Gerald Jackson spent his final days with COVID-19 lying just centimetres from another man’s bed, separated by a curtain in an eighth-floor room. A third man lay about three metres away.
It was not what Darlene Metzler had pictured for her father, the 21-year navy veteran who loved dancing the jive, singing and travelling on cruise ships.
But Jackson, 84, had been diagnosed with dementia and his medical needs were beyond what home care or assisted living could provide. In May 2019, he moved to a triple-bed room inside the Centre building at the Northwood long-term care facility in Halifax.
In mid-April Metzler got a call: one of her father’s two roommates had tested positive for COVID-19. The staffer on the phone told Metzler the COVID unit was full; there was no way to separate Jackson from the others.
Gerald Jackson, who was a veteran of the Royal Canadian Navy, died April 28 of COVID-19 at Northwood. (Submitted by Darlene Metzler)
“There was only one way to feel, and that was to prepare for the phone call that said my dad is positive,” she said.
Metzler and her siblings didn’t know that triple rooms existed at Northwood until they learned their father would be placed in one. Now, they place the blame for his death on April 28 on the configuration of the 44-year-old building.
“This was like a hospital room,” Metzler said in an interview. “I challenge somebody to walk in that room and tell me that doesn’t look like institutional living where seniors are being warehoused.”
It is one of many difficult lessons learned at Northwood, where the virus has claimed the lives of 53 residents, making it one of the deadliest COVID-19 outbreaks in the country and accounting for the bulk of the 60 victims in Nova Scotia.
Some families have called for a public inquiry or a class-action lawsuit to examine the facility’s decisions, particularly around shared rooms.
For its part, Northwood said it’s long been concerned about the issue. For three years, it’s had a plan before the province to make all rooms private — a proposal that continues to sit with Department of Health.
Those tight quarters, combined with a crucial misunderstanding by health officials early on of how the virus could spread asymptomatically, proved fatal.
Jackson, his twin daughters and Jackson’s social worker pose for a photo on his first day at Northwood, May 8, 2019. (Submitted by Charlene Chiddenton)
Northwood bills itself as the largest not-for-profit continuing care organization in Atlantic Canada. It dates back to 1962 and a social movement created to help seniors living in poverty. It cares for some of the most frail and vulnerable people in the province.
Its Halifax facility, located off Gottingen Street near the Macdonald Bridge, is made up of three buildings — the Tower, the Manor and the Centre. Their original purpose was not to warehouse seniors, but standards for such residences were different when they were built.
Today, single rooms with ensuite washrooms, grouped around a central living room or kitchen area are preferred — not a possibility in most of Northwood’s downtown campus.
Of the three buildings, the Centre is the youngest, dating from June 1976. It’s also the building where COVID-19 has raged longest and hardest. It has 297 beds in total. More than half are in double or triple rooms. There are another 188 long-term care beds in the Manor, in both shared and private rooms.
But right now the old arrangements are moot. By late May, Northwood had been able to separate all but 25 of its 485 beds. Some residents have been moved to a hotel.
Space has also opened up for another reason — many who lived at Northwood are now dead.
Northwood has dealt with communicable diseases like influenza and gastroenteritis before, and early in March the facility started taking the same sort of infection control steps for COVID-19. They included cleaning door knobs, handrails and elevator buttons more often, and tracking flu-like symptoms in residents.
On March 12, it restricted visits from families and volunteers who had recently travelled outside Canada. Two days later, it applied the same rule to staff who had travelled internationally and told them to self-isolate. All workers were screened daily for fever and cough.
At the time, public health officials recommended against healthy people wearing masks. The position was that the virus was only spread by those who were symptomatic, a belief that turned out to be wrong.
Among the COVID-19 victims at Northwood are, from left, Thelma Coward-Ince, 86, Hermance Cormier, 87, and Derrick Carvery, 37. (CBC/Joe Cormier/Joy O’Brien)
In hindsight, Northwood now knows the virus had started spreading and incubating among staff and residents shortly after the no-visitor order was issued.
Northwood CEO Janet Simm said contact tracing later determined an asymptomatic person could have been in the facility as early as mid-March.
