As of October 18, 2023, Shared Health has updated its mask requirements in health facilities to increase precautions during the respiratory virus season. The key change is a return to universal masking for physicians and health care workers while interacting with patients in all health care settings, including acute, long term care, and community. For patients and visitors, masks are recommended, but not required except in limited designated areas that primarily treat immuno-compromised populations. 

You can access key guidance from Shared Health here from their PPE resources page and Infection Prevention and Control page including:

• See this Shared Health memo about the changes for this virus season (dated Oct 16, 2023).
• Point of Care Risk Assessment Tool: a two-page document to assess the risks and which precautions to take.

In Hospitals and RHA Facilities

According to Shared Health, effective October 18, 2023, health-care workers will be required to wear a medical grade mask while interacting with patients, long-term care residents and clients. This applies to all health-care workers in all settings (acute, long term care and community).

Masks are not required in common areas such as elevators, cafeterias, hallways, or nursing stations as well as any area where direct care is not provided.

Where routine practices and additional precautions require additional personal protective equipment, staff are to follow existing guidance including point of care risk assessment. Medical masks and N95 respirators remain available to you and point of care risk assessments continue to be a valuable tool in assessing the presence of risk.

Aerosol-Generating Medical Procedures (AGMPs) carry an increased risk of transmission/​spread of COVID-19. AGMP accommodation and cohorting recommendations are unchanged. See the current guidance here.

For Family Medicine / Outpatient Clinics

Physicians and medical directors in independent medical clinics or health facilities continue to have more discretion to set their own mask policies. A bulletin from Manitoba Public Health notes ​“Public health officials note other community-based health settings, like doctors’ offices or supportive housing, will continue to be able to decide how and when masks may be used based on the needs of their clients, patients and staff. Decision-making at the local level ensures organizations take an approach that works for their situation.” 

In setting guidelines, physicians should use guidance from Shared Health, Public Health and the College of Physicians and Surgeons of Manitoba, along with your medical assessment of the risks in your clinic space and among your patient population.

Generally, this would include:

• Clearly communicating your mask policy to patients, including when patients book their appointment and with signage posted at your clinic entrance (see link to poster below).
• Asking patients with cold/​flu symptoms to call ahead. Use your judgment in responding, including whether a virtual visit is appropriate. If an in-person visit is necessary or requested by the patient, consider how best to accommodate this to minimize the risk to providers and other patients. Symptomatic patients can be asked to wear a mask, but cannot be denied care if they refuse, as per CPSM direction. However, they can be asked to wait in their car or be escorted to an exam room to bypass a general waiting area. They could also be scheduled at a time of day that minimizes risk to others.
• Adopting a mask-friendly environment where mask-wearing is recommended for patients and visitors. Consider continuing to have masks available on site for symptomatic patients.

Doctors Manitoba has created two printable posters for your practice:

• Poster 1 — Virus season, masks recommended.
  
• Poster 2 – Asking those with symptoms to wear a mask and notify staff, encouraging mask use by all.

If you have concerns or need further advice, contact us at practiceadvice@​doctorsmanitoba.​ca.