Q & A with health unit: Pinecrest Nursing Home challenged by small size in COVID-19 outbreak

On March 20, the Haliburton, Kawartha, Pine Ridge District Health Unit announced that three residents of the Pinecrest Nursing Home in Bobcaygeon had tested positive for COVID-19.

The tests came after the Health Unit declared a respiratory outbreak at the facility on March 18 and tests were done on three symptomatic residents. As of the information available on March 26, there have been 14 staff members confirmed as COVID-19 positive, and four who have had negative results. Test results are still expected for 16 staff.

While no additional residents were tested, 35 others did develop symptoms and two of those residents have
died – one on Tuesday night and the other on Wednesday.

Q. How many staff have been tested? How many confirmed?

Beginning March 20, the day we were advised that COVID-19 was confirmed in three residents in the Pinecrest Nursing Home, symptomatic staff were already off work and were advised to be tested and to self-isolate. To date, we have received test results for 18 symptomatic staff. All other results are pending.

Q. How many residents have been tested? How many confirmed?

Three residents were tested and were confirmed positive. Routinely, as per outbreak protocol, in an outbreak situation we only have swabs obtained from three to four residents to determine the virus circulating and then stop swabbing. There are currently 35 other epidemiologically-linked cases with symptoms among the residents.

Q. Why not test all residents?

Under outbreak protocols, no further residents were tested as the three positive cases demonstrate the virus is already circulating among the residents.

Q. What are the protocols for testing?

In an outbreak situation, as soon as respiratory illness is identified in two or more residents, the long-term care homes report an increase in illness to the health unit and an outbreak is declared. All outbreak management precautions are put in place as soon as an increase in illness is reported before the specific virus is determined.

Up to a maximum of four swabs are taken among symptomatic residents and they are submitted to the public health laboratory in Toronto for testing. Results can take up to three days to be returned depending on the time the swabs were taken and the laboratory pick-up to get to Toronto. Results are returned to the ordering physician affiliated with the home, the public health unit and provided to the resident and/or their family as appropriate.

Q. Is everyone still in isolation?

All staff who are currently symptomatic are self-isolating and the entire facility is still in isolation.

Q. What is the home doing about lockdowns and restrictions? What measures are in place? Quarantine?

The long-term care home is following all outbreak management protocols to help stop the spread of the illness and contact tracing by our public health staff is ongoing. Once the outbreak was declared, staff at the long-term care home implemented all infection prevention and control precautions including the use of the proper protective equipment.

All staff who are working with the residents are using the appropriate personal protective equipment to prevent the spread of the virus to others. Residents were isolated as well as they could be within the facility, and group activities cancelled and gatherings for meals were replaced with individual tray service for the residents.

Q. There have been two deaths at the home. Are they COVID-related?

There have been two resident deaths; which occurred in epidemiologically-linked cases — these were not residents who were swabbed for COVID-19 but did develop symptoms.

Q. Is the high number of cases in CKL related to the outbreak at Pinecrest? Why so many staff at this facility testing positive?

Yes, the outbreak at the long-term care home is behind the higher number of cases in Kawartha Lakes. Pinecrest Nursing Home faces some unique challenges in an outbreak situation. The residents share rooms and there is not a lot of extra room within the facility to isolate or separate residents and staff work assignments. Larger facilities have
more ability to isolate to a wing or separate building; unlike Pinecrest.

Q. What assurances would the Health Unit give to family members questioning the safety of other residents of this home?

This is a challenging time for everyone involved – the staff at the facility, the residents and the family members who are concerned about their loved ones. We know that we have community transmission of COVID-19 in our area and we know that our older, medically fragile community members are vulnerable and most at risk from this virus.

The federal and provincial governments, as well as local health units, have been urging people to follow the recommendations to help stop the spread of COVID19. These include the messages about washing your hands, covering coughs and sneezes, staying home if you are ill and staying at least two metres away from people (physical distancing). The provincial government has closed schools and daycares, shut down non-essential workplaces, restricted groups larger than 50 from meeting, and restricted visits to long-term care homes.

We have seen municipalities shut down playgrounds and recreation facilities and now we have the federal government forcing self-isolation on people returning from travel. All of these measures were put in place to help stop the spread of COVID-19, and yet we still get multiple calls and emails every day from people who tell us that
people are visiting others, having play dates, not self-isolating.

This is a serious virus, and for some people in our community, it can be deadly. Everyone needs to work together to protect all of their family members, whether they are in a long-term care home, or on their own. Our long-term care facilities are doing the best they can to protect the people in their care but we need everyone to follow all of the recommendations to help keep everyone safe.