Union sounds alarm after patient-care workers asked to break quarantine, return to work

Quebec's health minister is defending the decision by a regional health board to call patient-care workers who were exposed to COVID-19 back to work before their 14-day quarantine period was up.

Danielle McCann said Thursday the decision was made based on "scientific advice" provided by Quebec's public health institute (INSPQ).

"This is exceptional," she said.

"Leaving people all by themselves without services, we cannot do that."

Starting March 23, several dozen workers at the CHSLD Laflèche, a long-term care home in Shawinigan, were sent into isolation after they had been in contact with positive COVID-19 case, said Pascal Bastarache, president of the union that represents 5,700 employees across the Mauricie-Centre-du-Québec regional health agency's territory.

Those employees were not wearing the proper protective gear when they came in contact with the person, he said.

But some were called back to work after just a week because the seniors' home was running out of personnel. 

"We were extremely surprised," Bastarache said. 

"We understand this is a crisis that Quebec has never faced before. We understand that there's a job to do, but we're deeply concerned about the risks that this could create."

The regional health board confirms that, as of Thursday, 37 patients and 17 staff members at the CHSLD Laflèche had tested positive. Three patients have died. 

Neither Bastarache nor the health board was able to say whether any of the employees who were called back to work later tested positive. 

'Is there a risk? Of course,' says doctor

Kellie Forand, spokesperson for the health board, pointed out that none of the employees who were called back to work were showing any symptoms.

Forand says this policy is in line with the recommendations of Quebec's public health institute, which state that in exceptional circumstances, where the CHSLD is at risk of not being able to provide care, asymptomatic employees can be called back to work after seven days, or even earlier.

In those situations, workers must wear a mask, their symptoms must be monitored, and their temperature must be taken twice a day, according to the public health institute.

The situation is not ideal, but it's about balancing risks, according to Dr. Matthew Oughton, infectious diseases specialist at the Jewish General Hospital in Montreal. 

"Is there a risk? Of course there is," says Oughton. "But ... if you had no health care workers...does that come with a risk? Of course it does."

"It's not a policy that anyone wants to have to make."

Oughton said on average, people will start showing symptoms after five or six days, but for some it could be longer. 

He says health officials don't have all of the answers yet about asymptomatic transmission of the illness, but he points to research out of Iceland that suggests roughly half of people who tested positive for COVID-19 did not have symptoms. 

He said in circumstances where workers who were exposed to COVID-19 must come back to work without completing a full 14-day isolation period, it's critical to make sure that they have all the necessary protective equipment in case they do become contagious, and to track their contact with patients.

Workplace health and safety board asked to weigh in

Bastarache said the union asked the province's workplace health and safety board (CNESST) to weigh in on the situation.

Audrey-Anne Lafrenière, CNESST spokesperson, said board representatives held a meeting with both the union and the CIUSSS this week, and were satisfied that the employer was taking steps to protect workers' health. 

Bastarache said there should be clearer directives on what steps health boards must take before resorting to calling workers back early.

"We know the Quebec government announced it had received 20,000 CVs from people not currently in the health system. Here in the Mauricie they got 900 CVs and, last we heard, 50 of them were orderlies," he said.

"Was this really the last resort?"