New COVID-19 rules for health workers aim to preserve the system amid Omicron wave

Health workers who are high-risk contacts of COVID-19 patients may continue working in hospitals under new test-to-stay protocols aimed at maintaining the health-care system amid surging Omicron cases.

Those protocols are already in place at The Ottawa Hospital, President and CEO Cameron Love said Tuesday. In rare cases, he said, some workers who have tested negative for COVID-19, but have symptoms might also be able to continue working if it means continuing to offer a critical service.

Instead of isolating at home, as normally required, asymptomatic health-care workers who are high-risk contacts will be given daily rapid antigen tests in order to continue working, the province’s Chief Medical Officer of Health, Dr. Kieran Moore, confirmed during an update Tuesday.

Moore said the action was aimed at preventing high absentee rates among health workers from crippling the already-strained system.

“We anticipate in January there will be a risk of too many health care workers isolating even though they don’t have symptoms. We will need them in January and February.”

The provincial protocols, expected to be announced this week, are aimed at assessing risk and preserving critical parts of the health-care infrastructure.

Key to those new rules is testing — with both PCR tests and regular rapid antigen tests. Ottawa health officials have already said PCR tests will be prioritized for health and other essential workers. Moore said it was also important that rapid tests be preserved to allow daily testing of health and long-term care workers who would otherwise have to self-isolate.

Love said the new rules opened the door for retaining symptomatic COVID-negative workers in rare cases when it could otherwise mean a critical part of the health system might have to be closed or patients sent elsewhere.

“It is a triage model to manage risk in the health-care system.”

One of the big concerns about the unprecedented spread of the now-dominant Omicron variant is the impact it might have on critical infrastructure if large numbers of essential workers are required to isolate because of potential contact with COVID.

Even if Omicron proves to be less virulent than Delta and higher vaccination rates result in more mild cases, the impact on already stretched hospital staff could paralyze the health and other essential systems.

Moore said Tuesday it was still too early to determine whether the highly contagious variant was less virulent than past variants. There are some signals that suggest less virulence — of 4,600 confirmed cases of Omicron in Ontario, just 15 have been admitted to hospital, for example. But, even if it is much less virulent, Moore said Omicron’s high attack rate could have a negative impact on hospitals due to the sheer volume of cases.

Worsening staffing shortages in hospitals, long-term care homes and elsewhere during a traditionally busy time of year are among key concerns about Omicron.

Omicron’s unprecedented rate of spread, compared to previous variants, and its ability to evade some immunity from vaccines and previous illness is behind the new protocols to keep health workers on the job. One person can infect seven or more other people. With Omicron cases doubling every few days, that opens the door for a significant proportion of the community to come in contact with the virus.

Workers who are high-risk contacts, but have tested negative and continue working would not share break rooms or lunchrooms with other workers, Love said.

Ottawa’s move to prioritize PCR tests for essential workers means those who test positive can get results quickly and return to work sooner to help keep essential systems functioning and “maintain a workforce,” Love said.

The Ottawa Hospital has been struggling with staff shortages in recent months, Love said, at a time when it is attempting to catch up on a backlog of procedures and surgeries.

Emergency, urgent and time-sensitive surgeries have gone ahead throughout the fall, but some elective surgeries have been postponed and rescheduled, he said, because of human resource challenges.

COVID-19 hospitalizations remain low at The Ottawa Hospital even as cases in the community rise exponentially. Cases at the hospital have ranged between five and 12 in recent days, he said. By comparison, when daily cases in the community reached 300 and above in previous waves, there were upwards of 70 patients in hospital with COVID-19.

Love said The Ottawa Hospital would the capacity to handle an influx of COVID-19 patients in the coming weeks if it has to.

He also said the hospital was monitoring to see if lack of access to COVID-19 tests for the public resulted in an influx of patients to emergency departments seeking assessment.

Moore, meanwhile, said Ontario was on track to have more cases of COVID-19 per day than at any time during the pandemic.