Quebec 'cast aside' seniors in long-term care, needs to make changes now, ombudsman says

Quebec's ombudsman has submitted her final report into what went wrong in the province's long-term care homes during the first wave of the pandemic, saying residents were "cast aside" and imploring the government to right its wrongs by making recommended changes immediately. 

Marie Rinfret says she is asking Quebec Health Minister Christian Dubé to provide her with ongoing progress updates, starting this spring, until all 27 recommendations in her report are implemented.

Rinfret's investigation is separate from the Quebec coroner's inquiry into the pandemic death toll at seniors' residences and the impact of the pandemic on the sector as a whole — though both share the goal of uncovering what went wrong and identifying what needs to change.

Rinfret released an interim report last fall in which she identified major problems in the government's pandemic planning, noting the province's long-term care facilities — commonly known by their French abbreviation CHSLD — were a "blind spot."

Most of the 3,890 deaths in Quebec during the first wave were among CHSLD residents, while staff watched helplessly, fled the overwhelming conditions or were themselves sick with the virus.

In her final report released Tuesday afternoon, Rinfret concluded long-term care workers "bore the brunt of public authorities' inaction."

Those workers represented 25 per cent of COVID-19 cases at the time and 11 died.

Officials knew how under-resourced long-term care homes were before the pandemic, Rinfret said, yet failed to act accordingly in the first wave. She also highlighted the fact that the homes were expected to deliver services similar to hospitals, despite lacking the expertise and personnel to do so.

Meanwhile, hospital resources were beefed up. The document details how Quebec officials were distracted by the disaster in European hospitals, notably in Italy, and believed the province's would be under siege by the virus as well.

Staff and personal protective equipment were transferred to hospitals, but the type of patient surge they expected never came. At the same time, hundreds of seniors were dying in long-term care facilities.

Officials grossly underestimated what would happen if the virus entered the establishments, where Quebec's most vulnerable live, Rinfret said.

A lack of "real-time data about the health-care system as a whole" meant that the gravity of the situation flew under the radar. 

"While Quebec's eyes were turned toward Italy, no risk analysis tailored to Quebec's residential-resource model and its specific features was carried out," Rinfret wrote. "This is how CHSLDs slipped through the cracks of any scenario."

The report also provides a portrait of the results of that lack of foresight.