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…
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:
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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@TheLancet study reported a combined 74% vaccine effectiveness for #Pfizer and #AstraZeneca starting 42 days after the first dose (77% for the #Pfizer vaccine alone).
Today #Ontario enacted a new emergency measure providing hospitals with the authority to transfer patients who no longer require acute care (so-called "alternate level of care" or ALC patients) to #LTC and retirement homes without their consent.
This action is being taken to create additional room in #Ontario's acute care sector for the 3rd wave of #COVID19.
There are currently 4,288 ALC patients in hospital, and 1,854 are waiting for #LTC beds.
There are also 5,401 vacant #LTC beds available for new admissions.
2/15
The reality is that many of the #LTC homes with large vacancies are those that had the deadliest #COVID19 outbreaks (e.g., Tendercare, St. George's, Orchard Villa).
Residents (and their families and caregivers) will be justifiably hesitant to move into these #LTC homes.