Doctor retracts call for wider N95 mask use on Campbellton hospital COVID-19 unit, says Vitalité
Anonymous front-line worker describes stresses of treating COVID-positive patients
The northern New Brunswick doctor who voiced concerns about the prevention and control protocols on the COVID-19 unit at the Campbellton Regional Hospital has retracted her statements and apologized, according to a statement from Vitalité Health Network.
Dr. Vona MacMillan told Radio-Canada that she was a "little nervous" starting on the unit and called on the health authority to allow staff to wear N95 masks while treating COVID-positive patients, regardless of the procedure being performed.
She made those comments on Thursday and, at 4:20 p.m. on Friday, Vitalité released a statement saying MacMillan "wishes" to retract her comments.
"I recognize that what I said yesterday was wrong," MacMillan was quoted as saying in the statement from Vitalité. "That is why I would like to withdraw my statements and correct the facts. "
The facts she raised Thursday were around her unease about beginning the first of three shifts on the ward starting Friday after 10 hospital employees have tested positive for the virus.
"It's a very contagious virus that we have and I've seen since our COVID unit has opened that staff working there are being infected despite using the proper precautions that are provided for us," MacMillan, a family physician based in Charlo, 30 kilometres east of Campbellton, told Radio-Canada on Thursday.
"To me, something with the proper precautions is not proper."
Vitalité said Wednesday the hospital is following proper protocols to the letter, and the positive tests are in part due to lax attitudes of staff while on break.
But three front-line care-givers who have worked on the ward told CBC News this week the root cause is problematic prevention measures and the denial of extra personal protective equipment for staff treating COVID-positive patients — specifically the wider use of N95 masks beyond certain procedures that produce airborne droplets.
MacMillan said she purchased her own N95 masks to wear while treating patients and called on Vitalité to run a trial for continuous use of the masks for staff on the unit.
"We try it for two weeks and see what our numbers are, see if less are infected," MacMillan said. "If they are, then we know our N95s are better. If the numbers don't change, then we can go back to the other protective equipment.
"At least give us a fighting chance."
The Vitalité statement issued late Friday afternoon said the doctor "acknowledges that wearing the N95 mask on a continuous basis when caring for patients with COVID-19 is neither necessary nor recommended."
The health authority has previously told its employees as well as reporters it's following the recommendations of provincial Public Health and the Public Health Agency of Canada.
Vitalité's statement included an apology from MacMillan.
"I apologize to Vitalité Health Network, my physician colleagues and the public if my comments yesterday cause concern," she was quoted as saying. "I can assure you that all measures are being taken to ensure a safe work environment for the employees and patients of the Campbellton Regional Hospital."
Doctor said she may be disciplined
CBC News could not immediately reach MacMillan for comment following the statement
During the interview Thursday, MacMillan said that she may be disciplined for speaking out and that putting her job on the line is a "hard thing to do."
Other health-care workers at the hospital are "all pretty much on the same page," she said. "We don't feel we're being treated fairly.
"For me, I'm here for the community and for my patients, and I think it's important enough that this community needs to be heard."
Doctors should be able to speak, society says
The president of the New Brunswick Medical Society said Friday following the statement that the society supports doctors expressing their opinions.
"The New Brunswick Medical Society supports physicians expressing clinical opinions pertaining to the COVID-19 pandemic," Dr. Chris Goodyear said in an emailed statement.
"These are challenging times for health-care providers; asking critical questions about guidelines and the availability of specialized equipment is certainly appropriate. We encourage an open dialogue with both regional health authorities and the province's physicians."
On Thursday morning, CBC News published a story detailing the fears of three health-care workers who say they feel unsafe under the existing prevention and control protocols. They said they fear for their safety and the safety of vulnerable family members at home.
CBC News agreed not to identify the workers, who said they have been warned by Vitalité not to talk to the news media.
Stressful working environment
A care-provider who's worked on the COVID-19 unit described the experience as "every stressor of being a health-care worker amplified because you're on edge about the virus."
