Space is being cleared in at least one long-term care home in St. John's to make way for a dedicated COVID-19 unit, while front-line staff await word on when more of them will be receiving vaccinations, says the union representing the province's nurses.
Some residents at Pleasantview Towers have been moved in an effort to prepare for long-term care residents who may develop symptoms of the virus and require a dedicated unit for care, says Yvette Coffey, president of the Registered Nurses' Union of Newfoundland and Labrador.
"They did this last year. There were no admissions to that unit. However, they've still got to be prepared and have staff ready in case needed," Coffey said.
"Hopefully we will not need to open that unit to patients, but we have to be prepared. We do not want to be caught like Ontario and Quebec when it comes to our vulnerable population."
Our members are tired. They're stressed. They've been on the front lines now for over a year, and there's no end in sight yet. - Yvette Coffey
Prior to the outbreak of coronavirus variant B117 earlier this month, centred mainly in the metro St. John's region, the COVID-19 pandemic was generally under control, Coffey said. But with hundreds of cases and, as of Saturday, 10 people in hospital — six in intensive care — Coffey said being prepared for a possible influx of residents requiring extra care is essential.
"We've all watched across the country and we all know that if COVID gets into our long-term care facilities, it's going to be very challenging for us, so, you know, they're doing what they can to ensure safety and continuity of care for our patients and residents," Coffey said.
That could include redistributing where nurses are assigned to work, Coffey said.
In an email Saturday, Eastern Health told CBC News the unit at Pleasantview Towers will have 28 beds, with some residents being temporarily relocated to Chancellor Park to create space for the unit.
The health authority said the plans were made in consultation with residents and their families and there is no timeline right now for the residents' return.
Eastern Health staff are working to prepare the unit at Pleasantview Towers and a date for the opening of the unit will be confirmed "in the near future."
Each individual long-term care facility also has its own plan for how to isolate residents, if necessary, the health authority said.
At the start of the pandemic last year RNUNL and other health sector unions signed a "good neighbour agreement" with the province and the four regional health authorities that would allow them to move staff around as needed.
There were already regulations under the registered nurses' collective agreement that allows them to be reassigned to where the health authority feels they're most needed, Coffey said, but the good neighbour agreement expands on it.
One of the places where Coffey said members are being deployed is to long-term care.
"Staffing levels have reached a point in some areas that we can't provide the services without deploying nurses there, and one of those areas is long-term care, and … critical care as well," Coffey said.
"In order to provide services, what the regional health authorities have first done is ask for volunteers … with the skill set and experience in the areas that they need to deploy to. If there are no volunteers, they have looked at the people who have previous experience in those areas, and that's who they are redeploying first."
Eastern Health CEO David Diamond said the health authority had been short staffed in long-term care even before the pandemic, and staffing has been an ongoing challenge.
Vaccines only 1 part of protection
One of the concerns about reassigning staff is where things stand with COVID-19 vaccine rollout for front-line workers.
Phase 1 of Newfoundland and Labrador's vaccination plan identified vulnerable populations, including long-term care residents and Indigenous communities, as well as front-line workers who would be the most likely to be exposed.
The province released its plans for Phases 2 and 3 of vaccine rollout Friday afternoon, identifying who will be able to sign up, and when they're expected to get vaccinated. But those timelines will rely on supply of the vaccine, while also prioritizing people 70 years and older in the pre-registration plans.
Front-line health care workers not immunized in Phase 1 will be covered under Phase 2, with inoculations happening some time between April and June.
That could mean some of the registered nurses now being assigned to work in COVID-19 units like the one being established in Pleasantview Towers may not be vaccinated yet, Coffey said.
However, vaccines is only one part of protection for registered nurses, Coffey said.
"The vaccine keeps our workforce from being sick, but it doesn't prevent transmission of the virus. Our registered nurses have to use their judgment and wear the appropriate PPE — that is their best line of defence with COVID-19."
The reason vaccines haven't been distributed more widely, Coffey said, is simple: "We don't have vaccine."
Vaccine supply has been a challenge across Canada, and since the supply is distributed to the provinces from the federal government, that means there isn't any vaccine to be administered.
Coffey said she was told as of Thursday that it's expected everyone identified in Phase 1 of the vaccine rollout in this province would have received their inoculations by March 5.
"We have pushed that those who are being reassigned, especially to COVID units and long-term care or all areas that were identified in the Phase 1 group, that they be vaccinated prior to going to those areas," Coffey said.
Judy O'Keefe, Eastern Health's vice-president of clinical services, said priority has been given to any staff member who would work in the ICU, emergency, case rooms and COVID-19 units, as well as community-based high-risk staff.
"The last couple of weeks, for sure, our greatest concern has been the seniors' population in congregate living," O'Keefe said Friday afternoon.
"We've been vaccinating people as we have vaccine."
O'Keefe said Eastern Health thinks that all staff identified in that Phase 1 category should be fully vaccinated with their second doses by the end of March.
As the pandemic drags on, Coffey said, union members are feeling the strain, and ask that members of the public do their best to adhere to health guidelines.
"Our members are tired. They're stressed. They've been on the front lines now for over a year, and there's no end in sight yet," Coffey said.
"We do ask the public, we plead with the public, to please follow public health guidelines, because the less people we have coming into our hospitals and acute care, the less pressure there is on the system."