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Alberta auditor says staff shortages led to major care home problems during pandemic

EDMONTON — Alberta's auditor general says the province’s continuing-care system worked desperately to cope in the early waves of the COVID-19 pandemic mainly due to crippling staff shortages.
Alberta Auditor General Doug Wylie speaks at a press conference as Ethics Commissioner Marguerite Trussler, left, and Alberta Public Interest Commissioner Marianne Ryan look on, in Edmonton on Friday, Oct. 4, 2019. Wylie says the province’s continuing-care system struggled desperately to cope in the early waves of the COVID-19 pandemic mainly due to crippling staff shortages. THE CANADIAN PRESS/Jason Franson

EDMONTON — Alberta's auditor general says the province’s continuing-care system worked desperately to cope in the early waves of the COVID-19 pandemic mainly due to crippling staff shortages.

Doug Wylie said the problem worsened considerably when the province mandated that workers could not work in more than one facility. However, he added that the measure reduced the spread of the disease.

“Facilities really struggled to ensure that they had enough of the right staff to provide safe resident care,” Wylie told reporters Thursday after releasing his report on COVID-19 and care homes.

“This was especially true during an outbreak (of COVID-19) when up to 20 to 50 per cent of an already-stretched staff could be off due to illness or isolation requirements.”

Wylie said planning for such a massive outbreak was hampered by poor communication between agencies and inadequate infrastructure. Lagging test results compounded the crisis.

His report examined how health officials and those in Alberta’s 355 continuing care centres coped over the first eight months of COVID in 2020.

The report found during that during that time there were 379 COVID outbreaks, more than 8,300 cases and 1,042 deaths, with most of them care home residents.

Wylie noted that continuing care centres, employing mostly part-time and casual workers, felt the staffing crunch even before the first wave hit in March 2020.

“Facilities not having enough staff was by far the most common issue identified,” states the report. 

The single-site rule alone, it said, cut the available staffing pool by one-third, but "the degree of (COVID) clustering decreased noticeably.”

The staff who remained saw their workload rise, which included cleaning, sterilizing, monitoring visitor restriction rules and helping residents in day-to-day activities previously done by volunteers and family members.

The normal stopgap for staffing help was staffing agencies, but Wylie found that during COVID even that broke down. The report found in some instances the agencies wouldn’t send extra help, or if they did, the staffers wouldn’t show up or work a couple of days and not come back.

Care centres also scrambled to keep up with a flurry of rapidly changing health orders from the province, although it noted the communication got better over time.

In the early days of the pandemic, said the report, “facility operators learned about new rules the same way as all Albertans — while watching a press conference.”

The facilities themselves were a challenge, he said, with aging infrastructure, shared rooms and inadequate ventilation accelerating a virus transmitted through aerosols and droplets in enclosed spaces.

Nevertheless, the report says staff did their best to find workarounds and temporary solutions to help residents.

Wylie made eight recommendations to improve the system, including formalizing a centre of expertise to address future outbreaks.

Health Minister Jason Copping said the government accepts all eight recommendations and that next week's provincial budget will provide more details on implementing the changes.

“Alberta’s government is already working to address the concerns listed in the report, like enhancing infection control measures,” said Copping in a statement.

“These improvements have relevance and provide benefits far beyond the COVID-19 response, including helping the continuing care system to be better prepared for future pandemics and other smaller communicable disease outbreaks such as seasonal influenza."

Premier Danielle Smith, who took over the top job in October, has blamed Alberta Health Services and former chief medical officer of health Deena Hinshaw for failing Albertans during the pandemic. 

Smith said officials provided inadequate advice and failed to scale up as patient numbers overwhelmed hospitals. 

She has since moved Hinshaw out of the top job and fired the board of Alberta Health Services.

Smith has questioned the efficacy of pandemic health restrictions such as vaccine mandates and masking when set against violations of personal freedoms and the long-term effects of isolation on mental health.

Last month, Smith announced a panel led by former Reform Party leader Preston Manning will examine government decision-making during COVID-19. 

NDP health critic David Shepherd said Wylie’s report underlines the United Conservative Party government’s failure to respond effectively to COVID-19 and said the future looks even bleaker given Smith’s resistance to health restrictions.

“Imagine if Danielle Smith had been in charge. I fear it would have been one of the worst responses in the world,” Shepherd said.

“It’s frightening to contemplate what would have happened if Alberta had followed Danielle Smith’s advice to copy the disastrous responses in South Dakota or Florida and simply let the virus rip through seniors' homes, schools and workplaces.”

This report by The Canadian Press was first published Feb. 23, 2023.

Dean Bennett, The Canadian Press