The recommendation was contained in a document posted on Ontario’s COVID-19 Science Advisory Table website on Wednesday. The report looks at how best to target seniors who live in Toronto’s 489 naturally occurring retirement communities (NORCs), which are buildings where at least 30 per cent of the residents are 65 and older and have at least 50 people in that demographic.
Medical experts with the advisory body highlighted a majority of the buildings (256 out of 489 and home to 40,955 out of 70,013 seniors) are in neighbourhoods where there have been elevated numbers of COVID-19 cases.
“Targeting NORCs through mobile on-site vaccination could be an efficient and equitable approach to protecting those at highest risk of COVID-19 hospitalization, morbidity and mortality,” the document said.
“Such an approach is also age-friendly as it is less complicated and physically taxing for frail or homebound older adults who might otherwise face challenges with booking appointments, travelling to and from mass vaccination clinics, and have difficulty waiting in lines.”
Margot Fleming, who is 92 and lives in an assisted-living facility, received a COVID-19 vaccination through a mobile clinic program operated by a Toronto hospital. She said as someone who has diminished vision, she appreciated the help of workers who came to her home.
“They took the needle and gave it to us here, so that was good. We didn’t have a problem that way,” Fleming said.
“It was exciting, they just came to us and told us they were coming and we’re having it.
“It’s a good feeling, it’s really a good feeling, because we know we’re being protected, right?”
The report said by organizing mobile clinics, it would work to help remove barriers for people who can’t navigate the vaccine booking website, who have cognitive or sensory impairments and those who aren’t fluent in English or French (the only languages serviced on the website).
The experts said a similar model of clinics was instituted at some of the NORCs in 2020 for influenza vaccines.
However, the document outlined logistical challenges that need to be addressed. For example, outreach would need to be done with representatives of each of the buildings to coordinate the program and door-to-door vaccinations would likely need to be done. Also, such a program would need access to a vaccine that doesn’t require deep cold storage requirements.
The report also said if the building is at a higher-risk, health-care workers might have to consider vaccinating everyone in the building versus just those who are 65 and above since residents and their interactions are “heavily intertwined.”
The pandemic has also raised questions among experts about the design of buildings and how residents are aging at home.
“Currently available housing and care options can perpetuate the sense of loneliness, social and physical isolation, and result in institutionalization as people age. COVID-19 has exposed these shortcomings in a stark and dramatic way,” the document said.
“When many older adults live right next door to one another, separated by just a wall or a ceiling, this opens up the possibility of re-designing services to make use of these natural densities and deliver a more expansive notion of care on-site.”
— With files from Miranda Anthistle