Here are the B.C. seniors' residences hardest hit by COVID-19 outbreaks

There are 21 seniors' residences in B.C. where more than 40 per cent of residents were infected with COVID-19, including four homes where more than a third of residents have died. 

Some ranked among the lowest in B.C. in terms of the hours of care the provincial government funded them to provide in 2020.

While some seniors homes have faced intense scrutiny from families and media reports, several facility outbreaks where over 70 per cent of residents contracted the virus have not been widely reported.

For two months last spring, family members watched in anguish as 53 seniors at the Lynn Valley Care Centre in North Vancouver became infected, just over a quarter of the facility's residents. Twenty of them eventually died from their illness, including the first Canadian to die of causes related to COVID-19. 

Ten months later, the Lynn Valley outbreak doesn't even appear in a list of the 21 hardest-hit homes in B.C.

A deadly second wave

While deaths in Ontario and Quebec care homes made headlines during the first wave, B.C. saw deaths in care more than triple during its second wave.

"I think the second wave for British Columbia was horrific compared, for example, to Ontario and Quebec, which had horrific first waves," said B.C. seniors advocate Isobel Mackenzie. 

The pandemic claimed 174 lives in B.C. care homes between March 9 and Oct. 19 of last year at which time Provincial Health Officer Dr. Bonnie Henry declared the second wave had begun.

During the second wave so far in B.C., 652 seniors in care homes have died, bringing the province's deaths in care to 826 out of a total of 1,240 people who have died.

Fewer hours of care in hardest-hit homes

In the year leading up to the pandemic, only five out of the 21 facilities identified by CBC received enough funding to meet the Ministry of Health's staffing guideline of at least 3.36 direct hours of care per resident per day. Of those 21, two are completely private  — and therefore do not receive public funding  —  and four are operated by their respective health authorities.

The funding care homes receive from the provincial government is based on a formula that takes into account the cost of delivering care and the number of beds at a facility.

Health Minister Adrian Dix told CBC that since March, 13 of the facilities have been funded above the 3.36-hour threshold and the remaining six are funded above three direct care hours.

"This was a major initiative of the government, partly because of past seniors' advocate reports, which identified care standards and the overwhelming majority of contracting facilities which were funded below what our standard is."

Dix doesn't believe fewer care hours explains why some outbreaks were more widespread.

"Some of the care homes that are the highest funded in terms of care hours have also had significant outbreaks," he said. "Drawing conclusions from a single set of facts doesn't tell the whole story."

Mackenzie says the number of care hours facilities were funded to provide doesn't necessarily represent the care hours that were delivered.

"We found that the not-for-profits directed more of their funding toward care," she explained. "They tended to, on average, pay staff higher wages and benefits. They had a higher cost per hour worked, and they tended to deliver on average more hours of care than they were funded to deliver."

Varying levels of care 

Across facilities experiencing major outbreaks, families had differing perspectives about the care their loved ones received.

Lisa Spetch says she was confident in the care her mother received at Jubilee Lodge in Prince George when she became infected during an outbreak in December.

"They had moved in and segregated the COVID patients from other non-COVID patients and they said she was resting comfortably and watching TV and needed a minimum amount of oxygen," Spetch said. "She looked sick, but she didn't look bad. She was sitting up in bed and she made it. She tested COVID-free."

However, Monica Rogers, whose mother died at Little Mountain Place in Vancouver shortly before an outbreak was declared in November, says her care was still impacted by the pandemic.

"As her needs changed, her level of care did not change commensurate with her needs," said Rogers. "I have no doubt about the intention of the staff that were there to do a good job to provide loving care. But I have every concern that they did not have the time and resources to do what they knew to be a good job."

Facility design at play, says operator

Facility operators and health officials have pointed to a number of factors to explain why some outbreaks were so widespread, including access to PPE, staffing levels and how strictly infection protocols were followed by staff.

In a statement, a Fraser Health spokesperson said "it is not always possible to isolate the exact cause of virus transmission" and that by the time a resident has tested positive for COVID-19, transmission may already have occurred in the facility.

CBC has reached out to a number of the facilities with the worst outbreaks and only one operator responded. 

"If one thing could be changed, it would be the design of homes like Tabor Home where 70 people live in one long hallway, one long area," said executive director Dan Levitt. "It's very difficult to contain that area, to prevent spread of infections."

Long-term impacts on homes

Mackenzie says it's too early to tell the full impact of these outbreaks. 

"I think the care homes that experienced an outbreak have been absolutely impacted in a way that many of them may not realize or recognize right now. Sometimes it takes time for the magnitude of things to sink in in the totality of the experience to really weigh on a person."

Methodology

CBC News examined Ministry of Health outbreak data from long-term care, assisted living and independent living facilities between the start of the pandemic in March 2020 and Jan. 27, 2021. This included 218 outbreaks at 155 facilities. We cross-referenced it with data from the Office of the Seniors Advocate on long-term care facilities, which contains the number of beds for all long-term care facilities in B.C. that receive public funding, current as of March 31, 2020. 

Data for facilities where 54 outbreaks occurred is not included in the Office of the Seniors Advocate data because they are classified as assisted or independent living and do not receive public funding. CBC News obtained figures for the number of beds or units in these facilities either from Ministry of Health listings or the websites of the facilities.

Infection rates per outbreak (not per facility) were calculated by dividing the number of residents infected by the number of beds or units. Death rates were calculated by dividing the number of resident deaths by the number of beds or units.

The infection and death rates reported in this story represent an estimate because in most cases the bed count is current as of March 31, 2020, and the number of beds can fluctuate. This methodology underestimates infection rates in facilities that are not at capacity. It overestimates infection rates in assisted or independent-living facilities where there is more than one person per unit, such as couples sharing a suite.