New Directive #5 Rules October 6, 2020
“Directive 5” is the government’s rules about COVID-19 and Personal Protective Equipment
(“PPE”) for healthcare staff that hospitals and long-term care homes must follow.
OCHU/CUPE, SEIU and Unifor recently sued the government to force them to increase the
protections for workers. To resolve this court action, the government agreed to make changes
to Directive 5. These changes mean that hospitals and long-term care homes will have to give
workers clearer access to better protections when they are dealing with patients or residents
who may have COVID-19. These are the rules under the new Directive 5:
Workers at hospitals and long-term care homes who are
interacting with suspected or confirmed COVID patents/
residents always have to be given, at a minimum, the following
PPE regardless of distance from the patient/resident:
• Surgical/procedure masks;
• Face shields or goggles;
• Appropriate isolation gowns.
In long-term care homes, workers have to wear surgical masks
at all times during a shift, except when on a break or when they
are not in contact with residents.
New Directive #5 Rules
Workers also have the right to an N-95 respirator in three situations:
1. When the workplace is in an “outbreak” and you are within 2 metres of a
When a hospital or a long-term care home has an outbreak of COVID-19, workers who may come
within two metres (or six and a half feet) of a known or suspected COVID-19 patient/resident
have a right to an N-95 respirator.
You have to ask your employer for an N-95 respirator, but they must give it to you. Ask for an
N-95 mask any time you are doing work and cannot be sure that you will be able to stay more
than two metres away from a COVID-19 patient or resident.
Whether or not your workplace is in an “outbreak” of COVID-19 is decided by the local medical
officer of health, not your employer.
For hospitals, an outbreak is usually when two people contract COVID-19 while at the hospital
within two weeks of each other.
For long-term care homes, an outbreak is usually when one staff person or resident has a
positive COVID-19 test. This may change to 2 cases in the near future.
2. When a regulated health professional (e.g. an RPN) decides an
N-95 is needed
Every time a doctor, RN, RPN or other regulated healthcare professional interacts with a known
or suspected COVID patient or resident, they have to conduct a point of care risk assessment or
PCRA to decide if they need to wear an N-95 respirator.
If a regulated healthcare professional decides that an N-95 respirator is required when
interacting with a COVID-19 patient, then the hospital or long-term care home has to give
an N-95 respirator to that worker and every other worker who is present for that patient
interaction and this cannot be denied by the employer.
3. When certain kinds of medical procedures are done on a COVID patient
All workers in any room where an “Aerosol Generating Medical Procedure” (also called an
AGMP) is being done or is probable to be done on a COVID-19 patient must wear an N-95
You also have to wear an N-95 respirator if you are in a room where AGMPs are frequently
done, even if they are not doing an AGMP at the time you are in the room.
There are many different kinds of AGMPs. If you are in a room when an AGMP is being done, you
should be told that this is happening. You can always ask if an AGMP is being performed if you
are not sure.
Ford Long term care inquiry long overdo
To Read the article please follow the link below.
Unifor celebrates personal support workers (PSWs) in Ontario, and Continuing Care Assistants (CCAs) in Nova Scotia on May 19, Personal Support Worker Day.
Across Canada these workers provide the highest quality patient-centred care every day in our communities, our homes, and in long-term care homes and hospitals.
“PSWs and CCAs are incredible caregivers who make sure our loved ones are healthy and safe,” said Jerry Dias, Unifor National President. “This pandemic has further exposed the unjust working conditions these workers face every day due to insufficient government investment and continuous cost cutting. These workers deserve better as they continue to serve our most vulnerable despite being overworked and undervalued by governments and employers.”
In the years prior to the COVID-19 pandemic, Unifor has raised the alarm on the crisis in long-term care where many PSWs and CCAs work. The pandemic has shed more light on the sector’s deteriorating working conditions. PSWs and CCAs have faced increasing workloads and have often work short-staffed due in part to the sector’s unfair practices and below inflation wage increases.
For many years, Unifor has specifically called on the Ontario government to address the issues facing PSWs. The union has long advocated for a regulatory minimum of four hours per patient as the standard of care in long-term care homes.
“The pandemic must serve as a wake-up call to Doug Ford that ignoring the risks PSWs face are extreme the crisis in long-term care can no longer be tolerated,” said Naureen Rizvi, Unifor Ontario Regional Director. “The health of Ontarians relies on the government immediately developing a holistic strategy that attracts more PSWs back to the industry, regulates minimum hours of care and increases wages beyond the pandemic pay premium. These workers have shown their value time and time again. Now Doug Ford must show them the respect that they deserve.”
In Nova Scotia, Unifor joined with five other unions to advocate for better protection for CCAs, including providing the proper Personal Protective Equipment (PPE) to all health care workers.
