B.C. advocate's report looks at 800 COVID-19 deaths in long-term care

long term care

The deaths of more than 800 residents of long-term care and assisted living facilities in B.C. have been attributed to COVID-19.

The disease took hold in the province in 2020, when relatively little was known about how it spread.

Over the following weeks and months, more was understood about COVID-19 and the novel coronavirus. It quickly became clear that outbreaks in health-care facilities were capable of claiming many lives.

Policies were developed and changed as information spread. Testing became more common, and vaccines were made available to the province's most vulnerable first.

But for many, these updates came too late. And there's still more to be done to prevent further deaths of COVID-19.

just-published report from the Office of the Seniors Advocate of British Columbia outlines what happened in the province's long-term care system in the first year of the pandemic. Specifically, seniors advocate Isobel Mackenzie looked into the contributing factors behind outbreaks between March 2020 and February 2021.

Mackenzie's office looked at more than 100,000 records when completing its investigation, and 365 outbreaks at 210 sites.

In the report, Mackenzie outlined seven recommendations she believes will help save lives.

WHY FOCUS ON SENIORS?

Mackenzie acknowledged the challenges and emotional impact the pandemic has had on everyone. Whether they've had COVID-19 themselves, lost a loved one, lost a job or anything else, she noted people have been making sacrifices to help keep their communities safe.

"While all of us have been affected by this pandemic, it is seniors, particularly those who live in long-term care and assisted living, that have felt the deepest personal impact, since they are disproportionately at risk of serious illness and death from COVID-19," Mackenzie wrote in her report, released Wednesday.

She said it's important to remember when looking at her report that this is more than numbers on a page. The review is about people.

FINDINGS IN THE REPORT

Among the findings, Mackenzie said her office noted about 75 per cent of outbreaks were contained to four or fewer cases.

Three-quarters of outbreaks resulted in no deaths at all.

Interestingly, she noted only 45 per cent of B.C.'s long-term care and assisted living facilities are located in B.C.'s Lower Mainland, but 84 per cent of outbreaks were in that region.

The office also found the vast majority of outbreaks were in the second wave of the pandemic: nearly nine in 10.

"We learned of the extraordinary stress and strain on the system," Mackenzie wrote in her report.

"Every site experienced significant increases in overtime and those sites that experienced a large outbreak saw a 178% increase in their overtime in the past year."

Overall, she wrote, the majority of outbreaks in B.C. were contained, and no one died. She attributes this to the "herculean efforts" of devoted staff members, site operators, public health officials and others.

Still, more than 800 people did not survive that first year.

She noted the physical impact as well as the trauma of life in long-term care.

Among the issues that came up were problems with the understanding of how COVID-19 spread. Initially it was believed a person wasn't contagious until they displayed symptoms.

Workers who felt unwell still came to work, though their reasons were "often benevolent" and related to concerns about the overburdened health-care system. Many of these workers were worried about the impact their co-workers and residents.

There were also issues with communication and learning new protocols.

Some noted "conflicting direction" from health authority staff, which was often an issue in places where multiple people were involved in managing the outbreak. Many were not accustomed to "this level of PPE vigilance" brought on by the pandemic.

Others who spoke to Mackenzie's office suggested notification and contact tracing, once someone tested positive, wasn't timely enough.

According to the report, several operators said the process would have been improved by giving them the opportunity to be involved, and by more widespread and frequent testing.

NEXT STEPS

The advocate listed seven recommendations that arose from her investigation:

  •  Increase paid sick leave for staff;
  •  Increase the pool of direct care staff;
  •  Increase the levels of registered nursing staff as a proportion of direct care staff;
  •  Decrease contracting for direct care services;
  •  Eliminate shared rooms;
  •  Increase testing scope, timelines and frequency; and
  •  Require staff of long-term care to be vaccinated and provide booster shots to residents.

Mackenzie noted the challenges of the pandemic in her report, including the heartache felt by those who lost loved ones.

"However, we also witnessed the tenacity, commitment, and opportunity to use what we have learned… It is clear that British Columbians care deeply about the health and well-being of its oldest citizens. This more than anything gives hope for a better tomorrow."

 

with files from CTV News