Manitoba

Winnipeg emergency department nurse tests positive for COVID-19

A Winnipeg emergency department nurse has tested positive for COVID-19, prompting calls from the Manitoba Nurses Union for access to the N95 mask in some clinical situations. 

Nurse had not travelled internationally and had cared for patients with the virus, union says

The number of COVID-19 cases reached 234 on Monday, with Middlesex-London Health Unit (MLHU) reporting another death and 20 new cases. (Romeo Ranoco/Reuters)

A Winnipeg emergency department nurse has tested positive for COVID-19, prompting calls from the Manitoba Nurses Union for nurses to have access to the N95 mask in some clinical situations. 

The union, which confirmed the nurse's positive test, believes the nurse contracted COVID-19 while working in the emergency department caring for patients sick with the virus. She hadn't travelled internationally for several months and hadn't travelled domestically for at least a month.

"As a front-line health-care provider, you have no idea when you come in contact with a patient or a family, whether that patient could be positive," said Darlene Jackson, MNU president. 

The province would not confirm on Tuesday that the Winnipeg nurse was infected with the illness.

"Right now I'm not going to confirm any specifics," said Dr. Brent Roussin, the province's chief public health officer, when asked about the nurse at the Winnipeg hospital. 

He did, however, make reference at Tuesday's daily COVID-19 news briefing to a health-care worker at the Selkirk Regional Health Centre who has tested positive for the illness.

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According to the Manitoba Nurses Union, the Winnipeg nurse who contracted the illness had access to personal protective equipment. The union did not want to identify the Winnipeg hospital where the nurse works for privacy reasons, but Jackson said she believes all Winnipeg hospitals have had seen patients with cases of COVID-19 now.

"Front-line providers are at much, much higher risk than the general public, just because they're out there and coming into contact with patients continuously during the day," said Jackson.

"We knew that this type of transmission was going to happen and we really need to demand that the government address the nurses' concerns. That means increasing access to personal protective equipment."

The nurse is recovering in self-isolation at home. 

Investigations underway

Roussin said Tuesday the Selkirk Regional Health Centre worker who has tested positive is self-isolating, that the incident is being investigated by occupational health and safety, and that public health officials are working to contact everyone that person came into close contact with.

The worker had recently travelled within Canada and the case is directly related to that, he added.

There are multiple investigations underway, Roussin said, which will focus on whether adequate personal protective equipment was used and who workers came in contact with. He said transmission is possible between patients and health-care workers, and that's why as many protocols as possible are in place to protect workers.

"We have been investigating some cases where that type of transmission is considered. I can't confirm that [type of transmission]. But when we see such cases the investigation will centre around that."

The province will update the public when its investigations are complete, if a large number of people could potentially be affected, he added.

Jackson said for various reasons, some nurses have asked to be supplied with N95 respirators. The union believes they should be made available in some cases — for some people involved in screening, for example, who have asked for the masks.

The World Health Organization states that transmission of COVID-19 is primarily through respiratory droplets and contact with surfaces they've landed on, and there is no evidence yet of airborne transmission. However, in situations where aerosol procedures are used, there could be some airborne transmission, the WHO says, and N95 masks are recommended for those circumstances.

N95 respirators are believed to provide increased protection compared to surgical masks.

The evidence still isn't entirely clear about the transmission of the virus, Jackson said, and "when in doubt you always err on the side of caution and provide the most appropriate [personal protective equipment], which are N95 masks."

"We need to talk about that now, and I think that we really need to talk about broader testing for health-care providers," Jackson said.

Best evidence 

The province's chief nursing officer, Lanette Siragusa, said staff follow contact and droplet precautions when caring for patients with COVID-19 — meaning the use of surgical gowns, gloves and surgical masks.

The N95 masks are made available for aerosol-generating procedures, she added, which include suction and intubation of patients. She said the province's decisions are based on evidence from the World Health Organization and the Public Health Agency of Canada

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"We do appreciate that there can be some difference in evidence, but that to us was the best evidence available. And we also relied on clinical experts within the system," she said. 

"Making sure that our staff and the public are safe is our No. 1 priority.  And we are relying on evidence to guide our decisions.

She added proper use of the protective equipment, hand-washing and social distancing will be the best defence against the virus. 

"At a time where equipment is limited, we have ordered more than enough, and we continue to search and find and get more N95 masks or whatever it be … so that our staff are protected," she said Monday, adding it's imperative staff know how to properly don and doff their personal protective equipment. 

The province is also asking medical supply companies to donate any extra medical supplies to designated locations across Mantioba.

The MNU says it's critical that nurses have improved access to testing. The union would also like the province to allow nurses to use their clinical judgment about whether a situation calls for an N95 respirator.

The union would like to meet with government officials to strike a deal on when the N95 respirators can be used, similar to what unions in Ontario and Alberta have done.

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