Quebec's lack of preparation led to disastrous 1st wave in long-term care homes, report finds

Poor communication and sluggish decision-making by public health officials, a "paternalistic" attitude toward seniors and a lack of a coherent pandemic plan left Quebec's health system unprepared to switch to crisis mode when the first wave of the COVID-19 pandemic hit Quebec's long-term care homes, according to a new report.

Quebec's health and welfare commissioner, Joanne Castonguay, presented her final report Friday morning, into why the health-care system failed seniors during the first wave of the pandemic.

Among other findings, the report tells of a "perception of a lack of independence of Quebec's public health director" as well as a "lack of transparency in the creation of directives."

Quebec's former public health director, Dr. Horacio Arruda, stepped down earlier this month, amid criticism of Quebec's pandemic measures. 

Castonguay's preliminary report, released in September, said health officials lacked such basic information as up-to-date employee schedules and reserves of personal protective equipment, leading to "one of the worst crises that modern Quebec has ever seen, if not the worst."

While the final report looks at the health system as a whole, it laid out the full extent of the deadly wave in long-term care homes in Quebec. 

There were 3,675 deaths in CHSLDs, the French acronym for long-term care homes, alone. That represents 64 per cent of the deaths in the first wave, even though the residents of CHSLDs represent only 0.5 per cent of the population.

The report found that 40 per cent of CHSLD residents who caught COVID-19 died, compared to only 2 per cent of the general population.

It also found that nearly half of the 14,000 health care workers who were infected with COVID-19 during the first wave worked in CHSLDs.

The report found a lack of governance and resources in the management of services for seniors and found "insufficient leadership to make decisions using a 'seniors lens.'"

While the report does not lay out a timeline of the health system's failings or lay blame on specific people, it makes recommendations on how to avert a similar crisis in the future. 

Castonguay's recommendations are split into two main sections: reinforcing the strategic role of Quebec public health and improving the governance of the health system. 

The health commissioner's report is one of several parallel investigations looking into the devastating toll of the first wave of the pandemic. 

Quebec's ombudsman also released a final report in November, finding that Quebec seniors were "cast aside" as health officials focused on the need to prepare hospitals for the pandemic, rather than on CHSLDs.