Ontario has more than 1,000 COVID-19 isolation beds, so why are they less than half full?

Harjeet Sahota wonders whether a COVID-19 isolation hotel could have saved his grandmother's life. 

Sahota, a lawyer in Peel Region, tested positive for the novel coronavirus on Dec. 15. As soon as he started experiencing symptoms, he isolated in his self-contained basement suite in his family's home in Brampton.

But eventually the rest of the family — his mom, dad and grandmother — tested positive. His grandmother died on Jan. 7.

"I think what was going to happen, in my belief, was going to happen. There's no way to overcome that. My faith teaches me that," he said. 

But he'll always wonder, Sahota added.

He said when Peel Public Health called him to discuss his positive result, he wasn't informed voluntary isolation hotels were an option. The facilities were opened to allow people somewhere to safely isolate after a positive COVID-19 diagnosis. They're geared to people and families who live in small spaces and multi-generational households, like Sahota's 

"They basically asked me who I live with and what are my living conditions. I told them and they said, 'It's fine if you just stay there and stay isolated,'" he said.

Had he known, Sahota would have jumped at the opportunity to move into one of the hotels for the 14-day period. He looked into booking a regular hotel to keep his family safe, but realized it would put hotel staff members at risk. He even considered sleeping in his car.

"We lost a family member potentially because of this mistake and maybe someone else's life could be saved if they inform people when they call," he said. 

Sahota said he and his grandmother isolated in separate rooms. His mom, who remained asymptomatic, wore a mask and left meals outside their doors using disposable plates and cutlery.

"We were being pretty careful," Sahota said. "It's just amazing how this thing spread."    

His grandmother was 95 and Sahota said she was extremely healthy and independent for her age. 

"She was happy. She was very concerned about everyone else's happiness. Like most grandmas, she was concerned if everyone ate," he said. "She was the type of person to overcome challenges."

When Sahota got COVID-19 the only isolation site that existed at the time in Peel was in Mississauga, but Peel Public Health confirmed residents in anywhere in Peel, including in Brampton, were being referred to the site since it opened in March.

Peel Public Health says it can't comment on specific cases, but in an interview with CBC News on Monday while providing a tour of its fourth and newest isolation hotel, Peel Region's human services manager said public health is making the sites more accessible by widening criteria and doing more to promote them.

"We wish they would be at capacity," Leslie Moreau said.

She said it's now doing COVID testing at the hotel and allowing people to isolate while waiting for results.

"Getting [people] here sooner rather than later is definitely what we're looking for," she said.

Isolation hotels at less than 40% capacity in January on average

January was Ontario's deadliest month of the pandemic with 1,658 deaths and 86,025 new cases, yet just under 40 per cent of the province's isolation rooms were occupied, on average.

In that time period, there were 959 COVID-19 voluntary isolation beds in six cities, though most opened in December and January, including in Peel, Oshawa, Waterloo, York Region and Ottawa. 

Ontario's first site opened in Peel last March, followed by Toronto's in mid-September. There are nine sites with a tenth set to open next month.

The province's newest hotel opened Monday in south Mississauga, adding 90 rooms. Peel plans to open a fifth hotel next month. Based on isolation periods of 10 to 14 days, the hotels have capacity for rooms to be used by two different guests each month.

The hotels are funded by the provincial and federal governments. Ottawa provided $13.9 million for Toronto Public Health to run its hotel for a year. Ontario is spending $42 million to create and expand centres across the province.

Since it opened, Toronto's hotel has been operating, on average, at just below 40 per cent capacity, but each month has seen more use. In January, the hotel was 60 per cent full.

But Toronto's Associate Medical Officer of Health Dr. Vinita Dubey said it's more about ensuring those who need the site can access it, rather than how full it is. 

"I think if there are more people who need to use the isolation and haven't used it, that's really what we need to address next," she said.

Access 'incredibly difficult,' Toronto nurse says 

Bernadette Lettner is a registered nurse with South Riverdale Community Health Centre and is part of the COVID case management team at Michael Garron Hospital.

She said in the last two months, the team has worked with more than 250 families, including more than 1,000 people. Of them, just two individuals used Toronto's voluntary isolation site.

"Isolation sites are a lovely public health intervention, but getting access to those sites has been something that's been incredibly difficult for the people in the communities that we're working with," she said.

Lettner said that's due to a number of factors, including timing. She said by the time public health officials call someone to discuss their positive diagnosis, it's often too late in the course of their infection for people to be referred to the hotel, or for them to leave their homes. 

They've already been isolating as best they can, but possibly infecting family members.

"The unfortunate thing is we're using these on day four and five instead of days one and two," she said.

Lettner suggested access to the isolation hotel be available upon testing for those who need it and that public health workers could discover that through questions about living situations and risk factors.

She also said it can be difficult for people who care for children or elderly family members to leave and isolate for 14 days.

Community approach needed

Dr. Andrew Boozary, the executive director of population health and social medicine at Toronto's University Health Network, said the sites are interim solutions for larger social issues and could be more effective if community agencies are more involved.

"We really need to ensure that this is not a top-down approach," he said. "Communities are able to best communicate what's available and also what the needs are like."

Dubey said Toronto Public Health has recently partnered with community agencies to promote the hotel and better understand the barriers people experience when it comes to accessing it. She also said from now on people will be informed about the site upon testing, so they can prepare for the possibility of going to a site.

Dubey stopped short of suggesting people isolate in the hotel while waiting for test results to keep them safe if they are COVID-negative.

"It's all about balancing risks," she said.