BURNABY—In Part Two of our feature on CUPE Community Health workers and COVID-19, our members from the Health Science Professionals Bargaining Association and Community Health Bargaining Association reflect on the personal challenges they have faced as workers since the pandemic began, what has inspired them during this period, and what lessons can be learned for health care delivery in the future. Here’s what they told us:

Name and CUPE Local: Nadia White, CUPE 15
Position: Environmental Health Officer (EHO), Level II – Health Protection
Employer: Vancouver Coastal Health
Job entails: Enforcing sections of the BC Public Health Act and regulations/guidelines pertaining to public facilities, including inspections of food premises, personal service establishments, and publicly run facilities to ensure compliance with provincial public health standards.

One of the biggest challenges has been the STEEP learning curve. Although the COVID work I am doing is public health, it is vastly different from my day-to-day duties. I went from having to focus on my own work and progress to leading a team of six members. Teams, systems and workflows are being created quickly and are ever-changing, all while trying to keep up with the spread and characteristics of the virus. Although not frontline workers dealing with COVID cases, we are working extremely hard behind the scenes to prevent the spread and relieve the burden on our healthcare system. Testing and tracing the spread of this virus is going to be our best defense until a vaccine is made and I’m truly proud of all of my coworkers doing this work.

Despite some unsavoury behaviour during these times, many people are trying to do their part in preventing the spread. I have seen stores and banks be diligent with the physical distancing of customers and provide sanitizer. Groups have formed on social media to help those in need in their communities, from accessing food to finding toilet paper. At work we’ve had a few organizations support us by donating meals, and of course the discounts that companies are providing. The biggest support I feel is the 7 p.m. cheer for healthcare workers: it’s quite emotional, looking out the office window and seeing restaurant workers banging their pots, people clapping on the street, and a convoy of first responders flashing their lights and blaring their sirens. It’s a reminder that, although the days are long and tiring, we are doing great work and doing right by the public. COVID has provided an opportunity to see the strengths and weaknesses of healthcare delivery. Although we’ve had other outbreaks such as SARS and H1N1, none have been this paramount. Nor could we have predicted how it was going to manifest. This is not the time to find fault or blame but to learn and grow from the experience.

Name and CUPE Local: Dawn Moon, CUPE 1978
Position: Dental Hygienist
Employer: Vancouver Island Health
Job entails: Working in the community to support the oral health needs of adults with developmental disabilities.

The biggest challenge has been the constant changing of directives for when PPE is worn, the lack of information around mitigating the risks when providing oral care, and the unknown of what dentistry will look like in the future. Since the transmission route is from the mouth, the caregiver and client are both at high risk. My role includes developing protocols on how to provide safe oral care. Currently, there are no guidelines that state what PPE is required and what disinfecting is needed after oral care to ensure that any droplets or aerosols produced do not put others at risk. Many caregivers have questions I am unable to answer around how to protect themselves when they do not have enough PPE or the correct PPE for the task.

I have seen the dedication of caregivers to provide a safe home for these clients during the pandemic. One group home supervisor told me that all the caregivers avoid interacting with other people outside of their family so they can reduce the risk of transmission to the clients when they come to work; they only have one person go to the grocery store from the group home, and that person only goes once a week. Seeing people put other’s needs ahead of their own is inspiring. The pandemic has highlighted that privatized long-term care puts people at risk, as it is run by for-profit companies who are motivated to cut corners to save money. There is not enough oversight to ensure that these service providers follow proper standards of care. This may have contributed to outbreaks in these communities during the pandemic. The pandemic has also showcased the role of allied health professionals in the health care system. I am so proud of my fellow CUPE members that are integral to the fight against COVID-19.

Name and CUPE Local: karina czyzewski, CUPE 15
Position: Social worker and Concurrent Disorders Counsellor
Employer: Vancouver Coast Health, Downtown & Pender Community Health Centres
Job entails: Working through a primary care clinic in the Mental Health and Substance Use unit, navigating systems and identifying resources available to clients, and using one-on-one sessions to provide advocacy, support recovery and healing, and facilitate access to needed services.

