Health-care workers make up 26 per cent of local cases

Considering they are also most likely to be tested, is the high number a true reflection of the community?

More than one-quarter of Hamilton’s confirmed cases of COVID-19 are people who work in health-care facilities.

However, it’s hard to know if that staggering number is an accurate reflection of community infection.

On one hand, congregate living — particularly seniors’ homes — are the epicentre of COVID-19, with17 staff infected at Cardinal Retirement Residence alone. There have also been outbreaks at Hamilton Health Sciences and St. Joseph’s Healthcare.

But health-care workers are also more likely to be tested than anyone else.

“Testing is not an even playing field,” said Dr. Mark Loeb, an internationally known infectious disease researcher at McMaster University. “There is a much lower threshold for testing healthcare workers. Someone would have very mild symptoms in the community and wouldn’t be tested, but a health-care worker would.”

In addition, Hamilton’s public health department is doing mass testing in some congregate living, as well as everywhere there is an outbreak. That testing includes all of the staff.

“Now we’re finding more that were asymptomatic,” said Dr. Elizabeth Richardson, Hamilton’s medical officer of health. “We’re finding more of the infections in health-care workers because we’re testing them way more.”

Richardson said staff in health-care facilities accounted for 112 of 425 confirmed and probable cases as of Wednesday.

“The other 75 per cent (of confirmed cases) would be an underestimate (of total cases),” said Richardson. “With any disease you only see the tip of the iceberg. The way we test for it determines how much of that is revealed to us.”

Health-care workers are more at risk of getting and spreading the virus, which is why they get tested.

“You’re looking at an environment where social distancing is more difficult,” said Loeb.

“A lot of the outbreaks in the province are not coming from patients; It’s a health-care worker to health-care worker outbreak.”

But knowing the true rate of infection is important to answer questions about whether they’re being properly protected. Unions have raised concerns about a number of issues, particularly personal protective equipment.

But Loeb says the real number likely won’t be known until serologic tests, which can determine on a wider level who has been exposed to the virus, become available.