COVID-19 Update: Meetings with PHAC and AHS to discuss IPC recommendations for front line health care workers

March 20, 2020

Representatives from United Nurses of Alberta participated in a meeting today with union partners across the country to review and provide feedback on the Public Health Agency of Canada (PHAC) draft of updated COVID-19 IPC guidance. The Canadian Federation of Nurses Unions (CFNU), on behalf of nursing unions across the country, provided detailed feedback on the new draft guidelines. PHAC has indicated that they plan to release the updated guidelines within the next week or so, which we hope will incorporate the important feedback provided by CFNU.

Following that meeting, UNA representatives, including President Heather Smith, met with representatives from the two other health care unions (HSAA and AUPE) and with senior Alberta Health Services (AHS) leadership representatives, including President & CEO, Dr. Verna Yiu, to discuss concerns around Personal Protective Equipment (PPE) including recommendations around use of N95 masks, PPE stockpile and supply, and access to PPE supplies.  

AHS indicated they were confident in their stockpiles for basic PPE supplies including surgical masks, gowns, gloves, and face shields; however, expressed that they may start to face challenges with their N95 stockpiles, beginning at the end of April, based on recent usage patterns. They continue to meet with vendors to try and source more N95 masks including looking at alternative respirator products. They also indicated they have submitted a request under the federal procurement order for PPE that is being made.

Following our meeting with AHS, Heather Smith sent the attached letter to Dr. Verna Yiu outlining UNA’s minimum PPE recommendation to protect front-line health-care workers in contact with suspected or confirmed COVID-19 patients:

• Designate airborne precautions and the use of N95 respirators at all times in clinical areas considered aerosol-generating medical procedure “hot spots” (e.g. intensive care units (ICU), emergency rooms, and trauma centres that are managing COVID-19 patients.
• Recognize the critical importance of the point-of-care risk assessment – that individual health care workers are best positioned to determine the appropriate PPE required based on the situation or their interactions with an individual patient. In other words, if an RN asks for an N95 based on their own assessment, they shouldn’t be denied.

Following our written communication, Dr. Yiu responded with the following message: 

• Dear Heather, Appreciate the letter and the clarity in the position of UNA. We will work with our teams and provide you with a response. I know that we all want what is best for our staff. Please stay well yourself and we will be in touch. All the best. Verna

UNA recognizes that there are multiple perspectives from leading experts and institutions on the issue of COVID-19 transmission and minimum PPE requirements (see attached letter to Dr. Yiu). We also recognize that we aren’t experts in infectious diseases or infection prevention & control; however, as the primary advocate for the health and safety of front-line Registered Nurses and Registered Psychiatric Nurses in Alberta, we cannot pretend that uncertainty doesn’t exist in these areas, and as such, we are applying the precautionary principle and recommending the highest standard of protection be available to our members. 

We also recognize that these conflicting perspectives create uncertainty and even fear for our members and that is why we will continue to dialogue with CFNU, PHAC, AHS, and the other health care Employers in Alberta to try and establish a united message. And we will continue to support our members with any questions and concerns they bring forward related to these issues and we will strive to be as transparent as possible in keeping you up to date on these conversations. 

We encourage our members to review the attached letter, which summarizes the basis for UNA’s position and to familiarize yourself with the COVID-19 IPC directives from your Employer. We strongly believe in the right and ability of our members to decide what protection they need to keep themselves safe and we will be there to support you in whatever decision you make.

If you have any questions or concerns don’t hesitate to contact us. Phone:1‑800‑252‑9394; Email: ProvincialOffice@una.ca