“It’s very good news and gives certainty.”
That’s from BC Seniors Advocate Isobel Mackenzie after the province announced yesterday (Tuesday) residents at long-term care homes (LTC’s) can designate their own visitor.
This is in addition to any essential visitors that were already appointed.
However, Mackenzie told Vista Radio there are still some minor barriers that need to be resolved on the topic.
“You know, there are still outstanding issues where essential visitors are determined by the care home and not by the resident. That we haven’t really sorted yet and we do need to sort that out.”
“If we find ourselves in a situation where we need to close care homes to all but essential visits then we will know that every resident can designate an essential visitor. If the intent is that when there are closures we will close to all but a single designated visitor then that looks different. But, we are unclear right now on what the language is describing.”
Mackenzie would also like to see testing requirements modified at LTC’s.
Currently, all visitors are required to take a rapid test before each visit, but staff members are only tested if they show symptoms.
The Seniors Advocate stated it has been proven time and again, people are most infectious before they show any symptoms.
“And many people are unaware of symptoms or don’t disclose their symptoms for any variety of reasons when they go to work and we found that when we reviewed COVID outbreaks prior to vaccines where 40% of staff reported to work when they weren’t feeling well.”
“So if you wait until someone has symptoms (to test them) it’s too late, they have already spread the virus in the care home. You want to catch them as early in the disease as possible and if we rapidly test everybody when they report for work we will catch people who have COVID and we will remove them from the workplace for their infectious period.”
However, Mackenzie is equally as opposed to a change announced by Dr. Bonnie Henry that will allow medical health officers to decide when to declare an outbreak.
Previously, outbreaks were declared if two residents tested positive for the virus.
She admitted while the horizon looks a lot different with fully vaccinated residents in an Omicron-dominated world, how a facility responds to a future outbreak is what’s most crucial.
“We’ve always had a criteria of two cases of an infectious disease because if there are two cases it tells you that there is transmission happening in that setting, what you do when you declare an outbreak though can look different.”
“That can all be calibrated differently in different circumstances to respond to the outbreak. But to not declare the outbreak is to allow an infectious disease to be knowingly circulating in a care home and the people living there and the people visiting may be unaware of that and maybe putting themselves at a risk they would choose to not put themselves in if they knew it was circulating.”
“A resident might feel they are unwilling to participate in group activities personally because they don’t want to take that risk or a family member might not decide to visit while there is an active outbreak because they are susceptible. If you don’t know there is an outbreak it’s hard to make those decisions,” added Mackenzie.
While Henry didn’t disclose how outbreaks would be reported on going forward they would be posted on the BC Centre for Disease Control’s website.
Mackenzie mentioned if everyone wants to return to life as it was prior to the pandemic, outbreaks still need to be dealt with in a standardized way.
“In the first year of COVID I think we had nearly 220 outbreaks at long-term care homes but in 2015-16 we had 276 outbreaks. We are accustomed in long-term care to having a significant number of outbreaks in a particular year. I think we can go back to that and I think we can go back to an individual basis on how to best manage the outbreak.”
“We are seeing the case fatality rate drop dramatically. It’s not zero but it’s gone from 30% down to about 4.3%. So, how we respond to the pandemic doesn’t have to be the same when compared to how the virus was at its most virulent.”