In its first analyzes carried out in February 2020 on COVID-19, the Institut national de santé publique du Québec (INSPQ) considered that the probability of the virus attacking long-term care settings was one of the “anticipated risks” of the epidemic.
“Towards the end of January, at the beginning of February, what we were saying was that if there was community transmission, long-term care settings could be impacted”, indicated Wednesday morning the DD Jocelyne Sauvé, Vice-President for Scientific Affairs at the INSPQ. She testified at the coroner’s public inquiry into the deaths that occurred in CHSLDs during the first wave of COVID-19.
In the pandemic scenarios presented to the Ministry of Health on March 9, 2020, the INSPQ mentioned that of all age groups, seniors would be the most affected. But it is above all the impact of the increase in cases on Quebec hospitals that was detailed there, explained the DD Safe. “In the most catastrophic scenarios is that it blew the network short, like what we saw in Italy,” she said.
The DD Sauvé explained that the first cases of COVID-19 in Quebec came from outside the country and that the scenarios presented to the government emphasized that these cases could recur and “have a major impact on the hospital system”.
The lawyer for the Ministry of Health objected to the projections presented by the INSPQ to the MSSS on March 9 to be filed in evidence, noting that these documents had been submitted to the executive council and are therefore protected by parliamentary privilege. . Coroner Géhane Kamel left the prosecutor until tomorrow to take the necessary steps. The coroner however recalled that the public inquiry “is based on the search for the truth”. “I would not want her to imply to the population that we are not acting in full transparency when we are trying to find out what happened before,” she said.
Overwhelmed with questions
On March 17, 2020, the National Director of Public Health of Quebec, Dr Horacio Arruda, entrusted the INSPQ with the mandate of health monitoring of COVID-19 and of coordination and integration of scientific production.
The challenge was immense, explained the DD Safe. “There were thousands of items produced every day” on COVID-19, she said. The INSPQ, which normally gives opinions in 6 to 12 months, now had to produce them in 30 minutes, illustrated the DD Safe. “The speed of production created an issue,” she says. More than 8,000 questions were asked of the INSPQ in the four months of the first wave of COVID-19.
The DD Sauvé reiterated that the INSPQ “is not a public health authority” and “does not take a decision”. The mission of the INSPQ is to “support the minister and the regional authorities” by producing scientific knowledge. “We propose, the authorities have”, summarizes the DD Safe.
Asked whether the INSPQ took into account shortages of stock, including protective equipment, in its opinions, the DD Sauvé said that his colleague Jasmin Villeneuve, of the Committee on nosocomial infections of Quebec (CINQ), will detail this aspect in his testimony scheduled for Wednesday afternoon. However, she mentioned that there are field practitioners on the INSPQ committees. “We try to be realistic in what we propose,” she said.
Twenty members sit on CINQ, including microbiologists and infectious disease specialists, infection prevention and control nurses and occupational health experts. A single nurse in prevention and control of infections from CHSLDs sits there. “It’s not the majority,” said the DD Safe.
A public health vision that takes precedence over occupational health?
Recalling that 14,000 healthcare workers have been infected with the virus, Coroner Dr Jacques Ramsay asked the DD Saved if the vision of public health took precedence over the vision of health at work in the opinions of the INSPQ. The DD Sauvé assured that the INSPQ tries to “protect individuals, whether they are workers or beneficiaries”.
She recalled that the divisions over the mode of transmission of the disease were global. She mentioned that the INSPQ tried to determine “what is the most frequent mode of transmission in healthcare”.
“This is what we base our recommendations on for both workers and people at risk of being infected,” said DD Sauvé, while saying that “it remains, even today, a controversy.