More than 20 per cent of staff at a Kawartha Lakes long-term care home where two residents died of COVID-19 have tested positive for the virus.

Thirty-four of the 66 staff members at Pinecrest Nursing Home in Bobcaygeon, Ont. have reported feeling ill, according to Dr. Lynn Noseworthy, the medical health officer for the Haliburton, Kawartha, Pine Ridge District Health Unit. Fourteen tested positive, four tested negative and the results of the remainder are pending.

Two residents of the home died this week and three others tested positive for the virus on March 20.

Noseworthy said it's the largest COVID-19 outbreak in the province she knows of. She believes there could be more resident deaths going forward.

"They are the people most at risk of having adverse outcomes of COVID-19," she said.

Not all of the 64 residents are being tested as per existing provincial guidelines for respiratory outbreaks in long-term care homes. A few positive tests are needed to create what's called a "case definition," based on similar symptoms.

The two residents who died were not tested, but are considered to have died from COVID-19.

"Anybody who meets the case definition is considered to be a case at that point without lab testing," Ontario's associate chief medical health officer Dr. Barbara Yaffe said in a news conference Friday. "We don't want to use up the limited lab resources to test everybody when we already know what the cause of the outbreak is."

'This might take her'

Jessica Echeverri's 98-year-old grandmother is a resident of the nursing home.

Echeverri said she's afraid her grandmother, Marguerite Adams Miller, will contract the virus, if she hasn't already.

"As heartbreaking as that is, it's reality," she said.

She's also afraid of the worst case scenario — that she'll lose her grandmother to COVID-19.

"This might take her," Echeverri said. "The most heartbreaking [part] as well is that they're suffering alone. She doesn't have anyone with her."

Jessica Echeverri, second from the left, is seen with her grandmother Marguerite Adams Miller, who is a resident at Pinecrest Nursing Home. (Supplied/Jessica Echeverri)

The facility told families they would be contacted if their loved one began experiencing symptoms.

Echeverri and her family haven't heard from staff that Adams Miller is feeling ill.

"We're definitely worried for her life," Echeverri said.

Staffing issues

A March 25th email to to residents' families from the facility, provided to CBC Toronto, outlines the staffing issues the outbreak left in its wake. The home's administrator put out a call for personal care and developmental services workers, and for help with laundry and housekeeping.

"We are being challenged to find sufficient staff for each shift without burning out our well staff," the email wrote.

Echeverri has been trying to help by posting on social media, contacting colleges and the local MPP's office. She wanted to help or volunteer, but since she's eight-months pregnant and staying home, she felt she needed to do something.

"This is what I can do," Echeverri said. "I just want to see them be staffed accordingly so that they can handle the outbreak."

MPP for Haliburton-Kawartha Lakes-Brock Laurie Scott said in a statement that staff from the long-term care company Extendicare are now working at the home to help with staffing challenges.

"Since the onset of COVID-19, I've been working tirelessly and collaboratively with my cabinet colleagues and long-term care operators, including but not limited to Pinecrest, to ensure that they have every tool available to prevent new infections and respond to staffing challenges," part of the statement reads.

'Doing the best they can'

Residents' families were sent an email from the nursing home on March 18 advising them of a respiratory outbreak at the facility. It said the home was following COVID-19 protocols put in place by the health ministry.

It also outlined measures being taken to protect staff and residents, including cancelling volunteer programs and downsizing or postponing activities.

"I know they're doing the best they can," Noseworthy said.

She noted the facility is small and there are either two or four residents in a room — making it more difficult to isolate residents and control an outbreak.

Dr. Lynn Noseworthy, the medical health officer for the Haliburton, Kawartha, Pine Ridge District Health Unit, said the COVID-19 outbreak at Pinecrest Nursing Home is the largest she knows of in Ontario. (Submitted/HKPR District Health Unit)

"When you've got an outbreak in a facility that small and residents who are in closer contact with other residents because of the size of the rooms, it's more easy to transmit the infection because you don't have that six foot distance in space between residents."

Still, she said, ill residents are kept from those that are well and staff that care for those experiencing symptoms are kept from residents who are not.

Noseworthy said there are strict measures in place to ensure newly added staff helping at the facility are protected.

Pinecrest Nursing Home did not respond to a request from CBC News for an interview, but administrator Mary Carr told The Canadian Press on Thursday there could be additional deaths given the fragility of some of the residents.

"This is truly a horrible time for the families and friends of the residents, as well as our staff," she said. "We have a number of medically fragile and vulnerable people living in our home. Our residents are like family to our staff."