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TORONTO — Ontario's chief medical officer of health strongly recommended Monday that residents wear masks in indoor public settings to protect children from a "triple threat" of respiratory viruses, while Alberta's premier said she will not impose a mask mandate and urged people not to panic.

Dr. Kieran Moore said a mask mandate remains on the table, as pediatrics hospitals have been overwhelmed by as influx of patients in recent weeks. COVID-19 is still circulating, but the larger threats to young children at the moment are influenza and respiratory syncytial virus, or RSV, he said, noting that capacity in children's hospitals is at 100 per cent.   

"We're asking more people to mask up," Moore said.

He did not mandate masking, but said he is "discussing and reviewing" the possibility of requiring masks in schools again. He also recommended children between two and five wear a mask, if possible.

Moore said a mask mandate is possible if the province's health-care system continues to see an increase in pressure due to respiratory illnesses, though he said that would be "the furthest we'd have to go" in terms of measures.

In Alberta, Premier Danielle Smith was asked about Ontario's mask recommendation and said there will be no mandate.

"I think it's important that we not cause an overreaction or a state of panic," she told reporters in Sherwood Park, Alta.

"Anyone who feels comfortable to wear a mask should wear a mask. That should be a personal choice.

"But we are not going to be mandating masks. We heard loud and clear from parents that they want a normal school environment for their kids, and we are going to let kids be kids."

Alberta schools are seeing high rates of absenteeism due to the wave of illnesses. The Alberta Children’s Hospital in Calgary and the Stollery Children’s Hospital in Edmonton are dealing with a spike in patients, some seriously ill.

Saskatchewan Health Minister Paul Merriman said the flu and RSV are affecting communities now more than COVID-19, and he hasn't discussed a mask mandate with the province's chief medical health officer. 

"I don't think we have to have mask mandates. I think it's everyone's own decision whether they want to do that."

In Quebec, the province's college of physicians urged people to wear masks in public, as respiratory viruses there are also filling up emergency rooms. The order recommends masks be worn on a "voluntary and preventive basis" in public places, crowded private spaces and on public transit.

A report by the Canadian government for the week ending Nov. 5 found that levels of influenza and RSV across the country are higher than expected for this time of year.

The Ontario government said experts have been meeting daily and emergency departments are being instructed to plan for an "extreme surge."

While a broad mask mandate might help reduce illness in the community, Moore said the biggest risk to children is in social settings, where it is hard to mandate behaviour.

"Masking at a population level will help, but we really have to focus on where we can protect our children," he said. "What might be a cold to you can lead to a severe respiratory infection in a child four and under."

Some Ontario children's hospitals have had to cancel non-urgent surgeries to redeploy staff to emergency departments and intensive care units operating over capacity.

Ottawa pediatrics hospital CHEO has opened a second pediatric ICU, Toronto's Hospital for Sick Children is cancelling non-urgent surgeries, and children 14 and older needing critical care are being sent to adult ICUs.

"We're currently experiencing extraordinary pressure in our pediatric system," said Dr. Chris Simpson, the chief medical director of Ontario Health, the agency that oversees the province's health-care system.

He said all children who go to a hospital will be seen.

Last week, data from Critical Care Services Ontario said there were more children in ICUs than beds, with 122 children needing critical care Wednesday. Five had COVID-19.

Adults can transmit respiratory viruses to kids, and young children under the age of five are the most susceptible, Moore said. He recommended people mask around young children in social settings, and parents should mask at home if they have symptoms.

Moore said the influenza season is "fully underway" in the province, with the peak expected in early-to-mid-December. 

"The time to get your shot is now," Moore said. "Please, please do not delay. It is not too late to get protected."

This report by The Canadian Press was first published Nov. 14, 2022. 

— With files from Colette Derworiz in Calgary and Mickey Djuric in Regina

Liam Casey and Allison Jones, The Canadian Press