Team of Toronto doctors and nurses fill in for personal support staff at nursing homes hit by COVID-19 outbreak

In her day job, Dr. Kathryn Tinckam is a transplant kidney specialist and director of the University Health Network’s laboratory medicine program.On Saturday, she volunteered to work a 12-hour shift as a personal support worker, feeding, bathing and toileting residents in Sherbourne Place, a downtown Toronto nursing home on lockdown with a COVID-19 outbreak that has left it struggling to find staff.Tinckam is one of 100 doctors, nurses and psychiatrists from UHN who agreed to pick up front-line shifts at the Rekai Centres’ two nursing homes after hospital CEO Dr. Kevin Smith asked staff to help.Smith offered his physicians and nurses to Rekai Centres on Wednesday, after Premier Doug Ford promised hospital “SWAT teams” to help the staff crisis in long-term care.Ford’s announcement came after a public outcry over the crisis of COVID-19 infections and deaths in long-term care. At least 933 residents and 530 staff have tested positive for the virus. Many workers were too afraid to show up for their shifts, or sick with COVID-19 themselves or worried about infecting children or aging parents. A spokesperson for the Ministry of Long-Term Care said Sarnia’s Blue Water Health is also helping local nursing homes with COVID testing.When Smith’s email arrived, Tinckam signed up for the Saturday day shift, starting at 7 a.m., saying she was “put in the hands of very capable charge nurses” who handed out tasks, with directions to clean or bring meals to residents. She wears a surgical mask, a face shield, gown and gloves.“Very soon after that, the breakfasts trays arrived,” Tinckam said. “That’s when we really started meeting the patients, you got to deliver their meals, introduce yourself, find out a little bit about them, if they are able to communicate with you.“It’s really clear that the staff here know each individual resident, they know their preferences and those are very important pieces of information that allow us to parachute in and do some of these tasks,” she said.“It’s a matter of being very present and alert to each patient’s need and completing the tasks as every patient might require them.”Last Wednesday, the day of Ford’s announcement, was like every other day for the last three weeks or so, at Rekai Centres. CEO Sue Graham-Nutter and her managers were struggling to fill the staffing schedule as front-line workers stopped coming to work.One of her managers spent four days calling 1,000 former nursing interns, asking for help. Seven are now working in Sherbourne Place or, Rekai’s other home, Wellesley Central Place.“I understand why people are afraid, why they don’t want to come in,” Graham-Nutter said.On Wednesday afternoon, an email arrived from the CEO of UHN. Smith asked Graham-Nutter if he could call her that evening. When they spoke, he offered to send leading doctors, infection control experts, psychiatrists and psychological support services for staff who, Graham-Nutter said, are traumatized by the pandemic.“The virus is not kind,” she said.Smith’s offer felt like he had wrapped Rekai’s homes in a “giant bear hug,” she said. They started working out the details. As her remaining staff struggled, working 16-hour shifts, Graham-Nutter said she couldn’t tell them until the plan was finalized. “I kept saying, ‘Help is on the way.’”On Friday and Saturday, when Smith, the CEO and Dr. Brian Hodges, UHN’s chief medical officer, walked the hallways of Sherbourne Place, Graham-Nutter said staff recognized that reinforcements were coming.“I really hope that all hospitals will help long-term care homes — it’s making such a difference,” she said.“I’m sitting here on the main floor at Sherbourne. On the floors above me, there is a nephrologist, (kidney specialist) there is an organ transplant nurse, there is a psychiatrist, there are RNs — and they are all working as PSWs (personal support workers).”Graham-Nutter said details are still being worked out on how long UHN will offer its staff but said she expects it will continue for some time. “This isn’t a one-day photo-op,” she said.Mornings now begin with an 8 a.m. huddle between Rekai managers and UHN staff, she said.They quickly work through a long list of daily needs, a “bucket list,” she said. At the top of that list is personal protection equipment, called PPE. The hospital is sending additional supplies, she said. It also sent a mobile shower so UHN staff can potentially wash off the virus before returning to their homes.The hospital sent an infectious disease expert to train staff on the importance of carefully “doffing” or removing PPE, to avoid infection. Graham-Nutter said the doctor recommended the addition of large garbage pails outside every resident’s door, for old PPE, to limit the potential for spread, and is returning next week for education sessions for union reps on staff.“Before this, people kept asking, how is your PPE supply? I’d say, ‘Do you realize that we have to have the people to wear the PPE?’” she said.“Now, we have real, on the g

Team of Toronto doctors and nurses fill in for personal support staff at nursing homes hit by COVID-19 outbreak

In her day job, Dr. Kathryn Tinckam is a transplant kidney specialist and director of the University Health Network’s laboratory medicine program.

