Note from Michael, Dec. 21, 2021 | Town hall, work isolation, PPE, vaccinations

From the desk of Dr. Michael Gardam, Health PEI CEO

Hi everyone,

The province announced 29 new cases of COVID-19 today. We are now assuming any new cases are Omicron variant. Premier King and Dr. Morrison announced new restrictions including four-day isolation for vaccinated people entering PEI. I encourage you all to read about them in detail here: https://www.princeedwardisland.ca/en/news/four-day-isolation-required-for-fully-vaccinated-travelers-to-pei-changes-to-contact-tracing 

We can expect more cases every day for a few weeks at least. The restrictions in place are meant to slow the spread, to space out cases so that our health care system will have the capacity to care for those who need it. To be clear, they will not stop this wave.  I am encouraged that once again, our province is taking this virus very seriously.

This wave has already touched our health system – we have staff members who are close community or family contacts and even some who are positive who are currently isolating. We have some patients who are COVID-19 positive (but none at this time who are hospitalized due to COVID-19). 

In order to protect privacy of our staff, we are not announcing individual cases unless there is an outbreak on a unit, which we don’t have as yet, although outbreaks are likely. We do notify close contacts within the system and if you are working with a COVID-19 positive patient within the circle of care, you will know in advance as the patient will be on precautions. I hope you all understand why we do it this way – to both protect those who need to know and to protect the privacy of those affected.

As the Omicron wave progresses we can expect more areas to be affected, and we can expect services to be disrupted. But we’re planning and working on ways to minimize the impact to staff and Islanders. 

TOWN HALL (AND HOW TO WATCH THE RECORDING)
Today I held a town hall with leaders from across the health system about Omicron. You can watch the recording:

It will also be uploaded to the Staff Resource Centre COVID-19 hub tomorrow. 
 
I would like to be able to invite all staff to a townhall, but the technology won’t allow it. Leaders did bring forward a lot of questions that we think will be useful, and they really centre around a few common themes. We will host more of these in the coming days.  Below are summaries of the themes and our messages. 

Theme 1: Staffing and work isolation
Leaders were concerned about how we’ll continue to offer services to the public when more and more staff become close contacts. As the variant spreads, it will become more difficult. This will mean we will need to shift our thinking and practices to ensure the stability of our health care system. We expect and are planning to implement a “test and stay” protocol in the near future where close contacts who are asymptomatic would be allowed to work isolate under a specific testing regime and specific PPE and infection control protocols. We don’t have complete control over this, and we are working with CPHO on how this will work. We will share those details once they are developed, but this is certainly a shift from the past where close contacts have had to stay home. 

Similarly, we have been advised that health care workers who are returning from travel will be allowed to work-isolate within the four days of isolation now required for those entering PEI. This is meant to ensure our system has capacity to care for Islanders – it is not meant to encourage travel. Health care workers are strongly encouraged to stay close to home, keep your circles small, and follow public health measures. More details will come on that as well. 

Theme 2: PPE and mask use
People across the system have been asking about mask use. As we have said in recent emails, clinicians are encouraged to do your own point of care risk assessments to make a judgement on whether a medical mask is sufficient or whether you need an N95 respirator. That being said, we have created a new guidance document for N95 and PPE use for those caring for patients with confirmed or suspected COVID-19, based on a recent shift in practice from Public Health Ontario. This includes a fit-tested, seal-checked N95 respirator (or equivalent or greater protection), eye protection, gown, and gloves. Other appropriate PPE in this setting includes two well-fitted surgical/medical masks, or a non-fit tested respirator, eye protection, gown and gloves. The full guidance is being shared separately and will also be posted and kept up-to-date on the COVID-19 Staff Resource Centre page.
 
We have literally millions of medical masks on hand and more than 100,000 N95s respirators, with about a quarter million ordered. While that sounds like a lot of N95s, we will go through those quickly. Please be judicious in your use of these, included implementing extended wear practices so one mask is used for longer. While we really want to leave the decision to clinicians, we do have to maintain our supply of these respirators for when they are most needed, as with aerosol generating procedures. To be clear, the N95 respirators are meant to be used for patients in whom COVID-19 is a real possibility or who actually have it.  They are not meant to be used routinely for all patient contact.
 
I also want to put a plug in for visor use: if you are in a clinical situation where a mask is needed (which is all the time) a visor or goggles should be worn as well. This virus can cause gain access to your nose and throat through the eyes. Fortunately (and thanks to good planning from our purchasing teams) we have millions of these as well. Please use them.

Finally, we know some of you may still need a fit test for an N95 if you are to wear one. Our Occupational Health and Safety team is working on expanded fit testing across the system, and they will be in contact with areas for testing.

Theme 3: Vaccinations
Our Employee Health Nursing team were superstars this week, with team members coming back from vacation to offer two vaccine clinics for staff. More third dose clinics are coming within Health PEI in the coming days and weeks. You can also visit local pharmacies for third doses. Our health system overall has 44 per cent of staff with third doses which is higher than most provinces. Some areas have higher rates because they got their second dose quicker. While we are rolling this out as fast as possible, remember that vaccines won’t get us out of this immediate wave. PPE and good infection prevention and control practices will blunt the force of the wave, and public health measures will slow it down. Third dose vaccines are for future protection later in this wave and beyond. 

The question was also asked about whether it’s safe to work with unvaccinated staff. Unvaccinated staff are at a higher risk of getting very sick, as is anyone who is unvaccinated. All staff, including vaccinated staff, can contract this variant and transmit it. So essentially, unvaccinated people are at a higher risk of getting sick, but they do not really pose more of threat to you as a vaccinated person. Please continue to work with them.

Thanks everyone for reading these messages. They are being posted online for quick reference on the Staff Resource Centre. 

I know there are a lot of moving pieces here, and there are a lot more questions to answer. In many cases, we’re still working on the solutions to manage new issues as they are identified, so the answer to your questions may be “we’re working on it” for a little while. 

We are getting to where we need to be though to be prepared for increased cases. Health PEI really does have excellent people who step up to the challenge, even after a marathon 22 months. Every day that inspires me.

Please send questions, comments, or submissions for these notes to emclean@gov.pe.ca, subject line “Notes for Michael”.

Last Updated
Tue, 12/21/2021 - 23:39