NOVEMBER 19 TOWN HALL: Q&A
The following Town Hall questions were answered with information that was current at the time. Information around COVID-19 and our response continues to evolve. If you are unsure if the information below is still current, or if you can’t find the information elsewhere on the website, please talk to your leader or email: COVIDfirstname.lastname@example.org
- What's the difference between medical grade masks and regular masks?
- Medical grade masks meet quality specifications in the areas of fluid resistance, differential pressure, filter efficiency and flammability. Non-medical face mask should be made with proper material, structure and fit. For more information on making or purchasing non-medical masks, please refer to the Public Health Agency of Canada website
- How will PHC support us with patients who refuse to wear a medical grade mask?
- We need to approach patients professionally and compassionately. Remind patients that wearing masks is a provincial mandate and in hospitals, we all need to do what we can to reduce COVID-19 transmission. For patients who refuse, discuss this with your team to better understand how to best approach this considering patient understanding and whether there may be exemptions.
- Are there any known side-effects to wearing masks?
- Some people can have a skin reaction to the mask material. OHS will work with them to find the mask that will work for them. Others may have a specific medical condition that prohibits them from wearing a mask. However there is no evidence that mask wearing creates any inherent risk.
- Please clarify the staff expectations for medical masks upon entry. Are there ways that it can be made easier for to do (e.g. adequate space and sanitizer)?
- As per November 9 provincial direction, health-care workers working in a clinical unit or setting or a patient-care area must wear a medical mask upon entry and while they are on-site, including in common areas and break rooms unless eating or drinking. Clinical staff can wear a non-medical mask while commuting to and from work but it is expected that they will wear a medical mask once they are on the facility premise, as they move from common areas, locker room to the clinical or patient-care areas.
- What is the difference between an induced cough versus a natural cough and what determines the use of a surgical mask versus an N95 when doing an aerosol generating medical procedure (AGMP)?
- When performing an AGMP on patients with confirmed COVID-19 or suspected COVID-19 (person under investigation), and N95 respirator is required. For potential aerosol generating non-medical procedures (eg. natural cough), N95 respirators are not generally required based on the provincial PPE guidance.
- I work in a non-clinical setting. Do I need to wear a medical/surgical mask? Or, can I wear a non-medical mask?
We're still getting some information from the Ministry of Health and clarification around all of this.
We do provide medical masks if people want them, but we are allowing non-medical masks in non-clinical settings until further notice. You still need to maintain physical distance from one another.
Just to clarify, if you work in an administrative type setting, but you're on site at St. Paul's or MSJ, please wear a medical mask.
If you work at Hornby or any of the other non-clinical settings, cloth masks are okay.
- For corporate meeting rooms and private offices, do we need to wear a mask if sitting alone?
If you are in a hospital setting or a long-term care facility, then yes, you should be wearing a mask. The types of interactions that occur throughout the day.
Remember, the purpose of the mask is to ensure that there's source control as well as protection to the wearer. In a closed off space, or even in an office, we know that the ventilation and circulation of air may not be optimal. So as other people come into your office, at unpredictable times, it's probably best to just keep the mask on if you're in a health-care setting.
- What should I do if I see someone not wearing a mask at the hospital?
We will have to deal with some of those situations on a case-by-case basis.
We try to help everybody as much as we can and we understand that there are various reasons for not wearing a mask. We don’t assume, in terms of compliance, that people who are not wearing a mask, that they're supposed to be.
If we are educating people properly, hopefully we are helping them figure out what to do and the number of people that will continue not to wear masks will be relatively minimal.
WELLNESS CHECKS + SCREENING
- How are wellness checks being done at PHC sites?
- In clinical areas, it is being done on sign in and in non-clinical administrative areas, it’s being done via an Outlook invitation.
- Is non-clinical staff screened for COVID-19 before entering the workplace like clinical staff are required to do?
- Non-clinical staff are held to the same expectations as clinical staff – they must do their self-assessment before arriving at work, and then an assessment at work.
- Is there a possibility of virus transmission via food especially that is kept open in supermarkets?
- There are currently no cases of transmission related to food transmission. Please see the guidance from the Public Health Agency of
Exposures + Outbreaks
- I’m anxious that there will be an exposure at my site. I'm doing my best to stay safe. But what do I need to know if this happens?
- We all need to continue to practice the protocols around PPE, IPAC, physical distancing, and staying home when we’re sick. We get notifications of exposures on a daily basis. However, they don't usually turn into an event because everybody's following the right protocols. Continue to wear your PPE, physically distance, stay home when you're sick and wash your hands. That is what you need to continue to do to minimize the risk.