On Saturday, she volunteered to work a 12-hour shift as a personal support worker, feeding, bathing and toileting residents in Sherbourne Place, a downtown Toronto nursing home on lockdown with a COVID-19 outbreak that has left it struggling to find staff.

Tinckam is one of 100 doctors, nurses and psychiatrists from UHN who agreed to pick up front-line shifts at the Rekai Centres’ two nursing homes after hospital CEO Dr. Kevin Smith asked staff to help.

Smith offered his physicians and nurses to Rekai Centres on Wednesday, after Premier Doug Ford promised hospital “SWAT teams” to help the staff crisis in long-term care.

Ford’s announcement came after a public outcry over the crisis of COVID-19 infections and deaths in long-term care. At least 933 residents and 530 staff have tested positive for the virus. Many workers were too afraid to show up for their shifts, or sick with COVID-19 themselves or worried about infecting children or aging parents.

A spokesperson for the Ministry of Long-Term Care said Sarnia’s Blue Water Health is also helping local nursing homes with COVID testing.

When Smith’s email arrived, Tinckam signed up for the Saturday day shift, starting at 7 a.m., saying she was “put in the hands of very capable charge nurses” who handed out tasks, with directions to clean or bring meals to residents. She wears a surgical mask, a face shield, gown and gloves.

“Very soon after that, the breakfasts trays arrived,” Tinckam said. “That’s when we really started meeting the patients, you got to deliver their meals, introduce yourself, find out a little bit about them, if they are able to communicate with you.

“It’s really clear that the staff here know each individual resident, they know their preferences and those are very important pieces of information that allow us to parachute in and do some of these tasks,” she said.

“It’s a matter of being very present and alert to each patient’s need and completing the tasks as every patient might require them.”

Last Wednesday, the day of Ford’s announcement, was like every other day for the last three weeks or so, at Rekai Centres. CEO Sue Graham-Nutter and her managers were struggling to fill the staffing schedule as front-line workers stopped coming to work.

One of her managers spent four days calling 1,000 former nursing interns, asking for help. Seven are now working in Sherbourne Place or, Rekai’s other home, Wellesley Central Place.

“I understand why people are afraid, why they don’t want to come in,” Graham-Nutter said.

On Wednesday afternoon, an email arrived from the CEO of UHN. Smith asked Graham-Nutter if he could call her that evening. When they spoke, he offered to send leading doctors, infection control experts, psychiatrists and psychological support services for staff who, Graham-Nutter said, are traumatized by the pandemic.

“The virus is not kind,” she said.

Smith’s offer felt like he had wrapped Rekai’s homes in a “giant bear hug,” she said. They started working out the details. As her remaining staff struggled, working 16-hour shifts, Graham-Nutter said she couldn’t tell them until the plan was finalized. “I kept saying, ‘Help is on the way.’”

On Friday and Saturday, when Smith, the CEO and Dr. Brian Hodges, UHN’s chief medical officer, walked the hallways of Sherbourne Place, Graham-Nutter said staff recognized that reinforcements were coming.

“I really hope that all hospitals will help long-term care homes — it’s making such a difference,” she said.

“I’m sitting here on the main floor at Sherbourne. On the floors above me, there is a nephrologist, (kidney specialist) there is an organ transplant nurse, there is a psychiatrist, there are RNs — and they are all working as PSWs (personal support workers).”

Graham-Nutter said details are still being worked out on how long UHN will offer its staff but said she expects it will continue for some time. “This isn’t a one-day photo-op,” she said.

Mornings now begin with an 8 a.m. huddle between Rekai managers and UHN staff, she said.

They quickly work through a long list of daily needs, a “bucket list,” she said. At the top of that list is personal protection equipment, called PPE. The hospital is sending additional supplies, she said. It also sent a mobile shower so UHN staff can potentially wash off the virus before returning to their homes.

The hospital sent an infectious disease expert to train staff on the importance of carefully “doffing” or removing PPE, to avoid infection. Graham-Nutter said the doctor recommended the addition of large garbage pails outside every resident’s door, for old PPE, to limit the potential for spread, and is returning next week for education sessions for union reps on staff.

