Expert consensus statement on pandemic report

The following is a letter of consensus from leading international and Canadian experts endorsing the central recommendations from Mario Possamai’s independent report, A Time of Fear: How Canada failed our health care workers and mismanaged COVID-19.

A Letter from the Signatories to Mario Possamai’s Independent Report

The severity of the impact of COVID-19 on Canada underscores serious issues in our public health system and health emergency preparations, especially our inability to guarantee the safety of health care workers. The extraordinary infection rates of nurses, care aides and personal support workers highlight the health care system’s tragic failure to take proper precautions against nosocomial transmission. Health care workers, providing care in hospitals, long-term care facilities and homes, make up nearly one in five of all COVID-19 cases in Canada compared to approximately 10% globally, according to figures released in September by the International Council of Nurses.

Canada is clearly not following the precautionary principle – an idea designed to encourage safe workplaces by requiring that reasonable actions to reduce safety risks should not await scientific certainty. In response to this failure, occupational health and safety experts have repeatedly called for airborne precautions, including N95 respirators or better, when caring for COVID-19 patients, but their requests were repeatedly ignored by governments. This serves as a powerful reminder that policymakers need to remember the importance of the precautionary principle, which has been so quickly forgotten since SARS, and restructure the public health system to put the safety of health workers front and center.

As scientists, occupational health and safety experts and public health specialists, we stand firmly behind the recommendations in Mario Possamai’s independent report. It is clear from our expertise that the prior adoption of many of the proposed recommendations would have mitigated the devastating impact of COVID-19. Those recommendations included:

• That the precautionary principle be expressly adopted as a guiding principle throughout health, public health and worker safety systems by way of policy statement, by explicit reference in all relevant operational standards and directions, and by way of inclusion, through preamble, statement of principle or otherwise, in all relevant health statutes and regulations.
• That guidance on the safety of health care workers be made on a precautionary basis by workplace regulators, health care worker unions and worker safety experts working collaboratively, and that those decisions form the basis of health worker safety guidance issued by public health agencies.
• That a worker safety research agency be established as an integral part of the Public Health Agency of Canada, with legislated authority for decision-making on matters pertaining to worker safety, including the preparation of guidelines, directives, policies and strategies. It would be modeled after NIOSH, an essential part of the U.S. CDC, and would be focused on worker safety and health research, and on empowering employers and workers to create safe and healthy workplaces. Like NIOSH, its staff would represent all fields relevant to worker safety, including epidemiology, nursing, medicine, occupational hygiene, safety, psychology, chemistry, statistics, economics and various branches of engineering.
• That federal and provincial/territorial governments collaboratively act on an urgent basis to ensure that there are sufficient supplies of N95 respirators or better to ensure that all health care workers can be protected at a precautionary level. This must include maintaining and regularly refreshing strategic stockpiles and developing a made-in-Canada supply chain.
• That governments and public health agencies be open and transparent on levels of PPE stockpiles.
• That federal and provincial chief medical officers of health be statutorily required, on an annual basis, to report to their respective legislatures and to the public that they are mandated to protect, on the state of their jurisdiction’s public health emergency preparedness, and to make recommendations on addressing any shortcomings. This report should reflect the concerns and perspectives of health worker unions and safety experts.
• That Canada have the resources and capabilities for pandemic containment measures, including sufficient worker safety and aerosol expertise, to independently assess guidance from the WHO and formulate policies that meet the needs of Canada and of Canada’s health care workers.
• That all jurisdictions be required to publicly report to their stakeholders and to the federal government — in a consistent, detailed, transparent and timely manner — health care worker infections in their jurisdictions.

Signatories

Experts

Alec Farquhar, LLB
Occupational Health and Safety and Disability Consultant

Alireza Afshari, MSc, PhD, Docent
Professor, Department of the Built Environment (BUILD), Aalborg University, Denmark

Christopher Chao, PhD
Dean of Engineering, Chair Professor of Mechanical Engineering, The University of Hong Kong

Donald K. Milton, MD, DrPH
Professor of Environmental and Occupational Health, University of Maryland School of Public Health

Erna Bujna
Occupational Health and Safety Specialist, Ontario Nurses’ Association (retired)

Dr. Julian W. Tang, PhD, MRCP FRCPath FHKCPath FHKAM
Honorary Associate Professor/ Clinical Virologist, University of Leicester

John W. Cherrie, PhD, BSc, CFFOH
Emeritus Professor Human Health, Heriot Watt University, and Principal Scientist, Institute of Occupational Medicine, UK

