To date, most countries across the world have been affected in some way by the COVID-19 pandemic. Along with workers, particularly hard hit have been seniors — including those living in long term care where many are already increasingly frail and suffering from multiple chronic conditions.[i]
To protect vulnerable populations, jurisdictions in Canada (including B.C.) and internationally have taken various approaches to prevent and reduce the spread of COVID-19, such as increased use of personal protective equipment (PPE), implementing infection prevention and control (IPC) measures and by limiting those who can visit or work at seniors care homes. Despite these actions, the long-term care sector in Canada has been particularly hard hit, accounting for the majority of COVID-19 related fatalities.
In late June, for example, the Canadian Institute for Health Information (CIHI) issued a report highlighting long term care residents made up 80 per cent of all reported COVID-19 fatalities in Canada, in contrast to an average of 42 per cent among other countries studied.[ii] These findings were reiterated in an October 2020 report by Public Health Agency of Canada (PHAC) noting that as of mid-August, Canada had one of the highest fatality rates among long-term care residents out of the 37 countries in the OECD.[iii] A recent study looking at deaths per 100 population, however, shows Canada in the middle of countries surveyed when looking at the number of residents per 100 living in long-term care (see Figure 1).[iv]
While British Columbia has fared better than other provinces in terms of the number and percentage of deaths in long-term care (see Figure 2) the effects of COVID-19 have still been devastating to providers, seniors and their families.[v] In response to COVID-19 there have been numerous actions and steps taken provincially to protect seniors although some have questioned whether these directives, along with efforts to test residents and staff for COVID-19, were applied quickly or comprehensively enough.[vi]
While, in B.C., there was a decline in the number of COVID-19 long-term care outbreaks over the summer reaching close to zero, we have seen increases over time (see Figures 3 and 4) particularly as community transmission increases as this is one of the main contributing factors for such outbreaks.[vii] As of mid-October, for example, B.C. had 17 long term care and assisted living sites with COVID-19 outbreaks, while the number in Ontario (86) had also quadrupled over the past month, and other provinces such as Quebec (39), Manitoba (7) and Alberta (13) [viii] were also dealing with outbreaks coinciding with overall increases in the community.[ix] While younger age groups have largely been driving infections during the second wave, the cases are now starting to enter long-term care homes.[x]
As cases continue to increase and as jurisdictions enter the second or even third waves of the pandemic, BC Care Providers Association (BCCPA) believed it was important to be better prepared. Therefore, in late July, the BCCPA’s Advisory Committee on COVID-19, issued initial draft recommendations to better prepare government and the sector.[xi] In total, 17 initial recommendations were issued under four key areas or themes including: 1) Pandemic Preparedness & Coordination; 2) Reduce Infection Transmission; 3) Support Staff and Operators; and 4) Provide Social Supports.
BCCPA thought it was also important to engage with care providers and other stakeholders to discuss these recommendations further and also identify any further areas or gaps not initially outlined. In coordination with BCCPA, this engagement process was led by the Howegroup and also included a comprehensive survey and literature review. Based on findings from the engagement process, BCCPA will be releasing its final report which will also be the focus of a Care to Chat event titled COVID-19 and Seniors Care in B.C.: Navigating the Next Wave to be held virtually via Zoom on Friday, November 27th.
This Care to Chat will focus on some of the key findings from the engagement process and the recommendations outlined in the final report that will be made public just prior to the event. In particular, building off these findings and discussions at the BCCPA Virtual Conference in September, this Care to Chat will also highlight how we can better prepare and mitigate the effects of COVID-19 in seniors care and living in the four areas or themes outlined earlier such as: developing appropriate plans and communication processes; reducing transmission through use of PPE, testing and IPC measures; addressing staffing and training issues; as well as providing social supports including improving quality and ensuring safer family visits for seniors.
