Scrapping five-day COVID isolation guideline “bad news” for workers: advocates

Ontario’s chief medical officer of health Dr. Kieran Moore announced on Wednesday, Aug. 31 that those who contract COVID-19 no longer have to isolate for five days and can return to work 24 hours after they begin to feel better.

A positive COVID-19 rapid test also doesn’t mean you have to isolate, as long as you have no symptoms.

The announcement caught many by surprise given colder months are just weeks away and children head back to school – both occurrences that are known to exacerbate the spread of respiratory viruses.

Deena Ladd, executive director of the Workers Action Centre, says without a mandatory masking policy and now removal of the isolation period, many low-income workers or those who are precariously employed are left with no workplace protections.

“I think the announcement is really bad news for Ontario workers,” she tells CityNews. “At least the five day mandatory isolation period gives you the opportunity to be able to say to your boss, ‘I have to stay home. I have to take care of myself,’ … and it gives you a bit of a buffer against the pressure to return to work while you’re sick. So that’s going to be completely removed now.”

Ladd says without that buffer, many workers who have no choice but to return to work or risk losing one day’s pay – or their jobs entirely – will go back before they fully recover.

Concerns are also being raised about the impact on the children of these workers.

“Removing this isolation period really places parents in the awful position of now having to choose between caring for their child who may be sick and putting food on the table by going to work,” says Dr. Shazeen Suleman, a pediatrician and member of the Decent Work and Health Network (DWHN).

“I like to remind people that children are often the folks who bear the brunt of these decisions that we make for adults because children can’t work. They are dependent on someone else to put food on the table, to put a roof over their heads. They are dependent on their caregivers. And that’s why, when we’re talking about the health or any decision that affects their caregivers, there is a trickle down amplified effect on their children.”

Calls for permanent sick days for all workers

Suleman says workers find themselves between a rock and hard place in these cases and that is why advocacy groups like DWHN have been calling on the province to implement paid sick days for all workers in Ontario.

“We have been repeatedly calling on the government to legislate 10 permanent paid sick days. We know that this is an evidence-based policy that protects workers, that protects children, it protects families,” she says. “We need the province to listen to us and heed the science because we know that without the presence of adequate accessible paid sick days we are going to miss opportunities to keep our children healthier, keep our economy healthier, keep our workers healthier.”

Ladd reiterates that workers are in an untenable situation and she calls the current provincial policy granting three paid sick days over a period of two years “ridiculous.”

“No employer seems to really know about [the three-day policy]. And we know most workers may have used those three days for vaccinations … or workers don’t even feel comfortable saying to their employer, ‘hey, you know that you can get a subsidy from the government if I take a paid sick day?'” she says.

Ladd adds that based on the learnings over the pandemic, public health policy should reflect the realities workers are facing and help them protect themselves and others they come in contact with.

“If the woman that I get my groceries from at the grocery store is at work sick because they can’t take time off, that’s going to impact me as a customer. So if we are looking at public health policy, especially during this moment in the pandemic, why isn’t Dr. Moore actually saying to premier Ford, ‘you need to implement 10 permanent paid sick days.’ That has to be a vital public health initiative, especially if we’re going to scrap five days of isolation,” she says.

Increased pressure on the healthcare system

Suleman fears that as children return to school, the scrapping of a mandatory isolation policy could have a domino effect that will impact the already overburdened healthcare system.

“Many children are also at increased risk of severe illness from several respiratory conditions, but especially COVID. Now we’re placing these children at additional risk by removing this isolation period and removing any protection for their parents to stay home with them while they’re sick,” she says. “We also see then, families who can’t take their child to a caregiver’s appointment while their child is sick because they’re working. And that means they often go to the emergency department after hours. [We’re all] familiar with the state of our healthcare system right now and the incredible volumes and burden that the emergency department is facing.”

Ladd also points out that without the backing of a provincial mandate to isolate for five days while infected with COVID, many workers will likely be forced to get doctor’s notes to prove they need to stay home.

“Again, we know that doctors are overburdened right now, it’s hard to see your doctor. Then you have to pay for a sick note,” she says.

Pre-pandemic, she says workers often went to emergency rooms to get sick notes, but currently that is an impractical thing to do given the state of emergency rooms in the province.

“The healthcare system right now is in crisis and emergency rooms (ERs) are closing down … we don’t want people infected positively with COVID-19 going into medical buildings or hospitals, trying to get sick notes so that they can stay home and not get fired from their jobs,” she says.

Will the new policy lead to increased virus spread?

When it comes to fears of a marked increase in the spread of COVID-19, infectious disease physician Dr. Isaac Bogoch says the new policy will likely not make a marked difference to the already soaring levels of transmission in the community.

“The previous policy was that if you’re positive for COVID, you stay home for five days and you should be wearing a mask for a 10 day period of time. The new policy is you stay home until you feel better, plus 24 hours, and you need to wear a mask for 10 days,” he explains. “With both approaches, you can have people who are still testing positive, who are still transmissible to others, leaving isolation when they feel better and potentially exposing others.”

He says many are ignoring the masking portion of the policy and it is vital that people wear a mask for the recommended number of days, at the very minimum, if they choose to leave isolation while infectious.

“I know there’s a lot of outrage about this, but I think if we just take a step back and look at what was happening before and what’s happening now, I think the key message to me is number one, wear that mask for 10 days, that will help protect those around you. Two, we’ve got rapid tests – use them. And if you’re positive, acknowledge that you’re still very likely to be transmissible to others, especially in that day five to day 10 window … it’s not perfect, but it’s a helpful tool. So it can help guide behavior to ensure that we protect those around us and we can prevent people from getting infected.”

Bogoch also reiterates that the current conversations about the new policy highlight the importance of paid sick leave.

“We just don’t want people to go to work and infect others. We don’t want people to feel pressured where they have to go back to work because they have to put food on the table and pay the rent. There have to be supports in place so that they can stay home while they’re ill,” he says.