Town Hall Q+A: September 16, 2021

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: COVID-19@providencehealth.bc.ca

Please note the corresponding time stamp if you would like to see the question answered in the Town Hall recording.

Will there be flu shots for staff this year? Can flu shots interfere with the efficacy of COVID shots?  (34:47 – 36:37)

We will continue to have flu shots, we are gearing up the campaign and we'll start as usual in mid-October. It will be a real imperative for us, not just for staff, but also for patients and our residents, that we do get the flu shots as efficiently as we can. 

It is considered safe to receive both vaccines and there is no evidence that when vaccines are administered together that there should be a problem. 

If vaccines don't stop transmission shouldn't daily testing be required for all employees? I understand viral load is comparable if vaxxed or unvaxxed? (36:38 – 37:47)

Vaccines will reduce the chance of transmission. Testing daily as an intervention is probably not as valuable unless it's targeted.   

When we have higher rates of transmission in certain areas - and we have seen from the Singapore literature - and looking at viral loads in individuals who are vaccinated and not vaccinated, the cycle threshold or the PCR shows that the viral loads may be similar during the first six days; however those who are vaccinated have a rapid decrease in their viral load. 

Even if they show the same viral load some of the viral culture studies have shown that they have less ability to culture in vaccinated individuals. This means that the genetic material is there, but it may not be an actively replicating virus that is transmissible or as transmissible as in those who are unvaccinated. So overall, it's a good thing to get vaccinated because it will reduce transmission. 

Provincial requirements for vaccinations of health care workers (38:21 – 38:58 & 58:09 – 59:30)

There are very strong opinions on different sides to this. I would reiterate that the vast majority of our staff are vaccinated and say thank you to them for that. I would also say, as an intro to this that we will, we are aware that the small group of people who are not yet vaccinated.   

There are many concerns and worries, and we want to genuinely support those staff in terms of answering those questions and trying to encourage everyone to feel confident to get vaccinated, and to ensure that we make, that ensures that our workplaces as safe as we can make it for colleagues as well as patients and residents. 

I work in Health Records and have zero patient contact. Will there be any attempt to exempt my coworkers & I from being vaxxed against our will to keep our jobs? (40:03 – 43:53)

While we wait for some clarification from public health at this point in time, we are considering that everyone is a health care worker and needs to get vaccinated. So if you're on site, you may not have patient interaction when you're walking to your office, but it's the same as masking, you're going to have to do this. Wait for further clarification but at this point in time we are considering that all health authorities are considering everyone as a health care worker.   

There will be a lot of conversations happening about if you're choosing not to, what does that look like and why.  

There's different reasons why people are currently choosing not to get vaccinated. Every indication that we've been given from public health is that this is required and overrides everything except a medical exemption. 

Once the deadlines pass for being fully vaccinated, conversations will continue so now we can you follow up. We are still waiting for some sort of definition on whether it's termination with clause, whether there's termination, or what are the conversations going to look like. We need to have continued conversations so it will be about those conversations and then the outcomes but public health will be very clear on what those outcomes are. 

If you are unvaccinated by the deadline as of right now, people will be put on unpaid leave.  

Again, we're waiting for definitions as to what health care workers were on the assumption that it's for all employees, but there will be a conversation, and so you won't expect that just one day you'll be terminated. If you’re unionized, the conversation will be with your union  because we want to understand why you’re not vaccinated and what we can do to support you. 

Ultimately, everyone should understand that this is a public health order and that you are unable to work with the employer should you not be vaccinated, so one has to have that in the back of their mind as we start having these conversations that there could be negative consequences to employment status. We don't want to sugarcoat that piece of it but we will work with you in order to be able to support you in the decisions you make. 

It’s an important point that public health orders do have legal power. We absolutely have to follow those. We want everyone to be vaccinated, we follow the advice and guidance of our experts, some of whom you hear today who are really clear that being vaccinated is absolutely the right thing and the safest thing for us. And we want to support staff who have anxieties about that. 

