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Anson Place long-term care home in Hagersville, Ont., on April 6, 2020. At Anson, eight residents have died of COVID-19 and several dozen more are infected.

Glenn Lowson/The Globe and Mail

It is a job that is unregulated and poorly paid, with part-time schedules that often force the mostly female workers to take shifts at two or three facilities to eke out a living.

Personal support workers, the aides who bathe, dress and feed the elderly and chronically ill, are now on the front lines of the fight against COVID-19 in nursing homes, the places that have suffered most as the novel coronavirus has swept across Canada.

“We are in crisis mode,” said Rebecca Piironen, a PSW at Anson Place Care Centre, a retirement and nursing home near Hamilton, where eight residents have died of COVID-19 and several dozen more are infected. “These people are dying, gasping for air.”

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Doctors for Ontario long-term care facilities face off with public health officials over resident testing

Alberta allows anyone 65 and older to be tested for COVID-19

Alberta bans most visits to long-term care and group homes in bid to limit spread of COVID-19

PSWs who haven’t fallen ill with COVID-19 themselves are struggling to meet the needs of residents at the hundreds of homes across the country that have recorded at least one case of infection. Some of the worst-hit are the short-staffed facilities with widespread outbreaks, including a home in Bobcaygeon, Ont., where 27 residents have died.

Another major outbreak has killed eight and sickened more than 100 at the Sainte-Dorothée long-term care centre in Laval, a suburb of Montreal. At the Laflèche long-term care centre in Shawinigan, Que., there have been 12 deaths due to COVID-19 and 101 confirmed infections.

Seventeen residents of the Lynn Valley Care Centre in North Vancouver have died of COVID-19.

Calgary’s McKenzie Towne Continuing Care Centre is home to the largest outbreak in Alberta, with the facility’s 11 deaths accounting for nearly half of the province’s 24 fatalities, as of Monday.​ About half of the residents have been infected.

At least eight are dead of COVID-19 at Seven Oaks, a municipally owned home in Toronto, while six have died at the Markhaven Home for Seniors in Markham, north of Toronto.

“PSWs are crying before they go in for their shifts in long-term care," said Miranda Ferrier, president of the Canadian Support Workers Association. “They cry in their cars.”

They cry, she said, because they are afraid of catching the coronavirus, and afraid of what it might do to the vulnerable people they care for. They also cry because they are exhausted from carrying a workload that was heavy even before the pandemic began, resulting in high turnover and chronic staff shortages.

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Personal support workers, or health-care aides, as they are known in some parts of Canada, make up about 85 per cent of the staff in long-term care homes, according to Ms. Ferrier, who is also the president of the Ontario Personal Support Workers Association.

At least 22 of Ms. Piironen’s colleagues at Anson Place, in the town of Hagersville, Ont., had tested positive for the coronavirus as of Monday, according to the Haldimand-Norfolk Health Unit.

Ms. Piironnen, who has been off sick since March 22, is not among them. She tested negative.

As the virus spread through the home, Ms. Piironen said she and her fellow PSWs were kept in the dark by management.

One issue, she said, is that unlike registered nurses and registered practical nurses who are licensed and governed by professional colleges, PSWs are unregulated. “Nurses have [the Ontario Nurses’ Association], and RPNs have their licence, and people to back them up," Ms. Piironen said.

Lisa Roth, executive director of Anson Place, did not address specific questions about Ms. Piironen’s concerns, but she said in a statement that the home is “working with Public Health and the Ministry of Health to ensure all necessary steps are being taken to manage the outbreak.”

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It’s difficult to say how many of Canada’s approximately 275,000 PSWs have contracted COVID-19, but the union SEIU Healthcare is aware of at least 403 members in isolation in Ontario, 99 of whom had tested positive as of Monday.

The union represents about 25,000 workers in long-term care, most of them PSWs.

Sharleen Stewart, president of SEIU Healthcare, said the precarious nature of personal-support work has contributed to the spread of the coronavirus in Ontario, where the government has directed homes to work with employees to limit the number of places they work, but has not banned working at multiple sites.

In B.C., the Provincial Health Officer has taken control of staffing at long-term care homes in the Vancouver Area, giving workers full-time hours and forbidding work at more than one location.

“In hindsight, when this is all evaluated, this was spread by exactly that – people working in multiple places," Ms. Stewart said. “Seniors don’t get out of their homes very often. The virus was brought in.”

She and other union leaders have also been ringing alarm bells about a lack of personal protective equipment for long-term care workers, including PSWs.

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Personal support worker Darcia Hall said it’s “very common” for workers in her field to hold two or three jobs to make ends meet.

Until the pandemic forced her to choose, Ms. Hall, a 50-year-old single mother of four, worked full-time at a nursing home and a retirement home in Pickering, Ont., putting in a total of 80 hours a week.

She earned about $17 an hour at the retirement home and a little over $21 an hour at the nursing home, where she decided to keep working after the corporate operators asked staff to pick one location.

Some regular workers have left as a result, leaving the facility short-staffed even without a coronavirus outbreak. “We’re constantly working short," Ms. Hall said.

Jeff Begley, president of FSSS-CSN, a Quebec trade union representing 43,000 personal support workers, said Quebec employees in long-term care centres have been dealing for years with a heavy workload.

“This coronavirus probably arrived at the worst possible moment,” Mr. Begley said.

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Some of the long-term care centres that are now the sites of significant local outbreaks were already in the news because of their inadequate staffing.

At the Sainte-Dorothée long-term care centre in Laval, relatives complained two years ago that they had found loved ones with mouldy food on their hands, or who had been left on the ground after they fell.

Katie Scott, a PSW in Guelph, pointed out that if there were more full-time positions with benefits there wouldn’t be such a shortage of qualified staff at homes.

“It is definitely a wake-up call,” said Ms. Scott, adding that that there is no real oversight of who can do the work of a PSW and what credentials they need to have. “The government really needs to step in.”

With reports from Tu Thanh Ha and James Keller

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