In the last 24 hours, two more Ontario #LTC residents died of #COVID19: ottawacitizen.com/news/local-new…
There remain 22 active Ontario #LTC home outbreaks (see figure).
@ASPphysician has challenged me to say what must be done to get this under control.
Here it is (a thread).
1/8
We need swift action to control community transmission of #COVID19 which is getting out of control.
In our @CMAJ study, the prevalence of #COVID19 in the community surrounding a home was strongly associated with the odds of an outbreak (aOR = 1.91): cmaj.ca/content/192/33…
2/8
Controlling community transmission is imperative, as staff neighborhood characteristics are also significant predictors of outbreaks: medrxiv.org/content/medrxi…
As @DFisman showed, lagged staff infections were associated with death among #LTC residents: jamanetwork.com/journals/jaman…
3/8
The #LTC staffing study (ontario.ca/page/long-term…) and the @RSCTheAcademies report (rsc-src.ca/en/restoring-t…) emphasized the need to address the staffing crisis and make #LTC a better place to work.
Ontario's pandemic pay has dried up and staffing remains very precarious.
4/8
Immediate action is needed to:
1. Increase basic staffing levels: rnao.ca/news/rnao-resp…
2. Ensure full-time work with fair pay and benefits—part-time staff can still work at multiple homes within a 14-day period.
3. Create accelerated training programs for PSWs (like QC).
5/8
There is no clear emergency management plan—the province must:
1. Establish guidelines & expectations for hospital SWAT Teams, and provide the necessary support: news.ontario.ca/en/release/567…
2. Develop policies for transferring #LTC residents to hospital: advantageontario.informz.ca/advantageontar…
6/8
There is also no emergency workforce, and #LTC homes have been told they cannot rely on hospitals during this second wave (see enclosed letter).
The province must establish an emergency workforce—organizations like the @redcrosscanada could assist: redcross.ca/about-us/media…
7/8
Ontario's "identifiable lives bias" focused its initial pandemic response on acute & critical care to the exclusion of #LTC: jamanetwork.com/journals/jama/…
The current focus is similarly myopic with all attention on issues like back-to-school. We must act now to avoid catastrophe.
8/8
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