"Knowing that these patients can fluctuate in severity at the drop of a dime really keeps you on your nerves at all times; let alone the fact that if you make the mistake to remove that strand of hair that's in your face or scratch your seemingly always itchy face, you may very likely contaminate yourself and acquire the virus," they said.
The N95 mask not only offers a greater level of protection, employees say, it reassures them as well. The workers said staff are fit-tested to ensure proper size and seal.
"We all heard that these basic masks are not to protect us but to protect others," they said.
"Should we, as front-line health-care workers, not be protected while being in such close proximity to the positive patients?"
The N95 masks filter out 95 per cent of airborne particles and are considered critical personal protective equipment for front-line health-care workers.
The alternative face coverings offered to staff are surgical or procedure masks paired with face shields or goggles.
"In most cases, the full PPE including gloves, gown, surgery or procedure mask and eye protection is appropriate when providing care to a COVID-19 patient or a suspected COVID-19 patient," Vitalité CEO Gilles Lanteigne said in a statement to CBC News.
Senior officials from the health authority say they're following the recommendations of the provincial Public Health and the Public Health Agency of Canada.
Employees suggest New Brunswick adopt an Ontario protocol — that was championed by the provincial nurses association — that allows nurses to determine, based on their clinical judgment, if they require a N95 mask when treating a suspected or positive COVID-19 patient.
In late May, after two weeks of no reported active cases in the province, Public Health announced a new cluster of the virus in the Campbellton region.
The outbreak has resulted in more than 40 new cases, a handful of new hospitalizations — that's down to two currently — and New Brunswick's first two COVID-related deaths.
In addition to the 10 COVID-positive employees, there were, as of Wednesday, 31 others in self-isolation out of precaution. Vitalité said Friday one of the COVID-positive employees is no longer in isolation.
Lanteigne confirmed Wednesday at least one of the infected employees had not set foot in the COVID-19 unit.
He said a "number of factors" have contributed to the spread in the hospital, but staff have not been "on their guards as much as they should be" in the break room, describing their attitude as "pre-pandemic."
One employee described his comments as "degrading and offensive," saying it's unlikely that 10 workers contracted the virus while on break, considering the gaps in protection.
"Our necks are open, our hair is not covered, our sneakers are constantly contaminated, from our knees down are completely uncovered," they said. "These nurses in other facilities are covered from head to toe."
The three Campbellton hospital employees who spoke to CBC News say being denied extra PPE, and what they see as risky protocols, created the risk of spread to COVID-19 unit staff and elsewhere in the facility.
They say staff have also been refused hair and shoe coverings — protection, they say, would reduce the risk of spread beyond the ward — and COVID-19 unit staff shared the same locker room with the rest of hospital staff.
The health authority has addressed some of their concerns, including establishing a larger break room for COVID-19 unit staff where a two-metre distance could be kept and stopping the rotation of staff to other wards.
Health minister questioned
Vitalité, Public Health and the New Brunswick minister of health have all said this week the supply of PPE is well-maintained.
After CBC News published the concerns of some front-line workers, Liberal MLA Guy Arseneault, the representative for Campbellton-Dalhousie, questioned Health Minister Ted Flemming on ensuring access to appropriate PPE during Thursday's legislative sitting.
"I can assure, as far as the government is concerned," Flemming responded, "Vitalité Health Network and everyone in it is being provided the full resources of government, they're provided unlimited PPE, they're provided training for that, things like that, and if that's not the case, I will look into it. I certainly will."
On Friday, Premier Blaine Higgs said Vitalité is renewing efforts to ensure the proper protocols are in place, and the situation in Campbellton will help inform how other New Brunswick health-care facilities react in the event of an outbreak.
"We will try to work with officials there to ensure their concerns are recognized and we're mitigating them," Higgs said during an update on the provincial recovery plan.
With files from Serge Bouchard of Radio-Canada