BY PAMELA FAYERMAN
Terry Lake, the former B.C. health minister who now leads the BC Care Providers Association, was stunned by what he heard on CBC radio this morning. Government officials, including public health leaders like Dr. Bonnie Henry, have, for many weeks, dismissed pleas for rapid tests from those in the long-term care sector, mostly on the grounds that rapid tests are not as accurate as PCR tests.
But faced with mounting deaths in long-term care and hundreds of illnesses among staff, the government has abruptly shifted course.
It couldn’t happen soon enough since more than 1,000 long-term care residents are now battling COVID-19 on top of over 500 staff at such facilities. There are outbreaks in more than 50 facilities across B.C.
On The Current today, Dr. Reka Gustafson, B.C.’s deputy provincial health officer, told host Rosemary Barton that B.C. was “absolutely” going to start doing rapid testing in long term care facilities. Her announcement came just days after Lake pleaded for rapid tests in public and private facilities.
Condensed excerpts from the CBC interview, which included Karen Biggs, the CEO of a severely affected facility, are below. I have asked the provincial government for more information about the rollout of rapid testing. And I’ve highlighted in red the specific mention of rapid tests.
DR. REKA GUSTAFSON: Well, I think what we’ve learned about Covid-19 is that there is a surge in the winter. And like everywhere else in the world, we’re experiencing a winter surge. There are increasing cases throughout B.C. but the increases are actually concentrated quite a bit into one particular regional health authority. And I think the other thing to think about is that doing well needs to be defined in terms of what our goals are and our goals are to prevent severe illness and death and to minimize societal disruption. And over the last few weeks, we have seen more hospitalizations and admissions to critical care, which means that we are starting to be more concerned about severe illness. And therefore, at this time, we need to take additional measures.
RB: And what kind of strain is that putting on your health care system on hospitals, for instance?
DR. REKA GUSTAFSON: So at this time, when I’m speaking to my critical care colleagues, they are certainly managing and are anticipating the potential increase in need and are planning for that. So I would say that our health care system is absolutely managing. And I think that’s important to remember because the ability for critical care to manage actually has a significant impact on how well people do who need critical care. And we are seeing more outbreaks in long-term care facilities, which is a concern to us all.
RB: Well, I’m glad you brought that up, because I’m going to bring in another voice, as I’m going to do throughout this part here. One of the sectors, as you said, is, is long term care homes. And as I mentioned, more than 50 outbreaks right now, including Menno Place in Abbotsford. And I’d like to bring in Karen Biggs, the CEO of Menno Place. Karen Biggs, good morning. Can you tell us what’s going on in your home right now, your long term care home?
KAREN BIGGS: Good morning. Yes, we have 700 seniors on our campus and we’ve managed to keep Covid out all for nine months. But unfortunately, on November 17th, one of our seniors was sent to (hospital) and came back. And unfortunately, she brought back Covid with her. That unit that she lives on now has 26 positive residents out of the 45 who live in that unit and 16 of our staff that worked in that unit are also very ill. So we then yesterday had our first tragic death related to Covid. So it’s been very, very upsetting for our staff.
RB: I’m sure, and for the residents too. What is it like now for this to happen after nine months of successfully keeping it out?
KAREN BIGGS: It’s very, very disappointing, you know, we’ve worked so very, very hard to try to protect our seniors and the staff has worked hard to try to save face when they’re off work and the staff did not bring it into our home. It’s been very, very sad.
RB: And you are, in order to address some of those staffing issues, because that’s the other part of this, of course, taking a sort of unconventional approach to addressing some of those concerns. What is it that you’re doing?
KAREN BIGGS: Well, you know, we’re absolutely desperate for stuff. The first thing that happens when you get an outbreak is you cohort staff on one unit. We, in fact, have been cohorting most of our staff since March, but occasionally we had some staff, like cleaning staff, working on two units. So they cleaned on one unit in the morning and one unit in the afternoon. With an outbreak, you also have to enhance cleaning. So we’re using about four times the number of cleaners per unit. So what we’ve done is we’ve gone actually to family, we ran a number of ads first and we got no people that we could hire, was running out. And so we went to family and we ran a Facebook post actually on Saturday. And to date, we’ve got 58 family members that are interested in coming. And we’ve been getting their resumes. And we’ve hired two. They started yesterday. And these are very qualified people. They may be cleaners in hotels or other services. And so we’re very excited about having this partnership.
RB: What are your fears about how to protect the rest of the residents at this stage?
KAREN BIGGS: My fears are that it will spread to other units. That’s always a fear because we have six buildings on our campus. You know, we have 350 people in long term care. We’ve got assisted living. These are very vulnerable seniors. You know, their average age is 87. We’ve got lots of people over there, 100 years old, fighting off this virus when they get it is very, very difficult.
RB: And how are residents that you’ve spoken to feeling about the fact that it is now amongst them?
KAREN BIGGS: The residents are confident because this is their home. I think it’s the staff who are more worried because we feel so responsible for trying to protect them.
RB: Let me bring back Dr. Rebecca Gustafson. How bad is the situation in long term care homes in B.C. right now?
DR. REKA GUSTAFSON: So long term care homes are a big challenge for us all, for two reasons. One, we’re in the middle of a pandemic, which means that transmission is occurring and that means the likelihood of introducing or having someone get Covid-19, either staff or resident, as it was just described, is higher. There are a number of things that we are focussing on to try and minimize outbreaks in long term care facilities or minimize their impact. Maintaining appropriate staffing levels, and screening staff before every shift for symptoms is critical. In this case, the virus was not introduced that way. But we know that staff are a part of the community and therefore they are more likely to be exposed to Covid-19 than residents. Active surveillance of residents, which means that you monitor them for symptoms all the time so individuals can be isolated early and of course appropriate use of personal protective equipment. One of the challenges that were just mentioned is that long term care facilities are people’s homes. And so they’re there all the time. And the use of personal protective equipment constantly and consistently in that setting becomes that much more challenging. And of course, we know that Covid-19 disproportionately causes severe illness and death in the frail and elderly. So when introduced into a long-term care facility, that’s where we are seeing that impact of severe illness and mortality.
RB: Can I ask if you’re using rapid testing in long term care homes in B.C.? Because it seems to me that would be another layer of protection for you.
DR. REKA GUSTAFSON: So that testing is being actually about to be piloted for feasibility. Rapid testing is one of those things that we are absolutely rolling out in British Columbia. I think it’s often seen as a relatively simple answer to a big problem. It isn’t necessarily so. It requires training, it requires staffing. And as we mentioned, in long-term care facilities, one of the biggest, biggest challenges we have is staffing. So we need to make sure that the rapid test actually adds something before we add that extra burden on the staff to make it happen. So it is being piloted for feasibility and utility. I think we have to be thoughtful about it. It is a great technology. I think it has potential in a number of settings such as rural and remote settings, potentially in long-term care facilities. I think it’s unlikely to be a silver bullet or a quick answer to a complex problem.