Long-term care homes set up isolation units in fight against COVID-19

Seniors residences across Nova Scotia are bracing for the possibility of COVID-19 outbreaks, and facilities with confirmed cases are setting up isolation units to try to contain the spread of the virus.

Across the province, seven operators have confirmed COVID-19 cases, either among employees or residents at assisted-living facilities and nursing homes.

Chief medical officer of health Dr. Robert Strang said Thursday that 42 long-term care residents and 23 staff have been diagnosed so far.

There are about 136 licensed long-term care homes across Nova Scotia with 6,941 beds in nursing homes and 924 in residential care facilities. This does not capture all the seniors who live in retirement homes and assisted living facilities. 

Strang said Wednesday they won't always be naming the facilities when there is a positive case as it involves balancing people's privacy with what is necessary for people to know.

So far, the "most worrisome" long-term care outbreak is at Northwood, he said. As of April 15, 38 residents and 21 staff at the Halifax campus have the virus, as do four home support workers and two health services staff.

Josie Ryan, Northwood's executive director, told CBC News it's been a "struggle" to contain the virus and "one of the most complicated situations" she's seen in her 30 years of nursing.

Enhanced testing, cleaning protocol

The province is requiring all long-term care homes to check the temperatures of residents daily, as well as staff's temperatures at the beginning of every shift. Staff will be sent home immediately if they show any possible symptoms.

There are also heightened cleaning requirements. High-touch surfaces must be disinfected twice a day.

Starting Sunday, staff were also required to wear surgical masks, though some homes had already been doing that.

In the event of an outbreak, staff who work with residents showing symptoms are not supposed to work with patients who are not sick.

Shannex, the largest operator in the province, has about 1,125 licensed long-term care beds, which accounts for about 14 per cent of the total number of licensed beds in Nova Scotia. 

It has chosen nine sites across the province, including specific wings and floors, that will house residents with COVID-19 and the company said it's taking precautions to ensure the virus doesn't spread to other residents in the facilities.  

"The employees who are working in these designated care areas will come and go through the designated entrance that goes directly into a designated care area. They will not care for any other residents," said Catherine MacPherson, senior vice-president of operations.

Meals are even being sent to residents with disposable cutlery and dishes.

The company chose the sites based on the existing layouts, preferring areas with separate entrances and direct access to the ground floor, said MacPherson.

They also wanted units that could be cordoned off from the rest of the buildings, either by existing fire doors or by constructing barriers at the end of hallways.

"We needed to find areas that had enough suites for us to be able to, No. 1: accommodate a certain volume of residents on the outset and the ability to grow these spaces and increase the number of suites, if we needed to do that," she said.

This week, one resident of Maplestone Enhanced Care in Halifax tested positive for COVID-19 and was transferred to Parkstone Enhanced Care in Clayton Park. So far, that person is the only resident housed in one of the reserved areas.

Shannex sent a letter to some families Tuesday informing them some residents would be temporarily relocated to another part of Parkstone as a result of the changes.

In addition to physical barriers in the designated COVID-19 areas, MacPherson said staff will be wearing personal protective equipment — including masks, face shields, gloves and gowns — and they won't return to working in other areas until they self-isolate for two weeks.

MacPherson said staff have been given the option of whether they wanted to work with COVID-19 patients and if they chose to, Shannex will also provide accommodations if they don't want to return home after their shifts. The company is working with hotels to do this.

A resident at Shannex's Harbourstone Enhanced Care in Sydney, N.S., was found to have the coronavirus after they were already in hospital.

Three Shannex employees, one each from Arborstone Enhanced Care in Halifax, Lewis Hall and Harris Hall in Dartmouth, have also tested positive.

After tracing who people with COVID-19 came in contact with, further tests were done and MacPherson said Wednesday they're still waiting for the results.

She said the company would be making any further confirmed cases public after residents, families and staff are notified.

To contact Elizabeth McMillan about long-term care homes and COVID-19, email her at elizabeth.mcmillan@cbc.ca.