Nearly half of all coronavirus-related deaths in Canada happen in long-term care homes, and the number is only expected to increase, chief public health officer Theresa Tam said Monday.
The ratio fluctuates from province to province, but care homes are implicated in about half of 760 deaths across the country.
“We know that close to half of the deaths that we’re tracking are linked to long-term care facilities, but that ratio is actually different in different provinces,” Tam told reporters during her daily ministerial update on the virus.
“These deaths will continue to increase, even as the epidemic growth rate slows down.”
She said government data showed initial outbreaks occurring in British Columbia, but eventually began impacting all larger provinces.
As numbers of coronavirus-related deaths in long-term care facilities continue to soar, the federal government has released guidelines aimed at helping provinces, territories and vulnerable facilities prevent further spreading.
The voluntary guidelines include suggestions that include limitations for visitors, and increased screening for workers and residents.
Joining Tam was Seniors Minister Deb Schulte, who lauded the efforts of provincial governments for “stepping up” preventative measures in care residences.
Marguerite Blais, the minister responsible for seniors and informal caregivers in Quebec, recently announced $133 million in added funding for residential care homes, and Ontario’s government is spending $243 million that will work towards increased screening, personal protective equipment and infection control measures in affected nursing homes.
Meanwhile in British Columbia, Schulte said $10 million was being spent on enhanced infection protection measures in long-term care facilities.
Dr. Amy Hsu has been compiling research with the Bruyère Research Institute on the COVID-19 death toll in long-term care homes in Canada. Given the frailty of this population, Hsu said the death toll was “not surprising,” but “still heartbreaking to see.”
In general, seniors are more susceptible to severe outcomes from respiratory failure, she said.
“Because they already have high rates of diabetes, heart and lung disease — particularly those in long-term care — they’re not able to withstand COVID-19 infection as well as healthier counterparts who live in the community,” said Hsu.
As of Sunday, she said 41 per cent of coronavirus-related deaths in Ontario could be attributed to long-term care facilities.
There have been promising advancements on the testing front. On Sunday, Ottawa-based company Spartan Bioscience said its rapid portable tests was recently approved by Health Canada, and Ontario government recently announced that it will be increasing the number of tests it processes each day to 14,000.
But challenges remain.
Hsu said the lack of testing in long-term care homes leading to delayed diagnosis plays a role. But physical distancing is also more challenging in long-term care homes, given shared accommodation and residents’ dependency on others with daily activities, such as meals, toileting and bathing.
Older adults can also show different COVID-19 symptoms than younger people. Hsu said they can display atypical symptoms such as malaise and nausea.
“It’s challenging for all health-care professionals to respond when we don’t have full understanding of the disease symptomology at this point, given how rapidly the virus is evolving and spreading,” she added.
Her research team is examining the early impacts of the emergency measures in response to COVID-19 in the hopes of developing recommendations to improve infection prevention and control in long-term care in the future.
The full report, co-led by Dr. Natasha Lane at the University of Toronto, will be released on Wednesday.
Nearly identical coronavirus-related death ratios are sweeping Europe, where a study based out of the London School of Economics (LSE) in the United Kingdom found similar results.
The study, which was published by the International Long-Term Care Policy Network on Sunday, conducted epidemiological studies in five different European countries: Italy, Spain, France, Ireland and Belgium.
It found that between that long-term care home residents accounted for between 42 per cent and 57 per cent of all deaths linked to the coronavirus.
Adelina Comas-Herrera, an assistant professorial research fellow at LSE who authored the report, told Global News the high percentage of COVID-19 deaths associated with care-home residences was surprising.
“We had been seeing lots of reports and we could see it appeared very high, but we just thought it happened to a few homes,” she said in an interview. “We didn’t realize it was actually quite so much in such a high proportion of all the deaths.”
In Italy, for example, the study showed that out of 14,555 deaths caused by COVID-19, 57 per cent of people who died were living in long-term care homes.
In Ireland, researchers found that out of 6,444 cases of COVID-19 and 288 deaths that were registered on Saturday, 156 (or 54 per cent) were care home residents.
She said providing nursing home employees with personal protective care and ramping up testing for residents would be crucial in reducing the rate of the viral spread in these facilities.
Finding innovative ways to separate the sick and healthy residents will also be pivotal in ensuring long-term care homes don’t become overwhelmed as numbers increase, she said.
“It is very important to see if it’s possible to take some of the residents to alternative settings for self-isolation that are more conducive to that,” said Comas-Herrera.
— With files from the Canadian Press