Jim Brophy, occupational health expert, says guidelines are not based on scientific evidence
By Zaid Noorsumar
Gloria Turney, is incensed at the death of her fellow union member and home care worker, Arlene Reid.
Reid, aged 51, tragically died a few days after contracting COVID-19. Her primary job was as a home care worker for the Victorian Order of Nurses (VON) in Peel Region (Mississauga, Brampton, Caledon).
It’s not clear if she caught the infection while providing home care, or through her other jobs.
As of May 12, 3,485 health care workers had been infected with COVID-19 across Ontario, accounting for just above 16 per cent of the province’s cases.
Turney, who grew up with Reid in Jamaica, questions the level of safety for health care workers, even as they are lauded as heroes.
“I am so mad at all of you!!!!!” reads one of her social media posts. “HOW MANY MORE OF US HAVE TO DIE BEFORE YOU DO RIGHT BY US?”
Jim Brophy, faculty member at University of Windsor and an occupational health expert, says that the government’s guidelines on personal protective equipment (PPE) for workers are not based on scientific evidence.
He believes they are based on the global PPE supply shortage, and says the government should be honest with the public and ensure frontline workers are protected.
The Ontario government’s directives for health care workers are consistent with the federal government’s guidelines. They’re premised on the belief that COVID-19 is spread through droplets or contact, and there are some experts who back this assertion. They contend that there isn’t enough evidence to suggest that it’s transmitted through airborne particles.
The government recommends using a surgical mask along with other protective gear when workers are providing care to patients suspected or confirmed with COVID-19.
Thereby, health care employers don’t need to provide N95 masks to workers, which are essential when dealing with an aerosolized virus as they filter out 95 percent of small particles.
Government guidelines instead state that N95s should only be provided during aerosolized procedures, such as intubating patients on a ventilator.
But Brophy says that multiple studies over the past several weeks indicate that the virus can be aerosolized. In other words, COVID-19 can spread merely through breathing, or through the release of small particles coming from coughs and sneezes.
The precautionary principle
Since the start of the pandemic, Ontario’s health care unions have been advocating for maximum protection for workers based on the precautionary principle.
The principle was invoked by the SARS Commission report in 2006, authored by Justice Archie Campbell, who cautioned that healthcare workers’ safety should not be jeopardized when scientific evidence is inconclusive.
“One example was the debate during SARS over whether SARS was transmitted by large droplets or through airborne particles. The point is not who was right and who was wrong in this debate…We should be driven by the precautionary principle that reasonable steps to reduce risk should not await scientific certainty,” the Judge wrote.
Theoretically, abiding by the precautionary principle should be a non-issue. Except we are in the midst of a global pandemic and supplies are running short.
On Friday, the Ontario Ministry of Health itself referenced the supply crunch in response to CTV’s query about watering down an April directive that provides greater access to PPE. After consulting with unions, the ministry decided not to change the directive.
On April 10, the Ontario Ministry of Health released Directive 5 for long-term care and hospitals. The document, authored by the province’s chief medical officer, empowered “health care workers” to access N95s and other PPE based on their “clinical assessment.”
However, this directive is limited to registered staff and excludes personal support workers, and is only applicable at hospitals and long-term care homes. That leaves out a whole range of health care professionals including personal support workers delivering services in hospitals, long-term care and in the home and community sector.
But even as nurses are empowered by the directive, the situation on the ground is different. The Ontario Nurses Association still had to take employers to court to access N95s in a case which it won.
Just last week, Rankandfile.ca was approached by workers at a long-term care home in Haileybury who are concerned about lack of protective equipment for both nurses and PSWs who are caring for a solitary COVID-19 patient.
The Canadian Union of Public Employees has filed a grievance against the employer, but until the issue is resolved, the workers remain unprotected.
Brophy says that Canadian federal and provincial governments need to be honest with the public to foster an open dialogue based on the existing evidence, and then make every effort possible to protect frontline workers.
He says viable measures can be taken such as increasing testing, improving contact tracing and better screening practices, plus better administrative controls at institutions.
But he says this will require a major shift in mindset. For one, it will further expose the government’s lack of preparedness for a pandemic and its history of not heeding advice of multiple reports warning about such an eventuality.
“[The government ignored] the SARS Commission and every other commission that followed afterwards because our system was being defunded and privatized,” Brophy says, referring to the lack of PPE stockpiling by the Canadian government.
Canadian health care underfunding is rooted in the fiscal restraint policies of the Mulroney PCs and the subsequent significant reductions in federal health transfers by the Jean Chretien Liberals.
The toll on health care workers
Brophy believes that Canadian governments also need to view health care workers differently, as they face systemic exploitation.
Brophy, who has previously co-authored research on shocking levels of violence in Ontario’s hospitals and long-term care in collaboration with fellow academic Margaret Keith and Ontario Council of Hospital Unions (OCHU/CUPE) president Michael Hurley, says the poor working conditions are related to privatization, underfunding and sexism.
“They got the big E for exploitation written all over their back,” he says of the predominantly female workforce in the health care sector. “And whether it’s home care, or in long-term care, they’re expected to do this work under the worst possible conditions.”
With over 2,000 positive cases among health care workers, including at least seven deaths, Brophy says the equipment guidelines don’t seem to be working.
“If they are so well protected, how come they are getting sick? How come 16 percent of the cases are health care workers?” Brophy asks.