Public health officials in Sudbury are seeking ongoing provincial funds for a program to limit outbreaks of infectious disease in long-term care homes and other congregate-living settings.
This past September, the Doug Ford government announced the establishment of Infection Prevention and Control (IPAC) hubs across Ontario after a series of tragic deaths from COVID-19 at nursing and retirement homes exposed weaknesses in the system.
“This really comes from concerns about the lack of effective prevention and control processes and procedures, particularly among our long-term care homes and other institutions,” said Dr. Penny Sutcliffe, medical officer of health, during a meeting of the Board of Health on Thursday.
In southern Ontario, the IPAC hubs took shape through hospitals, but those in the North have been operated by health units, including Public Health Sudbury and Districts.
Ontario committed $2.8 billion overall to the creation of the hubs, with Public Health receiving a share of $840,000 to carry out the work locally, under the supervision of Holly Browne, a manager in the health protection division.
Browne said the health unit already worked with long-term care homes on preventing infection but the one-time infusion “has allowed us to enhance our presence in the community and specifically in the congregate-living settings.”
The IPAC team is small — four practitioners and one manager — but energetic, she said, and “hit the ground running” as soon as the funding became available.
“To date, 92 congregate settings have received an on-site visit and almost 800 IPAC requests have been responded to through emails and phone calls,” said Browne.
The on-site visits are conducted to “assess the setting’s preparedness for an outbreak,” she said, with comprehensive audits — taking about two hours to complete at each home — conducted and a written report of findings presented afterward.
“We also report to the Ministry of Health’s emergency management sector,” noted Browne.
While the hub initiative is a new one, the issues it is meant to address have been known for some time, and predate the recent COVID crisis by quite a few years.
The final report of a provincial commission on long-term care, delivered in April, “underscored the urgent need for dedicated and sustained programming and supports for effective IPAC practices in long-term care and for the benefit of all clients in congregate-living facilities,” said Browne.
“Throughout the report, there was reflection on the measures put in place following the outbreaks of SARS in 2003 and H1N1 in 2009, with the intention to ensure that long-term care homes, and possibly other congregate-living lettings, were prepared for the next pandemic,” she said.
Steps that should have been taken included having an ample supply of personal protective equipment available, creating agencies to support IPAC training, and ensuring there were trained staff in long-term care homes and hospitals.
The commission found, however, that “measures implemented in response to these prior learnings were unfortunately not sustained,” said Browne. “And had they been sustained, congregate-living settings would have been better prepared when faced with COVID-19.”
The hub leader said the efforts of her team have made a difference over the past six months but more funding will be necessary to truly have an impact.
“A lot of work has been completed to date but there is a lot more to be done,” she said. “The plans for this year and hopefully beyond are to visit every congregate-living setting to complete an assessment and audit, provide education sessions, and enhance our agency’s website to include resources geared to these various types of congregate settings.”
Providing a single on-site visit to each home “is a great start,” she noted, but as the commission on long-term care outlined in its report, “ongoing support is crucial to success.”
With that objective in mind, a motion was put forward Thursday calling on the province to “transition the IPAC hub model to an ongoing program with stable annual funding to provide for the protection from infectious diseases for residents in long-term care and other congregate-living settings.”
The board unanimously endorsed the resolution, which will also be shared with the ministers of Health and of Long-Term Care, area partners, Northern boards of health, Ontario Health, and the province’s chief medical officer of health.
“This is a much-needed program to support our vulnerable citizens, particularly as we’ve seen with the tragedies that have occurred during COVID,” said Sutcliffe. “This is about prevention and, as Holly said, it is an effective intervention. Our concern, of course, is there is no funding beyond this year, and it really needs to be the recipient of ongoing funding.”
The hub approach taken locally through the health unit is a “made-in-the-North solution,” she added. “We really have something good that’s working well in Northern Ontario and the motion of course is about continued investment in that model, which leverages on supports and resources that already exist in our community.”