CHSLD Sainte-Dorothée was unprepared for COVID-19, witnesses tell inquiry

Long-term care facility had the highest death toll, with 100 fatalities during first wave

CHSLD Sainte-Dorothée, the Quebec long-term care home most impacted by COVID-19 during the first wave of the pandemic last year, was missing senior staff, most of whom had come down with the virus, a Quebec coroner’s inquest into the situation at the CHSLD heard while receiving testimony last week.

Death toll: 100

Christian Gagné, CEO of the CISSS de Laval, confirmed to the inquiry that a death toll of 100 made CHSLD Sainte-Dorothée the worst-hit long term care home in the province.

Gagné said a lack of managers during the crisis made the situation worse, even though replacement staff was found to make up for workers who fell sick or quit.

He said that before the pandemic hit in March last year, the residence was down nearly a quarter of its usual staff, and that eventually nearly two-thirds were missing because they were sick.

Testing difficult

Testing for COVID-19 was difficult at the beginning. “Initially, there was only the national laboratory in Winnipeg that could confirm a case,” said Dr. Jean-Pierre Trépanier, the public health director for the Laval region. Although a few more labs eventually began analyzing tests, the delay for results was several days.

On April 3 last year, CISSS de Laval took the step of having all residents at CHSLD Sainte-Dorothée tested for Covid, which revealed the extent of the outbreak, although there was little that could be done, said Dr. Trépanier.

Asymptomatic spread

On March 25 last year, the first patient with COVID-19 at CHSLD Sainte-Dorothée was confirmed, and within a week of that date the virus had spread asymptomatically to many others, which was a little-known phenomenon during that early stage of the pandemic. Dr. Trépanier said there were almost no health ministry guidelines then on how to react in such a crisis.

Also during last week’s hearings, Dr. Trépanier said CHSLD Sainte-Dorothée was in the midst of a vast program to digitize medical records which were on paper. He said the digitization process taking place at the same time as the onset of the pandemic made the crisis all the more difficult to deal with.

A mistaken assumption

Apart from the 100 fatalities from Covid, a total of 211 residents became infected at CHSLD Sainte-Dorothée, while 173 staff tested positive for the coronavirus. According to Trépanier, the long-term care residence’s pandemic response plan hadn’t been updated since 2006.

He said the fact the provincial government had mistakenly assumed that hospitals, rather than long-term care homes, would be the epicentre of infections worsened the situation at CHSLD Sainte-Dorothée.

Trépanier said his team realized at one point in March and April last year that they would need a lot more personal protective equipment (PPE) to deal with the rapid spread of infections, but there was an acute shortage of these.

The provincial government had mistakenly assumed that hospitals, rather than long-term care homes, would be the epicentre of the pandemic

He said management and staff at CHSLD Sainte-Dorothée were unprepared for what happened because information from higher public health authorities was sketchy and the nature of COVID-19 was mostly unknown at the beginning of the pandemic.

LPD investigated deaths

Also last week, Sgt.-Det. Jules Briand of the Laval Police Department testified about an investigation he undertook in October last year into the 100 Covid deaths during the first wave at CHSLD Sainte-Dorothée.

Among the issues he uncovered were a lack of staff and equipment, and improvised measures made necessary because there were few resources.

He said he also found that the CHSLD had hired staff who were not regulars, and that as a result infection was allowed to spread indiscriminately.

However, he and fellow investigators concluded that no criminal charges were warranted because of the overwhelming circumstances.