Earlier this week, chief public health officer Dr. Theresa Tam announced half of Canada’s coronavirus deaths stem from outbreaks in long-term care facilities for seniors.
With now more than 1,000 COVID-19-related deaths reported across the country, hundreds of seniors who were living in those homes now make up a large portion of those deaths.
“These deaths will continue to increase, even as the epidemic growth rate slows down,” Tam said at a press conference on April 13.
Prime Minister Justin Trudeau also addressed climbing death rates in long-term care homes on April 15, announcing that he’d work with the provinces to boost wages for workers in those facilities who, prior to the coronavirus outbreak, would work shifts at multiple homes to make ends meet.
“The uncomfortable and tragic truth is that the very places that care for our elderly are the most vulnerable to COVID-19,” Trudeau told reporters.
“Right now, seniors are worried about falling ill and not being able to see their kids and grandkids again. These are the things that we need to focus on as a country.”
Trudeau and provincial leaders are working to make changes to curb the high death rate seen at homes across the country. Quebec Premier Francois Legault is asking the prime minister for military aid for the homes and Ontario Premier Doug Ford announced a new plan for these residences that includes stricter testing and access to personal protective equipment (PPE).
While there are hundreds of homes across the country reporting outbreaks, some are being hit harder than others.
Based on an analysis by Global News, a total of 16 seniors homes have reported at least 10 or more deaths due to the virus. Numbers provided by public and provincial health units across the country and local news reporting contributed to the data.
Not all Ontario public health units will disclose which homes have reported deaths due to privacy concerns. The data is confirmed as of April 16 and may be higher due to reporting delays between Ontario’s public health units and the provincial health ministry.
A Toronto Star investigation this week found that some public health units are disclosing more deaths than what is being reported by Public Health Ontario.
In an email to Ontario’s Ministry of Health, Global News requested a breakdown of deaths per long-term care facility. In a statement, the ministry said it couldn’t provide this information.
Why do these homes have more deaths than others?
Residence Herron in Dorval, Que., has seen one of the highest numbers of deaths in a home in the country, with 30 seniors dead within weeks. Global News reported this week that some nurses say the home had unsafe working conditions.
The Pinecrest Nursing Home in Bobcaygeon, Ont., has been fortunate not to report any new deaths due to COVID-19 this week. According to health officials, the 29 deaths reported at the facility is so far the deadliest long-term care outbreak in Ontario.
Long-term care homes are considered highly vulnerable to COVID-19 due to the frailty of residents as elderly people are more susceptible to worse health outcomes from the virus.
Lack of access to PPE along with workers sometimes having to work at multiple homes to make ends meet contributes to the spread, according to a previous Global News report. Seniors in those homes are particularly vulnerable as they are often cognitively impaired and cannot identify their symptoms.
Shared accommodations, less physical space in common areas, and more residents who may not understand instructions like handwashing could make one seniors’ home more vulnerable to COVID-19 than another, said Dr. Barbara Liu, executive director of the Regional Geriatric Program of Toronto.
Some homes may have more people flowing in and out of them, but it could just be by chance that a facility sees a more serious outbreak, she said.
“It only requires contact with one infected person to introduce the virus into the home,” she said in an email to Global News.
The number of residents sharing a room could also impact how many become infected if there’s an outbreak, said Colin Furness, an assistant professor and epidemiologist at the University of Toronto who specializes in infection control.
Click on the map below to see where Canada’s hardest-hit homes are.
“Having two or sometimes four people sharing a room could be a risk factor,” he said.
He shares Liu’s sentiment that the proportion of able-bodied and cognitively aware residents is also an important factor, as they are more able to follow safety procedures.
Homes that are worse off are currently concentrated in dense urban centres like the Toronto and Montreal areas. Those regions simply have more people and more cases of the coronavirus, increasing the chances of the virus entering a long-term care home, said Furness.
More strict protocols on personal protective equipment and its availability to workers is also a factor in how well a home may fare, he said.
At the root of the issue, however, is that long-term care residents and workers are not prioritized and COVID-19 has exposed underlying cracks in the system that had long been present, he said.
“We spend lavishly on hospitals, but we don’t spend on long-term care,” he said.
While it’s difficult to currently discern what has happened at each specific home leading up to an outbreak, it’s clear long-term care hasn’t been a priority in Canada, said Kerry Bowman, an assistant professor and bioethicist at the University of Toronto’s Dalla Lana School of Public Health.
“The big picture is they’ve all done very badly and we’re all responsible because we’ve allowed this to happen. We don’t value older people. And, you know, this has been the price we’re paying,” he said.
Questions about COVID-19? Here are some things you need to know:
Health officials caution against all international travel. Returning travellers are asked to self-isolate for 14 days in case they develop symptoms and to prevent spreading the virus to others.
Symptoms can include fever, cough and difficulty breathing — very similar to a cold or flu. Some people can develop a more severe illness. People most at risk of this include older adults and people with severe chronic medical conditions like heart, lung or kidney disease. If you develop symptoms, contact public health authorities.
To prevent the virus from spreading, experts recommend frequent handwashing and coughing into your sleeve. They also recommend minimizing contact with others, staying home as much as possible and maintaining a distance of two metres from other people if you go out.
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