As early as January or February, the national director of public health, Horacio Arruda, worried that COVID-19 was spreading in residential settings for the elderly, he admitted on Monday, causing surprise to the public inquiry into the deaths that occurred in CHSLDs in Quebec in the spring of 2020.
“I have something that troubles me a bit as I listen to you. If we had planned it, it was [donc] in the scenarios that it was going to hit the CHSLDs? “Asked, incredulously, the coroner Géhane Kamel, who is leading the investigation.
Just before, the Dr Arruda replied “yes, that’s for sure” to a question from lawyer Patrick Martin-Ménard, who represents the families of six people who died in CHSLDs. “In January, February, you envisioned that the CHSLDs were going to go there as well? He had asked.
The lawyer obviously wanted to know if Quebec could have foreseen – and avoided – the sad scenario which played out in the CHSLDs.
“CHSLDs, was it really the blind spot of the preparation that was made in relation to the pandemic? “Asked Mr.e Martin-Ménard. “It depends on what you mean by a blind spot,” replied the D.r Arruda. “We knew that the elderly, wherever they were, were at risk. And as I tell you, from March 12, during the press briefing. And we very quickly banned visits to communities, ”he recalled.
The public health expert said he knew that “infectious diseases, in general, affect the most vulnerable” and that “the most vulnerable are in CHSLDs”.
Except that “in fact”, replied Coroner Kamel, “the hospitals, in mid-March, are more than ready to receive people”. “The teams are mobilized, but that’s not at all that in CHSLDs. The preparation is zero and one bar ”, she stressed. “These discussions [sur les dangers en CHSLD] took place before March 13 and it’s going full swing. It’s a bit disturbing, ”she added.
Whose responsibility?
Throughout the day, lawyers participating in the public inquiry attempted to determine the level of responsibility of the experts called to testify.
After the Dr Arruda, Lucie Opatrny, Assistant Deputy Minister of the Directorate General of University, Medical, Nursing and Pharmaceutical Affairs, was questioned at length about a directive from the office of the one who was Deputy Minister of Health during the first wave , Yvan Gendron. On March 18, this instruction stated that “transfers of residents in CHSLDs to hospital centers [devaient] be avoided and become an exceptional measure ”.
Was this directive, which wanted to limit pressure on hospitals, a “way of prioritizing upstream who would have access to health care? “Asked lawyer Martin-Ménard to Mme Opatrny. On several occasions, she has said that the intention behind this instruction was “to provide the necessary care in the right places”.
Except that it was interpreted as a ban on making transfers to hospitals, replied Mr.e Kamel. “There are people who have had to call journalists to get relatives out of CHSLDs. So, this is not anecdotal. […] Today, what you give us as testimony, it is not the feedback from the field, ”she underlined.
At most Mme Opartrny admitted that there had been a “gap” between the directive and the interpretation of the land. “You cannot blame the field for having interpreted the directive the way it was done”, reacted Jacques Ramsay, who assists Me Kamel in the investigation. “The directive said it was exceptional. This is what the field did ”, he continued, mentioning that the assistant deputy minister should“ at least be able to recognize that the directive was confusing ”.
Mme Opatrny also declared that it was not his responsibility to ensure that the CHSLDs had the capacity to offer the care required by the elderly, especially in a context where transfers were, so to speak, suspended. That responsibility fell to the CEOs, she said. “So, at the level of your committee, no one asked himself this question: will the CHSLDs be able to follow the bus? Asked Me Martin-Ménard. “It was not the role of the committee,” replied the senior official.