We must do more to stop airborne illness spread in hospitals

One of the top news stories this month was a sobering analysis of two forest firefighter deaths in 2023. The safety reviews revealed severe shortcomings in processes and recommendations to rectify deficiencies, and governments committed to doing better. This stands in stark contrast to the response to Health Care Worker (HCW) occupational COVID infections and deaths, and resulting hospital-acquired infections and deaths among patients.

As of March 2022, 12 AHS HCWs had died from COVID-19. Presumably, this hasn’t stopped, but AHS stopped reporting them as of that date. Meanwhile, there has been no apparent efforts by hospitals and clinics to reassess our infection protocols despite ample research that clearly demonstrates COVID is airborne. To make matters worse, the inadequate contact-droplet protections that were initially in place have now been rolled back to essentially none, with universal surgical masking removed in June 2023. Yet COVID continues to harm, disable and kill patients and HCWs in our hospitals.

Why do HCWs’ work-related deaths not require the same urgent and serious investigations and review of firefighters' work-related deaths? We need to know—and HCWs, their loved ones, and the public deserve to know, as a matter of occupational health and safety. Reviews of responses to past medical crises—such as the Krever inquiry looking into tainted blood, or the Campbell inquiry looking at the first SARS epidemic in 2003—have been hard-hitting and very useful. Of course, we have to actually change how we do things, and sadly, few to none of Campbell’s recommendations informed our responses to the COVID-19 pandemic. 

We can only speculate why there has not yet been a serious inquiry into these HCW deaths and the ongoing illness, death and disability caused by this airborne disease.  We imagine it is difficult for health leaders to challenge a government that is anti-vaccine and, at best, lukewarm towards masking.  We also imagine it is extremely difficult for medical leaders to question their own decisions that may have caused harm.  But, by not looking for ways to better handle this airborne outbreak, our healthcare situation only continues to worsen.

A large number of our HCW colleagues have stopped requiring masking with patients in June of 2023.  Since this change, not only at AHS but in the vast majority of healthcare facilities in the Western world, there have been ongoing outbreaks at institutions. These outbreaks cause illness, disability and death amongst our patients, all of whom  are very vulnerable. They impact our fragile healthcare staffing crisis, with acute and chronic COVID illness and increased incidence of conditions triggered by COVID, such as heart attacks and strokes. Despite all of this, there has been no apparent examination of how to minimize or stop the impact of airborne COVID on our patients and HCWs.

We don’t begrudge individual HCW who have stopped masking. The mask mandate removal has essentially given them permission to do so. And institutions have failed to provide clear and up-to-date guidance on COVID transmission, including: 1) transmission is largely airborne, making handwashing less useful, and masking an essential component of infection protection, 2) asymptomatic transmission is substantial, requiring masking even if feeling well, and 3) post-COVID chronic illness (often referred to as long COVID) occurs in up to 3.5% of first COVID infections (a huge number) even more in subsequent infections, even in fully vaccinated, healthy individuals. How can HCWs make informed choices for their and their patient’s safety given the lack of accurate information?

We HCWs have dedicated our lives to saving lives. And yet we are currently trapped in a system where infecting each other and our patients with a deadly, debilitating illness has apparently become acceptable. With no end to COVID waves on the horizon (FYI, we’re in a substantial one right now), what is the end game our health care leaders are hoping for? Are we destined to continue hurting patients and HCWs  endlessly?

It is well beyond time for our health care leaders to empower an objective review of our system’s handling of this deadly and disabling airborne pandemic.  It’s their duty to ensure a safe working environment, and it’s their duty to ensure a safe care environment for patients. If it is important to protect firefighters from harm, let’s have the same for us healthcare workers. 

^{Dr. Joe Vipond is an emergency room doctor in Calgary, AB, and the cofounder of the Canadian Covid Society.} 

^{Dr. David Keegan is a family physician in Calgary and a Professor of Family Medicine at the Cumming School of Medicine at the University of Calgary.}

^{This article was first published in the Calgary Herald and has been republished with permission from the authors.}