Hecatomb in CHSLD: the diagnosis of Dr. Boileau

Hecatomb in CHSLD: Dr. Boileau's diagnosis


For the Legault government, the day promises to be difficult. Health Commissioner Joanne Castonguay submits her final report on “performance” of the health system in CHSLDs and RPAs during the pandemic.

All the more difficult since the Castonguay report falls at the very moment when coroner Géhane Kamel is finishing her own hearings on the carnage of the first wave in CHSLDs.

In short, nothing to alleviate the mounting pressures for a real independent public inquiry – a vital condition if we want to understand how to improve for good the conditions of care and of life.

In this thick fog, I explained yesterday why Marguerite Blais' testimony before coroner Kamel is the most plausible of all.

Friday, the Minister of Seniors and Caregivers confirmed that before March 2020, while the Ministry of Health was preparing hospitals for the pandemic, nothing had been done for the CHSLDs, which were already very fragile.

This total lack of preparation, combined among other things with the deleterious effects of the Barrette reforms, the cuts under the Bouchard and Couillard regimes and the crass negligence of the CHSLDs under the previous governments, was the chronicle of an announced catastrophe.


A “shock very difficult to manage”

Interestingly, very recently, Dr. Luc Boileau, now called upon to play a major role in the management of the pandemic as the new acting national director of public health, seemed to agree.

In October 2021, then CEO of the National Institute of Excellence in Health and Social Services of Quebec, he was one of the guest speakers at the Health Meetings in Nice, France. Dr. Réjean Hébert, former Minister of Health, was also one of them.

Asked about the tragedy of the first wave, Dr. Boileau's answer, like that of Minister Blais, was clear and lucid. Because he now occupies important functions for the future, what he said in Nice is worth dwelling on. Here are some excerpts.

“One of the great characteristics [in Quebec] was this first wave, which was fatal for, unfortunately, the much older people. […] It was a particular risk for people who were in accommodation. In our CHSLDs and even our RPAs, there have been disasters, really harsh and unworthy of a system that was supposed to be solid. » […]

“We bet, at the beginning, on protecting the critical space of hospital care and critical care, and we abandoned the attention that we had to pay to others, in a certain way, but it It was a system that was already extremely fragile on that side. » […]

Perfect recipe for a case explosion

“Where we had a defect was probably in the anticipation, before COVID existed, of the needs or the organization of the services that had to be done for the elderly, particularly in accommodation.  » […]

“And the dramatic arrival of COVID, with these poorly managed spaces, weak protection in terms of infection, a call for resources to the hospital sector and a transfer of heavy cases to CHSLDs, was a perfect recipe for an explosion of cases. » […]

“When we look at Quebec – even if the population is generally very satisfied with the evolution of the management of COVID – the fact remains that if we withdraw Quebec from Canada, and we compare ourselves to Canada, we have had twice as many deaths. These deaths are of the elderly, the majority of whom [lived] in institutions. So, there is something there, which is a shock and which is very difficult to manage. »

That is what is said… and repeated.

Hecatomb in CHSLD: Dr. Boileau's diagnosis

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