COVID-19 outbreaks rising in long-term care homes across the country

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Nursing homes in New Brunswick have been hit hard by the fourth wave of COVID-19, driven by surging infections in the province not seen since the pandemic began.

The coronavirus has torn through a dozen homes since mid-September. Nine are still battling outbreaks, including the 118-bed Drew Nursing Home in southeastern New Brunswick, where eight of the 29 residents who tested positive have died. Until last month, not a single resident or staff member in the vast majority of the province’s 71 homes had fallen ill with COVID-19.

The Maritime province is far from alone in dealing with a recent influx of cases. As of Tuesday, 243 seniors homes across the country had outbreaks, according to a Globe and Mail tally. Provinces in Western Canada and New Brunswick that lifted public-health restrictions over the summer have borne the brunt of the fourth wave.

Alberta, where the fourth wave is overwhelming the province’s health care system, accounts for 60 per cent of the outbreaks. While cases are significantly lower than during the peak of the second wave last December, the government said 78 people died in long-term care and supportive-living homes between Sept. 10 and Oct. 6.

The exponential growth in COVID-19 infections is occurring even as the tools that can keep the coronavirus out of seniors homes are readily available, health care experts say. But provincial leaders have been slow to roll out vaccine booster shots to residents as an extra layer of protection against the highly transmissible Delta variant, as well as make it mandatory for staff, family caregivers and visitors to get inoculated against COVID-19.

“Why we would hold back on two measures we know could materially make a difference really boggles my mind,” Samir Sinha, director of geriatrics at the University of Health Network and Sinai Health System, said in an interview.

Residents in seniors homes were among the first to be vaccinated against COVID-19 in January and February. Scientific evidence shows that protection against the virus among the elderly begins to wane six months after receiving two doses, leaving them vulnerable to breakthrough infections just as the more dangerous Delta variant is spreading.

All but three provinces – Alberta, Saskatchewan and Ontario – waited until the National Advisory Committee on Immunization recommended third doses for people living in seniors homes, on Sept. 28, before announcing their booster programs.

British Columbia began rolling out booster shots to residents in long-term care and assisted-living homes last week, well after several Delta-fuelled outbreaks. Thirty-two people in long-term care homes in the province have died since early August, according to a BC Centre for Disease Control outbreak report dated Oct. 6.

B.C. Seniors Advocate Isobel Mackenzie said people living in seniors homes should have received a third dose in August. “We need to get more aggressive about managing outbreaks,” she said in an interview. “We know that the older, frail person in long-term care has a greater challenge mounting a robust antibody response.”

Alberta, Saskatchewan and Ontario were first to offer booster shots. In Ontario, roughly 90 per cent of 55,647 long-term care residents medically able to take a third dose have rolled up their sleeves.

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Still, Lori Brazeau questions why residents of Hillsdale Estates, a long-term care home in Oshawa, Ont., didn’t get their booster shots before an outbreak of COVID-19 killed eight of them, including her mother.

“It didn’t help us,” said Ms. Brazeau, whose mother, Gail Candusso, died at the home after becoming ill with the Delta variant. Ten days later, on Sept. 15, 208 residents at the home received a third shot of the vaccine.

The provinces have also unveiled a patchwork of policies governing vaccination for staff. British Columbia has gone the furthest – making it mandatory not only for staff in all health care settings, but also for visitors, to show proof of vaccination beginning later this month. In Ontario, by contrast, vaccination is mandatory only for staff in long-term care homes.

In New Brunswick, all government staff – including those in seniors homes – who are not inoculated by Nov. 19 will be sent home without pay unless they have a valid medical exemption.

It was among a flurry of measures Premier Blaine Higgs announced in recent days to combat record-high COVID-19 cases. Families were asked not to mingle with other households on Thanksgiving weekend; no one can travel to and from regions with high transmission; and everyone entering the province must preregister online.

Nursing-home officials never imagined they would be living through the kind of lockdowns that were all too common west of Atlantic Canada during the first three waves, where thousands of residents died – many of them alone – in virus-stricken, understaffed homes.

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Several events have fuelled the recent surge in infections in New Brunswick, including the emergence of the Delta variant, low vaccination coverage and the Premier’s decision to remove most restrictions in July – including wearing face masks in indoor public spaces.

The province reported 109 new cases on Tuesday, with 63 people in hospital. The rising number of COVID-19 patients led some hospitals to move to the Red Alert level on Tuesday, allowing them to suspend elective surgeries.

“We kind of all had our chests puffed out a little bit, but obviously something happened when we ‘went green,’ ” said Michael Keating, interim director of the New Brunswick Association of Nursing Homes, referring to the full-speed-ahead lifting of restrictions.

So far, 57 of the 106 residents and staff at the homes who tested positive have recovered, provincial government spokesman Robert Duguay said.

The coronavirus has worsened a chronic shortage of staff in the sector. The Canadian Red Cross deployed 22 workers to the Drew Nursing Home in Sackville on Sept. 29 to help deliver meals to residents and visit with those missing their families.

The outbreak at the Drew Nursing Home began two weeks earlier, after an unvaccinated staff member tested positive. She is isolating at home, as are other staff members ill with COVID-19. Eighty-two per cent of staff at the home had been vaccinated.

Linda Shannon, executive director of the home, said two sisters who worked in the kitchen quit after they refused to get tested. Their mother had erroneously told them that the nasal swab used for testing would cause brain damage.

These days at the home, Wednesday afternoon bingo games are cancelled, visitors are banned and residents with dementia who usually roam the corridors are confined to their rooms behind plywood barricades.

Residents spend their days in their bedrooms, dressed in hospital gowns – laundry attendants are pitching in to help feed residents, leaving them with less time to wash and sort clothing. Even so, many meals arrive late and cold, said Amy Johnson, a personal support worker at the home.

Ms. Johnson has worked several 16-hour days since the outbreak, but still feels she is shortchanging the 27 residents on her unit. The shared bathroom area is off-limits during the outbreak, and Ms. Johnson only has time to give residents a bed bath every second day.

“The hands-on care that these human beings deserve is suffering,” she said.

Ms. Shannon said all the residents are fully vaccinated, and the home has followed all the COVID-19 guidelines.

“We kind of got shocked that this happened at this point,” she said. “I think we got into the perfect storm where we were past the six months and Delta got in.”

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