Health Minister Dorothy Shephard, who was the minister of Social Development when the first COVID-19 outbreak happened last spring, says there were "issues" at the Atholville nursing home then, but the government dealt with them and learned many lessons as a result.
Shephard spoke with Harry Forestell, the host of CBC News New Brunswick at Six on Tuesday in response to concerns raised by health-care workers about conditions at Manoir de la Vallée in June.
An outbreak in the Alzheimer's and dementia unit at the Atholville home led to New Brunswick's first two COVID-related deaths. The owner of the home said all 17 residents of the unit eventually tested positive for the virus.
CBC spoke with several of the health-care workers who volunteered to help care for residents when regular staff were COVID positive, self-isolating or too scared to enter the infected unit.
The workers are not being identified because they fear repercussions from their employer. They say when they arrived at the Manoir de la Vallée, residents were malnourished, dehydrated and in need of bathing.
Health-care workers say no one from the departments of Health or Social Development entered the COVID-positive wing where they were trying to care for 15 Alzheimer's and dementia patients, and that no one from government completed a risk assessment before sending workers in.
They told CBC they felt abandoned by government, and described the outbreak as "a fire burning out of control."
Here is Harry Forestell's conversation with Shephard, edited for clarity and length.
Q: You were the minister of Social Development when the first outbreak in Atholville occurred. How aware were you of the conditions inside the Manoir de la Vallée as described by the health-care workers who volunteered to be sent there?
A: We had social workers who went into the Manoir that very night and we had staff on location throughout the outbreak. It was our first punch in the gut that everybody kind of knew was going to happen at some point. And then we had extramural move in the next day, and continuing conversations on a daily basis with staff that were there.
Q: We heard staff describe malnourished and dehydrated residents, dirty conditions, unsafe conditions, a real state of despair. Is that what you understood at the time as well?
A: No, I can't say that I did. I don't have an indication that I received reports such as what you're explaining. It was a challenging time, it was the first incident in our province with a long-term-care facility being affected, and I think that we've gained some very positive lessons from it.
WATCH l A 'punch in the gut': Health Minister Dorothy Shephard on Atholville outbreak
Q: Our reporter Vanessa Blanch spoke with some of the 10 individuals who volunteered to go in and that's how they described the situation. How do you reconcile the differences between your understanding and theirs?
A: Well, I believe that throughout this pandemic and throughout the outbreak, our Social Development staff were there, Department of Health staff were there, extramural staff were there, Ambulance New Brunswick was there. I think there were issues, but I believe they were dealt with.
Q: What kinds of issues were you hearing about?
A: We knew that meals needed to be prepared offsite because the kitchen staff had to isolate, so the meals might not have been served at the same time as they were previously. We knew that we had to bring in more cleaning staff, that pretty much the entire staff was isolating.
That was one of the very important lessons we learned from Manoir, was that we couldn't send all of the staff home. We had to work in a more methodical way with our public health and clinical staff to ensure that everyone, every resident was cared for properly.
Q: We understand that the person sent by the Department of Health to be, in a sense, the outbreak manager wouldn't even enter the affected Alzheimer's and dementia unit. Was that a reasonable and appropriate response, do you think?
A: I can't confirm that information today, but what I will say is this is that on every level there needs to be crisis management. So I don't know the situation which has been described with regards to a single employee, but I do know that nothing of this nature can happen without a team effort. And it was my understanding that everyone was trying to pull together to ensure that the care of the residents was paramount.
Q: One of the volunteer workers we spoke with says she wants a government inquiry to determine why workers were sent into that home without a risk assessment being completed first. Is that a question you're willing to entertain?
A: 'Inquiry' is a very strong word. I believe that we need to review all of our operations at every single incident, and that collaboration between social development, health, extramural ambulance, New Brunswick, all of these entities, I believe that's the route we need to take.
Q: Are you willing to say that you will do everything you can to protect the employees who spoke to us if they do come forward to publicly explain the circumstances they found?
A: As minister of Social Development, I often had off-the-record conversations where people wanted to convey information that they felt was valid. It's really about learning. ... I would welcome the opportunity to share what we can (but some of these) issues are, by nature, private and confidential. So I want this to be public and I am very supportive of accountability, but I also need to protect individuals.
Q: What would you say are the two key takeaways from Atholville?
A: First of all, even before we had an outbreak, we understood that people at special care homes were residents and they didn't have a clinical application to their care. So I think it's important that that partnership with extramural was created right away, so that we would have a clinical resource available at a phone call.
But the most important idea that came out of Atholville was the provincial rapid outbreak management team. They are there within hours to do rapid testing and to help us understand the situation we're dealing with (when there is an outbreak or the concern of a potential for outbreak).
Q: The association that represents special care home owners and operators says they want anyone who contracts COVID-19 in such a home to be isolated in hospital. Would you support that?
A: No, I don't support moving anyone who is not in need of hospital services to a hospital where we risk, for lack of a better word, contaminating many other individuals in a very serious health resource. Long-term care facilities are the front of the line where we need to ensure that we have the supports ready should there ever be an outbreak.
Q: Given what we've seen over the past few months, do you think special care homes should now be under the umbrella of your current department, the Department of Health, rather than Social Development?
A: No, I am not a proponent of that, never have been a proponent of it. There needs to be a very strong collaboration between the Department of Health and the Department of Social Development, but these niches are supported well in their environments.
Q: What would you say to reassure people that residents in special care homes are being well cared for and that the homes are prepared for a potential COVID outbreak?
A: Immediate plans for an initial outbreak are there, we have the provincial rapid response teams in place, and we have staff who are second to none. I'm very confident that overall we're delivering very good care.