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The COVID-19 pandemic has not been an equal-opportunity killer in Canada. Of 9,228 confirmed deaths to date, 94 per cent occurred in Quebec and Ontario – even though the two provinces are home to just 61 per cent of the population.

The chief reason for this discrepancy, statistically speaking, is that Quebec and Ontario each had their own subset of disproportionate deaths in a shared area of their populations: people living in public and private long-term care facilities and retirement homes.

According to the National Institute on Ageing (NIA) at Ryerson University in Toronto, whose data are gathered across the widest possible number of sources, 80 per cent of deaths in Quebec have involved residents of public and private LTC facilities. In Ontario, the figure is 73 per cent.

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The disproportionality isn’t limited to those two provinces: Nova Scotia is at 88 per cent, Alberta is at 60 per cent and British Columbia is at 58. The only two deaths to occur in New Brunswick were in seniors’ homes.

Nationally, 77 per cent of deaths have been in LTC facilities and retirement homes, according to the NIA.

But Quebec and Ontario were by far the worst hit in the pandemic’s first wave. Both called in the Canadian Armed Forces for assistance in homes that were overrun by deaths, and whose staff were unable to cope.

The military’s report on what they found described homes that were ill-prepared, in terms of staff and equipment, to handle a severe outbreak.

Now, as a second wave of COVID-19 steadily builds, the same calamity appears poised to happen again.

The Public Health Agency of Canada reported Tuesday that LTC and retirement residences are the leading single source of new outbreaks in September, as they were through most of the pandemic.

In Ontario, 29 LTC facilities had active outbreaks as of Monday, six more than the day before, according to the provincial government.

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This week, a group representing Ontario’s long-term care industry warned the Ford government that many homes are still ill-equipped to handle a second wave – even though the Ontario Long Term Care Association, as well as a group of infectious disease experts, both submitted urgent proposals to the government in June on shoring up COVID-19 protections.

Both proposals pushed the government to hire dedicated infection-control managers in every home, along with additional staff trained in infection prevention and control. Homes would be attached to hospitals in a “hub and spoke” model that would allow them to call in reinforcements during outbreaks.

From all appearances, Ontario has done nothing in the three critical months since those proposals were made. The Globe and Mail obtained a copy of a government presentation that proposes a watered-down version of the June proposals, with a timeline that extends into mid-October.

In Quebec, the government said there were 207 cases in 55 private and public LTC facilities on Monday, a sharp rise from the beginning of the month.

The Legault government announced in August that it would put a person responsible for infection control in every publicly run LTC facility. In June, it had announced a plan to hire and train 10,000 orderlies to work in its understaffed homes, and planned to have 8,000 of them at work by the middle of this month.

Quebec has taken needed action but, then again, its death toll in LTC facilities was so high during the first wave that the province is still among the very worst jurisdictions in the world in terms of COVID-19 deaths per capita.

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One thing is certain: If the current surge in new cases in LTC facilities in Quebec and Ontario results in another crush of preventable deaths, the governments of each province – which run public homes, and regulate and license the private sector – will not get a mulligan.

The public is unlikely to again accept that a disproportionate death toll can be written off to the fact the scale of the COVID-19 pandemic was unprecedented in its first wave, and that some homes were overwhelmed.

Simply put, it would be criminal to discover that any province had failed to take basic steps to protect the people who were hit the hardest the first time around.

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