LTC home with 145 COVID-19 resident cases puts out mayday call as it runs out of staff – The Globe and Mail

A nurse wearing personal protective equipment works in the Tendercare Living Centre, a Scarborough long-term care home on Dec. 23, 2020.
Carlos Osorio/Carlos Osorio
Doctors have issued an urgent plea for help at a Scarborough long-term care home where 145 residents have tested positive for COVID-19 and workers are so thin on the ground that ill and dying patients arent receiving regular care.
The situation at Tendercare Living Centre is a physicians worst nightmare, said Silvy Mathew, a family doctor who worked a shift on Sunday at the private, for-profit home east of Toronto, where 26 people have died of the coronavirus. She and others have questioned why the Ford government has not once again deployed the military to homes struggling with massive outbreaks.
Most of the 16 infected residents Dr. Mathew cared for on Sunday were weak from illness and a lack of food and water. There were not enough staff to sit with sick patients to help them eat and drink, she said. Six had to have fluids delivered under the skin to keep them hydrated.
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They were severely dehydrated. Its not to say that the rest of them didnt need [fluids.] Its triaging, Dr. Mathew said. I havent personally had to do any sort of triage like that, ever.
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North York General Hospital announced on Wednesday that the Ontario government has asked it to temporarily take over management of Tendercare. A hospital team has been at the home since Monday, completing an assessment and developing a plan to stabilize the facility and protect the health and safety of residents and staff, hospital spokeswoman Melissa Londono said in a statement.
The Tendercare Living Centre in Scarborough, Ont., on Dec. 23, 2020.
Carlos Osorio/The Globe and Mail
Scarborough Health Network (SHN) has been helping out at the nursing home since Dec. 14, according to the Ministry of Long-Term Care, but the network and its three hospitals are already stretched thin caring for COVID-19 patients in one of the hardest-hit regions of the province. (SHN referred questions about its role at Tendercare to the ministry.)
Tendercare is far from the only Ontario nursing home grappling with a major outbreak during the second wave, but the fact that it had to turn to a second hospital farther afield for support underscores how severe the shortage of health care staff has become in coronavirus hot zones.
Last week, the Ministry of Long-Term Care called in Markham Stouffville Hospital, north of Toronto, to provide temporary management of Faith Manor Nursing Home in virus-battered Brampton, west of Toronto. Eighteen people have died of COVID-19 at Faith Manor.
In nearby Etobicoke, the ministry issued a mandatory management order on Dec. 14 requiring Revera Inc. to retain UniversalCare Canada, Inc., another for-profit operator, to manage Westside Long Term Care Home, where 31 have died.
Ontario hospitals are currently managing a total of 16 long-term care homes in outbreak. The virus has killed 2,537 residents in long-term care homes in Ontario to date.
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Nathan Stall, a geriatrician at Mount Sinai hospital in downtown Toronto, said he is getting acute-care patients all the time from Scarborough and as far away as Brampton.
This is just reflective of the fact that the system is in crisis, Dr. Stall said. We keep borrowing resources from areas that arent as hard-hit.
As the number of COVID-19 cases continues to surge, he said, theres going to be a breaking point where there wont be enough hospital staff to support long-term care homes or take acute-care patients from other sites.
Tendercare Living Centre on Dec. 23, 2020.
Carlos Osorio/The Globe and Mail
At Tendercare, Reed Zhao has not been able to talk to his 96-year-old grandmother since Saturday, when the home relocated her to a COVID-19 ward it has set up on the east wing of the third floor. He said his grandmother tested positive for the virus last Friday.
His grandmother, Ping Qiu, moved to Canada 10 years ago from her home in China to be with her three children. Shes a tough lady, Mr. Zhao said. Shes been through the Communist regime and nothing took her down.
Mr. Zhao cant talk to his grandmother because there is no land line or internet access in the room where she is in isolation with other residents who have tested positive. He has left several phone messages at the home, seeking more information about the outbreak, but no one has called him back. He cant understand how his grandmother contracted the virus; she hasnt left her room for months during the pandemic.
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The only contact he has had with the home is a brief call from a staffer on the weekend, telling him, we got an order to move residents. The staffer said she was too busy to answer any questions.
Family members raised concerns during a virtual town hall on Tuesday night about a shortage of staff in the home. One family member was told by a nurse in the home that only three staff were working on the second floor.
We hear your concerns, said Donna Lee, manager of risk and quality for Extendicare Inc., the homes manager. She said the home has reached out to a number of agencies and is hoping to hire 10 extra staff for each floor during days and evenings.
Separately, a pair of Ontario Medical Association leaders issued an urgent request on Monday evening for physicians to pick up shifts at Tendercare.
A body is removed from Tendercare Living Centre, on Dec. 23, 2020.
Carlos Osorio/Carlos Osorio
Family members also asked during the Zoom call why the virus spread so quickly since Dec. 9, when the home reported its first case of COVID-19.
It is a very, very strong wicked virus that has been hitting many homes in many cities, Trish Talabis, regional director of Extendicare replied.
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Ms. Lee said during the town hall that 145 of the homes 188 residents had tested positive for the virus and 26 had died.
Prior to the town hall, a spokeswoman for Tendercare quoted lower numbers in an e-mailed response to questions from The Globe and Mail.
A COVID-19 outbreak is extremely difficult to mitigate when case rates in the surrounding community are high, Candy Chan wrote. Tendercare has been hard-hit by the virus, and as a result, a significant number of staff are infected and have been forced to isolate. We have reached out to the surrounding hospitals, Ontario Health and staffing agencies for additional resources to support resident care.
Dr. Mathew, who works regularly in two long-term care homes that havent experienced outbreaks, said she has barely slept since her shift at Tendercare on Sunday. I think the word is shock, she said.
She said she worked alongside an excellent RPN and two personal support workers during her day at Tendercare, but all three were new to the home and none spoke Chinese, the mother tongue of most Tendercare residents. With so many sick patients to treat, the new staff didnt have time to get to know residents or sit with them for long periods, coaxing them to eat or drink.
I think maybe a couple of [residents] were in pain, but they could have been agitated, and thats why knowing them really helps, Dr. Mathew said, but most of them were just so dehydrated and they were so weak. One patient died during her shift and another had to be transferred to hospital for additional care, Dr. Mathew added.
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Dr. Mathew said the government should have had the Red Cross or the military on standby to help nursing homes overwhelmed by the second wave. That should have been our ready-to-go disaster-planning scenario, she said, instead of hospitals trying to overextend [themselves] and not be able to do enough.
Long Term Care workers received some of the first set of COVID-19 vaccines developed by Pfizer-BioNTech as the Unity Health Toronto vaccine program opened on December 22nd.
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