Nearly 80 seniors’ homes across Ontario are now reporting cases of COVID-19, according to a list released on Thursday by a leading Canadian geriatrician.

Most of the cases are in the long-term care sector, where the most vulnerable seniors live, but at least 20 are reported in privately operated retirement homes, said Dr. Samir Sinha, director of geriatrics at Sinai Health System and the University Health Network.

His research found 40 deaths, most in nursing homes.

“Retirement home residents are just as vulnerable as people living in nursing homes … and at greater risk,” Sinha said.

There are roughly 750 retirement homes in Ontario, with government-funded, home-care workers visiting daily to help seniors with dressing, bathing, wound care or physiotherapy. Most of those workers spend their days moving from one home to the next, helping numerous seniors across their region.

While retirement homes must follow government directives that ban families from visiting unless the resident is gravely ill, Sinha said, home-care workers are still coming and going each day, increasing the likelihood that COVID-19 will spread from the community into the homes.

One home had continuing regular visits by 38 different home-care workers.

“We might be seeing the beginning of a real catastrophe,” said Sinha, of COVID-19 spread across 1,380 long-term care and retirement homes.

A spokesperson for the Ontario Retirement Communities Association said, it is working “collaboratively and actively” with the government and home care agencies to solve the problem.

Doris Grinspun, president and CEO of the Registered Nurses Association of Ontario (RNAO) said the province had underfunded the seniors’ care industry for years, forcing frontline staff to work part-time jobs in multiple homes.

“Pre-pandemic, you had the perfect conditions to create chaos,” Grinspun said.

Now the virus is spreading across the sector, and many homes are not providing surgical masks as an active measure. “They give the surgical masks after there is an outbreak and even then, not always.”

Grinspun said the RNAO is sending nursing students into homes to support workers, but “I told the ministry I will not release them until the outbreak home has surgical masks.”

There is a wide discrepancy on numbers of COVID-19 cases in long-term care and more recently, retirement homes. Sinha said numbers come from homes that share information with his office, public health reports and media.

Numbers of deaths released by the Ontario government are, according to Toronto Public Health, only those deaths that are formally recorded in the province’s integrated Public Health Information System (iPHIS), the public health database, when investigations are complete.

“This is an evolving situation, and these numbers are constantly changing. We are also aware of other deaths that our team is actively investigating,” a Toronto public health spokesperson said.

This week, Toronto reported 11 deaths of long-term care residents.

The public health spokesperson cautioned that it has now declared some of those deaths — it did not say how many — related to pre-existing health conditions and not COVID-19, even though the resident tested positive for the virus.

Toronto public health will now only report deaths after the investigation is complete, the spokesperson said.

On Thursday, Ontario’s associate medical officer of health Dr. Barbara Yaffe said there are outbreaks in 26 long-term care homes and eight retirement homes. Ontario counts one case as an outbreak, while Toronto Public Health defines an outbreak as two cases.

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Yaffe said 19 long-term care residents have died from COVID-19, either confirmed by lab tests or “epidemiologically linked” because other residents died of the new coronavirus.

Chief medical officer of health Dr. David Williams said the number of outbreaks in nursing homes will appear to increase because the “trigger point” for declaring an outbreak has been lowered so “any mild symptom in any resident is declared” and testing is done.

“We’re probably going to have a lot more outbreaks reported quicker, but we may have a lot more quickly defused after we do the more direct testing.”