| November 19, 2020
- No. 79 Workers
in Action Across Canada to Contain COVID-19 Firm
Opposition to the Untenable
Status Quo
September 9, 2020. Health care workers' rally for rights,
Ottawa. (OCHU)
•
Single-Site Order in Alberta Must
Be Enforced
• Measures Put Forward by
Saskatchewan Health Care Workers
• Manitoba Health Care
Workers Demand Adequate Protective Equipment
•
Unconscionable Situation in
Manitoba Long-Term Care Homes
• Demands of Ontario Long-Term Care Home
Workers
• Health Care Workers Are
Entitled to the Highest Level of Protection
Possible
- Interview, Marjolaine Aubé
Workers
in Action Across Canada to Contain COVID-19 
As infections from the second wave of COVID-19 continue
to rise dramatically across Canada, more provinces are seeing
record-breaking numbers of infections, hospitalizations and deaths.
Faced with a mounting health crisis that is reaching
proportions far greater than what Canadians faced in the spring,
governments at all levels are failing to take up their responsibility
to protect the well-being of the people. Instead of using the lessons
learned from the first wave of the pandemic, provincial governments are
using emergency
measures to attack workers' rights and impose pay-the-rich schemes
which they claim are "building back the economy." As
far as implementing the measures necessary to fight the
pandemic the status quo prevails with a refusal by provincial
governments to follow the guidelines of public health experts and
listen to the experience of frontline workers who know exactly what is
needed in this crucial situation. The important and urgent actions
needed now are being
suppressed under the blackmail that if all health and safety measures
are taken to protect everyone, this will amount to shutting down the
economy. This is the untenable status quo that people are rejecting.
It
is an excuse being given to justify doing nothing.
Instead of using available resources to build up the capacity to do
more testing and establishing an organized tracking and tracing system
to identify sources of infection, the premiers of Alberta and Ontario,
among others, continue to claim that the main issue is "individual
responsibility" to
follow the guidelines. Such attempts to blame the people cannot hide
the fact that these governments are continuing to fail to meet the
needs of the people at this crucial time. Instead of finding solutions
they are actually a block to having the discussion needed to find
solutions to the problems we face. And this is indeed how the system
works -- it deliberately blocks the people from exercising their right
to govern the society they depend on for their living and well-being
and that of society itself. It recently
came to light that some public health
officials who provided advice to the Premier of Ontario were even asked
to sign a non-disclosure agreement to prevent them from speaking
publicly about the discussion that took place. In
Alberta, more than 430 doctors together with the Alberta Union of
Provincial Employees, the Health Sciences Association of Alberta and
the United Nurses of Alberta have signed an open letter sent to Premier
Kenney and the health minister urging immediate action. The letter
states:
"We believe that the conversation should not be
framed
as a choice between 'lockdown' akin to the prolonged experience
in April-June or no mandatory restrictions. "Instead
the province should consider a two-week short
sharp lockdown to drop the effective reproductive number and allow
contact tracing to catch up. We believe it is time we had a clear
direction from our provincial government. We need rules not
suggestions." This is a critical moment in which
urgent action must be taken. What
is crucial is the mobilization of the working class and people to raise
the demand from coast to coast that what workers are demanding in terms
of measures that must be taken to contain the disease must be
implemented. The Criminal Code defines "criminal
negligence" as conduct
"that shows wanton or reckless disregard for the lives or safety of
other persons." The alarming figures regarding new cases and deaths due
to COVID-19 across the country and especially in the "hot spot" zones,
as well as the false report submitted by management on staffing levels
at one long-term care home in Manitoba, leaves no doubt that it was the
wanton disregard for the lives of others by those in "control"
that allowed staffing levels to drop to "such a level of criminal
negligence." Activating the human factor/social consciousness
by
raising the demand that what the workers are asking for must
be
implemented can protect the people at this time by hitting at the block
to providing the serious problems facing us with solutions.
This issue of Workers'
Forum reports on stands taken by workers, doctors and
others across the country. 
