On December 28, in a hotly anticipated press conference concerning the post-Christmas return to school, Dr. Robert Strang, Nova Scotia’s beloved and much-memed Chief Medical Officer of Health, explained that schools would return to in-person classes on January 10, but would no longer be part of Public Health’s contract tracing efforts. Furthermore, PCR testing — the gold standard for detection of COVID-19 virus — will only be available for certain groups of people, with teachers and students not on the list.
Social media was swiftly ablaze with comments decrying the chief medical officer of health’s decisions as having left us all behind, destroying the legacy that has set Nova Scotia apart during the pandemic — so significantly apart that our population grew to more than one million people this year, and our housing market is literally on fire.
But as a nurse working in the system — and a critical, political opponent of every ill-advised government announcement — I want to offer my support for this latest decision and explain why: We simply do not have enough human resources to keep going on as was.
Contact tracing is not a robotic endeavour. Public Health nurses staff the phone lines and map out the webs of social interactions between COVID-19 positive people, making connections and following up to ensure potentially exposed people are informed and isolating, and the public is safe. These nurses are human beings and there aren’t enough of them to keep up with numbers in the 500-plus cases/day range.
I work in reproductive health services, and during the pandemic I have seen the negative impact of Public Health being deployed almost exclusively to COVID-19 management. Pregnant people do not get education about childbirth and newborn care. Postpartum parents are not supported in community to succeed with breastfeeding and manage depression and anxiety. Access to sexually transmitted infection testing is limited. And so on.
It’s been hard and harmful. This latest wave is worse than ever.
PCR testing is not a robotic endeavour. Nurses do the testing, and skilled laboratory technicians run the analysis. Last spring, I pushed for a campaign of appreciation for said technicians — dubbed Loved Letters for Lab Workers — because I felt this contribution was relatively invisible and went inadequately appreciated. And now, in this fourth wave with Omicron, we don’t have enough human beings to test and analyze results for everyone. We don’t. We must prioritize.
As a nurse who cares for a typically very healthy population —pregnant people who choose abortion, or who deliver healthy babies — I am, for the first time in the pandemic, seeing many colleagues unable to come to work because they are either COVID-19 positive or a close contact, and required to isolate. That leaves the rest of us stressed, overworked, and anxious. So, it does not matter right now that Omicron is seemingly less severe in terms of hospitalizations. Hospital staff nurses are still overworked, and the system is seriously impacted.
At this point in the pandemic, we need the public to do their part. Yes, this is asking more of a public already stretched beyond what they can handle. But some of us are in a position to step up and step up we must. For over a year, volunteers have made Nova Scotia’s asymptomatic testing program possible. Volunteers continue to staff several rapid testing sites daily and assemble rapid antigen testing kits for people to administer at home. We need the public to do those tests when they are worried, and definitely when they are symptomatic. We need them to self-report results to Public Health. And we need them to do their best to contact trace on their own and ask those contacts to test themselves and hunker down for public safety.
Not everyone is able to do this easily. Disability rights advocates have pointed out that rapid tests do not have a meaningful display option for the partially sighted, and that the Halifax Convention Centre, the epicentre of rapid test distribution, sits on a steep hill that makes the whole building inaccessible for people with mobility restrictions. For lots of people, frankly, it isn’t easy to make the trek downtown. Rural people are not impressed with the Halifax-centricity of testing efforts. These criticisms need to be acknowledged and urgently addressed.
I wish more publicly funded workers were able to help out right now, but they aren’t. We need to train way more nurses and health care workers, and retain them, which is a complicated and essential endeavour. That is a medium-term goal. In the long term, this province needs to reverse the economic inequity that divides people who have managed the pandemic easily from those who have not. In the short term, we need to come together to make the best of what we have got.
Test yourself. Test your neighbour. Test their kid. If you are in a high-risk group, report positive results to Public Health. Talk to your contacts. Get every vaccine and booster on offer. Look out for each other. Let’s get through, so we can continue to work on the big picture, together.
Martha Paynter is a registered nurse working in reproductive health care in Nova Scotia. She is a PhD Candidate at the Dalhousie University School of Nursing, and the chair of Wellness Within: An Organization for Health and Justice.
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You say we should use the rapid test if we are worried or symptomatic. But how can we test when we can’t get test kits? I had to ‘borrow’ from a friend’s kit on Christmas Day, and now I have none. I have limited testing to special circumstances, such as a visit of relatives from Alberta. If I could get a kit of 5 tests, that would do me for many weeks. But I am worried right now, because I can’t get a kit. Advice?
Thank you Martha Paynter for your perspective. There is no shortcut outta this. It is a slog and none of us likes it. The more each of us picks up some of the load – the better for everyone else.
thank you, Martha and Bill!