If you’ve been reading the papers or watching the evening news in recent months, you’ve probably noticed a narrative emerging that questions the safety of long-term care homes during the ongoing global COVID-19 pandemic.
There has been a lot of finger-pointing directed at the long-term care sector after homes across Ontario and Canada experienced outbreaks of the virus; and indeed, some of these outbreaks resulted in multiple deaths in homes and, in some cases, resulted in staffing crises.
However, what is not being discussed at large are the underlying factors that have led to COVID-19 infection and spread in long-term care homes.
A June 25 report from the Canadian Institute for Health Information (CIHI) states that, as of May 25, Canada has the highest percentage of COVID-19 deaths in long-term care homes in the world.
As has been the case worldwide, Canadian long-term care homes have been significantly affected.
At the same time, Canadian “lockdown” measures are regarded as very effective in containing overall spread, significantly impacting the comparability of this measure to the experience of other countries.
But why have Canadian long-term care homes been impacted so heavily by COVID-19 infection?
To begin with, COVID-19 is a highly infectious virus. Seniors, particularly those with other health issues, are more vulnerable to infection and mortality than other segments of the population.
Because of the extensive care needs of residents, long-term care is delivered in congregate living settings. The particular design characteristics of older homes creates more extensive infection prevention and control challenges. It is essential that government policy and funding be addressed so that these older homes can be redeveloped.
In all settings, it is vital to detect the presence of the virus early in order to properly isolate the virus and protect residents from spread.
In virtually all the long-term care homes that saw significant infection, such as Almonte Country Haven, an OMNI Health Care long-term care home in Lanark County, the spread began early because the virus was introduced early, most likely through transmission from visitors who had contracted the virus from within the community prior to the provincewide introduction of non-essential visitor restrictions.
At the time, Public Health Units in Ontario were facing a shortage of testing supplies, and testing was generally limited to up to three symptomatic residents to confirm the presence of COVID-19.
It is now widely accepted that the virus is spread by affected staff and residents who are asymptomatic and who were not otherwise identifiable through active screening measures.
Widespread testing was not available to detect those individuals, representing 27 per cent of the population in Almonte, until well after the outbreak had occurred in late March.
Facing a highly infectious and dangerous pandemic, it also needs to be said that long-term care homes have done a very credible job of containing and controlling the spread of COVID-19.
Homes that were infected early are coming out of outbreak, and many are not showing new cases. The staffing crisis faced by many homes has been eased through recruitment and emergency measures adopted by government, though it remains a significant concern looking forward.
Infection control practices, social distancing and adhering to strict ministry-mandated infection prevention and control protocols, such as visitor restrictions, have gone a long way in stemming COVID-19’s spread, protecting residents and helping many who contracted the virus recuperate.
Widespread testing of all residents before entering the home and continuing widespread and frequent testing of staff are key elements to containment strategies for COIVD-19 that are now available to homes.
The COVID-19 pandemic has demonstrated the resilience and resourcefulness of long-term care home staff, their personal sacrifices, and their dedication to the residents.
Much needs to be written and said about these heroes of the pandemic.