Quebec Healthcare June 2020-

Written by  //  May 16, 2022  //  Health & Health care, Québec  //  No comments

COVID-19 pandemic in Quebec
Where are the Family Doctors?
Mise en demeure

Quebec coroner slams province for response to 1st wave deaths in long-term care
Coroner Géhane Kamel publishes final report after hearing from hundreds of witnesses
The lack of independence granted to Quebec’s public health director may have slowed the government response at the beginning of the pandemic, as hundreds were dying in long-term care homes across the province.
Coroner Géhane Kamel published a report Monday following months of inquiry into deaths in seniors’ residences, where the pandemic killed more than 5,000 in the spring of 2020.
After hearing testimony from 220 government officials, long-term care home employees, and the loved ones of people who died, Kamel issued 23 recommendations targeting the provincial government, its Health Ministry, local health boards and the Quebec College of Physicians.
One of the report’s first recommendations calls on the government to review the role of its public health director so that whoever is in the position can exercise their functions “without political constraints.”
In her report, Kamel notes that in the early days of the pandemic, infection control measures were far more strict in hospitals and at testing clinics than in long-term care homes, where there were far more COVID-19 cases.

7 May
More people are living in Quebec’s Laurentians, but its health-care system can’t keep up
Chronic underfunding plus aging, growing population is a ‘perfect storm,’ says doctor
Municipalities and doctors say that as the population of the Laurentians has grown, the funding for the area’s health-care system hasn’t kept up, leaving residents in the lurch
Dr. Simon-Pierre Landry, an emergency room physician at Laurentian Hospital, said it’s a problem that’s been years in the making.
“The hospitals were not designed to accommodate such a large population,” he said. “We used to see surges in the summertime and at Christmas. But now it’s all over the year.”
Some areas have been hit harder than others. The city of Mirabel saw its population grow by 21 per cent in five years, an increase of almost 11,000 people.
Even small town populations are exploding, with the tiny village of Gore ⁠— with a 2016 population of 1,904 ⁠— growing by a whopping 19.9 per cent.
And it’s not slowing down. According to a report by the province’s statistics agency, the Laurentians’ population is set to grow another 20 per cent by 2041, adding approximately more 127,000 people to the region.

3 May
Quebec reaches deal with family doctors to improve access to basic care
After years of failed attempts and long months of negotiations, the province has reached a tentative deal with family doctors. As Gloria Henriquez reports, it’s a deal that will radically change the way Quebecers access health care
In a statement published Sunday, the government said the deal will allow patients signed up with a family doctor to have access to that doctor or another one from the doctor’s group within 36 to 72 hours, depending on their medical situation.
For those without family doctors, an online platform under development will let them make an appointment to consult with the right health professional within a “reasonable” delay.

29 April
12 organizations demand a law on safe healthcare ratios in Québec
(FIQ*) No less than twelve groups, associations and professional orders are launching a petition today demanding a law on safe healthcare ratios in Québec. As one, they are demanding the government pass a law now, guaranteeing minimum safe ratios to ensure the safety and quality of the care provided to the entire population of Québec and begin the gradual implementation of this law immediately.
All the spokespersons have no doubt that safe ratios should be a mandatory standard applicable everywhere in order to always have complete and competent care teams. They are necessary to attract staff to the network and so the staff already working in the network can remain healthy and enjoy a rewarding work environment, for the benefit of the care provided to the people of Québec.
“Many people think, incorrectly, that because of the staff shortage ratios cannot be implemented. On the contrary, ratios will be the impetus needed to attract and retain healthcare professionals in the public health network. That is exactly what California and the State of Victoria in Australia succeeded in doing by implementing ratios.”
*The FIQ is a labour organization that represents près de 76 000 nurses, licensed practical nurses, respiratory therapists and clinical perfusionists who work in health institutions province-wide.

