An elder living in a center where a quarter of the nursing assistants were missing was three times more likely to catch COVID-19 and was more likely to die from it, according to Dr. Sophie Zhang, who came to testify at the hearings of the coroner Géhane on Monday Kamel on the deaths of elderly or vulnerable people in residential settings during the first wave of COVID-19.
This is what emerges from her master’s report, in which she analyzed data from the 17 CHSLDs of the CIUSSS du Center-Sud-de-l’Île-de-Montréal, after having worked there herself during the first wave.
“The nursing assistant is very close to the patient,” she explained. “She will give all the medicine, be at the bedside. She is the one who will see if he starts to develop symptoms ”or if his habits change because of the disease, especially when it comes to eating.
Another shocking statistic: a good systematic screening of residents “was associated with a 12-fold drop in the incidence” of the disease two weeks later, due to the fact that those who were infected, even without symptoms, could be quickly isolated.
It was only on April 10, 2020, in the heart of the first wave, that the CHSLDs were able to do a massive screening, but often, “this directive was not completed for lack of swabs”, recalled Dr. Zhang. Systematic screening was only authorized on April 23.
“Each increase of 100 beds [par centre] was associated with slightly less than double the death odds, ”she added. “Smaller environments should be favored”, since the risk of transmission is lower.
Surprisingly, the administration of oxygen or fluids does not appear to have had an impact on mortality, if Dr. Zhang’s data is to be believed. In contrast, a treatment for blood clots called thromboprophylaxis “halved the odds of death.”
Excess mortality
Although many have questioned the fact that the deaths in CHSLDs are really attributable to COVID-19, Dr. Zhang has two to four times more deaths than usual during the first wave.
This equates to 428 excess deaths in his CIUSSS. A similar number, 456, has been attributed to COVID-19.
Even if “we are not always certain of the cause of death”, for lack of sufficient tests, these figures show according to her that “the doctors gave good diagnoses”, since the number of excess deaths corresponds roughly to the number of deaths caused by the coronavirus.
The context of the investigation
The coroner’s inquest is looking into the deaths of elderly or vulnerable people who have occurred in residential settings during the COVID-19 pandemic.
During this period, from February 25 to July 11, 2020, Quebecers aged 70 and over accounted for 92% of deaths from COVID-19, according to data from the Institut national de santé publique du Québec.
Its objective is not to identify a culprit, but to formulate recommendations to avoid future tragedies.
Six CHSLDs and a retirement home were designated as a sample. One death was examined for each establishment. Since November 1, the coroner has been looking into the provincial management of the crisis.