Could B.C.’s approach to long-term care COVID-19 outbreaks work in Ontario?

Posted: April 11, 2020

(April 10, 2020)

By: Katrina Clarke, The Hamilton Spectator

After the deadly outbreak at the Lynn Valley Centre care home in North Vancouver, British Columbia is tackling COVID–19 outbreaks in long–term care homes by mandating workers only work at one home, designating them public service workers, hiring them full-time and paying them standardized wages.

British Columbia is tackling COVID–19 outbreaks in long–term care homes by mandating workers only work at one home, designating them public service workers, hiring them full-time and paying them standardized wages.

Could that happen in Ontario? Should it? Not everyone agrees.

In B.C., the directive from provincial health officer Dr. Bonnie Henry came following the province’s experience with Canada’s first deadly COVID–19 outbreak beginning in early March. A least 17 residents have died at Lynn Valley Care Centre in North Vancouver, and dozens more staff and residents are infected.

The B.C. seniors’ advocate says valuable lessons learned from Lynn Valley are now preventing or slowing outbreaks in other care homes.

One lesson learned: when care home staff work in different facilities, their risk of spreading the virus in vulnerable populations increases, said B.C. seniors advocate Isobel Mackenzie.

Now, “we have been actively eliminating that,” Mackenzie said of inter-home movement.

The province believes a worker employed at more than one care home unwittingly brought the virus into Lynn Valley in the early days of COVID–19 spread in Canada.

Last week, the province deemed care aides — or personal support workers (PSW) — to be provincial employees, in turn ensuring they have full-time work within one home and are all paid a fair wage, as opposed to different wages depending on their employer. Mackenzie expects the mandate, which is still being rolled out, to come fully into effect within days.

Mackenzie believes her province’s measures — including ramped up testing and lower thresholds for declaring outbreaks — are working. So does Henry.

“All of those enhanced measures have led to very few cases in most of the other outbreaks that were detected very early,” the provincial health officer said Wednesday.

While more than 220 of B.C.’s more than 1,300 cases — or 17 per cent of all cases — involve long–term care home residents or staff, most of those cases are concentrated in two homes, including Lynn Valley.

In Ontario, more than 850 of the province’s more than 5,200 cases — or 16 per cent of all cases — involve long–term care home residents or staff. However, unlike in B.C., the cases here are spread more evenly across more nursing homes, with a few outliers including Pinecrest Nursing Home in Bobcaygeon where nearly 30 residents have died.

In late March, Ontario directed long–term care employers to limit the number of homes staff work at to stop the spread of COVID–19.

But Ontario health-care advocacy groups are calling on the province to do more to keep workers safe, fairly compensated and employed within one home.

Miranda Ferrier, president of the Ontario Personal Support Workers Association (OPSWA), said she agrees long–term careworkers should work only at one home during a pandemic.

“In terms of mandating the PSW as public workers and standardizing their pay, the OPSWA would welcome this insofar as it would work within our professional mandate of self-regulation and title protection,” she said.

She said the OPSWA “welcomes any support to be recognized as equal members of the interprofessional health team.”

Meanwhile, inter-home movement is still happening, say front-line workers. Hamilton-area PSW Cindy Hasler told The Spectator earlier this week that some workers don’t have time to even shower between jobs.

Still, unions and advocacy groups worry workers will lose out on pay — and homes could lose out on staff — if they have tochoose one job.

“We’re very aware of how many long–term care workers work multiple jobs,” said Natalie Mehra, director of the Ontario Health Coalition. “Even if they could increase the workers’ hours, that would leave a number of homes completely devastated of staff.”

In principle, Mehra agrees with B.C.’s model. She’s just not sure how it would work here.

“At this point, the staffing shortages are indescribable, unspeakable,” she said, calling “crisis” too weak a word. “The problem is, where are they going to find the staff for all the homes? If the idea is not to cause harm, in some cases would that not cause more harm than good?”

In any case, the province won’t say if it’s considering a B.C.-type approach.

“All options for protecting staff and resident safety continue to be on the table as we address this serious, evolving situation,” said Ministry of Long–Term Care spokesperson Gillian Sloggett, when asked if Ontario is looking to replicate B.C.’s model.

Sloggett said the province is giving long–term care homes “much-needed flexibility and funds” by amending regulations and producing $243 million in emergency COVID–19 funding, allowing homes to “rapidly hire personal support workers and other front-line staff they need, when they need them.”

“Funds are directly available to help homes cover the incremental costs of increasing hours for part-time staff to help those staff to limit their work locations,” she said. “This comes hand in hand with clear direction from Dr. David Williams, Ontario’s chief medical officer of health, for homes to work with employees to limit their number of work locations wherever possible.”

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