Prologue
I write this in the middle of a pandemic.
There is much that we don’t know. Scientists are racing to create a vaccine. Immunity from a second round of COVID-19 is unclear. The virus’s timeline in our lives remains a mystery, although public health officials say it could last a few years.
Here is what we do know.
When COVID-19 landed in North America, we had already witnessed its death march through seniors’ homes in Italy, Spain and France, killing thousands — retired teachers, accountants, electricians and bakers. The parents and grandparents of Europe.
We knew that elders, winners in the lottery of long life, were vulnerable.
When the virus arrived, in cities large and small, nursing-home deaths surged and soon, New York, Chicago and Los Angeles became COVID-19 hotbeds. In Ontario and Quebec, infections decimated long-term care, but not before a young geriatrician tweeted a warning: seniors’ homes will blow up like a tinderbox.
Dr. Samir Sinha was right. So were countless others, from AARP, the influential advocacy organization for older adults, to the Registered Nurses’ Association of Ontario, all telling governments to focus on COVID-19 in nursing and retirement homes. Give all staff masks, test everyone, not just those with symptoms because, as we soon learned, the telltale signs in older people were as innocuous as an upset stomach or nothing at all. The virus used stealth.
Those were the infection control actions, but the bigger crisis, the spark to the tinder that Dr. Sinha cited on Twitter, was the system that controls seniors’ homes. For decades, long-term care has operated on a tight budget, draining the life pleasure of the people who reside within while devaluing the work of staff, forcing many to work in two or three locations just to make a living wage. This is how a virus spreads from one home to the next.
As I write this in June 2020, we still don’t know how many elders will die.
We do know that the coronavirus-related deaths of older people are forcing the industry and politicians to confront reality, even though it was there to see all along. Going into the pandemic, governments mostly viewed nursing homes as a second-tier system for residents whose frailties were similar to those in acute care hospitals.
It remains to be seen if these flaws laid bare will lead to improvements, but the suffering will not soon be forgotten. Families were banned from visiting, a policy meant to keep residents safe, even though workers unintentionally brought COVID-19 inside, infecting the people in their care. Without proper protections, the virus spread. As weeks passed, and staff grew sick or terrified, families realized that parents and grandparents were dying, alone.
There will be a generation of adult children who live with the trauma of knowing their mother or father spent the final moments of life with no one to hold a hand or speak quiet words of love. As a journalist with the Toronto Star newspaper, I have spent the pandemic writing about seniors’ homes, speaking to families that were emotionally destroyed. People who had the means