1. The disaster at Vancouver's Little Mountain Place care home - 41 elders dead, 87% infected - is stunning. How did it occur? A leaked briefing by VCH investigator says infected staff tried to "push through" symptoms & kept going to work. Result? Tragedy https://www.scmp.com/news/china/article/3116863/vancouver-coronavirus-disaster-infected-staff-tried-push-through-their

2. Pre-outbreak covid detection system at LMH (and across BC homes) is based on "active self-monitoring" by staff, instead of having them tested. It failed. Multiple infected carers infected numerous frail residents, other staff, said VCH officer Dr Andrew Hurlburt in Dec 29 call

3. As staff started going down, it created roster shortages, and a deadly snowball effect. Other staff fell prey to the phenomenon of "presenteeism" - they downplayed their own symptoms because they felt compelled to make up for the shortages. All told, 70 staff would be infected

4. Dr Hurlburt:

5. Relatives of LMP residents (who are mostly members of the Chines and Asian communities) told me they were bewildered as the death toll mounted: 5, 17, 31, 38...each weekly update came like a bombshell. They are angry at the handling of the crisis

6. What can be learned? Without talking directly to LMP epidemiologist Ashleigh Tuite says rapid tests shd be embraced in care homes. Screening staff w/ questionnaires? "Somebody can be asymptomatic. You won’t know they are infectious if they are asymptomatic/mildly symptomatic"

7. TL;DR? BC's non-testing pre-outbreak detection system for care homes failed catastrophically at Little Mountain Place. Infected staff - asymptomatic or downplaying their symptoms - kept coming to work, with best of intentions. But a horrific outcome: BC's deadliest outbreak

(PS: rather oddly, I've received some negative comments for mentioning Little Mountain Place catered to Chinese community. Most residents - 50-70%, say relatives - are Chinese/east Asian. My response? The SCMP reports on Vancouver's Chinese communities. That's in my mandate)

And full credit to @NEWS1130 and @lisa_steacy and @Bernardo1130 for being the first to reveal the extent of this outbreak, BC's worst, at a time when VCH and LMP refused to even discuss the numbers. They were on this before Christmas