COVID CARNAGE
Why Quebec seniors are hardest hit by coronavirus
Poor preparation, underfunding of CHSLDS blamed
It was clear from the start that Quebec’s seniors’ homes and longterm care centres were certain prey for COVID-19.
Two-thirds of all Quebecers who die of the novel coronavirus do so in one of those centres. Now people are starting to question whether more could have been done to save them.
On March 2, health authorities announced 50 out of nearly 300 patients and staff at the Life Care Centre of Kirkland in Washington state had symptoms of COVID -19. Nine days later, authorities announced 19 confirmed cases there, and it became the first cluster of coronavirus deaths in the United States.
Canada’s first COVID-19 death was recorded at the Lynn Valley Care Centre in North Vancouver on March 8. Within two weeks another seven would die, and 54 more residents and staff would become infected. Similar stories emanated from France and Italy, China and Spain.
Here in Quebec, the patients’ advocacy group Conseil pour la protection des malades implored the government in mid-march to test all patients and staff at seniors’ residences and long-term care facilities, known in French as Centres d’hébergement de soins de longue durée, or CHSLDS, to limit the spread.
“At least a month ago we knew and the government knew that the worst place for this disease was in the long-term care facilities,” said Conseil president Paul Brunet.
“We asked to test everyone and they said ‘Paul, we can’t do that, we don’t have the time, we don’t have the resources.’ They had resources to test younger people with symptoms, but not for elders.”
The government announced this week that of 150 deaths in Quebec, 44.7 per cent were at long-term care centres and 20 per cent at seniors’ residences. Quebec had freed up 7,000 beds in its normally full-to-capacity health care system, but hospitalizations to date have been lower than predictions, with 632 people staying in hospitals, including 181 in intensive care, as of Wednesday.
While that might indicate things are going well, patients are dying and staff are ill-equipped and exhausted at long-term care facilities, said David Lussier, a doctor at l’institut universitaire de gériatrie de Montréal, which cares for seniors.
“The government has put all its efforts into preparing hospital beds and intensive care units, but it neglected to prepare CHSLDS in the same way,” he said.
Premier François Legault and Health Minister Danielle Mccann announced Wednesday they will transfer 450 doctors and 500 nurses to long-term care facilities and staff and residents will be tested.
“In the seniors’ centres, I want to remind you that we rapidly took strict measures, remember at the beginning, we immediately forbade visits, and we increased the budget by $133 million,” Legault said during his daily briefing.
What it didn’t do, at least not early on, was bar patients and residents from venturing out of their centres to visit family and friends and restaurants and cafés, allowing them to potentially contract the virus on the outside and bring it in, said Roxane Borgès Da Silva, a professor with the Université de Montréal’s School of Public Health. That, and a failure to institute widespread testing early on contributed to the outbreaks, she said.
“Could we have been better prepared? Yes,” she said. “It was a choice between individual liberties of people or more propagation. And they decided to go with liberties.”
The underfunding of Quebec’s long-term care centres has led to long-standing labour shortages, Da Silva said. That leads to reduced care and difficulty recruiting trained personnel for orderly jobs that are mentally and physically challenging but pay as little as $13 an hour in the private system, and a maximum of $22 in the public sector.
A scathing 2018 report by Quebec ombudsman Marie Rinfret found services for the elderly or people living with disabilities in long-term care homes are chronically “deficient and flawed.”
The situation is perilous as well for workers, said Alain Croteau, president of the orderlies union du CIUSSS Centre Sud de l’île de Montreal, noting that 137 members of the regional health care authority have tested positive as of April 5.
“We are learning every day of more workers who have fallen in combat,” he said. “Instructions on what kind of protective gear we need changes every day, so workers don’t know if it’s based on scientific evidence, or is it just because they don’t have enough stock.
“People are scared.”