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People wait in line to get a COVID-19 test at Mount Sinai Hospital in Toronto, on Nov. 23, 2020.

CARLOS OSORIO/Reuters

Workplaces have overtaken long-term care as the settings with the highest number of COVID-19 outbreaks in Canada’s two most populous provinces, and experts are calling for stronger measures to reduce the spread of the coronavirus and avoid further business closings.

Workplaces are a driving factor in the second wave of the pandemic, making up 30 per cent of all active outbreaks in Ontario and 40 per cent in Quebec. Infections spreading in manufacturing, warehouses and construction sites have propelled workplace outbreaks to surge past those of long-term care homes, which account for 15 per cent of continuing outbreaks in Ontario and 22 per cent in Quebec.

In the past two months, workplaces were linked to more than 1,900 infections in Ontario – 40 per cent of the more than 4,600 work-related cases this year, according to data from the province. Most of the increase was driven by manufacturing plants, warehouses, mining, distribution centres and transportation, which combined saw infections nearly triple since Oct. 1, to 2,182 from 769 cases.

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These workplaces have stayed open during the second wave even as the two provinces tightened restrictions on retailers, restaurants and gyms or forced them to close entirely in regions where COVID-19 infections remain stubbornly high.

While Quebec shut down manufacturing and construction companies in the spring and Ontario limited some construction, the provinces said they are not planning on mandating any further closings on these sectors, according to statements from Ontario’s Labour Ministry and Quebec’s Health Ministry.

Warehouse outbreaks have been widespread in communities around Toronto, leading to rapid household and community spread. One of the country’s largest industrial hubs – Peel Region, which includes the municipalities of Mississauga, Brampton and Caledon – has grappled with workplace outbreaks in manufacturing and food processing. The region entered the province’s strictest lockdown category on Nov. 23, closing non-essential retail shops, restaurant dining and hair salons.

Closings in some sectors in manufacturing, food processing and distribution businesses would be challenging as many provide essential goods and services, according to Peel Region’s Medical Officer of Health, Dr. Lawrence Loh. Manufacturing accounts for 34 per cent of the region’s 137 workplace outbreaks, which overshadow the 105 outbreaks in long-term care and hospitals.

“Our picture in Peel remains quite turbulent, but at this moment in time I’m not recommending any additional restrictions,” Dr. Loh said during a press conference on Wednesday. “With many of these industries, especially food processing, there are questions around supply and food security issues if these were to close.”

Instead, Ontario and Quebec have increased workplace inspections to ensure that employers are taking preventive measures to keep workers safe. Infectious-disease and public-health experts say that further closings should be a last resort to help keep people employed in an already devastated economy, and that stronger enforcement and faster testing are needed to avoid shut downs.

In Ontario, the 229 active workplace outbreaks are almost equal to outbreaks in both long-term care and schools combined, with 117 and 121 outbreaks respectively. Outbreaks in “other work places” – an expansive category that includes warehouses, manufacturing, shipping and distribution centres, construction sites and offices – top the list of workplace outbreaks with 159 active outbreaks, overshadowing retail with 29; food processing with 20; and health care with 15, according to provincial data.

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Quebec’s 479 continuing workplace outbreaks surpass schools and living and care institutions, with 349 and 268 outbreaks respectively, according to provincial data. Manufacturing and retail have made up 41 per cent of all workplace outbreaks since June, and accounted for the most workplace outbreaks in the third week of November with 117 outbreaks and 366 infections. Construction took the third spot for the most continuing outbreaks, reporting 26 new outbreaks and 57 cases, according to data from the Institut national de santé publique du Québec, or INSPQ.

The province has struggled to bring down its COVID-19 infections, even though restaurant dining and gyms have been closed since early October and private gatherings severely restricted. Workplace outbreaks have been cited as a primary reason for the continued spread of the respiratory disease.

In mid-October, Quebec launched an inspection blitz by fanning 700 inspectors across the province. Since then, workplaces outbreaks have continued to climb for 11 consecutive weeks according to the INSPQ. While the increased inspections may have prevented outbreaks from reaching worse levels, they may have come too late in the second wave, or the penalties may not be strong enough to influence employer and worker behaviour, according to University of Montreal public-health professor Benoît Mâsse.

The province’s Commission des normes, de l’équité, de la santé et de la sécurité du travail, or CNESST, has conducted more than 2,350 inspections and reported more than 3,200 correction notices since Oct. 19; however, CNESST would not provide the number of charges it has issued during the blitz. Since the beginning of the pandemic, it has issued 35 charges to businesses.

“We’ve seen this in the construction sector in Quebec where, without inspections or enforcement, after a few weeks, workers go back to a prepandemic way of working and they forget their masks and stand too close together during lunch,” Dr. Mâsse said.

To avoid closings, rapid testing should also be made widely accessible at manufacturing and construction sites to identify workers with asymptomatic cases before they enter the workplaces, said Dr. Don Sheppard, director and founder of the McGill Interdisciplinary Initiative in Infection and Immunity.

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Most provinces received the first batch of rapid tests in early November. In Quebec, the first tests are being distributed to the hard-hit Saguenay-Lac-St-Jean region in mid-December after a delayed rollout while the government sought advice from health experts on how to best use the tests. Ontario started rolling out its rapid tests at the end of November, to regions with high infections, health care institutions and some workplaces.

“If you wait until you have a symptomatic case, you’re only testing the tip of the iceberg and missing all the spread going on behind it,” Dr. Sheppard said. “The Quebec government sat on the rapid tests, and did nothing with them until now.”

Canadian authorities are assessing COVID-19 vaccine candidates while trials are underway, speeding up any eventual approval for wide use. But science reporter Ivan Semeniuk says it’s likely high-risk people will be prioritized for receiving any vaccine first, with some possibly getting it as early as the first part of 2021. The Globe and Mail

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