Southern Manitoba health-care workers question lifting of COVID-19 vaccine, testing requirements

Some working in the health-care system in Manitoba's least vaccinated region have lingering questions over a provincial decision to allow their unvaccinated peers to come to work again without undergoing routine COVID-19 testing.

Starting Tuesday, Manitoba's proof of vaccination requirement for health-care workers will no longer be in effect.

That means about 1,500 unvaccinated staff forced to undergo testing several times a week in recent months will no longer need to do so, according to worker estimates from Shared Health. Another 119 unvaccinated workers who refused testing accommodations have been on unpaid leave since last fall, with the majority (63) located in the Southern Health region.

One doctor who works at Boundary Trails Health Centre, located between Winkler and Morden in Southern Health, argued lifting the vaccination and testing requirement was done for political reasons. 

The Boundary Trails doctor called refusing vaccination unethical and a denial of scientific consensus. 

"I don't think it is ever OK to lift the requirement that health-care workers be vaccinated for COVID-19," said the doctor, who spoke on condition of anonymity because they fear becoming a target of harassment locally. "We have a duty of care to patients to 'do no harm.'"

The doctor reiterated COVID-19 vaccination is safe, reduces the risk of infection and significantly minimizes the risk of severe outcomes including death. A vaccinated person who becomes infected with COVID-19 also has a lower risk of passing it on, including with Omicron, which has shown higher rates of breakthrough infections than with past variants. 

The doctor questioned whether having unvaccinated health-care workers in the system was ever wise in the face of "mountains of accumulated evidence" on the safety and efficacy of COVID-19 vaccines, and the severe risk posed by COVID-19.

To at this point not accept that evidence, or doubt institutions that have adopted it in their approaches — such as Health Canada, Manitoba Public Health and the Centre for Disease Control in the U.S. — raises other concerns, the doctor said.

"Either scenario calls into question their clinical judgment and raises the possibility that they use their own opinions to override standards of care in other areas of their job."

Hospital numbers down

Manitoba's chief provincial health officer said last week the policy shift was possible due to a waning Omicron-driven coronavirus wave, and hospital numbers that continue to decline. 

Patient volumes are coming down but remain high: 474 COVID-19 patients remained in hospital as of Monday, including 30 in intensive care units.

"Some have said this is too early, some have said this is the right time, and I think the proof as always will be when the rubber hits the road," said Dr. Don Klassen, a physician at Boundary Trails and C.W. Wiebe Medical Centre in Winkler.

Boundary Trails is within Southern Health, which has the lowest vaccination rates in Manitoba, and is surrounded by the health districts of Stanley and Winkler, where uptake stands at 23.6 per cent 45.7 per cent, respectively.

Klassen said he hopes some of the lessons from the pandemic help guard against workplace transmission moving forward. The old adage of toughing it out and showing up at work when you have symptoms is now "ancient history," he said. 

"As long as people tend to follow those rules, I don't think this is going to have a drastic impact," said Klassen.

He said the bigger impact will come from the community generally when other restrictions expire. Proof of vaccination to get into restaurants, entertainment venues and more also expires Tuesday; mask mandates will end March 15.

Jim Neufeld, executive director of the C.W. Wiebe Medical Clinic, said removing the vaccination mandate and testing requirement in health-care came as a surprise. 

He noted that most health-care workers must be vaccinated against other diseases or illnesses as a pre-condition of employment. Students and workers in the Winnipeg Regional Health Authority must be immunized against hepatitis B, measles, rubella and chickenpox.

"I don't really have a good sense of why we would be going down that road right now," he said. "It was put in place for a good reason and largely supported certainly by the health-care system and most other entities."

'Mixed messaging'

Despite hospital numbers and test positivity rates moving in the right direction, epidemiologist Cynthia Carr has reservations about the move.

"We're certainly not at what we would consider a low level yet compared to where we'd been in previous waves," said Carr, founder of Winnipeg-based EPI Research Inc.

"My concern always when we make changes based on positive trends is those changes can actually move that positive trend back in the wrong direction."

Carr said a significant amount of asymptomatic spread is possible in health-care settings, where vulnerable patients "need as many safeguards around them as possible." 

She is also concerned about the message this sends to the public.

"I think [this] will really call into question for people whether or not this was really important to be vaccinated, and that mixed messaging is only detrimental to all of us."