{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,29]],"date-time":"2026-10-29T00:44:20Z","timestamp":1793234660431,"version":"4.5.0"},"reference-count":71,"publisher":"SAGE Publications","issue":"4","license":[{"start":{"date-parts":[[2020,11,11]],"date-time":"2020-11-11T00:00:00Z","timestamp":1605052800000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["New Solut"],"published-print":{"date-parts":[[2021,2]]},"abstract":"<jats:p>Healthcare workers (HCWs) in Ontario, Canada have faced unprecedented risks during the COVID-19 pandemic. They have been infected at an elevated rate compared to the general public. HCWs have argued for better protections with minimal success. A worldwide shortage of N95s and comparable respirators appears to have influenced guidelines for protection, which stand at odds with increasing scientific evidence. In-depth interviews were conducted with ten frontline HCWs about their concerns. They reported that the risk of contracting COVID-19 and infecting family members has created intense anxiety. This, in conjunction with understaffing and an increased workload, has resulted in exhaustion and burnout. HCWs feel abandoned by their governments, which failed to prepare for an inevitable epidemic, despite recommendations. The knowledge that they are at increased risk of infection due to lack of protection has resulted in anger, frustration, fear, and a sense of violation that may have long-lasting implications.<\/jats:p>\n                  <jats:p>Sacrifi\u00e9: Le personnel de la sant\u00e9 ontarien \u00e0 l'\u00e9poque de la COVID-19<\/jats:p>\n                  <jats:p>R\u00e9sum\u00e9<\/jats:p>\n                  <jats:p>En Ontario, au Canada, le personnel de la sant\u00e9 a eu \u00e0 faire face \u00e0 des risques sans pr\u00e9c\u00e9dent durant la pand\u00e9mie de COVID-19. On y a constat\u00e9 un taux d'infection plus \u00e9lev\u00e9 chez les travailleuses et travailleurs de la sant\u00e9 (TTS) qu'au sein de la population en g\u00e9n\u00e9ral. Les TTS ont revendiqu\u00e9 des moyens de protection am\u00e9lior\u00e9s, sans grand succ\u00e8s. Une p\u00e9nurie mondiale de masques respirateurs de type N95 ou similaires semble avoir jou\u00e9 sur les directives en mati\u00e8re de protection, qui ne cadrent pas avec une accumulation de preuves scientifiques. Lors d'entretiens en profondeur, dix TTS de premi\u00e8re ligne ont \u00e9t\u00e9 invit\u00e9s \u00e0 donner leur avis sur la situation. \u00e0 les entendre, le risque de contracter la COVID-19 et d'infecter les membres de leur famille leur cause beaucoup d'anxi\u00e9t\u00e9. Associ\u00e9e \u00e0 un manque de personnel et \u00e0 une charge de travail accrue, cette anxi\u00e9t\u00e9 se traduit par un \u00e9puisement physique et professionnel. Les TTS se sentent abandonn\u00e9s par leurs gouvernements, qui ont manqu\u00e9 de se pr\u00e9parer \u00e0 l'in\u00e9vitabilit\u00e9 d'une \u00e9pid\u00e9mie, malgr\u00e9 ce qui leur avait \u00e9t\u00e9 recommand\u00e9. Leur r\u00e9alisation d'\u00eatre expos\u00e9s \u00e0 un plus grand risque d'infection par manque d'\u00e9quipement de protection s'est mu\u00e9e en col\u00e8re, frustration et peur, et en un sentiment de violation de leurs droits dont on peut craindre qu'il subsiste fort longtemps.<\/jats:p>","DOI":"10.1177\/1048291120974358","type":"journal-article","created":{"date-parts":[[2020,11,11]],"date-time":"2020-11-11T11:33:15Z","timestamp":1605094395000},"page":"267-281","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":92,"title":["Sacrificed: Ontario Healthcare Workers in the Time of COVID-19"],"prefix":"10.1177","volume":"30","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-2391-6236","authenticated-orcid":false,"given":"James T.","family":"Brophy","sequence":"first","affiliation":[{"name":"University of Windsor, ON, Canada"},{"name":"University of Stirling, Scotland"},{"name":"Athabasca University, AB, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Margaret M.","family":"Keith","sequence":"additional","affiliation":[{"name":"University of Windsor, ON, Canada"},{"name":"University of Stirling, Scotland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael","family":"Hurley","sequence":"additional","affiliation":[{"name":"Ontario Council of Hospital Unions, Toronto, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jane E.","family":"McArthur","sequence":"additional","affiliation":[{"name":"University of Windsor, ON, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2020,11,11]]},"reference":[{"key":"bibr1-1048291120974358","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMp2011027"},{"key":"bibr2-1048291120974358","unstructured":"Senior J. 