Unions cry foul over 1-mask-a-day policy for Manitoba home-care workers

The unions representing thousands of home-care workers say they're baffled and disappointed that grievances and complaints haven't been enough to get workers the personal protective equipment they need to do their jobs safely. 

Across a variety of health-care settings in Manitoba, workers are expected to wear a procedural face mask and eye protection for every patient, and gloves and gowns if necessary. Workers are expected to use one mask per shift, which can be replaced only if wet or soiled.

The restrictive policy is proving to be especially problematic for home-care workers, who provide personal care to up to 20 clients in their homes per day, because scoring an extra mask requires them to drive back to a central site and provide proper justification before returning to their clients.

Home-care workers generally get one to two masks per shift, sometimes a few more, but typically visit 15-20 clients a day, according to the Manitoba Government and General Employees' Union, which represents about 1,000 home-care workers in the Prairie Mountain and Interlake Eastern Health Authorities. 

"It's the bare minimum," said Michelle Gawronsky, MGEU president.

And even that was the result of a hard-fought battle, the union says. After weeks of complaints to CEOs and home-care co-ordinators about inadequate PPE, the MGEU's recent complaint to Workplace Safety and Health finally prompted an order that the authorities comply with provincial standards. 

It's still not enough, argued Gawronsky, especially given the transient nature of home care and uncertainty of where the clients have been or who's been in their homes.

"Why aren't we just giving these people a box of gloves, a box of masks, giving them their shield, giving them a box of alcohol swabs … this should get you through three days worth? And if you need more than that, then we need to sit and figure out why.

"We're all being told to stay home.… And yet the folks that are going door-to-door to provide care to our most vulnerable Manitobans don't have the protection needed for both the clients and for themselves."

Grievance filed by CUPE

Unions say the situation is no better for home-care workers in Winnipeg, prompting the Canadian Union of Public Employees to file a grievance on April 29 against the Winnipeg Regional Health Authority about the one-mask-a-day policy for home-care workers, which it's also been fighting to change.

"A client could cough or something could get onto that mask and when they leave the client's house they have to go to another client's house," said Debbie Boissonneault, president of CUPE, which represents about 5,000 home-care workers in Winnipeg.

"We need to make sure health-care workers are protected, but also that our seniors and long-term-care residents are protected. By limiting already inadequate PPE during a pandemic, we could be putting workers and residents at risk."

She said the situation for personal protective equipment has improved since the pandemic began, but workers still don't always have what they need; only two procedural masks are allotted per shift, no hand sanitizer is provided by the employers and at times kits are missing gloves or face shields. 

"To me, this is a massive shortage and somebody's responsible here," said Gawronsky. 

Premier Brian Pallister has repeatedly said the province has enough personal protective equipment to protect against the spread of COVID-19, and Chief Nursing Officer Lanette Siragusa has reiterated that if health regions don't have enough supply, they should receive it "soon."

"Yet they're so restricted to be able to use them, the stock just doesn't appear to be here. Why are the restrictions when this is just a basic safety and health issue?" asked Gawronsky. 

Many home-care clients have cancelled, said Boissonneault, in part due to concerns they won't be protected from the virus.

"I believe there's a lot of fear out there. They don't know where they're going, from one place to another. There's fear for the people that actually go out and take care of loved ones because they don't know who's been in their homes."

In a statement, a spokesperson for Shared Health wrote that the organization's top priority is the health and well-being of staff. 

The PPE guidelines during COVID-19 are created and updated based on the latest evidence, wrote the spokesperson, leading practices from other jurisdictions and with guidance of local experts. 

"PPE is a supplement to our normal rigorous infection prevention and control protocols as well as the staff and patient screening we have put in place, moves to offer services virtually where possible and other changes intended to mitigate risk based on activity and setting. In home care, providers have been screening patients before entering the home for weeks now.

"The extended wearing of procedure masks is recommended for a number of settings and aligns with guidance from the Public Health Agency of Canada," added the spokesperson. 

Both union presidents would like to see more protection and spare masks for those working in and out of people's homes.

"There's a constant risk of contamination happening and yet they are still only given two masks in that kit for that day," said Gawronsky.

"If they're assigned to 15 different clients there's a very, very good chance they could use both of those masks by noon and now they're going to run another six hours without having proper equipment or they have to go back into the office and again they have to justify why they've used more than what's given to them.

If there is indeed a massive shortage of the equipment, she'd like the province to say so publicly, so that everyone can work toward solutions together. But she says the restrictions, and the flak workers sometimes get for needing a top-up, need to end.

"No one should be made to feel guilty for providing safe workplaces for themselves and the clients they're supposed to be looking after."