Variation in Care of Community and Nursing Home Residents Who Died of COVID-19 in Ontario, Canada

Worldwide, nursing home residents have experienced disproportionately high COVID-19 mortality because of the intersection of congregate living, multimorbidity, and advanced age. Among 12 OECD countries in July, Canada had the highest proportion of COVID-19 deaths in nursing home residents (78%), raising concerns about a skewed pandemic response that averted much transmission and mortality in community-dwelling residents, without adequately protecting those in nursing homes.1 In Canada's most populous province of Ontario, there was no official policy denying hospitalizations for nursing home residents with COVID-19, yet media reports and a provincial commission suggest that resident transfers to hospital were strongly discouraged at the onset of the pandemic.