We don't want to lose anyone, but we also acknowledge that that we follow the public health orders, because those are the law. 

With the recent news from Alberta and their ICUs at capacity, what is our plan if we end up in the same scenario?  (44:20 – 47:05)

Overall, we always have our surge plans in place.  

We are looking at our transmission rates or hospitalization rates, and what is happening. They are different from Alberta and you can see a stabilization here in a way that Alberta hasn't.   

We've learned in the last year and a half to not predict what will happen in two weeks time because it's been unpredictable, but equally to say that we are in a very different place from Alberta right now and we can see that our trends are not at the minute, taking us that way. 

Numerous times a week, leaders across the province meet around patient transfer network, all the health authorities, and the BC Ambulance. We look at what the demand is across the province, and share that the patient care demand we do our best to keep people as close to their families as we can, but when necessary we move patients between the different health authorities in the province. So we are in close, and frequent contact about making sure that all people in the province get the care that they need in the most appropriate place. And we do have our surge plans in place and we're adjusting them as we go along.  

We do know that sometimes this puts our clinical staff in a place where, well more than sometimes recently, where we're feeling even more burdened with the care that's required, so we just want to take the opportunity on behalf of the clinical program directors to thank everybody all of the clinical staff and physicians for all the hard work. We see you and we know how hard you're working and we're so thankful for the care that you provide every single day.  So all of us and our professional practice department are here to support you the best we can, we know there's lots of hard days that have happened and I think we might have a couple of more weeks ahead of us. We're working hard. Within Providence Vancouver Coastal Health and with our, our provincial partners as well. 

How will the mandatory vaccination policy be rolled out? Will we receive an email and link to update our status? (47:07 – 49:34)

We're still working out some of the details. So of course, long term care rural, assisted living in our provincial mental health facilities, rolled out prior to the rest of the organization. What we've done is provide the information to the managers as to who is not vaccinated, so that conversations can happen. The initial conversations were done by OH&S because they have access to the information.   

From there, the privacy leads have signed off on the sharing of information through the Public Health Office, and the Ministry of Health. Now managers have access to only their staff and their immunization status so those conversations are also happening.  

We're doing the best we can to make sure that have conversations are face-to-face or on the phone, versus just a mass email because not everyone has a PHC email or not everyone continually checks their email. So we've got a variety of communication. We’ll hammer out the final process of how this will actually look across the organization soon and communicate it to everyone. 

We're going to use every avenue of communication that we have to ensure that people understand what this means and what the potential consequences are, and who they can contact for information or to have a conversation about some of their questions about the actual vaccine, and their concerns. 

When will Moderna/Pfizer create shots targeted to variants? There was news they were working on this, but nothing seems to have come out of this. (49:37 – 51:15)

We don’t have any more information. We know that there's this concern that if we do a third dose, should the third dose be the same or should it be a modified form that targets more of the variants, or at least the Delta variant? The constraints are that currently the third dose being offered to the clinical extremely vulnerable. So time is important, and given the current circumstances, we've seen that in areas that have provided third doses to this group of individuals, there is an increase in correlative protection. Can't be 100% certain, but there are rising, neutralizing antibodies and those individuals who at least there is some effect with the current vaccine. 

The manufacturers of the vaccine will be looking at ways to optimize and modify mRNA and the vaccine to target variants, when that will occur and how quickly it will be done is uncertain. 

What are the guidelines for corporate areas? Will the vaccine mandate apply to employees in non-pt areas? And what if these staff enter health care facilities? (51:37 – 52:00)

Currently we are considering all health care employees as being under the order and need to get vaccinated.   

Just because you're corporate staff doesn't mean you aren't going to the facilities and that you're not interacting with the public and patients, so, currently, it will apply across the board until we hear anything different. 

