B.C.’s top doctor repeated her call for people to stay vigilant and not let their guard down when asked about allegations that not all staff at Royal Inland Hospital had been wearing masks in the weeks before a deadly COVID-19 outbreak.

Dr. Bonnie Henry says people are human and they tend to slip up every now and again.

“We have provincial protocols about when masks should be work, how they should be worn, what should be done for infection prevention and control in every health care facility, in every long term care home,” she said during her COVID update on Monday.

“We minimize the number of people in the room, we set up the waiting areas so that there aren’t people right next to each other, that masks are available, that hand hygiene is available.”

Henry says it is why there are layers of protection so that people don’t only rely on things like mask wearing to prevent large scale outbreaks of COVID-19. As of Wednesday, the outbreak at Royal Inland Hospital had grown to 66 cases – 43 of those in staff members – with one death reported over the weekend.

In a statement, Interior Health says masks are mandatory for all staff but for patients it depend on their circumstances – for example young children, people who are pregnant, unconscious, or have extreme agoraphobia or asphyxia phobia.

“All patients must wear a medical mask when entering and moving around a health care facility, including patient/client transport, except when requested to remove their mask by a health care professional,” the policy states.

“Patients will generally not be required to wear a Medical Mask in the private patient/client Environment. Health care professionals can request that a patient don a mask when the health care professional is in the room, however, attention should be paid to ensuring this does not compromise care or put the patient in danger.”

Kamloops woman says not all nurses routinely wore masks

The allegations first came about after Marilyn Hawrys told NL News she went to RIH the morning of Dec. 24 for severe vertigo. She was there for a week for tests and was released on Dec. 31.

Speaking on the NL Noon Report, Hawrys says she got a positive COVID test result on Jan. 6 adding that while in hospital only two of six nurses caring for her routinely used masks.

“I was in a room that had three other beds and through that time that I was there, there was a total of six different patients that came and left, as well as some family members and out of all those people none of us wore masks,” she said.

Hawrys says she had contact with four people between when she got out of hospital and when she got her COVID test result. One of those people is still battling COVID-19 after they tested positive for the virus. The other three – including her doctor and family members – had to miss school and work to self isolate.

“I wish I had been a little bit more conscientious during my time there and asking for masks but I just let my guard down,” Hawrys added. “I felt that you know I’m here in this unusual environment with health professionals that are taking all the precautions required.”

Hawrys’ allegations were echoed by a few other patients who shared her sentiments, though other patients told NL News that all of the nurses they came in contact with were wearing the appropriate PPE at all times.

When asked about the concerns, the Chief Medical Health Officer for Interior Health says they’re trying to ensure that staff follow all of the COVID-19 protocols that are in place.

“If it doesn’t happen, we do have processes in place as well – reminders – and we want to make sure we support staff as well,” said Dr. Albert de Villiers. “In general, I think our staff have been really good and have been following the guidelines.”

“We try to find the source of the outbreak but most times though we cannot find a specific source. Because COVID is out in the community, we’re not sure whether a patient got it first or whether a staff member got it first. We try to not point fingers and we try and just deal with the outbreaks as they happen.”

Calling the outbreak a ‘wake-up call’, Dr. Henry says there have been many instances where health officials have seen COVID-19 spread if there is a momentary lapse in judgement.

“It may be when we’re inadvertently letting things slip, when we’re in the lunchroom with the people that we work with every day,” she said, noting she is not able to directly monitor all outbreaks in the province.

“All of those things are the things that we pay attention to once we start detecting cases, once we see how far its spread and we need to reinforce those infection control measures.”

de Villiers statements were corroborated by Dr. Elizabeth Parfitt, a clinical infectious diseases specialist at Royal Inland Hospital.

“Yes there may be stories of someone not doing everything right but my eyes inside these walls have seen the majority doing the right thing,” she said on twitter. “It’s not just humans being human, it’s hospital structure and the nature of the work of health care. It is a vulnerable environment.”

“Hospital staff can’t always distance, certainly not from their patients who often require very close contact for their care. Please, as per usual, resist the urge to shame, blame. Right now our staff need support and encouragement.”

The outbreak is still contained to surgical unit 6 South and the RIH’s designated COVID ward – 6 North.

“All of the staff working in those units are trained in appropriate precautions and personal protective equipment as they have been working in that COVID unit for months,” said Kamloops Medical Health Officer, Dr. Carol Fenton.

“All the other precautions are being taken throughout the hospital as well, so it is still safe to go to emergency or to an appointment, if you need to.”

Fenton also noted staff at RIH have been stressed since the pandemic was declared.

“They have been working very hard under unprecedented conditions requiring them to wear PPE that is uncomfortable all day,” she said.

“They deserve and appreciate and need our community’s support right now.”

Nurses union reports shortage of PPE across B.C.

Meantime, the BC Nurses Union is suggesting a shortage of personal protective equipment (PPE) may have been a reason not everyone was masking up at RIH.

President Christine Sorensen says she is still hearing of PPE shortages from members across the province.

“N95 masks are not available in some cases. Nurses are supposed to be making point-of-care risk assessments and determining the PPE they need but when they ask for that PPE they don’t have it,” she said on the NL Noon Report.

“If masks were not available and nurses couldn’t wear them, that isn’t the responsibility of the nurse in the sense that the employer should be providing them and making them easily accessible.”

She says it’s concerning if the lack of equipment was a reason why masks weren’t being routinely used at Royal Inland Hospital.

“I implore all parties to look at why that was really occurring,” she said. “It is extremely unfortunate that there was not greater vigilance earlier, that nurses did work short, nurses were pressured to work if they were unwell, and that nurses didn’t have access to the personal protective equipment they needed to keep themselves and others safe.”

It’s not yet known if there was any PPE shortage at RIH in late December and early January.

Interior Health’s Vice President of Pandemic Response, Karen Bloemink, told media that even with 43 staff members affected, they are managing to cover off shifts for now.

“We’re paying close attention to that going forward and we do have plans in place to bring staff in place from other areas if the need arises,” she said today.

Dr. de Villiers meanwhile noted that health officials are not aware of any community spread in Kamloops as a result of this outbreak.

Further, he also said all new patients being admitted to Royal Inland Hospital will be tested for COVID-19 as an added layer of protection.

– With files from Brett Mineer