A panel moderated by BCCPA CEO Terry Lake, and consisting of experts including providers from the BCCPA COVID-19 Advisory Committee as well as academia who also assisted with the review will discuss these and other important issues. Prior to beginning the formal panel discussion, those registered for the Care to Chat will also have the opportunity to participate in at least one of four breakout sessions based on themes outlined earlier. We hope you can join us for what we believe should be an important and timely discussion on protecting the most vulnerable seniors against COVID-19. For further information and to register please click see the following link.
Document link to Figures 1 to 4
END NOTES
[i] According to data provided by the B.C. Ministry of Health in July about twenty percent of cases of COVID-19 that resulted from outbreaks at B.C.’s long-term care homes were fatal, which is significantly higher than B.C.’s overall fatality rate of 6.1 per cent. See: COVID-19: Going Forward (B.C. Modeling update – July 20, 2020, accessed at:
https://news.gov.bc.ca/files/Covid19-Modelling_Update.pdf.
[ii] Canadian Institute for Health Information. Pandemic Experience in the Long-Term Care Sector How Does Canada Compare with Other Countries? June 2020. Accessed at: https://www.cihi.ca/sites/default/files/document/covid-19-rapid-response-long-term-care-snapshot-en.pdf
[iii] Public Health Agency of Canada. From risk to resilience: An equity approach to COVID-19. October 2020. Accessed at: https://www.canada.ca/en/public-health/corporate/publications/chief-public-health-officer-reports-state-public-health-canada/from-risk-resilience-equity-approach-covid-19.html#t2
[iv] Comas-Herrera A, Zalakaín J, Lemmon E, Henderson D, Litwin C, Hsu AT, Schmidt AE, Arling G and Fernández J-L (2020) Mortality associated with COVID-19 in care homes: international evidence. Article in LTCcovid.org, International Long-Term Care Policy Network, CPEC-LSE, 14 October. Accessed at: https://ltccovid.org/wp-content/uploads/2020/10/Mortality-associated-with-COVID-among-people-living-in-care-homes-14-October-2020-4.pdf
[v] According to Sept. 4th data from the Ministry of Health, since the first case of COVID-19 was reported in British Columbia in late January, 736 people have reported sick in health care settings (mostly in long-term care facilities), including 291 staff. One hundred and fifty-four people have died. In total, 211 people have died from COVID-19 related causes in B.C.
[vi] Covid-19 in Long-Term Care: Reflections from Ontario, Canada. Jour Nursing Home Res 2020;6:45-46. July 2020. Moser et al. Accessed at: https://www.jnursinghomeresearch.com/2301-covid-19-in-ltc-reflections-from-ontario-canada.html
[vii] Journal of American Geriatrics Society. Characteristics of U.S. Nursing Homes with COVID‐19 Cases. Hannah R. Abrams, Lacey Loomer, Ashvin Gandhi, and David C. Grabowski. June 2020. Accessed at: https://onlinelibrary.wiley.com/doi/full/10.1111/jgs.16661
[viii] Globe and Mail. Delays in COVID-19 testing results putting long-term care homes at greater risk. October 20, 2020. Accessed at: https://www.theglobeandmail.com/canada/article-delays-in-covid-19-testing-results-putting-long-term-care-homes-at/
[ix] Towards the end of October more than 100 seniors care residences in Canada were reporting outbreaks including 79 in Ontario, 14 in Alberta, 21 in British Columbia and 19 in Manitoba. (Source: Global News. Opposition, advocates say Ottawa needs to fix long-term care homes now. October 29, 2020. Accessed at: https://globalnews.ca/news/7431028/coronavirus-long-term-care-fixes/)
[x] Times Colonist. Long-term care deaths surged in COVID-19 first wave, Tam hopeful it won’t repeat. October 28, 2020 Accessed at: https://www.timescolonist.com/long-term-care-deaths-surged-in-covid-19-first-wave-tam-hopeful-it-won-t-repeat-1.24228755
[xi] BCCPA. BCCPA/EngAge BC release Pandemic “2nd Wave” Recommendations. July 28, 2020 Accessed at: https://bccare.ca/2020/07/bccpa-engage-bc-release-pandemic-2nd-wave-recommendations/
