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Ontario nurses group urges strict protections against novel coronavirus

Infection experts believe the new virus is likely spread through airborne droplet transmission, such as through the coughs or sneezes of an infected person, and generally requires close personal contact to spread.
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Ontario health officials say some frontline workers scarred by their experience with SARS are stepping up precautions against the novel coronavirus.

Ontario Nurses Association president Vicki McKenna says she fully supports members who wish to wear N95 masks even if they're not required to, as well as those who prefer the more protective respirator masks reserved for invasive procedures like intubation.

Infection experts believe the new virus is likely spread through airborne droplet transmission, such as through the coughs or sneezes of an infected person, and generally requires close personal contact to spread.

Those in contact with suspected cases are typically required to don full protective gear including a fitted N95 mask to cover their nose and mouth. But McKenna says some health-care providers are taking precautions more typically seen when treating a more easily transmissible airborne virus, which requires a "higher level of mask."

"Certainly the N95s are one thing but the respirators are the other. That's the level to be prepared. They need the stuff on hand, they need to have the proper masks and the proper interface with patients," McKenna said Tuesday. 

"That absolutely is the highest level of respiratory protection and those are the respirator masks that we are expecting when they're working with patients who are identified as at risk."

Toronto has one confirmed case of the illness and is awaiting confirmation on a second. Meanwhile, health officials in British Columbia say a man in his 40s is presumed to have coronavirus and is recovering at home.

McKenna said provincial guidelines for primary care workers were expected from the Ontario government Tuesday and she's hoping they include strong protective measures for nurses.

Dr. Jeff Powis, medical director of infection prevention and control at the Michael Garron Hospital in east Toronto, said there are definite "SARS scars" among some frontline workers who remember what it was like to face the devastating outbreak of Severe Acute Respiratory Syndrome, which killed 44 Ontarians, including two nurses and a doctor.

"Certainly people are a bit on edge.... They've been through this before and that probably is a bit traumatizing for some individuals in particular," said Powis, who helped develop hospital protocols that include ensuring those in contact with suspected cases wear fit-tested N95 masks, a face shield protecting their eyes, a gown and gloves.

"If they feel they need something different than that or they want to wear precautions when I don't feel they need to then I'm also trying to be understanding that that's their right to do so."

Nevertheless, Doris Grinspun of the Registered Nurses' Association of Ontario says the panic seen during the SARS epidemic of 2003 does not exist now and that her members feel "well-prepared" and that "the mood is good."

"We are doing extremely better than what we did with SARS," Grinspun said of a time marked by a lack of communication, overworked staff and fear of infection among frontline workers.

McKenna said staff who screen those with possible symptoms may also consider added protections, even though they are not required to wear masks because they are generally behind a Plexiglas barrier.

"That's where it's most unpredictable, because you don't know all the facts when someone comes in," she said, adding that the triage layout in hospitals and clinics can vary but are generally very secure.

"We can't let our guard down. We have to be prepared. And we have to be able to care for people properly who are ill. That's what our job is. We want to make sure that the nurses out there are protected, therefore Ontarians will be protected as well."

This report by The Canadian Press was first published Jan. 28, 2020.

Cassandra Szklarski, The Canadian Press




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