COVID-19 in Quebec: Long-term care seniors arriving at hospital underfed and dehydrated, doctor says

The latest:

  • Quebec has 20,965 confirmed cases of COVID-19, and 1,134 people have died. The majority were residents of long-term care institutions and other seniors’ homes.
  • There are 1,278 people in hospital, including 199 in intensive care. Here’s a guide to the numbers.
  • Quebec will release details on how it will ease restrictions next week. The process is expected to start May 4.
  • The Jewish General Hospital has lifted its ban on allowing partners in the maternity ward delivery room.
  • A patients’ rights group is filing a human rights complaint for how long-term care homes have handled the spread of COVID-19. 
  • Director of public health Dr. Horacio Arruda says guidelines on wearing masks are coming later this week. 

A doctor at Montreal’s Jewish General Hospital says patients from long-term care homes are arriving in need of urgent care, not necessarily because of COVID-19, but because they are underfed and dehydrated.

“These are patients who are required to be fed by someone else. They need to be given water by someone else,” Vinh-Kim Nguyen, an emergency physician, told CBC Montreal’s Daybreak. “They’re not, and so they’re coming with quite serious health consequences as a result.”

Nguyen, who is also vice-president of Doctors Without Borders Switzerland, where he lives part of the time, said what is happening in long-term care homes known in French as centres d’hébergement de soins de longue durée (CHSLD) is a “humanitarian crisis.” 

Roughly 80 per cent of Quebec’s total deaths due to COVID-19 have been residents of seniors’ homes and CHSLDs.

And, with many health-care workers forced into isolation after contracting the illness themselves, many long-term care homes have been unable to provide residents with the most basic level of care.

Quebec Health Minister Danielle McCann said up to 4,000 health-care workers have fallen ill, and more than half of them are still needed in long-term care homes. 

At the Jewish General Hospital, Nguyen said it is increasingly getting patients from overwhelmed CHSLDs.

“What we are seeing is that some of these facilities are so overwhelmed that they are sending us patients for basic nursing care that they are no longer able to offer,” he said. 

In many cases, Nguyen said staff immediately set up an IV (intravenous) line to give them fluids and restore their electrolyte balance. He said the hospital has newly purchased iPads, which allow patients to speak with their family and lift their spirits.

“If a patient isn’t motivated, there’s not much we can do,” he said.

On Wednesday, Quebec Premier François Legault said he requested another 1,000 members of the Canadian Armed Forces to assist with the crisis. 

Prime Minister Justin Trudeau said Thursday that 350 members are currently in the province’s long-term care homes and that more military support is coming.

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Legault described the pandemic in Quebec as existing in two worlds: the beleaguered CHSLDs and seniors’ homes and the rest of the population where community transmission is decreasing. 

The rising death toll among seniors in care puts the province on pace to surpass the most optimistic scenario presented by public health experts earlier this month: 1,263 deaths by April 30.

Lack of care a human rights issue, advocacy group says

A patients’ rights group has filed a complaint against the province’s long-term care homes for their treatment of residents amid the COVID-19 pandemic. 

Paul Brunet, president of the Quebec Council for the Protection of Patients, says residents have faced discrimination and exploitation in the lack of care provided by the homes. 

“Some seniors are not getting minimum health-care services, which is required by virtue of our Constitution and Charter of Rights,” Brunet said.

“They are not treated humanely. They’re not respected. They are infringed in their right to integrity, security and dignity.”

In 2018, the same group launched a class-action lawsuit targeting all the government-run CHSLD care facilities in the province, which house around 37,000 people.

The lawsuit was approved in 2019, but still hasn’t been heard in Quebec Superior Court.

You play a role in how effectively the virus moves from person to person, says family physician Dr. Peter Lin. 0:48

Ethical questions

In light of the unfolding situation at the homes with the pandemic, Brunet says the group decided to make a complaint to Quebec’s Human Rights Commission. 

“We thought a complaint … would be the best, the fastest and certainly the most relevant way of telling and asking the commissioner for a statement and eventually for monetary compensation for patients,” Brunet said. 

Premier Legault said the government will release details next week about how and when the lockdown and other restrictions imposed due to the pandemic will be relaxed.

Reopening the province poses ethical questions, such as how to balance the desire to remove restrictions with the fact that the coronavirus will still be circulating, given that no vaccine is likely to be available for at least 12 to 18 months.