5.2 Social Impacts

5.2.1 Neglect & Isolation of Seniors Amidst COVID-19 Interventions

Introduction

This topic was included in the original November 28, 2023 NCI Report as section 7.2.1 Neglect and Isolation of Seniors in Canada Amidst COVID-19 Interventions.

Witness Testimony

Additional testimonies were received from witnesses working within long-term care facilities during the time that the COVID-19 interventions were implemented.

Testimonies were received from the following witnesses:

Allison Nesdoly

Ms. Nesdoly is a licensed practical nurse who worked in several long-term senior care facilities during the pandemic, where she was responsible for providing direct care to patients. She continued working in these facilities following the rollout of the vaccination program in 2021. During this time, she observed a noticeable decline in the health of many patients after they received the COVID-19 vaccines. This decline manifested in various forms which included rashes, pain, and an overall deterioration in both physical and cognitive health.

Ms. Nesdoly also observed that shortly after each round of vaccinations there would be an outbreak of COVID-19 and Respiratory Syncytial Virus (RSV) within the facility. These outbreaks typically occurred within a week of the vaccinations. She testified that many of the residents had received multiple doses of the vaccine.

Despite being vaccinated multiple times, the residents were subjected to lockdowns and isolation whenever there was an outbreak in the facility. These lockdowns lasted from several days to weeks, and Ms. Nesdoly noted that the periods of forced isolation had a profoundly negative impact on the residents‘ well being.

Ms. Nesdoly herself chose not to be vaccinated based on her own research and her history of adverse reactions to previous vaccines. She also noted that her colleagues experienced various side effects following their COVID-19 vaccinations. These included rashes, skin lumps, open sores, and headaches. Alarmingly, two nurses suffered seizures shortly after receiving the vaccine. Many of her co-workers discussed these issues among themselves, expressing concerns about the effects they were experiencing.

Ms. Nesdoly’s testimony highlights the troubling health impacts observed in both residents and staff in long-term care facilities following COVID-19 vaccinations, as well as the detrimental effects of repeated lockdowns and isolation on vulnerable populations.

Sheena Clarke

Ms. Clarke is a registered nurse from New Brunswick who had extensive experience working in two local hospitals across most departments until 2017, when she transitioned to long-term home care. During the pandemic she observed widespread fear and depression among residents in the long-term care facilities where she worked. She described how many patients felt so lonely that they expressed a desire to die, with some residents even sleeping with their masks on out of fear.

Despite the pervasive fear, there were no COVID-19 infections in her facility. However, within days and weeks of the vaccination rollout, Ms. Clarke observed a troubling increase in health issues among residents. These issues included shortness of breath, chest pains, seizures, blood clots, heart attacks, herpes, shingles, and strokes. Alarmingly, some elderly women even began menstruating. As time passed, the number of complaints related to these issues grew, as did the frequency of these adverse events following vaccination.

Ms. Clarke also noticed significant changes in patients’ blood analyses after they received the vaccine. Concerned about these developments, she reported her observations regarding the negative effects of the measures on residents. She was instructed to add her concerns to the “Doctor’s Board.“

However, when she reported these issues, she was informed that the only recognized side effects of the vaccines were anaphylaxis and arm pain. She was told she was not authorized to report these issues since she was not the designated person responsible for such reports. Furthermore, she was instructed to stop reporting her findings because they were causing alarm among the staff.

Ms. Clarke took her concerns to various regulatory bodies, including her union, but found little support. The staff in her facility were also living in fear, facing constant revisions to the rules that governed their work. The availability and adequacy of personal protective equipment (PPE) and operational requirements were frequently changing, often in ways that seemed illogical.

Although Ms. Clarke herself was not vaccinated and had received an exemption, she was ultimately terminated when vaccine mandates were implemented. Her testimony underscores the profound challenges and distress faced by both residents and healthcare workers in long-term care during the pandemic.

Sarah Choujounian

Ms. Choujounian, a registered practical nurse, worked during the pandemic in both a nursing home and with children in the community. As the chief steward of her union, she raised concerns about the loss of rights experienced by both staff and patients during this period. However, the union advised her to comply with the pandemic measures.

She observed that the lockdowns and other restrictions had significant negative effects on the residents of the nursing home. Deprived of family visits, many residents began to “fail to thrive.“ Ms. Choujounian stated that these negative outcomes were predictable, given the severity of the measures being implemented.

Fourteen-day lockdowns were enforced, and some residents became increasingly agitated, leading to the sedation of many individuals. If any resident tested positive for COVID-19, regardless of whether they showed symptoms, the lockdowns were extended by an additional 14 days. Ms. Choujounian noted that doctors did not visit the facility to observe the situation firsthand, and she had no direct access to report her observations to them.

She also pointed out that no representatives from regulatory bodies visited the facility to monitor the conditions. There were no daily meetings or discussions to assess the situation within the facility or to evaluate the impact of the measures on the residents. All rehabilitation and physical therapy services were halted, further exacerbating the residents’ decline.

