The cloud is clearing up on everything that converged to cause 5,060 seniors to lose their lives during the first year of the pandemic in CHSLDs in Quebec. The main culprits will remain the virus and the uncertainties surrounding the right response to oppose it. But for men and women, did the management and political professionals in charge during the first weeks of the tragedy make choices that worsened the situation? In other words, could other choices have reduced the death toll? It’s easy to say yes after the fact. Had we known, we would have done otherwise.
The sharper question is whether decision-makers failed to incorporate data available at the time of the decision or listened to those who told them that their choices were going in the wrong direction.
The evidence accumulated in her hearings by coroner Géhane Kamel and the elements added by a trio of journalists from The Press finally allow us to answer in the affirmative. In their excellent work 5060. The carnage of COVID-19 in our CHSLDs (Boréal), Gabrielle Duchaine, Katia Gagnon and Ariane Lacoursière allow us to put names and dates on the accountability grid.
No one obviously has the will to harm anywhere, quite the contrary. The decision by Health Minister Danielle McCann and her team to transfer hundreds of hospitalized patients to CHSLDs met two imperatives: to free up places in hospitals for the tsunami of adults returning from trips abroad from which they thought—reasonably, but wrongly—that they would form the bulk of the sick; protect seniors by taking them out of a potentially contaminated environment, hospitals, and cramming them into CHSLDs where, they thought, again wrongly, they would be safer.
This risk calculation was fundamentally flawed. The numerous visits made in the previous year to CHSLDs by the Minister responsible for Seniors, Marguerite Blais, and her chief of staff, Pascale Fréchette, showed that it would be physically impossible to take care of these new patients, even if they did not have COVID. A conservative and well-known estimate established that there was a staff shortage of at least 30% in this network before the crisis. If only one patient or one beneficiary attendant were to be infected, CHSLDs, organized as living environments where interaction is the rule, would be much more conducive to rapid contagion than hospitals, which are much better equipped. , them, to close the sanitary hatches.
Why was this essential argument not taken into account? First, because the expert committees convened by the Assistant Deputy Minister at the Ministry of Health and Social Services (MSSS), Lucie Opatrny, in charge of the operation, did not include any representative of the CHSLDs. Why didn’t the Assistant Deputy Minister of Health specifically responsible for seniors and caregivers, Natalie Rosebush, provide a counterweight? Mystery.
Politically, then, because the Minister of Seniors was not informed — her department does not report directly to the Department of Health. “It never came to our ears,” said Mr.me Fréchette to the investigators of The Press. We were never told: “We empty the beds.” As soon as we found out, we said, “You stop doing that!” Because we knew that we didn’t have the staff in the CHSLDs to treat this world. The biggest battle, the major sticking point, has been getting this to stop. »
They are not the only ones to say it. Radio-Canada revealed that even before the decision to move the patients, taken on March 19, the director general of the Association of private establishments under agreement (AEPC), Annick Lavoie, had asked for all new admissions to be stopped. On the very day of the 19th, she returned to the charge, described to Deputy Minister Rosebush the situation as “critical” and saw a “catastrophic scenario in the event of a case of COVID in a CHSLD”. Which will happen three days later.
Informed of this growing trauma in the days following March 19, Ms.my Do Blais and Fréchette talk about it at meetings of the crisis unit, chaired by the Prime Minister? Yes, said M.me Blais interviewed for the book. “We scream, we scream, Pascale and I. We scream all the time. This interview was conducted in the summer of 2021. Six months later, before the coroner, Ms.me Blais will not repeat these remarks, on the contrary. Why ?
From the end of March 2020, and for ten days, the Prime Minister therefore has access to this crucial information. His Deputy Minister of Health, Yvan Gendron, told him that the CHSLDs are able to take the shock. His minister of seniors and his chief of staff tell him otherwise. They say it so much that an adviser to François Legault advises Pascale Fréchette that “his interventions are becoming predictable”. A way, let’s say, rude, to tell him to calm down.
The information was therefore available and verifiable, but not believed. It was not until April 8, with the publication in the Gazette of Aaron Derfel’s article on the horrific conditions in which dozens of seniors died at the CHSLD Herron, that the Prime Minister and his team wake up, very belatedly, to the extent of the disaster.
And begin to doubt the quality of the information transmitted through the official channels of the MSSS. The book tells us that the secretary general of the government, Yves Ouellet, then ensures that two people with detailed knowledge of the CHSLD network listen, anonymously, on the telephone, to the exchanges of the crisis unit. They can thus confirm, invalidate or complete the information transmitted to high places.
The Prime Minister’s confidence is broken with Danielle McCann, on the one hand, and with Yvan Gendron, on the other. They will lose their positions two months later. The question that could have saved lives, however, is this: why did François Legault not listen to those who were screaming?
Too bad Coroner Kamel did not see fit to summon the Prime Minister to ask him.
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