At the time, there were outbreaks in the communities of Enfield and Elmsdale, and in the Prestons-Lake Echo-Lawrencetown area. Simm said contact tracing has shown it’s “very clear” that’s how staff members first became infected.
It is also certain that a significant number — more than 10 — were unaware they had COVID-19 as they worked in different areas of the building.
“It was very, very early on. The symptoms that we’re now screening for are very different than what we were screening for way back in early April,” said Simm. “So those poor staff had no idea that they were putting residents or co-workers at risk.”
On April 5, the first staff person inside Northwood tested positive. The next day, all staff were told to don masks through their shifts — a move that came before the Public Health Agency of Canada issued long-term care guidelines that called for similar measures.
A day later, five residents tested positive, yet only one had any contact with the staff person. It was becoming clear the virus was spreading asymptomatically.
Two wards set aside for COVID-19 patients filled up. Staff soon decided not to shuffle roommates, even if they tested negative. The decision drew sharp criticism from many families but is defended by Simm, who said they quickly learned that even if a roommate of a positive resident had tested negative, chances were they had already caught the virus.
On April 17 and 18, the first three residents died of COVID-19. Dozens of other residents and staff were sick. The facility was no longer able to cope on its own.
The worst weekend
From Toronto, Michele Heath could tell something was wrong. At the beginning of the pandemic the Northwood staff had time every day to set up a video call so Heath and her siblings in Dartmouth, N.S., could chat with their mother, Ruth, a resident of the nursing home.
But that changed as time went on.
It culminated on the evening of April 18, a Saturday, when Heath called the nursing station every quarter of an hour, letting the phone ring until it stopped. No one answered.
“My family and I found that very disconcerting and a clear message that the staff must be run off their feet and just going full out just to try to respond to the needs of the residents,” Heath said.
She does not blame staff and believes they took good care of her mother. But two days later the siblings decided to remove her from Northwood, even though it meant taking on an exhausting schedule of 24-7 care.
By that weekend, so many Northwood workers were sick or self-isolating that staffing at times sunk to just “a couple of people” per 33-bed floor, according to Northwood executive director Josie Ryan. The care workers could not keep up.
“They may not get a shower but their personal hygiene needs are being met,” Ryan said.
“So it’s been a good day so far this morning.”
With the help of more than 40 extra people, the staffing situation stabilized. That weekend, the first resident had been moved to a 29-bed “recovery unit” set up by the province at a nearby hotel.
Regular swabbing of residents and staff in order to test for the virus continued, with the expectation that more cases would be found. By the end of May, Northwood had recorded 345 cases of COVID-19, nearly 30 per cent of them among staff.
Janet Simm is the CEO of Northwood. (Dave Laughlin/CBC)
Metzler, the daughter of COVID-19 victim Gerald Jackson, is concerned the province has said little so far about whether Northwood will be able to maintain the new arrangement where most residents have single rooms.
“I think we need to keep the momentum going so that people hear that this isn’t acceptable, that change is required,” she said of shared rooms. “It’s not good for infection control measures. It’s not good for privacy.
“I don’t think it’s good for the staff either. My heart goes out to those wonderful caregivers that work there, that are doing the best they can every day with what they have.”
Heath, whose family made the decision to move their mother out of Northwood on April 20, said her mother was in a “very small” shared room with one other person.
“I think that’s one of the key elements that needs to be examined here,” she said. “What should the physical structures look like? How should they be designed to best ensure, certainly, infection control and prevention, but also to create a home-like environment for individuals? Because really that’s what I think everybody would like to have for their loved ones.”
Darlene Metzler is shown outside her Dartmouth, N.S., home. Her father, Gerald Jackson, died of COVID-19 on April 28. (Shaina Luck/CBC)
Northwood had a full house in the weeks leading up to the outbreak: 17 people were admitted in March, including 11 transferred from the hospital system and six from the community. There were 16 vacant beds, but none in the most in-demand long-term care.
The facility has been worried about the effects of crowding for years. In 2017, it sought $13 million from the Department of Health to add three floors to the Centre building, a change that would allow all residents a single room.
The board of directors of Northwood had concerns about infection control, and was so worried it considered converting some of its affordable seniors housing units into long-term care beds.
The province did not approve the funding proposal in 2017, nor in 2018 or 2019, when Northwood submitted it again.
