SUPPORT FOR CARE HOMES A KEY FOCUS
CORONAVIRUS New emergency measures to help protect residents
Fearing that elderly residents of long-term care homes will suffer the worst mortality in the coronavirus pandemic, Canadian authorities have introduced emergency measures, from financial support in Quebec to a loosening of regulatory burdens in Ontario.
The decisions come as new scientific evidence shows the virus spreads easily among asymptomatic people, so simply monitoring symptomatic residents may have left a crucial gap in the defence of care homes.
Ontario Premier Doug Ford spoke of creating an “iron ring” around longterm care homes, which were hit early and hard by COVID-19, leaving some of them crippled by staffing shortages as workers are forced to self-isolate.
At the Pinecrest Nursing Home in Bobcaygeon, Ont., seven residents died over the weekend, which is approximately one out of every 10 living there, and many staff tested positive and are now in mandatory isolation.
“It’s tragic, and we have to do absolutely everything that’s possible,” said Merrilee Fullerton, Ontario’s minister of long-term care, who is also a physician.
The emergency measures in Ontario include increased screening and isolation for staff and new residents, and a redeployment of health ministry inspectors to help with urgent care, as was done in the 2003 SARS outbreak.
The measures also include removing the requirement to report certain complaints to the ministry, and allowing homes greater freedom to hire workers at their discretion under looser training requirements.
The government said in a statement these emergency measures are necessary to give long-term care homes “the flexibility they need to deploy staff when and where they are needed.”
As they have in other countries, long-term care homes have proven to be hot spots of the pandemic in Canada.
Canada’s first known COVID-19 death occurred March 8 in the Lynn Valley Care Centre in North Vancouver, which still accounts for most of the deaths so far in British Columbia.
Now there are 13 care homes with outbreaks in B.C.’s Lower Mainland alone.
Quebec, likewise, saw many of its first cases at a seniors residence in Lavaltrie. Nova Scotia announced three workers at long-term care homes had tested positive.
Outbreaks in Ontario long-term care homes include Stoney Creek, Oshawa, Markham, and Toronto.
On Friday, two cases at a Welland, Ont., retirement community were traced to a person who infected an 80-year-old woman after returning from abroad, and is now showing symptoms. By the time the woman was taken to hospital, another elderly resident had caught it too.
Newly published research in a Seattle nursing home showed that isolating patients who become symptomatic is not enough to contain the virus’s spread through a care home’s population.
The virus spread rapidly among residents largely through people who were not symptomatic, or had not yet become symptomatic, but were still shedding large amounts of viral RNA, the genetic material in the novel coronavirus.
“Once a facility has confirmed a COVID-19 case, all residents should be cared for using CDC-recommended personal protective equipment (PPE), with considerations for extended use or reuse of PPE as needed,” according to the research by an American team released early by the Centers for Disease Control and Prevention.
Surveillance has been a key part of pandemic response, but disclosure of raw numbers about COVID-19 cases has not always revealed the clusters.
Partly for privacy reasons, and partly for limitations in the testing scheme, the province has not announced some of these links among cases, and the Bobcaygeon cluster was first reported by the Globe and Mail.
Fullerton said she is in discussions with the province’s chief medical officer of health about further disclosure of cases.
This week the Ontario government replaced its daily numbers update with a more detailed epidemiological summary.
Monday’s document notes that the median age of cases in the province is 50, and ranges from an infant to a centenarian, affecting males and females in equal numbers.
CARP, which advocates for seniors, said it was worried by the emergency measures because they may leave vulnerable residents exposed to added risk, attended to by unqualified staff, and unable to have complaints properly addressed.