This is the third in a series looking at lessons learned from the first months of the COVID-19 pandemic, and at how Canada moves forward.
Dini Cameron has watched Canada’s long-term care catastrophe unfold with a mounting sense of dread.
The 84-year-old recently spoke to CBC News from the home in Ashton, Ont. she shares with her 86-year-old husband Doug. He’s been in a wheelchair since suffering a stroke but the couple “managed for three months without help and did quite well,” she said.
“How we will be in the next few years we don’t know,” she added. “I’m already afraid. I will look for an [alternative] rather than go to one of those (long-term care homes) for both of us.
“Depending on how far gone I am and if my mind is clear, I think I would prefer euthanasia …”
Pandemics, like the viruses that drive them, attack weak points. The novel coronavirus exploited a weakness in Canadian society — this country’s tendency to warehouse its elderly in poorly supervised long-term care homes.
The result, say the experts, was completely predictable: as of May 25, long-term care residents made up 81 per cent of all reported COVID-19 deaths in Canada.
“This has been an issue and has caused older adults to die of infections prior to this, and this has just really put it in the limelight,” said immunologist Dawn Bowdish, who holds a Canada Research chair on aging at McMaster University. She said the poor infection control at long-term care facilities was well known before the pandemic struck.
“In fact, we know that we’ve had transfer of influenza — which is the next big infectious disease killer of older adults — between homes because people worked part-time, because they moved from home to home, because we don’t have the same infectious disease control that COVID has shown us that we so desperately need.”
Long-term care with long-term problems
The SARS outbreak of 2003 led to strong recommendations to improve the management of long-term care facilities, she said — recommendations that faded from view once the crisis passed.
“People cut a corner when you need to cut cost,” she said. “It’s easy to do because one hopes it never happens. But now we’re paying the price for that.”
Dr. Sandy Buchman, president of the Canadian Medical Association, said no one should assume that the shockingly high number of deaths in long-term care facilities is due entirely to the age and frailty of the people living there.
“It’s an absolute tragedy what happened to elders that lived in Canadian long term care facilities,” he said. The CMA has convened an advisory panel of experts to recommend preparations for the next pandemic.
“It’s not just about their biological vulnerability … If you were a senior at home with the same vulnerabilities, you were one hundred times less likely to die than you were if you were in a long-term care institution.
Anson Place Care Centre, in Hagersville, Ont., experienced a severe outbreak of COVID-19. (Evan Mitsui/CBC)
“So it was about the staffing issues. It was about the underfunding. It was about personal support workers having to travel between different long-term care homes. So there are system issues that need to be addressed.”
Michael Villeneuve, chief executive officer of the Canadian Nurses Association, will sit on that CMA expert panel. He said the early focus of politicians and policy experts on the pandemic’s threat to hospitals — the risk that an overwhelmed hospital system might collapse — led them to focus on that problem at the expense of long-term care.
“We had our eyes over here when there was a really critical problem over there,” he said. “And that’s got to have a very very close examination before round two comes — if it comes.”
No more ‘duct tape solutions’
People should start by understanding that the fix for long-term care won’t be quick or cheap, said Villeneuve.
“Long-term care needs a long term solution. It’s not going to get fixed overnight,” he said. “And our concern certainly now at the Canadian Nurses Association is it’ll be a sort of duct tape solution — throw a few more staff in and pay them a little bit more and it will be fine. And it won’t.
“There are fundamental issues that need to be tackled in long-term care. One is [that] the structure of the physical plant of many of these homes is really old.”
Villeneuve said the design of many long-term care facilities helped open the door to COVID-19.
“So you have people in rooms of four or two, or you have a single room with a Jack and Jill bathroom — all kinds of places for disease to move,” he said.
“It’s hard to to imagine but many of those places don’t have air conditioning. So one of the things that staff do to make residents more comfortable is they will congregate them in a lounge or in a hallway and put large fans on them to help them cool off. Well, that’s a recipe for disaster right there.”
Watch: Dini Cameron on why she is worried about moving into long-term care
Dini Cameron, 84, says she and her 86-year-old husband weathered the pandemic at home in Ashton, Ontario but are worried about the prospect of one day moving into long-term care. 0:41
Demolish and start over
Bowdish argues that, for some older and poorly designed homes, the solution may start with a wrecking ball.
