Premier mulls complete overhaul of Quebec's long-term care institutions

Quebec Premier François Legault has once again suggested the government may be prepared to take over all private long-term care institutions as his government comes to terms with the devastation COVID-19 has wreaked on elderly residents of both public and private CHSLDs.

The premier raised that possibility at a news briefing in Montreal Friday, where he announced Quebec had recorded just 50 more deaths linked to the coronavirus since Thursday — the lowest daily death toll since mid-April.

It was also the first day the number of new cases of COVID-19 has dropped below 700 since April 25.

However, thousands of health-care workers remain ill or absent from work due to the virus, meaning that finding enough staff to care for elderly and ill residents of long-term care institutions remains a major issue.

Legault repeated a vow he made earlier in the crisis to revamp long-term care facilities in Quebec, finding ways to make them homier yet more spacious. He said private rooms for everyone would make infection control easier, allowing health-care providers to isolate and care for residents when they are sick.

"These are living environments, but they are also care environments — just as important as hospitals," said Legault. 

"A lot of Quebecers are not proud of what happened in CHSLDs, myself first."

Of the 3,401 people who have died of COVID-19 in Quebec to date, more than 2,000 were residents of long-term care homes.

There have been calamitous outbreaks at both public and private CHSLDs, but some of the worst have been at privately operated facilities, including four long-term care homes run by Vigi Santé.

At its CHSLD Vigi Mont-Royal, all 226 residents of the home were infected and at least 70  have died. At its sister home in Dollard-des-Ormeaux, 96 per cent of the residents were infected, and there have been 66 recorded deaths.

Past cutbacks in infection control haunt CHSLDs

Legault said he has met with the 16 heads of regional health agencies and hospitals in the greater Montreal region, to discuss what's gone wrong and how to make all health-care institutions safer.

He said they identified several problems, including past cutbacks that saw the jobs of infection control officers eliminated, the dilapidated state of some buildings, and in many institutions, a leadership vacuum: some facilities do not have a manager taking responsibility for their operations. 

The premier said the greatest challenge remains attracting more personnel. He said the province is in continuing discussions with health-care workers' unions, with the goal of making temporary bonuses that have been offered to workers in this pandemic permanent. 

"But this isn't only a question of salary," said Legault. 

"Our society needs to value these jobs." 

He issued a call-out to young people in Quebec and others who have been laid off to consider taking the training now to become préposés aux béneficiares, or patient attendants.

"Taking care of other people, those that are more vulnerable, older — it seems to me that would be very rewarding," he said. 

Those patient attendants and auxiliary nurses have also been the ones falling sick to the virus, however, and Legault was asked how he hoped to attract new people to those fields given the dangers of contagion. 

The premier said those dangers have now been minimized, reiterating that there is now enough personal protective equipment to go around in all Quebec's health settings and that testing is being done in a timely way.

"We are systematically testing all CHSLD employees, both public and private — even employees that are asymptomatic," the premier said.

Death of 27-year-old prompts warning

Legault also reiterated the importance of wearing masks when out in public, especially in the city's so-called hot zones — neighbourhoods like Montréal-Nord, Ahuntsic and Hochelaga-Maisonneuve, where infection rates are high

"All people who can make their own mask, I invite you to do so," he said. 

Montreal's public health director, Dr. Mylène Drouin, who joined Legault at Friday's briefing, said in the wake of the death of a 27-year-old Montreal woman — the youngest Quebecer to date to die from COVID-19 —  people need to remember the elderly are not the only ones who need to take extra precautions. 

"Now that we have community transmission in some neighbourhoods, what we have to be aware of is that we see younger people contracting the virus," said Drouin. "We see that we have some younger people who are vulnerable also with chronic diseases."

"Those people have to be more vigilant also in the way they protect themselves because they're more vulnerable to have high consequences if they have COVID-19."