Once again, the coronavirus pandemic has thrown a spotlight on Ontario’s long-term care homes. Two reports criticize the lack of action by the government, as well as existing problems in the homes, which left hundreds of residents and staff easy targets for the pandemic -- and they paid the ultimate price.
A scathing report from the government watchdog outlined neglect and said the nursing homes were badly prepared for COVID-19. A second report from a provincial COVID-19 commission, that was given to the government on Friday night, said there also was no plan to protect long-term care residents from the pandemic.
Some 3,700 residents of long-term care homes in Ontario died because of COVID-19, more than half of them during the first wave last year.
Ontario’s auditor general Bonnie Lysyk said the provincial government’s decision to delay implementing measures to control the spread of the coronavirus in nursing homes might have contributed to the devastating toll on residents and staff during the first wave of the pandemic. Lysyk said Ontario didn’t appear to learn any lessons from the SARS outbreak almost two decades ago.
"Ultimately, senior management in the long-term care homes are the ones that are responsible for protecting the people inside their homes. So there needs to be some accountability on that front,” she said.
Lysyk also said the government was not prepared and that it had canceled surprise and comprehensive inspections of long-term care homes in 2018.
"Instead of doing comprehensive inspections, they would catch up on the backlog of complaints," Lysyk said. "I think there were outstanding ones of about 3,000. So in that sense, they then did that instead of continuing and doing comprehensive inspections."
Lysyk said in February 2020, the medical officer of health issued a guidance on infection prevention and control, but that left it up to the home operators to decide what action to take. By the time an emergency order was made two months later mandating staff and essential visitors to wear masks, there were more than 800 confirmed cases of COVID-19 among residents and staff.
Ontario’s Long Term Care Commission also released its report just before the weekend, saying critical decisions by the government came too late and its response proved inadequate to protect staff and residents from COVID-19. It said problems in the homes go way back: insufficient staff, residents in overcrowded rooms and a lack of personal protective equipment.
Merrillee Fullerton, Ontario’s minister of long-term care, said it wasn't the fault of the current government.
"It’s kind of like running into a burning building," Fullerton said. "You know you’re trying to save it and you’re doing your very best, but you know the fire had started well beyond the pandemic."
Premier Doug Ford did some buck-passing of his own, but also promised action, saying that what happened in the long-term care homes can never be allowed to happen again.
"I could point to 30 years of underinvestment from government after government, Liberal and Conservative, but none of that matters because I’m your premier today," he said. "I will stand here and tell you that I’m doing everything in my power as premier and I’m sparing no expense to fix the system."
However, Dr. Vivian Stamatopolous, a long-term care researcher, said the government didn’t implement the recommendations of experts to safeguard long-term care homes ahead of the second wave.
"You can build as many fancy facilities as you want, but if you don’t address the root problems within these homes -- the working conditions and the absent standard of care in addition to the laughable penalties for noncompliance -- nothing is gonna change," she said.
The Ontario COVID-19 commission laid out 85 recommendations, including preparation for future pandemics, prioritizing infection protection and control practices, improving staffing and strengthening healthcare system integration with the homes.