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Jun. 5, 2020 | Friday
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UPDATE: 'Respiratory virus' outbreak at NOTL long-term care home is not COVID-19, public health says
Niagara LTC Residence (formerly Chartwell Niagara) is facing a respiratory outbreak. (Jessica Maxwell/The Lake Report)

Public health officials investigating a "respiratory outbreak" at Niagara Long Term Care (formerly Chartwell) in Niagara-on-the-Lake say the virus is neither COVID-19 nor the flu.

The virus in the  NOTL facility was confirmed not to be COVID-19 on Thursday, said Dr. Mustafa Hirji, acting medical officer of health for Niagara Region.

"Tests have shown that neither COVID-19 nor influenza seem to be the infection circulating in the long-term care home. Tests for other respiratory viruses are still pending," Hirji said in an email to The Lake Report/Niagara Now.

The cause of the respiratory outbreak on the facility's second floor is still undetermined, Hirji said, and there's a chance a cause won't be identified.

"Some outbreaks never have a cause identified because labs only have tests for the 10 most common infections that circulate in winter, and not all 600 infections that cause respiratory illness," Hirji said.

Hirji had been waiting since Tuesday for test results to confirm whether the outbreak was due to COVID-19 and he announced the results late in the afternoon.

On Wednesday, he said, “The samples for the tests have been collected from several residents and sent off. We don’t have the COVID-19 result yet. It certainly could be, but it could be one of many other viruses.” 

"There’s some individuals who have developed symptoms. In case it might be infectious, they have been isolated and we’re undergoing testing to figure out what might be the cause of the infection," Hirji said.

Long-term care residences across the country have been major sources of COVID-19 outbreaks and nearly half of all deaths in Canada have occurred in care facilities, so there was a legitimate concern it could be related to the virus that's caused the global pandemic.

“The starting point really for any of these is detecting if there is an outbreak at all," Hirji said in explaining how outbreaks are handled. 

"And so what staff at a long-term care facility do is that they’re checking in on their patients or residents at least once a day, if not more often, to see, is there any change in their health, are they developing symptoms.”

“If they’re developing respiratory symptoms, that’s, of course, a potential concern it could be COVID-19. And so the first thing that’s done is that those individuals are isolated to their room, so that there’s no additional contact with other people."

Any staff entering that room will wear personal protective equipment which they dispose of once they leave that room so there’s no contamination, he said.

He noted there are currently outbreaks of different respiratory viruses in addition to COVID-19.

So the NOTL patients are being tested for "about 10 different respiratory viruses, which are the most common ones that can occur. One of the tests is, of course, also for COVID-19."

Deaths in long-term care homes from COVID-19 are a "tragedy we are seeing everywhere,” Hirji said.

“I think these kinds of settings are kind of a perfect nexus of where the virus is going to transmit easily and the individuals are going to get severe infections. So you have a large number of people living in the same building in relatively close quarters, possibly with frequent interaction, so a virus that starts to spread can spread through that group," he said.

He also noted "long-term care homes generally work on fairly tight budgets. That means that there’s not a lot of specialized capacity that can be hired for infection control purposes."

While the staff in care homes all have the basic training on infection control, they don’t have the "dedicated capacity that can really help out when there’s a more acute problem. As well, because they are tight on budgets, they often have a fairly transient staff."

Some long-term care staff work in more than one facility, but the province has now ordered that practice to stop due to the pandemic.

“Depending on the physical structures at some of these locations, it can be harder to isolate someone effectively," Hirji said.

Then if staff also become ill, "they might be well enough to work, because you don’t want them spreading an infection. That makes all of those staffing challenges more acute." 

When a facility is in the midst of an outbreak, there’s all kinds of additional measures that need to be put in place, so staff are working extra hard during those periods and unfortunately sometimes errors could possibly be made," he said.

Those are some of the "underlying issues that unfortunately we are seeing with long-term care homes and I think they become much more acute with the COVID-19 outbreak.”

While COVID-19 outbreaks are bad news and get a lot of attention, Hirji said, "We have had two outbreaks end in the last couple of days, where they had very few infections, things were well-controlled. And so there’s definitely some good news stories here as well."

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