The fifth wave is starting to look very much like the first for seniors across Canada living in homes like Lakeside Long Term Care Home in Toronto.
Despite 98 per cent of residents being double or triple vaccinated, all 120 people in this facility are isolated to their rooms, with some having been under lockdown for a month.
The cause? Infections among staff are triggering increasing periods of isolation for residents who were in contact with them, all while Omicron drives soaring case levels outside of long-term care homes.
Eighty-three year old Jennifer Brown is triple vaccinated and doesn't have COVID-19. But she can't leave her room.
“I feel depressed […], anxious and angry, because they could have learned lessons from the last time around and they did not,” Brown said.
Speaking to CTV News over Zoom, she panned the camera around her empty room.
“I have no family so I have no one coming to see me,” she said. “It is like being in solitary confinement.”
Omicron is showing how little things have changed in long-term care — and families are livid.
Denise Schon, whose 96-year-old mother Barbara lives at Lakeside, told CTV News that her mother is losing her mobility and her understanding of her surroundings since being confined to her room on Christmas Day.
“They won't let her walk around. And she's losing a sense of where she is.”
Schon explained that because her mother can’t walk the hallways of the care home, she is losing her ability to grasp where it is that she lives.
“She thinks she’s in a rooming house,” Schon said.
Schon believes the strictness of the lockdown procedures don’t balance the need for safety with the residents’ other needs.
“All of them should be allowed to walk around the hallways,” she said. “They can do it in stages. They have a beautiful balcony. They can take them out to the balcony. They can do things with them — but they're not. They are afraid that they're going to get another headline which says ‘people have died of COVID in a long-term care.’
“They don't care if they die of loneliness or depression. They just don't want them to die of COVID.”
On December 8, 2021, two staff members of Lakeside tested positive for COVID-19, and two residents who had been in contact with those staff members also tested positive.
Those two residents have since recovered, and no subsequent residents have tested positive. But the lockdown has stretched on as more staff members contracted the virus.
Currently, 18 staff members of Lakeside are at home after a positive test.
Under public health rules, seniors who had been in contact with them are considered high risk and, vaccinated or not, must also isolate for 10 days.
But this can lead to longer and longer periods of isolation, Schon said.
“So what happens is that a staff member tests positive and they say, ‘Oh, the whole floor has to be shut down,’” she explained. “Then eight days later, another staff member tests positive, so they say, ‘Now we have to shut down for another 10 days.’ And then eight days later, another staff member shuts [it] down. And so given how prevalent it is in the community, when does this stop?”
It’s devastating for residents who received their vaccines hoping to get back to some semblance of a normal life after months of lockdown in earlier waves.
In an email sent to CTV News, Brown described how difficult it was to live in lockdown for 16 months during 2020 and the start of 2021.
“Gowned and goggled, they they looked more like Martians than the kind people I had come to cherish,” she wrote of her caretakers bringing her meals. “Too exhausted to do more than utter brief words of comfort as they entered and left in a matter of minutes.”
She said that returning to lockdown in December was hugely demoralizing.
“I have some question[s] for the Ministry of Long-Term Care,” she wrote. “Did no-one consider our emotional and mental health before issuing this latest edict? Was no thought given to the terrible after-effects of the earlier lockdowns? If not, why not?”
Extendicare, which operates the home, said in a statement to CTV News that it "complies with local Public Health unit’s infection control guidelines.”
A long-term care home is considered to be in an outbreak if two or more cases appear, and having everyone isolate in their rooms is the standard for all homes across Ontario.
According to the latest data released Thursday evening, there were 291 long-term care homes with an outbreak of COVID-19 in Ontario. The 7-day average is now 212. According to the provincial website, dozens of long-term care homes have zero cases among residents.
On Wednesday, there were 254 long term care homes with an outbreak of COVID-19 in Ontario. The 7-day average displayed on the provincial website is 186 homes in outbreak, 65 of which involve zero cases among residents.
There are 870 active cases of COVID-19 in residents across the province, which is a jump of almost 300 cases since Wednesday.
A spokesperson for the Minister of Long-Term Care told CTV News in an email that they “have not directed long-term care homes to restrict residents to their rooms during outbreaks.
