Ontario Premier Doug Ford promised to “move heaven and earth” to protect seniors in long-term care. It would be too gracious to say he has failed. More accurately, it seems he didn’t try.
Mr. Ford vowed months ago to create an “iron ring” around long-term care homes to spare residents, staff and families the same unconscionable suffering they experienced during the first wave of the pandemic. But the only thing that changed was the expectations, and even that was a transient shift. Indeed, the same horrifying scenes of disorder and neglect are playing out in residential care homes across Ontario, where the government has undeniably failed to deliver on its promise to protect those most vulnerable to this disease.
Some long-term care homes – including Tendercare in Toronto, where nearly every person tested positive for COVID-19 in December – are so understaffed that residents’ basic necessities such as food and water aren’t being met.
There is no excuse for this calamity. Not when we’re nearly a year into a pandemic, months into a predictable second wave; not when a summer lull in active infections offered the province a reprieve to prepare for the inevitable; not when experts around the world have produced a wealth of best-practice advice.
There was plenty of blame to go around for the susceptibility of Ontario’s long-term care homes early in the pandemic. Decades of underfunding and neglect under successive provincial governments – including the expansion of private ownership under the Mike Harris government and broken promises of improved standards of care and the scaling back of annual inspections under the Dalton McGuinty and Kathleen Wynne governments – left the sector vulnerable to all-out disaster by the time COVID-19 came to Canada.
A lot of warnings went out about the need for better standards and infection protocols over the years, including from the SARS Commission, which referenced an outbreak of Legionnaires’ disease at one Toronto care home to highlight “systemic problems that remain unfixed.” But those warnings largely went unheeded.
So when COVID-19 first seeped into long-term care back in March, it was inevitable that the consequences would be catastrophic. During the first-wave peak back in May, 190 homes were in outbreak and more than 1,400 residents had died, which accounted for roughly 74 per cent of all deaths in the province.
But now, months later, we’re back to where we started and on a trajectory that looks as though it will crest at a far worse point than in the first wave. At the time of writing, 192 homes across the province are again battling outbreaks, and an additional 883 long-term care residents have died since Sept. 1.
This time, however, the blame can’t be dispersed across previous governments. It was ultimately Mr. Ford’s responsibility to enact emergency measures to prevent a second-wave crisis where homes would again be dangerously understaffed and residents left to suffer. Despite his promise, he dithered, wasted time and limited himself to incremental measures. Ontario seniors are now paying for it with their lives.
During the first wave in Finland, the government actively recruited retired care staff and students to provide backup support for its personal support workers. Singapore moved thousands of its long-term care home staff into hotels to try to prevent the virus from getting into residences. The Netherlands instructed care homes to establish “corona teams” that would care only for COVID-19 patients, while other workers cared for uninfected patients. Ireland created clinical support teams to provide regional support and oversight for long-term care homes.
Although none of these measures alone were a panacea, a government truly committed to moving “heaven and earth” to protect vulnerable populations might combine some of these practices – and perhaps, paid sick days for everyone working in long-term care, and more frequent testing of staff beyond once every two weeks – to try to mitigate the severity of outbreaks in residential facilities.
Instead, Ontario is only snapping into action now, launching a recruitment program to get more help in long-term care in early November, by which time the province was well into the second wave and 90 long-term care homes were already in outbreak. Just this week, Long-Term Care Minister Merrilee Fullerton announced the province would be opening a new centre to deal with surge capacity from overburdened care homes. Hospitals and public-health agencies have again taken over homes in crisis, just as they did during the first wave of COVID-19.
Ontario is seeing a hellish déjà vu in long-term care that could have been curtailed if this government chose dramatic action early. Instead, it satiated itself with its early measures and moved onto other things. There’s no excuse for this – not again, not this time.
Long Term Care workers received some of the first set of COVID-19 vaccines developed by Pfizer-BioNTech as the Unity Health Toronto vaccine program opened on December 22nd.
The Globe and Mail
Sign up for the Coronavirus Update newsletter to read the day’s essential coronavirus news, features and explainers written by Globe reporters and editors.