What went wrong? What can Canada do to fix it before the next wave hits? This look at the tragedy in Canada’s long term care homes and the emergency measures to protect the most vulnerable is part of the Post’s ongoing Lessons from a Pandemic series.
From the first COVID-19 outbreak in British Columbia to the devastation in Ontario and Quebec, seniors in long term care have been hit hardest by the coronavirus pandemic.
The causes for this are not only demographic and epidemiological. They also reveal the weak points of an elder care system that has long been recognized as failing, but never actually made to succeed, until it was too late.
Now Canada’s long term care home system is being remade on the fly through emergency legislation to cope with the pandemic.
Canadian Forces troops are deployed to help as long as needed, to maintain what Ontario Premier Doug Ford called an “iron ring” around long term care homes.
Provincial laws have been drawn up to staff long term care homes with more casual labour with lower training requirements, and to loosen the complaint reporting requirements on private management. There are political noises about long term fixes, and major disagreements are being staked out on the role of private providers. What those reforms look like, if they ever come, will say a lot about how Canada regards its seniors.
Canada’s first known death in this pandemic occurred on March 8, when a man in his 80s died at the Lynn Valley Care Centre in North Vancouver.
Briefly, that site was the focus of the public concern, until new focal points emerged — the Pinecrest Nursing Home in Bobcaygeon, Ont., the Résidence Herron in Dorval, Que. — until they all became single stars in a countrywide constellation of seniors home outbreaks, many of them completely overrun by infections, people dying in some cases faster than their bodies could be removed.
Quebec has called in more than 1,000 military medical personnel such as nurses and paramedics, Ontario a smaller number, backed by support troops, which Defence Minister Harjit Sajjan said was “not a typical Canadian Armed Forces operation.”
More than four out of five deaths, or approximately 4,000, have been of seniors in long term care homes, plus significant numbers of staff.
The vast over-representation of long term care home residents in Canada’s death toll has revealed a terrible aspect of the pandemic — that the weakest and most vulnerable in our society are in the most dangerous places.
The institutionalized elderly are a unique class, not quite like inmates in prisons, who are being punished, and not quite like patients in hospitals, who are surrounded by the trappings of high level medical care.
Rather, through nothing more than their own age and infirmity, they are forced to endure the greatest exposure to the coronavirus risk, to live communally with other victims, surrounded by cinderblock walls, attended to by overwhelmed staff who turn to overwhelmed private management for support, and do not always get it, as new litigation has revealed.
In some segments of society, the pandemic’s heavy burden on the aged has created a selfish optimism among the relatively young and healthy, especially in America, where loyalists of President Donald Trump aim to justify an economic re-opening, despite the continued preventable deaths of society’s most accomplished and experienced members.
In Canada, Prime Minister Justin Trudeau has been more empathetic in his messaging about the problem, but was clear not to take over federal responsibility for it, offering only to “help the provinces find lasting solutions” to these “serious, underlying challenges.”
“COVID-19 has exposed some uncomfortable truths about our society, including how we care for seniors in Canada,” Trudeau said this week. “We’ve seen heartbreaking tragedies in long term care facilities and nursing homes right across the country. Overworked staff, understaffed residences, grieving families.”
Jagmeet Singh, the federal NDP leader, told CTV’s Question Period that Canada should end the private provision of long term care and bring all such homes under new federal regulation.
“I think we need to end them, I think there’s no question about it given the results we’re seeing, the evidence we’re seeing that some of the worst conditions that seniors are in and some of the highest deaths have happened in the for-profit long term care homes,” he said
His suggestion illustrated a broad theme of pandemic response in Canada, which is that it has largely been a provincial patchwork rather than a coordinated national program, especially on matters that are federally funded but constitutionally under provincial control, such as health care and education.
This is also partly the result of Toronto’s SARS outbreak in 2003, and efforts by provinces since then to update their emergency management legislation.
But even that is being done again on the fly, in response to new crises and disagreements over how to handle the pandemic at the institutional level.
