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Minoru outbreak

On December 31, an outbreak was declared throughout the entire Minoru Residence home. Outbreak measures have been implemented and we are taking critical steps to ensure the safety of residents, staff and their families and mitigate transmission of COVID-19. Unfortunately, visits to Minoru Residence will not be possible until the outbreak is declared over; the exception is compassionate visits at the end of life.

We acknowledge this is a very difficult and stressful time for everyone. The health and safety of residents and staff remains an utmost priority as we manage the outbreak and we appreciate your patience and support.

Communication to families

Click the + symbol below to find the most recent and archived communications to Minoru residents and families. 

Support for families 

For families with outstanding questions, requiring emotional support or needing assistance navigating the health-care system, please contact the PHC/VCH LTC Family Support Line at 1-844-824-2219 or 604-875-4953. Please note that the PHC/VCH LTC Family Support Line cannot provide specific resident status reports. 

For information regarding the status of a resident at Minoru Residence, please directly contact the social worker on site at 236-818-1246.  

Frequently asked questions

What is the criteria for an outbreak?

An outbreak is declared when a resident tests positive for COVID-19 and there is a likelihood of transmission to other residents or staff.

How did this outbreak happen?

COVID-19 is still prevalent in our community at this time. Public Health is currently investigating to determine how the virus transmission occurred in the home.

What steps are you taking to address the situation?

We have strict infection prevention and control protocols that are implemented when a COVID-19 outbreak is declared in a long-term care facility.

A VCH Medical Health Officer leads the outbreak response closely through daily on-site meetings with facility staff and several VCH leaders to ensure appropriate infection prevention and control precautions are in place for the safety of residents and health care providers.

Outbreak measures include preventing potential resident exposures outside of their rooms, including during mealtimes, and cancelling group activities and non-essential services, in addition to enhanced cleaning, and appropriate use of personal protective equipment by staff.

To help reduce further spread, we are doing proactive and low-barrier COVID-19 testing of both residents and staff who may have been exposed to the virus, even if they have mild or no symptoms. Early identification of cases, prompt isolation, testing, monitoring and execution of proper infection, prevention and control practices are key to managing an outbreak.

What does droplet and contact precaution mean?

Droplet precautious are an infection prevention and control intervention that is used to prevent the transmission of pathogens, including viruses that are spread via respiratory secretions. This transmission could occur if an infected individual coughs or sneezes while in close contact with another person. 

Contact precautions are used to prevent transmission of microorganisms that may be transmitted easily by contact with an individual’s intact skin or a contaminated surface, for example, a light switch or a bedside table. 

For both interventions, staff wear appropriate PPE to prevent the potential transmission of the virus while they are providing essential care to residents.

How many people live in the facility as a whole? What percentage of residents have COVID-19?

There are 250 beds at Minoru and we have 226 residents. With our recent number of cases, this means that roughly 26 percent of residents at Minoru have been diagnosed with COVID-19 during this outbreak. (*As of January 12, 2021).

What is VCH doing to ensure the same situation that occurred at Little Mountain Care Home doesn’t happen at Minoru? Is there more regular testing being done on regular staff and extra staff being brought in to help out?

VCH and Minoru are doing everything we can to control the outbreak at Minoru and reduce the transmission of COVID-19 in the home. We have received support from every level of our organization including Medical Health Officers from Public Health, Infection Control and Prevention physicians, additional staffing and housekeeping resources, and much more. The week of January 11, we began rapid testing for staff entering the home. This will allow us to test staff and determine if they have COVID-19 within 15 minutes—even if they are not showing symptoms. While this test is less accurate than the nasopharyngeal swab, it is another tool we can use in addition to regular testing to screen those who may be infected.

While every outbreak and every long-term care home is different, we have incorporated learnings from our colleagues at Little Mountain so that we can control the outbreak at this stage. The implementation of the rapid testing for staff is one example of this.

If everything is under control, why are more people getting infections? Are we past the peak?

While we have implemented all of the outbreak measures and protocols, some residents may have been incubating the virus prior to some of these measures being implemented. 

