While doctors and advocates were calling on Ontario to prepare nursing homes quickly for the second wave of COVID-19, the government was telling homes it was their responsibility to find extra staff — and warning that hospitals might not have resources to help.
“Ensuring the provision of required staffing is ultimately the responsibility of the licensee and I ask that you continue to do what you can to address this most pressing need,” Richard Steele, deputy minister of long-term care, wrote to licensed homes in a memo on Sept. 11.
“Please note that going forward, the supply of hospital resources is becoming more scarce as hospitals address their own human resource challenges and ramp up services. As such, they may not be available to assist to the extent that you may require.”
Long-term care homes bore the brunt of the first wave of COVID-19. Of the 3,022 people who have died with the disease in Ontario, 1,977 — or 65 per cent — either lived or worked in long-term care.
The province has ordered hospitals, the military and now the Canadian Red Cross to take over homes that could not contain outbreaks on their own.
Earlier: Ontario puts new restrictions on Ottawa, Toronto and Peel. Story continues after video.
After the September memo went out, Ontario said it would invest hundreds of millions of dollars to help homes with infection control, staffing, renovations and personal protective equipment. But Premier Doug Ford had already said, one day earlier, that the second wave of infections had begun.
“After weeks of insisting that long-term care facilities were ready for a second wave of COVID-19, the Ford government is once again scrambling to contain outbreaks,” Opposition Leader Andrea Horwath said in a statement Tuesday.
“This is a total failure and Doug Ford needs to tell us today: what homes are at risk and what are they doing to prepare?”
The September memo and another one, dated July 31, were provided to HuffPost Canada by the Ontario NDP.
In his July letter, the deputy minister told long-term care homes to assess how ready they were for the second wave by the end of August. He did not provide a template or questionnaire for the assessments but sent a “common framework.”
A spokesperson for the Ministry of Long-Term Care did not provide HuffPost with the framework when asked, but said that it focused on “human resources, infection prevention and control, partnerships and sustained operations.”
Homes were not required to submit their assessments to the ministry, Mark Nesbitt said by email.
“Since the outset of the pandemic, the Ministry of Long-Term Care has been monitoring the developing situation and has taken aggressive measures.”
“In other words, these homes are on their own.”
- NDP Leader Andrea Horwath
When Horwath first mentioned the memos at the legislature in September, she said Ford was breaking his promise to protect long-term care residents.
“The government is walking away from the help that long-term care needs. In other words, these homes are on their own.”
Minister Merrilee Fullerton called that “categorically wrong.”
“We have never stopped working on this. It is our government’s number one priority—the safety and well-being of residents and staff in long-term care—and we will continue to focus on this.”
Expert and advocate Vivian Stamatopoulos says it is “absurd” that the province left staffing up to the homes.
“We absolutely cannot place the onus on these homes” to deal with the second wave of COVID-19, she told HuffPost.
“The province has to step up. The bottom line is that they have failed consistently to oversee and to hold to account negligent homes.”
Most long-term care homes are now operating with staffing below what they had before the pandemic because workers are burnt out or afraid of returning to work, Stamatopoulos said, and for-profit chains have a disincentive to hire new staff because of the cost.
“We simply cannot assume that they’re going to do the right thing, the right thing by residents and not solely the right thing by shareholders, because that has historically been the issue that we’re facing right now,” she said.
‘Literally a deja vu’
It didn’t work to rely on chains to staff up adequately in the first wave, she said, which is why hospitals and the Canadian Armed Forces had to be called in.
“We already saw this happen. It is literally a deja vu of what happened in the spring, recurring right now in the fall,” Stamatopoulos said. “And we all warned about this. We all saw it coming. And we’re standing by angrily right now, watching it come to fruition again.”
She noted that the patient ombudsman says she’s heard complaints from staff that homes were not doing enough training on infection control and use of personal protective equipment (PPE).
“So no, we cannot place the onus on these homes. The province has to step up, start redirecting some funds and put money where their mouth is,” Stamatopoulos said.
Ontario missed the chance to use the summer months to prepare for the second wave, she said, but should now be sending teams to homes to help them manage on their own, providing training to homes with outbreaks, sending resources and proper PPE, forcing homes to comply with staffing levels and mandating more frequent, in-person inspections.
Stamatopoulos said that doing preparedness assessments in August wouldn’t have given the province enough time to address concerns before the virus’ second wave hit.
She also suggested the province follow the lead of Quebec, which announced it would appoint a manager to each of its long-term care homes to oversee their pandemic preparedness.
The ministry’s spokesman says the government had ongoing communication with homes throughout the summer and that its $540-million plan was informed by what the homes said they needed.
The plan will “ensure that most vulnerable seniors and those who care for them are protected during a second wave of COVID-19 by enabling necessary measures to improve infection prevention and control, shoring up personal protective equipment (PPE) stockpiles, and building a strong healthcare workforce,” Nesbitt said in his email to HuffPost.
“The ministry is also working to develop a comprehensive staffing strategy for the sector by the end of the year.”