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Ontario’s long-term care sector says it is not equipped to handle a second wave of COVID-19 and that urgent government intervention is required to ensure the safety of residents and staff.

In a letter to Premier Doug Ford and the Ministers of Health and Long-Term Care, a coalition of major stakeholders said that the sector had informed the government of significant vulnerabilities back in June. At the time, the sector asked the province for help addressing staffing shortages and infection prevention and control deficiencies among other things – but nothing has been done.

“We need to say plainly and directly that the government of Ontario has not yet put the necessary supports and preventative measures into place that we in the sector have long made clear are essential to protecting our residents [and] staff,” stated the letter, which was delivered to the Premier late Monday afternoon.

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“In the absence of these measures and support from government, Ontario’s long-term care homes are not currently ready to manage a second wave of COVID-19.”

The stakeholders' plea for help comes after it was announced another resident of the West End Villa home in Ottawa died of COVID, bringing the total number of deaths to 11. More than 60 residents have tested positive in that facility. Two other centres in Ontario are experiencing outbreaks with more than three diagnosed cases.

On Monday, Ontario NDP Leader Andrea Horwath hammered Mr. Ford over a report in The Globe and Mail on Monday that revealed the province had failed to act on warnings from senior infectious-disease doctors that long-term care homes lacked the basic resources needed to combat COVID-19 outbreaks. More than 1,800 long-term care residents have died of COVID in Ontario since the pandemic began.

Three months ago, these experts put forward a proposal to build out proper infection prevention and control (IPAC) measures inside long-term care facilities, mirroring the systems that hospitals use. That plan, which was focused on the Toronto region but was positioned as a model to be used across the province, called for the government to hire more than 40 specialized infection control staff who would be deployed to long-term care facilities. These individuals would be trained, managed and overseen by experts at a local hospital.

The long-term care sector has “significant deficiencies" in infection prevention and control practices and lacks "expertise and accountability” in that area, the doctors' proposal stated, a fact the sector acknowledges.

In June, the Ontario Long Term Care Association submitted a similar proposal, asking the government to “train, certify and hire an army of infection prevention and control (IPAC) specialists” and to provide funding to retrofit older care homes in order to more effectively prevent disease from spreading.

Both plans were submitted three months ago.

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“Can the Premier explain why he has not acted on the recommendations of his own experts?” Ms. Horwath asked.

MPP Merrilee Fullerton, the Minister of Long-Term Care, replied that “actions are being taken, and they have been taken all along” but hours later, six organizations that respectively represent long-term care residents, operators, and clinicians submitted their letter claiming otherwise.

Of particular concern for both the infectious-disease doctors and the long-term care sector is that the delay means it may already be too late to get in front of a second wave.

Donna Duncan, the chief executive officer of the OLTCA, said they were informed in the summer that it would take three months to recruit and train IPAC staff.

Ms. Duncan, who is one of the letter’s signatories along with the Ontario Long Term Care Clinicians, AdvantAge Ontario, CanAge, Family Councils Ontario and Ontario Association of Residents' Councils, said severe staffing shortages are the biggest risk facing the sector, but that workplace safety concerns are exacerbating that problem.

“For us to recruit new staff and retain current staff and protect our residents, infection prevention and control is going to be very important,” Ms. Duncan said.

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In addition to reiterating the need to hire infection-control staff, the stakeholders’ letter asked government to loosen regulations around personal-support workers, by allowing interested recruits to fast-track certification through on-the-job training.

The stakeholders noted that Ontario, which has the largest number of long-term care residents in Canada, is behind other provinces in preparing for the current surge. British Columbia, for example, announced $160-million in funding to hire as many as 2,040 additional staff who would be dedicated to ensuring infection-control measures are followed.

“We know what actions need to be taken today in order to protect our residents, families and staff," the letter concludes. “You must act now if we are to avoid the events of the first wave.”

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