A matter of Conscience: Why we need to act on long term care right now, and why transparency with Covid data is more critical than ever

It came as a surprise to no one, that the recent report from Seniors Advocate, Isobel Mackenzie revealed that many if not most residents in long term care, worried less about Covid than going without seeing their loved ones. They are wasting away from lonelieness and being drugged at unprecedented rates. The full report can and should be read here. https://www.seniorsadvocatebc.ca/osa-reports/staying-apart-to-stay-safe-survey/

It has been horrendous to see the stories shared online from family members of those in long term care.

Residents who stopped eating, residents who families report they died of loneliness and isolation, refusing to eat, rather than covid. I remarked in my last post, that it was ironic that this was the year we released inmates early, while locking up seniors, both in the name of safety. And it’s not working. Not for residents and not for families.

The stark truth really is that keeping families and residents separated to keep covid out of long term care homes, is cruel and hasn’t worked. Outbreaks continue to occur, staff and residents continue to get sick and some sadly, continue to die. So its time we acknowledge this and act immediately to fix this. 9 months is a ridiculous amount of time and care homes are not complying with visitation consistently. I just spoke with an old friend who shared her story of being separated from her mum all this time. It brought me to tears.

This does not need to wait until a new minister is sworn in. This can be implemented by ministry staff immediately. And it is long past time for the public health officer, Dr. Bonnie Henry, to mandate frequent testing of staff, to ensure asymptomatic, or pre-symptomatic staff do not continue to inadvertently bring in the virus. This is something many have been calling for, for months to no avail. Concerned citizens have been calling for this for months online, and families continue to, particularly loudly now that we are in a second wave.

Most recently,care workers and their union joined the call for mandated and frequent testing, because it is a terrible burden on the staff to bear, and unconscionable when the movie industry in BC mandates more frequent testing of everyone on set, than we do of those in care of our most vulnerable members of society.

So why aren’t we doing this?

Why was it deemed exceptionally critical for NHL players to have routine, frequent testing so fans can watch hockey…and yet care home staff are not?

This is, after all, the segment of the population most at risk from serious complication and death. The ones we are told we need to protect the most. Mandatory frequent testing *will* reduce outbreaks and make it easier and safer to reunite families.

Dr. Bonnie Henry was asked about this on August 24th of this year. The video is below. She speaks to false positives and false negatives, and that in her mind, it is not the best use of resources, something repeated even in news stories linked to above.

I’m not a scientist, or a doctor and won’t pretend to be, so I’m not even going to bother speaking to false positives or false negatives. But I will speak to the fact that in every industry – NHL, NFL, and movie – mandated and frequent testing has and does catch people who are positive before or without symptoms, and it keeps those people isolated until tested negative. If it saves lives of staff and residents of long term care, how can anyone say it isnt a good use of resources?

Blanket testing is what ultimately was used – only when the outbreak continued into a third week – in the first Holy Cross outbreak, as told by Vancouver Coastal Healths Patricia Daly, in this video presentation.

When we have community spread as significant as there is in Metro Vancouver, with as many as 20% of cases not having an identified source of transmission, it is my view that we have an obligation to both these long term care residents, and to the staff caring for them, that is not being met.

These staff have lives, children, spouses and elders of their own. When we fail to use the tools we have at hand to ensure asymptomatic/pre-symptomatic staff are caught, we are being negligent because the vast majority of deaths have incurred in or related to long term care. And even if up to 30% of tests give false positives or negatives, that means 70% are accurate. Tell me how this isn’t the best use of resources if minimizing deaths is a key goal of all we are doing? We know it isn’t family bringing it in. This was confirmed.

At the very least, it seems we have failed to learn to apply the precautionary principle on so many aspects a lesson many failed to learn from SARS. https://www.google.ca/amp/s/lailayuile.com/2020/03/31/lessons-not-learned-from-the-sars-inquiry-the-precautionary-principle-be-expressly-adopted-as-a-guiding-principle/amp/

And then yesterday… this:

At a time when public trust is lagging in many areas, giving less info isn’t the right thing to do. Particularly when it is is followed on the heels by this story: https://www.cbc.ca/news/canada/british-columbia/bc-data-sharing-health-workers-phac-holes-1.5788386

“B.C. has stopped sharing data on the occupational status of people who test positive for COVID-19, deeming that data too sensitive to share, according to the Public Health Agency of Canada (PHAC).

That data includes how many positive COVID-19 cases involve doctors, nurses or health-care workers.

Data analysts say that’s a problem because tracking such positive cases is a crucial marker that can reveal if the health-care system is coming under too much stress — but there’s not much the federal agency can do about it except “ask nice” because the data is owned by the province.

“[PHAC] can confirm that we have not received any information on occupational status of COVID-19 cases from the province of British Columbia since June 2020,” reads an email from a Statistics Canada analyst.

Provincial Health Officer Dr. Bonnie Henry denied this was the case when CBC asked her about the issue on Oct. 15

“We have not stopped sharing that. … We do provide that information and certainly provide it on request,” she said. “

Henry said the B.C. Centre for Disease Control gathers occupational information and there have been some recent changes to how cases are defined to collect more detail, so reporting “changed slightly … but we’ve certainly reported on health worker data.”

??? ??? Either this is a significant miscommunication, or someone isn’t telling the truth, but either way this data is critical to ensuring evolving policy and procedures with respect to health care workers. This shouldn’t be an issue, yet data and information hoarding has been a hallmark of how Covid is handled in BC. Since the beginnng, there has been a data void with respect to case details. Location was taboo. Stigma was brought up as the reason and not one city knows how many cases they may have at any given time. Is it any wonder people become complacent and fatigued?

In September, a coalition of BC First Nations filed an application with the information and privacy commissioner to have the info shared, so they can protect their own communities better. The fact they had been denied this info before, is bizarre. https://vancouverisland.ctvnews.ca/b-c-first-nations-coalition-calls-for-covid-19-case-location-information-1.5105592

Since then, we still remain largely in a data void and what data is given isnt specific. Parents have created their own website tracking school exposures in metro van, often far ahead of public health. We are short of contract tracers and the publics interest in paying attention is waning in many areas.

Now more than ever, we need transparency to keep people on board. Justin McElroy got to the heart of this in some recent tweets following a presser earlier this week.

Excellent and thoughtful points.

I also suggest something that would help to keep people vigilant,would be to include a new statement on the number of ” recovered ” people being followed for long haul symptoms and complications, right after the total number of recovered patients. This is being documented in BC, Dr. Henry confirmed this in an earlier presser, and the numbers are not small. This keeps the reality that many covid patients of all ages are sometimes left with long term symptoms…something I just recently saw the BC Government twitter account mention in a reply:

I think many forget about this. And it isn’t covered enough locally in the news, despite it being a serious and ongoing aspect of Covid. Too many discount Covid on the small death toll in BC alone, forgetting.many are left unable to work for months if not indefinitely.

When you withhold info, people grow suspicious.

When you provide all the info, trust is earned.

For now, I go, with the hope that our leaders act fast to ensure our elders see their loved ones and don’t continue to sit drugged and/or alone. Think out of the box. Rapid tests for visitors, outside tents with heaters, I fail to see why these things can’t be done. Share the data, build trust by acknowledging failures and mistakes, and move forward. Its going to be a long winter and we need to get through it as unscathed as possible, and that requires a lot of trust.

On a personal note, posts will continue to be sporadic, but I am toying with ideas of how to keep people engaged and checking in through this winter, when darkness and isolation will close in for many. Is there something you would like to see? Let me know.