Thirteen residents at a Vancouver long-term care home have contracted COVID-19, fuelling disagreement between health officials and health advocates over appropriate virus containment measures three years into the global health emergency.
The cluster of infections comes two weeks after British Columbia lifted its universal masking requirement for health care settings, as well as a proof-of-vaccination requirement for care homes specifically – the last of broad COVID-19 restrictions.
In a letter sent to families on Friday, Renzy Azcueta, executive director at Revera Inc., a large owner and operator of seniors’ residences and long-term care homes, said the 13 residents at Arbutus Care Centre have been put on contact and droplet isolation. This can include measures such as placing signage outside a patient’s room, drawing privacy curtains and keeping residents physically distanced.
It did not mention that infected residents are still sharing rooms with healthy residents, which is allowed under B.C.’s COVID-19 protocol for long-term care homes, last updated in August.
Mr. Azcueta added that while Vancouver Coastal Health has not declared an outbreak, the facility has put both floors of the building on “enhanced surveillance status,” which typically involves measures such as more frequent cleaning and COVID-19 screening.
The letter said visitors are “highly encouraged to wear medically graded face masks” and must go directly to and from the resident’s room. Those in a high-risk group are advised they “may want to delay visiting until after precautions are lifted,” and residents with COVID-19 can still have visitors so long as those visitors wear full personal protective equipment.
“Our team will ensure that all residents in isolation are served meals in their rooms and continue to have all their care needs provided for,” Mr. Azcueta wrote.
The Globe and Mail was provided the letter by a family member of a resident at the care home who was concerned that sick and healthy residents are sharing rooms, and that families are not explicitly informed of this.
In a statement, Vancouver Coastal Health said provincial guidance for managing COVID-19 in long-term care homes has evolved throughout the pandemic based on the nature of strains circulating and the level of vaccine coverage.
“The protection measures remain proportionate to the risk posed,” the statement said. “Importantly, the evolving guidance also allows for best quality of life for residents, which is a critical priority.”
Lyne Filiatrault, a former emergency physician and a member of Protect Our Province B.C., a group of health professionals that advocates for COVID-19 protections, believes that governments and public health, focused on moving past the pandemic, are failing to consider its long-term consequences.
She cited as examples the lasting effects of long COVID; the links to long-term cardiovascular problems, even among those with mild infections; and the relatively quickly waning protections offered by bivalent boosters against COVID-19′s most severe outcomes, particularly among older populations.
Dr. Filiatrault added that “outbreaks in long-term care have never gone away; what has changed is the reporting.”
Early in the pandemic, a single COVID-19 case in a care home constituted an outbreak, but the definition has changed over time. On Monday, Vancouver Coastal Health’s website said that, generally, “an outbreak is declared if three or more cases involving patients and/or staff occur within a designated time frame and in a specific area or unit.” The medical health officer determines when an outbreak will be declared, the site said.
B.C.’s protocol on COVID-19 in long-term care, meanwhile, said an outbreak will not be declared solely on the basis of cases among residents or staff, but that health leadership would consider multiple factors including vaccination coverage and severity of illness.
According to the BC Centre for Disease Control’s archived weekly COVID-19 outbreak reports, the last mention of an active outbreak in a Vancouver Coastal Health long-term care facility was on Feb. 9, 2022.
“As soon as the definition made it discretionary, VCH stopped reporting,” Dr. Filiatrault said.
Earlier this month, B.C. Human Rights Commissioner Kasari Govender said the lifting of masking requirements in health care settings has a disproportionate impact on marginalized people, seniors and those who are extremely clinically vulnerable.
“Masks minimally impair those who wear them, but the impacts of COVID-19 on vulnerable people are well known and they vary from the mild to the deadly,” she said in a statement issued April 12. “If there is one space that all vulnerable people should be able to rely on to prioritize their safety, it is in health care settings, including long-term care facilities.”
COVID-19 hospitalizations in B.C. reached 316 on April 20, the second-highest the province has recorded so far this year, according to the BCCDC.
Andrea Woo