COVID-19: Comparing mortality rate in long-term care homes in Ontario and British Columbia.

Season's Greetings and Happy New Year (Dr. Noorali Bharwani)
Season's Greetings and Happy New Year (Dr. Noorali Bharwani)

An article in the Canadian Medical Association Journal (CMAJ November 23, 2020 – COVID-19 in long-term care homes in Ontario and British Columbia) compares care and mortality rate in the long-term care institutions in these two provinces.

The article emphasis five important points:

  1. Many more residents living in Ontario long-term care homes have died from coronavirus disease 2019 (COVID-19) than in British Columbia.
  2. Before the pandemic, the long-term care system in British Columbia exhibited a number of potential strengths relevant to pandemic preparedness compared with Ontario. These were:
    • there was better coordination between long-term care, public health and hospitals
    • there was greater funding of long-term care;
    • there was more care hours for residents;
    • fewer shared rooms;
    • more non-profit facility ownership;
    • more comprehensive inspections.
  3. During the first wave of the pandemic, British Columbia was faster than Ontario in responding to COVID-19, with actions to address public health support, staffing, and infection prevention and control.
  4. Leaders in British Columbia were more decisive, coordinated and consistent in their overall communication and response.

People living in long-term care homes in Canada have been far more likely to die of coronavirus disease 2019 than the rest of the population. However, the effect of COVID-19 on residents in long term care has varied across provinces and territories.

The authors of the CMAJ article say, “Our analysis suggests that the difference in outcome has been primarily due to differential risk in residents in long term care acquiring SARS-CoV-2.”

There are many reasons why COVID-19 affected nursing home patients in British Columbia did better than nursing home patients in Ontario. One of the reasons was, nursing home residents in Ontario were more likely to reside in shared rooms (63 per cent of residents) than those in British Columbia (24 per cent).

Overview of Restoring Trust: COVID-19 and The Future of Long-Term Care, is a Policy Briefing Report on Long-Term Care. The report begins by reviewing the research context and policy environment in Canada’s long-term care sector before the arrival of COVID-19. The report makes several suggestions to improve care in nursing homes. I will just mention a few.

  • All long-term care homes must have comprehensive plans for preventing and managing infectious disease outbreaks.
  • Public health units must conduct regular and unannounced inspections.
  • Long term care homes should have adequate personal protective equipment (PPE).
  • Staff at long-term care homes must have the option for full-time work with equitable wages, benefits and pandemic work supports including sick leave and mental health support.

All long-term care homes must have the capacity to isolate residents in the event of an outbreak.

Residents in long-term care homes will always be vulnerable to infectious pathogens. The experience to date suggests that better preparedness and responses could save the lives of thousands of people living in long term care homes in Canada.

The year is coming to an end. Do not forget to use your PPE diligently. Follow the guidelines set by our Chief Medical Officer of Health, Dr. Deena Hinshaw.

Let me wish you all Merry Christmas, Season’s Greetings and Happy New Year. May you all be blesses with good health and happiness. As some body has said, tough times never last but tough people do. Research has shown positive thinkers do better in life. Maybe even as much as 40 per cent of our happiness is due to actions that we control.

Take care. Be safe.

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