Outbreaks rising in LTCs
Numbers started going up as temperatures fell
Atrend of increasing COVID-19 outbreaks in Ontario longterm-care homes has experts worried vulnerable seniors will once again bear the brunt of an expected fall wave of the virus.
There are 150 long-term-care homes in the province with active COVID outbreaks, according to the latest Public Health Ontario data. That compares to just14 at the same time last year and 51 this time back in 2020.
While the number of current long-term-care outbreaks is down from close to 200 experienced this past summer, the growth trend has clearly been upward in the past two weeks.
Similarly, the number of active cases among LTC residents has increased by 243 over the past week to a total of 1,263. That’s more than 30 times the 40 active cases recorded at the same time last year, and more than nine times the 136 cases seen this time in 2020.
COVID deaths among longterm-care residents are also on the rise, but the overall rate remains much lower than what was experienced during the early part of the pandemic.
“I personally cannot accept any declaration of the pandemic ending because it has to really end for the people who are most impacted first,” said Dr. Amit Arya, palliative care lead at Kensington Health in Toronto.
He notes that while COVID death rates have decreased significantly thanks to the vaccine and antivirals, the virus still worsens the quality of life of those infected and those around them.
“It’s the Thanksgiving long weekend. Families of course want to gather together and residents will often go out. We’re used to having celebrations in long-term care, such as communal dining, creating a sense of community. All of that has to be put on hold and cannot happen when we have an outbreak on a floor in longterm care.”
A rise in COVID cases was not unexpected. Scientists have warned for months that cases would likely increase with a return to full-time, in-class learning at Ontario schools, the dropping of most public health mandates and waning immunity in the general population. Since the beginning of September, the provincewide wastewater surveillance signal has been on a very clear upward trend along with laboratory-confirmed weekly case counts.
The most prevalent variant in recent weeks in Ontario is the Omicron sub-variant BA.5.2.1.
“Right now it’s not clear of course how much longer that rise will persist or the level to which it will reach, but a rise in cases in any major part of society, including long-term care … I think would be expected based on the fact that we’re seeing this in general across the province,” said Dr. Fahad Razak, an internist at St. Michael’s Hospital and former scientific director of the Ontario COVID-19 Science Advisory Table.
But given that COVID has proven most devastating to seniors, many with underlying health conditions, an overall increase in cases across the province is worrying, Razak said.
Those 80 and over have the highest rates of infection in the province. As reported this year by the Star, Omicron has been more deadly for those 60 and over than the previous two waves combined.
“We need to keep a very close eye on the long-term-care sector to make sure that we don’t have a repeat of some of the absolute disasters we saw in the first major waves of the pandemic in 2020,” Razak said.