A week or so before the lockdown, I attended a presentation by a nursing home’s chief physician on the implications of an infectious disease like COVID on nursing homes and the elderly patients sheltering within. A key aspect of the talk was the impossibility of keeping a highly contagious respiratory infection like COVID out of nursing homes. The only effective way to do this, she said, would be for the employees to shelter inside with the patients for the duration of the crisis, which most employees would not be willing to do. As we would later see in many Canadian nursing homes, the employees were often not even willing to show up:
The question then becomes, did the lockdown strategy work? Was it effective in protecting the elderly from the virus? The answer to that question is a resounding no:
Across provinces, across countries, the virus penetrated these institutions despite a stringent lockdown and despite family members not being allowed to visit their relatives. Beyond this, family members were not able to supervise the care received by their elders. Some suffered from the consequences, both psychiatric and physical, of neglect. Cognitive decline in the elderly is exacerbated by a lack of physical, emotional, and conversational contact.
The administrators of the nursing homes, health officials, and the government implemented a strategy that they knew would not work in the long run. They knew it wouldn’t keep the virus out if it spread widely amongst the general population, which it did, and they knew that the sheer number of employees, some working in multiple different homes and moving freely between them, represented a significant infection vector. The only thing the lockdown was effective in doing was eliminating any substantive social contact that these elderly patients had with their loved ones. And for some, myself included, it robbed us of some of the final moments we would have of spending time with our grandparents.
Ask yourself what is worse? A quick death from a COVID infection, or several long months surrounded by employees who don’t care, that barley feed you, that don’t move you, leave you for hours in soiled diapers (all of which happened in Canadian nursing homes). And the only social contact you get with loved ones is a five-minute facetime call once a week. The plight of our elderly was so shocking that one of the family members with a patient in the Camilla Care nursing home launched a hunger strike and chained himself to a tree outside of the facility.
If the chief physician, the administrators, and government officials all knew the lockdown wouldn’t keep the virus out of nursing homes, why did they rob us of our precious final moments of contact? The reason is the constant and ever more common pursuit of an unobtainable goal, absolute safety, absolute security, absolute fairness, and equality – utopia. We live in an age of governance by hysteria, exacerbated by the media. Where government officials, businesses, and the healthcare system must be seen to be doing something, even if it is not effective.
It’s the reason we have those peculiar arrows in malls and shopping centers, which, from what I’ve seen, most people completely ignore. Or the requirement to wear a mask in a restaurant for the length of time it takes you to cross the few steps to your table, after which you can take it off until you’re finished eating. If you question some of the more ridiculous obsessive-compulsive behaviors (like the arrows), you’re treated like a bald headed neo-nazi, adding factionalism to these substanceless decisions.
I keep hearing, trust the experts – the very ones that told us initially not to wear masks? The same ones that have been mandating these completely ineffective temperature tests:
The very same media that overacted to Trump’s statements on hydroxychloroquine during the height of the COVID pandemic, and all but stifled research into medicine that may have been an effective prophylaxis for front line workers:
The Crown Coronation trial headed by Washington University in St. Louis was set to study hydroxychloroquine as a prophylaxis for 40,000 front-line health workers, but researchers were told to switch gears because of RECOVERY’s findings, said Mills. An ethics board in South Africa halted a trial on using lopinavir on COVID outpatients because of RECOVERY’s hospital patient results. Investigators eventually persuaded the board to change its ruling, but lost eight crucial weeks amid the debate, said Miils.
The experts in this context refers to the bureaucrats and government officials who have been setting these nonsensical policies, and it particularly refers to the media, who have so frequently bungled COVID reporting and lied to the public that their credibility has finally begun to affect their business model. By all means, continue to trust them. Trust them when they say one thing, like don’t wear masks, and then trust them again when they tell you how important is – without any data to back those statements up and without any differentiation between good masks and bad:
His team believes the stretchy, porous material is actually fracturing bigger, heavier droplets, splintering them into tinier particles that can more easily remain suspended in the air.
Trust them when they maintain, again without sufficient data and evidence, that hydroxychloroquine should be ignored simply because its efficacy was mentioned by the beloved Donald Trump. Trust them even if they tell you to bounce on one leg and flap your arms like a bird because it stirs the air and prevents the virus from settling.
If any single thing should be clear by this point, it’s that the minute-by-minute updates on the science of COVID by the media are harmful. Good science takes time; it cannot be expected to adhere to the 24-hour news cycle. Fanning the flames of panic and then demanding instantaneous updates from bureaucrats, physicians, and scientists has done nothing except perpetuate ineffective preventative measures and, in some cases, has even delayed the collection of data on treatments that would prove to be effective during certain stages of infection, like hydroxychloroquine.
