‘I really am totally speechless’: With about half of Ontario LTC residents still not vaccinated, experts question province’s priorities

Only about half of Ontario’s long-term-care home residents — deemed by the province to be our “most vulnerable” citizens — have received the COVID-19 vaccine, prompting fears among doctors that nursing home deaths from the virus will eclipse those in the first wave. More than a month since vaccinations began, about 48 per cent of Ontario’s more than 72,000 long-term-care home residents have received a vaccination, according to the latest figures from the province. The province notes this number is an underestimation, as it does not account for paper-based reports of Moderna vaccinations not yet entered into the provincial database. Still, compared to other large provinces in Canada, Ontario’s progress vaccinating its most vulnerable does not appear favourable. Quebec has already vaccinated more than 75 per cent of its 40,000 long-term care residents, while Alberta has given doses to more than 90 per cent of about 25,000 residents in its publicly funded continuing care facilities.“This is a breathtaking failure,” said Dr. Nathan Stall, a geriatrician at Mt. Sinai Hospital in Toronto. “I cannot comprehend why they would not move heaven and earth to vaccinate every single long-term-care resident as soon as possible.”Stall noted that Ontario had enough doses to vaccinate every long-term-care and retirement home resident by the end of December 2020. The provincial government’s goal is to have all long-term-care residents vaccinated by Feb. 15.“When you’re talking about a population that has accounted for nearly two-thirds of all COVID-19 deaths to date, I really am totally speechless why this would not be the No. 1 priority to get this done.”During Ontario’s first COVID-19 wave, about 1,850 long-term-care residents died. In the second wave since early September 2020, there have been nearly another 1,400 deaths in long-term care. There are currently 1,497 confirmed active cases in long-term-care residents, up from just one on Sept. 1.Last March, as COVID-19 cases were first tearing through long-term-care homes, Premier Doug Ford tweeted that the province was “putting an iron ring of protection around our seniors.” Two weeks later, he said: “We’re throwing everything we got at our long-term-care homes. We’ll spare no expense.”In a news release Tuesday, the province announced that it had completed the first round of vaccinations in all long-term-care homes in four hot-spot regions, as well as in Ottawa, Durham and Simcoe-Muskoka.Ford was quoted in the release as saying this was the “first of many victories to come” against COVID-19 and that “we are making steady progress, but we will not rest until the residents and staff of every long-term-care home and all Ontarians have had the opportunity to get a vaccine. Only then will we be able to get our lives back and return to normal.”About 238,000 people have been vaccinated in Ontario to date.While Phase 1 of the province’s vaccination rollout clearly targets seniors living in congregate care settings as a “high-risk” population, there seems to be a divergence between the plan on paper and what has been happening, said Rebecca Greenberg, a bioethicist at Sinai Health and an associate professor in the department of pediatrics at the University of Toronto. “There’s a disconnect between the goals to vaccinate this population in an expedient way and what’s materializing across the province,” she said. “If you think about the value of reciprocity, long-term-care homes shouldered the biggest burden of COVID and therefore we have a greater duty not to allow that to happen again and minimize the burden going forward,” Greenberg added. “The ethics arguments in my mind are very clear: long-term care residents and staff should be prioritized.”In recent days, some Toronto hospitals have faced questions — many from their own employees — over decisions to vaccinate executives and other staff who don’t treat patients while the COVID-19 death toll in long-term-care continued to rise. At Michael Garron Hospital, for example, vaccines were offered to executives, and the University Health Network offered doses to all staff, including researchers.Last week, a video of a UHN virtual town hall posted online revealed discontent among employees at the hospital over who is receiving the vaccine while other areas in the province experiencing severe outbreaks continue to wait. The province’s plan prioritized the “hot-spot” regions of Toronto, Peel, York and Windsor-Essex, which initially had the highest transmission rates of COVID-19. In recent days, other regions, such as Niagara and Lambton, have seen their population-adjusted incidence rates grow to match or exceed these hot spots. “Every region is a priority in the province when it comes to long-term-care homes,” said Stall, who says he expects the death toll in long-term care from COVID-19 will be higher in the second wave than the first wave. “We had an opportunity to ensure our death toll during the second wave did not eclipse that of the

‘I really am totally speechless’: With about half of Ontario LTC residents still not vaccinated, experts question province’s priorities

Only about half of Ontario’s long-term-care home residents — deemed by the province to be our “most vulnerable” citizens — have received the COVID-19 vaccine, prompting fears among doctors that nursing home deaths from the virus will eclipse those in the first wave.

More than a month since vaccinations began, about 48 per cent of Ontario’s more than 72,000 long-term-care home residents have received a vaccination, according to the latest figures from the province. The province notes this number is an underestimation, as it does not account for paper-based reports of Moderna vaccinations not yet entered into the provincial database.

