'It's not safe': Campbellton hospital staff troubled by working conditions amid COVID-19 outbreak
3 employees say protocols not strong enough, staff denied extra PPE
Some staff who have worked on the COVID-19 unit of the Campbellton Regional Hospital say they do not feel safe under the existing safety protocols.
"It's not safe. I don't feel safe," one employee said of the working conditions inside the hospital at the centre of the outbreak of coronavirus in the Zone 5 health region.
Three health-care workers are speaking out as the number of infected staff and those forced into isolation grows. CBC News has agreed not to identify the workers, who say they have been warned by Vitalité not to talk to the news media.
As of Wednesday, 10 employees had tested positive for the virus and 31 others are self-isolating. Vitalité Health Network announced Saturday that the hospital is effectively on lockdown in closing its emergency room, cancelling non-urgent services and prohibiting visits.
The presence of COVID-19 in the hospital has led staff to question the effectiveness of key protocols to reduce the risks of transmission and call on Vitalité for change. The employees say staff have been refused extra protection when treating COVID-19 patients, and lax protocols create a risk of spread throughout the hospital.
The employees say they're fearful of bringing the virus home to vulnerable family members.
"Do I want to bring that home to them?" said one employee. "Adults are having a hard time breaking the fever from it. I don't want to see my kids fighting this virus."
They say their concerns are shared by the majority of staff.
Vitalité CEO Gilles Lanteigne said during a virtual media scrum Wednesday the health authority is "very, very confident" in the current controls and continues to follow best practices.
"I think what you're hearing by some of the staff is that they're worried, they're concerned," he said. "That's why our role is to reassure them that the techniques and their training are good."
Employees describe risks
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. It was linked to a medical professional who travelled to Quebec and didn't self-isolate upon his return, but he is challenging the assertion and seeking an apology from the premier.
The outbreak has resulted in more than 40 new cases, a handful of new hospitalizations — there are four currently — and New Brunswick's first two COVID-related deaths.
The three employees all described the same series of protocols they viewed as problematic as the cluster grew and made its way into the hospital. The most concerning include:
- COVID-19 unit staff shared the same locker room with the rest of hospital staff.
- COVID-19 unit staff were refused hair and shoe coverings — protection, they say, would reduce the risk of spread beyond the ward.
- COVID-19 unit staff were told to have take breaks inside a small office, where a two-metre distance could not be met — a break room that was used by at least one staff member who has tested positive, one employee says.
- COVID-19 unit staff have moved to other units after treating patients.
- as of last week, there was no screening of employees, such as taking temperatures or symptom questions, when entering the building.
- Staff have been refused wider use of N95 masks after making an official request to their employer.
Two of the issues have recently changed: staff can take their breaks in a larger room, and Vitalité said it has stopped, as of last week, rotating COVID-19 unit staff to other wards.
One employee said COVID-19 unit staff would change gloves between patients but not gowns, which, they say, does not follow standard PPE procedure. Surgical or procedure masks are changed every break, they said, and replacement masks aren't on the unit.
"I had a positive COVID patient cough in my direct line of fire, right in my face, and it was not the patient's fault," one employee said. "[The supervisor] said, 'You should've put a mask on their face, and I said, 'How am I supposed to do that when there aren't replacement masks on the unit?"
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." He did not elaborate on the other possible factors.
N95 mask use
The employees say the N95 mask issue, in particular, is important to concerned staff. Staff are only permitted the masks during certain procedures that produce airborne droplets.
The masks filter out 95 per cent of airborne particles and are considered critical personal protective equipment for front-line health-care workers.
"I don't understand why we aren't wearing them," said an employee involved in more routine patient care, saying their options are a mask with a face shield or a surgical mask with goggles.
"I, personally, wear glasses, and my glasses fog up very easily wearing masks, the face shield especially, because all the air just goes up into the face shield and fogs my glasses. If the air is escaping the regular mask, that means we can breathe in [droplets]."
Vitalité has told staff surgical and procedure masks suffice when treating patients, and N95 masks should be limited to "specific cases, for example, if an aerosol generating medical procedure (AGMP) is performed on a patient of if a patient is undergoing a diagnostic bronchoscopy."
That was the response staff received from Vitalité and subsequently leaked to CBC News.
"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," said the statement attributed to Gisèle Beaulieu, vice-president of performance and quality and vice-chair of the infection prevention and control committee.
The health authority maintained Wednesday it has followed the prevention and control protocols set by the provincial Public Health and the Public Health Agency of Canada.
'That's been the advice during the entire pandemic'
Dr. Jennifer Russell, the province's chief medical officer of health, said during Monday's COVID-19 briefing the use of N95 masks for specific procedures is in line with Public Health guidance and the word of the federal health agency.
"That's been the advice during the entire pandemic."
Russell said an aerosol-generating procedure produces droplets that become airborne, creating a risk of transmission, and staff have access to the masks in those instances.
Both Russell and Lanteigne said the supply of PPE is well maintained and that Vitalité is reviewing its prevention procedures.
A March 31 memo, which was signed off on by 23 health officials, offered direction to all New Brunswick health-care facilities on the use of PPE and cautioned against the liberal use of masks.
The memo said the guidelines at the two regional health authorities for managing COVID-19 patients complied with federal guidelines.
"Liberalizing use of PPE beyond our current guidelines will only serve to provide a false sense of security and rapidly exhaust a finite supply," it said.
On N95 masks, the memo stated they "do not provide superior protection" against COVID-19 except during medical procedures that trigger aerosol spray from patients.
A revised memo, issued in early April, clarified that N95 masks "must be used" in any room where aerosol-generating procedures "are being performed, are frequent or probable, or with any intubated patients."
It was agreed to by the province, the two health authorities, Medavie Health Services NB, as well as the New Brunswick Nurses Union, the Canadian Union of Public Employees and the New Brunswick Union.
The memos came as the number of COVID-19 cases in New Brunswick was growing and after the province had difficulty securing N95 masks from a U.S. manufacturer.
Asked if the protocols should be changed at this point in the pandemic, considering the province's active cases are almost entirely in the Campbellton region, Public Health maintained the directives in the memo remain best practice.
Bruce Macfarlane, communications director for the Department of Health, said in an emailed statement on June 12 that a joint statement between employers and unions "set the bar high" for appropriate and safe PPE use — requirements also reviewed by WorkSafeNB.
"We understand the anxiety that this outbreak is causing amongst staff and have been assured that Vitalité is having discussions with our workers in Campbellton to better understand how transmission occurred in the facility in order to address any gaps that may exist," Macfarlane said.
Vitalité engaged in a testing blitz over the weekend and into Monday, testing 930 of the more than 1,200 employees between the Campbellton Regional Hospital and the adjacent Restigouche Hospital Centre.
Lanteigne said Wednesday about half of the 41 employees now off work will return by next Friday. He said the majority of affected hospital staff are nurses.
The nurses union told Radio-Canada on Friday that it's had many discussions regarding PPE with the province's COVID-19 task force, and president Paula Doucet said the current use of N95 "has been the advice during the entire pandemic."
The union has not responded to a CBC News question on whether the policy would be revisited in light of its members' concerns.