COVID-19 Cutting Its Deadly Path in Canada Through Long-Term Care Facilities Housing the Elderly and Health-Impaired

"All the provinces and territories are trying to do the best they can to strengthen the response in that area [long-term care facilities country-wide]."
"Because that is driving the severe outcomes in Canada. That is absolutely a key feature of this epidemic."
Dr.Theresa Tam, Chief Public Health Officer, Canada

"Providing consistent guidance for long-term care homes across the country will save lives. But it will take much more than these guidelines to keep our seniors and vulnerable Canadians safe."
"It would be impossible to keep them safe without individual Canadians practising social distancing."
Seniors Minister Deb Schulte, Ottawa

"We have to look after the most vulnerable. We have a duty to look after those who cannot look after themselves."
"I know it's difficult, but this virus is ruthless and it's deadly."
Ontario Premier Doug Ford

Funeral home workers remove a body from the Centre d'hébergement Sainte-Dorothée, on April 13, 2020, in Laval, Que. There have been 26 deaths related to the novel coronavirus at the Sainte-Dorothée centre.  Ryan Remiorz/The Canadian Press

The grim situation of rising case statistics in Canada and consequent deaths among those hardest hit by COVID-19, has been enormously exacerbated by the revelation of the carnage done to elderly, incapacitated individuals being cared for in long-term care facilities, most of which are not equipped to deal with a raging epidemic, are understaffed and under-managed. The recently revealed outbreaks in a number of long-term care homes have underlined their role in pushing up overall numbers of deaths in Canada.

A projection by the government of Canada released on April 9th conjectured between 400 to 700 deaths by April 16, caused by COVID-19, but by April 12 it was clear that the death total stood at 717, handily passing the presented worst-case scenario. It took another day for the total death number to rise to 734, and it is the impact of the outbreaks in those long-term care facilities countrywide that has expanded those death numbers.

In a facility in Bobcaygeon, Ontario alone 29 elderly residents died of the effects of COVID-19. There were 21 reported deaths earlier in the month in such facilities in Vancouver. And while the impact of the dread novel coronavirus on such elder-care, health-impaired facilities may vary from province to province, the end result is that this most vulnerable demographic has become a target of the deadly pathogen.

Not only are these frail elderly people dying, the end effect is that the virus has spread from the facilities to the greater public.

So that even while officially the country's confirmed COVID-19 cases are tracking in a positive direction, it is the fatality rate among the elderly frail that is increasing with continuing outbreaks in the facilities housing them and caring for them. In Dorval, Quebec last month 31 residents of a private seniors' residence died. Many in the residence were neglected, people found dead in their beds, others unfed and unwashed, some lying on floors where they fell.

Residence Herron, Dorval, Quebec, April 13, 2020. REUTERS/Christinne Muschi

Untrained staff had been unable to cope, were frightened for their personal well-being, and had simply abandoned their charges, leaving only four attendants to try to cope with 60 patients in yet another long-term for-profit care home in Quebec. In the Dorval facility there were 150 residents 'abandoned' by the staff, leaving the elderly lying in soiled beds, requiring immediate assistance to be fed, leading to the tragic outcome.

Infection prevention and control were entirely missing in the facilities. Some were crowded with multiple residents in one room, sharing common spaces, making it impossible to impose social distancing. Attendants in many of the residences did not wear masks for the duration of their shifts. Added to the dangers inherent in crowded facilities with overworked attendants improperly trained to rise to the occasion of an epidemic, that many health-care providers and other staff work at multiple facilities.

Vital recommendations have been reached that include visitor restriction to admit only those essential for medical or compassionate care. All staff to be screened along with visitors to ensure that anyone entering the premises, including staff with questionable symptoms be forbidden from entrance, sent home to self-isolate to recovery. Training on infection-control measures, routine cleaning of trafficked areas and limiting employees to work in a single facility are critical guidelines to be implemented.

Former federal cabinet minister Jane Philpott, a medical doctor herself and formerly Canadian Minister of Health, has volunteered to work at a facility in Markham, Ontario housing residents with developmental and physical disabilities. The facility, Participation House, is caught in a staff crisis, struggling to cope with the pandemic, reflecting what is happening all over the country.

Anson Place in Hagersville, Ontario, where 55 residents and 30 staff members have tested positive for COVID-19, seen here on April 2, 2020. (Dan Lauckner / CTV Kitchener)