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Ontario Premier Doug Ford says the province has launched an investigation that could lead to criminal charges against five long-term care homes rocked by COVID-19.
The investigation comes after the Canadian Armed Forces issued a scathing report on the state of five long-term care facilities in the Greater Toronto Area.
The report includes a stunning list of allegations that the military says may have contributed to large outbreaks experienced at each of the homes.
Military service members, who have been providing assistance at the homes since April 28, say they have observed numerous forms of unhygienic and dangerous behaviour.
The list of allegations includes:
The repeated use of medical equipment between COVID-19 patients and others who had not tested positive, without it being disinfected.
The improper use of personal protective equipment (PPE) by staff and doctors.
The housing of COVID-19 patients with residents who had not tested positive.
Staff reusing gloves or not washing hands between resident interactions.
Staff being aggressive with residents during medical procedures.
Residents calling for help with no response for up to two hours.
The presence of insects, including cockroaches and ants.
"It was so disturbing ... It was the worst report, most heart-wrenching report I have ever read in my entire life," Ford said Tuesday.
"Until yesterday morning, we didn't know the full extent of what these homes, what these residents, were dealing with."
You can read the full report here.
The premier, whose mother-in-law lives at a long-term care home in Toronto's west end that has a confirmed outbreak, promised "justice" to the families who have lost loved ones to COVID-19.
These are the five facilities listed in the report, along with their most recent death tolls attributed to COVID-19.
Orchard Villa in Pickering: 77 deaths (as of Monday).
Altamont Care Community in Scarborough: 52 deaths (as of Monday).
Eatonville in Etobicoke: 42 deaths (as of May 23).
Hawthorne Place in North York: 43 deaths (as of May 23).
Holland Christian Homes Grace Manor in Brampton: 11 deaths (as of Monday).
At Hawthorne place, the military observed a "significant deterioration of cleanliness standards," the report says.
"Protocols in place have a near 100 per cent contamination rate for equipment, patients and overall facility."
COVID-19 patients at Eatonville were reportedly allowed to wander throughout the home without restrictions, the report also says. Staff at Eatonville also displayed a "general culture of fear to use supplies because they cost money."
Prime Minister Justin Trudeau called the report "extremely troubling" during his news conference on Tuesday.
Ontario's official COVID-19 death toll grew by 21 on Tuesday and now stands at 2,123. Of those who died, 1,538 were residents in long-term care homes, according to the Ministry of Health.
Data compiled directly from regional public health units, however, suggests the province's overall COVID-19 death toll was at least 2,194 as of Monday evening.
Fourteen military members have become sick with COVID-19 while serving at the homes in Ontario, while 22 members have tested positive in Quebec.
Minister of Long-term Care Merrilee Fullerton said the situation at the five homes in the report has since stabilized, though Ontario is asking the military to extend its assistance mission for another 30 days.
The investigation will include the province's chief coroner, who has been assigned to investigate at least one of the deaths. Fullerton said her ministry's investigative branch will also begin immediately looking into specific "critical incidents" detailed in the report.
Ontario also has plans to launch an independent commission into the state of its long-term care system in September, though many health-care groups have called for a more rigorous public inquiry.
When asked if he will now reconsider the possibility of a full public inquiry, Ford suggested he would consider it.
"Everything's on the table. I'm not ruling out anything after reading this," he said.
Ford has repeatedly called the long-term care system "broken" during the coronavirus crisis, though he has not yet shared a detailed plan to address the problems. He has said Ontario will need help from the federal government to make substantive changes to the system.
The Ontario Long-term Care Association, which represents around two-thirds of the province's long-term care homes, repeated its calls for improved access to PPE, more rapid testing, and for the province to invest in older facilities.
"Ontario's long-term care homes have been clear about the dire situation on the front lines of this unprecedented fight against COVID-19," CEO Donna Duncan said in a statement. "The virus has exacerbated systemic issues, like the long-standing staffing challenges, as it impacts homes in varying degrees."