In the first extensive review of COVID-19 deaths in British Columbia’s long-term care system, seniors advocate Isobel Mackenzie has found care homes should have had more rigorous testing for staff and a more comprehensive sick pay program.
In the 45-page report released Wednesday, Mackenzie outlines seven recommendations including expanding sick pay and increasing the scope and frequency of testing.
“Overall, the majority of outbreaks in B.C. were contained and did not result in any deaths from COVID-19. This was achieved by the herculean efforts of devoted staff who worked tirelessly under immense pressures and stressful circumstances,” Mackenzie writes.
“However, even with everyone’s best efforts, we have tragically lost over 800 residents to COVID-19. In addition, the lives of residents and family members were upended with the trauma of life in care homes under pandemic-imposed restrictions.”
Recommendations also include eliminating shared rooms for residents and requiring vaccinations for long-term care and assisted living staff. The province has already put the staff mandate in place.
“We learned of the extraordinary stress and strain on the system. The staff who work in long-term care and assisted living, the people managing the facilities, and the health system supporting them have been through an 18-month marathon that continues,” Mackenzie writes.
“Every site experienced significant increases in overtime and those sites that experienced a large outbreak saw a 178 per cent increase in their overtime in the past year.”
The report examined care-home outbreaks from March 2020 to February 2021.
During that time period, long-term care and assisted living staff and residents were almost three-and-a-half times more likely to contract COVID-19 and residents were 33 times more times likely to die from COVID-19. In total there were 365 outbreaks at 210 sites in B.C.
Almost three-quarters of outbreaks were contained to four or fewer cases and 75 per cent of outbreaks had zero COVID-19 fatalities.
While the Lower Mainland has 45 per cent of the province’s long-term care and assisted living sites, it experienced 84 per cent of the outbreaks and this higher proportion of outbreaks was linked to higher local community transmission.
In B.C., there was a vast difference between the pandemic’s first wave and second wave, the latter of which saw 87 per cent of outbreaks.
“We observed that B.C.’s long-term care and assisted living sector did perform proportionately better than other provinces, such as Ontario, in Wave 1, but these early achievements were lost in the magnitude of Wave 2, where outcomes in long-term care and assisted living were more similar between B.C. and other provinces,” Mackenzie writes.
“We learned that knowing who was the first case, how the facility was notified about this first case, and the testing strategy directed by public health all had a relationship to whether the outbreak was likely to be larger. The amount of paid sick leave provided, the level of registered nursing staff, and whether the operator contracts for direct care services also influenced if an outbreak was larger or small.”
Here is the full list of recommendations:
- Expand paid sick leave: Only 60 per cent of staff are entitled to paid sick leave and one-third receive six days per year or less.
- Continue efforts to increase the pool of staff
- Decrease contracting for direct care staff
- Increase the proportion of registered nursing staff at non-health authority sites
- Increase the scope and frequency of testing
- Eliminate shared rooms
- Vaccinations in long-term care and assisted living should be mandatory for staff and booster shots should be provided to residents