Quebec’s top doctor defends COVID-19 response to long-term care death investigation

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MONTREAL – Quebec’s director of public health said during a coroner’s inquest on Thursday that he did not recall whether he had recommended preventing staff in long-term care homes from working in multiple facilities for elderly people at the start of the pandemic.

Dr Horacio Arruda told the inquest he should check whether he had given formal written advice on the risks associated with workers moving from one establishment to another. The movement of staff between long-term care homes in the spring of 2020 is considered one of the reasons for the high number of COVID-19 outbreaks and the high number of deaths among vulnerable Quebec seniors.

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“We had discussions that this was a risk factor,” he said. “Anyone who moves from one place to another could increase the risk of infection.”

Arruda was the last to testify at the inquest led by Coroner Gehane Kamel into deaths in long-term care homes in Quebec during the first wave of the pandemic. About 4,000 people died from COVID-19 at these facilities in the spring of 2020.

The doctor defended his decision during the first wave of the pandemic to ban visits by caregivers, which left many residents alone to die of COVID-19, being able to say goodbye to their families only by video.

He said there was no vaccine or effective treatment for the novel coronavirus at the time. He added that the only “weapon” public health had to prevent transmission was to reduce contact inside struggling long-term care homes.

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Staff had access to personal protective equipment, Arruda said, but added that he was concerned that caregivers would not know how to use it properly.

“It was really to protect them as to protect the establishment,” he told the inquiry into his decision to ban caregivers’ visits.

At one point during Arruda’s testimony, Kamel said she was troubled the Department of Health did not have pandemic preparedness plans in place. Arruda responded that the COVID-19 pandemic was historic and hit the province at a time when its healthcare system was facing an unprecedented labor shortage.

“I found myself in a pandemic like the Spanish flu, in terms of speed, impact, etc., in a system that was already fragile,” he said.

Arruda said the province faced a shortage of masks and testing kits at the start of the pandemic, adding that personal protective equipment was a priority for places where it would have the most impact.

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When asked why some workers who brought their own masks were told to stop wearing them, Arruda said that directive did not come from public health authorities. Arruda, however, said some individual facilities may have banned workers from wearing masks they brought from home.

Arruda’s testimony is to continue Monday morning.

Earlier Thursday, Dr Richard Masse, Arruda’s strategic medical adviser, told the inquiry that the province had struggled to obtain personal protective equipment during the early days of the pandemic when there was a “Fierce battle” for things like masks and tests.

Even if the authorities had enough protective equipment, it is not clear whether they would have known the best ways to use it, he told the inquiry. Until the end of March 2020, the virus was believed to be spread mainly through people with symptoms.

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“There were people who said ‘we believe it is transmitted by asymptomatic people’, but there was no consensus,” he said, adding that neither the United States authorities nor the World Health Organization have recognized asymptomatic spread as an important mode of transmission. .

Public health officials, he said, had no idea how quickly the virus was spreading in long-term care facilities, including the Herron Residence in Montreal, a private center where 47 people died.

“It was a shock to see that there were epidemics of this magnitude so quickly,” Masse said.

Meanwhile, Quebec on Thursday reported 663 new cases of COVID-19 and four other deaths attributed to the new coronavirus.

Health officials said COVID-19-related hospitalizations fell five from the previous day to 215, and 42 people were in intensive care, down from three.

The Quebec public health institute said 90.8 percent of residents aged 12 and older received at least one dose of the vaccine and 88.3 percent were considered to be adequately vaccinated.

This report by The Canadian Press was first published on November 11, 2021.

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This story was produced with the financial assistance of Facebook and the Canadian Press News Fellowship.