Seniors Advocate examines Covid-19 epidemic in nursing homes


BC Seniors Advocate is offering a review of Covid-19 outbreaks in long-term care homes during Wave 1 and Wave 2.

When proposing a review of Covid-19 outbreaks in long-term care homes and assisted living facilities in British Columbia, senior lawyer Isobel Mackenzie included factors such as what contributed to the outbreaks during the first and second waves while examining how to minimize the number of staff and residents who would be infected in the event of an outbreak.

By examining 365 homes at 210 sites from March 1, 2020 to February 28, 2021, it was discovered:

84 percent of outbreaks occurred at sites in the Lower Mainland

72 percent of outbreaks were contained in four cases or less

75 percent of outbreaks have had no deaths from COVID-19 with an overall case fatality rate of 30 percent

87 percent of outbreaks occurred during wave 2 (September 2020 to February 2021)

“We’ve seen how quickly COVID-19 can spread in long-term care and assisted-living facilities, and we’ve seen the devastating impact this virus has on the older population,” Mackenzie said. “Even with everyone’s best efforts, we have tragically lost over 800 residents to COVID-19. It’s not just a bunch of numbers, it’s people. Residents and their families have seen their lives turned upside down by the trauma of living in long-term care and assisted living facilities during a pandemic, and those who operate and work in these care homes have been deeply affected by experience. “

The data collected was used to examine the physical characteristics of each site, the specific characteristics of its residents and staff, and the specifics of each outbreak in order to identify factors that may have contributed to the onset and / or the spread of an epidemic to more staff and residents.

In most outbreaks (76%), the first case of COVID-19 was a staff member. In 22% of the outbreaks, a resident was the first case and there was only one outbreak where the first confirmed case was a visitor.

The report identifies that one site was more likely to have a large outbreak:

If the first case was a resident (four times more likely)

If the first case was a night worker (five times more likely)

If the first case was a registered nurse or a licensed practical nurse (1.5 times more likely)

The report also identifies that prompt notification of the first case and testing staff within the first 48 hours were more likely to contain an outbreak and 40% of outbreaks that did not test all staff by day four turned into outbreaks. more important.

The review analyzed the most common factors in larger outbreaks and found:

Sites that offered fewer days of paid sick leave were more likely to experience larger outbreaks (while almost all sites offer paid sick leave to staff, the number of days ranged from 2.5 to 18 days per year)

Sites with lower levels of RNs as a proportion of direct care hours were more likely to experience large outbreaks

Sites that had shared rooms were more likely to experience a larger outbreak

Overall, the likelihood of experiencing an outbreak (defined as a positive test case among staff or residents) was most closely associated with the level of local community transmission of COVID-19.

The review included comments from more than 6,500 staff who said they feared infecting residents and their own families, and reported that their overall health and well-being was in jeopardy. through the experience of working during the pandemic. Overtime was up 63 percent, with sites that experienced a major outbreak increasing overtime by 178 percent. A total of 2.3 million overtime hours were worked during the year.

In addition, site operators have experienced significant increases in the workload associated with managing staff, residents’ families, supplies and health authority officials.

The review found that British Columbia outperformed Ontario at wave 1 – likely due to both lower rates of community transmission and early protective measures taken in long-term care and assisted living facilities in British Columbia. Ontario adopted the same measures as British Columbia, the percentage of all COVID-19 cases in long-term care was the same for both provinces.

The report includes seven recommendations:

1. Increase paid sick leave for staff

2. Increase the pool of direct care personnel

3. Reduce contracts for direct care staff

4. Increase the levels of RN staff as a proportion of direct care staff

5. Increase the scope, speed and frequency of testing

6. Eliminate shared rooms

7. Require long-term care staff to be vaccinated and provide reminders to residents

The results of the report show:

210 sites have experienced a COVID-19 outbreak

48 percent of sites have experienced more than one outbreak

Out of 365 households:

87 percent occurred in long-term care facilities (98 percent of large outbreaks) and 13 percent in assisted living facilities

32 percent of outbreaks included both resident and staff cases

64 percent were staff-only cases and four percent were resident-only cases

26 days was the average duration of an outbreak with a range of six days to 107 days

55% of sites only experienced a small outbreak

The full report is available on Seniors Advocate report.


Comments are closed.