The Science and Rationale Behind Our Call for Specific Personal Protective Equipment and Training

The pandemic that has finally reached our shores has gravely impacted nurses, doctors, techs, paramedics, administrators, and governments the world over. I want to share information that nurses unions, health organizations and our own leadership feel is important as we brace for our own battle with the novel coronavirus (COVID-19).

Working with public health and following their lead on this rapidly evolving crisis, NSNU has tried to keep members informed via our website and regular Campaigner e-memos. We held a telephone townhall on March 12th to hear your concerns, we created a webpage dedicated to this conversation, we regularly post on social media, and I speak directly with members and media, daily. Your labour relations representatives are at the ready and have been fielding calls since the day the virus made its introduction to North America.

Elsewhere in the world, including south of our border, scores of nurses and other health care workers have been quarantined and hospitalized due to exposure to the virus, which clearly demonstrates the importance of putting the strongest protections in place. Failure to do so severely inhibits our ability to respond to an outbreak. Our union is working closely with CFNU member-organizations across the country to help keep nurses and patients safe. 

We have been talking publicly and internally about preparedness in hospitals, and other care settings, training, fit testing and access to personal protective equipment (PPE) during this extremely rare world event.

It is our contention that nurses and other health care workers must receive the highest level of protection in their workplaces, as determined by the precautionary principle. Nurses need to be safe in order to provide the care they will be called on to deliver. 

The full protection of healthcare workers is a fundamental and necessary part of limiting the spread of viruses - this has been proven time and again with SARS, MERS, H1N1, Ebola, and others. It is critical that our nursing workforce is kept safe not only to provide critical care for patients with potential COVID-19 infection, but also to continue caring for other patients.

Healthcare employers should have in place the proper screening protocols, isolation procedures, and PPE to protect healthcare workers caring for possible or confirmed COVID-19 cases, so as to safely respond to a possible surge in patients. 

Employers care about the safety of their employees and have been communicating regularly with nurses and other staff regarding COVID-19 preparedness, protocols, and the many unprecedented changes to both our work and personal lives.  Closures, restrictions on travel and gatherings, the hoarding of food and other supplies, and general fears are taking their toll.

Health care unions have been meeting regularly with employers and representatives of the province to do our part and allow changes under the collective agreement to occur. We are committed to the Good Neighbour Protocol, which we signed in 2009. This agreement allows government to require health care workers to work in other facilities or areas during a public health emergency, both protecting workers’ rights and ensuring seamless support across the province in times of crisis. It ensures workers will be properly compensated and protected, and it will apply to both workers and volunteers.

Unions are cooperating with employers who must cancel vacations in anticipation of an outbreak in Nova Scotia. Although we understand the hardship this may cause some members, with travel restrictions making it more difficult and potentially unsafe, and with a pre-existing health human resources shortage, our union recognizes that flexibility is in order.

We are more reluctant to compromise when it comes to PPEs. In our view, and that of the US Center for Disease Control, N95 respirators stop the wearer from breathing in airborne particles containing viruses, while surgical masks are only meant to stop the wearer from spreading their germs to others. PPEs and proper training will ensure that all health care workers, first responders, and others at risk of exposure are protected.

On March 16th the World Health Organization declared that airborne precautions are likely necessary for medical staff after a new study showed the coronavirus can survive in the air in some settings. Further validation of our claims.

Complicating our call for the use of N95 respirators is a worldwide shortage, creating consternation between the NSNU and others. The NSNU is not arbitrarily asking employers to provide these masks, there is science and historical data behind our position.

On March 15th, the Nova Scotia Health Authority president and CEO Dr. Brendan Carr publicly asked workers in the health system to stop pilfering supplies. Dr. Carr is accusing health care workers of stealing. Even if this were true, making such public accusations does nothing to ensure the trust of patients and their families during these challenging times.

As expected, the NSNU is experiencing a high volume of member inquiries - we appreciate your patience in the coming days and weeks. We are committed to responding to your calls and emails in a timely manner, while also keeping you informed via e-memos and updates on our website (nsnu.ca).

Be advised that if a nurse is placed on precautionary leave, that leave must last for a minimum of fourteen days and the employer must maintain all pay, seniority, and benefits for the entire length of the leave. 

Our hearts and thoughts go out to the people affected by this worldwide pandemic, those who are ill and those who have lost loved ones, and those who are on the front line working to contain this coronavirus.

Nurses are strong and resilient professionals who are not afraid to care for those afflicted with this disease. Know that the NSNU is here for nurses on the front lines and those caring for patients, residents and clients with other health challenges.