At the time, influenza was considered the main problem, but the experience with COVID has put those concerns in a new light.
“Influenza is a really huge issue — not necessarily something that the public is aware of, but in long-term care influenza [and] other types of infections in vulnerable populations is something that we deal with every day,” Simm said.
A sketch Metzler drew of the configuration of her father’s room at Northwood, which he shared with two other men. (Darlene Metzler)
“I know staff continue their discussions with the facility provider as to opportunities,” Delorey told the House on Feb. 28. “It would be inaccurate to suggest that the submission was not considered; they continue to have discussions with the provider about their proposal.”
Those discussions continue to this day.
Simm said the Department of Health has been “very supportive” of Northwood moving to single rooms, but ultimately the decision on whether residents can keep the private rooms they now have rests with the province.
Both Delorey and Premier Stephen McNeil have said questions about shared rooms will be reviewed once the outbreak is over.
“The work for decisions about the future of what long-term care infrastructure facilities are going to look like, that hasn’t, as part of our review, taken place yet. Our focus has been on our response and the care for individuals,” Delorey said in an interview.
The 29 Northwood residents who have been living in a hotel for weeks must eventually be placed somewhere. There is not enough space at Northwood to give each a single room, so some will be returning to roommates.
Minister of Health Randy Delorey said the wait-list for long-term care has grown by 10 to 12 per cent since the start of the pandemic. (Craig Paisley/CBC)
Delorey also pointed out that Northwood is not the only facility in the province with multiple-occupancy rooms. It’s a feature of many older nursing homes.
The province announced last year the construction or conversion of 162 new long-term care beds, most of them in Cape Breton, and last week said another 23 were coming to the Halifax area. New construction will be to modern standards, but not one of those facilities is ready yet.
Metzler said she worries about a resurgence of the virus, and that flu season is also not far off. She said Northwood residents should not be placed back in shared rooms.
“I get the impact of it backing up the hospital system, for instance, there’s probably patients in a hospital waiting for long-term care beds. So then that’s backing up the hospitals and so on and so forth. I don’t have the answers, but I know what needs to be done.”
TORONTO – Health Canada has authorized Moderna’s updated COVID-19 vaccine that protects against currently circulating variants of the virus.
The mRNA vaccine, called Spikevax, has been reformulated to target the KP.2 subvariant of Omicron.
It will replace the previous version of the vaccine that was released a year ago, which targeted the XBB.1.5 subvariant of Omicron.
Health Canada recently asked provinces and territories to get rid of their older COVID-19 vaccines to ensure the most current vaccine will be used during this fall’s respiratory virus season.
Health Canada is also reviewing two other updated COVID-19 vaccines but has not yet authorized them.
They are Pfizer’s Comirnaty, which is also an mRNA vaccine, as well as Novavax’s protein-based vaccine.
This report by The Canadian Press was first published Sept. 17, 2024.
Canadian Press health coverage receives support through a partnership with the Canadian Medical Association. CP is solely responsible for this content.
TORONTO – Sanniah Jabeen holds a sonogram of the unborn baby she lost after contracting listeria last December. Beneath, it says “love at first sight.”
Jabeen says she believes she and her baby were poisoned by a listeria outbreak linked to some plant-based milks and wants answers. An investigation continues into the recall declared July 8 of several Silk and Great Value plant-based beverages.
“I don’t even have the words. I’m still processing that,” Jabeen says of her loss. She was 18 weeks pregnant when she went into preterm labour.
The first infection linked to the recall was traced back to August 2023. One year later on Aug. 12, 2024, the Public Health Agency of Canada said three people had died and 20 were infected.
The number of cases is likely much higher, says Lawrence Goodridge, Canada Research Chair in foodborne pathogen dynamics at the University of Guelph: “For every person known, generally speaking, there’s typically 20 to 25 or maybe 30 people that are unknown.”
The case count has remained unchanged over the last month, but the Public Health Agency of Canada says it won’t declare the outbreak over until early October because of listeria’s 70-day incubation period and the reporting delays that accompany it.
Danone Canada’s head of communications said in an email Wednesday that the company is still investigating the “root cause” of the outbreak, which has been linked to a production line at a Pickering, Ont., packaging facility.
