One in seven Ontario residents who have tested positive for COVID-19 are health-care workers, a rate that is steadily rising, provincial data reveals.

That puts Ontario at one of the highest rates of health-care worker infection worldwide. As of Tuesday, almost 14 per cent (2,144) of Ontario’s 15,381 confirmed cases are nurses, personal support workers, doctors and other health-care workers.

“We don’t have enough personal protective equipment,” says Michael Hurley, first vice-president of the Canadian Union of Public Employees in Ontario, which represents registered practical nurses, personal support workers, hospital cleaners and other health-care workers.

He said the growing number of health-care workers infected is a sign that there are not enough N95 masks and proper gowns in the workplace, and that infection protocols in some areas are lagging, particularly as some scientific studies are suggesting that in some circumstances the virus could be airborne.

“The SARS Commission taught us to err on the side of caution,” said Hurley, referring to Justice Archie Campbell’s report on the outbreak in the early 2000s.

A provincial spokesperson said Ontario is working hard to provide proper equipment.

Meanwhile, although there is a major push the world over to celebrate the efforts of front-line health-care workers, data collection and release related to infected workers does not match that push.

In the early days of the virus spreading in Canada, there was no breakdown on the type of job an infected person held.

The first positive tests of health-care workers were confirmed by health officials the third week of March. Toronto Public Health told the Star that 13 health-care workers tested positive as of March 21. Neither the city nor the province was making that information available at the time.

Ontario began releasing data on infected health-care workers several weeks ago as part of a daily epidemiological chart. They show, for example, that from Monday’s report to Tuesday’s report, 128 more health-care workers in Ontario had tested positive, a 6.3 per cent increase in one day. Health ministry spokesperson Hayley Chazan told the Star the ministry’s data does not break down how many are nurses, doctors or other categories. At the start of April, as a comparison, one in 10 positive tests were health-care workers.

Other jurisdictions have been providing information on the rate of health-care worker infections only occasionally, or in response to media queries.

Alberta officials reported this week that 427 health-care workers have tested positive (9 per cent of the province’s 4,696 cases). Quebec, which has 25,757 confirmed cases, recently announced at a press conference that 4,000 health-care workers have tested positive, which indicates that 15.5 per cent of their positive tests have been health-care workers, just higher than Ontario.

Information from British Columbia, another hard-hit province, was not immediately available.

Internationally, Ontario’s almost 14 per cent infection rate (13.94 per cent) for health-care workers as a proportion of positive cases appears much higher than China, which is reporting 3.8 per cent, and the United States where recent reports put the country’s overall health-care worker infection rate at 3 per cent.

The caveat with all of these numbers is twofold. First, they rely at least in some part on choices made regarding who will be tested. Related to that, they do not factor in the unknown number of people who likely have the virus (no matter what their line of work is) but have not been tested due to the scarcity of tests. Also, at one point during the outbreak, the last week in March, public health officials in Ontario and across Canada began focusing testing resources on health-care workers because of a scarcity of tests.

The U.S. Centers for Disease Control and Prevention published a study recently on infected health-care workers in the U.S., stating that while some states (the study did not say which ones) reported infection rates for health-care workers as high as 11 per cent of total cases, the national rate was 3 per cent. That study’s data was current to April 9.

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Given the high number of people infected in the U.S. (more than one million at most recent count) even the CDC is skeptical of the 3 per cent number, stating in its report “this is likely an underestimation.”

In a recent data release by the European Centre for Disease Prevention and Control, the agency reported that health-care worker infections in Italy make up 10 per cent of cases overall, though that rises to 20 per cent in the hardest-hit regions. Spain reported a 20 per cent rate.

Health-care worker infection rates for other countries were not immediately available.

Public health leaders have cautioned that an infected health-care worker is not necessarily indicative of a person contracting the virus in a health-care setting.

“The fact that a health-care worker is infected with COVID does not tell us where they got that infection,” Dr. Deena Hinshaw, Alberta’s chief medical officer of health said in her Tuesday briefing. She said it is possible that a health-care worker contracted the virus on a trip before the provincial shutdown, or “at a social gathering or had a household contact who was a case of COVID.”

CUPE’s Hurley said he has a growing concern that Ontario is basing many of its decisions on a belief that COVID-19 is “principally transmitted through contact and droplets except in aerosolizing procedures (such as intubation of a sick patient).”

While most health authorities say the virus is spread by droplet transmission when a person is in close contact and there is a cough or a sneeze, Hurley points out that there are some new studies suggesting the virus could be airborne in certain circumstances, or that the virus could linger on the floor where medical staff put on and take off protective equipment. Other studies show that the virus has been detected on the shoes of health-care workers.

Hurley said Ontario “watered down the safety protocols” by not insisting that everyone wear N95 masks. Some of his members have only been given surgical masks, which provide less protection.

“Science catches up,” said Hurley, referring to new studies and information not available at the start of the outbreak.

Chazan, the Ontario health ministry spokesperson, said the province “continues to ensure that patients and frontline health-care workers have the critical equipment and supplies they need to protect themselves during the COVID-19 outbreak. More than 13 million surgical and procedural masks, 200,000 N95 respirator masks, and 38 ventilators have been delivered to Ontario’s pandemic stockpile warehouses,” she said in a statement sent to the Star.

“Over the last few weeks, shipments of 6.5 million surgical and procedural masks as well as shipments of all types of PPE were made to over 650 providers across the province to protect our frontline workers, patients and residents,” Chazan said.