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A dose of the measles, mumps, and rubella (MMR) vaccine. Alberta is at the centre of Canada’s measles outbreak, having recorded nearly 2,000 cases, the highest figure per capita of any province.Geoff Robins/The Canadian Press
One day after a central Alberta hospital alerted the provincial government and senior health care leaders that it had implemented a strict masking policy to prevent the spread of measles, the facility-wide safety measure was discontinued, documents obtained by The Globe and Mail show.
Internal e-mails between officials at the provincial health agency, provided through a Freedom of Information request, show enhanced masking measures were implemented at Two Hills Health Centre on April 1, because of increasing cases of measles and other respiratory viruses − and the high risk of exposure inside the hospital. It made masking mandatory for all staff and visitors.
Alberta Health Services (AHS) staff were discussing on April 1 plans to alert Two Hills staff and increase signage to warn patients of the policy. Over the next 24 hours, AHS also fielded questions from the province on the justification for enhanced masking and whether it was likely to extend to other sites, internal e-mails show.
The masking order was withdrawn on April 2. The documents do not make clear who made the decision to abandon the directive.
“Effective this afternoon, facility masking is no longer required,” wrote Tammy Tarkowski, Two Hills site manager, on April 2 to colleagues. No reason was provided. “If you have any questions or concerns, please do not hesitate to contact me.”
Internal documents show how Alberta’s measles outbreak began to spiral out of control
The Globe previously reported that the United Conservative government delayed efforts by public health officials to curb the spread of measles, including for visitor restrictions in hospitals. The newly released 42-page document, which is partly redacted, raises further questions about the provincial measles response.
Premier Danielle Smith became leader of the UCP in 2022 in large part because of her opposition to COVID-19 public health restrictions, including mask mandates. She has blamed AHS, which is an arms-length agency, for pandemic restrictions and frequently attacks the agency for health system shortfalls.
Alberta is at the centre of Canada’s measles outbreak having recorded nearly 2,000 cases, the highest figure per capita of any province. Measles is one of the world’s most contagious viruses; it can be transmitted through contact with an infected person and airborne spread.
Two Hills was one of the first communities exposed to measles after the provincial outbreak began. Cases had spread so quickly by the second week of April that public health officials considered ditching safety measures such as contact tracing, and excluding infected individuals from public settings.
On April 10, roughly one week after the local hospital dropped its mask mandate, then chief medical officer of health Mark Joffe told public health leaders that enforcement of public health measures was “not a realistic option,” The Globe previously reported.
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Maddison McKee, press secretary to Minister of Primary and Preventative Health Services Adriana LaGrange, said in a statement that AHS, not the government, made the decision to rescind masking at Two Hills.
“As is common practice, clarifying questions are asked around operational decisions being made so that we can fully understand the approach, including how decisions align with existing standards and policies,” Ms. McKee said.
Internal e-mails show Kyle Warner, with the Ministry of Hospital and Surgical Health Services, wrote to AHS on April 2. He said: “Can we get some more info on this before the decision is made please?”
Christine Myatt, a spokesperson for AHS, an agency that is overseen by the government, said in a statement that enhanced masking was a “temporary measure” while Two Hills introduced a better process for directing potentially infected individuals through the site for measles testing without putting others at risk.
“Once the process was in place, the enhanced masking order was rescinded on the authority of local AHS leadership,” she said.
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Ms. Myatt did not respond to additional questions, including how risk had been mitigated.
Internal e-mails indicate AHS expected masking to continue past April 2.
In responding to questions from the government on the implementation of the masking mandate, Heather Kipling, AHS communications director for the Central Zone, said the responses included in her e-mail were based on discussion with health leaders for her zone and medical officers of health.
Ms. Kipling said enhanced masking – a measure that was implemented widely during COVID – would remain in place until it was determined that the risks assessed as part of implementation, such as case numbers and risk of service disruption, were reduced. “Exact time frame is unknown at this time,” she added.
Ms. Kipling said the executive leadership of the zone and the local medical officer of health were in support of the directive.
Two Hills is home to a large Mennonite population and Ms. Kipling said cultural beliefs around vaccination, distrust in public health and “very low” childhood vaccination rates put the area at higher risk for rapid measles spread.
She added that some patients who went to Two Hills Health Centre for measles testing have ignored directions aimed at keeping them apart from other patients, increasing the risk of contact with undiagnosed cases in a site that has no separation between acute and long-term care.
There were also concerns that neighbouring health care facilities, in places such as Vegreville and St. Paul, would be affected by the measles surge in Two Hills because of service disruptions on nights and weekends, internal e-mails show.
