EDMONTON -- Some Alberta doctors are concerned the new rules for mask exemptions could flood them with people wanting exceptions, whether warranted or not.

In Alberta, mask use is mandatory when in indoor public spaces, workspaces, places of worship, and anywhere else when a person may come within two metres of people outside of their household.

Dr. Deena Hinshaw, chief medical officer of health for Alberta, announced new requirements Thursday where anyone exempt from wearing a mask due to a medical condition will need a letter from a health professional authorizing the exemption.

“Wearing face masks is a critical public health measure that helps prevent the spread of COVID-19,” Hinshaw said.

She added that the letters will play an important role in verifying if someone has a medical condition and close a loophole people may have been exploiting.

“This change is not meant to punish people unfairly,” Hinshaw said. “It’s meant to ensure anyone who is capable of wearing a mask complies with this important public health measure intended to keep us all safe.”

Medical conditions for which a health professional can issue an exemption letter from wearing a mask letter includes sensory processing disorders, cognitive impairment, facial trauma, recent oral surgery, allergic reactions to mask components, acute respiratory distress, developmental delays, and some mental health illnesses including depressive or anxiety disorders.

Only nurse practitioners, psychologists, or physicians are able to issue exemption letters.

According to the regulations, those using an exemption letter should be prepared to present it in a public setting if requested by enforcement officials or in court after a ticket for non-compliance is issued.

In an interview with CTV News Edmonton, local physician Dr. Ernst Schuster said he is concerned many will try using the broad mask exemptions set by the province to get one without proper need.

“To include things like depression or anxiety disorder,” Schuster said with concern, “I mean anybody could say that."

While he has not experienced any patients seeking an exemption yet, he is worried about how this rule could damage the province’s fight against COVID-19.

“People are going to walk in clinic or virtual care clinics and say, ‘I have a little bit of asthma, I need that (exemption),’ or, ‘I am anxious.'

“They’ll just get (the exemption),” Schuster said. “I think that’s totally against public health interest.”

Dr. Schuster and the College of Physicians & Surgeons of Alberta (CPSA) both said doctors are asked to use their best judgement when they approve exemptions, but according to Dr. Schuster, there is already pressure for doctors to comply with the new requirements.

“The college of physicians and surgeons has told us that if we don’t give that note… we could be guilty of unbecoming conduct,” Schuster said.

In a statement to CTV News Edmonton, CPSA says it is "quite concerned" with Dr. Schuster's "incorrect interpretation."

"We certainly understand it’s a challenging time for physicians, but our goal is to work collaboratively where possible, rather than in a punitive manner," the statement read.

A Mask Exemption Guidance Document on the CPSA website asks doctors, in part, to "only provide medical exemption letters when their patient meets the criteria noted above and the physician provides treatment for the condition noted above."

OTHER APPROACHES TO MASK EXEMPTIONS IN CANADA

While new in Alberta, this type of approach to mask exemptions has been in place in Saskatchewan, Quebec, and Manitoba.

Quebec implemented the need for medical certificates for mask exemptions last summer in July where only people who are physically incapable of putting a mask on themselves, have a facial deformity or skin disorder, and those with physical or mental conditions where wearing a mask would lead to “significant distress” can qualify.

In Manitoba, mask exemptions required a medical note since August. The medical conditions eligible for mask exemptions included children under five, those who cannot put on or remove a mask without assistance from someone else, and medical conditions or disabilities causing difficulty breathing.

There are even fewer exemptions to mask wearing in Saskatchewan. Exemptions include persons who have an intellectual disability, medical condition, cognitive impairment, or severe mental health condition preventing their understanding of the mask requirement. Those rules came into place in December.

Ontario does not require documentation to support any medical exemptions from using a mask.

With files from CTV News Edmonton’s David Ewasuk