Two health-care unions that are fighting for access to N95 masks have made a chain of long-term care homes where there have been more than 50 deaths a primary battleground.
The Ontario Nurses' Association (ONA) has filed for an injunction against Rykka Care Centres and its operating partner Responsive Group, which own and manage long-term care homes in Ontario including Eatonville Care Centre, where 33 residents have died; Anson Place, where 24 residents have died; and Hawthorn Place, where two residents have died. It's filed a similar application concerning Henley Place, managed by Primacare Living. A hearing is set for Wednesday.
At the same time, SEIU Healthcare has been calling on the province to take over the management of Eatonville and Anson Place and filed applications to the Labour Board seeking orders to that end this week. It is seeking the same for Altamont Care Community, a long-term care home in Toronto, owned by Sienna Senior Living, where 24 residents and one staff member have died.
There is no question that the situation at the homes is dire. Rebecca Piironen, a personal support worker employed at Anson Place in Haldimand County described in an interview with QP Briefing a chaotic environment where workers and residents alike were terrified, falling sick, and grieving loss on an unimaginable scale.
"Just knowing that 24 of their residents, their friends, their neighbours who live under the same roof, when three weeks ago they were chatty in the hallway and smiling at each other and eating dinner together," she said of the residents she has come to love. "I can't imagine what's going through their heads."
At the root of the disputes is the unions' demand that their workers — nurses and personal support workers — be given access to N95 masks. When used correctly, the respirators protect the wearer from airborne and aerosolized viruses. They are also the piece of personal protective equipment in shortest supply, both in Ontario and around the world.
"This virus is just so potent in that place the normal surgical mask and plastic shield isn't going to do, and our union's saying we need the N95," said Piironen, an SEIU member.
The unions have been fighting with the provincial government and employers for widespread access to N95 masks since the early days of the pandemic. However, the official guidance from Chief Medical Officer of Health Dr. David Williams — which is based in both the need to conserve the supply of N95 masks and the scientific evidence on the coronavirus — says that the more common surgical masks should be used in most patient interactions.
"N95 respirators SHOULD NOT be used by providers caring for COVID-19 or suspected COVID-19 patients unless the patient is undergoing an aerosol-generating medical procedure," such as putting a patient on breathing support, the guidance document says.
His advice isn't ambiguous — particularly given the use of all caps in the original document.
However, the ONA reached an agreement with the provincial government on additional language that provides a caveat — it states long-term care homes must provide N95 masks if health-care workers decide, based on their professional and clinical judgment and a risk assessment concerning their interaction with a patient, that one is necessary.
The unions have taken the position that they are necessary for interactions with all suspected and confirmed patients, arguing that the science on the issue is not clear and because of that, the higher level of precaution should be taken.
Court documents filed by the ONA show how the dispute escalated. They allege the homes initially locked up and rationed their supply of N95 masks, the union filed grievances, and the homes did not co-operate.
Correspondence filed with the court shows the ONA labour relations officer at Eatonville asked the home for information about the status of the COVID-19 outbreak and the availability personal protective equipment. His email includes an implicit threat — suggesting to executive Director Evelyn MacDonald that not providing that information would make her home a "focus point" in the union's dispute over masks with the province.
"As you may know ONA is disputing some of the direction the Ministry is giving homes and feels it has put nurses and patience (sic) at risk," the labour relations officer wrote in an April 8 email. "You have been one of my better employers to deal with so I would like to avoid your home being a focus point of any disputes arising out these disputes. I just cant (sic) do that nor help advise nurses without the information below. Information that we believe the employer is obligated to supply."
MacDonald's reply didn't provide that information, saying only: "At this time our priority is managing the outbreak, I hope you can understand our focus is resident care."
The dispute has since escalated to the application for an injunction.
The ONA also alleges the Rykka Care Centres homes have failed to implement a directive from the province's chief medical officer to cohort residents and staff — to separate the sick residents from those who haven't contracted COVID-19, and have separate staff care for the ill and the well to avoid spreading the virus.
However, that guideline also says that might not be possible in small homes.
Piironen said that's the case at Anson Place, which has ward rooms with two or four beds just a couple of feet apart, separated by curtains.
"They've basically had no chance of being able to isolate themselves from their roommates," she said. "Our home is very small. We have a very old building and I really, really feel that the building itself is the reason why it spread so badly."
Anson place is split with a 40-bed retirement home on one floor and a long-term care home with 60 beds on another.
According to Piironen, there were other failures to contain the spread of the virus after the home was warned on March 18 by the local public health unit that a visitor at the home on March 6 had tested positive for COVID-19. She said the home was slow to test residents and staff and didn't initially isolate residents of the long-term care floor, even after the administration knew there was an outbreak in the retirement home.
Today, 21 residents have died and there are 29 more positive cases in the long-term care side, which has a capacity of 60, and three residents have died and another 18 are infected in the retirement home side, which has a capacity of 40, according to the home's administration.
That doesn't account for the staff members who have fallen ill, creating a staffing shortage, Piironen said.
"Because the staff has dwindled they brought in two paramedic students and they have now tested positive, so they are not there anymore," she said.
Piironen said the home bas begun to recruit people with no health-care experience and no experience using personal protective equipment, to help at the home, asking only that they're under 50 years old and healthy.
Despite the province's announcement that "SWAT teams" of highly trained hospital staff would be sent to long-term care homes in need, that has not happened at Anson Place.
A spokesperson for Minister of Long-Term Care Merrillee Fullerton said the province is "working around the clock" on staffing issues at long-term care homes and said Anson Place is on a list of 21 "high-risk homes" that have been provided staffing support, but did not elaborate on what that has entailed.
Responsive Group did not reply to QP Briefing's request for comment for this story, but did forward email updates the executive director of Anson Place has been sending, one of which states that physiotherapist assistants and a registered practical nurse have been added to the staff, and "volunteers from the community" will be oriented at the home next week.
"Someone's got to get that place under control," said Piironen. "Maybe there won't be a home when it's said and done but the people who are left, from staff to the residents, deserve to live and be cared for."
Piironen said she has been reaching out for help wherever she can, but doesn't understand why none has arrived.
"I even actually called the OPP because I thought this was murder."
(Photo by Richard Lautens/Toronto Star)
Leave a Reply
You must be logged in to post a comment.