Why did Commons drop everything and focus in on long-term care? Because the vast majority of deaths are happening in those homes. Because we should have known that was going to be the case, but we let it happen anyways. And because the level of suffering, isolation and trauma happening in long-term care today is almost too much for us to face up to.
Featured in this episode: Nathan Stall, Jane Meadus
Additional production on this episode by Tiffany Lam.
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EPISODE 2 – “WHEN THE PLAGUE CAME”
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Canada has now confirmed its first death from coronavirus.
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We are deeply saddened to, uh–to hear that, uh, one of the residents of the Lynn Valley Care Home, who was infected with COVID-19, passed away last night.
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We are following a tragic situation that’s unfolding at a long-term care facility in Laval, Quebec this morning. It has one of the worst outbreaks of COVID-19 in this country.
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A significant proportion of these deaths are linked to outbreaks in long-term care facilities.
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Seventy-nine percent of COVID-19 deaths clustered in long-term care and seniors homes.
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This is a national disgrace.
We should have seen it coming. All the warning signs were there.
In Spain, which a month ago was the second-hardest hit country in Europe, elderly people in long-term care were found dead or dying in their beds by the military. When the outbreak hit the United States, long-term care homes in Washington state were hit early and they were hit hard.
We said, oh, this couldn’t possibly happen to us, but it did happen to us. It happened in Dorval. And we’ve seen Bobcaygeon and the… And even the Lynn Valley Care Center, where people weren’t abandoned. But the virus tore through the place with the sort of intensity that it did. We knew this was coming. People just didn’t prioritize this sector or this group of individuals that someone that we should pay special attention to.
That’s Nathan Stall, a geriatrician with the Sinai Health System and University Health Network in Toronto.
In Canada, the plague truly arrived on March 8th. The man was in his 80s. He lived in a long-term care home in North Vancouver, and he died of COVID-19. He was the first person in Canada killed during this pandemic.
The Lynn Valley Care Center in British Columbia in North Vancouver had the first step of COVID in Canada and had the first major outbreak of COVID in Canada. And that didn’t seem to move the needle in terms of societal concern at all.
That man’s death made the news, sure. You’re bound to when you’re the first for pretty much anything. But it wasn’t until a few days later that most of us really tuned in. You remember the day. Italy went into lockdown.
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All of Italy is now in lockdown over the coronavirus.
The NBA shut down.
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This astounding an unprecedented story continues to evolve. The NBA is suspending the season. I say that…
Tom Hanks tested positive.
[NEWS CLIP 8, FEMALE]
Academy Award-winning actor Tom Hanks and his wife, Rita Wilson, have announced that they have both tested positive for coronavirus.
By this time, six workers and another resident at Lynn Valley had tested positive.
We still didn’t understand what was happening. The response from the politicians, health authorities and the press focused on the hospitals.
All the initial conversations were focused on, “How are we gonna get more ventilators? How are we gonna get more ICU beds?” And we didn’t think about all the people who were in congregate living settings like long-term care homes,
Nathan Stall blames this blind spot on ageism.
Ageism also impacts the way that we’ve neglected the long term care sector as well.
And what did it take for us to wake up to the problem, for us to realize what people and what places were going to be the most devastated by this new virus?
It wasn’t until we had accumulation of probably several hundred deaths until this was on the front burner. Right? Every day, it was still, “What are our ICU beds? What our acute care beds?” It took hundreds of deaths, and families basically screaming, saying, “We don’t know what’s going on inside the homes and we can’t get any information.” Or the absolute horrific tragedy we saw in Dorval in Quebec, where they arrived and 30 people were dead. No, 30 people don’t die of an infectious disease like this in one day.
Health care workers, who were putting their lives on the line inside of these facilities, were screaming from the frontlines. “We are not equipped for this. Please, help!”
