Report on COVID-19 impact on B.C. care homes calls for greater gov't oversight of sector

A report on the impact of COVID-19 on B.C.'s long term care homes calls for greater government oversight of a sector that contains both privately run businesses and homes operated by health authorities.

The firm Ernst & Young was hired to put the report together in the summer of 2020.

Although the report notes that B.C.'s long term care homes have weathered the storm of the pandemic better than in many other jurisdictions, it makes 14 short-term and five long-term recommendations for a sector that has seen a much higher death rate overall than in the general public.

The report found that policy directives could be "confusing, inconsistent, or lacking in detail" and that a "lack of clarity on oversight and access to supplies in unique circumstances" left private operators scrambling to find the personal protective equipment that was in low supply at the start if the pandemic.

Among the recommendations are a call for a way to ensure that short term decisions can be made while ensuring accountability up the chain of ministerial command, the need for clearly outlined policies to provide financial support to operators, improved pandemic response communication and the need for better data collection.

A need to 'assess and incorporate lessons'

The report praises a decision restricting care home employees to working at a single site only and says the government needs to focus audits of homes on pandemic control and outbreak preparedness. The report also says B.C. needs to address critical staff shortages and high turnover rates in the sector.

"B.C.'s health system needs to assess and incorporate lessons learned as we prepare for additional pressure on health services over the fall and winter months," the report says.

"B.C. has been actively responding to COVID-19, but it is important to comprehensively evaluate how these lessons learned should be implemented in a consistent, equitable and timely manner.

The report focuses on how COVID-19 outbreaks were handled at care homes, and how the virus was able to spread at different facilities. 

In B.C., roughly two-thirds of COVID-19 deaths are linked to long-term care homes.

Questions over why report wasn't released sooner

Participating organizations have voiced their concern about why the Ministry of Health did not make the independent report public earlier, as B.C. deals with a second wave of COVID-19 infections.

"We were approached back in July," said SafeCareBC CEO Jennifer Lyle.

The report has been complete since October.

Shirley Bond, interim leader of the B.C. Liberal Party as well as the critic for seniors services and long term care, said transparency is critical.

"If a government can sit on a report for three months when we're losing lives in long-term care and if any single one of these recommendations could improve the circumstances of people who live in long-term care, of course it should have been made public," said Bond on CBC's On The Coast.

"There should have been more transparency and if the government had done all the work it said it needed to do, it shouldn't have been worried about releasing the report."

'I apologize': Health Minister

Health Minister Adrian Dix said Monday that the report was not released earlier because people working in the area of expertise are "working their guts out." He said he only learned about the report 10 days ago, but took responsibility for the delayed release.

"The report should have been released earlier," Dix said.

"I apologize. In terms of frustrations people may feel about that, put it in context. When you read the report you'll see action has been taken on that."

The report was commissioned by the Health Services Division of the ministry.

Dix, speaking Monday on CBC's The Early Edition, said the government had the report in the fall and did not release it earlier because "people were incredibly busy."

"They got the report and they took it and they started to make the changes that were required ... it was about due diligence," said Dix. 

He said the ministry takes responsibility for not releasing it sooner.

Rapid testing concerns

Terry Lake, CEO of the B.C. Care Providers Association and a former health minister with the B.C. Liberal Party, said interviews for the report were done with the board chair, the acting CEO at the time, and long-term care home operators that are members of the association.

He said their biggest concerns were about a lack of rapid testing being done on people working at long-term care facilities.

"We don't need to test every worker, only those that are not vaccinated ... I think it would be an effective way to make sure that asymptomatic or pre-symptomatic workers are not coming in and starting an outbreak," Lake said Monday on The Early Edition.

B.C.'s seniors' advocate, Isobel Mackenzie, said in January that her office, too, is reviewing care homes. That report is expected to include facilities that experienced major, fatal outbreaks such as Little Mountain Place in Vancouver, Tabor Village in Abbotsford, Lynn Valley Care Centre in North Vancouver and Langley Lodge.