COVID-19 in British Columbia: Insufficient sick leave is responsible for many outbreaks in long-term care homes; the prime minister asked about next steps



The premier of British Columbia has acknowledged that his government’s “stopgap” policy of three days of paid sick leave was not enough for workers trying to balance health and financial woes during the pandemic.

John Horgan was asked at a press conference Thursday about a newly released report by the province’s Seniors Advocate, who, among other findings, noted links between COVID-19 outbreaks in the long-term care facilities and sick leave policies for their employees.

The NDP government introduced a temporary policy in the spring, following outbreaks in other workplaces, in an effort to prevent those who felt sick from coming to work to ensure they still receive a check payroll.

At the time, this policy for workers not already receiving paid sick leave from their employers was three days. The idea was that this would allow enough time for a person with symptoms of the novel coronavirus to get tested and get their results before returning to the workplace.

The province is starting to consider options for more permanent changes, with three days as one of the options. But is it enough?

Some will say no.

According to an internal survey, one in six of the 20,000 members of the Hospital Employees’ Union said they used all of their paid leave during the pandemic.

Horgan was asked if three days was enough and said his government had hope at the time.

“He didn’t pass the test, quite frankly,” he said. But he added it was a stopgap as the province held broader consultations before committing to a permanent plan.

But his opinion doesn’t mean the longer-term solution will involve more days. He said this is an ongoing dialogue that includes both workers and employers, and as this will come at a cost, it requires further analysis.

“We will try to find the best way to protect workers, to maintain the economy and to make sure that the costs of this are separated and distributed as best as possible.”

The Prime Minister denied having a preference for how many days will ultimately be decided, but admitted it was a challenge highlighted by the Seniors Advocate on Wednesday.

In her report, Isobel Mackenzie noted several findings from a review of the first year of the pandemic in British Columbia

During that time, the deaths of more than 800 residents of long-term care facilities and assisted living facilities across the province have been attributed to COVID-19, and data she and her office have gathered suggests that the sick leave has been a key factor in many deadly epidemics. checked in.


The disease took hold in the province in 2020, when relatively little was known about how it spread.

Over the following weeks and months, we gained a better understanding of COVID-19 and the novel coronavirus. It quickly became clear that epidemics in health facilities could claim many lives.

Policies were developed and changed as information spread. Testing became more common and vaccines were first made available to the most vulnerable in the province.

But for many, these updates came too late. And there is still a long way to go to prevent more deaths from COVID-19.

In his report, Mackenzie looked at the factors that contributed to outbreaks between March 2020 and February 2021.

Mackenzie’s office reviewed more than 100,000 files upon completion of its investigation and 365 outbreaks at 210 sites.

In the report, Mackenzie made seven recommendations that she says will help save lives.


Among the findings, Mackenzie said his office noted that about 75% of outbreaks were contained in four cases or fewer.

Three quarters of epidemics have resulted in no deaths.

Interestingly, she noted that only 45 percent of long-term care and assisted living facilities in British Columbia are located in the Lower Mainland of British Columbia, but 84 percent of the outbreaks have occurred in that region. region.

The office also found that the vast majority of outbreaks were in the second wave of the pandemic – nearly nine in 10 – and that a visitor would have been the first case in just one of hundreds of outbreaks in the first. year.

Overall, she wrote, the majority of outbreaks in British Columbia have been contained and no one has died. She attributes this to the “Herculean efforts” of dedicated staff, site operators, public health officials and others.

Yet more than 800 people did not survive that first year.

She noted the physical impact as well as the trauma of living in long-term care.

Among the issues that were raised were issues of understanding how COVID-19 has spread. Initially, it was believed that a person was not contagious until they showed symptoms.

In most outbreaks, the first case was recorded with a staff member. Why this was the case was a major topic in the report.

“We have learned about the extraordinary stress and pressure on the system,” Mackenzie wrote in his report.

“Each site has seen a significant increase in overtime and sites that have experienced a significant outbreak have seen their overtime increase by 178% over the past year.”

Workers who were not feeling well did come to work anyway, although their reasons were “often benevolent” and linked to concerns about the overburdened health care system. Many of these workers worried about the impact on their colleagues and residents.

But others cited financial reasons, and sites that offered fewer paid sick days were more likely to have larger outbreaks in the first year. Mackenzie said this was the number one issue and his strongest recommendation.

There were also problems with communication and learning new protocols.

Some noted “conflicting guidance” from health authority staff, which was often a problem in places where multiple people were involved in managing the outbreak. Many were not used to “this level of PPE vigilance” caused by the pandemic.

Other people who spoke to Mackenzie’s office suggested that notification and contact tracing, once a person has tested positive, was not timely enough.

According to the report, several operators said the process would have been improved by giving them the opportunity to be involved, and by more widespread and frequent testing.

Also related to contact tracing: initially many workers were employed at multiple sites. It also provided further potential for transmission between care homes, as employees traveled back and forth between their workplaces.

Halfway through the pandemic, the province imposed a single-site ordinance to prevent these problems.


The lawyer listed seven recommendations arising from her investigation:

  • Increase paid sick leave for staff;
  • Increase the pool of direct care personnel;
  • Increase the levels of registered nurses as a proportion of direct care personnel;
  • Decrease contracting for direct care services;
  • Eliminate shared rooms;
  • Increase the scope, time and frequency of testing; and
  • Require long-term care staff to be immunized and provide booster shots to residents.

The report and associated recommendations have been sent to the provincial health ministry, who will determine which, if any, will be implemented.

During the question-and-answer period following Mackenzie’s presentation of her report at a press conference, she repeatedly said that increasing paid sick leave is one of the biggest changes. impact that the province could bring, as well as the end of the outsourcing of care. Staff.

In a statement, BC’s largest health care union appeared to agree.

The Hospital Employees Union called for the restoration of common standards in long-term care and assisted living.

The union said the inconsistency of sick leave policies within the current system, which includes for-profit care – what Mackenzie called a legitimate but separate conversation – was also among the top issues identified by its members.

About 17 percent of union members interviewed internally said they had used up their paid sick leave.

Union calls for restoration of common wages, benefits and working conditions in long-term care in British Columbia

Mackenzie noted the wide range of challenges of the pandemic in his report, including the heartache felt by those who have lost loved ones.

“However, we have also witnessed the tenacity, the commitment and the opportunity to use what we have learned… It is clear that British Columbians care deeply about the health and well-being of their people. older citizens. More than anything, this gives hope for a better future. . “

For now, she said families of people in long-term care should take a “constant vigilance” approach and speak out if they have safety concerns.

She said the sites are much safer now than they were when the pandemic began, as more is known about COVID-19 and as staff, residents and visitors are immune to the disease.


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