Stevenson Review - Maples Personal Care Home COVID Outbreak

During the COVID-19 pandemic seniors were at high risk of serious illness and death. The virus was easily spread. Extra care was taken in senior's group living facilities to prevent outbreaks. However, outbreaks did occur. One of the worst outbreaks was declared at the Maples Long Term Care Home in Winnipeg.

The outbreak began on October 20, 2022. It lasted for more than 12 weeks and was over on January 12, 2023. In that time:

  • 74 staff tested positive for COVID-19
  • 157 residents tested positive for COVID-19
  • 56 resident deaths were linked to the outbreak

An external review was needed to understand more about how the outbreak got so bad. In November 2020, the Manitoba government hired an advisor. The advisor would review the outbreak and provide feedback and recommendations.

The main areas of focus included:

  • determining staffing levels
  • defining the level of care provided
  • infection prevention
  • control policies and procedures

The report, now called the Stevenson Review, shows what pandemic plans were in place. In brief, it found that:

  • pandemic plans had been prepared and were in place
  • the plan did not address the sudden loss of staff who tested positive and had to self-isolate
  • the urgency of requests for more staff and supports was not understood until the situation became critical

The Stevenson Review made 17 recommendations for changes at:

  • the facility
  • regional management
  • Health Incident Command
  • Manitoba Health

A plan to implement the recommendations was shared on March 2021. In February 2022, the province released the final implementation plan which included four key areas:

  1. Resident safety
  2. Staffing complement
  3. Pandemic preparedness
  4. Communication with families and staff

The plan also shares positive changes already being made. These plans will continue to be made to benefit all personal care home residents, their families, and staff.

Stevenson Review (pdf)