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As the second wave of #COVID19 intensifies, I am deeply concerned about Ontario's #LTC homes.
There are now 20 homes with outbreaks ( https://www.ontario.ca/page/how-ontario-is-responding-covid-19), including Ottawa’s Extendicare West End Villa involving 47 cases and 6 deaths: https://ottawacitizen.com/news/local-news/sixth-resident-dies-in-west-end-villa-covid-19-outbreak
A THREAD.
1/10
There are now 20 homes with outbreaks ( https://www.ontario.ca/page/how-ontario-is-responding-covid-19), including Ottawa’s Extendicare West End Villa involving 47 cases and 6 deaths: https://ottawacitizen.com/news/local-news/sixth-resident-dies-in-west-end-villa-covid-19-outbreak
A THREAD.
1/10
#COVID19 outbreaks in #LTC homes are unsurprising.
As @DavidCGrabowski says “the strongest predictor of whether or not we’ll see cases in [a particular setting] is community spread": https://www.washingtonpost.com/health/covid-19-surges-back-into-nursing-homes-in-coronavirus-hot-spots/2020/08/13/edbff5fe-dd75-11ea-b205-ff838e15a9a6_story.html
We've since this very clearly in the US: http://www.kff.org/coronavirus-covid-19/issue-brief/rising-cases-in-long-term-care-facilities-are-cause-for-concern/
2/10
![#COVID19 outbreaks in #LTC homes are unsurprising.As @DavidCGrabowski says “the strongest predictor of whether or not we’ll see cases in [a particular setting] is community spread": https://www.washingtonpost.com/health/covid-19-surges-back-into-nursing-homes-in-coronavirus-hot-spots/2020/08/13/edbff5fe-dd75-11ea-b205-ff838e15a9a6_story.htmlWe've since this very clearly in the US: http://www.kff.org/coronavirus-covid-19/issue-brief/rising-cases-in-long-term-care-facilities-are-cause-for-concern/2/10](https://pbs.twimg.com/media/EiDxjUSXgAElVye.jpg "#COVID19 outbreaks in #LTC homes are unsurprising.As @DavidCGrabowski says “the strongest predictor of whether or not we’ll see cases in [a particular setting] is community spread\": https://www.washingtonpost.com/health/covid-19-surges-back-into-nursing-homes-in-coronavirus-hot-spots/2020/08/13/edbff5fe-dd75-11ea-b205-ff838e15a9a6_story.htmlWe've since this very clearly in the US: http://www.kff.org/coronavirus-covid-19/issue-brief/rising-cases-in-long-term-care-facilities-are-cause-for-concern/2/10")
As @DavidCGrabowski says “the strongest predictor of whether or not we’ll see cases in [a particular setting] is community spread": https://www.washingtonpost.com/health/covid-19-surges-back-into-nursing-homes-in-coronavirus-hot-spots/2020/08/13/edbff5fe-dd75-11ea-b205-ff838e15a9a6_story.html
We've since this very clearly in the US: http://www.kff.org/coronavirus-covid-19/issue-brief/rising-cases-in-long-term-care-facilities-are-cause-for-concern/
2/10
Unsurprisingly, one of the best ways to prevent #LTC home #COVID19 outbreaks is to reduce community transmission.
We need immediate action...as @DrMikeRyan says "Be fast, have no regrets...the virus will always get you if you don’t move quickly.”: https://edition.cnn.com/world/live-news/coronavirus-outbreak-03-13-20-intl-hnk/h_0c6db53f2d95cd6d09d1f5674c1c65dd
3/10
We need immediate action...as @DrMikeRyan says "Be fast, have no regrets...the virus will always get you if you don’t move quickly.”: https://edition.cnn.com/world/live-news/coronavirus-outbreak-03-13-20-intl-hnk/h_0c6db53f2d95cd6d09d1f5674c1c65dd
3/10
The second wave of #COVID19 has clearly taken off in Ontario, and it is therefore likely that we will see many more #LTC home outbreaks (and deaths).
So the question is, are Ontario #LTC homes prepared to deal with COVID19 outbreaks? There are many reasons to be concerned.
4/10
So the question is, are Ontario #LTC homes prepared to deal with COVID19 outbreaks? There are many reasons to be concerned.
4/10
Many things have improved since the start of the pandemic:
-Understanding of a/pre-symptomatic transmission
-Access to PPE and testing
-Established IPAC and clinical guidelines
-Policies to limit staff to one home and the number of residents/room
-Family caregiver access
5/10
-Understanding of a/pre-symptomatic transmission
-Access to PPE and testing
-Established IPAC and clinical guidelines
-Policies to limit staff to one home and the number of residents/room
-Family caregiver access
5/10
Despite these gains, there are many serious deficiencies, top of which is staffing. @AmitAryaMD, @DrVivianS and @AminaJabbar have highlighted many of these issues, and emphasized how "preparing nursing homes for a second wave starts with staffing": https://www.thestar.com/opinion/contributors/2020/08/27/preparing-nursing-homes-for-a-second-wave-starts-with-staffing.html
6/10
6/10
Unfortunately, insufficient action was taken over the summer to address these issues:
-Increased staffing ratios
-Full-time employment, sick pay and building a career ladder for workers
-Accelerated training of PSWs (provinces like Quebec did this: https://thereview.ca/2020/06/02/quebec-government-announces-new-training-program-for-long-term-care-support-workers/)
7/10
-Increased staffing ratios
-Full-time employment, sick pay and building a career ladder for workers
-Accelerated training of PSWs (provinces like Quebec did this: https://thereview.ca/2020/06/02/quebec-government-announces-new-training-program-for-long-term-care-support-workers/)
7/10
Many #LTC homes are also struggling financially, with pandemic funding having dried up.
In the spring resources were redeployed from the education sector and hospitals—with school restarting and hospitals ramping up services, homes were told they can't rely on this again.
8/10
In the spring resources were redeployed from the education sector and hospitals—with school restarting and hospitals ramping up services, homes were told they can't rely on this again.
8/10
It really feels as if we're abandoning #LTC homes all over again.
Canada had the national shame of having the highest proportion of #COVID19 deaths occurring in #LTC homes: https://ltccovid.org/wp-content/uploads/2020/06/Mortality-associated-with-COVID-among-people-who-use-long-term-care-26-June-1.pdf
This tragedy "must not be allowed to happen again": https://www.cmaj.ca/content/192/23/E632
9/10
Canada had the national shame of having the highest proportion of #COVID19 deaths occurring in #LTC homes: https://ltccovid.org/wp-content/uploads/2020/06/Mortality-associated-with-COVID-among-people-who-use-long-term-care-26-June-1.pdf
This tragedy "must not be allowed to happen again": https://www.cmaj.ca/content/192/23/E632
9/10
We need immediate action to support the #LTC sector.
As @DorisGrinspun says “I basically am afraid we will finish a whole generation of seniors in nursing homes if we don’t do something fast...it will be one tragedy on top of another tragedy": https://www.thespec.com/news/hamilton-region/2020/09/08/is-ontario-ready-for-a-second-wave-of-covid-19.html
END
10/10
As @DorisGrinspun says “I basically am afraid we will finish a whole generation of seniors in nursing homes if we don’t do something fast...it will be one tragedy on top of another tragedy": https://www.thespec.com/news/hamilton-region/2020/09/08/is-ontario-ready-for-a-second-wave-of-covid-19.html
END
10/10
