FRIDAY, APRIL 3, 2020 | THE GLOBE AND MAIL O NEWS | A 9ily trained to deal with long-term-
care issues, they’re not trained to
deal with infection-control is-
sues,” she said. “Do we appreciate
that there is a crisis and providers
need relief? Absolutely, but those
measures can’t come at the
health and safety risk of the peo-
ple who are living and caring for
the residents.”
On Thursday, CUPE Ontario
members in the long-term-care
sector wore stickers on the job to
protest what they see as second-
class treatment when it comes to
their access to personal protec-
tive equipment.
Ontario Health Minister Chris-
tine Elliott said Thursday that
most front-line health-care work-
ers haven’t asked for wage in-
creases, but rather the equip-
ment they need to do their jobs.
“The most important thing
first is that we make sure that allfront-line health-care workers in
hospitals, home care and long-
term care have the personal pro-
tective equipment that they need
to remain safe and healthy,” she
said.
In the case of Bruce County’s
long-term-care homes, Gateway
Haven in Wiarton and Brucelea
Haven in Walkerton, retaining
staff has not been a problem, ac-
cording to Jill Roote, the county’s
emergency information officer.
The county’s offer to library
and museum workers was simply
an attempt to plan ahead, she
said by e-mail. “In order to be
pro-active under a health crisis, it
is important to put measures in
place to ensure the protection of
the most vulnerable – our long-
term care residents.”WithreportsfromJillMahoneyand
LesPerreauxAt least two provinces have bowed to union pressure to let
some health professionals use specialized respirator face
masks when treating COVID-19 patients, sparking concern
among infection-control experts this will undermine health
workers’ trust in their advice.
Alberta and Ontario have reached agreements with
unions to allow some health-care workers to use N95 respi-
rator masks if they feel it is necessary. Nova Scotia’s largest
nursing union is now calling on provincial officials to do the
same.
But the Canadian Union of Public Employees criticized
Ontario for not going far enough, as the new policy on N9 5
masks applies only to registered nurses working in hospi-
tals.
Michael Hurley, CUPE’s Ontario Council of Hospital
Unions president, said on Thursday that all health-care
workers should have the choice to wear N95 masks. He said
the union is set to have more discussions with Ontario
about expanding its directive.
Every province, as well as the Public Health Agency of
Canada, recommends that health-care workers take “drop-
let precautions” when treating suspected or confirmed CO-
VID-19 patients. Droplet precautions include the use of reg-
ular surgical masks, as well as gowns, gloves and face
shields. According to mounting evidence, this provides suf-
ficient protection from infection.
But many unions and other associations representing
health-care workers have been pushing provinces to move
to “airborne precautions,” claiming it is not entirely clear
whether droplet precautions are enough. One important
distinction with airborne precautions is that they require
the use of N95 masks, which are specially designed to block
tiny viral particles that can remain in the air for longer
periods. Airborne precautions are typically used when treat-
ing patients with measles, where small particles remain
suspended in the air for hours.
For COVID-19, provincial andfederal governments rec-
ommend using airborne precautions only when workers
are doing what is known as “aerosol-generating proce-
dures,” such as an intubation. Such procedures can generate
small viral particles that can remain in the air longer than
they would under other conditions, such as when a person
coughs or sneezes.
The new agreements in Alberta and Ontario give some
health-care workers discretion to decide when to use air-
borne precautions and don N
masks. In Ontario, the directive
specifically applies to registered
nurses working in hospitals.
Janine McCready, an infec-
tious-diseases physician at To-
ronto’s Michael Garron Hospital,
said Ontario made the new deci-
sion without consulting infec-
tion-control experts. The direc-
tive risks sending the false im-
pression to health-care workers
that droplet precautions are in-
sufficient.
“It’s been very challenging
and kind of undermines a lot of
work we’re doing at the hospital level to work with our
staff,” Dr. McCready said.
