Doctors Identify Reasons For Northwood Outbreak That Killed 53 People
HALIFAX — Staffing shortages, space constraints, shared bathrooms, and inconsistent cleaning were some of the main factors responsible for the deadly Covid-19 outbreak at Northwood that killed 53 people.
That conclusion comes from the doctors hired to review the outbreak. On Monday, their explanation of the causes, as well as the 13 recommendations they issued after completing their review, were publicly released by the Nova Scotia government.
Infectious disease consultant Dr. Chris Lata and former British Columbia associate deputy minister of health Dr. Lynn Stevenson gave the report to Health Minister Randy Delory last week after speaking with more than 350 stakeholders involved in the Covid-19 outbreak at Northwood.
Northwood’s long-term care facility in Halifax suffered the largest Covid-19 outbreak in Nova Scotia. Between April 5 and May 26, 246 residents and 114 staff tested positive. Fifty-three of those residents died.
Delory did not release Lata and Stevenson’s full report, opting instead to share the executive summary with the public. In the 10-page summary, the doctors praised Northwood and its staff for the care they provided during the outbreak.
“Northwood delivered excellent care to its residents and had a pandemic plan in place that was consistent with other long-term care homes. Staff worked diligently to address the outbreak and many residents reported high levels of satisfaction with their care,” they wrote.
However, they recommended Northwood and the provincial government take several steps to prevent similar outbreaks happening in the future.
Those steps include reviewing and updating the pandemic action plan, acknowledging housekeeping staff as critical to infection prevention and keeping them staffed at appropriate levels, creating a better system for communicating with families and stakeholders, reducing the number of people living at Northwood, and establishing an infection prevention and control (IPAC) team.
Delory told reporters today he agrees with the report’s recommendations and said work to implement them is “already underway.”
He said the province will spend $26-million this fiscal year carrying out short-term recommendations vital for controlling a potential second wave of Covid-19. Over the next two years, the government will spend an additional $11-million to implement longer-term recommendations.
Delory did not give firm timelines for when he expected all the recommendations to be put in place but said work on many had already begun.
The province is already in the process of establishing mobile infection prevention and control teams in each of its four health zones. It’s also working to ensure staff at long-term care facilities can get tested and back to work as quickly as possible, to help with staff shortages.
Monday afternoon, Delory also answered questions about some of the concerns raised by the report.
Chief among them was how the province plans to address the issue of residents in long-term care facilities sharing rooms.
Delory pointed out the province has had standards in place since 2007 that have been slowly moving long-term care facilities to single rooms; essentially, renovations and new construction prioritize single rooms over shared ones.
However, he said shared rooms likely weren’t a major factor in Covid-19 spread.
“That wasn’t flagged as one of the more critical elements,” he said.
There are 133 licensed long-term care facilities in Nova Scotia with a total of about 8,000 beds. Only Northwood suffered such a devastating outbreak, something Delory said was more due to its size.
“The review that was conducted at Northwood has not indicated that a move to single rooms was in and of itself something that would have prevented the infection outcome,” he said.
In their executive summary, Lata and Stephenson said Northwood’s size “rendered it especially susceptible to staff loss and infection spread in the COVID-19 pandemic.” They acknowledged room sizes couldn’t be easily changed at the facility but did list “shared rooms” among the key factors contributing to the outbreak.
Delory said Northwood did have empty beds set aside as a “Covid ward” to help isolate infected residents but that the outbreak was too big for those 30 beds to handle.
Delory also answered questions about cleaning practices at Northwood during the height of the pandemic.
He admitted that enhanced cleaning requirements put extra pressure on, and with the facility suffering staffing shortages cleaning sometimes took a back seat.
“Staff were … pursuing those tasks that were seen as most important and critical to preventing the spread of the infection at the facility,” he said, and that meant some routine cleaning was left “lower down on the priority list.”
Delory acknowledged the changes his department is making will come too late for the families who lost loved ones to the outbreak, but that things will get safer.
“I know that the review itself will in no way make up for what transpired at Northwood, and the 53 lives lost,” Delory said. “It will never take away the pain, and it will never bring back what was lost.”
He said the province has learned a lot in the wake of Northwood’s Covid-19 outbreak but “we know there’s more to be done. We know we have to do better and we’re committed to doing so.”