November 12, 2020
This email contains information regarding a recent communique issued by the BC Ministry of Health on November 4, 2020 and subsequent clarification Provincial Health Officer (PHO) Dr. Bonnie Henry provided to the Health Profession Colleges dated November 11, 2020.
The November 4, 2020 Ministry communique pertains to mask use in health care facilities during the COVID-19 pandemic. It sets out policy, including that:
- All persons working in a long-term care facility or seniors assisted living residence must wear a medical mask at all times, including in common areas and break rooms unless eating and/or drinking;
- In other health care facilities and settings where health care is provided, all persons working in a clinical unit/setting/patient care area must wear a medical mask, including in common areas and break rooms unless eating and/or drinking and all persons working in non-clinical settings must follow guidance for mask use in accordance with their workplace COVID-19 Safety Plan(s) required by WorkSafe BC.
The policy further stipulates that all health care facilities must provide medical masks for all health care workers, nonclinical staff, patients and visitors where indicated in the policy. A medical mask is defined as “a medical grade face mask that meets ASTM International and ISO (or equivalent) performance requirements for bacterial filtration efficiency, particulate filtration efficiency, fluid resistance, pressure differential, flame spread, skin sensitivity and cytotoxic testing.”
If you work in a long-term care facility, a seniors assisted living residence, or another health care facility or setting where health care is provided, you are responsible for familiarizing yourself with the policy document. A link to the full policy may be found at: http://www.bccdc.ca/Health-Professionals-Site/Documents/Mask_Use_Health_Care_Facilities.pdf
The Health Professions Regulators sought clarification from Dr. Henry regarding the intended scope of this policy, and she responded that the policy does not apply to allied health practitioners in community settings. She referenced previously developed guidance provided by the Colleges for safe operations and plans by registrants, which included the use of non-medical masks and other infection and prevention control measures. She emphasized the importance of patient screening as the key to keeping operations safe for staff and clients/patients. In addition, she requested that Colleges encourage registrants in the Fraser Health and Vancouver Coastal Health regions where the majority of outbreaks are, to review, update and rigorously follow COVID-19 Safety Plans.
The College previously sent guidance pertaining to providing in-person community care during COVID-19 in an email on May 15, 2020. Registrants are reminded that the May 15, 2020 College document pertains to the delivery of care outside of hospitals, health authority settings, and long-term care facilities, such as private practice, school-based, and other community-based practices. It sets out guiding principles and assumptions, prioritization of client/patient care services, and ongoing best practices during the pandemic. As a reminder, best practices include maintaining physical distancing of at least two metres (six feet) and increased screening for signs, symptoms and risk factors for COVID-19. The May 15, 2020 document specified that registrants must:
- Adhere to all BC Centre for Disease Control (BCCDC) and BC Provincial Infection Control Network (PICNet) guidance regarding infection prevention and control measures applicable to the practice environment, including PPE use where required and environmental cleaning best practices to enable safe practice.
- Adhere to all BCCDC and WorkSafeBC guidance regarding occupational health and safety exposure control plans to ensure a safe work environment for staff. This includes robust policies, procedures and organizational cultures that ensure no employees associated with the practice attend work when they have symptoms of illness.
- Registrants are reminded that if they are exhibiting signs of COVID-19 or respiratory illness, including cough, runny nose or fever, they must not provide in-person care and should not be in attendance at clinics or other practice settings where other staff and clients/patients are present.
- Follow BCCDC and WorkSafeBC guidelines for self-isolation when an employee is sick with any respiratory illness, support access to primary care provider assessment and testing, and provide sickleave support where possible until symptoms have resolved and it is safe to return to work.
- Implement COVID-19 screening practices for clients/patients:
- The BCCDC has on its website a self-assessment tool, developed with the BC Ministry of Health. The tool helps to determine whether a person may need further assessment for COVID-19 testing by a healthcare provider.
- Clients/patients can complete this assessment for themselves or the assessment can be completed by someone else on behalf of the client/patient.
- Registrants may wish to use this tool as a screening measure for clients/patients as well as themselves and clinic staff: https://bc.thrive.health/covid19/en
- Clients/patients should also be encouraged to make use of COVID-19 resources by calling 811 or visiting healthlinkbc.ca.
- If client/patient screening reveals risk factors for COVID-19, or symptoms of COVID-19, where reasonable, defer services until signs and symptoms have resolved.
- The College does not expect any registrant to provide services unless, in their professional opinion, it is safe to do so for both clients/patients and staff.
The May 15, 2020 College document also specified that use of PPE in the practice environment should follow the directives and recommendations provided by the BC Centre for Disease Control and WorkSafeBC. A link to the full document may be found at: https://collegeofpsychologists.bc.ca/docs/CPBC%20Guidance%20for%20Registrants.pdf
As the Ministry policy communique notes:
Personal Protective Equipment (PPE), including masks, are one part of the hierarchy of infection prevention and exposure control measures for communicable diseases. As such, PPE are supplemental to, and not replacements for other measures on the hierarchy. These other measures include, but are not limited to:
- population-level measures (crowd limits, closures, quarantine/isolation, contact tracing),
- environmental measures (physical distancing, physical barriers, cleaning and disinfection),
- administrative measures (changes in work practices, decreased density), and
- personal measures (staying home when sick, hand hygiene).
This hierarchy of infection prevention and exposure control measures applies regardless of practice setting. The College encourages all registrants to consider all appropriate measures, to maintain awareness of all directives and recommendations relevant for one’s practice setting, and to take all appropriate measures to safeguard your own health and that of your clients/patients.
Andrea M. Kowaz, R.Psych.