Kill: to deprive of life : to cause the death of
One can hardly believe them all to have been accidental? When common sense, and past history along with well known problems in LTC homes would have or should have made the outcomes of these decisions knowable. Predictable? That available information, widely accessible to governments, would clearly and unequivocally have allowed those that made the suspect decisions to know of their inevitable outcome.
Globe and Mail "Long-term care homes: Thousands of seniors were discharged from hospitals to nursing and retirement homes to makes space in hospitals"
As a result, it appears most of the nursing- and retirement-home residents who have succumbed to COVID-19 died inside the virus-stricken, understaffed facilities, while many of the hospital beds opened for coronavirus patients sat empty.A scenario that played out globally.
Globe and Mail: How Shoring Up Hospitals for Covid 19 Contributed to Canada's Long Term Care Crisis
In the early days of Canada’s coronavirus response, when officials were consumed with fears of overwhelmed hospitals and rationed ventilators, a hospital in Oshawa, Ont., discharged an elderly patient named Nina Watt to a nearby nursing home.
Three weeks later, Ms. Watt was dead. Orchard Villa, the nursing and retirement home to which she had been transferred, went on to experience one of the worst outbreaks in the country, with 77 dead of COVID-19, including Ms. Watt.
Ms. Watt, 86, was one of thousands of seniors discharged to nursing and retirement homes as Ontario, Quebec and other provinces rushed to clear beds for a flood of COVID-19 patients that has so far not swamped hospitals, thanks in large part to shutdowns and physical distancing.Orchard Villa is one of the 5 LTC homes the military has been working in. And Orchard Villa is included in the report mentioned in this post:
Cockroaches and flies. Patients sleeping on bare mattresses. Rotten food smells. Patients left in diapers filled with excrement. Patients fed supine, including an incident of code blue choking, in the presence of military, the patient was not revived. If you're resident in Ontario and you haven't read this report? What the hell is wrong with you?
At the same time the acute-care sector was searching for space, some hospitals, physicians and long-term care facility administrators were discouraging families from sending infected nursing-home residents to the hospital, saying little could be done to effectively treat COVID-19 in patients who were old and chronically ill.Were the LTC homes afraid of losing money?
As a result, it appears most of the nursing- and retirement-home residents who have succumbed to COVID-19 in Canada died inside the virus-stricken, understaffed facilities, while many of the hospital beds opened for coronavirus patients sat empty.
“There’s a lot of age discrimination. There’s this presumption that, well, everybody in long-term care is there to die,” said Jane Meadus, a lawyer with the Advocacy Centre for the Elderly in Toronto. “Of course, that doesn’t deal with the fact that, had they moved people out [of nursing homes] when they became aware they were COVID-positive, they might have been able to slow or stop the infections from continuing through the homes.”The beds were clearly available in the hospitals. Why weren't the sick moved out of the LTC homes?
An estimated 80 per cent of the Canadians who’ve died of COVID-19 have been residents of seniors’ facilities, according to the Public Health Agency of Canada.
No province has been hit harder than Quebec, where 2,355 long-term care residents and 653 retirement-home residents have succumbed to the coronavirus and its resulting COVID-19.The latest date for Quebec, as of today, May 29/2020 shows deaths from Covid at 4302.
From Quebec's Data for ages 60- 90+ it's clear that this age group accounts for 97 percent of the deaths, undoubtedly the vast majority, if not all of them in LTC homes.
Globe and Mail continued
Ontario has reported 1,427 deaths among nursing-home patients and 125 among residents of retirement homes, while British Columbia and Alberta have each managed to keep COVID-19 deaths at seniors’ facilities below 100 as of Wednesday. (all stats are from the time of G&M's article and have likely changed as of today's date)
At the start of the coronavirus crisis, the Quebec government justified its decision to move patients out of the hospital network on two grounds.
First, Health Minister Danielle McCann said that during the H1N1 pandemic in 2009, patients with flu-like symptoms flooded emergency wards. In addition, this time, officials wanted to prevent the more pessimistic projections for the impact of COVID-19, what Premier François Legault called “an Italian-style scenario,” in which hospitals would run out of ventilators and intensive-care beds.The 2009 Swine Flu Pandemic was another claimed pandemic that amounted to a hill of beans,
mild, nothing even remotely as severe as previous non pandemic flu seasons. Of course people died as they do every viral season. Which is always tragic. But nothing occurred then that justified the hype of the time. I wrote extensively about "swine flu" at that time.
Premier Francois Legault did not avoid "an Italian- style scenario". He, in fact, recreated the Italian scenario. Exactly.
On March 8, a resolution by Attilio Fontana, president of the Lombardy region – Italy’s economic engine and the epicenter of the epidemic with 12,213 deceased - sentenced hundreds of elderly people ( ←the order as issued) hosted in nursing homes to death.
