For-profit long-term care homes in Ontario saw significantly worse outbreaks of COVID-19 and more related deaths than their non-profit or municipally run counterparts, according to a new study released on Wednesday.
The paper in the peer-reviewed Canadian Medical Association Journal raises questions about the ownership status of nursing homes, a factor the association that speaks for the facilities said last year had no impact on quality of care.
The research looked at all 623 long-term care homes in Ontario, from March 29 — the date of the first reported case of coronavirus in a home — until May 20. Collectively, the facilities housed more than 75,000 seniors — most of them with multiple health conditions, both physical and cognitive.
In all, more than 5,200 residents contracted COVID-19 during the study period. More than one-quarter of those infected — 1,450 — died.
In Ontario, 57 per cent of nursing homes are set up to be profit-making — the highest rate in the country. Another 26 per cent are non-profit and 16 per cent are municipally run. While profit status had no impact on whether a facility had a coronavirus outbreak, the study finds, it did play a significant role in what happened if one occurred.
“We did find evidence that for-profit LTC homes have larger COVID-19 outbreaks and more deaths of residents from COVID-19 than non-profit and municipal homes,” the study finds. “Those with older design standards appear to show worse outcomes.”
The study, co-authored by Dr. Nathan Stall with the Sinai Health System and University Health Network in Toronto, also suggests chain-operated for-profit homes — 85 per cent of the commercial facilities — run a significantly higher risk of worse COVID outcomes.
An accompanying commentary notes upgrading facilities — many beds are at or below 1972 standards — likely won’t fix the situation at for-profits if further research confirms chain ownership is a key factor on its own.
Dr. Samir Sinha, a Toronto-based geriatrician not involved in the study, said 30,000 long-term care beds in Ontario are in dire need of upgrades.
“Many of these older multi-bedded homes happen to be owned by for-profits,” Sinha said. “The study really speaks to the need to redevelop that.”
The government of Premier Doug Ford initially promised to build 15,000 beds in five years and redevelop another 15,000, Sinha said. However, only a relative handful have been built or redeveloped, and the government has now significantly tempered its ambitions.
Last week, the government announced it is changing the way it funds long-term care home expansions in a bid to spur construction while conceding it would now pay for 8,000 new beds, and 12,000 renovated beds in the same five-year period.
In the interim, it has also limited room occupancy to two, further exacerbating bed shortages.
The Ontario Long Term Care Association, which speaks for nursing homes and has complained about underfunding, did not respond to a request for comment on the study.
Separately Wednesday, the Ontario Health Coalition said 95 per cent of staff in the province’s nursing homes reported basic care needs of residents — such as bathing, oral care and emotional support — were going unmet due to staff shortages.
Others said they didn’t have enough time to properly feed residents, get them to the washroom on time, or make sure they didn’t develop pressure ulcers — a situation especially problematic at night and on weekends. Most respondents reported the situation had worsened since the pandemic hit in March.
In response, Ford said the survey findings show why his government passed ongoing emergency powers to be able to “flow staff from the hospitals into long-term care.”
Previous research has shown staffing levels play a key role in COVID-19 outcomes, with one California study finding under-staffing doubled the chances of residents’ becoming infected.
“If requirements to fund adequate levels of staffing affect the bottom lines of for-profit facilities, then it might be time for this care to be turned over to public and non-profit entities,” the journal commentary says.
This report by The Canadian Press was first published on July 22, 2020.
Colin Perkel, The Canadian Press
What you need to know about COVID-19 in Ottawa on Sunday, Aug. 9 – CBC.ca
- Ottawa Public Health reported 13 new cases of COVID-19 on Saturday, bringing the city’s total to 2,623.
- Some private cannabis retailers in Ottawa say Ontario’s move to Stage 3 has meant a drop in their sales.
- The Nunavut government is spending millions to have their residents self-isolate in an Ottawa hotel before returning to the territory.
What’s the latest?
On Saturday, Ottawa Public Health reported 13 new cases of COVID-19, the fourth day of double-digit increases since an earlier drop in the number of new cases early last week.
Ontario also reported fewer than 100 cases of COVID-19 for the sixth straight day. There were only 70 new cases across the province Saturday.
