A dozen Edmonton nurses challenged an order from Alberta Health Services to resume testing for the N95 mask-less coronavirus.
Occupational Health and Safety (OHS) confirmed Monday that it had launched an investigation after nurses filed a complaint.
It is the latest development of an ongoing dispute after the CBC revealed that around 30 nurses stopped testing for COVID-19.
AHS investigated and determined that the job was safe.
But nearly half of the nurses who ordered to start testing again are refusing, said Sandi Johnson, vice president of Edmonton’s local chapter of the United Nurses of Alberta (UNA).
“They are disheartened,” Johnson said. “They are feeling they are not being heard.”
COVID-19 tests are conducted using a nasopharyngeal swab that collects specimens from the back of the nose and throat.
But AHS and UNA disagree on the requirements for conducting the test. AHS states that the most vaguely suitable surgical masks are appropriate, but the union claims that a higher standard is needed because the scientific evidence on transmission is not conclusive.
According to AHS, COVID-19 is known to be transmitted by droplet through contact with nasal and oral secretions.
Alberta guidelines are best known practices for protecting against droplet transmission, says the health authority.
AHS’s position follows the guidelines of the Public Health Agency of Canada (PHAC), the World Health Organization and provinces across the country.
“AHS hasn’t changed his [personal protection equipment] standards and expects all staff to conform to those standards, “Williamson said in an email Monday.
In contrast, the UNA position is in line with the Canadian Federation of Nursing Unions, the US Centers for Disease Control and the European Center for Disease Prevention and Control.
“There is conflicting scientific evidence that COVID-19 is airborne and for how long,” said Heather Smith, president of the UNA, adding that the swab tends to trigger a cough or sneeze.
“Let’s say in that case, one should always be wrong on the side of the highest possible precautions.”
Smith said that a nurse’s clinical judgment should be respected “and if an N95 is warranted in her clinical judgment, it should not be denied.”
The PHAC guidelines also recommend nurses to carry out a risk assessment that includes personal protective equipment to assess the probability of exposure, Johnson observed.
Nurses do alternative jobs
Brittany Baltimore, press secretary of the Minister of Labor and Immigration Jason Copping, said that a worker who makes a complaint may continue to refuse to carry out tasks of concern.
“OHS legislation allows the employer to temporarily assign nurses to alternate jobs,” said Baltimore.
The recommendation to use surgical masks instead of N95 masks may be a practical necessity, but it is not based on the science that indicates that surgical masks provide good protection.– Anice Lowen, flu virologist
Little research has been conducted on the transmission of the agent causing COVID-19 because it is “a very new human pathogen,” said Anice Lowen, a flu virologist at the Emory University School of Medicine in Atlanta.
“Consequently, the recommendation to use surgical masks instead of N95 masks may be a practical necessity, but it is not based on the science that indicates that surgical masks provide good protection.”
Lowen, a former Edmontonian, is the Lowen Lab’s chief scientist, who studies the evolution and transmission of the flu virus.
In an email, Lowen said that to determine which mask is needed, scientists should first understand if the virus can transmit short distances via an aerosol pathway.
He said aerosols are made up of small droplets that aren’t actually blocked by standard surgical masks. And while evidence suggests that aerosol does not transmit more than one meter, “the short-range spread of aerosol remains unknown.”
“We know that small droplet aerosols are released when humans breathe, speak and cough,” Lowen wrote.
“The nurses who make the swab are in a relatively vulnerable position because any infectious aerosol generated by a patient would not be diluted – through time and space – before reaching the nurse.”
Last week Ottawa announced a plan to increase the production of protective equipment for healthcare professionals.
When asked about a possible shortage of N95 respirators, AHS said the province has an adequate supply that must be used appropriately to ensure it continues.
The health authority will not say how many N95 masks Alberta has or if others have been ordered from Ottawa.
The union and AHS will meet on Tuesday.
OHS said that the results of its investigation will be communicated to the parties involved but have not provided a timetable.