COVID-19 outbreak at North Van care home spread before it was recognized

One reason the COVID-19 outbreak at a North Vancouver care home grew out of control so quickly and with such deadly consequences, including Canada's first coronavirus death, is the illness was so mild at the beginning that it wasn’t recognized until it had already spread through the seniors home.

“It was not detected at its early stages, and it was well advanced by the time it was recognized,” said Dr. Bonnie Henry, chief medical health officer for the province, on Wednesday, about the Lynn Valley Care Centre outbreak.

In retrospect, said Henry, “there were quite a few people, both residents and staff,” who had the coronavirus by the time the outbreak was recognized.

That is a similar situation to what happened in Washington State at the beginning of the outbreak there, said Henry.

“They had a number of care home outbreaks as well.”

From the end of February to early March, one seniors care home in Washington State reported 129 cases of COVID-19, including cases among 81 residents. A total of 35 residents died and eight other nearby care homes also had outbreaks.

A Center for Disease Control report, however, found about half of the residents of the home who tested positive didn’t have symptoms on the day they were tested. Other reports have pointed to many of the typical symptoms of COVID-19 – like cough and a high fever – not being present in the same way in the elderly.

In another report on the Washington State care-home outbreak at the end of March, the CDC pointed to several contributing factors, including care workers who worked in long-term care facilities while experiencing COVID-19 symptoms, care aides who worked in multiple facilities, lack of personal protective equipment and difficulty identifying cases among elderly residents based on symptoms alone.

By then, however, the outbreak at the Lynn Valley Care Centre was already underway.

The experience in the North Vancouver care home showed health officials how challenging it is to manage outbreaks in long-term care facilities, said Henry on Wednesday.

“This just shows us how challenging it is to play catch up with this virus when you don’t detect an outbreak early,” said Henry.

Measures now in place around the province, which limit care facility staff to working in one facility only, are a direct result of lessons learned from Lynn Valley, she said.

Before health officials realized what was happening, care aides who frequently worked at more than one facility and who may not have known they had the virus were likely spreading it between long-term care homes.

The increased testing of both residents and staff at care homes and stricter controls now in place are “a testament to learning from the initial outbreaks,” said Henry.

On Wednesday, Henry reported one more death at Lynn Valley Care Centre in the last day, bringing the total number of residents who have died of COVID-19 at the care centre to 18. Two residents of the Amica retirement home in North Vancouver's Edgemont Village also died of the virus on Tuesday.

The Lynn Valley Care Centre has been one of the two worst outbreaks in the province.

There are about 15 residents and 24 staff currently testing positive for the virus, while more than 30 residents and staff members have recovered.

Haro Park care centre in Vancouver has also been hard hit, with nine deaths reported and more than 40 residents and more than 25 staff members testing positive for coronavirus.