After a two-year-long state of emergency, Nova Scotia lifted pandemic restrictions for the general public on March 21. But as COVID-19 cases climbed, restrictions remained to protect the most vulnerable: those living in long-term care.
“There’s an awful lot of isolation, investigation, lockdown,” said Michele Lowe, executive director of the Nova Scotia Nursing Home Association.
“No question, COVID has certainly had an impact in the fifth and sixth wave.”
There were a total of 316 cases of COVID-19 detected in long-term care residents during the first four waves — more than 80 per cent of which were during the first wave, before vaccines were made available.
During waves five and six, where Omicron became the predominant variant, more than 2,000 cases were detected in long-term care — over half of which have been since March 1. Despite the dramatic increase in cases, deaths have remained comparatively low.
During the first wave, 57 long-term care residents died with COVID-19. That represents 21 per cent of all long-term care cases.
Twenty-two people died in wave five and 30 in wave six, representing 2.8 per cent and 2.4 per cent of cases, respectively.
Lowe says every death is difficult for families, and their hearts go out to all impacted families, but she notes the situation is not unique to COVID-19.
“When influenza is in the community it has a significant impact on long-term care and has had that long before COVID,” she said.
“(It) would be common, you could have anywhere from two to 10 residents die per month as a result of complications of influenza.”
What has changed with COVID-19 is infection control policies and procedures. Masks and physical distancing have helped to limit spread, and vaccinations have been a key in protecting residents.
“We know that vaccinations have a huge impact on the severity of the virus, and certainly deaths,” said Lowe.
Fourth-dose vaccines are now being rolled out for long-term care residents, giving them even further protection from the virus, and Lowe says it’s time to reconsider the stringent restrictions long-term care facilities are forced to adhere to.
“We need to understand the impact that continued restrictions is having on the mental well-being of our residents,” said Lowe.
Lowe says that outbreaks, which can be classified as even two residents testing positive in a unit, can lead to lockdown situations for all residents, and many residents are isolating for up to 10 days at a time. She says the rules imposed by public health mean some residents go weeks without seeing their families.
“Contact with family is significant for folks that have dementia, and having a regular routine really supports their wellness, but if they’re isolated in their room by themselves without contact from families, it is definitely having an impact and we are seeing that level of decline.”
Minister for Seniors and Long-Term Care Barbara Adams was not available for an interview on Friday but in a statement, says “we know that long-term care residents are at higher risk of having serious outcomes from COVID-19 infections. We are doing everything we can to protect them, while balancing the need to visit with family.”
But Lowe says there needs to be a better balance.
“We’ve seen a toll on families and it’s just not sustainable. So what is the happy place? Or that fair balance, safe balance where we can really try to support folks in long-term care, but at the same time allow them to live.”
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