Canadians in U.S. health care debated

TORONTO — It takes Renee Amyotte just 15 minutes to get from her home in Windsor, Ontario, to her job at the Detroit Medical Center’s Hutzel Women’s Hospital.

The 24-year-old nurse works 12-hour shifts in the hospital’s neonatal intensive care unit, looking after infants whose mothers have tested positive for the coronavirus in a city hit hard by the pandemic.

Amyotte is one of about 1,600 Ontario nurses who cross the border to work in Detroit. Now, as Michigan suffers one of the worst outbreaks of the deadly virus in the United States, some Canadian officials are calling for curbs on their travel — a move that could devastate U.S. hospitals.

More than 1,300 people have died of the coronavirus in Michigan — nearly twice as many as in all of Canada. Canadian officials say the country is in an early stage of its outbreak; in a best-case scenario, they say, as many as 22,000 people could die.

Wajid Ahmed, the top medical officer in Windsor-Essex County, Ontario, is one of the loudest voices calling for more stringent border restrictions. As of April 9, he said health-care workers made up 88 of the 314 confirmed cases in the county. Forty of those workers traveled to Michigan.

Ahmed said Canada should consider halving the number of medical personnel working across the border, or requiring them to stay in Detroit during the pandemic. He and other local officials have raised the issue with their counterparts in the provincial and federal governments.

“When you’re fighting a battle against covid-19, we need to use every measure to contain it,” Ahmed said. “It’s not a call to abandon our neighbors when they need us … The safety of my community is my number one responsibility and my number one concern.”

Justin Klamerus, president of Detroit’s Karmanos Cancer Institute, said restrictions on the travel of Canadian nurses would “cripple” the hospital. Roughly 1,200 employees, including a quarter of the nurses caring for bone marrow transplant patients, cross the border from Windsor. Others are doing “essential” work in clinical trials and CAR T-cell therapy for leukemia and lymphoma patients.

“We would like to think that borders don’t exist in health care,” Klamerus said.

Windsor Mayor Drew Dilkens said there’s been some “angst” in the city about the cross-border trips. He thinks the current measures suffice.

The United States and Canada agreed last month to close the 5,500-mile frontier to nonessential traffic. A laminated orange placard on Amyotte’s dashboard identifies her to border guards as an essential health-care worker.

When 3M said this month that President Donald Trump requested it not send N95 respirator masks to Canada, Prime Minister Justin Trudeau cited the Canadian doctors and nurses who work in Detroit as an example of the close supply chains between the two countries and why they shouldn’t be disrupted.

David Musyj, president and chief executive of the Windsor Regional Hospital, said 57 of the hospital’s 4,000 employees work in facilities on both sides of the border. Thirty-five said they would stay with his hospital.

Musyj said the hospital was not trying to “[draw] the line” on these workers, but implemented the policy to quiet the “shortsighted” officials criticizing their cross-border travel.

He said it was improper to focus on the number of covid-positive cases among Canadian nurses who work in Detroit, an issue he called a “red herring.”

“To unilaterally stop Windsorites from working in health care in Detroit is not appropriate,” he said. “That will devastate a city and region at a time they can ill afford to lose health-care workers.”

Amyotte changes out of her scrubs at the door of the Windsor house where she lives with her family. On her day off, she tries to stay in her bedroom to avoid potentially infecting them. On a recent drive home, she said, Canadian border agents applauded health-care workers — a “sweet” moment.

As a young girl, she loved to “play nurse,” rushing to get Band-Aids when someone was hurt. She has watched with concern as she and other cross-border nurses have found themselves thrust into the middle of a political debate.

Klamerus said some Canadian nurses feel they’ve been stigmatized for working in Detroit. Amyotte said she’s witnessed backlash on social media.

“It is a little bit frustrating and it is sad to see your own community turning on healthcare workers,” she said.

“My patients know no borders and I know no borders. Everybody deserves care.”