A report says it will cost Toronto an additional $14.3 million to maintain changes that the city has made to its long-term care homes to ensure the safety of residents in the event of a second wave of COVID-19.
The report, by the city’s Seniors Services and Long-Term Care Division (SSLTC), outlines the response by staff before the pandemic, its actions during the crisis, and 16 recommendations from staff on how the city can maintain safety at its 10 long-term care homes.
Mayor John Tory released the report at a city hall news briefing on Monday.
“Seniors, as we know, were particularly devastated by COVID-19. Change across the sector is needed and the city will gladly participate in a review as promised by the province,” Tory told reporters.
“We will do everything we can as a city government to protect seniors in our long-term care residences to make sure the entire provincial system is improved in the wake of COVID-19.”
City staff were asked to look ahead in terms of preparedness for a second wave of COVID-19. The “new normal,” as the homes gradually reopen, will mean extra health and safety measures, including screening, testing, physical distancing and appropriate personal protective equipment (PPE), based on guidance from Toronto Public Heath and the Ontario ministries of health and long-term care, the report says.
According to the report, the health and safety measures include:
- Maintaining active screening of staff, essential visitors and residents, with an estimated cost of about $3.5 million a year.
- Maintaining mandatory masking and access to personal protective equipment (PPE), with an estimated cost of about $7.5 million a year.
- Maintaining strong infection prevention and control practices and improving processes based on emerging scientific evidence and best practices, with an estimated cost of about $2 million a year for additional supplies and staff.
- Continuing to focus on staffing levels needed to achieve a ratio of 70 per cent full-time to 30 per cent part-time staff, with an estimated cost of $1.2 million a year.
The city said it took action before the World Health Organization declared COVID-19 to be a pandemic to ensure that the more than 2,600 residents in its long-term care homes were safe.
“In an attempt to stop the virus from entering our homes, we introduced enhanced active screening early, including taking and recording temperatures of all staff entering a city-owned home. Masking protocols were enforced, and all non-essential visits were suspended,” Tory said.
“Enhanced infection, prevention and control practices and procedures, including staff education, high-touch cleaning and disinfection, were all done to help prevent the spread of COVID-19.”
Despite the city’s efforts, the virus has been “extremely difficult” to contain, the mayor said.
“Mitigation efforts were enacted, including active surveillance and precautions, including isolation, physical distancing, tray rather than dining room service during mealtime, and use of personal protective equipment, such as masks, isolation gowns, gloves and eye protection when caring for residents, as well as enhanced testing of both residents and staff members,” Tory said.
According to the report, there were significant outbreaks at three city-run long-term care homes, Seven Oaks, Kipling Acres and Lakeshore Lodge, in the early days of the pandemic. But the report says the city learned from these early outbreaks.
“Although these outbreaks placed extensive demands on divisional resources and there were challenges maintaining staffing levels, the division was able to redeploy city staff and made adjustments in real-time to promote resident and staff safety,” the report says.
“Furthermore, these early outbreaks provided an opportunity for the division to better understand staffing supports, new outbreak protocols, and supplies that the homes would require during an outbreak to maintain resident care standards.”
All city-run homes had cases
At one point during the pandemic, all long-term care homes run by the city reported COVID-19 cases among residents or staff or both, the city said. Now, 11 residents in three city homes are positive for COVID-19.
“Implementation of these key recommendations will enable SSLTC to continue its proactive and nimble COVID-19 response, and ensure the city’s long-term care homes are prepared for a potential second wave of COVID-19,” the report reads.
Lawvin Hadisi, spokesperson for the mayor’s office, said in a statement on Monday night: “The $14.3 million for city-run long-term care homes this year is part of the additional costs the city is incurring responding to COVID-19. And that’s why the mayor is advocating so strongly for provincial and federal financial support for cities.”
The city noted that the province, through the ministries of health and long-term care, regulates and licenses long-term care homes.
All operators, whether the homes are run by the city, private companies or non-profit organizations, receive the same provincial funding, charge the same accommodation rates and must adhere to the same compliance and regulatory standards under the Long-Term Care Homes Act, the city said.