“Local public health units are responsible for managing outbreak response in long-term care homes and have the authority and discretion as set out in the Health Protection and Promotion Act (HPPA) to co-ordinate outbreak investigation, declare an outbreak based on their investigation, and direct outbreak control measures,” the statement reads.
The trouble is that even though residents are vaccinated, they are still at a higher risk of severe illness or death from a breakthrough case than other populations.
And with the province reporting more than 13,000 new cases of COVID-19 on Thursday, the ninth day in a row that daily cases have exceeded 10,000, concern is high.
Dr. Samir Sinha, director of geriatrics at Mount Sinai, told CTV News that it seems long-term care homes are following the right steps from a public health standpoint in having close contacts isolate.
“We don't know even which of the double or triple vaccinated people might get seriously ill and might end up dying,” he said.
“We have an uncontrollable situation that's causing our hospital strain our entire health care system strain. And that's why we've literally gone back to wave two levels of homes in outbreak in Ontario, and with a much more highly contagious variant.”
He called it a “horrible situation,” acknowledging that it’s not easy for residents or families.
“I think the challenge right now is that following the protocols, unfortunately, to try and protect these people from getting COVID is also having this other nasty effect, where it's creating severe levels of isolation, which are really something that we have to recognize as well.”
One positive, adopted after earlier waves, is that "designated caregivers" are still allowed to visit.
But many seniors don't have family to visit and provide that essential social element.
Mea Renahan, who is the essential caregiver for her 105 year old mother Marita at Lakeside, says while she is allowed to help her mother she can’t help others because of COVID-19 protocols.
It's a situation that makes her emotional, and she described how she can see other residents declining .
“They are no longer moving, hardly eating and no longer talking,” she told CTV News. “This [new lockdown] has only been since Christmas Day and they're already going downhill physically, mentally, and it's going to continue.”
She said she has witnessed the exhaustion that staff are facing as well, explaining that every worker has around seven residents to care for. She personally takes care of all of her mother’s meal times, as her mother requires more attention due to a neurological condition that interferes with eating.
Brown agreed that many residents are shrinking into themselves in this new lockdown.
While she has the ability to entertain herself with books, music, watching TV or having Zoom chats, some residents are in need of more aid.
“There are people who are not as cogent or coherent as I am,” she said.
“It makes me so sad to watch the decline of all these people,” Renahan added. “They deserve to be treated better.”
Schon said there’s an impression that long-term care homes are awful places to be. But what’s being lost in this pandemic is that they can be real homes full of community.
“Long-term care can be a lovely place, you know, when it's working well, there's lots of activity,” she said. “There's a real sense of kind of joy. There's fun. My mother plays bingo, my mother goes to exercise classes. She really likes it there.
“It's like a prison now.”
Schon is worried that ultimately, her mother will lose the ability to walk if lockdowns stretch on.
“She doesn't cry in front of me,” she said. “But I hear from the nurses that she cries.”
Brown wishes that the residents’ opinions were taken into account in lockdown decisions.
“Even if we could walk around the floor, if we could have meals in the dining room in shifts, but nobody seems interested in asking how we feel about this,” she said.
“This makes absolutely no sense that there isn't a single resident with COVID, yet the residents are the ones being penalized because staff are contracting it,” Renahan said.
She believes that if residents are fully vaccinated, they should undergo isolation if they contract COVID-19, but the other residents who are fully vaccinated should be allowed to continue their lives without a full-scale lockdown.
Some solutions would be more staffing and allowing more family to visit, as was called for in reports on long-term care after the earlier waves -- but there hasn't been the time, or the effort, put in to fix those cracks in the long term care system in time for Omicron.
Leaving care homes and residents stuck on the same tightrope, trying to balance physical and mental health.
“This feels like a pivot point for me with long-term care. It feels as if maybe we could end up at the end of this pandemic with major improvements to the system, but it's going to cost money,” Schon said.
“It needs to take some political will to get a rethinking. There's lots of really wonderful people working in long term care who are thinking about how do we make it better, [who] have great ideas on how to make it better. There's lots of pathways to making it better. My fear is that we will get through this and then nothing will get better.”
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