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Designated visitor for long term care welcomed, but outbreaks unclear


Dr. Bonnie Henry announces that every long-term care resident is entitled to a designated visitor in addition to the essential visitor.

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Every long term care resident in B.C. can now choose a designated visitor who will be granted unlimited visits even if an outbreak is declared in the facility.

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Provincial health officer, Dr. Bonnie Henry, Tuesday said this effort is in “adjusting our outbreak management approach in long term care.”

“We are acutely aware of the impact of the extended social isolation that comes with the full closures of long term care homes,” said Henry. “And we’ve been trying to find the balance between limiting the risks to residents in long term care, minimizing transmission of the virus as well as having that all-important contact with loved ones.”

B.C.’s seniors advocate and families of long term care residents have been calling for that change for close to a year.

Previously, care homes determined who could be an essential visitor if the home was unable to provide required care for the resident.

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Henry confirmed fewer than one third of long term residents currently have an essential visitor who is allowed unlimited visits even during outbreaks.

“Every resident is entitled to a designated visitor who can come at any time and that is in addition to the essential visitor,” Henry said. “And you can have a backup in case somebody is ill or can’t come in.”

Seniors advocate Isobel Mackenzie supports the move, but opposes another change that allows local medical health officers to decide when to declare an outbreak in a care home.

Outbreaks were automatically declared if two residents tested positive for COVID-19.

Dr. Bonnie Henry, provincial health officer.
Dr. Bonnie Henry, provincial health officer. Photo by Government of B.C. /PNG

Henry did not provide details how outbreaks will now be declared. She said that information will be posted on the B.C. Centre for Disease Control website.

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“When it comes to declaring an outbreak we are using a criteria approach based on judgment and the scope and severity of the outbreak,” Henry explained.

But Mackenzie said the standard that’s been followed for 20 years is to declare outbreaks of infectious disease in LTC in-resident cases.

“That is the confidence that the public has that the care home can’t hide an infectious disease transmitting in its facility because public health will come in and declare an outbreak and that is made public,” Mackenzie said.

Henry said health officials will continue to monitor homes with COVID-19 and will take measures to prevent widespread transmission.

Mackenzie said the problem is there is no requirement for a care home to inform anyone whether COVID-19 or any other infectious disease is circulating in the facility unless an outbreak is declared.

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“Visits should continue — and don’t make everyone isolate and don’t suspend all activities. But if you don’t declare an outbreak, the people living there and the people visiting them don’t know there’s an outbreak and they don’t get to decide what risk they want to take,” she said.

Mackenzie also is concerned that all visitors are required to take a rapid test before each visit, but staff is only tested if they show symptoms.

“I thought we learned from my report that people came to work with symptoms they did not recognize or disclose — 40 per cent came to work when they weren’t feeling well,” Mackenzie said.

“It has been recognized by the provincial health officer that people are likely more infectious before they show symptoms,” said Mackenzie. “I wonder, are we really taking a risk-based approach?”

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Currently there are 46 outbreaks at long term care homes in B.C.  On Tuesday, the province reported 1,236 new cases of COVID-19 and nine more deaths. There are 1,035 people in hospital who have the virus an 139 of them are in intensive care.  Henry said approximately 40 per cent of those in hospital were admitted because of illness from the virus, while 60 per cent tested positive but were not admitted to hospital for that reason.


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