Public health orders hospital to take over management of long-term care homes

a statue in front of a window: Long-term care

© Provided by Ottawa Citizen
Long-term care

Medical officer of health Dr. Vera Etches has ordered The Ottawa Hospital to take over management of two long-term care homes in the city that are experiencing large second-wave COVID-19 outbreaks: West End Villa and Laurier Manor. Both homes are operated by Extendicare.

Etches said she took the “unprecedented” action under the provincial Health Protection and Promotion Act with the full support of the hospital, the homes and the provincial government in order to act quickly to try to turn around the growing outbreaks.

“I asked The Ottawa Hospital to assist Extendicare in managing the homes so that the level of medical expertise and care would be strengthened to they could look at all the other aspects that make it possible to control an outbreak.”

a sign on the side of a fence:  Extendicare West End Villa

© Provided by Ottawa Citizen
Extendicare West End Villa

West End Villa, where 11 residents have died since the end of August, is the site of the most deadly ongoing COVID-19 outbreak in the province.

Sixty four residents and 28 staff members have tested positive for COVID-19 at the home, which had 214 residents as of the end of August.

a sign in front of a building:  Laurier Manor on Montreal Road.

© Tony Caldwell
Laurier Manor on Montreal Road.

At Laurier Manor, 12 residents and six staff members have tested positive since the latest outbreak there was declared on Sept. 1. There have been no deaths during the current outbreak, but 25 of the home’s residents died in an outbreak last spring.

The move to give The Ottawa Hospital oversight over the homes comes as a staff member and union representatives say workers at West End Villa feel unprotected and fear for their safety because they are not getting access to N95 masks, which they believe would better protect them and residents.

A spokesperson for Extendicare said N95 masks are not recommended for long-term care, but added, “If our staff indicate they would prefer to have an N95 mask, we make them available.”

The PSW and union representatives say that has not been happening up to now. They point to growing evidence that COVID-19 is, at least partly, spread through fine droplets and the high number of staff testing positive at the home, as evidence that staff are at high risk and not well enough protected.

“A lot of people are getting sick really fast,” said the PSW. “Residents are getting sick. Staff are getting sick. We really think that we are not given proper personal protective equipment in order to help and to feel safe in our jobs.”

This newspaper has agreed not to name her in order to protect her job.

She said nurses working in the home wear N95 masks, but PSWs have not had access to them until now.

“Nobody really knows why this is spreading so fast in a home that is contained. Nobody is moving from floor to floor.”

Some staff working at the home have been staying at a hotel during the outbreak, she said. That protects their families from possible spread but adds an additional burden to those with families who can’t see them. Some of the staff members who have tested positive for COVID-19 have been sent to hospital. Others are isolating at home.

The outbreak and changes that limit staff to one home at a time have dramatically reduced staffing at the home, said the PSW. Some are isolating because they are sick; others have chosen to work elsewhere. At times, she said, there have been two PSWs looking after 60 COVID-19 patients on the evening shift. “That has happened one too many times.”

Staffing shortages are often the thing that tips homes from small outbreaks into larger ones, said Etches.

“If people don’t have enough staff in the home, you start to see challenges. These are the things that we flag and we look to find solutions with partners. We are continuing to go out to homes and promote good practices after the first wave.”

Meanwhile, the PSW from West End Villa said the outbreak is taking a toll on staff.

“It has gotten to the point where one of my co-workers said she can’t do this anymore. She said, ‘I can’t cope.’ All our residents around us are dying. They are really sick. It has taken a toll on the mental health of our workers. The ones working right now are away from their families. They are fighting a battle with Extendicare (for N95 masks). They feel they are not getting the proper PPE to do their jobs.”

Three long-term care-home workers — two from Madonna Care Community and one from Peter D. Clark — died from COVID-19 during the first wave of the pandemic, the biggest concentration of health-care worker deaths in the country.

The use of N95 masks has largely been limited to aerosol generating procedures since the WHO declared COVID-19 to be spread by droplets. But a growing body of research since then has suggested it can be spread through the air.

This week, the U.S. Centres for Disease Control issued a warning that COVID-19 can be airborne and later removed it from its website.

While some nurses have better access to N95 masks, other frontline workers say the Ontario government is ignoring a recommendation from the SARS commission that better protective equipment should be available to frontline workers as a precautionary principle to make sure they are protected.

Source Article