As COVID outbreak raged at Atholville home, volunteer workers felt abandoned by province
Workers describe dirty, disorganized, unsafe conditions at Manoir de la Vallée during June outbreak
Overflowing laundry hampers, coughing COVID-positive residents wandering unchecked, and no one in charge.
When the first COVID-19 outbreak in New Brunswick was declared at a special care home in Atholville, that's what health-care workers from all corners of the province found inside when they responded to a desperate call for help.
It was early June, the province was coming out of the worst of the first wave, and virtually all of the regular staff at Manoir de la Vallée had COVID-19, were self-isolating, or were too afraid to care for COVID-positive residents.
The Department of Health appealed for caregivers, and those who responded told CBC News what they saw in the Alzheimer's and dementia unit at the centre of the outbreak was "a nightmare."
"The conditions were — they were deplorable really," said one of the workers, describing residents who were dehydrated, malnourished and required bathing.
"We had no housekeeping, no kitchen staff. Everybody had left. So it was a very overwhelming feeling. It was like a fire burning out of control."
I would liken it to a firefighter walking into a burning building. They don't know what they're walking into, nor did we. And that was pretty scary once our feet hit the ground.- Carol, health-care worker
Registered nurses, licensed practical nurses, personal care workers and respiratory therapists all travelled to Atholville to help. CBC News has agreed not to name the health-care workers we spoke with, because they fear repercussions from their employers.
Two of them, to be known here as Sandy and Carol, did agree to recorded interviews about the weeks they spent caring for 15 residents at Manoir de la Vallée.
"It looked nice on the outside," Carol said when asked about first impressions of the home, but on the inside "it was in total shambles."
Unit 'pretty scary'
"They had no medication administration sheets, they had no charts for us to to go through to find out about them," Carol said of the challenges caregivers faced.
"I would liken it to a firefighter walking into a burning building. They don't know what they're walking into, nor did we. And that was pretty scary once our feet hit the ground."
Guy Tremblay, president and CEO of the Lokia Group, which owns Manoir de la Vallée, was not there during the outbreak but was on the phone with his director and with government officials every day from his office in Quebec.
He knew from the moment the first test came back positive for one of his caregivers that staffing would be his number one challenge, particularly in northern New Brunswick, where it was already difficult to find qualified workers.
"The first problem is not COVID," Tremblay said. "It's human resources."
Tremblay said that in the first video conference he had with government officials he advised them "the first step will be preparing staff because we'll be short of staff soon."
He was right. Of his 28 staff, Tremblay said, five tested positive for COVID-19, another 10 were ordered to self-isolate because they were close contacts, and the remaining 13 refused to continue working in the Alzheimer's and dementia unit.
"They were so scared that they leave the situation."
Before the outbreak was over, Tremblay said, all 17 residents in that wing were infected with the coronavirus. Two of them died from the virus.
WATCH | Health-care workers say government wouldn't provide PPE needed in Manoir de la Vallée outbreak
'There was really no plan'
Tremblay said Manoir de la Vallée was as prepared as possible, with twice weekly video conferences with the home's director since March going over pandemic procedures and prevention.
However, during the outbreak, infected residents were wandering into one another's rooms, and there was "really no plan on how we were going to isolate COVID-positive residents," Sandy explained.
"The residents were agitated, they were confused, they didn't know what was going on. They were showing symptoms … they were yelling, they were spitting out their pills, they were incontinent."
Who is going to replace me? And how could I abandon these residents?- Sandy, health-care worker
The Alzheimer's and dementia wing has a long hallway with double doors to the outside at one end, and double doors to the other wing of the home at the other. The residents have private bedrooms but shared bathrooms. There is also a common dining and recreation area, which was closed during the outbreak.
"We were so busy trying to police them not going to the other units, not going outside and not going into each other's rooms, that it left very little time for actual care at the beginning," said Carol.
When Sandy arrived, two residents had already been taken to hospital, and with just two or three workers caring for the remaining 15 residents in the early days of the outbreak, there was no way to control the environment.
"We were expected to just do what we could under the circumstances and put our safety at risk."
Even with that risk, Sandy said refusing to help wasn't an option.
"As a health-care provider … who is going to replace me? And how could I abandon these residents?"
Special care homes provide support such as meals and supervision to residents. In New Brunswick, these homes are licensed by the Department of Social Development and are considered a step between living independently and moving to a nursing home, which offers a higher level of care.
No risk assessment, limited PPE
With wandering and agitated residents showing symptoms of COVID-19 and no cleaning staff or cooks willing to enter the unit, Sandy, Carol and the others worked shifts of "immense chaos" that often lasted 16 hours.
"We had asked from the very beginning to have a representative come from Public Health or social development or someone from the medical field to come and see the conditions but yet nobody came," Sandy said.
"A risk assessment should have been done before we even got there."
From the first day they arrived at Manoir de la Vallée, health-care workers asked repeatedly for N95 face masks, head coverings and foot coverings to increase their protection, but they were told by the outbreak manager on site — who refused to enter the Alzheimer's and dementia unit — that policies indicated this equipment wasn't necessary.
"When you're giving personal care you cannot stay the allotted distance, and Alzheimer's patients — they want to touch your face, they want that connection," said Sandy.
"As a nursing professional, it was a state of despair," Carol said. "We couldn't get answers to our burning questions about the changing outlook on gear that we were supposed to be provided."
Sandy explained that the residents who suffered from Alzheimer's and dementia would often pull at the face shields and masks of caregivers, trying to remove them or approach them for a hug. An N95 mask fits more tightly and workers believe they would have offered better protection in an environment with unpredictable patients.
"We were sent into a known active COVID area … yet not given the best PPE that the government had to offer," said Sandy. "If we were willing to go and look after this very vulnerable and sick segment of society, then why weren't we given the best equipment that they had to offer?"
