A worker is seen cleaning surfaces inside Little Mountain Place, a long term care home in Vancouver, on January 7, 2021. THE CANADIAN PRESS/Darryl Dyck

A worker is seen cleaning surfaces inside Little Mountain Place, a long term care home in Vancouver, on January 7, 2021. THE CANADIAN PRESS/Darryl Dyck

B.C. care home allowed group activities to continue after positive test: family

Little Mountain Place became the deadliest care home outbreak in British Columbia

Parbs Bains had a “sinking feeling” when she heard a single staff member tested positive for COVID-19 at her grandmother’s care home.

On Nov. 20, Little Mountain Place sent an email to families that said an employee had contracted the virus and was in isolation. A Vancouver Coastal Health medical health officer determined there was “minimal exposure risk” and was not declaring an outbreak, it said.

Instead, the health authority placed the home on “enhanced surveillance,” including heightened monitoring of residents, hypervigilance in screening visitors and stronger infection control practices. Visitors were still welcome and group activities were continuing, the email said.

Bains felt certain that this was the beginning of the end for her 89-year-old grandmother.

“I was like, ‘This is it.’ I was bawling because I just knew this was going to be it,” Bains recalled.

The facility declared an outbreak two days later.

It has become the deadliest care home outbreak in British Columbia. Ninety-nine out of 114 residents have been infected and 41 of those have died, including Bains’s grandmother. Seventy staff members also tested positive, but most have recovered.

Two families are questioning whether some deaths could have been avoided if the home had taken stronger measures immediately after the first case was identified. They also say that a hard-working but understaffed nursing team struggled to keep residents isolated and care for those who were sick as the virus spread through the facility.

During a Zoom call with her grandmother after she contracted COVID-19, Bains said another female resident entered the room and began hugging and kissing the elderly woman on the forehead. After several minutes, a nurse rushed in and ushered the other resident out, she recalled.

Bains said that while she didn’t know if the other woman had the virus, it alarmed her that residents were able to wander between rooms without staff immediately noticing.

On other occasions, Bains said her grandmother’s oxygen tubes were out of her nose and she would desperately yell for help over the Zoom call. Nurses told her that her grandmother was actually one of the fortunate ones because her room was close to their station, Bains said.

Bains said she is “so angry” at the way the outbreak was handled.

“Something had to have gone wrong at Little Mountain Place … for this to be so lethal,” she said.

Little Mountain Place referred questions to Vancouver Coastal Health, where Chief Medical Health Officer Dr. Patricia Daly said the provincewide standard is that outbreaks are not automatically declared when one staff member tests positive.

The health authority determines whether the employee was in the care home during their infectious period and whether they potentially exposed other staff or residents, for example by not properly using personal protective equipment, she said.

If there is no evidence of exposures, the authority places the home on “enhanced surveillance” and monitors for other cases, she said. Some testing may be done, and group activities continue but must always follow a COVID-19 safety plan, she said.

Declaring an outbreak every time a single staff member tests positive would be too hard on residents who suffer when they are isolated and their visitors are restricted, Daly said.

“We’re trying to find that right balance.”

Vancouver Coastal Health said there was no mass testing of all residents and staff after the first case was identified. It was only on Nov. 22, after a resident tested positive and the outbreak was declared, that full-facility testing was done, it said.

Daly said broad testing is not always necessary because it depends on the risk and timing of potential exposures.

At Little Mountain Place, it became clear transmission occurred before the initial case was identified, she said.

She said during an outbreak, residents are supposed to stay in their rooms, but it is very challenging for patients with dementia to follow those rules. Staff are advised to monitor residents who wander but not to lock anyone in or restrain them,

she said.

“Keeping residents with cognitive impairment in their rooms, that has been a common challenge across all facilities in all of our outbreaks,” Daly said.

Bains and another relative, Bernadette Cheung, have demanded an investigation of the care home’s response to the virus.

Daly said she received a letter from a family member last week and has ordered Vancouver Coastal Health’s licensing team to conduct a review once the outbreak is over.

The team will examine whether the home is following regulations under the Community Care and Assisted Living Act and, if not, will require it to develop a plan to address those gaps. In very rare cases, reviews by the team have led to a change in management, Daly said.

B.C. Seniors Advocate Isobel Mackenzie said she wants to see routine testing of all staff members at care homes. At Little Mountain Place, all staff and residents should have been tested immediately after the first employee tested positive, she said.

Screening for symptoms is inadequate because people can be asymptomatic and contagious, she noted.

“The fact that more people were infected two days later, if you had tested everybody before then, you’d have caught some people,” she said. “You would have been able to isolate them if they were residents or you would have been able to pull them from the roster if they were staff.”

Dr. Bonnie Henry, the provincial public health officer, said Monday the province is “looking at” regular rapid testing of staff in care homes. Ontario started doing rapid testing at long-term care facilities in November.

Cheung, whose grandmother died of COVID-19 at Little Mountain Place and has been outspoken about her concerns, said Health Minister Adrian Dix called her on Monday. She said he promised an “intense review” of the outbreak and to follow up again with her about his conversations with the care home and the health authority.