14 April
Bill 96 language-law changes could put people’s lives in danger, doctors warn
The reform proposes that public services be offered in French only to immigrants once they have been in Quebec for six months.
The Coalition pour des services sociaux et de santé de qualité (CSSSQ) delivered their warning in an open letter published in French-language media on Wednesday.
The group argues that in its present form the proposed legislation “could put people’s lives at risk or have negative mental impacts if enforced.”
“It is already difficult enough to understand information under stressful conditions. Adding unnecessary barriers will only increase this risk and impair the ability of providers to offer optimal care,” wrote the coalition, which includes 500 doctors and medical professionals as well as 30 groups and organizations.

9 April
Band-Aid on a health crisis: Montreal doctors give their prognosis
For overwhelmed GPs in the Montreal region, Quebec’s latest reform is “not going to solve the underlying problem.”
Positive reforms to the medical system are undermined by the fact “there are 650,000 citizens in Montreal without a family doctor. That’s outrageous,” says Dr. Mark Roper
Chief among the remedies prescribed by Health Minister Christian Dubé last week in his government’s reform of Quebec’s medical system was the promise of quick access to a health-care professional via a telephone and online access portal.
By expanding on pilot projects in Rimouski and Rivière-du-Loup that have proved successful, Dubé pledged the government would be able to provide rapid access by this summer to a health-care provider — be it a family doctor, psychologist, nurse or social worker — for roughly half of the 945,000 Quebecers on a waiting list to find a family physician.
Using this form of telephone or online triage system will ensure fewer patients go to overcrowded emergency departments and hopefully ease the pressure on general practitioners by sharing the load with other professionals, Quebec’s Ministry of Health said.
The problem, say family doctors, is that while there may be enough general practitioners in some regions of Quebec to meet this goal, there is a distinct lack of resources and GPs in the areas of the province in which most people live — namely Montreal, Laval, Montérégie and Quebec City.

5 April
Email reveals Legault government knew about CHSLD Herron crisis earlier than thought
Premier defends how ministers responded to crisis, says they believed local health authority was on it
When workers from the local health authority, the CIUSSS Ouest-de-l’Île-de-Montréal, arrived at Herron on March 29, 2020, there were three employees caring for 133 residents, according to a report released later that year.
By then, at least 31 people had died. A total of 47 people died in the spring of 2020 at the Herron CHSLD, but precisely who is to blame for what transpired remains the subject of debate.
During a provincial inquiry into deaths in several seniors’ residences led by Coroner Géhane Kamel late last year, lawyers representing both Herron and the CIUSSS offered different versions of what led to the dire situation. Kamel’s final report is expected later this year.

31 March
Quebec public health director says ‘all options are on the table’ in face of 6th wave
Quebec’s interim public health director Dr. Luc Boileau isn’t excluding the idea of bringing back some health protection measures, as COVID-19 cases surge in the province.
But Health Minister Christian Dubé says there are no plans to add restrictions

29 March

Quebec’s 2022 health reform explained
(Montreal Gazette) The “foundations” of the action plan include major upgrades in staffing, access to care, the way medical data is stored and shared — and more privatization.
Its main priority is to offer all citizens access to a family doctor or other health-care professional to receive quick front-line care. Health Minister Christian Dubé recently estimated that as many as 1.5 million Quebecers still don’t have access to a general practitioner.
In an 80-page document titled Human and Efficient, the Coalition Avenir Québec government chronicles the system’s ailments, including a lack of personnel (the government estimates roughly 50,000 workers were missing from the health system in January; of those, 20,000 were off because of COVID-19), an aging population, lack of access to rapid care and an outdated medical data system.

22 March
Highlights of the Quebec 2022-23 budget
Spending increases below are over five years unless otherwise noted.
Health care and social services
$1 billion on health care facility reform
$2 billion to improve working conditions for staff
$757.5 million to hire more administrative staff
$370.6 million to improve paramedic services
$262.7 million to hire more hospital technicians and pharmacists
$789 million to modernize the health system
$546 million to improve accessibility to services, including deploying clinics for “complex diseases” including $20.5 million to establish 15 long COVID-19 clinics
$508 million to improve services for youth in difficulty and mental health initiatives
$72.4 million for medically assisted reproduction

