Thousands of long-term care residents, workers need COVID booster shots

Thousands of vulnerable long-term care residents, and the workers who care for them, have not received a third dose of the COVID-19 vaccine, raising fears that they may be hit the hardest again as cases of the disease rise. COVID in the province.

Health experts say giving more restraints to those living and working in long-term care is essential to protect immunosuppressed residents and prevent staff shortages, which can lead to social isolation and neglect of residents.

“The biggest concern right now is what happens when these workers have mild cases (of COVID) and then they have to isolate them, presumably all in a very short period of time,” said Vivian Stamatopoulos, long-term care researcher and professor. associated. Professor at the Ontario University of Technology. “Who will be in charge of the residents?”

According to the Ontario Ministry of Long-Term Care, as of December 16, 87 percent of all eligible long-term care residents and 37 percent of all eligible long-term care staff had received their third dose. . That’s a rebound from Dec. 8, when they rose 86 percent and 32 percent, respectively. In total, there are approximately 70,000 residents in long-term care and 100,000 staff, which includes cleaners, cooks, personal support workers, and nurses.

The Ontario Long-Term Care Association, which represents 70 percent of the province’s long-term care operators, including private, nonprofit, charitable and municipal, says households are helping staff to get a boost as they become eligible.

The best way to increase reinforcements for residents, staff and essential caregivers is to ensure that homes have vaccines for on-site clinics, says Executive Director Donna Duncan. “If a household lacks the staff capacity to administer vaccines on site, and if their local public health unit cannot help, they are encouraged to reach out to community contacts to help prioritize their staff and caregivers. essential for vaccines in hospitals, family health teams and pharmacies ”.

The ministry says it is closely monitoring the situation in long-term care and will work with the medical director of health to determine if further action is needed. She is working with partners in health, labor, and long-term care to encourage staff and residents to get a third dose.

Dr. Amit Arya, a palliative care physician who works in long-term care, says that “two doses is insufficient protection with Omicron,” the highly communicable variant that increases the number of cases. About Thursday, The province reported a record 5,790 new cases of COVID-19, 440 people hospitalized and 169 in hospital intensive care units.

“We are already in the midst of an Omicron tsunami, with very high rates of community spread,” said Arya, hospice leader at Kensington Health in Toronto, a nonprofit center for specialty health services. “We cannot have runaway rates of Omicron in the community and expect it to stay out of hospitals and long-term care facilities. He’s already coming in. “

Thursday, sprouts were reported in 19 of the 626 long-term care homes in the province, compared with nine outbreaks on December 11. The local public health unit declares an outbreak when there are two or more laboratory-confirmed COVID-19 cases in residents. staff or visitors, with an epidemiological link, within a period of 14 days, in which at least one person may have contracted the infection at home.

“The great fear throughout the health care system, but especially in long-term care, is that we will have a large number of residents who will be neglected and also COVID-19 again,” Arya said. Long-term care is already “very understaffed,” with no replacement staff, he says, calling the situation an “emergency.”

Arya recalls “horrible” events that unfolded earlier in the pandemic, with residents dying from COVID and neglect because there were no staff to monitor, feed or hydrate them. He notes that when there is an outbreak, residents are confined to their rooms, and notes that social isolation and loneliness can accelerate its decline.

OLTCA’s Duncan says households will do everything possible to support residents’ quality of life during an outbreak.

“Unlike the first waves of the pandemic, provincial guidelines now allow essential caregivers to be at home during an outbreak,” he said. “Essential caregivers are invaluable and provide care and emotional support to your loved ones.”

Duncan also says that long-term care homes will work with the government “to ensure that emergency personnel plans are implemented, as needed, as the COVID-19 pandemic affects different regions of the province to varying degrees.” .

But Stamatopoulos worries about staff shortages and what happens to residents without an essential caregiver.

The ministry began working with public health units and long-term care homes to administer third doses to eligible residents last August, and health workers, including those receiving long-term care, have been eligible for a reinforcement since the beginning of November. This week, booster eligibility was extended in the province to anyone over the age of 18, as long as three months have passed since their second dose. As of December 21, more than two million reinforcements had been administered in Ontario.

In Toronto, many long-term care homes are administering COVID-19 vaccines to residents, staff, and essential caregivers, but when they have requested mobile support from Toronto Public Health or a hospital, any staff wanting a booster have received one.

Stimulating residents is essential, Arya says, noting that recent data from the Centers for Disease Control and Prevention in the United States shows that nursing home residents who do not receive a booster are 10 times more likely to become infected with COVID than those who do.

When it comes to boosting staff, there are several considerations, he says. Many work long hours and cannot make it to the clinic, some are hesitant and need their concerns addressed, and some fear that the pain of a flat tire will make an already physically demanding job more challenging. Also, any on-site clinic should have flexible hours because many employees are shift workers.

As of November 30, almost all residents had received two doses. And 99 percent of the staff had been shot twice, which was ordered by the province. The Star asked Long Term Care Minister Rod Phillips if a third dose will also be required for staff.

“The minister is in regular contact with Dr. Moore, the medical director of health,” said spokeswoman Vanessa De Matteis. “They are closely monitoring the situation and will continue to take the necessary steps to protect those who live and work in long-term care homes.”

Last week, the province introduced additional measures for long-term care. Among them, all visitors must be fully vaccinated and undergo rapid tests; all staff, students, volunteers, and caregivers must undergo rapid tests at least twice a week; and caregivers must be fully vaccinated after receiving a first dose before December 20 and a second before February 21. Visits indoors are limited to two people per resident and four outdoors.

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