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Ontario Health Minister misinformed: 87 per cent of province's health care staff polled say not enough PPE on hand to keep them safe, 30 March 2020, https:\/\/cupe.ca\/ (accessed 1 November 2020)."},{"key":"bibr6-1048291120974358","first-page":"334","volume":"23","author":"Sandelowski M.","year":"2000","journal-title":"RINAH"},{"key":"bibr7-1048291120974358","unstructured":"Public Health Agency of Canada. SARS (Severe Acute Respiratory Syndrome), https:\/\/ipac-canada.org\/sars.php (2020, accessed 5 August 2020)."},{"key":"bibr8-1048291120974358","unstructured":"SARS Commission. 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For-profit long-term care homes and the risk of COVID-19 outbreaks and resident deaths.\n                      CMAJ\n                      2020; 192: E946-E955.","DOI":"10.1503\/cmaj.201197"},{"key":"bibr14-1048291120974358","unstructured":"Canadian Institute for Health Information.\n                      Pandemic experience in the long-term care sector: how does Canada compare with other countries?\n                      Ottawa, ON: CIHI, 2020, https:\/\/www.cihi.ca\/ (accessed 1 November 2020)."},{"key":"bibr15-1048291120974358","author":"DeClerq K.","year":"2020","journal-title":"CTV News"},{"key":"bibr16-1048291120974358","author":"Alam H.","year":"2020","journal-title":"Toronto Star"},{"key":"bibr17-1048291120974358","unstructured":"World Health Organization.\n                      Keep health workers safe to keep patients safe: WHO\n                      . 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Aerosol and surface contamination of SARS-CoV-2 observed in quarantine and isolation care.\n                      Sci Rep\n                      2020; 10: 12732.","DOI":"10.1038\/s41598-020-69286-3"},{"key":"bibr21-1048291120974358","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2020.3227"},{"key":"bibr22-1048291120974358","author":"Lednicky JA","year":"2020","journal-title":"medRxiv preprint"},{"key":"bibr23-1048291120974358","doi-asserted-by":"crossref","unstructured":"MacIntyre CR and Wang Q. Physical distancing, face masks, and eye protection for prevention of COVID-19. (Comment).\n                      Lancet\n                      2020; 33: 1950-1.","DOI":"10.1016\/S0140-6736(20)31183-1"},{"key":"bibr24-1048291120974358","doi-asserted-by":"crossref","unstructured":"Petsonk EL and Harber P. 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Medical workers should use respirator masks, not surgical masks.\n                      The New York Times\n                      , 1 June 2020, https:\/\/www.nytimes.com (accessed 1 November 2020)."},{"key":"bibr30-1048291120974358","doi-asserted-by":"crossref","unstructured":"Zhu S, Zong Z. Why did so few healthcare workers in China get COVID-19 infection.\n                      QJM\n                      , https:\/\/doi.org\/10.1093\/qjmed\/hcaa254 (2020, accessed 1 November 2020).","DOI":"10.1093\/qjmed\/hcaa254"},{"key":"bibr31-1048291120974358","unstructured":"Leo G. Health minister reviewing management of Canada's emergency stockpile.\n                      CBC News\n                      , 15 April 2020, https:\/\/www.cbc.ca\/news\/ (2020, accessed 1 November 2020)."},{"key":"bibr32-1048291120974358","unstructured":"Public Health Ontario.\n                      IPAC recommendations for use of personal protective equipment for care of individuals with suspect or confirmed COVID-19\n                      , 27 July 2020, https:\/\/www.publichealthontario.ca\/ (accessed 1 November 2020)."},{"key":"bibr33-1048291120974358","first-page":"1837","volume":"323","author":"Bourouiba L.","year":"2020","journal-title":"JAMA"},{"key":"bibr34-1048291120974358","unstructured":"Mandavilli A. \u2018A smoking gun\u2019: infectious coronavirus retrieved from hospital air.\n                      The New York Times,\n                      11 August 2020, https:\/\/www.nytimes.com (accessed 1 November 2020)."