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In Quebec – a resident seen here on April 15, 2020 outside the Residence Floralies in Montreal – a longstanding history of neglect in provincially run homes no doubt contributed to this crisis.

Ryan Remiorz/The Canadian Press

The COVID-19 pandemic has revealed two different Canadas: one that has done better than many other countries at limiting the spread of the coronavirus in the general population; and another that allowed its seniors facilities to become killing fields.

This disparity was made plain last week when the National Institute on Ageing (NIA), a Toronto-based think tank, said that 82 per cent of the COVID-19-related deaths in Canada involved residents of nursing homes and seniors residences.

Theresa Tam, Canada’s Chief Public Health Officer, effectively confirmed that number when she said federal data put the figure at 81 per cent.

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It’s been obvious for a while that elderly people warehoused in public and private facilities were bearing the brunt of the pandemic’s devastation. Horror stories out of Quebec, where residents in soiled diapers were abandoned by their caretakers, had made that clear. So had reports about outbreaks in seniors facilities across Ontario in mid-April.

But no one realized that two entirely different pandemics were occurring simultaneously in this country.

One, in Canada’s general population, can be qualified as a modest success story.

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On May 6, the national death toll from COVID-19 was 4,167. Of those deaths, according to the NIA, 3,436 involved seniors in homes, plus six staff members.

That means there had been only 725 deaths in the general population. This is almost entirely because Ottawa and the provinces put the country on lockdown relatively early in the pandemic.

Samir Sinha, the director of health policy research at the NIA, credits that broad response with saving many lives. In particular, he said, limiting community transmission has protected seniors still living at home from a virus that has “a predilection for older, frailer people.”

But while Canada ranks among those countries that have done a decent job of suppressing the infection curve in the general population, it is doing far worse than other nations when it comes to protecting those in seniors facilities.

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The disparity is there in the statistics. The death rate from COVID-19 is higher in Quebec than in the United States, and the vast majority of Quebec’s more than 2,700 deaths as of May 8 were in nursing homes or seniors residences. In Nova Scotia, of 46 province-wide deaths from the virus as of May 8, 40 are from the Northwood long-term care home. That one facility in Halifax has more than double the number of virus fatalities as the combined totals for Manitoba, Saskatchewan, Newfoundland and Labrador, New Brunswick, Prince Edward Island, and the three territories.

How did this happen? There is no simple answer.

In Quebec, a longstanding history of neglect in provincially run homes no doubt contributed to this crisis. But privately run homes in Quebec and Ontario have also been hit with terrible outbreaks.

Critics have pointed to the fact that many care workers are underpaid and must piece together a living wage by taking jobs in multiple facilities, causing cross-contamination.

There is also the reality that many publicly funded homes, most often filled with people with little or no money to spend on their care, warehouse as many as four residents to a room and have limited space for social distancing. As well, their staffs, unlike those in hospitals, are not equipped and trained to handle an outbreak of this magnitude.

All these things need to be addressed. But if there is one common and essential issue in this tragedy, it is the failure of too many homes to keep people from bringing the virus in through the front door with them in the first place.

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Among other security measures, British Columbia banned all non-essential visits in seniors facilities, and stopped care providers from working in more than one facility, at least a week before any other province. As of May 6, the number of resident deaths in B.C. facilities was 72, according to the NIA. That compared to 1,242 dead in Ontario, and 2,000 in Quebec.

At the very least, seniors facilities in every province should have gone on lockdown at the same time as the country and its hospitals.

Combined with better training, equipment and staffing, it might have stopped the carnage. The low number of deaths in seniors residences and nursing homes in B.C. are a reminder that the high and rising toll in Quebec and Ontario was not inevitable.

Globe health columnist André Picard examines the complex issues around reopening schools and businesses after the coronavirus lockdown. He says whatever happens as provinces reopen, there's also a second wave of COVID-19 illnesses looming in the fall. André was talking via Instagram Live with The Globe's Madeleine White.

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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