An RN’s Perspective

The following letter to Premier Scott Moe was shared with me today. I am publishing it with permission of the author who has asked to remain anonymous for fear of backlash in their professional and personal life. Unfortunately, our society is so divided at this time, that speaking freely often means losing family, friends and/or career.

It is an exceptionally well-stated letter addressing the current emergency order and associated restrictions and mandates in Saskatchewan. It very eloquently describes the journey of many Saskatchewan people as we navigated the last two years.

February 11, 2022

Dear Honourable Scott Moe, Premier of Saskatchewan

The overburdened healthcare system has always been one code orange away from the brink of complete collapse every day. Yet unfortunately after two years, our healthcare system has not changed one iota. We are still on the brink of collapse every day, but not just because of COVID. While COVID was the wake up call to truly realize just how fragile our system is, the reality is the system has always been fragile, and despite having two years to attempt to improve it – nothing impactful has changed.

I believe the public health measures put in place were appropriate at the time two years ago because of this fragile system. The goal was to not overburden our healthcare system and flatten the curve. As an ER RN of 16 years and COVID 811 RN, I had great anxiety heading in to work, opening up day one of COVID alley in the ER, stripping naked in my cold garage getting home post shifts, making sure my husband kept my young boys held away from me when I got home while I tip toed to have the hottest shower of my life for fear of giving this unknown virus to my children. 

 I heavily advocated for lockdowns and strict public health measures then. We simply did not know what we know now, and had to embrace the precautionary principle. This included drastic measures, expecting an incredibly virulent disease with widespread transmission and high mortality rate knocking on our doorstep. The predictive modeling of death we were given was horrific and something I truly had nightmares about in anticipation of what I was about to endure in my career.  As an ER nurse, I’ve seen a lot of tragedy, but it was hard to grasp what was truly coming, watching what was happening in Italy at the time. As such, we felt blessed in a way that we had warning, giving us the opportunity to try to prepare for the worst and hope for the best. Hence the lockdowns and extreme public health measures were implemented.

The problem is, two years later, we have learned so much since March of 2020, yet we continue to implement public health measures that no longer make sense. While the measures in place now made sense then when we had no knowledge of this virus, these extreme public health measures simply aren’t scientifically justifiable anymore, and certainly not demonstrably justified as in section 1 of the Charter of Rights and Freedoms.

 If COVID was an incredibly virulent disease with a high mortality rate of all demographics that was treatable with a sterilizing or near sterilizing vaccine as we have historically been gifted with, like the smallpox vaccine, perhaps another discussion could be had and these measures would be scientifically and demonstrably justifiable.

 Temporary mandates or further lockdown measures would make sense in that context of disease virulence and ease of transmission. Truthfully though – if that were the case – I don’t think there would be any problem with sleeves rolling up or a need for mandates as the risk vs benefit ratio would have clear heavy tipping scales to the benefit ratio amongst all demographics with a highly virulent disease, like Ebola. That’s not to discount the current benefits of the COVID vaccine or devalue all of the hardships and deaths that have occurred from this horrible virus, or those that still suffer from long haulers problems. I myself still have smell issues being COVID recovered. The disease is real and has caused widespread global death and harm.

The unfortunate reality though is that this vaccine provides neither sterilizing or near sterilizing immunity. As such, vaccine mandates for this particular vaccine have little scientific clout to fall back on with what we now know. Additionally, while they may be safe and help decrease disease severity, we must still acknowledge that all medical treatments come with an element of risk. While risk vs benefit is variable, and risk of adverse reactions are rare, they still happen. Not acknowledging this devalues and insults those that have been vaccine injured and these people need to be validated in these discussions, not labeled as a rare statistical event.

 I’m not saying these particular vaccines don’t have their place and benefits. I believe they help decrease disease severity and should be promoted and encouraged still, especially for high risk individuals. However, unless the virulence of this virus has a high mortality rate of all demographics or the vaccine offers sterile or near sterile immunity, mandates for its use have no place at this time. Certainly not in the context of Omicron, or any place that has high vaccine uptake in conjunction with widespread natural infection to assist with obtaining herd immunity. 

