While happy for mandatory mask orders that take effect in Ottawa tomorrow to limit coronavirus spread, I really wish Public Health had included a face shield as an allowable option. Asthma gives me big trouble after about fifteen minutes masked. Although my asthma is generally mild unless we add serious ragweed (a problem that goes on for months in Ontario), multiple antibiotic, cat and various other environmental allergies into the mix, I first discovered how the humid air of a face mask triggers my asthma in a doctor's waiting room about fifteen years ago, while masked. I can wear a surgical mask or cloth equivalent for a short time, but the clock runs down on that pretty quickly and then I'm gasping for breath, running for the door so I can rip off the dang thing and breathe.

There are, of course, some health exemptions for the new public health orders but I worry how people will react if I'm wearing a face shield rather than a mask as I've been doing anytime up to now that I had to be indoors in public longer than a few minutes. An atmosphere of intolerance is developing in reaction to people who simply don't want to wear a mask or, bizarrely, seem to see it as some challenge to their civil liberties, and the nuance of certain people not being capable of wearing a mask without considerable risk or harm to themselves seems to be getting lost in the clash between the mask-up and anti-mask sides. Unfortunately, some folks can be pretty militant and inflexible. Even some people with asthma have belligerently told me they tolerate the masks just fine, which hey, terrific for you if that's the case! But I don't understand why anyone would automatically think that means everyone with asthma would be all right in one, let alone for longer durations of time.

In fact, humidity and cold air are both common asthma triggers. As Asthma Canada president and CEO Vanessa Foran has pointed out, simply wearing a mask can create risk of an asthma attack. "Wearing masks means breathing hot and humid air, so that can trigger asthma symptoms." She also mentions people with severe allergies might find wearing a mask difficult at this time of year too (75% of asthmatics have allergies). My own health history involves allergies severe enough to warrant nine years of allergy shots as a child and then another ten (so far!) in middle age. 

I know there are folks who suffer from anxiety disorders or claustrophobia as well as other medical conditions who will also be unable to wear a mask and I ask for understanding and consideration for all of us. People say, "Just wear a mask dammit", like it's easy. But in reality, that's not always the case. Be aware before you confront someone about not wearing a mask or looking daggers at them from across the supermarket aisle, they may have good reasons for it. There are more than two angles to this mask issue.

* Studies have linked nasal congestion with severe asthma. A 2012 study looked at why patients with mild asthma have difficulty breathing in humid conditions. "Results showed that breathing of hot, humid air triggered an immediate increase in airway resistance in patients with mild asthma, but caused either only a very small or no response in healthy subjects. Breathing hot, humid air also triggered consistent coughs in those with asthma."

Update, July 11

Sadly, new mask regulations are already proving an issue for people unable to wear masks. Two hospitals in Ottawa, the General campus of the Ottawa Hospital and Queensway Carleton Hospital both refused entry to a woman in need of medical attention who is unable to wear a mask due to a combination of health issues including COPD, asthma, anxiety and claustrophobia. If a hospital, of all places, doesn't readily understand and recognize medical exemptions for mask-wearing, it doesn't bode well for acceptance by the larger community.  The health officials and governments who have imposed these rules need to do a much better job of communicating the fact that there are legitimate exceptions to mandatory mask orders, otherwise this lamentable incident will just be the first of many for a segment of the population already concerned about the hostility and disapproval they face while out in public.

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