Opinion

Amit Arya

Patient safety:

  • We need to protect vulnerable patients. Patients in hospitals, long-term care and other health-care settings are often immunocompromised and can also be unvaccinated. Immunocompromised patients, even if vaccinated, have a higher chance of having serious complications if infected with COVID-19. Unvaccinated patients also have a full right to receive safe health care and have a much higher risk of serious illness and death from COVID-19, and must also be protected.
  • The harms of patients developing COVID-19 go beyond death. They also result in social isolation and increased suffering. As a front-line health-care worker, I have seen this in long-term care and in hospital settings. For example, in a hospital ward with an outbreak, essential caregivers (usually family members) are often blocked from coming in. Many of our vulnerable patients are dependent on their caregivers to help with feeding, changing, translation, and goals-of-care conversations. Residents in long-term care would end up confined to their rooms, unable to come out and participate in meaningful activities and socialization, which has a negative impact on their quality of life.
  • Therefore, given the risk of COVID-19 to vulnerable patients who may experience increased suffering and even death, we have a duty to do all we can to protect them, and one of the most effective tools we have is vaccinations, including a vaccine mandate for health-care workers.

Vaccine mandates should not be blamed for staffing shortages:

  • I hear concerns about vaccine mandates causing staffing shortages. But mandates are not the only reason for staffing shortages and should not be blamed. Staffing shortages are multifactorial, long-standing and have worsened throughout the pandemic. Some of the reasons include low wages, lack of permanent full-time jobs, lack of benefits like 10 permanent paid sick days, Bill 124 (wage-suppression legislation for nurses), as well as no support for grief, bereavement and trauma that health-care workers have experienced. The root causes of staffing shortages, which are often related to exploitation and poor working conditions, should be addressed rather than blaming vaccine mandates, which prioritize patient safety.
  • Moreover, a provincial mandate will ensure that unvaccinated health-care workers can’t just move to different areas of the health-care system where there is no mandate.
  • Unvaccinated health-care workers are much more likely to get COVID-19, and will need time off later. They will also infect their colleagues, who will then need time off too. Either you pay for it now or pay for it later.

We’ve already successfully mandated vaccination in long-term care:

  • Reminder: the devastation of the first and second waves was almost all caused by well-meaning staff coming into long-term care infected with COVID-19, leading to an outbreak. Some of the sickest people live in long-term care. With a median prognosis of 18 months, the vast majority of people have an advanced life-limiting illness like dementia, frailty, COPD, or CHF.
  • As of November 12th, just before the first-dose deadline of November 15th, the data from a couple of weeks ago showed that over 95 per cent of health-care workers in long-term care were fully vaccinated, and 98 per cent of health-care workers in long-term care had received one dose.
  • There are now only four long-term care outbreaks, four out of 626, even though cases are going up around the province. And there are also only three long-term care resident cases right now.
  • Long-term care has had ZERO deaths since October 20th.
  • If we can prevent suffering in long-term care where some of our sickest patients live, we can also prevent it in other settings such as hospitals and retirement homes – because we know: vaccine mandates work!

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Authors

Amit Arya

Contributor

Amit Arya is a palliative care physician working at North York General Hospital and Kensington Gardens Long-Term Care Facility.

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