“In Canada, it’s really expensive to heat our homes in the winter and it’s expensive to cool them in the summer,” she said. “So we really love to recycle our air and we know that this virus, because it can live in those itsy-bitsy little two-micron droplets, it can float around in that recycled air for a long time and infect people.”
Research shows that SARS-CoV-2, the virus that causes COVID-19, can travel through air ducts and remain suspended in the air for long periods of time. Researchers at the University of Alberta have found that, under certain conditions, airborne droplets carrying the virus can travel tens of metres.
“Air circulation is going to be increasingly important, and in fact this is one of the reasons we’re expecting a second wave” later in the year when the weather changes, Bowdish said.
“Because just like colds and flus, we go inside more, and we breathe more of that recycled air with more of these little droplets with some of the virus in it.”
The Ontario Long Term Care Association (OLTCA) has responded to the pandemic and to the dire reports out of some long-term care homes by acknowledging the sector needs help — and by pointing out that it has asked for help before now.
OLTCA CEO Donna Duncan said in a statement to CBC News that “nearly half of the province’s” long-term care homes “are older and in need of redevelopment.
“OLTCA has been advocating for a workable program to rebuild older homes for more than ten years.”
Trade-offs could hurt home care
British Columbia was able to stave off the disaster that befell Quebec and Ontario long-term care by acting quickly to seal off its homes and banning the practice of staff working in multiple locations.
The lesson seemed clear: pay long-term care workers enough to allow them to live off one salary, and you close off a potential disease vector.
But that risks pitting the long-term care sector’s needs against those of the personal care workers who are performing the home visits that allow many elderly Canadians to stay out of long-term care facilities.
“Pre-COVID, we used to be able to help 12,000 people on the island of Montreal,” said Judy Bambach, general manager of the non-profit home care agency Répit-Ressource de l’Est de Montréal. “In COVID, all of us together, I don’t even think we’re going to reach 750 by the end of this month.”
Experts say that if home care falters, more elderly people will end up in long-term care, further burdening the system.
The profit motive
The long-term care sector has many different kinds of players: provincial, private for-profit, not-for-profit and municipal homes all operate together.
Not all for-profit homes in Canada are the same. At one end of the spectrum are modern, comfortable and well-staffed homes that cost over a thousand dollars a week. At the other end are the kind of homes where Canadian soldiers found shocking examples of poor sanitation and neglect.
Bowdish said COVID has revealed a pattern, though.
“We see more deaths in private homes than we do in public homes. And I don’t know if we can ever get over the profit motive,” she said.
Canadian Armed Forces personnel arrive at the Villa Val des Arbes seniors residence, Monday, April 20, 2020 in Laval, Que. (Ryan Remiorz/The Canadian Press)
In Ontario, Doug Ford’s government moved to take over management of several privately operated homes that were called out in a scathing report by the Canadian military.
“All types of homes have been affected by COVID-19, and each has had a different experience with the disease,” said Duncan in her statement to CBC News. She said the OLTCA’s “preliminary analysis” indicates that the magnitude of an outbreak at a long-term care facility depends on a range of factors, including its staffing complement, whether it’s an older home with multiple beds per room, and whether it received “external support” when it needed it, such as staff and resident testing and personal protective equipment.
‘The one good thing’
Bowdish said she hopes this moment might be a catalyst for change.
“Maybe the one good thing that will come out of this whole episode is that we will understand how important it is to have these really basic health care and infectious disease control practices,” she said. “And we’ll also learn a lot about how to best train the people who work in these homes.”
But pandemic measures on their own won’t lead to lasting change unless Canadians themselves change the way they think about aging and elder care, she said.
“I think the public has to step up and agree that our elders are important to us,” she said. “They’re important to our families and our society. They paid their taxes. They worked hard. They deserve the best care in life. And unfortunately that’s going to come at a cost.”
Dini Cameron isn’t holding her breath.
“I don’t feel confident at all that the right choices will show up, and that they’ll get this under control,” she said. “I think those long-term care homes will always look like prisons to me.”
BUFFALO, N.Y. (AP) — Hearing the familiar sounds of clacking sticks and pucks banging off the boards and glass while watching Columbus Blue Jackets prospects from the stands of a cold rink on a warm late-summer afternoon was not enough to wash away the lingering residuals of grief for Don Waddell on Saturday.