First, I found it really hard to work remotely…I thought it would be easier, but I find it exhausting for my mental health not to be sitting right across from someone. (And remote counselling is only accessible to people who have phones, which is not the case for many of our people.) Also, PPE medicalizes my job more than I am comfortable with. More recently, I was redeployed into a more acute-care situation at Vancouver Detox Centre, so I had to put all of my work on hold for two weeks. It was largely discharge planning, which is different from what I do. I’ve also had to put on hold things like community-based research that involves patient engagement, where clients receive income for advising us on how to make changes to ensure more equity-oriented care approaches. So that’s been really hard. Finally, people are really big on conspiracy theories down here, so there’s been a lot of people coming up to me when I’m wearing my mask, or coming to the clinic, and accusing us of making stuff up or overdramatizing, or they’re blaming the Chinese. So that’s been very hard to take as well.

The first time I heard people cheering at seven was literally right outside one of the clinics I work at, in Gastown. People were walking past Pender clinic and clapping or driving by and blowing their horns. It made me tearful and was super helpful to my morale. We’ve had so many moms of colleagues sew us masks, or headbands with little buttons, so we don’t hurt our ears with the PPE. That was really sweet. Some of the buildings have been able to provide honoraria to their residents to disinfect doorknobs and handles, so it’s been kind of cool to see people get into doing that and be compensated for it. It’s also been good to see the Health Authority be willing to show flexibility in prescribing, allowing people to isolate and follow the protocol when they have a substance use issue. One of the sweetest things I heard was when a client’s mom told me, ‘Thank you for working.’ It was unnecessary, but sweet and comforting.

We struggled with having clarity in our workflow before COVID, and I don’t think that’s been made easier with COVID. Clarity with the public health messaging, for example. My colleagues and I have been frustrated when we go outside and see people just hanging out. It would also help to have some clarity around the benefits process. Unfortunately, benefits are not actually accessible to people who are on disability or anyone who already receives provincial or federal money. Now it means that people in the community who do get that money could be audited and have to pay it back. So the process and criteria need to be clearer. And unfortunately that creates a health crisis in itself, because people who receive lump sums can end up OD’ing. One other thing is that all of us have pushed up our hand-cleaning and disinfecting skills in ways that weren’t happening before. And I think COVID has also raised the bar in terms of people’s understanding of food security in the Downtown Eastside.

Name and Local: Andy Healey, CUPE 1004
Position: Dayshift Coordinator/Mental Health Worker
Employer: Portland Hotel Society
Job entails: Providing homes to the homeless, supporting people through meals and programs such as gardening and artistic activities, and advocating for residents’ health care, helping to connect them with clinics and other services.

The number one, biggest challenge has been staffing. We need extra bodies to help out with the required sanitizing and support, particularly with the Home Support aspect of the job, but we’re constantly short staffed. Many employees left on medical leave at the beginning of the pandemic and they haven’t been adequately replaced.  As for inspiration: even though many of our residents may not grasp the importance of physical distancing and the other behavioural changes that we need to be making, they’re really coming together as a community and looking out for each other. Our building has always felt a sense of community, but I feel like these days there’s a bit extra there. [But] frontline workers have been undervalued for far too long. We need faster access to supplies and services.

Name and Local: Allison Bell, CUPE 15
Position: Program Assistant
Employer: Vancouver Coastal Health
Job entails: Working with a team of nurses and clerical assistants on a school-based immunization program, as well as running twice-weekly clinics for youth and other clinics for adults and youth.

The biggest challenge is keeping up with the ever-changing rules and procedures for staying safe during the pandemic. The second challenge is navigating non-health workers’ opinions and reliance on misinformation about how I should be living and working during the pandemic. The most inspiring stories are of those people who are making the best of the situation while still keeping everyone safe. I applaud seniors’ residences that have found a way for their residents to visit family while social distancing. I cheer for all those friends and families who have thought outside the box and organized neighbourhood dinners and tailgate meetups while still social distancing. What we’ve learned is that we can no longer assume someone is healthy and not infectious just because they show no symptoms of illness. From this we could see a complete change in how public health is delivered. We could see public health services only be provided with Personal Protective Equipment being donned by health care providers.

Name and Local: Lindsay Fumalle, CUPE 1978
Position: Social Work Case Manager
Employer: Vancouver Island Health
Job entails: Developing guidelines, practice standards, workflows, forms, and education curriculum as part of the Community Resource Team with Home Care Strategy, and delivering education to support roughly 1,200 Community Health Services Clinicians and Management across Vancouver Island. 

The biggest challenge has been the constant changing of directives and needing to be on top of creating resources that are relevant to the clinicians that use our documents and processes. My team is the practice resource support, so we also get constant e-mail and phone requests for clarification of information. As a team, we have a huge sense of responsibility to be able to answer questions and create resources quickly so that clinicians can provide quality care to clients. Another big challenge is working from home. I have spent the past seven weeks working on the computer from my kitchen table [with] two elementary-age children at home. Trying to juggle their needs while working from home has its difficult moments. Then you add in that their teachers set up mandatory virtual meetings for them during the day, while I am attending meetings of my own. I have never had to multitask to this extreme before.

