Ontario Health Plan for an
Influenza Pandemic (OHPIP)
The Ministry of
Health and Long-Term Care has released the most recent version
of its Plan for an Influenza Pandemic. The plan is a resource
document to guide health planning and response efforts at the
provincial and local levels. It can be downloaded from the
MOHLTC website in its entirety (477 pages) or one chapter at a
time.
The MOHLTC
notes that occupational health and safety measures in the plan,
in particular its position on personal protective equipment, are
under review. It recommends health care workers (HCW) use N95
respirators only when performing certain high-risk procedures on
influenza patients. Otherwise, workers are advised to use
droplet and contact precautions and to wear surgical masks as
protection against influenza transmission.
Based on what
is known as the ‘precautionary principle, OPSEU’s position is
that N95 respirators should be provided to HCWs at risk of being
exposed to influenza virus when working with patients with
diagnosed or suspected pandemic influenza, no matter what kind
of procedure is being performed. Enough evidence exists of
airborne transmission of influenza that it makes sense to take
reasonable precautions to protect workers from this mode of
transmission. OPSEU is joined in this position by most other
health care unions in the province.
Organized
labour had some input into this version of the plan. A
representative from OPSEU and one from the Ontario Nurses’
Association (ONA) are members of the OHPIP Steering Committee.
Both unions have had representatives on subcommittees that
provided input on various chapters.
The chapter
with some of the most important information to OPSEU members is
Chapter 7: Infection Prevention and Control and Occupational
Health and Safety Measures. This chapter, in particular the
material in 7A, addresses occupational health and safety
measures. Unfortunately, one of the assumptions underpinning the
occupational health and safety measures recommended by the
MOHLTC, is the opinion that influenza is transmitted primarily
by droplets released when a sick person coughs or sneezes. In
this chapter and throughout the plan, the MOHLTC has decided to
downplay the importance of airborne transmission of influenza.
Consequently, MOHLTC does not recommend that workers practice
airborne precautions, except in very specific circumstances.
Evidence
presented at a recent conference organized by the Public Health
Agency of Canada (PHAC) to address modes of influenza
transmission demonstrated that the science around influenza
transmission is inadequate. Participants at that conference
learned that we don’t know which route of influenza transmission
is most important or even if some routes are possible. The
evidence for droplet, contact, droplet nuclei, and airborne
transmission can all be used in arguments to either support or
deny the importance of each mode of transmission.
In the next few
months, OPSEU will be surveying health care sector Joint Health
and Safety Committee members to discover the status of pandemic
planning across the province. The survey will also assist OPSEU
to update its list of JHSC members in health care. Additionally,
the union will develop a worker’s guide to the Pandemic Plan for
the health care sector.
The Pandemic
Influenza Plan is on the MOHLTC website at:
http://www.health.gov.on.ca/english/providers/program/emu/pan_flu/pan_flu_plan.html
Health and Safety Index
