On Friday, an independent commission released its final report on how Ontario’s long-term care sector responded to the COVID-19 pandemic.
The report, which is more than 300 pages, is intensely critical of the sector’s preparedness. It cites decades of neglect and staffing shortages, and excoriates politicians for failing to address these issues.
The commission uses two of Durham’s most devastating outbreaks to tie a thread through the triumphs and failures of Ontario’s pandemic response.
It begins with Orchard Villa, a long-term care and retirement complex in Pickering.
As the first wave unfolded and employees got infected, Orchard Villa’s staffing levels began to plummet. Dr. Robert Kyle – Durham’s medical officer of health – is quoted as saying ministry inspectors were “basically missing from action and invisible to us.” This led to the April 21 order that sent Lakeridge Health into the home.
The report notes that Orchard Villa is a “C” type building – one of the oldest types in Ontario. Since rooms and common areas were connected, residents were initially able to wander freely. Eventually, the home was down to a quarter of its normal staffing levels.
Staff members are described as overworked, and having little understanding of how to protect themselves with PPE. As well, low staffing meant little time to disinfect surfaces and pick up garbage. According to the report, Orchard Villa wound up requiring a deep-clean, costing almost $500,000.
Over the course of the first wave, 70 deaths were linked to the Orchard Villa outbreak.
Eventually, the wave subsided. During the dip, an Ontario Health preparedness survey flagged Whitby’s Sunnycrest Nursing Home as one of a number of high-risk homes. According to the report, this information wasn’t passed on to either Lakeridge Health or Dr. Kyle.
An outbreak was declared at Sunnycrest on November 23, after a staff member tested positive. It had taken five days for test results to come back, and the commission notes that a number of infections likely happened during that period.
As the virus spread, staffing levels fell. Lakeridge Health arrived on November 27.
Similarly to the Orchard Villa outbreak, staff at Sunnycrest are described as having insufficient knowledge on how best to use the PPE, which was in short supply.
The commission alleges that at one point, Lakeridge Health had to bring in their own thermometers as there were none working at the home.
Over the course of the second wave, 29 deaths were linked to the Sunnycrest outbreak. The home has since been hit with a class-action lawsuit.
The commission recommends sweeping changes to the sector, including increased staffing, better funding and a more-rigid pandemic plan. It recommends that the province maintain a stockpile of personal protective equipment in case another pandemic arises.
The report also acknowledges the psychological toll of the past several months. It recommends that long-term care home licensees pay out-of-pocket for counselling services for both the staff and the residents who were caught in the crisis.
There is also an emphasis on responsibility for patient care. The report recommends that homes set up video monitors for family members to keep an eye on their relatives – provided the resident (or a chosen decision-maker) offers consent.
According to the report, Ontario’s long-term care sector saw 28 per cent more deaths in April 2020 than had been expected, given previous years’ numbers.
As of May 2021, the deaths of more than 3,900 long-term care residents have been linked to COVID-19 infections.
“This Commission is grateful to the families, staff and residents who courageously shared their often-harrowing experiences,” reads the report. “This province must not forget the difficult lessons that were learned at their expense.”
Left image courtesy of Google Maps Street View; right image taken by Durham Radio News