COVID outbreaks with more than 100 infections persist at Hamilton seniors’ homes

Premier Doug Ford has promised to put an iron ring of protection" around seniors since the beginning of the COVID-19 pandemic, particularly those in long-term care and retirement homes.

But nearly three years after Hamilton had its first case of COVID in March 2020, the virus still spreads rapidly through local seniors' homes in large outbreaks - some with more than 100 infections.

Things really haven't changed in long-term care," said Natalie Mehra, executive director of the Ontario Health Coalition. The staffing crisis is still terrible. The (annual) inspections have not been reinstated. Personal-protective equipment (PPE) is still rationed ... There is rapid testing but it is not followed by all homes and not for everyone."

So far in 2023, three Hamilton long-term care homes have had nearly half of their residents test positive in large COVID outbreaks.

Chartwell Willowgrove in Ancaster with 169 beds had an outbreak in January in which 80 residents were infected and two died. In total, the outbreak hit 103 cases when infections of staff, visitors and others were included.

Parkview Nursing Centre in west Hamilton with 126 beds has an ongoing outbreak that was up to 60 infected residents and two deaths as of Wednesday. The total number of cases has climbed to 78 since Jan. 9.

Grace Villa on the east Mountain with 184 beds had 89 residents test positive in an outbreak in January that had a total of 124 cases.

It's not the first time these homes have grappled with COVID - Grace Villa was the site of Hamilton's worst outbreak with 234 cases and 44 deaths from Nov. 25, 2020, to Jan. 20, 2021.

There isn't enough staff to provide care and do proper infection control," said Mehra.

Provincial inspections during the most recent outbreaks at Grace Villa and Chartwell Willowgrove noted issues with infection prevention and control (IPAC). No inspection has been posted during Parkview's current outbreak.

At Grace Villa, a staff member was observed to enter a room where droplet precaution signage was posted, without donning a N95 respirator," stated the Ministry of Long-Term Care inspection report dated Jan. 18. The donning and doffing signage was clearly visible on the door, with N95' written in black marker on the sign."

Hamilton Public Health Services also raised inconsistent use of PPE by staff" in an inspection dated Jan. 17 during the Grace Villa outbreak.

The same issue was noted as well at Chartwell Willowgrove in a provincial inspection report dated Jan. 20. A personal support worker was found to have worn a medical mask instead of the more protective N95 respirator despite signage on the resident's door about a suspected infection.

In addition, Chartwell Willowgrove was found to be using expired alcohol-based hand rub.

Provincial inspectors concluded all of the above increased the risk of spreading infection.

Lastly, a Chartwell Willowgrove resident was found to have the wrong signage on their door about what IPAC precautions were required - luckily they needed fewer measures than what was listed.

The recent inspections by the ministry reported minor infractions, all of which have been resolved," Chartwell spokesperson Mary Perrone-Lisi said in a statement.

An issue with IPAC was also flagged at another Hamilton long-term care home the same month a COVID outbreak was declared.

Staff at the Village of Wentworth Heights were found to have failed to assist residents with washing their hands before lunch two days in a row in a provincial inspection report dated Dec. 16, 2022.

The central Mountain long-term care home had an outbreak declared Dec. 21 that spread to 42 infections before it ended on Jan. 23. There was also an overlapping outbreak in the retirement home that saw 67 cases and one death from Jan. 5 to Feb. 2.

A statement from owner Schlegel Villages said that the main priority is the well-being of the 120 long-term care residents at the Village of Wentworth Heights and those who live in the nearly 260 retirement suites

We maintain robust infection prevention and control measures," said spokesperson Kristian Partington. As we have seen in hospitals and other congregate environments in this most recent wave, however, the latest COVID-19 variants are highly transmissible. We have a large number of independent residents at Wentworth Heights and there was rise of infections driven by community spread over the holiday season."

Chartwell Willowgrove also put some of the blame for its outbreak declared Jan. 1 on the time of year.

The outbreak started during the holiday season when many visitors were entering our building," said Perrone-Lisi.

Liz Richardson's 82-year-old mom was one of Chartwell's residents who got COVID in January.