28 February
Quebec doctors who provide care in English say they’re concerned about new language legislation
(CTV) Doctors at the Jewish General Hospital were given a briefing this week on Quebec’s new language legislation meant to strengthen French in the province.
“The law is written in the most complicated way possible,” said Eric Maldoff, a prominent Montreal lawyer and long-time language rights advocate.
Under Bill 96, Maldoff said only people who attended English school in Canada will be allowed to receive health-care services in English.
That could disqualify between 300,000 and 500,000 English speakers in the province, Maldoff said.
Under Bill 96, Maldoff said only people who attended English school in Canada will be allowed to receive health-care services in English.
That could disqualify between 300,000 and 500,000 English speakers in the province, Maldoff said.
“It says that the provider has an option to provide services in English in certain limited number of circumstances. And even when they do, they should do everything possible not to be providing services in English – and when they do, it shouldn’t be systematic,” he said.
Bilingual institutions like the Jewish General Hospital and the MUHC are excluded from that, but Maldoff said he worries about English speakers who don’t live near those facilities.
“Two thirds of the English-speaking population get their services from institutions which are not bilingual services, but obligated to make services available in English,” he said.

14 February
These COVID-19 restrictions have been lifted in Quebec, others are upcoming
(CTV) The Quebec government’s deconfinement plan continued Monday as the province continues to chip away at restrictions put in place during the fifth wave of the COVID-19 pandemic.
Masks and vaccination passports remain in place but the following lightened restrictions are now in place.
There is now no restriction on the number of people permitted at private gatherings though public health officials suggest a maximum of 10 people or three households.
Restaurant staff can seat 10 people per table from three addresses so long as everyone has a valid vaccination passport.
Two people (informal caregivers or visitors) can visit a loved one in a private seniors’ home (RPA) at a time with a valid vaccination passport. A maximum of four people per day are permitted to visit.
One person can visit a loved one at a public seniors’ home (CHSLD) at a time with a two-person maximum per day. Outings are now permitted for seniors.

10 February
Next month, lawyers Julius Grey and Michaëlla Bouchard-Racine will challenge this absurd system as a breach of the rights of equity and access to health care. Change is long overdue.
Equity needed in Quebec’s distribution of family doctors
“It seems that doctors are not just care providers, but vote providers for our political parties,” Dr. Mark Roper writes.
Logically, one would think that most new doctors would be allocated to areas with the highest demand, but it seems that’s not what happens.
There are huge differences between regions.
Saguenay—Lac-St-Jean, with its 92-per-cent registration rate, is to receive a net increase of 10 family doctors, to register the remaining 20,787 citizens without a family doctor.
By comparison, the sub region of de la Montagne, which includes Montreal’s Côte-des-Neiges area, has a similar population and a 63 per cent registration rate, but will receive a net gain of two family doctors to care for the 92,405 citizens without a family doctor.
There are numerous flaws in the present process:
… Compounding the problem is that Quebec allows fewer spots to be filled than it graduates, thereby ensuring an outflow of our graduates of about five per cent. The entry of doctors into Quebec is effectively blocked. As a result, some regions of Quebec have the lowest rates of registration with a family doctor in the country, including the Plateau region in central Montreal, at 61 per cent, while the health ministry calculates there are too many family doctors in primary care in this region.
Evidence shows that for every 100,000 citizens without a family doctor, 39 extra people die every year.

26 January
As Quebec moves to ease COVID-19 restrictions, daily death toll remains in double digits
Quebec announces plan to reopen restaurants, cinemas in coming weeks
Still no word for bars and gyms, which have been closed since late December
Restaurants will once again be allowed to reopen at half capacity as of Monday, Jan. 31. Up to four people from four different addresses or a maximum of two family bubbles will be allowed to share a table. However, restaurants will have to stop serving alcohol at 11 p.m. and will have to close at midnight.
The same numbers will apply to indoor private gatherings, which will be allowed as of next Monday after being banned since New Year’s Eve
Cinemas and theatres will also be allowed to reopen as of Feb. 7 — a week after restaurants — though also at half capacity, with a maximum of 500 people per room.
That limit also applies to the Bell Centre, despite the fact that it’s a large amphitheatre.
Places of worship are also allowed to reopen as of Feb. 7 but, with a few exceptions, they must be at half capacity, with a maximum of 250 people. Vaccination passports will be required for entry.

