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The confirmed COVID-19 infection of four staff and two residents at three other nursing homes in the province has prompted Northwood Inc. to step up its preparations. With 485 beds at its Halifax location, Northwood is one of the largest nursing home operators in Nova Scotia. And although Northwood has no cases, its staff are moving residents within the Gottingen Street complex to clear an entire floor to care for residents who could become infected in the future.
“At this time, we do not have an identified case of COVID-19 in any Northwood facility,” says Josie Ryan, the the executive director for long term care at Northwoord.
“This is a preparatory measure. If we identify a COVID case, everyone will be made aware. We are sorry for the short turnaround but feel it is essential to move this forward quickly. This is a large undertaking that will occur rapidly. Some residents will be relocated to other rooms/locations through the facility temporarily to create the space for the cohort floor. We have stopped admissions in the short term.”
An isolation floor in Northwood Manor will open with private rooms for 13 residents who contract COVID-19, with an option to expand. Another 12 beds in a separate COVID unit will be created at its Ivany complex in Bedford. This action is in response to the recent detection of the virus in other Nova Scotia long-term care homes.
On Monday, a 71-bed care facility in Enfield called Magnolia Manor learned two of its employees and two of its residents have contracted COVID-19. This followed reports on the weekend of one infected employee each at R.K. MacDonald nursing home in Antigonish (136 beds) and at Lewis Hall (72 beds), part of the Shannex Parkland campus in Dartmouth.
It’s well documented that nursing homes regularly work short-staffed and struggle to find replacement workers when a Continuing Care Assistant or Licensed Practical Nurse calls in sick. The emergence of the virus at these locations has exacerbated the problem by forcing co-workers who were in contact with the four infectious employees to also stay home for 14 days.
“This is creating significant staffing issues and the Nova Scotia Health Authority and Health Department have policies in place to provide support,” acknowledged Chief Medical Officer Dr. Robert Strang Monday.
Those policies include a “Good Neighbour” protocol which during emergencies allows CCAs, nurses, and other staff who work in homecare and hospitals to be deployed to long-term care facilities. It’s a reciprocal agreement. According to the Department of Health, this policy has been activated to provide additional staff to Magnolia Manor.
Residents at all nursing homes around the province are now required to have their temperature taken twice a day. Any nursing home resident or staffer who displays symptoms of COVID-19 will be swabbed (tested).
Personal protective equipment (masks, gloves, and disposable gowns) is supposed to be available outside the room of any resident known or suspected of having COVID-19. Front-line workers who interact with these residents are supposed to be instructed on how to dress (it takes practice and more than five minutes) before entering the room.
“Appropriate personal protective equipment (PPE) for droplet and contact precautions should be available outside the resident rooms for use by staff when caring for residents with suspected or confirmed cases of COVID-19, which would include the proper training of putting on and removing PPE,” said the Department of Health’s Shannon Kerr in response to a question.
The Department of Health said it was unable to confirm whether residents in the homes with COVID-19 are taking their meals in their rooms or still gathering in the dining area and for activities such as music and watching TV.
“While we cannot comment on the specific activities of residents in long-term care homes, if residents have not been exposed, regular activities would resume while maintaining social distancing and no group activities larger than five.”
The “no comment” reference seems questionable. This group is at the greatest risk from the virus. The Department of Health is both the licensor and the regulator of more than 100 long-term care homes in the province, with the largest number of people housed in privately-owned facilities and the remainder in facilities operated by non-profit groups. If the government can’t tell us what is happening inside these facilities during a public health emergency and who is making those decisions about allowable and prohibited practices, who will?
Updated 8:20pm:
After our story published, the Examiner received this information Tuesday evening from Katherine VanBuskirk, Communications director for Shannex, which operates many nursing homes in the province:
“At Lewis Hall, all residents in the neighbourhood where this employee worked were tested for COVID-19 and their tests were returned negative,” said VanBuskirk’s email. “ At this point, everyone is doing well, but we want to be sure we are being as cautious as possible with the health and wellbeing of our residents.
In consultation with Public Health and with support from our Infection Prevention and Control Specialist, we are taking additional precautions and keeping residents in their suites to monitor them for symptoms for 14 days since their last contact with this employee.
In all of our retirement living communities, of which Lewis Hall is one, we have moved to a system of delivering meals to resident’s suites and closed our closing dining room meal service. This was one of many measures we have taken over the past number of weeks as part of our pandemic response to provide an extra layer of protection and comply with social distancing principles.
Questions emailed to administrators of the other affected homes did not generate a response, undoubtedly because they are too busy dealing with the pandemic and working hard to minimize its spread. That’s understandable.
But we’re living in a fraught period when family visitors are not allowed to see their relatives. Those family members are also reading or hearing news media reports of clusters of outbreaks and deaths in nursing homes in Canada and the U.S. And while administrators are fully occupied, the situation around long-term care in Nova Scotia calls out for a greater degree of transparency from the Department of Health.
* as initially published, this article misidentified Josie Ryan’s position at Northwood.
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