(Quebec) The situation is so critical in hospitals that the Legault government is preparing for the worst, that is to say, it plans to provide “B instead of A+” care if it becomes impossible to treat all patients in Quebec, whether or not they are infected with the Omicron variant of COVID-19.
Posted at 2:25 p.m.
Updated at 5:54 p.m.
The Ministry of Health and Social Services presented on Tuesday the outline of a new “Guide for the prioritization and management of short-term hospitalizations in the context of a pandemic”, which would be deployed if hospitals were overwhelmed. The Assistant Deputy Minister of Health, the DD Lucie Opatrny, affirmed that everything was done to avoid using this protocol, but added that “we have a duty to be prepared for any eventuality”.
“The situation is tense, but we haven’t gotten there. And besides, we are not activating this prioritization guide now. We are in the preparation phase, ”said the president of the Association of specialists in internal medicine of Quebec, Dr.r Hoang Duong, in a technical briefing for the news media.
The Deputy Director General of Hospital Services, Medicines and Clinical Relevance of the Ministry, the DD Lucie Poitras, also confirmed that hospitals are currently evaluating the use of their short-term beds to increase hospital capacity. With this first step, Quebec hopes to find 600 to 800 beds throughout the territory.
Call for families
While the Ministry of Education indicated last week that it could call on volunteer parents to monitor classes, it is the Ministry of Health’s turn to challenge families to successfully get patients out of hospitals. that could be treated elsewhere.
To free up beds and treat as many patients as possible, Quebec is now aiming to “continuously ensure the relevance of hospitalization” and to “treat outside the hospital, when patients do not have or no longer have need for clinical monitoring or care that cannot be given outside the hospital”.
At the hospital, the guide also plans to “change the perspective of controlling the pandemic, [partant] from zero risk to harm reduction. [On ne doit plus] make every effort to curb the entry [du virus], but rather deal with the constraints it generates and make the most of it”.
Review the quality of care
If the crisis justifies it, Quebec provides that it will be necessary “to redefine the minimum quality of care in the context of a pandemic with a view to treating as many people as possible at lower intensity rather than treating fewer people at optimal quality”. In this regard, the Ministry of Health calls on the orders of health professionals in Quebec to adopt these “temporary” standards.
Decreasing the intensity of care to be able to care for more patients is not something you learn in medical school, but it is something that may be necessary if it comes the.
The Dr Hoang Duong, President of the Association of Internal Medicine Specialists of Quebec
“If someone had asked me one day if I would work on such a document, I would have replied: ‘Never, it’s inconceivable.’ But we got there. […] We have to recognize the seriousness of a situation, we have to recognize that despite all the efforts we have made, perhaps one day will come when we will not have all the resources to treat everyone as we usually does,” he added.
Calculated risks
The Dr Duong agrees that this strategy, which could be rolled out in four to six weeks, according to Quebec, puts patients at increased risk. “As there is a drop in the intensity of care, there are risks that can come with that, [mais] these are calculated risks. I think that for these risks, it is all the patients who benefit, ”he said.
For the Dr Gilbert Boucher, president of the Association of Emergency Medicine Specialists of Quebec, it is clear that optimization practices can indeed be put in place.
“Let me give you an example: if we can give pills to a patient instead of making him wait 16 hours in a queue, to call him back in 48 hours and see how he is doing, we would have just [libérer] a bed,” he explained.
We are not here to play with people’s lives. Yes, it involves taking risks, [mais] we won’t cut corners with people’s lives, that’s for sure.
The Dr Hoang Duong, President of the Association of Internal Medicine Specialists of Quebec
Plunged “into the dark”
On the political level, the leader of the Liberal Party of Quebec, Dominique Anglade, said Tuesday that the Legault government had lost control of its management of the pandemic.
“The last few weeks have been clear demonstration that François Legault has lost control. […] He also closed the door to our hospitals, while there are thousands of people waiting for care. It has closed the door to the economy, when what they are asking for, our traders, is truly predictability. By governing by closures, and despite all the powers he has, François Legault has plunged Quebec into darkness,” she said.
“Quebecers no longer find themselves there. On the one hand, the Prime Minister tells us that he sees the light at the end of the tunnel, while on the other, the Minister of Health affirms that the health network is at the end of its rope and that it must not let go of the sanitary measures. This contributes to pandemic fatigue, ”lamented Vincent Marissal, of Quebec solidaire.
“This is where 22 months of a state of emergency under the CAQ government, unable to anticipate things or to give more robustness to the health network, have led us,” said Joël Arseneau, of the Parti Québécois.
With Ariane Lacoursière, Fanny Lévesque and Henri Ouellette-Vézina, The Press