"A key issue facing us is ‘why’ has so much been examined and reported on and so little done to fundamentally redesign the system or clarify the continuum of services to support older adults and their families?"
— Long-Term Care and COVID-19: Report of a special task force prepared for the Chief Science Advisor of Canada, April 2020
There have been many failings in Canada’s health systems during the SARS-CoV-2 pandemic, but public data availability is the most intolerable of those deficiencies.
It isn’t news to Canadians that long-term care (LTC) homes were rife with systemic issues related to reduced workforces, or that infectious outbreaks could ravage a care home and kill due to poor infection control.
It certainly didn’t help that in Manitoba, LTC homes were dealing with a lack of personal protective equipment and that many staff were working at multiple care homes where residents lived in multi-bed rooms.
A 74-page report on the external review of the Maples Care Home in Winnipeg points to numerous issues with staffing shortages where — according to that report — staff was below 70 per cent of normal for both nursing and health-care aides.
The report made 17 recommendations. Among those was a call, yet again, for the province to "mandate and fund a provincewide health-care system response for pandemic outbreaks to reduce fragmentation and delays in outbreak response."
Data from May 2020 showed that of Canada’s total COVID-19 deaths the proportion of LTC home deaths was at 62 per cent, and that number rose at one point to above 80 per cent nationwide. The country knew early on that this would be an issue and that residents in LTC were highly vulnerable, yet regardless of this information, provincial health systems chose instead to focus on its hospitals.
And administrative decisions in those hospitals may have exacerbated the LTC home situation by moving many alternate care patients out of hospitals and into long-term care homes. That’s a throwback to pandemic policies put in place when SARS touched down in Canada in 2004, when it was discovered that inadequate masking, gloving and cleaning were the cause of widespread transmission of SARS in hospital settings.
The long-term care system saw thousands leave their jobs during the first wave of the novel coronavirus, and it’s not clear that many returned to jobs within facilities across Canada.
The Manitoba government made a half-hearted attempt to improve staffing for its care homes with its five-day training program for "uncertified care aides." But that, in no way, can meet the needs of such a demanding job that normally is a 32-week college program in some provinces and up to 870 hours of training in others.
It is clear from the past 10 months of the pandemic that reactive government policies don’t solve long-standing issues in the province. The issue of how SARS-CoV-2 would affect LTC homes wasn’t news to our government — this was public knowledge a mere few months into the pandemic.
Reactive policies won’t fix the issues with care homes that have been swept under the rug for decades or help our most vulnerable people. It’s only when the province makes changes to the models we use to care for our elderly that real changes will happen.
And while Health and Seniors Care Minister Heather Stefanson said last Thursday her department is committed to "implementing the recommendations in the review" and will have an implementation team and plan in place within 30 days, it begs the question: why it has taken so many deaths and an external review to elicit a response from Manitoba’s government?
Seniors, those whom the province built itself upon, should not be seen as a commodity to be put into for-profit homes, but as a responsibility of all Manitobans where we ensure appropriate care is given and received.