It has been refreshing to see how understanding most people are. I have been teaching education sessions where people could actually see my kids running around behind me, or I’ve been on a call with my manager and she can hear them asking for more snacks and it’s been okay. For the most part, everyone understands that we don’t always have the answers right away, that we are doing our best to get things out as quickly as we can. On a personal side, I love seeing how people are connecting. And there is an increasing sense of not taking the people in your life for granted, of really appreciating them and what they mean to you. I hope this continues once the restrictions are lifted. The pandemic has brought the issues of private, for-profit healthcare to light: tax dollars going to companies that are cutting corners and not providing adequate care for our seniors, just so they can increase profits…It has also bought to light what unions such as CUPE have been fighting so hard to get and protect. Things such as safe work environments for all workers and paid sick time.

Name and Local: Sandy Bains, CUPE 15
Job Title: Pediatric Speech-Language Pathologist
Work Place: Public Health – South Community Health Centre
Job entails: Working with families of children aged 0-5 to provide assessment, consultation, and therapy addressing a wide range of speech-language needs. (These include vocabulary development, improving understanding and response to directions and questions, as well as improving sentence length, understanding and use of appropriate grammatical structures, speech sound production, speech fluency, and social communication skills.) 

The biggest challenge is being in a constant state of uncertainty. When the pandemic began, my team was directed that we would be redeployed to help support Public Health response to COVID-19. When my team’s redeployment was placed on hold, it was difficult to plan my week knowing that the possibility of redeployment was imminent. Working during the pandemic has forced me to take things day by day and set achievable daily goals for myself. Having so many people from the community participate in the seven-p.m. cheer, leave hearts and rainbows in their windows, and write messages on the sidewalk for healthcare workers, has been so inspiring. As for what we’ve learned: telepractice/virtual health can be a good option for some families, especially in reducing the barriers of accessing services (e.g. a long commute for family to attend an in-person session) or in reducing clinician travel time for outreach visits.

Name and Local: Toby Rader, CUPE 3403-01
Job Title: Homeless Outreach Social Worker
Work Place: Canadian Mental Health Association (Port Alberni Branch)
Job entails: Providing services, funded by BC Housing, to people experiencing homelessness or are at risk of homelessness.

The biggest challenge has been limiting my face-to-face contact with people, and the lack of services available to the marginalized population, whom I service the most. The one inspiring thing I have seen the most is the community of homeless and marginalized people helping each other out with places to sleep inside, sharing food and showers. We had nearly 30 people sleeping outside before COVID, and now there are fewer than 15 people. This is due to the community around the people sleeping rough bringing them inside. What we can learn is that [COVID-19] is often not just affecting the people who have jobs or are middle class or upper class. Our marginalized are affected to a great extent. While they are not at a higher risk of contracting COVID, they are often left with limited access to health care services during normal times. With COVID-19, the limited and often over-stretched health care services are even more siloed and full of barriers for those who live on the margins and are vulnerable already.

BURNABY—CUPE members in the Health Science Professionals Bargaining Association and Community Health Bargaining Association have faced numerous challenges since the COVID-19 crisis began. Like all front-line health care workers responding to the planet’s worst pandemic in a century, they’ve had to be alert in anticipating new problems, adjusting to new information, and staying on top of a constantly shifting regulatory environment.

Before emergency measures were relaxed, CUPE Communications asked members from across the union’s community health sector to share their experiences on the impact that Phase One of COVID-19 had on their working lives. We’re sharing their thoughts in a two-part feature.

For Part One, we asked them: Before the pandemic, what did the average workday look like for you, and what differences has COVID-19 made to your workplace?

Name and CUPE Local: Nadia White, CUPE 15
Position: Environmental Health Officer (EHO), Level II – Health Protection
Employer: Vancouver Coastal Health
Job entails: Enforcing sections of the BC Public Health Act and regulations/guidelines pertaining to public facilities, including inspections of food premises, personal service establishments, and publicly run facilities to ensure compliance with provincial public health standards.