That, the Blue Jackets’ general manager acknowledged, will take more time than anyone can guess — weeks, months, perhaps an entire season and beyond.
What mattered is how spending the weekend attending the Sabres Prospects Challenge represented a start to what Waddell called among the first steps in refocusing on hockey and the future in the aftermath of the deaths of Columbus star Johnny Gaudreau and his brother, Matthew, who were struck by a suspected drunken driver while riding bicycles on Aug 29.
“We got to play hockey,” Waddell said. “We’re not going to forget about Johnny and his family, the Gaudreau family.”
“Everybody knows that Johnny wants them to play hockey,” Waddell said. “And everybody’s rallying around that.”
The resumption of hockey in Columbus began last week, when most Blue Jackets players returned to their facility to be together and lean on each other at the urging of Waddell and team captain Boone Jenner. And it will continue on Thursday, when the team opens training camp, exactly three weeks since the Gaudreaus were killed.
“Tragic. Senseless. But now we got to focus on trying to get our team ready to play hockey this year,” Waddell said. “We all mourn and heal differently, but I think as a team being together like that is going to be critical for them to get moving forward.”
Waddell was general manager of the then-Atlanta Thrashers in 2003 when Dany Heatley lost control of his car and struck a wall, with the crash killing passenger and teammate Dan Snyder. In 2021, Blue Jackets goalie Matiss Kivlenieks died during a July Fourth fireworks accident.
Waddell placed the emphasis on himself and coach Dean Evason — both newcomers to Columbus this offseason — to guide the team through what will be an emotional season.
“Now, do I think there’s going to be some dark days? I won’t be surprised,” Waddell said.
Reminders of the Gaudreaus’ deaths remain apparent, and reflected in Buffalo on Friday night. A moment of silence was held in tribute to the brothers before the opening faceoff of a game between the Blue Jackets and Sabres.
Afterward, Columbus prospect Gavin Brindley recalled the times he spent with Johnny Gaudreau in Columbus and as teammates representing the United States at the world hockey championships in the Czech Republic in May.
“He was one of the biggest mentors for me at the world championships,” Brindley said. “I couldn’t tell you how many times we hung out with Meredith, pictures on my phone. It’s just so hard to look back and see that kind of stuff.”
The NHL and NHL Players’ Association are providing the Blue Jackets help in the form of grief counseling, crowd security at vigils and addressing hockey issues, such as potentially altering the league’s salary cap rules to provide Columbus relief from having to reach the NHL minimum payroll because of the void left by Gaudreau’s contract.
“The Blue Jackets, I don’t think anybody’s focused from an organizational standpoint, from a hockey standpoint as to what comes next, because I think everybody’s still in shock,” NHL Commissioner Gary Bettman told The Associated Press last week. “I don’t think anybody’s focused right now other than on the grieving part, which is understandable.”
Much of the burden has fallen to Waddell, who has been in discussions with the NHL and the NHLPA and dealing with outreach programs with the Blue Jackets’ partner OhioHealth, while also overseeing preparations for training camp and gauging his prospects in Buffalo.
There’s also his roster to attend to, which he said has two openings at forward, one involving Justin Danforth, who may miss the start of the season because of a wrist injury. Waddell didn’t have to mention the second opening.
Tiring and emotional as it’s been, Waddell found comfort being in his element, a rink, and looking ahead to the start of training camp.
“The guys are in really good shape. We’ve done a lot of testing already and they’re eager to get going,” Waddell said. “We have a reason to play for. And we’ll make the best of it.”
The Blue Jackets later Sunday signed veteran winger James van Riemsdyk to a one-year contract worth $900,000.
“James van Riemsdyk has been a very consistent, productive player throughout his career,” Waddell said. “Bringing him to Columbus will not only provide depth to our group up front, but also valuable leadership and another veteran presence in our dressing room.”
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AP Hockey Writer Stephen Whyno in New York contributed to this report.
PARIS (AP) — Paris Saint-Germain defender Nuno Mendes was the target of abusive and racist comments on social media after a French league game.
The club condemned the abuse and expressed its “full support” Sunday for the Portugal left back, who was targeted following PSG’s 3-1 win against Brest on Saturday.
Mendes, who is Black, shared on his Instagram account a racist message he received.
During the match, Mendes brought down Ludovic Ajorque in the box for a penalty that Romain Del Castillo converted to give Brest the lead.
