Daily briefing
Dr. Robert Strang today announced an additional death at the Northwood long-term-care facility (LTCF) in Halifax, bringing total deaths there to 50.
I haven’t done the math on this before but today I did and it is grim: the fatality rate among residents at Northwood has been roughly 21% while the infection rate among residents (there are 485 in total) is just over 50%.
Dr. Robert Strang NS COVID-19 Update 19 May 2020
There was only one new case of COVID-19 announced today, but it was a Northwood resident.
Strang said there were three cases announced on Saturday, three on Sunday and three on Monday, all of which were in the Central Zone, which includes the Halifax Regional Municipality (HRM). The case numbers for the Eastern Zone, which includes the CBRM, remain unchanged at 51.
Strang said that contact tracing has indicated that five of the 10 new cases announced since Friday involved residents or staff at Northwood, three were contacts of a known case and one was travel related (asked “how that could be,” Strang said it was involved someone transporting goods into the province). One case, however, could not be traced to a known case or to travel and was deemed community spread, which is why, he said, we must “remain vigilant” about social distancing and handwashing.
Revisiting Friday’s announcement regarding “bubbles,” Strang said it is important to “choose safely” when deciding who you will bubble with and gave three criteria to consider: the age, occupation and health condition of the people in the household.
The chief medical officer also went over the rules for social gatherings — people not “bubbling” may still get together as long as they respect the six-foot distance rule and gather in groups of no more than five. He repeated that outside is better than inside for such gatherings, and if people are using this opportunity to eat together, they should avoid sharing food or utensils and “think about handwashing.”
Strang also reminded anyone with two or more symptoms of COVID-19 — fever, new or worsening cough, sore throat, runny nose, headache — to call 811 or do the self-assessment online and get tested if necessary.
Numbers
Total new cases: 1
Total cases: 1,044
Total hospitalized: 9
Total in ICU: 5
Total recovered: 956
Total deaths: 56
Total long-term-care facilities (LTCF) affected: 2
LTCF residents: 19 (Northwood) 1 (other LTCFs)
LTCF staff: 7 (Northwood)
Total positive and negative tests to date: 37,482
Age range of patients: under 10 to over 90
Reopening
Asked when the public would get a look at a detailed reopening plan for the province, Premier Stephen McNeil said that Strang continues to consult with the associations representing businesses that were shut down as a result of the Public Health order, while Business Minister Geoff MacLellan is reaching out to business owners who closed because their customers decided to stay home.
McNeil said that when Strang has completed his consultations, which should happen by the end of this week, “decisions” will be made and communicated first to the affected sectors and then to the public.
He repeated his intention to have all the rules businesses must follow in place when the economy begins the first phase of its reopening, which may happen in early June.
As for subsequent phases of the process, McNeil said they will be driven by the epidemiology, not a set timeline.
McNeil said he his having ongoing conversations with our “sister provinces” — New Brunswick and PEI — as to what the summer will look like, taking the opportunity to add that of course people wanted to come to Nova Scotia because it is the “crown jewel” of the east coast and “obviously” people want access to this part of Atlantic Canada. (I’m still feeling that mean girl vibe, but he did acknowledge that people in NS who own properties in NB and PEI would want to get to them too). All of this will require balancing public health with people’s desire to travel.
Testing
Noting that the number of lab tests is down significantly (the QEII Health Science Centre’s microbiology lab processed on 384 on May 18), the CBC’s Michael Gorman asked Strang if he was considering other methods of ensuring effective monitoring of the virus.
Strang said it is a topic being discussed a lot among the nation’s public health officers. He said the work the NSHA has done to establish testing centers and the effectiveness of the 811 system for triaging people will both be useful going forward.
Although the test has its limits when used on too many asymptomatic people, Strang says they’re considering ways of using it to test strategically, targeting “certain settings or populations.”
He also mentioned the serology test that has been approved in Canada for testing for antibodies and said its use is also the subject of conversation at the present time.
Endemic
Asked about the likelihood — as predicted by the WHO and chief medical officers of other countries — of the virus never going away and instead becoming endemic to Canada, Strang said he was “well aware” of those conversations, which are informing our recovery plan. Just because we’re coming out of the first wave, he said, doesn’t mean the pandemic is over. We are moving into a “new normal” where we’re living with COVID-19.