21 January
Aaron Derfel: Quebec’s health-care system has already reached the point of no return
The situation is so dire that many Quebecers haven’t seemed to notice that emergency-room overcrowding has returned with a vengeance.
This pandemic will one day end. But perhaps it’s time for Quebec and countries around the world to consider something even bolder — not merely a reform — but an international Marshall Plan to rebuild health systems and prevent another pandemic in the future. Among other things, this would involve massive investments in better ventilation in buildings and air transportation to guard against COVID and every other respiratory virus, including the flu.

19 January
Caregivers groups worried exhausted families will have to take on more work
As Quebec prepares for its hospital network to be overwhelmed, professional orders are reminding their members to maintain their standards.
Groups representing caregivers in Quebec fear the province’s new contingency plan for hospitals could further burden family members already exhausted from two years of the pandemic.
Announced on Tuesday, one of the axes of the plan is to call on families and caregivers to help care for patients, both inside and out of hospitals.
CHSLD system completely unprepared for pandemic, health commissioner says
Quebec health and welfare commissioner Joanne Castonguay has issued a blistering report on the state of long-term care residences.
Quebec was completely unprepared to handle the COVID-19 pandemic and had no crisis management plan in place, resulting in the tragic deaths of thousands of seniors in long-term care homes, Quebec’s health and welfare commissioner says.

17 January
Nawaz: Quebec’s selective relationship with COVID-19 reality makes me want to shout
By most metrics — case numbers, deaths, hospital capacity, health care worker absences — everything is worse. Nothing makes sense. Again.
Central to all this is the INSPQ’s continued claim that there is no direct evidence that COVID-19 is airborne — even though the World Health Organization, the CDC and the Public Health Agency of Canada have all updated their guidance after months of urging from leading experts. But because of this lagging acknowledgement, Quebec continues to make risky and contradictory recommendations.
The thing that I feel I can’t take any more isn’t the restriction of my civil liberties or the limiting of my social contacts or the prospect of waiting in line to get into the SAQ — though I don’t enjoy any of those. The thing that makes me want to shout out my window is the government’s selective relationship to reality.
Sure, the curfew is over and in-person classes resume this week at primary and secondary schools in Quebec. Those are good things, in theory. Except that by most metrics — COVID-19 case numbers, deaths, hospital capacity, health care worker absences — everything is much worse than before. Nothing makes sense. Again.
When I saw that Arruda had resigned , I felt some brief excitement that he would be succeeded by someone who might dare to offer some independent public health guidance. But any hopes I had from his replacement, Dr. Luc Boileau — a former head of the INSPQ — were quickly dashed on Thursday when he reiterated Arruda’s claim that surgical masks were just as good as N95s in workplace settings and that it wouldn’t be any safer for teachers to wear N95s in the classroom.

14 January
Her mother received a dementia diagnosis. The doctor said, ‘Good luck, Mrs. Webster’
Claire Webster calls the dementia education program she launched at McGill “the gift of my mother’s illness.”
Alzheimer’s disease has cast a long shadow over Claire Webster’s life. She has used her experience to help other family caregivers.

11 January
Horacio Arruda resigns as Quebec’s public health director
Public comments cast doubt on “the credibility of our recommendations and our scientific rigour,” he writes in a letter to the premier.

2021

Allison Hanes: 2021 was a roller-coaster ride
The year began in a dark, lonely tunnel. And now it feels an awful lot like we’re back where we started.
There were lockdowns. We were confined to home and subject to a curfew. It was an unprecedented suspension of civil liberties. But what choice did we have, as we waited anxiously for vaccines to arrive?
Eventually they did come. Quebec worked its way through the age groups, with approval granted to vaccinate teens 12 and over by late spring. Things we looking up. In the sunshine, with many everyday activities resuming, life did feel relatively normal again. Thanks to vaccines, a testament to human ingenuity and scientific prowess, we could breath a bit easier.
But not everyone jumped at the chance to inoculate themselves against a virus that had upended our world. The conspiracy theories and misinformation that spawned such covidiocy as anti-mask protests turned instead toward opposition to mass vaccination, vaccine mandates and vaccine passports. The refusal of a few to use the tools available to protect the many has frayed social bonds and tested patience.