COVID-19 cases in health and seniors' care are
exploding in Alberta. As of November 18, there were outbreaks in 12
acute care hospitals and 102 continuing-care facilities and there are
1,254 residents and 465 staff with active cases. A total of 3,162
Alberta health-care workers have been infected since the pandemic began
and 296 long-term care home residents have died. Health
care unions and workers have called for the
government and Alberta Health Services to take control of the privately
owned and operated seniors' homes. Full-time positions at one site,
additional pay for all long-term care workers, adequate personal
protective equipment, increased
staffing, and no staff reductions or layoffs have been urgently needed
since the
pandemic began.  The
single site order for long-term care was created to prevent the spread
of COVID-19 in continuing-care facilities. It limited health care
workers to work at only one long-term or continuing-care site. The
order is now on the verge of collapse in the midst of a staffing
crisis, the Alberta Union of Provincial Employees (AUPE) said in a
November 12 news release. In only one week, Alberta Health gave nine
continuing-care sites exemptions to the single-site rule, including six
private for profit sites (three owned by Revera), and three run by
"not-for-profit" operators.
"The government
introduced the rule in April because it
was seen as a vital tool to save lives and prevent the spread of
COVID-19 between continuing-care facilities," says Susan Slade,
Vice-President of AUPE. "Continuing-care operators are abandoning this
rule because they cannot find enough workers to care for the residents.
Employers are
begging our members to work at second sites to relieve the staffing
crisis created by so many workers getting infected or having to
isolate. They are being told they can move between sites with outbreaks
and without outbreaks if they are not symptomatic, even though we know
that the virus can be spread by people without symptoms." "Workers
are receiving desperate pleas from employers to
volunteer to work at multiple sites. They are being asked to go into
facilities where the virus is rampant and then to return to their
original site, with no period of isolation, and risk spreading the
virus further," she says. Slade says: "Dr. Hinshaw
and the Alberta government must
answer this question: If the single-site rule was saving lives before,
how many Albertans in continuing care will die with it being abandoned?
We have nine exemptions in one week. How many will it be next week?"
"Our members are scared and exhausted, but they are
doing everything they can to care for residents, but putting this
burden entirely on their shoulders will not work," says Slade. "This is
not sustainable, and yet we see no leadership from the government on
how
to tackle this staffing and care crisis."
Western Canada is now
experiencing a COVID-19 surge
which is much more serious than the first wave. Saskatchewan now has
the fourth highest active COVID-19 case rate per 100,000 people in the
country, with Manitoba the highest, followed by Alberta second and
Quebec third. Saskatchewan is now averaging more than 150 cases
per day. There are 1,928 active cases of COVID-19 in the province
and 68 people are in hospital province-wide, including 16 in ICUs.
Thirty-one people have died of COVID-19 in Saskatchewan
since the pandemic began. The low number of deaths compared to other
provinces is attributed to the relative success in keeping COVID-19 out
of long-term care facilities, personal care homes and seniors'
residences. But 10 seniors' facilities have reported outbreaks in the
past 10
days, and health care unions are calling on the province to act now.
 The
Canadian Union of Public Employees (CUPE) Saskatchewan on November 13
called for immediate action to protect workers and families from the
spread of COVID-19. Pointing to the outbreak in a long-term care
facility in Indian Head, CUPE called for mandatory masking for small
towns as well as cities, where it is already in place.
"We
all need to be taking extraordinary steps to protect
each other from the spread of this virus -- and to protect the
frontline workers who are sacrificing so much to be there when we need
them," said Judy Henley, President of CUPE Saskatchewan. "That is why
this government should implement a province-wide mandatory masking
policy in
indoor public places immediately." Organizations
representing registered nurses, pharmacists and physicians also issued
a joint statement calling for: - mandatory masks in
indoor public spaces extended throughout Saskatchewan;
- targeted closing of bars and nightclubs until the surge is blunted;
- redoubling of efforts to test and trace. As
a result of the active intervention of doctors and health care workers,
on November 17 the government of Saskatchewan amended its orders and
made masks mandatory province wide. "We believe
three measures are essential to drive the
numbers down again and allow the fullest possible resumption of normal
activities. Importantly, they are all essential -- think of them as the
three pillars that support the entire containment structure," the
statement said. Saskatchewan Union of Nurses (SUN)
President Tracy
Zambory called on the provincial government to listen to health care
workers, noting that Saskatchewan is surrounded on all sides by soaring
COVID-19 case both in Canada and in the U.S. border states. Service
Employees International Union (SEIU)-West
President Barbara Cape said that all staff, including members working
in long-term care, diagnostic testing and as care aides are affected.
