Thank you, Michael.
While I hold many titles, I want to speak to you, first and foremost, as one of Canada's only 305 geriatricians who work with older adults and their families challenged by complex health and social care issues like navigating long-term care needs. The aging of Canada's population should be seen as a triumph as we've extended our life expectancy from 51 years in 1900 to 82 years today. When we established medicare, the average Canadian was only 27 and would not live beyond their sixties, so it's understandable that the provision of long-term care was not an original priority.
While other countries acted clearly and decisively to address these shortcomings as they have aged, Canada didn't. This inaction cumulatively helped to sow the seeds of the tragedy we have been witnessing, in which 81% of Canada's deaths to date from COVID-19 have occurred in long-term care settings, and in which Canadians are 24 times more likely to die from it than they would be if they were living in their own homes in the community.
While some thought I was being alarmist on April 2 when I was quoted in the Globe saying that if my mom were in long-term care I would pull her out, most Canadians have come to appreciate that our long-term care system was utterly ill-prepared to deal with this pandemic. Our NIA research shows that at least 430,000 Canadians have unmet home care needs while 40,000 were on wait-lists for care homes even before COVID. Of course, people have the right to pay privately for their own services but this is not an option for the majority of Canadians who retire without a workplace pension and with only $3,000 on average in the bank.
Public long-term care funding has also been inadequate. Its nurses or personal support workers, for example, make far less than they would in our hospitals. With 80% of homes before the pandemic reporting trouble recruiting and retaining staff, the majority of workers they could recruit were often racialized women who didn't really have many other options. We owe them a debt, the 10,000 who have contracted COVID and the nine who have died so far, because they are caring individuals trying to make ends meet, who were willing to keep doing this dangerous work. If we think our usual staffing approaches are the right way to enable the system that we may all need in the future, then we are deluding ourselves.
Indeed, to contain costs, most homes employed those workers on a part-time basis without benefits, such as sick days, so many would work across multiple settings, placing them at increased risk of contracting and spreading COVID. After SARS, many countries ensured that their homes offered only single rooms, but we still have Canadians receiving care in rooms with two, three and even four beds. All together, these staffing and physical plan deficiencies have become known as our systemic vulnerabilities, which led to the rapid introduction and spread of COVID in and between Canada's homes.
During a pandemic, quickly applying definitive actions to prevent the introduction and spread of a novel infection based on rapidly emerging evidence is key. B.C. gets top marks for implementing key preventative measures well ahead of any other province. They stemmed their outbreaks to 11% of their homes while in Ontario, for example, close to 30% of the homes have now experienced outbreaks.
The NIA issued its evidence-informed “iron ring” guidance on March 27, which informed your April 8 federal guidance, and yet some provinces still hesitated to act on these recommendations for at least another week. Ontario and Quebec have tried to stabilize their situations with the help of hospitals, the armed forces and even school board employees, but this has not been seen as a stable solution for a system that has lost the faith of many of its residents, families and workers that their care needs and safety can actually be ensured.
Where do we go from here? Most experts agree that we will be living with COVID-19 for a while. We did better than many other countries in implementing our lockdowns early, allowing us to keep our community dwelling population and elders relatively unscathed. As we anticipate future waves, we need to take the early lessons we have learned and apply them to further protect the 411,000 Canadians who are living in our 5,800 long-term care and retirement homes, who've not yet been infected or killed by COVID-19. Our provinces and territories need to act more definitively to apply the current evidence-based recommendations. We still have inadequate public health data collection and reporting systems to help us understand how and why COVID-19 is affecting our long-term care settings and what makes them more vulnerable.
The NIA thus created a LTC, long-term care, tracker for this purpose. Most of what we need to do has been well known for years and luckily isn't rocket science, but it will take political will and federal-provincial-territorial coordination of efforts.
We thus recommend that the federal government create a national, representative long-term care task force or advisory board with clear deliverables and timelines to provide a thoughtful, evidence-informed approach that will be a resource to provinces and territories in addressing these issues once and for all.
Thank you.