25-29 December
Some health-care workers in Quebec who test positive for the virus no longer need to isolate, according to Quebec’s Health Minister Christian Dubé
Quebec reported 13,149 new cases of COVID-19 on Wednesday and 10 new deaths.
Since the start of the pandemic, there have been 572,419 confirmed cases and 11,702 people have died.
There are 804 people in hospital (an increase of 102 from the previous day), including 122 in intensive care (an increase of seven).
The province has administered 14,900,242 doses of COVID-19 vaccines as of Wednesday.
89 per cent of the eligible population in the province (ages five and up) has received one dose of vaccine, 82 per cent has received two doses, and 14 per cent have received three doses.
28 December
Hospitalizations soar as Quebec reports a record 12,833 COVID-19 cases
The seven-day rolling average of infections in the province is now at an all-time high of 9,133. A total of 559,269 infections have now been confirmed in the province since the first one was reported in February of 2020.
While people who do not have the protection of even one vaccine dose make up just 18.7 per cent of the province’s population, they accounted for the majority of the 158 hospital admissions due to COVID-19 in the past 24 hours.
Legault warns tough weeks ahead as COVID-19 cases mount
…officials reported more than 10,000 new COVID-19 cases, a new daily record, and 9,206 cases on Christmas Day.
Quebec tightened restrictions this week, cutting private gatherings to six people or to two family bubbles, beginning on Boxing Day. Bars, movie theatres, gyms and entertainment venues were abruptly ordered to close earlier this week, while restaurants were permitted to stay open at 50 per cent capacity with a strict 10 p.m. closing time.

4 December
Quebec government must fully reopen Lachine Hospital now, doctors say
A staff shortage forced the reduction of services at the Lachine Hospital last month, and now a group of doctors is calling on the provincial government to reverse that decision.
Premier François Legault’s administration has opened bars and dance clubs by decree, and now advocates want the premier to use that power to open the hospital, Saba said, speaking alongside a group of medical professionals in front of the hospital.
The McGill University Health Centre (MUHC), which manages the hospital, reduced the emergency room hours to between 8 a.m. and 3 p.m. Ambulances are being re-routed, and only walk-ins are accepted.

15 November
Some family doctors in Montreal are going private, with burnout and Quebec meddling to blame
(CTV) The Quebec government’s latest attempt at telling Montreal’s family doctors they should be seeing more patients has landed with a thud, according to two general practitioners who said they are demoralized and tired of being micromanaged by the province.
Taking early retirement is also now seen as a viable option, and may become a more palatable idea each time the government floats a new plan to change doctors’ workflow.
In addition, there is the cohort of female family doctors, who are starting families of their own and are placed in a no-win situation, Buch said.
…“Is that the intent of this manoeuvre, to make it so bad in Montreal that we start going to private doctors?” said Dr. Mark Roper … who is currently investing a lot of time and energy into fighting for a strong public health care system. He also lamented that with so many Montreal residents doctor-less and in need of care “nowadays it is more possible to have a successful private practice, unfortunately.”
The province sends doctors to regions that ostensibly need them through a permit system known as PREM –a regional physician resource plan. Roper would like to see the system suspended.
The PREM plan for 2022 was released in October.
In a few months, he’ll be voicing his critique on the record. Aside from running a busy GMF [family medicine group], he has initiated a legal challenge against the government, with a first court date scheduled for Feb. 22.

