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Forty-six new cases of COVID-19 were identified yesterday, the highest number since the pandemic arrived in mid-March. Thirty-six of the 46 cases are at Northwood’s Long-Term Care facility in Halifax.
Nova Scotia now has a total of 721 confirmed cases. Twelve people are currently in hospital, four in ICU. Two hundred and forty-eight people have recovered, including a 98-year-old woman at Northwood.
Today, the chief medical officer of health, Dr. Robert Strang, delivered a difficult message at a time when dozens of families across Nova Scotia are mourning the loss of loved ones killed by a man on a shooting rampage. Strang warned there can be no coming together or lining the streets to pay respect to slain police officers and nurses. And no gatherings or traditional funerals for families and friends, a double blow for a province which is already reeling.
“COVID-19 is not going to pause because of our pain,” said Strang at the online media briefing. “This unprecedented situation we face with the virus makes this unspeakable tragedy and how we deal with it that much more difficult. We need to mourn in a way that does not create an environment for COVID-19 to spread. As part of the Public Health Order, we must keep all gatherings to five people or less [sic].”
Strang said he has also rejected requests from international media outlets to send reporters and crews to Nova Scotia to cover what has become Canada’s largest mass shooting. “It’s difficult but we’re not making an exception,” said Strang.
If there is any glimmer of hope in today’s news, it’s that the majority of cases are concentrated in the Halifax Regional Municipality with only “sporadic” numbers showing up elsewhere across the province. However, Strang said those “clusters” or hotspots at Northwood and in East Dartmouth, and more recently in North Dartmouth, will require considerable effort to tamp down.
Northwood outlines plan
One hundred and twenty seven residents and 61 staff have the virus at nine licensed and unlicensed long-term care homes. Eight of the province’s nine reported COVID-19-related deaths have been nursing home residents.
Northwood CEO Janet Simm and executive-director Josie Ryan held an online news conference this afternoon to express their condolences to the five families who have lost loved ones at Northwood during the outbreak. They also wanted to reassure other families they now have enough staff in place to maintain essential care for 485 residents; 111 residents and 40 staff have tested positive, with 36 new cases since Saturday.
As of today, says Ryan, the home now has four people staffing each floor (usually about 30 residents to a floor) thanks to reinforcements from the VON, the Red Cross, students in the Continuing Care Assistant program at Community Colleges, Emergency Health Services, and nurses and respiratory technologists borrowed from the Halifax Infirmary’s COVID-19 unit.
Asked why Northwood didn’t request help earlier, Ryan said that “last Friday, we had an escalation of the virus. We saw residents with symptoms and we did the swabbing. We jumped from just under 50 to almost 100 cases. That’s why we reached out to the Health Authority and said we just can’t sustain this and we need help with staffing. The union (Unifor) also put out a call to its members. So there are lots of people in this but lots of people are scared, too.”
Janet Simm, Northwood’s CEO, thanked employees who have continued to provide care despite being reduced to only half their regular workforce because many must self-isolate until they no longer test positive. Simm called them “our health-care heroes” while acknowledging “we can no longer manage on our own.”
She apologized for breakdowns in communication over the past week between Northwood and the families of residents. She committed to doing better at sharing information. A new email address, email@example.com, has been established to assist with improving communication.
“And there will be more cases emerging throughout the next two weeks,” said both Northwood executive director Josie Ryan and Dr. Strang. The numbers will climb because the facility will continue to test every resident in the building this week, as well as staff when they have symptoms. Another reason the cases will rise is because of people who have no symptoms (asymptomatic) but carry the virus and infect others during the 14-day incubation period.
“People can have the virus and have symptoms on Day 2 or Day 12,” said Ryan. “What we were seeing is that even if you moved a roommate out, within a few days the person left in the room would also test positive. So we are swabbing and we will continue to swab.”
Northwood CEO Simm repeated that the virus was introduced and transmitted through the nursing home by a number of workers who were asymptomatic and did not know they were infected.
Then there is the uncomfortable and unavoidable fact most floors of the Northwood complex have rooms shared by two people. There are also private rooms but the majority are doubles. This means a resident who tested positive for COVID-19 will continue to share a room and a bathroom with a resident who tested negative. A smaller number of rooms are triple-bunked with three people to a room.
Premier McNeil noted that all newly-built nursing homes in Nova Scotia contain only private rooms, and that in the post-COVID world, that will continue. In the meantime, though, Strang noted that although the number of active cases around the province is moving slightly downward, it’s in crowded places such as nursing homes and homeless shelters where the numbers will rise.
As Northwood residents recover from the virus, they will be moved off-site to a room in a hotel. The rooms vacated by dozens of recovering residents will allow more people to live alone. But that will take weeks to play out and until then, there are few barriers to impede the spread of the virus except frequent hand-washing. Residents won’t wear masks and those with dementia don’t have any concept of physical distancing.
Only private rooms for residents, or acting weeks ago to provide masks for staff, could likely have prevented an outbreak at the largest nursing home in the province. Strang says scientific certainty about asymptomatic spread is still less than two weeks old. Much smaller numbers of cases involving residents and staff have been reported at Harbourstone Enhanced Long-Term Care in Sydney and at The Admiral in Dartmouth.
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