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Politicians and health officials are facing more questions about what’s being done to protect the elderly as COVID-19 outbreaks hit seniors’ homes and long-term care facilities across Canada.

Police and the coroner were at a privately owned Dorval, Que., seniors’ residence over the weekend after 31 residents have died since mid-March. The government has said at least five of the deaths are linked to COVID-19.

“We are aware that people are waiting for answers,” said Insp. Andre Durocher, of the Montreal Police Service. Police are working as quickly as they can but cannot skip any steps or rush the process, he said. “We have to be very thorough.”

WATCH | Quebec Premier François Legault talks about what happened at long-term care home in Dorval:

On Monday, Premier François Legault said authorities will inspect all of the province’s 2,600 long-term care facilities — both public and private. In 30 homes in Quebec, more than 15 per cent of residents are infected with the novel coronavirus, he said. Inspections of 40 private, long-term care facilities in the province were completed over the weekend, he added, and in the majority of cases, “the situation is stable, the patients are well-treated.”

But he said four or five private residences will be monitored more closely.

Legault also acknowledged there are staffing shortages and said the government is looking at how to get more employees to those facilities that need it. “Where the situation is critical, we are sending people,” he told reporters.

One of the issues is that orderlies and attendants are not paid enough, he said.

Seniors are at higher risk of a severe illness and death if they contract COVID-19, the illness caused by the novel coronavirus. Health officials across the country are on high alert after deadly outbreaks at long-term care homes everywhere from North Vancouver to Bobcaygeon, Ont.

When asked why all residents and staff at residences with known COVID-19 outbreaks are still not being tested, as was promised last week, Ontario Premier Doug Ford says he has been told by his health officials that it is happening or going to happen. But he again expressed frustration at the fact that more widespread testing is not yet in place in the province.

“Get these damned tests done,” he said. “Simple. I don’t know what takes so long, what’s hard about it.

Ontario Health Minister Christine Elliott said the province is also looking at ways to move residents out of homes where there is no physical way to keep people apart.

“We are looking at other options where we can move people to safer places to stay. Of course they would need to be tested before being moved to a retirement home, for example, or [a] hospital.”

Dr. Theresa Tam, Canada’s chief public health officer, on Sunday lamented the deaths that COVID-19 has caused in long-term care facilities across the country, which she described in a statement as a “tragic legacy of this pandemic.”

“These heartbreaking events underscored the need for stringent infection prevention and control measures and led to the development of infection prevention and control guidance for long-term care homes,” she said. 

Deb Schulte, the federal minister for seniors, said the guidelines from the Public Health Agency of Canada were developed in close consultation with provincial and territorial counterparts. Long-term care facilities fall under provincial jurisdiction, but Shulte said the guidance provides recommendations that “complement provincial and territorial efforts to monitor, prevent and control health-care associated infections.”

The guidelines touch on issues like restricting visitors, screening staff, training on infection control, and mask use, the minister said.

“Providing consistent guidance for long-term care homes across the country will help save lives,” she said, and went on to reiterate the government’s message about the importance of physical distancing.

When asked why more wasn’t done earlier around guidelines for long-term care, Tam said Monday that public health officials have learned lessons since the outbreak began that were then built into the interim guidance. She said Canada has a “very varied landscape” in long-term care in Canada, with both private- and public-sector ownership, and that one of the key lessons from the pandemic will be around the need to improve infection control and prevention measures.

When asked whether the federal government could make the guidelines mandatory, Schulte said Ottawa preferred to work “co-operatively with our partners” across the country.

As of 3:30 p.m. ET on Monday, there were 25,552 recorded coronavirus cases in Canada. The provinces and territories that list recovered cases posted a total of 7,679 resolved cases. A CBC News tally put the number of deaths tied to COVID-19 at 799, with two additional coronavirus-related deaths of Canadians abroad.

Health officials have cautioned that actual case numbers are likely much higher as recorded case numbers don’t capture people who haven’t been tested or cases still under investigation.