Mental health
A reporter referenced comments by a Dalhousie psychologist who has said that deaths by suicide are likely to rise in the province due to the effects of unemployment and isolation, suggesting this Public Health risk might outweigh the risk posed by COVID-19. The reporter asked the premier if he was taking the mental health effects of unemployment into consideration when planning for reopening the economy.
Note: I couldn’t find this story, although I did find this Chronicle Herald interview with Dalhousie clinical psychiatrist Simon Sherry, who warned that this province is:
…ill-prepared for the suicide crisis that is occurring and will continue to occur owing to the pandemic.
Our decrepit and underresourced suicide prevention strategy will not withstand the suicide crisis we are now facing.
Sherry’s comments followed reports that the suicide rate among young men in Nova Scotia rose sharply between 2012 and 2018 (the Herald story gave the percentage — 60% — but not the absolute numbers).
McNeil responded by discussing how his focus has always been on working to reopen the economy, which he says has been a “leading economy in Canada” in recent years (I’m writing for Cape Bretoners, so I’ll wait a moment to let the hooting die down).
He didn’t address the province’s “decrepit and underresourced suicide prevention strategy” but in his defense, he wasn’t asked to.
Not normal
Kyle Shaw of the Coast asked Strang (again) when we might expect to see active, rather than cumulative, COVID-19 case numbers on the health zone map and Strang said they were still working to address “privacy” concerns over releasing such low numbers.
Shaw then asked Strang to address a rumor that the deaths at Northwood were nothing out of the ordinary for a LTCF.
Strang said that was “absolutely incorrect,” and that the monthly mortality rates at Northwood have been significantly higher than normal showing COVID-19 has had a “substantive” effect on the facility.
Free the regions?
Asked again if he would consider opening the Health Zones in regions with low disease activity before the Central Zone where the COVID-19 outbreak has been worst, Strang repeated that the fear was that if you did this, people from the Central Zone would travel to the other zones to shop or for entertainment and bring the disease with them.
Seafood plants
A reporter from Cheticamp asked Strang how the public could be assured seafood processing plants were following the necessary health and safety rules related to COVID-19.
Strang said if there were specific concerns about a plant, they should be brought to the nearest Occupational Health and Safety Division, but he said that he felt Cheticamp had paid a “substantive” (the word of the day) amount of attention to workers coming in from other Maritime provinces in concert with “local law enforcement.”
The briefing ended with the announcement that there were “no more reporters on the line.”
Double bunking
Jennifer Henderson who, as I’ve said before in this space, is the closest thing to a beat reporter I’ve seen in the LTC space, has a very good piece in the Halifax Examiner today about Northwood’s attempts to deal with its double — and triple — occupancy problem.
The subject was raised by Halifax Needham MLA Lisa Roberts during a February 28 debate over the provincial budget estimates. Roberts asked Health Minister Randy Delorey why, for three consecutive years:
…the government did not support a capital funding request from Northwood to build new floors above to eliminate some of the “double and triple-bunking” of residents in the Centre.
“The Board of Northwood has determined they are not meeting the standard of care required, in terms of infection control, in rooms that have double and even triple occupancy,” said Roberts. “The initial proposal was for 13-million-dollars and would permit Northwood to maintain the same number of beds but in single occupancy rooms that would meet the standard we now require given the increased medical needs of long-term care residents.”
Delorey characterized the Northwood proposal as “a complete replacement” and said discussions with the Department of Health were continuing. He noted the province had allocated $15 million more for new long-term care facilities and had announced a total of 162 new beds for Cape Breton, Meteghan, and Halifax.
“There is no provincial standard that requires licensed homes to have single-occupancy rooms,” said Delorey. “We do have preferences for single rooms and that’s why most new-builds have more single rooms. But we still need the bed capacity we have.”
Henderson also explains that most residents in long-term-care homes in this province share rooms and that the difference at Northwood is the size of those rooms — they’re smaller, having been built in the 1960s.
There’s much more to the article, which is why I highly recommend you read it.
