Staffing shortages key concern as Alberta's continuing care homes battle 5th wave

Alberta's fifth wave is driving yet another rapid surge of COVID-19 outbreaks in continuing care homes.

Data provided to CBC News by Alberta Health late Thursday shows there are 222 open outbreaks in long-term care and supportive living facilities in the province. Those involve 2,250 active cases in residents and staff. 

The active case numbers are higher than any previous wave of the pandemic. At the peak of the devastating second wave a year ago, there were 232 outbreaks involving 1,331 active cases. 

"We still need to be diligent and wrestle this thing to the ground," said Wayne Morishita, executive director of the Alberta Continuing Care Association, who's been watching as the highly transmissible Omicron variant drives outbreak numbers sky high.

According to Morishita, roughly two-thirds of the current cases are staff and the rest are residents. As of Tuesday, when he was last updated by Alberta Health Services, he said 60 Alberta care home residents were hospitalized, with one in intensive care.

"What we've seen across the country — and in Alberta as well — is just an explosive growth in the number of continuing care environments that are actually experiencing outbreaks just because Omicron is that contagious," said Dr. Samir Sinha, the director of geriatrics at Sinai Health and the University Health Network in Toronto.

"And as it spreads widely in the community, it's only a matter of time before it gets into the home via people coming into the home, like workers or potentially visitors as well."

Milder illness, less deadly

But this wave is playing out differently than earlier surges, according to Sinha, who has been tracking these outbreaks throughout the pandemic.

"While we're seeing an unprecedented number of homes in outbreak, we're seeing an unprecedented number of cases overall. What we aren't seeing is a significant rise in the death rate. And that really reflects the success of vaccines in this population," said Sinha.

According to Alberta Health, there have been three deaths connected to care home outbreaks so far during this wave. During the fourth wave, there were 153 deaths, and the during the second wave (from December 2020 to January 2021), there were 1,042 deaths.

"While Omicron is causing a rapid increase in cases in continuing care in parallel with spread in the wider community, deaths in continuing care have fallen dramatically, showing the remarkable effect of vaccines in reducing the severity of cases," a government spokesperson said in an email to CBC News.

Albertans in continuing care became eligible for third doses of the COVID-19 vaccine in September, and, according to Morishita, the vast majority of them have received their third doses.

Staffing shortages

The key concern during the Omicron-driven wave is staffing shortages due to so many workers in isolation, according to Sinha.

"We're more concerned that the level of isolation and lack of care that residents will experience during this wave is more likely going to cause harm and kill them as opposed to COVID-19 itself," he said.

It's a worry echoed by families with loved ones in these homes.

"We're still allowed to come visit, which is nice and I think essential for their mental health and well-being," said Nina Vaughan. Her mother Dorothy, 83, lives in the McKenzie Towne retirement residence.

Vaughan is concerned about staffing levels.

"They're short. So things like the amount of showers or baths that a resident might get are reduced. Or the staff aren't getting any breaks. So you can really see the fatigue setting in with them. So that's worrisome for their mental health, too."

Vaughan said she is confident her mother is receiving good care at the moment. 

"But if the numbers of staff out sick increase exponentially like the virus is, then I think we're going to be in trouble here pretty quick."

Morishita agrees.

"Even though from a severe outcome standpoint, that may not be a driving force, just overall care — the quality of care within our sites — could come under additional stress if staffing is dramatically decreased," he said.

Preserving staffing and maintaining care are a key focus for Mike Conroy, president and CEO of the Brenda Strafford Foundation, which operates five care homes in the Calgary area. All of them are experiencing outbreaks.

Both residents and staff, he said, are experiencing milder symptoms with Omicron.

"We've had over 80 staff that have tested positive [during this wave]. Thankfully, over 60 have recovered and now returned," he said.

Conroy estimates between five and 10 per cent of the workforce in his facilities have been impacted.

"If we have a large number of staff that have to go home regardless of the low level of symptoms, that affects the workforce. So we've tried to be proactive and overhire and overstaff in anticipation," said Conroy.

In addition to regular rapid testing of residents, staff and visitors, at the end of January the organization is bringing in a mandate that all workers must have three doses of the vaccine rather than just two.