‘You can’t replace lockdown with nothing’

As the pandemic spreads, different countries are at different stages. More than 1.9 million infections have been reported and more than 118,000 people have died worldwide, according to Johns Hopkins University. The U.S. has the highest numbers, with more than 568,000 cases. The figures certainly understate the true size and toll of the pandemic, due to limited testing, uneven counting of the dead and some governments’ desire to play down the extent of outbreaks of the virus, for which there is no proven vaccine or treatment.

On Monday, Tedros Adhanom Ghebreyesus, director-general of the World Health Organization, addressed the fact that as some countries are weighing whether to start easing restrictions, other countries are still considering whether to introduce them.

The WHO chief said the Geneva-based organization will publish updated guidance Tuesday on criteria to review when considering easing restrictions, including measures around testing and tracing, supporting the health system and educating the public.

Dr. Mike Ryan, director of WHO’s emergencies program, said “now is the time to be very, very careful,” even as countries start to think about exit strategies.

“You can’t replace lockdown with nothing,” said Ryan. “We are going to have to change our behaviours for the foreseeable future.” 

“The only way to get out of this is to find the virus,” he said, when asked about how the situation is evolving in Europe, pointing to the need to test, trace contacts and isolate. He also said the health system also needs to be able to absorb any increase of cases.

WATCH | Dr. Mike Ryan talks about how to lift lockdowns:

Maria Van Kerkhove, the COVID-19 technical lead at WHO, said it’s important to not lift all the restrictions at once, but instead have to happen slowly and in a controlled manner.

Read on for a look at what’s happening in Canada, the United States and around the world on Monday.

Here’s what’s happening in the provinces and territories

In British Columbia, families of inmates at the Mission Institution want answers amid an outbreak that has led to at least 35 COVID-19 cases. The medium-security prison has been on lockdown since the start of the month as staff try to deal with the outbreak. Read more about what’s happening in B.C.

Alberta is sending much-needed personal protective equipment to hard-hit provinces, including Ontario, Quebec and B.C. Read more about what’s happening in Alberta.

WATCH | How Alberta stockpiled medical equipment before COVID-19 struck:

Saskatchewan has yet to report a COVID-19 case in long-term care facilities as other provinces struggle to contain growing outbreaks at seniors’ residences. Dr. Saqib Shahab, the province’s chief medical officer, on Saturday urged people to be careful around older people. Read more about what’s happening in Saskatchewan.

In Manitoba, Dr. Brent Roussin, the province’s chief public health officer, extended orders shutting down non-essential businesses and limiting public gatherings for an another two weeks. They will now be in place until April 28.  Read more about what’s happening in Manitoba.

WATCH | Family gives Winnipeg great-grandmother Easter celebration — from a distance:

Ontario, which has more than 7,000 reported cases, is aiming to improve its COVID-19 testing. As the province sees more cases, CBC News went inside a busy Toronto hospital to see how staff there are dealing with the novel coronavirus. Read more about what’s happening in Ontario.

In Quebec, which has 13,557 reported cases, Health Minister Marguerite Blais said Monday that it is too soon to allow visitors back into long-term care residences — even in instances where there is a shortage of staff and family members want to help care for their loved ones. “It’s very important, because we don’t want another wave,” she said of the risk. “We don’t want this situation coming back again.” Read more about what’s happening in Quebec.

New Brunswick’s chief medical officer of health, Dr. Jennifer Russell, said the province is changing COVID-19 testing protocols. Russell said testing would be recommended for people exhibiting at least two of the following five symptoms: fever above 38 C, a new cough or worsening chronic cough, sore throat, runny nose, or headache. Read more about what’s happening in N.B.

Nova Scotia has reported its third COVID-19-related death, saying a man in his 80s died of complications related to the novel coronavirus. Read more about what’s happening in N.S., including how some in the hospitality industry are shifting focus to help those in need.

WATCH | Finding a way to help during the pandemic:

In Prince Edward Island, the chief medical officer said Monday that despite no new cases in the past five days, she is not ready to lift restrictions put in place to prevent the spread of COVID-19. “What we are doing is making a difference, but we need to keep going,” Dr. Heather Morrison said. Read more about what’s happening on P.E.I.