We believe the peak was somewhere around January 1 and that we are now coming down the other side of the curve. We are now seeing a slower amount of new cases coming in than we were before. We are also now two weeks past when we first began immunizations at Minoru, so residents will now be more protected against COVID-19 than they were two weeks ago. While we might still see some new cases over the coming weeks, we hope that symptoms will be milder and will hopefully have less severe outcomes. 

In your regular updates, can you provide the latest infection, hospitalized, recovered, and death numbers?  What is the breakdown of outbreak numbers per wing? 

We know that get the latest information and updates is important to everyone throughout this outbreak. To protect patient confidentiality, we will be sharing overall site outbreak numbers during our virtual family town hall meetings. The situation can change rapidly and we want to ensure you have the most up-to-date information. If you have specific concerns about your loved one, please contact us directly.

The Ministry of Health is also sharing numbers from long term care outbreaks to the public once a week. You can access the report from the Ministry of Health here

If we are considered high risk, why was Minoru not locked down right away when the first case was found?

When we discovered the first case on the first floor, we did lock down the entire floor immediately. Our hope was that cases would be contained to that single floor so that we wouldn’t have to impose these difficult outbreak protocols on all residents and families. As soon as we discovered that there had been transmission on another floor, we made the difficult but necessary decision to implement outbreak measures throughout the entire home.

Has the new strain of COVID been detected at Minoru?

The UK variant of COVID-19 has been detected in BC, but not at Minoru Residence. That being said, not all samples from COVID-19 tests are being examined to see if they contain this variant. Priority for these tests are being given to high-risk samples—such as those who returned from travel. Even if the UK variant were to be detected at Minoru, our medical management of the resident and treatment would remain the same as it is still the COVID-19 virus. 

Evidence does not show that the new variant results in more severe illness following infection. 

Why did we hear about the all-site outbreak declaration from the facility 24 hours after it had already been listed on the VCH website?

When an outbreak is declared, there are multiple communications pieces that happen at once. Our process is to ensure that families and loved ones are notified of the outbreak declaration before the public is notified. We apologize for the delay in getting this important communication out to you in a timely manner. We are committed to providing you with regular updates on the health and wellbeing of your loved one.

How long will this go on/ What is the criteria to declare the outbreak over? When can I see my loved one?

To ensure the safety of all residents and staff in the home, outbreaks are declared over 28 days after the last infection was discovered. Until this time, all outbreak precautions, including suspended in-person visitation will remain in place. We will keep you informed as to when these restrictions will be lifted.

In the meantime, virtual visitation is still available for all loved ones. If you would like to arrange a virtual visit, please contact our Recreation/Rehab office at 604-244-5304, Monday through Friday.

Can residents borrow a phone if they don’t have one?

Connection between residents and their loved ones is very important for both their emotional and physical well-being. While we do have some on-site tablets to support virtual visitation, if your loved one is able to manage a cell phone or tablet on their own, you are encouraged to drop it off and we will bring it to them. We also have tablets available at the facility that we can use to facilitate a virtual visit with you and your loved one. If you would like to arrange a virtual visit, please contact our Recreation/Rehab office at 604-244-5304, Monday through Friday.

Can we bring an iPad for our family member so we can do virtual visits?

Connection between residents and their loved ones is very important for both their emotional and physical well-being. While we do have some on-site tablets to support virtual visitation, if your loved one is able to manage a cell phone or tablet on their own, you are encouraged to drop it off and we will bring it to them.

I have been immunized as has my mother living in Minoru.  When can I visit?

Once all of the outbreak measures have been lifted, in-person visitation will be able to continue at Minoru. 

Can we still drop-off necessities (non-perishable) to residents? 

Yes—families can reach out to our social workers if they would like to drop off things such as cell phones or tablets for their loved ones. We would be happy to help facilitate your requests. The social workers can advise how to package and label the items you want to provide a Minoru resident.

Are residents being kept informed about what is happening?

We continue to provide updates to all residents on the outbreak and protocols being implemented to keep them safe. 

What are the procedures to inform families when residents test positive? How do we receive regular health updates?

When a resident tests positive for COVID-19, it is part of our process to inform the family as soon as possible. Families are always updated when a resident’s health status changes. If you do not hear from nursing staff, which means your loved one’s health status has remained the same. Families can of course always contact social work for more regular updates and health statuses.

