The tragedy of deaths in long-term care homes
by Dr. Rey D. Pagtakhan
Canada confirmed on May 30, 2020, its share of 90,934 (1.52 per cent) of the world’s 5.99 million total COVID-19 cases and 7,065 deceased (1.93 per cent) of the 366,875 deaths worldwide. Of the total deceased in Canada, much more than half of them were from long-term care homes and residential care facilities. (The term “long-term care home” is used here to encompass nursing homes and residential care facilities, also known as CHSLDs in Quebec.)
The eye of the COVID-19 pandemic storm first landed at The Lynn Valley Care Centre in Lynn Valley, North Vancouver, British Columbia in the west before travelling east.
The Lynn Valley Care Centre
It was the morning of Friday, March 6 when the director of the centre confirmed the rumour to the outgoing night shift, nearly all of whom are middle-aged Filipina Canadians, – that a co-worker nurse had earlier tested positive for COVID-19.
“Why didn’t you let us know?” was the spontaneous sentiment of the anxious, shocked and angered staff at the 200-bed facility, as reported by Jonathan Hayward of The Canadian Press and the Globe and Mail.
A day later on March 7, British Columbia’s Provincial Health Officer Dr. Bonnie Henry confirmed the outbreak and indicated that two residents and one health care provider had tested positive for the virus. It would be announced the following day on March 8 that one of the residents had died, becoming the first person in Canada to succumb to COVID-19 – a preventable death.
“This is one of the scenarios that we have been, of course, most concerned about,” said Dr. Henry at the media scrum. The subsequent two weeks documented that 18 providers of care had been infected and seven elderly residents had died. There lies the first setting for the tragedy of deaths as a consequence of COVID-19.
Tragedy of COVID-19 deaths in Ontario and Quebec
Chris Fox of CTV News reported on May 13 that “there have been 249 outbreaks at Ontario’s 626 long-term care homes and the sector now accounts for more than three quarters of all COVID-19 deaths.”
Verity Stevenson and Benjamin Shingler of CBC News posted early on that “more than 1,000 of the 1,340 Quebecers who have died from COVID-19 were seniors in care.”
Indeed, both Ontario’s long-term care homes and Quebec’s CHSLDs – a string of them – experienced such overwhelming numbers of sickened and dying patients that both provinces had to request the assistance of the Canadian Armed Forces.
In explaining “how B.C. controlled COVID-19 while Ontario, Quebec face disaster,” Kathleen Harris and Ashley Burke of CBC News made the following observations on May 28th:
- There have been 111 deaths in long-term care homes in B.C., compared to more than 2,500 in Quebec and 1,500 in Ontario;
- B.C. took swift, coordinated and decisive actions … providing adequate protective gear and financially supporting front-line staff to restrict their movement between sites;
- They stopped extra people from coming into the homes;
- B.C. facilities are modern infrastructure with fewer four-bed units;
- “Canada needs stronger inspection systems with tough enforcement measures to strengthen the long-term care system nationwide,” they said, quoting CBC’s resource expert, Dr. Pat Armstrong);
- The B.C. government had more time to warn international travellers against actions that could bring the virus home with them;
- The B.C. government had to take over three care homes because residents were not getting the care they need; and
Harris and Burke underlined the findings of the Canadian Armed Forces, of whom more than 1,600 members were deployed to assist in the crisis in Ontario and Quebec. In five of the home care facilities the military found incidents of neglect, aggressive treatment toward residents, cases of residents being improperly fed and left in soiled clothing or going unbathed for weeks, insect infestation and the smell of rotting food. In 25 facilities they found improper use of protective equipment and staffing shortages.
Premiers’ and Prime Minister’s response as reported
“What I am feeling, what we all are feeling is little in comparison to the hardship that these residents and their families have had to endure, “said Ontario Premier Doug Ford upon reading the military report on the provinces’ situation, and went on to promise “justice for these residents and their families.”
Premier Legault of Quebec said he wasn’t especially surprised by the findings. He expressed great appreciation for the military’s help. “Thank you very much, we are so happy to have you.” He asked that “1,000 members of the Canadian Armed Forces remain in Quebec until September 15 to continue helping out.”
Deputy Prime Minister Chrystia Freeland called it “truly heart-wrenching.”
The report is “deeply disturbing,” said Prime Minister Justin Trudeau, adding “several of the report’s findings, such as the understaffing, are among the reasons why Premier Legault asked for help from the Armed Forces a month and a half ago.” The Prime Minister also said he would further address the situation in Canada’s senior’s residences and long-term care facilities during his weekly call with Canada’s premiers. “I will once again offer our government’s support as they try to get the situation under control.”
“As I’ve said many times, we need to do a better job of caring for seniors,” said Trudeau. “They raised us, they built this country.”
Hon. Dr. Rey D. Pagtakhan, P.C, O.M., LL.D., Sc.D., M.D., M.Sc. is a retired lung specialist and former professor of pediatrics and child health from the Children’s Hospital of Winnipeg and the University of Manitoba Faculty of Medicine. Widely published and lectured, he made a presentation on “The Global Threat of Infectious Diseases” at the G-8 Countries’ Science Ministers and Advisors Carnegie Group Meeting held in June 2003 in Berlin, Germany. Contact: firstname.lastname@example.org.