Pandemic forced big changes at Northwood, other nursing homes
EDITOR’S NOTE: This is the second in a five-part series looking at what has been done and what needs to be done to keep our elderly population in longterm care homes safe during COVID-19.
HALIFAX — The COVID-19 virus killed 65 Nova Scotians in the first wave of the pandemic last spring.
All but 12 of those people died at one nursing home, Northwood Halifax. On April 18, the deaths of three residents were announced. The toll rose until May 30 when the final death — the 53rd — was reported.
Some died without even seeing family as the building was quarantined.
A government-appointed expert panel cited staffing shortages, shared rooms and bathrooms, inadequate cleaning processes and staff unknowingly carrying the virus into the facility.
Northwood CEO Janet Simm said in a recent interview the facility has taken steps to reduce the risk of this ever happening again.
Reflecting on the facility’s response in the spring, Simm said the general lack of knowledge about such things as the importance of masking and the best ways to control viral spread limited Northwood’s options.
For example, the consensus now is that screening for fever isn’t an effective diagnostic tool but Simm said Northwood was advised in the spring to set up infrared cameras to monitor people’s temperature.
“What we were advised to screen for and what the evidence was telling us what we should be screening for has changed dramatically.”
MORE TESTING
As of Nov. 27, staff and designated caregivers must undergo COVID-19 testing every two weeks. Residents only leave for medical appointments. Everyone entering the facility must wear a mask and be screened for COVID-19 symptoms. Anyone entering a resident living area must sign in and out to provide contact tracing information.
As well, Northwood has reduced its beds from about 485 pre-pandemic to about 385 with about 16 shared rooms.
The move to cut 100 beds enabled Northwood to meet the recommended physical distancing requirements but it’s come at a cost.
“Certainly the 385, that reduction, has posed huge challenges to the rest of the health-care system because there are many individuals who require long-term care,” Simm said.
On Friday Jan. 29, the Nova Scotia government announced funding to ensure Northwood doesn’t have to take back those 100 residents and can ensure each who remains has a room of their own.
SAFETY COMES WITH A COST
The order to set aside space to create internal COVID19 treatment units has also “created huge pressure” on long-term care facilities. As the largest nursing home in the province with multiple points of entry and — at the time — many shared rooms, Northwood was particularly vulnerable to a virus that is now known can be transmitted asymptomatically, Simm said. It has also become apparent that the virus may have been present in Nova Scotia as early as January 2020.
“Northwood is part of the community and what happened in Northwood was a reflection of that community ... What happened once it got inside the walls is a different story but that introduction of COVID-19 into the facility was a reflection of what was happening in that community.”
Northwood residents and staff were the first to receive COVID-19 vaccine shots in the long-term care sector in Nova Scotia last month.
An internal Health Department
review of the impact of the pandemic on long-term care across Nova Scotia highlighted the need to develop additional infection prevention and control resources, education, strategies and practices.
“In advance of the second wave of COVID-19, it will be incumbent upon government, health authorities and sector stakeholders to align on priorities, direction, and information sharing,” the review concluded. A Health Department spokeswoman said the department has used the Northwood and IPAC report recommendations to better prepare the continuing care sector for a second wave.
In an earlier interview, Vicki Elliott-Lopez, the Health Department’s executive director of continuing care, said the most significant lesson out of the pandemic “is how important it is to increase cleaning measures around infection prevention and control," particulalry shared bathrooms.
She said $4.5 million had been set aside to expand cleaning services in nursing homes.
STAFFING SHORTAGES
But unions that represent long-term care workers and the Nursing Homes of Nova Scotia Association say overall staffing remains inadequate.
During a virtual meeting of the legislature health-care committee on Jan. 12, the Nova Scotia Nurses Union and the NSGEU sought a near-doubling of the minimum daily hours of care for residents from the current 2.45 hours to 4.1 hours.
Michele Lowe, the nursing homes association’s managing director, also pushed for an increase in minimum patient care but she was hesitant to limit it to 4.1 hours. Lowe said some nursing homes require more time per patient, noting that over 80 per cent of long-term care residents have some form of dementia.
COMMUNICATIONS TARGETED
An updated long-term care tool kit that has been distributed across the sector has “a very comprehensive” communications strategy, ElliottLopez said.
During the first wave, nursing home operators were confused by the overlapping responsibilities of the health authority and the Health Department.
“We’ve created together a COVID-19 rapid response team and so the sector is now aware when we have an outbreak who they call, how the process is facilitated and how things are going to roll out.”
The long-term care reviews also recommended the creation of health and safety “drop teams,” to go into every long-term care home and review their operational strengths and weaknesses prior to any outbreak. Those were included in a September funding announcement.
Tomorrow: Early warnings saved lives