Ontario had no plan to address pandemic or protect residents in long-term care, final commission report says
Ontario was not prepared to address a pandemic and had no plan to protect residents in long-term care thanks to years of neglect, according to a final report from an independent commission released Friday evening.
The province's Long-Term Care COVID-19 Commission submitted its final 322-page report to the provincial government Friday night, which highlighted the actions and inactions that contributed to the devastation in long-term care during the COVID-19 pandemic.
"Many of the challenges that had festered in the long-term care sector for decades — chronic underfunding, severe staffing shortages, outdated infrastructure and poor oversight — contributed to deadly consequences for Ontario's most vulnerable citizens during the pandemic," the commissioners wrote.
The report found that the province failed to learn lessons from the SARS epidemic in 2003 and that sweeping reforms are needed to protect Ontario's vulnerable residents in the future.
"Now is the time to revisit the delivery model for long-term care and adopt a better way to provide care for Ontario's seniors," the report said.
The commission said poor facility design and resident overcrowding heightened sickness and death in the nursing homes, with nearly 4,000 residents and 11 staff dying of COVID-19 by the end of April.
It said a severe staffing shortage and a workforce poorly trained in infection control measures compounded the situation.
"It is plain and obvious that Ontario must develop, implement, and sustain long-term solutions for taking care of its elderly and preparing for a future pandemic."
Reacted too slowly
New facilities need to be built to address the needs of the province's aging population, the commission said, adding that the government also needs to reconsider how those nursing homes are managed, with a focus on quality care.
It suggested a new model to build long-term care homes in the future, similar to what's in place for privately funded hospitals, courthouses and light rail transit systems.
"All involve the construction of infrastructure that is paid for upfront by private investors who receive a return on their capital with profit over time. However, others actually operate the infrastructure — the courts, hospitals, etc. — once built," the report said.
Then, the commission suggests, a mission-driven organization — be it public, not-for-profit or for-profit — would handle the care of the residents.
The commission took particular issue with long-term care homes that are owned by investors.
"Care should be the sole focus of the entities responsible for long-term care homes," it said.
It also suggested that the provincial government — and Dr. David Williams, the chief medical officer of health, in particular — was too slow to act on emerging information about COVID-19.
The province was hesitant to acknowledge that community spread was happening, that asymptomatic patients could spread the virus and that masks would be helpful when it comes to prevention.
"Delay is deadly," the commissioners wrote.
Ontario launched the commission on May 19, 2020, in an effort to determine what went wrong in long-term care homes during the pandemic's first wave.
At that time, long-term care residents accounted for nearly 1,400 of the province's 1,904 COVID-19 deaths. Five staff members had also died of COVID-19 at that point.
But even after the commission was launched — and after it released two interim sets of recommendations — the virus continued to tear through the facilities.
The commission, led by Frank Marrocco, associate chief justice of the Superior Court, heard from long-term care residents, staff and management.
It questioned government officials from Williams to Long-Term Care Minister Merrilee Fullerton to Health Minister Christine Elliott.
Military leaders who organized a deployment into long-term care homes also gave testimony, detailing the circumstances surrounding the mission that led to a damning report on conditions inside the facilities.
In all, the report said, the commission heard from more than 700 people. CBC