We will also offer a once-weekly update on the total number of residents and staff who have tested positive for COVID-19. This information is then published on the Ministry of Health website. You can access this information here

How are staff working in the facility?

The majority of Minoru staff are assigned to work in a single unit and to not move between units. There are, however, some exceptions, such as the spiritual care provider, as there is only one spiritual care provider for the entire facility. Any staff that are required to work across the facility are provided with PPE to help keep both staff and residents safe and to minimize the potential spread of COVID-19.

How frequently are staff at Minoru Residence being tested?

All staff and residents at Minoru were tested for COVID-19 when the outbreak was first declared. Since then, we continue to actively monitor for symptoms in all residents and staff. Should anyone who has not tested positive develop symptoms, they will be re-tested. The Medical Health Officer may also request testing of a resident at any time if they are a close contact of another resident or staff member that has tested positive.

Given the number of staff who have been ill (tested positive), how has staffing been maintained?

During outbreaks, Vancouver Coastal Health works to ensure that the home has enough staff to provide the appropriate level of care to all residents. During the outbreak at Minoru, we have increased our staffing levels by 20 percent. This is done through a number of ways such as hiring of new staff, giving extra hours to part-time and casual staff, and existing staff from within VCH who volunteer to work in long-term care facilities during outbreaks. In some cases, retired health care workers have also returned to assist.

Where are extra staff coming from?

During outbreaks, Vancouver Coastal Health works to ensure that the home has enough staff to provide the appropriate level of care to all residents. This is done through a number of ways such as hiring of new staff, giving extra hours to part-time and casual staff, and existing staff from within VCH who volunteer to work in long-term care facilities during outbreaks. In some cases, retired health care workers have also returned to assist.

Do you still have casual employees working in the facility?

We have temporary staff working onsite in addition to the permanent staff working at Minoru.  All staff working at Minoru Residence are only permitted to work at one long-term care home and work on the same wings for all their shifts.

What makes the people assessing the staff members think that they wouldn’t lie when they’re answering the questions? 

VCH offers a sick leave benefit for all of our employees. Therefore, if employees are not feeling well when they come to work, they can call in sick for their shift and they will be compensated. 

Is the Richmond newspaper article about the Minoru staff member true?

Due to patient confidentiality, we cannot release details related to specific cases or individuals. Public Health has looked into the staff case and determined that the allegations in the news story/family member email are false and we have since issued a correction to the original story with the reporter.

Public Health conducts thorough contact tracing for each individual diagnosed with COVID-19 and will follow up with all individuals who are deemed close contacts of the positive staff member. Patient and staff safety is our number one priority. Minoru Residence continues to follow all guidance from Public Health and infection prevention and control to protect the safety of residents and staff and stop the transmission of COVID-19.

Are there cohorts created to separate staff taking care of COVID positive vs negative residents? 

Staff are cohorted per unit. So staff working on 1 West for example, will continue only working on 1 West until the outbreak is declared over. When going from one resident who does not have COVID-19, to a resident who is positive for COVID-19, all staff don new PPE between residents. All residents are also on droplet and contact precautions to reduce the risk of transmission. 

Are the care aide staff levels adequate to provide extra help to residents who are frail requiring help in their meals, fluid intake and other personal care?  

During the outbreak, we have increased our frontline staffing levels by 20 percent to ensure that we have extra support to care for our residents. This increase in staffing ensures that each resident’s needs are met, that they’re fed and have their personal care attended to.

What is the frequency of having a physician with COVID experience visiting the facility?  Is it possible to have my parent’s FP come to the facility?

There is a physician on-call to support Minoru and our residents 24/7. In addition, we are working with our partners at the Richmond Division of Family Practice as well as Richmond Hospital to have a physician on-site on a regular basis to help support residents and staff throughout the outbreak.

Your family physician is welcome to come on-site to visit your loved one at any time. Our nursing team is in contact with all of their family physicians to let them know when their health status changes.

Will staff who refuse the vaccine be required to wear extra PPE? How do we ensure they don’t spread to residents?

