A horrific spectacle is unfolding in Ontario’s nursing and seniors’ homes.
Out of a total of 626 long-term care homes in the province, 114 have reported outbreaks of COVID-19. 34 seniors’ homes have also been affected. In Ontario as a whole, half of the reported deaths have taken place in one of these two institutions, resembling patterns seen in countries like Italy and Spain.
The vast majority of those dying from COVID-19 are elderly. In many cases, they suffer agonizing deaths, unable to breathe and slowly succumbing to the virus. They also often die alone, as they are denied visits from family due to fears of spreading the virus. In some cases, families may be able to interact with their loved ones through a window before they die—but even then, only if they’re “lucky” enough to have that option. In any case, it is no way to say goodbye.
The situation is hardly better for those not infected by COVID-19. They know that, at any moment, the virus may spread to them. The cramped spaces in care homes make it easier for the virus to circulate there than among the general population. Moreover, many residents have no option to leave, due to their age or medical condition.
In many ways, life in care homes is comparable to that in prisons. To be more precise, it resembles sitting on death row—cut off from the outside world, and knowing your death may be only weeks away.
An avoidable crisis
Ontario Premier Doug Ford has described this situation as a “wildfire.” The government, he suggests, was taken by surprise, while doing all it could to prevent more deaths.
The facts tell another story.
Evidence from Italy and Spain suggested early on that most COVID-19 deaths take place in nursing and seniors’ homes. Data from the European Union has now confirmed this, showing that half of COVID-19 deaths in Europe take place in care homes.
Nursing and seniors’ homes are often confined spaces, with most residents suffering from ongoing medical conditions. This makes them ideal incubators for the spread of viruses. The recent string of outbreaks was therefore entirely predictable, even without the data.
In Ontario, the situation has been made worse by years of cost cutting by both private and public institutions. Residents at some locations share their room with as many as four other people. Care workers, meanwhile, are often forced to work at multiple locations, as management refuses to offer them full-time work (and the benefits it would entail). These policies, aimed at minimizing expenses and increasing profits, have now made it easier for the virus to spread.
Ford has for his part reduced oversight for these institutions since coming to office. From 2015 to 2017, the government carried out unannounced inspections at most nursing homes in the province. In 2018, inspections of this sort were only carried out in half of all nursing homes. In 2019, this number dropped to nine.
Even at the best of times, nursing and seniors’ homes are uniquely vulnerable to the impact of disease. In Ontario, years of cutbacks and neglect have made the situation even more precarious.
Too little, too late
Despite this, the government has until now taken no serious measures to protect care home residents. Ford has only recently banned care workers from working at multiple residences, weeks after BC took similar measures.
Even then, his government has avoided ordering an increase in care workers’ wages—much to the delight of private residence owners. This has raised concerns that, given the lack of full-time positions, many care workers may find it preferable to quit work and claim unemployment benefits instead. Others predict they might flock to employers that offer the highest wage, leaving many homes unstaffed.
Ford has also done little to address the chronic lack of space, protective equipment, and tests for COVID-19. In recent weeks, residents have complained of being denied testing, despite being in close contact with COVID-19 patients.
Care workers, meanwhile, have been asked to work without protective equipment, leading to many simply refusing to go to work for their own safety. This has left many homes in a desperate state. One resident told the CBC she screamed for one-and-a-half hours and never received help.
Ford has promised more funding to address these concerns. Unfortunately, the money has yet to materialize. If even doctors are being denied protective equipment and test kits, as is sadly the case in Ontario, care home residents can only imagine where that leaves them.
The ongoing carnage in nursing and seniors’ homes was not just predictable, but avoidable. Even in normal times, understaffing and lack of space leads to poor health outcomes for residents. In the era of COVID-19, it becomes a death sentence.
However, as before, Ford and private residence owners have been slow to help, opting to put profits before desperately needed care.
In truth, the money has long existed to massively expand our nursing and seniors’ home system, ensure adequate staffing at decent pay, and to produce or purchase the equipment care workers need. If this were done, deaths could have been minimized.
Instead, that money was absorbed into the profits of residence owners, or handed away in bailouts and corporate tax cuts by the state. The end result is the disproportionate increase in nursing and seniors’ home deaths that we see today.
Perversely, certain politicians have used the concentration of deaths in nursing homes to justify “re-opening” the economy. In private, they believe that if COVID-19 mostly targets the elderly, then they should be sacrificed for the sake of business writ large. In their view, the elderly are at best a cash cow, as they are to private residence owners, or at worst a burden—but in any case, they are not worth saving.
The behaviour of both business and the state, if committed by an individual, would be labeled as manslaughter, if not murder. However, these actions are carried out, not by one individual, but by many; not as a result of personal malice, but due to an illogical system that places profits before all else. It is, as Friedrich Engels once described, therefore an act of social murder.
It is not any one individual, but capitalism itself that stands guilty of this act, not directly, but indirectly through years of neglect, careless profiteering and callous indifference towards the lives of our most vulnerable.