This Health Hazard Alert for OPSEU members is provided to supplement information from Public Health, Ministry of Health, and Health Canada, and explains your rights under the Occupational Health and Safety Act and the Workplace Safety and Insurance Act.
How many cases of SARS are there in Ontario now?
As of May 15, the Ministry of Health reported 10 active probable cases, compared with 29 on May 6. Ten active probable cases remain hospitalized. Twenty-four people in the province have died of SARS. A total of 205 probable and suspect cases have been discharged from hospital. For complete reports on cases, go to the Health Canada or Ministry of Health links at the
end of this document.
Change in the Status of Toronto
On May 14, the World Health Organization (WHO) removed Toronto from the list of areas with local SARS transmission. Canada is also off the list of areas for which the WHO has issued recommendations pertaining to international travel. The decision followed a teleconference with Health Canada, when it was confirmed that Toronto had broken the SARS transmission chain,
or gone 20 days (double the incubation period) without developing a new case of SARS. The last SARS case in Canada occurred on April 20.
New POC Directives to remain on guard after SARS
As Toronto prepares to return to normal after SARS, the Provincial Operations Centre (POC) is implementing a new set of directives effective 8:00 a.m. Friday May 16, 2003. In introducing the new directives, the POC maintains Ontario must prepare for entering a new phase of practice—the ‘new normal’. Preventing exposure, early
detection, appropriate management, and protecting people both in health care settings and the community are important to deal with threats from communicable diseases in the future.
With the focus moving from the emergency phase to the recovery phase, and to the ‘new normal’, the government acknowledges that health care facilities and service providers in the GTA may need an intermediary step to fully comply with the May 13 Directives. In advice issued to Greater Toronto health care facilities,
the POC calls for them to maintain the screening of staff, patients, and visitors for 10 days after the discharge of or contact with the last SARS patient, and then comply with the May 13 Directives.
Directives to All Ontario Acute Care Facilities – May 13, 2003
Hospitals are no longer required to screen outpatients, staff or visitors using the Screening Tool except, in category 2 or 3 facilities, as part of an admissions history, and in emergency departments in hospitals. For any patients with respiratory symptoms suggesting an infectious disease, N95 masks, gloves and eye
protection are required for all attending staff and visitors. In these situations, a surgical mask is to be put on the patient when staff are in the room. In addition, hospitals are being told to limit facility entrances to a minimum, to maintain enhanced surface cleaning in high-risk areas and to reinforce hand-washing/hand hygiene with staff, patients and visitors.
The directive lists in detail the levels of activity for all categories of facilities.
Directives to All Ontario Acute Care Hospitals for High-Risk Procedures involving SARS Patients Critical Care Areas – May 13, 2003.
The directives state that high-risk procedures are to be avoided whenever possible. If necessary, they should be performed by a minimum number of experienced staff using strict adherence to SARS precautions.
Directive to All Ontario Non-Acute Care Facilities – May 13, 2003.
Non-acute facilities include Complex Continuing Care Hospitals, Rehabilitation Hospitals, Long-Term Care Facilities, Private Hospitals, Specialty Hospitals and Psychiatric Hospitals. The directive incorporates enhanced routine precautions, and measures to be invoked in the event of another outbreak. In routine practices, staff, physicians and students should wear
the N95 mask or equivalent, and protective eyewear when in contact with patients/residents who have respiratory symptoms (unexplained cough, hypoxia, shortness of breath or difficulty breathing) suggesting infectious disease.
Directive to Ontario Health Care Providers in Community Settings and Community Health Care Agencies (excluding Community Care Access Centres) – May 13, 2003
This directive should be used by all health care providers in community settings, and community health care agencies, including physicians, nurses, nurse-practitioners, midwives, dentists, allied health professionals, and others whose activities are directed by the Regulated Health Professionals Act 1991. Again, this directive outlines enhanced routine procedures
as well as procedures during a SARS outbreak. Like in the Non Acute care facilities, N95 masks or equivalent should be routinely worn when near someone with signs of respiratory infection. For additional protection against respiratory infection, protective eyewear should always be worn with the N95.
Directive to All Community Care Access Centres – May 13, 2003
This directive outlines enhanced routine procedures and procedures during a SARS outbreak. The procedures are similar to those described for non-acute and other community agencies.
Directives to All Ontario Prehospital Care Providers and Ambulance Communications Services – May 13, 2003
This directive outlines procedures for prehospital care personnel such as Paramedics, EMA’s and First Responders. Emergency Medical Services Personnel face the particular risks involved in performing droplet-generating procedures such as intubation, non-invasive ventilation, aerosolized therapy, and suctioning. The Directive covers general measures, emergency
calls, interfacility transfers, procedures for entering a category 2 or 3 facility, transport and cleaning measures, and particular procedures for SARS patients in the prehospital environment.
Are there any other measures that can be taken to protect workers’ health and safety in the healthcare sector?
All the directives stress the importance of hand washing to avoid the transmission of SARS or other infectious diseases. All facilities should continue promotional campaigns to encourage and reinforce the importance of hand washing and awareness of healthy behaviours like not coming to work if feeling unwell.
OPSEU continues to advise that Joint Health and Safety Committees (JHSCs) within the health care sector meet to discuss these new directives and analyze them to determine how to apply them to best protect the health and safety of workers. Committees must also consider if the Directives are protective enough for the risks in their facility.
For more information, contact OPSEU’s Health and Safety Unit: 1-800-268-7376, 416-443-8888, ext. 772. Check the OPSEU website at www.opseu.org for future updates.
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