Staff who choose not to receive the COVID-19 vaccine will be required to follow the same infection prevention and control measures we currently have implemented. These include following proper PPE protocols, staying home when sick, donning new PPE between caring for different residents, as well as practicing good hand hygiene and physical distancing. Wearing more PPE does not help increase protection around the transmission of the virus.

Why does my family member have to stay in their room?

At this time, it's important for us to reduce the spread of COVID-19 throughout the facility in order to protect other residents and staff. All residents at Minoru have been asked to stay in their rooms during the outbreak so that we can reduce their potential exposure to the virus outside of their room. It is important that while residents are being asked to stay in their rooms, that they remain active, rather than staying in bed. Minoru staff are working closely with residents to ensure they get some movement throughout their day, while remaining safely in their rooms.

What medical treatments will be provided for COVID-positive residents? 

The treatment provided to residents varies depending on their specific case, including if they have other underlying medical conditions. For further information about the medical care provided to your loved one, please speak to the Director of Care/Manager at Minoru. 

What are the meal arrangements for residents? Can we bring packaged food for our loved ones?

All residents are currently eating their meals in their rooms as we have suspended all dining room activities as part of our outbreak control measures. At this time, unfortunately, we are not allowing any food or drink to be brought into the facility to comply with our infection prevention and control protocols.

Do people who are in wheelchairs get any activity or are they bedridden? 

Our occupational therapists and physiotherapists continue to provide the care residents need in order to maintain their mobility. Exercises are done in resident rooms.

Why are residents who are positive not transferred to the hospital?

Not all residents who receive a positive COVID-19 test result require hospitalization. Our team of nurses and physicians monitor all of our residents to ensure they receive the appropriate level of care. Many residents are able to recover from COVID-19 without requiring hospitalization.

Are there enough ventilators?

We do not have any ventilators on site at Minoru Residence. If a resident's condition declines, they will be transferred to Richmond Hospital where they will receive the appropriate level of care from expert clinical staff.

Should residents be wearing masks?

Based on provincial health orders, residents in long-term care facilities are not required to wear masks while in their rooms. Masks are required in communal areas, where the risk of COVID-19 transmission is higher. At this time, we are limiting the amount of time residents spend in these settings to further reduce this risk.

How would we know if a resident who is non-verbal if they are not feeling well?

The health and safety of all our residents is of the utmost importance. Care staff are experienced in assessing residents who are non-verbal. All residents are assessed twice daily for symptoms and note any changes in their usual behaviour.

Do residents have a dedicated physician looking after them?

There is a physician on-call to support Minoru and our residents 24/7.

When is a resident considered recovered from Covid-19?

A resident is considered recovered from COVID-19 once they are clear of symptoms and have returned to their baseline level of health.  They are considered no longer infectious from COVID-19 20 days after their symptom onset.

Can you please provide more details about your infection control measures?  

Our staff all follow strict infection control and prevention guidelines. When supporting residents, they don a new set of PPE and all equipment and surfaces are cleaned and sanitized often through our enhanced cleaning protocols. We have also implemented a number of single use items—such as blood pressure cuffs, plates and cutlery—to reduce the risk of transmission when using these items. In addition, all laundry is washed in industrial washing machines and meet all infection control and quality standards to ensure that personal clothing and linen are washed thoroughly.

We also received a special UV light disinfection device to help us further disinfect rooms, surfaces and equipment.

Have any health officers visited the facility to advise on procedures and processes or potential improvements?

Yes. We have had Medical Health Officers, Infection Control and Prevention Physicians, Family Physicians, Senior Medical Directors, Executive Leadership representatives from VCH, in addition to a variety of other experts to advise and review our procedures and processes. This has allowed us to make improvements and find any opportunity to implement changes that can help reduce the transmission of COVID-19 in the home.

Has the ventilation system been assessed regarding role in transmission? Further, has there been a discussion to clean the ventilation system? Are windows open to let fresh air in for the residents? 

The ventilation system at Minoru is in good operating condition.  Poor ventilation is not contributing to COVID-19 transmission at the facility. The entire building HVAC system and ducts were cleaned last year by a commercial contractor and we maintain regular maintenance to ensure it is inspected and or replaced if needed. This also includes ensuring the system is bringing fresh air into the building.

