Canada’s COVID-19 death rate in long-term care homes more than double OECD average … solutions seem obvious, and it will be costly

Devine musings

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Perhaps the biggest surprise about the number of COVID-19 deaths in Canada’s long-term care (LTC) homes is that people are surprised at all. After all, we’ve known about the troubles in that sector for a very long time.
Here’s a number that tells a stark tale. According to an analysis by the Canadian Institute for Health Information, more than 80 per cent of all COVID-connected deaths in Canada occurred in long-term care facilities. That’s almost double the average found in other OECD (Organization for Economic Cooperation and Development) countries, where the average COVID death rate in LTC homes was 42 per cent.
Premier Doug Ford announced this week the creation of a commission to investigate how the virus spread through long-term care homes, and what can be done to fix the problems by the time the next virus comes calling. All good and fine, but as said it’s not as if this should come as a surprise to anyone.
We have all read the stories about residents being left unattended due to a range of issues, including overcrowding and inadequate staffing. If we really want to fix the problems and give residents the safe and dignified life we all say they deserve, we should start with those two areas.
Here are some terms that are being applied to the reopening of workplaces and schools that could also work in long-term care homes.
• Density: This refers to the number of people gathering in a limited space, like a shared room or cafeteria. The more people gathered in close proximity, the more likely it is for a virus to spread.
• Geometry: In a post-COVID-19 world, consideration will have to be given as to how furniture is laid out, to minimize contact and adhere to distancing protocols.
• Division: This is about installing screens, panels, and barriers designed to enhance safety to achieve minimum distancing requirements.
When the commission has done its work and filed its report, expected next April, it would be surprising if it didn’t offer these solutions and others, that include:
• Reduce or eliminate overcrowding in rooms and common areas. Residents should have their own rooms, complete with washrooms, showers, and other basic amenities. If they did and got sick, then the ability to isolate them in their own room, while providing care, would minimize the risk of a virus being spread. It’s also more dignified.
• Increase wages for nurses and other staff. The practice of staff working in various homes has been pegged as a significant contributor to the spread of the virus. Pay people enough so that they don’t have to work for more than one facility.
• Regardless of whether homes are operating privately or publicly, they should have to meet strong quality-of-care standards. Also, they should be subject to a rigorous inspection protocol, which likely means hiring more inspectors.
• Maintaining people in their own homes as long as possible is another direction we need to take more seriously.
All of this, of course, will cost money, perhaps a lot of money. Currently, if you have the financial resources, you can and do get the treatment and dignity money can afford. If we are serious about solving the problems that COVID-19 has exposed, it will mean raising standards for seniors who perhaps can’t afford the best.
That’s not to say it should be a free ride, but perhaps fees could be tied to income, say 80 per cent of available monthly income with an upper cap limit. Generally speaking, and from my perspective, the solution would seem to involve bringing standards and quality of care closer to what can be found in the very best of the long-term care home sector.