Ontario's infection prevention team sidelined due to politics, commission hears

Bureaucratic turf concerns prevented a highly trained team of infection prevention and control experts from helping Ontario long-term care homes in the early days of the COVID-19 pandemic, an independent commission has heard.

Dr. Gary Garber, the former medical director of infection prevention and control at Public Health Ontario, testified last week that his department was asked to maintain a "low profile" in order to avoid being "subsumed" by the newly created Ontario Health.

The reorganization, which the province said would modernize the health-care system and save millions of dollars, occurred on Jan. 22, 2020. The next day, a Toronto hospital admitted the first patient in Canada with the novel coronavirus.

In March, when a growing number of long-term care homes in the province were reporting COVID-19 outbreaks, Garber said 25 to 30 highly trained experts from Public Health Ontario watched from the sidelines.

"At the time, I was explaining it to people that COVID really was the IPAC (infection prevention and control) Olympics, that we had people who had been training for years," Garber told the Long-Term Care COVID-19 Commission.

Instead, he said, the team was told not to get involved.

"We were basically told, 'No, we don't have the bandwidth for that. No, we can't do that. No, it's ... the health unit's responsibility to do that."

Public Health Ontario said in a statement to The Canadian Press that it did not prohibit its infection prevention specialists from going into nursing homes, but it noted that "with a small team at PHO, it was not possible to meet every request."

The commission has heard about numerous failures in infection prevention and control in nursing homes in the pandemic's first wave, from not isolating sick residents from healthy ones to the lack, or misuse, of personal protective equipment.

In its first set of interim recommendations to the Minister of Long-Term Care on Oct. 23, 2020, the commission said major improvements in infection prevention and control were needed. It also said inspections teams should be sent in to nursing homes immediately to evaluate and improve IPAC protocols.

Garber said the infection prevention and control experts were finally allowed to help out the homes in late April.

He said one of his most frustrating moments came in March when he was on the line with a nursing home that had reported only a couple of COVID-19 cases.

"Can you cohort? Can you move the sick people? Can you take the ones you know have COVID in one place, the sick people in another and separate them from the rest?" Garber recalled asking the home, which he did not name.

"And the answer I was told was no. And it was the one time — maybe one of the few times in my career that I just felt helpless because I just knew what was going to happen."

He said about 90 per cent of the residents in that home became infected with COVID-19.

The commission is investigating how the novel coronavirus spread in the long-term care system and will submit its final report on April 30, 2021.

Hearings are not open to the public, but transcripts of testimony are posted online days or weeks later.