A Saint John reporter writes of his mother's death from COVID-19, two provinces away
Connell Smith felt helpless as COVID-19 spread to his mother's Ontario nursing home. This is his account
If I look back, the COVID-19 era really begins for me on March 12, when I go out to cover a public meeting on the future of Saint John Transit. Just before I leave, there is an internal email: face-to-face interviews are no longer permitted at CBC News. Am I going to a public meeting where I can't talk to anyone?
About 45 people are in the room. It opens with a note on physical distancing. We are to space ourselves. No handshakes, only elbow bumps. Will that catch on, I wonder. Everyone splits up into groups, gathering around consultants armed with flip charts and magic markers. Is this going to work?
Within minutes all pretence of physical distancing has vanished. It gets noisy. To hear or be heard, you have to get in close. And to catch what is going on, I do the same.
As an early exercise in keeping two metres apart, the Saint John Transit Operational Audit Public Open House is a disaster.
But this was an early chapter in the COVID-19 era and we were all still finding our way.
Over the next several weeks I help report on the outbreak as it evolves here in New Brunswick, but I can only watch from a distance when it comes for someone in my own family.
Initial signs at Markhaven
I barely notice another development that evening. It is an email titled "Information for Markhaven Families," announcing new protocols at the nursing home in Markham, Ont., north of Toronto, where my 85-year-old mother, Cleta, has been a resident for the past four years.
Group activities at the home, the email says, are now cancelled. Visiting will be discouraged (but not prohibited). Before they enter, visitors and staff will be screened via a questionnaire. Their temperatures will be checked.
Things continue to build the following day, March 13, when, with agreement from an all-party committee, New Brunswick Premier Blaine Higgs announces the closing of public schools, universities and community colleges for two weeks.
The following day, the province's second presumptive case of COVID-19 is announced, a man in his 50s and a close contact of the first case, revealed earlier in the week.
I get a text that day from my brother, Mike, who serves on the nursing home's family council. The Ontario government has just ruled long-term care homes are in lockdown. No visitors will be allowed until further notice.
There are family members at Markhaven who come in daily to feed their loved ones at lunch or dinner. It takes pressure off the staff. Can the home even function without that help? Staff have always seemed so stretched that I've wondered how they don't come down with some form of PTSD.
On Monday, March 16, I speak with my mother by phone. Because she no longer picks up on her own, calls have to be pre-arranged via text message with the private caregiver we have hired. Mom says, 'Hello,' but there is little response after that. She always loved rhyme and wordplay. I read some poems to her and get the cat — cats are another of her loves — to meow into the phone before I say goodbye. I'm pretty sure she wasn't really there for much of it. Things have been this way for a couple of months.
The following day, March 17, the number of confirmed and presumptive COVID-19 cases in New Brunswick climbs to eight.
In Ontario, concern is clearly building. To help keep up morale, Markhaven establishes a gratitude board. Family members are invited to send messages of encouragement to the staff.
March 18. New Brunswick now has 11 presumed and confirmed cases.
Mom shows symptoms
My brother in Ontario gets two calls from Markhaven. On the first he's told Mom has a runny nose. No temperature. She will be kept in her room. On the second, he's told she is being tested for COVID-19. They don't believe she has the illness, but the Ontario government has mandated testing for anyone in long-term care homes with signs of cold, fever or other symptoms. The results won't be known for a few days.
It was a huge relief to find a nursing home bed for our mother. Her dementia advanced quickly over a short period around 2016. On one occasion, a man patiently drove her around the supermarket parking lot until she found her car. On another she was seen by a nephew driving along the wrong side of the median for a very long city block.
Taking that car away was one of the most difficult things we've ever done. It symbolized her freedom. She had travelled widely throughout her life, even moving us to southern Spain for a school year in the mid-1960s, long before it was a tourism hotspot. We rented a house outside Malaga and played with the Spanish kids in our neighbourhood.
When she lived in Keswick and Newmarket, north of Toronto, it was nothing for her to set off on a road trip to stay with friends in Cobourg on Lake Ontario or with a cousin in Ottawa.
But dementia eventually left her anxious, and she could not be alone even for a couple of hours. She'd begun to barricade the door to her apartment.
On March 20, an email arrives: "A resident at Markhaven Home for Seniors has tested positive for COVID-19," it begins. I know it is not Mom. We have not been notified. But I get an uneasy feeling things are starting to roll along a track with no branches and no stops.
I've spent a fair bit of time at Markhaven. It has just 96 residents. There are a handful of nurses and nursing aids, physiotherapy and dietary staff, a small office staff and a larger group of cheerful, caring personal support workers , known as PSWs, who seem stretched to the very limit. Can they handle this?
On March 22, an email update from Markhaven informs families that a week earlier, on March 15, residents in "a variety" of areas of the home were showing symptoms of either cold or flu. Two days later a respiratory outbreak is declared by Public Health. As of March 22, all residents are isolated in their rooms. Staff are wearing personal protective equipment and have been directed to home-isolate when not at work.
The importance of PSWs
March 23. The number of cases in New Brunswick now sits at 17. But the word from Ontario is more ominous.
"We received some horrible news today that one of our PSWs has also tested positive," says the update from Markhaven. That's one resident and one personal support worker.
PSWs are the backbone of a nursing home. They are, in effect, family for the residents in their care. They feed the residents, wash them, take them to the bathroom. They brush their hair. They say their names. They whisper to them, they encourage them, they comfort them, they touch them.
I truly believe Mom has been a favourite there, especially in earlier years when she heaped praise on nearly everyone she met. A lifelong photographer, she regularly told her PSWs how beautiful they are, promising to take their portraits one day.
