The Union of Nurses, Respiratory Therapists and Nursing Assistants of Laval (FSQ-SIIIAL-CSQ) presented on Tuesday her recommendations to the coroner's inquest on deaths in CHSLDs during the first wave.

"We cannot take care of our seniors if our health system itself is sick," the union's Amy Nguyen said.

She pointed to the Barrette reform of 2015, which created the organizational megastructures that are the CISSS and CIUSSS. To the coroner, she said that the conclusions of her report "should affect the very core of the health system, its functioning, its management."

As far as the CHSLDs are concerned, "everyone is responsible for something, and therefore no one is responsible: there is always someone to whom the ball can be thrown," added Sophie Brochu, who represents the Alliance du personnel professionnel et technique de la santé et des services sociaux (APTS). She also believes that "it is the entire system that has failed, in a systemic way."

Over the past week, several government officials have appeared before Coroner Gehane Kamel, most without accepting responsibility for the death toll.

Those at the top of the pyramid "have the luxury of distance," said Brochu, while the members of the APTS, who were dumped in senior care facilities without sufficient training or supervision, "will have to live with what they experienced in CHSLDs for the rest of their lives," many of them even having suffered post-traumatic shock.

This bureaucratic imbroglio, as well as the long distance between the decision-makers and the field, has cost many residents their lives, the lawyers argued, pleading for proximity management, where the decision-makers on the ground could themselves make quick decisions adapted to their environment.

Nguyen cited the directives sent out by the Ministry of Health, which were often misunderstood, such as the order to limit transfers to hospitals, which ultimately prevented sick seniors from receiving care in the emergency room. She also raised the fact that "the directives took so long to arrive that the ministry had already had time to modify them" before they even arrived in the CHSLD.

"How many patients would still be alive if we had enough staff," asked Nguyen, "and not just staff, but enough health care workers, and especially not sick and contagious with viruses?," which was a reference to some of the testimony of nurses who had been forced to work despite their symptoms.

The improvement of working conditions is for her the key to success, since "if we do nothing for the health personnel, there will be less and less workers who will want to stay in this field."

This vicious cycle, she says, was created upstream, where seniors' settings are "the poor child of the health care system," where "there has always been minimal investment."

Not only was there not enough investment upstream, but the CHSLDs were also "in the blind spot of the first wave," added Brochu, saying that the alarm bells were not rung until "late February, early March" when they should have been in January.

The lawyers also both asked that, in the future, the precautionary principle prevail, in particular with regard to the wearing of protective equipment.

BACKGROUND OF THE INQUEST

The coroner's inquest is looking into the deaths of elderly and vulnerable people in residential settings during the first wave of the COVID-19 pandemic.

During this initial wave, from Feb. 25 to July 11, 2020, Quebecers aged 70 years and older accounted for 92 per cent of COVID-19 deaths, according to data from the Institut national de santé publique du Québec (INSPQ). A total of 5,211 of them died from the disease.

The coroner's inquest is limited to events that took place between March 12 and May 1, at the height of the crisis. Its objective is not to point the finger of blame, but to make recommendations to avoid future tragedies.

Six CHSLDs and one private seniors' residence were chosen as a sample. A death was examined for each facility and then the coroner looked at the provincial management of the crisis.

This week's hearings focus on recommendations from various stakeholders.

This report by The Canadian Press was first published in French on Jan. 18, 2022. 

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This article was produced with financial support from Facebook and The Canadian Press News Fellowships.