Pregnant people, adults over 60, and those with weakened immune systems are most at risk of becoming sick with severe listeriosis. If the infection spreads to an unborn baby, Health Canada says it can cause miscarriage, stillbirth, premature birth or life-threatening illness in a newborn.
The Canadian Press spoke to 10 people, from the parents of a toddler to an 89-year-old senior, who say they became sick with listeria after drinking from cartons of plant-based milk stamped with the recalled product code. Here’s a look at some of their experiences.
Sanniah Jabeen, 32, Toronto
Jabeen says she regularly drank Silk oat and almond milk in smoothies while pregnant, and began vomiting seven times a day and shivering at night in December 2023. She had “the worst headache of (her) life” when she went to the emergency room on Dec. 15.
“I just wasn’t functioning like a normal human being,” Jabeen says.
Told she was dehydrated, Jabeen was given fluids and a blood test and sent home. Four days later, she returned to hospital.
“They told me that since you’re 18 weeks, there’s nothing you can do to save your baby,” says Jabeen, who moved to Toronto from Pakistan five years ago.
Jabeen later learned she had listeriosis and an autopsy revealed her baby was infected, too.
“It broke my heart to read that report because I was just imagining my baby drinking poisoned amniotic fluid inside of me. The womb is a place where your baby is supposed to be the safest,” Jabeen said.
Jabeen’s case is likely not included in PHAC’s count. Jabeen says she was called by Health Canada and asked what dairy and fresh produce she ate – foods more commonly associated with listeria – but not asked about plant-based beverages.
She’s pregnant again, and is due in several months. At first, she was scared to eat, not knowing what caused the infection during her last pregnancy.
“Ever since I learned about the almond, oat milk situation, I’ve been feeling a bit better knowing that it wasn’t something that I did. It was something else that caused it. It wasn’t my fault,” Jabeen said.
She’s since joined a proposed class action lawsuit launched by LPC Avocates against the manufacturers and sellers of Silk and Great Value plant-based beverages. The lawsuit has not yet been certified by a judge.
Natalie Grant and her seven year-old daughter, Bowmanville, Ont.
Natalie Grant says she was in a hospital waiting room when she saw a television news report about the recall. She wondered if the dark chocolate almond milk her daughter drank daily was contaminated.
She had brought the girl to hospital because she was vomiting every half hour, constantly on the toilet with diarrhea, and had severe pain in her abdomen.
“I’m definitely thinking that this is a pretty solid chance that she’s got listeria at this point because I knew she had all the symptoms,” Grant says of seeing the news report.
Once her daughter could hold fluids, they went home and Grant cross-checked the recalled product code – 7825 – with the one on her carton. They matched.
“I called the emerg and I said I’m pretty confident she’s been exposed,” Grant said. She was told to return to the hospital if her daughter’s symptoms worsened. An hour and a half later, her fever spiked, the vomiting returned, her face flushed and her energy plummeted.
Grant says they were sent to a hospital in Ajax, Ont. and stayed two weeks while her daughter received antibiotics four times a day until she was discharged July 23.
“Knowing that my little one was just so affected and how it affected us as a family alone, there’s a bitterness left behind,” Grant said. She’s also joined the proposed class action.
Thelma Feldman, 89, Toronto
Thelma Feldman says she regularly taught yoga to friends in her condo building before getting sickened by listeria on July 2. Now, she has a walker and her body aches. She has headaches and digestive problems.
“I’m kind of depressed,” she says.
“It’s caused me a lot of physical and emotional pain.”
Much of the early days of her illness are a blur. She knows she boarded an ambulance with profuse diarrhea on July 2 and spent five days at North York General Hospital. Afterwards, she remembers Health Canada officials entering her apartment and removing Silk almond milk from her fridge, and volunteers from a community organization giving her sponge baths.
“At my age, 89, I’m not a kid anymore and healing takes longer,” Feldman says.
“I don’t even feel like being with people. I just sit at home.”
Jasmine Jiles and three-year-old Max, Kahnawake Mohawk Territory, Que.
Jasmine Jiles says her three-year-old son Max came down with flu-like symptoms and cradled his ears in what she interpreted as a sign of pain, like the one pounding in her own head, around early July.