11 November
Quebec tables bill to improve public’s access to GPs
Bill 11 contains no punitive measures, but would oblige doctors to be more transparent about the hours they work.
The bill proposes to deploy a time management platform across Quebec where doctors are obliged to list their availability and patients seek appointments where there are openings.
The bill states Quebec will oblige doctors to “make themselves available,” for people seeking a family doctor by posting openings on the website.
Doctors will only be allowed to take on new patients already waiting on the appointment booking system operated by the Régie de l’assurance maladie du Québec.
Quebec can also, by regulation, determine the percentage of blocks where a doctor must make themselves available from Monday to Friday, before 8 a.m. and after 7 p.m. as well as Saturday and Sunday.
Dubé made one new revelation. He said he believes the number of people seeking a family doctor is actually much higher, about 1.5 million, than the current official number which is 800,000.
Bombarded with questions on how he expects the system work, Dubé said a few things have changed in Quebec. For one thing, the COVID-19 pandemic revealed such appointment websites such as Clic santé can work. So can more telemedicine .

5 November
Head of Lachine Hospital physicians’ council calls on Legault to keep ER open
The partial closure of the hospital’s ER and intensive care beds “will cause unprecedented damage to local citizens and overwhelm the already overcrowded emergency rooms on the island of Montreal,” Dr. Paul Saba writes in a letter to the premier.
The McGill University Health Centre announced the partial closure a week ago . The temporary reduction in service is the result of a “critical shortage” of nurses and respiratory therapists, MUHC president and executive director Pierre Gfeller said at a news conference at the hospital on Oct. 29.
“We ask you to pass a decree to keep the emergency room and intensive care open 24 hours a day, seven days a week,” Saba’s letter to Legault said.
“This decree must include financial incentives of a $15,000 wage premium per year for nurses and health workers in intensive care for at least two years and a 14 per cent critical care bonus that is (already) given to downtown hospitals that stole our health-care workers. This measure will cost the government about $200,000 per year for the missing health-care workers who are needed to keep the emergency room and intensive care at Lachine Hospital open.”
Saba has said that four of the respiratory therapists who left Lachine Hospital this year were lured away with the critical care bonus the government offers to work downtown.

27 October – 3 November
Opinion: Don’t blame family doctors for shortage in Quebec
Premier’s threats of coercion only bring bitterness and physician departures.
Family physicians have absorbed more than 1.1 million patients into their practices in the past five years. Patient registration has stagnated because of the pandemic and doctor retirements. To grow from 400,000 to 800,000 Quebecers without family physicians in three years is certainly not because the population has grown substantially or because doctors dramatically cut their practices.
It is primarily because of retirements . What other profession is singled out when its members retire, leave the profession or die? We were short 1,000 family physicians three years ago. Among the 9,500 in Quebec, there are 3,147 over the age of 65, including 1,281 over 70 and 164 over 80.

Dr. Mark Roper: Here is my response to the article by Isabelle Porter le 7 octobre 2021 “Les omnipraticiens de Montréal ne prennent pas assez de patients en charge, dit le ministre Dubé”
It is clear that Mr Dubé needs to have a closer analysis of the data available to him . Lets us take, for example, the Montreal sub region of Côte-des-Neiges – Métro – Parc Extension (622) (De la montagne)MSSS data shows there are 190 fulltime doctors doing primary care, nearly enough family doctors to register all 252,334 inhabitants of the territory. In fact the MSSS calculation of need claims they need just 3.5 family doctors to register all their inhabitants . How surprising then, that the registration rate for a family doctor in this region is only 63% and there remain 92,405 local citizens to register. What is going on here?
Is Mr Dubé’s conclusion correct that the family doctors do not register enough patients? Actually no. The physicians of the territory have actually registered 271,817 patients , 19,483 more than the local population. 146, 675 or 58% of the registered patients live in another sub region. More surprisingly, only 125,142 inhabitants are registered by the local family doctors.
It is well known that the Canada health act allows portability of health care services and throughout Quebec and Canada. This allows citizens to choose where they register with a family doctor and receive primary care. A study by the MSSS and FMOQ showed that there is a net migration of 320, 000 workers every weekday to Montreal. This is a significant phenomenon and renders simple physician population ratios inaccurate as an indicator of medical services. Registrations rates with a family doctor are a better indicator and should guide the minister in the allocation of new family doctors.
‘My patience has run out’ with doctors who don’t work enough, Legault says
The premier acknowledged most doctors work hard, but said he’s ready to pass a law forcing Quebec doctors to accept more patients.
(Montreal Gazette) Premier François Legault says he’s ready to play hardball with family doctors who are unwilling to take on a bigger workload.
But the doctors have responded saying Legault’s tough guy approach won’t work. More coercion, such as obligatory overtime or imposing more patients on doctors, will only lead to “chaos, exhaustion and psychological distress.”
Later, emerging from a meeting of the cabinet, [Health and Social Services Minister Christian] Dubé told reporters Quebec has an issue with about 40 per cent of family doctors. According to ministry figures, 52 per cent of family doctors currently list fewer than 1,000 patients while 14 per cent say they treat fewer than 500.
That in part explains the logjam in emergency wards. Right now about 40 per cent of patients showing up in emergency wards have minor problems (category P4 or P5) which should be treated elsewhere, Dubé said.

