Provide Physicians Guidance On the "Safety Bar" With Regards to PPE

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Dear Canadian Physician Leaders,

Thank you for your continued service to support the safety of physicians working at the front-lines during COVID-19.

As hospitals prepare for the upcoming wave of COVID-19 patients across the country, clinicians have noticed several measures by their hospitals to conserve personal protective equipment (PPE). Measures differ greatly from hospital to hospital and there appears to be little guidelines that exist to protect clinicians as hospitals ramp up their conservation strategies.

Frankly, at the front lines morale is low amongst clinicians and our allied healthcare colleagues. Contributing to the low morale are mixed messages we hear from different bodies (CDC/NIOSH versus WHO) with regards to the safety of PPE and in particular N95 vs surgical masks. Further complicating the experience are stories of countless healthcare workers in the United States being provided unsafe PPE ranging from rationing 1 mask per week to bandanas, scarves and even garbage bags.

We work at the front line and we put our lives at risk every day to provide high quality care for Canadians. With that being said, nobody in healthcare should be expected to be put in undue harm as a result of a system that has failed to provide us with the necessary equipment to work safely. 

The CPSO has provided some guidance suggesting that clinicians decide for themselves whether they “no longer legitimately feel able to practice safely”. According to the PPE guidelines produced by the OMA: we are recommended to wear at minimum droplet pre-cautions when caring for a patient who has COVID-19 in accordance with WHO guidelines. With that being said, what if the standards offered to us by our hospitals in the upcoming weeks fall short of this? How far can the “safety bar” be lowered before it is “legitimately unsafe to practice”?

We are asking simply for a set of guidelines applicable to all physicians in Canada that protects us moving forward as PPE shortages become a potential reality. What is considered an unsafe work environment with regards to PPE? Is it anything that falls below the standards you have set in your recommendations? If so, is the safety bar set at 1 mask per day? 1 mask per week? Bandanas? Garbage bags?

Many clinicians will continue to work despite feeling unsafe because we feel a moral imperative to be at the front lines. With that said, we look to you as our advocates to guide us and to protect us from organizations potentially abusing our good will. Please provide us with guidelines so that we can advocate for ourselves moving forward.

Thank you,

Your Local Doctors