Of the more than 22,330 coronavirus deaths recorded in Canada to date, 55 percent of them were in long-term care facilities. That is a startling statistic that highlights a system of healthcare that appears to be broken.
In June 2020, as the first wave of COVID-19 in Canada began to subside, its 2,039 homes for older people accounted for about 80 percent of all COVID-19-related deaths, according to an article published in Lancet on January 16, 2021.
Today, the figures are not much better, and Canada’s long-term facilities remain dangerously prone to the disease. The number of issues is astounding and includes the difficulty in accessing PPE, overcrowding, understaffing, and most importantly, insufficient infection control, according to CTV News Canada.
Lawyer and seniors’ advocate Laura Tamblyn Watts describes what happened to seniors over the last year as a “senicide.” The term “senicide” refers to the killing of the elderly or their abandonment to death.
“We have blood on our hands. We have a senicide of seniors and we’re seeing it still happen again. We haven’t learned the lessons. When you know that older people are dying and you refuse to give the measures required to save them. There’s nothing else to call it but a senicide.”
Watts says, “Most of the infectious threat is coming in through staff and staff can’t often afford to take time off, particularly women who are often racialized and low income, who are working in these homes. So 10 to 14 days of sick leave would make a huge difference.”
This explanation is fairly close to what Pat Armstrong, a sociologist at York University in Toronto who has studied Canada’s long-term care facilities for almost 30 years, has to say about the problem.
Canada’s dismal record stems from a historical decision to exclude long-term care facilities from Canada’s network of 13 provincial and territorial public health systems. “This has resulted in under-training and poor treatment of workers, substandard and aging facilities, overcrowding, and poor infection control capabilities”, she says.
And Armstrong takes aim at the privately-owned for-profit facilities, which make up 54 percent of all the long-term care homes. Armstrong says there are plenty of studies that back up the lack of government oversight and accountability to residents. “There’s plenty of evidence of lower-quality care in the privately-owned facilities”, says Armstrong.
“It was noticed very early on during the COVID-19 pandemic that some of the worst outbreaks were happening in for-profit, privately owned homes”, explains Nathan Stall, a geriatrician at Toronto’s Mount Sinai Hospital, and lead author of a recent study investigating care quality and rates of mortality in 623 Ontario care homes.
Just to be clear – these observations do not include all for-profit or other facilities. Some facilities do give good care to their charges. However, Stall emphasizes that the community-based spread of COVID-19 is the key driver of outbreaks in long-term care facilities of all ownership types.
A new study in Quebec
The Government of Canada, through its COVID-19 Immunity Task Force (CITF), is supporting a new $2.7 million study aimed at identifying the factors putting people in long-term care homes at risk of developing severe COVID-19 symptoms and medical complications that may lead to a fatal disease.
“We still do not understand why some long-term care residents have gotten so sick and died of COVID-19, whereas others, at the same facility, have had milder versions of the disease or have not been infected at all,” says Donald Vinh, MD, infectious disease and immunity expert at the Research Institute of the McGill University Health Centre
