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Cent dealing centers, Quebec finally gets a handle on COVID outbreaks in long-term care, but is it ready for a 2nd wave?

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Lynn Mucci, Sullivan's daughter, is grateful her mother's home has been a safe haven amid the fears over the quality of care at these facilities. Keep safe and hold your heads up high. You are my heroes!

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Stories from worried family members and reports -- including a damning one by the Canadian Armed Forces that alleged neglect and described overwhelmed, poorly trained, and ill-equipped workers hit by massive staffing shortages -- have shocked Canadians. However, amid the alarming numbers, are the lesser-known stories of nursing homes that did not face a crisis.

In interviews with several long-term care providers cent dealing centers roughly two dozen long-term care facilities that had no or very few cases and were quickly contained, a combination of early planning, monitoring and timing seemed to have helped put these facilities on a different course. This meant taking precautions and action before they were mandated or recommended by the government.

Screenings as far back as January, sourcing extra personal protective equipment PPE before the shortages hit, reorganizing and beefing up staffing early were just some of the measures these homes say helped prevent an outbreak like the ones that ravaged numerous other facilities, especially across Ontario and Quebec.

While facilities have seen big improvements, experts worry several issues remain

The Notre-Dame-de-la Merci in Montreal reported 93 deaths in its bed residence. The Quebec government operates both facilities and many other hard hit locations.

More than 3, out of the more than 5, deaths in the province so far have happened at public long-term care homes CHSLDs. Another plus have been at private care facilities.

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According to Loreto's database of deaths in residential care facilities -- collected through public health data, media reports, reports from homes, obituaries and families -- nine of the 10 worst-hit homes were in Quebec, all reporting more than 65 deaths each. Camilla Care Community in Mississauga, a bed residence had 68 deaths, while Altamont Care Community in Toronto had 53 deaths at its bed home.

Eight of Cent dealing centers residences accounted for deaths combined, while another eight reported under five deaths each. Ontario and Quebec bore the brunt of the staggering number of deaths.

More than homes in Quebec and more than in Ontario have experienced some level of outbreak, according to data compiled by the National Institute on Ageing. And overall, Loreto's data shows that more than 7, -- roughly 84 per cent -- out of the more than 8, deaths related to the coronavirus in Canada have been attributed to nursing homes. But with a vaccine still far away and a resurgence in cases a constant possibility, homes that escaped the first wave unscathed are aware how easily the virus can still slip inside.

About are in long-term care, and close to reside in the retirement home. Most of those in retirement are on the waiting list to move into long-term care. Another or so live independently.

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Since the virus was first detected in Canada, all but two staff members have tested negative at Shepherd Village, according to Beckles. A number of the measures taken at Shepherd Village were implemented at other homes as well. However, she added, "You know, I'm not going to get on my high horse about this because it is an invisible enemy.

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The organization is self-described as "culturally appropriate" —they offer menus, spiritual, religious, cultural support and celebrations, and have linguistically trained staff that primarily serve Chinese and other Asian communities. Some seniors call Yee Hong home, while some others live in independent housing. Both Jones and Beckles said they were monitoring the news closely in January as the disease spread in China.

They knew they had to start planning because it was "just a matter of time. Screenings at both facilities began in late January as staff came back from the Lunar New Year holiday.

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Both places implemented a one-employer policy before the government made it a requirement. Vacations at Yee Hong were put on hold to mitigate worries about staffing shortages and cent dealing centers were wearing masks and face shields well before they were mandated.

They were also trained on proper usage.

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Social gatherings, including celebrating the Lunar New Year, which fell on January 25 this year, were cancelled at Yee Hong. We've been watching what was happening in China.

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We have employees that were travelling, coming home," said Jones, who said their organization quickly decided that staff returning from their trip would be put on a day, paid quarantine. Meanwhile, the screenings became more comprehensive throughout February and into March, with temperature checks initiated weeks before it was mandated by the chief medical officer of health, Beckles said.

