Posted by Sad record in the fight against COVID.
Here’s a true story that demonstrates some of what has gone wrong with pandemic management since the beginning almost a year ago.
On December 27, 2020, due to lack of clear indications, a PAB found herself working in two rooms with COVID positive patients without an N-95 mask. When the PAB realizes the situation, she notifies the nurse and is told to get tested and stay home for 14 days.
The very next day her manager calls her and in a threatening tone tries to force her to go back to work the same day.
The union requested the intervention of CNESST, which issued an inspection report that was very complacent to the employer, despite the employer’s attempt to force the BAP to return to work immediately and despite the fact that the MUHC does not always provide N-95 masks to employees working with COVID patients.
Then the Union contested with the Révision Administrative of the CNESST which, has just refused our contestation of the inspection report. Our challenge aimed at forcing CNESST to issue derogations to force the wearing of masks for any person called to work in a red or yellow zone of a health establishment.
We are currently appealing this unacceptable decision of the Révision Administrative.
What is most revealing in this case are the reasons by which the Révision Administrative of the CNESST justifies its refusal to act.
Here is CNESST’s argument: as of December 27, 2020, the directives that were in effect were those of the INSPQ dated November 26, 2020. These directives did not require the N-95 mask to be worn in the presence of a COVID patient who is connected to a respirator (OPTIFLOW), so no fault would have been committed on December 27.
However, on January 4, the INSPQ changed its directives and from January 4th, workers who must enter the rooms of patients assisted by an OPTIFLOW system must wear an N-95 mask.
Our poor PAB… she entered the patient’s room on December 27th without N-95, 7 days before the new INSPQ directives….
The new version of the INSPQ rules dated January 4, 2021, is called version 3.2. So, we can see that the INSPQ has changed the rules for protection against COVID inside health care institutions at least 3 times in less than 10 months.
Is the problem fixed? No, the January 4, 2021 version still contains restrictions on the use of the N-95 mask in the Institution. N-95 is still not authorized in all cases where employees must work in a yellow or red zone of the institution.
If COVID is to impose a third wave, this restrictive version of the INSPQ of January 4th would in turn be relegated to oblivion.
The INSPQ tries to justify its multiple changes to the rules of prevention by claiming that their guidelines change as science advances in its understanding of the SARS-COV-2 virus.
This is not true.
For nearly a year, the most prestigious scientific studies have been stating that COVID is most likely transmitted by aerosol mode, in other words, in the air we breathe in closed environments such as health care institutions.
In fact, on March 16, 2020, the prestigious Center for infectious Disease[1] research and policy published a statement on the subject:
” The precautionary principle suggests we should approach this organism as we would any novel highly transmissible respiratory disease—as a contact, droplet and airborne disease, but with one important caveat: Short-range aerosol transmission is also a strong possibility. »
Then, studies were multiplying and all of them warn us about the most probable transmission of the virus in the air in aerosol mode.:
– the Center for Disease Control[2] on April 9, 2020,
– the Oxford Academic journal[3] on April 16, 2020,
– The Lancet journal[4] on June 1, 2020,
– the National Academy of Science[5] on June 2, 2020 and
– an open letter addressed on July 9, 2020 to the World Health Organization[6] signed by 239 specialists worldwide.
So what exactly is the point of these many versions of the INSPQ, which increasingly resemble a refusal to admit scientific facts and a refusal to take adequate measures to avoid contamination within our health care institutions?
At the MUHC alone, as of March 8, 2021, we have a total of 936 patients and employees infected with VIDOC since the beginning of the pandemic, 277 in the first wave and 659 since September 1, 2020. The second wave of the pandemic hit harder than the first and a alarming proportion of employees and patients were infected within our facilities.
Even today, despite version 3.2 of the INSPQ’s prevention measures, we still do not have a prevention policy worthy of the name. We risk continuing to suffer from contamination in the workplace, whether by other employees or by patients.
What is stopping the widespread imposition of N-95 masks in our health care institutions if science recognizes aerosol transmission? The INSPQ seems to be guided by the fragility of the N-95 mask reserve stocks and other protective equipment.
It is in the fragility of the supply chain that we can trace the source of the multiple limiting versions of the INSPQ guidelines. It is not so much a matter of science as of managing the possible shortage in the midst of a pandemic.
The INSPQ fears shortages since everything is manufactured in China or outside of Canada. Quebec can’t plan anything because we don’t know who will want to sell us equipment or at what price? Same thing for vaccines. We are at the mercy of decisions made by multinationals who have no accountability to us.
The government is playing with the health of our guardian angels with half-measures on occupational health and safety. It has to stop. The INSPQ must put forward measures based on a precautionary approach, starting with N-95 masks for anyone working in a yellow or red zone of an establishment.
There is no excuse that can justify Quebec still being at the mercy of private producers and the outrageous prices that can be demanded in times of crisis. Quebec must set up its own program for manufacturing equipment and vaccines within the public sector.
[1] https://www.cidrap.umn.edu/news-perspective/2020/03/commentary-covid-19-transmission-messages-should-hinge-science
[2] https://www.cdc.gov/niosh/npptl/topics/respirators/factsheets/respsars.html
[3] https://academic.oup.com/jid/advance-article/doi/10.1093/infdis/jiaa189/5820886
[4] https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(20)31142-9/fulltext
[5] https://www.pnas.org/content/118/9?current-issue=y
[6] https://www.who.int/news-room/commentaries/detail/transmission-of-sars-cov-2-implications-for-infection-prevention-precautions