Will Vaccine Card be necessary when eating in the hospital cafeteria or other communal eating place? Why or why not? (52:13 – 53:30)

Our understanding is that, as we are following the public health rules, because the hospital cafeteria does not have table service the vaccine card will not be required. It doesn't fit within the instructions from public health and the government in terms of the vaccine card requirements. We will continue to try to make sure that we're following those legal rules.    

As they change, we will change. 

  

Will frontline patient care staff be receiving a booster shot? If so when and if not, why not? (53:38 – 55:40)
Currently the only priority group is the most clinically extremely vulnerable group. The criteria are set and includes: solid organ transplants, logic, stem cell transplant recipients and those who have therapies that are severely B-cell T-cell depleting, as well as some severe primary immune deficiencies. They are working out how they notify individuals that belong to that group. If you are a health care worker that belongs in that group and haven't been notified by September 17, please connect with your health care provider. There is a process for your health care provider to review and attest to the fact that you fall within that category, and they can proceed with vaccination, those forms are coming out on the doctors of BC site soon. 
  
Is it mandatory to wear a mask in group onsite meetings? Everyone in the room is double vaccinated. Is it ok not to wear masks? (55:45 – 57:00)

We all know that the vaccine is highly effective, but not 100% effective. So, we are still sticking with if you cannot have an appropriate distance between yourself and others you should continue to wear masks, despite being fully vaccinated. Please ensure that you can still have an appropriate distance. It is important to take the measures to protect yourself and others so we would recommend continuing to mask in group settings if you cannot maintain distance.   

The VCH policy highlights that even in break rooms, although you can have more people in the break rooms, it is still required that masking is done in congregate settings inside health care facilities. 

  

SUBMITTED QUESTIONS

More questions will be added soon.

VACCINE PROVINCIAL ORDER FOR HEALTH CARE WORKERS 

Will those who work remote and have no need to be on site ever, be excluded from this mandatory requirement? 
At this time, we consider all PHC staff as being covered under this mandate. 
Is PHC concerned about the impact on employee wellness and retention with the current mandates? 
We understand that a mandate can be difficult and have resources to support those employees struggling with the mandate and/or the vaccine. Staff and managers are encouraged to reach out to ohs@providencehealth.bc.ca for support. 
Why not mitigate the virus in ways that respect free and informed consent? 
This is a Public Health Order, which means it is a law that we must follow.  There is also a lot of scientific data that supports the effectiveness of the vaccine on preventing serious illness/death from the virus.   
It seems like we already feel stretched as to staff capacity. If are people banned from working due to vaccination status, do we have a plan to fill these gaps? 
Providence has relatively few unvaccinated and partially vaccinated staff spread across the organization. Managers are aware of how many are in their departments and plans are in place to minimize the impact of those staff who will not be able to work effective October 27th.  We believe the number of staff who will remain unvaccinated will be minimal. 
Informed consent is a pillar in health care. What is PHC's stance on employee's difficulty to exercise this for vaccines? 
The mandate is a Public Health Order and as such, must be complied with. 
Is PHC liable in case of vaccine injury?  
No, Providence Health Care is not liable in the event of vaccine injury. 

TRAVEL

What are the recommendations around travel? Do we get paid if having symptoms after? I am fully vaccinated.    
Please check the BCCDC website for travel restrictions before you go. If you have symptoms, you would be paid sick leave if you are entitled to it.   

COVID RESPONSE

Alberta Health says it may reach out to other provinces to take in patients. Has PHC been asked to do this? 
B.C. Minister of Health Adrian Dix gave an update in an email statement on September 16, 2021: “Given the current demands on B.C.’s health-care system, we will not be able to assist with taking patients at this time.” More background can be found in this news story: https://bc.ctvnews.ca/b-c-turns-down-alberta-s-call-for-covid-19-help-am...
Do patients with mild COVID that are in the COVID wards for other health issues count in the COVID hospitalization numbers? 
Yes, everyone who is on isolation for confirmed COVID infection, regardless of their symptoms, is counted in our COVID numbers.   
This page last updated Oct 19, 2021 5:24pm PDT