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Provincial Health Minister Christine Elliott said on Wednesday that health-care workers are not in a separate category when it comes to the need to self-isolate after returning to Canada from international travel.Frank Gunn/The Canadian Press

Some Ontario hospitals are still requiring staff to come to work immediately after travel, despite the province’s recommendation that everyone – including doctors and nurses – self-isolate after being abroad to minimize the spread of COVID-19.

Provincial Health Minister Christine Elliott said on Wednesday that health-care workers are not in a separate category when it comes to the need to self-isolate after returning to Canada from international travel.

On Thursday, Ontario’s Chief Medical Officer of Health, David Williams, issued a memo to the province’s hospitals, noting that “where employees have travelled outside of Canada within the last 14 days and are seeking to return to work, it is important to balance the protection of the health system and the continued operation of these settings.”

For those have been out of the country, he said, “I am recommending that [they]…self-isolate for a period of 14 days starting from their arrival in Ontario. Health-care workers should not attend work if they are sick.”

Asymptomatic workers who are deemed “critical” to hospital operations may be an exception, Dr. Williams said.

In an e-mail on Friday, Ms. Elliott’s office clarified that this memo, and her comments on Wednesday, are recommendations, not formal directives: “It’s our expectation that hospitals abide by our guidance, but it’s not a directive."

But some Toronto-area hospitals are still instructing staff who’ve recently been out of the country to come to work.

Sinai Health – which oversees Mount Sinai Hospital and Bridgepoint Active Healthcare – issued an all-staff memo on Friday stressing that its policy is unchanged.

“Never has there been a time where our people are more crucial,” said the memo, co-signed by president and chief executive officer Gary Newton and executive vice-president Susan Brown. “In order to continue to deliver care in our hospitals, our current policy remains in place that all health care workers are critical for hospital operations, unless otherwise decided by the executive team of the hospital and/or our chiefs of service.”

They said that because Ontario now has community transmission of COVID-19, travel is no longer the driving risk factor.

“People who have NOT travelled may now be at similar risk for having COVID-19 as those who have travelled. The crucial principle for now and moving forward is that monitoring for any symptoms of fever or upper respiratory illness is the most important criteria for a safe work environment and essential for all health-care workers,” the memo said. “We have simple goals – to care for our patients, and for our people. That means if you are healthy, you can and should be working to care for patients. You can depend on us to create an environment in our hospitals to keep you safe, and if you are ill, we will care for you.”

Michael Garron Hospital is maintaining a similar policy.

“Hospitals are complex organizations that need many functions to maintain operations," a spokesperson said on Friday in an e-mail. "In addition to a strong and robust front-line health-care work force, we have hundreds of critical roles, such as food services, security, payroll, information management, diagnostics, lab and pharmacy staff, housekeeping, portering, supplies management and distribution, facilities maintenance, registration, and leadership – to name a few. We are therefore adopting the policy that all health-care workers are critical for hospital operations, unless otherwise decided by the executive team of the hospital and/or the chief of staff.”

Holland Bloorview Kids Rehabilitation Hospital sent out a memo to staff on Friday apologizing that the “moving target” of self-isolation requirements has been “confusing and anxiety provoking.” They are now requiring staff who’ve recently returned from out of the country to self-isolate, except for those deemed “essential.”

Other hospitals in the Greater Toronto and Hamilton Area, including the Centre for Addiction and Mental Health, West Park Healthcare Centre, and those under the University Health Network and Hamilton Health Sciences umbrellas, have similarly adjusted their policies to reflect the province’s recommendations.

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