Winnipeg health authority needs to step in at Parkview Place, as outbreak leads to 22 deaths: geriatric expert

An expert in geriatric medicine says staff from the Winnipeg Regional Health Authority need to be called in to deal with Manitoba's worst COVID-19 outbreak in a care home — followed by the military, if need be, to stop the rise in infections at Parkview Place.

"We've seen this scenario play out repeatedly, where homes have been struggling and where homes have waited too long to get the help they need from external resources like the military or from hospital partners," said Dr. Samir Sinha, director of geriatrics at Mount Sinai Hospital in Toronto.

"This is a home that is in crisis … that needs to have all the support it can, because at the end of the day, we're now left with dozens of residents who've been infected and close to two dozen who've died."

On Friday, the province announced the deaths of three more Parkview Place residents from COVID-19, bringing the death toll in the outbreak at the Winnipeg care home to 22. To date, 106 residents and 32 staff have been infected.

Parkview has been plagued by infection control problems and staffing shortages for years, according to inspection reports.

A mid-October surprise inspection by the Winnipeg Regional Health Authority revealed the care home requires 40 additional health care aides and 20 extra nurses. Revera, the for-profit company that owns the home, said it recently added 11 staff. 

Family members of residents have witnessed other residents moving around the home, despite assurances by Revera that residents are isolating in their rooms.

On Oct. 8, Dr. Rhonda Collins, Revera's chief medical officer, said as of that date, residents on all floors were required to isolate in their rooms.

"Residents who have tested positive are being cohorted on two floors, to reduce the risk of spreading the virus," she said.

CBC News learned of an incident on Tuesday where a COVID-positive resident was talking to residents who didn't have the illness.

This follows at least two other examples where visiting family members saw residents failing to abide by isolation requirements Revera said were in place.

Sinha, who is also an assistant professor at the University of Toronto and the Johns Hopkins University School of Medicine and has been following the reports about Parkview, says these sorts of incidents show the need for additional staffing in these homes. 

"In this case, not keeping people isolated from each other can actually result in people becoming infected and actually dying," said Sinha.

On Monday, the WRHA's chief health operations officer, Gina Trinidad, revealed there are COVID infections on virtually all floors of the 12-storey care home, despite early efforts cohort residents to two floors.

"People with dementia … often wander out into the hallways," said Trinidad.

The home is using "supplemental staff or supporting staff, through the security and general workers," to keep residents in their rooms as much as possible, she said, "but it is a challenge."

Revera did not directly respond to the incident where the COVID-positive resident was mingling with COVID-negative residents, but did outline some of the measures it is taking to prevent residents from spreading the virus. 

"For safety purposes, Revera continues to engage security personnel on each floor to monitor resident movements and redirect wandering residents to their rooms. Security personnel are also assigned one-on-one duty to keep wandering residents isolated, if necessary," Collins said in an emailed statement. 

"Personal care homes are social environments in which residents have rights."

At a Friday news conference announcing new pandemic restrictions across Manitoba, Chief Public Health Officer Dr. Brent Roussin said he did not know the specifics of the Parkview incident involving the infected resident talking to non-infected residents.

He did say all people with COVID need to self-isolate for at least 10 days. If isolation precautions are followed, "we'll be able to manage this virus," he said.

Manitoba Health Minister Cameron Friesen addressed questions about sending in extra help on Tuesday. He said many additional resources have been added that "were not there even weeks ago."

Last week, a doctor attended the care home for in-person consultations for the first time since the Parkview outbreak was declared on Sept. 15, and a full-time nurse practitioner started a new position there on Monday.

"It's all hands on deck and nothing's off the table," said Friesen, who receives daily status updates about Parkview.  

"If it would be presented as evidence that somehow the operator was no longer able to operate safely and in the best interest of the residents, then that would be the point at which we would be flexing to other plans. But of course, we are not at that stage."

But Sinha says Parkview would have been in a much better position if they just asked for help right at the beginning of the outbreak, which is now into its sixth week.  

"I just really feel that so many of these deaths and so many of these cases were just preventable right from the beginning," he said.

"Calling in for additional help is not a sign of weakness. It's a sign that they really value their residents. They want to do everything they can to protect them and do whatever is possible."

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