Nursing homes brace for second wave of virus,
Thousands of workers gone as industry pleads for help from province
Shattered by the first deadly wave of COVID-19 and losing frightened staff by the thousands, the nursing home industry is girding for a second wave and warning that the Ontario government is not preparing for it quickly enough.
Many homes remain desperately short of workers despite Premier Doug Ford’s promised $4 hourly pandemic bonus, little has been done about fourbed rooms where the virus spread easily, and Canadian Armed Forces medical teams are set to pull out from five of the hardest-hit locations on June 12.
Meanwhile, hospitals that are managing nine nursing homes in crisis while loaning “SWAT teams” to care for residents and bolster infection control in dozens of others will eventually leave them to resume normal operations — or face a potential rush of patients themselves.
“The next wave could come before September. It could come in July. We don’t have the luxury of time,” Donna Duncan, chief executive of the Ontario Long-Term Care Association, told the Star.
“I’m not sensing urgency,” added Duncan, whose group represents a range of nursinghome operators, from for-profit and municipal to charitable and not-for-profits.
Ministry of Health numbers quantify the damage and point to the challenges ahead.
More than 5,200 of Ontario’s 78,000 nursing-home residents have contracted COVID-19 and 1,679 have died, along with seven staff members, whose unions say masks and other personal protective equipment were in short supply or not available.
At least 1,865 long-term-care employees have been infected, representing almost 40 per cent of the health-care workers in the province who contracted the virus. There have been more than 300 outbreaks in Ontario’s 626 nursing homes, with 89 still active. Just under 1,000 residents remain ill, along with 805 staff members who are off sick instead of caring for them.
“There is no confidence that if a second wave comes we’ll be able to handle it,” said Sharleen Stewart, president of SEIU Healthcare, a union representing thousands of nursing-home workers.
“They’re risking their lives. They’ve proven that already,” she added, calling on nursing home management to improve pay, supplies of PPE and working conditions by listening to employees, particularly on infection control concerns.
Duncan is pushing for contingency plans, such as overflow facilities to ease crowding, recruiting workers with applicable skills from other industries (such as restaurants largely idled by the pandemic to provide food services for residents) and arranging fail-safe measures after some doctors would not see patients in person in nursing homes. “A lot of telemedicine was happening. In many cases around the province, physicians were not going in,” Duncan said.
Health Minister Christine Elliott pledged the government won’t leave nursing homes “without assistance,” but was short on details, other than noting hospital teams will assist in the five homes that currently have military help.
“We’re working on all of those issues to make sure that when the time comes for hospital staff to leave, that there will be the appropriate staff, with the appropriate measures in our long-term-care homes.”
The hardest-hit homes, including the five GTA facilities assisted by 50-person military teams, saw staff levels fall as low as 20 per cent, Duncan said, leaving residents and the few remaining workers in dire straits amid conditions described as “horrific” and “inhumane.”
They included underfeeding and forceful feeding to the point of choking, dispensing medications months past their expiry dates, masks under lock and key to save money, and residents kept in their beds for weeks, leading to painful pressure ulcers, or left crying for help in soiled diapers.
Pandemic pay, which will expire in mid-August, hasn’t been enough to retain many staff concerned for their own physical and mental health, said Duncan.
She estimates half the labourintensive industry’s 80,000 prepandemic employees have been staying away.
“Staff are just quitting because the stigma and the fear is too much for them. We have to replace a workforce. I’m not sure they’re coming back,” Duncan added.
“That’s the thing that really keeps me up at night. If we can make sure staff feel safe and supported, I think we can stabilize and have people come back.” Stewart agreed with the 40,000 figure and Duncan’s sentiment, but said many nursing homes “won’t have those conversations” about better wages, proper access to PPE, infection control and care standards. “Until they do, I don’t have any answers for them.”
Wages at nursing homes for many jobs start at the $14 hourly minimum, with personal support workers who dress, groom, feed and toilet residents earning $16 to $19 and registered practical nurses earning about $23 hourly.
“Some of them make less than Tim Hortons servers do. They feel like nobody cares about them,” said Stewart.
Elliott acknowledged retention is a problem, particularly in the wake of the PPE shortages.
“We need to make sure that, first and foremost, we have a safe workplace for people, whether it be nurses or personal support workers. It has to be a clean environment, for both their sakes, as well as for the residents.”
Advocates for nursing-home residents and workers have repeatedly pressed for changes, including pay levels at the same rate as equivalent hospital staff, guarantees of full-time work with benefits for personal support workers so they don’t have to hop from one home to another as potential virus vectors, and a minimum standard of four hours personal care per resident daily.
The Registered Nurses Association of Ontario has cited “deadly delays” in giving nursing home workers PPE and a lack of isolation facilities, as well as the government’s “low prioritization” of nursing homes as the pandemic approached among key problems to fix.
“The best way to do that is to ensure nursing homes in Ontario are adequately funded and the staff supported to fully protect the health and safety of everyone,” said RNAO chief executive Doris Grinpsun.
“As COVID-19 has shown, this is not the case today and the results are devastating for residents, their loved ones, and the staff who heroically care for them under the most trying circumstances.”
Opposition parties are also raising the alarm, given that Ford initially promised an “iron ring” of protection around vulnerable nursing home residents that faltered when the virus hit full force in April.
“We certainly can’t go down that road again,” said NDP Leader Andrea Horwath. “I would like to see some kind of a plan.”
“Staff are just quitting because the stigma and the fear is too much for them.” DONNA DUNCAN ONTARIO LONG-TERM CARE ASSOCIATION