There are two sides of harm we must acknowledge. I recognize the harmful and infuriating delays of surgeries (I experienced them first hand in my own family members awaiting surgery and had delayed cancer treatment). However, I also witnessed the other side of shutting things down and the harms we never anticipated: keeping beds open for the influx that never came, meanwhile many elderly were too terrified to come to the hospital and stayed home for fear of this virus, only to come in to the hospital far too late with severe congestive heart failure exacerbations, bowel blockages or sepsis that could have been prevented with early treatment rather than tertiary. As for the socio-economic harmful impact (I don’t just mean financial impact – I mean the entire negative snowball effect these extreme public health measure have had on a healthy community) – I’m not sure that will ever be easy to quantifiably measure to determine if the lockdowns and public health measures put in place outweigh the harm, although I did just read a good article discussing this I will share in the footnotes. 1.

Currently, forced vaccination is not law. Rather, we have vaccine mandates. However, when antigen testing is not presented as an option for many people as within some federal positions/ certain Provinces and these individuals have to decide between vaccination they may not want due to various medical, religious or personal reasons or risk losing their livelihood to financially support their family to provide them with those basic necessities of food and shelter – I have a problem with that.

While vaccination should certainly be promoted, the bottom line is that many people are not actually being presented with a CHOICE with such mandates (for example to continue to work at their place of employment, particularly if they are not offered antigen testing). They are being presented with an ULTIMATUM. There is a big difference…..

Repetitively we often hear those that are pro-mandates state:

 “Yes it’s always a choice ….. But choices have consequences”. 

To repeat: This is NOT a CHOICE. The correct term would be an ULTIMATUM:

“An ultimatum (Latin for last one) is not a choice, but a conditional demand with a threat which, if not met, leads to the consequences of the threat. On the other hand, a choice is an option without a threat and an opportunity to choose or select something voluntarily.”

This was recognized widely in the influenza mandate of 2015 at the Supreme Court level and within our own Union. The word coercion was publicly accepted and recognized as evident in that court case and the Union fought tooth and nail to ensure its members were not subject to coercive intent from its employer. Its case law set precedence to vaccine mandates. Somehow 7 years later – people seem to forget what that word means.

Coercion is a powerful misuse of authority and should never be ignored or taken lightly. I am extremely disappointed and frustrated in our Union allowing this coercion to carry on in our workplace and publically supporting vaccine mandates and vaccine passports in the community without appropriate consultation of its members. They have not represented many of us fairly as within their duty to do so as I can corroborate with a long list of members that feel the same and as evident by the lack of responses when concerns of such nature are brought forward to them. The violation of section 6 (1) (d) of HIPA: obtaining voluntary consent free of coercion, has yet to be acknowledged by our Union or the Privacy Access Officers of SHA. The report of the breech of these terms have been communicated to the Privacy Access Officers of SHA on numerous occasions. The response – crickets.

Furthermore, I am disgusted by the gross misuse of Government overreach and amending the Saskatchewan Employment Act to allow these mandates, disguising coercion as “choice” when in fact it is an ultimatum and has purely punitive and unreasonable measures attached to the terms required for those that choose to utilize testing in the context of Omicron and high rates of transmissibility regardless of vaccination status.

“Go get another job then”, we hear. It’s not that easy for many and frankly is absurd to suggest when the science behind this virus and vaccine simply don’t logically or rationally warrant these extraordinary measures anymore. They most certainly have not been proven to meet any bona fide occupational requirement as within the Supreme Court three stage test to be a job requirement or condition of employment. 

Risk vs benefit is variable for everyone, as is risk tolerance. While the choice is easy and clear as day for some, it simply isn’t for others. We have an obligation to promote vaccination, but we have an equal obligation to respect body autonomy and freedom of medical choice, even if we don’t agree with those choices. As long as they are informed choices, we have to respect them, and if that’s too difficult to do, reluctantly accept them.

