PPE use 'sloppy,' Saskatoon Extendicare workers say, even after deadly outbreak at Regina home

The owner of a Regina care home where 43 COVID-19-infected residents died says the outbreak there is finally over after two months.

But at a Saskatoon Extendicare home still dealing with an outbreak, staffers are not properly using personal protective equipment at all times, according to two employees.

They agreed to speak to CBC News on the condition of confidentiality.

"All it takes is one single staff member making one mistake to infect a resident and have that resident later pass away," said a male worker at Extendicare Preston in Saskatoon.

In an emailed statement, Extendicare spokesperson Laura Gallant said workers are doing everything possible to follow all provincial and local health directives.

"Our team audits PPE practices regularly to make sure everyone is following best practice protocol," she said. "We conduct on-the-spot training to ensure staff know what to do."

Health officials declared an outbreak at Preston on Dec. 10. The facility, which is operated by Extendicare under a contract with the Saskatchewan Health Authority, has 82 beds, about 78 of which were occupied at the start of the outbreak, a female worker said. 

As of Wednesday, 33 residents were infected with COVID-19 after six others recovered, according to a note to workers that day. Thirteen staff members were positive for the illness, while two had recovered.

Three residents who were infected have died, Gallant said. 

Eating in the hallway

"Some co-workers, and I've witnessed it firsthand, are not using PPE properly," the male worker said.

One staff member entered a COVID-positive resident's room wearing PPE, left to grab a water bottle from a staff break room, and then went back inside the resident's room with the same PPE, he said.

In the last week, employees have taken masks off inside residents' rooms because they were hot, or ate food in hallways instead of the designated "green rooms" for staff, the female worker said.  

"[They're] touching their masks or faces with gloved hands that have touched residents who are COVID-19 positive," she said.

Some staffers were wearing ill-fitting respirators because they were not supplied N95 respirators, even though air filters have been installed in parts of the home, she added. 

"They have the HEPA filter machines in certain rooms. People are just like, 'If they're cleaning the air, then why aren't they giving us N95s?" she said.

Extendicare found problems with the air ventilation during the outbreak at its Parkside home in Regina, stoking fears about a similar problem at Preston, she said. 

In the note to workers on Wednesday — which also stressed the importance of properly using PPE — Extendicare senior administrator Jason Carson said Saskatchewan Health Authority guidelines only require workers to wear N95 masks when carrying out certain tasks, such as intubating a resident.

"The home continues to have an ample supply of PPE for all staff," Gallant said. "The SHA has determined that N95 masks are not required for all homes in outbreak and has confirmed that the existing PPE complement in use at the home is compliant with provincial direction."

Carson's note also addressed the "air scrubbers." 

"We are not sure it will help but we are taking the extra step to help keep our [COVID-19] negative residents negative," Carson wrote.

"It removes air pollution, surface contaminants, odours and dust. It provides a cleaner, healthier and more efficient air within your home."

'I would call it lazy'

Many Extendicare Preston employees have received their first dose of the Pfizer-BioNTech vaccine — which the workers CBC spoke with say may be providing a false sense of security.

Thirty employees and 52 residents had been vaccinated as of Friday, according to Extendicare. 

"I had a sneaking suspicion that people would start slacking because of getting the vaccine," the female worker said.

According to Health Canada, for the vaccine to work best, people need to receive two doses.

Clinical trials have found it also takes time for bodies to react — meaning people aren't protected immediately after getting a shot.

The male Preston worker said he believes some co-workers are being "sloppy" with PPE because they don't know better. 

"I would call it lazy," the female worker said of what she's observed. 

Gallant said managers conduct daily walk-arounds to demonstrate PPE best practices and provide guidance to any employees with questions.

"The SHA has been on site regularly to support our team and review infection prevention and control practices and PPE use," she said. 

When the Saskatchewan Health Authority took over day-to-day operations at the Regina Parkside home as the outbreak there reached its apex in early December, CEO Scott Livingstone said part of the reason for the move was to ensure "the PPE is there and being used appropriately to care for the patients."

Asked a week later why the Parkside outbreak grew so bad — at its worst, more than three-quarters of the home's 200 original residents became infected — Livingstone said some things needed to be put in place at Parkside, including "infection control practices up to the SHA standard [and] the additional PPE."

The authority had "heightened our measure for N95 usage" at Parkside, it told CBC News that same week.

The SHA has not taken over operations at Preston as it did at Parkside.

No active cases at Parkside Regina

Extendicare operates three other care homes in the province, including a Moose Jaw home where an outbreak was declared on Nov. 12. It has since been declared over.

In an update to family members of Parkside residents on Thursday, Extendicare said Regina's medical health officer had declared the outbreak over, "now that the standard 28-day period has passed after the onset of the last COVID-19 positive resident case that had the potential to contribute to transmission at the home." That outbreak had been declared on Nov. 20. 

Extendicare's five Saskatchewan homes are the only long-term care centres in the province operated by a private company under contract to the SHA, according to the health authority.