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In face of deadly pandemic, Ontario long-term care homes continue breaking COVID-19 safety rules

Ten months into the COVID-19 pandemic, inspectors were still catching Ontario long-term care homes violating crucial infection prevention and control measures.

A CBC News data investigation has found 1 in 12 long-term care facilities in the province were caught breaking COVID-specific government directives between June 2020 and January 2021. Many infractions occurred during or after outbreaks.

“To have egregious infractions in terms of not following standard operating procedure for things like infection prevention and control, these operators need to be held to account,” said Dr. Nathan Stall, a geriatrician at Mount Sinai Hospital in Toronto.

The COVID-19 death toll in Ontario’s long-term care homes was 3,743 residents as of Feb. 26, 2021, according to the province. Of those deaths, 1,848 occurred before Aug. 31, 2020, which means the second spike in long-term care homes was even deadlier than the first.

Improper screening was a frequent issue at homes. Many were cited for not asking staff members or visitors questions or taking their temperatures, and failing to ensure they were wearing masks as they entered or left the premises. 

Some of the reports from provincial inspectors also detail long lists of infection control issues. While other companies are reflected in the data, the number of Caressant Care-owned homes with inspection violations of COVID-19 directives is high relative to the number of homes owned by the company.

WATCH | Several Ontario nursing homes broke rules meant to prevent COVID-19 outbreaks:

A CBC News investigation has revealed that multiple Ontario long-term care homes didn’t follow infection prevention rules meant to prevent COVID-19 outbreaks with some breaking the rules during or after an outbreak. 2:50

At Caressant Care Listowel Nursing Home west of Toronto, where an outbreak infected nearly every resident of the home in January, an inspector found 12 major infection control violations during the outbreak. 

“That probably explains quite a bit about how [COVID-19] got through so quickly,” said Alycia Houchen, whose grandfather, Edwin Rutherford, was one of 13 residents who died in the home, which has room for 45 people.

In all, 43 residents and 26 staff were infected during the winter outbreak at the home.

The violations included staff not being aware of the correct personal protective equipment to wear and not cleaning their hands after taking care of residents; staff working with both COVID-19 positive and negative residents; and hand sanitizer not being available in all areas of the home. 

Houchen, herself a personal support worker at a different retirement home, says the inspection report findings are “disturbing and disgusting.”

“They have had plenty of time to prepare and to do whatever they needed to do, and they obviously didn’t do it.”

Caressant Care owns 15 homes in Ontario. Four of those facilities were caught breaking COVID-19 safety directives during inspections. Like the location in Listowel, two others were found to be in violation of the infection control rules during outbreaks in December or January.

The company declined to comment for this story.

Big operator accounts for more than 20% of violations

Extendicare, one of Ontario’s largest long-term care operators, which owns or manages 69 facilities in the province, was cited for the most violations of infection control and prevention directives.

Homes owned by the company accounted for 13 per cent of the provincial total of 60 violations. When homes the company manages are included, that increases to 22 per cent of the violations. 

Other big chains such as Sienna Senior Living and Revera accounted for three and five per cent, respectively.

Inspection citations against Ontario’s long-term care homes hardly ever come with any consequences. Homes are asked to fix the problem, but even if an inspector returns and finds the same issue, there are no fines or penalties. In very rare cases, homes are barred from accepting new residents. 

Extendicare says inspectors visited its owned and managed homes almost 200 times in the past six months. 

“While some inspections do report issues related to COVID directives that require attention, these represent a small minority of the visits,” Extendicare said in a statement to CBC News. “While our goal is to have no issues, it’s important to note that in 93 per cent of the inspections, there were no COVID-related compliance issues.”

For-profit long-term care homes received 70 per cent of the violation citations despite accounting for 56 per cent of the homes in the province. An additional eight per cent of the violations were found in non-profit homes managed by for-profit companies.

