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Police cruisers are shown outside Maison Herron, a long term care home in the Montreal suburb of Dorval, Que., on April 11, 2020, as COVID-19 cases rise in Canada and around the world.

Graham Hughes/The Canadian Press

Residents sitting in their own urine and feces because their incontinence pads had not been changed in days. Others dehydrated, starving and disoriented, having not been fed or given their medications. Two patients on the verge of death.

That’s the horror show public-health inspectors found when they visited Résidence Herron, a 134-bed private long-term care facility in Dorval, Que., on March 29.

Now we know that there have been at least 31 deaths.

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The details, first revealed by the Montreal Gazette, are sickening. The questions the situation raises are profoundly troubling.

How is it possible, in 2020, in Canada, that elders entrusted to a licensed care home can be treated worse than dogs at the city pound?

How is it conceivable that vulnerable seniors – some with dementia and severe mobility issues – could be left to fend for themselves? (There were only two orderlies left when inspectors arrived.)

And how can the managers of Katasa Holdings Inc., which boasts about offering its clients “luxury, comfort, convenience, security,” be so crass that they would try to cover up the debacle? (Public health had to get a court order to get access to residents’ files and it was only then they learned there were 31 deaths.)

On Saturday, Quebec Premier François Legault, visibly shaken, said there had been “gross negligence” at the home and he has asked police to determine if criminal charges are warranted.

While this situation is egregious, it is sadly not unique.

Hundreds of nursing homes and seniors’ residences across Canada have been hit by outbreaks of coronavirus, often with deadly consequences.

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The most publicized case is Pinecrest Nursing Home in Bobcaygeon, Ont., where 29 people have died so far.

But there are so many others that it’s hard to keep track.

At the Centre d’hébergement de LaSalle there have been 20 deaths, and 19 at the Ste-Dorothée long-term care centre; both are in the Montreal area.

And there have been 18 deaths at McKenzie Towne Long-Term Care Home in Calgary.

All told, half of the almost 750 COVID-19 deaths in Canada have been in institutional settings.

More than a month ago, a deadly outbreak occurred at Lynn Valley Care Centre in North Vancouver (where 18 have now died) and it should have sounded an alarm that all seniors’ residences were at serious risk from the new coronavirus.

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Yet, business continued more or less as usual, with homes restricting visitors and installing hand-sanitizer dispensers and isolating people only after they fell ill.

Essential safety measures such as routine coronavirus testing, measures banning staff from working at multiple sites, and the use of personal protective equipment have still not been fully implemented

What the horror stories (and the data) tell us is that we should be testing every single person in institutional care, and isolating the infected aggressively. (Read: Not four to a room.)

Where routine testing has been done, the results are frightening; at the Ste-Dorothée long-term care centre, for example, 115 of the 174 residents have tested positive.

Both B.C. and Alberta have banned health-care staff from working at multiple institutions, a common practice that allows the coronavirus to spread quickly.

This should be a permanent policy, not a temporary one.

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There is no lack of work in nursing homes and long-term care. In fact, there are dire personnel shortages.

But many employers refuse to offer full-time work so they can avoid paying benefits. This forces staff, especially low-wage ones such as personal support workers, to juggle shifts at various locations.

We can self-righteously denounce workers who abandoned their charges at places like Résidence Herron but who wants to put their life on the line for fifteen bucks an hour, no benefits – and no PPE?

COVID-19 is a disaster in seniors’ residences. But, more than anything else, it has exposed a crisis that already existed – a crisis of neglect for our elders.

Terrible food, one bath a week, over-medication, inadequate personal care such as changing incontinence pads – all these complaints arise far too regularly in institutional care.

It shouldn’t take dozens or hundreds of deaths on top of that for us to finally be outraged.

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The challenge – no, the moral imperative – now is not just to get through the pandemic without much more carnage, but to deal with these issues permanently.

Nursing homes and long-term care homes are a necessity in modern society. There is a lot of good institutional care in this country.

But there is still far too much inadequate care, and that means the system needs a fundamental rethink.

Sign up for the Coronavirus Update newsletter to read the day’s essential coronavirus news, features and explainers written by Globe reporters.

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