Waterloo Region Record

Larger retirement homes have higher COVID risk

As more staff come in and out to provide care, risk of an outbreak grows, new study shows

JOHANNA WEIDNER Johanna Weidner is a Waterloo Region-based general assignment reporter for The Record. Reach her via email: jweidner@therecord.com

KITCHENER — The serious impact of COVID-19 on long-termcare homes has been closely studied, but retirement homes have been largely overlooked even though they also house many vulnerable seniors.

“A very important part of that picture is also retirement homes,” said Andrew Costa, research director of the McMaster School of Medicine’s Kitchener campus.

Since the start of the pandemic, the number of COVID-19 cases and deaths in Ontario’s retirement homes has continued to grow. Residents in those homes accounted for about eight per cent of COVID-related deaths by mid-April.

New research led by Costa identified common factors that put retirement homes at higher risk for outbreaks, which means prevention efforts can be targeted to avoid more serious illness and death.

“It’s important we pay attention to the risk factors now because we might not be out of this,” Costa said. “Come the fall if we have a bad variant, it could be a whole new game.”

The researchers looked at 770 retirement homes with nearly 56,500 residents — almost the same population size as longterm-care facilities — from the start of the pandemic in March 2020 to late December last year.

More than a third of homes had one or more outbreaks and most cases were in residents compared to employees. Cases were distributed unevenly across retirement homes with nearly 82 per cent in 10 per cent of homes.

Factors that boosted the risk of an outbreak include a home being larger, connected to a long-term-care facility, part of a big chain, and providing many services on site.

Larger retirement homes had three times the increased risk of an outbreak, likely due to more staff coming in and out to provide care. Limiting the number of different workers providing care and services in a home as well as moving between facilities can help to reduce the risk of spreading the virus.

“It gets in because of the community around the home. That’s how the infection comes in the door,” Costa said.

While long-term-care facilities have provincial funding and oversight, retirement homes are private residences providing a range of support and services, and are independently regulated.

Retirement homes are very mixed in terms of both the residence style and the people who live there. They range from apartment-style buildings that offer some services to residents who are fairly independent to facilities that provide a lot of support to residents with significant care needs.

“One in five look a little more like nursing homes,” Costa said.

In those homes, fatality rates for COVID-19 approached those of long-term-care facilities. But those retirement homes at higher risk are easily identified, which also means they can be targeted for prevention.

“Some retirement-home residents are more at risk than others. We know what retirement homes they are, so we should be prepared,” Costa said.

The pandemic’s first and second waves showed the dire consequences of poor prevention strategies in group homes for vulnerable seniors, which were hit hard by outbreaks that often were difficult to contain and many deaths followed.

“In a time of crisis, we know where to put our resources,” he said.

“They shouldn’t just be an afterthought or retirement homes are left to their own devices.”

The study was published Monday in the Canadian Medical Association Journal.

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2021-05-10T07:00:00.0000000Z

2021-05-10T07:00:00.0000000Z

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