Tamara Daly, director of York University’s Centre for Aging Research and Education, says research suggests conditions are better at non-profit care facilities. (Submitted by Tamara Daly)

That for-profit operators are over-represented in the findings isn’t surprising to Tamara Daly, the director of York University’s Centre for Aging Research and Education. She has been studying the differences between for-profit and non-profit care for years.

“I think, at the end of the day, the working conditions and the caring conditions have been shown to be worse at for-profit facilities and the research data backs this up, both pre-pandemic and during the pandemic,” she said.

CBC News sent the Ontario Ministry of Long-Term Care its findings from the inspection reports. It responded with a statement that said inspectors monitor for the health, safety and quality of care of residents.

“Repeated non-compliance is a serious concern and can result in escalated measures and sanctions by the ministry,” the statement says.

However, past CBC News investigations have found many homes have been cited for repeated issues without any consequences.

Inspectors spot infection control issues during outbreaks

Of the infection control and prevention violations, 52 per cent occurred in homes either during or after an outbreak.

The fact that inspectors were finding repeated violations in the same home, or violations after an outbreak, is very concerning, said Daly.

“To get those reports indicating that there’s still improper use of PPE after an incident, that concerns me greatly, because where is the learning?”

Ten homes were cited for denying entry to essential caregivers. Short staffing in homes has been well documented, and restricting family access means residents often don’t get the care they need, said Daly.

It’s also a quality of life issue, she said.

“Being in long-term care is very different than being in a hospital bed,” she said. “You’re there to live. And I think what we essentially did is we removed that part of their care, the living part, the part that makes life worthwhile.”

Infection control important after vaccinations

Even as residents at Ontario nursing homes get vaccinated, the number of infection control violations is still concerning, said Stall, the geriatrician at Mount Sinai Hospital.

“Vaccine euphoria is a good thing. We should all be excited about this,” he said.

However, he said, we don’t know definitively that the vaccines prevent transmission.

Dr. Nathan Stall is a geriatrician at Mount Sinai Hospital in Toronto. He says operators not following the rules need to be held to account. (David Common/CBC News)


The vaccine supply didn’t make it in time to help at Caressant Care Listowel.

For Houchen, the tragedy was hard to watch from the outside. 

She didn’t get to say goodbye to her grandfather, and as a personal support worker, not being able to help him in his final days made it worse, she said.

“I followed it with my heart breaking,” she said. “Every time [the deaths] climbed up, my heart was just breaking more because there’s nothing you can do, there’s nothing you can do to help.”

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Inspector saw Hamilton hospital staff breaking COVID-19 rules

An inspector from Ontario’s Ministry of Labour warned staff at Hamilton General Hospital about not following COVID-19 protocols after they didn’t physically distance in the hospital cafeteria and were in “close, face-to-face contact,” according to a staff memo obtained by CBC News.

The ministry confirmed it also issued Hamilton Health Sciences (HHS), the organization which runs the hospital, an order and is currently investigating.

It would not reveal why it issued the order. But the hospital network says the order is unrelated to staff breaching COVID-19 rules and is instead “related to mask labelling and communication with joint health and safety committees at our site. Something already resolved.”

Veronica Magee, an HHS spokesperson, confirmed via email on Friday that the inspector “observed some of our staff who were sitting too closely together.”

“The inspector addressed the group [and] said they could be subjected to fines in the future if the behaviour was seen again, and that HHS had communicated the need to abide by masking/distancing rules on many occasions.”

‘Staffing crises’

The staff memo says non-compliance is mainly occurring among staff, physicians and residents, with people socializing, sitting too close together and not wearing masks properly.

HHS also said in its communication to employees that, in many cases, their lack of masking and distancing is causing “staffing crises” among critical teams.

Magee confirmed the memo, saying “we do believe that in some cases, that non-compliance has resulted in staffing issues on some units.”

Despite the concerns, part of the internal memo says most staff are following the rules.

