The weak link turned out to be at the nursing homes where more than half the COVID19 deaths in Ontario took place

Rivers 100x100By Ray Rivers

April 17th, 2020



It’s a mess.

Long term care homes are host to about half of all of Canada’s COVID-19 fatalities. Ontario has 626 nursing homes, a little over half are privately operated, a quarter non-profit, and the rest municipal. There are close to 80,000 beds in use and there is a waiting list almost half as long again.

The costs of long term care are co-funded between the province and the patient. In 2018 provincial funding totalled $4.28 billion, less that a tenth of the provincial health budget, which amounts to about $150 per resident a day. That is board, room, cleaning and care for a little over $50,000 per patient per year plus the patient’s co-fund.

There was this idea once that for that kind of money, one could book a year-long ocean cruise, and get everything except the medical care. But nobody ever thought that they might also get stuck, like the 4000 Canadians on some 70 cruise ships, as of late March this year, who can’t get off because of COVID 19.

Star quote For seniorsQuebec has called on the federal government to bring in the army’s medical corps to help with their lack of health care at long term facilities But Ontario is putting an ‘iron ring’ around its institutions according to its premier, who has promised to leave no stone unturned, spare no expense.…

Next week he finally will ban support staff from working in more than one long term facility, thereby eliminating a potential source of spread. But B.C. had brought in a similar regulation almost a month ago and Ontario had enacted a similar rule back during the SARS crisis. So why has it taken this long for Ford to act? Perhaps he empathized with the long term support staff, having to take on extra employment to make up for their miserable pay levels.

It’s not Ford’s fault that COVID 19 came to Canada and Ontario. The virus arrived here with travellers arriving first from China, then from other places. As the contagion got a foothold and spread, we remained calm on the advice of Canada’s chief medical officer.

Tam Teresa

Dr. Teresa Tam: Chief Medical Officer of Health

Dr. Tam told us that the risk to Canadians was minimal and there was no need for travel restrictions, quarantine or protective masks to reduce the risk of exposure. So today Ontario has had over 500 deaths and over half of those are in long term care.

But Ford’s record in this is anything but spotty clean. Jurisdictions, like South Korea, which have minimized the coronavirus casualties, have used extensive testing to identify, isolate and treat the infected. Ontario has the lowest record of testing in Canada, and that may explain why its infection numbers appear lower than they actually are – and why our death rate is so high.

Following the SARS crisis masks and other personal protection equipment (PPE) were stockpiled, but they got stale dated and eventually junked. But nobody, even in the previous administration, thought to rebuild the stockpile. So now Ford and his health minister are promising to fix this, even if late and too little.

Ford changed the labour laws in the province reducing sick leave days for employees and allowing employers to demand a medical certificate. In the early days of the epidemic this may have contributed to the virus spread, since sick employees would need to still go to their jobs to get paid, and those who didn’t needed to visit their doctor’s crowded offices for their medical certificate.

Bobcagen nursing home

A nursing home in Bobcaygen where 29 patients in a 65 bed facility died of COVID19

But perhaps worst of all, when it comes to long term care the Ford government had stopped inspecting health and safety conditions in nursing homes as a matter of policy. These annual inspections are the only way the province had to ensure that a nursing establishment was meeting it’s health, safety and licensing requirements.

Inspections went from 100% in 2017, under the previous Liberal government, to almost zero last year. Is it any wonder infection has spread so rapidly?

Instead of an annual snap Inspection for all homes conducted during the previous government only 9 of 626 were inspected in 2019.

Unfortunately this brings back memories of another Conservative premier who rolled the dice, deregulating water safety. That ended up with 7 people dying and half of a town’s people sickened. That policy, like Ford’s decision on inspections, was ideological, about cost cutting, eliminating red tape and promoting deregulation.

Australia has a different take on long term care. Their system is national and publicly run under strict rules and inspections. Australians saw where this virus might be heading before anyone called it a pandemic and responded much faster and more effectively than Canada, even though their first case arrived two days after ours.

And their long term deaths have been low, making them a model for us to emulate in this country. In fact there have been twice as many COVID 19 deaths in Ontario’s long term care homes than among Australia’s entire population of 25 million. Clearly they are doing something right.


The government of the day – Mike \Harries Tory’s failed the people of Walkerton.

