Dr. Michael Herman can’t get much closer to the front lines of pandemic health care than he already is. During every recent shift in the emergency department at Queensway Carleton Hospital, he has treated at least three or four COVID-positive patients, sometimes performing procedures with a high potential risk of spread.
And, while the emergency doctor uses full personal protective equipment, he does not have the same level of protection as many of his colleagues, even those who don’t see patients face-to-face: He has not received a second dose of COVID-19 vaccine.
Herman admits his friends and family were “a bit gobsmacked,” and worried, to learn that, as a front-line emergency physician treating COVID-19 patients, he is not fully vaccinated.
But he is far from alone.
Dr. Alan Drummond, an emergency doctor in Perth and co-chair of public affairs for the Canadian Association of Emergency Physicians, said it is common for emergency physicians to not yet be fully vaccinated and there is a “growing unease” among them about it as the third wave continues to put unprecedented pressure on hospitals.
“They feel vulnerable.”
The association has called for full vaccination of emergency department staff, saying their exposure puts them and the fragile emergency health system at risk.
Those fears were heightened recently when a partially vaccinated staff member in the emergency department at Montreal’s St. Mary’s Hospital became infected, leading to an outbreak that spread to more than a dozen partially vaccinated staff members.
Many emergency departments, especially smaller ones, would be decimated by such an outbreak, said Drummond.
Ottawa nurses who are being redeployed through hospitals have also told this newspaper they are terrified because they have had just one dose of vaccine.
“It’s like sending soldiers to the war with stones,” said Doris Grinspun, chief executive officer of the Registered Nurses’ Association of Ontario. She, like others, is calling for immediate full vaccination of all front-line health-care workers.
Herman is one of just a handful of doctors working in Queensway Carleton’s emergency department who have not yet received a second dose of vaccine.
With limited initial doses, older staff members in the department got vaccinated first, which made perfect sense, said Herman, who is 32. Those physicians have now received two doses. But Herman and the others who got their first doses later have now had their second dose delayed by up to four months, in keeping with provincial policy.
Herman said he understands the decision to push back second doses by up to four months as a means to give more Canadians partial coverage.
“But a bit of subtlety and nuance needs to be applied to people who are providing care on the front lines. People working in emergency departments and ICUs are a different beast than your average Canadian. It is not only a health and wellness issue, but a human resources issue.”
What rankles Herman, and others, is that many other hospital staff and health workers who are not on the front lines and don’t even see patients face-to-face are now fully vaccinated.
According to the National Advisory Committee on Immunization, which recommended extending dose intervals to vaccinate more Canadians, the first dose of Pfizer has up to 92 per cent efficacy after 14 days.
But Herman argues someone like an emergency physician who is face-to-face with seriously ill COVID patients on a daily basis, especially now that the more contagious, more virulent variants of concern are dominant, likely faces higher risk than people with little or no direct contact.
“I have sent people under the age of 40 into the ICU. This wave is much more pronounced than the first two. The sheer volume of younger, healthier people coming in is quite something.”
The province has said it might shorten the space between first and second vaccinations, but has no plans to change the policy, noting that one shot offers significant protection.
Queensway Carleton Hospital, though, says it would welcome full vaccination for health-care workers on the front lines.
In a statement, the hospital said it appreciates that the faster vaccines can get into more arms “the sooner our community will be safe,” but it would like to see front-line health workers get fully vaccinated.
“Many of our team are exhausted, and the staffing gaps we have as a region are significant. Hopefully we can show them how much they are valued, appreciated and will be protected. We would welcome it if there was an opportunity for healthcare workers to get their second doses sooner if there is sufficient vaccine supply.”
When health workers began getting early vaccines in Ontario, emergency staff often felt like afterthoughts, said Perth’s Drummond. Now, with the full vaccination gap, that feeling persists.
“We are not asking to be preferentially vaccinated for personal protection. We are asking for full vaccination to maintain the integrity of the emergency health system, which is fragile.”