generalspeaking

The COVID Pandemic "Shock Wave"

"Those lives lost unnecessarily had value. Those older adults deserved a good closing phase of their lives and a good death. We failed them."
"[Causes of the failure are complex, but rooted in] systemic and deeply institutionalized implicit attitudes about age and gender."
"[Those unregulated workers] receive the lowest wages in the health-care sector, are given variable and minimal formal training in [long-term care], and are rarely part of decision-making about care for residents."
"We have a duty to care and to fix this -- not just to fix the current communicable disease crisis, but to fix the sector that enable that crisis to wreak such avoidable and tragic havoc."
"[Provinces must] immediately implement appropriate pay and benefits, including sick leave, for the large and critical unregulated workforce of direct-care aides and personal support workers [and offer them ongoing training and mental health support]."
Royal Society of Canada report

The report chaired by University of Alberta 's Dr.Carole Estabrooks representing the working group created by the Royal Society COVID-19 task force, comprised of scientists and researchers, concluded that the causes of the failure to protect Canada's most vulnerable, the elderly and health-compromised housed in long-term care institutions, is a damning one, both for the disinterest of the federal government to institute badly needed national guidelines and for the provincial oversight bodies that failed their due diligence in ensuring that best practices reigned at these homes for the elderly.

The pandemic, they emphasize, represented a "shock wave" that had the effect of exposing long-standing deficits in the system, causing high levels of "physical, mental and emotional suffering" for seniors who were  highly dependent and whose plight failed to provoke the interest of authorities until it was too late. An astonishing 81 percent of COVID-19-responsible deaths in Canada occurred in long-term care homes. A rate far in excess of those occurring elsewhere in comparable countries.

In the United States, with its much-higher overall case load and death rate, a much-reduced 31 percent figure relating to deaths in long-term care homes places Canada's figure in stark perspective. Australia suffered a 28 percent death rate in their homes, while Spain, one of the countries of Europe hardest hit by the SARS-CoV-2 virus had a 66 percent rate. Canadian homes, pointed out the report's authors, permitted staff-to-patient ratios to drop, shifting work and responsibility increasingly to an unregulated workplace.

Patients, the report points out, are living longer with diseases requiring increasingly complex care, particularly those patients suffering from dementia. Many of these overworked staff members suffering from high rates of burnout, cope as best they can in the absence of an appropriate representation of registered nurses, where many residents lack access to comprehensive care; medical, health and social services along with therapies to match the needs of patients.

The complaints and wishes of long-term care residents are ignored by authorities, as well as the needs of those  who are tasked with their care. In most instances, both groups are represented overwhelmingly by women. Along with the fact that when family members are called upon increasingly to fill gaps in the system, it is women who respond. Conditions in many of the long-term care homes were such that already-ill patients living in crowded conditions, sharing bedrooms and bathrooms, left them more susceptible to the novel coronavirus.


Canadian long-term care homes tend to be of an older vintage, badly in need of upgrading, with an emphasis on separating residents from close proximity both to protect their health and their dignity. the fact that basic infection controls and personal protective equipment were in short supply and many home workers found employment in multiple facilities to make up a living wage, increased opportunities of virus contagion.

Recommendations for improvement include that the federal government collect data on resident quality of life, the standard of care and worker satisfaction, ensuring such data be analyzed to effect change where needed. Disparities caused by ethnicity, gender, poverty and associated vulnerabilities should all be taken into account. Full-time employment should be offered to unregulated staff and policies preventing employees from multiple home employment must be put in place.

Sick leave, along with appropriate pay rates and benefits must be overseen by provinces on behalf of the unregulated workers and direct-care aides along with personal support workers, offering them opportunities for ongoing training and mental health support. It's long past time for both the federal and provincial governments to commit themselves to ensuring that long-term care residents and those who care for them live and work in conditions favouring overall experiences of quality care and security.

A resident and a worker watch as 150 nursing union members show support at rchard Villa Long-Term Care in Pickering, Ontario on Monday June 1, 2020. (THE CANADIAN PRESS/Frank Gunn)

Europe's Urgency to Return to Business As Usual

"[The jump in the infection and death rate was] probably due to the delay in inputting [the deaths] and the fact that we are coming out of a weekend."
"That's an indicator that the epidemic is continuing its advance."
"We have not yet reached the peak [even if the rate of admissions was slightly diminishing. So], to talk about lifting confinement makes no sense."
Jerome Salomon, health director, France

"One of the most important parts is not to let go of the measures too early in order not to have a fallback again."
"It's similar to being sick  yourself; if you get out of bed too early and get running too early, you risk falling back and having complications."
Christian Lindmeier, WHO spokesman

Ambulances outside the NHS Nightingale hospital. Photograph: Matthew Childs/Reuters

On Tuesday night the grim statistics revealed that the COVID-19 death toll had reached 10,000 in France, leading health officials to warn that discussions around the lifting of confinement "currently makes no sense"; since the peak of the epidemic in France had not yet been reached. With a daily death toll of 1,427 once deaths in care homes were included in the total, the situation is beyond critical. Including deaths from cornavirus taking place in retirement homes is of recent vintage.

Over 30,000 people are hospitalized at the present time in the country, with 7,131 of that total in intensive care. That, in and of itself is more than ample indication that France is nowhere near seeing an improvement in the infection and death rate as it rampages on. On the other hand, the number of patients leaving intensive care is now higher by a figure of 59 than the number of those entering those emergency hospital services.

Confinement, according to the nation's scientific committee, is slated to continue beyond the current deadline set for April 15, and likely to be extended until early May. The government of Spain, speaking of the first rise in the daily death toll in five days from COVID-19, dismissing it as a blip, with the insistence that the numbers were "going in the right direction", chose to extend their lockdown as well to April 26, at the very least.

In Italy, the hardest-hit of the European countries to be ravaged by the novel coronavirus, businesses have been begging the government to think about lifting confinement, even while the World Health Organization has strongly urged countries to refrain from lifting lockdowns too early. In the last 24 hours up to Tuesday morning, 743 people died in Spain, in comparison with 637 deaths that took place the previous day.

The figure, noted chief government spokesman Maria Jesus Montero was a mere "ripple" in the statistical trend owing to the weekend data processing. "The tendency of the data says we are going in the right direction", said Montero with confidence in announcing Tuesday's cabinet meeting had approved an extension of the nation's state of emergency.

A view from the empty Plaza de Colón in Madrid, Spain