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TORONTO — Ontario's top doctor will recommend the public begin masking on Monday in an effort to help overwhelmed children's hospitals, two government sources said Saturday.

There will be no mask mandate, just a general recommendation to wear masks, especially in crowded situations, said the sources, who are speaking on condition of anonymity because they were not authorized to discuss the process publicly.

Chief Medical Officer of Health Dr. Kieran Moore has previously said this fall and winter would see a resurgence of respiratory illnesses and he would recommend masking in certain indoor settings if hospitals began cancelling surgeries to deal with a surge of patients.

Meanwhile, medical officials are increasingly calling for the public to mask up. 

Children's hospitals across the province are already overwhelmed with young patients flooding emergency departments, pediatric wards and intensive care units.

The chief executive of the Hospital for Sick Children in Toronto wants Ontarians to do three things: wear masks, get vaccinated for the flu and for COVID-19 and stay away from work, family and friends when sick.

"I would definitely encourage universal masking right now, there's no question that would help," said Dr. Ronald Cohn. 

The hospital announced Friday it would be ramping down surgeries to redeploy staff to those areas, Cohn added.

"It is extremely busy and although I recognize that words like crisis and historic and even unprecedented have gone from signal to noise over the last two and a half years, we are seeing historic volumes of children in our emergency room, on our regular pediatric wards and in our ICUs," Cohn said in an interview.

The children who are coming in are very sick, he said, noting more than half of the 38 kids in the hospital's ICU are currently on a ventilator. 

"So far none have died, thank God," Cohn said.

SickKids' ICU capacity stood at 132 per cent on Saturday, he said.

"I want to reassure you that all these children continue to get the safe and high quality care that they've always been receiving, and for now I can tell you that everybody still gets that kind of care," he said.

But Cohn acknowledged the cancellation of surgeries is a big blow to children, their families and health-care workers.

"We had to significantly reduce all of the scheduled surgeries that are not life saving or very urgent in order to create the capacity for the children who either need these very urgent life saving procedures or need other life saving admissions to the ICU and to the pediatric wards," he said. "This is devastating for families who have been waiting already for so long. But it's important for people to know how incredibly morally distressing this is for all of us, too, as health-care professionals."

The viruses that are bringing children to SickKids have changed over the past month, Cohn said. Rhinovirus and enterovirus infections were driving admissions a few weeks back, but he said the current surge is fuelled by influenza and respiratory syncytial virus cases.

Ontario Health, the agency that oversees the province's health-care system, has directed general hospitals in recent weeks to accept children 14 years and older who need intensive care, as well as those who have just left a pediatric ICU but need more time to recover. 

The Children's Hospital of Eastern Ontario in Ottawa has opened a second pediatric ICU and had to cancel surgeries to redeploy health-care workers to staff the new space. 

The Hamilton Health Sciences' McMaster Children's Hospital said Friday their pediatric in-patient unit is operating at over 140 per cent.

There were 53 children with RSV, the flue and other viral illnesses. Less than two weeks ago they had 14 patients with the same illnesses, the hospital said.

Its emergency department is seeing upwards of 200 children a day, with wait times of 12-13 hours. It takes nearly 24 hours before those patients can get a bed, the hospital said.

Figures released earlier this week showed the province's pediatric intensive care units were operating over capacity. There were 122 children in pediatric ICUs on Wednesday, though the system is only set up to handle 112. Just five of those children had COVID-19.

The provincewide problems at pediatric hospitals prompted the Ontario Hospital Association to also ask Ontarians to wear masks indoors.

The hospitals are "increasingly concerned about the deepening impact of these pressures through the fall and winter," association president Anthony Dale said in a statement released on Saturday.

"A large number of children being hospitalized do not have COVID, are not immunocompromised and have no underlying health conditions," Dale said.

"Everyone in our province has a role to play in protecting children and other vulnerable people in our society."

This report by The Canadian Press was first published Nov. 12, 2022.

Liam Casey, The Canadian Press