The ministry did not immediately respond to a request for comment.

Though the conversation was light on details, Cheung said she appreciated his empathy.

“That gives us hope, at least, that it is a priority for him.”

She said she has also received confirmation from Vancouver Coastal Health that her formal complaint against the care home will proceed.

Cheung has criticized the care home for not being transparent with families. She wants to know more about why the health authority determined there was “minimal risk” of exposure from the first infected staff member and declined to declare an outbreak on Nov. 20, she said.

“Essentially, we’re being kept in the dark and it raises concerns and even suspicions,” she said.

ALSO READ: Canada secures 20M more Pfizer vaccine doses; U.S. border closure extended to Feb. 21

Laura Dhillon Kane, The Canadian Press


Like us on Facebook and follow us on Twitter.

Want to support local journalism during the pandemic? Make a donation here.

CoronavirusSeniors

Get local stories you won't find anywhere else right to your inbox.
Sign up here

Just Posted

West Coast General Hospital in Port Alberni received some good news about an expansion to its emergency department on Jan. 15, 2021. (SUSAN QUINN/ Alberni Valley News)
B.C. health ministry commits $6.25M to hospital expansion in Port Alberni

Plans for larger emergency department have been on hold since 2015

A Tla-o-qui-aht First Nation guardian took this photo of dozens of vehicles parked along a forest service road in the Kennedy watershed. (Submitted photo)
Alberni-Clayoquot Regional District looks at enforcement of illegal camping

ACRD currently does not have an existing bylaw service to tackle the issue

Ucluelet local Geoff Johnson snapped this photo of a Risso’s dolphin that washed up near Chesterman Beach in Tofino on Wednesday, Jan. 13. (Geoff Johnson photo)
Washed up Risso’s dolphin offers glimpse into “whole other world” near Tofino

“It’s like a UFO crash landed and you can come look at it.”

(B.C. government)
POLL QUESTION: Would you report a neighbour in breach of COVID-19 regulations?

Would you report a neighbour in breach of COVID-19 regulations? READ MORE:… Continue reading

Health Minister Adrian Dix and provincial health officer Dr. Bonnie Henry head for the press theatre at the B.C. legislature for an update on COVID-19, Jan. 7, 2021. (B.C. government)
B.C.’s COVID-19 spread steady with 509 new cases Friday

Hospitalized and critical care cases decline, nine deaths

Seasonal influenza vaccine is administered starting each fall in B.C. and around the world. (Langley Advance Times)
After 30,000 tests, influenza virually nowhere to be found in B.C.

COVID-19 precautions have eliminated seasonal infection

Prime Minister Justin Trudeau listens to a question during a news conference outside Rideau cottage in Ottawa, Friday, January 8, 2021. THE CANADIAN PRESS/Adrian Wyld
Trudeau says Canada’s COVID vaccine plan on track despite Pfizer cutting back deliveries

Canadian officials say country will still likely receive four million doses by the end of March

Jobs Minister Ravi Kahlon shared a handwritten note his son received on Jan. 13, 2021. (Ravi Kahlon/Twitter)
Proud dad moment: B.C. minister’s son, 10, receives handwritten note for act of kindness

North Delta MLA took to Twitter to share a letter his son received from a new kid at school

Lilly and Poppy, two cats owned by Kalmar Cat Hotel ownder Donna Goodenough, both have cerebellAr hypoplasia, a genetic neurological condition that affects their ability to control their muscles and bones. Photo by Alistair Taylor – Campbell River Mirror
VIDEO: Wobbly Cats a riot of flailing legs and paws but bundles of love and joy to their owner

Woman urges others to not fear adopting cats with disabilities

Dr. Shannon Waters, the medical health officer for the Cowichan Valley Region, is reminding people to stay the course with COVID-19 measures. (File photo)
‘Stay the course’ with COVID measures, Island Health reminds

Limit social activity, wash hands, wear a mask, and isolate if you feel sick

Cowichan Tribes members line up at a drive-up clinic on Wednesday, Jan. 13 to receive the first doses of the COVID-19 vaccine in the region. (Kevin Rothbauer/Citizen)
BCAFN condems racism against Cowichan Tribes after COVID-19 outbreak

“Any one of us could do everything right and still catch the virus”: Regional Chief Terry Teegee.

Chief public health officer Dr. Theresa Tam provides an update on the COVID-19 pandemic in Ottawa on Friday, Jan. 8, 2021. THE CANADIAN PRESS/Sean Kilpatrick
Canada’s top doctor says to avoid non-essential travel as B.C. explores legal options

Premier John Horgan says he is seeking legal advice on whether it can limit interprovincial travel

Martin Luther King Jr. addresses the crowd during the march on Washington, D.C., in August of 1963. Courtesy photo
Government reinforces importance of anti-racism act on Black Shirt Day

B.C. Ministers say education “a powerful tool” in the fight for equity and equality

Most Read