An internal report detailing the most lethal COVID-19 outbreak in British Columbia painted a grim picture of Langley Lodge’s long-term care home disorders and establishments.
The 30-page report, dated August 11 and written through Langley Care Society Executive Director Debra Hauptman, was anonymously leaked to Glacier Media through a user claiming to be the manager of one of the province’s fitness authorities.
Glacier Media contacted Hauptman, who described the document as a fact record intended to be shared in the public domain.
“The goal is not to blame or point the hand or impose duty on other parties,” he told Glacier Media. “For us it was technical the moment I arrived. “
However, as the report points out, mistakes were made to varying degrees in two outbreaks that allegedly resulted in the deaths of 26 citizens with COVID-19, the number in any nursing home in the province.
The 139-bed facility was first affected by a single case of COVID-19 on March 26 when an inflamed nurse on a night shift moved away from pre-work detection protocols and transmitted the virus while having acute symptoms, the report notes.
But this epidemic was limited to this single nurse and it wasn’t until the time the virus came through some other staff member on April 27, that the collection outbreak took a fatal turn.
“The staff worked more than 2 shifts and did not feel well in any of the shifts, but did not report or avoid the screening workplace during the last shift,” says a timeline of the outbreaks included in the report. Array “He paid attention to 16 citizens in two setsArray. . PPE violation imaginable. “
At the time, it was already transparent that mass swabs for asymptomatic patients were an essential tool for detecting poaching cases, but Hauptman told Glacier Media that the house’s medical director had to try “hard to get large samples” and that not until May 4, Fraser Health conducted widespread testing for the first time.
As the virus spread from one soil to another, 15 and 51 citizens were eventually affected by the virus, and 26 in one unit for others with dementia and other cognitive disorders.
“Staff have not been able to socially isolate citizens from each other. because of wandering and complex dementia,” explains one of the points contributing to the epidemic. “There is a lack of clinical recommendation on precautions opposed to COVID-19 with this population. “
Or as Hauptman told Glacier Media, the Behavioral Stabilization Unit was the worst position to have an epidemic: “They don’t perceive social distance, social isolation, they stay in their room, they don’t touch each other. “authorities. “
“We are very afraid that this will be back in this unit, just like my colleagues,” he added.
Like many long-term care homes, the average age of a Langley Lodge resident is 85, many of whom were on the teams of maximum medical complexity and risk of COVID-19.
As the virus swept through the facility, the report described a “dramatic and unforeseen reduction in staffing, resulting in continued shortages and criticism of staff,” nurses who fled due to insufficient non-public protective devices and household chores experienced a “huge dropout rate. “because of exhaustion.
The staff who stayed in the pictures did their best for themselves.
“Due to the concern of the infection, many members wore double robes and the robes were incredibly thin and not resistant to liquids. Some members bought dangerous fabrics and put on/take off their robes on the settings,” the report says, referring to the procedure of applying and cutting non-public protective devices (IPDs).
Threading and cutting PPE is a thorough procedure to the point where hospitals often have someone who detects staff to make sure they don’t make mistakes. But even after schooling intensified with Fraser Health nurses, audits revealed “more education and guidance” to prevent contamination.
Of the 59 pieces evaluated in an infection audit and prevention on May 12, 18 did not meet the standards. In one case, Fraser Health would have provided 4 other PPE panels, each of which was considered the “wrong poster”. In other cases, the audit revealed a threat of contamination after laundry carts and trash cans were discovered in the same laundry facility.
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The singles site order issued through the provincial health administrator, Dr. Bonnie Henry in late March largely limited staff to a singles facility and was hailed by many experts across Canada as a vital buffer containing transmission of the virus from a single facility in British Columbia. Care house to another.
But according to the report, the order did not take much account of the wishes of the operators and resulted in a widespread shortage of emergency workers, as control was quick to seek support. it is still imaginable that the personnel crisis will be repeated if the rest house is affected again by the virus.
Overall, according to the report, long-term care homes “are not ecologically designed for the strictest infection processes needed to eliminate this highly virulent COVID-19 virus. “
Fraser Health began shipping more to the facility as of the week of May. By May 14, a Fraser Health “clean team” had moved from backup roles to COVID-19 spaces with positive cases.
On the same day, Fraser Health’s first agent tested positive for the virus. A day later, the common dining room closed in favor of delivering food to citizens’ rooms, a resolution that the report describes as “extremely expensive” because of the charge. disposable dishes and containers, as well as the difficulty in distributing food while observing citizens who have a “risk of suffocation. “
Throughout the epidemic, phone calls and emails from some enjoyed were described in the report as “furious, accusatory and threatening” as they spoke to the media about their concerns.
At the same time, the report notes that the rules of some fitness officers have confused the response. Fraser Health, he said, provided conflicting data on the wear of the mask, at one point requiring a mask consistent with the employee consistent with the day, and in time, 4 consistent with the employee consistent with the day. Meanwhile, WorkSafe BC has changed “the right mask for COVID-19 care”, first recommending N95, then switching to “COVID-19 care surgical mask; N95 for the generation of aerosol procedures. »
Despite switching to Fraser Health’s provider, the report says the care home has gone out looking for its own gowns, masks, face shields, hand sanitizers, and contactless dispensers, which are occasionally purchased at local businesses such as breweries. and distilleries that had been renovated to make hand sanitizers. or facial protectors.
Just as Langley Lodge has been hit by a developing cost of coronavirus, its core maximum operating procedures, based on palliative care where patients and their families are included in discussions about where they will receive care, have come into play. collide with a new fighting style. COVID-19, which states that “the desires of the network would possibly outweigh the wishes of Americans in such a crisis” and that “personal rights and freedoms will have to be limited. “
In an ideal world, Hauptman stated that Fraser Health would eliminate all COVID-19 patients, or at least those with dementia or similar diseases, and place them under one roof in a hospital rehabilitation unit or long-term nursing facility. they are home to their incubation period.
“They’re preparing for a momentary wave. I know for sure,” he says. “[But] this is a point of controversy that has yet been resolved. “
Other recommendations in the report come with devising a screening strategy to catch undetected asymptomatic virus carriers by screening twice daily, and creating a one-way traffic flow and simple access to EPP at home for old people.
The report states that it intends to provide an old record for langley Care Society archives and for other nursing homes to identify gaps in their pandemic preparedness plan and expand a “backup plan. “
But through the development of a detailed schedule for the outbreak, the report also paints an image of a crisis, detailing the accumulation in the death toll overnight, as well as how they have fought. to keep the virus under control.
In retrospect and unlike hospitals, Hauptman stated that long-term care is too far from epidemiology specialists who predicted the arrival of a virus like COVID-19 and, although cases continue to increase in British Columbia, many unanswered questions remain.
“We were not expecting us to go through an epidemic of this degree,” Hauptman said, “we still don’t have the answers and we don’t know what’s coming. “
“We weren’t going to have this virus. “