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Comment by dmix | Hacker News Reader

> “This study suggests that HEPA air cleaners, which remain little-used in Canadian hospitals,

What, they are "little used"? I'd assume that's the first place that would have adopted them. So strange how some hospitals operate.

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Early on in the pandemic, the Canadian IPAC (Infection Control and Prevention) establishment came down hard against theories of airborne COVID transmission, at first even going so far as to not recommend masking. Even now that the science of airborne transmission has been established, they're waging a rearguard battle to obfuscate/deny it and airborne protections such as better ventilation and masking. If you go to a Canadian hospital wearing an N95 these days there's a good chance they will insist you to take it off in favour of a "clean" surgical mask with gaps around the sides and nose.

Airborne transmission and the usefulness of filters still doesn't seem that clearly established - this study didn't find that much virus in the air even without the filters, and most of the real-world transmission seems to involve people who were directly exposed to virus particles before they even had a chance to go through a filter, via standing next to someone or directly in an airflow path coming from their direction.

thanks for pointing this out. it gets lost in the fervor of trying to "fight the virus". most of our interventions are useless, and yet, we still insist on doing them. the virus just isn't aloft and active for very long. that's why the most dangerous activity is close conversation, something we tend to do around people we know well (friends & family), not strangers in public.

That's certainly the dominant narrative, but it flies in the face of superspreader events where it appears that one or a few people infected hundreds. Did they directly breathe on everybody they infected?

https://montreal.ctvnews.ca/outbreak-at-quebec-city-gym-link...

https://www.cdc.gov/mmwr/volumes/69/wr/mm6919e6.htm

https://elpais.com/especiales/coronavirus-covid-19/a-room-a-...

> Did they directly breathe on everybody they infected?

Maybe they coughed over shared food/drink trays.

The first case linked above was in a gym where patrons were supposed to be masked and two meters apart, and the second case had a CDC investigation which would have mentioned that as a factor if it were present.

> If you go to a Canadian hospital wearing an N95 these days there's a good chance they will insist you to take it off in favour of a "clean" surgical mask with gaps around the sides and nose.

Wouldn't that just be because of protocol, ie. they don't know if you, a member of the public, actually have a legit N95 mask, or if you know how to correctly implement it, etc.

Is a surgical-mask better than a fake N95 mask?

actually have a legit N95 mask

Incidentally, if you want to validate 3M N95 masks, 3M has a web site for that.[1] You type in the code on the bottom of the box and 3M checks it. You can only do this once per code; the site will tell you if a valid code has been used before. They suggest signing and dating the box after doing this, to indicate that check has been done.

[1] https://www.3m.com/3M/en_US/worker-health-safety-us/3m-safeg...

How do they know that one is not wearing a fake surgical mask then? The obvious conclusion is that parts of the medical establishment are still being dumbasses about masks, two years into the pandemic.

> If you go to a Canadian hospital wearing an N95 these days there's a good chance they will insist you to take it off in favour of a "clean" surgical mask with gaps around the sides and nose.

Happened to me many times. Sometimes they let me wear it over my (certified) N95, sometimes they don't.

I am so confused… how do they think covid spreads, then? Why should you wear a surgical at all, then?

The sign I saw at a hospital in Toronto said no fabric masks, only surgical. It’s probably about uniform coverage not overall efficiency, a compromise of most big central systems.

My corner flower shop has a sign saying surgical or FFP2, just like most shops I’ve seen in my area of Germany. If they can manage it, so should a hospital.

N95s often have exhaust filters which make a surgical mask safer for everyone else around you.

You can put tape over the valve on the inside and the outside and that works fine.

It's quite easy to find ones that don't.

Having some experience with hospitals and N95 they asked that we put a surgical mask over the one we came with. Pointless and unnecessary but I guess it’s easier than having staff validate the mask your wearing.

They never required we remove a mask.

I suppose the cost of installation outweighed the minor inconvenience of colds and flus spreading in the past. Only now that we have a deadlier virus does it make sense.

Most likely. Canada also has a habit of under-spending on healthcare in general. The system is also hypersensitive to political whims and can end up getting neglected as a result. This is because the provinces have direct control over every aspect of the healthcare system, and set the budget for them directly.