Still, compared to other large provinces in Canada, Ontario’s progress vaccinating its most vulnerable does not appear favourable. Quebec has already vaccinated more than 75 per cent of its 40,000 long-term care residents, while Alberta has given doses to more than 90 per cent of about 25,000 residents in its publicly funded continuing care facilities.

“This is a breathtaking failure,” said Dr. Nathan Stall, a geriatrician at Mt. Sinai Hospital in Toronto. “I cannot comprehend why they would not move heaven and earth to vaccinate every single long-term-care resident as soon as possible.”

Stall noted that Ontario had enough doses to vaccinate every long-term-care and retirement home resident by the end of December 2020. The provincial government’s goal is to have all long-term-care residents vaccinated by Feb. 15.

“When you’re talking about a population that has accounted for nearly two-thirds of all COVID-19 deaths to date, I really am totally speechless why this would not be the No. 1 priority to get this done.”

During Ontario’s first COVID-19 wave, about 1,850 long-term-care residents died. In the second wave since early September 2020, there have been nearly another 1,400 deaths in long-term care. There are currently 1,497 confirmed active cases in long-term-care residents, up from just one on Sept. 1.

Last March, as COVID-19 cases were first tearing through long-term-care homes, Premier Doug Ford tweeted that the province was “putting an iron ring of protection around our seniors.” Two weeks later, he said: “We’re throwing everything we got at our long-term-care homes. We’ll spare no expense.”

In a news release Tuesday, the province announced that it had completed the first round of vaccinations in all long-term-care homes in four hot-spot regions, as well as in Ottawa, Durham and Simcoe-Muskoka.

Ford was quoted in the release as saying this was the “first of many victories to come” against COVID-19 and that “we are making steady progress, but we will not rest until the residents and staff of every long-term-care home and all Ontarians have had the opportunity to get a vaccine. Only then will we be able to get our lives back and return to normal.”

About 238,000 people have been vaccinated in Ontario to date.

While Phase 1 of the province’s vaccination rollout clearly targets seniors living in congregate care settings as a “high-risk” population, there seems to be a divergence between the plan on paper and what has been happening, said Rebecca Greenberg, a bioethicist at Sinai Health and an associate professor in the department of pediatrics at the University of Toronto.

“There’s a disconnect between the goals to vaccinate this population in an expedient way and what’s materializing across the province,” she said.

“If you think about the value of reciprocity, long-term-care homes shouldered the biggest burden of COVID and therefore we have a greater duty not to allow that to happen again and minimize the burden going forward,” Greenberg added. “The ethics arguments in my mind are very clear: long-term care residents and staff should be prioritized.”

In recent days, some Toronto hospitals have faced questions — many from their own employees — over decisions to vaccinate executives and other staff who don’t treat patients while the COVID-19 death toll in long-term-care continued to rise. At Michael Garron Hospital, for example, vaccines were offered to executives, and the University Health Network offered doses to all staff, including researchers.

Last week, a video of a UHN virtual town hall posted online revealed discontent among employees at the hospital over who is receiving the vaccine while other areas in the province experiencing severe outbreaks continue to wait.

The province’s plan prioritized the “hot-spot” regions of Toronto, Peel, York and Windsor-Essex, which initially had the highest transmission rates of COVID-19. In recent days, other regions, such as Niagara and Lambton, have seen their population-adjusted incidence rates grow to match or exceed these hot spots.

“Every region is a priority in the province when it comes to long-term-care homes,” said Stall, who says he expects the death toll in long-term care from COVID-19 will be higher in the second wave than the first wave.

“We had an opportunity to ensure our death toll during the second wave did not eclipse that of the first wave, but by failing to vaccinate the residents in a timely and complete manner, we are going to guarantee that the death toll in the second wave eclipses that of the first wave,” he said. “The first time was shameful. This is totally unforgivable.”

University of Toronto bioethicist Kerry Bowman said the definition of “front-line health care worker” seemed to have gotten stretched during the initial vaccine rollout.

“I think we lost a fair amount of time focusing on the hospitals and really extending the range of vaccines to people who are not involved with direct-patient care,” he said, adding that the vaccine rollout so far has been “ethically flawed.”

“The ethical flaw is that we have not been really putting our money where our mouths are and if we’re saying these are the most vulnerable people — and they are, that’s evidence based — we have not been targeting them first.”

Kenyon Wallace is a Toronto-based investigative reporter for the Star. Follow him on Twitter: @KenyonWallace or reach him via email: kwallace@thestar.ca

Source : Toronto Star More