The kicker for the workers came when people from a local cleaning company entered Manoir de la Vallée each day to spray disinfectant on the walls and clean high-touch surfaces such as doorknobs. Sandy said they were in "full hazmat suits and respirators," while those providing personal care to infected residents had surgical masks, face shields, gowns and gloves.
"Even if it was overkill on this company's part, why not give frontline workers a bit of overkill too?"
Health officials wouldn't enter COVID unit
According to people who were there and Lokia president Tremblay, a manager from the Department of Health was on site to manage the outbreak. Workers said that person did administrative tasks such as ordering PPE, scheduling staff and ordering food but refused to go inside the Alzheimer's and dementia unit to see the conditions.
"We never saw anybody from the Department of Health, the Department of Social Development inside," said Carol.
In a statement, a spokesperson for Social Development said, "several local staff from the department were on site for various amounts of time to help assist" and additional support was provided "off site."
"The department was in regular contact with the operator and manager of the Manoir de la Vallée. There were meetings held daily where all partners including the operator and manager of the facility participated."
We sat and listened while we were up in Atholville to Dr. Russell every day saying how good it was going up there, and we were appalled.- Carol, health-care worker
When asked about the conditions inside the home, and whether anyone from the Health Department went into the COVID-infected unit at Manoir de la Vallée, Dr. Jennifer Russell, the chief medical officer of health, said: "I think the thing is you have to work with what you have at that time."
Russell said many lessons were learned.
"With the first outbreak, it was difficult in the sense that it took time to mobilize," she said. "But now we have the teams ready to go. So it's not like we have to track down people and try to ask them to volunteer. We have lists of people that we can send on a dime to any location in the province on very, very short notice."
Government officials 'did their best'
The caregivers who were there describe a disorganized scene with no one from government or the special care home taking charge.
Carol said some of the people who were recruited to help had no health-care experience at all, and those who were already there were expected to offer them training.
"It would be like me bringing you into a dementia care unit and asking you to put on protective gear and help me out," said Carol.
"We were doing laundry, we were doing housekeeping, we were doing some food prep, we were doing teaching, plus we were trying to look after these residents, their daily needs."
CBC News tried to ask Dr. Russell about a risk assessment, the provision of increased PPE to those caring for unpredictable patients, and why an outbreak manager from the Health Department would refuse to enter the Alzheimer's and dementia unit at the Manoir.
A spokesperson for the department responded in an e-mail: "The Department of Health does not comment on personnel matters as it relates to employees. The health and safety of our health-care and essential workers remains a top priority for the department in the COVID-19 response."
Tremblay said from his perspective, the support from officials with the Department of Health and Department of Social Development was good, and they "did their best."
'It was not under control'
The outbreak in June in the Campbellton area was the first in New Brunswick, and at the time it was the only COVID-19 outbreak.
Healthcare workers who spoke in interviews said their blood would boil as they watched and listened to Russell and Premier Blaine Higgs giving updates at daily news conferences.
"We sat and listened while we were up in Atholville to Dr. Russell every day saying how good it was going up there, and we were appalled," said Carol.
Sandy remembers feeling "completely unsupported" and "abandoned" by government.
If I had a patient and had put their life in jeopardy the way ours had been, I would be behind bars. I would be disciplined to the highest extent of the law.- Sandy, health-care worker
"Then we hear with the updates every day that the situation was under control, the residents were being well looked after — yes they were being well looked after to the best of our ability, but it was not under control."
During the two weeks Sandy helped care for residents at the Manoir, workers were tested every few days. Four of them contracted COVID-19 in that time. At least one had to be hospitalized.
"So that alone was a very emotionally stressful time for all of us working there because each time somebody didn't show up the next day … we thought, 'Well, maybe next time it will be me.'"
Caregivers feel like 'schmucks'
Four months later, Sandy still struggles with the emotional toll and experiences flashbacks to "the conditions and the residents."
"I know we saved lives and that brings me some comfort," said Sandy. "We went to help because we cared and we wanted to make a difference, but we felt let down by every organization involved — every single one — including the government. Because nobody — nobody — came."
Claims by Russell and Higgs at recent news conferences that many lessons were learned from the outbreak at Manoir de la Vallée aren't good enough for Sandy, who said those types of comments make caregivers feel like "schmucks."
Sandy is demanding an internal government inquiry into why a risk assessment was not completed before caregivers were sent in to help at Manoir de la Vallée, and why the home was not better prepared.
"If I had a patient and had put their life in jeopardy the way ours had been, I would be behind bars. I would be disciplined to the highest extent of the law. So why is the opposite true for us when our safety was put on the line?"
No thank-you from Higgs or Russell
Since returning home, many of the workers have sent in reports to government to show their "disgust and disappointment," said Carol, but at the end of the day they are proud of what they were able to accomplish at Manoir de la Vallée in June.
Of the 15 residents who were in the infected wing when workers began to arrive, none died or went to hospital, according to the workers CBC spoke with.
"They were COVID-free before we left, and they were starting to get back to their normal routines, and that's quite a feat when you're talking about that age and that group of people with dementia and Alzheimer's," Carol said.
"We did that as a group — not with the support of anybody else, not with the support of the home, not with support of the Department of Social Development."
Carol said those who responded put their heads down and got the job done, but they have yet to receive a note of thanks or appreciation from Higgs, Russell or members of the all-party COVID cabinet committee.
"Not once has anybody said to this group of people, 'Here's a dinner on us' or something, you know?"
On Tuesday, in part two of this story, members of the New Brunswick Special Care Home Association discuss what steps the Higgs government could take to support caregivers who are trying to keep vulnerable special care home residents safe.
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