7. A problematic enforcement practice culminated with the Ministry completely discontinuing, in fall 2018, its proactive comprehensive inspections of homes to focus on clearing a growing backlog of critical incidents and complaints
5/7
8. A lack of structured collaboration between different government bodies and agencies on issues such as infection prevention and control inspections.
9. Measures to contain #COVID19 were initially left up to home operators.
6/7
The Auditor General of #Ontario's report unsurprisingly concludes that:
"Overall, the Ministry of Long-Term Care and the #LTC homes were not sufficiently positioned, prepared or equipped to respond to the issues created by the pandemic in an effective and expedient way."
7/7
• • •
Missing some Tweet in this thread? You can try to
force a refresh
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.
Yet in the last 14 days, older adults still accounted for 76/85 (89%) of deaths and 715/1171 (61%) of hospitalizations: publichealthontario.ca/en/data-and-an…
#CRSB is limited to those workers who miss at least 50% of their work week because they are unwell or isolating from #COVID19: canada.ca/en/revenue-age…
1/5
This means that #CRSB doesn't cover shorter absences, thereby excluding:
-Worker time off to get tested or vaccinated
-Workers who stay home due to symptoms or exposure, subsequently test negative for #COVID19, and are cleared for return to work within <50% of a work week.
2/5
#CRSB is limited to a 1-week period, is not renewable and can only be used 4 times/year.
This may not be enough for workers in high exposure occupations.
These limitations may discourage testing and isolation of workers, thereby hindering mitigation of workplace outbreaks.
With #COVID19 vaccine supply ramping up, there is lots of discussion about #Ontario's vaccine distribution plan and how individuals are being prioritized.
Ontario's ethical framework is clear that prevention of illness/death is not the only priority: ontario.ca/page/ethical-f…
1/8
These multiple and divergent priorities (reduce illness/death vs. promote economic/social wellbeing) aren't clearly ranked.
e.g., 1.5 million essential workers have similar priority to 3.5 million older adults (who account for 96% of COVID19 deaths): files.ontario.ca/moh-covid-19-v…
2/8
This leads to frustration, anger and fear for older adults who are at highest risk of death and see other vaccination programs like the UK's focus on age and have the singular goal of "prevention of mortality and supporting the [healthcare system]": gov.uk/government/pub…
This is a bad idea for several reasons—not only is this infeasible, but it will be practically impossible for most homes to complete.
1/9
Currently asymptomatic staff undergo weekly PCR testing, much of which is completed on-site at #LTC homes and testing is staggered throughout the week.
Essential family caregivers complete PCR testing off-site at assessment centres or pharmacies (some are done at homes).
2/9
A shifts towards rapid antigen testing will require testing 2-3x/week (in Yellow/Orange/Red/Grey high prevalence zones) or 1x/week (in Green zones): health.gov.on.ca/en/pro/program…
The high frequency of testing compensates for the test's poor sensitivity: bmj.com/content/372/bm…
3/9
The #COVIDzero approach recognizes that there is a disjointed approach to #COVID19 in Canada that is causing uncertainty, unnecessary suffering, economic hardship, and preventable deaths.
#COVIDzero is based on a goal of 0 cases with 0 tolerance for community transmission.
2/8
The "moderate" or "balanced" camp scoffs at this aspirational strategy, minimizing it to "hashtags and platitudes...on social media", highlighting its impossibility, and contends that we need to focus on "improving our ability to live with #COVID19": nationalpost.com/opinion/opinio…
3/8