While all Manitobans are being asked to self-isolate after travel, directives have been more lenient for those working on the front lines of the COVID-19 response — depending on a risk assessment and operational need.
Both the Manitoba Nurses Union and the Manitoba Association of Health Care Professionals — who, combined, represent 18,500 workers — told the Free Press that some "essential" employees who have returned from international travel and are asymptomatic are being directed to forgo the 14-day self-isolation period.
Instead, the unions say employees are returning to work with instruction to monitor their symptoms.
"Our members know that it’s not safe. We could be shedding viruses with no clue we even carry it," said Bob Moroz, president of the Manitoba Association of Health Care Professionals, which represents respiratory therapists, rural paramedics and lab technologists, among others.
"We understand the issue of priority testing and all those sorts of things, but being told to report to work when everyone else in the province — and in the world, for that matter — is being told stay at home, lock the door, have someone bring you groceries … The equation isn’t balancing."
There are a total of 20 probable and confirmed COVID-19 cases in the province. All but one have been linked to travel. The overwhelming majority have been connected to travel to Europe, Asia and the United States.
One has been connected to a trip to B.C. while another is still under investigation. The province did not specify what kind of travel was involved in the latest probable case announced Sunday, which involves a Winnipeg man in his 40s.
So far, there have been no reports of cases being transmitted between health care workers and patients in Manitoba.
'Our members know that it's not safe' ‐ Bob Moroz, president of the Manitoba Association of Health Care Professionals
In a statement to the Free Press, Lanette Siragusa — the province’s chief nursing officer — said all returning health-care workers are required to self-identify to occupational health before undergoing a staff health risks assessment that is "a more extensive process" than the public screening, she said.
"For staff deemed operationally required, a manager will consult with occupational health services to perform a risk assessment, taking into account the type of work, exposure to high risk clients, and the relevant travel exposure to determine if an exception can be made," Siragusa wrote.
"Should employees be deemed operationally required and approved to work following the staff health risk assessment and they’re asymptomatic, staff may return to work avoiding high risk patients. They will be required to wear a mask at all times and self-monitor for the 14 day period."
Out of precaution, Manitoba Nurses Union president Darlene Jackson said nurses must be treated the same as everyone else when it comes to following self-isolation and social distancing directives. Jackson also raised concerns about both a nearly "critical" shortage of nurses and N95 masks in the province.
During an earlier press conference Sunday, Siragusa said the province has recruited senior practicum nursing students and Shared Health retirees, in addition to introducing an online self-assessment page and adding phone lines, to account for an increase in demand.
As politicians and public health professionals continue to promote basic hygiene and limiting trips outside the house as the best ways to slow the spread of the virus, the World Health Organization has called for more stringent tactics to test and isolate to ensure there will not be a resurgence of COVID-19 in the future.
Sitting about two metres away from Siragusa at a press conference, Dr. Brent Roussin stuck to the province’s repeated messaging Sunday, when asked about testing. He said the province continues to look to increase lab capacity while focusing on testing people with symptoms.
"You have to focus on the most at-risk and we know that almost all our cases are from international travel and we know that almost all spread comes from symptomatic people, but we’re also dealing with that through our social distancing strategies.
"There’s a lot of built-in things in our strategy that protects against that asymptomatic spread, should it be occurring."
Anyone who receives a negative result is also still asked to follow-through with their quarantine, Roussin said. With students now out of school for a three-week period due to the virus, he also asked parents refrain from making playdates.
As for walks around the block, Roussin said Manitobans should continue to get fresh air as long as they are following the two-metre rule at all times.
"Everyone’s got to fit this in into their daily lives," he said. "Social distancing has to be part of our lives for the foreseeable future."
“From a general moral and ethical standpoint, we have to do what we can to protect the most vulnerable in society and those around us.” ‐ Dr. Jason Kindrachuk, Canada Research Chair in emerging viruses at the University of Manitoba
Both Roussin and Siragusa said they don’t believe any community transmission is occuring at any sustained rate because Manitoba hospitals continue to see low intensive care unit bed occupancy rates and emergency room visits for respiratory-related issues in Manitoba hospitals, compared to the usual this time of year.
Dr. Jason Kindrachuk, Canada Research Chair in emerging viruses at the University of Manitoba, applauded the province’s moves so far, as well as the citizens taking social distancing seriously.
"From a general moral and ethical standpoint, we have to do what we can to protect the most vulnerable in society and those around us," Kindrachuk said, noting that there has been a presentation of serious cases in younger adults who don’t meet the aging, immuno-compromised criteria.
A new report from the Centers of Disease Control and Prevention suggests severe illness leading to hospitalization, including ICU admission and death, can occur in adults of any age.
The authors analyzed the severity of COVID-19 cases in the United States that occurred between February 12 and March 16 by age group. Among the known cases that required hospitalization, nine per cent of patients were 85 and older, 36 per cent were between 65-84, 17 per cent were aged 55-64, 18 per cent were in the 45-54 category and 20 per cent were aged 20-44. Less than one per cent were among people 19 or younger.
Kindrachuk said that while it would be ideal for every single person to get tested as per the World Health Organization’s recommendation, that’s simply not possible given the supply of reagent and other testing supplies.
"The biggest limitation right now is we have to be cognizant that this is going to continue on — not for a couple weeks, but probably for a few months to quite a few months," he said. "For those that are mildly symptomatic or asymptomatic, basically, we can curb transmission by self-isolating."
Maggie Macintosh reports on education for the Winnipeg Free Press. Funding for the Free Press education reporter comes from the Government of Canada through the Local Journalism Initiative.
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