- Is there a process in place for supervisors/managers if a staff member tests positive? Contact tracers take a few days to connect, what do we do until then?
- Yes, there is a process. The manager informs Infection Prevention and Control (IPAC) and Occupational Health & Safety (OH&S). OH&S contacts the employee to explain the Public Health process and asks questions about PPE usage plus break time behaviours (ie, was physical distancing always practiced when unable to wear a mask). Information is passed to Public Health, manager, IPAC and EOC and then Public Health does their contact tracing interviews and determines the risk to the workplace.
Environment + Safety
- Is there an issue using heaters and fans in the office in terms of preventing COVID?
- Additional heaters and fans should not be used in hospital settings. The heating, ventilation and air conditioning systems in hospitals are managed by our facilities management teams. Modifications to this should not be implemented by individual users.
- Should there be people placed in the cafeteria to monitor during peak times to ensure everyone is staying safe?
- We need to ensure our limited resources are used most appropriately. We rely on users of the cafeteria to follow the basic principle of physical distancing, mask use and hand hygiene. Masks should be kept on until one has found a place to sit and eat. Please do your part in following these guidelines and remind others if you see non-adherence.
- How can we ensure hand sanitizers do not run empty? Can a system be worked out so staff can call or text to notify housekeeping when empty?
- If you find an empty dispenser stations around the hospital, please call the Crothall EVS telephone line. 1-844-372-1959. Report the empty machine and it is prioritized to get done.
We have a robust system in place to refill the hand sanitizer dispensers, with a back-up system of housekeeping supervisors supporting additional refills. We have put 50+ new dispensers in place, including doubling up on high volume area.
- If there is a risk of disease remaining in poorly ventilated spaces, what is the plan for non-essential admin staff if distancing is no longer helpful?
- We need more clarity on what is meant by “non-essential admin staff”; however, we would look at who can work remotely to try and address the situation, if they aren’t already doing so.
- Will all meeting rooms be equipped with sanitizing supplies?
- They should currently be supplied with sanitizing supplies – if missing in your area, please contact the party responsible for maintaining the booking of those rooms.
- Will there be any spot checks to ensure departments are following protocol re: physical distancing?
- That is a manager’s responsibility to ensure all PPE and IPAC protocols are being followed.
- My kid has tested positive and it’s taking a while to get my results. I’m asymptomatic. Can I still come to work?
- Public health will determine the risk around whether or not you need to self-isolate. Generally speaking, if you are considered a close contact of a positive person, you've been in a risk area. Frequently, public health will decide that you need to self-isolate. However, that is their decision. They will be in contact with you about the positive results.
- If we develop symptoms during a shift can we still get tested in the ER or do we have to go to one of the designated community testing sites?
- Yes, you can get tested in the ER.
- I heard that rapid COVID tests may be available soon. If these are available in BC, will we require all staff to get a COVID tests before starting their shift?
- Yes, rapid point-of-care tests will soon be available in BC. Only a small number of point-of-care tests are currently approved by Health Canada. The deployment of these tests in BC is still being determined, but may initially include screening individuals in high-risk settings (e.g., DTES), or testing in remote parts of the province where access to a COVID-19 laboratory is more limited.
- Will we see use of different types of testing such as a throat swab instead of the invasive nose one?
- The nasopharygeal swab NP is considered the specimen of choice for most people with a viral respiratory tract infection. Saline gargles and mouth rinses are increasingly available for children and others, although the sensitivity of testing for SARS-CoV-2 may be compromised using these specimen types.
- I understand people who were infected do not have persistent antibodies. Do they still have protection equivalent to a vaccine?
- While our knowledge of immunity after COVID-19 is rapidly expanding at this time, there appears to be individual variation in the duration of detectable antibodies following resolution of the infection. The duration of protective immunity following natural infection is also likely variable, and vaccine-induced immunity is still being investigated.
- If a patient tells us they have been in contact with a Covid-19 positive person one day before surgery, will testing clear them for admission to the hospital?
- This depends on many factors, including the type of contact (casual vs. significant), the incubation period, the type of test performed. In general, a clinical assessment of the situation is required. Admission to hospital should be based on medical need. Patients who are considered high-risk for COVID-19 should be managed according to the appropriate hospital protocols.
- We understand that the PPE spotters are doing their part in "enforcing" eye protection. Has there been adequate evidence for eye protection against the virus?
- We know that the virus is transmitted through droplets and the significance of transmission through eyes is unknown. However, because the eyes are directly connected to the sinus, as well as the respiratory tract through the lacrimal canal, the possibility of transmission of the virus through the eyes is there.