Ontario moved this week to give the provincial government authority to replace management at long term care homes, but has not used the new power. The Ford government also said it would review its long term care system after the pandemic, but only internally, not via a public or independent inquiry. Minister of Long Term Care Merrilee Fullerton said all forms of review are “on the table.”
“We know the system’s broken,” Ontario Premier Doug Ford said. “We’re going to have a complete review, not just of long term care — I think the whole system of government.”
The problems are not just systemic, they are also architectural. Radio-Canada reported this week that the Vigi Mont-Royal home in Montreal was completely infected, with every single resident and 148 workers testing positive, according to an internal document, which noted a ventilation system was faulty and need to be cleaned and repaired.
We know the system’s broken
Many homes have residents in shared rooms, with common eating areas and washrooms, on wards that were not designed to facilitate isolation.
The problems are also legal, about workers rights and the ability of an industry to protect those who carry out its most crucial functions of feeding and caring for the elderly.
One long term care home in Niagara Falls has been hit with a proposed class action lawsuit over its handling of an outbreak that killed 18 residents, for allegedly failing to train staff and having them move between patient rooms in the same protective gowns.
There is a similar dispute by registered nurses working at four privately owned long term care homes in Ontario, who allege management failed to provide personal protective equipment and failed to launch pre-existing pandemic plans, resulting in widespread exposure of uninfected people to symptomatic patients who had not yet formally tested positive. In some cases, staff were allegedly forced to care for patients who were confirmed positive wearing only surgical masks.
They filed union grievances, but that system takes too long to resolve, so the Ontario Nurses Association asked Ontario Superior Court for what Judge Ed Morgan described as an “unusual” form of urgent action from the bench.
Morgan was scathing as he granted the nurses request and ordered the homes to obey a provincial government directive about providing personal protective equipment.
The long term care homes had unsuccessfully argued that the balance of convenience should favour their interests, because if nurses decide who gets masks, the entire province could suffer a shortage. As Judge Morgan put it, the long term care homes “suggest that nurses and other medical staff treating COVID-19 patients in LTC homes represent their own narrow, personal interests, while the privately-owned LTC homes represent broad, community-based interests.”
The judge was having none of that.
“I can imagine that the irony of that submission is not lost on the (nurses),” he wrote. “One need only read the affidavits of the individual nurses in this Application record to understand that they spend their working days, in particular during the current emergency situation, sacrificing their personal interests to those of the people under their care. And given the nature of the pandemic, they do this not only for the immediate benefit of their patients but for the benefit of society at large. To suggest that their quest for the masks, protective gear, and cohorting that they view as crucial to the lives and health of themselves and their patients represents a narrow, private interest seems to sorely miss the mark.”
Canada’s latest national numbers show 70 per cent of deaths from COVID-19 have been of people over 80, and 25 per cent of people between 60 and 79.
Alberta partners with fast-food restaurants to distribute 4 non-medical masks to every resident – Globalnews.ca
The Alberta government will provide every resident with four non-medical face masks, as the province continues its phased approach to relaunch the economy.
Health Minister Tyler Shandro announced Friday morning that the government has partnered with A&W, McDonald’s Canada and Tim Hortons to distribute the masks at the restaurants’ drive-thru locations.
The masks will be free of charge.
“Alberta is the first and so far, as far as I know, the only province that has decided to distribute masks province-wide,” Shandro said. “This program will help Albertans get back to work and enjoy everyday activities safely.”
While mask use is not mandatory, Alberta’s chief medical officer of health has recommended Albertans wear a non-medical mask when two metres of physical distance cannot be maintained, such as on public transit.
A total of about 20 million non-medical masks will be distributed at a cost of around $20 million. Shandro said partnering with the fast-food restaurants will cut down on the distribution cost to government, which is around $350,000.
“These three partners are doing it without added expense to the Alberta taxpayer,” Shandro said.
The drive-thru pickup also provides safe physical distancing for Albertans, as people will be able to stay in their vehicles.
Shandro said the three restaurant companies have about 600 drive-thru locations in the province, and 95 per cent of Albertans live within 10 kilometres of one of these locations.