},{"key":"bibr35-1048291120974358","doi-asserted-by":"crossref","unstructured":"Prather KA, Wang CC and Schooley RT. 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The association between the perceived adequacy of workplace infection control procedures and personal protective equipment with mental health symptoms: a cross-sectional survey of Canadian health-care workers during the COVID-19 Pandemic.\n                      Can J Psychiatry\n                      2020; 21: 706743720961729.","DOI":"10.1177\/0706743720961729"},{"key":"bibr37-1048291120974358","volume-title":"Qualitative inquiry and research design: choosing among five traditions","author":"Cresswell JW.","year":"1998"},{"key":"bibr38-1048291120974358","doi-asserted-by":"publisher","DOI":"10.1191\/1478088706qp063oa"},{"key":"bibr39-1048291120974358","doi-asserted-by":"publisher","DOI":"10.1177\/1049732318803885"},{"key":"bibr40-1048291120974358","volume-title":"The coding manual for qualitative researchers","author":"Saldana J.","year":"2015"},{"key":"bibr41-1048291120974358","volume-title":"Qualitative research and evaluation methods","author":"Patton M.","year":"2001"},{"key":"bibr42-1048291120974358","unstructured":"Van Beusekom M. Report spotlights heavy pandemic toll on health workers. Report spotlights heavy pandemic toll on health workers.\n                      CIDRAP News,\n                      14 July 2020, https:\/\/www.cidrap.umn.edu\/ (accessed 1 November 2020)."},{"key":"bibr43-1048291120974358","unstructured":"Ontario Council of Hospital Unions-Canadian Union of Public Employees. Bloodied, broken and burned out: 88% of long-term care staff experience violence.\n                      Cision,\n                      8 April 2019, https:\/\/www.newswire.ca\/ (accessed 1 November 2020)."},{"key":"bibr44-1048291120974358","doi-asserted-by":"publisher","DOI":"10.1177\/1048291117732301"},{"key":"bibr45-1048291120974358","doi-asserted-by":"publisher","DOI":"10.1177\/1048291118824872"},{"key":"bibr46-1048291120974358","doi-asserted-by":"publisher","DOI":"10.1057\/palgrave.jphp.3200021"},{"key":"bibr47-1048291120974358","unstructured":"Goodyear-Grant E, Harell A, Stephenson L. Concern about pandemic differs across gender and race lines.\n                      Policy Options,\n                      21 May 2020, https:\/\/policyoptions.irpp.org\/ (accessed 1 November 2020)."},{"key":"bibr48-1048291120974358","unstructured":"Messing K. If it's a war against COVID-19, who are the soldiers on the front lines? In: BTL Editorial Committee (eds)\n                      Sick of the system - why the COVID-19 recovery must be revolutionary\n                      . Toronto: Between the Lines, 2020, pp. 20-38."},{"key":"bibr49-1048291120974358","unstructured":"Ontario Council of Hospital Unions-Canadian Union of Public Employees.\n                      Sticker day \u2013 April 2, 2020\n                      , https:\/\/ochu.on.ca\/ (2020, accessed 11 August 2020)."},{"key":"bibr50-1048291120974358","unstructured":"Ontario Council of Hospital Unions-Canadian Union of Public Employees.\n                      Day of Action \u2013 May 6, 2020\n                      , https:\/\/ochu.on.ca\/ (accessed 11 August 2020)."},{"key":"bibr51-1048291120974358","volume-title":"Armstrong H and Fuller C. Health care, limited","author":"Armstrong P.","year":"2000"},{"key":"bibr52-1048291120974358","author":"Zafar A.","year":"2020","journal-title":"CBC News"},{"key":"bibr53-1048291120974358","doi-asserted-by":"publisher","DOI":"10.1111\/j.1744-6198.2011.00228.x"},{"key":"bibr54-1048291120974358","doi-asserted-by":"crossref","unstructured":"Sriharan A, Ratnapalan S, Tricco AC, et\u00a0al. Stress, burnout and depression in women in healthcare during COVID-19 pandemic: rapid scoping review.\n                      BMJ Yale\n                      , medrxiv ahead of print, 14 July 2020.","DOI":"10.1101\/2020.07.13.20151183"},{"key":"bibr55-1048291120974358","unstructured":"Tomlinson K, Robertson G. Ottawa had a playbook for a coronavirus-like pandemic 14 years ago. What went wrong?\n                      Globe and Mail,\n                      9 April 2020, https:\/\/www.theglobeandmail.com (accessed 1 November 2020)."},{"key":"bibr56-1048291120974358","unstructured":"Tomlinson K, Robertson G, Keller J, et\u00a0al. Head of Canadian Medical Association pushes Ottawa to explain lack of preparation ahead of pandemic\u2019s arrival.