That’s why we have the added layer of protection to ensure that even if you have masks which cover your nostrils and your mouth, you still have the opportunity to introduce virus through the eyes. Wearing eye protection is recommended in the high-risk settings, such as hospitals and health care facilities.
COVID-19 + FLU VACCINE
- For comparison, in regards to the effectiveness of the new COVID-19 vaccines, what is the percentage for vaccines that we currently use?
- Vaccine effectiveness will vary depending on the type of vaccine. If you have specific questions for other vaccines, please consult with your health care provider. A general resource for vaccinations in Canada can be found here.
- If there are limited doses of flu vaccine for hospitalized patients, should we be targeting specific populations to receive the vaccine?
- Hospitalized patients are a high risk group who should be vaccinated for influenza. Hospitalized patients are a targeted population at higher risk and should be vaccinated while they are in hospital if they have not yet received this year's seasonal influenza vaccine.
- Do people who had COVID require a vaccine? How long immunity last after?
- COVID-19 vaccine indications and durability of the vaccine have not yet been fully established. More information will be available based on studies of the vaccines.
- Is the flu vaccine mandatory for non-clinical staff this year?
- There was an agreement last year with the Ministry of Health that stated that the flu vaccine would not be mandatory unless it fell below an agreed upon rate. Staff who choose not to get vaccinated must still wear a mask, which is the policy everywhere.
- How do I explain to those saying: “I’m careful with distance, mask, handwashing so the likelihood of getting the flu is low, I’m not getting the flu vaccine?”
- Whether or not to get vaccinated is a personal choice and it’s not your role to try and change their mind. If all staff are following PPE and IPAC protocols, the risk of transmission is significantly reduced.
- There are staff who refuse the flu vaccination, what will be the approach with staff that refuse the COVID-19 vaccine?
- The Ministry has not yet released guidelines with regards to the new vaccine. Staff should continue to follow all IPAC and PPE guidelines in place.
- With the expedited trials for the vaccines compared to the traditional process, what risk or long-term risk is there for individuals that choose to take it?
- We are still waiting for information on the new vaccine, as there are currently two coming available in coming months, with a third potentially following shortly afterwards.
- If a vaccine is available in the future, is it mandatory to take it?
- That hasn't been determined at this point. We'll just have to wait for direction from the ministry on that.
- Will all health care staff, including non-clinical staff, get the COVID vaccine ahead of other groups and the general public?
- This will be a provincial decision — the ministry will establish some sort of triage system. We won’t be surprised if healthcare workers, especially those that work with the elderly and vulnerable populations, will get the vaccine earlier than some other groups.
We are having the discussions with the region at the moment. Our understanding is that we'll be looking at a similar type of rollout as the flu vaccine. Healthcare workers, because of their need to be on site dealing with our populations, will be prioritized along with the more vulnerable populations. This still needs to be determined on what exactly this will look like. But our understanding from the get go is that that we will be prioritized.
We do know that the vaccines often don't work quite as well with frail and very elderly people. That’s why it's so important to get the flu vaccine. Our immune systems are much stronger and can make those antibodies that sometimes our patients can’t. This will most likely factor into the decisions around the COVID vaccine as well.
- There are quite a few people working at the corporate offices. Are there any plans with the rising cases to have people work from home more?
- If people have the ability or think they have the ability to work from home, talk to your leader to see whether or not you can.
There is a PHC working remotely policy that went to senior leadership yesterday and it should be rolled out within the next few weeks. And with that, there will be a toolkit, assessment and agreement between the leader and staff member.
Our offices are safe. We have done everything from the beginning to ensure that we have the tools to be able to work in the office, if that's needed. We have the ability to physically distance. We put the max capacity on our rooms; we’ve also provided masks when they're required. We have hand sanitizers everywhere — it is safe to come into the office.
- Can people working from home be supported with equipment, like a keyboard and/or monitor? Or are those people encouraged to work in the office instead?
- Only those who have the technology at home are able to work from home. PHC will not be providing additional equipment to be able to work from home. If you can’t work from home, please be assured that the offices are safe locations to work from. The working remotely policy will be available soon.
- In the future, will staff be able to work remotely between provinces or countries?
- The PHC working remotely policy only covers working within BC. Anything outside of the policy would have to be reviewed on a case-by-case basis. There are concerns around privacy legislation and work safe issues when outside BC.
- There is news about people having to pay for driving into the downtown core soon. Will HCP that commute with car be exempted from this?
- We don’t have an answer to this question at this time.
- Will PHC be issuing T-2200s, so that those of us working at home can deduct some of our at home expenses (i.e. internet, space, personal cell phone use)?
