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       B.C. seniors advocate Isobel Mackenzie at her office in Victoria.

       CHAD HIPOLITO/The Canadian Press

       Nursing and retirement homes on the West Coast must expand and improve paid sick leave and hire more care aides and nurses to prevent future fatal outbreaks, says a review of how the first two waves of COVID-19 hit these facilities.

       British Columbia’s seniors advocate, Isobel Mackenzie, said on Wednesday she considers expanding and improving sick pay benefits for these workers to be her top recommendation after 40 per cent of staff polled admitted they went to work at least once in the past year feeling unwell.

       Ms. Mackenzie, who was appointed seven years ago and reports to the provincial health ministry, said sick pay for subcontracted part-time workers is important, as only about 10 per cent currently have it. She also recommended increasing the number of sick days full-time staff get at these facilities, noting half of for-profit sites and a fifth of non-profit homes allow six or fewer. In contrast, her report found, every facility operated by one of the province’s five health authorities offered its employees 18 sick days.

       “Perhaps this is the least surprising of the findings: that lower amounts of paid sick leave were much more likely to link to larger and, in particular, our largest outbreaks,” Ms. Mackenzie told reporters at a news conference in Victoria. “We can expand paid sick leave, so that those staff who are displaying any symptoms of any infectious disease can stay home and that those who need to isolate because of exposure can stay home.”

       Her report found residents of B.C.’s nursing and retirement homes were 3.5 times more likely to contract COVID-19 and 33 times more likely to die of it. The review examined 4,484 COVID-19 cases in these facilities, which resulted in 782 deaths in the period up until February, 2021.

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       Ms. Mackenzie said while everybody has been affected by the pandemic, seniors, particularly those living in care facilities, have felt the deepest effect since they are disproportionately at risk of serious illness or death from COVID-19.

       More than 6,500 staff were surveyed in her review, which also examined 365 outbreaks at 210 facilities. Workers said their main reasons for going to work sick were that they felt an obligation to their co-workers and the residents or pressure from their employer, or could not afford to take a day off without pay.

       The B.C. government is conducting a survey on sick pay ahead of permanent pay provisions due early next year. Two more recommendations from the report – mandatory vaccines for all staff and booster shots for residents – are being implemented.

       Health Minister Adrian Dix said on Wednesday his government has added 5,000 staff to this sector in the past year, but acknowledged that the quality of life for those living in these facilities still needs to be improved.

       Ms. Mackenzie’s report also recommended hiring more registered nurses, eliminating shared rooms and increasing the scope and frequency of COVID-19 testing.

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       Terry Lake, chief executive officer of the BC Care Providers Association, said his organization appreciated Ms. Mackenzie’s work, but added that a more comprehensive public inquiry into the COVID-19 deaths is needed once the pandemic ends. He disagreed with the new report’s recommendation that subcontracting in the sector needs to be curtailed, and said health authorities can offer more paid sick leave to their staff because for-profit providers have different levels of funding.

       But Mr. Lake, a former provincial health minister who created the seniors’ advocate position and hired Ms. Mackenzie, agreed with other recommendations, stating that testing more people more frequently is key to keeping these facilities safe.

       “We’ve all learned that testing is critical and we didn’t do enough,” he said.

       Mike Old, a spokesperson for the Hospital Employees’ Union, which represents about 20,000 members who are employed directly in seniors’ care, said improved sick pay for workers and eliminating the contracting out of services would help address the shortage of aides in many facilities.

       “We were trying to hire more workers even before the pandemic hit and certainly trying to hire more health care workers during a very scary, uncertain pandemic is a challenge,” Mr. Old said.

       Almost 40,000 seniors live in long-term care and assisted living at 487 facilities in B.C., and staff at many of these places have worked overtime during the pandemic to provide care, the advocate’s report says.

       “Every site experienced significant increases in overtime and those sites that experienced a large outbreak saw a 178 per cent increase in their overtime in the past year,” the report states. “This speaks to the tremendous dedication of staff and management in caring for residents in long-term care and assisted living sites in B.C.”

       With a report from The Canadian Press

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