COVID-19 in long-term care homes in Ontario and British Columbia
Pat Armstrong
Refereed Article, 2020
Liu, M., Maxwell, C. J., Armstrong, P., Schwandt, M., Moser, A., Mcgregor, M. J., Bronskill, S. E., & Dhalla, I. A. (2020). COVID-19 in Long-Term Care Homes in Ontario and British Columbia. Canadian Medical Association Journal, 192(47), E1540–E1546.
People living in long-term care (LTC) homes in Canada have been far more likely to die of coronavirus disease 2019 (COVID-19) than the rest of the population.1 However, the effect of COVID-19 on residents in LTC has varied across provinces and territories. For example, as of Sept. 10, 2020, according to publicly available data, there were 5965 resident cases and 1817 resident deaths in Ontario LTC facilities compared to 466 cases and 156 deaths in British Columbia care facilities (Table 1).2,3 Rates of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection (7.6% v. 1.7%, respectively) and COVID-19 mortality (2.3% v. 0.6%, respectively) among residents in LTC were several times higher in Ontario than British Columbia, although case fatality rates were similar. We consider the reason for these differences by examining pandemic preparedness in LTC and subsequent first-wave pandemic responses in LTC in Ontario and British Columbia by means of a comparative case study (Appendix 1, available at www.cmaj.ca/lookup/doi/10.1503/cmaj.201860/tab-related -content).4 We focused on Ontario and British Columbia because these large provinces had stark differences in COVID-19 outcomes, despite similar LTC systems. Our analysis suggests that the difference in outcome has been primarily due to