13-14 October
André Picard: Quebec’s decision to delay COVID-19 vaccine mandate for health workers is an insult to patient safety
Evidence from other jurisdictions is that the vast majority of health workers will get vaccinated if you force the point. And that’s exactly what Quebec (and other provinces) should be doing.
That’s an insult to patient safety, and to the workers toiling to end the pandemic and protect the public.
It will also embolden anti-vaxxers, which is the last thing we need to do at time when COVID-19 has become a pandemic of the unvaccinated.
By blinking first on vaccine deadline, Quebec may have given unvaccinated health workers upper hand
Health minister’s decision to delay vaccination mandate for health-care staff was ‘weak,’ says nurse
(CBC) Thousands of unvaccinated health-care workers in Quebec have been given an extra 30 days to get COVID-19 vaccine doses that have been available to them for months.
Wednesday’s compromise on a vaccination mandate is raising concerns the Quebec government has all but squandered its leverage when it comes to pushing holdouts in the health-care system to get their shots.
Quebec decision to delay mandatory vaccination sign of tough decisions for provinces
(Global) On Wednesday, Quebec Health Minister Christian Dubé postponed by a month a requirement for health-care workers to get vaccinated against COVID-19, saying it would have been “irresponsible” to suspend thousands of unvaccinated workers at a time when the health-care system is already fragile.
Dr. Katharine Smart, president of the Canadian Medical Association, said the difficult situation Quebec found itself in is the result of larger systemic problems that predate the pandemic.
“What’s happened in Quebec is really highlighting the legacy of underfunding and under-planning in the system that has left them with no wiggle room,” she said in an interview Thursday. Canada faced a shortage of nurses and other health-care professionals before the pandemic, she said, which has only grown worse.
Quebec delays vaccine mandate for health-care workers by one month, fearing staffing crisis
Risk of staff shortages ‘too high,’ health minister says, as deadline moved to Nov. 15
(CBC) Quebec Health Minister Christian Dubé said the decision to push back the vaccination deadline for health-care workers was ‘difficult,’ but necessary to avoid ‘hitting a wall’ when it came to providing health-care services to Quebecers.
After weeks of insisting Quebec would go ahead and impose a vaccination mandate for health-care workers and suspend those who don’t comply without pay, the province’s health minister, Christian Dubé, has backtracked and is now giving them an extra month to get adequately vaccinated.
Currently, 93 per cent of Quebec health-care workers are fully vaccinated, but that still leaves almost 22,000 facing suspension because they have had only a single dose or are unvaccinated. Dubé said the health system wouldn’t be able to handle losing so much staff.
Earlier on Wednesday
Beryl Wajsman: Quebec decisions are disastrous for Montreal health care
This week we are being slammed with two health care decisions that could spell disaster for Montreal’s health care system and our capacity to deliver medicine to families. Though the decisions affect all of the province, nowhere else will their effects be so harshly felt because this island is the largest population centre. And the imminent harm has roused leading lawyers to take action and seek injunctive relief to stop them. We urge all our readers to contact your MNAs and evidence your support for these legal challenges.
Health Minister Christian Dubé has decided to reduce the number of general practitioner positions allowed for Montreal. He is moving dozens of positions out of Montreal and into the Monteregie. It is part of what are called the PREM guidelines that Quebec regularly adjusts. But this adjustment doesn’t help. It cripples. This change of allotment has so stunned so many seasoned observers that it has even been suggested that the reason for reducing Montreal and increasing the Monteregie allotment is that the CAQ gets a lot of votes in the latter region. We would hope that this cynicism is not correct.
If all this was not enough, this Friday, October 15th, is the deadline for all health care workers to be double vaccinated. Those who are not will be suspended without pay. Now it is understandable that the government has been pressuring these workers since the beginning of September to get this done. Minister Dubé’s efforts in this regard have resulted in a reduction of unvaccinated healthcare staff from 25,000 in September to this week’s 15,000. … But when we see that a policy has not achieved all of its goals, and the consequences of carrying out a threat are disastrous, perhaps it is time to rethink deadlines.

