BY TERRY LAKE
It is almost 10 months since Canada recorded its first COVID-19 fatality – a resident of the Lynn Valley Care Centre.
Since then, more than 12,000 Canadians have died and vulnerable seniors in care have borne the brunt of the pandemic, representing nearly 80 percent of fatalities. While B.C. has fared somewhat better than the rest of Canada when it comes to deaths of seniors in care, we are now seeing an alarming surge in cases, particularly in the Fraser Health Authority region.
This devastating increase in outbreaks should come as no surprise as studies have pointed to the prevalence of the virus in the community as the single biggest factor leading to outbreaks in long-term care. The virus does not care about who owns the nursing homes, although the greater the size, the more rapid the spread. And the older the home, the harder it is to contain.
What really matters at this juncture in the pandemic, is what we do now to keep the transmission in communities to a minimum. We’ve seen the tragic consequences of what happens when we let our guard down: community spread spikes up.
Are there things we learned from the impact of the first COVID-19 wave on seniors continuing care that helped mitigate the impact of the second wave? Or did we fail to incorporate additional measures that would have prevented today’s situation in which about 600 residents in care are battling the deadly disease?
The BC Care Providers Association, representing the majority of non-government owned operators of long-term care and assisted living, as well as private home health and independent living, carried out a study following the first wave and produced a set of recommendations to help mitigate the second wave. The report found that while the response from the provincial government and the provincial health officer had some flaws, like an over-emphasis on acute care and an insufficient supply of personal protective equipment (PPE), it quickly pivoted. And by working with major stakeholders like the BCCPA and SafeCare BC, the government helped turn the situation around.
With a reprieve from the first COVID-19 wave, the health ministry, health authorities, and operators of long-term care homes worked 24/7 to try to reconnect families in a safe environment and secure the material and human resources necessary for the winter ahead. While supplies of PPE became more readily available through a centralized supply chain, human resources were not so easily generated — leading to exhaustion and deterioration of mental and physical health to the point where operators, particularly in Fraser Health, are at the breaking point.
We are now dangerously close to the situation Ontario faced in the first wave in which the Canadian Armed Forces were pressed into action. Already, one care home in Abbotsford is looking to hire family members to come to the rescue.
Questions remain about whether the implementation of a broader testing program would have reduced the number and extent of the current outbreaks in long term care. Rapid tests are available that are used to screen film industry workers, athletes, and most recently, air travelers. But they have yet to be deployed in seniors care homes in B.C. While not a replacement for current screening protocols, many, including Dr. David Grabowski of Harvard, feel they are important tools to prevent staff from bringing the virus into care homes. The leading expert on infectious diseases in the U.S., Dr. Anthony Fauci, says more testing, including the use of rapid point of care tests, needs to be done.
We would expect that, as in Ontario, the B.C. government would pay for these tests. It already has more than 500,000 of these tests in its possession. We hope any rollout of a rapid testing program would be in conjunction with health authorities.
We should ensure there is a research component to any rapid testing program so that we learn best practices and share that with others. We envision testing of staff and essential visitors about three times per week. Hopefully, new measures like rapid tests to reduce COVID-19 will result in fewer nursing home outbreaks.
It is one way we can urgently find ways to reconnect families to their loved ones in care, especially as we approach the holiday season.
Terry Lake, who submitted this guest post, is a former veterinarian and was minister of health under the Liberal government. He became CEO of the BCCPA a few months ago.
The BCCPA represents non-government operators providing continuing care services. Its membership includes over 350 organizations delivering long-term care, home health, and assisted living.
BCCPA members support more than 16,000 seniors in the long-term care and assisted living settings, and over 11,000 each year through home care & home support services.