If hospital workers don’t face mandatory vaccinations, then who does?
There is no place for politics in the response to a global pandemic. Canadians have had front row seats to the devastation resulting from the political theatre in the U.S., where masks morphed from being tools to prevent the spread of COVID-19 into political props, and the “freedom to choose” not to get vaccinated has resulted in record-setting deaths.
With Canada officially in a fourth wave of COVID and the vast majority of new cases and hospitalizations being among the (relatively few) unvaccinated, you would think that it would be a no-brainer to mandate vaccinations for hospital workers.
But on Aug. 17, the Chief Medical Officer of Health (CMO) for Ontario issued a directive under the Health Protection and Promotion Act that allows workers in high-risk hospital settings to opt for “regular” antigen testing instead of getting vaccinated.
If fortune favours the bold, then the Ontario’s government’s anemic response leaves our health-care system, and those using it, at risk. This weak position in such a vulnerable, high-transmission sector may also undermine the confidence of other employers who want to implement firm policies that would terminate workers who refuse to be vaccinated for non-human-rights protected reasons. If Ontario isn’t willing to stand up and mandate vaccinations for hospital workers — who pose a real risk to vulnerable patients and the capacity of the health-care system if they contract the virus — then where is it appropriate to mandate vaccination?
Instead of shouldering the responsibility and potential liability directly, Ontario has effectively pushed the obligation to take the correct and responsible action — mandating and enforcing the vaccination status of hospital workers (unless there is a legitimate medical or religious exemption) — to hospitals. Passing the buck to hospitals is a well-trodden path that is characteristic of the government’s approach to dealing with the complexities of COVID when it comes to the health-care system.
And where is the Ontario Hospital Association in all of this?
Unfortunately, hospitals are not responding consistently. Late last week, Ontario’s largest health network, University Health Network (UHN) and the Hospital for Sick Children (HSC) took strong, rational positions requiring mandatory vaccinations for hospital workers, suggesting that workers without legitimate exemptions may be terminated. UHN’s CEO has taken the position that they will do everything that they can to encourage their employees to get vaccinated, but “If, in the end, someone decides that they cannot be vaccinated, an unpaid leave of absence will be the last choice open to us…. I don’t want to lose any member of this team — but my responsibility is to make UHN as safe as I possibly can for our patients and for you.”
Both UHN and HSC released their positions on mandatory vaccination within days of the release of the directive, and cite the directive for what it doesn’t say as much as for what it does. As UHN’s CEO notes in his correspondence to UHN workers: “The Directive also provides for the ability to take the next step to protect our patients and our employees — the requirement for vaccination of everyone who works for UHN.”
Unfortunately, while the directive does allow hospitals to require “mandatory” vaccination, it does not expressly state that hospitals can decline to offer the “regular” antigen testing option to its workers. Hospitals can determine the frequency of the antigen testing, with the directive only providing for a minimum of once every seven days.
In contrast to the position of UHN and HSC, the Ottawa and Montfort Hospitals have announced that they will be following the government’s directive and not requiring mandatory vaccinations of employees. Those who choose not to be vaccinated can continue to work in hospitals but will be subject to COVID testing “regularly.”
Where do these developments leave hospitals that have decided to take a firmer stance on mandatory vaccination? Essentially, they have been undermined both by the directive and the chasm in approaches between Ontario hospitals. If all hospitals had taken a unified approach to mandatory vaccination, it is possible they could have made that outcome a reality. Instead, hospitals may struggle to enforce such policies, even though they are firmly rooted in scientific evidence and public safety.
The government, for its part, has decided this matter based on politics not science. Requiring the mandatory vaccination of workers without an option for antigen testing would not force hospital workers to get vaccinated — it would force them to choose whether to risk termination or get vaccinated. With this directive, Ontario’s government has made it possible for hospital workers to continue to work in hospitals and not receive the vaccine. Of course, hospital unions do not have to choose to represent unionized hospital workers who are terminated or put on unpaid leave for not getting vaccinated because unions, contrary to public misconception, have very broad legal latitude to decide which cases to take and how to spend their members’ money.
The saving grace of this situation may end up being Ontarians themselves. Canadians have not fallen prey to fake news and fear mongering around vaccine safety to the same degree as Americans, so we can rely on the strong majority of the population’s judicious choice to vaccinate (particularly evident in those working in a health-care environment) to keep this gaping loophole in common-sense pandemic response measures from becoming another health disaster.