Hit hard in COVID first wave, this Windsor LTC home is determined to stay safe in second wave

When COVID-19 first hit Windsor, the outbreak at Heron Terrace Long-Term Care Community was one of the worst. 

Between March and June, more than 100 individuals at the home, between residents and staff, became sick with COVID-19, dozens of residents were moved to the field hospital for some time, and more than 20 people died.

There are no cases there now, and the company that runs it is doing what it can to keep it that way, even as the second wave takes hold of Ontario and much of the country, with outbreaks at long-term care homes continuing to be a serious challenge.

Canada surpassed 11,000 COVID-19 deaths this week. Close to 80 per cent of them were long-term care residents.

John Scotland, the CEO of the Steeves & Rozema Group, which runs Heron Terrace and a number of other LTC and Retirement homes across southwestern Ontario, says the homes are in a "much better place" now than they were earlier this year. 

"We're thankful to be operating in communities that have so far not seen the brunt of the second wave, such as the GTA," Scotland said.

"But we are mindful and are holding our breath that it's working its way toward us, and that gives us great cause for concern."

What's changed? 

Scotland explained that heightened awareness has been key.

"Back in March, this was a pandemic that was somewhere on the other side of the world," he said. 

He explained that when COVID first entered one of their homes, they didn't know it was there, and they had instead declared a respiratory outbreak. He added that testing wasn't available, and when it was, there were many false negatives. 

"We didn't know it was there until after it was too late and had taken a foothold," he said. 

Having a much better understanding of COVID-19 levels in the community and the type of spread that's occurring, based on daily briefings from the health unit, help inform the response from the homes, he said.

Scotland added that universal masking inside of homes, and the widespread bi-weekly testing of staff has also been critical to monitoring the virus, and curb asymptomatic spread. 

PPE shipments from China

"I remember those early days. Beg, borrowing, stealing, pleading for PPE," Scotland said, explaining that they had resorted to ordering a shipment of masks from China back in the spring, to stock up at all of their homes.

"We were literally on the edge of our seats when we knew that it was it was leaving the airport. And it was at the time that some of those shipments were getting diverted for what we understood were suitcases full of cash."

Scotland explained that his company placed two major bulk orders from China through an Ontario Licensed medical importer. 

The first shipment was placed in March for 400,000 surgical masks, 100,000 KN95s and 20,000 face shields. The complete order cost the company about $900,000, including the air freight cost. 

A second bulk order was placed from China in August for 500,000 surgical masks, costing the company more than $75,000. 

While some KN95 masks were re-called by Health Canada earlier this year, Scotland said, the masks that his company ordered were not impacted. They were ordered from an authorized manufacturer along with all the required paperwork, he said.

Other mask purchases were made through a Toronto area supplier, and other regular supply lines. 

But N95s continue to be difficult to secure, Scotland explained, though the company is still able to get them from large medical supply companies, they come in limited amounts.

Staffing levels an issue

Staffing levels at long-term care homes have been flagged as problematic throughout the province. 

"They're stable, but we don't have enough," Scotland said, of his homes.

He explained that homes rely heavily on casual employees to fill shifts whenever someone calls in sick or if they're away on vacation. Those casuals were completely eliminated under the order that requires staff to work at one site only, Scotland said.

A home like Heron Terrace would have about 160 employees, but 20 to 40 of those employees were a part of the casual pool. 

Now, when someone calls in sick, Scotland said they don't have anyone to call to fill the shift. 

"So now we offer overtime for it or someone who is on part-time, we ask them if they'll take an additional shift to cover," he said. 

"So, our people are tired and we need more of them is really the bottom line. But everybody's hiring, and there's just not enough of them."

External supports

When Heron Terrace was experiencing the worst of the pandemic, it relied heavily on the field hospital to take in those were sick. 

"I can't say enough about Windsor Regional Hospital with the support they provide us during the outbreak. Field hospital, absolutely critical. And, you know, I think it was a bold decision on their part. And we are forever, forever grateful as our staff or residents for that," Scotland said. 

He added that the hospital continues to provide support with Infection Prevention and Control audits, to make sure that their teams are doing things correctly, and point out areas of improvement. 

"That was really valuable for both practicality and morale," he said. 

Fighting to keep COVID out

He added that the homes are also doing what they can to keep spirits up for both residents and staff. The goal is to keep everyone safe and keep life as normal as possible in the home.

Scotland added that the restoration of allowing visitors at the home has been helpful to allow for resident interaction with family and friends in a safe and controlled way, especially during the summer.

Plexiglass separators have been put up in dining areas so that people can see one another and enjoy the social aspect of dining but in a physical distancing way. The return of some things "that make life worth living" have been helpful for residents, Scotland explained.

"It's not normal, though. People like to say it's the new normal. I hope it's not. I hope it's not permanent," he said.

"The sooner we're back to real normal, the better."