Canada’s fight against the novel coronavirus has left front-line health-care workers exhausted and concerned over shortages of personal protective equipment (PPE).
The federal government has been quick to reassure citizens, touting a stockpile of equipment and ventilators as well as equipment production with the message that Canada has enough PPE to protect its citizens and front-line health-care workers — despite pleas from provincial premiers for more.
But speaking from Rideau Cottage in Ottawa on Wednesday, Prime Minister Justin Trudeau was unable to promise Canadians they would not face a shortage of much-needed equipment, raising questions about the government’s supply and whether sufficient quantities could make it to the front lines in time.
With Canada’s situation evolving so rapidly, the prime minister said it was impossible to guarantee anything but noted the government was working hard to fulfil the country’s needs for equipment and ensure it was distributed properly.
According to Trudeau, the federal stockpile has been ensuring provinces have the equipment needed to prevent health-care systems from becoming overwhelmed, but Health Minister Patty Hajdu disagreed.
On Wednesday, she told reporters the reserve “likely did not have enough.”
“Federal governments, for decades, have been underfunding things like public health preparedness. And I would say that, obviously, governments all across the world are in the same exact situation,” she said.
On Tuesday, Trudeau announced he was allocating $2 billion to be spent on PPE for front-line health workers, including bulk purchases with provinces and territories.
Shortly after, Procurement Minister Anita Anand said Ottawa had already secured 16.9 million N95 masks and 157.5 million surgical masks, some of which were being produced inside Canada.
But health workers from several provinces have made public requests for more. Officials from Quebec, which has been hit hardest by COVID-19, said the province may run out of PPE within three to seven days.
PPE is the equipment worn to minimize a person’s risk of exposure — in this case, face shields, fluid-repellent medical gowns, N95 masks, goggles and latex gloves that will protect health-care workers from patients who may be ill.
The Canadian government describes PPE on its website as the “last line of defence” when a “hazard” cannot be removed or properly contained.
During Trudeau’s announcement, he said incoming shipments are expected to be distributed within the coming days and weeks, but he was unable to get more specific than that.
“We are going to be receiving shipment very soon of necessary equipment, and there are more to come in the coming days and weeks as well,” he said.
But chief public health officer Dr. Theresa Tam said Wednesday that regardless of the country’s actions, it is looking at a surge that could test the capacity of its health-care system.
“Fundamentally, in the end, some very difficult decisions may have to made about the prioritization of existing resources.”
As confirmed cases of COVID-19 continue to increase, health-care workers, too, have expressed concerns about shortages they are already seeing on the front lines and the havoc those shortages could wreak upon the country.
Doris Grinspun, CEO of the Registered Nurses’ Association of Ontario, told Global News in a previous interview that front-line health-care workers need those shipments of PPE “right now.”
More than 174,000 people have also signed a petition calling on Trudeau to engage in a “war-like effort” to arm front-line health-care workers with PPE or repurpose factories to manufacture the sought-after items.
Melissa Yuan-Innes, an emergency physician who helped organize the petition, told Global News that having access to PPE like N95 surgical masks or fluid-repellent gowns was a matter of survival.
“Having protective equipment is essential in this war against COVID-19,” she said. “You can’t have doctors, nurses, respiratory therapists, orderlies, any cleaning staff — you can’t have us going out there and us getting sick and dying because it means there’s no one left to take care of you.”
On the front lines, Yuan-Innes has been witness to what she described as “hospital rationing.”
“There are some politicians who are saying there is no shortage. But I can tell you that for those of us on the ground, we see a shortage,” said Yuan-Innes.
Right now, she said doctors across Canada are being told to limit themselves to wearing two masks a day, saving most of them for aerosol procedures, which can involve inserting a breathing tube, performing CPR and clearing mucus.
Things have become so dire, Yuan-Innes said, that she has asked staff to refrain from throwing away their used face shields and soiled N95 masks — just in case.
