Opinion: Despite a study that was conducted primarily when the province was all but done with COVID, public health officials were too busy for interviews.

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VICTORIA – Senior Advocate Isobel Mackenzie began this week’s review of how BC handled nursing home outbreaks in the first and second waves of the pandemic by acknowledging all those who made the findings possible.

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“The work incorporated in this report reflects a significant contribution of time, data, and information from facility operators, health authorities, the Ministry of Health, the BC Center for Disease Control, and staff at the health centers. long-term care and assisted living. ”He wrote in the cover letter for his report, published on Wednesday.

“My deepest thanks to everyone who participated in the review.”

More than 200 industry “leaders”, including home operators, ministry officials and representatives from health care unions, professional associations and the BC Center for Disease Control, participated in four consultation sessions.

Some 6,500 employees in long-term care and assisted living facilities completed an extensive survey. Resident families made contributions through an earlier outreach.

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The advocate organized focus groups with facility operators with the 25 largest and 25 smallest outbreaks, identifying points of comparison, good and bad.

But you had to read the fine print in the first appendix of the 45-page report to discover that a key group of players had been reluctant to accept it.

“Medical health officials and public health personnel involved in managing long-term care and assisted living outbreaks were invited to participate in interviews in June and July,” Mackenzie revealed. But they warned that they “were unable to participate due to urgent responsibilities related to the pandemic.”

In the two-month period set for the interviews, the third wave of the pandemic ended.

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Dr. Bonnie Henry herself downplayed the need for vaccination passports, suspended the mask’s mandate, and signaled an end to regular briefings with the media.

“We have seen a dramatic and sustained decrease in new cases across the province,” he declared on June 29. “We have also seen a decrease in hospitalizations and deaths.”

The occasion was Prime Minister John Horgan’s announcement that the province was moving toward the third step in the NDP government’s economic restart program.

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Henry shared the platform with him and did not seem particularly concerned about “urgent responsibilities related to the pandemic.”

Rather, he shared the prime minister’s enthusiasm for moving forward, declaring: “Indeed, today is a great announcement that we are ready to come together again.”

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Therefore, it seems unlikely that in the space of two months, public health officials “couldn’t find a couple of hours for an interview” with the ombudsman for older people, as columnist Les Leyne wrote in the Victoria Times. Colonist on Thursday.

Unless they were discouraged from doing so.

Rather than undergo face-to-face interviews, “the office of the provincial health official submitted written responses to questions provided by the office of the ombudsman for the elderly.”

They were received only last month, leaving little time for tracking specific outbreaks.

Of the 100,000 records collected and reviewed by the ombudsman and her team, only about 100 comprised written responses and public health documents.

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Still, Mackenzie graciously admitted that she “appreciated your cooperation in these unprecedented times,” just as it was or not.

It is not the first time that the ombudsman for the elderly and the provincial health official have clashed.

Mackenzie spent much of 2020 urging Dr. Henry to relax visiting rules in long-term care, arguing that the overwhelming risk of transmission came from the staff.

“To date there is no record of any outbreak in long-term care transmitted by a visitor,” he told reporters in the fall. “We have to look at it objectively.”

The senior advocate also urged public health to use rapid tests to identify infected staff who could unknowingly bring COVID-19 to long-term care facilities.

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“We’re going to catch some of those people, maybe not all, but some,” Mackenzie said.
The tests have their limitations, as he immediately recognized. ‘What’s the harm in using them? We have nothing at this time. “

This week’s report rejected both points.

The review examined 365 outbreaks between March 2020 and February 2021. In 76 percent, the first case was traced to a staff member and in 22 percent, it was a resident.

“There was only one outbreak where the first confirmed case was a visitor,” Mackenzie reported. (Which suggests that the visitor restrictions, however onerous, did their job.)

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It also calls on the government to “increase the scope and frequency of testing” in long-term care and assisted living, and to do so “on a daily basis until the outbreak is under control.” Rapid tests should also be viewed as a screening tool “at sites that are not in an active outbreak.”

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Otherwise, his recommendations were more of a challenge for the government: expand sick leave, hire more registered nurses, eliminate shared rooms, increase staff pool to cover licenses and shortages, end outsourcing.

It sounds expensive, particularly given the NDP government’s preference for unionized, government-owned or non-profit facilities.

More than 800 long-term care and assisted living residents died during the one-year period of the first and second waves. The third and fourth waves (which continue) remain unexamined by either Mackenzie or anyone else.
At some point, another independent review will be necessary.

Perhaps then the government will ensure that the provincial health official fully cooperates in the autopsy. Excuses are not allowed.

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