The union representing provincial health care workers at Nova Scotia’s largest long-term care home is demanding a public inquiry into an outbreak that is one of the worst in the country and the epicentre of the province’s COVID-19 fight.
Northwood Manor, a nursing and retirement home in Halifax, reported its 32nd death from the virus on Monday. With another six deaths on the weekend, the outbreak at Northwood accounts for nearly 85 per cent of all COVID-19 fatalities in Nova Scotia.
Almost half of Northwood’s residents, or 220 people, plus 85 staff, have tested positive for COVID-19. While Nova Scotians rally outside the building, banging on pots and pans and honking their horns in a show of support, the situation inside is worsening.
“I’m very fearful of where this is all going,” said Jason MacLean, president of the Nova Scotia Government and General Employees Union (NSGEU). “When you have nearly 50 per cent of the residents positive with COVID, I’d say that’s pretty dire.”
While more than 50 NSGEU members have been transferred to the facility, most of the staff at Northwood are represented by another union, Unifor, which has also raised concerns about the situation in the building. Dozens of those employees are off work and self-isolating because of exposure to the virus.
A public inquiry is needed to understand how provincial decisions and delays affected the problems at Northwood, and may have contributed to the death toll at the facility, Mr. MacLean said.
The union alleges that in the early stages of the outbreak, the province’s Department of Health and Wellness prevented appropriate personal protective equipment (PPE) from being distributed to health care providers at nursing homes and home-care workers who go to seniors’ private homes. When a special COVID-19 team was transferred to Northwood as the outbreak grew, the union says nurses, respiratory therapists and others were forced to work for four days before they were provided with PPE.
“If the government had acted sooner, and more pro-actively, this wouldn’t be what it is today,” Mr. MacLean said. “There was a total lack of collaboration and communication by the Department of Heath and Wellness, and that’s where this all begins."
Officials from the provincial health department said they could not meet a deadline to comment on the union’s concerns on Monday. Previous issues raised by the union around infection control at Northwood were dismissed last month as “fear mongering” by Dr. Robert Strang, Nova Scotia’s Chief Medical Officer of Health.
Northwood president and chief executive Janet Simm has said workers never had a shortage of protective supplies and has called the union’s public complaints “disheartening,” although the facility has acknowledged some delays in getting equipment to all floors when first needed. Mr. MacLean says it wasn’t a case of supply – but rather that protective gowns and masks provided weren’t the kind needed to best prevent infectious disease.
The COVID-19 outbreak at the Northwood nursing home is “one of the biggest outbreaks in Canada,” said Samir Sinha, the director of geriatrics at Mount Sinai Hospital and the University Health Network, both in Toronto.
Dozens of other seniors’ facilities, mostly in Ontario and Quebec, have logged COVID-19 death tolls in the double digits, but few, if any, are reporting as many confirmed cases as Northwood, which is the largest long-term care home east of Montreal.
Wayne MacKay, a Dalhousie University law professor, said a public inquiry may be the only way to get answers that can change policy around how future pandemics are handled at nursing homes. At the very least, a more narrowly focused fatality inquiry before a provincial court judge should ask some pointed questions about the Northwood case, he said.
That includes probing delays around issuing PPE and testing for staff that may have contributed to the outbreak at Northwood getting out of control, he said.
Nova Scotia waited until April 17 to limit the movement of staff between nursing homes, and until April 12 to require all workers and essential visitors to seniors’ homes to wear masks, according to Ryerson University’s National Institute on Ageing, which has been tracking policy responses to COVID-19 in long-term care.
“I think that’s one of the things we’re seeing at Northwood, that perhaps the government didn’t proceed as quickly as they should, in following through on some of those guidelines,” Prof. MacKay said.
“One of the lessons from COVID-19 is that even a few days’ delay can make a huge difference. And while one can understand that in the context of a pandemic, the consequences can be quite large."
The Northwood outbreak, like those at nursing homes around the country, has exposed problems with institutionalized elderly care in Canada, Prof. MacKay said. Northwood, with its sheer size and many shared rooms, may offer lessons for the design of future nursing homes that are more virus-resistant.
“Out of all this tragedy and loss of life, we really do need to change the way we think about how we care for people as they age," he said.
The tragedy unfolding at Northwood is more proof that Canada is experiencing “a tale of two epidemics,” Dr. Sinha said.
Physical distancing is – for the most part – keeping the virus in check in the larger community. But in seniors’ facilities, the coronavirus is sweeping through at a frightening pace, prompting the governments of Quebec and Ontario to ask for military aid for the hardest-hit homes.
At least 2,330 residents of Canadian seniors’ homes have died of COVID-19 as of Friday, according to Dr. Sinha and a team of researchers at the National Institute on Ageing, which has also been tracking deaths in nursing and retirement homes. That works out to about 70 per cent of Canada’s COVID-19 deaths.
Theresa Tam, Canada’s Chief Public Health Officer, put the figure even higher, saying last week that 79 per cent of deaths caused by the new coronavirus could be traced back to seniors’ facilities.
Some provinces have been more successful than others at shielding long-term care homes and their vulnerable residents from the virus.
British Columbia, site of the country’s first major nursing-home outbreak, moved swiftly to enact policies to protect residents, including prohibiting staff from working at more than one home and requiring caregivers to wear surgical masks at all times; this happened before the end of March. “By doing that,” Dr. Sinha said, “what we’ve seen is that [B.C.] has kept the number of homes affected at less than 10 per cent [of B.C. nursing homes].”
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