81% of COVID-19 deaths in Canada were in long-term care – nearly double OECD average
KELLY GRANTHEALTH REPORTER
PUBLISHED JUNE 25, 2020UPDATED 5 HOURS AGO
Canada has done a far worse job of protecting nursing-home residents from the coronavirus than other wealthy countries, according to a new analysis that shows the places that fared best made sweeping changes at seniors’ facilities as soon as they shut their societies down.
Just over 80 per cent of Canada’s known COVID-19 deaths were in residents of nursing or retirement homes as of May 25, nearly double the average for countries in the Organization for Economic Co-operation and Development, says a new report from Canada’s health care statistics agency.
Spain was next, with 66 per cent of its total COVID-19 deaths in residents of seniors’ facilities, followed by Norway and Israel at 58 per cent and Ireland at 56 per cent. Some of the countries examined in the report, including Slovenia, Hungary and the Netherlands, had fewer than 20 per cent of their COVID-19 deaths in such homes.
The new report, published Thursday, highlights some of the ways that Canada’s long-term care sector was set up to fail before the pandemic, with fewer nurses and personal-support workers, older residents and less coherent regulation than in some other countries.
Jurisdiction Percentage 65+ in LTC
But it was actually Ontario and Quebec’s failure to enact safeguards for seniors’ facilities at the outset of the crisis – such as broad testing, mandatory use of personal protective equipment and the isolation of infected residents – that seemed to doom the sector, the Canadian Institute for Health Information (CIHI) found.
“Those countries that layered on more mandatory prevention measures [in long-term care], along with their stay-at-home orders and their closure of public places, have done better,” said Tracy Johnson, CIHI’s director of health systems analysis and emerging issues. “They’ve had fewer COVID-19 infections and fewer deaths in long-term care.”
The most recent in-depth report from the Public Health Agency of Canada (PHAC), released last Friday, shows Canada has logged coronavirus outbreaks in 971 nursing and retirement facilities, leading to nearly 6,000 deaths. PHAC reported 8,454 COVID-19 deaths overall as of Tuesday.
The tragedy that unfolded inside Canada’s long-term care homes during the first wave of the coronavirus pandemic has prompted Quebec to call a public inquiry and Ontario to launch an independent commission.
Both provinces called in the military to help at the hardest hit homes.
For Greg McVeigh, the findings of the CIHI report make it clear that Canada failed vulnerable seniors like his parents, both of whom died of COVID-19 inside the first Toronto nursing home to suffer a major coronavirus outbreak.
His mother, Joan McVeigh, 79 and his father, Joseph McVeigh, 77, died within nine days of each other at Seven Oaks, a city-owned home where 41 residents succumbed to the virus. His father tested positive for COVID-19 after his death.
“I believe the province treated my parents and the people in long-term care as not full citizens, so they didn’t fully protect them,” Mr. McVeigh said. “Their priorities were to protect the hospitals and to prevent the spread in the community.”
The CIHI report, which drills into data from Canada and 16 other countries, divided the countries into four categories, ranging from the countries that did the most the earliest to protect long-term care to those that waited longest to act.
The countries deemed to have dragged their feet – Canada, France, Norway, Spain, the United States and Britain – saw a higher proportion of their overall COVID-19 deaths in long-term care than those who acted to protect seniors’ facilities at the same time they imposed their first stay-at-home orders.
COVID-19 deaths in long-term care as a percentage of all COVID-19 deaths
As of May 25
OECD average 42
Samir Sinha, the director of geriatrics at the Mount Sinai and University Health Network hospitals in Toronto, said the same pattern held true within Canada.
“The standout province in Canada has been B.C.,” he said. The government there acted early to protect long-term care homes and it has had far fewer outbreaks and deaths than central Canada as a result, Dr. Sinha said.
The flip side of the tragedy in long-term care is that Canada has done a better job of protecting people outside of seniors’ homes from the virus than many of its peer countries.
As of May 25, Canada had recorded fewer COVID-19 deaths per million than the OECD average, better than Belgium, Spain, Britain, the U.S. and others, but worse than standouts such as Australia, Israel and Norway.
The CIHI report only looked at data up to May 25.