After three years of the pandemic, the impact of COVID on the health and social services workforce is immense. Since 2020, more than 112,000 of the 291,000 network employees have been compensated by the CNESST due to COVID, for sick leave or preventive withdrawal. And this already very heavy toll does not include the thousands of other infected employees compensated by salary insurance who also had to forfeit.
According to the commission that deals with compensation claims for work-related injuries or illnesses, no less than 92,252 (as of March 5) of the 104,683 claims accepted since March 2020 in connection with COVID have been for workers of health. Added to this enormous burden are nearly 22,000 compensation payments made to employees who were taken off duty preventively to avoid infection due to health conditions, including pregnancy.
According to figures from the Canadian government, employees and professionals in the health sector have been hit harder by the virus in Quebec than anywhere else in Canada. At the start of 2022, 9% of Quebec health care workers reported having been infected, almost three times more than in Ontario (3.3%), more than in British Columbia (5.4%) and that in Alberta (6%). Thirteen of the forty-six deaths deplored among nursing staff in Canada occurred in Quebec.
If the first year of the pandemic (2020) generated more than 15,000 absences due to COVID recognized by the CNESST, it was the year 2022, with the arrival of Omicron, which caused the number of claims to explode in the health network, to more than 61,000. In 2023, some 6,087 workers have been compensated for COVID to date, proof that the pandemic is far from having disappeared from the landscape.
The Ministry of Health measures the impact of absences due to COVID on the network in the ratio of hours paid in CNESST and in salary insurance. Thus, the ratio of hours paid in CNESST went from 1.5% in 2019-2020 to 2.09% in 2022-2023 (until February 11).
Prolonged absences
In three years, these outbreaks of infections have also led to many prolonged absences among affected employees. Since 2020, nearly 500 network employees compensated by the CNESST have withdrawn for more than three months, including 40% for more than six months. Even today, 634 workers compensated for COVID for more than three months — nearly 80% of them for more than six months — have still not returned to work.
But these figures represent only the tip of the iceberg, say several unions. Because since the end of 2021, claims related to COVID for work-related illnesses are only accepted in dribs and drabs by the CNESST. This is because the commission judges that the majority of employees contracted the disease in the community and not at work.
Indeed, figures obtained from the Fédération interprofessionnelle de la santé du Québec (FIQ) and the CSN show that since 2021, the compensation paid by the CNESST is no longer representative of the burden that COVID places on the health network. , and that salary insurance claims have exploded.
From January to April 2022, there were thus more than 68,000 absences due to illness, of which barely 12,000 were covered by the CNESST. “The rate of acceptance of claims by the CNESST took a nose dive, while salary insurance claims soared. Concretely, this means that many employees who are sick with COVID are given a two-week waiting period, and dip into their personal leave or their vacation to make up for the loss of salary,” explains Isabelle Groulx, health and safety spokesperson for the FIQ. .
The same observation is made at the Federation of Health and Social Services (FSSS-CSN). “There is no longer any presumption that the employee is infected in his environment, so no compensation from the CNESST in the majority of cases. Those who have symptoms therefore almost all end up on salary insurance, which also implies a lack of referral and specific medical follow-up,” laments Réjean Leclerc, president of the FSSS-CSN. “Yet they are just as sick with COVID. We see that salary insurance claims follow exactly the curves of the waves of the pandemic, ”he says.
According to a 2022 study of 6,000 health care workers with COVID by the Institut national de santé publique du Québec (INSPQ), 40% of them said they still had symptoms more than 12 weeks after their infection. .
According to Réjean Leclerc, the decline in requests accepted by the CNESST will have direct consequences on several employees of contracted private establishments suffering from long-term COVID and persistent symptoms who are on salary insurance. “After 24 months, if they are not deemed totally disabled, they are not entitled to long-term salary insurance, even if they still have symptoms preventing them from returning to their jobs. They find themselves with nothing, he explains. If the establishment does not have positions that can accommodate the sick employee, we could end up with what are called administrative dismissals. »
Since 1er March, a new CNESST rule further complicates matters, adds the FIQ spokesperson. While a positive PCR test result was enough to recognize an absence due to COVID, the organization now requires a medical note to confirm a COVID diagnosis.
“Imagine the heaviness that this imposes for the doctors, who have better things to do, and for the nurses who will have to be absent to obtain these certificates. Does that make sense? relaunches Isabelle Groulx. Every day, more than 1,500 healthcare workers are still absent due to COVID. “It’s still not nothing,” she said. This is in addition to other absences and the exodus to private agencies, ”she adds.
According to the FIQ, the weight of absences aggravated by the pandemic has made certain questionable ways of doing things more common, sometimes irreconcilable with the code of ethics of health professionals. “There are constant shifts to other tasks. The head nurses no longer even hide to say to reduce the contingencies of tasks, suggests Isabelle Groulx. This means that we go below what our profession requires for various tasks, in particular the monitoring of vital signs, or medication. However, we can see the consequences, with the numerous investigations launched into failures in the emergency room. And that plays a big role in the moral distress of health professionals. »