Auditor General’s report shows Long-Term Care Ministry was not “positioned, prepared or equipped” to respond to pandemic

AG says Long-term care ministry didn't learn from SARS or heed advice since

A report out from the province’s Auditor General indicates the province was ill-prepared to combat a pandemic within long-term care homes.

Auditor General Bonnie Lysyk released her report into the readiness and response of long-term care to the COVID-19 pandemic on Wednesday, and it says lessons weren’t learned from the past, recommendations weren’t taken to heart, and measures weren’t put in place fast enough and had some unintended consequences.

Lysyk’s report indicates there were three underlying issues that prevented timely action. The report claims some very specific recommendations made following the SARS outbreak, to prepare for future outbreaks. “Actions taken over the years have been insufficient to ensure that we would be better prepared as a province for the ‘next time’.” according to the report.

Additionally, Lysyk’s report shows some recommendations to improve the system were ignored for years. “Ongoing and repeated concerns raised for well over a decade about systemic weaknesses in the delivery of long-term care to the elderly have not, for the most part, been adequately addressed.”

The report said a third major factor in the lack of adequate pandemic response was the failure to integrate long-term care into the healthcare system entire. This prevented these facilities from fully benefitting from needed lifesaving expertise and infection control.

“By late March 2020, when COVID-19 had begun its ravage of long-term-care homes, it became blatantly obvious that aggressive infection prevention, detection and patient care actions were needed—and needed quickly—to prevent staggering death rates from becoming the norm across Ontario’s entire long-term-care community.” reads Lysyk’s report. “Unfortunately, neither the Ministry of Long-Term Care nor the long-term-care sector was sufficiently positioned, prepared or equipped to respond to the issues created by the pandemic in an effective and expedient way.”

The report contained 16 recommendations and 55 action items to be addressed. Lysyk pointed out in her report many of the issues and recommendations contained within have been highlighted by her office before.

Lysyk ends the opening comments of her report by pointing out the province has committed to improving long-term care through a number of steps including increasing the average direct care time provided per resident per day and increasing the number of beds available in the system. “Continued attention to the implementation of these commitments and additional recommendations would go a long way toward ensuring seniors living in Ontario’s long-term-care homes are accorded the well-deserved dignity, safety and comfort that is clearly envisioned in Section 1 of the Long-Term Care Homes Act, 2007.”

Minister of Long-Term Care Merilee Fullerton reacted to the report by passing the buck.

Speaking to reporters at Queen’s Park on Wednesday, Fullerton referred to the sector as a “broken system” largely as a result of inaction by previous governments.

“Our government is fixing a broken system,” she said.

“I take responsibility for the wellbeing of residents in long-term care and accountability of fixing the disaster of the last 15 years,” she said.

She said that while her government did its best to limit the spread of COVID-19 in long-term care homes in the early days of the pandemic, it was stymied by certain “structural inadequacies” in the system.

“It is kind of like running into a burning building. You are trying to save it and you are doing your best but the fire had already started well beyond the pandemic,” Fullerton said. “Everyone knew it was an aging population. We have known that for decades and here we were with a global pandemic and we had no vaccines, our PPE was in short supply, the testing reagents could not be found. Do I accept responsibility for all that? I am not a public health expert. I am here to try to fix long-term care but if the building is on fire and you are running into it to try and save people, yeah that is pretty much what we tried to do.”

As of Apr. 28, 3,756 residents and 11 staff members in the province’s long-term care system have died of COVID-19.