Long-term care homes in Canada step up pandemic plans for COVID-19

As a seniors' residence in Washington state continues to be at the centre of one COVID-19 outbreak, long-term care homes in Canada are preparing should the coronavirus come to one of their facilities. 

Long-term care homes are vulnerable to outbreaks because frail residents live in close quarters that can facilitate the spread of infections. Officials at the World Health Organization say COVID-19 transmission in prisons, hospitals and long-term living facilities in China suggest that the cramped spaces, contact among people and the high potential for contaminated surfaces are important factors that could ramp up infections passing from person to person.

That's why the facilities are updating their pandemic plans.

"We go through this on a regular basis," said Dr. Rhonda Collins, chief medical officer at Revera, a national chain of long-term care homes. "We've just stepped it up a notch."

Collins said that behind the scenes at a care home in Oakville, Ont., they're preparing to have materials, resources and appropriate staffing, particularly for residents with cognitive impairment.

"If we don't have the appropriate staff to engage them in recreational activities, for instance, that means more isolation, more risk of delirium, more risk of decline both cognitively and functionally, so those are the things that we think about."

Staff are looking for symptoms of COVID-19, such as high fever, dry cough and shortness of breath, not only in seniors but also themselves. 

Dr. Anthony Fauci, director of the U.S. National Institute of Allergy and Infectious Disease, said Tuesday that about 80 per cent of individuals who get infected recover on their own, based largely on data from China. 

"However, about 15 to up to 20 per cent of individuals, usually those who are elderly and in risk groups, wind up getting serious disease, requiring supportive care," he said.

"That could be oxygen, that could be intensive care, that could be intubation or even more dramatic interventions."

COVID-19 death rate 8-15% in seniors

Dr. Samir Sinha, director of geriatrics at Sinai Health System and the University Health Network in Toronto, said older adults tend to be more vulnerable to illnesses because the immune system tends to weaken with age, making them more likely to be harmed by infectious diseases.

"To bring some perspective here, when we had SARS for example, if you are 65 or older and you got that illness, you actually had a 50-per-cent risk of dying," Sinha said. "The nice thing that we know about COVID-19 is ... the death rate in the elderly right now seems to be between about 8 and 15 per cent, so much lower."

He said nursing homes and retirement homes across Canada are also revising their pandemic plans to ensure that they have the right supplies in case outbreaks occur in their facilities.

Sinha said older people can protect themselves by:

• Getting vaccinated against influenza and pneumonia.

• Washing their hands.

• Being mindful of other people who are infectious around them.

• Asking relatives to avoid visiting if they're sick.

"I think it's a moment to pause and just breathe and realize that there are things that we should be doing already and that we can do. We can stay informed and make sure that we're prepared in case COVID-19 becomes a greater issue in Canada."

Faria Ali, a registered nurse and director of care at Three Links Care Centre in Vancouver, said because it's flu season, they've enhanced some cleaning procedures for commonly touched areas.

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She also said there was "a bit of an issue around masks disappearing." Masks are now kept in a separate, locked storage area. 

The centre is also reassuring families about their outbreak plans, Ali said.

"You have to be able to communicate to people [with newsletters] but also give them a number to call, too, if they want to get some information about their loved ones," she said. "That kind of reduces the chaos."