The following piece was written by Barb Wahl, a former president of the Ontario Nurses Association.
In 2003, Toronto was hit by SARS, a coronavirus. The city had the second-largest SARS outbreak in the world. Patients and health care workers became ill – two nurses died.
There was much discussion about how SARS was spread. The conventional wisdom suggested it was spread through contact with heavy droplets. Others suggested lighter, smaller droplets were suspended in the air and inhaled. No one was sure. Nurses of course must be close to their patients – bending, lifting, speaking into an ear – any droplets expelled by a patient could easily land on a nurse’s face. Any sneeze from a SARS patient could become lethal. The Ontario Nurses Association knew that to ensure worker and patient safety, nurses must have respiratory protection to keep SARS from being inhaled. The minimum protective respiratory standard for nurses was a face mask with at least N95 certification.
In the fall after the SARS outbreak ended, at the demand of nurses, doctors, and all other health care providers, a thorough investigation led by Chief Justice Archie Campbell was carried out. His final report cited a sharp criticism of Ontario’s health care system and its failure to protect frontline nurses. It also included many recommendations; Justice Campbell said when science is not certain, the precautionary principle (i.e. err on the side of safety) must be followed. A key result to ensure the safety of Ontario’s nurses was the subsequent practice that every nurse in Ontario be annually fit tested for an N95 respirator, readily available to her in case of need.
Fast forward 17 years to COVID-19: a highly contagious coronavirus very similar to the original SARS. Once again, some argue that this new virus is spread by droplets. Growing evidence suggests it may be airborne as well. I won’t argue the science. But when you consider that nurses are routinely bending, lifting, and leaning over patients, a surgical mask will not protect a nurse’s airway in such close proximity to an infected patient.
Once again, decision-makers contend that surgical masks are adequate, but nurses know that isn’t true. EMS paramedics wear N95, gowns, gloves and eye protection. We must also give every nurse an N95 mask to protect them from any patient who could be carrying the virus. It would also be wise to put the surgical mask on the patient while care is being given. But give the nurse the N95 mask they need to protect their airway. We must not lose another nurse.