From Cruddiness to Catastrophe: COVID-19 and Long-term Care in Ontario.

Over 80% of Canadian COVID-19 first wave deaths occurred in long-term care homes. Focussing on Ontario, I trace the antecedents of the COVID-19 crisis in long-term care and document experiences of frontline staff and family members of residents during the pandemic. Following Povinelli, I argue that the marginalization of both residents and workers in Ontario's long-term care system over two decades has eroded possibilities for recognition of their personhood. I also question broader societal attitudes toward aging, disability and death that make possible the abandonment of the frail elderly.

Limited Technology Access Among Residents of Affordable Senior Housing During the COVID-19 Pandemic.

While U.S. adults living in affordable senior housing represent a vulnerable population during the COVID-19 pandemic, affordable housing may provide a foundation for interventions designed to improve technology access to support health. To better understand technology access among residents of affordable senior housing, we surveyed members of a national association of resident service coordinators to assess their experiences working with residents during the pandemic (n = 1,440). While nearly all service coordinators report that most or all residents have reliable phone access, under a quarter report that most or all have reliable internet access; they also report limited access to technology for video calls. Lack of internet access and technology literacy are perceived as barriers to medical visits and food procurement for low-income older adult residents of affordable housing. Policies to expand internet access as well as training and support to enable use of online services are required to overcome these barriers.

COVID-19 in Nursing Homes: Calming the Perfect Storm.

The pandemic of viral infection with the severe acute respiratory syndrome coronavirus-2 that causes COVID-19 disease has put the nursing home industry in crisis. The combination of a vulnerable population that manifests nonspecific and atypical presentations of COVID-19, staffing shortages due to viral infection, inadequate resources for and availability of rapid, accurate testing and personal protective equipment, and lack of effective treatments for COVID-19 among nursing home residents have created a "perfect storm" in our country's nursing homes. This perfect storm will continue as society begins to reopen, resulting in more infections among nursing home staff and clinicians who acquire the virus outside of work, remain asymptomatic, and unknowingly perpetuate the spread of the virus in their workplaces. Because of the elements of the perfect storm, nursing homes are like a tinderbox, and it only takes one person to start a fire that could cause many deaths in a single facility. Several public health interventions and health policy strategies, adequate resources, and focused clinical quality improvement initiatives can help calm the storm. The saddest part of this perfect storm is that many years of inaction on the part of policy makers contributed to its impact. We now have an opportunity to improve nursing homes to protect residents and their caregivers ahead of the next storm. It is time to reimagine how we pay for and regulate nursing home care to achieve this goal. J Am Geriatr Soc 68:2153-2162, 2020.