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In the last 24 hours, two more Ontario #LTC residents died of #COVID19: https://ottawacitizen.com/news/local-news/two-more-residents-die-in-covid-19-outbreak-at-extendicare-west-end-villa
There remain 22 active Ontario #LTC home outbreaks (see figure).
@ASPphysician has challenged me to say what must be done to get this under control.
Here it is (a thread).
1/8
There remain 22 active Ontario #LTC home outbreaks (see figure).
@ASPphysician has challenged me to say what must be done to get this under control.
Here it is (a thread).
1/8
We need swift action to control community transmission of #COVID19 which is getting out of control.
In our @CMAJ study, the prevalence of #COVID19 in the community surrounding a home was strongly associated with the odds of an outbreak (aOR = 1.91): https://www.cmaj.ca/content/192/33/E946
2/8
In our @CMAJ study, the prevalence of #COVID19 in the community surrounding a home was strongly associated with the odds of an outbreak (aOR = 1.91): https://www.cmaj.ca/content/192/33/E946
2/8
Controlling community transmission is imperative, as staff neighborhood characteristics are also significant predictors of outbreaks: https://www.medrxiv.org/content/medrxiv/early/2020/09/11/2020.09.10.20192203.full.pdf
As @DFisman showed, lagged staff infections were associated with death among #LTC residents: https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2768539
3/8
As @DFisman showed, lagged staff infections were associated with death among #LTC residents: https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2768539
3/8
The #LTC staffing study ( https://www.ontario.ca/page/long-term-care-staffing-study) and the @RSCTheAcademies report ( https://rsc-src.ca/en/restoring-trust-covid-19-and-future-long-term-care) emphasized the need to address the staffing crisis and make #LTC a better place to work.
Ontario's pandemic pay has dried up and staffing remains very precarious.
4/8
Ontario's pandemic pay has dried up and staffing remains very precarious.
4/8
Immediate action is needed to:
1. Increase basic staffing levels: https://rnao.ca/news/rnao-responds-long-term-care-staffing-study-report
2. Ensure full-time work with fair pay and benefits—part-time staff can still work at multiple homes within a 14-day period.
3. Create accelerated training programs for PSWs (like QC).
5/8
1. Increase basic staffing levels: https://rnao.ca/news/rnao-responds-long-term-care-staffing-study-report
2. Ensure full-time work with fair pay and benefits—part-time staff can still work at multiple homes within a 14-day period.
3. Create accelerated training programs for PSWs (like QC).
5/8
There is no clear emergency management plan—the province must:
1. Establish guidelines & expectations for hospital SWAT Teams, and provide the necessary support: https://news.ontario.ca/en/release/56737/ontario-takes-immediate-steps-to-further-protect-long-term-care-residents-and-staff-during-covid-19
2. Develop policies for transferring #LTC residents to hospital: https://advantageontario.informz.ca/advantageontario/data/images/Letter%20on%20Decanting%20to%20Hospitals%20Policy.pdf
6/8
1. Establish guidelines & expectations for hospital SWAT Teams, and provide the necessary support: https://news.ontario.ca/en/release/56737/ontario-takes-immediate-steps-to-further-protect-long-term-care-residents-and-staff-during-covid-19
2. Develop policies for transferring #LTC residents to hospital: https://advantageontario.informz.ca/advantageontario/data/images/Letter%20on%20Decanting%20to%20Hospitals%20Policy.pdf
6/8
There is also no emergency workforce, and #LTC homes have been told they cannot rely on hospitals during this second wave (see enclosed letter).
The province must establish an emergency workforce—organizations like the @redcrosscanada could assist: https://www.redcross.ca/about-us/media-news/news-releases/red-cross-recruits-1-000-canadians-to-join-its-humanitarian-workforce-in-long-term-care-homes-in-que
7/8
The province must establish an emergency workforce—organizations like the @redcrosscanada could assist: https://www.redcross.ca/about-us/media-news/news-releases/red-cross-recruits-1-000-canadians-to-join-its-humanitarian-workforce-in-long-term-care-homes-in-que
7/8
Ontario's "identifiable lives bias" focused its initial pandemic response on acute & critical care to the exclusion of #LTC: https://jamanetwork.com/journals/jama/fullarticle/2767950
The current focus is similarly myopic with all attention on issues like back-to-school. We must act now to avoid catastrophe.
8/8
The current focus is similarly myopic with all attention on issues like back-to-school. We must act now to avoid catastrophe.
8/8