“COVID-19 has revealed what Unifor has been saying for years about long-term care being under-funded and under-supported by government,” said Linda MacNeil, Unifor Atlantic Regional Director. “Despite the Nova Scotia government having commissioned an Expert Panel on Long-Term Care, to which Unifor contributed recommendations, and the findings of that panel in early 2019 have not been corrected due to the lack of urgency by McNeil’s government. Workers continue to be over-worked and underpaid, recruitment and retention issues persist.”
Dias calls it an embarrassment that provincial governments have not acted on pleas from long-term care workers, their unions, employers and other advocacy groups.
Personal Support Workers and Continuing Care Assistants are vital members of the patient care team. Their hard work and professionalism is critical to and appreciated by residents and clients. The union will continue to call on governments and employers to provide adequate personal protective equipment, maintain sufficient staffing levels and give fair compensation for long-term care workers during and beyond the COVID-19 pandemic.
Unifor calls on employers to raise the bar for all food, pharmacy and other essential retail workers by making pandemic wage premiums permanent.
For Canada’s retail workers, a wage increase is long overdue—workers across Canada deserve better than low wages and precarious work.
Sign this petition [unifor.org] to help raise the bar for everyone by encouraging CEOs and senior executives at Canada’s largest retailers to make COVID-19 wage premiums permanent.
Workers essential to the functioning of our country report living paycheque to paycheque, struggling to cover rent or food costs, and being unable to get ahead in order to reduce debt, start a family, or become a home-owner.
Hazard pay for workers during the pandemic is the minimum that employers can do during these unprecedented times. Employers must commit to permanently improving the living conditions of workers.
Unions and labour activists have been calling for a living wage and better work protections for Canadians for decades.
It’s time for employers to take bold steps toward a living wage for all.
Share the petition (www.unifor.org/fairpayforever [unifor.org]) on your social media to help spread the word.
Videos from the frontlines: what we've learned from unifor covid heroes
Unifor members working the frontlines of the COVID-19 crisis have been sharing videos that have inspired us, made us cry, and taught us what really matters as we all struggle with this unfolding pandemic. Click on the image below to view their stories.
Resources for Support During the Covid-19 Outbreak
- CMHA- Mental Health & Addiction Crisis
648 Huron Street
- Ontario Medical Association
MD Led Virtual Chats: The OMA Physician Health Program invites you to drop in virtually between noon and 1 p.m. each weekday to support one another during the COVID-19 pandemic. The sessions will be led by Dr. Kasra Khorasani, a psychiatrist at Mount Sinai Health Systems and St. Joseph’s Health Centre in Toronto.
Meeting Daily from 12:00 p.m. – 1:00 p.m. (EDT)
http://php.oma.org/virtual-chats/ – Meeting ID and phone Number updated on link
- Canada Suicide Prevention Service (CSPS) by Crisis Services Canada
Enables callers anywhere in Canada to access crisis support by phone, in French or English: toll-free 1-833-456-4566 Available 24/7
- Finding Services
For people between the ages of 17-25, for post-secondary students in Ontario and provides professional counseling and information and referrals for mental health, addictions and well-being. This is free, confidential and anonymous helpline, Open 24 hours a day, 7 days a week. Call: 1-866-925-5454
Meant for all ages and provides information about counselling services and supports in your community. Listens, offers support and provide strategies to help you meet your goals. Provides basic education about mental illness Call: 1-866-531-2600
- CMHA REACH OUT Crisis Hotline- 519-433-2203 (24/7)
Walk In’s welcome at 648 Huron St (24/7).
- ARK AID STREET MISSION
Providing evening meal and some take home meals when available.
If you or someone you care about are feeling overwhelmed with emotions like sadness, depression, or anxiety, or feel like you want to harm yourself or others call:
- Visit the disaster distress Helpline or call 1-800-985-5990 and TTY 1-800-846-8517.
- Text TalkWithUs to 66746
- Visit the National Domestic Violence Hotline or call 1-800-799-7233 and TTY 1-800-787-3224.
