The Glebe Centre: the story of a COVID-19 outbreak
By Barbara Duggan
It was Sunday, October 25 when the fax machine delivered the news that we had been evading for the previous eight months – COVID-19 had hit the Glebe Centre.
Before then, our long-term care home enjoyed favour from the gods. No COVID-19 had entered our doors, though life at the Glebe Centre had changed considerably since March. We became a closed fortress with one goal – keep our residents safe. While many long-term care homes around us were in a panic and the litany of human loss was on everybody’s lips, we nervously counted our lucky stars. Yes, we had taken safety measures early. Is that why we were safe?
September loomed large amid the frenzy and fear of the expected second wave. We tested staff weekly with nasal and throat swabs. Our nursing staff and administration team became a well-oiled testing machine and the invasion of our noses and throats was completely tolerable. Medical masks and shields were ubiquitous.
But on that Sunday in October, reality hit us with hard numbers. Two staff had tested positive for COVID-19 after being tested two days before. Quickly, we deployed our prepared Outbreak Plan. Signs went up outside the building denying entry to all but the most essential of staff and contractors. Elevators were restricted to two people at a time. Staff was informed, and we prayed we wouldn’t lose any to fear because we absolutely needed all hands on deck at this critical juncture.
Early in March, staff had been restricted to working for only one employer even before a government directive made that a rule. This left us with a significant number of vacancies which we struggled to make up for by offering overtime, double time, double chocolate – anything to cajole and convince staff to stay and work longer. Recruitment of personal support workers (PSWs) has long been a struggle and the dearth of them available for hire was a serious complication. Former PSW staff gracefully accepted redeployment from other departments to nursing. Administrative staff jumped in to assist where they could.
We now had COVID-19 in our home and the fear and worry were real. Imagine the courage of our frontline staff who came in every day, delivered the care as best they could, then went home to change in the garage, shower and be with their families.
All residents and staff were retested on Sunday and Monday. By Tuesday, resident results started coming in positive. First two, then five, then an additional eight until 23 out of 28 residents on one floor tested positive over the next few weeks. That all cases were restricted to that one floor was a small mercy. At the same time, PSW staff on that floor began to display symptoms; one by one, they tested positive. During their required quarantine of 14 days, they experienced only mild to medium symptoms and, with a couple of exceptions, returned to work to continue their duties. In total, 23 residents and 19 staff tested positive.
Our medical director Dr. Ben Robert, along with nurse practitioner Kathryn May, executive director Lawrence Grant and director of care Kate Cholewa, took charge. We enjoyed strong support from our colleagues at the Perley and Rideau Veterans’ Health Centre Care and personnel from Ottawa Public Health visited daily.
Regional partners from Ottawa Public Health, Ontario Health and the Ontario Ministry of Long-Term Care participated in daily teleconferences with Lawrence Grant. After 10 months, they were a well-honed team, providing sound advice and encouragement which was much appreciated.
A daily briefing was held to review the ever-changing situation on resident and staff numbers, supply needs, training requirements, meal and dining changes and most-responsible persons (MRPs) for the various tasks – all of it changing on the fly as the level of urgency grew.
Daily communication with families and residents was initiated to ensure complete transparency. This took the form of emails and webpage posts.
Very sadly, one resident passed away, then another. The loss and disappointment were palpable, yet the virus was still spreading like wildfire. We couldn’t stop to grieve. The few residents who tested negative were moved to private rooms or shared a room with each other. Staff was isolated on the unit, eating meals and taking breaks on the infected floor. Residents were restricted to their rooms. A small and efficient army of housekeeping staff disinfected all high- and low-touch areas multiple times each day.
The spread stopped at the door of that one floor. After several days without further positive results, Ottawa Public Health declared us out of outbreak on December 5. We emerged as exhausted as fire fighters after battling a blaze. We were humbled by the voracity of the virus and dismayed by the price it extracted. All staff recovered and so did 19 residents. We lost four residents to COVID-19.
Barbara Duggan is director of quality management at The Glebe Centre long-term care home.
