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Canada Edmonton nurses refuse to perform COVID-19 swabs without N95 masks

15:20  21 march  2020
15:20  21 march  2020 Source:   cbc.ca

Swabs used to test for COVID-19 running 'critically' low, BCCDC says

  Swabs used to test for COVID-19 running 'critically' low, BCCDC says The supply of swabs used to test for COVID-19 is 'critically limited,' according to the The B.C. Centre for Disease Control's website.The warning over the nasopharyngeal swabs, which are used to collect samples from patients, appear in guidelines for lab testing on the BCCDC website. Any supply issues could effect the rate of testing at a critical time, as the World Health Organization (WHO) urges increased testing for the disease caused by the novel coronavirus.

Although COVID - 19 test kits are available, some doctors lack the protective gear necessary to safely Doctors in the group agree that it's too dangerous for them to perform the swabs without protection Supplies of N - 95 masks have grown so sparse that during a White House briefing Tuesday, Vice As a workaround measure, Viswanathan is experimenting with having patients perform the swabs

The union representing nurses in Saskatchewan says they' re running out of resources, including personal protective equipment and swabs to conduct WATCH: SUN said nurses are running out of nasopharyngeal swabs , which they use to test people for COVID - 19 , along with personal protective

The union and AHS disagree on whether N95 masks are required to protect nurses swabbing patients. © Tyson Koschik/CBC The union and AHS disagree on whether N95 masks are required to protect nurses swabbing patients. Some 30 nurses in Edmonton have refused to swab patients for the coronavirus because Alberta Health Services (AHS) won't provide N95 masks, their union says.

The United Nurses of Alberta (UNA) Local 196, says the community nurses "have exercised their right to refuse work" at three assessment clinics in the city.

"Based on their assessment of what they need to be properly protected, and the information that they have available to them, which is what everybody has available to them, they believe they need N95 to properly protect themselves," union vice-president Sandi Johnson told CBC on Friday.

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N 95 respiration masks are in short supply at Canadian hospitals, which are bracing for an influx of Having that mask could be the difference between life and death for a patient, because doctors and nurses need to Some regions are running low on nasal swabs used to test patients for COVID - 19 .

"They believe that when they request one, they should be provided one from the employer without question."

Unlike surgical masks worn by Alberta nurses who conduct swabs, the N95 respirator fits more tightly and protects against aerosol transmission.

On its website, the union says all frontline workers in contact with patients suspected or confirmed of having COVID-19 should have access to the N95 mask because "the science remains uncertain on how the virus is transmitted."

"My biggest concern is that one of these nurses, at least one of these nurses, is going to contract disease as a result of doing the work of the employer," Johnson said.

The COVID-19 test in Alberta is performed with a nasopharyngeal swab, which looks like a Q-Tip. 

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Covid 19 was confirmed to have spread to South Korea on 20 January 2020 from China. reportedly managing to send 50,000 N 95 masks and 1,500 protection suits to hospitals in the Hubei Science Rapid PREreview was launched to perform rapid open peer review of preprints related to emerging

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The swab is inserted into the nostril to collect cell samples by rubbing the back of the nose and throat. During the test, people are likely to cough or sneeze, the union said.

The UNA and AHS disagree when it comes to recommendations on minimum requirements.

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"According to the Public Health Agency of Canada (PHAC) guideline, a Nasopharyngeal Swab process does not require the use of an N95 respirator," said Kerry Williamson, AHS spokesperson, in an email.

"We are confident that the guidelines and equipment we have in place will protect our workers from exposure to COVID."

Williamson said COVID-19 is not an airborne illness, but rather "an illness known to be transmitted by droplet" through contact with nasal and oral secretions from a case.

"The personal protective equipment guidelines in place in Alberta are the known best practice to protect against illnesses transmitted by droplet," Williams wrote.

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Coronavirus Disease 2019 ( COVID - 19 ). Section Navigation. CDC Home. Coronavirus ( COVID - 19 ). How to Protect Yourself. N 95 Respirators. Healthcare Personnel with Potential Exposure to COVID - 19 .

COVID - 19 swab test at checkpoint (updated as at 13 Mar 2020) From 13 Mar 2020, travellers entering Singapore and exhibiting fever and/or other symptoms of Singapore Permanent Residents and long-term pass holders who refuse testing may have their immigration facilities and work pass privileges

However, the union notes that, according to the U.S. Centers for Disease Control (CDC), the research on transmission isn't conclusive. 

"Because of the conflicting opinions on PPE (personal protective equipment) from leading public health institutions and uncertainty around transmission, we must practice the precautionary principle and recommend the higher standard," the union states on its website.

Its position is in line with the Canadian Federation of Nurses Unions (CFNU), the CDC and Prevention and the European Centre for Disease Control in Prevention, the union added.

On Friday afternoon, Williamson said AHS had completed an investigation to assess the safety for the Edmonton nurses refusing to swab.

"In all of these cases, the investigation was completed and determined that the work was safe and that the procedure mask provided was appropriate for the Nasopharyngeal Swab process," Williamson said.

He said AHS met with unions on Friday to discuss the protection requirements and they are "working toward common ground."

'Adequate supply'

The union said it tried unsuccessfully to find out how many N95 masks the province has. When CBC inquired, AHS did not provide a number.

"AHS has an adequate supply of N95 respirators," said Williamson. "To ensure we continue to have an adequate supply, we must ensure that equipment is being used appropriately."

On Friday, Prime Minister Justin Trudeau unveiled a plan to ramp up production of medical supplies and protective gear for health workers.

Public Services and Procurement Minister Anita Anand said the government has so far secured 11.3 million N95 masks. She said it is beyond what provinces, territories and other health organizations have asked for.

Ontario hospital staff told to ration masks as COVID-19 spreads .
Major Toronto hospitals are rationing surgical masks amid the current COVID-19 pandemic, and in some cases, even urging nurses and other front-line staff to use just one mask for an entire shift, according to memos obtained by CBC News. Provincial officials have said there are enough supplies in Ontario for health-care workers, and that more masks have been ordered and are on the way. But some front-line workers in the Greater Toronto Area say they feel their safety is increasingly at risk."They're treating us like we're disposable," said a veteran nurse from Markham Stouffville Hospital, who did not want to be identified for fear of retaliation from hospital management.

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