Two NOTL long-term care homes with outbreaks

The message from the acting medical officer of health for Niagara hasn’t changed: “Don’t follow the example of some of the politicians in the news of late. Do what we did back in the spring, stay home, and minimize contact with other people.”

That’s the first line of defence in protecting those in our long-term care homes from COVID-19, says Dr. Mustafa Hirji, where new outbreaks continue, including, for the first time since the start of the pandemic, in to Niagara-on-the-Lake facilities.

If we don’t give COVID the opportunity to spread to others, says Hirji, “hopefully that will bring the numbers down, we can recalibrate, and we’ll have the vaccine soon so we we can at least protect the most vulnerable in our community.”

The most vulnerable includes residents and staff in the Niagara Long Term Care Residence on Wellington Street in NOTL, formerly a Chartwell home.and at Radiant Care Pleasant Manor in Virgil.

An outbreak was declared in the Old Town home on Saturday, although “fortunately not affecting a large number of people,” says Hirji.

“We were declared in an outbreak by Public Health on Saturday, Jan. 2, when we received a positive staff case through our weekly surveillance testing,” says Chris Poos, executive director of the facility. “Since then, we have received two resident-positive cases, and one additional staff member. Both staff members are asymptomatic and self-isolating at home.”

Staff remain vigilant in all infection prevention and control measures, “including twice-daily screening of residents and staff for any signs of the COVID-19 virus, and regular testing,” says Poos.

“Residents are isolated to their rooms, receiving in-room meal service, and are being cared for by staff on contact droplet precautions. Staff are wearing full personal protective equipment at all times, which is well stocked in the home,” Poos continues.

 “We are in daily contact with Public Health to assist us in managing the outbreak, and hope for the good news to come soon that the Pfizer-BioNTech and/or Moderna vaccines become available to all residents and staff in the Niagara area.”

Lord Mayor Betty Disero says she was saddened to hear about an outbreak at Niagara Long Term Care Residence on Wellington Street in Niagara-on-the-Lake.

“They have been so successful keeping the virus out for almost a year,” she says.

“Now, with all the variants showing up, it’s making the disease even more contagious.”

As the numbers of COVID cases increase in long-term care facilities, she says, “it seems like they’re trying to bail water out of a boat that’s sinking. They can’t keep up with it.”

On Tuesday, the 124-bed residence was reporting two staff members and two residents infected. The staff members were asymptomatic, and self-isolating at home.

“My heart breaks for them. They’ve worked so hard, and just as we start to see a vaccine in sight, they get their first outbreak. It’s just awful. They were so close to being infection-free.”

All three NOTL long-term care homes have managed to keep COVID at bay, with this the first in town to have an outbreak.

The Town’s Emergency Control Group has been in touch with Public Health, and has offered to be available to help out in any way they can, says Disero.

“It must be so difficult for them,” says Disero. “I’m sure they are are taking every precaution to prevent infection from spreading, and keep their residents and staff safe. We’ll do anything we can to help.”

When she learned of the outbreak at Pleasant Manor, she and Town staff would be offering help, and she had already dropped off masks, which she was also offering to Niagara Long Term Care.

With the numbers going up in the community and across the region, she says, to keep people safe in long-term care, the rest of us have to be vigilant. “Wear a mask, keep a distance, wash your hands, and stay within your own households.”

When the number of COVID cases increase in the community,  visitors and staff have a greater risk of introducing the infection to long-term care homes, hospitals and retirement homes, Hirji says.

“As the number of cases increases, we see that to be the case in long-term care.”

About one-third of the new cases in the last week are in the climbing number of outbreaks in 15 long-term care facilities, with hospitals and retirement homes bringing the total number up to 23 facilities as of Tuesday fighting the coronavirus. The Greater Niagara General site of Niagara Health has an outbreak involving the entire facility, declared Dec. 10, and the St. Catharines General Site has been dealing with an outbreak in one unit since Dec. 31.

“The current situation with rising numbers (in the community) isn’t good,” Hirji says.

We have to wait another week, maybe two or three to see the impact of the lockdown that began Boxing Day, he says, but Hirji is also concerned about new cases as a result of Christmas gatherings.

He says we can definitely expect “a bit of a short-term worsening before we see things get better.”

In Niagara, Hirji says, “we’re fortunate that right now, although our hospital numbers are higher, we’re not in a critical situation where we can’t provide hospital care to the people who need it.”

The limiting factor to hospital care, he says, is now on the staffing side. “I think we are still constrained, but we’re managing. As far as I know everyone is getting the care they need.”

Staffing issues are also stressing long-term care homes, he says. “In an outbreak, the need for staff increases, to continue care and do all the extra infection and prevention control measures to control the outbreak. But what actually happens is maybe staff members are out sick, or have been in high-risk contact with people who are sick, and are not able to to work, and need to be isolated. Long-term care homes really struggle with having the staff to provide the care that’s needed, and it becomes harder to control the outbreak. When they don’t have the staff to control the outbreak, it spreads and makes the problem more difficult. It becomes a vicious cycle, with staff exhausted, and long-term care homes struggling with that issue.”

In the early stages of the pandemic, it quickly became obvious that having staff move from one long-term care home to another, which was standard practice, was causing virus spread. There was a stop put to that, but now, with staff shortages, “in some cases, it does happen,” says Hirji.

Facilities need to reach out to agencies for temporary staffing,  and those people might be moving from one home to another, providing critical staffing.

That also applies to health-care workers who provide specialized services, including primary physicians, who go into multiple long-term care homes, he adds.

“Our first line of defence in keeping outbreaks out of the homes, is to reduce the number of cases in the community. That’s the first thing that needs to happen. All of us need to do the hard work of the shutdown, do what we’re supposed to do, and stop interaction between people. That’s what we have to do to protect long-term care homes,” says Hirji.

Additional staffing would be helpful, “but I don’t hold out a lot of hope for that.” The shortage extends across the province, and staff available to work in long-term care homes “are all tapped out,” he says.

“Getting the vaccine to Niagara in the next few weeks, for staff, visitors and residents of long-term care homes, will also prevent outbreaks and will be a great game-changer.”

Causes of new cases are similar to recent weeks. In addition to the long-term care homes, there has been a lot of spread within households, a few more cases of family gatherings in the lead-up to Christmas, and some cases within workplaces, says Hirji.

In NOTL, the cases this Tuesday were up to 110, with 26 new cases in two weeks. The outbreak in Niagara Long Term Care declared Saturday “is part of the story,” he says.

In the last two weeks, there have been several cases in NOTL households, family gatherings and meeting with friends.

Also, there are a few cases in NOTL linked to work or visits outside the community, he says.