What kind of expert chases an unobtainable goal, one they knew wouldn’t work, and that deprives patients of necessary social contact, emotional support and family supervision. If you think the precautions were rational, I would challenge you to visit an average nursing home. Spend a few days there, watch the staff, watch the patients, find one who has no one to visit them, and watch how quickly they decline. What I’m realizing is that “trust the experts” essentially means do what I say, because none of the policies that I’ve been subjected to are particularly rational, and as we’ve seen from above, they’re not even very effective. Without people to visit the patients, they are not nursing homes. They are living tombs for the elderly.
With my grandmother, it wasn’t COVID that got her; it was the lockdown. It was not seeing her family in-person for almost six months. She went from smiling and laughing to barley talking and not eating. After several COVID scares in the home and many false-positive COVID tests, it was the complete lack of social contact by people that cared that caused her decline. The only way that these homes would let you in to visit a family member was if you placed them on a palliative care notice, which meant no CPR and no other life-saving measures (something which they told us was irreversible once we made that decision). When it was clear she was not doing well, we felt forced to place her on palliative care. When we would visit her, the PSWs at the door would take our temperatures, fasten masks on our faces, gloves, face-shields, and splash-guard gowns – not to protect them, but to prevent us from catching COVID from inside the home after a series of positive COVID tests from some of the patients and one of the staff.
I hear similar stories from people with family in other nursing homes, and many other individuals are expressing concerns that their family members are suffering the same fate. If you’re going to criticize this as being anecdotal, you’re right, but you have to consider that the province is often not gathering substantive data on this segment of the population at all. The Royal Society of Canada indicated in a report released on the Long-Term Care homes that the province wasn’t gathering basic empirical data on something as simple and necessary as the amount of staffing needed to maintain quality of life in nursing homes, and I suspect that data on the impact of social isolation on elderly during the COVID crisis is also non-existent. Anecdotal is often all we have.
The facility my grandmother was in was one of the better ones, and even there, I saw things that made my soul ache. One of the patients who always stood out was an elderly lady who used sing opera while she sat in the halls or in the recreation room. I would hear her singing as I walked through the halls towards my grandmother’s room. Sometimes instead of opera, she would be crying. When you waved at her and said hello, she would smile and beam, and when you passed her by shortly afterward her face would drop. I only remember seeing her family come once or twice. One day, on my usual route towards my grandmother, I didn’t hear any singing. Without people constantly visiting her, she declined in less than a year. The important thing to remember, particularly with geriatric patients, is that six months to a year is an eternity for them. It may be the last moments they have to spend with loved ones and taking that away from them to apply an ineffective fix is inhumane.
To be clear, I am not wholly against partial closures of these facilities to the public for the duration of the COVID crisis as a strategy. What I am against are the decisions to prevent family members from visiting once these patients begin to show clear signs of cognitive decline and a drastic drop in their health, tying their visitation to placing them on an irreversible DNR order. Furthermore, the assumption with the lockdown was that these facilities were running properly, which just about everyone in the country knew was not the case. The plight of the elderly in Canada is so well documented in the media, that for an elected official or senior healthcare bureaucrat to not know would be an amazing feat by itself.
Canada’s lockdown strategy also completely disregards the necessity of social and physical contact by loved ones to the long-term health of the patients within these facilities. I understand that the hope was to prevent the virus from breaching the facilities, but it should be clear at this point that the strategy hasn’t worked, and that it cannot work, so a more nuanced approach to these issues in the future is necessary, because we don’t live in a utopia and, as we’ve seen, our institutions are sometimes only as robust as a child’s arts and crafts project – lopsided and held together with glue and good intentions.
Years ago, during my morning commute to university, I would cross a bridge with a breathtaking view of the river valley below – trees, water twisting around a sharp bend in the river valley, and if you opened your window, amidst the sound of traffic you would hear the rush of running water. Then one day, a man on his bicycle, during his morning commute, bumped his front tire against the edge of the railing of the bridge and went over the bars, over the railing, and died. People were shocked. The family was devastated, and rightfully so. It was one of those hapless accidents that leaves you shaking your head. Sometime later, the construction crews showed up, and they built a massive concrete barrier on the side of the bridge facing the river valley. There was no more view, just a concrete wall constructed so that no one could ever have another such accident. I remember thinking it was absurd, an attempt to bubble wrap the world, the destruction of something beautiful for the pursuit of perfect safety. One person had an accident, which was not a regular occurrence; he was simply unlucky.
The massive overreaction reminds me of our current predicament with COVID. There will be events in the world that are outside of our control, even though we think of ourselves as beyond the reach of nature, where all we can do is shore up our infrastructure and hold on. These signs, temperature tests, blanket bans without any nuance are almost like declaring an area a hurricane-free zone and expecting the weather to oblige our declarations, the modern equivalent of Caligula ordering his legions to stab at the sea because he was angry with Poseidon. I feel like I’m watching a patient with obsessive-compulsive disorder but on a global scale. My one request for elected officials and bureaucrats is to do what is effective, not what is politically expedient.