CANADA
Deaths From COVID-19 In Long-Term Care Homes Will Rise, Even As Cases Slow: Theresa Tam

The federal government has released non-binding guidelines for all care homes in the country.

NON BINDING WELL THAT'S AS EFFECTIVE AS SELF
REGULATION
Laura Osman Canadian Press

ADRIAN WYLD/CPChief Public Health Officer Theresa Tam responds to a question during a news conference in Ottawa on April 13, 2020.

OTTAWA — The number of deaths in long-term care facilities is expected to keep rising, even as the growth of overall COVID-19 cases begins to slow, Canada’s top public health official warned Monday.

Dr. Theresa Tam, the chief public health officer, said the spread of the virus in nursing and retirement homes has been at the root of half of the more than 700 deaths across the country.

“Even as the numbers of cases slows down the number of deaths, unfortunately, are expected to increase,” Tam said at a media briefing in Ottawa.

Last week the federal government released its projected trajectory for the outbreak. The total number of deaths projected in Canada — between 4,400 and 44,000 in the best-case scenario — was based on a fatality rate of 1.1 per cent.

On Monday, Tam said that fatality rate is expected to rise given the outbreaks in long-term care homes across the country.

The news follows a gruesome weekend discovery in a private long-term care home in Dorval, Que., where police are investigating the deaths of 31 people since March 13. Five of the deaths have been definitively linked to COVID-19.

Quebec Premier Francois Legault alleged there was “gross negligence,” at Residence Herron.

But Quebec is not alone in its struggle to contain cases in seniors’ and long-term care homes, Tam said.

“Almost all jurisdictions are essentially trying to deal with the outbreaks at long-term care facilities,” she said. “That’s really across the board.”

Twenty-nine residents in a 65-bed nursing home in Bobcaygeon, Ont., have died amid the pandemic. Eighteen deaths at North Vancouver’s Lynn Valley Care Centre have been attributed to COVID-19. Other facilities from coast to coast have had outbreaks and in many cases numerous workers have been sickened as well.

While provinces and territories are ultimately responsible for their own public health response to the pandemic, federal Seniors Minister Deb Schulte highlighted new federal guidelines for all care homes in the country to try to stall the spread of the virus in other facilities that care for vulnerable people.

Coroner Investigating 31 Deaths At Residence Herron Quebec Seniors' Home

Premier Francois Legault said at least five deaths were linked to the coronavirus.


Morgan Lowrie Canadian PressNEWS
04/12/2020

MONTREAL — The Quebec coroner’s office announced Sunday it will investigate the deaths of dozens of seniors at a private long-term care facility west of Montreal linked to what Premier Francois Legault has described as a possible case of “gross negligence.”

The office said in a statement that it will probe the circumstances surrounding the deaths and issue recommendations if needed.

“Remember that coroners intervene in cases of deaths that are violent, obscure or could have occurred following negligence,” the coroner’s office said in a statement.

A police investigation was launched over the weekend after regional health authorities were able to access patient files at the Residence Herron and found that 31 of the residence’s 150 or so seniors had died since March 13. Quebec’s health department is also investigating.

THE CANADIAN PRESS Quebec Premier Francois Legault coughs into his hand as he speaks at a news conference on the COVID-19 pandemic on Saturday.
Legault said at least five of the deaths were due to COVID-19, but that number could rise.

“Quite honestly, I think ... there was gross negligence at Residence Herron,” Legault said on Saturday.

The authorities first inspected Residence Herron on March 29, three days after word of the first death. They found the residence “deserted” as staff had walked off the job.

Lynne McVey, head of the health board, has said her team began assisting the short-staffed workers to feed, wash and change patients, but only learned the full scope of the problem after getting a legal order allowing them to view families’ contact information and patient medical files.
Residences linked to large portion of COVID-19 deaths

Katasa Groupe, which owns the residence and several others, has not answered requests for comment, and the home is now under government trusteeship.

The Residence Herron story is only the latest report into troubling conditions at seniors’ and long-term care homes, which have been linked to a large percentage of the country’s COVID-19 deaths.

That includes another residence in Laval, north of Montreal, where 21 people have died and 115 have tested positive for COVID-19.

The coroner’s office said in its statement that it is not currently investigating other homes, but is watching the situation and could intervene if needed.

In a statement on Sunday, the provincial health department confirmed it would proceed to inspect all the province’s 40 private long-term care centres in the coming days.

“Every effort is being made to protect seniors and avoid tragic situations such as the one observed in the Herron private residential and long-term care centre that is not covered by an agreement,” the statement said.

Dr. Theresa Tam, Canada’s chief public health officer, on Sunday lamented the deaths that COVID-19 has caused in long-term care facilities across the country, which she described in a statement as a “tragic legacy of this pandemic.”

“These heart-breaking events underscored the need for stringent infection prevention and control measures and led to the development of infection prevention and control guidance for long-term care homes,” she added.

That guidance includes strict rules around who can enter such facilities and detailed instructions on how to minimize the chances of an outbreak through proper hygiene and screening.

The Quebec ombudsman launched an investigation into the Residence Herron in 2017 after it received complaints including inadequate nursing care, a poor approach towards patients with cognitive difficulties, complaints over food and a lack communication with families.

The investigation found that the facility was providing adequate care, but the ombudsman cautioned in its report that management needed to ensure there was enough suitably-trained staff, given its intention to increase its number of patients.

In 2019, an inspection by Health and Social Services did not note any particular problems with clinical practices, but issued recommendations including the development of a policy to combat mistreatment, as well as improved communications with residents and their families, particularly in the areas of residents’ rights, end-of-life decisions and palliative care.

This report by The Canadian Press was first published April 12, 2020

With files from Lee Berthiaume