Quebec LTC staff kept working despite COVID-19 exposure, inquest hears

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One of the first Quebec nursing homes hit by COVID-19 had to ask exposed staffers who didn’t show symptoms to keep working, otherwise the facility wouldn’t have been able to feed and care for its elderly residents, a coroner’s inquest heard on Monday.

It was March, 2020, and the Laflèche long-term care home in Shawinigan had to rely on asymptomatic employees with moderate-to-high risk of exposure to the novel coronavirus to remain at their posts, the inquest was told.

“We were up against the wall,” testified Carol Fillion, the chief executive officer of the local health authority.

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Coroner Géhane Kamel is investigating the high death tolls at seven care homes during the first wave of the pandemic. The inquest looks this week at CHSLD Laflèche, a public long-term care centre where 84 employees and 107 residents became infected, with 44 of the latter dying.

“For nearly 10 days, we nearly lost it. … I am saddened by some of the consequences of that, mostly for the families. I am saddened,” Mr. Fillion said.

The inquest is focusing on one representative case at Laflèche, the April 6, 2020, death of 92-year-old Maria Lermytte. Her daughter, Sofie Réunis, described in a deposition filed as an exhibit the disorderly conditions at Laflèche even in the months before the pandemic.

Ms. Réunis said she had to buy a $1,920 a recliner with a lift because there was no furniture other than the bed for her mother, who had osteoporosis. She said she later learned that the staff never used the furniture she bought because it was too much trouble transferring her mother between the bed, a wheelchair and the recliner.

She also said orderlies weren’t informed about her mother’s osteoporosis and didn’t handle her properly. On one occasion, Ms. Lermytte was given a double dose of morphine by mistake. Other visitors told Ms. Réunis they had seen her mother fall twice.

In February, 2020, against the wishes of Ms. Réunis, her mother was given a cough medicine that gave her diarrhea. “Each day I visited I found my mother was soiled. … I had to call and complain to stop the medication because the visiting nurses didn’t want to assume that responsibility.”

Another document filed as an exhibit, a written statement by a physician practising at Laflèche, Yolanda Gonzalez, also mentioned the staff shortage.

Every six weeks, at scheduled meetings between doctors and administrators, “we were always making the same demands about the lack of personnel and equipment,” Dr. Gonzalez wrote. “The administration said they would deal with the demands, but for years I didn’t see any improvements. I felt I was wasting my time going to those meetings.”

The Laflèche home, a 154-bed care centre, has been understaffed for years and relied on employees who juggled shifts between several care homes, the inquest heard.

Unlike facilities in Montreal and its suburbs, small town homes like Laflèche can’t get placement agency workers, Mr. Fillion said.

“The facility had built its mode of operations on personnel working multiple locations,” testified the local public-health director, Marie-Josée Godi. “So it was a big challenge [when the outbreak started] to shift the paradigm.”

Mr. Fillion said the decision to keep asymptomatic employees at their posts was necessary to prevent residents from suffering bedsores, malnutrition and dehydration. “I had to choose to hydrate and feed people and face this risk.”

He and Dr. Godi said the exposed employees who kept working wore masks and other protective equipment.

However, Frédéric Losier, one of the provincial police investigators assisting the inquest, testified that doctors who were interviewed believe that despite the protective gear, employees contaminated each other during lunch and smoke breaks.

At the time, provincial public-health guidelines didn’t take into account that people without symptoms could carry the virus, several health officials testified on Monday.

“Each step we made, the virus was two steps ahead of us,” Chantal Rivard, a deputy director in charge of support for the autonomy of the elderly, told the inquest.

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