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COVID-19 in Quebec: ‘We need you,’ says Legault of 9,500 workers absent from health-care network
The latest:
- Quebec has 21,838 confirmed cases of COVID-19, and 1,243 people have died. The majority were residents of long-term care institutions and other seniors’ homes.
- There are 1,411 people in hospital, including 207 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.
Quebec Premier François Legault says there are 9,500 workers absent from Quebec’s health-care network, as the number of COVID-19 cases continue to rise.
In the last 24 hours alone, 800 more people have not shown up to work, bringing the total number of absences to 9,500, he said. This labour shortage is especially felt in the province’s long-term care homes.
Among those absent, 4,000 workers are infected with COVID-19. In his daily update on the situation in Quebec on Thursday, Legault issued a plea to healthy workers who have finished their 14-day quarantine period, but are still at home.
“We need you,” he said. “We are not taking any risks with your safety.”
He said the province has the necessary protective equipment, such as masks and gloves. The supply of gowns was running low, but Quebec companies are now stepping up to make more.
On Thursday, the premier announced 109 more deaths related to COVID-19, bringing the total to 1,243. There are 873 more cases in the province, for a total of 21,838.
Eight more people are in intensive care, bringing the total to 207, and 1,411 people are currently hospitalized.
Legault has described the pandemic in Quebec as existing in two worlds: the beleaguered long-term care homes, known in French as centres d’hébergement de soins de longue durée (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.
About 80 per cent of those who have died were in long-term care homes or seniors’ homes, and 97 per cent were over the age of 70.
To help control the spread of the virus, public health director Dr. Horacio Arruda is asking Quebecers to wear masks when it is not possible to leave one to two metres of space between people.
He said it is a “strong recommendation” but not obligatory, and that the government will be posting videos explaining how to make a mask at home and how to safely wear it.
Seniors arriving at hospital underfed, dehydrated: doctor
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.
WATCH | Health impact of Quebec’s long-term care crisis goes beyond coronavirus:
The long-term care crisis in Quebec is having an impact on seniors’ health even if they don’t have COVID-19. Doctors are seeing elderly patients coming to hospital with signs some basic needs aren’t being met. 2:04
“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 is a “humanitarian crisis.”
Nguyen said Jewish General Hospital is increasingly getting patients from CHSLDs that have not been provided the most basic level of care.
“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, Legault 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 and that more military support is coming.
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.”
Watch | How does COVID-19 spread?
You play a role in how effectively the virus moves from person to person, says family physician Dr. Peter Lin. 0:48
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.
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.
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‘You must stay at home’: Boris Johnson orders British shops closed, no gatherings in coronavirus lockdown
British Prime Minister Boris Johnson on Monday ordered Britons to stay at home to try to halt the spread of coronavirus, closing non-essential shops, telling people not to meet with friends or family and warning those who do not follow the rules face fines.
Deaths from the virus in Britain jumped to 335 on Monday as the government said the military would help ship millions of items of personal protective equipment (PPE) including masks to health-care workers who have complained of shortages.
“From this evening I must give the British people a very simple instruction — you must stay at home,” Johnson said in a televised address to the nation, replacing his usual daily news conference.
Johnson said people would only be allowed to leave their homes to shop for basic necessities, exercise, for a medical need, to provide care or traveling to and from work where absolutely necessary.
“That’s all — these are the only reasons you should leave your home,” he said, adding that people should not meet friends or family members who do not live in their home.
“If you don’t follow the rules, the police will have the powers to enforce them, including through fines and dispersing gatherings,” he warned.
The new measures would be reviewed in three weeks, and relaxed if possible.
The government will close all shops selling non-essential goods, Johnson said, including clothing stores, as well as other premises including libraries, playgrounds and outdoor gyms, and places of worship.
Advice to stay at home and avoid social gatherings went unheeded by millions at the weekend who took advantage of sunny weather to flock to parks and beauty spots, ignoring instructions to stay two metres apart.
Under the new measures, the government will stop all gatherings of more than two people in public who do not live together, and stop all social events, including weddings and baptisms but not funerals.
Parks would remain open for exercise but gatherings would be dispersed, Johnson said.
Later on Monday, Britain’s lower house of Parliament is expected to approve emergency legislation giving authorities sweeping powers to tackle the outbreak, including the right to detain people and put them in isolation to protect public health.
“Without a huge national effort to halt the growth of this virus, there will come a moment when no health service in the world could possibly cope; because there won’t be enough ventilators, enough intensive care beds, enough doctors and nurses,” Johnson said in his address.
Earlier, in a letter pleading with him to increase PPE supplies, more than 6,000 frontline doctors warned they felt like “cannon fodder” and were being asked to put their lives at risk with out-of-date masks, and low stocks of equipment.
Health Secretary Matt Hancock admitted there had been issues but promised action was being taken. He said the army would drive trucks throughout the day and night to get supplies to medical staff.