\n                      Globe and Mail,\n                      9 April 2020, https:\/\/www.theglobeandmail.com\/ (accessed 1 November 2020)."},{"key":"bibr57-1048291120974358","unstructured":"McArthur JE, Keith MM, Brophy JT, et al. Novel virus, old story: governments failings put health care workers at risk. In: BTL Editorial Committee (eds)\n                      Sick of the system - why the COVID-19 recovery must be revolutionary\n                      . Toronto: Between the Lines, 2020, pp. 39-58."},{"key":"bibr58-1048291120974358","unstructured":"Armstrong P and Armstrong H. Contradictions at work: struggles for control in Canadian health care.\n                      Socialist Register\n                      2010; 46: 145-167."},{"key":"bibr59-1048291120974358","doi-asserted-by":"publisher","DOI":"10.1177\/1048291120938232"},{"key":"bibr60-1048291120974358","unstructured":"60. Canadian Federation of Nurses Unions (CFNU). Nurses launch investigation into Canada\u2019s failure to protect health care workers from COVID-19, 22 June 2020, https:\/\/nursesunions.ca\/ (accessed 1 November 2020)."},{"key":"bibr61-1048291120974358","doi-asserted-by":"crossref","unstructured":"Watterson A. COVID-19 in the UK and occupational health and safety: predictable not inevitable failures by government, and trade union and nongovernmental organization responses.\n                      New Solut\n                      2020; 33: 86-94.","DOI":"10.1177\/1048291120929763"},{"key":"bibr62-1048291120974358","author":"Tasker JP.","year":"2020","journal-title":"CBC News"},{"key":"bibr63-1048291120974358","unstructured":"Ontario Council of Hospital Unions-Canadian Union of Public Employees. Health care unions welcome significantly improved COVID-19 protections for 400,000 health care workers, https:\/\/ochu.on.ca\/ (accessed 7 October 2020)."},{"key":"bibr64-1048291120974358","unstructured":"Canadian Union of Public Employees. To save lives, federal and provincial governments must order GM to make N95 masks says coalition, 24 September 2020, https:\/\/cupe.ca\/ (accessed 1 November 2020)."},{"key":"bibr65-1048291120974358","author":"Ralph J","year":"2020","journal-title":"The Conversation"},{"key":"bibr66-1048291120974358","author":"Horton J.","year":"2020","journal-title":"Globe and Mail"},{"key":"bibr67-1048291120974358","unstructured":"Possamai M.\n                      A time of fear: how Canada failed our health care workers and mismanaged Covid\u201019.\n                      Report, Canadian Federation of Nurse Unions, Ottawa, 5 October 2020, https:\/\/nursesunions.ca\/ (accessed 1 November 2020)."},{"key":"bibr68-1048291120974358","author":"McArthur JE.","year":"2020","journal-title":"The Conversation"},{"key":"bibr69-1048291120974358","doi-asserted-by":"publisher","DOI":"10.1097\/JOM.0000000000001235"},{"key":"bibr70-1048291120974358","doi-asserted-by":"crossref","unstructured":"Braquehais MD, Vargas- C\u00e1ceres S, G\u00f3mez-Dur\u00e1n, E, et al. The impact of the COVID-19 pandemic on the mental health of healthcare professionals.\n                      QJM\n                      2020; 113: 613-617.","DOI":"10.1093\/qjmed\/hcaa207"},{"key":"bibr71-1048291120974358","doi-asserted-by":"publisher","DOI":"10.1503\/cmaj.200519"}],"container-title":["NEW SOLUTIONS: A Journal of Environmental and Occupational Health Policy"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/1048291120974358","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/full-xml\/10.1177\/1048291120974358","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/1048291120974358","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,5,2]],"date-time":"2026-05-02T00:30:20Z","timestamp":1777681820000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.sagepub.com\/doi\/10.1177\/1048291120974358"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2020,11,11]]},"references-count":71,"journal-issue":{"issue":"4","published-print":{"date-parts":[[2021,2]]}},"alternative-id":["10.1177\/1048291120974358"],"URL":"https:\/\/doi.org\/10.1177\/1048291120974358","relation":{},"ISSN":["1048-2911","1541-3772"],"issn-type":[{"value":"1048-2911","type":"print"},{"value":"1541-3772","type":"electronic"}],"subject":[],"published":{"date-parts":[[2020,11,11]]}}}