COVID‐19 and Ontario's Long‐Term Care Homes

Abstract

AbstractOntario long‐term care (LTC) home residents have experienced disproportionately high morbidity and mortality, both from COVID‐19 and from the conditions associated with the COVID‐19 pandemic. As of July 10, 2021, a total of 3,975 LTC home residents have died of COVID‐19, totaling 43.0% of all 9,245 COVID‐19 deaths in Ontario.The most important risk factors for whether a LTC home will experience an outbreak is the daily incidence of SARS‐CoV‐2 infections in the communities surrounding the home and the occurrence of staff infections. The most important risk factors for the magnitude of an outbreak and the number of resulting resident deaths are older design, chain ownership, and crowding.Many Ontario LTC home residents have experienced severe and potentially irreversible physical, cognitive, psychological, and functional declines as a result of precautionary public health interventions imposed on homes, such as limiting access to general visitors and essential caregivers, resident absences, and group activities. There has also been an increase in the prescribing of psychoactive drugs to Ontario LTC residents.The accumulating evidence on COVID‐19 in Ontario's LTC homes has been leveraged in several ways to support public health interventions and policy during the pandemic. Several further measures could be effective in preventing COVID‐19 outbreaks, hospitalizations, and deaths in Ontario's LTC homes. This includes improving staffing, minimizing LTC worker infection, decrowding LTC homes, enhanced infection prevention and control (IPAC) measures, a more balanced and nuanced approach to public health measures, and additional strategies to promote COVID‐19 vaccine acceptance amongst residents and staff.