Horacio Arruda defends Quebec's handling of crisis in seniors' homes

Quebec's top public health officials sought Thursday to explain the decisions made in the early stages of the pandemic, when the coronavirus ravaged the province's system of long-term care homes. 

At a public inquiry into the system, Dr. Horacio Arruda, the province's public health director, insisted the safety of seniors was their main priority in the spring of 2020.

Arruda was pressed, in particular, on why the province prohibited caregivers from visiting long-term care homes and why staff who had been in contact with COVID-19 patients were instructed to isolate themselves for 14 days, even if they didn't display symptoms.

Earlier witnesses have said those two decisions exacerbated staffing shortages in the early stages of the crisis

Coroner Géhane Kamel also asked why the province didn't put in place a plan to reschedule health-care appointments and non-urgent surgeries to free up additional staff to assist in long-term care homes.

Arruda replied the situation was complex and that he wasn't in a position to speak for the whole system given that his job relates to public health, rather than the organization of the health-care network. 

But he stressed the pandemic was "historic" in nature. 

At the outset of his much-anticipated testimony, the public health director traced what he knew about the virus beginning in January 2020 through to April of the same year. 

He recounted how the potential risk was unclear early on and that, as the virus began to spread in Quebec, there was an international shortage of personal protective equipment and masks.

Until late March 2020, as well, it was thought the virus was spread mostly by people with symptoms.

Hospital system 'better protected'

The inquiry has heard previous witnesses criticize the province's slow response in the early days of the pandemic, as well as its failure to grasp the seriousness of what was to come or to anticipate that seniors would be adversely affected.

On Thursday morning, Dr. Richard Massé, a strategic medical adviser to Arruda, acknowledged that the hospital system was "better protected" than the network of long-term care facilities during the first wave.

When asked if the province's response was "optimal" after seeing what was happening in Europe and China, Massé said the province followed other jurisdictions closely but that early scientific literature on the coronavirus wasn't always complete.

Massé said the province had difficulty securing personal protective equipment during the early days of the pandemic, when there was a "ferocious battle'' for things such as masks and tests.

Even if authorities had had enough protective equipment, he said it's unclear whether they would have known the best ways to use it.

"There were people who said, 'we think it's transmitted by asymptomatic people,' but there was no consensus,'' he said, adding that neither authorities in the United States nor at the World Health Organization recognized asymptomatic spread as a significant mode of transmission.

Public health officials, he said, did not have a sense of how rapidly the virus was spreading at long-term care facilities, including at the Herron senior's residence, a privately-run long-term care home where 47 people died.

Questions blocked due to cabinet confidentiality

Last week, patients' rights advocate Paul Brunet told the inquiry that he considered Arruda's handling of the early days of the pandemic — alongside the health minister at the time, Danielle McCann — to be so awful that he filed a criminal complaint with provincial police accusing them of negligence.

Brunet said the province should never have transferred hundreds of patients from hospitals to CHSLDs during the first wave.

He also said it should have stockpiled more personal protective equipment, instituted mass testing in care homes earlier, and allowed family caregivers to continue to visit their loved ones.

Brunet said the failure to take those actions contributed to thousands of seniors dying.

The inquiry tried to get answers on some of those questions Wednesday, but was stonewalled by a lawyer for the Health Ministry.

Jocelyne Sauvé, a specialist with the province's public health institute, was testifying about various scenarios presented by the institute to the ministry in a meeting on March 9, 2020.

At one point the lawyer for the ministry objected, saying discussing those scenarios would violate cabinet confidentiality rules.

Kamel agreed to stop the questions at that point, although the coroner said she hoped to arrive at a compromise so those scenarios could eventually be shared with the inquiry.

"I do not feel at all that we are within the scope of parliamentary privilege," Kamel said, stressing that being prevented from seeing those scenarios could give the impression that her inquiry lacks transparency.