As COVID-19 deaths mount in long-term care homes, families demand more timely information

People with family members in some Ontario long-term care homes are demanding answers about unclear communication on the spread of COVID-19 infections in these facilities.  

There are 112 long-term care homes in Ontario with outbreaks of COVID-19 as of Sunday, roughly one out of every six facilities province-wide. Yet it's not always possible to find out how many cases of the novel coronvairus have been confirmed among the staff and residents at each home. 

Toronto's chief medical officer of health Eileen De Villa acknowledged that frightened families and the public deserve information quickly and said her team is striving to do so.

"I know that this is not always as fast or as detailed as you may want," she said during the city's televised briefing on Thursday. "Please know that we are doing everything we can to keep you informed." 

Some of Ontario's 34 public-health units are refusing to provide information about the number of cases and the number of deaths at each facility where an outbreak has been declared. Some public health units cite confidentiality rules, others say the disclosure is the responsibility of each home. 

Meanwhile, some long-term care homes have been slow to inform families about outbreaks, or are refusing to reveal whether a resident in a shared room has a confirmed case, on the grounds that it violates the privacy rights of the infected person.  

That's the situation that confronted Jaqueline Mitchell, whose 94-year-old mother Lena Mitchell is in a two-bed room at the Eatonville Care Centre in Toronto's west end. Its COVID-19 death toll has reached 31, more than any other long-term care facility in the province. 

Mitchell learned in late March from the Toronto Public Health website that the home had a case of COVID-19. She spoke to a staff member, who Mitchell says revealed that residents had cases too, but would not indicate whether her mother's roommate was among them.

"As the days wore on, we didn't hear anything more, so I just figured everything is fine there," she said this week in an interview on CBC Radio's Metro Morning. 

As of April 1, Eatonville was reporting just one confirmed case involving a staff member. By April 12, there were 14 residents dead.

Mitchell learned of the deaths in what she calls a "stunning" recorded phone message sent to the family members of residents by the home's executive director. 

"I never knew people were dying," Mitchell said. "That was just unbelievable, that suddenly this information is just dropped in the middle of my supper." 

The executive director, Evelyn MacDonald, later apologized to families for the recorded call.

Everyone at the home is now being tested for COVID-19. As of Friday, Toronto Public Health reported 111 positive cases among residents and staff.

"We expect to get additional test results back over the coming days and, as always, we will personally call the families of any residents who are COVID-19 positive." said MacDonald in a statement Friday.

Mounting deaths, heightened anxiety

The sudden revelation of deaths at Eatonville last weekend illustrates an issue of growing concern for family members of long-term care residents across Ontario as they too anxiously await word of further cases.   

Paul Gilbert is a Bowmanville, Ont., resident whose mother lives nearby in Ajax at the Winbourne Park Long Term Care Home, where an outbreak has been declared. Gilbert said an official from the home informed him promptly that a staff member had tested positive for COVID-19. He is now hoping that everyone at the facility — with symptoms or not — gets tested soon. 

"Is our mother coming into contact with other residents or staff members who are already infected but nobody knows about it?" Gilbert asked in an interview this week.

"We don't know." 

In York Region — where 13 long-term care homes have outbreaks of COVID-19 — the public health unit is not publicly revealing the number of confirmed cases or deaths at each one. 

It has left the mayor of Markham, Frank Scarpitti, to be the official source of death figures at homes in his city, via his Twitter feed. 

York Region Public Health meets its obligation to report instances of COVID-19 to the province's database, but decides how to report that data to the public, said Patrick Casey, director of corporate communications

"How we report may be different than how other health units report," said Casey in a statement Friday night. "York Region Public Health continues to be open and transparent when it comes to communicating this information related to COVID-19 with media members and the public."

In Niagara Region, where 26 people have died with confirmed cases of COVID-19, the public health unit is also declining to state where the deaths have occurred. 

"We provide the total number of deaths in Niagara," said Meredith Maxwell, communications manager for Niagara Region Public Health, in an email to CBC News.

"However, we defer to the long-term care home or retirement home to share specifics around number of cases or deaths."

By contrast, Toronto Public Health has been providing daily updates about the number of cases and deaths at each long-term care facility in the city.

Under provincial law, the administrators of long-term care homes are required to report all outbreaks of communicable diseases such as COVID-19 to the local medical officer of health, while physicians and nurses must report any related deaths. 

Local public health units (PHUs) are then required to report all confirmed cases of the illness. However, there are no provincial requirements about the level of detail that must be made public.  

"Each public health unit is accountable to their own board of health, not the Ministry of Health or the Chief Medical Officer of Health. As such, each of the PHUs will make decisions on their public reporting," said Hayley Chazan, director of media relations for Health Minister Christine Elliott, in an email Friday to CBC News.