CHSLDS’ plight mirrors Diamond Princes
Very early in the COVID -19 crisis — even before the World Health Organization declared it a pandemic — people around the world closely followed the fate of more than 3,700 passengers and crew stranded aboard the Diamond Princess off the coast of Japan.
Japanese authorities refused to let the passengers disembark in mid-february until they could go through a two-week quarantine. In retrospect, the quarantine backfired, with the Diamond Princess inadvertently becoming an incubator for the coronavirus. Ultimately, more than 700 passengers and crew would become infected and 13 people died.
Here in Quebec, and especially in Montreal, it has become clear that our landlocked long-term care centres (CHSLDS) have also become incubators for the coronavirus. As was the case with pre-symptomatic ship workers who unwittingly transmitted the coronavirus to confined passengers aboard the Diamond Princess, so have poorly equipped nurses and préposées aux bénéficiaires (PABS or orderlies) passed COVID -19 to the elderly residents of CHSLDS.
Health Minister Danielle Mccann has confirmed that underpaid PABS working in multiple CHSLDS and seniors’ residences unknowingly carried the coronavirus from one institution to another. On Wednesday, the premier announced that, to date, 5,139 mostly elderly Quebecers have contracted COVID-19 in CHSLDS, seniors’ residences and other institutions across the province.
In total, there have been 332
COVID -19 outbreaks in these institutions. In Montreal alone, 149 outbreaks have erupted in CHSLDS and seniors’ residences. More than 80 per cent of the 2,063 people who have died from COVID-19 in Montreal have died in these institutions.
So where did we as a society go wrong and where can we go from here? Premier François Legault has acknowledged that CHSLDS were the blind spot in the government’s pandemic response. The government was so worried that Montreal’s hospitals would become overwhelmed — as emergency rooms were in northern Italy — that authorities did not pay the necessary attention to the network of CHSLDS.
Quebec wasn’t alone in this oversight. This is a national tragedy that has occurred in longterm care centres in almost every province.
The purpose of this column is not to compare provinces, however, but to focus on a series of grave errors made by Quebec. First, authorities didn’t provide (and still haven’t) enough personal protective equipment to those caring for CHSLD residents. That’s one of the reasons the outbreak took root in the Résidence Herron before the mass desertion by staff.
On April 8, Mccann announced that all staff and patients would be tested for COVID-19 in CHSLDS, yet 10 days later she conceded this was not possible. Belatedly, as authorities ramp up testing, Quebec’s chief public health officer, Dr. Horacio Arruda, has declared this will now be done.
Like the passengers on the Diamond Princess, authorities in Quebec were late in transferring residents out of CHSLDS. They did so only after many fell ill, moving them to acute-care hospitals like the Jewish General Hospital and the Mcgill University Health Centre. Some of those residents were malnourished and dehydrated.
The Canadian Red Cross set up a field hospital in a hockey arena in Lasalle for many of the infected CHSLD residents. Hôtel-dieu, which closed as a hospital three years ago, reopened for the express purpose of treating overflow CHSLD patients. The question to ask is, why couldn’t authorities have opened these facilities earlier in the pandemic before hundreds got infected?
Once introduced into the CHSLDS, the coronavirus in all likelihood is at risk of spreading outside of them back into communities across Montreal, the epicentre of Canada’s pandemic. In a laudable move toward greater transparency, the Montreal public health department on Wednesday released a highly detailed breakdown of the spread of the coronavirus by neighbourhood.
One of the graphs regarding daily COVID -19 cases shows that the epidemiological curve is descending noticeably in the “milieux fermés,” which include CHSLDS and hospitals, among other institutions. But the number of cases is not yet plummeting in the so-called open milieu — in other words, the communities outside CHSLDS. To a lesser extent, the same could be said of cases among health workers, many of whom work in CHSLDS and who return home at night.
This graph should be of great concern to authorities, as it suggests the coronavirus could be spreading silently in neighbourhoods across the city, as it has in Montreal North, for example.
It’s not too late to prevent the pandemic from taking a turn for the worse in Montreal. Authorities must redouble efforts in testing everyone in CHSLDS and providing health workers with enough protective equipment, including N-95 masks that haven’t expired. And Montrealers shouldn’t hesitate to wear homemade masks when taking the bus or métro.