HALIFAX — Nova Scotia’s largest nursing home is planning for a future of private rooms to keep residents safe, but it has taken a wrenching pandemic death toll to create the shift — and it remains unclear whether government will fund a long-term fix.
“We’re currently down to fewer than 25 rooms with shared accommodations at the Halifax campus,” Janet Simm, the Northwood facility’s chief executive, said in a recent interview.
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That’s a huge shift from before the pandemic when more than 240 residents lived in two- or three-person units. Now, fewer than 50 people remain in the shared spaces, some of whom are couples or others who specifically request a roommate, Simm said.
But the facility’s desire to create more space, which its board sought for years before the pandemic, unfolded through tragedy rather than design.
COVID-19 illnesses spread among the 485 residents after asymptomatic workers brought the virus there in early April, and Simm says the bulk of the 53 who had died, as of Tuesday, and the 240 infected were in shared units.
“We would swab the roommate immediately, and they may have tested positive immediately, but the majority — even if they didn’t test positive immediately — within three or four days, they tested positive,” Simm said.
In addition to the vacancies created by the deaths, shared rooms have been decreasing as families worried about the novel coronavirus transfer Northwood residents out of the facility, she added.
And with the expectation of a second wave of the pandemic later this year, Simm says Northwood is looking to further decrease the number of shared quarters by converting some common areas into single rooms.
An application for a class action lawsuit filed Monday against Northwood cites shared rooms as a factor in its allegations of “inaction and inadequate response” on the part of management.
Representative plaintiff Erica Surette said in a news release that she lost her 66-year-old mother, Patricia West, to COVID-19 on April 22, after West had been moved from a single to a shared room in the midst of the pandemic.
The statement of claim alleges a failure to limit risks posed by the building’s design, “including its shared private and communal spaces and its crowded nature.”
Dr. Samir Sinha, director of health policy research at the National Institute on Aging at Ryerson University, says it’s crucial over the next 16 months that large Canadian homes like Northwood move to single-room layouts, even if it requires more government funding.
“I hope nobody is haggling over the costs here, especially when so many lives have already been lost,” he said in an interview.
Still, in the longer term, it remains unclear whether Nova Scotia will fund Northwood’s request for renovations that would allow it to serve its pre-pandemic population of more than 480 people.
Simm said that in recent years her board had gone to the province seeking to create about 100 additional private rooms, saying the dignity and privacy of residents was driving the earlier proposals.
Last year, the home requested over $12.5 million to develop three additional floors on top of the existing apartment tower, she said.
Now, plans are being prepared to transform a penthouse floor used primarily for group activities into residential space. No precise cost is available yet.
But it’s unclear how open the government is to expanding Northwood’s private room capacity, even though the province had a waiting list of 1,452 people for nursing home beds as of last week.
Health Minister Randy Delorey said in an interview last week his staff “had concerns about some of the specifics” in last year’s proposal to add three floors, though he declined to provide specifics.
The wider question is whether the province wants to have facilities with such large numbers of people in one location, the minister said.
“When you have more residents, and a virus like this gets in, the risk of the number of people could be affected obviously goes up,” he said.
Last week, the province announced funding for 23 new long-term care beds to help meet the need caused by the pandemic, as Northwood and others imposed a freeze on new admissions. The beds were assigned to a private facility in the Halifax area.
Janice Keefe, director of the Nova Scotia Centre on Aging at Mount Saint Vincent University, says there are many facilities in the province with shared rooms, and she has doubts the province would fund Northwood to convert to all single rooms “without considering (similar) changes at many other facilities.”
“And, yes, I think that would be a good idea,” she added.
The Unifor union, representing over 400 personal care workers at Northwood, says a reduction in the number of residents should help staff care more effectively for residents, provided funding is maintained.
Linda MacNeil, the Atlantic area director for Unifor, says her union has been advocating for years for lower patient to staff ratios in long-term care facilities.
“Hopefully this will give our members the extra time to give to the residents, to give them the attention they need,” she said of the proposed transition to single rooms.
For some relatives of residents who died during the pandemic, alternatives to Northwood’s prior living conditions should be part of the legacy from the heavy losses.
Debi Upshaw, whose 94-year-old mother died in the facility from COVID-19, said her family expects the home will move swiftly to end the practice of sharing rooms and to expand the size of common areas to help continue physical distancing.
Her mother, Evelina Upshaw was a 94-year matriarch known in Halifax as the overseer of 33 years of daily lunches for 100 children offered at her north end church. She had a private room, but nonetheless became infected and died.
“I think it can be fixed if they care more about the seniors than the money,” her daughter said. “The place (Northwood) can be fixed and upgraded to run the way it should run.”
This report by The Canadian Press was first published June 3, 2020.
The Canadian government says it will donate up to 200,000 vaccine doses to fight the mpox outbreak in Congo and other African countries.
It says the donated doses of Imvamune will come from Canada’s existing supply and will not affect the country’s preparedness for mpox cases in this country.
Minister of Health Mark Holland says the donation “will help to protect those in the most affected regions of Africa and will help prevent further spread of the virus.”
Dr. Madhukar Pai, Canada research chair in epidemiology and global health, says although the donation is welcome, it is a very small portion of the estimated 10 million vaccine doses needed to control the outbreak.
Vaccine donations from wealthier countries have only recently started arriving in Africa, almost a month after the World Health Organization declared the mpox outbreak a public health emergency of international concern.
A few days after the declaration in August, Global Affairs Canada announced a contribution of $1 million for mpox surveillance, diagnostic tools, research and community awareness in Africa.
On Thursday, the Africa Centres for Disease Control and Prevention said mpox is still on the rise and that testing rates are “insufficient” across the continent.
Jason Kindrachuk, Canada research chair in emerging viruses at the University of Manitoba, said donating vaccines, in addition to supporting surveillance and diagnostic tests, is “massively important.”
But Kindrachuk, who has worked on the ground in Congo during the epidemic, also said that the international response to the mpox outbreak is “better late than never (but) better never late.”
“It would have been fantastic for us globally to not be in this position by having provided doses a much, much longer time prior than when we are,” he said, noting that the outbreak of clade I mpox in Congo started in early 2023.
Clade II mpox, endemic in regions of West Africa, came to the world’s attention even earlier — in 2022 — as that strain of virus spread to other countries, including Canada.
Two doses are recommended for mpox vaccination, so the donation may only benefit 100,000 people, Pai said.
Pai questioned whether Canada is contributing enough, as the federal government hasn’t said what percentage of its mpox vaccine stockpile it is donating.
“Small donations are simply not going to help end this crisis. We need to show greater solidarity and support,” he said in an email.
“That is the biggest lesson from the COVID-19 pandemic — our collective safety is tied with that of other nations.”
This report by The Canadian Press was first published Sept. 13, 2024.
Canadian Press health coverage receives support through a partnership with the Canadian Medical Association. CP is solely responsible for this content.
HALIFAX – The Nova Scotia government says it could be months before it reveals how many people are on the wait-list for a family doctor.
The head of the province’s health authority told reporters Wednesday that the government won’t release updated data until the 160,000 people who were on the wait-list in June are contacted to verify whether they still need primary care.
Karen Oldfield said Nova Scotia Health is working on validating the primary care wait-list data before posting new numbers, and that work may take a matter of months. The most recent public wait-list figures are from June 1, when 160,234 people, or about 16 per cent of the population, were on it.
“It’s going to take time to make 160,000 calls,” Oldfield said. “We are not talking weeks, we are talking months.”
The interim CEO and president of Nova Scotia Health said people on the list are being asked where they live, whether they still need a family doctor, and to give an update on their health.
A spokesperson with the province’s Health Department says the government and its health authority are “working hard” to turn the wait-list registry into a useful tool, adding that the data will be shared once it is validated.
Nova Scotia’s NDP are calling on Premier Tim Houston to immediately release statistics on how many people are looking for a family doctor. On Tuesday, the NDP introduced a bill that would require the health minister to make the number public every month.
“It is unacceptable for the list to be more than three months out of date,” NDP Leader Claudia Chender said Tuesday.
Chender said releasing this data regularly is vital so Nova Scotians can track the government’s progress on its main 2021 campaign promise: fixing health care.
The number of people in need of a family doctor has more than doubled between the 2021 summer election campaign and June 2024. Since September 2021 about 300 doctors have been added to the provincial health system, the Health Department said.
“We’ll know if Tim Houston is keeping his 2021 election promise to fix health care when Nova Scotians are attached to primary care,” Chender said.
This report by The Canadian Press was first published Sept. 11, 2024.
ST. JOHN’S, N.L. – Newfoundland and Labrador‘s chief medical officer is monitoring the rise of whooping cough infections across the province as cases of the highly contagious disease continue to grow across Canada.
Dr. Janice Fitzgerald says that so far this year, the province has recorded 230 confirmed cases of the vaccine-preventable respiratory tract infection, also known as pertussis.
Late last month, Quebec reported more than 11,000 cases during the same time period, while Ontario counted 470 cases, well above the five-year average of 98. In Quebec, the majority of patients are between the ages of 10 and 14.
Meanwhile, New Brunswick has declared a whooping cough outbreak across the province. A total of 141 cases were reported by last month, exceeding the five-year average of 34.
The disease can lead to severe complications among vulnerable populations including infants, who are at the highest risk of suffering from complications like pneumonia and seizures. Symptoms may start with a runny nose, mild fever and cough, then progress to severe coughing accompanied by a distinctive “whooping” sound during inhalation.
“The public, especially pregnant people and those in close contact with infants, are encouraged to be aware of symptoms related to pertussis and to ensure vaccinations are up to date,” Newfoundland and Labrador’s Health Department said in a statement.
Whooping cough can be treated with antibiotics, but vaccination is the most effective way to control the spread of the disease. As a result, the province has expanded immunization efforts this school year. While booster doses are already offered in Grade 9, the vaccine is now being offered to Grade 8 students as well.
Public health officials say whooping cough is a cyclical disease that increases every two to five or six years.
Meanwhile, New Brunswick’s acting chief medical officer of health expects the current case count to get worse before tapering off.
A rise in whooping cough cases has also been reported in the United States and elsewhere. The Pan American Health Organization issued an alert in July encouraging countries to ramp up their surveillance and vaccination coverage.
This report by The Canadian Press was first published Sept. 10, 2024.
