COVID-19 outbreaks at long-term-care facilities weren’t ‘prepared for properly’
‘We've been talking about this for years'
April 28, 2020
Virologists and epidemiologists have long warned of the rise of new viruses, drawing their wisdom from historical episodes that include the 1918 flu pandemic, also known as the Spanish flu, that killed at least 17 million people worldwide.
This has also translated into a call for more health funding as part of a contingency plan locally at home, especially at long-term-care facilities, who have part-time workers flocking from one place to another to make ends meet.
Long-term-care workers and nursing homes have become a news headline staple. Some even have described York Region’s long-term-care facilities as being the “hardest-hit” in the Greater Toronto Area.
In mid-April, Canada’s chief public health officer, Dr. Theresa Tam, announced that half of Canada’s coronavirus deaths stem from outbreaks in long-term-care facilities for seniors.
“Was this predicted? Yes. Was this prepared for properly? No,” said Doug Sheppard, chair of the York Region and Long-Term Care units of CUPE Local 905.
Sheppard represents more than 4,000 members in total, which include paramedics, public health and all the support staff there. Part of this figure is about 500 long-term-care workers at York Region.
“The province is now scrambling to try to deal with the issue,” Sheppard said, after Doug Ford finally issued an emergency order prohibiting employees from working at multiple long-term-care facilities in an effort to slow the spread of COVID-19.
“You can't go between nursing homes,” he added. “We've been talking about this for years. If people had full-time jobs, they wouldn't be working at different nursing homes, and we saw that during SARS with nurses.”
In one article entitled “What has SARS taught us about infection control in nursing homes,” published in the Journal of the American Medical Directors Association in 2004, it elucidated how the regular influenza’s mortality rate tends to be higher when there is an outbreak in a nursing home, let alone the mortality rate of a whole new ailment.
“What this means is that familiar respiratory viruses pose a risk to nursing home residents that is similar to SARS among those living in the community,” it said, adding, “For me, this is a sobering thought and a reminder that we should be very careful about transmitting the usual respiratory viruses to nursing home residents.”
One way to cut down the risks is to offer the staff full-time jobs.
“That’s something we've been advocating for years, that there should be permanent full-time employment that pays decently so they don't have to go between different homes,” he said.
“We did that before the provincial order just to work in one home, to make York Region the employer of choice.”
For instance, prior to the COVID-19 outbreak last year, the government of Ontario announced their intention to make some changes, including a reduction in funding to the province's public health units.
So far, there are 35 public health units in Ontario.
“One of the proposed changes could be a reduction to 10 public health units,” Sheppard said. “From the union's perspective, it would be negative for the province to make changes that would reduce public health funding.”
However, “Now more than ever, it is clear that we need a strong and well-funded public health system to help keep our community safe and healthy.”
Sheppard urged that the provincial government “continue to recognize the critical role played by all, including public health and long-term-care workers, as well as paramedics, in preventing and controlling the spread of COVID-19, and ensure the services these workers provide are funded appropriately now and in the future.”
According to the Ontario Long Term Care Association, there are 626 homes that are licensed and approved to operate in Ontario. About 58 per cent of these homes are privately owned while 24 per cent are nonprofit/charitable, and only 16 per cent are municipal.
York Region has two municipally-run long-term-care facilities where the union’s members work: Newmarket Health Centre and Maple Health Centre.
“We haven't had any cases of COVID-19 at either one of our large homes,” Sheppard said, adding there was no issue of a PPE shortage as well.
“The struggle (for PPE) is in non-municipally-run long-term-care facilities,” he added, describing how there is a “sharing of resources” when it comes to municipally-run facilities, “everything from the minor to the major.”
“So the non-government-run facilities, some of them are for profits, some they're not-for-profit. So their funding levels are not adequate to provide the service. So the municipally-run homes are funded jointly by the province and the regional tax base.”
“They're down at that facility (Participation House) in Markham,” Sheppard said.
Recently, a third resident at Participation House has died after every one of its 42 residents tested positive for COVID-19, according to York Region Public Health.
The facility for adults with physical and mental disabilities has been grappling with a COVID-19 outbreak and staff shortages since just before the Easter long weekend.
On April 12, Laura Meffen said she removed her daughter Emily from Participation House; staff had participated in a walkout days before due to the lack of proper PPE.
While Meffen has tested negative for COVID-19, she has all the symptoms and is currently quarantining at home, and her daughter is luckily improving.
Mother wants more funding
Participation House is private, but it's also “funded through the Ministry of Children, Community and Social Services,” Meffen said. But, she added, “I think there needs to be more funding through the Ministry of Children, Community and Social Services, and long-term health as well.”
In addition to the “lack of funding” and no proper “access to all PPE,” Meffen said, there needs to be “mapping training,” which she dubbed as “important.”
“They need to update their training on how to deal with a pandemic.”
To be fair, Meffen praised Participation House and how it helped her daughter, who suffers from a rare neuromuscular degenerative disease called NGLY1, to see her “independence blossom.” She urged parents not to be reluctant to send their kids to such facilities.
She also understands that it's hard to “isolate” people without affecting their “mental state,” as such facilities do require some “congregate” setting.
“It’s really hard” for some of these residents to sit in a room by themselves; after all, “some residents who can't do anything for themselves, like, they can't even change the channel or turn on the TV.”
For Sheppard, there needs to be a “cultural change.”For seniors, the union chair said they are the ones that paid taxes for the last “50, 60, 70 years, and this is the way they're being treated at the end of their life. We have a much greater responsibility than this."