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Coronavirus: Ontario directive clearing asymptomatic staff for care home work raises questions

Posted: April 15, 2020

(April 14, 2020)

By: Morganne Campbell, Global News

At a time when Ontario is implementing stricter measures to help protect the province’s most vulnerable living in long-term care homes, questions are being raised about a directive issued by the province’s top doctor, saying staff who are COVID-19 positive and asymptomatic can go to work.

The document, obtained by Global News, is titled “Directive #3 for Long-Term Care Homes under the Long-Term Care Homes Act,” authored by Dr. David Williams, Ontario’s Chief Medical Officer of Health.

In part, it reads: “Staff who have tested positive and are symptomatic cannot attend work. Staff who have tested positive and have symptom resolution and are deemed critical may return to work under work isolation.”

During a media conference at Queen’s Park Tuesday, Williams said the directive is aimed at helping to alleviate staffing levels.

“The essential worker … could, if it was really critical and agreed on by all parties … return to the work situation if they were still asymptomatic and wear proper PPE (personal protective equipment) while on the job,” explained Williams.

Advocacy groups say the staffing issues plagued long-term care homes well before COVID-19 ever presented itself, arguing the current crisis has only exacerbated the situation.

“I believe this recommendation was made in reflection of the fact there are just not enough staff in long-term care, and when a home goes through an outbreak, there’s even less staff,” said Lisa Levine, who represents AdvantAge Ontario, a seniors’ advocacy group based in Toronto.

The province’s minister of health says Ontario recently learned that someone can be asymptomatic and still be able to transmit the virus to another.

“We have to be particularly careful, so that’s something I would be very concerned about as a province-wide strategy,” added Christine Elliott.

Shortly thereafter, Liberal Leader Steven Del Duca tweeted his criticism of the Ford government.

“Incredibly disappointing Christine Elliott actually said today she only ‘recently learned’ asymptomatic COVID-19 carriers can spread the virus,” the tweet read.

“This borders on incompetence and only increases risk to patients and healthcare workers across Ontario.”

One medical expert, an infectious disease specialist at University of Toronto says outbreaks happen in long-term care homes because of improper infection control practices.

“Clearly these people [staff in care homes] are vulnerable – clearly there have been breaks in infection control these people should not be working if they’re positive for COVID-19,” explains Dr. Anna Banerji.

“Sending someone in who doesn’t have symptoms but is positive for COVID, to me it just doesn’t make any sense.”

The Ontario Personal Support Workers Association (OPSWA) is also condemning the practice.

“Implementations of directives such as these are an indication that the province must move to a self-regulatory model for the PSW in order to prevent chronic staffing shortages like this from causing future harm to innocent members of the public,” writes Miranda Ferrier, the national president of OPSWA.

The Ontario Health Coalition says it plans to call for a full inquiry into how the Ministry of Health and Long-Term Care dealt with the novel coronavirus in nursing homes across the province.

“I cannot imagine, what critical staff could actually be isolated in the home. So the practicality of that directive is a huge question in our minds,” explains Natalie Mehra.

“You do expect I think that there would be policy mistakes but some of the things just require an explanation.

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