Questions raised on delay declaring Evergreen COVID outbreak

A North Vancouver woman is raising questions about COVID-19 outbreaks in long-term care homes after her elderly family member died at North Vancouver's Evergreen House after contracting COVID – over a week before any outbreak was declared there.

Vancouver Coastal Health declared an outbreak at the long-term care home on Jan. 21, noting "restrictions" had been put in place Jan. 20. It's the first declaration of a COVID-19 outbreak in a North Shore care home since the Omicron variant began surging in December.

But the outbreak declaration came 10 days after the woman said her relative died after contracting COVID in the care home, a 284-bed facility run directly by Vancouver Coastal Health.

The woman – who asked not to be named to protect her family’s privacy – said her relative was in her 90s and already in frail health.

“She had gone downhill since the first lockdown (restricting visitors to long-term care homes),” said the woman. “She didn’t understand why we couldn’t go and see her.”

Later, the woman’s husband was allowed in as an essential visitor to help feed the relative, who has dementia.

He was given a rapid test each visit, she said.

But recently, the family was surprised by a phone call from care home staff on Jan. 12 telling them the elderly relative had tested positive for COVID.

Family not told of COVID in care home

When they asked where she had contracted the illness, they were told a number of other residents on the same floor in the care home had the virus. The relative died just a few days later, on Jan. 15.

While the elderly relative did have underlying medical conditions, COVID was listed as the primary cause of death on the death certificate, the woman said.

But the woman said the presence of COVID in the care home was a surprise as Evergreen House had not been on the daily outbreak list.

That's a concern, she said, as family members weren't aware they or their loved ones were at particular risk of contracting the virus.

In her family’s case, neither she nor her husband contracted the virus, although as a teacher, she said that was an initial worry.

Nor did the family observe any protocols in place to keep residents apart during dining or recreation activities, despite multiple residents testing positive for the virus.

Evergreen House is an older care home, with most beds in rooms shared by four residents.

When the woman and her husband went to pick up their relative’s belongings, they found a sign about COVID infection attached to a curtain in their relative’s room. But three other residents still occupied the other beds, she said.

She saw similar signs posted in other rooms.

No answers about outbreak

But when she asked staff why an outbreak hadn’t been declared, the woman said she got no clear answers.

Ironically, she said when her family phoned the funeral home to make arrangements, they seemed to already know about the outbreak at the care home.

Sources within the health-care system, who were not authorized to speak on the issue, told the North Shore News that residents in Evergreen began testing positive for COVID in the first week of January and that the virus spread quickly among both residents and staff. They also confirmed that group activities had continued during that time, and that no outbreak was declared despite numerous residents on every floor testing positive for COVID and questions being raised by staff.

Vancouver Coastal Health did not respond to several requests for information last week about why an outbreak hadn’t been declared at Evergreen.

An outbreak was only acknowledged at the end of the day on Jan. 21, with indications that “restrictions” had been put in place Jan. 20.

VCH also did not provide any further information about what is considered an “outbreak” in long-term care homes.

Protocols changing, says Henry

Dr. Bonnie Henry, the province’s health officer, indicated Jan. 18 the definitions of outbreaks have been changing.

“This is another one of those areas where we have had to modify and adapt our approaches as the virus has changed,” said Henry.

Henry said health authorities have to balance restrictions that have previously been put in place during outbreaks with the harms caused by those restrictions, particularly in the case of the highly transmissible Omicron variant.

Henry added health authorities are looking at each situation individually.

The North Vancouver woman said, however, that approach is confusing for families and leaves them in the dark, adding she has filed a complaint with Vancouver Coastal Health. She added while many people have mild illness, her relative died within days of contracting COVID.

Age remains the key risk factor in developing complications of COVID, with those over 80 28 times more likely to be hospitalized for the virus than younger people.