Quebec thought COVID-19 threatened hospitals, not long-term care homes, seniors minister says

As the threat of COVID-19 loomed before the pandemic, the Quebec government focused on protecting hospitals, oblivious to the damage the virus would soon inflict on those living and working in long-term care settings, according to the provincial minister responsible for seniors.

Marguerite Blais appeared Friday at the inquiry into deaths in long-term care homes, delivering her much-awaited testimony as a coroner tries to get to the bottom of what led to thousands of deaths during the pandemic's first wave.

As Blais was making her opening statement, Coroner Géhane Kamel pointed to a letter the province's Health Ministry sent on Jan. 28, 2020, in which it asked the heads of regional health boards to begin preparing for the virus.

The letter made no specific mention of CHSLDs; the initials, in French, for long-term care homes.

Kamel asked Blais if the directive put the focus on hospitals, and not enough on CHSLDs.

"On Jan. 28, we didn't know that [the virus] could affect elderly people," the minister responded.

Blais said it was not until March 9 that she became aware of the danger the virus posed to seniors, after receiving that information from the World Health Organization.

"There was no one that believed that it was going to affect living environments [like long-term care and seniors' homes]. We thought it was going to affect hospitals," she testified.

Kamel repeatedly asked Blais if the government only began putting the focus on long-term care facilities on March 9.

"We didn't prepare CHSLDs as we prepared hospitals," the minister eventually answered. She said staffing shortfalls and the lack of protective equipment for those working in long-term care institutions exacerbated the dangers posed by COVID-19.

"The blind spot with CHSLDs didn't start with the pandemic," Blais said.

Contradicts Arruda

Blais's testimony stands in sharp contrast to what Dr. Horacio Arruda told the inquiry last fall.

The former provincial public health director, who resigned last Monday, testified in November that he had had internal discussions about the possible risks COVID-19 could pose to seniors in long-term care as early as January and February 2020.

Kamel found Arruda's statement to be problematic, considering the sheer volume of witness testimony before the inquiry regarding the lack of pandemic preparation in CHSLDs.

On Friday, Blais was shown an internal note sent by Quebec Public Health, dated Feb. 7, 2020, which explained that the coronavirus put seniors at risk.

Blais said she had never seen that note and was unaware of its existence.

Backtracks on comments about Legault

Blais's comments regarding the lack of preparation in CHSLDs mirror what she told Radio-Canada in 2020.

Asked in that interview if she thought she had enough power to act within the Health Ministry, she appeared to suggest Premier François Legault limited her ability to protect seniors.

"Power is extremely relative. Power is what the premier gives you. It's the premier who has the power," she said at the time. "He is the one who decides the direction and what he wants to do with his government. So what does that mean, power?"

On Friday, the minister attempted to clarify her earlier comments, saying the crisis in long-term care facilities was still unfolding at the time of that interview, and she was still experiencing "extreme emotions."

"I hadn't taken the necessary steps back," she told the coroner. "That interview does not reflect the objectivity that I have today."

The coroner said she understood that the minister needs to show loyalty toward her political party.

'We were at war'

Blais was originally supposed to appear last fall, but her testimony was delayed because she was on sick leave.

On Friday, Blais offered her condolences to families who lost loved ones during the pandemic.

"I was in the front row, in a way, of what happened. I am part of your investigation," she told the coroner. "I believe that you are conducting a fundamental investigation for the improvement of care."

Blais said officials and staff across the provincial government worked tirelessly to protect Quebecers from the coronavirus.

"Seven days a week, almost 24 hours a day, these people spared no effort, [they sacrificed] their health, they put their families aside, and worked hard to save lives," she said.

"That's what it was in the end. We were at war, and we were saving lives."

Blais also said long-term care facilities had had experience with managing outbreaks prior to the pandemic. 

Witness testimony at the inquiry was supposed to have wrapped up by now. 

Kamel added extra witnesses this week in order to find what she calls the "missing puzzle piece" regarding the province's plan to protect long-term care settings from the coronavirus.

In a scathing report released last fall, Quebec's ombudsman found it took the government weeks to react to the crisis in long-term care homes, where most of the deaths during the first wave took place.

Martin Simard, a Health Ministry bureaucrat, began testifying on Friday afternoon. He'll face questions on Monday.

The closing remarks from lawyers representing various interested parties are scheduled to start next week.