How did all of this happen again?
Posted: December 23, 2020
(December 22, 2020)
By: Anne Jarvis, Windsor Star (Print Edition)
What happened at The Village at St. Clair long-term care home in Windsor? How did the novel coronavirus spread to so many residents and staff so fast? The outbreak was first reported Dec. 8. A week later, 89 residents and staff had been infected. By Monday, less than two weeks later, there were 143 active cases among residents and staff.
Eight residents had died. Everyone there is screened, the home says. They have an infection control lead and enough personal protective equipment and disinfectant. They follow public health guidelines. They have an emergency plan.
It’s one of the newest longterm care homes in the region. It opened only five years ago, meaning it should be designed for infection prevention and control.
“Safely managing this outbreak is of utmost priority,” Joanne Potts, vice-president of operations for owner Schlegel Villages, wrote in a letter posted last week.
“We are confident that the necessary precautions are in place for the containment of the virus,” she wrote.
So what happened? Potts admitted to a “lapse in surveillance protocols.” A staff member dressed as Santa Claus for a holiday event for residents didn’t wear proper PPE. That person later tested negative for COVID-19, and all staff are undergoing “re-education” on proper PPE use.
But it leaves you asking, what other lapses were there? And why do they still need to “re-educate” staff about protecting themselves and others nine months into this pandemic? It’s not only Schlegel. There were 13 outbreaks at long-term care and retirement homes in Windsor and Essex County as of Monday. Three of those homes have had dozens of cases – Berkshire Care Centre has had 56, Chartwell St. Clair Beach 47, Extendicare Tecumseh 45.
It’s not only this region.
Between Sept. 1, when the pandemic’s second wave hit longterm care homes in Ontario, and Dec. 15, 4,594 residents and staff had been infected, and more than 700 residents died, according to the latest report by the Ontario Health Coalition, released last week. There are currently 262 outbreaks in long-term care and retirement homes in the province, according to Public Health Ontario’s most recent daily epidemiological summary Dec. 20.
What happened? Long-term care homes experienced outbreaks of respiratory and gastrointestinal illnesses regularly before the pandemic. They should know how to handle infectious diseases.
But they were also riddled with problems that everyone knew and did little about before the pandemic – ward rooms with up to four beds in one room, staff shortages, underpaid staff, burned-out staff, lack of proper infection prevention and control.
We should have known, as concern grew about the new pathogen spreading around the world, that the frail elderly in these homes would be at high risk of infection. We prepared hospitals.
But we forgot about long-term care homes.
Eighty per cent of people who died in the first wave of COVID-19 in Canada were residents of long-term care homes. It was appalling and shameful, and we vowed to do better for our elders.
We’ve been living with this for nine months. We’re in the middle of a second wave that we knew would happen. And long-term care homes are being hit again. Again, it’s spreading like wildfire in some homes.
How can this happen? There have been improvements. Long-term care staff are no longer allowed to work at more than one home. But temporary staff are excluded from this ban, according to the Ontario Health Coalition’s 66-page report, A Call to Conscience.
Ward rooms are being eliminated, but some remain.
There is more access to PPE, but as the “lapse” at The Village at St. Clair shows, there are, well, lapses. Having a proper supply and using it properly is not enforced, according to the report.
Long-term care and retirement homes here are paired with hospitals for support.
But there are still staff shortages, according to the report. Homes still aren’t being held accountable for ensuring that proper infection prevention and control practices are followed. Some residents with symptoms still aren’t being separated from those who aren’t infected to stop transmission. There has been a failure to plan a systematic response early in an outbreak when it can still be stopped.
“Clearly the measures taken in and after Wave 1 were not sufficient,” the report states. “There has been a failure of leadership in this province and a failure to competently plan for the second wave.”
The first doses of the Pfizer-BioNTech vaccine for Windsor and Essex County arrived Monday. They’re vials of hope.
Vaccination of long-term care staff here is scheduled to start Tuesday. Residents will be among the next group to be inoculated.
But it will be too late for many.
They won’t survive the latest outbreaks.
Condolences aren’t enough.
We need to know why this is happening again.