Ontario Premier Doug Ford says the province has launched an investigation that could lead to criminal charges against five long-term care homes rocked by COVID-19.
The investigation comes after the Armed Forces issued a scathing report on the state of five facilities in the Toronto area.
The report includes a stunning list of allegations that the military says may have contributed to large outbreaks experienced at each of the homes.
Military service members, who have been providing assistance at the homes since April 28, say they have observed numerous forms of unhygienic and dangerous behaviour.
The list of allegations includes:
- Repeated use of medical equipment between COVID-19 patients and others who had not tested positive, without it being disinfected.
- Improper use of personal protective equipment (PPE) by staff and doctors.
- Housing of COVID-19 patients with residents who had not tested positive.
- Staff reusing gloves or not washing hands between resident interactions.
- Staff being aggressive with residents during medical procedures.
- Residents calling for help with no response for up to two hours.
- The presence of insects, including cockroaches and ants.
"It was so disturbing ... It was the worst report, most heart-wrenching report I have ever read in my entire life," Ford said Tuesday.
"Until yesterday morning, we didn't know the full extent of what these homes, what these residents, were dealing with."
'Fear to use supplies'
The premier, whose mother-in-law lives at a long-term care home in Toronto's west end that has a confirmed outbreak, promised "justice" to the families who have lost loved ones to COVID-19.
These are the five facilities listed in the report, along with their most recent death tolls attributed to COVID-19.
- Orchard Villa in Pickering: 77 deaths (as of Monday).
- Altamont Care Community in Scarborough: 52 deaths (as of Monday).
- Eatonville in Etobicoke: 42 deaths (as of Saturday).
- Hawthorne Place in North York: 43 deaths (as of Saturday).
- Holland Christian Homes Grace Manor in Brampton: 11 deaths (as of Monday).
At Hawthorne Place, the military observed a "significant deterioration of cleanliness standards," the report says.
"Protocols in place have a near 100 per cent contamination rate for equipment, patients and overall facility."
COVID-19 patients at Eatonville were reportedly allowed to wander throughout the home without restrictions, the report also says. Staff at Eatonville also displayed a "general culture of fear to use supplies because they cost money."
WATCH | Ford reacts to the military's report:
Later Tuesday, some of the homes named in the report, and a hospital network that supported one of the institutions, responded to the findings.
"The severity of the COVID-19 pandemic has presented unique challenges to our health system, our home, and our staff," said Evelyn MacDonald, the executive director at the Eatonville Care Centre, in a written statement.
MacDonald pointed to the 104 cases of COVID-19 confirmed among Eatonville staff, and to other team members who "did not come to work due to personal health reasons" as a significant challenge for the home, saying "those who remained were overwhelmed by the pressures" brought on the pandemic.
Sienna Senior Living, which operates the Altamont Care Community, also said in a statement it was "deeply saddened" by the impact of the pandemic and pledged to deal "immediately and permanently" with the problems.
Lakeridge Health, the hospital system in Durham Region that sent support personnel to assist staff at Orchard Villa, said it "took immediate actions to begin to manage" the outbreak at the home, including deep cleaning and adding more front-line personnel.
More than 1,500 deaths
Prime Minister Justin Trudeau called the report "extremely troubling" during his news conference on Tuesday.
Ontario's official COVID-19 death toll grew by 21 on Tuesday and now stands at 2,123. Of those who died, 1,538 were residents in long-term care homes, according to the Ministry of Health.
Data compiled directly from regional public health units, however, suggests the province's overall COVID-19 death toll was at least 2,194 as of Monday evening.
Fourteen military members have become sick with COVID-19 while serving at the homes in Ontario, while 22 members have tested positive in Quebec.
Minister of Long-term Care Merrilee Fullerton said the situation at the five homes in the report has since stabilized, though Ontario is asking the military to extend its assistance mission for another 30 days.
WATCH | Trudeau called the reports 'deeply disturbing':
Independent commission planned
The investigation will include the province's chief coroner, who has been assigned to investigate at least one of the deaths. Fullerton said her ministry's investigative branch will also begin immediately looking into specific "critical incidents" detailed in the report.
Ontario also has plans to launch an independent commission into the state of its long-term care system in September, though many health-care groups have called for a more rigorous public inquiry.
When asked if he will now reconsider the possibility of a full public inquiry, Ford suggested he would consider it.
"Everything's on the table. I'm not ruling out anything after reading this," he said.
Ford has repeatedly called the long-term care system "broken" during the coronavirus crisis, though he has not yet shared a detailed plan to address the problems.
He has said Ontario will need help from the federal government to make substantive changes to the system.
Nurses say they've long raised concerns
The Ontario Nurses Association said issues within long-term care extend far beyond the five homes observed by the military and that urgent action is needed to improve conditions in across the province.
"We have been elevating our concerns about a growing number of long-term care homes for some time now," said ONA president Vicki McKenna.
"We are grateful that the report from the military and the involvement of Prime Minister Justin Trudeau has finally resulted in attention being paid to deficiencies in these homes."
McKenna said the recommendations made in previous long-term care investigations — including calls for more staffing, funding, better training and increased resources — have yet to be fully implemented.
The Ontario Long-term Care Association, which represents around two-thirds of the province's long-term care homes, repeated its calls for improved access to PPE, more rapid testing, and for the province to invest in older facilities.
"Ontario's long-term care homes have been clear about the dire situation on the front lines of this unprecedented fight against COVID-19," CEO Donna Duncan said in a statement.
"The virus has exacerbated systemic issues, like the long-standing staffing challenges, as it impacts homes in varying degrees."