, we can ask for better, not only for the most vulnerable, but for everyone.

Sophia Crabbe-Field is associate editor of the Washington, D.C.-based policy journal Democracy: A Journal of Ideas. She lives in Montreal.

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