Meet Laurie and Kim. They are over 80, and need help with activities daily living and the care of a nurse. They both live in privately operated nursing homes in Canada. Both homes receive public funding. During COVID-19, neither Laurie nor Kim can have any visitors from the community (not even their spouses). Their home is the site of a COVID-19 outbreak. What happens next depends on where they live.
At Laurie’s home, when the outbreak began, the government took over responsibility for managing the COVID-19 response. All staff at Laurie’s home are working there and only there. Any staff member who was part time has been given full time hours. Individual staff are being paid on parity with their counterparts in other nursing homes (some staff have seen their wages rise by $7.00 per hour).
At Kim’s home, the nursing home operator is responsible for leading the response during COVID-19 outbreak. In normal times, an outside agency provided most of the daily assistance that Kim received, a practice that continued during COVID-19. The agency’s staff are allowed to work at more than one nursing home. This week, personnel from Canada’s armed forces are being deployed to help manage the outbreak and provide care at Kim’s home.
How is it working out?
Laurie and Kim live in British Columbia Ontario respectively. Both provinces have COVID-19 outbreaks in nursing homes, but have chosen different ways to manage the response. The result for Laurie and Kim is profoundly different. Nursing home staff in British Columbia are working one job, full time, until COVID-19 ends. Their wages are the same as workers in other homes. They have some degree of financial stability. They can concentrate on supporting Laurie and other residents. If a staff member should fall ill, they continue to be paid and know there is work to come back to.
In Ontario, there’s no shortage of part time work through agencies. Staff can cycle through a number of homes as they piece together enough time to make a living wage. If they fall ill or must take time off work for any reason, there is no income and future employment is not assured.
Like agency workers, staff employed by nursing homes in Ontario are also often part time and work at more than one nursing home. Both agency and nursing home staff live with the possibility of being exposed to COVID-19 at multiple sites and of transmitting it from one site to another, especially if they are symptom free. Regardless of whether they are working for the nursing home or an agency, every part time worker is faced with a difficult decision. If they work at one site, they reduce the risk of infection. They also lose income. If they work multiple sites, they sustain their income, while at the same time increasing the risk of infection.
Two recent events suggest that the part-time agency-based strategy may not be working as well as hoped. As noted, the armed forces have been called in, which suggests staff shortages. Armed forces personnel are now working at four homes in Ontario in addition to Kim’s. The Ontario government has also announced a $4/hour wage subsidy for people who work in nursing homes, beginning April 24, 2020. The federal government is helping to pay the subsidy. There is no provision to apply it retroactively. See at CBC: Ontario Announces $4 An Hour Pandemic Pay Increase For Front-Line Workers
What’s going on elsewhere?
COVID-19 outbreaks in nursing homes are not unique to British Columbia or Ontario: they are reported in other provinces and in other countries. See in the Guardian: Care Homes Across Globe In Spotlight Over Covid-19 Death Rates
There’s a lot of diversity in the way the responses are managed. Ontario is not alone in calling on the armed forces for help.
British Columbia’s decision to take over from the daily management seems to be unique.
Why has British Columbia gone a different route?
The BC government decided that nursing home residents are especially vulnerable to COVID-19 and normal emergency procedures for an outbreak would not be enough to provide a robust response. The vulnerability is certainly evident in these early investigations, reported in the Guardian: Half Of Coronavirus Deaths Happen In Care Homes, Data From EU Suggests
Why does this matter?
We need to protect people in who live in nursing homes. Let’s remember that they are home for Laurie, Kim, and thousands of others.
Laurie’s and Kim’s stories are constructed from information presented by Fay Faraday, a lawyer specializing in labour and human rights, during a podcast organized by the Broadbent Institute: Lift the Floor: How Provinces Can Provide Protection For All
Fay was joined on the podcast by Jesse Hajer, a Labour Economist at the University of Manitoba, and Michael Mendelson, who during his career was a deputy minister in the Manitoba and Ontario provincial governments. Fay’s comments that are specific to this post begin around the 17 minute mark.
The podcast also contains a discussion about financial assistance for renters, and how to pay for the COVID-19 response. It is well worth a listen.
