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Paramedics take away an elderly patient at the Tendercare Living Centre, long-term-care facility during the COVID-19 pandemic in Scarborough, Ont., on December 23, 2020.Nathan Denette/The Canadian Press

Ontario long-term care operators are being asked to do more to improve COVID-19 vaccine uptake among staff, with the government recommending on-site vaccinations or paid transportation to clinics.

The associate deputy minister of long-term care wrote to licensees last week about next steps for the sector during the pandemic, noting that nearly 80 per cent of staff have received a first dose.

“We know there is wide variation in the staff vaccination rate among homes, and we need to find ways to get these numbers up,” Erin Hannah’s April 1 memo said.

“We are asking all of you to work with the leadership in your homes to further amplify messages about the benefits of vaccination and to see whether there are additional actions that might help and make sense in your homes.”

The memo suggests having one-on-one conversations with all staff, inviting trusted leaders such as physicians and faith leaders to share their experiences, and tailoring messages to the needs of the home.

It also recommends holding on-site vaccinations for staff and new residents, and offering paid time off and transportation to clinics if shots can’t be arranged at work.

One major chain welcomed the guidance regarding on-site vaccinations. A spokesman for Revera, Inc., said its employee vaccination rate across its long-term care homes and retirement residences was at about 50 per cent as of April 1.

Larry Maxwell said Revera compensates workers for visits to clinics but staff have reported access “is a challenge that has delayed their vaccination.

“We believe it would make a big difference to have the vaccines offered to our employees on site, as it was for our residents,” Mr. Maxwell said in a statement. He said the company and the provincial government are meeting to discuss on-site clinics.

“The staff in our long term care homes and retirement residences have been working long hours throughout the pandemic, caring for their residents, and we believe we need to make it as easy for them to access vaccines as possible.”

Ontario’s long-term care homes were devastated by the pandemic, with 3,755 residents and 110 staff killed by the virus as of Monday, according to government statistics.

Targeted vaccinations in homes starting in December, 2020, have been linked to a drop in deaths. The ministry of long-term care said 90 per cent of residents had been fully vaccinated as of April 1, and the government has said nearly all residents have received at least one dose.

A paper published last month from scientists advising the government on the pandemic reported hundreds of lives saved from vaccinations in long-term care homes but noted lower-than expected uptake among staff. Researchers recommended financial supports like transportation and paid time off for staff to get vaccinated.

As of Monday the province reported 50 homes with active virus outbreak, with most of the cases affecting staff.

A spokesperson for the Minister of Long-Term care said Monday that people are hesitant to receive a vaccine for many reasons and said the ministry is encouraging all staff to get vaccinated.

“We will continue to work with the long-term care sector partners, as well as community and faith leaders to promote vaccine confidence so we can see those numbers rise,” Krystle Caputo said in a statement.

Donna Duncan, chief executive of the Ontario Long Term Care Association, said protecting residents and staff from COVID-19 is “the highest priority.” She said taking a vaccine is a personal decision and education campaigns about the benefits must be accessible, multilingual and come from trusted sources.

“The discussion about vaccine uptake by staff should be around understanding, compassion and education of our staff in the homes to support the decision to take the vaccine,” Ms. Duncan said in a Monday statement.

“The OLTCA supports the education programs reaching more staff and is seeing an uptake increase in vaccines.”

Ms. Hannah’s memo sent April 1 outlined other steps for the sector during the next stage of the pandemic, now that the majority of residents have received vaccines.

It asked homes to review policies to ensure residents can go outdoors, following calls from residents and activists to allow more freedoms after over a year of confinement, noting that the homes are now “highly vaccinated settings.”

It also shared updated guidance defining an “outbreak” of COVID-19 now that 90 per cent of residents are fully immunized. As of April 7, an outbreak will be defined as two or more confirmed cases among residents, staff or visitors over two weeks where one person could have been infected in the home.

Ms. Hannah said the change will offer relief from the stringent protocols put in place during outbreaks, now that the “large majority” of outbreaks involve on case acquired outside the home.

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