Doug Ford has told us that his wife’s mother is a patient at a Toronto nursing home. One has to wonder what she thinks. After all, his is the kind of subtle negligence which eventually came back to haunt former PC premier Mike Harris. We’ll see eventually if this is really an iron ring or just Mr. Ford’s Walkerton.

Nobody wants to criticize a political leader during a time of an unprecedented health crisis. Doug Ford rose up in everyone’s expectations with his early daily briefings, closing the schools, declaring a state of emergency and gradually locking down the province’s economy. It was comforting to see someone in charge.

He could have moved faster and shut down more non-essential workplaces earlier, like construction. And public transit across the province should have been shut down as it has been in other places where social distancing is impossible. Ford’s people should have embraced masks earlier, instead of simply regurgitating the mis-truths from the World Health Organization and Canada’s own Dr. Tam.

And he could have left the provincial parks open. After a month of lockdown people need to get out for some exercise and fresh air. It would be easier to social distance on a park trail or open field than a crowded sidewalk, wouldn’t it?

Lately Ford has pretty much run out of ‘breaking news’ for his daily press conferences. They’ve started to morph into poorly staged political rallies, as the Premier and his beleaguer health minister tell us how they are there for us and doing all they can. And watching the two of them in action confirms for me that the PC’s did the right thing in nominating Ford for the top job.

Ford staring

Ontario Premier Doug Ford

Ford recently got angry complaining about Ontario’s pathetic rate of COVID 19 testing. But then seriously, isn’t he the premier? We want Ford to succeed in fighting this epidemic. It’s in all of our interests regardless of any political stripe.

But we need to have faith and believe in our premier. And that means some straight talk instead of hype and empty promises. Ford could begin by recognizing what has gone wrong and assuring us that he has learned from his mistakes.

Rivers hand to face

Ray Rivers writes weekly on both federal and provincial politics, applying his more than 25 years as a federal bureaucrat to his thinking.  Rivers was a candidate for provincial office in Burlington where he ran against Cam Jackson in 1995, the year Mike Harris and the Common Sense Revolution swept the province.


Background links:
Long Term Care in Ontario –    Ford Didn’t Protect Them –    COVID 19 Spread in Ontario Nursing Homes

Masks Destroyed –   Long Term in Australia

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6 comments to The weak link turned out to be at the nursing homes where more than half the COVID19 deaths in Ontario took place

  • fran - tyandaga

    Former premier Mike Harris is Chair of the Board for Chartwell… low wages, deregulation… inspections? hmmm…go figure
    ask Hilda…

  • Alan Harrington

    “Handwashing and social distancing” we are told is the way to stop COVID-19.

    Either this policy is not practiced by professionals at long term health care facilities – or the policy is not effective.

  • I said long ago that longevity had lost its attraction. But I keep waking up anyway.

  • fred Pritchard

    Ray, dumb doug dropped the ball on so many fronts. He almost eliminated inspections in long term care homes in 2019. He unnecessarily created upheaval in our health system in trying to merge local area health agencies and had them focused on busy work that does nothing for the health of Ontario residents. He falsely claimed he would end hall way medicine, but in fact, in 2019 it was actually worse under his plan. He was told 6 weeks ago to copy the BC approach to old age homes, but dragged his feet which has caused dozens and dozens of needless deaths. Not only is he the wrong guy to be in charge now, he doesn’t have the smarts to fix and grow Ontario once things get back to normal. While it is easy to say he is dong a good job compared to the US, it is time we stop measuring performance based on the worst example.
    When we look back, he will be judged as a complete failure who was completely out of his depth.

  • Steve Holman

    Likely no point discussing the lack of inspections because there are allegations that the standards currently in place are themselves woefully inadequate, if you ask UNIFOR. They are calling for almost doubling of care hours per patient per and much increased pay and benefits for workers. They site Chartwell as one of the “fat cat” operators squeezing staff while senior people enjoy outsized compensation. If you look at Chartwell’s financials you will see that they barely broke even in 2019 and are taking steps to shore up liquidity this week. The question is, assuming the system needs significantly more funding, more resources and more oversight that is actually done (its hard to argue this is not the case), where is the money coming from? It is another sector with serious needs at time when operators, customers and governments can least afford it.