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Families left portable fans for their parents at the doorsteps of nursing homes. Dehydrated medical workers staggered under their protective gear. Health officials scrambled to install air conditioners and worried about whether ventilation systems could spread the coronavirus.

The first week of the year with sweltering weather has added to the misery in seniors’ homes in Ontario and Quebec, underlining another weakness in the elder-care system: aging buildings without appropriate cooling equipment.

Past heat waves have been lethal in Quebec, with more than 90 dying two years ago, and there are concerns that the pandemic will make things worse this year for care-homes residents and those without home cooling.

One man who is volunteering in several Montreal seniors’ homes said the recent spell of hot weather was already causing a strain for residents and employees. Staffers became tired more quickly, moved more slowly and had to be careful not to drip sweat as they fed residents, the man said.

The Globe is not publishing the man’s name because he is not authorized to speak with the media.

In some homes, only those who are not infected can go to a cooler common room, the man said. He added that, in any case, the common rooms have an underpowered air-conditioning unit that just lowers the temperature a little.

Donning a protective gown felt like wearing a plastic bag, he said. He also had to deal with sweat trickling from his face shield.

Conditions were also challenging in Ontario. Jane Meadus, a lawyer with the Advocacy Centre for the Elderly legal clinic in Toronto, said the province’s most recent design standards for new long-term care homes, last updated in 2015, still do not require rooms to be air conditioned, only common areas.

“I have been in rooms in new homes on a hot day, which is 30-plus, and I couldn’t stand it,” said Ms. Meadus, who fears many long-term care homes are now left without options if a heat wave strikes. “The plan [on hot days] is to take 40 people and stick them in the lounge, which is not something you are going to do, because of COVID.”

The toll of hot weather on long-term care residents in Ontario will be harder to discern, as the province does not properly track heat deaths, she said.

Outside elder-care facilities, the pandemic is also challenging for people without home air conditioning while shopping malls, cinemas and swimming pools are still shuttered.

As temperatures spiked in Toronto earlier this week, municipal officials opened six temporary emergency cooling centres in community recreation facilities. The city stressed the spaces were meant as a “last resort,” and pledged to release a broader strategy, adapted for the pandemic, for future heat waves.

The centres looked like classrooms, offering visitors only a chair, a bottle of water and a plea from the city to keep their stay short, said Cathy Crowe, a nurse and long-time advocate for Toronto’s homeless. “Imagine if you made your way all the way down there and you just get to sit there for half an hour.”

City Councillor Joe Cressy, chairman of Toronto’s board of health, said the city knows it has to do more as more hot weather approaches. “COVID-19 has exposed and is taking advantage of our existing inequalities and failures as a society.”

In Quebec, the government has been on the defensive after Luc Despatie, the owner of an air-conditioning company, told Quebec media that he tried unsuccessfully in early April to warn health officials of the impending heat problem.

Premier François Legault and his ministers said Mr. Despatie didn’t get a response because nursing homes are locked down and there were no public-health guidelines on the use of cooling equipment during the pandemic.

“We had no expert opinion, we didn’t have approval from Public Health, we didn’t know if the virus could be spread through ventilation systems,” Minister for Elders Marguerite Blais said in the legislature Wednesday.

That afternoon, it was 35 C in Montreal, with a humidex reaching 40 C.

Some patients were in tears because of the heat, orderly Boguslawa Solski told Le Journal de Montréal as she headed in for her shift at the city’s Grace Dart extended care centre.

The AQRP, an association of retired Quebec public servants, has long raised concerns before about the lack of cooling equipment in seniors’ homes. “It’s a recurring problem. Governments come and go and the problems of elderly people isn’t their main concern,” AQRP president Rose-Mary Thonney said in an interview.

Only a third of long-term care rooms in Quebec have air conditioning, according to government data AQRP obtained through access-to-information law.

Mr. Legault said nearly all Quebec care homes now have at least a common area with air conditioning. “Of course, we didn’t expect at the time there would be COVID-19,” he acknowledged.

“We got caught unawares. A heat wave in May is not very common,” Health Minister Danielle McCann said Monday, explaining that the government only expected to deal with the issue in June.

The Quebec National Public Health Institute said there was little literature about COVID-19 contagion from portable air conditioners or fans, but warned that “these devices can be hazardous due to the possibility of dispersion of airborne micro-organisms.”

It said the air flow should be aimed away from residents’ faces and exit doors, to avoid scattering infected droplets.

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