Increasing COVID outbreaks, a lack of rapid tests and confusion over visitor rights is causing some in long-term care to say it feels like March 2020 again.
This week, with 49 outbreaks in B.C. health-facilities, Island Health is advising care homes to monitor their rapid tests to ensure supply for essential visitors, while the majority of residents who apply for essential visitors are still being denied.
Terry Lake, president of the B.C. Care Providers Association, said care homes are currently receiving about three tests per resident, about a week’s worth for most facilities.
Eden Gardens in Nanaimo, which has 130 residents and is experiencing a COVID outbreak, has received 360 tests so far, said executive director Erin Beaudoin. “This is not very much. It’s not going to last very long.”
The facility has 42 designated essential visitors and would have up to 85 social visitors when they’re permitted. Provincial health officer Dr. Bonnie Henry has said social visitors will be allowed in seniors homes when rapid testing is in place.
“I’m going to run out of tests,” said Beaudoin. “So what’s the direction when we run out? Do I stop visits or testing?
On the heels of a memo from Island Health asking operators to prioritize their supply of tests for essential visitors “until a stable supply and time of deliveries is confirmed,” Beaudoin wrote to families asking them to “consider keeping the visits to your loved one to a minimum or absolutely necessary so that we can ensure residents are able to receive an essential visitor.”
Island Health said Wednesday the memo was sent to ensure essential visits are “prioritized and continue.”
B.C. Health Minister Adrian Dix said Tuesday B.C. has received a total of 4.85 million rapid tests and is deploying more than half — 2.85 million — to key areas.
But seniors advocate Isobel Mackenzie is concerned long-term care homes aren’t being prioritized for those tests.
“They need to be used where they are going to be of the greatest use in reducing the risk of serious illness, hospitalization and death and we know that that means, if we follow the evidence — it means people in long-term care and seniors in the community,” said Mackenzie. She said for rapid tests to be effective, they have to be regularly given to all visitors and staff — and not just when health-care workers are symptomatic or caught in outbreaks.
The province reported 2,859 new COVID-19 cases Wednesday, including 451 in Island Health, for a total of 36,641 active cases in B.C., of which 4,245 are in Island Health. Six more people died due to COVID-related illness, two of whom were in Island Health.
Mackenze said people over 65 account for 80% of the deaths in the latest wave of COVID-19. “It is very clear where the risk is and we have to manage it.”
Lake said the criteria for declaring an outbreak has morphed so much since 2020, he’s not entirely clear what it is. Based on the original criteria for declaring an outbreak in March 2020 — one person infected — at least double the reported 49 health facilities have outbreaks, he said.
While the fatality rate in COVID-19 outbreaks in care homes is down to 5% from 30% prevaccination and before the generally milder Omicron variant, the risk is “not zero,” Mackenzie said.
As well, the outbreaks reduce visitation to designated essential visitors only and result in more staff absences during a staffing shortage.
Mackenzie said if the provincial health officer declines to order homes to approve an essential visitor for each resident, then health authorities should direct them to do so, so care homes can no longer arbitrarily decide who gets visitors, which some consider a human right.
Only about 25% of residents in long-term care are granted an essential visitor. Ken Leffek, 87, whose wife lives at Broadmead Care Veterans Memorial Lodge, was recently denied essential visitor status even though he visited her two hours for virtually every one of the 164 days she resided there before restrictions were put in place on Jan. 1.
The facility said the criteria is strict and it did its best in a short period of time, approving 19 of 69 requests. Leffek’s case has since been reviewed and he’s been granted the designation.
Mackenzie argues that every resident should qualify for a visitor to help with their “emotional health and well being,” which is one of the criteria.
Beaudoin said deciding essential visitor status is not easy and it would help if the province ordered it or the health authority directed it. At the same time, with Omicron, “we’ve had more exposure from visitors than we’ve ever had before.” She said the latest outbreak started with a visitor.
While Lake maintains that every resident in the province has a right to a visitor and the province should mandate that, he notes that care homes are highly regulated, with licensing officials dropping in regularly who may not have the same liberal interpretation of the rules.
Broadmead is a “wonderful example of care and so they are trying to do everything they can, but they’re also extremely cognizant of ensuring they’re in compliance with the health authority and licensing and the medical health officer, so they’re kind of the meat in the sandwich and it’s very difficult to put them in that position,” Lake said.
“If you want to be clear, just say: ‘Look, everyone gets a visitor’ — full stop.”