Rapid testing will add to strain on long-term care sector, advocates warn

While most long-term care homes in Ontario are pleased that rapid antigen testing is now available, provincial requirements will add pressure to an already distressed sector, according to advocates.

Rapid antigen testing isrelatively accurate, inexpensive and fast to deploy, taking just minutes to get results, according to proponents.For Ontario'slong-term care sector, which has seen more than 3,700 deaths since the pandemic began, preventing the virus from getting in is key, and rapid testing is a step in the right direction.

It's like they're opening up little mini-labs, and then they have to structure the shifts of their staff around the testing.- Lisa Levin, AdvantAge Ontario

"We're happy that there will be rapid testing," said Lisa Levin, CEO of AdvantAgeOntario, which represents non-profit nursing homes in the province. "But it's quite a logistical challenge.... It's like they're opening up little mini-labs, and then they have to structure the shifts of their staff around the testing."

The transition to rapid testingstarts Feb. 16, and by mid-March it will be mandatory for care homes in the province to use the rapid tests for anyone who enters a facilityincluding staff, student placements, volunteers, caregivers, support workers and visitors. For full-time staff, the tests will be administered three times a week, while family caregivers must undergo a testbefore every visit.

That means managers will have tofree up workers to administer the swabs and analyze the results, or hire more staff.

"The catch-22 is that is if you do them three times a week, you're taking away from the absolutely skeleton staffing that nursing homes already have. So it's a very difficult situation, and homes cannot basically afford the time," said Doris Grinspun, CEO of the Registered Nurses' Association of Ontario.

There will also be an added cost. The government plans to reimburse the homes, but Levin said it often takes time for promised money to flow.

Levin said any pushback isn't about the teststhemselves;it's aboutlong-term care workers already at their breaking point.

"This is a sector that's been under siege for a year in terms of COVID,so people are tired, people are burnt out," she said. "They were understaffed before COVID, so having to find the manpower to get this thing going is very challenging."

Particular concern in remote areas

Since the government announced plans to make the rapid testing mandatory, it has heard complaints from advocates and managers. But the ministry is listening, according to Levin, and has made a few concessions to the earlier rules.

She notedthere has been particular concern in rural and remote areas.

"In those parts of Ontario, it's almost impossible to find staff, and so we let the province know that that is just not going to happen, and so they have retracted the requirement there," said Levin.

In a statement, the Ministry of Long-Term Care stands by the rollout, pointing out that"identifying and isolating individuals before they can enter the home is critical."

While the rapid testing rollout is "logistically challenging,"Patrick McCarthy, CEO of OMNI Health Care, which owns several nursing homes, saidthere are also significant benefits.

"While there have been some staffing adjustments required to accommodate the testing, and challenges in terms of additional biowaste collection and disposal, we believe we can overcome the concerns," said McCarthy.

But the head of the nurses' association warned the rollout won't go smoothly everywhere.

"The first thing to fix is the staffing, so if you're asking me, what really is the solution,it's what RNAO has been saying for the last 10 years:put the staffing there, let's not continue to delay the staffing increases that are urgently needed in nursing homes," said Grinspun.