CFNU Message

As the world grapples with the rapid spread of COVID-19, I know that Canada’s incredible frontline health care workers are doing everything we can to keep the public safe and healthy.

I want you to know that I have been fighting to ensure health care workers are protected on the job. For weeks, I have been asking the Public Health Agency of Canada to beef up guidelines to protect all health care workers from potential airborne transmission.

With conflicting scientific evidence of how COVID-19 is spread, the precautionary principle – to err on the side of caution – must be followed. This was the lesson of the 2003 SARS outbreak that resulted in the death of 44 Canadians, including two nurses and one doctor.

The WHO has declared COVID-19 a pandemic. Our federal public health agency is realizing we can’t stop this if our health care system is not ready and health care workers are not protected.

Our message is simple: safety is not negotiable. If nurses are at risk, then we all are.

We are calling for protections to be strengthened and for the meaningful involvement of health care unions in decisions affecting members’ health and safety, including the supply and provision of personal protective equipment.

The time to act was yesterday. Now, together we can work on strengthening our health care system so we can do our job caring for the public.

In solidarity always,

Linda Silas
President, Canadian Federation of Nurses Unions

What we learned from SARS

During the SARS outbreak in 2003, almost half of Ontario’s 247 probable SARS cases were nurses and other health-care staff who carried the burden not only of their own illnesses, but also of the risk that they could transmit it to others, potentially vulnerable patients.

Nurses and occupational health and safety experts across the country are indignant that guidance from the Public Health Agency of Canada (PHAC) asks health-care workers to wear surgical masks rather than N95 respirators. They say this leaves them less protected than the American Centre for Disease Control and European counterparts.

CFNU president Linda Silas says those in power are failing to protect health-care workers. We need to do a better job in making sure every health-care facility is provided with the right training, personal protective equipment, and that the policies are up to date.

The science and evidence speak loudly

SARS and health worker safety: lessons for pandemic planning and response

The outbreak of severe acute respiratory syndrome (SARS) in 2003 provided valuable lessons for protecting health workers during an influenza pandemic or other public health crises. In its final report, the SARS Commission concluded that a key lesson in worker safety was the precautionary principle. It stated that reasonable actions to reduce risk should not await scientific certainty.

As recommended by the SARS Commission, this principle has now been enshrined in the Health Protection and Promotion Act (2007), Ontario’s public health legislation and in Ontario’s influenza pandemic plan. Another vital lesson for worker safety involves the occupational hygiene concept of a hierarchy of controls. It takes a holistic approach to worker safety, addressing each hazard through control at the source of the hazard, along the path between the worker and the hazard and, lastly, at the worker.

Absent of such an approach, the SARS Commission said worker safety may focus solely on a particular piece of personal protective equipment, such as an N95 respirator or on specific policies and procedures, such as fit testing the N95 respirator to the wearer.

The third and final worker safety lesson of SARS is the importance of having a robust safety culture in the workplace in which workers play an integral role.

Who to call

NSHA staff are NOT to call the 811 hotline for COVID-19 information and screening. Please call the Healthcare Worker Inquiry Line 1-833-750-0632. You will be asked worker identification information to verify that you are a healthcare employee.

Long term care and community care workers should speak with their employers to determine if they have established similar screening processes. Otherwise, use the 811 self-assessment tool (811.novascotia.ca) or 811 to determine if you are potentially ill with the virus.

Travel Insurance

Please be advised that nurses and others who choose to travel internationally during the pandemic, against recommendations from federal health officials, should review their travel insurance policies as they may not qualify for benefits and coverage during the COVID-19 pandemic if you become ill or suffer an injury while out of the country.

As you know, should you choose to travel, you will have to self-isolate for 14 days following your return.

Thank You to Our Members

As you prepare for a surge of patients, the Nurses’ Union wishes to thank you for your courage, commitment and confidence. This pandemic has upended workers, the public, and governments across the globe. We thank our nurses for preparing for the worst while always being at your best.

Thank you to those who are struggling to find childcare. The closure of schools and daycares has been very difficult for families to navigate.

For those who lost their vacation time and trips to warm destinations and elsewhere, thank you. We hope that you will be able to reschedule time away from work when it is safer to travel. The NSNU will do all that we can to work with your employers to ensure that happens.

Thank you to nurses who are juggling; taking on new assignments to help during the pandemic. Whether you volunteered or graciously accepted a reassignment, please know that your actions mean there is continuity of care across the system.

We urge you to take all the precautions necessary to keep you and your families safe. Please practise self-care. Be kind to yourself and reach out when you need a helping hand.


CFNU Canadian Labour Congress