When Jiles heard about the recall soon after, she called Danone Canada, the plant-based milk manufacturer, to find out if their Silk coconut milk was in the contaminated batch. It was, she says.
“My son is very small, he’s very young, so I asked what we do in terms of overall monitoring and she said someone from the company would get in touch within 24 to 48 hours,” Jiles says from a First Nations reserve near Montreal.
“I never got a call back. I never got an email”
At home, her son’s fever broke after three days, but gas pains stuck with him, she says. It took a couple weeks for him to get back to normal.
“In hindsight, I should have taken him (to the hospital) but we just tried to see if we could nurse him at home because wait times are pretty extreme,” Jiles says, “and I don’t have child care at the moment.”
Joseph Desmond, 50, Sydney, N.S.
Joseph Desmond says he suffered a seizure and fell off his sofa on July 9. He went to the emergency room, where they ran an electroencephalogram (EEG) test, and then returned home. Within hours, he had a second seizure and went back to hospital.
His third seizure happened the next morning while walking to the nurse’s station.
In severe cases of listeriosis, bacteria can spread to the central nervous system and cause seizures, according to Health Canada.
“The last two months have really been a nightmare,” says Desmond, who has joined the proposed lawsuit.
When he returned home from the hospital, his daughter took a carton of Silk dark chocolate almond milk out of the fridge and asked if he had heard about the recall. By that point, Desmond says he was on his second two-litre carton after finishing the first in June.
“It was pretty scary. Terrifying. I honestly thought I was going to die.”
Cheryl McCombe, 63, Haliburton, Ont.
The morning after suffering a second episode of vomiting, feverish sweats and diarrhea in the middle of the night in early July, Cheryl McCombe scrolled through the news on her phone and came across the recall.
A few years earlier, McCombe says she started drinking plant-based milks because it seemed like a healthier choice to splash in her morning coffee. On June 30, she bought two cartons of Silk cashew almond milk.
“It was on the (recall) list. I thought, ‘Oh my God, I got listeria,’” McCombe says. She called her doctor’s office and visited an urgent care clinic hoping to get tested and confirm her suspicion, but she says, “I was basically shut down at the door.”
Public Health Ontario does not recommend listeria testing for infected individuals with mild symptoms unless they are at risk of developing severe illness, such as people who are immunocompromised, elderly, pregnant or newborn.
“No wonder they couldn’t connect the dots,” she adds, referencing that it took close to a year for public health officials to find the source of the outbreak.
“I am a woman in my 60s and sometimes these signs are of, you know, when you’re vomiting and things like that, it can be a sign in women of a bigger issue,” McCombe says. She was seeking confirmation that wasn’t the case.
Disappointed, with her stomach still feeling off, she says she decided to boost her gut health with probiotics. After a couple weeks she started to feel like herself.
But since then, McCombe says, “I’m back on Kawartha Dairy cream in my coffee.”
This report by The Canadian Press was first published Sept. 16, 2024.
Canadian Press health coverage receives support through a partnership with the Canadian Medical Association. CP is solely responsible for this content.
VANCOUVER – Mayors and other leaders from several British Columbia communities say the provincial and federal governments need to take “immediate action” to tackle mental health and public safety issues that have reached crisis levels.
Vancouver Mayor Ken Sim says it’s become “abundantly clear” that mental health and addiction issues and public safety have caused crises that are “gripping” Vancouver, and he and other politicians, First Nations leaders and law enforcement officials are pleading for federal and provincial help.
In a letter to Prime Minister Justin Trudeau and Premier David Eby, mayors say there are “three critical fronts” that require action including “mandatory care” for people with severe mental health and addiction issues.
The letter says senior governments also need to bring in “meaningful bail reform” for repeat offenders, and the federal government must improve policing at Metro Vancouver ports to stop illicit drugs from coming in and stolen vehicles from being exported.
Sim says the “current system” has failed British Columbians, and the number of people dealing with severe mental health and addiction issues due to lack of proper care has “reached a critical point.”
Vancouver Police Chief Adam Palmer says repeat violent offenders are too often released on bail due to a “revolving door of justice,” and a new approach is needed to deal with mentally ill people who “pose a serious and immediate danger to themselves and others.”
This report by The Canadian Press was first published Sept. 16, 2024