Directive #3 for Long-Term Care Homes under the Long-Term Care Homes Act, 2007
Issued under Section 77.7 of the Health Protection and Promotion Act (HPPA), R.S.O. 1990, c. H.7
WHEREAS under section 77.7(1) of the HPPA, if the Chief Medical Officer of Health (CMOH) is of the opinion that there exists or there may exist an immediate risk to the health of persons anywhere in Ontario, he or she may issue a directive to any health care provider or health care entity respecting precautions and procedures to be followed to protect the
health of persons anywhere in Ontario;
AND WHEREAS pursuant to O. Reg 68/20 made under the Retirement Homes Act, as part of the prescribed infection prevention and control program, all reasonable steps are required to be taken in a retirement home, to follow any directive pertaining to COVID-19 that is issued to long-term care homes under section 77.7 of the HPPA;
AND HAVING REGARD TO the emerging evidence about the ways this virus transmits between people as well as the potential severity of illness it causes in addition to the declaration by the World Health Organization (WHO) on March 11, 2020 that COVID-19 is a pandemic virus and the spread of COVID-19 in Ontario, and the technical guidance provided on March 12, 2020 by Public Health Ontario on scientific recommendations by the WHO regarding infection prevention and control measures for COVID-19;
AND HAVING REGARD TO the declaration by the Premier of Ontario and Cabinet of an emergency in Ontario under the Emergency Management and Civil Protection Act on March 17th, 2020 due to the outbreak of COVID-19 in Ontario;
AND HAVING REGARD TO residents in long-term care homes and retirement homes being older, more frail, and more medically complex than the general population, and therefore being more susceptible to infection from COVID-19;
I AM THEREFORE OF THE OPINION that there exists or may exist an immediate risk to the health of persons anywhere in Ontario from COVID-19;
AND DIRECT pursuant to the provisions of section 77.7 of the HPPA that:
COVID-19 #3 for Long-Term Care Homes under the the Long-Term Care Homes Act
Date of Issuance: March 22, 2020
Effective Date of Implementation: March 22, 2020
Issued To: Long-Term Care Homes under the Long-Term Care Homes Act, 2007 referenced in section 77.7(6), paragraph 10 of the Health Protection and Promotion Act.
Coronaviruses (COVID-19) are a large family of viruses that cause illness ranging from the common cold to more severe diseases such as Middle East Respiratory Syndrome (MERS-CoV), Severe Acute Respiratory Syndrome (SARS-CoV), and COVID-19. A novel coronavirus is a new strain that has not been previously identified in humans.
On December 31, 2019, the World Health Organization (WHO) was informed of cases of pneumonia of unknown etiology in Wuhan City, Hubei Province in China. A novel coronavirus (COVID-19) was identified as the causative agent by Chinese authorities on January 7, 2020.
On March 11, 2020 the WHO announced that COVID-19 is classified as a pandemic virus. This is the first pandemic caused by a coronavirus.
On March 17, 2020 the Premier and Cabinet declared an emergency in Ontario under the Emergency Management and Civil Protection Act due to the outbreak of COVID-19 in Ontario and Cabinet made emergency orders to implement my recommendations of March 16, 2020.
Symptoms of COVIDCOVID–1919
Symptoms range from mild – like the flu and other common respiratory infections – to severe, and can include:
• difficulty breathing
Complications from COVID-19 can include serious conditions, like pneumonia or kidney failure, and in some cases, death.
There are no specific treatments for coronaviruses, and there is no vaccine that protects against coronaviruses. Most people with common human coronavirus illnesses will recover on their own.
Required Precautions and Procedures
Long-term care homes should immediately implement the following precautions and procedures for residents:
• Residents of long-term care homes should not be permitted to leave the home for short-stay absences to visit family and friends. Instead, residents who wish to go outside of
the home should remain on the home’s property and maintain safe social distancing from any family and friends who visit them.
• Wherever possible, employers should work with employees to limit the number of different work locations that employees are working at, to minimize risk to patients of exposure to COVID-19.
In accordance with O. Reg 68/20 made under the Retirement Homes Act, retirement homes must take all reasonable steps to follow the required precautions and procedures outlined in this Directive.
Note: As this outbreak evolves, there will be continual review of emerging evidence to understand the most appropriate measures to take. This will continue to be done in collaboration with health system partners and technical experts from Public Health Ontario and with the health system.
Long-term care homes, retirement homes and HCWs may contact the ministry’s Health Care Provider Hotline at 1-866-212-2272 or by email at firstname.lastname@example.org with questions or concerns about this Directive.
Long-Term Care homes and HCWs are also required to comply with applicable provisions of the Occupational Health and Safety Act and its Regulations.
David C. Williams, MD, MHSc, FRCPC
Chief Medical Officer of Health
Ministry of Health
Office of Chief Medical Officer of Health, Public Health 393 University Avenue, 21st Floor Toronto ON M5G 2M2 Tel.: 416 212-3831 Fax: 416 325-8412
March 19, 2020
Re: Managing Health Worker Illness and Return to Work COVID-19
Ontarians rely on our health system everyday to stay healthy and sustain life – this is true now more then ever. As we continue to implement enhanced public health measures to mitigate the spread of COVID-19 in Ontario, it is vital that health services, and the workers who contribute to these areas, continue to provide care to the people of Ontario.