Workers are already at the point of exhaustion, she said, with a worker
reporting she had worked 20 shifts without a day off. SEIU-West and SUN
are
calling on the province to enact necessary measures now to ensure staff
are not overwhelmed and there are enough staff to care for patients, do
contact tracing and other essential work.
Health care support staff across Manitoba are calling on the provincial
health organization Shared Health to update personal protective
equipment (PPE)
guidelines to reflect the Public Health Agency of Canada's (PHAC)
recognition that COVID-19 can be transmitted through both respiratory
droplets and aerosols. Since the pandemic began, 476 health care
workers in
Manitoba have contracted COVID-19 and two workers have tragically died.
"Shared Health's PPE guidelines related to N95 masks
have not been changed since July," said Debbie Boissonneault, President
of CUPE Local 204 representing health care support workers within the
Winnipeg Regional Health Authority (WRHA) and Shared Health. "Health
care support staff are catching COVID-19 at work in unacceptable
numbers, so something is not working, and it needs to be changed."
Despite the new knowledge about COVID-19 transmission
and PHAC's guidelines, N95 masks are not provided to health care
support staff unless there is an "aerosol generating medical procedure
taking place."  "CUPE has been
calling for N95 masks to be immediately provided to support workers who
are working with
COVID positive patients, residents, or clients, and this has not been
happening," said Abe Araya, President of CUPE Manitoba. "Our members
are being denied N95s based on outdated protocols, and this needs to be
changed
now."
CUPE has also filed grievances across the
WRHA, Shared
Health, Southern Health-Santé Sud, and at Parkview Place
calling
for stronger PPE. "Frontline support staff are telling us they are not
being protected," said Boissonneault. "What we are hearing back from
management is 'grievance denied.'" It is
unconscionable that despite new evidence of how
COVID-19 is transmitted, and all the proclamations that thousands of
preventable deaths of seniors in care must not be repeated, the
authorities are still refusing such reasonable demands. Health care
workers must be provided all protection in line with science and their
actual experience of
what is needed.
Manitoba is experiencing
uncontrolled spread of COVID-19, and both
health officials and health care workers say the health system is being
overwhelmed. There are now 7,011 active cases, with record breaking
numbers of new cases and deaths being reported day after day. Manitoba
has 172 reported COVID-19 deaths, with most deaths
occurring during the second wave which began in October. There
are COVID-19 outbreaks at more than three dozen long-term care homes
and assisted living centres, with at least 642 cases.  Sixty-four
deaths have occurred in just two Winnipeg long-term care homes, both
with ongoing outbreaks, Maples and Parkview Place. The homes are owned
by Revera, a wholly-owned subsidiary of the Public Sector Pension
Investment Board (PSP), a federal Crown corporation, and operated on a
for-profit basis. The extent of the outbreak and gross neglect of
patients at the Maples home became public only after staff called 911
on November 7. Paramedics who responded found residents who had died
and residents who were critically ill and were severely malnourished
and dehydrated. Maples had 121 residents and 55 staff members infected
with the coronavirus at the time.
Revera
claimed that it had adequate staffing at the Maples home, reporting the
"normal" staffing levels for the November 7 afternoon shift -- 19
personal care attendants and seven nurses -- and the health authority
repeated this claim publicly. The Canadian Union of Public
Employees (CUPE) which represents the health care aides issued a
statement on November 8 exposing this misleading information, and
clarifying that there were actually only seven personal care attendants
to care for 200 residents. Revera claimed this "mistake" was due to
reporting scheduled workers, not workers actually providing care.
Maples also failed to report deaths from COVID-19 as required. Revera
stated this was because the nursing staff were involved in direct care
as opposed to "paperwork." The
Winnipeg police homicide unit is investigating the deaths, and the
Winnipeg Regional Health Authority (WRHA) is conducting a safety
review. There are widespread calls for the WRHA to take over the
long-term care homes, which have shown they cannot be trusted with the
care of our seniors. It is apparent that the drive for profit has
trumped everything. Even "normal" staffing would have been totally
unacceptable with the greatly increased care needs, and when everyone
knows this old "normal" was never adequate. Under conditions of an
active outbreak, to allow staff levels to drop below established
requirements in the opinion of Workers' Forum shows
that continued control by those motivated by maximizing profits is to
be outlawed. Both those directly profiting from the understaffing and
refusal to care for residents/patients and staff, as well as
those in government permiting this to happen and claiming
ignorance should be held to account. Workers must identify and hit at
the mechanism which permits
this state of affairs to continue.