“Paris Saint-Germain doesn’t tolerate racism, antisemitism or any other form of discrimination,” the club said. “The racial insults directed at Nuno Mendes are totally unacceptable … we are working with the relevant authorities and associations to ensure those responsible are held accountable for their actions.”
MONTREAL – Tadej Pogacar was so dominant on Sunday, Canada’s Michael Woods called it a race for second.
Pogacar, a three-time Tour de France champion from Slovenia, pedalled to a resounding victory at the Grand Prix Cycliste de Montreal.
The UAE Team Emirates leader crossed the finish line 24 seconds ahead of Spain’s Pello Bilbao of Bahrain — Victorious to win the demanding 209.1-kilometre race on a sunny, 28 C day in Montreal. France’s Julian Alaphilippe of Soudal Quick-Step was third.
“He’s the greatest rider of all time, he’s a formidable opponent,” said Woods, who finished 45 seconds behind the leader in eighth. “If you’re not at your very, very best, then you can forget racing with him, and today was kind of representative of that.
“He’s at such a different level that if you follow him, it can be lights out.”
Pogacar slowed down before the last turn to celebrate with the crowd, high-five fans on Avenue du Parc and cruise past the finish line with his arms in the air after more than five hours on the bike.
The 25-year-old joined Belgium’s Greg Van Avermaet as the only multi-time winners in Montreal after claiming the race in 2022. He also redeemed a seventh-place finish at the Quebec City Grand Prix on Friday.
“I was disappointed, because I had such good legs that I didn’t do better than seventh,” Pogacar said. “To bounce back after seventh to victory here, it’s just an incredible feeling.”
It’s Pogacar’s latest win in a dominant year that includes victories at the Tour de France and Giro d’Italia.
Ottawa’s Woods (Israel Premier-Tech) tied a career-best in front of the home crowd in Montreal, but hoped for more after claiming a stage at the Spanish Vuelta two weeks ago.
“I wanted a better result,” the 37-year-old rider said. “My goal was a podium, but at the same time I’m happy with the performance. In bike racing, you can’t always get the result you want and I felt like I raced really well, I animated the race, I felt like I was up there.”
Pogacar completed the 17 climbs up and down Mount Royal near downtown in five hours 28 minutes 15 seconds.
He made his move with 23.3 kilometres to go, leaving the peloton in his dust as he pedalled into the lead — one he never relinquished.
Bilbao, Alaphilippe, Alex Aranburu (Movistar Team) and Bart Lemmen (Visma–Lease) chased in a group behind him, with Bilbao ultimately separating himself from the pack. But he never came close to catching Pogacar, who built a 35-second lead with one lap left to go.
“It was still a really hard race today, but the team was on point,” Pogacar said. “We did really how we planned, and the race situation was good for us. We make it hard in the last final laps, and they set me up for a (takeover) two laps to go, and it was all perfect.”
Ottawa’s Derek Gee, who placed ninth in this year’s Tour de France, finished 48th in Montreal, and called it a “hard day” in the heat.
“I think everyone knows when you see Tadej on the start line that it’s just going to be full gas,” Gee said.
Israel Premier-Tech teammate Hugo Houle of Sainte-Perpétue, Que., was 51st.
Houle said he heard Pogacar inform his teammates on the radio that he was ready to attack with two laps left in the race.
“I said then, well, clearly it’s over for me,” Houle said. “You see, cycling isn’t that complicated.”
Australia’s Michael Matthews won the Quebec City GP for a record third time on Friday, but did not finish in Montreal. The two races are the only North American events on the UCI World Tour.
Michael Leonard of Oakville, Ont., and Gil Gelders and Dries De Bondt of Belgium broke away from the peloton during the second lap. Leonard led the majority of the race before losing pace with 45 kilometres to go.
Only 89 of 169 riders from 24 teams — including the Canadian national team — completed the gruelling race that features 4,573 metres in total altitude.
Next up, the riders will head to the world championships in Zurich, Switzerland from Sept. 21 to 29.
Pogacar will try to join Eddy Merckx (1974) and Stephen Roche (1987) as the only men to win three major titles in a season — known as the Triple Crown.
“Today gave me a lot of confidence, motivation,” Pogacar said. “I think we are ready for world championships.”
This report by The Canadian Press was first published Sept. 15, 2024.
