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Listening to what the experts say

Let’s base the future of long term care on facts, not ideology.
By Tom Wellner
I was encouraged to read an excellent, research-based opinion piece in the Toronto Star by Dr. Bob Bell and Dr. Walter Wodchis about what Ontario has learned from the COVID-19 pandemic. Both men have extensive expertise and their findings support the reality that the critical debate on the future of long term care needs to be based on facts not ideology.

Dr. Bell is a former Deputy Minister of Health for Ontario, as well as a retired surgeon and hospital CEO, and the chair of the expert advisory panel for Revera’s report The Perfect Storm: The COVID-19 Experience for Revera and the Long Term Care Sector. Dr. Walter Wodshis is a professor of public health at the University of Toronto’s Dalla Lana School of Public Health. These two experts conducted simple statistical analysis which determines what many have been saying for months: ward rooms where there are 3 or 4 people to a room and a shared bathroom - not ownership model - is associated with mortality in long term care homes with COVID-19 outbreaks.
I want to give credit to the Toronto Star for publishing this op ed which clearly demonstrates that the narrative their editorial team, along with others in the news and social media, has been espousing since early in the pandemic is factually incorrect.

Rather than summarize the Bell-Wodchis op ed, I will share with you this excerpt which is so clearly written and which captures the relevant points of their findings:

  • To evaluate what factor is primarily associated with COVID-19 mortality, we determined whether each For Profit and Not for Profit home in the province housed three or more residents in a room. Complete information was available for 510 homes. We excluded municipally owned homes which (unlike FP and NFP homes) receive extra funding from municipal taxes.

  • We documented how many residents died due to COVID-19 in each home to March 1, 2021. Thankfully, vaccination has dramatically reduced COVID deaths following this date. The number of COVID deaths was divided by the number of residents to determine a mortality ratio for each home.

  • A standard statistical test called “multiple regression” was done to figure out whether the ownership model (FP versus NFP) or the presence of three or more people in a room was associated with a higher mortality ratio.

  • The answer is clear. FP ownership was not linked to higher mortality (for statisticians, this factor had a p-value of 0.43). However, the presence of three or four people in a room was strongly associated with higher mortality (p=0.002). This routine statistical analysis showed that the Star conclusion about for-profit care increasing mortality was wrong.

  • I want to give credit to the Toronto Star for publishing this op ed which clearly demonstrates that the narrative their editorial team, along with others in the news and social media, has been espousing since early in the pandemic is factually incorrect.

I am sharing this because we are at a point in our collective history where we need give serious thought to the delivery of long term care in our communities. And in so doing, we need to know what problems to fix and where to invest. These decisions need to be based on facts not opinion or ideology.

I want to thank Drs. Bell and Wodchis for adding their voices to this important discussion.

Tom Wellner
By Tom Wellner
Tom Wellner is President and CEO of Revera. He has led Revera since 2014 and has guided its strategic direction to grow, innovate and lead in the sector. He has a passion for innovative solutions to complex problems and believes that innovation is key to designing a better aging experience.