Once
more, the
failure to implement the recommendations of the health care workers is
leading to more tragedy and preventable deaths. The mechanism that
perpetuates this state of affairs must be identified and dismantled.
CUPE's call for an investigation into long-term care homes in
October went unheeded by the government, as have the recommendations
for staff/resident ratios that permit staff to provide humane care.[1]
Manitoba requires 3.6
hours of total care per day for each resident. The Manitoba Nurses
Union (MNU), which has for years called for an improved staff
to patient ratio, has pointed out that the standard does not
reflect actual hours
of care, but only scheduled hours. The scheduled hours of workers who
are off sick, on break, or carrying out administrative or other duties,
not direct care of residents are all counted.[2] The MNU calls for
at least 4.1 hours of direct personal care per day. Notes
1.
A report prepared by the Manitoba Nurses Union in 2018 entitled "The
Future of Long-Term Care Is Now: Addressing Nursing Care Needs in
Manitoba's Personal Care Homes" can be found here.
2. On
October 27, CUPE issued a letter to public health officials
stating, "We need to be proactive and have public officials inspect
these privately-operated homes," says Shannon McAteer, CUPE Health Care
Coordinator. "The results of the inspection during the Parkview Place
outbreak yielded important findings and recommendations,
including staffing and personal protective equipment (PPE) that can
help that facility fight the spread of COVID-19, but we cannot let
other facilities get to that point." "Government
and private operators dragged their feet before, and we
cannot have a repeat of what happened at Parkview Place," said McAteer.
"We are asking for public health inspectors to immediately conduct
in-person reviews at all private care homes with current outbreaks, and
automatically launch inspections at future outbreaks to ensure
each home is prepared for, and can prevent an outbreak."
On November 4, the Ontario
Public Service Employees Union
(OPSEU) submitted its recommendations to the province's Long-Term
Care COVID-19 Commission. The Commission was established by the
provincial government in July to study the situation in long-term care
homes in the province in light of the number of outbreaks
and deaths from COVID-19 in the first wave of the pandemic. The
three-person Commission's report is to be delivered to the Minister of
Long-Term Care no later than April 30, 2021 but in light of the
seriousness of the situation the Commission decided to make an interim
report to government on October 23. The Commissioners reported that
they had already heard from about 200 people from almost 50 different
organizations in the long-term care (LTC) sector, and, based on what
they had heard, "felt compelled to submit these early recommendations
in the short-term to help protect the lives of long-term care residents
and staff in light of the current rising COVID-19 case numbers in
long-term care homes." Among their recommendations was that immediate
action be taken to address the shortage of 6,000 workers in LTC and to
ensure four hours a day of direct care for each resident. The
government's response was the same as it has been since the spring. The
Minister of Health told the press, in response to the report, that the
government is "working on a plan." As
of November 18, the Ontario government website reports that there are
100 LTC homes in the province with outbreaks (up from 77 on October
23). Since January 15, there have been 2,109 residents and eight staff
who have died. On November 17 there were 678 residents and 541
staff infected.
 OPSEU
represents 2,400 workers in long-term care homes. In its submission to
the Commission, OPSEU put forward several concrete demands for the
government to increase investment in long-term care, chiefly by
investing in workers. This is essential to stop the spread of the
coronavirus, enhance protection of workers and residents, and
address the longstanding problems of under-staffing, precarious work
and low wages that greatly contributed to the tragedies of the first
wave and have still not been addressed. Among the recommendations,
which echo those of organizations representing health care workers
throughout the LTC sector are:
- increased access
and waived tuition fees in community
colleges to assist students interested in becoming personal support
workers; - standardization of training; -
mandated staff-to-patient ratios, guaranteed hours of
work, more full time positions and increased wages, pensions and
benefits to recruit and retain staff and eliminate the need for workers
to work at multiple sites; - guaranteed four hours
of direct care for each resident every day; -
sufficient and appropriate personal protective equipment (PPE) and
training in its proper usage; - that the Ministry
of Long-Term Care develop a
province-wide pandemic protocol which includes a clear chain of
command, PPE available at all times and timely provision of
information to workers; and  - measures to be
taken to increase access to homes for
family members and, in situations in which family members have limited
physical access, that staff are given extra time to tend to the social
and emotional needs of residents, including helping residents connect
with families on social media.