They loved to say her name, often stretching it out: "Clee-tah."
March 23. A second PSW at Markhaven has tested positive.
March 25. The number of cases in New Brunswick now stands at 26. The province announces checkpoints will be set up at the Quebec, Nova Scotia and Prince Edward Island borders. Our private caregiver can no longer see Mom. She works part time for the nursing home itself, and they now need her full time. She's isolated to another wing. It will be difficult to find out much about how Mom is doing.
A text from Mike. The home's director of care reports Mom's COVID-19 test is negative. I'm not the slightest bit relieved.
March 26. New Brunswick's total stands at 33. Six staff at Markhaven are at home after testing positive. Others with symptoms are also at home. Through an arrangement with the Registered Nurses Association of Ontario, student nurses will fill in for missing PSWs. The first has already arrived.
March 27. There are 12 new cases in New Brunswick. The total now stands at 45. In Ontario, 16 nursing homes are reporting COVID-19 cases.
Markhaven's first death
March 28. Mike gets a call from the doctor at Markhaven. Mom is calm and resting quietly. Her lungs are clear. But the situation, the doctor says, is bad for the residents. They only see people in their rooms three or four times a day, and those they do see are in full gowns with masks and face shields.
I wonder if that would frighten her. Are they the same staff who have been caring for her?
Mike phones later in the day. There's been a second call from the doctor. Mom is not well. It is not certain she has the strength to fight off the bug. There have been a number of false negatives, and the doctor has ordered the COVID-19 test be performed again.
You guys are awesome! You are the true Canadian heroes in this battle. Please stay safe.- Connell Smith, in a message to Markhaven staff
Today's email update from Markhaven says seven staff and two residents are now positive.
March 29. The first death at Markhaven. It is a man in his 80s. He had been tested for COVID-19, but the results are not yet known. Eight staff are now positive. I send a note for the gratitude board:
"You guys are awesome!" I write. "You are the true Canadian heroes in this battle. Please stay safe." Since I'm only known there as the son from the Maritimes, the one they see less often, I add: "Cleta's New Brunswick son" to my name.
March 30. The total number of cases in New Brunswick hits 68. At Markhaven, 10 staff and six residents are now positive.
March 31. A headline in the Toronto Sun reads: Nursing home workers 'crying in their cars.'
I debate whether to go up to Ontario. Surprisingly, there does not appear to be a requirement in that province to self-isolate on arrival. But I would have to quarantine on my return to New Brunswick.
There's no way I could visit my uncles and aunts once there; most are in their 70s and 80s. For that matter, I really shouldn't even visit my brother, friends and their families. I check flights anyway; it gives me something to do. There's no longer anything direct from Saint John. The route to Toronto — via Halifax — costs more than double what it usually does.
My brother calls on the morning of April 1. He's on Highway 401 between Windsor and Toronto. His phone at home rang at 7:30 a.m. to tell him he should come to Markhaven as soon as possible. They will suit him up to see Mom.
Mike calls again just after lunch. Mom has died. He's still 20 minutes from the home, but the director of care now tells him to stay away. He's over the age of 60 and there's a risk just being there.
I feel numb and completely helpless. My father died in 1990 and my sister, Charlotte, 11 years ago. But we have our own families and that evening and throughout the next few days we hear from extended family and friends. It helps a lot.
She had so many friends who shared stories with us: She'd played matchmaker for a couple who have now been married 52 years. A cousin tells me that when she was 10 years old, her aunt Cleta wrote her a letter every week for months after learning she felt left out because she got no mail.
Mom tests positive for COVID-19
Thursday, April 2. Ninety-one cases now in New Brunswick. Schools in the province will remain closed for the remainder of the school year. At Markhaven, four residents are dead from COVID-19. The number does not include Mom, who was officially negative for the disease. Thirteen staff have tested positive. Results are pending on others.
April 3. It is revealed the outbreak at Markhaven is "home wide." Five residents are dead. Fourteen staff are positive. I can imagine the stress the staff must be under, worrying for the residents, worrying for themselves, worrying for their families. The Markhaven community — residents and staff combined — is fewer than 200 people. How can they not feel alone in this?
The people in our homes need tenderness, they need someone to hold their hand, they need to be touched. Physical distancing is not an option.- Connell Smith
April 5. Incredibly, there have been no deaths in New Brunswick, though the total has now reached 101 cases. In the meantime, a sixth resident at Markhaven has died.
Later in the day, Mike gets a call from the home. The second test, taken two days before Mom's death, has returned positive. She is now the seventh COVID-19 death at the home.
Over the next few days New Brunswick's total starts to level off. Dozens are now recovered. On the other hand, by April 12, there were 11 dead at Markhaven. Two more people died on April 15. On April 20, a 14th resident succumbed. On April 24, two others slip away, and another on April 27. By my count, that leaves 79 residents in a home that had 96 less than a month earlier.
It could be much different in New Brunswick
New Brunswick has fared better than other provinces in controlling the COVID-19 outbreak. Had the disease reached residents of a nursing home here the picture would be different.
The people in our homes need tenderness, they need someone to hold their hand, they need to be touched. Physical distancing is not an option.
I continue to follow developments at Markhaven, an institution I respect and appreciate. Staff are committed to the residents in their care, and the home has been clobbered by COVID-19. The PSWs certainly carry the load for the rest of us.
We will eventually hold a celebration of Mom's life. We first considered a date in June, which was hopelessly optimistic, then August, and in the end decided it will have to wait until fall or even later.
There is so much that can be said, and others will want to chime in. She had close friends right across the country, in Europe, California and a half dozen other places. COVID-19 will not define her. She meant far too much to so many people.