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Concerns over training, use of protective equipment, as outbreaks of coronavirus continue in long-term care facilities

Coronavirus outbreak: Questions over proper training for staff at long-term care homes
WATCH ABOVE: The federal government is implementing new guidelines for workers in long term care homes to help facilities grapple with the covid-19 pandemic. Many provinces continue to deal with a shortage of personal protective equipment and staffing shortages. But questions surrounding proper training for front-line staff have been brought to the forefront in the wake of an inquiry made by Global News. Morganne Campbell has more in this report.

Editorial note: The headline on this story was updated at 9:58 a.m. ET on April 11 to clarify that contaminated equipment may have led to the spread of the virus. The article was rewritten and updated with comments made by Ontario PSW Association president Miranda Ferrier.

As the number of COVID-19 infections and fatalities rises in long-term care facilities across Canada, federal and provincial health officials are struggling to ensure the country’s most vulnerable citizens — and the people caring for them — are protected from the pandemic.

One of the country’s hardest-hit facilities is the Pinecrest Nursing Home in Bobcaygeon, Ont. — where almost half of the facility’s 65 residents have died a few weeks after its COVID-19 outbreak started.

During a news conference on Thursday, Ontario’s chief medical officer, David Williams, said the administration of each individual facility was ultimately responsible for ensuring staff was properly trained.

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“That’s part of the challenge of each organization,” Williams said. “It may seem, on paper, easy. But when you start to do it, you have to practise and do it. And so ongoing education and training is critical for all levels and so I would be as supportive of ongoing training and education of PSWs (personal support workers), such that they would totally be informed and aware of what they might and should do in every situation.”

Lack of training for care home workers could fuel COVID-19 spread
Lack of training for care home workers could fuel COVID-19 spread

Williams’ comments come after new images captured by Global News revealed several support workers at Pinecrest wearing their protective equipment, including masks, gloves and medical gowns outside the building.

Experts say this type of equipment is meant to be discarded in rooms following each interaction with patients in order to prevent viruses and bacteria from spreading.

Pinecrest administrator Mary Carr declined to comment about the images showing workers wearing their personal protective equipment outdoors, but she sent Global News a statement saying that staff “are working hard each and every day to fulfill the physical and emotional needs of our residents as their care and safety continues to be our number one priority.”

She also said that Pinecrest is “working closely with public health authorities as new information regarding the outbreak is made available” and that it was “committed to implementing all ongoing and new care directives.”

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Canadian’s send special message of ‘Courage’ to residents of ‘Bobcaygeon’
Canadian’s send special message of ‘Courage’ to residents of ‘Bobcaygeon’

After an earlier version of this article was published, Miranda Ferrier, the president of an association representing personal support workers, posted a video saying she was furious about how Global News had reported on the images showing people wearing protective gear outside of the Pinecrest facility. She explained that workers knew how to protect patients, but were not given the proper equipment to do their jobs.

“I myself am a PSW and I know already what you guys are going at on the front line in long-term care, in-home care across our province,” she said. “The people we already care for our scared. You guys are scared. I’m hearing from PSWs every single day stating that they are sitting in their cars before they go to work at long-term care and they’re crying because they’re scared to bring [COVID-19] to their loved ones at home.”
People wear personal protective gear outside the Pinecrest Nursing Home in Bobcaygeon, Ont., on April 1, 2020.
People wear personal protective gear outside the Pinecrest Nursing Home in Bobcaygeon, Ont., on April 1, 2020. Global News

Ferrier also said she believed it wasn’t fair to draw attention to the absence of training related to COVID-19, noting that the workers had other infectious diseases training.

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“This virus literally just hit our long-term care homes three weeks ago,” she said. “I don’t know any entity that could have training out that fast when you’re dealing with mass hysteria and war zones on the front lines.”

Ferrier did not directly comment on why workers were wearing their protective equipment outside.

Carr sent a new statement on Saturday saying that workers were properly trained and that her facility had an adequate supply of personal protective equipment for the staff.

But at a news conference organized earlier in the week by the Canadian Union of Public Employees, one personal support worker who spoke anonymously said that some front-line staff are weighing the odds about how to use their equipment since it is in short supply.

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“Can there be errors made? I’m going to say there can be,” she said.

Similar stories of the virus spreading in seniors’ residences have played out across the country.

In Quebec, about 25 per cent of the province’s 2,200 long-term care homes have already detected at least one case of the disease, with some homes now seeing over half of their patients infected by COVID-19.

READ MORE: Coronavirus outbreak at Bobcaygeon, Ont. nursing home claims 29th resident

And almost half of over 200 Quebecers who died in recent weeks after contracting COVID-19 were residents of the long-term care homes.

Coronavirus: Ontario looks to free up long-term care beds and move hospital patients in nursing homes
Coronavirus: Ontario looks to free up long-term care beds and move hospital patients in nursing homes

This indicates that some personal support workers haven’t been taught about safe hygiene practices, according to Anna Banerji, a Toronto physician and an expert on the spread of infectious diseases.

“That’s how these infections spread,” Banerji told Global News in an interview.

“Maybe we need some intervention in these seniors’ residences for infections control people to go in and have strict measures and strict education so that people know that — even if you have gloves on — you can’t use those same gloves and go out, have a smoke, come back, touch something else. That’s not how it works, because all you’re doing is spreading it.”

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Banerji’s warnings are consistent with a new survey of some 2,000 personal support workers in long-term care homes, conducted by the Canadian Union of Public Employees.

The survey found that 95 per cent of the respondents said they had no access to training about how to deal with or interact with patients with COVID-19.

Long-term care homes are also particularly vulnerable to outbreaks since they don’t have enough private rooms to quarantine someone who is sick, and often have shared rooms.

READ MORE: Canada’s nursing homes worry coronavirus outbreak will mean residents ‘dying alone’

In addition, Ontario public health officials had previously asked long-term care homes to accept the transfer of hospital patients, without requiring that any of these patients be tested for COVID-19 before they were moved — a practice that provincial officials reversed on Thursday.

Ontario has also been allowing staff to rotate between different facilities, instead of placing restrictions that prevent them from circulating.

Williams, the province’s chief medical officer, said he is recommending that staff don’t work in multiple facilities, but said additional discussions are needed with other stakeholders, including provincial labour officials, in order to make it mandatory for workers to be restricted to a single facility.

He said he had just spoken to his provincial and territorial counterparts who are also trying to figure out how to restrict traffic between different facilities.

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READ MORE: What to know before removing loved ones from nursing homes amid COVID-19

“Each province and territory is struggling with the same issue in a way that protects those at risk but respects the rights of the individual working in those settings as our democratic process allows,” said Williams. “So we’re trying to understand that and help us to work out a solution that is amenable to all and for the protection of those most vulnerable.”

Tim Deelstra, a representative from the United Food and Commercial Workers, which represents more than 2,000 staff members including PSWs at long-term homes across Ontario, said government officials and facilities need to do more to address staffing shortages and offer higher wages and better working conditions for the workers on the front lines.

“They definitely need to have the assurance from their employer and from the government that they will have the equipment they need to provide that care,” Deelstra said.

Many workers have also expressed concerns about a shortage of personal protective equipment, which is leading some to re-use equipment that may be spreading the virus.

“It is absolutely a perfect storm, headed directly for disaster,” said Candace Rennick, CUPE Ontario secretary-treasurer.

– with files from Jigar Patel