Delays plaguing Canada’s COVID-19 testing programs are preventing nursing homes from quickly identifying infected residents and staff, and controlling the spread of infections, just as a growing number of facilities are declaring outbreaks.
The problem is most acute in Canada’s two most populous provinces. The number of long-term care homes with outbreaks in Ontario has quadrupled to 86 over the past month and 58 residents have died. In Quebec, 39 homes have outbreaks. The virus has sickened just over one-third of the residents at CSSS Du Granit in Lac-Mégantic, the province’s hardest-hit home.
COVID-19 is rapidly spreading beyond the country’s hot spots to other provinces. In Alberta, 13 homes have outbreaks. At one home – Millwoods Shepherd’s Care Centre in Edmonton – eight of the 61 residents who have tested positive have died.
Seven nursing homes in Manitoba are dealing with outbreaks. Four residents at Parkview Place in Winnipeg have died in little more than a week and another 73 residents have tested positive. Two deaths were linked on Monday to Heritage Lodge, also in Winnipeg.
Health care experts say fast turnaround of test results is crucial to preventing and managing outbreaks in long-term care homes and other congregate settings where the elderly are most vulnerable to the virus.
Multiple health regions across the country are missing target turnaround times for test results.
Manitoba Chief Public Health Officer Brent Roussin told reporters on Monday the province tries to prioritize testing for health care workers and institutional outbreaks. He could not say how long nursing homes wait for results, but said the median turnaround time for COVID-19 tests in the province is 60 hours.
In Ontario, where labs are turning around an average of 46.1 per cent of tests within two days – well short of their goal of 80 per cent of tests within that time frame – some nursing homes are facing lengthy waits for results.
With each passing day, homes lose an opportunity to isolate positive staff or residents before they pass the virus on to others, hindering their ability to control an outbreak, said Kieran Moore, Medical Officer of Health for the Kingston, Frontenac, Lennox and Addington Public Health Unit.
“Everything hinges on good rapid access to testing and quick turnaround times for decision making in these high-risk facilities,” he said.
The health unit for the Kingston region requires labs to expedite testing for staff and residents in long-term care and retirement homes with an outbreak. After the Fairmont long-term care home declared an outbreak on Oct. 8, Dr. Moore said he knew within 24 hours that no one except one staff member had tested positive and that the virus had not spread further.
Other regions, however, are experiencing lengthy delays in getting test results.
Simcoe Manor Home for the Aged, a 126-bed municipally owned facility in the rural community of Beeton northwest of Toronto, is dealing with a massive outbreak. Seven residents have died and another 40 have tested positive, said Jane Sinclair, general manager of health and emergency services for the County of Simcoe.
The fact that the home is reporting new cases every day is because of delays in getting test results, not an indication that the virus is spreading, Ms. Sinclair said. A majority of the positive cases, including 28 staff members who are sick with the virus, date back to when everyone was tested at the beginning of the outbreak on Oct. 2.
“We’ve had test results trickle in every day, and we report them as we receive them,” she said.
Ms. Sinclair and others in the sector have called on the government to make testing a priority in congregate settings. “It’s very important whenever there is an outbreak for us to have the ability to know very quickly who might have been exposed and who might actually have contracted the COVID-19 virus,” said Lawrence Loh, Medical Officer of Health for Peel Region.
Extendicare, a for-profit chain operator that owns 34 homes in Ontario, says the turnaround time for test results ideally should be within 24 hours.
Long-Term Care Minister Merrilee Fullerton abruptly walked out of a news conference on Monday, after refusing to take a question from a reporter from QP Briefing, a publication that covers Queen’s Park. Both her office and that of Health Minister Christine Elliott referred questions on testing to Ontario Health, the agency that oversees the delivery of health care.
“Ontario Health is working with its partners on a process to prioritize tests for any congregate settings in outbreak,” agency spokeswoman Jennifer Schipper said in an e-mail to The Globe and Mail. The agency is also working with the Ministry of Health to expand capacity in the province’s laboratory network, she said.
In Alberta, tests from long-term care homes experiencing outbreaks are prioritized, with the goal of turning them around within 24 hours, according to Alberta Health spokesperson Tom McMillan.
Extendicare says it has avoided more than 20 outbreaks by isolating staff who test positive with COVID-19 before they pass on the virus to residents. “However, our efforts are rendered completely ineffective if we don’t get timely results for those tests,” the company said in an e-mail.
All but one of Extendicare’s five homes in Ottawa have an outbreak. The Ottawa Hospital is temporarily managing West End Villa, where 19 residents have died over the past month. The hospital is now processing COVID-19 tests for residents and staff at West End Villa, Extendicare said. As a result, it said, turnaround time has significantly improved.
Katerina Cizek finally learned Monday afternoon, after waiting all weekend, that her 82-year-old father does not have the virus. Jiri Cizek lives at Lakeview Long Term Care Centre, a 128-bed nursing home in Toronto owned by University Health Network (UHN) that declared an outbreak on Oct. 3.
“My dad is currently imprisoned in his room, because his neighbour directly across the hall has symptoms,” Ms. Cizek said on Sunday.
As of Monday, 14 residents, seven staff members and two essential care providers have tested positive, said Gillian Howard, a spokeswoman for the UHN network of hospitals.
All test samples for Lakeside are being processed as “outbreak priority," Ms. Howard said, but one batch was delayed because it was left at the wrong address on Friday evening.
“With the exception of the wrongly routed batch, Lakeside outbreak samples have been completed within 12 hours, 90 per cent of the time,” she said.
With reports from Tu Thanh Ha and Laura Stone
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