Despite the troubling conditions, no one within the facility voiced complaints, and no Informed Consent was obtained before altering the residents’ treatment schedules. Concerned about what she was witnessing, Ms. Choujounian began sharing her observations with a private group on social media. As a result, she was placed under investigation for her posts.

After speaking at a public hearing, Ms. Choujounian was terminated from her employment. Her testimony underscores the severe impact of the pandemic measures on vulnerable nursing home residents and the lack of oversight or accountability within the facility.

Discussion of NCI 2023 Report

Section 7.2.1 of the original 2023 NCI Report addresses the overall impact of COVID-19 lockdowns on seniors in long-term care facilities. The section highlights issues such as isolation, mental health deterioration, and inadequate medical care. Key points include:

• Increased isolation due to lockdown measures leading to mental health issues like depression and anxiety.

• Limited physical activity and rehabilitation services causing physical decline.

• Challenges with maintaining adequate staffing levels and PPE.

• Lack of regular medical oversight and insufficient reporting of adverse events.

Summary of New Testimonies

Allison Nesdoly (Regina, SK)

• Observations on Health Post-Vaccination: Patients experienced deterioration in health that included rashes, pain, cognitive and physical decline post-vaccination. Noted outbreaks of COVID-19 and RSV shortly after vaccinations.

• Staff Health Issues: Staff experienced rashes, skin lumps, open sores, headaches, and seizures following vaccination.

• Isolation Impact: Frequent lockdowns, regardless of vaccination status, negatively impacted residents’ well being.

• Personal Vaccine Hesitancy: Chose not to vaccinate due to personal history and research.

Sheena Clarke (Regina, SK)

• Observations on Health Post-Vaccination: Increased incidence of shortness of breath, chest pains, seizures, blood clots, heart attacks, and other serious health issues post-vaccination. Blood analyses showed changes post-vaccination.

• Isolation and Fear: High levels of fear and depression among residents; some wore masks even while sleeping. Staff lived in fear due to constantly changing rules and PPE shortages.

• Reporting Issues: Faced resistance when reporting adverse effects and was eventually terminated for vaccine non-compliance despite having an exemption.

Sarah Choujounian (Regina, SK)

• Union and Reporting Challenges: Reported concerns about loss of rights to the union; and was instructed to comply with pandemic measures.

• Negative Effects of Lockdowns: Lockdowns led to significant negative impacts, including residents being deprived of family visits, sedation of agitated residents, and a halt to rehabilitation services.

• Lack of Medical Oversight: Doctors did not visit the facility, and there were no regulatory checks or Informed Consent for treatment changes.

• Social Media and Termination: Posted observations on social media and was investigated and terminated after speaking publicly.

Additional Critical Information from New Testimonies

Health Deterioration Post-Vaccination:

New testimonies provide specific details on the physical and cognitive decline of residents, post-vaccination, including severe side effects like seizures, blood clots, heart attacks, and even menstruation in elderly women.

Mention of outbreaks of COVID-19 and RSV following vaccinations added a new layer to the understanding of post-vaccination effects.

Staff Health and Vaccine Reactions:

• Reports of adverse reactions among staff that included rashes, headaches, and seizures which were not covered in the original report.

Reporting and Oversight Failures:

• Detailed instances of obstructed reporting with staff being instructed not to report issues and facing termination for non-compliance or speaking out.

• Lack of medical oversight and regulatory visits highlighted that showed a systemic failure in monitoring and addressing the issues within facilities.

Impact of Isolation and Lockdowns:

• Specifics on the duration and frequency of lockdowns and their severe impact on residents’ mental health and physical well being.

• Description of the negative consequences of isolation, including the increased use of sedation and the halting of rehabilitation services, provided a deeper understanding of the adverse effects of lockdown measures.

Personal Experiences and Professional Risks:

• Personal accounts of facing professional risks for not complying with vaccination mandates or for speaking out against the observed issues.

• Testimonies provide a human element—showing the fear and frustration experienced by both residents and staff during the pandemic.

Overall, the new testimonies offer a more detailed and nuanced picture of the challenges faced by seniors and healthcare workers during the COVID-19 pandemic by highlighting significant gaps in care, oversight, and the negative impact of both vaccination and lockdown measures.

Conclusion

Based on the new information provided in the three testimonies from Allison Nesdoly, Sheena Clarke, and Sarah Choujounian, the following additional conclusions can be drawn beyond those made in the original NCI Report:

Post-Vaccination Health Decline:

There is a noticeable and concerning pattern of health deterioration in both residents and staff following COVID-19 lockdowns and vaccinations—including severe physical and cognitive declines—which was not fully addressed in the original report.

The testimonies suggest a potential correlation between the vaccinations and subsequent outbreaks of COVID-19 and RSV, indicating a need for further investigation into the timing and nature of these outbreaks.

Adverse Effects Among Staff:

The adverse effects of vaccinations on healthcare staff, including serious conditions like seizures and persistent skin issues, were not highlighted in the original report. This underscores the broader impact of the pandemic measures on the entire healthcare ecosystem, not just the residents.

Staff experiencing these effects may have implications for the quality of care provided, as their own health issues can impact their ability to perform their duties effectively.

