MONTREAL -- The coroner investigating COVID-19 deaths in Quebec's long-term care homes said Monday she was troubled by the fact officials knew there were risks to the care homes but failed to protect them from the pandemic's first wave.

Coroner Gehane Kamel was reacting to the second day of testimony from Quebec public health director Dr. Horacio Arruda, who said his department had been worried about the impact of COVID-19 in long-term care centres as early as February 2020.

Kamel said his comments were "troubling" because it was the first time she heard that authorities were aware of the risks to long-term care residents that early in the pandemic. She said previous testimony during the inquest indicated authorities took fewer precautions to protect those facilities compared to what they did to prepare hospitals.

She said she hadn't realized officials had discussed the risks to long-term care homes before March 13, the day before the government declared a public health emergency.

"The hospital sector, by mid-March, were more than ready to receive people," she said. "Equipment was available; the teams were mobilized." In long-term care, however, there was zero preparation, she added. Nearly 4,000 people died in long-term care homes in the early months of the pandemic.

"In what we've heard, there was no staff, no equipment, no preparation to face this," Kamel said about long-term care homes in mid-March 2020.

Arruda said a planning guide had been sent to long-term care homes on March 12, 2020, but he added that Quebec's focus was on preparing hospitals, based on the experience in Italy, where hospitals had been overwhelmed.

Kamel said she was also concerned that the 40 private long-term care homes in Quebec -- including Residence Herron, where 47 residents died during the first wave -- were left out of public health's plans. She said the lack of attention to the long-term care sector raises questions about whether "we let people die."

Arruda admitted the situation suggested long-term care wasn't properly organized in the province pre-pandemic.

Patrick Martin-Menard, a lawyer who represents family members of six people who died in Quebec long-term care facilities, asked Arruda whether those care homes were a "blind spot" in the Health Department's pandemic planning.

"That depends what you mean by 'blind spot,"' Arruda responded. "We knew that the risk was there."

The coroner's inquest is examining the deaths of elderly and vulnerable people in residential settings during the COVID-19 pandemic in order to formulate recommendations to avoid future tragedies.

 On Thursday, Arruda testified that he did not remember whether he had issued a formal recommendation against long-term care staff working in multiple facilities, a practice that has been linked with the spread of COVID-19.

On Monday, Arruda confirmed he had not sent such a recommendation.

- This report by The Canadian Press was first published Nov. 15, 2021. This story was produced with the financial assistance of the Facebook and Canadian Press News Fellowship.