Opinion

Kali Barrett

Patient safety must be our top priority:

  • The primary purpose of vaccine mandates is to ensure that patients (who are more susceptible to severe infection if exposed to SARS-CoV-2 even if vaccinated) are guaranteed the safest environment in which to receive treatment.
  • The hierarchy-of-control framework is used to help guide decision-making and inform policies that aim to prevent exposure to occupational hazards. At the top of the inverted triangle, representing the most effective strategy is “removing the hazard.” Vaccines remove the hazard, and are the single most effective mechanism to reduce the risk of transmission. This is achieved by both a reduction in the likelihood that a health-care worker will bring COVID-19 into work, and via a reduction in the chance that a health-care worker or patient will become infected if exposed.
  • At the very bottom of that inverted triangle, reflecting its inferior ability to protect, is personal protective equipment (PPE). PPE alone is not sufficient to keep either patients or health-care workers protected. PPE can fail. PPE can be insufficient.  People remove their PPE to eat. Patients don’t and can’t wear PPE at all times during a hospitalization.
  • This is why removing the hazard has to be our priority and primary goal if we want to keep patients safe.

The rights of the employee do not trump the rights of patients:

  • Working in health care itself is a privilege, not a right. People choose to work in this sector, and when they do, there are many prerequisites that have to be met in order to protect the public and patients: medical professionals have to satisfy the requirements of licensure, anyone working with the vulnerable has to have a background check, and health-care facilities themselves have to be accredited. Proof of immunity against other communicable diseases, like measles and hepatitis, has been a requirement for employment in health care for years. Vaccine mandates for COVID-19 are not a unique measure or policy; instead, they follow from many other policies that exist to ensure the safety of patients and the public
  • The Ontario Human Rights Commission is on side with this mandate. They wrote that receiving a COVID-19 vaccine is voluntary, but at the same time, the OHRC’s position is that a person who chooses not to be vaccinated based on personal preference does not have the right to accommodation under the Code. While the Code prohibits discrimination based on creed, personal preferences or singular beliefs do not amount to a creed for the purposes of the Code. The duty to accommodate can be limited if it would significantly compromise health and safety – such as during a pandemic.
  • The OHRC couldn’t be more clear: the personal preferences of health-care workers do not meet the criteria for accommodation under the Ontario Human Rights Code.

Vaccine mandates actually help with the staffing crisis:

  • There is a health-care worker staffing crisis. Vaccine mandates help protect the workforce. Unvaccinated health-care workers are far more likely to become infected if exposed either at work or in their community, and they can’t come to work if they’ve had a high-risk exposure.
  • Unvaccinated health-care workers are at risk of dying. Even if exposure doesn’t result in death or serious illness, they have a high risk of Long COVID, which could render them unable to return to work. We don’t yet fully understand the impact of Long COVID. But many of its sufferers describe long-term debilitation
  • While rapid testing might prevent an unvaccinated health-care worker from coming to work while infectious, it won’t prevent that health-care worker from being off work due to acute illness or Long COVID symptoms.
  • Moreover, these staffing shortages further exacerbate health-care worker burnout.
  • Fear and anxiety about potential exposure to COVID from colleagues adds to the emotional stress in health-care settings. 
  • After over 20 months of the pandemic, the exhausted Ontario workforce deserves to know that policies are in place to ensure that they’re not going to have to pick up extra shifts or be asked to work overtime, again, because their unvaccinated colleague can’t work because they’re off sick due to a preventable infection, and that they’re not having to work alongside unvaccinated colleagues. 

Hospitals are the temples of science:

  • Universities and hospitals lead the scientific inquiry that drives health care globally. 
  • Data-driven decision-making is fundamental to medicine and health care. 
  • Health-care institutions must be leaders of data-driven decision- and policy-making. 
  • If you don’t believe in science, you shouldn’t be working in health care. Patients deserve to know that those taking care of them believe in science. 
  • When the science is so clear, and the risks so high, health-care settings, and especially hospitals, must follow the science and mandate vaccination for health-care workers.
  • This protects patients, protects the public, and helps protect the health-care workforce. 

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1 Comment
  • Rachel Mary says:

    There is a disturbing and unscientific trend towards what looks to me like a kind of religiosity in the media and certain health institute officials of late (“I am Science” – Anthony Fauci) that is making me less trusting, not more. And this statement in your post above exemplifies it: “Hospitals are the temples of science:” followed by this: “If you don’t believe in science, you shouldn’t be working in health care. Patients deserve to know that those taking care of them believe in science.”

    The concept of “belief in science” has come to mean, I’ll tell you what the ‘truth’ is, and if you ‘believe in science’ you will simply believe me, not ask to look at the data yourself.

    The scientific method is supposed to be open to genuine debate where we look at the actual, well collected data. Not what’s happening now, with dishonest data collection, for example: died WITH as opposed to OF Covid, or the fact that, at least in BC, a person in the first two weeks after vaccination is categorized as unvaccinated (and so if they end up in hospital with a reaction, they are considered unvaccinated, or if they get covid in that two weeks, which seems to be something that happens with more frequency, the unvaccinated get blamed). That is dishonest.

Authors

Kali Barrett

Contributor

Kali Barrett is affiliated with the Department of Medicine, Interdepartmental Division of Critical Care Medicine, at the University of Toronto.

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