Rob MacIsaac, CEO and president of Hamilton Health Sciences, said staff are following rules and not getting each other sick during a COVID-19 media briefing on Friday. (Samantha Craggs/CBC)

“Because distancing and masking rules were followed, there was no impact on coworkers or on the specific departments’ ability to keep functioning,” Magee wrote.

HHS president and CEO Rob MacIsaac also emphasized, during a Friday media briefing, that “staff are not putting each other at risk because they’re following the rules.”

74 staff in self-isolation

Magee also confirmed 74 staff members and physicians are in self-isolation due to a “combination of reasons.”

“Not all of them have COVID-19 but are isolating in accordance with public health requirements,” she wrote.

This comes as HHS deals with a pair of outbreaks in its Juravinski Hospital and Cancer Centre. Three patients and two staff members have been diagnosed with the novel coronavirus. More test results are pending.

In total, HHS has 29 COVID-19 patients in hospital, five of whom are in intensive care, MacIsaac says.

In the Friday media briefing, he said the hospital network won’t be able to manage a significant second wave of COVID-19 without scaling back services.

“We are preparing for some policy changes … we’ll be increasing testing for our patients starting Monday, people who are going to have procedures or surgeries. We’re also introducing some additional restrictions to visiting,” he said.

“Our health-care system is facing some very difficult choices.”

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Scott Moir refutes online allegations of breaking quarantine guideline

Scott Moir says he is in Florida during the pandemic to support his fiancee, and not because he’s on “vacation.”

Moir, 32, took to social media on Thursday because he felt he need to defend the couple from online attacks.

The Canadian figure skater posted a video on Instagram and Twitter on Thursday, explaining that he and fiancee Jackie Mascarin are in Tampa, Fla., because Mascarin works as a physician’s assistant in the respiratory unit of a local hospital.

Moir, of London, Ont., also said the pair were planning to return to their home in Ilderton, Ont., next week, though not via plane.

“The people who are stepping foot in the hospital, front-line workers, first responders, they’re heroes in a time like this and they’re putting their families at risk for the good of the society,” Moir said. “And I feel like as a life partner I should stay here in Tampa and support [Mascarin].”

Moir appears to have posted the video over claims he went to a resort outside of Canada in mid-March, after quarantine guidelines intended to help stop the spread of COVID-19 were put into place.

Moir was supposed to participate in the opening act of the figure skating world championships in Montreal, one of the first major events cancelled over concerns about coronavirus. The event was scheduled to begin Mar. 16.

“There’s people saying that I’ve been back and forth and that I went on vacation after worlds and fact of the matter is we’re in Tampa and we have been in Tampa and we’re in isolation and we’re following the guidelines,” Moir said.

Some others are now claiming it is irresponsible for him to return to Canada, citing those same guidelines and saying he could put others at risk by travelling across borders.

In the video, Moir said he and Mascarin would have “an incredible quarantine action plan” upon their return to Ontario.

“We are Canadians and we wanna help and that’s the whole reason Jackie wanted to be a physician’s assistant — she wanted to help people in need — so we decided that we would stay down here for a couple months and now that that’s done we’re headed home next week.”

Moir won five Olympic medals, including ice dance gold in 2010 and 2018, alongside long-time figure skating partner Tessa Virtue. Virtue has remained in Canada throughout the pandemic alongside boyfriend and Toronto Maple Leafs defenceman Morgan Rielly in Vancouver.

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Hoda Kotb Opens Up About Breaking Down in Tears on Air Over Drew Brees’ Coronavirus Donation (Exclusive)

Hoda Kotb Opens Up About Breaking Down in Tears on Air Over Drew Brees’ Coronavirus Donation (Exclusive) | Entertainment Tonight

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Breaking down Connor McDavid’s spectacular goal


Edmonton Oilers’ Connor McDavid took Toronto Maple Leafs defenceman Morgan Rielly for a ride on Monday, scoring one of the best goals you will ever see.

