Merrilee Fullerton failed Ontarians in long-term-care. But if you’re pointing fingers make sure you have enough

There should be reckonings when this is over, and attempts to assign or escape blame are already underway. Browsing Dr. Merrilee Fullerton’s testimony to the Long Term Care Commission — the one the government is trying to bury in a ditch under a mountain of late-arriving documents, while refusing to extend its deadline — is an exercise in both. Fullerton is the minister of long-term care. Ontario’s record on taking care of our older population has been grim.

So how did we fail older Ontarians? Lots of ways. The long-term-care system was broken, it’s true, from Mike Harris to the ensuing Liberal mini-dynasty to the Doug Ford government, and then COVID-19 arrived. Provincial inspections were cut pre-pandemic, and failed to meaningfully resume. In the first wave, PPE didn’t arrive, staff fled, and Ontario more or less locked the doors and said, good luck. And then the second wave, unforgivably, was worse than the first.

So Fullerton is clearly trying to elide responsibility. She says it wasn’t her ministry’s fault, because after all, they worked furiously. She notes the province spent $20 million on improved infection prevention and control (IPAC) measures; she says the province moved to hire supplementary staff in the fall, and that she and her people constantly wonder, what could they have missed? She says the problem, basically, belongs to Premier Doug Ford, and his office. Because the problem was community spread. Which is the truth, even if she wrapped it in a lie.

Q: So if the Deputy Minister is correct, Minister, why did more people die in Wave 2 in long-term care than Wave 1?

A. Yes, and so I have looked at that really carefully. And Wave 1 did not have the same level of community spread as Wave 2. Wave 2 had far greater community spread.

This is wrong. We didn’t have enough testing to figure out how much community spread we had in the first wave, but Dr. Peter Juni, the scientific director of Ontario’s independent volunteer science table, has said there were as many as 10 Wave 1 Covid cases for every one we found, versus two or three times the cases in the second wave.

That said, of course community spread was the problem, because enough of the virus will find its way to the most vulnerable, and that was long-term care. At the time, advocates for long-term care, epidemiologists, infectious disease specialists and public health officials said it. Of Canada’s 22,000 deaths, over 16,000 have been in long-term care. But in the name of economic balance, Ontario let the virus spread all through the fall.

So yes, it belongs to Ford, and to chief medical officer of health Dr. David Williams, and to this government. Choices were made.

Fullerton doesn’t escape the hook, though. She parroted the line from for-profit health-care operators that while better pay and full-time staff might solve staffing challenges, staff may not want full-time work. (British Columbia went ahead and paid for it, giving workers the choice, in the first wave.) She said the age of buildings was a determining factor. (The Star has shown there was a significant difference in private and public LTCs, regardless of building age.) This government loves defending private long-term care.

And her defences on IPAC and staffing are empty. Dr. Samir Sinha, the director of geriatrics at Mount Sinai and the University Health Network, points out that British Columbia moved faster in the first wave by spending $10 million a month to offer full-time staffing and pay bumps. And that Quebec — after a brutal Wave 1 in long-term care — managed to get it under control with a staffing campaign that started in May 2020, four months before Ontario’s, and an IPAC official in every home.

Ontario didn’t announce a staffing drive until late September, with a second wave underway, and spent $20 million on IPAC when an official in every home required spending four times that.

“Someone made the decision not to send PPE in early, or to promote universal masking,” says Sinha. “Someone made the decision to not improve the employment situation in these homes, or to take steps in the funding of IPAC. So out of $1.3 billion spent so far, why was only $20 million spent on IPAC, which will get you one limb per long-term-care home, as opposed to a whole body?”

“They failed to secure IPAC practitioners, they failed to decrowd homes, and they failed to improve staffing. I put those on the Ministry of Long-Term Care,” says Dr. Nathan Stall, geriatrician at Mount Sinai Hospital. “I put failure to control community transmission and to vaccinate residents — it took almost nine weeks and we went through nearly 500,000 doses to do it — in a timely manner on the province and Ministry of Health.”

If you want to point fingers, make sure you have enough. The chief medical officer was slow in the first wave, and the province was not proactive. But far worse, the planning for the second wave was slipshod, and then the attempts to control the virus were half-hearted, and now we are at the part where blame is being sloshed around. Fullerton wasn’t blameless. She wasn’t the only problem, either.

Meanwhile, Monday, it was noted by Rob Gillies of The Associated Press that Toronto police had suddenly been moved up in terms of vaccine priority, and that nearly half the 5,000-person force was now being vaccinated — ahead of 80-year-olds in the community, 70-year-olds, 60-year-olds, and other front-line workers.

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So someone pushed police to the front of the line, and the people running vaccination let them, even though the guidelines of the province’s vaccine task force are heavily weighted to age, because age is the single biggest risk factor, followed by where you live. As Sinha notes, 20 Ontarians died Saturday. Nineteen were over 60.

Maybe the answer is deceptively simple. How did Ontario fail older Ontarians? Deliberately, of course. Step by step.