An average workday begins with following up on voicemail and e-mail messages by, for example, operators requesting an opening inspection or someone filing a complaint. Also checking which facilities are due for a routine inspection based on a risk rating and completing an inspection history review to see what actions had been taken in the past. I then show up at a facility, unannounced, to complete the inspection. Although inspecting to confirm compliance with the Provincial regulations, I also provide a great deal of education and resources to my operators, to assist them in doing so in successfully.

COVID has changed the scope of work and my department immensely, due to imminent need for staff to assist with outbreaks.  My coworkers and I have been assigned to several pods, of which we are closely working alongside medical health officers, physician consultants and public health nurses from different sites in Vancouver. We are actively managing facility outbreaks with those in charge at the facilities and also managing community acquired cases. We are contacting lab-confirmed COVID-positive cases and tracing their close contacts to place them all on isolation. We conduct daily symptom monitoring calls for cases and contacts on isolation to ensure successful recovery. We also have a team visiting facilities to assist in implementing infection control measures and a team completing environmental swab tests to determine where the virus may be hiding on surfaces. My workdays have changed from Monday to Friday to Tuesday to Saturday and often long hours are being put in by many of us.

Name and CUPE Local: Dawn Moon, CUPE 1978
Position: Dental Hygienist
Employer: Vancouver Island Health
Job entails: Working in the community to support the oral health needs of adults with developmental disabilities.

Before the pandemic, an average workday would include visiting clients in group homes to assess their oral health, creating plans to address their dental needs, and teaching caregivers how to provide safe and effective oral care. I would also spend time liaising with dental offices, troubleshooting issues with caregivers, and consulting with other health care professionals. Since the pandemic, I have reduced the number of visits to my clients, as they are at high risk, and have focused on creating protocols to reduce the risk of transmission during oral care. I am educating caregivers around prevention of dental disease, as the pandemic has created more barriers for my clients to get treatment for oral infections. COVID-19 has serious implications for anyone needing dental care, as dental offices are an extremely high-risk environment. Dental professionals are only seeing people for emergencies and have strict protocols around what procedures can be performed, what PPE must be worn, and how rooms are disinfected after treatment. Any clients that are in pain may not be able to have their dental needs addressed. There is an overwhelming feeling of helplessness as I am unable to provide a solution to their dental issue and know it will only get worse as time passes.

Name and CUPE Local: karina czyzewski, CUPE 15
Position: Social worker and Concurrent Disorders Counsellor
Employer: Vancouver Coast Health, Downtown & Pender Community Health Centres
Job entails: Working through a primary care clinic in the Mental Health and Substance Use unit, navigating systems and identifying resources available to clients, and using one-on-one sessions to provide advocacy, support recovery and healing, and facilitate access to needed services.

Before COVID I had a specific drop-in day, and it would be pretty hopping—with lots of people showing up for that. I also led a women’s night, when we opened our clinic only to women, trans and non-binary people, so a lot of work went into planning that and providing services during it. There was also lots of outreach, and a fair number of one-to-one appointments. For those first few weeks of the pandemic, no one was dropping in. People just weren’t accessing our services, coming to the hospital or going to the clinic—which of course was following the isolation message, but a lot of our people are not well so they needed to be coming in or we needed to find them. We’ve had to cancel all of our groups and programs, which is pretty devastating because we have a lot of people who already isolate in general. It’s important to get them to come to groups so they can feel more connection, which is good for their mental health, and we haven’t been able to do that. I deal with a lot of vulnerable people. Because we’re a community health centre in the downtown east side, people have used the space as a drop-in centre. They could hang around, and we could serve them oatmeal. But now we can’t do that anymore, and we have to screen everyone at the door. It was also awkward in the beginning, when they talked about “essential workers”, to hear about which of our colleagues were deemed “essential,” because we’re all essential.

Name and Local: Andy Healey, CUPE 1004
Position: Dayshift Coordinator/Mental Health Worker
Employer: Portland Hotel Society
Job entails: Providing homes to the homeless, supporting people through meals and programs such as gardening and artistic activities, and advocating for residents’ health care, helping to connect them with clinics and other services.

Working in a Temporary Modular Housing program, I assist clients with employment programs, or with things like making it to court dates or keeping appointments with probation officers or social workers. My job is to run all aspects of the building: this includes cleaning, light maintenance and monitoring the front door to prevent unwanted guests from entering, and monitoring the Overdose Prevention Site/Injection Room at the same time. If there are overdoses in or around the building, I attend and perform CPR and administer Naloxone if required. My main job is to make personal connections with the residents and be there for them as they go through life. The big difference since COVID is that we’ve temporarily restricted visitors to the building. Residents generally agree that this is necessary, but it’s been a bit of a challenge at times. There’s more of a need for general cleaning and more focused sanitizing, although our current staffing crisis is making this extremely difficult and stressful. We have more PPE on the job now, particularly masks. We try to establish physical distancing protocols with residents, but it’s very difficult and, in fact, nearly impossible. We have residents with all kinds of physical disabilities who require varying degrees of assistance and sometimes you can’t offer this help from two metres away.