Newfoundland and Labrador announced two new cases of COVID-19 on Monday, bringing the provincial total to 244. Read more about what’s happening in N.L., including tougher restrictions for people working in long-term care homes.

A brewery in the Yukon held an innovative fundraiser over the weekend, giving away hand sanitizer it produced and asking people who could to donate food or funds in return. Read more about what’s happening across Canada’s North, including four more cases in Nunavik in northern Quebec.

Here’s a look at what’s happening in the U.S.

From The Associated Press and Reuters, as of 4 p.m. ET

U.S. President Donald Trump said Monday it is his decision when to reopen the U.S. economy — not that of state governors — as the country continues to grapple with the COVID-19 crisis. 

“It is the decision of the president, and for many good reasons. With that being said, the administration and I are working closely with the governors, and this will continue. A decision by me, in conjunction with the governors and input from others, will be made shortly!” Trump wrote on Twitter.

The president accused news media of incorrectly saying it was the governors’ decision. Some 40 states have issued stay-at-home orders of varying lengths in a bid to stop the spread of the illness caused by the novel coronavirus.

But the U.S. president’s contention was quickly panned by legal experts and on social media.

Legal experts say a U.S. president has quite limited power when it comes to ordering citizens back to their places of employment, or in telling cities to reopen government buildings, transportation or local businesses.

Under the 10th amendment of the U.S. constitution, state governments have power to police citizens and regulate public welfare.

Dr. Anthony Fauci, the top U.S. infectious disease expert, said parts of the country could be allowed to reopen as early as next month but there’s no light switch that will be clicked to turn everything back on.

He said a “rolling re-entry” will be required based on the status of the coronavirus pandemic in various parts of the nation. Fauci said those factors include the region of the country, the nature of the outbreak it already has experienced and the possible threat of an outbreak to come.

WATCH | Trump optimistic despite reports he brushed off early notice of COVID-19:

Meanwhile, a U.S. navy sailor died on Monday after contracting the coronavirus, marking the first death of a sailor assigned to the coronavirus-stricken aircraft carrier Theodore Roosevelt. The sailor, who had been admitted to an intensive care unit (ICU) in Guam last week, died from coronavirus-related complications, the navy said in a statement.

The death Monday was the first among the crew of approximately 4,860, of which 585 had tested positive for coronavirus as of Sunday. About 4,000 crew members have been moved ashore. A number have been kept aboard to attend to the enormous ship’s nuclear reactors and other sensitive systems.

A database maintained by Johns Hopkins University puts the recorded coronavirus case numbers in the U.S. at more than 558,000, with more than 22,000 recorded deaths.

About half the U.S. deaths have been in the New York metropolitan area, but hospitalizations are slowing in the state and other indicators suggest that lockdowns and physical distancing are “flattening the curve” of infections.

Here’s a look at what’s happening around the world

From The Associated Press, Reuters and CBC News, 11:45 a.m. ET

People at Spain’s main transport hubs were handed face masks on a rainy Monday morning as the government relaxed some of the tough lockdown measures designed to rein in the coronavirus health crisis, which has claimed nearly 17,000 lives in that country.

Spain’s overnight death toll from the coronavirus fell to 517 on Monday from Sunday’s 619, bringing the total death toll to 17,489, the Health Ministry said, noting that it was the smallest proportional daily increase since tracking began. The ministry said in a statement that overall cases rose to 169,496 from 166,019.

British Prime Minister Boris Johnson, the first major world leader to test positive for the virus, paid an emotional tribute to the country’s National Health Service following his release from the hospital, saying its doctors and nurses had saved his life “no question.” He especially thanked two nurses who stood by his bedside for 48 hours “when things could have gone either way.”

A total of 18,000 tests for coronavirus were conducted in the United Kingdom in 24 hours and the country was making good progress toward its target of 100,000 daily tests, a spokesperson for Johnson said on Monday.

A total of 11,329 people have died in hospitals across the United Kingdom after testing positive for coronavirus, up by 717 in a day, the health ministry said on Monday. The number of confirmed cases has risen by 4,342 to a national tally of 88,621. The number of deaths are as of 5 p.m. local time on Sunday, while the confirmed case numbers are as of 9 a.m. local time on Monday.