The Government of Nunavut has spent nearly $5 million since the end of March to house more than 1,200 of its residents at an Ottawa hotel so they can self-isolate before returning home. The territory is taking these steps to keep its COVID-19 case count at zero.
Some cannabis retailers in Ottawa are decrying the province’s move to halt home deliveries late last month. They said they’ve seen a drop in sales they attribute to the province’s decision.
How many cases are there?
There have been 2,623 confirmed cases of COVID-19 in Ottawa since the pandemic began. The number of deaths is at 264.
The majority of cases in the city — 2,204 — are classified as resolved.
In all, public health officials have reported more than 4,000 cases across eastern Ontario and western Quebec, with more than 3,400 cases resolved.
COVID-19 has killed 102 people in the region outside Ottawa: 52 in Leeds, Grenville and Lanark counties, 17 in other parts of eastern Ontario and 33 in the Outaouais.
What’s open and closed?
Ottawa is now in Stage 3 of Ontario’s reopening plan, which means many more businesses are allowed to reopen, including dine-in restaurants and movie theatres.
Indoor gatherings of up to 50 people and outdoor gatherings of up to 100 are now allowed in that province but attendees must adhere to physical distancing guidelines.
The Canada Aviation and Space Museum opened to the public this weekend.
Most Ottawa Public Library branches will be open for in-person browsing and computer use Aug. 17.
Elementary students in Ontario will be heading back to school full time come September, while most high school students will split their time between the classroom and online learning, depending on the board.
Quebec’s back-to-school plans will bring students to classrooms again this fall.
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Distancing and isolating
The novel coronavirus primarily spreads through droplets when an infected person coughs or sneezes on another person or object. People don’t need to have symptoms to be contagious.
That means physical distancing measures such as working from home, meeting others outdoors as much as possible and keeping distance from anyone they don’t live with or have in their circle, including when you have a mask on.
Masks are now mandatory in indoor public settings in all of eastern Ontario and Quebec, where transit officials and taxi drivers are now required to bar access to users over age 12 who refuse to wear one.
Masks are also recommended outdoors when you can’t stay the proper distance from others.
Anyone who has symptoms or travelled recently outside Canada must self-isolate for at least 14 days.
Anyone waiting for a COVID-19 test result in Ontario must self-isolate at least until they know the result. Quebec asks people waiting to only self-isolate in certain circumstances.
A negative <a href=”https://twitter.com/hashtag/Covid19?src=hash&ref_src=twsrc%5Etfw”>#Covid19</a> test can be a relief but it DOES NOT MEAN it’s okay to let your guard down. You and those within your social circle can still get Covid-19. Remember to wear a mask, physically distance and wash your hands to protect yourself and others! <a href=”https://t.co/HCy1blb07V”>pic.twitter.com/HCy1blb07V</a>
People in both provinces should self-isolate if they’ve been in contact with someone who’s tested positive or is presumed to have COVID-19.
Ontario’s Chief Medical Officer of Health strongly urges self-isolation for people with weakened immune systems and OPH recommends people over 70 stay home as much as possible.
What are the symptoms of COVID-19?
COVID-19 can range from a cold-like illness to a severe lung infection, with common symptoms including fever, a dry cough, vomiting and the loss of taste or smell.
Less common symptoms include chills, headaches and pinkeye. Children can develop a rash.
If you have severe symptoms, call 911.
Where to get tested
In eastern Ontario:
In Ottawa any resident who feels they need a test, even if they are not showing symptoms, can be tested at one of three sites.
Inuit in Ottawa can call the Akausivik Inuit Family Health Team at 613-740-0999 for service, including testing, in Inuktitut or English on weekdays.
In the Eastern Ontario Health Unit area, there is a drive-thru centre in Casselman that can handle 200 tests a day and assessment centres in Hawkesbury and Winchester that don’t require people to call ahead.
Others in Alexandria, Rockland and Cornwall require an appointment.
In Kingston, the Leon’s Centre is hosting the city’s test site. Find it at Gate 2.
Napanee‘s test centre is open daily for people who call for an appointment.
You can arrange a test in Bancroft, Belleville or Trenton by calling the centre and in Picton by texting or calling.