But we didn’t listen to them. It wasn’t long until the deaths began to mount. In absolutely staggering numbers. At Lynn Valley, 20 people have died. You heard about Residence Herron in our last episode. That was 33 deaths. We know today that almost 80 per cent of COVID-19 deaths are linked to long-term care homes or retirement homes. That’s around 2,300 people who have died in less than two months.
At least sixty facilities across five provinces have recorded deaths in the double-digits. The numbers alone make it clear that long-term care is where this fire is raging.
But the story can’t be told in numbers alone. People in long-term care are experiencing isolation and loneliness and suffering on a different scale than most of us.
The first thing that happens when you get one of these outbreaks is they immediately stop families and visitors, and I think that’s just one of the most difficult parts of the whole thing.
That’s Jane Meadus. A staff lawyer and institutional advocate at the Advocacy Centre for the Elderly in Toronto.
People living in long term care these days are often quite sick, have dementia, may not understand why their daughter isn’t coming in. They may not be able to use a phone. So, they’re really dependent on the home.
There’s also the fear factor. You know, they don’t know what’s going on. They hear a lot of rumors. They’ll say, “Oh, I heard there was somebody on our floor with COVID, or that floor.” And it may or may not be true.
Before this pandemic hit, long-term care residences were often short-staffed. So, what happens when people can’t come to work because they’re infected with the coronavirus? And if you’re a person with dementia living in a long-term care facility, you’ve now lost access to some of your best advocates.
Families and visitors often act as the eyes and ears of the residents. So they’re the ones that often will be making the complaints, will be bringing issues to the management. So that’s all gone. So there’s a lot of fear from families as to what’s going on in those homes because they can’t see what’s happening.
The people with dementia may not be able to follow the news, but they can sense the tension around them. They can tell that something is wrong.
For these individuals, they’ve been in facilities that are in complete lockdown. The staff are dressed up entirely in foreign garb to them, right? Because they’re in face shields and masks and gowns, and for people who have cognitive impairment or dementia, that’s very troubling.
So there’s not only the physical, but there’s also a real psychological effect against, you know, everyone in the home, whether it’s the staff, but also the residents and even people with dementia. They’re not even getting that little socialization that, you know, they had before and they don’t understand why.
If you’re in a long-term care home and you’re used to having a family member come in, and they say, “Oh, it’s because of the pandemic,” they may not understand. Or they may forget five minutes later and just say, you know, “Where’s my daughter?” “Where’s my daughter?” “Where’s my daughter?”
But the scariest thing to me is what it means to be living in a home where people are dying every day.
At the Pinecrest Nursing Home in Bobcaygeon, Ontario, almost half the residents have died. Imagine living somewhere, in close contact with people, and then half of them die in a matter of weeks.
If a nursing home resident gets infected with COVID-19, we know from the United States, about a third of them die. So they’ve also experienced, like, mass death within their own homes. And these are people that may have lived with for years.
It’s the kind of trauma that’s so big, it seems almost impossible to face up to. But the thing is, we’re still early in this pandemic.
I’m still very concerned that as we upscale testing, particularly in Ontario, we’re going to discover a lot more homes, probably by an order of magnitude of 2 to 3 times, that we didn’t know were under outbreak. They are gonna have a substantial proportion of residents who are infected with COVID-19. So there are people who, right now probably have COVID, are approaching the end of life and it’s just not been recognized, as unbelievable as that sounds.
We’re probably going to see a lot more casualties as a result of this, particularly in nursing homes.
This is the crisis we’re facing. Thousands of people dying lonely, undignified deaths. Hundreds of thousands of people faced with the prospect of being cut off from their loved ones indefinitely. We don’t know how long this pandemic will last. We don’t know if people in long-term care simply have to remain isolated from their families for the next two or three years. That’s almost unthinkable.
This pandemic has only just begun. The shape of it is certain to change. But our attention and our resources should be aimed at who it is hurting the most. And right now, indisputably, that’s the people in long-term care.