“We don’t have any tests”

Long before the start of the slaughter at the CHSLD Herron, a doctor demanded measures for screening

Gabrielle Duchaine
The Press

Even before the crisis began in Herron, one of the doctors at the CHSLD asked the CIUSSS de l’Ouest-de-l’Île-de-Montréal more than once to train the personnel of the private establishment so that he can perform COVID-19 screening tests on site if users become ill. His demands went unheeded, even after the first positive cases appeared.

This is revealed by emails and text messages exchanged between the D^D Orly Hermon and CIUSSS managers, recently added as additional evidence in the context of coroner Géhane Kamel’s public inquiry into the management of the pandemic in CHSLDs in the province.

It is this same D^D Hermon who alerted the D^D Nadine Larente, director of professional services at the CIUSSS, on March 29, 2020, of the tragedy that was playing out in Herron. “SOS”, had texted the doctor to the D^D Larente, who then rushed to the CHSLD with his family. It was that night that the CIUSSS took control of the establishment “in the name of the government”.

It was only after April 11 that a massive screening of residents was carried out. It has since been established that such screening would have helped reduce the spread of the virus within the establishment, which was considered a single red zone for weeks. Remember that 47 seniors died there during the first wave.

As of March 23, the D^D Hermon, who followed about a third of the residents of the Dorval establishment at the start of the pandemic, wrote to the assistant director of professional services at the CIUSSS to let her know that the staff would need training in screening, “if we end up by having tests”.

A plan “being finalized”

The next day she asked, “Do we have an answer on how we test?” “We have” no tests in our CHSLD. No training was given to the staff”.

His interlocutor at the CIUSSS replied that a plan was being finalized for all CHSLDs, including private establishments, concerning screening.

On March 27, the tone of the D^D Hermon has changed. There was then a confirmed case of COVID-19 among the beneficiaries of the CHSLD Herron.

The answer was intended to be reassuring. The directorate of support for the autonomy of the elderly, responsible for establishments for the elderly, “is aware”, it was said, and is implementing an intervention “which takes this into consideration”.

“I hope something can be done before the end of the day,” wrote the D^D Hermon. She offered to collaborate with another private CHSLD located nearby, which, according to her, had tests to give. “But we need training. »

Emergency line unanswered

The CIUSSS executive then referred her to an emergency line set up to answer questions from CHSLDs. ” Yes. No answer,” replied the doctor.

Then, on March 30, she sent a series of text messages to the D^D Nadine Larente. “We have sicker patients upstairs. We try not to transfer them [à l’hôpital] if possible, but can we do on-site testing for COVID-19? Right now we have no tests and no training for our nurses. I know for now we’re assuming everyone is positive… just for the families, if their loved one deteriorates or dies… we know the cause. »

The D^D Hermon is not the only one to have asked very early for a screening at the CHSLD Herron. Calls from owner Samantha Chowieri to the Info-Santé 811 service on March 28 and 29, including The Press reported, reveal that it too has been clamoring for its residents to be tested. In vain.

A priority that “could not be applied”

In Quebec, symptomatic beneficiaries of CHSLDs were added on March 23 to the list of screening priorities, alongside travelers and their symptomatic contacts. However, revealed the investigation by the Ombudsperson on the management of the COVID-19 crisis in CHSLDs, “the directive could not be applied simultaneously in the field. At that date, the ability to detect was still limited, which explains why the virus was able to enter several of these living environments. Many voices denounced the delays of several days before obtaining the results of the tests, leaving vulnerable elderly people and their loved ones in uncertainty and insecurity”.

At the time of the crisis at the CHSLD Herron, according to government directives filed with coroner Géhane Kamel, priority for screening in the health network was first given to symptomatic hospitalized patients, then to health professionals. Sick residents of CHSLDs came next.

On April 11, after the crisis in Herron erupted in the media following an article in the daily Montreal Gazette, the government has decreed that users and staff of accommodation facilities must be tested as soon as a new non-isolated positive case is identified in the establishment. Massive screenings have taken place in several areas struggling with major outbreaks.

Other establishments, such as the CHSLD de Sainte-Dorothée in Laval (102 dead), had done the exercise from the beginning of April.