To protect the health system and its workers from COVID-19, we must balance public health measures and the need to control the spread of disease with appropriate flexibility to ensure that critical health services continue to operate.
I am therefore making the following recommendations to all parts of the health sector:
Travel and Return to Work
Where employees have travelled outside of Canada within the last 14 days and are seeking to return to work, it is important to balance the protection of the health system and the continued operation of these settings.
Consistent with my earlier recommendations, it is very important that all health system organizations and employers immediately cease all non-essential business travel outside of Canada until further notice and likewise discourage employee travel.
I am recommending that Health Care Workers who have travelled outside of Canada within the last 14 days self-isolate for a period of 14 days starting from their arrival in Ontario. Health Care Workers should not attend work if they are sick. If there are particular workers who are deemed critical, by all parties, to continued operations, I recommend that these workers undergo regular screening, use appropriate Personal Protective Equipment (PPE) for the 14 days and undertake active self-monitoring, including taking their temperature twice daily to monitor for fever, and immediately self-isolate if symptoms develop and self-identify to their occupational health and safety department.
Practice Social Distancing and Facilitate Virtual Arrangements
Everyone in Ontario should be practicing social distancing of 2 meters to reduce their exposure to other people. Employers should facilitate arrangements to ensure that this is practiced in the workplace to every extent possible.
While other services are decreasing their operations, in health care you are being called upon to care for patients and to be ready for surge. I am asking, where there may be an opportunity, for all health system employers to facilitate work arrangements that enable appropriate employees to work from home or to work virtually, if not re-deployable.
Health system employers should also consider a review of their services and practices to identify how they can provide services to patient groups virtually or remotely
Ongoing Screening, Self-Monitoring and Self-Isolation
The ministry has provided recommendations and tools to specific sectors for both active and passive screening – these are available on the ministry’s COVID-19 website. Each workplace should have a comprehensive strategy for screening and symptom monitoring where there are inpatients or residential or institutional settings and tailor their approach to screening to their unique setting. Screening activities should be focused on patients/residents, volunteers, visitors and staff, and should be done over the phone, upon arrival, at entrances and on a regular basis throughout the day. The goal of screening programs should be to ensure that no person with clinical symptoms consistent with COVID-19, whether they are visitors, caregivers or staff, enters the building – except where they are identified and being clinically assessed by an appropriate provider.
The symptoms of COVID-19 include fever, new cough and difficulty breathing, and these may occur within 14 days of an exposure to a case.
All health care providers and health care entity workplaces should monitor for signs of illness. Health system employees should diligently monitor themselves for signs of illness over the course of the pandemic and identify themselves to their manager and/or occupational health and safety departments if they feel unwell. If a health worker begins to feel unwell while at work, they should immediately don a surgical mask and notify their manager and/or occupational health and safety department. It is imperative that we keep hospitals, long-term care homes, health care offices and other health settings free of illness to protect vulnerable patients and residents and other workers in these settings.
Public Health Ontario has excellent fact sheets on how to self monitor and self isolate.
We appreciate the unique circumstances of health workers who may work in different care settings and may have different employers.
Health workers who work in multiple locations should identify themselves to their managers and develop an individualized plan to manage their employment across these settings over the course of the pandemic. In some high-risk settings, it may be possible to coordinate arrangements for staff to only work in one institution.
Continuity of Operations and Curtailing Non-Essential Services
All health sector organizations should have a Continuity of Operations plan to redeploy resources, whether human resources, equipment or space, to protect critical services. This may include cross training, cross credentialing or formal redeployment to different functions. As part of these plans, organizations should also have minimum thresholds of staffing in place to ensure that critical services continue to operate.
Employees with comorbidities should also identify themselves to their employers and consider ways to redeploy away from duties associated with COVID-19.
Return to Work after Illness
Health workers should consult their local public health unit and their manager/occupational health and safety department to plan their safe return to work.
Thank you for all of your support. This will be an important part of keeping our health system and its workers protected during this outbreak.
Original signed by
David Williams, MD, MHSc, FRCPS
Chief Medical Officer of Health
Caring in Crisis: Ontario's Long Term Care PSW Shortage
Report and Recommendations from the front lines across Ontario. Commissioned from the Ontario Health Coalition by Unifor.
better care. safer work.
Nursing homes should be a safe place to live.
In a perfect world, this would go without saying. But in Ontario today, the ratios of staff to residents is simply too high to provide safe care with dignity.
Please visit CareTakesTime website for more info. Click button below.
Stay Up to Date
Check out the latest edition of the Pulse! The Pulse provides national, provincial and regional information on the work of Unifor members in the health care sector. The newsletter is a compilation of articles and updates provided by local union leadership, provincial health care councils and Unifor national representatives on bargaining, health and safety, community activism and other sector-based issues.