Looking back on the previous year from 2021, hindsight is 20/20.
One year after the COVID-19 pandemic was declared, the County of Simcoe has released a new COVID-19 Infection Prevention and Control (IPAC) Guidelines and Outbreak Management Compendium, hoping to share the lessons they have learned with other long-term care homes to help in the fight against COVID-19, other viral outbreaks and any future pandemics.
“We’ll be sharing this with hundreds of long-term care homes across the province and we hope it helps them with their fight against COVID. It’s really an A-to-Z on everything you might need,” said Jane Sinclair, the county's general manager of health and emergency services. “We’re all in this together. The more we can share the learnings with one another, the stronger we all are together.
“COVID took the world by surprise. We’ve had positive cases and outbreaks. This isn’t the time to judge others. This is the time to reach out and help one another, and that’s what we want to do,” she added.
Over the past year, all four Simcoe County-owned long-term care homes have experienced outbreaks of COVID-19. Simcoe Manor in Beeton has experienced five outbreaks since the start of the pandemic, Georgian Manor in Penetanguishene has had two, Trillium Manor in Orillia had one and Sunset Manor in Collingwood had one. Currently, all of the homes are COVID-free and all residents and staff who opted to participate have been fully vaccinated.
“Being in long-term care, dealing with infectious diseases is something we all have done. Historically, we’ve managed very well. But I think, our learnings through COVID-19 have been about applying IPAC (infection prevention and control) to this virus specifically. It’s not like any other virus we’ve dealt with,” said Sinclair.
Sinclair mentions PPE (personal protective equipment) protocols, social distancing, and cleaning protocols as examples of how long-term care homes have completely changed how they are managed throughout the pandemic, once learning how transmittable and infectious the virus can be.
She says cohorting is a major part of managing outbreaks from an IPAC standpoint.
“Keeping staff on the same units with the same resident assignments, and being able to cohort our residents in a particular area of a unit is really important in helping (reduce) transmission,” she said. “It’s tough when people call out sick and you have to ensure you have certain levels of staff.”
Audits are also a major part of managing COVID-19.
“We’ve always done them, but we’re doing a lot more in an expanded number of areas,” said Sinclair, noting cleaning, PPE use and hand washing are all protocols that are now being audited regularly.
“We’ve worked very, very hard to create this culture of long-term care that provides a safe, comfortable home-like environment. Part of the challenges have been to apply some of these IPAC principles within a long-term care setting. This is not a hospital or acute-care setting, so things that may be common practice in a hospital don’t necessarily fit very well in a long-term care home,” she said.
Sinclair cites an example of quarantining and isolating residents in their rooms when necessary.
“There’s a whole psycho-social component. So we really had to adapt our programming to make sure we’re maintaining that part of their health and mental wellness,” she said.
Throughout the pandemic, Sinclair said communications have been significantly expanded for staff, residents and families.
“We’re using technology a lot more. We’re hosting virtual town halls, connecting our families with our residents through FaceTime and other technologies,” she said. “Communication keeps our staff informed and helps them understand... why we’re doing the things we’re doing. It helps to reassure.”
During outbreaks at county-run homes over the past year, Sinclair has, upon occasion, donned her own scrubs and full PPE to offer assistance within the homes. She worked in long-term care and health care for many years before working for the county in a management capacity.
“I was in the homes during the outbreaks, but not just myself. Other leaders from the corporation were also there to support the entire team,” said Sinclair. “The staff need as much support as we can give them. ... There are so many additional things we needed to do with COVID to keep it from spreading.”
Sinclair describes the feeling of working in a long-term care home in outbreak during a pandemic to be “very humbling.”
“I have this huge appreciation for the staff who work in these long-term care homes. They are truly special people,” she said. “It’s like a family environment.”
Approximately 100 staff members employed through the county were redeployed during the pandemic to help out in long-term care, including staff from the Simcoe County Museum, roads, and Ontario Works.
“Being on side and working hand-in-hand, it’s so fulfilling. It’s hard to describe how wonderful it makes you feel,” she said. “It was truly a moving experience.”
Throughout the pandemic, Sinclair points to many community partners that jumped in to help out when county homes experienced outbreaks, such as Orillia Soldiers' Memorial Hospital, Royal Victoria Regional Health Centre in Barrie, the Red Cross, and Stevenson Memorial Hospital in Alliston.
So, when Roberta Place in Barrie was experiencing one of the worst outbreaks seen in the Simcoe-Muskoka area in January and February, Sinclair says the county did not hesitate to repay the favour.
“They helped us around IPAC assessments and rapid testing. When Roberta Place was experiencing their serious outbreak, we participated in their outbreak meetings and anything we developed, we were sharing with Roberta Place to help them,” she said. “This is nothing like any of our long-term care homes or hospitals have seen in the past.”
The compendium released this week is a living document that is intended to change over time as more lessons are learned in relation to COVID-19. The resources and aids included have been developed through hands-on experience battling outbreaks and through the knowledge sharing and support from county partners at the Simcoe Muskoka District Health Unit, Ontario Health LHINs, local Health Teams, and community hospitals.
“Because we’ve learned, developed and revised, we want to share with our partners across the entire region. Anything we can do to help someone else is what this is all about,” she said. “We’re going to keep building and adding over the next few weeks. Then other long-term care homes or organization that are looking for support around procedures or education, we will share.
"It’s an opportunity, in a pandemic, to help each other out," Sinclair added.
Post-pandemic, Sinclair says she thinks there are a lot of changes to protocol that will continue, as they have changed the environment of long-term care locally to make it better overall.
“When the pandemic has come and gone, there are a lot of things that will become our new normal,” she said. “We’ve been able to connect in ways that we didn’t prior to the pandemic through virtual means. Those things are here to stay. That communication is so important.”
Mental health and wellness supports will also be different moving forward.
“Mentally, it can be a huge burden. Having those supports, whether they’re one-to-one, access to information online or group virtual meetings, it does make a difference,” she said.
She hopes long-term care will look different after the pandemic is over, but still maintains that home-like feeling.
“What I hope we’ll see is a balancing. We don’t want long-term care homes to become hospitals. They’re two very different environments. I’m hoping we’ll see a blend (where we’ll) apply all these learnings around IPAC into a home-like environment that still preserves that culture that’s really important for our long-term care residents to thrive,” she said. “If we turned our homes into institutions, we’d be doing a disservice to our residents.”
To view the compendium, click here.