The following resource is intended for CUPE Local executives in the Hospital sector and their members on Joint Health and Safety Committees (JHSC). Please note that the information provided on this sheet does not constitute legal advice. If you have any questions about occupational health and safety law, speak with your National Representative.
As of December 2021, the vast majority of COVID-19 related admissions to hospitals and those in the ICU continue to be unvaccinated individuals. However, the new COVID-19 variant Omicron is 3-4 times more virulent than all previous strains of SARS-CoV-2. The variant can evade vaccine effectiveness among the fully vaccinated, including individuals with compromised or suppressed immunity and others with waning immunity who haven’t received a third dose (booster).
Health care workers are not immune to infection, regardless of vaccine status. While staffing has been a challenge, the past 18 months we are seeing even greater challenges as a result of:
- layoffs and terminations because of vaccination policies;
- health care workers leaving the sector due to traumatic stress and burnout;
- sector-wide challenges in finding and hiring qualified staff.
The rapid transmissibility of the Omicron variant coupled with a staffing crisis could mark a new and unprecedented phase for hospital workers in an already unprecedented pandemic. To protect the health and safety of staff, hospitals must adopt and implement a comprehensive surge capacity plan. Occupational health and safety must be a core element of the plan. Hospitals are not immune to outbreaks. As we’ve seen in other workplace sectors, the virus can be easily spread among workers, clients and contractors where adequate controls (measures and/or procedures) are not in place. Workers must receive information and instruction about the plan and timely communications of the plan’s stages.
During these challenging times, staff must be further encouraged to signal any concern for worker or patient safety to a supervisor without fear of reprisal. Surges and staffing shortages are not excuses to put workers in danger. Under the Occupational Health and Safety Act, a worker’s duty includes signalling to a supervisor any dangerous or hazardous situation and flagging the absence or defect in protective equipment/ device or inadequate procedures. Any unsafe condition or situation that the employer or a supervisor does not resolve may form the basis of a grievance, a complaint to the Ministry of Labour, Training and Skills Development, or a work refusal under the OHSA.
The following additional resources provide more information:
- Making a complaint to the MLTSD
- CUPE Fact Sheets:
NOTE: The following is a non-exhaustive checklist for worker members of the JHSC and the Union to highlight occupational health and safety considerations that should be incorporated in surge plans. It is not an exhaustive evaluation of a hospital’s surge assessment and plan. For more information on organizational IPAC assessment and plans, see:
- CDC – Comprehensive Hospital Preparedness Checklist for Coronavirus Disease 2019 (COVID-19)
- WHO – Rapid hospital readiness checklist: Interim Guidance
- Ontario – Critical Care Strategy – Surge Capacity Management Toolkit (2009)
A no answer to the following question will require further follow-up with the hospital’s occupational and environmental health department or the JHSC.
|Surge and staffing assessment||Yes||No||Unsure|
|Has the hospital performed an organizational COVID-19 pandemic surge assessment?|
|Has the assessment been updated recently to reflect the broader acceptance of aerosol transmission and increased transmissibility from the Omicron variant?|
|Is there a multidisciplinary team in place to handle a surge? Is there worker representation on the team?|
|Do IPAC surge assessments contemplate both patient and occupational health and safety|
|Does the surge assessment contemplate possible staffing shortage? E.g. minimum staffing needs, contingency for increased staff absenteeism, redeployment, training/onboarding of new staff.|
|Does the surge assessment consider staff self-monitoring for COVID-19 symptoms?|
|Does the surge protocol clearly spell out that the employer will only call back self-isolating asymptomatic workers under exceptional circumstances when patient safety would be severely compromised?|
|Does the surge assessment contemplate the use of makeshift wards or field hospitals? If yes, see the JHSC section.|
|Does the employer use a PPE burn rate calculator for surge and outbreak scenarios?|
|Does the assessment contemplate increased PPE use, in particular respirators?|
|Are staff receiving clear communications during huddles and shift changes?|
|Have workers received information and instruction on the changes to Directive 5?|
|Has the hospital removed all physical and procedural barriers to allow staff unfettered access to respirators when entering areas with suspected or confirmed cases of COVID-19?|
|Are staff asked to self-monitor for COVID-19 symptoms?|
|Are symptomatic staff strongly encouraged to stay home regardless of potential staffing concerns?|
|Are frontline screeners wearing N95 respirators?|
|Are there signs on the floor or physical barriers to individuals to encourage physical distancing?|
|Is security stationed at each screening station?|
|Is the screening station ventilated and well-lit?|
|Do screening stations have a supply of clean PPE, hand sanitizer and containers to dispose of used or damaged PPE?|
|Are visiting policies prominently displayed at the screening station?|
|Is there a prominent link to the visiting policies on the hospital’s home web page?|
|Has a mechanical inspection of the HVAC systems occurred within the last six (6)months?|
|Have measurements or calculations been taken to ensure areas/rooms achieve minimum air changes per hour? E.g., Are airborne isolation rooms meeting a minimum of twelve (12) air changes per hour? See: https://www.cdc.gov/infectioncontrol/guidelines/environmental/appendix/air.html|
|Are filter changes up to date? See manufacturer’s recommendations.|
|Do surge plans contemplate protecting the mental health of staff? Note: EAP is a recovery measure, not a preventative measure.|
|Is there onsite mental distress support for staff?|
|Can staff access mental distress support after-hours, online or by telephone?|
|Are there peer-support programs in place?|
|Is the employer sharing information on the PPE supply and stocks?|
|Is there a contingency plan if the supply of N95 respirators is low? Options: extended use, reusable elastomeric respirators, obtaining supplies from the community, decontamination using UV machines when supply runs out (see more information below)|
|Will the employer consult with the JHSC on plans to use makeshift isolation wards?|
|Will the JHSC be allowed to inspect the area before they’re used?|
|Will the employer consult with the JHSC on plans to construct a field hospital?|
|Do external contractors have experience building field hospitals?|
|Will the JHSC be allowed to inspect the area before they’re used?|
|Cleaning, Disinfecting and Hand Hygiene|
|Is there a team dedicated to the stewardship of PPE?|
|Does the team include input from the JHSC and staff?|
|Is there a contingency plan if PPE supply runs low? Consider extended use of PPE (if safe) before reusing or decontamination.|
|Is PPE stored in an easily accessible and sanitary location?|
|Has the hospital partnered with local organizations and manufacturers to provide PPE in case of a provincial supply depletion?|
|If PPE is not in its original packaging, can workers easily know/confirm they are wearing
the appropriate level of protection? Can they easily confirm if the PPE is new, reused or expired?
|Is fit-testing up to date?|
 Hospital workers have the right to refuse work that endangers health and safety, except in circumstances where the work or task, is inherent in the worker’s work or a normal condition of the worker’s employment; or would directly endanger the life, health and safety of another person.