Kudos to the staff because, in my opinion, they handled it well," said Richardson, who travels from her home in Stoney Creek to visit her mom regularly. They were always on top of communications. From my point of view, in the area my mom was in, there was constant care and attention."

Staff are still vulnerable during these outbreaks, with the Ontario Ministry of Labour reporting that between Dec. 1 and Jan. 30, it received notifications of occupational illnesses related to COVID from Hamilton seniors' homes Chartwell Willowgrove, Grace Villa, Parkview, Heritage Green Nursing Home, Macassa Lodge and Regina Gardens Long Term Care Residence. Ministry inspectors have been assigned to investigate.

Seniors age 80 and over are most at risk from COVID, accounting for two-thirds of Hamilton's pandemic fatalities.

Like many long-term care residents, Richardson's mom has a number of health issues, including dementia, lung cancer and breast cancer. She had radiation treatment in December so a COVID diagnosis was stressful.

When she did get COVID in January after these treatments with your body being weakened by radiation, it was a little bit worrisome," said Richardson. It hit her hard but not as hard as I thought it would. She's a trooper."

Richardson's mom is up to date on her COVID shots. Good vaccine coverage in the home overall was credited by Chartwell Willowgrove with lessening the toll of recent outbreaks.

Throughout 2022, similar to the broader community, we experienced an increase in COVID outbreaks," said Perrone-Lisi. Thankfully the number of severe outcomes was much lower than in previous years, thanks in part to high vaccine rates among our residents, with 96 per cent of them having the bivalent shot and 90 per cent with four doses of the COVID-19 vaccine."

Provincewide about three-quarters of residents in long-term care have had a booster shot.

COVID-19 vaccines continue to play a critical role in preventing serious illness and loss of life among long-term care residents," Jake Roseman, spokesperson for Long-Term Care Minister Paul Calandra, said in a statement.

In addition, he credited antiviral treatments - over 10,000 courses have been dispensed to Ontario residents in long-term care as of Jan. 16.

We've made it easier for residents in long-term care to access antiviral treatments, such as Paxlovid, which helps mitigate severe health outcomes," said Roseman.

Public health also raised the difference that COVID shots and antiviral treatments have made in seniors' home outbreaks despite the large number of cases.

Before the COVID-19 vaccine was available in Ontario, the average deaths per outbreak in these high-risk settings was nearly five times more than outbreaks in the previous two months," Jordan Walker, director of the communicable disease control division, said in a statement. Hospitalizations in these settings were 12-times higher on average pre-COVID-19 vaccine availability compared to December 2022 and January 2023 ... Available treatments for influenza and COVID-19 are also helping to reduce the severe outcomes of these respiratory illnesses."

At Grace Villa, the public health inspection noted all staff were vaccinated against COVID and all but a few residents. However, it did flag that 40 per cent to 50 per cent of residents had refused the flu shot.

Overall, public health is getting away from doing both proactive and reactive infection prevention and control inspections and turning that work over to an IPAC Hub that has been created to help congregate settings in Hamilton, Niagara, Haldimand, Norfolk and Brant. The hub is a partnership of all of the local health units, St. Joseph's Healthcare, Hamilton Health Sciences, Haldimand War Memorial Hospital and the province. Its team includes infectious disease physicians, public health inspectors and nurses.

It was the IPAC hub that made an on-site visit to the Village of Wentworth Heights on Jan. 23.

The visit was upon request from the facility to address areas of potential concern that required additional support from infection prevention and control experts," stated Walker. The home was co-operative and implemented these recommendations that were made during the inspection."

Walker says Parkview and Chartwell Willowgrove also received support from the hub by phone during their outbreaks.

The hope is the provincially funded hub might finally be able to provide some of that long-ago promised protection.

Hamilton Public Health Services understands how concerning an outbreak can be for staff, residents and their loved ones," stated Walker. An effective and rigorous infection prevention and control program is essential to improving resident and staff safety by preventing the occurrence or limiting the spread of infections, including COVID-19."

Joanna Frketich is a health reporter at The Spectator. jfrketich@thespec.com