Memramcook-Tantramar MLA Megan Mitton is calling for a formal, independent investigation into the the outbreak of COVID-19 at the Drew Nursing home in Sackville.
“We’ve had eight deaths at the Drew Nursing Home,” says Mitton, extending condolences to those who lost loved ones. “We’ve had many residents and staff who have contracted the virus. And so the thing is, we need to know whether the government’s response was adequate, and what went wrong here.”
Catherine Gaw is the chair of the board for the United Church Home for Senior Citizens, which operates the Drew Nursing Home. Gaw issued a press statement on Wednesday outlining the situation and calling for a “pause” on scrutinizing what’s happened.
“At this point in time we would urge everyone to push pause on any calls for a review of the process,” writes Gaw. “Please know that the Executive Director, Linda Shannon, is in regular meetings with medical and government officials and the workings of the response efforts are monitored constantly. The important thing is to support the ongoing efforts to bring this outbreak to a resolution.”
It’s been just over a month since the first case in the outbreak was discovered at the Drew on September 13. According to accounts from staff, Public Health did not complete testing on all staff and residents until five days later, on Saturday, September 18.
On September 20, Chief Medical Officer of Health Jennifer Russell responded to a question about the situation at the home saying that she did not have “situational awareness” around the Drew, but confirmed “that particular location has not been declared an outbreak.” At the time, the Drew had 10 confirmed cases. By the next day, September 21, the confirmed case count was up to 22, with 16 residents and 6 staff testing positive. On September 26, executive director Linda Shannon announced the first two deaths at the home related to the outbreak.
Eight residents in all have passed away with COVID-19 at the Drew, and a total of 40 cases have been diagnosed. The latest round of testing yielded no new cases, and the previous round found only one. Just one case remains active.
HAS PROVINCE CHANGED THE WAY IT HANDLES LONG TERM CARE OUTBREAKS?
“We have seen government report less and less on situations like long term care facilities having cases,” says Mitton. “We need more transparency. And luckily the Drew has been transparent.” Executive Director Linda Shannon has been sharing regular updates on the ongoing situation at the Drew in letters to families of residents.
In previous waves of the pandemic, government communications around outbreaks in long term care homes were handled differently, with details of outbreaks given in daily COVID news updates published by the province. A look back at those updates shows that outbreaks in previous waves were handled differently by the province as well.
Back in October of 2020, when only two people had yet died from COVID-19 in the entire province, and the total case count was a mere 205, two cases appeared at a special care home in Moncton.
[Though the terms might sound similar to a layman, special care homes and nursing homes have key distinctions. Special care homes serve residents with less complex medical needs. The level of care may vary at a special care home, while nursing homes provide 24/7 nursing care. There are 71 nursing homes like the Drew in the province, but there are hundreds of special care homes, with 79 licensed facilities in the Moncton region alone.]
Notre-Dame Manor in Moncton was identified with two cases on October 6, 2020. The previous night, Public Health had started an investigation at the facility, with additional staff deployed who “started contact tracing and rapid testing of the facility’s residents and staff,” according to a provincial news release.
At a press conference on October 7, 202, Dr. Jennifer Russell described the work of the rapid response team: “So we were able to test almost the entire population of residents and staff in a four hour period, and get those results really quickly so that we could begin to contact tracing really quickly,” said Russell.
Flash forward to September 2021, and there’s no indication that rapid tests were deployed at all at the Drew, and though testing began the day after the first case was discovered, it wasn’t completed for five days. Executive Director Linda Shannon did not answer a question about when the provincial rapid outbreak management team (PROMT) arrived at the Drew, or if rapid tests were used at the outset of the outbreak. CHMA has requested confirmation on the timeline and nature of the public health response from provincial health communications director Bruce MacFarlane, and will publish an update as soon as we hear back.
Previous questions about the apparent change in response to cases in long term care homes have gone unanswered.
“SOMETHING IS DIFFERENT”
Mitton says she doesn’t doubt that the Drew was following government guidelines, but says she was concerned early on that not enough resources were being directed there.
“Obviously, something is different with this outbreak,” says Mitton.
The MLA says she reached out to the premier, Dr. Russell, and Minister of Health Dorothy Shephard in September, and again in October after receiving no response. “Some of the concerns I had were, why are testing times taking so long? Especially when I think priority should be given to test results from an outbreak in a long term care facility,” says Mitton. “And I expressed that I was concerned that potentially PROMT wasn’t containing the virus. It wasn’t containing the situation as much as it needed to.”
Mitton says she thinks the handling of the Drew outbreak is part of “a broader problem, that the Higgs government really scaled back the pandemic response in August. And then as the fourth wave ramped up in September, they were caught flat footed and couldn’t respond,” she says. Mitton says part of the need for an investigation comes from a desire to prevent similar mistakes in future.
NURSING HOMES MOSTLY SPARED UNTIL FOURTH WAVE
A number of special care homes experienced outbreaks during the first three waves of the pandemic, but luckily, the province’s nursing homes were mostly spared. The only nursing home to experience an outbreak was Tucker Hall, a nursing home with 72 beds operated by Shannex in Saint John. That outbreak lasted several months, and consisted of 50 cases which included 29 residents and 21 staff. Seven residents passed away with COVID-19 during the outbreak.
Michael Keating, interim director of the Nursing Home Association of New Brunswick, says that the rate of deaths at the Drew, and at Tucker Hall, are below the average rate of deaths seen in other COVID-19 outbreaks in nursing homes across the country. “On average, if it got into a nursing home, 30% of the residents were dying,” says Keating. “And we were worried that we were going to be on average like that. So at the Drew, we could have lost close to 40 people. And I think Linda [Shannon, Drew executive director] obviously must have managed well. There’s lots of people that came in to help.”
The Canadian Institute for Health Information reported that after the first two waves, an average of 27% of long term care residents who were infected with COVID-19 died across Canada. That is roughly in line with the rate of death of infected residents at both the Drew and Tucker Hall, 27% and 24% respectively.
Keating says the relative safety of New Brunswick nursing homes in the first three waves was partly luck and partly good management. “If it wasn’t for the staff, and the management and the visitors all being so careful during those first three waves,” says Keating. “I think it’s really good management, but I also think it’s really good luck, you know, to keep something out you can’t even see.”
But that luck appears to be over. Keating says 12 nursing homes in the province have experienced outbreaks so far in the fourth wave.
As for the call for an investigation from Megan Mitton, Keating is staying out of it. “We’re not getting involved in political stuff,” he says. “I mean, as far as we’re concerned, we know what happened. The employee brought the disease in. And protocols were followed. There was a close working relationship [with Public Health]. But suffice it to say, just let the politicians do what they [do]. We’re not going to enter into that debate with them at all.”
SHEPHARD’S RESPONSE: “WE’RE VERY TRANSPARENT”
At a news conference on Tuesday, CBC reporter Bobbi Jean McKinnon asked health minister Dorothy Shephard about Mitton’s call for an investigation. Shephard dismissed the request as opposition posturing, and promised to answer any questions that didn’t violate privacy laws.
“We’re very transparent,” said Shephard. “I’m not quite sure what questions she’s looking to have answered. But I’d be more than happy to take questions under advisement and give as much information as we can.”
CHMA has a number of outstanding information requests to the province, including a question about the apparent change in response to COVID-19 cases in long term care facilities, and what qualified as an outbreak. We’ll publish an update as soon as we get those answers.
