Lessons from the front line
Re Evidence shows virus is almost exclusively spread by droplets, Letters, May 9
The COVID-19 pandemic is a case of déjà vu all over again. When the pandemic was declared, there were assurances that Ontario had learned the lessons of SARS. Unfortunately, this has not been the case.
For nurses, this has been made crystal clear by the letter to the editor from a group of infectious disease specialists.
During SARS, nurses were repeatedly assured by a group of infection control specialists that SARS was spread by droplet transmission and that N95 respirators were unnecessary.
Only later did some of these same infectious disease specialists admit that the virus was airborne, and only later did they reverse their stance on proper protective equipment.
That was far too late for many who had unnecessarily been infected. Two registered nurses and a physician died, and dozens of health-care workers were infected unnecessarily.
Fast forward 17 years and we are back to those dark days. Although there is considerable discussion regarding how COVID-19 is transmitted that points to droplet transmission, there is an equal amount of literature that shows evidence of aerosol transmission.
The specialists cite the lack of widespread outbreaks in hospitals as proof that good hand hygiene and other measures point to droplet transmission.
Are they aware of the five outbreaks at Toronto Western Hospital? The argument that they are not seeing large and widespread outbreaks in places adhering to droplet protection is not convincing when their own hospitals have outbreaks, and when outbreaks at long-term-care homes are uncontrolled.
Nurses are on the front lines of health care. We learned during SARS that we could not afford to wait until the science was clear — and that the lives of our patients and of nurses depended on it.
We need to make it loud and clear that the precautionary principle must be used.
The willingness to put front-line workers’ health, and lives, in the hands of others took far too high a price during SARS.
All health-care workers want to see an end to the pandemic. Discounting the concerns of those on the front lines is condescending and disrespectful. Vicki McKenna, president, Ontario Nurses’ Association
As occupational hygienists, we have concerns with this letter from Dr. Ari Bitnun and 18 other infectious disease doctors.
We are not conspiracy theorists, but have examined evidence about viruscontaining particles in air, which has implications for protection of workers who are potentially exposed to the coronavirus.
When infected people cough, sneeze, talk or even breathe, they can release infectious particles. These particles come in a range of sizes, from droplets that tend to settle rapidly to smaller aerosols that can remain airborne longer, disperse more widely, and be inhaled by those in the vicinity.
Recent research is providing increasing evidence for aerosols containing the coronavirus.
We can understand that given the regrettable shortage of sufficient PPE, hard decisions must sometimes be made about distribution of approved respirators to those at greatest risk. But this does not mean we should dismiss evidence of possible sources of transmission.
One does not need to resort to conspiracy theories to keep an open mind where uncertainty remains, and take reasonable precautions to protect exposed workers. Marianne Levitsky and Dr. Kevin Hedges, Toronto
Once again, the province has left frontline workers in long-term-care homes frustrated and dejected.
The government set up the Ontario Long-Term Care Staffing Advisory Group to provide advice on how to deal with the chronic shortage of personal support workers (PSWs) in long-termcare homes.
One would presume that direct input by active PSWs would be of utmost importance. It appears that it is not so. The advisory group is composed of academics, researchers and directors of for-profit LTC companies. It shuts out the Ontario Personal Support Workers Association and PSW unions, which are the voice for these front-line workers.
My fear is that any report this group submits to the premier will read well, but will result in no substantive changes to improve the crisis. Profits come before quality care in too many homes.
About 80 per cent of COVID deaths in the province have occurred in LTC and retirement homes, so it is imperative that officials engage and listen to the comments of PSWs who have horror stories about the directions they were given and their working conditions.
When changes are made, we do not need more regulations and bureaucracy to hamper the care that workers want to provide and that residents deserve. This is the time to listen to PSWs and front-line workers and heed their suggestions and advice. Terry Martyn, Sudbury, Ont.
Re Community spread is confusingly persistent, May 9
Dr. David Williams is perplexed that major headway isn’t being made reducing person-to-person spread of the virus. Perhaps I can help with that.
A person close to me tested positive for the virus at St. Joseph’s Health Centre in Toronto.
She was asked both if she went out to work every day — she didn’t — and also if she lived with anyone else — she lives with her daughter — and was told they should both self-isolate and use different washrooms if possible.
No other questions were asked. The daughter wasn’t tested.
The daughter works at a bakery-café. Toronto Public Health didn’t know that until I wrote to them to express my dismay at the followup to the test. It didn’t concern them.
Why was it not, at the very least, strongly recommended that the daughter be tested? She could be asymptomatic and still spread the virus.
It seems that the only thing that was accomplished by the test was to have one more case to add to the tally. Sean Moore, Toronto
As many of your writers warn, we cannot return to the old normal, and must be cautious about any easing up of restrictions.
All the more reason to address other potential factors in flattening the curve, that have lots of evidence regarding health outcomes.
These include: poverty and inequity, housing, water, nutritious food, air and chemical pollution, soul-destroying and hazardous working conditions and violence. Dr. James Deutsch, Toronto
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