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People wait to be screened before entering Little Mountain Place, a long-term care home that has had 38 residents die since a COVID-19 outbreak was declared at the facility in November, in Vancouver, on Jan. 3, 2021.

DARRYL DYCK/The Canadian Press

Ninety-five per cent of seniors at Kelowna’s Spring Valley long-term care home have been vaccinated to protect them against COVID-19, but only two-thirds of caregivers at the facility had rolled up their sleeves for their shot when an outbreak was declared in mid-May. Over the past month, 11 residents have died because of the virus.

Since British Columbia began its vaccine program in December, workers in long-term care homes have had the choice over whether to be vaccinated. Employers are not even allowed to require employees to say if they have been vaccinated.

Al Jina owns the Spring Valley care home, one of 30 facilities under the Park Place Seniors Living umbrella, mostly in B.C. and Alberta. In both provinces, the legal landscape surrounding employee rights related to vaccinations is complex.

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Employers are navigating privacy laws, employment standards, labour arbitrations and the Canadian Charter of Rights and Freedoms.

“We are at the intersection of all of this legislation and law; operators are in a legal stranglehold,” he said. “But we have to take action, the public demands it. So we have implemented mandatory vaccination for new hires.”

That’s the part he can control. But he would like B.C. and Alberta to take a stronger stand, as the governments in Ontario and Quebec have. “Government cannot look at employee rights in isolation,” he said. “We have to look at the wellness of the residents we look after.”

At the end of last month, Ontario announced that staff at long-term care homes would have to show that they are vaccinated or provide proof of why they can’t be. Anyone who declines to be vaccinated will be required to attend an education session about the benefits of vaccine and the risks of not being vaccinated.

In April, Quebec announced that workers in certain sectors will have to prove that they are vaccinated and, if they cannot, they will have to be tested three times a week. Anyone who is won’t comply can be transferred to another position that doesn’t deal with patients. If an alternate position is not available, the worker can be suspended without pay.

British Columbia is now rethinking its soft-touch approach. The province is expected to move to the next stage of reopening on June 15, now that COVID-19 cases are down and vaccination rates are up. But as restrictions ease, the risk to vulnerable seniors in care may increase.

Bonnie Henry, B.C.’s Provincial Health Officer, said she is looking at the policy again in light of the reopening.

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“We’re looking at all of the options around how do we ensure that residents in long-term care are protected to the fullest extent possible,” she told reporters during a briefing on June 10. “Part of that will be ensuring that people who work in long-term care are immunized.”

That’s a shift from her long-standing reliance on collaborative rather than punitive measures. B.C. had won two rounds of arbitration over the right of employers to require vaccination of health care workers, in 2006 and in 2012. In both cases, Dr. Henry was called as an expert witness in communicable disease control, and she testified about the risk to seniors posed by unvaccinated care workers. B.C.’s policy was upheld.

But Dr. Henry, after taking up the post in 2018 as head of the public health office, faced another arbitration and chose a more collaborative approach.

On her order, the provincial policy was amended in December, 2019. Now, health care workers – who are one of the most common sources of flu transmission to patients in health care settings – are expected to do the right thing but will face no penalty if they refuse to immunize or mask up.

Dr. Henry said things are changing now as B.C. learns how effective the COVID-19 vaccines are, and how vaccination rates affect facilities and residents. “As part of moving forward into the next phase of this, we will be looking at how do we ensure that everybody in these most highly vulnerable settings are immunized with two doses as much as possible.”

Mr. Jina said there is a way to improve vaccine rates among staff without using a hammer.

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After the outbreak started at Spring Valley, the local health authority sent in a team to offer shots to unvaccinated staff while they were providing booster shots to residents. Vaccination rates among staff climbed to more than 80 per cent when they no longer had to take time off work to get to a vaccine clinic.

“I would say this is more an access issue than hesitancy, for those who have not taken it,” he said.

Bring the vaccines to the workers – what a simple solution, in such a critical setting.

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