“Before this, people kept asking, how is your PPE supply? I’d say, ‘Do you realize that we have to have the people to wear the PPE?’” she said.

“Now, we have real, on the ground support.”

Moira Welsh is a Toronto-based investigative reporter. Follow her on Twitter: @moirawelsh

Source : Toronto Star More   

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Amid COVID-19, inmates are leaving Toronto South jail to grim prospects with less help

When the weather warms up, inmates being released from the Toronto South Detention Centre with no place to go might again find help from John Howard Society workers.Since mid-March, the society’s reintegration trailer in the parking lot near the Etobicoke provincial jail’s discharge door has been empty, closed because physical distancing was not possible, and there is no running water. The society hopes to soon set up outdoors.When the trailer was up and running, two workers were there to assess needs, make referrals to community supports, help with clothing and transit and offer harm-reduction tools, such as Naloxone. There was support for families, even some snacks.But, for now, there’s nothing in the parking lot.Amid growing calls to get more inmates out of Canada’s jails and prisons — described recently by one Ontario judge as “one of the most dangerous places imaginable” to be during this pandemic — many of the people being released are facing a grim reality.Many of the services supporting inmates fresh out of custody are unable to function as they did before COVID-19, and pre-existing weak points in a safety net mainly made up not-for-profits and charities like the John Howard Society of Toronto have been exposed bare.The result: An already vulnerable population with mental health illnesses, addictions and compromised immune systems is emerging into a new landscape with limited or no means of support, leaving them at high risk of contracting and spreading the virus.This also increases the risk reoffending and ending up back in jail, where outbreaks are likely and inmates with positive cases are being admitted, which has already happened at the Toronto South.As of this week, the jail had three confirmed cases, though it is unclear how many are currently active. On Thursday, the Ministry of the Solicitor General, which oversees the province’s jail, announced three guards had tested positive for COVID-19 at another GTA jail, in Brampton, and that “rush testing” had been ordered for some inmates.Aside from the few federal releases to mandatory halfway houses and inmates being granted bail — with conditions, including sureties agreeing to keep an eye on them and living arrangements in place — the options are grim.Shelters are prime for breakouts, leaving the streets as the alternative for many.In New York City and California, governments have stepped in and inmates who have no place to go are being housed in hotels. In Ontario, there has been no co-ordinated provincial government response for inmates, beyond efforts to reduce the jail population.According to the Ministry of the Solicitor General, the jail population has fallen by 31 per cent since March 16, to 5,726 inmates from 8,344For those released inmates from the Toronto South who can get to John Howard’s Lake Shore Boulevard West office, about a 30-minute walk or 20 minutes using transit, there are the usual supports, including free sleeping bags, said Amber Kellen, the society’s director of community initiatives.Other sites also remain open, albeit with reduced staff. Once out of those doors, however, there is a lot of “confusion” within the community of service providers, with media announcements about increased shelter beds that “seem not to have made their way to anything too tangible on the ground in terms of additional space,” Kellen said in an email.“Shelters and respites continue to be full and other programs have shut down their intake systems (and) are not taking any new clients. This includes some detoxes and safe beds,” Kellen said. “We are extremely concerned.”There is some good news: The city of Toronto’s Shelter, Support and Housing Administration has been talking with the Ministry of the Solicitor General about the need to accommodate high-risk homeless people after release, Kellen said, adding she is “optimistic” there will be progress on that front.A ministry spokesperson could not speak to that particular conversation, but told the Star the ministry “works with community service providers, municipalities, Indigenous communities and Indigenous organizations to ensure that upon release, inmates are supported during their transition into the community.” Where feasible, ministry staff will help the homeless and those with travel barriers contact friends and family to get home or to shelter, and provide advice and resources around COVID-19, the spokesperson said.Once a week, there us an open phone call for organizations across the province that support inmates during and after incarceration. The Prisoners with HIV/AIDS Support Action Network (PASAN), a community-based, Canada-wide, prisoner health and harm reduction organization is on the Ontario call.It’s a brainstorming session on how to support inmates in the time of the virus.PASAN staff also meet daily. Its toll free number for prisoners gets forwarded to staff working remotely, and, through word of mouth, the number is spreading and calls are up. Inmates wanting to connect with a

Amid COVID-19, inmates are leaving Toronto South jail to grim prospects with less help

When the weather warms up, inmates being released from the Toronto South Detention Centre with no place to go might again find help from John Howard Society workers.

