COVID-19 is surging in Toronto long-term-care homes, with public health reporting three new deaths as tests confirm the virus is now in 15 nursing homes, with outbreaks in six.

The numbers are fluid as test results for residents and workers continue to come back positive but Toronto Public Health released details on new cases Tuesday. It shows the virus has spread in homes where it already existed and is also causing outbreaks, sometimes with deadly results.

In the nine long-term-care homes with a single positive test, two homes have finished their 14 days of “full precautions” without any new transmission, public health said. Toronto considers two cases to be an outbreak while cities like Ottawa consider one case an outbreak.

Last night, Toronto Mayor John Tory said he is discussing additional protections for long-term-care homes with the medical officer of health to see if there are “additional measures we can undertake as soon as possible to protect long-term-care residents.

“Any outbreak in a long-term-care home is deeply concerning given the age and vulnerability of the residents and the relatively close quarters in which they often live,” Tory said.

In Mississauga, Trillium Health Partners said there is an outbreak of COVID-19 as four patients in its Credit Valley Hospital have tested positive and have been isolated. The other patients in the unit — an in-patient rehab unit — are being monitored for symptoms.

According to Toronto Public Health, Toronto’s current list includes:

Seven Oaks, a City of Toronto home, with 23 confirmed cases including 14 residents and nine staff;

St. Clair O’Connor long-term care, with six confirmed cases among three residents and three staff;

Extendicare Bayview, with four confirmed cases among two residents and two staff;

West Park Health Care Centre with four cases among two residents and two staff;

Chartwell Gibson with three confirmed cases among residents;

The Rekai Centre’s Sherbourne Place with one death and three confirmed cases;

Of the three new deaths, two are “presumptive” cases at Seven Oaks, where two residents died from the virus last week.

The third death was a 66-year-old man living in the Rekai Centre’s Sherbourne Place, who tested positive late last week. Rekai’s CEO Sue Graham-Nutter said the man was stable all weekend but declined quickly on Monday and died that evening.

“It’s really tough,” Graham-Nutter said. “In long-term care it is not unusual for a resident to pass away unfortunately, because when they come to us, they are quite sick.

“But this is an invisible enemy.”

The three Sherbourne Place residents who tested positive all live in the same room. Like many long-term-care homes across Canada, Sherbourne Place was built decades ago when residents lived with two to four in a room. Their close proximity and diminished health leave them vulnerable to outbreaks.

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Last week, when the man who died showed symptoms of COVID-19, the runny nose, fever and cough, Graham-Nutter said he was immediately tested. Later, the three roommates were tested and their results came back positive. As of late Tuesday afternoon, she was waiting for the test results for two other residents.

Some homes are not testing more than three residents for COVID-19, even if dozens more have the symptoms. Hillsdale Terraces, operated by Durham Region, had three residents test positive and another 25 residents who have COVID symptoms but have not been tested.

Graham-Nutter said she’s not taking any chances.

“We just want to know for certain which residents have it,” she said. “We are trying to separate, literally, the individuals who have unfortunately contracted COVID-19 and those who have a regular cold or flu.”

She said frontline workers are working double shifts and Rekai is paying for hotel rooms so they don’t go back to their families and risk infection. “They work, sleep and repeat,” she said.

To help, Rekai staff called nursing students who previously worked in the home and asked them to return, mostly acting as personal support workers. The home is able to bring in students under the emergency measure order the province filed over the weekend, she said, calling them “our Florence Nightingales.”

Lisa Levin, CEO of Advantage Ontario, said her association worked with the Ministry of Long-Term Care on the emergency measures. The temporary regulations, which last for 14 days, lessen training requirements so different types of workers can come into homes to help staff, she said.

The Canadian Union of Public Employees in Ontario questioned the temporary lessening of the regulations, but Levin said they will support homes as workers grow ill or exhausted.

Levin said her association is working with the Registered Nurses Association of Ontario to connect 5,000 nursing students to long-term-care homes that need help. Within two days, Levin said 135 homes contacted the RNAO for help.

Toronto’s seniors’ advocate, Councillor Josh Matlow, said he is speaking with families across the city who have elderly relatives in long-term care.

“The reality of COVID-19 is that it does affect seniors but the vast majority will survive if all of us do our part and stay at home to prevent the spread.”