TORONTO -- As Ontario’s Progressive Conservative government planned its COVID-19 response in the early weeks of the pandemic, one key group was left out of the conversation—long-term care associations.

The revelation came during testimony given to the Long-Term Care COVID-19 Commission by the Ontario Hospital Association (OHA) on Oct 5.

OHA President Anthony Dale told the commission that long-term care was “treated separately from the rest of the health-care system” when it came to coordinating the pandemic response.

“Right from the very time when the Ministry (of Health) established a stakeholder relations table comprised of a very wide range of health provider organizations, the two long-term care associations were not present,” Dale told the commission.

“They hadn't been invited, and it took weeks for that to be rectified.”

Dale testified the exclusion dated back to February, as the province was slowly ramping up its COVID-19 response, and said it was clear the long-term care community felt more on the “outside than on the inside” of the government’s plan to battle the pandemic.

Dale testified that on March 21, he was invited to a teleconference with the Ministry of Long-Term Care, the Associate Chief Medical Officer of Health and others to discuss how hospital infection prevention and control tools could be used to stabilize homes.

Even then, Dale said he felt “the conversation could have had a more urgent tone.”

Meanwhile, the province was scrambling to prepare for a projected deluge of COVID-19 patients in hospitals and intensive care units, leading to a decision to free up hospital beds by shifting patients to available long-term care beds.

“When we were originally planning for wave one, the emphasis was to move as many people out of hospital into long-term care and take up every available long-term care bed,” testified Gillian Kernaghan, CEO St. Joseph's Health Care.

“If you look at the numbers of people that were transferred in February and March, there was a significant upswing in getting everybody out of hospitals as much as possible and to create the capacity in the hospital.“

Kernaghan testified that decision put additional pressure on long-term care homes because when COVID-19 arrived “they had no places to isolate people because they were full.”

On April 10, sensing a “state of paralysis and indecision”, the OHA sent a public letter to Premier Doug Ford pleading to urgent action to prevent unnecessary loss of life in long-term care.

“The government needs to act now and open another front in the war against COVID-19 to protect the most vulnerable Ontarians,” the letter read.

On the day the letter was sent, Dale said he received a call from Merrilee Fullerton, Minister of Long-Term Care who expressed gratitude before making a startling comment.

“She felt it (the letter) would help generate momentum for necessary change,” Dale testified.

Five days later the government launched the COVID-19 action plan for long-term care homes, which advocates have testified made a significant impact in stabilizing the sector.

By the time, however, the virus has already claimed hundreds of lives in long term care, contributing to the nearly 2,000 nursing home deaths so far.