Since mid-March, the society’s reintegration trailer in the parking lot near the Etobicoke provincial jail’s discharge door has been empty, closed because physical distancing was not possible, and there is no running water. The society hopes to soon set up outdoors.

When the trailer was up and running, two workers were there to assess needs, make referrals to community supports, help with clothing and transit and offer harm-reduction tools, such as Naloxone. There was support for families, even some snacks.

But, for now, there’s nothing in the parking lot.

Amid growing calls to get more inmates out of Canada’s jails and prisons — described recently by one Ontario judge as “one of the most dangerous places imaginable” to be during this pandemic — many of the people being released are facing a grim reality.

Many of the services supporting inmates fresh out of custody are unable to function as they did before COVID-19, and pre-existing weak points in a safety net mainly made up not-for-profits and charities like the John Howard Society of Toronto have been exposed bare.

The result: An already vulnerable population with mental health illnesses, addictions and compromised immune systems is emerging into a new landscape with limited or no means of support, leaving them at high risk of contracting and spreading the virus.

This also increases the risk reoffending and ending up back in jail, where outbreaks are likely and inmates with positive cases are being admitted, which has already happened at the Toronto South.

As of this week, the jail had three confirmed cases, though it is unclear how many are currently active. On Thursday, the Ministry of the Solicitor General, which oversees the province’s jail, announced three guards had tested positive for COVID-19 at another GTA jail, in Brampton, and that “rush testing” had been ordered for some inmates.

Aside from the few federal releases to mandatory halfway houses and inmates being granted bail — with conditions, including sureties agreeing to keep an eye on them and living arrangements in place — the options are grim.

Shelters are prime for breakouts, leaving the streets as the alternative for many.

In New York City and California, governments have stepped in and inmates who have no place to go are being housed in hotels. In Ontario, there has been no co-ordinated provincial government response for inmates, beyond efforts to reduce the jail population.

According to the Ministry of the Solicitor General, the jail population has fallen by 31 per cent since March 16, to 5,726 inmates from 8,344

For those released inmates from the Toronto South who can get to John Howard’s Lake Shore Boulevard West office, about a 30-minute walk or 20 minutes using transit, there are the usual supports, including free sleeping bags, said Amber Kellen, the society’s director of community initiatives.

Other sites also remain open, albeit with reduced staff. Once out of those doors, however, there is a lot of “confusion” within the community of service providers, with media announcements about increased shelter beds that “seem not to have made their way to anything too tangible on the ground in terms of additional space,” Kellen said in an email.

“Shelters and respites continue to be full and other programs have shut down their intake systems (and) are not taking any new clients. This includes some detoxes and safe beds,” Kellen said. “We are extremely concerned.”

There is some good news: The city of Toronto’s Shelter, Support and Housing Administration has been talking with the Ministry of the Solicitor General about the need to accommodate high-risk homeless people after release, Kellen said, adding she is “optimistic” there will be progress on that front.

A ministry spokesperson could not speak to that particular conversation, but told the Star the ministry “works with community service providers, municipalities, Indigenous communities and Indigenous organizations to ensure that upon release, inmates are supported during their transition into the community.”

Where feasible, ministry staff will help the homeless and those with travel barriers contact friends and family to get home or to shelter, and provide advice and resources around COVID-19, the spokesperson said.


Once a week, there us an open phone call for organizations across the province that support inmates during and after incarceration. The Prisoners with HIV/AIDS Support Action Network (PASAN), a community-based, Canada-wide, prisoner health and harm reduction organization is on the Ontario call.

It’s a brainstorming session on how to support inmates in the time of the virus.

PASAN staff also meet daily. Its toll free number for prisoners gets forwarded to staff working remotely, and, through word of mouth, the number is spreading and calls are up.

Inmates wanting to connect with a lawyer. Inmates distressed over conditions. Complaints that institutions are not communicating enough about how the virus is being handled.

Missing, says PSAN executive director Janet Rowe, is clear messaging from the provincial government about what exactly is the plan inside Ontario jails, and for after.

“There’s the policy at the corporate level, and then the implementation, and who is doing the oversight in terms of that implementation of any policy?” Rowe said in a phone interview. “And then, it’s certainly in a public health crisis, who is overseeing this?”

