Health workers inside a Port Coquitlam care home battling a COVID-19 outbreak are alleging senior management has failed to respond to their concerns, leading to a systematic breakdown in communication, delayed outbreak response and inadequate staffing as case numbers continue to rise.
The Nicola Lodge workers, who brought their concerns to the Tri-City News on condition of anonymity, allege a failure to properly staff the unit at the epicentre of the outbreak has forced employees to work while awaiting a pending COVID-19 test result.
“You have one care aide working this entire unit, who’s going back and forth between healthy people and people who are infected. Now, you don’t need to know much about infection control to know that’s a giant faux pas,” one of the workers said.
The outbreak has spread to two units, where upwards of 60 residents live, according to the workers. As of Dec. 23, the virus had spread to 12 staff and eight residents, confirmed a spokesperson for Sienna Senior Living Inc., the parent company which owns Nicola Lodge.
LOW STAFFING, COMMUNICATION BREAKDOWN
Two nights after an outbreak was declared, health-care workers said only a single care aide was deployed to the floor where the outbreak began, and that they worked 16-straight hours.
Some staff members allege they were forced to work while waiting for swab results from a COVID-19 test, something they said puts the entire facility, its staff and residents at risk.
In one case, a health-care worker was at home feeding her son breakfast when a co-worker called to say they had seen their swab result and it had come back positive.
"They’re calling [management] and saying, ‘Hey, I heard I’m positive. What’s going on?’” said one worker. “The more people that aren’t properly informed if they’re negative or positive are going to be working, or they’ll be bringing it home to their own families.
“It’s only going to get worse.”
The poor communication extends to families of residents, too, allege workers. When the outbreak was first declared, staff say both they and family members learned about it from reporting in this newspaper or from Global News.
“There was no notification from management, from Sienna, that the place had gone on outbreak,” added another worker. “Imagine you’re a family member and you’re not told there’s an outbreak until you watch it on the six o’clock news. Like, why am I not being notified right away?”
Overwhelmed workers said when they’ve asked management to inform family members of infections on their floor, senior administrators have failed to follow through.
Sienna Living spokesperson Nadia Daniell-Colarossi denied claims of mismanagement, stating staff were only required to isolate at home after testing positive and, in the meantime, they are actively screened twice a day and told to monitor for symptoms in accordance with direction from Fraser Health.
“When a resident is confirmed as positive for COVID-19, we immediately inform the resident and their family members and then communicate information more broadly to all families,” wrote Daniell-Colarossi in an email.
WAS AN OUTBREAK DECLARED TOO LATE?
Fraser Health publicly declared the outbreak at the Nicola Lodge long-term care home in the afternoon of Dec. 19, though two employees with access to COVID-19 test results for the facility told the Tri-City News the first lab-confirmed positive case was on Dec. 17, two days earlier.
But a spokesperson for Fraser Health said the protocols around declaring an outbreak changed last month, and only occur when a medical health officer has found COVID-19 has spread from one test-positive person to another inside a seniors home.
“This policy, which is in alignment with provincial guidance and other health authorities, was implemented in November and has been communicated to all of our long-term care and assisted living partners,” wrote the Fraser Health spokesperson.
In between a positive case and the declaration of an outbreak, a risk assessment is done by health officials, which may lead to enhanced COVID-19 surveillance and additional infection prevention and control measures.
NO SOLUTIONS TO OLD PROBLEMS
Beyond the affected units, other sections of the home are under droplet protocol, meaning they must don and doff personal protective gear with every resident. But health workers inside Nicola Lodge said they have had little direction on how to manage residents with dementia, who often wander from room to room without regard for social distancing.
Such challenges have not gone unrecognized. In a leaked report detailing the deadliest seniors home outbreak in British Columbia, Langley Lodge CEO Debra Hauptman pointed to behavioural units as a major stumbling block in preventing the transmission of the virus.
“They do not understand social distancing, social isolation, staying in their rooms, not touching one another. That’s where I really appealed to the health authorities,” Hauptman told the Tri-City News in response to the leaked report in September.
“We’re very fearful of that happening in that unit again — and so are my colleagues.”
Those fears do not appear to have abated inside Nicola Lodge, where health-care workers say they have received no direction on how to deal with dementia patients during an outbreak.
“It’s going to spread with the lack of staff because we can’t redirect everybody and say, ‘Hey Bob, go back into your room,’” said one worker.
A spokesperson for Fraser Health, however, said it has provided guidance to long-term care and assisted-living sites around the use of droplet precautions when dementia patients are involved.
“Our expectation is for all our partners to follow these protocols when there is a COVID-19 outbreak,” said spokesperson Dixon Tam in an email.
’NOT ASKING FOR A UNICORN’
This isn't the first time Sienna Living has been accused of mismanagement during a COVID-19 outbreak.
Earlier this year, a $100 million class-action lawsuit was launched against Sienna Living on behalf of family members in Ontario after serious allegations of neglect, incompetence and abuse surfaced from whistleblowers and in a damning military report.
In June, Sienna Living launched an independent, company-wide investigation as part of what it called a “sweeping set of initiatives” aimed at protecting residents.
The results of the investigation led to a series of recommendations in August, including improving staffing and labour relations policies; formalizing a complaints process; protecting whistleblowers; and reviewing and reinforcing a zero-tolerance approach to resident abuse.
But staff inside Nicola Lodge say little has changed and the latest outbreak has revealed cracks in management’s ability to manage a crisis while keeping people safe. That includes a lack of O2 concentrators — portable machines that provide oxygen to patients dealing with a life-threatening situation.
But Sienna Living spokesperson Daniell-Colarossi said Nicola Lodge has all the necessary personal protective equipment and medical supplies, as it continues “to prioritize training and education for team members.”
“There has been no interruption to care or services, and all of our team members meet daily to review staffing levels to ensure all residents’ needs are fulfilled,” she wrote.
Meanwhile, one worker said they feel “like we’re just bodies — whether we test positive or test negative, it’s as long as we’re willing to work on the floor.”
Another added: “All they’re asking is for help. We’re not asking for a car. We’re not asking for a unicorn. We’re just saying, 'Hey, we need some help. Can you make sure we’re properly staffed, we have the equipment? Can you provide us with these phone calls to families?'"