The province is working on a plan to ensure distribution of masks is possible to the remaining five per cent of the population, Shandro said.
“Even if you don’t have an A&W, a McDonald’s or a Tim Hortons in your community, you will be able to get your four masks,” he said.
The government’s distribution cost is “for us to be able to pay for the gap distribution for the other five per cent of folks who may not be able to get to a drive-thru,” according to Shandro.
Distribution will be done on the honour system.
“We’re not asking for folks to bring in their health-care card and get a punch to show that they’re already picked up,” Shandro said.
“This is on the honour system, but Albertans are responsible and they’ve shown us that. Throughout the response to this pandemic, Albertans have shown us that they are responsible.
“Obviously there may be some folks who will be unable to make their way to a drive-thru — I’m thinking about one of my parents in particular — and whether it’s me or one of my siblings who has to go pick up for my parents, that’s going to be the case. And the folks at the 600 stores, the employees, are going to just have to trust Albertans and we’re going to have to trust Albertans.”
Alberta’s Dr. Hinshaw lays out best practices for wearing face masks to slow COVID-19 spread
The health minister stressed the three-layered, non-medical face masks are not part of the provincial supply of personal protective equipment (PPE) meant for health-care workers and first responders.
The masks are single-use, Shandro said.
“They are not medical grade masks. We are not taking away any of the PPE from our front lines,” Shandro said.
In a media release from the province, all three restaurants expressed their pleasure to be part of the mask program.
“A&W is very pleased to support the government of Alberta with this great initiative. Our restaurants across the province have been quick to step up and help organize the distribution of masks, and are looking forward to welcoming Albertans at our drive-thrus,” A&W Canada president and CEO Susan Senecal said.
“McDonald’s Canada, together with our franchisees, have been committed to helping our communities throughout this pandemic. We welcome this opportunity to use our drive-thru operations to assist the Alberta government, and do the right thing for Albertans when they need us most,” said Jeff Kroll with McDonald’s Canada.
“Throughout the pandemic, the 1,500 Tim Hortons owners across Canada have been eagerly supporting their local communities and stepping up to answer calls for assistance. When we were asked by the Alberta government to help distribute masks through our drive-thrus we did not hesitate. We’re proud to have been asked to participate in this important program and do our part to help Alberta move forward on its relaunch strategy,” Tim Hortons COO Mike Hancock said.
Tanya Doucette, a Tim Hortons owner who runs eight locations across central Alberta, said the province has asked that they not hand out the mask bags inside the restaurant, just through the drive-thru.
“They want to ensure safe social distancing, and I think because they’re worried people might show up in large numbers and queues in person, that could create risk,” Doucette said.
“We have acrylic shields in our drive-thrus and our team members are wearing non-medical grade masks, so this is a safe distance option to hand out the masks.”
She said people must be in a vehicle, they cannot walk through the drive-thru.
“What you can do if you don’t have a vehicle or you don’t have access to a vehicle, you can ask a friend or family member to pick up your allotment of masks for you through a drive-thru location at Tim Hortons,” she said.
Representatives from McDonald’s and A&W also say that masks will only be handed out through the drive-thru, and people must be in a vehicle.
The masks have arrived and will be ready for distribution early next month. Further details of the rollout will be released in the coming days.
Shandro encouraged Albertans to source their own non-medical masks through local businesses or make their own at home.
“This is not meant to be able to provide Albertans with an unlimited supply.”
More information on how to safely put on and take off a non-medical face mask can be found on the government’s website.
Hinshaw clarifies that N95 masks are not required for ‘typical care to a patient’
Shandro said that on Friday morning, Alberta surpassed the 250,000 mark when it comes to how many COVID-19 tests have been performed in the province. He said about 220,000 unique Albertans have been tested, as some people have been tested twice.
On Thursday, Alberta Health reported 29 new cases of COVID-19 in Alberta and two additional deaths related to the disease.
There were 652 active cases of COVID-19 in Alberta on Thursday afternoon.
© 2020 Global News, a division of Corus Entertainment Inc.