The regional resolution offering150 euros ($163) to nursing homes for accepting Covid-19 patients to ease the burden on hospitals, contributed to the uncontrolled spread of the virus among health workers and elderly guests, turning these institutions into virus hotbeds.
Hosting Covid-19 patients in nursing homes was like lighting a match in a haystack.Quebec undertakes "load shedding" including paying LTC homes to take possibly infected patients, exactly as Italy had done.
"During the month of March, Quebec hospitals were directed to do “load shedding,” freeing beds by postponing elective procedures and transferring patients.
Other local health authorities turned to private elder-care homes.The health board for Montreal North, for example, agreed to pay a total of $133,800 to three private seniors’ facilities for a dozen residents, “to apply our load-shedding plan because of COVID-19,” the procurement contracts said.
“It had to be done, taking people who could be transferred to LTC homes to free beds in hospital and eventually handle the incoming wave caused by COVID-19,” Mr. Legault later told reporters to justify the decision.
In Ontario, hospitals transferred out nearly 2,200 alternate-level-of-care, or ALC, patients from March 2 to May 3 – 1,589 of them to long-term care homes and 605 to retirement homes, according to the province’s Ministry of Health.
Ms. Watt, who had Parkinson’s disease, had been at Oshawa General Hospital, part of the Lakeridge Health network east of Toronto, since a fall in January left her incapable of returning to the apartment where she lived on her own.
She did not want to move to Orchard Villa, but she reluctantly agreed to the transfer on March 23, her son, Andrew Watt, said. Andrew Watt, said. Ms. Watt died of COVID-19 on April 15, three days after testing positive.
“When I talked to her at the hospital, she told me she didn’t want to go there,” her son said. “But they were telling her that was the only option she had.”
In preparation for the pandemic, the Ontario government made regulatory amendments on March 24 that allowed placement co-ordinators to send ALC patients to any long-term care home with an appropriate bed, although patients technically had a right to refuse.
Normally, patients choose a handful of preferred homes and wait for an opening. In Ms. Watt’s case, Orchard Villa was last on her list, and she only added it at the urging of the local health authority that co-ordinates placements, Mr. Watt said"Local health authorities urged her to add Orchard Villa to her list of homes? When? Why?
"Nursing-home patients infected with the coronavirus were never supposed to be denied hospital care if they needed it, according to Ontario’s Ministry of Health, but it’s not clear how much of that message filtered down to the independent players in the system.What was wrong with this doctor? Why was he so adamant about patients not getting necessary treatment in hospital?
Linda Cottrell, whose 93-year-old father, Manuel Marques, also died of COVID-19 at Orchard Villa, said a doctor at the home called and chastised her for trying to send her father to the emergency room at Lakeridge Health’s Ajax Pickering Hospital, east of Toronto.
It was a step Ms. Cottrell only agreed to after an Orchard Villa nurse called to ask what she wanted done with her father, who had spiked a high fever. Mr. Marques was awaiting his coronavirus test results at the time.
“[The doctor] was angry with me that I had sent him to the hospital,” Ms. Cottrell said, adding the doctor accused her of putting her father at risk with the move. “Then [the doctor] said they didn’t even take him into the hospital. They turned him around, and they sent him back.”
"Sharon Navarro, a spokeswoman for Lakeridge Health, said she could not comment on the cases of Mr. Marques or Ms. Watt for privacy reasons. The executive director of Orchard Villa declined to answer a list of questions sent by e-mail, instead referring The Globe and Mail to a statement from Ms. Navarro. The Central East Local Health Integration Network, which co-ordinates placements in long-term care, also declined to speak about Ms. Watt’s case because of privacy.
The Quebec government also tried to cut down on movements back toward hospitals. Clinical guidelines issued on March 23 said that residents in long-term care facilities who contracted the new illness should only be sent to hospitals “on an exceptional basis and after consultation with the doctor on duty.”
Jean-Pierre Ménard, a lawyer specializing in patients’ rights, wrote to the Health Minister, raising concerns about the guidelines. In his letter, Mr. Ménard argued that it was hard to get elderly patients to give proper consent on their level of care since they had been locked down in care homes with no access to their relatives since mid-March.
At first, Quebec’s Premier and Health Minister insisted that it was better to keep elderly residents in long-term care facilities. “It is never good to transfer people, to move people to other facilities, including the elderly, who get settled in and then become distraught when they change locations,” Mr. Legault told reporters on April 2.Why didn't the Quebec government, upon realizing that the hospitals were NOT overwhelmed, as per their "dire forecasts", aka fudged models, not move the elderly into the hospital beds that were available, sitting empty, waiting to be used for treating covid patients? Why wasn't this done? Why didn't Ontario's Ford government take appropriate actions either?
A few days later, the Quebec government realized that, with fewer than 700 COVID-19 patients in hospital, the dire forecasts of overwhelmed emergencies and intensive-care units weren’t materializing."
Part 2 has been published- here
Part 3 has been published- here