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The Leeds, Grenville and Lanark unit asks you to get tested if you have a symptom or concerns about exposure.
It has a walk-in site in Brockville at the Memorial Centre and testing sites in Smiths Falls and Almonte which require an appointment.
Residents in Renfrew County should call their family doctor and those without access to a family doctor can call 1-844-727-6404 to register for a test or if they have health questions, COVID-19-related or not.
In western Quebec:
Outaouais residents now can get a walk-in test in Gatineau five days a week at 135 blvd. Saint-Raymond and at recurring clinics by appointment in communities such as Gracefield, Val-des-Monts and Fort-Coulonge.
They can call 1-877-644-4545 to make an appointment or if they have other questions.
Local communities have declared states of emergency, put in a curfew or both.
It has a mobile COVID-19 test site available by appointment only. Anyone returning to the community on the Canadian side of the international border who’s been farther than 80 kilometres away is asked to self-isolate for 14 days. It’s 100 miles or 160 kilometres away on the American side.
Anyone in Tyendinaga who’s interested in a test can call 613-967-3603 to talk to a nurse. Face coverings are now mandatory in its public buildings.
People in Pikwakanagan can book an appointment for a COVID-19 test by calling 613-625-2259.
Kitigan Zibi is planning for an Aug. 29 election with changes depending on the status of the pandemic at that time. It plans on starting to open schools and daycares next month.
For more information
Daughter of man in Burnaby care home with active COVID-19 cases says health protocols not met – News 1130
BURNABY (NEWS 1130) — A woman whose elderly father is living in a B.C. care home with active cases of COVID-19 says the facility isn’t following proper health protocols.
Heather was visiting her father at Burnaby’s George Derby Centre last week and says she’s worried for her father’s health.
“It was like a zoo in there,” she says. “There were so many people, the care patients downstairs just sitting around in wheelchairs all right next to each other.”
Staff also didn’t use a temperature gauge on visitors and didn’t provide anyone with hand sanitizer before they walked into the building, according to Heather.
“My dad just went in there, he was perfectly fine in this other place, it was much better, and when i saw it was not the same at all, not the same quality of care.”
Heather says she didn’t say anything at the moment but when she went home and talked to a friend, it made her realize the number of protocols not followed.
Two cases of COVID-19 reported Friday at the Burnaby healthcare facility include one worker, and one in a resident which are unrelated, according to Fraser Health.
The George Derby Centre is a “campus of care” which includes an independent living facility and a long-term care home.
The staff member works in the independent living facility, Derby Manor.
Ottawa Public Health asks businesses to encourage mask use by staff in break rooms, kitchens – CTV Edmonton
Ottawa Public Health is urging all businesses to promote wearing face masks by employees in areas not covered by Ottawa’s mandatory face mask bylaw, including break rooms and changing areas.
And businesses are being encouraged to do “active screening” of all employees during the pandemic to help limit the spread of novel coronavirus.
Associate Medical Officer of Health Brent Moloughney says the health unit is still seeing cases of COVID-19 where employees are going to work while symptomatic.
“For this reason, OPH strongly encourages all businesses to do active screening of employees to make sure no one is going to work when they are sick or feeling unwell,” said Dr. Moloughney in a statement released on Friday afternoon.
Ottawa Public Health has a health-screening questionnaire available on its website.
“Reminder, Ottawa Public Health does not recommend asymptomatic employees be tested before starting work since the results reflect just a snapshot in time and can be falsely reassuring,” said Dr. Moloughney.
Council passed a bylaw in July making face masks mandatory in all indoor public spaces. Ottawa’s mandatory face mask bylaw includes an exemption that allows employees working in non-public areas or behind a physical barrier to go maskless while working in public buildings.
Dr. Moloughney says public health encourages businesses to “promote mask use in areas not covered by the bylaw including non-public common areas such as break rooms, kitchens, changing areas, etc. to help further prevent COVID-19 transmission among staff.”
Since the first case of COVID-19 on March 11, there have been 2,623 laboratory-confirmed cases of COVID-19 in Ottawa, including 264 deaths.
A total of 2,204 people have recovered after testing positive for novel coronavirus.
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