“It’s like a war effort — it is a war against this virus and so the army have been incredibly helpful in getting those logistics so we can get the supplies to protect people on the front line,” he told the BBC, saying the health service now had 12,000 ventilators, 7,000 more than at the start of the crisis.
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‘You could literally go around the Earth’ before symptoms start: Screening for new coronavirus
Medical screening at airports, border crossings and health-care institutions takes on new urgency when a viral threat looms.
Tuesday’s announcement of the first infection in the U.S. — a man who returned to the Seattle area last week after travelling to the outbreak’s epicentre in Wuhan, central China — adds to more than 400 people infected with the new coronavirus, which has sickened people in China as well as Thailand, Japan and South Korea.
U.S. health officials will expand airport screening from New York, San Francisco and Los Angeles to Chicago and Atlanta.
The Public Health Agency of Canada acts as the lead agency for the coronavirus through the Quarantine Act.
As part of the federal government’s response, Canada Border Services Agency officials will ask travellers: “Have you been in Wuhan, China in the past 14 days?” There are no direct flights from Wuhan to Canada.
Additional signs at airports in Toronto, Montreal and Vancouver will remind passengers to speak to border officials if they have flu-like symptoms such as fever and cough.
“We are in the process of putting up signs on the electronic screens warning travellers that if they’ve been to an affected area to essentially determine if they’ve been in contact with live animals, sick people,” Dr. Theresa Tam, Canada’s chief public health officer, said Tuesday on CBC’s Power & Politics.
“We are certainly preparing for the potential of a first case in Canada,” says <a href=”https://twitter.com/CPHO_Canada?ref_src=twsrc%5Etfw”>@CPHO_Canada</a> Dr. Tam, as the deadly coronovirus outbreak in China continues to spread. She says it’s “not surprising” the U.S. has detected a case, given the heightened alerts to local health systems. <a href=”https://t.co/TCIuQApWD3″>pic.twitter.com/TCIuQApWD3</a>
—@PnPCBC
If so, CBSA agents can alert a federal quarantine officer to do an assessment, which could include a temperature check.
“The current assessment of the risk to Canada is low,” Tam said.
Dr. Vanessa Allen, chief of medical microbiology at Public Health Ontario, said three potential cases in the province were investigated and ruled out.
“We were aware of the link,” Allen said. “Co-ordinated calls were arranged by the ministry and we discussed the cases and the three individuals more subsequently tested. So they all had, you know, some degree of a link to Wuhan with respiratory symptoms. We did in fact test in an abundance of caution.”
Canada’s National Microbiology Laboratory as well as provincial government labs in Ontario, British Columbia and Alberta have a battery of tests to detect respiratory pathogens, including one that’s in the works for the new coronavirus, Allen said.
Temperature checks and SARS lesson
So far, Canada is not planning to use thermal imaging to monitor travellers en masse as was tested during the 2002-03 outbreak of severe acute respiratory syndrome or SARS that affected nearly 8,100 people and caused 774 deaths, according to the World Health Organization.
Steven Hoffman, a law professor and director of the Global Strategy Lab at Toronto’s York University, an expert on global health, supports Canada’s screening approach so far.
“Not everyone who has a high temperature is going to have this novel coronavirus. In fact, only a very small percentage would,” said Hoffman.
It’s also important that health-care systems in Canada prepare.
“There’ll likely be a case in Canada at some point. But the key then is once you have cases how much are you able to contain it before it further spreads,” Hoffman said.
The first U.S. patient illustrates one of the weaknesses of airport screening — the man in his 30s did not have symptoms when he arrived and was in good condition, so he wouldn’t be picked up in a check for fever.
Rather, when the man started feeling ill, he went to a doctor, with a fever and cough. Lab tests confirmed the infection and he was put into isolation for monitoring.
Engaging travellers
Dr. Kamran Khan, an infectious disease physician in Toronto, said there’s a time between when people are infected and when they develop symptoms — the incubation period. For coronaviruses in general, such as those that can cause the common cold, the incubation period is typically five or six days.
With coronaviruses such as SARS and Middle East Respiratory Syndrome, MERS, the incubation period can extend to two weeks.
“You can imagine if an individual is infected and they get on a plane and it could be up to two weeks before they manifest symptoms. In today’s world you could literally go around the Earth before you start to develop illness,” said Khan, founder and CEO of BlueDot, a digital health company that helps predict the spread of infectious diseases globally.
“We need to kind of think about that in the context of how airport screening works. The value of airport screening and engagement with travellers, if you will, is more about giving them the information they need so that if they do become sick after they’ve left the airport they know what to do.”
Tam called the airport measures one layer of protection on top of alerting health systems to be on the lookout for travellers who may be infected.
Otherwise, health officials are stressing precautions for travellers to prevent the infection while in China, such as staying away from animal markets, washing hands, observing cough hygiene, not contacting sick people and telling health-care providers about their travel if flu-like symptoms occur.
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