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Opinion Canada has failed nursing home residents during the pandemic

Seniors waiting for the second dose of the Pfizer vaccine in Toronto on April 1. (Cole Burston/Getty Images)

According to the latest estimates, 69 percent of Canada’s covid-19 fatalities — which is to say, more than two-thirds of the country’s over 23,000 dead — have occurred in long-term care homes used to house senior citizens. It’s a trend that has been consistent for the entire pandemic: A report released last week by the Canadian Institute for Health Information (CIHI) found 7,260 Canadian seniors living in care homes died in the first wave (March to the end of August 2020), while 7,479 died in the second wave (which, for the report’s purposes, ended in February).

These numbers form a uniquely Canadian tragedy. Citing a recent report from the London School of Economics’ International Long-Term Care Policy Network, the CIHI notes that the “international average” for the share of care home residents as a percentage of covid deaths is41 percent, making Canada’s rate about 28 points higher than that of other nations. The New York Times currently estimates 33 percent of U.S. covid deaths are “linked to nursing homes,” while Britain’s Office for National Statistics offers a similar estimate for England and Wales. Even New York — whose governor has been embroiled in much scandal over alleged attempts to hide his state’s supposedly horrifying number of care home deaths — is not believed to have them representing more than 37 percent of its total.

Canada’s numbers can’t be dismissed as just one outlier province skewing the average, either. CIHI data says Canada’s four biggest provinces all have care home residents representing a majority of their covid deaths, with Quebec and Alberta on the high end (75.5 percent and 71 percent, respectively) and Ontario and British Columbia on the low (65.2 percent and 53.3 percent).

As this pandemic edges closer to an end, it’s possible to look back at Canada’s worst experiences with covid-19 as a phenomenon whose most severe suffering was largely borne by a narrow minority. According to the most recent Canadian census, only about 1 percent of Canadians live in a seniors’ residence or nursing home, with the bulk of those being the 4 percent of Canadians who are over age 80 — a group that also represents 68.8% of the country’s total covid deaths.

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The conclusions to be drawn will vary based on one’s ideology and disposition.

Is it fundamentally a care home problem? The poor quality of many Canadian seniors’ homes has been well-documented — often luridly — which left-wing activists have sought to blame on the degree senior care is one of the more heavily privatized realms of Canadian health care, prone to corner-cutting and penny-pinching.

Full coverage of the coronavirus pandemic

Less partial observers, including those behind the inquiries the CIHI says have been done on the state of Canadian senior care since the pandemic started, have made more generalized recommendations on the need to improve staff training and coordination and so on, which are no doubt supremely obvious to all who work in the sector. Improving the overall output of any nationwide network of sovereign, service-providing entities — be they private, public or some mix — is rarely a swift business. Knowing Canada’s track record of reforming sclerotic institutions, there’s plenty of reason to believe covid has simply exposed a particularly deficient piece of Canadian infrastructure that’s likely to remain so.

Those who are more conservative-minded — or at least increasingly resistant to harsh covid protocols of the sort recently reimposed on British Columbia and Ontario — will be inclined to look at Canada’s unevenly distributed deaths and conclude that government’s initiatives are equally maldistributed. Efforts currently being devoted to shutting down shops or restaurants, whose outbreaks — when they happen — are often small and nonfatal, would be better allocated toward stopping outbreaks at care homes, which have a track record of spreading wildly and causing mass casualties.

The admittedly cold rebuttal would declare the disproportionate number of senior home deaths as vindication that Canada is actually doing an excellent job at preventing larger spreads elsewhere. Consider that, according to the Long-Term Care Policy Network, a staggering 75 percent of Australian covid deaths occurred in seniors’ homes — a fact that shocks only until you remember Australia has had fewer than 1,000 covid deaths overall. If we accept that the pandemic’s effects were inescapable at some level, then having most of your country’s deaths concentrated in a community that has been identified since the beginning as the “highest risk” can be darkly validating.

A great deal of Canadian covid commentary has consisted of strained efforts to weave the country’s experiences into something flattering and patriotic, but the virus has shown scant interest in playing along. In the end, it seems Canada’s most pronounced covid legacy will simply be the death of thousands of isolated grandparents holed up in unpleasant conditions. There may be nuance in that story, but no joy.

Read more:

Nora Loreto: Canada’s covid-19 crisis needs a targeted response. When will its leaders learn?

J.J. McCullough: Canada’s covid-19 second wave is a humbling moment after a summer of bragging

Leana S. Wen: Debunking five common concerns about the covid-19 vaccines

Coronavirus: What you need to know

Vaccines: The CDC recommends that everyone age 5 and older get an updated covid booster shot designed to target both the original virus and the omicron variant. Here’s some guidance on when you should get the omicron booster and how vaccine efficacy could be affected by your prior infections.

Variants: Instead of a single new Greek letter variant, a group of immune-evading omicron spinoffs are popping up all over the world. Any dominant variant will probably challenge a key line of treatment for people with compromised immune systems — the drugs known as monoclonal antibodies.

Tripledemic: Hospitals are overwhelmed by a combination of respiratory illnesses, staffing shortages and nursing home closures. And experts believe the problem will deteriorate further in coming months. Here’s how to tell the difference between RSV, the flu and covid-19.

Guidance: CDC guidelines have been confusing — if you get covid, here’s how to tell when you’re no longer contagious. We’ve also created a guide to help you decide when to keep wearing face coverings.

Where do things stand? See the latest coronavirus numbers in the U.S. and across the world. In the U.S., pandemic trends have shifted and now White people are more likely to die from covid than Black people.

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