'No coverup' in reporting COVID-related deaths, says health minister

The family of a woman who died last week at a Saint John nursing home where there is a COVID-19 outbreak alleges her death — and possibly others — are being misrepresented as non-COVID-related by either Public Health or the operator, Shannex.

Joan Davis died at the Tucker Hall nursing home, Lily Court memory care unit, last Thursday, 16 days after testing positive for COVID-19.

The mother of six, "Nana" of nine, and great-grandmother of two, was 79.

"She went from being this lady cruising down the halls of the Shannex to a person that couldn't speak, eat or communicate in less than 48 hours after being diagnosed with COVID," her son Peter Lewis posted on Facebook.

The family was shocked, he said, when a Shannex official called to advise him Public Health would not be including her death as COVID-related during its daily update.

"She got COVID, she was in the Lily Court COVID unit, she died in the COVID unit."

Lewis, a Rothesay councillor, declined to be interviewed Monday, but said in his Facebook post he was "very upset" with Shannex "for not accepting" that his mother had died from COVID-19.

Public Health has to be fair and transparent with the way they report deaths.- Peter Lewis, son of deceased

"After things started to settle," he called Shannex back, looking for an explanation. "Come to find out it is Public Health that makes the decision on how a person's death is perceived," he wrote.

"As someone who is in the political arena and seeing first hand, what a great amount of stress our health system is under, I do have to question have we come to a point where it is all about numbers? Public Health has to be fair and transparent with the way they report deaths."

'Heart and lungs were strong'

Davis's younger brother, Trevor Jones, agreed "it appears there is a possibility that someone is trying to fudge the numbers of COVID deaths either in the province [Dept. of Health] or at the Shannex [management]."

"First of all, Joan tested positive, she was in the COVID unit, her health tanked in a few days and within 14 days she was dead," Jones posted on Facebook Sunday afternoon.

His sister, who had previously received "outstanding care" at Tucker Hall and "was happy," tested positive Jan. 5. When he last spoke to her on Jan. 7, she was badly congested and coughing, "a painful sounding cough."

She had underlying health conditions, including stomach cancer, he said, "but her heart and lungs were strong."

"This needs to be investigated and explained by all parties involved," wrote Jones, urging people to share the Facebook posts.

On Monday, Health Minister Dorothy Shephard said "there's absolutely no reason for Public Health to not be upfront" about the causes of death of people who test positive for COVID-19.

"So there's absolutely no coverup, no skewing of data," she told CBC News. "This is a clinical decision and we leave that up to the clinicians to give it to us."

Chief Medical Officer of Health Dr. Jennifer Russell said the decision of whether to deem a death COVID-related is "a team effort between the attending physicians as well as Public Health."

On Sunday, Shannex announced two COVID-positive residents of Tucker Hall, Lily Court, died last Thursday and Friday. Six COVID-positive resident deaths have been reported since the outbreak was declared at the 90-bed nursing home in the city's north end on Nov. 20 and resurged on Jan. 5.

Public Health did not mention any deaths at Shannex in recent days until Monday, when Russell announced a Lily Court resident in their 70s recently died "due to COVID-19."

"Sometimes these decisions and discussions take time," she said. "So if people are wondering why it took a little bit longer for us to declare this one COVID-related, that's why."

Questioned further, Russell said they have protocols around declaring a death COVID-related or not. She noted some people have multiple illnesses at the end of life and more than one factor may have contributed to their death.

Some of the issues reviewed during these "complex" discussions would include the timeline between when the person tested positive and their death, whether they had symptoms, and whether those symptoms were exacerbating pre-existing underlying medical conditions, she said.

This death represents the province's 14th COVID-related death since the pandemic began in March, she said.

Another person at the Shannex Parkland Saint John complex who tested positive also recently died, but this death is not being reported as COVID-related, said Russell.

She declined to provide any other details, citing confidentiality, but Jones told CBC News his sister's death is still considered non-COVID-related.

As of Monday night, the New Brunswick COVID-19 dashboard shows only one non-COVID-19-related death. This Shannex resident tested positive but did not die from the disease, Public Health has previously said.

The latest non-COVID-related death is still unaccounted for, yet the numbers work out when the active COVID cases, COVID recoveries, COVID-related deaths and the non-COVID-related death are subtracted from the total number of COVID-19 cases to date.

"I am not one to post on Facebook," wrote Lewis, "but I feel that this is such an injustice to our family and to other families who have seniors dying in nursing homes that can't speak for themselves and don't have the support that Mom had. Public Health needs to report real numbers whether they are good or bad.

"I really want to have this unjust decision reversed. This has been a very sad week for our family and the unjust Public Health has caused is very unsettling for all of our family members. Public Health is here to protect us and give us what we think is the correct information.

"We are doing what we are supposed to do. Are you?"

'Sometimes complicated'

Shannex spokesperson Isabelle Landry declined a request for an interview.

In a Sunday afternoon update on the COVID-19 outbreak, Shannex confirmed the deaths of two residents of Lily Court who had tested positive and described the deaths as being "related to COVID-19."

"During this time, we have said goodbye to so many without the opportunity to celebrate their lives and the freedom to grieve together," said Derek Green, vice-president of New Brunswick operations. "These two families have also had to deal with the added worry of losing a loved one related to COVID-19."

The company said reporting on whether a resident has died as a result of COVID-19 is "sometimes complicated" because of multiple health-care partners involved. 

"Communicating openly with our residents, families and employees is a priority at Shannex and we understand that the delay in communicating the details may create some confusion, and we apologize for this," the news release said.

In an email Sunday, a government spokesperson said "without getting into too many specifics and breaking confidentiality, a person who is positive for COVID-19 can die from other circumstances."