Canada: COVID-19 What Does This Mean for Your Dental Practice?

      Canada: COVID-19 What Does This Mean for Your Dental Practice?

      First and foremost, we hope you and your family are healthy and we want to let you know that we are very aware of the situation with COVID-19 and are staying informed as the situation continues to develop.

      Our primary concern is your health, the health of your staff and the health of your patients.

      We understand here at Stream Dental HR that you are facing some uncertain times ahead. With conflicting information and differing opinions, it can be difficult to know what course of action you should take in this time of ambiguity.

      Your regulatory dental bodies are likely highly recommending that you close your practices for the time being in order to follow social distancing policies and to maintain a safe and healthy workplace. As a health care practitioner, your duty of care may still extend forward to emergency procedures and it will be important that you follow your occupational health and safety best practices in order to keep your employees safe during this time.

      Below are recommendations for two scenarios, whether you choose to keep your practice open with skeleton operations, or if you close entirely.

      If you keep the practice open with regular operations (if your regulatory body has not issued a notice where you must close):

      1. Educate your employees on COVID-19

      o  Based on the fact that dental offices have direct contact with the mouths and saliva of patients, it is important to ensure that all risk management practices are followed as thoroughly as possible. If an employee has traveled back from an area with severe outbreak or has been in contact with anyone who has returned from an area with severe outbreak, they may be asked not to come into work during the 4-14 day incubation period of this disease.

      o   COVID-19 spreads in a manner similar to the flu - when there is close contact between people. This disease may be contracted by inhaling infected fluid and by touching contaminated surfaces and/or objects. The most identified at risk population for this disease appears to be people over 40, or those with weakened immune systems or other underlying health conditions such as diabetes, heart and lung disease 

      2. Practice the following methods to prevent the spread of infection

      o Wash hands with soap and water for at least 20 seconds or use an alcohol-based hand sanitizer that contains at least 60% alcohol if soap and water are not available

      o Avoid touching eyes, nose and mouth with unwashed hands

      o Avoiding close contact with people who are sick

      o Staying home when sick

      o Covering a cough or sneeze with a tissue, then throwing the tissue in the trash

      o Cleaning and disinfecting frequently touched objects and surfaces

      o Utilizing remote work opportunities as much as possible

      o Refraining from shaking hands

      o Using more teleconferencing (video conferencing/telephone calls instead of face to face meetings)

      o Pack your own lunch and eat it at your own workstation.

      o Screen patients for travel and any signs or symptoms of infection when they update their medical history

      o Take temperature readings

      o Make sure PPE is being used correctly

      o Use rubber dams when able to

      o Avoid high speed evacuations for dental procedures that require the use of aerosol

      o Autoclave handpieces after each use

      o Patients should rinse with a 1% hydrogen peroxide solution before all appointments

      o Public areas should be cleaned and disinfected frequently

      o If urgent dental treatment is necessary, dentists and patient's medical providers should work together to determine (on a case-by-case basis) and determine what is best for the patient and where it would be best to do the treatments

      o If you do stay open, and have a patient that tests positive for COVID-19, you do have a duty to report this to the Labour Program - 1-800-641-4049

      3.  Ensure that your team knows who to talk to

      As an employer you have a statutory duty of care for people's health and safety by providing a safe place to work. As well, there is a strong moral responsibility to ensure that your employees feel safe and secure in their workplace. As an employer, ensure that you remain proactive throughout this situation so that you can protect the people within your workplace and further minimize the risk of the virus spreading. 

      4. Continue to follow best practices for Infection Prevention and Control

      If you are going to be operating with a skeleton staff:

      1. Meet with your team to discuss the fact that the office will be closed for the foreseeable future until the need for closure has passed

      2. Discuss with your team that certain roles may be able to continue to work from home and will be compensated appropriately 

      • For example: the office manager may be able to do their job completely from home in a remote working capacity
      • Issue a Remote Working Policy to establish expectations and guidelines

      3. Any employees that cannot do any work for the practice can:

      • opt to take their paid vacation first (this is not mandatory)
      • Be laid off and apply for EI (employers must provide a Record of Employment (ROE))
      • Please note that the 1-week delay in applying for/receiving EI has been removed to support this emergency situation.
      • For more information please visit: https://www.canada.ca/en/services/benefits/ei/ei-sickness.html

      4. Discuss with your team the risks involved for continued work:

      • Employers are responsible for practicing in a way that supports the continued health and safety of their employees using preventative measures.
      • If there is a risk of exposure to COVID-19 for employees while working, employers must:  A) Identify the risk B) Assess the Risk C) Implement proper controls through their Hazard Prevention Programs
      • If an increase in Personal Protective Equipment is required, employers must provide training on these new procedures or equipment

      5. Remind employees of their rights based on the Canada Labour Code

      • Employees have the: A) Right to Know B) Right to Participate C) Right to Refuse Dangerous Work

      6. Follow the best practices (as listed earlier) to prevent the spread and transmission of infections

      If you close your practice:

      1. Provide your team with notice of temporary layoff

      • If the layoff lasts for more than 13 weeks, then it will not be considered to be a temporary layoff. If employees have been laid off for more than 13 weeks, then the layoff is classified as long term and the employer is required to pay the employee with a severance pay based on their length of employment
      • If you do not presently have a temporary layoff clause in your employment agreement, please contact an employment lawyer before issuing a notice of temporary layoff

      2. Instruct your employees with information on how to apply for EI (this can sometimes be done through your payroll company depending on which company you used)

      For more information, please visit: https://www.canada.ca/en/services/benefits/ei/ei-sickness.html

      3. Notify your provincial regulatory body that your office is closed for the time being

      4. Check with your business/practice insurance broker if you have any epidemic/pandemic coverage that will be able to help you through this situation.