The choice to be unvaccinated or vaccinated is a social choice as well as a personal choice. It affects you and your community. That’s where a lot of the discourse and ethical distress I think originates in this context.

As I was reviewing our CNA code of ethics recently, it states: 

 “Ethical reflection (which begins with a review of one’s own ethics and judgment) is required to determine how a particular value or responsibility applies in a particular nursing context. There is room within the profession for disagreement among nurses about the relative weight of different ethical values and principles. More than one proposed intervention may be ethical and reflective of good ethical practice.” 3

 While promoting healthy population and communities is important and perhaps carries heavier weight to one nurse as within the Code, it may not carry as much weight to another nurse that promotes the ethical values of social justice, dignity and respecting autonomy also as within the Code. Both are reflective of ethical practice, but creates ethical malalignment and disagreement and subsequent moral distress.  

Thus why the circular debate persists. Unless the weight of ethical values are equal across the board, the debate will never end, and in theory, both sides of debate are arguably ethically correct. Hence the division. So the tie breaker must be science – and science does not support mandates in this context.

Additionally, I often hear the argument “well you were mandated to take vaccines to become a nurse – how are these mandates any different?” While I love a good analogy, this is a poor one and is not comparing apples to apples. Those were sterilizing or near sterilizing vaccines to highly virulent diseases. I think the better comparison/analogy in context of this vaccine and COVID would be when the attempt was made to mandate the influenza vaccine to our profession in 2015. Ultimately, it went to the Supreme Court in Ontario, and the Union won against the mandates. They didn’t win because it’s not widely acknowledged that the flu shot is beneficial to individuals and subsequent healthy population, but because the ethical principles of promoting bodily autonomy and freedom of medical choice prevailed and the science to mandate a non-sterilizing vaccine for a low virulent virus was not demonstrably justifiable.

I believe in rules, and again this would be a different conversation in the context of a different disease or sterilizing vaccine. However, if mandates are going to be implemented, they really need to be demonstrably justified and ground on solid science to infringe on body autonomy and freedom of medical choice, and in the context of Omicron, it simply isn’t. Hence it’s time to end all mandates.

This was shared with me by a colleague in regards to when an attempt was made to mandate our profession to receive the influenza vaccine which I recall vividly. 2 It’s an interesting read. Both are a very highly contagious respiratory virus with similar virulence and offer a non-sterilizing vaccine, yet SUNs current approach to these mandates are night and day from 2015. Their current stance in support for further increased public health measures has not been grounded by science in the context of Omicron and most certainly not by polling its members. Our SUN president has not upheld her duty to fairly represent its members in public opinion, which as stated I can corroborate with a long list of members who oppose her unsolicited recent public opinions on the matter and feel unheard and unsupported. Many members including myself unfortunately fear repercussion from the Union for expressing dissenting views (albeit still ethically solid as per our Code of Ethics) and remain silent in fear of discipline, as many were reported to the College of Nursing for openly expressing their opposition to vaccine mandates and vaccine passports on social media outlets. The fear is real. We feel effectively muzzled when our views do not align with theirs. If only we had the ability to let our full truths be known and our voices truly heard. This, unfortunately, is wishful thinking. In the interim – the sounds of silence prevail on the exception of a few brave whistleblowers.

In summation – vaccine mandates, vaccine passports, mandatory antigen testing, and mandatory indoor masking need to end NOW. Not February 28th. A recent Angus Reid poll confirms that this is the will of the majority of Saskatchewan citizens and is corroborated by Science. 4 The people have spoken. The Provincial declaration of the State of Emergency needs to end NOW. We are not in a state of Emergency and keeping us in this state is a misuse of authority and power. There is no justifiable reason to continue to be in this state.



3Canadian Nurses Association – Code of Ethics 2017: