A study of long-term care homes across Ontario during the pandemic shows that aging facilities, whose designs date back to 1972 standards, were a significant factor in determining the likelihood of an outbreak.
The authors found the odds were higher with older homes — many of which are for-profit — and were also linked to the infection rate in the local health unit and number of people inside the building.
Dr. Andrew Costa, senior author and McMaster University professor, said he was surprised at how crucial the facilities’ design was when it came to managing an outbreak.
“We were frankly disappointed… at how many facilities still maintained essentially 1972 designs,” he said. “That’s a long time ago. And the philosophy of care has changed so much.”
The report, published in the Canadian Medical Association Journal, looked at all 623 long-term care (LTC) homes in Ontario — home to 75,676 residents — from March 29 to May 20, 2020.
Around 30 per cent of homes in the province experienced outbreaks during this peak period, with 110 occurring in for-profit homes, 55 in nonprofit homes and 25 in municipal homes.
There were 190 outbreaks of COVID-19 in LTC homes, which at this point killed 1,452 people. Their lives account for more than 80 per cent of Canada’s deaths.
Deaths up 178 per cent at for-profit homes
At for-profit homes, the report said the rate of cases was almost double compared to those with non-profit status. These homes also had a 178 per cent increase in the number of resident deaths.
For-profit homes, were “usually smaller, housed fewer residents, and had older design standards from before 1972 with multiple-occupancy rooms and chain ownership.” Costa said this was the case for around half of the for-profit places.
Newer designs, the authors said, allow for larger and more private rooms, and less crowded and self-contained common space. This limits infection.
But older designs use ward-style accommodations and centralized common spaces where people can interact with each other, allowing the virus to spread.
One in five of the nonprofits and very few municipal ones had old designs.
And it made a difference. If you factor in age and whether or not the home is a chain, Costa said, then “essentially there was no difference” between each type of residence.
“It’s only now that we’ve seen the infection control issue as cleanly and plainly, where we can’t disregard it, that it’s gotten attention. But it’s always been bad for the people living there,” he said.
The findings echo those in a CBC Marketplace investigation in June.
Of the 10 homes with the highest death rates, seven were for-profit homes with older design standards and chain ownership. Of the 15 homes with the highest rate of cases, 12 fell into this same category.
“From a Hamilton perspective, we have some old facilities in our midst…but it’s something that local public health units have to pay particular attention to,” he said and added that units and municipal government should identify these vulnerable facilities to create plans for evacuations and handling staff crises.
About 23.8 per cent of residents in for-profit homes had the virus, which is higher than the average for nonprofit and municipal homes (17.1 per cent and 7.1 per cent respectively.) Around 6.5 per cent of all non-profit residents died of COVID-19.
“It was clear that across the board, for all of our planning for covid, the long-term care sector was left neglected,” he said. “We were planning for a crisis in hospitals…that instead fell to long-term care. And we were on our back heels. And so now we have evidence, clear evidence [on] what the priorities are for prevention and we have to act.”
The authors write that with government commitment to independent commissions and inquiries into the long-term care systems, “it is important that policy recommendations and changes consider all root causes of the present crisis, including supporting capital projects to retrofit or rebuild older LTC homes.”
In May, the province announced an independent commission into long-term care.
The authors did not look at retirement residences since they are privately funded and not administered by the Ministry of Long-term Care.
BC records 30-50 new COVID-19 cases a day over weekend, no new deaths – Fernie Free Press
From Friday to Monday B.C. recorded 131 new COVID-19 infections, bringing the total number of active confirmed cases as of Monday (Aug. 10) to 445.
Nine of those people are battling the disease in hospital, three of whom are in critical care or intensive care, provincial health officer Dr. Bonnie Henry confirmed in a news conference Monday afternoon.
Broken down by day, 50 people tested positive for the respiratory illness Friday to Saturday, 37 on Saturday to Sunday and a further 44 on Sunday to Monday.
There have been no new deaths, leaving the total to 195 lives lost linked to the novel coronavirus.
Many of those who tested positive over the weekend were linked to prior cases, Henry said. There are currently 1,765 identified by contact tracing for being in close contact with an infected person who are self-monitoring or in touch with public health staff.
More to come.
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Manitobans to get more detailed regional breakdown of COVID-19 cases this week, says minister – CBC.ca
Manitobans can expect to get more details about where new COVID-19 cases are popping up by the end of the week, but it’s not yet clear how specific that information will be.
Health Minister Cameron Friesen said Monday the province will begin releasing more “nuanced” geographical breakdowns of where new cases emerge beginning later this week — a significant shift since the virus arrived in the province five months ago
Up until now, the province has generally only identified the regional health authority of new cases, occasionally offering more pointed information depending on the public health risk in those areas.
Moving forward those regions will be split down into finer zones or districts, said Friesen.
The impetus for the shift is that the province knows more now than it did in March when the coronavirus officially arrived in Manitoba, he said.
“We don’t think there’s any benefit in someone knowing that someone has COVID-19 that lives four blocks down from you or down the street, but it’s this balancing act of providing good information in a timely way to Manitobans and then of course on the other side making sure there isn’t a negative effect from over-identification.”
Another change that’s on the way is linked to hard-hit communities, said Manitoba’s chief public health officer.
Dr. Brent Roussin suggested that if things get out of control, certain communities in particular could see a return to past restrictions.
“As we move forward our approach is to not have widespread restrictions, take a much more surgical approach as any restrictions are required,” said Dr. Brent Roussin.
He said health officials don’t yet have anything too specific in mind. He didn’t share a possible timeline for region-specific restrictions.
But Roussin made the comments Monday after announcing 16 new cases and addressing a cluster in Brandon that has soared to at least 64.
Most of the active cases are in Prairie Mountain and Southern health regions.
There are early signs of community spread in Brandon, which is when health officials are unable to confirm where someone got the virus, but most of the clusters cases have a known source, he said.
That’s why Brandon hasn’t been hit with restrictions — yet.
“We’re certainly talking about Brandon where we see this cluster,” he said. “That area should be taking extra caution.”
Roussin acknowledged increasing enforcement is an option but he would prefer to see businesses, organizations and individual take actions now to prevent that.
“By messaging, by things that Manitobans have learned, this is our opportunity to live with the virus, not shut things down,” he said.
“It shouldn’t be necessary to have to enforce these things to protect the health of Manitobans, but we will.”
B.C. records 131 new COVID-19 cases over three days, as active cases surge past 400 – Global News
Health officials reported 131 new cases of COVID-19 in B.C. over the past three days and no new deaths.
There were 50 cases from Friday to Saturday, 37 cases Saturday to Sunday, and 44 from Sunday to Monday.
The number of active cases in the province jumped from 386 on Friday to 445, an increase of just over 15 per cent.
B.C. health officials to provide latest on COVD-19 curve
There are 4,065 confirmed cases of the disease in B.C. Of those, 3,425 patients have fully recovered, or about 84 per cent.
B.C.’s death toll from COVID-19 remains at 195 as the province has not recorded a death related to the virus since July 31.
Nine COVID-19 patients are in hospital, a decrease of two since Friday. Three of those patients are in intensive care, a decrease of one.
The province says 1,765 people are in self-isolation.
Health officials have repeatedly warned B.C. residents as more COVID-19 cases emerge from large social gatherings.
Three Vancouver police officers and two Vancouver police patrols are in isolation after breaking up an out-of-control party with more than 100 people attending, Ralph Kaisers, president of the Vancouver Police Union, said on social media on Friday.
Global BC political panel: August 9
Kaisers told Global News the party took place in an apartment in downtown Vancouver in late July.
Between 16 to 20 officers are in self-isolation as a result, Kaisers said.
In addition, hundreds of people are now self-isolating following a house party in North Vancouver.
“The numbers of contacts related to that are in the 400 range,” B.C. provincial health officer Dr. Bonnie Henry said on Thursday.
People under the age of 40 make up a disproportionately large number of coronavirus cases in the Okanagan and throughout the wider Interior Health region, according to statistics from the BC Centre for Disease Control.
Forty-seven per cent of diagnosed cases in the Interior Health region involve people aged 20 to 40, compared to a provincial average of 34 per cent for the same age demographic.
The rise in coronavirus cases among young people is related to private parties in and around Kelowna, B.C., over the Canada Day long weekend, health officials have said.
— With files from Amy Judd and Shelby Thom
© 2020 Global News, a division of Corus Entertainment Inc.
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