Nova Scotia launches reviews of Northwood COVID-19 outbreak, long-term care system

The Nova Scotia government has announced the details of a review that will look into how and why COVID-19 was able to sweep through the Northwood facility in Halifax, as well as a separate review of infection prevention and control in the province's long-term care sector.

Infectious disease consultant Dr. Chris Lata, and Lynn Stevenson, former British Columbia associate deputy minister of health, have been appointed to lead the review, which will begin immediately.

"Both reviews will make recommendations to help avoid and contain future outbreaks and will help Northwood and other long-term care facilities better prepare for future waves of this virus," Health Minister Randy Delorey said at a press conference Tuesday.

They will analyze the Northwood outbreak and the response, to determine what factors contributed to the spread of COVID-19 before applying that evidence to the facility's "physical design and operational procedures," according to the terms of reference.

Some of those issues include:

• Whether the preparedness for and response to COVID-19 infections were appropriate and timely.
• Staff scheduling practices and processes.
• Best practices in effectively controlling and preventing the introduction and spread of COVID-19.

Lata and Stevenson will conduct interviews with staff, physicians, administrators, the family members of Northwood residents, and others.

The review will be carried out under the Quality-improvement Information Protection Act.

Fifty-three of the 63 Nova Scotians who have died so far related to the coronavirus lived at Northwood in Halifax, a long-term care home.

A total of 246 residents and 99 staff have tested positive for COVID-19 at Northwood since early April, according to the province.

Some families are involved in a proposed class-action lawsuit against Northwood Halifax, as well as the province. None of the allegations have been proven in court.

Although Delorey said families will be consulted by the two committee experts, they will not be able to interview everyone. Instead, the committee will work together with Northwood to engage certain family representatives and decide how and when they will connect with them during the review.

When asked how quickly the province can implement any recommendations that come out of the Northwood review, Delorey said the province will make investments as quickly as it can.

Although many affected family members and citizens have been calling for a more lengthy investigation into what happened at Northwood under the Public Inquiries Act, Delorey said a quality-improvement review can be completed in a "very timely fashion."

The turnaround time may be vital, as predictions on when a second wave of COVID-19 could hit Canada have ranged from the fall and winter months of this year, to early 2021.

There is a lengthy wait list of roughly 1,450 people seeking long-term care in Nova Scotia, but those 53 empty beds at Northwood will not be filled until the review is submitted.

Will single-occupancy rooms become the norm?

Many Northwood residents share their room with one or two other people, a reality that the facility itself has been hoping to change for years. Since 2017, they have repeatedly asked for $13 million from the Health Department to add three floors to their Centre building, a change that would allow all residents a single room.

When Delorey was asked Tuesday whether the province would commit to single-occupancy rooms in long-term care facilities, he said they have allowed facilities to carry vacancies amid COVID-19 even as the system remains in high demand.

He said this should allow them to spread out existing residents and, in the face of another outbreak, more easily isolate those who are infected.

Delorey said he will wait to see what the review suggests about room configurations, and it would be too early to commit to expanding a large facility like Northwood.

Family says current vacancies might not be enough

Darlene Metzler was hoping to hear more specific details around what role the family members of those who died in Northwood would have as part of the review.

Her father, Gerald Jackson, died of COVID-19 in late April after one of his roommates caught it first.

Metzler said for the review to be restorative, families need to be able to understand exactly what happened and share how the situation has impacted them.

"What we saw, witnessed, and experienced is a very huge part," she said.

Second review to look at entire long-term care system

Delorey also announced a "separate, internal review" of broader infection prevention and control within the long-term care sector, which involves about 8,000 residents at 132 licensed facilities.

This initiative includes:

• Establishing a "joint sector-government" advisory panel to assess those infection policies within long-term care.
• Looking at current leading infection control practices.
• Assessing legislation, workforce capacity and infrastructure.

It will identify the tools, resources and education required to better support the long-term care sector, then create a proposed plan to address any gaps.

Both reviews will make recommendations to help avoid or contain future outbreaks.

The recommendations from both reviews will be delivered to the minister by Sept. 15, and will be made public afterwards. 

However, the detailed findings around what the experts discovered in their Northwood review will not be released publicly. Delorey said that is the reality of a review under this type of quality-improvement legislation.