Seite - 342 - in VULNERABLE - The Law, Policy and Ethics of COVID-19

VULNERABLE342 abortion,10 pharmaceuticals,11 mental health care,12 and substance dependence programs.13 Perhaps most egregiously, the failed promise of equal access to care is reflected in the massive death toll in long- term care.14 While we expect, and domestic and international human rights demand, that care be available based on need, COVID-19 has laid bare the reality that barriers continue to exist as a function of who patients are and where they are being treated. Focussing on the unfolding tragedy in long-term care, I will argue that governments and health care decision makers must recognize that access to a com- prehensive range of care is a fundamental right, and that human rights-based accountability is urgently needed in the battle against COVID-19, and beyond. COVID-19 and Long-term Care In 2018–2019 there were 191,835 long-term care residents in 1,319 facil- ities in Canada, outside Quebec.15 Their average age was 83, and over two thirds were women.16 Over 70% had heart/circulation diseases; over half, musculoskeletal diseases; and over two thirds, neurological diseases, including dementia.17 Like hospitals, long-term care facilities 10. Laura Osman, “Advocates Sound Alarm Over COVID-19 Limiting Access to Contraceptives, Abortion”, Globe  and  Mail  (2 April 2020), online: <www.theglo- beandmail.com/canada/article-advocates-sound-alarm-over-covid-19-limiting- access-to-contraceptives/>. 11. Jan Malek, “COVID-19 Shows that Pharmacare is Needed Now” (24 April 2020), online: Council of Canadians <canadians.org/analysis/covid-19-shows-pharmacare- needed-now>. 12. Kathleen Finlay, “So Far, Canada’s Answer to COVID-19 Mental Health Crisis Doesn’t Measure up”, Ottawa  Citizen (30 April 2020), online: <ottawacitizen.com/ opinion/finlay-so-far-canadas-answer-to-covid-19-mental-health-crisis-doesnt- measure-up/>. 13. Raina Delisle, “It’s a Risky Time for People with Substance Use Issues”, The  Tyee (14 April 2020), online: <thetyee.ca/News/2020/04/14/How-A-Pandemic-Affects- Substance-Use/>; Jeff Turnbull, Vern White & Mathieu Fleury, “Treat Drug Addiction Through Safe Supply”, Ottawa  Citizen (25 May 2020) A7. 14. Tonda MacCharles, “82% of Canada’s COVID-19 Deaths Have Been in Long- term Care, New Data Reveals”, Toronto Star (7 May 2020), online: <www.thestar. com/politics/federal/2020/05/07/82-of-canadas-covid-19-deaths-have-been-in- long-term-care.html>. 15. “Quick Stats: Profile of Residents in Residential and Hospital-Based Continuing Care, 2018–2019” at Table 1, online: Canadian Institute for Health Information <www. cihi.ca/en/quick-stats>. 16. Ibid at Table 3. 17. Ibid at Table 6. See eg “British Columbia Residential Care Facilities Quick Facts Directory 2018 Summary” (2018) at 1, online (pdf): Office  of  the  Seniors  Advocate