Ontario's chief medical officer of health is "strongly recommending" that the elderly and individuals who are immunocompromised self-isolate as the number of people with COVID-19 in the province continues to rise.
Dr. David Williams made the recommendation in a statement to Ontarians on Monday as the provincial government announced $5 million more to help subsidize the delivery of meals, medicines and other items to seniors. This also comes as officials said they're looking to issue more guidelines to long-term care homes as outbreaks of COVID-19 in these facilities continue to claim the lives of residents.
"Given the greater risk of severe outcomes to Ontarians who are elderly, I am also strongly recommending that individuals over 70 years of age self-isolate," Williams said in his statement. "This means only leaving home or seeing other people for essential reasons. Where possible, you should seek services over the phone or internet or ask for help from friends, family or neighbours with essential errands. This also applies to individuals who have compromised immune systems and/or underlying medical conditions."
He said "everyone has a role to play" in limiting the spread of COVID-19 and that "there is no option for anyone to opt out." Williams called on all Ontarians to stay home except for "essential reasons" such as grocery shopping, picking up medicines, walking pets, accessing health-care services or helping others with any of these tasks.
Speaking at Queen's Park on Monday afternoon, Premier Doug Ford said the province needed to protect its population of seniors and vulnerable people.
"We need to put an iron ring around our seniors and other vulnerable populations, we need to protect them," said Ford, reiterating Williams' advice.
"I want our seniors to know that we’re doing everything in our power to ensure that you continue to have access to medicine and essential items you need," the premier said, adding that they're asking grocery stores and pharmacies to find ways to support seniors including giving them priority access to home delivery or establishing shopping hours specifically for them.
Ford announced the government was investing $5 million in addition to the $5 million it announced in its March 25 economic update to work with businesses and community groups to coordinate "subsidized deliveries of meals, medicines and other necessities to seniors."
The premier said social isolation "can have a terrible effect on our seniors" and encouraged Ontarians to call seniors, check on them remotely and drop off groceries to them.
"I know these measures today are not easy for many families, I know it’s hard not being able to visit loved ones, but it’s the only way to protect them," said Ford. "We know each moment with them is precious and what we’re doing today to stop the spread of COVID-19, it may mean one more moment with your grandchild and that’s worth everything in the world."
New guidelines coming: Williams
Both Ford and Minister of Long-Term Care Merrilee Fullerton offered their condolences to the families affected by a COVID-19 outbreak at Pinecrest Nursing Home in Bobcaygeon, Ont. The Globe and Mail reported on Sunday that nine of the home's residents had already died and 34 staff were experiencing symptoms related to the novel coronavirus, with one nurse calling the situation at the facility a "war zone."
"We always knew that the population in long-term care homes is a particularly vulnerable, high-risk population for serious illness, complications and even death, so unfortunately we are starting to see that play out in places like Pinecrest," said Dr. Barbara Yaffe, associate chief medical officer of health, during a media briefing with Williams.
Fullerton said the government and health officials started weeks ago trying to understand the risk of COVID-19 to long-term care homes.
"The reality is that this is a virus that is new to the world and it is a threat and we are doing everything possible to make sure that all measures are taken to address the issue that happened in Bobcaygeon," she said. "We’re looking at really shining the light on this situation, this tragic situation with increased screening, increased isolation for people coming in, self-isolation for staff that need to be self-isolated."
When asked, Fullerton did not commit to posting information about outbreaks at long-term care homes on its website or doing more testing at these homes, but said those things are being discussed with the chief medical officer of health, who is the one making those decisions.
Speaking a few hours later, Dr. Williams said during his regular afternoon briefing that local public health units are typically going public when an outbreak occurs, and that co-ordination between provincial health officials, these units and the facilities has been occurring.
"It’s a lot better if it’s run at the local level in that way...because a lot of the citizens going there are from the local area," he said.
Fullerton stressed the importance of isolation, testing, treating and tracing — priorities outlined by the World Health Organization — and acknowledged "there is more we can do." Following the global shortage in test kits, Fullerton said long-term care homes will be given priority now that there is a greater supply.
As for personal protective equipment for staff in these homes, Fullerton said she's working with the chief medical officer of health to "understand and make clear exactly what is needed in what situation" and to ensure the homes have access to the needed equipment.
Dr. Williams said they're trying to "ramp up a number of things" in long-term care facilities related to screening and cohorting of patients and staff, and that he's hoping to have "new directions" out soon for these facilities.
"If you have a large facility, can all the people stay on the same floor...can you have limited staff movement between different facilities?" he said. "These things are being looked at intensively."
He said one of the challenges is seniors with COVID-19 don't always show "a lot of symptoms early on."
Williams said it's important to catch and react to COVID-19 cases in long-term care homes as soon as possible. He noted that previously a protocol was in place for influenza where testing would stop after four cases were found and then links were made based on symptoms.
"Now we’re saying we’re going to go much quicker on that; as soon as you have a case, someone symptomatic, we’re going to assume that it probably is an outbreak and it probably is COVID-19, to start doing your action right away, not waiting until you get your laboratory testing down," Williams said. "We modified some of our methods of carrying out investigations with our public health partners and working in partnerships with long-term care facility management on how to undertake investigating very early, very quickly (of) any suspected COVID-19 cases in those settings and trying to move as rapidly as we can."
Photo Credit: Steve Russell/Toronto Star