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Workers wave at passing cars honking their horns in support for Pinecrest Nursing Home after several residents died and dozens of staff were sickened by coronavirus disease in Bobcaygeon, Ontario, March 30, 2020.CARLOS OSORIO/Reuters

A battle is breaking out in southwestern Ontario between three long-term care facilities and local public health, with health officials refusing to test elderly patients for COVID-19 if they don’t have any symptoms.

The doctor serving the facilities says on at least two occasions, Southwestern Public Health officials refused to pick up swabs from residents who were transferred into long-term care from hospitals.

The newly-admitted residents were asymptomatic for the coronavirus. The problem, says Dr. Barry Roth, is that elderly people can carry the deadly virus without showing or being able to express their symptoms, leading to fears of potential outbreaks among the most vulnerable population.

“We want to know what’s coming into our facility. … We don’t want to stick our head in the sand and say, ‘Ok let’s wait and see if they get symptoms,'" said Dr. Roth, medical director for Woodingford Lodge, which has three locations and a total of 228 residents.

“Our whole goal during this thing is let’s keep COVID-19 out of our facilities. These are our residents, we treat them like I would treat my parents.”

Mark Dager, the facilities’ director, said the Local Health Integration Network (LHIN), which helps co-ordinate patient care, asked the homes to take in elderly patients who were in hospitals, even for the short-term, to open up space for a potential influx of new coronavirus cases. He also said community admissions have not stopped amid the COVID-19 pandemic.

“Our staff are coming to work each and every day and they are presented with so much uncertainty,” Mr. Dager said. “We need to do our due diligence and even swab the asymptomatic individuals.”

Patients admitted to the facilities are automatically isolated for 14 days. But Dr. Roth said if all residents were tested, the homes would be able to identify cases of COVID-19 earlier, never missing a potential asymptomatic transmitter of the illness. He said no one who was already admitted would be removed from the home.

The battle comes as Ontario is being urged to change its policy on admissions into long-term care homes to include testing all residents, even if they don’t have any symptoms of COVID-19.

Long-term care has been at the epicentre of the COVID-19 crisis in Ontario. At Pinecrest Nursing Home in Bobcaygeon, Ont., nearly half of the residents of the 65-bed nursing home have died, while at least 24 staff members have tested positive. As of Tuesday, Ontario logged at least 51 outbreaks in long-term care facilities across the province.

Ontario’s current directive for long-term care, from Chief Medical Health Officer Dr. David Williams, states that testing must be conducted “on every symptomatic resident and staff," including residents who are linked to a COVID-19 outbreak.

Dr. Joyce Lock, medical officer of health for Southwestern Ontario, said she supports Dr. Williams’ guidelines for testing only symptomatic residents.

“We believe this approach makes the best use of available resources and is in line with the evidence and the guidelines,” she said in a statement.

Dr. Barbara Yaffe, Ontario’s associate chief medical health officer, said Tuesday that residents admitted into long-term care can’t have symptoms or a fever, are quarantined for 14 days and monitored for symptoms twice a day. She said there is no evidence people with the virus have been admitted from hospitals into nursing homes.

Hayley Chazan, spokeswoman for Health Minister Christine Elliott, said Ontario can now conduct up to 13,000 tests a day, and will look at testing more people, including those in long-term care.

“We expect to have more to say about a new testing strategy that makes full use of this capacity shortly,” she said.

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