Quebec's worst-hit long-term care home woefully unprepared for COVID crisis, inquest hears

As the COVID-19 pandemic approached its first peak in the spring of 2020, the health board overseeing the worst-hit long-term care home in the province, CHSLD Sainte-Dorothe in Laval, scrambledto digitize its paper records.

"It was like building a plane in mid-air," said Dr. Jean-Pierre Trpanier in his testimonyat coroner Ghane Kamel's inquiry.

The Sainte-Dorothe residencehadQuebec'shighest death toll among long-term care homesknown in the province as CHSLDsduring the pandemic.

Trpanier is the public health director for Laval, one of the epicentres of COVID-19 cases during the first and second waves.

His testimony unveiled a number of issues at the beginning of the pandemic thatslowed the response in long-term care homes. The challenges included converting paper records and making work practices more efficient.

The facility on Samson Boulevard saw 100residents dieover the course of the pandemic and 211 becomeinfected. A total of 173 staff members also tested positive for COVID-19.

The coroner's inquiry into deaths in seniors' facilities during the pandemic has already heard what happened in other homes in Lvis, Longueuil, Shawinigan and Montreal.

The hearings into the Sainte-Dorothe residence beganTuesday,the same day Quebec announced thatthere are no moreactive cases in long-term care homes.

Trpaniersaid the health board the Centre intgr de sant et de services sociaux(CISSS) de Laval was, at first, relying on a pandemic plan that had not been updated since 2006.

He said it had been hard to predict the crisis in long-term care homes, given how focused the government was on protecting hospitals.

Trpaniersaid the government's plan came only three days after emergency measures were put in place across the province andmade little mention of long-term care homes.

Fragmented information and lack of plan for long-term care

Trpanier testified thathis team quickly realized it would need more resources and personal protective equipment to handle the outbreaks that were cropping up in March and April of last year, but supplies were limited.

He defended his health board's handling of the crisis, notingLaval was the first region to push for more testing, but that the government was rationing swabs at the time and test results had to be sent to a lab in Winnipeg.

Kamelwas at times pointed in her questions to Trpanier, asking him why, if therisks of the novel coronavirus were made public in February,his teamwas not prepared for an onslaught of cases.

Trpanierreplied that information from provincial public health officials was fragmented and that a lot remained unknown about the impact of the virus at the time.

Police investigation into deaths was dropped

Trpanier was the second witness to testify, after Sgt.-Det. Jules Briand of the Laval police force.

Briand's testimony was short, compared to Trpanier's which lasted a couple of hours. Briandwas asked in October 2020 to investigate the deaths that had taken place at Sainte-Dorothe during the first wave.

He said he conducted 25 interviews, which uncovered several issues at the home, including a lack of staff and equipment, as well as the improvisation of a hot zone for infected residents in the home's lobby, with some transferred to other floors despite being sick.

The home also lacked washrooms and wash stations and had hired staff from outside the home, allowing infection to spread. But heand other investigators determined no criminal charges could be laid because of the structural issues.

Later in the day, testimony from infection prevention and control staffpointed to staff shortages and a lack of testing.

The inquiry heard the first resident tested positive on March 26, 2020, but that it took the Health Ministry until April 11to implement mass testing, according toChristian Gagn, the CEO of CISSS de Laval.

Gagnacknowledged some kinds of equipment, such as masks, werelocked upso people wouldn't steal them. Headmitted that, at times, there were not enough employeeson hand to unlock cabinets and hand them out.

The head of infection prevention and control at the health board, Julie Huard, told the coroner she had to scramble to find and train people.

For the entire month of April, the personin charge ofinfection prevention and control assigned to Sainte-Dorothe was home sick and could only answer questions or analyze measures in place remotely.

Huard said that, on April 9, she saw an employee on site who seemed unwell, and asked one of the managers to speak with her and have her sent home.

She said it was that as far as she knew, it was the firsttimean employee was sent home by a person in authoritybecause they were exhibiting symptoms, despite the first wave being well underway.

The inquirycontinues Wednesday, when several nurses are expected to testify.

The son of one of theCOVID-19 victims at the home will be testifying on Thursday.

Jean-Pierre Dauboisalleged in a class-action lawsuit, filed in April 2020, thatemployees were forced to work even if they were showing signs of a COVID-19 infection.

His mother, Anna Jos Maquet, died at the age of 94 on April 3, after she contracted the disease while she was a resident of the CHSLD.