Name and Local: Allison Bell, CUPE 15
Position: Program Assistant
Employer: Vancouver Coastal Health
Job entails: Working with a team of nurses and clerical assistants on a school-based immunization program, as well as running twice-weekly clinics for youth and other clinics for adults and youth.

Immunizing kids is about 70 per cent of what we do. We enter immunization history and school enrollment information into our computer system for each kid attending school in our geographical area. Then we organize clinics at the schools and send out vaccination consents to all applicable parents. At the Youth Clinic, we offer drop-in appointments for young people aged 13 – 24 for sexual health issues. The other clinics at the health unit we offer for adults who are immune compromised and for kids who are unable to attend clinics at their school. With schools out, almost all of the services we offer are on hold. We have had to cancel all of our school immunization clinics and most of our health unit immunization clinics for healthy individuals. Our Youth Clinic services have been consolidated to another health unit, and most of the appointments are being done virtually, or over the phone, instead of in person.  We have continued to offer vaccinations to higher risk individuals (children aged 0 – 2 or immune-compromised individuals such as transplant patients). Our data entry of information has nearly stopped, as most information is attained through the schools. Anyone coming to the health unit for immunization is screened with questions to determine general health. Parents are also being required to attend appointments with only one parent per child, and to only arrive on time—when at all possible—to help with social distancing inside the building.

Name and Local: Lindsay Fumalle, CUPE 1978
Position: Social Work Case Manager
Employer: Vancouver Island Health
Job entails: Developing guidelines, practice standards, workflows, forms, and education curriculum as part of the Community Resource Team with Home Care Strategy, and delivering education to support roughly 1,200 Community Health Services Clinicians and Management across Vancouver Island. 

My typical day is spent on the computer and in teleconference meetings with others on the 14-member team, developing all the resources for Community Health Services. Since the pandemic started, we have been directed to create practice resources, update intranet sites and create and deliver education at a pace we have never seen before. We learned about a new virtual care platform, created the clinician education plan and curriculum, created the resources and quick reference guides, and started the education sessions all within four days. The speed with which the information changes and is updated is so fast that as soon as our team publishes something on the intranet we are working on updating the information again. I am regularly a part-time employee. I have picked up so many workload shifts that I am working full time to help my team get the work done. The pressure to create and deliver resources in a timely manner is huge.

Name and Local: Sandy Bains, CUPE 15
Job Title: Pediatric Speech-Language Pathologist
Work Place: Public Health – South Community Health Centre
Job entails: Working with families of children aged 0-5 to provide assessment, consultation, and therapy addressing a wide range of speech-language needs. (These include vocabulary development, improving understanding and response to directions and questions, as well as improving sentence length, understanding and use of appropriate grammatical structures, speech sound production, speech fluency, and social communication skills.)

An average work day consisted of several face-to-face appointments with clients and their family and the Behaviour Intervention team at the clinic or offsite (client’s home, childcare setting) and/or group therapy sessions, as well as care coordination with public health nurses and community partners, as needed. Since the COVID-19 pandemic began, my team has not been able to offer face-to-face assessment, consultation, or therapy appointments, or to hold meetings face-to-face. My team has quickly adapted to the use of virtual health tools (such as Zoom) and is now providing speech-language services through telepractice. Navigating the world of teletherapy has been a huge learning curve for me. I have learned how to create and adapt therapy materials to be used in teletherapy sessions. The technology side of things has definitely had its challenges, but overall, it has been an interesting and exciting experience.

Name and Local: Toby Rader, CUPE 3403-01
Job Title: Homeless Outreach Social Worker
Work Place: Canadian Mental Health Association (Port Alberni Branch)
Job entails: Providing services, funded by BC Housing, to people experiencing homelessness or are at risk of homelessness.

There is no real average day for me: things change by the minute in this job. COVID-19 has increased the need in the community from all factions. Service providers who have shut down need support, general community members need support, and the marginalized need support. Access to food resources was our first priority, followed by access to health care services for the marginalized. My agency ramped up service rather than cutting back when COVID-19 hit, so my work became even more busy and changing all the time.