Currently, due to the cold and rainy weather, we have not been opening windows within the home. Leaving the windows open also tends to put strain on the boilers and the HVAC system as they work harder to regulate the temperature in the building. It can also allow unwanted visitors—such as rodents—to find a way into the building.

Scientific evidence shows us that the most common transmission of COVID-19 is from person to person. We are taking all of the steps necessary to prevent further transmission of the virus. 

Why is the facility not creating separate cohorts of COVID positive and negative residents together?

During an outbreak in a facility, we want to reduce the risk of potentially infecting those who have not yet been exposed. If two residents are already sharing a room, and one person tests positive, there is an increased likelihood that the other resident will also test positive. Each of the bed spaces in a room are kept separate. As well, staff don new PPE in-between treating residents. 

In order to move a resident who does not have COVID-19, we need to find a single room where they will not expose others if they test positive. Moving them into a room with another resident who has tested negative isn’t a safe option as one of them could still be incubating the virus. Our nursing staff, leadership, as well as our Infection Control and Prevention teams have been working over the past few weeks to move residents from double rooms where possible. This continues to be a work in progress and we try to make more care spaces within the facility to safely isolate residents who do not currently have the virus.

What does ‘enhanced cleaning protocols’ mean? 

During an outbreak, a VCH Infection Prevention and Control Practitioner attends the facility regularly to provide training and to ensure staff are following appropriate precautions. Additional cleaning staff provide enhanced deep cleaning services.

Our staff also follow strict infection control and prevention guidelines. When supporting residents, they don a new set of PPE and all equipment and surfaces are cleaned and sanitized often through our enhanced cleaning protocols. We have also implemented a number of single use items—such as blood pressure cuffs, plates and cutlery—to reduce the risk of transmission when using these items. In addition, all laundry is washed in industrial washing machines and meet all infection control and quality standards to ensure that personal clothing and linen are washed thoroughly.

This week, we also received a special UV light disinfection device to help us further disinfect rooms, surfaces and equipment.

Can we confirm with the laundry department that they have added extra disinfection/chlorine to wash towels, bibs, residents' clothing during this outbreak?

All of our washing machines at Minoru Residence are industrial-grade appliances that allow for the proper cleaning and disinfecting of all clothing and linen. The machines are inspected regularly and our laundry processes are reviewed by Infection Control and Prevention to ensure they meet the highest infection control standards and best practices.

Why was everything on the walls taken down? It’s so bare for the residents.

In order to make it easier for our housekeeping staff to conduct a thorough cleaning of all surfaces and areas within the home, we have removed some personal items on bedside tables and walls. These will all be put back once the outbreak measures have been lifted. We continue to prioritize the health and wellbeing of our residents above all else.

What is the criteria to choose to transfer a resident to hospital? What are the resources and infrastructure the hospital can provide better than the Minoru residence? 

For residents who have stable COVID-19 symptoms, our team of nurses, along with their family physician, can provide the same treatment at Minoru as they would in hospital. Sending residents to hospital depends on many factors. If their condition worsens, then the medical team can request they be transferred to hospital to receive a higher level of care.  It’s important to remember that Minoru is home for our residents and just as those in the community, it is best they stay home with mild illness. The health and wellbeing of all of our residents remains our top priority.

Are you taking new residents?

At this time, due to the outbreak, Minoru Residence is not accepting any new residents or transfers. These will resume once the outbreak measures have been lifted.

Which test is being used for COVID-19 testing? If a resident has received the COVID-19 vaccine, will it skew the results? Are resident receiving the anti-body test?

We are currently using nasal swab and gargle tests for COVID-19- this is in line with provincial guidelines. The COVID-19 vaccine will not give a false positive result for those who are tested after having received their immunization. Residents are not currently receiving the anti-body test.

Have all residents been tested at least once? How often are they being re-tested?

As part of our outbreak measures, all residents at Minoru Residence have been tested for COVID-19. Any residents that develop COVID-19 symptoms, even mild symptoms, will be retested. Our care staff are also experienced in assessing residents who are non-verbal. All residents are assessed twice daily for symptoms and note any changes in their usual behaviour.

Why have we not been doing rapid testing since the beginning?

