Saskatchewan has now had 298 cases of COVID-19 with nine new cases reported Sunday, seven of which are confirmed and two of which are presumptive.

The province recorded its fourth death of the pandemic earlier this week, and on Sunday seven patients were listed as being in hospital. None were receiving intensive care. 

Of the province's almost 300 cases, 25 were the result of local exposure. Thirty-two cases are said to be in health-care workers, but it's unclear if they contracted the virus while working. 

The number of recovered cases continues to outpace the number of active cases. On Sunday 164 cases were listed as recovered, while 130 cases were listed as active. 

That milestone was reached for the first time on Saturday, and Premier Scott Moe said he was "cautiously optimistic" about the trend.

The province's cases are divided equally among people who are 44 and under and those who are 45 and up, with 149 each. Men have 53 per cent of cases, and 47 per cent of cases are in women. 

To date, the province has conducted 19,276 tests.

No cases in long-term care

Unlike other parts of the country, like Ontario and Quebec, where COVID-19 has entered the long-term care system, resulting in dozens of deaths, Saskatchewan has yet to see a single case in a long-term care facility. 

Because of the risk that COVID-19 presents to vulnerable populations, like those in long-term care facilities, the federal government has released an extensive set of guidelines for the facilities to follow in hopes of protecting people during the pandemic. 

On Saturday Deputy Prime Minister Chrystia Freeland said the Government of Canada is working "very closely" with provincial leaders to ensure those people are protected even further.  

One of the guidelines listed in the document, that spans over 6,000 words, is the recommendation of using staff and patient cohorts. This would see health care staff only assigned to a certain group of patients, like those who have COVID-19 or are suspected of having COVID-19, or a certain facility. 

This would be to ensure healthcare staff aren't spreading the virus between separate units in a facility, or between separate long-term care facilities.

SUN calls for cohorts across system

Tracy Zambory, president of Saskatchewan's Union of Nurses, said the guidelines are welcomed by Saskatchewan's registered nurses, but she'd like to see cohorting go beyond just long-term care homes. 

"We would even take it a step further and actually do it for all facilities, units and agencies," she said. "To us, it really makes sense. We talk about how we need to social distance, we need to stay home, and cohorting is the way to manage that really, inside of the healthcare system." 

She said protocols around the new guidelines should be introduced at long-term care homes immediately, on top of screening measures already in place. Zambory said SUN, and other healthcare unions, have been calling on the government to introduce a cohort model across the system in daily meetings, but said so far, there's been little interest. 

"It's a good start in long-term care, absolutely, because it's a vulnerable population," she said. "But cohorting across the system, we feel, is the smart next move. We want to flatten this curve as quickly as possible and we feel that's one way to do it." 

Zambory says SUN wants cohorting to be introduced alongside steps that are already being taken, calling it a "logical fit" to the overall plans. 

She hopes the new federal guidelines that recommend cohorting in long-term care homes will give more weight to their calls to see it introduced across Saskatchewan.

"We shouldn't have to think too long about it," she said, as the union feels it makes "perfect sense" as the move would protect both frontline staff and patients. 

CBC Saskatchewan reached out to the Ministry of Health for comment on Zambory's call for cohorting across the system, but a response was not received by deadline. Officials did note there was a chance Zambory's remarks could be addressed at Monday's provincial briefing on COVID-19.

In a separate statement sent to CBC, Premier Moe's office said the province is considering introducing more protective protocols in these facilities. 

"COVID-19 represents a serious risk to all Saskatchewan residents, particularly those that are elderly, immunocompromised, or living with pre-existing health conditions," the statement said. "Our government is seriously considering a number of further measures to protect our most vulnerable citizens living in LTC facilities across the province."

On Saturday, the province's chief medical health officer, Dr. Saqib Shahab, said while Saskatchewan has not had an outbreak of the virus in any long-term care facilities, the situation in other jurisdictions is a reminder for everyone to be careful around older people, especially those in long-term care, who he said are among the most vulnerable. 

He said this is why the province has reduced visiting at the homes to compassionate care and having staff at the facilities undergo a screening before work, noting if they show any symptoms, they must self-isolate. 

"This is something that we need to continue to manage and to prevent, as much as we can, the importation of COVID-19 in to, not just our healthcare facilities, but long-term care facilities, care homes and other settings where the vulnerable reside." 

Expert says number of healthcare workers infected must be monitored 

In Saskatchewan, 32 healthcare workers have been infected by the virus, making up roughly 11 per cent of the cases, but it's unclear whether or not they contracted the virus at work or elsewhere. The figure includes 11 doctors who contracted COVID-19 at a curling bonspiel in Edmonton in March. 

Steven Lewis is a health policy expert from Saskatchewan who now lives in Australia. He says that's a figure the province should be keeping a close eye on, as if more healthcare workers get sick, the system may experience a shortage in staff.

"If you have 500 cases and 50 of them are [health-care workers] and therefore out of commission for a period of time, that's absorbable," he said. "If the number of infections gets really high, let's say it got to 50,000 and 5,000 of those were health-care workers, then you have a real problem in the supply of personnel."

Lewis said this could result in a lack of frontline medical staff at a time when the spread of the virus is getting worse. 

"When you get to a crossover point where it's very hard to maintain the staffing levels that you need for a ramping up, then that's when you could get into a bit of a crisis situation." 

Shahab said the government is monitoring the number of healthcare workers who get infected "very closely" saying the public also has a role to play in protecting these essential workers.

"It's everyone's responsibility to help them to do their job and to minimize, as much as we can, exposure to COVID-19 through physical distancing, calling ahead when going to see a healthcare provider and using other proper precautions as advised."