Ontario’s long-term care homes were forgotten in the province’s initial plans to control the spread of COVID-19 “until residents started dying,” says the independent commission examining the sector, as it released early recommendations for the government to beef up staffing, improve testing and solidify infection control practices for the second wave.
In a five-page letter released on Friday, the commission said it is making early recommendations because of the urgency and high risk of COVID-19 spread in long-term care homes, including for priority testing and faster turnaround results for residents and staff. It also says the government should prioritize homes for point-of-care and less invasive tests when they become available.
Delays in testing have prevented nursing homes from quickly identifying infected residents and staff and controlling the spread of infection. The number of long-term care homes with outbreaks in Ontario has quadrupled over the past month.
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The three-member commission, led by Associated Chief Justice Frank Marrocco of the Superior Court of Justice, has heard from 200 witnesses and almost 50 groups so far. A final report is not due until the end of April.
“Many witnesses have shared heart-wrenching accounts of their experiences during the first wave of the pandemic that resulted in tragic loss of life, suffering and devastating impacts on residents, families and staff,” said the commission.
“We have heard that long-term care (LTC) homes were forgotten in the initial provincial plans to control the spread of COVID-19 until residents started dying, and pleas that this not be repeated when this crisis is over.”
The commission’s recommendations, many echoing those of a government staffing study released this summer, include hiring more personal support workers, increasing full-time positions, increasing funding for nurses and support staff, and further collaboration between homes and hospitals. The commission also calls for four hours of direct care for each resident, which the Registered Nurses of Ontario has also sought for years.
The Ontario government said many of the recommendations are already being worked on. The government is spending $461-million as part of its fall preparedness plan to boost wages for personal support workers by $3 an hour until at least next March.
The commission also reinforces calls to strengthen infection and prevention control (IPAC) measures in homes, including ensuring each home has an infection control and prevention lead and to provide basic training for all staff. It also calls for enhanced inspections to ensure these measures are being implemented. Senior infection control specialists have said they advised the government in June that the long-term care sector must overhaul its infection-control measures, but the recommendations have not been implemented.
“We heard that in many cases, it was unclear who was accountable for compliance with IPAC measures, including having sufficient supply and adequate training for staff,” the letter said.
It also says residents who have COVID-19 in older homes should be given the option to transfer to alternate settings, such as hospitals, if they can’t be isolated from other residents.
More than half of the province’s 626 long-term care homes have experienced outbreaks, the commission said, and 75 per cent of deaths during the pandemic occurred in long-term care. So far, more than 1,980 residents and eight staff from Ontario’s long-term care homes have died after contracting COVID-19.
The commission, announced in late July, will examine what happened in long-term care during the first wave of the virus, and provide recommendations on “how to better protect the residents and staff” in future.
Krystle Caputo, a spokeswoman for Long-Term Care Minister Merrilee Fullerton, said the government is “carefully reviewing” the recommendations to solve the “long-standing and systemic challenges facing the long-term care system.” The government is also spending $461-million as part of its fall preparedness plan to boost wages for personal support workers and others by $3 an hour until at least next March.
This article first published here www.theglobeandmail.com/canada/article-long-term-care-forgotten-in-first-wave-ontario-commission-says/