Laurentian Bank slashes dividend by 40 per cent as profits tumble – The Globe and Mail
Laurentian Bank of Canada slashed its dividend by 40 per cent on Friday following a sharp drop in profit, becoming the first large Canadian bank to cut its dividend payout in nearly 30 years.
The Montreal-based bank reported a 79-per-cent drop in profit for the three months ended April 30, with net income falling to $8.9-million from $43.3-million in the same quarter last year. This was largely due to a spike in provisions for potential loan losses tied to weakening economic conditions caused by the COVID-19 pandemic.
Laurentian responded by cutting its dividend to 40 cents a share, down from 67 cents. This is the first time a large Canadian bank has cut back dividend payouts since National Bank of Canada did so in 1992, according to data from Refinitiv.
“Although we believe that current earnings are not reflective of the future earnings power of the organization, we have reduced the dividend to $0.40 per share which improves operational flexibility until we reap the anticipated benefits of our strategic plan,” chief executive François Desjardins said in a press release.
Laurentian shares fell more than 9 per cent in trading Friday morning.
The bank’s earnings cap off a week of dismal results from Canadian banks, which saw profits eviscerated by a rise in loan loss provisions due to expectations of future defaults and weakening credit. Laurentian, a regional bank which focuses primarily on Quebec, managed to keep revenues flat on a year-over-year basis. But higher provisions slammed the bottom line.
Laurentian recorded $54.9-million in provisions for credit losses, compared to $9.2-million a year ago. Gross impaired loans, which are loans that the bank does not expect to be paid back in full, rose to $235-million, up 25.8 per cent year-over-year. The biggest increase in loan impairment came from the bank’s commercial loan book, where gross impaired loans rose 42 per cent year-over-year.
The results were worse than analysts had anticipated. The bank reported an adjusted earnings per share of $0.20, well below the $0.38 average that analysts had expected, according to Refinitiv data.
In a note to clients, National Bank analyst Gabriel Dechaine noted that the miss was driven by a combination of higher than expected provisions for credit losses and elevated expenses, which were partially offset by a lower-than-forecast tax rate.
“While necessary, a 40 per cent dividend cut may be viewed as insufficient, as pro forma payout ratios are still elevated,” Mr. Dechaine wrote.
The bank’s capital position deteriorated slightly in the quarter, with the closely watched common equity tier 1 ratio falling to 8.8 per cent from 9 per cent.
“This level of capital provides the Bank with the flexibility to pursue organic growth, as well as to continue to invest in the implementation of our core banking system,” the bank said in a news release.
However it added that it expects “regulatory capital ratios will remain below the level observed over the recent quarters.”
Alberta partners with fast-food chains to offer free masks at drive-thrus – CBC.ca
Albertans will be able to pick up free non-medical masks from the drive-thrus of A&W, McDonald’s and Tim Hortons starting in early June.
The Alberta government is distributing 20 million masks meant to help limit the spread of COVID-19, said Health Minister Tyler Shandro during a press conference Friday.
The masks are for situations where physical distancing is difficult to maintain, such as on public transit or while shopping, Shandro said.
“We recognize that as the province relaunches and we all adapt to our new normal, we all may sometimes find ourselves in a situation where physical distancing may not be possible.”
The province is distributing the masks through the three restaurant chains because they provide an ease of access, said the province’s health minister.
“We chose this method, quite honestly, because these partners have access through these 600 sites to about 95 per cent of our population,” Shandro said. “These three partners are doing it without expense to the Alberta taxpayer.”
Each Albertan is allowed one package of four masks, while supplies last. The masks also come with instructions on how to wear and dispose of them. No purchase is necessary.
“This is not meant to provide Albertans with an unlimited supply,” Shandro said. “We’re encouraging people to source their own masks on an ongoing basis.”
The province will also look at other ways to distribute the masks, like at high-risk transmission areas such as transit and places of worship, for people who can’t access one of the drive-thru locations.
A budget of $350,000 has been set aside to fill the gap in distribution, Shandro said.
The province is also working with municipalities, First Nations communities, Métis settlements and local agencies to distribute the non-medical masks to those who need them.
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