Saskatchewan workplaces must mandate vaccinations to fight the delta variant

This Opinion piece was written by Dr. Alexander Wong,an infectious disease physician in Regina, andDr. Sean Tucker, an associate professor of occupational health and safety in the faculty of business administration at the University of Regina.

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It is time for organizations with employees in essential public-facing roles health-care workers, long-term care workers, teachers, and others such as daycare staff and correctional workers to adopt mandatory vaccination policies.

Given the safety of vaccines and their effectiveness against the delta variant, the legal responsibility employers have to protect workers and the need to protect vulnerable groups of unvaccinated people (children under 12, persons who cannot be vaccinated for medical or religious reasons), mandatory vaccination just makes sense.

SARS-CoV-2 has changed significantly since Saskatchewan implemented significant public health restrictions in March 2020. Our understanding of the virus has also matured.

The delta variant now circulating across our province is 55 per cent more transmissible than the alpha variant that caused a surge of cases and deaths this spring, and twice as transmissible as the ancestral strain of COVID-19 we faced in 2020.

Delta is now causing a dramatic surge of cases in the southern United States, where vaccine uptake has been low. Case rates and hospitalizations in children aged zero to 17 in the United States are at their highest point of the pandemic, reflecting a dramatic increase in the number of children infected with delta.

In July, 18.4 per cent of all COVID-19 cases in Saskatchewan occurred in children under age 12. Though the vast majority of children recover uneventfully from COVID-19, a small number require hospitalization and intensive care support. The long-term complications of COVID-19 infection (Long COVID) in children remain unclear.

On July 11, the Saskatchewan government rescinded all public health measures related to COVID-19. Premier Scott Moe said the province would no longer look to control COVID-19 through government intervention or restrictions, but instead would rely on vaccinations.

This means the responsibility of mitigating the spread of the virus now falls to individuals and, critically, public and private sector organizations.

Employers, unions and employees have learned much from previous waves of the pandemic: the importance of working remotely, ventilation, the use of masks and other personal protective equipment, physical distancing, testing and self-isolating (with access to sick pay) when symptomatic or in close contact with someone who has tested positive.

Events in long-term care settings in Saskatchewan and across Canada have reinforced the consequences of inadequate measures.

Being fully vaccinated provides significant protection against symptomatic COVID-19 infection even with the delta variant and nearly eliminates the risk of severe illness, hospitalization and death. Saskatchewan's vaccine uptake is currently second lowest among provinces in Canada, behind only Alberta. Vaccines remain unavailable for children under 12, a situation that will not likely change until at least sometime this winter.

Unions and workers are justifiably concerned about employers mandating invasive measures such as vaccines. There are legitimate concerns about privacy implications. The related case law is varied.

However, given the existing case law and best available science, we believe a clear case exists to mandate COVID-19 vaccination as a bona fide occupational requirement for health-care workers, long-term care workers, teachers and other essential public-facing workers such as daycare staff and correctional workers.

The starting point for this work must be consultations with unions and discussions about accommodations for workers who have medical, religious or other justifiable reasons why they cannot be vaccinated. Wherever possible, accommodations must be provided.

For workers who are not fully vaccinated, regular rapid antigen testing would be of benefit. While antigen testing is not as sensitive as molecular testing for COVID-19 infection, it is another means to mitigate the spread of COVID-19.

Mandated rapid testing for unvaccinated persons would follow the lead of University Health Network in Toronto and the province of Quebec, both of whom require frequent testing for unvaccinated health-care workers.

Mandatory testing does raise questions regarding employee privacy and would require consultation with unions. Such a strategy would require universal access to rapid testing, along with education about its effectiveness and limitations.

Delta poses a significant threat to workers who are not fully vaccinated, the vulnerable populations they interact with and the public at large. Mandating vaccination for essential public-facing occupations will protect both workers and the public. This, combined with proven protective strategies (e.g., masking, self-isolation, enhanced ventilation) and pragmatic approaches such as requiring proof of vaccination to participate in non-essential activities where transmission risk of COVID-19 is significant, will mitigate the spread of the virus and help keep Saskatchewan citizens and their families safe.

The pandemic has devastated vulnerable populations and upended normal life for all. The evolution of the virus to the current delta variant, with its extraordinary transmissibility, means society must counter with similarly extraordinary measures.

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