The Italian government said weekend police patrols resulted in more than 12,500 people being sanctioned and 150 facing criminal charges of violating lockdown measures. On the hopeful side, officials said Italy recorded the lowest number of virus deaths in three weeks, with 431 people dying in the past day, to bring its total to over 19,800.

The overall death toll in France from the coronavirus has risen to nearly 14,400, but for the fourth day in a row, slightly fewer people were admitted into intensive care — 35 fewer. Sunday’s statistics issued by the Health Ministry confirm the country is reaching a “very high plateau” and reflect initial signs that nearly four weeks of confinement and the “drastic reduction in contacts” are producing an effect, a statement said.

WATCH | Coronavirus catastrophe in France: 

Russian President Vladimir Putin said Monday the coronavirus situation was getting worse and that Russia may draw on the Defence Ministry’s resources to tackle the crisis if needed.

Germany’s number of confirmed coronavirus infections has risen by 2,537 to 123,016, data from the Robert Koch Institute (RKI) for infectious diseases showed on Monday. That was lower than an increase of 2,821 reported on Sunday, and marked the third decline after four days of increases. The reported death toll has risen by 126 to 2,799.

South Korea’s vice health minister has pleaded with people to maintain alertness amid a slowing coronavirus spread, saying a quick return to pre-COVID-19 normalcy is “virtually impossible” considering a constant threat of new transmissions. Kim Gang-lip’s comments during a government briefing on Monday came as officials discuss converting the country’s weeks-long physical distancing campaign into a more sustainable guideline that Prime Minister Chung Sye-kyun said would allow people to engage in “certain levels of economic and social activity.”

China on Monday reported 108 new cases of coronavirus infection, 98 of them imported. Of the new domestic cases, seven were recorded in the province of Heilongjiang, which borders Russia, and three in the southern business hub of Guangzhou. Two more deaths were reported in the former epicentre city of Wuhan, bringing China’s totals since the illness emerged in December to 3,341 deaths among 82,160 official cases.

WATCH | COVID-19: How many asymptomatic people could be walking around?

Japan’s Prime Minister Shinzo Abe’s “stay home” message he tweeted Sunday has drawn angry reactions on social networks from those calling him insensitive to people who cannot rest at home because the government’s physical distancing measures do not come with compensation. Japan had 507 new confirmed cases of the virus for a national total of 7,255, plus 712 others from a cruise ship quarantined earlier this year near Tokyo, with 114 deaths.

Singapore’s Health Ministry confirmed 386 more coronavirus infections on Monday in the city-state’s biggest daily jump, taking its total to 2,918. A large number of the new cases are linked to outbreaks in migrant workers’ dormitories.

Pakistan Prime Minister Imran Khan issued a global plea directed at the world’s richer countries and international financial institutions to provide debt relief to poor countries that are being devastated by the battle against the coronavirus, where forced lockdowns to stem its rapid transmission are crippling already wretched economies and causing widespread hunger and misery for the poor.

The government has launched an ambitious program to help the millions of daily wage earners who barely rise to poverty level. The program provides roughly $75 US to 10.2 million low-income families hit hardest by the countrywide lockdown.

New Zealand recorded its fifth death from COVID-19 but only 19 new cases Monday as the rate of fresh infections continues to show signs of diminishing. The latest death, a man in his 80s, was the third connected with a rest home in Christchurch where several residents and staff are infected.

Mexican health officials reported on Sunday 442 new cases of the novel coronavirus and 23 new deaths, bringing the country’s total to 4,661 cases and 296 deaths. However, Deputy Health Minister Hugo Lopez-Gatell said last week the country might have 26,500 people infected with the fast-spreading coronavirus.

WATCH | How to handle physical distancing in tricky situations: 

Thousands of displaced Syrians have begun moving back to their homes in war-torn Idlib province despite the risk of renewed conflict, some driven by fear that the coronavirus could wreak havoc on crowded camps near the Turkish border.

In hard-hit Iran, the recorded number of cases has climbed to more than 73,000, with 4,585 deaths.

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