1. What is different about Omicron? What has changed since our last update?
This variant has not seemed to change since our last update. It still appears to be affecting the airways more than the lungs which explains why there’s been an increase in transmissibility. Additionally, those who have had two or more doses of the vaccine experience a milder illness.
2. I keep hearing that Omicron isn’t as severe or as deadly as previous variants, but there has been explosive growth in hospitalization. Can you help us make sense of that?
Even if the Omicron variant admits people who are fully vaccinated at one third of the rate as variants before, its high transmissibility means it has infected more of the population. Therefore, even if it admits just one third of the fully vaccinated population that number is still significant enough to overwhelm hospitals.
3. What should I do if I test positive for COVID-19? What is the process if I’m COVID positive exposed/someone I live with tests positive?
If you test positive or have been exposed, please go get a PCR test to confirm your diagnosis and begin the isolation process. COVID positive staff, whose symptoms have resolved or are improving and have completed two negative RAT’s on day 6 and day 7 can return to work on the 7th day after their symptoms began. If the positive staff member is still experiencing symptoms, or is still testing positive by day 7, their return to work will be postponed to the 10th day after on-set symptoms. After day 10, you are no longer contagious.
If you have been exposed briefly to the virus but are still considered to be high risk, please receive PCR testing to confirm your COVID status. When your results are pending you are required to work in self- isolation and receive rapid tests daily for 10 days to monitor any increasing viral load.
As of January 14, staff members are to report any COVID positive test results or exposures to this online form instead of dialing x1919. Occupational Health will follow up with you with next steps.
4. Will we allow staff who test positive for COVID, but are asymptomatic, to work? I’ve heard other hospitals are starting to think about implementing this.
Staff members who test COVID positive but are asymptomatic will still be treated as a symptomatic COVID positive staff member. Our priority is to stop the virus from entering the hospital and keep staffing levels sufficient. However, this protocol is subject to change based on certain circumstances.
5. Full-time non-union staff are told they do not qualify for the COVID paid leave because they have a sick leave benefit, yet the hospital will not allow them to use their sick time when required to self isolate as part of Bill 284. Can you provide clarity on this?
All full-time staff, not just non-union full-time staff, who cannot work due to a high-risk exposure are not covered by the HOODIP sick plan. The plans criteria requires that those who qualify for the sick pay must be totally disabled from work, which does not include time off work due to a high-risk exposure. As frustrating as it is, there is not a program or legislation that provides payment for employees who cannot work due to a high-risk exposure. However, if you require time off due to becoming ill from a COVID infection you will qualify for paid time off from the sick leave benefit retroactive to the first day of absence.
6. I’ve heard in the news that a hospital in Ontario has reversed their mandatory staff vaccination policy due to the Omicron surge. Will GRH be moving in that direction?
In an effort to protect our patients and staff, we do not have any plans for the previous unvaccinated staff members to return to their roles at GRH.
7. How effective are boosters?
The third dose or booster strengthens your immunity to the virus. The third dose will return your antibody immunity to the same levels it was after you received your second dose last year. Overall, Ontario citizens with only two doses of the vaccine may not receive as much protection against COVID if they experience an intense exposure.
8. Where can staff receive a booster shot? Are they still being offered on-site at GRH?
Staff can walk-in to the Cambridge Pinebush clinic without an appointment to receive a third dose. You will need to show your hospital ID badge. Staff can also receive their booster at other regional vaccination clinics or through local pharmacies.
Additionally, a walk-in booster clinic will be set up at the KW campus on Friday, January 21, 2021 from 7:30 a.m. to 3:30 p.m. and is available to all staff, we ask that you please show your I.D. badge and bring your health card in order to receive your booster. If you’ve already received your booster at on offsite location, please email your booster information to COVID@grhosp.on.ca to alert occupational health.
9. What is the recommended use for N95s at GRH? What is our current supply like?
During the Omicron wave, staff should be wearing an N95 that is fit tested and seal checked for the care of all suspect or confirmed COVID-19 patients. Staff who encounter patients in droplet contact precautions or work in a unit experiencing an outbreak should wear an N95 respirator, gloves, eye protection and isolation gowns when providing care as an additional protection. A point of care risk assessments is require prior to a patient interaction to determine what appropriate PPE is needed to protect you.
When following the extended use guidelines, it’s important to wear your N95 and eyewear protection from different cohorts of patients, and remove them prior to break or when you’re no longer providing care. Please read the full outline on GRHallthingscovid.com.
GRH has ample supply of N95’s, in particular 1870’s. The end date for the 1860’s masks to be provided is approaching, so supply is limited.
10. What are the recommended guidelines for getting a booster after having COVID-19? Is there a period of time you should wait?
There has not been a situation where it has been unsafe to receive a vaccine after being infected with the virus. The first 90 days after a natural COVID infection is seen as a time of relative protection, we do not see re-infections with other variants or within the same variant during this time. Some individuals use these 90 days as a natural cut-off to receiving their booster, but there is no risk to receiving your booster before then.
