Omicron wave in Ontario long-term care homes blunted by vaccines, boosters, province says

Ontario long-term care homes where the majority of residents have three or four COVID-19 vaccine doses, have been spared mass deaths during the Omicron wave despite infection levels similar to those seen in early 2020, according to new figures from the province.

New data from the province shows 6,572 residents caught the virus between Dec. 15, 2021 and Jan. 29, 2022 — more than the 6,001 infections confirmed during the first wave that ended in August 2020. But during the recent time period noted (Dec. 15, 2021 to Jan. 29, 2022) COVID-19-related deaths of 251 people were reported, compared with those of 1,940 people during the first wave.

Also in contrast to the first wave, the deaths represented a fraction of Ontario's total COVID-19 mortality in December and January.  There were over 1,440 deaths attributable to COVID-19 during those two months in the province, according to CBC tracking, with January the second deadliest month of the pandemic in Ontario.

The province provided a breakdown on the vaccination status of those who recently died in long-term care. Out of the 220 residents who died between Jan. 2 and Jan. 29, only one was a resident with four doses of a COVID-19 vaccine.

Of those, 149 had three doses, 36 had two doses, two had one dose and 32 were unvaccinated, according to the figures based on analysis from Public Health Ontario.

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The Ministry of Long-Term Care said the province took "swift action" to protect against Omicron, pointing to the push for resident fourth doses in December, increased testing and mandating third doses for staff.

"The measures the government have put in place are working and we will continue to closely monitor the situation in long-term care homes and adjust measures as necessary," ministry spokesperson Mark Nesbitt said in an email.

Ontario made long-term care residents eligible for fourth vaccine doses at the end of December as Omicron became the dominant virus strain, and four shots appeared to show the strongest protection against illness and death. The province said 36 long-term care residents with four doses were infected last month.

'Preventable death'

A top Canadian expert in geriatric medicine said the figures demonstrate the value of fourth doses for those in long-term care but said the province could have done more to administer both third and then fourth shots with greater urgency.

"There was a lot of preventable death that could have been avoided," Dr. Samir Sinha said.

The data shows 33,379 long-term care residents had third shots as of Jan. 31, and 30,867 had fourth doses.

Sinha, the director of geriatrics at Sinai Health and the University Health Network in Toronto, said the province could have taken more focused steps to ensure booster uptake when third shots became available to long-term care residents in August.

Instead, he said, the sector was "playing catch-up" when the threat of Omicron became apparent in December — at which time public health resources were already strained with campaigns to vaccinate young children and all adults with third doses.

Record-high numbers 

By January, long-term care homes in the province were reporting record-high numbers of COVID-19 cases and outbreaks.

Sinha credited existing levels of vaccination in long-term care for the lower death rate during the Omicron wave.

But he said "collateral damage" that did occur — including isolation and other issues he said stemmed from understaffing during outbreaks — could have been prevented with a more robust vaccine rollout.

Greater access to third shots for workers could also have prevented some of the hardships, he said. The province has mandated third shots for long-term care workers but pushed a January deadline to mid-March following outbreaks and staffing challenges from Omicron.

Provincial data also reveals that as of the end of January, a total of 4,810 residents — out of 73,576 in long-term care — had not received any doses of a COVID-19 vaccine.

Sinha said he was "shocked" at that figure.

Efforts to further vaccinate long-term care homes should continue, Sinha said, especially as the province pushes to roll back COVID-19 measures like proof-of-vaccination rules and masking in much of society over the next few months.

"The data has shown there's a heck of a lot of catching up to do," he said.