She has been interacting with COVID-19 patients for
weeks wearing a surgical mask, she added, and is confident
about that level of protection.
Michael Gardam, chief of staff at Toronto’s Humber River
Hospital and an infection-control expert, said the over-
whelming evidence shows droplet precautions provide
enough protection, but that conflicting warnings from
some medical groups is creating confusion among health
professionals.
“It’s really created big problems in health care,” Dr. Gar-
dam said. “You get people saying, well am I protected or am
I not protected?”
He added that advocating for use of N95s when they are
not necessary means Canada’s supply of the masks could
run out. This is particularly troubling, as Canada is expected
to see a surge in COVID-19 cases in the coming weeks and
many health professionals will have to perform aerosol-
generating procedures.
“If you want to take an extra level of precautions, I’m not
going to fight you,” Dr. Gardam said. “But that’s different
when you have limited supply.”
Sandy Buchman, president of the Canadian Medical As-
sociation, said there is a legitimate concern Canada will not
have enough N95 masks to protect workers in the coming
days. A new survey of nearly 5,000 CMA members found
more than one-third of community-based physicians said
they would run out of N95 masks and other protective
equipment within two days, while others said they had
already run out.Ontario,Albertagrant
accesstoN95masksfor
somehealthworkers
N95 masks aren’t needed for protection in most instances,
according to health-care experts who fear that the new policies
in Ontario and Alberta will lead to shortages in situations
when N95s are essential.NICHOLASPFOSI/REUTERSCARLY WEEKSHEALTH REPORTERTheCanadianUnion
ofPublicEmployees
criticizedOntario
fornotgoingfar
enough,asthenew
policyonN95masks
appliesonlyto
registerednurses
workinginhospitals.A Medigas worker,
above and top, delivers
oxygen concentrators
to the Seven Oaks care
home in Scarborough,
Ont., on Wednesday.
PHOTOS BY
MELISSATAIT/
THEGLOBEANDMAILequipment out of an auto-repair
shop and out of his house.
Some of the material came
from Canada, although author-
ities would not say exactly how
much or identify who shipped it.
“According to records from [U.S.]
Customs and Border Protection,
on or about March 25, 2020, [Mr.
Feldheim’s company] received a
shipment by truck from Canada
of approximately eight skids of
surgical face masks,” the FBI affi-
davit says.
Police and prosecutors say
that a New York doctor with
about 100 employees sought out
such goods to protect his staff.
“Feldheim agreed to sell the doc-
tor approximately 1,000 N
masks and other assorted mate-
rials for $12,000, an approxi-
mately 700-per-cent markupfrom the normal price.”
U.S. authorities say that Mr.
Feldheim’s overall stockpile in-
cluded 192,000 N95 respirator
masks, 598,000 medical-grade
gloves and more than 100,
other pieces of equipment. N
masks are designed to block tiny
viral particles that can remain in
the air for long periods.
The U.S.government is using
some newly enacted powers un-
der its Defense Production Act to
redirect these goods. Federal au-
thorities said in a statement
Thursday they “will pay the own-
er of the hoarded equipment
pre-COVID-19 fair market value
for the supplies and [have] be-
gun distributing to meet the crit-
ical need for the supplies among
health-care workers in New York
and New Jersey.”Canadian officials are not
commenting on the case.
University of Calgary law pro-
fessor Michael Nesbitt said Cana-
da has its own Defence Produc-
tion Act, which could be invoked
to restrict cross-border shipping
or to curb price-gouging. But it
hasn’t been used yet.
“We do have it at our disposal
should it be deemed necessary,“
he said.
James Moriarty, a lawyer for
Mr. Feldheim, pointed out in an
interview that his client had not
been charged with price gouging.
Even so, U.S. authorities are
publicly describing the suspect
as a man who “hoarded” protec-
tive equipment and who then
sought to resell it at steep
markups as goods started to run
short.alth-care staffafterseizingshipmentfromCanada