Dr. John H. Murphy, BSc, MHSc, MBA, PhD, ROH, CIH, MACE
President – Resource Environmental Associates Limited • Resource EHS America Inc., Adjunct Professor – Dalla Lana School of Public Health, University of Toronto

John Oudyk, MSc CIH ROH
Occupational Hygienist, Occupational Health Clinics for Ontario Workers

Jonathan Rosen, MS, CIH, FAIHA
Principal Industrial Hygiene / Safety & Health Consultant, AJ Rosen & Associates LLC

Jose-Luis Jimenez, PhD
Professor of Chemistry and Fellow of CIRES, University of Colorado-Boulder

Dr. Kevin Hedges, COH, CIH
International President, Workplace Health Without Borders; Certified Occupational / Industrial Hygienist, Occupational Health Clinics for Ontario Workers Inc.

Katherine Lippel, LLL, LLM, FRSC
Distinguished Research Chair in Occupational Health and Safety Law, University of Ottawa

Kevin P. Fennelly, MD, MPH, ATSF
Senior Research Clinician, Pulmonary Medicine Section, Division of Intramural Research, NIH/NHLBI

Christine Oliver, MD, MPH, MSc
Dalla Lana School of Public Health, Division of Occupational and Environmental Health, Medical Consultant – OHCOW

Lidia Morawska, PhD
Director, International Laboratory for Air Quality and Health (WHO CC for Air Quality and Health), Co-Director – Australia, Australia-China Centre for Air Quality Science and Management

Lisa M. Brosseau, ScD, CIH
Professor (retired), Research Consultant, University of Minnesota, Center for Infectious Disease Research and Policy

Nancy Johnson
Occupational Health and Safety Specialist, Ontario Nurses’ Association (retired)

Parker A. Small, Jr., M.D.
Professor Emeritus, Departments of Pediatrics and Pathology, University of Florida

Rachael M. Jones, PhD, CIH
Associate Professor, Department of Family and Preventive Medicine, School of Medicine, University of Utah

Raymond Tellier, MD, MSc, FRCPC, CSPQ, FCCM D(ABMM)
Medical Microbiologist, McGill University Health Centre

Shelly Miller, PhD
Professor, Mechanical Engineering, Environmental Engineering Program, University of Colorado Boulder

Simon J. Smith, ARCS, PhD, CChem, FRSC(UK)
Chair, Canadian Standards Biological Aerosols Working Group; Former Chair, American Industrial Hygiene Association Respiratory Protection Committee (2011-2012); Former President, International Society for Respiratory Protection (2006-2008)

Tom Polis, MD, FRCPC
Assistant Professor, Department of Anesthesiology and Pain Medicine, University of Ottawa

Yuguo Li, PhD
Chair Professor of Building Environment, the University of Hong Kong

Health advocates

Tim Guest, RN, BScN, MBA
President, Canadian Nurses Association

Miranda Ferrier
National President, Canadian Support Workers Association

Labour advocates

Hassan Yussuff
President, Canadian Labour Congress

Linda Silas
President, Canadian Federation of Nurses Unions

Larry Brown
President, National Union of Public and General Employees

Chris Aylward
National President, Public Service Alliance of Canada

Debi Daviau
President, the Professional Institute of the Public Service of Canada

Ken Neumann
National Director for Canada, United Steelworkers

Jerry Dias
National President, Unifor

Paul R. Meinema
National President, United Food and Commercial Workers Canada

François Laporte
President, Teamsters Canada; International Vice President, International Brotherhood of Teamsters

Sharleen Stewart
President, SEIU Healthcare

Mary Shortall
President, Newfoundland and Labrador Federation of Labour

Carl Pursey
President, PEI Federation of Labour

Daniel Légère
President, New Brunswick Federation of Labour

Danny Cavanagh
President, Nova Scotia Federation of Labour

Kevin Rebeck
President, Manitoba Federation of Labour

Lori Johb
President, Saskatchewan Federation of Labour

David Bob
President, Northern Territories Federation of Labour

Debbie Forward
President, Registered Nurses’ Union Newfoundland and Labrador

Mona O’Shea
President, Prince Edward Island Nurses’ Union

Janet Hazelton
President, Nova Scotia Nurses’ Union

Paula Doucet
President, New Brunswick Nurses Union

Vicki McKenna
President, Ontario Nurses’ Association

Darlene Jackson
President, Manitoba Nurses Union

Tracy Zambory
President, Saskatchewan Union of Nurses

Heather Smith
President, United Nurses of Alberta

Christine Sorensen
President, British Columbia Nurses’ Union

 

Note: Expert signatories have signed on to this statement in their personal capacity, with any current and/or previous positions as identifying information only.