In seniors’ homes, the virus is spreading fast.

Last Friday, COVID-19 was in 14 long-term care, retirement and assisted-living homes, according to Advantage Ontario. By late Monday afternoon, it was confirmed in 23 homes, the seniors housing association said in a communication to its members.

From the beginning of the outbreak, infection-control practices have been a constant worry for health-care workers, with hospitals and long-term care homes competing for scarce supplies of masks and other protective equipment.

The worries of a front-line worker at Extendicare Bayview in Toronto is one example among many. She fears the COVID-19 outbreak in her home will spread, saying though the home has staggered work breaks, staff handling infectious cases still mingle in the change room with those who are not.

“We don’t say anything because it’s their changeroom too,” said the worker, who asked that her name not be used for fear of job discipline. Many workers in care homes work for low pay and often must work several part-time jobs, but new government directives say they must only work in one home to limit the spread of the virus.

Extendicare’s head office confirmed three residents have tested positive for COVID-19. In a statement, Extendicare said the home is following all public health and government infection control protocols.

“The residents have been isolated within the home and staff have been sent home for self-isolation,” the statement said.

On Saturday, the Ministry of Health said it has purchased additional personal protection equipment. But in the early days of the virus, many homes rationed masks or didn’t have enough N95 respirators that, studies say, do a better job filtering out the virus if it is airborne in transmission.

“This is really important,” said Michael Hurley, president of the Canadian Union of Public Employees’ Ontario Council of Hospital Unions. “We are not saying it is airborne, we are saying it should be treated as if it is airborne.

“We were told in the SARS epidemic that the virus was not airborne, but science has since demonstrated that it was airborne,” Hurley said. The SARS Royal Commission recommended Ontario “always err on the side of being more careful,” he said.

In early March, CUPE Ontario filed a grievance to get masks for staff at Hillsdale Terraces in Oshawa, where a second resident, a man in his 90s, died on Sunday. Including the two people who died, six Hillsdale residents have tested positive for COVID-19 and another 25 have symptoms.

The Region of Durham, which operates Hillsdale Terraces, said three staff members are self-isolating after testing positive for COVID-19. Another 12 staff members are off work with “respiratory problems.” A spokesperson for the region said it could not comment on the grievance but said its long-term care staff are “extremely valued.”

Across Ontario, public health units are posting new long-term care death numbers, which increase by the day. Outbreaks and deaths in Bobcaygeon, Hagersville and Oshawa homes show seniors’ advocates accurately predicted the virus would empty a lot of long-term care beds, due to the deaths.

The number of infected workers is rising too. CUPE Ontario said in 13 of the roughly 100 homes it represents, there are 52 cases of residents with confirmed or suspected COVID-19 and 18 confirmed or suspected cases among staff. The union represents 35,000 long-term care workers in Ontario.

CUPE keeps a running tally of cases in the Ontario homes where its members work, updated by daily telephone calls with union representatives. In Hillsdale Terrace, CUPE officials estimate about 80 workers were exposed to COVID-19 before tests confirmed the virus. Some have been tested and are awaiting results.

Frank O’Malley is a personal support worker at Kensington Gardens in Toronto. He said his home quickly responded to employees’ concerns about infection control and distributed extra supplies. So far, O’Malley said, it appears the home’s one case of COVID-19 has not spread and no staff are infected.

“We are lucky to have the management that we have here,” he said. “People are worried. They have families at home. It weighs heavily on their hearts.”

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Workers in other homes, such as the front-line employee at Extendicare Bayview, worry if protocols that sound good on paper are working as planned.

The Extendicare worker said another staff member who works with infected residents has told management she has a cough and wants to stay home but was told that unless she has a fever she must report for work.

“She said, ‘I am coughing.’ It’s not OK. She was tested and is waiting on her results. The doctor is telling her she should be isolated for 14 days, but the home is telling her you can come if you don’t have a fever.”

Extendicare said the home is “following the protocols and requirements” of Toronto Public Health and the Ontario government and assesses all workers before their shifts begin.