OPSEU also called
for an end to privatization: "Media analysis of COVID-19 in
Ontario has
drawn clear lines between the private sector and dangerously inadequate
care. Private sector homes with lower wages and fewer staff have
suffered much more frequent outbreaks and higher
death-tolls than homes owned and managed by municipalities and other
non-profit organizations. It's all too clear that corporations have
boosted their profits by reducing their labour costs. And it's all too
clear that those decisions have had tragic consequences. Ontarians
understand that there should be no place for profiteering in our health
care
system. It is no different in long-term care -- the entire system
must be brought back under public ownership and control immediately."
-
Interview, Marjolaine Aubé -
Marjolaine
Aubé is President of the Union of
Workers at the Integrated Health and Social Services Centre of Laval
(CISSS de Laval-CSN). Workers'
Forum: What is the situation at the CISSS in Laval
regarding the outbreaks of COVID-19? Marjolaine
Aubé: We are recovering
from an outbreak at the Idola-Saint-Jean residential and long-term care
centre (CHSLD) during which 31 patients
and 35 workers were infected, including orderlies and
housekeeping staff. Sixteen patients died and the others
recovered. There were no deaths among the employees. All of them
recovered, but some
have after-effects such as headaches, shortness of breath and chronic
fatigue. Employees and patients in Idola-Saint-Jean are being tested
three times a week. So far, the outbreak has subsided. At
the CHSLD Fernand-Larocque, we have had two workers infected.
For the moment, we have no other cases of infection.
However, we fear a resumption of outbreaks after the holiday season if
public health rules are not respected. WF:
What are your main demands right now to curb
COVID-19? MA:
Our main demand is that adequate
personal protective equipment be provided to health care workers. We
have in mind mainly N95 masks to counter the aerosol transmission of
the virus, the airborne transmission. More and more researchers and
organizations are saying that COVID-19 is also transmitted by aerosols,
especially in closed, overcrowded rooms without adequate ventilation.
The World Health Organization, the Public Health Agency of Canada and
other organizations have reported the risk of aerosol transmission. In
our CISSS, many ventilation systems are outdated, especially in
our CHSLDs and even more so
in our Youth Centre. We want the N95 mask to be accessible to all
health care personnel. For now, the National Institute of Public Health
of Quebec (INSPQ) still denies that this needs to be done. We
have received confirmation that in Laval, in a warehouse, there is
currently an inventory of 415,000 N95 masks. The inventory is
controlled by the government. We are only allowed to have N95 masks in
certain cases; for example, in Intensive Care if the patient is
intubated. We made an offer to the CEO to do a pilot project in Laval.
We
want to provide all staff in the red zones with N95 masks to see if it
will make a difference. We hope the pilot project will go ahead. We are
also asking for ventilation reports everywhere, an air quality
assessment. We filed a complaint with Labour Standards, Pay Equity and
Workplace Health and Safety Board (CNESST) about the red zone at
Fernand-Larocque and they had to improve the air quality. With
respect to the CNESST, the Confederation of National Trade Unions (CSN)
filed a motion in
court requesting a ruling that the CNESST inspectors must do their job
according to the law and not just on the basis of INSPQ
recommendations. The complaint is not directed against CNESST per
se,
but to reinforce its adherence to the Occupational Health and
Safety Act (OHSA). CNESST inspectors tell us that it is no
longer
the law that takes precedence in their work but the recommendations of
the INSPQ, which change regularly. However, the health and safety
legislation requires that employers provide all necessary protections
to ensure the health and safety of workers and CNESST is bound to
enforce the
law. We are also advocating the creation of a
public
enterprise in Quebec for the production of PPE, laboratory equipment
and respirators. It is not right that we should be dependent on anyone,
multinational corporations or countries, when it comes to having the
necessary equipment. We must be self-sufficient in this area. This
proposal was put
forward by a CSN union advisor and the executive of the CSN union at
the McGill University Health Centre and we fully support it. WF:
Do you want to say something in conclusion? MA:
Our slogan is "We're not giving up on
anything!" We're fighting for N95 masks and we're fighting for
everything that concerns the health and safety of workers and the
public. 
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