Unlike other nations like Germany and Estonia, Canada's healthcare system is fully dependent on the provincial government to exist and be funded. If I'm not mistaken, in the two countries I mentioned, clinics can get private funding while providing universal access in most cases, which means they have a larger buffer between the political whims of the state, and their ability to provide service. If the state under-provides, the clinics can seek investors to cover the new costs, all the while maintaining universal coverage.

That's not something Canadians can do. Talk of any private involvement, or restructuring in general, in Canada's healthcare system is often very politically charged and not particularly honest, so change is not happening any time soon.

I suspect the issue here is that the hospitals know that having HEPA filters would be a good idea, but political will isn't there to give them what they need. Canadian politics on both sides lately has been more about the appearance of progress through large gestures, rather than careful consideration of long term solutions. It's very unfortunate.

Have you lived any length of time in Canada? If so, where? While I have been fortunate enough to not have needed to go to hospital, my dental office reopened after the initial lockdown last year with a HEPA filter, doorway screen and other paraphernalia which made each workarea look like a clean room. And they shifted from water to air-driven cleaning and dressed like sci-fi actors. I would imagine the hospitals were similar due to the stress put upon them. Anecdotally, my wife had a breathing test in hospital a few days ago and they checked vaccination status and accepted the mask she walked in with.

Given that the federal government is responsible for funding much/most of the provincial health care system, they have some input into how things operate. Most provinces have a good handle on covid unless their government went too deep into the "covid is over" bit (Alberta, Saskatchewan). The covid response here was delayed due to the need to secure vaccines from others, but the end result has been quite good.

I have lived all over N America, and the freedom/flexibility of the Canadian health system has been better than anywhere except St. Louis, MO when I was there - and that required full-time employment.

> Have you lived any length of time in Canada?

Yes, I am a Canadian. I lived there for 25 years. I have Canadian citizenship. Most of my family still lives there. I also ended up stuck in Ontario for most of COVID. I have family in Ontario, in Quebec, and elsewhere in the country. I don't think Ontario had a very good handle on COVID. It's also no secret that Canada is suffering a major staffing, and funding shortage in the healthcare sector right now.

While most of your reply is about dentists (I'll get to that later), I see you're comparing Canada's healthcare system to the USA. I'm not. Compared to other systems in NA, yes, it's much better since it's free and somewhat fair. But that's the problem. Canadians should be looking to other developed nations with public healthcare. Not to the United States which operates on a completely different paradigm. My comment that you're replying to is entirely contrasting Canadian healthcare with EU systems, not Americans.

> dental office reopened

The majority of dentists are private entities, and are not subject to the same funding rules as hospitals. They're not licensed through the same entities, funded, or managed in the same way at all. Likely why they were able to adapt so quickly. See: https://www.cda-adc.ca/stateoforalhealth/servicescanada/

> [..] they checked vaccination status and accepted the mask she walked in with.

I'm not really sure what you're getting at here, this does not really relate to funding, or anything I'm talking about really. This is more about safety policy, not funding, which is what I'm trying to discuss.

Don't get me wrong, I've had some good experiences with the system as well, but that does not mean it shouldn't significantly improved.

The masks might have been after seeing a different comment, sorry. The problem with improving the system is that 1/3 of the country seems to want the US system in healthcare and probably (lots?) of other things. So it goes. Re: Ontario, I was looking at Ottawa specifically, the province generally and while it's "blessed" with a Conservative premier he's taken more medical advice (or indulged his populist leanings) more than other such premiers. Canadians, for the most part, are willing to play along which also helps.

I'm not really sure what you're trying to say here. I don't really think there's any real reason to think that 1/3 of Canada wants the American system. That's certainly never something I've seen any evidence for. My impression was always that it was a point of general pride that the Canadian system "wasn't' like the American's". Only a small fringe want otherwise from what I can tell. It's not even in the platform of any small fringe parties as far as I can tell. I would suspect if a niche issue like Albertan separatism finds political expression, this would too.

Could you be conflating talks about "privatization" (allowing private clinics to exist and take OHIP) with private healthcare payments (you don't get OHIP) by mistake? Those two are not really the same at all, but get conflated in the media often.

That last part there about Ottawa or Ontario, not sure which one, doesn't really make much sense, sorry. It's unclear what you're getting at. Nothing there really sounds related to what I'm talking about.

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