Screening is not unanimous among healthcare workers

Health care workers refuse to take COVID-19 tests; a marginal movement which nevertheless suggests the existence of pockets of resistance to a possible vaccination campaign against the coronavirus within the health network itself.

The Ministry of Health and Social Services (MSSS) did not respond to our request to find out how many workers in the health network refused to be tested. Union organizations have confirmed to us that a few cases have occurred in the past few weeks.

Blogger Xavier Camus uncovered last week the case of a licensed practical nurse who works in a hospital and refuses to be tested. On his Facebook page, it mentions in particular that “forty 14 days is safer than Covid-19 negative test that can be [ sic ] wrong.” This nursing assistant also relays on her page videos questioning the merits
of confinement and echoing conspiracy theories.

Relying on his code of ethics, the lawyer Guy Bertrand did not want to confirm to us whether he represents this licensed practical nurse or other healthcare workers who wanted to exercise a right of refusal. M e Bertrand filed June 8 in an appeal in Superior Court judicial review to force the Quebec government to account for its management – considered exaggerated – of the pandemic. “It is in the same spirit [that the workers refuse to be tested]. A large part of the population – probably a small majority – is against everything that was imposed by the state [during the pandemic], “he explains in an interview.

The government would have the necessary levers to impose health workers on getting tested, said M e Bertrand. Currently, the MSSS states instead that screening is done on a voluntary basis, even for employees with symptoms compatible with COVID-19. Refusal cases are managed on a case-by-case basis by the establishments.

Some CISSS and CIUSSS have nevertheless told us that screening is compulsory in certain circumstances. At the CISSS de la Montérégie-Est, during a COVID-19 outbreak in a unit or when an employee is symptomatic, the screening test loses its optional nature.

At the CIUSSS du Nord-de-l’Île-de-Montréal, a recalcitrant worker will be returned home without pay if screening is deemed required, since “we must take all measures to ensure the safety of our residents”. At the CHUM, as in five CISSS and CIUSSS who agreed to answer our questions, there were either no refusal to be tested or “very rare refusals”. Several CISSS and CIUSSS, as well as the MUHC, did not answer our questions.

Both the Quebec Order of Nurses (OIIQ) and the Quebec Order of Nurses and Licensed Practical Nurses (OIIAQ) say they encourage their members to get tested; the OIIQ is mentioning that this is “a significant success factor in the fight against the spread [of COVID-19]”.

Remember that several asymptomatic workers are suspected of having spread COVID-19, particularly in seniors’ residences, during the first weeks of the pandemic.

What about vaccination?

If the refusal to be tested raises certain concerns, the question of vaccination raises even more. Could these workers, or others, resist a vaccination campaign that would primarily target front-line workers?

Difficult to predict, says Jeff Begley, President of the Federation of Health and Social Services (FSSS-CSN). “I hope [they will get vaccinated]. But we’re on new ground” A recommendation from the FSSS to get vaccinated will depend on the effectiveness of the COVID-19 vaccine and its side effects, he explains.

Linda Lapointe, vice-president of the Interprofessional Health Federation (FIQ), still believes that the vast majority of workers will want to be vaccinated. However, she agrees that there is a certain reluctance among healthcare workers to get the seasonal flu vaccine. “It’s not always the same strains that are expected [for influenza] as those that are active,” she tempers. But for COVID-19, I don’t think it will be hard to convince them to get vaccinated. “

In 2018, the influenza vaccination rate among healthcare workers was 40.8%, according to data collected by the Institut national de santé Publique du Québec (INSPQ). For the H1N1 flu in 2009-2010, vaccination coverage among healthcare workers aged 18 to 59 reached 85.3%, still according to the INSPQ.

Currently, no vaccination is compulsory in Quebec. But “a health care establishment may require as a condition of employment or for access to certain positions that a person receive vaccines, or provide proof of vaccination if these vaccines are prophylaxis measures or specified standards by the director of public health, ”said Robert Maranda, spokesperson for the MSSS.

Section 123 of the Public Health Act provides that during a state of a health emergency, the government may “order compulsory vaccination of the whole population or a certain part of it against smallpox or against another contagious disease seriously threatening the health of the population. “

A possibility which, if it materialized, would most likely lead to a legal struggle.

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