Province will test care home residents, staff
The Ontario government has ordered public health units to test every resident and staff member at long-term care homes for COVID-19, according to memos from senior government health officials.
The move, at a time when the majority of COVID-19 deaths in the province are connected with long-term care and nursing homes, goes beyond what was announced by Premier Doug Ford last week as part of an action plan for long-term care homes.
In two memos to health system organizations released late Tuesday, Deputy Minister of Health Helen Angus, Chief Medical Officer of Health Dr. David Williams and Matthew Anderson, the president and CEO of Ontario Health, asked public health units to immediately begin developing plans to test “every resident and staff at each long-term care home.”
The memo says the plan “should be implemented as soon as possible.” Homes with a “red” — or high risk — status and those with current outbreaks should be a priority.
More widespread testing in longterm care “will enable homes, public health units and the province to better understand the prevalence of COVID-19 in long-term care homes and inform future planning.”
Provincial officials suggest that health units seek support, including from community paramedics, to carry out the expanded testing.
That is something many advocates have long asked for, saying it is difficult for long-term care homes to manage outbreaks and isolate residents when they don’t know who is and isn’t infected.
At Laurier Manor in Ottawa, where at least 38 residents are infected with COVID-19, mainly on one floor, family members of residents on other floors say they would like to better understand if the virus has spread throughout the 240-bed home.
But ramping up testing to all long-term care residents and staff would also challenge Ottawa’s testing capacity.
On Wednesday, Chief Medical Officer Dr. Vera Etches said Ottawa Public Health has begun working on a plan while still waiting for more details after getting the order to begin testing everyone late Tuesday night.
“We are looking at how we can plan this in a way that allows this to move ahead as effectively and efficiently as possible,” she said.
Doing so will require a co-ordinated approach, she said, including having enough people to take swabs and a plan to make sure labs are not overwhelmed.
Eight hundred tests are currently being done each day in the region. That will likely increase to 1,000 a day in the next week, Etches said.
There have been 247 lab-confirmed cases of COVID-19 among residents and staff in Ottawa longterm care homes and 21 deaths.
But testing alone is not the solution to decreasing transmission in homes with outbreaks, Etches said earlier this week. Testing too early could produce a negative result that could provide a false sense of security if a patient then went on to have COVID-19.
“You would have to keep testing over and over.”
The most important factor in reducing transmission of COVID -19 in institutions is good infection control, she said. That is something Ottawa Public Health has been working with homes on.
Earlier, the province ordered an expansion of testing in longterm care homes to include all symptomatic staff and residents as well as asymptomatic residents or staff who had come in contact with someone who had COVID-19.
It also called for testing at some homes without outbreaks.
The memos sent out this week go far beyond those guidelines.
In addition, Ontario has begun daily reviews to update risk assessments for every long-term care home in the province “to ensure homes have the supports they need, when they need it.
“Based on these assessments, supports have already been deployed to homes, with a focus on infection prevention and control resources, health human resources to address staffing shortages and implement the enhanced testing direction and personal protective equipment to protect front-line staff and residents,” the memo said.
Families with loved ones in two Ottawa long-term care homes made public pleas for more help this week after workers there coped with outbreaks with severe staffing shortages.
On Wednesday, city officials said some recreation staff who are currently not working are being trained to assist long-term care residents in city-run facilities and some could eventually help with tasks including feeding.
Supports have already been deployed to homes, with a focus on infection prevention and control resources.