COVID-19: Q & A for Care Providers

gmcneil Occupational Health & Safety

How do we practice social distancing at work?

To the best of our ability. Many public sector workers are in workplaces that have been deemed essential and will continue to operate during the pandemic. In this context social distancing is a hazard control and must be followed whenever possible. Work should be arranged to minimize the direct contact workers have with one another and with clients/the public. In cases where distance cannot be maintained, frequent handwashing, disinfecting of commonly touched surfaces and use of Personal Protective Equipment (PPE) is recommended.

My co-workers aren’t practicing social distancing. What can I do?

Social distancing is now a form of “safe work procedure” in use by most workplaces. Just like with any other safety protocols, if they are not being followed, that creates an unsafe situation that should be reported to the employer. Reporting is not the same thing as “ratting”; reporting gets someone out of trouble (such as by ensuring protocols that protect us all are being followed). “Ratting” is getting someone else in trouble without enhancing safety for others.

Should we wear leg coverings?

The PPE protocol for suspected or confirmed cases of COVID-19 includes masks, face/eye protection, gloves, and a gown. There could be situations where additional or different PPE should be utilized and that would generally be identified through a point of care risk assessment. For some health care workers, this is a normal and routine task that is within the worker’s professional training. For those that have not been specifically trained in conducting a risk assessment, members are encouraged to use their professional judgement in identifying situations where the worker could contact a patient’s/resident’s respiratory droplets due to the work being performed. If the worker identifies a potential for contact not prevented by standard PPE, the worker should immediately report the concern to their immediate supervisor.

If a resident gets sick, will I still need to spend time with them?

COVID-19 is a potentially serious disease and those suffering from it may require lifesaving or life sustaining medical intervention. The risk of any communicable disease is increased or decreased based on the frequency and duration of a worker’s contact with a transmitting case. Infection Prevention and Control guidelines are designed to minimize unnecessary contact with those who could potentially transmit the disease, and work should be organized to reduce those contacts.

Should we have negative pressure rooms for sick residents?

Yes, where possible and available, negative pressure rooms (also known as “airborne infection isolation rooms” or “infectious isolation” facilities) are the preferred location to provide treatment to individuals who are or may be positive for a communicable disease. The negative pressure room reduces the likelihood of aerosolized respiratory droplets traveling outside the room where care is being provided.

If a negative pressure room is not available, a single room with a portable, high-efficiency particulate air (HEPA) filtration unit should be used. In the case of suspected patients with COVID-19 assigned to a single designated room or ward without negative pressure or a HEPA filter, an anteroom should be set up before entering/exiting the area where employees can don and doff their PPE.

Can we invoke our right to refuse as a group?

No, the right to refuse is individual, and each person who refuses must have reasonable grounds that the work they have been assigned is likely to endanger their health and safety. If a group of workers each decide to refuse, they must each report their refusal and their specific reasons to their immediate supervisor.

My spouse is in isolation after traveling. Do I still have to go to work?

If you cohabitate with someone who has been directed by public health officials to self-isolate, then you should contact public health (through 811) to see if you also need to self-isolate. These determinations are made on a case by case basis.

If I think I have come in contact with the virus, what should I do? Can I go home?

If the exposure happened at work then, like any hazard or injury, you must report the incident to your employer. In some health care workplaces, there may be occupational health nurses on site who initiate the next steps. If not, you should contact 811 to inquire about how to obtain a test. Being exposed to an infected person does not mean that you are necessarily infected, but depending on the nature of the exposure, public health may direct you to be tested.

I was fit tested last year. Is that still valid?         

It is recommended that fit tests are performed annually, but it is required once every two years. Fit tests need to be redone as changes in facial structure from weight loss or weight gain, or changes in facial hair, can impact the seal of your respirator. In the current environment, we are aware that some employers have stopped fit testing all together as it further depletes the scarce units available. If you feel that your respirator is not fitting properly, that is a potentially dangerous situation that must be reported immediately. At a minimum, every worker should be performing the daily users self-check (as demonstrated by the qualified person who last conducted a fit test on you) to ensure your mask is fitting properly.

I’m immune compromised. Should I get a doctor note to say it’s not safe for me to work?

The guidance from most public health officials is that it is safe for someone who is in the high-risk group to continue working in a health care environment as long as they can properly don and doff their PPE. That being said, every case is unique, and we would encourage you to discuss your concerns with your doctor. The potential of exposure to an infectious disease is always present in a health care environment so it may create difficulties in returning you to your employment if your doctor were to say it’s unsafe for you to work due to the risk of contracting an infectious disease.