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A disorganized and poorly evaluated health system for seniors contributed to the high COVID-19 death toll in the province, according to Quebec’s health and welfare commissioner.

Joanne Castonguay released her preliminary report Thursday about the state of the health and social services network for seniors on the eve of the pandemic.

During the first months of the health crisis, from March to August 2020, no fewer than 5,157 elderly Quebeckers died, accounting for 90 per cent of total COVID-19 deaths in the province at the time.

“This is probably one of the worst crises that modern Quebec has ever known, if not the most serious of all,” she said in the report.

A combination of several factors, she said, led to an unprecedented crisis for seniors in long-term care and other residences across the province. There was no comprehensive strategy to offer a uniform quality of care, services were disorganized and poor data collection prevented care providers from making timely and correct decisions, she said.

Tasked in August by the government to look at the province’s COVID-19 response, Castonguay spoke to about 100 health workers who experienced the situation first-hand. She said based on her interviews, it became clear “the management of the first wave of the pandemic has seriously undermined the dignity and integrity of the elderly, leading to a worsening of their physical and psychological health.”

Castonguay said there was no official body tasked with compiling results of the evaluations conducted in long-term care homes, adding that the government didn’t evaluate the care given to seniors in private residences that had contracts with the province.

As a result of the lack of proper evaluations, it was difficult to hold health-care providers accountable for their conduct during the pandemic, she said.

She said the problems in the network had been well-known under several governments and numerous reports had been produced on the shortcomings, but little had been done. The COVID-19 crisis exacerbated existing problems and the responsibility for the fiasco should be “collective,” she said.

“The governance of long-term care and services has received little attention in the major concerns of successive governments,” she noted. “We also observe that no mechanism has been provided to ensure the capacity of the state to finance long-term care and long-term services.”

The commissioner wrote that she wanted to understand why Quebec had not been able to better protect vulnerable seniors at the height of the pandemic and will provide solutions to prevent a repeat.

Castonguay’s final report is due at the end of December.

Health Minister Christian Dubé said in a statement Thursday that several elements raised in the report had been addressed during the last two waves of COVID-19.

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