Workplace-safety inspection reports obtained by The Globe and Mail through access-to-information requests detail the disarray and poor conditions in some of the Quebec long-term care residences hardest hit by the COVID-19 pandemic.
The inspections, which were conducted when employees complained that they weren’t safe from the novel coronavirus, are particularly harsh in the case of the Vigi Dollard-des-Ormeaux home, in Montreal’s West Island. They describe an understaffed, poorly equipped facility where workers kept moving between infected and uninfected areas without properly donning or removing protective gear.
A workplace-safety inspector ordered Vigi DDO to stop shifting employees between “hot” and “cold” zones. “I deem that there is a danger for the health, security and physical integrity of workers,” inspector Julie Martel wrote in her May 5 report.
More than 2,600 Quebeckers living in long-term care homes have died during the pandemic.
Quebec Ombudswoman Marie Rinfret said Tuesday she was launching an independent investigation into the province’s response to the COVID-19 pandemic in elder-care homes. The probe is to be completed in the fall of 2021, with an interim report this fall.
The Canadian Armed Forces are also expected to follow up on their report about appalling conditions in Ontario nursing homes with another one detailing the problems their personnel witnessed while deployed at 28 Quebec elder-care centres.
Many shortcomings were already noted in workplace-safety complaints filed in April and May at four Quebec long-term care homes where a total of 250 elderly residents have died of COVID-19.
Earlier this month, Quebec’s Director of National Public Health, Horacio Arruda, said outbreaks in care homes were likely driven by employees who were asymptomatic carriers and worked in several facilities at the same time.
The inspection reports show that, at the level of individual homes, circumstances were more challenging than how they were portrayed by officials in the government’s daily briefings.
Workplace-safety reports for three of the care homes were released through an access-to-information request. A report for the Sainte-Dorothée home had previously become public in court filings.
Many of the problems mentioned in the reports stemmed from similar roots – lack of staff, lack of protective equipment, confusion about steps needed to counter the contagion. However, they translated into different challenges in each of the homes.
At the Vigi DDO home, understaffing made it impossible to assign nurses to work solely with infected residents. On some shifts, for example at night or during weekends, there was only one nurse for the entire facility, according to the inspection report.
According to the local health authority, 66 residents at Vigi DDO have died of COVID-19.
“There were difficulties getting all workers to follow good IPAC [Infection Prevention and Control] practices,” the report said.
The document said a Vigi manager, Juliana D’Onofrio, blamed the local health authority for the lack of personal protective equipment (PPE).
Since March 20, Quebec’s Health Department has centralized PPE procurement, leaving it to local health boards to allocate the equipment rather than having individual homes contact suppliers, ministry spokesman Robert Maranda said in an e-mail to The Globe Monday.
According to the report, Ms. D’Onofrio complained that Vigi “regularly made requests to [local health authorities] for PPE. Because of the shortage of PPE, the [local health authorities] had trouble supplying them preventively and in sufficient quantities.”
The report also said there were no N95 respirator masks during aerosol-generating medical procedures – and in any case the staff hadn’t done tests to make sure such respirators fit them properly.
Questioned about the report, a spokesman for the local health authority said that there was good co-operation with Vigi DDO and that facilities under its jurisdiction received adequate supplies.
“We understand the concerns of the employees,” spokesman Guillaume Bérubé said, adding that the health authority had dispatched managers, nurses and geriatricians to assist Vigi DDO.
Lack of PPE and staff shortages were also a problem at other homes.
At the Laflèche long-term care home in Shawinigan, where 44 residents have died, management had to allow employees who had been exposed to the novel coronavirus to cut short their two-week quarantine period.
The decision was made “in a context of understaffing,” Jean-Pierre Bergeron, a medical adviser for the local health authority, told the labour inspector.
After 78 people were infected in early April, officials tested all Laflèche residents and staff and uncovered more than 30 asymptomatic cases.
“If we had that knowledge at the start of the pandemic, there are many things we would have done differently,” the local public-health director, Marie-Josée Godi, told reporters in April.
The highest death toll in a Quebec elder-care home was at Sainte-Dorothée, a home in Laval, north of Montreal, where 92 have died.
The Sainte-Dorothée inspection report mentioned complaints that employees who had COVID-19-like symptoms were required to show up for work. The report also noted that not all staff were issued masks even though physical distancing was not possible in some work areas.
On May 4, when the inspection report for the LaSalle home in Montreal was issued, 43 of the 130 residents had caught COVID-19.
The report noted some problems, such as overcrowding in the reception area, a lack of proper distancing measures in an elevator and at two work stations, and overflowing bins of dirty clothing. But the report said that generally protective equipment was available and guidelines were followed.
Nevertheless, 49 residents eventually died at the LaSalle home.
With a report from Kristy Kirkup in Ottawa
Scott Gottlieb says we will be better prepared for a second wave of COVID-19 in the fall, but a spike in new cases may also arrive at a time when other seasonal illness circulate. The head of the U.S. Food and Drug Administration between 2017 and 2019 adds that Sweden leads Europe in coronavirus deaths despite attempts at herd immunity.
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