- The direction we've been given so far from the Ministry is that health authorities will not be issuing T-2200s. But before anyone gets upset with that answer, please know the conversation is still ongoing. And as soon as we have more information, we'll make sure that you're notified of it.
VISITORS + PATIENTS
- Can we lift the visitation policy for patients who have ELOS of 1-2 days? Is there any room to make the policy stricter with these kinds of short stays?
- No. We believe that everyone who is in hospital requires an essential visitor, regardless of their length of stay. If there is public health direction that we should tighten our guideline around essential visitors, we will do so at that time.
- What policies will be put in place if confirmed Covid-19 positive patients are leaving their designated room/unit to go to around the hospital/community?
- At this time the policies in place will continue. Patients leaving their rooms will be asked to wear a mask. If the individual refuses, the staff member should undertake a point-of-care risk assessment to determine appropriate next steps. However, staff should ALWAYS ensure they are wearing their own PPE to maintain their own safety. Public Health will be notified of individuals who choose to leave prior to a formal discharge if these individuals have not been cleared from COVID-19.
WORKING AT MULTIPLE SITES
- I work in a clinical setting at PHC but emergency at VCH and FHA. Can I continue to do this?
- You can continue to work in multiple sites as long as it is not multiple LTC sites and as long as one of those sites is not an outbreak site.
PROFESSIONAL IMAGE POLICY
- How are we to stay warm but just wearing short-sleeved uniforms?
- This is probably in reference to our Bare Below the Elbow campaign, which we actually launched before COVID-19. This is an initiative to ensure proper hand hygiene, etc.
Putting something underneath your scrubs to keep warm (like a t-shirt) is completely fine.
- Can we send out earlier notification of the town hall like VCH do with place holder calendar invite last minute means cancelling meetings?
- Yes, calendar invites will be sent as soon as a decision is made by the pandemic response EOC to hold a town hall. Sometimes a virtual town hall is organized at short notice, but we will endeavor to send invites so there is plenty of time for people to rearrange their calendars.
- In the first wave, we did public health messaging, and it was effective, is there a plan for more public messaging that we can participate in?
- Providence Health Care is continuing to work with our Health Authority partners and the Ministry of Health on public health messaging and will communicate to our staff any opportunities that enable staff participation in such awareness campaigns. The best thing everyone can do is to be as informed and aware as possible with regard to the latest policies, practices, protocols and provincial public health orders. Health care workers are at the front lines of battling the pandemic and are constantly communicating to patients, residents and the public, reinforcing the key information and best practices regarding how best to stay safe from COVID. The Ministry of Health, the Provincial Health Office, Health Authorities and Providence Health Care are all endeavoring to provide the public with consistent and transparent communications and messages, utilizing the full breadth of communications vehicles, including social media and the press. This has been challenging, given the breadth and depth of issues, but health care workers can continue to play an integral role in amplifying, sharing and promoting these public messages. At Providence, since the start of the pandemic, staff and medical staff from throughout the organization have helped answer questions from the media, participated in media stories, and greatly assisted in public awareness building.
- Staff bulletin shows case numbers "hospitalized". Are the cases that are listed as in the ICU and those on ventilator additional or included in that category?
- The “hospitalized” number is the total COVID patients in our hospitals. The number of ICU patients is included in that total (is a ‘subset’ of the total); and the number of patients on ventilator are included in the ICU total (or is a ‘subset’ of the ICU number). The “hospitalized” number is the true total number of COVID patients in our hospitals.
- Will the City of Vancouver bring back free parking for staff in the West End? SPH lot fills up at 5:30AM with staff sleeping in their cars before their shift.
- We understand how frustrating it is when you get here so early and there still isn't parking and we are working with the City of Vancouver and the province around this, however, the best current option is paid parking around St. Paul's. We do have to ensure that it is a priority to have parking available for our families and our compassionate visitors.
LONG TERM CARE
- Will Providence be taking action on the recommendations from the BC Seniors Advocate’s report (Nov 2020) on the impact of visiting restrictions in LTC?
Currently, all health authorities are following the guidance and orders from the Provincial Health Officer. We are confident that Dr. Henry takes into account all expertise and feedback from varying sources, factoring in the impacts on seniors in care, and weighing all the options. Currently, the emphasis is to keep seniors in homes as safe from COVID as possible, while allowing controlled visits.
Providence Long Term Care Leadership has met with the Seniors Advocate to review her report. While we agree that maximizing visitors for our residents is a priority for the comfort and well-being of our residents, we are required to await Medical Health officer direction before initiating any change in our visitor protocol.
In the meantime, all sites are maximizing social, virtual and essential visits that conform to the current policy. Additional staff have been hired to support these visits.