Which workers, after how long and in what context, will be able to return to work sooner despite a positive diagnosis of COVID-19? Quebec presented on Wednesday the main lines of this plan which aims to avoid service disruptions in the health network and in the essential services offered to the population.
A health care worker declared positive for COVID-19, adequately vaccinated, will be able to return to work after 7 days of isolation, if a disruption of services threatens his workplace, the Ministry of Health and Social Services said on Wednesday. (MSSS). An unvaccinated person must however remain in confinement for 10 days.
“A study, which was very convincing, showed that it takes 5 to 7 days for the viral load of a double vaccinated person to be greatly reduced,” says Dr.r Donald Vinh, infectious disease specialist-microbiologist at the McGill University Health Center.
However, he urges caution. “After 7 days, a doubly vaccinated person who is infected does not have a viral load of zero. It can still infect someone, but the risks are less. So, we can understand that a person could return to work at this time, ”he adds.
In addition, an asymptomatic healthcare worker exposed to a case of COVID-19 will be able to continue working. However, he should be tested as soon as possible, and every two to three days, until the 10e day after contact with the infected person.
“This is not the ideal measure, but in the current context, it can be a good compromise,” says Dr Vinh.
A healthcare professional who lives with an infected person will only be able to return to his workplace if he has isolated himself for 7 days, is asymptomatic and works in a place where a disruption of services is imminent.
An unvaccinated or single-dose healthcare worker who has been in contact with an infected person will only be able to come to work if a service disruption is imminent. Otherwise, he must remain in isolation for 7 days.
Finally, if a professional has symptoms similar to those of COVID-19, they must get a negative screening test and wait for their symptoms to subside before returning to work.
IMAGE FROM THE SITE OF THE NATIONAL INSTITUT DE SANTÉ PUBLIQUE DU QUÉBEC
Until now, a worker had to remain in isolation for 10 days if they had been in close contact with someone infected with COVID-19 or if they had COVID-19. On Tuesday, the Minister of Health and Social Services, Christian Dubé, announced that this period could be reduced under certain conditions.
These new measures aim to limit load shedding in hospitals. “It is particularly a tool for maintaining level 3 health services,” said Dr Yves Jalbert, medical director of public health protection at the MSSS, during an information meeting for the media.
Last week, the Minister of Health announced that Quebec was at level 3 of its load shedding plan, out of a maximum of 4.
At the end of the day on Wednesday, the Collège des médecins du Québec said it agreed with these criteria, saying that this measure did not constitute a violation of its code of ethics.
Benoit Barbeau, virologist and professor in the department of biological sciences at the University of Quebec at Montreal, however, fears that the management of these returns to work will entail a burden for the health community. “Concern on the part of work colleagues could also hinder the proper functioning of these measures,” he said.
It should be noted that as of December 28, 8,577 health network workers were absent due to COVID-19, according to data from the MSSS obtained by Press. Of this number, 3,573 employees are positive for COVID-19 and 2,452 are on preventive absence. In addition, 2,097 workers are in the process of testing for the virus, while 455 have refused to be tested.
Other essential workers
Asymptomatic people who work in an essential environment, other than that of health, will be able to return to work after 5 days of isolation. However, they will have to isolate themselves at work and take their break and their dinner in a room reserved for infected people. This measure will only apply in the event of a break in services.
“Essential workers, like those who work in slaughterhouses, may be in tight spaces that are not ideally ventilated. In these cases, it might be better to wait 7 days instead of 5 before getting them back to work, ”says Dr.r Vinh. Postponing the time of their return to work would reduce the risk of outbreaks, he believes.
People who have been in contact with a positive case will be able to return to work after 5 days of isolation, if there is an imminent disruption of services. However, they must obtain a negative result on a rapid test taken at 6e day of their isolation and must self-isolate during their breaks.
In the event of a break in services, people who have been in contact with a positive case and have had three doses of the vaccine will only have to isolate themselves for 3 days, but will have to obtain negative rapid tests every 4e, 5e and 6e days.
As a last resort, the company must contact the regional public health department in its sector to determine a procedure to be followed.
“We are talking about extraordinary measures to preserve services that have a direct impact on health or safety,” said Dr Richard Massé, strategic medical adviser of the General Directorate of Public Health.
According to the National Institute of Public Health of Quebec, these measures could be applied in particular among employees of an emergency service (police, firefighters, ambulance), of an essential public service, such as the distribution of drinking water, or a food market that supplies a remote community.
With the collaboration of Lila Dussault, Press
Some questions
Will infected workers only work with patients with COVID-19?
The infected workers will be “in practice a very small portion of the people who will come out of their isolation, because this is the last category that we are going to look for”, insisted on the Dr Yves Jalbert. He said that there were currently no very strict guidelines to determine in which environment the infected professionals will work, and that this decision would be up to health establishments. “We will certainly tend to ensure that the people themselves infected work with people who are also,” however added Mr. Jalbert.
Will wearing the N95 mask be compulsory?
In the health sector, N95 masks are accessible for “a good part of the workers”, indicated the Dr Richard Massé. “At the moment, we are in the process of finalizing an approach that was developed with the CNESST to further expand the use of N95s,” he added. For the moment, the distribution of these masks in other workplaces is not planned, but it is not excluded that their use may be recommended.
Will a healthcare professional be required to tell his patient that he has COVID-19?
The Dr Yves Jalbert said that “discussions” would take place on this issue, but that for the moment, no directive in this direction had been adopted.
– Coralie Laplante, Press