Two provinces cauterizing the Covid-19 wound

di Priscilla Pajdo del 27 April 2020

TORONTO - In Ontario, mathematical models as of April 15 suggested that the rate of the spread of confirmed Covid-19 cases was headed downward because the rate of increase had slowed to 4.9% over the previous day. On April 21, more current numbers show the highest daily increase at 5.2% - 634 cases.

The Province is continuing testing, arguing that testing provides data for understanding the virus and for helping determine priorities as to what to do and who should be addressed first. As of April 21, it has performed 194,745 tests from its 14.5 million citizens. Numbers made available by the Ministry of Health (MOH) indicate that 12,879 of those tested confirmed positive for Covid-19.

That is not the complete story. The problem is significantly more serious in seniors’ residences and long-term care homes (LTCH), 651, according to the Ministry for Long Term care.

To date, there have been 132 Covid-19 outbreaks at LTCH in Ontario. Of the 78,800 residents in LTCH, 2,189 residents/patients and 1,058 staff have tested positive.

Sadly, 516 seniors living in LTCH have passed. These fatalities account for 72.4% of all Covid-19 related deaths reported in Ontario. Could any have been avoided?

Early reports suggest that seniors residing in these facilities are more vulnerable because they typically have other underlying complex medical conditions. As a result, they are at a higher risk for infection from Covid-19, when a “carrier” introduces the virus in their midst.

On April 22, Premier Ford launched an aggressive action plan to help “stem the tide” of the current epicentre of the Covid-19 crisis, LTC homes. In so doing, he struck a personal note, announcing that his own 95 years old mother-in-law living in a LTCH has tested positive for Covid-19.

New measures in the action plan, for which $50 million are allocated, will see increased testing across all LTCH for residents and staf, increased screening and surveillance. Also, specialized teams from hospitals, public health and the home care sector will be deployed to help support these facilities.

In addition, an LTC Covid-19 Response Team has been set up to help resolve staffing issues, replenish supplies of personal protective equipment (PPE) and to implement an infection control protocol. Increased testing will now include all sta/residents that are asymptomatic, not only those exhibiting symptoms, as was initially the case.

Moreover, the Premier has requested further aid from the Federal Government in the battle against Covid-19 in LTCH. This will see the Canadian Armed Forces deployed to selected LTCH at the epicentre of this crisis. Is this the solution to the problem? It cannot hurt.

Calling in the "cavalry" is perhaps necessary in this state of emergency. It will certainly help ease the stress on workers in homes experiencing critical staffing shortages as the effects of Covid-19 take their toll.

Prior to Covid-19, many staf members working in LTC worked a secondary job for any number of reasons, including insuœcient salary or hours of work. Several staff in LTC would work at multiple homes – thus creating conditions for increasing the risk of contagion. Under the new action plan, sta“ are now limited to working at only one location.

In Quebec, the Covid-19 crisis has hit the LTC sector very hard. As of April 25, a total of 79% of Covid-19 related deaths in the province are among seniors living in LTC.

Premier François Legault has taken "full responsibility" and is remorseful in not haven taken better care of the elderly in LTC. That may be refreshingly candid, but people are looking for action.

Chronic sta shortages and poor pay have been major issues in Quebec's LTC system, as in Ontario. On April 1st, Government boosted wages for staff working in LTC. He has also openly said the Provincial government is considering taking over all private seniors' homes.

Premier Legault claims to have grasped the need to create a more stable environment with less crowding, more sta“ and better living conditions for the elderly in LTC - province wide. This may prove to become the biggest long-term policy initiative in “health” and “infrastructure” during his mandate.

Perhaps moving forward, Ontario also needs to find a better strategy for addressing staœng shortages. It may be too late for those who have passed on but, if we continue with these measures combined with rigorous monitoring, we might save more lives down the road.

Priscilla Pajdo

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