BY PAMELA FAYERMAN

The last time I wrote about the number of health care workers in B.C. who had been infected with COVID-19, the numbers were staggering.

They still are but the latest information obtained from the BC Centre for Disease Control (BCCDC) shows that the proportion of infections in healthcare workers like nurses, physicians, care aides and others has shrunk a wee bit, relative to overall lab-confirmed case rates in B.C.

In April, health care workers (HCW) accounted for 428 or 21% of COVID-19 infections in B.C. In early June, 680 infections were among healthcare workers – representing 25% of COVID-19 infections. As of early August (the latest data provided by BCCDC), 756 health professionals had tested positive for COVID-19 which represents about 20% of all lab-confirmed cases at that time period.

I’ll be adding a graph showing the breakdown of infections in various categories of healthcare when the information is supplied.

According to this report, there’s a huge variation in infection rates among healthcare workers between countries, with fewer than 1% in Singapore and more than 30% in Ireland. B.C.’s rate is certainly on the higher side.

Healthcare workers have been tested more often than anyone else and they’ve been in the line of fire so it is perhaps not surprising that nearly a quarter of all infections would be diagnosed among their ranks. In my last article, I wrote about a nurse at St. Paul’s Hospital in downtown Vancouver who got COVID-19 in late March and is still on sick leave.

Provincial health officer Dr. Bonnie Henry drew some outrage when she said this a few months ago: “I think we need to be cautious when we look at the healthcare worker data because we include healthcare workers no matter where they were exposed. Many people who are healthcare workers were exposed at things like a (March dental) conference that we know a lot of people attended. There was personal travel. There was also transmission between workers in settings where they may not have realized there was a risk — in lunchrooms, in break rooms, and things like that.”

Throughout the pandemic, nurses and other healthcare workers in acute and long term care settings have complained that one of the big reasons why their health has been threatened is because access to personal protective equipment (PPE) has been rationed or restricted, even locked away in cupboards. Requiring a unit manager to unlock the supply closet causes delays that potentially compromises the health and safety of healthcare teams.

PPE is intended as a barrier against infectious pathogens, blood, and body fluids that are hazards of the job in health care settings. It includes gloves, N-95 respirators, face masks and/or shields, eye protectors, gowns, headcovers, and booties. Health Minister Adrian Dix has been transparent about PPE acquisitions and the staggering costs of stockpiling supplies but healthcare workers have countered with anecdotes of PPE rationing that goes on in many health care facilities because of shortages or attempts to avert shortages.

Nurses contend that healthcare employers maintain they have the right to determine how much PPE should be donned. Nurses, on the other hand, maintain they must be allowed to use their clinical judgment to decide whether they need more than the bare minimum.

Christine Sorensen, president of the BCNU

Christine Sorensen, the recently acclaimed president of the BC Nurses Union (BCNU), has said throughout the pandemic that members have complained about insufficient access to PPE.

The BCNU has now published a position statement on PPE based on a concept in law called the Precautionary Principle. After the 2003 SARS outbreak which affected individuals in Ontario and B.C., an Ontario commission issued a report that said, in part, that the precautionary principle should help guide actions meant to protect healthcare workers. The BCNU says that under the precautionary principle, safety comes first.

“Imagine a firefighter having to delay response to a burning building while they seek permission to unlock their helmet and boots. This circumstance would be intolerable for those firefighters, just as it should be for nurses and other healthcare workers who may have their PPE stored in locked cabinets and not be provided with the keys.

“More plainly, this precautionary principle dictates that it is appropriate to use the highest level of PPE available until there is definitive proof that such PPE is not required.”

Healthcare workers are invited to share their comments about this issue in the area below or by emailing me: pamela@medicinematters.ca