Long term care: Death for profit

I am a senior. I am a lung transplant recipient reliant on medication that suppresses my immune system. As a side effect that medication has destroyed my kidneys, so I must attend hospital 3 times a week for dialysis. If I encounter Covid-19 it will almost certainly kill me.

That’s bad enough. But if the virus kills me, it will be aided and abetted by a gang that argues that protecting “the economy” is more important than protecting human life.

That includes BC Tory MP Marc Dalton. He tweets: “Most deaths are in care homes where average life expectancy is 2 years and 65% usually pass in the 1st yr. Time to start moving Canada back to work?”

If I’m considering those sobering statistics about LTC facilities in Canada, my first thought isn’t “Well fuck ‘em, let ‘em die.” It is “That’s disgraceful. What can we do to make them safer and better.”

But hey, who cares what I think. I’m old, I’m unproductive, I’m costing the system more than I’m “worth” and I’m going to die anyway.  I am one of about a billion people–the old, the very young, the sick, the unemployed–on Earth who are surplus to capitalism’s system of production and consumption. So why not let the virus do the dirty work, cull the herd.

South of the now-closed border, Indiana congressman Trey Hollingsworth couldn’t agree more. He says it is time to “put on our big boy and big girl pants” and sacrifice useless, unprofitable geezers like me on the altar of capitalism: “[i]t is always the American government's position to say, in the choice between the loss of our way of life as Americans and the loss of life, of American lives, we have to always choose the latter.”

And it isn’t just elders whose lives are disposable. TV quack Dr. Oz wants America to “get our mojo back” by re-starting the economy, starting with schools: “Schools are a very appetizing opportunity. I just saw a nice piece in The Lancet arguing the opening of schools may only cost us 2 to 3%, in terms of total mortality. Any, you know, any life is a life lost, but ... that might be a tradeoff some folks would consider.”

Mass murder advocates like these trivialize the lives and deaths of human being with statistics. About 56.6 million kids attended US schools in 2019. So Dr. Oz is blithely shrugging off the potential deaths of between 1,132,000 and 1,698,000 children. Very appetizing.

Death for profit

There are some 5 million Canadians over 65, as of the last census. Of those about 7% live in LTC facilities, about 355,000 people. That is a small percentage of the population, yet more than half of our deaths (540 as of April 15) from Covid-19 have occurred in LTC facilities, retirement residences or residential care facilities.

You can look at this two ways.

You can join the “Nature is a killer, screw the old and the weak” school of thought with Dalton/Hollingsworth/Oz and the rest of the open-for-business crowd.

Or you can ask, as I do, what is there about our LTC facilities that makes them death traps.

First, for profit LTC is big business. If those 355,000 seniors spend an average of $2000 per month for residence that comes to around $17 billion annual revenue. Granted, some facilities are publicly run, bringing the number down a bit. But still–big money.

Most LTC residents do not have private space. Usually they live 4 to a room and social distancing is impossible. “Isolation” is a matter of pulling a curtain.

LTC care jobs are low paid, often minimum wage jobs. To keep labour costs down, workers are hired as contract or part time workers. This means bosses don’t have to pay for sick days and benefits. So workers have to find work in two or more LTC locations; if infected, they spread the virus among the most vulnerable population. Dr. Donald Low, in his book SARS: Lessons From Toronto called these workers “superspreaders”.

In Ontario, the Ford government waited until April 14 to prohibit health care workers from attending multiple locations. They knew this was unsafe but let the bodies pile up until they could no longer resist the public outcry.

But wait–at the behest of the LTC industry lobby, Ford exempted casual or temp employees from his ban. That means that a significant proportion of the LTC workforce are still functioning as superspreaders. Ford responded by saying that only 2% of LTC nurses and nurse practitioners are temps. He carefully neglected to mention that the bulk of temp workers are cleaners, food prep workers or other vital support staff.

On top of this, provinces were slow to restrict family and friends from visiting LTC facilities. There are heart breaking stories of dealing with the guilt of learning that they carried in the virus that killed their loved ones.

But visitors were allowed in because they performed free labour, providing care that their loved ones might not otherwise receive from over-stretched staff.

All of the issues leading to high mortality rates lead to the fact that this system is designed not to prioritize care, but to make money. For profit LTC is always looking for ways to cut costs, especially the labour of a workforce that is predominantly female, drawn from new Canadian populations, and underpaid regardless of their skills and dedication.

Racism, ageism and misogyny play their role in spreading Covid-19. Underfunding of public facilities parallels the private ones. A year ago Ford froze the pay for this sector. All but the most expensive facilities provide minimal care. From a human care point of view, from the point of view of the workers, the crisis in LTC started long before Covid-19. I encourage you to read this interview SW published last August, describing the wretched conditions faced by residents and workers alike.

It is true that the LTC population is vulnerable, but with real isolation, better working conditions and an approach that put human life over profit, many live could have been saved.

Don’t buy the merciless crap being spread by ghouls like Dr. Oz and Tory MP Dalton. The death toll isn’t just up to nature. It the result of a social system, of ruthless, conscious decisions. If it gets me, put their share of the blame on those who want to treat me and my generation as disposable.