Crisis in Ontario long-term care homes

BY PAUL JUNOR

As the pandemic continues, it has taken a terrible toll on some of the most vulnerable people in our society.

The death of 33 seniors in the Eatonville Nursing home in Etobicoke, 16 at the Sienna Altamount Care Community in Scarborough, 29 at Pinecrest Nursing Home, 23 at Almont Country Haven, 23 at Anson Place, as well as personal support worker (Christine Mandrgaran) on Thursday, April 17^th, highlights the magnitude of the crisis.

In the face of on-going criticism and reaction to concerns that have been expressed, the Ontario government has responded. They have issued two emergency orders (March 24^th, 2020 and March 28^th, 2020) as well as a new one on April 15^th to deal with this looming health crisis.

Concerns about the quality of care at long-term care homes have been vocalized for many years. Vicki McKenna, President of the Ontario Nurses Association (ONA) in a report by Newzdu.ca on April 4^th, 2020 stated, “Working conditions in some long-term care homes are abysmal. In some homes, there is limited personal protective equipment (PPE) for health-care workers, and many homes are reporting that they are running out of much-needed supplies.  It’s horrifying. In addition, the government must ensure directives regarding PPE are clear, proactive and updated to also apply to nurses in long-term care homes.”

ONA represents more than 68,000 registered nurses and health-care professionals as well as 18,000 nursing students. These concerns are magnified even further in the light of the social distancing and physical spacing requirements that are in place.

There are many issues that have been fomenting for years. The precarious nature of many nursing jobs, lack of full-time status with adequate benefits, and having to work in multiple facilities to gain a living wage are some of the challenges.

According to Vicki, “It is very common for nurses and health-care professionals to work in multiple long-term care homes. This piece-meal approach with casual and part-time workers coming in and out of various homes is very unsafe in this pandemic. Workers in long-term care must have the right to work in one home with full-time hours and work with the same residents. This approach is also best for our residents and decreases the impact of any potential spread of COVID-19.”

As a result of the ONA’s concerns 15,000 people sent their support through targeted email (www.ona.org/ppe) calling on the government to guarantee that health-care workers have access to personal PPEs.

In a news release from the Office of the Premier titled, “Ontario Ramping Up Protection for Long-Term Care Residents” it outlined the COVID-19 Action Plan. It adds vital new measures to prevent further outbreaks focusing on three specific areas:

1. Aggressive testing, screening and surveillance
2. Managing outbreaks and spread of the disease
3. Growing our heroic long-term care workforce

According to Premier Ford “We will do everything we can to protect our seniors and most vulnerable citizens because we all know they are most at risk during this pandemic. Our three-points build on the measures we have placed around our long-term care residents and those who care for them.” The government outlined that additional measures were being taken to ensure preparedness, and to respond to the situation:

1. Enhanced testing and surveillance for symptomatic residents and staff and those in contact with persons confirmed to have COVID-19
2. Testing of asymptomatic residents and staff in select homes across the province to better understand how COVID-19 is spreading
3. Risk and capacity assessment for all homes
4. Working with: Ontario Health, the Ontario Hospital Association, and public health units to assemble infection control and prevention teams and additional supports
5. Enhanced guidance on personal protective equipment and continued distribution to homes
6. Enhanced training and education to support staff working in outbreak situations
7. Redeploying hospitals and home care resources into homes

The government has taken extra steps to ensure these measures are enforced under the Emergency Management and Civil Protection Act (News Release on Friday, April 17^th, Ontario Takes Further Action to Protect Vulnerable People from COVID-19). According to Premier Ford, “In order to better protect our seniors people with various abilities, the homeless population, and our frontline workers, the government is adopting emergency measures to provide flexibility and a variety of staffing arrangements to help stop the spread of this terrible virus.”

These measures include:

1. Restricting retirement home employees from working in more than one facility
2. Ensuring that the Local Health Integration Network assigns frontline workers where they are most needed
3. Providing municipalities and District Social Service Administrative Boards with the power to move staff into local areas where they are needed.

The Ontario government has made $243 million in COVID-19 emergency funds available to ensure that long-term care homes are able to obtain additional staff supplies and the capacity needed. It has given long-term care homes until April 22^nd to ensure compliance.

These temporary measures are initiatives to address the urgency of the current pandemic. One wonder is, what will happen after the pandemic is over? There are important structural changes that have to be made to ensure that these workers receive: adequate wages, excellent working conditions, and proper benefits. This crisis is a wakeup call to address and deal with these systematic and ingrained issues that have been ignored for too long.