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Katerina Slater, personal care attendant at Kensington Gardens care home, left, screens visitor John Alvis upon entry to the building in Toronto, on March 12, 2020.

Galit Rodan/The Globe and Mail

When Ruth Potvin suffered a bout of bronchitis recently, she got a glimpse of what could happen if the new coronavirus keeps caregivers like herself out of nursing homes.

While she was sick, Ms. Potvin wasn’t able to spend her usual 30 hours a week at Toronto’s Kensington Gardens helping her 83-year-old mother, Jean Lee, eat her meals, attend physiotherapy and get in and out of bed.

Ms. Lee has advanced dementia, has difficulty speaking and can no longer walk.

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“The first time I came back after being away,” Ms. Potvin said, “when she saw me, she cried.”

As cases of COVID-19 pile up across Canada, long-term care homes like the one where Ms. Lee lives are in an excruciating bind. Elderly residents are the people most likely to die if infected by the new coronavirus, and also the likeliest to be hurt by social distancing – particularly if relatives who provide essential care are barred.

In British Columbia, outbreaks have been declared at two long-term care facilities, infecting seven health-care workers and three residents. This includes a man in his 80s who was the first person in Canada to die of the respiratory illness.

Dr. Michael Soboloff speaks with patient Gordon Lawson about precautionary procedures in wake of the coronavirus pandemic at Kensington Gardens care home in Toronto, on March 12, 2020.

Galit Rodan/The Globe and Mail

The first outbreak was declared last weekend at North Vancouver’s Lynn Valley Care Centre, where the man who later died, one other resident and five health-care workers tested positive.

On Thursday, an outbreak was declared at the Hollyburn House Retirement Residence in West Vancouver, where a man in his 90s and two health-care workers – who also worked at Lynn Valley – tested positive.

New Brunswick, Nova Scotia and Newfoundland and Labrador announced this week that they are barring anyone who has travelled outside Canada from visiting a nursing home for 14 days after their return.

The British Columbia government is advising people to visit long-term care homes one at a time, rather than in groups.

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Several provinces are testing all nursing-home residents who develop respiratory symptoms for COVID-19, even if they haven’t come into contact with a person known to have the virus.

Workers at Kensington Gardens care home hold a morning meeting on pandemic preparation.

Galit Rodan/The Globe and Mail

Ontario has ordered “active screening,” meaning a staff member is supposed to stand near the doors of long-term care homes to turn away staff, visitors, volunteers and others who have traveled to a coronavirus hot spot and are feeling unwell.

In the lobby of Kensington Gardens, a non-profit, 350-bed long-term care facility with a 10-bed hospice, personal support worker Katerina Slater sat at a table festooned with coronavirus warning signs on Thursday and asked everyone who came through the door five questions about their health and travel history.

Those who passed the screening were directed to a pile of pens to sign a paper visitors log. By the end of the day, Kensington’s management had decided to give the screening staff an iPad so visitors wouldn’t have to touch the pens.

Kensington also decided on Thursday to cancel all public tours, hold family meetings by phone for March and April, ask relatives not to take their loved ones out for anything other than essential appointments, and cancel all multigenerational programming. That means no more preschoolers to dance with the residents.

Katerina Slater, personal care attendant at Kensington Gardens care home, pumps disinfectant into a visitor's hand upon entry to the building.

Galit Rodan/The Globe and Mail

“If we take this all away, what does it mean for the vibrancy of the people we serve?" Kensington Health president John Yip asked on Thursday morning as the home’s operations committee met in another room to discuss which programs to cancel. “There will certainly be a decrease in their quality of life.”

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Still, Mr. Yip and other operators of Canada’s approximately 250,000 long-term care beds are keenly aware of the early evidence about how the coronavirus affects elderly people in poor health.

In China, nearly 15 per cent of people over 80 who contracted the virus died, according to data published last month by the Chinese Center for Disease Control and Prevention. The fatality rate among those aged 10 to 39 was 0.2 per cent.

If a visitor brings coronavirus into a nursing home, residents are not just in danger of being infected, they would also be forced to stay in their rooms to prevent it from sweeping through the building, said Rhonda Collins, chief medical officer for Revera Inc., which operates 75 long-term care homes and about 100 retirement residences in Canada.

If a visitor brings coronavirus into a nursing home, residents are not just in danger of being infected, they would also be forced to stay in their rooms to prevent it from sweeping through the building, said the chief medical officer for Revera Inc.

Galit Rodan/The Globe and Mail

“That is a particular problem for residents who have cognitive impairment, because they don’t understand why they’re being isolated,” Dr. Collins said. “It can increase confusion. It can increase agitation.”

If Ms. Potvin could not go to Kensington, she would have to pay for more hours of private care for her mother, whose dementia is so advanced she needs two people to help her out of bed.

Ms. Lee and her family already pay for an additional 50 hours of care at the nursing home, on top of the 30 hours Ms. Potvin spends helping her mother, a former hospital social worker.

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Many Canadian long-term care homes are understaffed, with some already struggling before the coronavirus hit, said Vicki McKenna, president of the Ontario Nurses’ Association, which represents some nurses who work in long-term care. The problem could get worse if staff get sick or are forced into quarantine, she added.

“I know our homes rely a lot on volunteers and family,” Ms. McKenna said. “We all know there’s a crisis in staffing in long-term care.”

With a report from Andrea Woo

Editor’s note: (March 13, 2020): An earlier version of this article said Ms. Lee cannot speak, when she has difficulty speaking.
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