A Quebec doctor testifying at a coroner’s inquest voiced his frustration at the bureaucratic inertia that led several elderly patients to be admitted to a nursing home even after COVID-19 had been detected there.
“It had to be us who said, ‘Listen there are COVID cases and you’re admitting people. We’re short three or four [people a shift]. There are orderlies and auxiliary nurses who are out of action. And no one had the decency to say, ‘Listen can we, at the very least, stop the admissions?’ ” Jean-François Turmel said.
“It had to be us who rang the alarm bell. We were in a completely absurd situation.”
Dr. Turmel was testifying Thursday at coroner Géhane Kamel’s inquest into the high death toll in Quebec elder-care facilities during the first wave of the pandemic.
Hearings this week focused on the Laflèche long-term care home in Shawinigan, where 44 residents died last spring.
The inquest has heard that the first COVID-19 case at Laflèche was an employee who was tested on March 19. The staffer’s infection was confirmed on March 22.
Three days later, the first resident tested positive.
In a confidential e-mail sent on March 26, Dr. Turmel warned his colleagues that, with eight other pending test results, more cases should be expected. “Unfortunately it has begun,” he said in the e-mail, which was filed as an exhibit.
Another e-mail from Dr. Turmel the next evening mentioned several new admissions to the nursing home.
By then, eight residents and seven employees had tested positive.
Before the first wave struck, Quebec health officials worried that they would face the same crisis that Italian hospitals endured weeks earlier, where COVID-19 patients overwhelmed emergency wards and intensive-care units.
The province pushed hospitals to free beds by transferring elderly patients who were not acutely ill to nursing homes.
However, those nursing homes were chronically understaffed. At Laflèche, the lack of staff forced the facility to adopt labour practices that opened the door to viral transmission, the inquest heard.
“We had no margin of manoeuvre, we had no buffer space. What happens then? Well it’s mandatory overtime, shuffling personnel from one floor to another, shuffling personnel from one facility to another,” Dr. Turmel said.
“So in late March, early April, unfortunately the dice had been rolled already.”
He said he and a Laflèche floor supervisor tried to get the regional health authority, known by the abbreviation CIUSSS MCQ, to stop admissions.
“It made no sense. It was totally absurd. Where is the proactivity at the CIUSSS? There’s an outbreak. No one anywhere is ringing the alarm bell.”
It was hard to get the regional health authority and the provincial Health Department to act, he said. “It’s a big machine, it’s like a cruise ship, a cruise ship with one engine and a rudder that’s not very sturdy. There’s an appalling inertia.”
The inquest heard that there was a turnaround starting April 10 when the CEO of the regional health authority, Carol Fillion, visited and a co-ordinator, Claudia McMahon, was dispatched to help with the crisis.
Ms. McMahon testified that in the following days there was more protective equipment for the staff, Plexiglas panes were set up at the nursing stations, and cellphones and tablets were supplied so residents could get in touch with their families.
Still, there were other blunders. Fearing that local funeral homes wouldn’t be able to handle the large number of deaths from Laflèche, officials tried to set up a temporary morgue.
It was supposed to be out of sight, in the garage, but instead a used refrigerated container was positioned near the main entrance, in plain view.
The container was never used but it was a shock to people such as Sofie Réunis, whose 92-year-old mother, Maria Lermytte, was among the residents who died during the outbreak.
She told the coroner that “we were not getting any news from inside and then you see a container like that appear. It hurt.”
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