B.C. does not have sufficient capacity to conduct rapid testing of all residents living in long-term care. In addition, the most accurate test is the nasopharyngeal swab. It uses a very sensitive technique called PCR to detect the presence of this virus. We have relied on this test during outbreaks to ensure accurate testing and tracing of all COVID-19 cases. 

Why not just test every day?

All of the residents at Minoru have been tested at least once—many of them more often than that. The  COVID-19 nasal swab is an uncomfortable procedure so we only use this test when residents are symptomatic. All residents throughout the facility are also already on droplet and contact precaution. We do not wait for a positive test result to treat them as such. Everyone throughout the home is treated as though they are positive. 

We will of course test any resident who needs to be tested. But we also have limited lab capacity and unfortunately many outbreaks still remain around the province. If all the facilities were to conduct tests on every resident every day, our lab would not be able to have the turn-around on results that they do today. Daily testing would also take necessary care team members away from their work of caring for the needs of our residents. 

Do you notify a family member when a resident tests positive?

Yes. It is our priority to ensure the family members are notified of any changing conditions to their loved one's health.

What is the schedule for more vaccinations of residents?

We continue to work with Public Health and Vancouver Coastal Health to administer the COVID-19 vaccine to eligible visitors, staff and essential visitors, in line with provincial guidelines. Currently, 94 per cent of our residents have been vaccinated.

When were the vaccines administered?

COVID-19 immunization began at Minoru Residence on December 23. Through our aggressive immunization campaign, we have now vaccinated 94 percent of our residents as of January 10. Work will continue to ensure that those who have not yet been immunized are able to receive their vaccine if they wish. 

When are the residents getting their second dose of the vaccine?

We are currently focused on providing the first dose of the COVID-19 vaccine to all residents and staff in long-term care. In line with provincial guidance, we aim to administer the second dose within 35 days of the initial dose. We will communicate with you once an immunization clinic is scheduled for second doses at Minoru Residence.

If a resident receives a first dose of vaccine, then tests positive, will they get the second dose?

At this time, we will not be providing any COVID-19 vaccinations (first or second doses) to those who currently have or have had COVID-19 in the past. Those who have been infected with COVID-19 already, are expected to have immunity for a period of time. Those who have not been exposed and are therefore unprotected, are at an increased risk of potential infection. Vaccinations for those who have already had COVID-19 will be done at a later date, once we receive more vaccine supply.

Will the outbreak affect the second round of vaccines being administered?

No, active outbreaks will not affect immunization clinics in long-term care sites.  Eligible residents, staff and essential visitors will receive a second dose of COVID-19 vaccine. However, residents that have developed COVID-19 will not be revaccinated at this time as we believe they are protected by natural immunity. As further vaccine becomes available, they may get vaccinated at a later date. 

Can you explain why you are delaying the second dose of the vaccine? Where is the proof that this will still be effective?

Last week, Dr. Bonnie Henry, Provincial Health Officer, explained the decision to extend the interval between doses for people in B.C. From looking at data, modelling from BC Centre for Disease Control, and using the COVID-19 Ethical Decision-Making Framework, it has been determined that administering the first doses of vaccine to as many people as possible in the priority groups in the early weeks of the campaign, when doses are limited, will protect the greatest number of at-risk people overall in the shortest possible time, and will have the greatest impact on reducing mortality, severe disease and hospitalizations. 

Based on this direction, we will be planning to provide the second dose of both the Pfizer and Moderna vaccines at approximately 35 days after the first dose.

Public Health is tracking who has received vaccine, which vaccine was administered, and when people will be invited to receive their second dose.

There are studies investigating if it is possible to mix the vaccine between doses; will residents be getting a different type for the second dose?

Residents who received the Moderna vaccine as their first dose will receive the Moderna vaccine for their second dose. The same applies to the Pfizer vaccine.

Does vaccination lessen the severity of the illness?

Vaccinations offer immunity to a disease, including COVID-19. Following vaccination, our bodies produce antibodies which allow our immune systems to respond to viruses in a more effective way. Scientific evidence shows very strong protection beginning 12-14 days after a single dose of either Pfizer or Moderna vaccine.


Resources
SOURCE: Minoru outbreak ( )
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