“They say PPE is coming, but it hasn’t arrived yet… As far as I’m concerned, don’t throw it in the garbage because you may need that.”
If front-line health workers are compromised or forced to choose between keeping themselves or their patients healthy, Yuan-Innes said Canada’s health-care system will fall apart.
“If you protect us, we can protect you. But if you don’t protect us, we can’t protect you,” she said.
Whether or not the country is in real danger of facing a shortage is unclear.
The federal government has been treading carefully between telling Canadians it is stocked with enough PPE for everyone and telling citizens they have to be careful with their supply, raising questions about the country’s current inventory.
The Canadian Pharmacists Association (CPhA) said it has noticed a lack of communication from the government.
Some pharmacies have been taking matters into their own hands to protect their front-line workers, the CPhA said, installing plexiglass shields or switching to predominantly phone and delivery service.
Barry Power, CPhA senior director of digital content, said there was a “huge” number of pharmacists at risk without proper PPE, despite pharmacies being deemed by the government as an essential service.
Power said the CPhA put in multiple requests for more protective equipment but has seen little response from Canada about if and when they will be receiving supplies.
“We’re constantly told that we’re an essential service, but we’re not being given personal protective equipment, such as masks and products we need to make sure that our staff and pharmacies stay healthy,” he said.
“Pharmacists and pharmacy staff are facing a lot of the same things that pretty much anybody else who works in an environment where they’re exposed to the public is facing. The difference is that they’re going to be expected to continue to go to work when everybody else is told to stay home.”
The national emergency strategic stockpile referenced by the federal government is located in undisclosed warehouses, which the government said it has “strategically” placed across the country.
The Public Health Agency of Canada said on its website that it has a supply of masks, gloves and disposable gowns that provinces and territories can access during times of crisis.
According to PHAC, supplies can usually be delivered within 24 hours of a province or territory’s request, but several provinces that have requested more supplies have yet to receive them.
Not much else about the stockpile — like how many items of personal protective equipment it has or how often the stockpile gets replenished — is known.
In order to produce PPE at a faster rate, the federal government has encouraged the production of the equipment domestically.
Last week, Canada launched its national plan to mobilize industry to fight COVID-19. Since then, Trudeau said over 3,000 companies have offered their expertise to help manufacture and distribute PPE that could help front-line health-care workers in Canada.
One of those companies, Toronto-based Canada Emergency Medical Manufacturers (CEMM), said it has begun mobilizing a collective effort for furniture and apparel manufacturers to produce medical gowns.
The demand for this item of equipment, company president Esther Vlessing said, is “astronomical.”
“What would normally take years to become an expert in, they’ve asked us to do it in days, and we need to rise to the challenge,” she said.
To do this, CEMM put together a consortium of 12 manufacturers — most of whom she said were shut down after they were deemed non-essential services by the Canadian government.
Vlessing said the company, which also works at helping manufacturers repurpose their tools to make PPE, will bring jobs back to an industry that has taken a hit due to COVID-19.
The company has the capacity to make thousands of medical gowns to protect front-line health-care workers, she said, and the company is working towards partnering with more manufacturers to be able to increase production levels and expand to other provinces.
Early on, Vlessing said she noticed many manufacturers wanted to start flipping and retooling their factories to make PPE but weren’t sure how — which is where her company came in.
“If you have a bakery that is perfectly equipped to make cupcakes but the government needs to make bread, you have the ingredients, you have the machinery and you have the skill, but you need the recipe,” she said.
According to Vlessing, Canada has “the infrastructure, the machinery, the skilled labour and the people” willing to step up to the plate in order to fulfil the demand for more PPE.
“We would be at a loss if we were to send our doctors and nurses to hospital… without the right protective gear — that being the medical gowns and the masks,” she said.
“This is not ‘business as usual.’ We will all benefit when we come together as a community and we use all of our resources available.”
— With files from Global News’ Emanuela Campanella and Andrew Russell