The Quebec government is giving its beleaguered health-care system six weeks to fix the problems that caused the novel coronavirus to spread throughout the province this spring, killing nearly 6,000 people in its wake.
Health Minister Christian Dubé revealed an ambitious series of reforms on Tuesday that he wants to see in place by Sept. 30. They range from faster testing to new staffing procedures, from better infection control to more accountable managers.
Dubé also announced $106 million in additional funding for regional public health authorities to hire 1,000 full-time employees to conduct contact tracing.
"We learned a lot of from the first wave," Dubé said at a news conference in Quebec City. "We drew lessons from the things we did well, and not so well."
Quebec — and Montreal in particular — was the epicentre of the COVID-19 outbreak in Canada between March and June. The province averaged nearly 1,000 new cases per day in early May and registered hundreds of deaths every week.
The vast majority of the deaths were residents of long-term care homes — known in French as CHSLDs — or private seniors' residences (RPAs).
It's believed the infections were often spread by staff who, at the outset of the pandemic, were forced to work at multiple locations because of severe personnel shortages.
'Consequences' for managers who ignore new rules
Hospitalizations and death have declined steadily since June, and government officials have spent the summer months trying to identify what exactly went wrong in the spring.
On Tuesday, Dubé and the minister responsible for seniors and informal caregivers, Marguerite Blais, blamed a host of pre-existing issues for the health-care system's inability to respond effectively to the crisis.
Both said long-standing staffing shortages in CHSLDs were a problem before their party, the Coalition Avenir Québec, took power in 2018.
Blais, who was seniors minister under the Liberals as well, said past budget cuts meant long-term homes were short on infection-control resources.
And Dubé said past reforms by the Liberals left CHSLDs without accountable managers.
A central element of his second-wave plan is bringing an end to the practice of patient attendants working in different long-term care homes or on different floors, in order to reduce cross-contamination.
"Let me be clear: there will be no mobility [of staff]," Dubé said. "Health-care managers who don't follow the rules will face consequences."
The province is in the process of rushing 10,000 new attendants through an abbreviated training program. Dubé said that should be sufficient to solve the staffing shortage issue.
Another important element of the plan is to ensure each CHSLD in the province has an accountable manager, who will be responsible for overseeing infection control as well as staffing.
Other elements of Dubé's second-wave plan include:
- Procedures to ensure vulnerable populations, such as homeless people and at-risk youth, can still access health and social services during a second-wave of infections.
- Hospitals being asked to avoid cancelling elective surgeries and other important medical procedures. Thousands of procedures were cancelled in the spring in order to free up hospital space that, in the end, wasn't needed.
- Increasing strategic reserves of medical supplies, including N95 masks and surgical gloves, and identifying local manufacturers for other medical equipment.
There will be a second wave
Though Quebec saw an increase in reported cases at the start of July as it lifted several lockdown measures, infection rates have dropped in recent weeks. The province is now averaging fewer than 100 new cases per day.
But with schools set to reopen at full capacity starting next week, and colder weather on the way, Dubé sought to prepare Quebecers for what to expect in the fall.
"There will be a second wave. I'm saying that because I wouldn't want people to be disappointed when there are outbreaks in a hospital, a CHSLD or even in a school," he said.
But this time, he added, "the health-care system will be able to respond more rapidly."