Edmonton Oilers’ Connor McDavid took Toronto Maple Leafs defenceman Morgan Rielly for a ride on Monday, scoring one of the best goals you will ever see. 1:30

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Breaking Down ‘Bachelor’ Feuds: Rachel Lindsay, Raven Gates, Colton Underwood

Breaking Down ‘Bachelor’ Feuds: Rachel Lindsay, Raven Gates, Colton Underwood | Entertainment Tonight

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Robert Forster, Star of ‘Jackie Brown’ and ‘Breaking Bad,’ Dead at 78

Robert Forster, Star of ‘Jackie Brown’ and ‘Breaking Bad,’ Dead at 78 | Entertainment Tonight

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Aaron Paul Says Making the ‘Breaking Bad’ Movie Felt Like a ‘Messed Up Family Reunion’ (Exclusive)

Aaron Paul Says Making the ‘Breaking Bad’ Movie Felt Like a ‘Messed Up Family Reunion’ (Exclusive) | Entertainment Tonight

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‘El Camino: A Breaking Bad Movie’: Jesse Pinkman Is Interrogated in New Teaser for Netflix’s Follow-up Film

‘El Camino: A Breaking Bad Movie’: Jesse Pinkman Is Interrogated in New Teaser for Netflix’s Follow-up Film | Entertainment Tonight

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Breaking down the walls of scientific secrecy

This is an excerpt from Second Opinion, a weekly roundup of eclectic and under-the-radar health and medical science news emailed to subscribers every Saturday morning. If you haven’t subscribed yet, you can do that by clicking here

Getting scooped by a competing researcher is one of a scientist’s biggest fears. And some of the most important discoveries in medical history have been tainted by competitive controversy.

Back in 1952, before he co-discovered the structure of DNA, James Watson got access to Rosalind Franklin’s revolutionary X-ray image of DNA without her knowledge.

That image, known as Photo 51, was a major clue that helped Watson and Francis Crick complete their Nobel Prize-winning discovery. The lack of credit given to Franklin remains a stain on the story of their breakthrough.

But what if Franklin had been informally publishing her research notes all along?

“She would have gotten credit instantly for her contribution,” said Susan Lamb, a historian of medicine who holds the Hannah Chair in the History of Medicine at the University of Ottawa.

“Would we have identified the structure of DNA even sooner? Could open [research] notes have changed the course of history in terms of DNA?”

Patent-free science

Sharing science in real time is the radical concept behind the Open Lab Notebooks initiative by the Structural Genomics Consortium (SGC), a Canadian research group at the University of Toronto with a team that also does work out of Oxford University in the U.K. The SGC is trying to break down the walls of scientific secrecy by encouraging its scientists to post their research notes every few weeks.

It’s hugely counterculture.– Aled Edwards, director of the Structural Genomics Consortium

The goal is to speed up science and develop low-cost drugs faster in a patent-free system, where research discoveries are immediately available for anyone in the world to use.

But opening their research notes to the public is daunting for many scientists in biomedical research.

Rosalind Franklin’s work was key to understanding the molecular structures of DNA. But she didn’t get credit for it at the time because her revolutionary X-ray image was accessed without her knowledge. (MRC Laboratory of Molecular Biology)

“It is really, really scary in our field,” said Aled Edwards, the director of SGC and a professor at the University of Toronto. “It’s hugely counterculture.”

Just a few days ago, Alfredo Picado, an organic chemist, posted the results of a failed experiment.

“I basically said [that in] the last set of reactions I carried out, the last step didn’t work.”

Picado is developing and testing compounds to see if they activate certain proteins. Normally, a failed experiment would not show up in the scientific literature. But by reporting that his experiment didn’t work, he hopes he might save another scientist some time.

“At least now it’s written there, so if someone wants to reproduce that, well, you don’t have to go all the way in the sequence to find out, because — at least in my hands — it doesn’t work out.”

Some sharing of unpublished research has always happened at conferences and seminars, but months and years can elapse between those gatherings. It can take even longer for the polished research to be published in a peer-reviewed scientific journal.

