Quebec considers asking hospital workers with COVID-19 to stay on the job

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The Quebec government is floating the idea of asking asymptomatic health care workers to stay on the job if they test positive for COVID-19, while other provinces are considering test-to-stay strategies as a means of keeping the fast-spreading Omicron variant from putting a critical mass of nurses and doctors into quarantine.

Already, Quebec hospitals have started or are planning the postponements of non-urgent surgeries, Francine Dupuis, associate chief executive officer of the West-Central Montreal health authority, said in an interview.

But Ms. Dupuis and two unions said that the Quebec government is also looking into assigning COVID-positive staffers who are not feeling sick to hot zones where they would care only for patients who have already been exposed to the virus.

The idea was raised Friday at a meeting between unions representing health care workers and assistant deputy minister of health Vincent Lehouillier, according to a source.

The Globe and Mail is not identifying the source because they are not authorized to discuss details of the meeting publicly.

The Quebec proposal puts a spotlight on a growing concern for Canadian hospital leaders and public-health officials as the Omicron wave gathers steam. So far, the variant is not sending many severely ill patients to intensive-care units, but it is spreading so widely in some communities that health care workers are being swept up in isolation protocols. (They are mainly catching Omicron in the community, not at work.)

That is compounding pre-existing staff shortages leading into the holidays, and contributing to some hospitals cancelling or cutting back on non-urgent surgeries, such as Unity Health, the network that oversees St. Joseph’s and St. Michael’s hospitals in Toronto.

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Unity on Monday began cancelling non-urgent surgeries and outpatient appointments, on top of its usual holiday slowdown, in part because of the number of staff in quarantine.

“[Staffing] is one of the key factors – if not the main factor – leading us to make this difficult decision,” Tim Rutledge, the chief executive officer of Unity Health, said of the move to postpone some procedures.

Thirty Unity Health staffers are off because they’ve tested positive for COVID-19, and five times that number are in isolation because of close contact with a known case.

Gerald Evans, an infectious-diseases physician in Kingston, agreed that, “The number one challenge is staffing.”

Kingston was already grappling with a large wave fuelled by the Delta variant when Omicron began washing over the area in early December. The area now has one of the highest per-capita case rates in the country.

At the Kingston Health Sciences Centre, between two and five staff members are now testing positive for the virus daily, while approximately 250 staff members are coming in every day under “workplace isolation” protocols because they’ve been exposed to a case in the community. Those protocols allow exposed staff to keep working if they have no symptoms, test negative on rapid antigen tests daily and eat in separate, isolated breakrooms.

Meanwhile, the number of patients with active cases of COVID-19 at KHSC had dropped to seven as of Monday, from heights in the low 20s earlier in December. Those earlier hospitalizations were driven by Delta, said Christine Wilkinson, the hospital’s executive director of patient care.

“This time we’re seeing [COVID-19] not so much impacting our patients as much as it’s impacting our staffing, whereas before it was the opposite,” she said.

In Kingston, Omicron has mainly infected young adults, who tend not to fall seriously ill with COVID-19.

As Omicron spreads in greater numbers and to older age groups, it may yet cause hospital admissions to soar, Canadian public-health leaders have warned.

But so far, of about 4,600 Ontarians identified as having a case caused by Omicron, only 15 have been admitted to hospital, according to Kieran Moore, Ontario’s Chief Medical Officer of Health.

He told a news conference that all of the 165 COVID-19 patients in Ontario’s ICUs on Tuesday were put there by the Delta variant.

Dr. Moore said he is “actively reviewing” how the province does case and contact management with an eye to preserving the province’s supply of rapid tests and laboratory tests to keep vital health care workers on the front lines.

“If there is a limited supply, we really need to use them for high-risk health care workers, essential workers … to keep them working if they’ve been in contact with someone with COVID,” he said.

Both Nova Scotia and New Brunswick’s top doctors said they’re concerned about growing staffing shortages in the health care system caused by front-line workers isolating because of exposure to the coronavirus.

Jennifer Russell, New Brunswick’s Chief Medical Officer of Health, said health care officials in her province, like those elsewhere in the country, are looking at ways to reduce the number of staff expected to isolate as the Omicron surge continues, including test-to-stay policies.

“We could see up to 30 per cent of our health care workers off the job in the coming weeks, which would make a bad situation even worse,” she said.

In Quebec, the possibility of keeping infected, asymptomatic workers on duty wasn’t welcomed by unions representing health care staff. “Considering the virus’ aerosol transmission, it would be irresponsible to expose other essential workers. … We urge you to reconsider this move,” Julie Bouchard, president of the Fédération interprofessionnelle de la santé du Québec, said in an e-mail to the government that the union made public.

Another trade union, the Confédération des syndicats nationaux, was meeting with the Quebec Health Department on Tuesday to voice its concerns. “It’s very worrisome,” CSN spokesman Hubert Forcier told The Globe in an e-mail.

Omicron has become the dominant variant in Quebec, with an 80-per-cent prevalence, the Quebec national public-health institute said Tuesday.

Quebec Public Security Minister Geneviève Guilbault confirmed in a tweet Tuesday that she had asked the federal government for the assistance of the Canadian Forces to vaccinate people.

The Omicron variant is behind many outbreaks affecting medical staff, said Mathieu Simon, head of intensive care at Laval University’s Heart and Lung Institute, a specialized cardiopulmonary hospital in Quebec City.

“The surge in hospitalization is going to coincide with significant medical/nursing absenteeism because of quarantines,” Dr. Simon told the Globe in an e-mail.

With a report from Greg Mercer in Saint John

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