Twenty-two people have died at this Toronto nursing home. Two nurses say they sounded the alarm weeks ago
Sarah glanced at the clock on the wall inside Meighen Manor. The young nurse working at the COVID-stricken care home felt her own forehead - she had a slight fever. She knew the likely reason. She had contracted the virus.
But she had one more thing to do before she left the facility for what would likely be weeks.
She suited up and prepared to enter the room of a woman in her early 70s. She had known the woman for more than five years, since she started working at the long-term-care home near Yonge and Davisville in midtown Toronto.
The resident had an ulcer and needed the bandages changed. Sarah, a registered practical nurse, cleaned her wound and dressed it carefully. She knew it would likely be days before someone else had time to change it again.
"I was the last regular nurse on my floor, the last one standing," she said. "It was extremely heartbreaking to leave, not knowing what was going to happen to these residents. A lot of them are going to die."
According to the Salvation Army, which runs the 168-bed home, 74 residents and 26 staff have tested positive for the virus as of Thursday.
Twenty-two residents have died.
As of Thursday evening, according to the Star's tally, there have been at least 468 deaths in long-term-care homes in Ontario, with 3,423 residents and staff testing positive. There have been 147 coronavirus outbreaks in more than 600 homes.
But weeks before coronavirus exploded in long-term-care homes in Ontario - and the virus was just starting to make its appearance among residents - executives at Meighen Manor were not doing enough to prevent an outbreak, say Sarah and her colleague Morgan.
The Star is not using Sarah and Morgan's real names, because they expressed fear for their jobs for speaking to a journalist.
Morgan, a registered practical nurse, recalled imploring managers two weeks ago to test all residents. Morgan said they responded that the policy was to only test residents if they showed symptoms.
Morgan was incredulous. "This is not the way to deal with infection control. It's not the way we have been taught in school. You shouldn't be taking any chances."
Salvation Army spokesperson Major Rob Kerr said the home follows provincial testing guidelines for long-term-care homes. Those health ministry guidelines state the homes must test residents who show COVID-19 symptoms.
On Wednesday, the province announced it would test every resident in a long-term-care home. It also called on the federal government to bring in the army in five especially hard-hit homes.
Kerr said all residents at Meighen Manor were tested Saturday and that the organization was working with Sunnybrook hospital to test care home staff as well. By Saturday, 10 people at the home had died from COVID-19.
But Sarah and Morgan believe the outbreak at Meighen Manor could have been prevented if the Salvation Army had acted sooner.
In response, Kerr said in an email that the Salvation Army has been "adhering to all public health guidelines throughout the development of the pandemic and as new directives have been issued and communicated they have been implemented within the Meighen Manor."
As recently as last week, Morgan said management at Meighen Manor was only providing personal protective equipment (PPE) to staff working in units with confirmed cases. Those in other units were given fabric masks.
Then on Sunday, Morgan read about the residence in the news with horror. More than a dozen workers had coronavirus; 10 residents were dead.
Morgan believes staff may have unwittingly spread the virus from resident to resident, unit to unit.
"Once there was one person tested positive, everyone should be in PPE," said Morgan. "How else are you going to stop a virus like this?"
Kerr confirmed Meighen Manor first discovered COVID-19 in the facility April 4. He also confirmed staff were given fabric face masks to wear when caring for residents who were not exhibiting symptoms.
"Working with supplies that were available and obtainable at the time, Meighen Manor purchased and issued fabric masks to all staff for use in non-COVID positive areas of the facility in mid-March," he said in an email to the Star.
He also said staff are at the home "are not shared between positive and non-positive COVID-19 areas," and that staff are being asked "to limit their work to only one location, in an effort to prevent the spread of COVID-19 across facilities in the city."
But Morgan pointed out that before all the residents were tested on Saturday, staff had no way of knowing which residents had COVID-19 and which ones did not, unless they were showing symptoms.
Dianne Martin, CEO of the Registered Practical Nurses Association of Ontario, said fabric masks "are not appropriate for a health-care facility." Workers should at the very least be wearing medical masks to protect themselves and residents, said Martin, who worked as a nurse in Toronto during the 2003 SARS outbreak.
Martin said she has heard wide-ranging stories about working conditions from her organization's 15,000 members. Some are in homes that have been proactive and contained COVID-19 outbreaks quickly. Others work in places like Meighen Manor, where widespread testing among residents was not conducted until after residents started dying from COVID-19.
Eatonville Care Centre in Etobicoke, Anson Place Care Centre in Hagersville and Hawthorne Place in North York are in such dire straits that the Service Employees International Union is asking the government to take over operations in those care homes. At Eatonville, more than half of the residents have tested positive.
At Meighen Manor, Kerr said 74 of 168 residents - just under half - have tested positive.
Sarah said she believes that those in charge at Meighen Manor are trying their best. "We're not trying to crucify this facility."
But it's been a difficult month for Sarah, who said "nursing feels like I am living my life and this is what I'm supposed to do."
Sarah said last week, four residents who lived in the same unit were coughing.
"I had to beg to get those residents swabbed," she said. She also asked for permission to test the other 24 residents living in the unit. She said was told no, unless they had symptoms.
The four tests Sarah conducted were positive. "I just know there is something wrong happening."
Twenty-six workers at Meighen Manor have fallen ill with the virus. In Ontario, 889 workers in long-term-care homes have tested positive as of Thursday, according to Public Health Ontario.
"It's very hard for me to watch the price that is being paid by the nurses that are present," said Martin of the Registered Practical Nurses Association.
Sarah has COVID-19. She received the test results Monday. She said she has a "bit of a cough," a headache, and some dizzy spells. The worst part so far is that she hasn't been able to taste anything.
Before getting sick, she had worked 16-hour days at the home, caring for dozens of residents. She had not taken a day off this month, because many staff had stopped coming to work after the home discovered its first case in early April.
Many fell ill - it is now known some had COVID-19 - and others didn't want to risk working so close to the virus.
Kerr acknowledged the care home had seen "a reduction" in its workforce in recent weeks. Last week, nurses from Sunnybrook arrived at the home to help.
"We are committed to ensuring our residents receive the care they require during this time and our remaining staff are working very hard to see this through," said Kerr in an email.
At home, Sarah's phone buzzed. It was a co-worker: two more nurses had tested positive. Nineteen people in one of the units she worked in had the virus. Only five had escaped, so far.
On Thursday, the Salvation Army sent out a news release with updates from the last 24 hours - two residents had died and 11 workers had tested positive for the virus. "We are doing everything possible to protect the health, safety and wellbeing of all our residents and staff," the release read.
Sarah spends most of her days in bed, worrying about the woman with the ulcer, and all the other people she used to see every day.
"I'm lucky because I am starting to get better but they would probably get progressively worse," she said of the elderly residents.
"A lot of them will be confused and alone."
Wanyee Li is a Vancouver-based reporter for the Star. Follow her on Twitter: @wanyeelii