I wrote this email on March 23, 2021 to the Emergency Operations Centre of the Ministry of Health in regards to Directive #3 which places significant restrictions on the residents of Long Term Care homes during the pandemic. The email has gone unanswered and so I making it public today.
I’m currently the medical director for Bay Haven Long Term Care in Collingwood Ontario. I had sent the email below asking for some easing of restrictions for our LTC as we now have all but two residents (new admits) who were fully immunized for COVID-19. Our medical officer of health, Dr. Colin Lee expressed that while he was sympathetic, he could not overturn Directive #3, and asked that forward you with my original email. I would ask that you please consider the overall well being of the residents in LTC centres like mine, where we have almost full immunization.
Begin original letter:
I understand you are the contact person at Public Health for Bay Haven. I’m hoping that you can help me advocate for the residents of the nursing home. As you are aware, most nursing home residents throughout the province are suffering from “confinement syndrome”. The year long isolation caused by the COVID pandemic has had a devastating effect on their emotional health and the residents are really struggling as a result.
As the Medical Director, I see these issues when I visit, and it pains me to see how much the mood of the residents has gone down in the past year. Don’t get me wrong, I do understand the rational behind some of the restrictions that have been put in place, and I have supported those restrictions. They were important to protect the health and safety of Bay Haven, and we have been fortunate to not have a COVID outbreak in our facility.
But we also now are in a situation where all but two of the residents (new admits) are immunized for COVID and a good number of staff are immunized as well. With that, I need to focus on the other aspects of care for the residents.
The blunt reality however, is that Bay Haven will not go against Public Health directives, no matter what I personally think of them. So I need your (or somebody in public health’s) support to change some of the directives.
I want to point out that the most recent data shows that the COVID vaccines DO, in fact, reduce transmission (https://www.nbcnews.com/health/health-news/pfizer-covid-vaccine-cuts-transmission-coronavirus-new-real-world-study-n1260542). This is unsurprising as every other successful vaccine also reduces transmission, but we now have proof of this. In fact, transmission of COVID is reduced after just ONE dose of the vaccine (https://www.huffpost.com/entry/pfizer-covid-19-vaccine-reduces-transmission-after-1-dose-study-finds_n_6038e92ec5b6b745c4b655ba).
With that, I would like to implement the following changes (and need Public Health to support):
1) We continue to have less than 100% of our staff immunized. To encourage more of them to be immunized, I would like to stop screening with np swabs, those that have been immunized (two weeks after their second shot). Nobody likes getting an NP swab. If the un-immunized staff see that they will not be subjected to this test, it might encourage them to get their own shots. And we get to save our swabs for those who really need it. (Addendum – Since this letter is public, what I was not aware of when I wrote the original is that Bay Haven actually has one of the highest percentages of nursing home staff who’ve been immunized in the province – almost 80%! Having said that, nothing wrong with going for the other 20%)
2) All the residents who have been immunized need to be allowed to go back to congregating as usual. This includes all their group activities and sessions.
3) We should allow an increased number of visitors to the facility. I would agree the visitors should have proof of either immunization, a recent negative COVID swab, or be willing to have a rapid swab done in our facility. I think each resident can assign 4 people who can come and visit, and we can work on putting a limit on the number of visitors at any one time.
4) If a resident has been immunized, they should be able to leave the facility for social gatherings, not just medical appointments. Whoever drives them would need to have proof of immunization, a recent swab or have an NP swab in our facility since they presumably enter the building. But the immunized resident cannot (as per the articles above) bring back and transmit the infection themselves.
If Public Health could support this, it would go a long way to improving the mental health of the residents and improve their quality of life. It’s the least we can do after all they have done for society over their years.
Sohail Gandhi, MD, CCFP
Medical Director, Bay Haven Seniors