In Ontario, provincial inmate health is not overseen by public health, and probably should be, said Rowe.

PSAN is monitoring what is happening in bail courts and people being released into a dilemma.

“People are being released from bail court to where?” said Rowe. “Some folks will be able to have housing, can be with family, but other folks have no housing and would have to rely on the shelter system.

“It’s one of the hardest things to convey to people, how invisible people become when they are incarcerated and it’s almost like they don’t exist. And so under these conditions it’s just frightening what’s happening.”

Rowe said her organization would jump at the chance to connect inmates with hotels.

“If there was a planned approach, we could be working with municipalities where there are correctional facilities to actually have hotel rooms available for people to be released to. But that’s not a plan that I’ve heard of,” she said.

The release from jail situation is on the radar of the United Way Greater Toronto. It funds both the John Howard and Elizabeth Fry societies, and what to do about the releases from jails is a topic at “cluster tables” the United Way has convened with the city


Robyn Keystone is very worried about what’s to come. She is co-founder of Literal Change, a charity that offers tutoring to inmates at Toronto South and Toronto East Detention Centre and also has a youth program.

She and twenty volunteer tutors were last in the jails, where they provide one-on-one sessions, the second week of March. The program has been on hold ever since, although for the youth it’s moving online.

For the duration, inmate students who range from being illiterate to learning English as a second language will no longer have one-on-one attention and individualized learning plans, which have proven to help with self-esteem

“For somebody with low literacy levels, there comes so many social and emotional layers of shame and embarrassment,” Keystone said.

Meanwhile, she said she expects many of the people she got to know inside are looking at homelessness on release, at a time when more people downtown are already struggling.

Recently, a colleague had patio furniture cushions go missing from her yard but nothing more — just enough to make a bed, Keystone thought.

“The transition from the inside to the outside was hard enough without support and now I just think it’s going to be even more difficult,” she said.

Counselling and group programs that would normally be part of a release plan are simply no longer being offered. This makes it harder to justify releasing some people early. It also raises questions about what resources will be available for inmates who are released under the province’s new early release program for non-violent, low-risk offenders close to the end of their sentences. At least 10 people have been released through the new program so far.

“Every program that normally supports the rehabilitative aspects of these plans is shut down,” said parole lawyer Jeff Rybak.

He had a client get parole from a provincial jail with a bed lined up at a residential drug-treatment facility. Between his parole being granted and his release two weeks later, the whole world changed and the facility closed its door to new people. The man was released anyway to the custody of his parents but — just as Rybak feared would happen without the treatment program — was rearrested not long after.

“A lot of the problems we are discovering are really just problems that always existed,” he said. Post-release supports for inmates are almost entirely reliant on community organizations, not services provided directly by the province. The pandemic is only further pressuring breaking points that were already there, he said.


For many service providers, including the Canadian Mental Health Association, courthouses operated as a hub to connect with people leaving bail court. Those courthouses are now mostly closed due to the pandemic and bail hearings are being conducted remotely.

It means CMHA mental health workers can’t connect with people leaving custody. They still get referrals, and their phone number can be passed along by lawyers — but many people leaving custody don’t have phones or any means to call.

“If they don’t call us, we don’t know where they are,” said Kathy Chau, director of the mental health and justice program at CMHA Toronto. “I would think there are folks falling through the cracks.”

Their Safe Bed program, which give new releases a place to stay while they do things like get ID or find a place to live, is not accepting new people right now. The people already in the beds are needing to stay much longer than the usual 15 to 30 days.

“We can’t accept new people because we can’t discharge people,” Chau said.

Where possible, CMHA is still providing services by phone, and some in-person visits with screening for people they know don’t have phones.

There has been some good news. Both Bell and Telus are donating free phones, and CMHA Toronto just put an order for 100. “Hopefully we will get all of them, we will take as many as they can give us,” Chau said.

They have also shifted to another immediate need: food. Community workers are now operating two food banks, taking orders and delivering food directly to clients who need that help.

It’s not what they usually do, but it’s what is needed now.

Jim Rankin is a reporter based in Toronto. Follow him on Twitter: @Jleerankin

Alyshah Hasham is a Toronto-based reporter covering crime and court. Follow her on Twitter: @alysanmati

Source : Toronto Star More   

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