      Are you required to pay staff while they are off?

      Unless you have explicit contracts that state that your business will provide paid sick leave, or if you have a benefits program that provides these benefits for your employees, then you are not required to pay your employees while they are off of work.

      If your staff can do some remote work, then you are required to pay them. If your employees have a greater than 40% loss of earnings during this time, then Employment Insurance (EI) programs in Canada have been extended to assist during this pandemic.

      Please contact an employment lawyer to discuss what compensation needs to be provided to your team at this time based on the applicable notice period

      What if we stay open but my staff refuse to come to work?

      If you choose to stay open because there is little to no danger (after conducting an internal investigation) and your employees still refuse to come to work, you can either grant them an unpaid leave of absence, or you can report their behavior to the Labour Program at 1-800-641-4049

      What if my employee was sick but now they feel well enough to come in, but it hasn’t been 14 days?

      Presenteeism can be one of the most dangerous issues that we face in the workplace - when employees are unwell and should likely be at home, but that they continue to come to work. Nationally, as many as 47% of employees nationwide have admitted to going to work when they were ill. The Canadian Federal Government has created a plan to make employment insurance available to employees without any waiting periods, as well as providing financial support for work-sharing programs. 

      If your employee was sick and they are confident that they are well enough to come into work then they may not have to wait the full 14-days of self-isolation before returning - however, if they are sick they are highly recommended to take part in this plan created by the federal government so that they make take a full period of two weeks in self-isolation before returning to the workplace. Additionally, the CDC recommends staying home for at least 24 hours after a fever has ended and employers have been recommended to ask for a doctor’s note that states that the employee is ready and able to return to work. If the employee was severely ill then the use of a comprehensive return to work program may be advised. 

      Ensure that you maintain your employees Human Rights.

      During this time, all human rights legislation still applies to all employees. This means that employees that are of certain ethnicity, race, ancestry, or place of origin cannot be discriminated against. Situations have taken place where employees of Chinese descent have been harassed or discriminated against since the outbreak of COVID-19. Maintain best practices by ensuring that your human rights related policies are all upheld to the highest standards.

      Communicate with your team!

      Remember, you are all in this together and no one is operating exclusively from the rest of your team! Talk with your staff and let them know their options, your expectations, and work together to create a plan for the future. 

      Our primary concern is your health, the health of your staff and the health of your patients. 

      We are currently putting together some information and recommendations that we will be helpful to you, as we all are doing our best to navigate through this situation. We want to support you during times like these so you can be the leader your team needs right now. 

      Stay safe and healthy!

      Further Resources:

      World Health Organization

      https://www.who.int/emergencies/diseases/novel-coronavirus-2019

      Public Health Agency of Canada

      https://www.canada.ca/en/public-health/services/diseases/2019-novel-coronavirus-infection.html

      Public Health Agency Travel Advice and Advisories

      https://travel.gc.ca/travelling/health-safety/travel-health-notices/210https://travel.gc.ca/destinations/china

      British Columbia

      https://www2.gov.bc.ca/gov/content/careers-myhr/all-employees/safety-health-well-being/health/covid-19

      Alberta

      https://www.alberta.ca/coronavirus-info-for-albertans.aspx

      Saskatchewan

      https://www.saskatchewan.ca/government/health-care-administration-and-provider-resources/treatment-procedures-and-guidelines/emerging-public-health-issues/2019-novel-coronavirus/covid-19-self-assessment

      Manitoba

      https://www.gov.mb.ca/covid19/index.html

      Ontario

      https://www.ontario.ca/page/2019-novel-coronavirus-covid-19-self-assessment

      Quebec

      https://www.quebec.ca/sante/problemes-de-sante/a-z/coronavirus-2019/

      Nova Scotia

      https://novascotia.ca/coronavirus/

      New Brunswick

      https://www2.gnb.ca/content/gnb/en/departments/ocmoh/cdc/content/respiratory_diseases/coronavirus.html

      PEI

      https://www.princeedwardisland.ca/en/topic/covid-19

      Newfoundland/Labrador

      https://www.gov.nl.ca/covid-19/

      Yukon

      https://yukon.ca/en/health-and-wellness/health-concerns-diseases-and-conditions/find-information-about-coronavirus-covid

      Northwest Territories

      https://www.hss.gov.nt.ca/en/services/coronavirus-disease-covid-19

      Nunavut

      https://www.gov.nu.ca/health/information/covid-19-novel-coronavirus