As coronavirus cases have risen in B.C. this fall, outbreaks in senior care homes have climbed along with them, with fatal consequences among frail elderly people.
B.C.’s worst day so far was Nov. 12, when outbreaks were declared in five care facilities and one hospital, where the sickest residents have to be transferred for ventilation treatment. That brought the total of active outbreak protocols in the health care system to 35, as the rising death total approached 300.
B.C.’s Seniors Advocate Isobel Mackenzie says investigation of the second surge of cases has found the weak spot seen in many workplaces, contact between staff members as they come to and from work or take breaks. Now staff are being tested only if they report symptoms, and as more is learned about COVID-19 transmission, another step is needed.
“We thought the virus was coming in with staff, being transmitted to residents and then that was how it was being transmitted through the care home,” Mackenzie told CFAX radio in Victoria Nov. 23. “What we’re learning is that staff are transmitting it to each other as well. That we’re great at personal protective equipment between us and our patients, and or the residents, but we’re not so great at PPE between ourselves. We don’t think of that as much, in the staff room or coming to work together in the same car, or having a chat in the foyer before we report to our different floors.”
Rapid saliva tests are being used in schools, and they give a result in 30 minutes or less, so they are practical to use every day to stop pre-symptomatic transmission. They are less sensitive than the standard nasal swab sent to a laboratory, but should be used as a first step, with positives kept out of the care home until the second test is complete.
Mackenzie said the second surge of the virus is showing community transmission rates much higher than this spring, and levels in the Lower Mainland suggest better protection of the most vulnerable is needed.
“If everybody comes on shift, nobody’s showing any symptoms, they all think they’re free of COVID, right now we’re not doing any testing,” Mackenzie said. “If we’re doing rapid tests on those people, we are going to catch some people who are asymptomatic or pre-symptomatic, but their viral load is high enough that they triggered an immune response and the test will catch that.”