Research from McMaster University shows the Ontario retirement homes impacted by the COVID-19 pandemic are those with more residents, those connected to a nursing home, owned by large corporations, or offering many on-site services.
They are also those in communities with a higher ethnic concentration or where COVID-19 cases are increasing.
Retirement homes are residential complexes for seniors offering a range of personal and medical care services, such as meals, bathing and medication management, that are less intensive than services offered at nursing homes which typically have more frail residents. In Ontario there are 770 retirement homes with almost 56,500 residents.
Retirement homes have been lumped in with nursing homes, but there are true differences with how they're doing with the pandemic."
Andrew Costa, Study Lead, Associate Professor, Department of Health Research Methods, Evidence, and Impact, McMaster University
His team found that between March 1 and Sept 24, 2020, 92 per cent of resident and staff infections occurred at 10 per cent of retirement homes. During that time there were 172 retirement home outbreaks involving 1,045, or 1.9 per cent, of residents and 548, or 1.5 per cent) of staff. Fifty-one retirement homes had one or more of the 215 resident deaths.
The full report is in pre-print at: https://www.medrxiv.org/content/10.1101/2020.12.08.20246124v1
By mid-November, the deaths of retirement home residents were 287 or 8.2 per cent, of the 3,505 deaths in Ontario.
"Retirement homes with more than 100 residents had more than a five-fold increase in the risk of outbreak," said Costa. "As visitors were severely restricted at that time, it's probably the staff and care providers seeded the infection in the homes."
He added that more research would be needed to identify why cases were higher in areas of ethno-culturally dense neighborhoods, but it may relate partly to cultural patterns of filial piety.
The study could not account for changes made in infection prevention and control, such as personal protective equipment, COVID-19 testing or staff shortages, nor changing provincial policies during the seven-month survey.
The data for the study was obtained from the Retirement Homes Regulatory Authority and the Ontario Ministry of Health.
Costa, A.P., et al. (2020) Risk factors for retirement home COVID-19 outbreaks in Ontario, Canada: A population-level cohort study. medRxiv. doi.org/10.1101/2020.12.08.20246124.