Post by Nadica (She/Her) on Aug 31, 2024 0:47:14 GMT
Protecting HCWs and patients: An impossible fix, or an essential one? - Published Aug 30, 2024
One of the top news stories this month was a sobering analysis of two forest firefighter deaths in 2023. The safety reviews revealed severe shortcomings in processes and recommendations to rectify deficiencies, and governments committed to doing better. This stands in stark contrast to the response to health-care worker occupational COVID infections and deaths, and the resulting hospital-acquired infections and deaths among patients.
As of March 2022, 12 AHS health-care workers had died from COVID-19. Presumably, this hasn’t stopped, but AHS stopped reporting them as of that date. Meanwhile, there have been no apparent efforts by hospitals and clinics to reassess our infection protocols despite ample research that demonstrates COVID is airborne. To make matters worse, the inadequate contact-droplet protections that were initially in place have been rolled back to essentially none, with universal surgical masking removed in June 2023. Yet, COVID continues to harm, disable and kill patients and staff in our hospitals.
Why do health-care workers’ deaths not require the same urgent and serious investigations as firefighters’ work-related deaths? We need to know — and health workers, their loved ones and the public deserve to know — as a matter of occupational health and safety. Reviews of responses to past medical crises — such as the Krever inquiry looking into tainted blood, or the Campbell inquiry looking at the first SARS epidemic in 2003 — have been hard-hitting and useful. Of course, we have to change how we do things and, sadly, few to none of Campbell’s recommendations informed our responses to the COVID-19 pandemic.
We can only speculate why there has not yet been a serious inquiry into health worker deaths and the ongoing illness, death and disability caused by COVID. We imagine it is difficult for health leaders to challenge a government that is anti-vaccine and, at best, lukewarm toward masking. We also imagine it is extremely difficult for medical leaders to question their own decisions that may have caused harm. But, by not looking for ways to better handle this airborne outbreak, our health-care situation only continues to worsen.
A large number of our colleagues stopped requiring masking with patients in June of 2023. Since this change, not only at AHS but in the vast majority of health-care facilities in the Western world, there have been ongoing outbreaks at institutions. These outbreaks cause illness, disability and death among our patients, all of whom are vulnerable. They affect our fragile health-care staffing crisis, with acute and chronic COVID-19 illnesses and increased incidence of conditions triggered by COVID-19, such as heart attacks and strokes. Despite all of this, there has been no apparent examination of how to minimize or stop the impact.
We don’t begrudge individual health workers who have stopped masking. The mandate removal has essentially permitted them to do so. And institutions have failed to provide clear and up-to-date guidance on COVID transmission, including that transmission is largely airborne, making handwashing less useful and masking an essential component of infection protection; asymptomatic transmission is substantial, requiring masking even if feeling well; and post-COVID chronic illness (often referred to as long COVID) occurs in up to 3.5 per cent of first COVID infections, even more in subsequent infections and even in fully vaccinated, healthy individuals. How can health workers make informed choices given the lack of accurate information?
We have dedicated our lives to saving lives. And yet we are trapped in a system where infecting each other and our patients has apparently become acceptable. With no end to COVID waves on the horizon (we’re in a substantial one right now), what is the endgame our health-care leaders are hoping for?
It is well beyond time for our health-care leaders to empower an objective review of our system’s handling of this pandemic. It’s their duty to ensure a safe working environment and safe care environment for patients. If it is important to protect firefighters from harm, let’s have the same for health-care workers.
Dr. Joe Vipond is an emergency room doctor in Calgary and the co-founder of the Canadian COVID Society.
Dr. David Keegan is a family physician in Calgary and a professor of family medicine at the Cumming School of Medicine at the University of Calgary.
One of the top news stories this month was a sobering analysis of two forest firefighter deaths in 2023. The safety reviews revealed severe shortcomings in processes and recommendations to rectify deficiencies, and governments committed to doing better. This stands in stark contrast to the response to health-care worker occupational COVID infections and deaths, and the resulting hospital-acquired infections and deaths among patients.
As of March 2022, 12 AHS health-care workers had died from COVID-19. Presumably, this hasn’t stopped, but AHS stopped reporting them as of that date. Meanwhile, there have been no apparent efforts by hospitals and clinics to reassess our infection protocols despite ample research that demonstrates COVID is airborne. To make matters worse, the inadequate contact-droplet protections that were initially in place have been rolled back to essentially none, with universal surgical masking removed in June 2023. Yet, COVID continues to harm, disable and kill patients and staff in our hospitals.
Why do health-care workers’ deaths not require the same urgent and serious investigations as firefighters’ work-related deaths? We need to know — and health workers, their loved ones and the public deserve to know — as a matter of occupational health and safety. Reviews of responses to past medical crises — such as the Krever inquiry looking into tainted blood, or the Campbell inquiry looking at the first SARS epidemic in 2003 — have been hard-hitting and useful. Of course, we have to change how we do things and, sadly, few to none of Campbell’s recommendations informed our responses to the COVID-19 pandemic.
We can only speculate why there has not yet been a serious inquiry into health worker deaths and the ongoing illness, death and disability caused by COVID. We imagine it is difficult for health leaders to challenge a government that is anti-vaccine and, at best, lukewarm toward masking. We also imagine it is extremely difficult for medical leaders to question their own decisions that may have caused harm. But, by not looking for ways to better handle this airborne outbreak, our health-care situation only continues to worsen.
A large number of our colleagues stopped requiring masking with patients in June of 2023. Since this change, not only at AHS but in the vast majority of health-care facilities in the Western world, there have been ongoing outbreaks at institutions. These outbreaks cause illness, disability and death among our patients, all of whom are vulnerable. They affect our fragile health-care staffing crisis, with acute and chronic COVID-19 illnesses and increased incidence of conditions triggered by COVID-19, such as heart attacks and strokes. Despite all of this, there has been no apparent examination of how to minimize or stop the impact.
We don’t begrudge individual health workers who have stopped masking. The mandate removal has essentially permitted them to do so. And institutions have failed to provide clear and up-to-date guidance on COVID transmission, including that transmission is largely airborne, making handwashing less useful and masking an essential component of infection protection; asymptomatic transmission is substantial, requiring masking even if feeling well; and post-COVID chronic illness (often referred to as long COVID) occurs in up to 3.5 per cent of first COVID infections, even more in subsequent infections and even in fully vaccinated, healthy individuals. How can health workers make informed choices given the lack of accurate information?
We have dedicated our lives to saving lives. And yet we are trapped in a system where infecting each other and our patients has apparently become acceptable. With no end to COVID waves on the horizon (we’re in a substantial one right now), what is the endgame our health-care leaders are hoping for?
It is well beyond time for our health-care leaders to empower an objective review of our system’s handling of this pandemic. It’s their duty to ensure a safe working environment and safe care environment for patients. If it is important to protect firefighters from harm, let’s have the same for health-care workers.
Dr. Joe Vipond is an emergency room doctor in Calgary and the co-founder of the Canadian COVID Society.
Dr. David Keegan is a family physician in Calgary and a professor of family medicine at the Cumming School of Medicine at the University of Calgary.