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Coroner Gehane Kamel prior to the inquest into Residence Herron on Oct. 26.Christinne Muschi/The Globe and Mail

As her inquest into COVID-19 deaths in Quebec nursing homes wraps up its proceedings for the year, coroner Géhane Kamel says she remains troubled by the province’s apparent lack of preparation to protect elder-care facilities when the new disease arrived in early 2020.

Ms. Kamel referred to the time that elapsed between when the Quebec Health Department first took notice of the new illness in mid-January, 2020, and the first steps taken specifically to protect nursing homes, in March.

“A lot of information was being transmitted. I think people were really hard at work to avoid a disaster. But it came too little, too late. That’s my impression,” the coroner said.

Ms. Kamel’s inquest is looking at the impact of the first wave of the pandemic at seven elder-care facilities in the spring of 2020, during a period when about 4,000 residents of Quebec nursing homes died either of COVID-19 or from neglect resulting from the crisis.

Two bureaucrats in charge of civil protection will testify when the inquest resumes in January. In the past month, senior public servants and former health minister Danielle McCann gave Ms. Kamel an account of the province’s readiness for the novel coronavirus. They said the government was gearing up in January, setting up emergency committees and monitoring the situation.

Natalie Rosebush, the assistant deputy minister responsible for elder care, testified on Wednesday that she was aware by the end of January or in early February that elderly people were vulnerable to the new disease.

But the inquest heard that specific steps to protect elder-care facilities were not initiated until after the first case in a Quebec nursing home was detected on March 2.

Ms. Rosebush said private nursing homes, which complained at the inquest they were left out of the loop, were first told to get ready for outbreaks on March 12.

Earlier this week, Jasmin Villeneuve, a medical adviser at INSPQ, Quebec’s public-health institute, testified that it was only around March 9 or 10 that experts in infection prevention began considering what to recommend for preventing the viral spread in nursing homes.

What was on the mind of the government at the time was a March 9 conference call in which senior health officials were briefed on an INSPQ mathematical model that predicted hospitals would be swamped with COVID-19 patients without public-health measures such as lockdowns.

That forecast played a key role in leading Quebec to focus on hospitals rather than long-term care. It made no mention of nursing homes.

“Was the flag raised? I am still left with a question mark,” Ms. Kamel said on Wednesday.

The coroner also asked why Quebec hadn’t emulated British Columbia, which reacted to its first nursing home outbreak by banning health care employees from working at multiple long-term care sites, a decision credited with helping contain the spread of the coronavirus. “British Columbia is in the same country,” Ms. Kamel noted.

Ms. Rosebush testified last month, but returned to the witness stand on Wednesday to clarify questions about surveillance visits that the Health Department conducted to check if medical directives related to the pandemic were followed in nursing homes.

From April, 2020, to this fall, 1,593 visits took place at nursing homes, although Ms. Kamel is focusing on the inspections at the seven facilities she is investigating.

Ms. Rosebush previously testified that no written records of those visits existed because inspectors filled in computerized forms rather than writing a report during their visits, and those records had been overwritten.

Ms. Rosebush said on Wednesday that backup copies had been recovered. Because of contamination concerns, she explained, inspectors didn’t carry pens or pencils during their visits, but went outside to use laptops to enter their observations onto digital templates.

Details from those inspections, which are now filed as an exhibit, mirror the testimony the inquest previously heard this year about the mayhem and suffering that nursing home residents endured.

An April 16, 2020, visit at the Sainte-Dorothée nursing home, for example, recorded that 263 residents hadn’t been fully cleaned or dressed in the previous three days.

At the René-Lévesque nursing home, an inspector found on April 20 that the short-handed staff were unable to care for 48 residents who had tested positive, so they hadn’t been cleaned, dressed or given a snack between meals. The staff was “trying to save the snacks for the diabetics,” the document said.

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