An Open Letter to Premier Doug Ford from the Ontario Nurses’ Association: Mandate Precautions for Airborne Transmission

January 25, 2021

Dear Premier Ford,

I am writing an open letter to you on behalf of 68,000 nurses and health-care professionals on the front lines of Ontario’s response to COVID-19.

On November 26, 2020, you were copied on a letter that I wrote to the Chief Medical Officer of Health (CMOH) urgently requesting that Ontario’s directives and guidance be revised to recognize precautions for airborne transmission of COVID-19. ONA advised Dr. Williams that aerosol transmission is now well-established by several public health agencies.

Premier, nurses and health-care professionals can wait no longer as they continue to become infected with COVID-19 at record rates. It is surprising that a developed jurisdiction like Ontario is experiencing such devastation. It is not inevitable but is preventable.

Nurses and health-care professionals expect urgent and decisive action – that you and the government immediately update your directives and guidance to mandate precautions for airborne transmission, including the use of N95 respirators for all nurses and health-care professionals who come into contact with any suspected or positive COVID-19 patients, residents or clients.

As you have been advised, the Public Health Agency of Canada (PHAC) recognized on November 4, 2020 that SARS-CoV-2 is transmitted by fine aerosols, as well as larger respiratory droplets. PHAC’s position was updated to be consistent with an earlier change made by The Center for Disease Control and Prevention (CDC) on October 5, 2020, which recognized that COVID-19 can be spread by airborne transmission, through exposure to virus in small droplets and particles that can linger in the air for minutes to hours. As well, the World Health Organization (WHO) has updated its guidance to include transmission via aerosols.

On January 4, 2021, 63 scientists, occupational health specialists, engineers, physicians and nurses from across Canada called on the Premiers and on public health officials from the federal, provincial and territorial governments, to recognize airborne transmission of COVID-19 and to act accordingly.

This is a significant shift and has implications for health-care worker protections, since only N95 respirators, at a minimum, or other superior respirators, are designed to protect the wearer against aerosol-transmitted diseases. Surgical masks do not protect against this mode of transmission.

As identified by the Ministry of Health and the Ministry of Long-Term Care, health human resources, including Registered Nurses, are critically needed to safely manage the predicted COVID surge. They must be safe and healthy to care for Ontarians ill with COVID. The government must face the realities of health-care workers and the perils they face. The pandemic began 10 months ago and despite persistent infection rates and consensus on aerosol transmission, the government has still failed to act.

Nurses and health-care professionals will remember this moment in time as pivotal. I urge you to meaningfully recognize the gravity that lives are at risk by taking immediate action to mandate airborne level of precautions for nurses and health-care professionals.

Vicki McKenna, RN, President
Ontario Nurses’ Association