Normal is the Problem: long term care and COVID

First published in the Winnipeg Free Press April 28, 2020

By Jim Silver

The heart-breaking tragedy of multiple COVID-19 deaths in Canadian long-term care facilities, and the often-horrific manner in which those deaths have occurred, are evidence of what appears to have become “normal” in many of those facilities.

It is impossible not to be moved by scenes of family members standing outside on lawns and sidewalks waving, tears in their eyes, at parents and partners in these facilities. That half of the COVID-19 deaths in Canada have occurred in long-term care facilities is inexcusable. That at least some of these deaths have followed upon confirmed cases of neglect is almost incomprehensible in one of the richest countries in the world.

How have we come to this? Why has this happened?

A major part of the reason is the breakneck speed at which corporations and governments have pursued economic growth and wealth accumulation—seemingly at any cost. Those unable to keep up are pushed aside. They can’t be allowed to impede the goal of economic growth. This has been the fate of the many people—those elderly and frail, or with various disabilities—in long-term care facilities.

At least three changes have to be made if we are to avoid a recurrence of this tragedy.

First, we can no longer place those who are in need of care in the charge of private, for-profit corporations. The goal of these corporations—indeed, their legal obligation—is to maximize returns for their shareholders. They will cut corners to maximize returns. It is naïve to think otherwise. They will reduce staffing and pay and benefit levels, and vulnerable people will suffer.

Second, governments will do no better if they are committed to austerity. The same problems will occur, not because of profit maximization but because cost minimization becomes the goal. Austerity means cost cutting. Cuts to wages, benefits and hours of front-line care workers have been a major factor in the multiple COVID-19 deaths in long-term care facilities. So too has the failure to monitor and enforce robust care standards—also a victim of austerity-driven cuts.

Third, the pandemic has made it clear that large numbers of people doing “ordinary” everyday jobs are in fact essential workers. The work they do is essential for the day-to-day functioning of our society. These are the health care workers, grocery clerks, truck drivers, cleaners, warehouse workers, garbage collectors and many more. Their work keeps our society running.

So it is in long-term care facilities. The workers are the ones that do what needs to be done. They are essential in any society that would lay claim to being civilized. Yet rather than being extolled as the essential workers they are, these front-line workers—like so many others—have had their working conditions steadily diminished.

This must change. Making the change will require putting in place strong labour standards that protect workers. In recent decades, labour standards have been eroded. Why? Because they get in the way of the narrow pursuit of economic growth and profit maximization.

To ensure that strong labour standards are in place and enforced, we need strong unions. Unions’ job is to protect the interests of those who are doing the essential work. They are the much-needed countervailing force to the power of corporations and austerity-driven governments.

When workers in long-term care facilities are paid well and have proper benefits, our parents and grandparents and other loved ones in those facilities are much more likely to be properly cared for.

The tragedy of the multiple, COVID-19 deaths of vulnerable people in long-term care facilities makes clear their failings. We do not want a return to normal in the aftermath of the pandemic. Normal is the problem. In what has become normal, we have lost track of what is important. Human lives are important. The dignity of human lives is important. That means all human lives, including and especially the most vulnerable.

The truth, as this pandemic is revealing, is that we are all vulnerable. This is glaringly clear in the case of workers and patients in long-term care facilities. There, normal is the problem. It must change.

Jim Silver is a University of Winnipeg Professor and a Canadian Centre for Policy Alternatives-Mb Research Associate.