It’s been over a year since COVID-19 arrived at the doorstep of Northwood’s Halifax campus and claimed the first three lives of an outbreak that would go on to infect 240 residents and kill a total of 53. And it’s been just under 11 months since the province declared that outbreak over. But on Tuesday afternoon, just as Nova Scotians were percolating over the latest (and strictest) “stay the blazes home” protocols announced in recent weeks, a new case of COVID was confirmed at the long-term care home that saw itself at the epicentre of Halifax’s first wave.
In a news release issued Tuesday to families of residents, Northwood confirmed to loved ones their worst fears: a staff member at the Halifax campus was a presumptive positive, and had gone into self-isolation. Soon the case was updated as confirmed positive, and the two floors the worker had contact with—1 Centre and 8 Centre—went into full lockdown.
“All residents on these floors have been swabbed and have been placed on isolation precautions,” said Northwood’s update. To mitigate the lockdown, Northwood invited designated family members to visit. “We understand the impact of isolation on our residents and are very happy to say we have been supported by Public Health to resume our Designated Care Giver Program.
During a third wave that has across the country been less dangerous for seniors and LTC residents—largely because of a prioritized vaccination rollout within these vulnerable populations—this recent case fell like a bag of bricks on the already worn backs of the families who witnessed the first wave outbreak at the home that ultimately accounted for most of Nova Scotia’s lives lost in the pandemic.
Cecilia Gray, whose 97-year-old mother lives in Northwood, lamented Thursday about how this week’s news was not only terrifying, but had immediate—and frustrating—consequences for her ability to care for her loved one. Gray is her mother’s designated caregiver but, as of Wednesday, Northwood’s policy stated that DCGs need to have both doses of the vaccine to come in and care for residents. Gray’s not due for her second jab till August.
“When they said you can’t come in…oh my god, I dropped a tear or two,” she said. “Here we go again with this damn stuff.”
On Friday morning, however, Northwood sent a note to families announcing they’d be reversing this policy. Going forward, Northwood would allow DCGs into the facility, with additional safety measures in place, if they hadn’t had their first dose or were still awaiting their second.
That reversal, however, hasn’t eased the minds of all families and caregivers. Renee Field, whose 77-year-old mother lives on the seventh floor of the Halifax campus—and who actually tested positive for the virus during its first wave—says she’s painfully aware of the fact that there are staff caring for her mother who are not vaccinated, some by choice.
And to her, that shouldn’t even be possible.
“If you’re working with a vulnerable sector, there’s a number of vaccines that are already mandatory,” she said. In New Brunswick and Ontario, for instance, students entering public school are required to provide proof of being immunized for diphtheria, tetanus, polio, pertussis, measles, rubella, mumps, varicella and meningococcal disease.
“I firmly believe the pressure should be on the government to say these are our rules and we’re setting the bar and we’re setting it high,” Field said. “You have to be vaccinated if you’re going to work in long-term care.”
Northwood has confirmed there is still only one C19 case currently, and that staffing levels remain unimpacted from the number of staff who are now self-isolating as a result of being a direct contact. But as measures tightened at the long-term care home this week, the tension over the vaccination status of the staff member who tested positive—and exactly how many others have received their first and second doses—began to reveal a deeper anxiety around mandatory vaccinations from within the community.
At a COVID briefing on Wednesday, when pressed by reporters about this very issue, Nova Scotia’s chief medical officer of health, Robert Strang, admitted he wasn’t “in the weeds in the details of knowing” what share of staff and residents were being tested and vaccinated. He was, however, “reassured” by what he saw in both groups as a “very high uptake” of the vaccine.
“It’s heart-wrenching. With just one positive case of a staff member, and now two floors are on full lockdown.”
“I have the least anxiety around long-term care facilities, simply because we know the residents are well-protected with vaccine,” Strang went on to add during the briefing.
Murray Stenton, the communications representative for Northwood, said the facility couldn’t comment on either the vaccination status of the infected person, or how many staff members were isolating as a knock-on effect of this recent case. Stenton did confirm the numbers from Northwood’s website that state that vaccination levels in the long-term care facility are above 95 percent in the residents and 80 percent or higher within staff.
Nova Scotia’s department of health and wellness, which is in charge of the province’s vaccination rollout strategy, was unable to provide comment on this article before publication.
Though vaccination uptake at the long-term care facility among residents seems to be nearly completed, this recent case of COVID among Northwood’s staff is creating a renewed sense of urgency from families of residents to get staff up to the same level. “I was annoyed off the bat, because initially they said all DCGs had to be fully vaccinated, but I know there are staff refusing the vaccine,” Field said. “It’s like lessons haven’t been learned from last year.”
Northwood is not forcing staff to receive the vaccine, and Stenton said he couldn’t comment on whether the facility plans to mandate this policy down the road. This legal minefield is one that’s on the forefront of many employers as they attempt to navigate this peculiar moment, labour lawyer James Green shared on Thursday. But the precedent, he admits, is still rather muddied.
“There's a good argument that vaccinations policy, which require vaccinations as a condition of employment, would be upheld especially in high-risk workplaces,” Green said. But, he cautioned, this hasn’t been tested yet.
“So it's still not clear in Canadian law. But I think there's a strong argument to say that policies of that nature would be enforceable.”
While vaccinations of staff weigh heavily on the minds of caregivers, it’s somewhat distracting from the larger systemic issues that are at the heart of the long-term care problem in Nova Scotia, Chris Parsons, director of the Nova Scotia Health Coalition, explained.
“The long-term care system is essentially being propped up by this volunteer labour force. It should be a scandal to people that we just simply do not hire enough staff at these long-term care facilities.”
“I think the designated caregivers are a good example of the fact that we simultaneously have to find ways to ensure that they're able to care for their loved ones while also trying to think about why it is that we built a system that relies on [these] people to do that,” said Parsons.
“The long-term care system is essentially being propped up by this volunteer labour force,” Parsons said. “It should be a scandal to people that we just simply do not hire enough staff at these long-term care facilities.”
In a damning multi-month-long investigation put out by The Coast earlier this month, reporter Stephanie Nolen laid bare how both the province’s policies around long-term care and Northwood’s own unique factors made the facility gravely unprepared for the first wave of the pandemic.
Parsons, who himself has strong ties to Northwood—he worked there and had a family member live there—believes the situation at the Halifax facility is a symptom of a larger issue in how we think about long-term care in Nova Scotia.
“If we were to only follow the current staffing levels and only rely on trained professionals who are paid, and not paid enough, but only rely on them, that the system simply would grind to a halt…that’s preposterous”
Field, who was able to visit her mother this week, agrees that the staff are indeed massively overwhelmed. “My mother’s been wearing the same clothing for the last two weeks. So I got to go in the room and get her dressed.”
But regardless of staffing levels, she still firmly believes the first priority should be making vaccination mandatory, and that that call should be coming down from the province. “It’s heart-wrenching. With just one positive case of a staff member, and now two floors are on full lockdown.”
Another area where Northwood could be stepping up in the interim, she said, is in vaccine education and outreach for staff. In just the last few weeks, she’s overheard conversations where staff members compare getting the COVID vaccine to the annual influenza shot.
“They’re like, ‘Well, you know, I’ve never gotten the flu vaccine and I didn’t get sick when it was here,’” she said. “Northwood has a duty to do some professional education for these people.”