Unvaccinated workers fuel concerns over surge in COVID-19 cases at care homes

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A recent surge of Delta variant-fuelled COVID-19 outbreaks at seniors homes across Canada is amplifying concerns that unvaccinated health care workers are contributing to the spread of the virus.

The rising number of long-term care and assisted living facilities battling breakthrough infections among vaccinated seniors underscores the urgency of getting a needle into the arm of every health care worker, medical experts say.

As provinces play catch up with the highly transmissible Delta variant, the experts say anything less than national, mandatory vaccination policies puts the frail elderly in seniors’ homes at risk of catching the virus from those individuals responsible for their care.

Only three provinces – British Columbia, Alberta and Quebec – are making vaccination a condition of employment for health care workers, meaning those who are not immunized against COVID-19 by October will be suspended without pay.

Other provinces with high rates of community transmission, including Saskatchewan and Ontario, are giving health care workers the option to either get vaccinated or tested regularly for COVID-19.

Long-term care facilities in Canada have borne the brunt of the pandemic. In Ontario, 3,791 people died during the first three waves, many of them alone in virus-stricken, understaffed homes. Another 728 people in Alberta care homes lost their lives.

Katharine Smart, president of the Canadian Medical Association, said political leaders need to move beyond the personal choice narrative on vaccinations, because that stand has consequences for everyone else in society.

“We really feel strongly that people have a right to expect safety, and the only way to ensure that is to have all the [health care] workers vaccinated against COVID-19,” Dr. Smart said in an interview. “It’s not reasonable to think that you can put the people who you’re caring for at risk to something that’s this deadly.”

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Hillsdale Estates, a 300-bed long-term care home in Oshawa, east of Toronto, declared an outbreak on Aug. 26, after a partly vaccinated staff member tested positive. Seven residents have since succumbed to the virus.

Gail Candusso died at Hillsdale on Sept. 5 after a brief illness with the Delta variant, leaving her daughter in shock. Lori Brazeau said her 82-year-old mother was fully vaccinated and had no ailments other than Parkinson’s Disease.

“My mom was so vibrant,” she said in an interview. “She had at least a couple more good years in her.”

In Western Canada, where provinces lifted most COVID-19 restrictions over the summer, the virus is spreading at an alarming rate.

Thirty-five people in long-term care homes in B.C. have died since early August, according to a BC Centre for Disease Control outbreak report dated Sept. 15. During the same period, just more than 300 people who live and work at 18 homes with outbreaks were sickened with the virus.

Alberta and Saskatchewan, the country’s two hot spots for infections, are struggling with a crush of unvaccinated COVID-19 patients. The number of long-term care and supportive-living homes with outbreaks in Alberta soared to 103 from 61 in just one week, according to a provincial update on Friday.

Saskatchewan, which has the worst rate of infection among the provinces and the lowest vaccination levels, had outbreaks in two dozen long-term care and personal-care homes as of Sept. 11, up from 15 homes four days earlier. The number of residents and staff testing positive climbed to 54 from 29.

In Saskatchewan alone, roughly one in five health care workers are not vaccinated.

Long-term care homes in B.C. began declaring a new round of outbreaks in late July and early August. “It was almost all unvaccinated workers who were bringing it in,” B.C. Seniors Advocate Isobel Mackenzie said. More recent outbreaks have started with fully vaccinated staff, she said.

Six long-term care homes in B.C.’s Okanagan Valley are struggling with outbreaks, according to the province’s latest update. At the 64-bed David Lloyd Jones Home in Kelowna, seven residents have died of COVID-19.

B.C. was the first province to roll out a vaccine policy for everyone working in long-term care and seniors assisted living facilities. Citing a changing level of risk driven by an increase in cases among unvaccinated and partly vaccinated people, the province announced on Aug. 12 that employees must be fully immunized by Oct. 12.

Ontario officials followed on Aug. 17, announcing that health care workers must be either fully vaccinated; have a medical exemption; or complete educational sessions and regular antigen testing.

The policy came into effect on Sept. 7, two days after Ms. Candusso died.

Hillsdale Estates, the municipally owned home where she had lived since 2017, emerged from seven previous COVID-19 outbreaks without any fatalities. What’s different this time around is the Delta variant.

Robert Kyle, Medical Officer of Health for Durham Region, said in a recent interview that a staff member tested positive for Delta. “I think it’s enough to assume that it’s the viral strain causing the outbreak,” he said.

Just more than 200 residents at Hillsdale received a third booster dose of the vaccine on Thursday. Dr. Kyle said 95 per cent of residents and 84 per cent of staff are fully vaccinated.

Those figures are too low, Ms. Brazeau said. “This far into the pandemic, they should all be vaccinated.”

In the obituary for her mother, her family expresses this wish: “That everyone, who is able, get fully vaccinated to protect their loved ones.”

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