Ontario’s Premier Doug Ford is famous for saying “the buck stops with me” following with a blanket admission that he bears all responsibilities for failed measures in fighting COVID-19. While his popularity surged during the first wave of the pandemic because he did a reasonably good job in keeping the virus under control, his slow response in the second wave cost the province a lot of unnecessary cases and fatalities and would ultimately cost Ford his votes in the next election.
Long-term care (LTC) homes have been a major battleground for COVID-19 last year, with strife around issues like mental health, isolation, staffing challenges, and access to personal protective equipment. In spite of the “horrendous conditions” detailed in the military’s report after concluding its mission to help the province’s LTC homes during the first wave of the pandemic, Ontario was reporting 224 LTC homes and 153 retirement homes in outbreak as of February 2. Opposition health critic France Gélinas said that the Ontario government promised to make changes after the first wave, but was very slow at going from talking to actually acting and doing something different in the second wave. As a result, Ontario was reporting 3,589 deaths in LTC homes as of February 2, representing about 58 percent of all virus-related deaths in the province.
Doug Ford and his LTC Minister Merrillee Fullerton promised in November to put an “iron ring” around LTC facilities to protect residents from a second wave of the virus. But during the second wave so far, 57 percent of all deaths in Ontario are in LTC homes. On top of that, 79 percent more deaths occurred in for-profit homes compared to public ones. Out of close to 6,000 COVID-19-related deaths in the province, more than 3,400 were in LTC homes.
Quebec, on the other hand, learned some key lessons after the first wave and currently has 84 homes with outbreaks while Ontario has over 200. A new report by Quebec’s national public health institute suggested the province has done a better job protecting LTC centres from COVID-19 outbreaks during the second wave of the pandemic than it did in the spring. During the first wave, 14 percent of the province’s LTC centres had more than 50 virus cases per 100 beds. That dropped to two percent during the second wave which is still ongoing.
The province deployed what it described as “swat teams” to four LTC homes where there were significant COVID-19 outbreaks last October. The emergency field teams were sent to bring the outbreaks under control and eliminate the spread of the virus. Quebec also put in place a prevention and infection control system in LTC homes with large outbreaks and appointed a general manager to each institution to ensure safety protocols are being followed.
Last week, more than 200 doctors and advocates in Ontario have signed a letter calling on the Ford government to act now to address deadly COVID-19 outbreaks at long-term care homes across the province. The letter, organized by Doctors for Justice in LTC, states that the group has grave concerns for the well-being of Ontarians in LTC homes. They are pushing the province to abolish for-profit LTC facilities, as advocated by the Federal and provincial NDP party leaders.
According to Dr. Naheed Dosani, a palliative care physician for the William Osler Health System, which has hospitals in Brampton and Etobicoke, for-profit homes are by design created for the profits for shareholders and not care for our seniors. After a lull in cases in the summer, Dosani said that LTC homes are still seeing poor infection control practices and a delayed response to outbreaks. He also referenced the report from Ontario’s COVID-19 Advisory Table, which found that in the first wave of the pandemic, the province saw 78 percent more deaths in people with COVID-19 in for-profit homes than in their public counterparts.
The CBC reported that the group of doctors is also calling on the province to take the following measures with respect to LTC facilities: hire appropriate levels of staff; set a minimum pay standard for frontline workers; ensure at least 70 percent of staff at every facility are working full time; let family caregivers have access to facilities; work with hospitals to establish partnerships for care; call upon the military if required; and accelerate vaccination rollout to LTC homes.
An independent commission – Ontario’s LTC COVID-19 Commission – has been looking into how the province handled the deadly spread of the virus in LTC homes and has flagged a lack of provincial oversight and uneven management standards.
The commission’s interim report on the situation late last year pointed to a provincial decision in the fall of 2018 to end comprehensive inspections and a lack of enforcement when issues are found. It also found that fines and prosecutions are rarely applied to home operators, leaving a lack of urgency to address violations. Earlier this month, the commission told the province it needed more time to finish its final report because the government itself wasn’t providing enough documentation. This request was rejected by the Ontario government.
While the improvement in the quality of Canada’s LTC homes might eventually require a total reform by the Federal Government, LTC care responsibility currently falls within provincial jurisdictions. During this second wave of the pandemic, Doug Ford and his team should stop making excuses and take immediate action to protect our most vulnerable population. The buck certainly stops with Ford and nobody else.
