64 COVID-19 outbreaks at long-term care homes as province adjusts to no restrictions

New Brunswick has active COVID-19 outbreaks at 64 long-term care homes, including nursing homes, as the province adjusts to the lifting of mandatory measures earlier this week.

Homes with outbreaks may soon have to foot at least some of the added expenses themselves, a memo from the Department of Social Development indicates.

And that has some operators worried, according to the head of the nursing homes association.

A total of 673 people are infected, figures released by the department Thursday show.

Fifty-one people have died, including 30 at nursing homes, 17 at special care homes and four at memory care homes.

They died some time during the Omicron-fuelled fifth wave, which began in early January, according to department spokesperson Rebecca Howland.

She did not provide any dates, but as of Feb. 11, 19 people had died, which means 32 of the deaths have been in the past five weeks.

New Brunswick lifted all COVID-19 restrictions on Monday, when the emergency order ended.

But long-term care homes continue to follow Public Health guidance "to protect those who are vulnerable to severe illness and hospitalization," the Department of Health has said.

"The facilities have been advised of the policies and protective measures, including the wearing of masks and isolating those who are ill, to address any outbreaks of COVID-19," it said in a news release.

Visitors are required to wear a mask, however, they may remove their mask when in a resident's room at the resident's discretion, according to the release. "The Department of Social Development will continue to ensure that standards and policies are followed through regular inspections," it said.

"Public Health officials understand the facilities will work to establish a balance between ensuring an appropriate level of protection for residents and allowing access to visitors, especially family members."

Howland said outbreaks continue to be under the mandate of Public Health, and it will declare when an outbreak is over. The Department of Social Development is working closely with them, she said.

"The safety of residents in our long-term care homes has always been a priority for us and remains one as we transition to life after the pandemic," Howland said in an emailed statement.

"The Department of Social Development is providing support and working with facilities to regain autonomy. During this transition, facilities will receive the tools they need moving forward.

"The department will continue to cover the costs of emergency cleaning and meals during an outbreak until April 30."

She did not clarify what will occur after that date. But a March 9 memo to nursing homes and other adult residential facilities indicates the situation will be reassessed at that time.

'De-escalating support services'

Social Development is "de-escalating the COVID-19 outbreak service supports" it has been providing during outbreaks, wrote Elizabeth Dubee, assistant deputy minister.

"This does not mean that all outbreak service supports will be removed immediately, rather we will begin the process of phasing out supports and providing long-term care facilities the tools you will need going forward," says the memo btained by CBC News.

The responsibility of cleaning and meal services during an outbreak will be transferred to homes, as of Monday, according to the memo.

"This means that when the [minister of health] declares a COVID-19 outbreak in a facility, the facility will now be responsible for securing and paying for emergency cleaning and meals when all options in your contingency plan have been exhausted resulting in a gap in service."

Social Development will continue to cover the costs of these services, up to certain maximums, until April 30, 2022 through budget amendments or invoicing. Then requirements will be reassessed."

The maximum reimbursable amount for cleaning ranges from $1,664 to $3,328 per day, depending on the size of the facility, for up to seven days, according to the appendix.

The maximum amount for meals is listed as $50 per day per resident, for up to seven days.

'Scrimp and scrounge' to make up for losses

Michael Keating, interim executive director of the New Brunswick Association of Nursing Homes, said the extra costs of an outbreak could add up quickly.

"With this Omicron variant, you could have one day, you know, somebody come and say, 'We're in an outbreak. We have two people.' By the end of the shift, they have six people, the next day they have 12. And within three days you've got 70 per cent of the population that's been affected."

If numerous staff who normally prepare meals fall ill, for example, the homes need to hire outside services, and while cleaning staff have their normal protocols, outbreaks require specialized cleaning for "every single surface."

Keating noted the nursing homes are non-profit. "So if you get a hit at that amount of money without some help, it does have an effect on the entire operation."

In addition, as per the collective agreement, homes must continue to bring in a full complement of scheduled staff to work, even if they have empty beds because of COVID deaths. But they can't bring in new residents to fill the beds during an outbreak, and the province starts cutting back on funding after a bed has been vacant for two days, according to Keating.

"In one home, the costs are well over $50,000 for having to keep employees in place because of the closures and the like. And ultimately, that has an effect on the bottom line," he said.

"Nursing homes end up having then to scrimp and scrounge in other areas to try and make up for these losses."

The current process for the delivery of personal protective equipment and point of care rapid test kits will remain the same as the department works on a transition plan, according to the memo

"An update on other COVID-19 related expenses (i.e. garbage cans, disposable cutlery, etc.) that have been covered by [Social Development] through budget amendments and invoices will be provided soon," it states.

Nursing homes are waiting to hear what the new protocols will be, said Keating.

"You can't really have staff be ordered to be vaccinated and then have visitors not be vaccinated."

Breakdown of outbreaks

Howland declined to release the names or locations of the outbreak facilities, citing confidentiality.

But the majority of the outbreaks, 29, are at special care homes, where 214 residents and 76 staff have tested positive.

Nursing homes account for 20 of the outbreaks, affecting 165 residents and 121 staff.

Nine community residences have outbreaks, with 39 residents and 28 staff infected.

Four of the outbreaks are at memory care homes, where 11 residents and seven staff are ill.

And the other two are at generalist care homes, with a total of nine residents and three staff impacted.

On Feb. 11, there were 65 long-term care home outbreaks with a total of 1,529 people infected.

As of that time, 96.8 per cent of long-term care home residents had received two doses of a COVID-19 vaccine, Howland had said.

She could not immediately say what the booster rate was but did say all eligible residents were offered boosters during the booster immunization clinics in long-term care facilities last November.

Boosters will continue to be offered as more residents become eligible, she added.

"Social Development continues to work with long-term care facilities to bring back a sense of normality and will continue to offer support as we work toward that," Howland said.

"We thank everyone for their hard work and dedication in keeping New Brunswick's seniors safe. This does not go unnoticed and we sincerely appreciate it."

There are about 540 long-term care homes across the province with roughly 12,000 residents and close to 13,000 staff.