Shepherd Village, Yee Hong, and many others were completely cent dealing centers within two days of the World Health Organization formally declaring a pandemic, with only staff and essential visitors allowed. By the beginning of March, long-term care cent dealing centers retirement home residents at Shepherd Village had to stay on site, tray service began, and staff were not allowed to move from floor to floor or leave the premises for lunch.

Yee Hong also implemented a similar cohorting scheme for staff and residents "very, very early. The early sourcing of new suppliers combined with donations from the community meant Shepherd Village maintained adequate levels of PPE at all times, Beckles said.

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This thing's going to hit like a tidal wave. Shepherd Village staff also increased their monitoring of residents for signs and symptoms of the virus. Even symptoms that were not on the list were treated with extreme caution. Both Yee Hong and Shepherd Village reported having two employees who tested positive early on that were immediately contained.

The two off-site cases at Shepherd Village put the community on high alert, Beckles said. The whereabouts of the infected staff over the previous 14 days were also investigated: the shifts they worked, the residents they interacted with, and who also worked those shifts. The entire floor of residents and everyone who worked with them were immediately tested. All other staff and residents have since been tested as well.

Beckles said cent dealing centers began using disposable utensils, which pushed up the cost, and they implemented hand hygiene audits to remind staff on cent dealing centers to properly wash and ensure compliance. Staff who worked at multiple jobs were asked to choose only one employer long cent dealing centers it was mandated.

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Shepherd Village, which typically employs about full and part-time employees, initially lost 20 per cent of its staff as a result.

The cumulative loss was up to 30 per cent after some could no longer work due to child or elder care responsibilities once the pandemic was officially declared. But Shepherd Village said they began looking to hire additional employees early on, not just to fill the vacancies from staff who left, but due to additional staffing cent dealing centers as a result of their early pandemic safety measures.

More help was needed for the additional screening and to fill in gaps created by staff having to cohort on a single floor. Even meals -- which usually entailed one staff member helping three or four residents at a dining table -- required more hands and one-on-one help cent dealing centers tray service was implemented. More help was also needed to facilitate phone calls, Skype, and FaceTime sessions between residents and family.

With assistance from the Ontario Long-Term Care Association, Beckles was hiring 30 people at a time, connecting with colleges to bring in nursing and personal support worker PSW students, getting retired nurses to come back and recertify, and hiring quickly outside the bargaining unit.

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They were able to return to their original staffing level and beyond, with managers going back to the frontline as new hires underwent training. Yee Hong also lost some of its 1, staff members.

Still, they were ultimately able to maintain between 90 and per cent of their staffing level, Jones said, as the organization made similar hires as those made at Shepherd Village.

At Yee Hong, when the adult day programs for the community were shut down, those staff were redeployed to its long-term care homes, cohorted, specifically to focus on virtual visits with family members and provide one-on-one time with seniors. The sense of isolation and confusion does happen -- "it does not replace the face-to-face of a family.

We know that.

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Waterford had its own minor outbreak, Mucci said, but "they really contained it -- they didn't fool around. Sullivan, who had suffered several falls, had been waiting four and a half years before a spot opened in the spring of at Waterford, Mucci's top choice.

But now, her friends are worried. Norma Sullivan poses for her birthday in this photo taken May 8, Photo provided by Lynn Mucci. Gifts had to be delivered the day before, to allow them to sit for a period of time, out of an abundance of caution. By the time she got home, there was already an email waiting in her inbox from one of the staff members who had brought Sullivan to the window: they had stayed with her afterward cent dealing centers she opened her presents.

I felt like they made an effort.

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How many more birthdays is she going to have? Like Shepherd Village and Yee Hong, Chartwell said it moved quickly to strengthen infection control protocols across all its facilities and launched a recruitment campaign that saw over 1, new hires during the pandemic.

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Like the others, they enacted screening and monitoring measures across the board and made PPE mandatory for staff before government directives were issued.

Data showed that five facilities also suffered a number of deaths, which Chartwell says were concentrated in older buildings.