Long-term care deaths expected to rise as growth of total cases slows: Tam

The number of deaths in long-term care facilities isexpected to keep rising, even as the growth of overall COVID-19cases begins to slow, Canada's top public health official warnedMonday.

Dr. Theresa Tam, the chief public health officer, said the spreadof the virus in nursing and retirement homes has been at the root ofhalf of the more than 700 deaths across the country.

"Even as the numbers of cases slows down the number of deaths,unfortunately, are expected to increase," Tam said at a mediabriefing in Ottawa.

Last week the federal government released its projectedtrajectory for the outbreak. The total number of deaths projected in
Canada between 4,400 and 44,000 in the best-case scenario wasbased on a fatality rate of 1.1 per cent.

On Monday, Tam said that fatality rate is expected to rise giventhe outbreaks in long-term care homes across the country.The news follows a gruesome weekend discovery in a privatelong-term care home in Dorval, Que., where police areinvestigatingthe deaths of 31 people since March 13. Five of the deaths have beendefinitively linked to COVID-19.

Quebec Premier Francois Legault alleged there was "grossnegligence," at Residence Herron.But Quebec is not alone in its struggle to contain cases inseniors' and long-term care homes, Tam said.

"Almost all jurisdictions are essentially trying to deal withthe outbreaks at long-term care facilities," she said. "That'sreally across the board."

Twenty-nine residents in a 65-bed nursing home in Bobcaygeon,Ont., have died amid the pandemic. Eighteen deaths at NorthVancouver's Lynn Valley Care Centre have been attributed toCOVID-19. Other facilities from coast to coast have had outbreaksand in many cases numerous workers have been sickened as well.

While provinces and territories are ultimately responsible fortheir own public health response to the pandemic, federal SeniorsMinister Deb Schulte highlighted new federal guidelines for all carehomes in the country to try to stall the spread of the virus inother facilities that care for vulnerable people.

New federal guidelines

She said long-term care homes are at particular risk, not onlybecause of the older populations they serve, but also communalliving spaces and the number of people who come and go.

Residents are exposed to visitors and health-care workers whotravel from facility to facility in some cases.

"Providing consistent guidance for long-term care homes acrossthe country will save lives," Schulte said Monday.The non-mandatory guidelines, developed in tandem with provincialand territorial health authorities, lay out how those risks can bemitigated.

The suggestions include limiting visitors, screening workers atthe beginning of each shift and screening residents daily.They also suggest limiting the number of homes workers serve tojust one, where possible.

Increasing funding

Some provinces, including Ontario, have already institutedsimilar measures. Ontario has so far reported outbreaks in 89 carehomes, leading to 120 deaths as of Sunday.

Premier Doug Ford said he knows from experience how difficult therestrictions on family visits can be, but said they arenecessary.Ford's mother-in-law is in a long-term care home, and Ford saidit is heartbreaking to watch his wife, Karla,stand outside intears.

"It's very, very difficult for families right now. Verydifficult. Especially when you want to help a loved one," Ford said
Monday."It's heart-wrenching, but we have to rely on our medicalprofessionals."

As for why federal guidelines are being released weeks after thefirst long-term care home outbreak was reported in British Columbiain early March, Tam said it took time to draw on the expertiseneeded to draft them.

She said the guidelines are the result of expert input fromlong-term care workers, infection-control experts, lessons learnedfrom provincial health authorities, and recently accepted evidenceabout asymptomatic transmission.

Those guidelines are likely to change as the epidemic continuesto unfold in Canada, she said.Meanwhile provinces are "stepping up" to support long-term carehomes and their workers, Schulte said, by providing funds for themto implement better protections against the virus.

She said B.C. has provided $10 million, Quebec has pledged $133million and Ontario has said it will spend $243 million to enhanceinfection-control measures in their respective centres.