Nova Scotia will spend $37 million to beef up infection control and long-term care staffing in the wake of the deadly COVID-19 outbreak at Northwood nursing home.
Health Minister Randy Delorey’s announcement Monday followed the release of recommendations from a review into the Northwood outbreak, which killed 53 residents at the Halifax facility.
Infectious disease consultant Dr. Chris Lata of Nova Scotia and former British Columbia associate deputy minister of health Dr. Lynn Stevenson conducted the review. They presented their findings at a news briefing in Halifax at noon today.
Some of their key recommendations - out of a total of 17 - include:
- improve infection prevention and control “within the existing architecture” at Northwood
- review and update pandemic plans
- create a mobile infection prevention and control resource to support facilities facing outbreaks
- address staffing challenges with more employees for housekeeping, resident care, screening and visits, and a human resources plan for the sector
- clarify roles and responsibilities within the Health Department and the Nova Scotia Health Authority, restructure their disaster response teams and improve communication
“We agree with the intention of all the recommendations and we are pursuing many of them immediately to ensure our long-term care facilities are even better prepared for a second wave of COVID-19,” Delorey said in a news release Monday morning.
“We will bring our partners together to determine a path forward on some of the longer-term recommendations.”
When asked at the news briefing if the deadly outbreak was preventable, Lata credited Northwood staff for what they did right such as creating COVID-19 isolation units and barring volunteers and family members from the site.
But “a lot of the systems that became relevant that would have been important in both an outbreak response and in consideration for preparation were a lot clearer after an outbreak occurred,” he said.
“It’s always easy to say we could have done this or we should have done this. The fact of the matter is, we as a health system were used to responding to and putting into place actions that were tailored to influenza and COVID-19 of course is not quite like influenza, so it’s really difficult to say.”
Lata compared Northwood, which has 485 long-term-care beds and more than 800 staff members, to a small city.
“This is an incredibly complex structure which has complex care-design pathways, complex resident needs,” he said.
Lata said the fact so many residents and staff had the virus but showed no symptoms “really impacted Northwood’s ability to respond given its incredibly high occupancy in a way that would have quelled this outbreak very quickly.”
At a later news conference, Delorey said despite the problems that such a huge facility presents, there are no plans to close Northwood. Instead the province will look into reducing the number of residents and limiting occupancy to two per room.
The health minister didn’t have a timeline for implementing the recommendations but work will begin immediately on some, such as hiring staff for the infection control “drop” teams.
Lata said these teams will go into every long-term-care home and review their operations so if an outbreak did occur, they would already know that facility’s strengths and weaknesses.
The Health Department conducted a separate review in collaboration with the health authority and long-term-care sector representatives. That review considered overall infection prevention and control practices in long-term care facilities and actions taken during the first wave of COVID-19. Its findings were consistent with those of the Northwood review panel, the news release said.
Two residents per room
The province will spend $26 million this fiscal year and $11 million over the next two years to implement the recommendations.
According to the news release, the Health Department’s plans include:
- ensure existing long-term care rooms have no more than two residents each. Since 2007, new facilities are built with single rooms and private bathrooms
- establish one mobile infection prevention and control response team in every health authority zone to support facilities facing outbreaks, as well as an infection prevention and control resource person per zone dedicated to long-term care
- ensure there are processes in place for long-term care staff to get tested and return to work as quickly as possible
- provide funding for all facilities to increase cleaning (staff and supplies) and for small capital projects and equipment purchases to support infection and prevention control such as lock boxes and carts for medications, hand-sanitizing stations, personal protective equipment carts and room dividers
- hire staff who can be deployed as needed to manage outbreaks
- develop a robust infection prevention and control program for the long-term care sector, including education and training, online learning platforms, resources, tools and best practices, monitoring and reporting, and guidance for outbreaks and surveillance.
In a news release before the recommendations were announced, the Nova Scotia Progressive Conservative party said it expected the review to be thin on answers.
“The format of the review seems designed to protect the province from embarrassing revelations on issues such as whether sufficient protective gear was available to staff,” Progressive Conservative Leader Tim Houston said in a news release.
“The process is important because what Nova Scotians need is a process that will instill confidence. For me, a public inquiry equals transparency, openness and has binding recommendations.”
The Nova Scotia Nurses Union said it was disappointed the province didn’t make a firmer commitment to boosting nursing levels and establishing minimum care hours for individual residents, which the Northwood review panel also recommends.
“Without an assurance that appropriate staffing levels will be an immediate priority, I cannot see how we’ll be fully prepared if a second wave of COVID-19 strikes our nursing homes,” said NSNU President Janet Hazelton in a news release.
Northwood administrators said they will review the panel’s findings and look forward to collaborating with health officials to implement the recommendations.
“As part of our commitment to continuous improvement, we have already taken significant steps to ensure we are prepared for a future wave of COVID-19 and know there is more we can do. Before the pandemic our occupancy at the Halifax Campus was at 485 residents,” Northwood said in a news release Monday afternoon.
“Currently, our occupancy is at 375 with 16 residents in double accommodations. We will maintain some shared accommodations for scenarios such as couples who want to live together, or those who prefer to have a roommate.”
