Respiratory virus outbreaks surging again in Alberta care homes

Respiratory virus outbreaks have beenpicking up steam in Alberta's care homes this fall.

Data reported through the province's respiratory virus dashboardshows the total number of outbreaks in long-term care and supportive living facilities has more than tripled since Sept. 23.

"Lots of outbreaks. Certainly we're seeing the numbers ramp up," said Dr. Cassandra Hoggard, medical director at Tudor Manor and Clifton House, two Calgary-area Brenda Strafford Foundation care homes.

While Hoggard hasn't seen any influenza cases yet, she is seeing plenty of other illnesses, including COVID-19.

Provincial data shows, as of Wednesday, there had been 358 respiratory virus outbreaks in long-term care and supportive livingsites since the start of the season, which it defines as Aug.27.

CBC News asked Alberta Health how many of those outbreaks are due to COVID-19. It did not answer the question.

While the province didn't provide the granular data requested, the dashboard shows the vast majority of facility-based outbreaks so far this season (including those at care homes, schools and hospitals) have been due to COVID-19.

According to Hoggard, her COVID-positive patients mostly have mild symptoms this fall, including a runny nose and cough.

"It's not like it was. I haven't personally had any folks need to be hospitalized this go around. I've not personally had anyone pass away from COVID," she said.

"I do know that it is happening after speaking to some of my colleagues ... in different facilities. So it is still out there. It is something to be taken seriously. But it's certainly not like it was with a 20 per cent mortality rate like it was in the early days of COVID."

University of Alberta Hospital infectiousdiseases specialistDr. Stephanie Smith said she's seen a steady stream of COVID-19 in the last few months. Her hospital is admitting between 45 and 60 COVID patients every day, she said.

"COVID has been predominant ... It just keeps chugging along," she said,

"I would say 95 per cent of all the respiratory viruses we're picking up in hospital are COVID."

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According to Smith most COVID patients are elderly.

Provincial data indicates that 1,120 Albertans 70 and olderhave been hospitalized due to COVID since the end of August. There have been 31 ICU admissions in that age range and 150 deaths.

The province wouldn't say how many hopsitalizations and deaths areconnected to care home outbreaks.

The question of masks

Ontario recently implemented a masking requirement at its long-term care homes due to risingoutbreaks, cases and resident hospitalizations.

While Alberta Health Services has a masking directive allowing individual hospitalsto bring in masking requirements (including wings with continuing care beds), a similar policy is not in place for stand-alone care homes.

AHS said staff at its facilities can choose to wear masks in addition to staying home when sick, washing their hands and getting immunized.

"For all continuing care spaces outside of acute care facilities, outbreak prevention processes continue to apply including hand hygiene, point of care risk assessment and routine practices," a spokesperson said in an email.

"Continuing care contracted service providers can adopt their own masking policies based on their local needs and in consultation with resident and family councils."

According to Hoggard, the question of masking in care homes has never gone away in Alberta.

"I think that's a conversation that continues to happen ... There are incredible positives for masking. We do know that it limits spread."

But Hoggard said there is also a downside because it can impact communication for vulnerable residents.

"There's a struggle for the non-verbal cues for folks that may have some cognitive impairment. So it's not a simple question of when to bring it in."

Voluntary masking is supported at the facilities Hoggard works in. Staff and residents are also urged to get vaccinated, stay home when they're sick and wash their hands, she said.

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Smith agrees it's a complicated issue.

"There's a lot more consideration that needs to be taken into account," she said

"But certainly I think if there's significant COVID activity at a long-term care facility, then it makes a lot of sense to ensure that health-care workers are masking. You certainly don't want health-care workers getting sick and then spreading it to more residents."

Smith believes as the season progresses, outbreaks grow and influenza picks up, it may be necessary to put a process in place,similar to the AHS directive for hospitals, that lays out guidelines for implementing masks at care homes on a case-by-case basis.