© Tara Walton for The Washington Post Renée Amyotte stands outside a medical building in Windsor, Ontario, before crossing the border to work a shift at Hutzel Women’s Hospital at Detroit Medical Center.

TORONTO — It takes Renée Amyotte just 15 minutes to get from her home in Windsor, Ontario, to her job at the Detroit Medical Center’s Hutzel Women’s Hospital.

The 24-year-old nurse works 12-hour shifts in the hospital’s neonatal intensive care unit, looking after infants whose mothers have tested positive for the coronavirus in a city hit hard by the pandemic.

Amyotte is one of some 1,600 Ontario nurses who cross the border to work in Detroit. Now, as Michigan suffers one of the worst outbreaks of the deadly virus in the United States, some Canadian officials are calling for curbs on their travel — a move that could devastate U.S. hospitals.

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More than 1,300 people have died of the coronavirus in Michigan — nearly twice as many as in all of Canada. Canadian officials say the country is in an early stage of its outbreak; in a best-case scenario, they say, as many as 22,000 people could die.

© Tara Walton for The Washington Post The Detroit skyline viewed from the Riverfront Trail in Windsor.

Wajid Ahmed, the top medical officer in Windsor-Essex County, Ontario, is one of the loudest voices calling for more stringent border restrictions. As of April 9, he said health-care workers made up 88 of the 262 confirmed cases in the county. Forty of those workers traveled to Michigan.

Ahmed said Canada should consider halving the number of medical personnel working across the border, or requiring them to stay in Detroit during the pandemic. He and other local officials have raised the issue with their counterparts in the provincial and federal governments.

“When you’re fighting a battle against covid-19, we need to use every measure to contain it,” Ahmed said. “It’s not a call to abandon our neighbors when they need us … The safety of my community is my number one responsibility and my number one concern.”

Justin Klamerus, president of Detroit’s Karmanos Cancer Institute, said restrictions on the travel of Canadian nurses would “cripple” the hospital. Roughly 1,200 employees, including a quarter of the nurses caring for bone marrow transplant patients, cross the border from Windsor. Others are doing “essential” work in clinical trials and CAR T-cell therapy for leukemia and lymphoma patients.

“We would like to think that borders don’t exist in health care,” Klamerus said.

Windsor Mayor Drew Dilkens said there’s been some “angst” in the city about the cross-border trips. He thinks the current measures suffice.

The United States and Canada agreed last month to close the 5,500-mile frontier to nonessential traffic. A laminated orange placard on Amyotte’s dashboard identifies her to border guards as an essential health-care worker.

© Tara Walton for The Washington Post A sign indicates the travel restrictions at the Detroit-Windsor Tunnel.

Dilkens was working at the Canadian Consulate in Detroit on Sept. 11, 2001, when the United States unilaterally closed its northern border. Even after it was reopened, he said, Canadian nurses trying to get to their jobs in Detroit were delayed for hours. Their absence was so worrying that hospital leaders in Detroit debated commandeering helicopters or ferries to get them to work. They eventually set up a bus system.

“If there are any further restrictions, what it ultimately means on the U.S. side is that people will die,” Dilkens said. “There’s no flowery way to say it.”

When 3M said this month that President Trump requested it not send N95 respirator masks to Canada, Prime Minister Justin Trudeau cited the Canadian doctors and nurses who work in Detroit as an example of the close supply chains between the two countries and why they shouldn’t be disrupted.

Zain Ismail, an administrative health-care worker, said he was recently greeted with a rolling banner reading “Thank you health care workers” while crossing the Ambassador Bridge to get to work in Detroit.

In addition to her job in Detroit, Amyotte also works as a continuing complex care nurse at Windsor’s Hôtel-Dieu Grace Healthcare, a post-acute-care facility. Some hospitals have asked Amyotte and other Canadian nurses to pick one institution during the pandemic.

David Musyj, president and chief executive of the Windsor Regional Hospital, said 57 of the hospital’s 4,000 employees work in facilities on both sides of the border. Thirty-five said they would stay with his hospital.

Musyj said the hospital was not trying to “[draw] the line” on these workers, but implemented the policy to quiet the “shortsighted” officials criticizing their cross-border travel.

He said it was improper to focus on the number of covid-positive cases among Canadian nurses who work in Detroit, an issue he called a “red herring.”

“To unilaterally stop Windsorites from working in health care in Detroit is not appropriate,” he said. “That will devastate a city and region at a time they can ill afford to lose health-care workers.”

The War Memorial Hospital in Sault Ste. Marie, Mich., lost five nurses after a hospital in Canada asked employees who work on both sides to pick one facility. David Jahn, the Michigan hospital’s president, said around 20 percent of its 150 nurses are Canadian.

A spokesman for Hôtel-Dieu Grace said its 16 workers who have jobs on both sides of the border were asked to choose one institution to help reduce the risk of asymptomatic spread.

© Tara Walton for The Washington Post Hôtel-Dieu Grace Healthcare in Windsor.

Amyotte is one of the 16. She and five others picked Michigan.

“It was a difficult decision,” she said. “Michigan’s being hit harder than Windsor … and it just seemed like the right thing to do to go help them out as much as possible in such a great time of need.”

The Detroit hospital also offered a full-time position, while Hôtel-Dieu Grace could promise only full-time hours. Spokesman Bill Marra said the six employees who chose Detroit were given leaves of absence and guarantees they can return.

Sarnia, Ontario, Mayor Mike Bradley asked a hospital to consider similar measures. He said that a small number of hospital employees work on both sides and that most chose to stay in Canada.



Bradley’s town sits across a narrow stretch of river from Port Huron, Mich., and is Canada’s second-busiest truck crossing. The U.S. response to the pandemic worries him.

“When you see in parts of the United States that they’re allowing large church services or they’re not respecting physical distancing, that concerns us,” he said.

Jim Diodati, mayor of Niagara Falls, Ontario, said he would support making his city’s health-care workers pick one institution or even banning their cross-border travel entirely.

“We don’t want to stop helping, but we need to be cautious,” he said.

© Tara Walton for The Washington Post The Ambassador Bridge spans the Detroit River between Windsor and Detroit.

Mark Sullivan, president and chief executive of Catholic Health in Buffalo, said the system employs up to 80 health-care workers who live in Canada. He’s offering all employees free hotel rooms.

Amyotte changes out of her scrubs at the door of the Windsor house where she lives with her family. On her day off, she tries to stay in her bedroom to avoid potentially infecting them. On a recent drive home, she said, Canadian border agents applauded health-care workers — a “sweet” moment.

As a young girl, she loved to “play nurse,” rushing to get Band-Aids when someone was hurt. She has watched with concern as she and other cross-border nurses have found themselves thrust into the middle of a political debate.

Klamerus said some Canadian nurses feel they’ve been stigmatized for working in Detroit. Amyotte said she’s witnessed backlash on social media.

“It is a little bit frustrating and it is sad to see your own community turning on health-care workers,” she said.

“My patients know no borders and I know no borders. Everybody deserves care.”

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