11. Care partners are allowed to wear a hospital mask over their own, but staff are discouraged from double-masking. Can you provide clarity on this?
The decision to allow care partners to leave their own mask on with a new hospital approved level 1 mask on top of their mask, has been implemented due to the low risk that care partners pose at the hospital under our current care partner visiting limits. Due to the nature of the work we do and direct interaction with patients, GRH staff should continue to follow the recommended PPE guidance as outlined here.
12. Wondering if we could have level 3 masks at the staff entrance? Currently we have level one masks.
There is not a large difference between a level 1 and level 3 mask. Both are rated by their bacterial filter efficiency and their particular filter efficiency. The level 1 masks have been tested to have 98% efficiency, so they provide just as much protection as a level 3 mask.
A level 3 mask is more suitable for high pressure situations where droplets could enter the mask. Examples of this are orthopedic surgery with high speed drills. A level 1 mask is more appropriate for care with lower pressure, or everyday use. For staff in non-clinical areas, a level 1 mask is sufficient protection.
13. Are there any predictions on when Omicron will peak?
We think we’re at the peak or close to it now. Unfortunately this is harder to predict than previous waves as the changes in testing guidance, the broader look in the general public, has been skewed. The positivity rate from testing is starting to drop and the wastewater findings are showing a lower level of Omicron presently. We haven’t formally seen the peak of hospitalizations/ICU admissions yet, but that will be another thing to watch for. There may be a small increase once children are back in school, so we will need to see how that plays out.
14. Is it possible to have testing kits at Freeport?
There is currently limited supply of rapid antigen tests (RAT) throughout the province. They are allocated very carefully by the Ministry of Health, for example long term care has different requirements than we do at the hospital. We will continue to offer RATs through Occupational Health for staff members who have been exposed or are returning to work after having COVID-19 so we can ensure they are available for everyone who needs it.
15. What is the direction for managers/team members regarding canceling approved vacation?
We are allowing staff members to cancel vacation and if they are not required on their particular unit, they can be redeployed to another area of the hospital with priority needs. Vacation balances will be carried over into the next year. If you would like to cancel your vacation, please speak to your manager directly.
17. Could you please explain if there are any concerns or issues with mixing vaccines: e.g. first 2 doses were Pfizer, 3rd dose Moderna. What side effects should be expected?
There are no concerning side effects beyond the usual mild flu-like reactions for mixing mRNA vaccines. Pfizer is being saved for the adolescent group to reduce the risk of myocarditis. There is minimal evidence that mixing mRNA vaccines with a Moderna booster shot may have slightly higher antibodies but there is likely no difference in the long term as those antibodies will naturally drop. There are no drastic, immediate benefits for having one over the other, based on evidence from the Delta and Alpha waves.
18. Will boosters be mandatory?
Until Health Canada changes its definition of fully vaccinated, booster shots will not be required. Currently, having two doses of the vaccine is considered fully vaccinated.
19. Can you please provide information on where staff can receive Rapid Antigen Tests for daily testing at home then daily testing when they have returned to work on a work isolation plan? Is Occ. Health providing any RAT kits to staff or is the drive-thru center providing enough RAT kits to staff when they receive their PCR to last for the 15 days of required testing?
RAT kits are given out at the door but they must be assigned by Occupational Health and Safety; staff members will be contacted by Occupational Health should you require a kit. They will leave a kit with your name at the main doors for pickup at KW or Freeport Campus. If a staff member is sent for PCR testing, they will be given a kit at that time. Staff members should only go to the drive thru for a PCR kit and will not receive a RAT kit.
20. Any consideration for putting HEPA filters in areas with less ventilation, such as the ED?
This is something that we’ve looked at extensively. GRH currently meets Health Canada’s standards for air exchanges and it is regularly re-evaluated. At this time, we are not considering HEPA filters because the air exchanges in the ED are adequate. Anything under two air exchanges could possibly pose a risk; the minimum for hospitals is at least six air exchanges and hospitals are well ventilated. The added degree of ventilation with HEPA filters would not create an immediate benefit outside of aerosol-generating medical procedures.
21. Can you speak to the recommendation for a fourth dose for long term care three months after the booster shot?
For those included in the long term care strategy or those who are immuno-compromised, this recommendation comes after heavy study of what the vaccine does and the two different arms of the immune system. The booster provides reasonable benefit for those in long term care or with immunocompromised conditions but they are not able to mount the same immune response. We are providing these boosters to try to mitigate their chance of getting COVID-19 from their living or community conditions. Historically, antibody levels will begin to drop off at the three month mark and are no longer sufficient to provide neutralization and reduce risk of infection.
22. What is the risk of allowing care partners in the hospital?
Our care partner guidance is currently aligned with St. Mary’s and other hospitals in Ontario. We have a number of processes in place such as greatly limiting the number of care partners in the hospital to mitigate the small increased risk of having care partners in place. We know some patient’s care and quality of life is impacted without care partner visits. A small number of care partners in the hospital is a low risk to most units, and comes with many benefits to patients as long as it is done in a controlled manner.