Systemic Reporting and Oversight Failures:

The systemic failure to properly report, acknowledge, and address adverse health effects post-vaccination is a significant concern. This includes the suppression of staff reports and the lack of proper channels for reporting these issues.

The lack of regulatory oversight and visits to the facilities indicates a failure in the monitoring systems intended to safeguard the health and well being of residents.

Negative Impact of Isolation and Lockdowns:

The detrimental effects of prolonged isolation and repeated lockdowns on residents’ mental and physical health were more severe than previously documented. The testimonies provide concrete examples of depression, increased agitation, and the use of sedation as a consequence of these measures.

The testimonies also reveal that lockdowns continued despite high vaccination rates among residents, which questions the efficacy and rationale behind such stringent measures.

Professional and Ethical Challenges:

The testimonies highlight significant ethical and professional challenges faced by healthcare workers, including the conflict between following directives and advocating for patient well being.

The professional risks faced by healthcare workers for raising concerns or refusing vaccination mandates reveal a climate of fear and suppression that likely affected the overall quality of care.

Impact on Rehabilitation and Long-term Health:

The cessation of rehabilitation and physical therapies, as described in the testimonies, indicates a long-term impact on residents’ physical health that may not have been fully appreciated in the original report.

The lack of Informed Consent for changes in treatment schedules raises serious ethical concerns and indicates a potential violation of residents’ rights.

Need for Comprehensive Review and Policy Adjustment:

The new information calls for a comprehensive review of the policies and measures implemented during the pandemic, particularly around vaccination, lockdowns, and isolation protocols.

There is a clear need for establishing better reporting mechanisms and ensuring transparency and accountability in handling adverse health effects and other issues arising from pandemic measures.

Holistic Support for Healthcare Workers:

The testimonies underline the necessity for better support systems for healthcare workers, including mental health support, clear communication, and fair treatment in the face of adverse reactions or professional disagreements regarding pandemic measures.

In conclusion, the new testimonies provide critical insights that highlight the need for a more nuanced and responsive approach to handling pandemics in long-term care facilities, emphasizing the importance of balancing infection control measures with the overall well being of both residents and staff.

Recommendations

Considering the new information provided by Allison Nesdoly, Sheena Clarke, and Sarah Choujounian, the following additional recommendations are proposed:

1. Comprehensive Adverse Effect Reporting System:

• Develop a mandatory, anonymous reporting system for adverse health effects following vaccinations or other medical interventions. Ensure that all reports are investigated promptly and thoroughly.

• Establish an independent committee to review and address these reports, ensuring transparency and accountability.

2. Improved Oversight and Accountability:

• Introduce regular, unannounced visits by independent medical professionals and regulatory bodies to monitor the health and safety of residents and staff.

• Ensure these visits include assessments of mental health and the overall well being of residents.

3. Support for Healthcare Workers:

• Provide mental health support and counselling services for healthcare workers to address the psychological impact of their work during the pandemic.

• Implement policies to protect workers from retaliation when they raise legitimate health and safety concerns, thereby fostering a culture of openness and support.

4. Re-evaluation and Adjustment of Vaccination Policies:

• Conduct independent studies to evaluate the long-term effects of COVID-19 vaccinations on both residents and staff. Use the findings to adjust vaccination policies to minimize adverse effects.

• Develop protocols for monitoring and managing vaccine side effects—ensuring timely and appropriate medical responses.

5. Ethical Treatment and Informed Consent:

• Ensure that Informed Consent is obtained from residents or their guardians before making significant changes to their treatment or care routines.

• Establish ethics committees within facilities to review and oversee decisions related to resident care during emergencies to safeguard ethical standards are upheld.

6. Balanced Approach to Isolation and Lockdowns:

• Implement targeted isolation measures that minimize disruption to residents’ daily lives while effectively controlling infections. Explore alternatives to lockdowns that allow for safe social interactions.

• Introduce regular, safe social activities and family visits to reduce the negative impact of isolation on residents’ mental health.

7. Continuation of Rehabilitation and Therapy Services:

• Ensure that rehabilitation and physical therapy services continue to be available even during pandemics, recognizing their importance in maintaining residents’ physical health and overall well being.

• Develop protocols to safely conduct these services during health crises.

8. Training on Ethical Decision-Making:

• Provide training for healthcare workers on ethical decision-making and residents’ rights, empowering them to make informed and compassionate care decisions.

• Include training on managing and reporting adverse vaccine reactions and other health crises.

9. Enhanced Communication and Transparency:

• Develop clear and consistent communication channels to keep residents, families, and staff informed about the measures being implemented and any changes in policies.

• Facilitate regular updates and meetings to address concerns and provide reassurance to ensure all parties are well-informed and involved in decision-making processes.

10. Public Health and Policy Adjustments:

• Review and adjust public health policies based on emerging data and feedback from frontline workers and residents to warrant they are effective and humane.

• Ensure policies are flexible and can be adapted quickly in response to new information or changing circumstances.

By incorporating these additional recommendations, long-term care facilities can provide a more comprehensive, ethical, and effective response to future pandemics, ultimately leading to better health outcomes and improved well being for both residents and staff.