Province failing its duty to protect

“There is the potential that it can spread in the air,” said Dr. Kieran Moore, Ontario’s chief medical officer of health, last month.

While some hailed Moore’s statement as revolutionary, labour advocates and experts are still shaking their heads.

Since the beginning of the pandemic, mounting evidence pointed to airborne transmission. The Diamond Princess cruise ship where one known case led to 700; Washington choir practice where at least half of the singers were infected and two died; Quebec gym linked to over 400 cases; the outbreaks in health-care settings, meat-packing plants, and distribution centres across Ontario.

Two perspectives emerged early on: one camp pointed to airborne transmission, and the other adamant that droplet spread was gospel.

The chasm largely played out between occupational health and public health. Public health and infection control bodies believed in a dichotomy between airborne and droplet spread, while occupational experts and others saw a continuum of respiratory particle sizes (aerosols) that can be inhaled depending on the setting and factors like ventilation.

Before COVID-19, for any pandemic flu in Ontario, all healthcare encounters with a suspected or confirmed patient required an N95 or powered air purifying respirator. Ontario was considered ahead of the game in January 2020. But pressure from infectious control experts insisted COVID-19 spread through droplets, and Ontario’s N95 policy “wastes precious resources.” When COVID-19 struck Ontario in March 2020, the Public Health Ontario (PHO) guidance was downgraded so only regulated health professionals could access N95 masks. In December, almost two years later, PHO finally recommended healthcare workers use N95s, only when providing direct care for confirmed or suspected COVID-19 patients. Appreciated, but far from revolutionary or protective enough for all front line workers.

As Premier Doug Ford and Moore send education workers and students back to in-person learning, PHO has released zero updates on precautions for education workers. School boards are finally providing workers with the option of unfitted N95 masks, but continue to disregard the ongoing recommendations from experts and education unions for increased minimum precautions such as significant improvements to ventilation, and have removed important safeguards such as contact tracing. Moore even went so far as to chastise Niagara medical officer of health, Dr. Mustafa Hirji, for requiring a higher level of protection in schools than the provincial recommendations.

We have been here before, when the World Health Organization and U.S. Centers for Disease Control (CDC) finally acknowledged airborne transmission. Or in 2015 when the threat of Ebola hovered in Toronto and labour pushed for the precautionary principle — planning for the worst, and preparing for it. Or with the 2003 SARS Commission, where Justice Archie Campbell said “We cannot wait for scientific certainty before we take reasonable steps,” using the N95 respirator as an example. If we do not learn the lessons from SARS, Campbell warned, we will pay a terrible price in the next pandemic.

We are in the fifth wave of that next pandemic. Workers and communities continue to pay the ultimate price because of this government’s failure to protect them. Public health nationally and internationally continues to let the economics of work and production influence what should be strictly public health concerns.

It’s not about, “We told you so.” It’s about, we told you to protect workers from potential airborne transmission using effective controls like ventilation and N95s. How many more must die before Ford’s government confronts the science, and protects workers and the public?