Alfredo Picado, an organic chemist and researcher at the University of North Carolina at Chapel Hill, hopes to speed up science by making his research notes public for other scientists to use. (UNC-Chapel Hill)

Jong Fu Wong is with the SGC U.K. team at Oxford. His research is aimed at accelerating the development of a molecule for a rare pediatric brain tumour, and he’s been posting his research notes every few weeks for over a year.

“It’s pretty radical, from the perspective of a traditional academic scientist,” he said. “The traditional way would be keeping everything more or less secret, and only when everything is finalized, and there’s a final result, only then would a researcher try to submit it to a scientific journal.”

The original concept of open-notebook science is attributed to a Canadian chemist, Jean-Claude Bradley, who, working alone, began publishing his research in real time. He died in 2014.

If we documented everything online in real time, we would preserve that knowledge that would otherwise be lost.– Rachel Harding, SGC scientist

Two years later, while working with SGC at the University of Toronto, Rachel Harding built on Bradley’s idea after she was about to repeat a series of experiments on a protein involved in Huntington’s disease.

“We knew other labs had done it but had never published on it, so there was no evidence in the literature to see what other people had done. And it was quite a technically challenging project,” Harding said.

An image posted by Picado on openlabnotebooks.org describes a failed experiment. (SGC)

“If we documented everything online in real time, then we would preserve that knowledge that would otherwise be lost.”

Harding said she was amazed by the feedback, especially from Huntington’s patients.

“It was very humbling. There’s no cure or disease-modifying therapies for Huntington’s. And the patients are incredibly well-read on the science,” she said.

“So, even though it wasn’t directly clinically relevant, they were just keen to see people working in the field. It was really incredible. It was so touching to receive so many amazing emails.”

When the researchers post an entry on openlabnotebooks.org, they provide a summary of their work in plain language for non-experts. But they also make all of their raw data available, including technical details of their experiments.

For example, “You can find out … what concentration of salt and what pH was experimented,” said SGC’s Edwards.

Jong Fu Wong, a postdoctoral cell biologist with SGC at Oxford University, is part of the Open Lab Notebooks initiative. Even though he risks getting scooped by other scientists, he posts his research notes online in real time. (Jong Fu Wong)

Both Picado and Wong admit they still worry a bit about being scooped by other researchers.

“Did it make me nervous? Yes, a little bit,” said Picado. “The good side is that we publish in such a way that we already have the credit for that.”

Taking profit out of the equation

“There are some concerns about [companies] coming in and using our data and bringing it to market,” said Edwards, adding that once the research is in the public domain, it can no longer be patented, which removes some of the profit-seeking incentive.

“Remember: people only steal things when they think they can make money.”

Edwards said taking money out of the equation changes everything. SGC’s research is funded by governments, charities and the pharmaceutical industry. But none of the funders gets special access to the discoveries.

So what’s in it for the drug companies? The overall advancement of science, Edwards said, because SGC is focused on understudied genes and other areas where knowledge is sparse.

Aled Edwards calls open-notebook science and patent-free research a ‘micro-hand grenade’ intended to speed up progress in science and drug discovery. (SGC)

“The purpose of our organization is to focus on the parts of science that nobody else does. And that’s how we made that ‘value proposition,'” said Edwards.

“We put science in the public domain without restriction, without patents, so that the world can take our research and run with it.”

The ultimate goal is to develop drugs that can be put on the market at the lowest possible price.

“We’re making too little progress, and it’s a lot because of the structures we put in place to carry out science,” Edwards said. “Our little effort of sharing is a way to try and throw a micro-hand grenade into it.”

There’s been some criticism of the data-sharing movement, including the potential to pollute the scientific record with incomplete work.  

“I could counter that argument by saying, well, at least every single thing is in there: all my raw data, materials, methods, everything,” said Harding.

“So even if I’ve done something wrong, we should be able to understand it.”

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