10 October
Montreal lawyer files safeguard order to avoid collapse of healthcare system
Montreal lawyer, Natalia Manole filed a safeguard order in Superior Court to challenge the decree for mandatory vaccinations for health care workers. The government decree is set to take effect on October 15th. It will force all health-care workers who are not fully vaccinated to be suspended without pay. The decree does not take into account whether or not the health care workers affected by it have direct or indirect contact with patients. It applies to all workers, including doctors, family physicians with up to 1000 patients, psychiatrists, secretaries, cleaning staff, paramedics and PAB’s.

8 October
Civil rights lawyer wants Quebec permit system for doctors declared unconstitutional
Fewer family doctors allowed to practise in Montreal, province’s health minister says
(CBC) Montreal-based civil rights lawyer Julius Grey says he will ask a judge to suspend Quebec’s system for determining how many family doctors can practise in a specific region.
The move comes after Health Minister Christian Dubé recently reduced the number of new family doctors who are allowed to practise in Montreal and increased the number who can practise in nearby suburbs.
“It’s very clear that even after the additional 30 being allocated to Lanaudière, Montérégie, to Laval, the number of patients per doctor is still lower in those regions than Montreal,” Dubé said at a news conference today.
Grey told reporters today the system is unconstitutional and he plans to file a court challenge next week to have the placement system suspended.
Dr. Mark Roper, a Montreal family doctor and the director of the primary care division at the McGill University Health Centre’s department of family medicine, says nearly 650,000 people in the city don’t have a family doctor, more than in any other region of the province.

21 September
COVID-19 live updates: Quebec may ban anti-vax protests outside schools, hospitals, Legault says
With case counts stable, Dubé urges Quebecers to remain cautious. After rising for a week, hospitalizations dropped on Monday.

COVID-19 updates, Sept. 16: Facing possible suspension, 20,000 Quebec health workers still not vaccinated
Province checking vaccination status of staff in schools, CEGEPs and universities, but won’t say whether it’s considering a vaccine mandate.

7 September
Allison Hanes: QCGN warns of new threat to English health services
The government plans to revamp a provincial access committee in a way that will compromise its independence and make it toothless, says the Quebec Community Groups Network.

7 August
Montreal restaurateurs, merchants, customers agree with vaccine passport
Though everyone the Montreal Gazette spoke to agreed with the measure, some business owners and employees questioned exactly how they’re supposed to enforce it.
So far in Quebec, 84 per cent of people 12 and older have received at least one vaccine dose and 68 per cent are fully vaccinated.
On Friday, Health Minister Christian Dubé noted that the same day the province announced it will use the passports, twice as many people signed up for their first dose as in previous days.
Vaccination appointments double in Quebec after province announces vaccine passport plan

COVID-19 updates, Aug. 6: No masks or distancing in CEGEP, university classes this fall: [Higher Education Minister Danielle] McCann
Extra-curricular activities and sports will be allowed but only for the fully vaccinated, minister says.
The government guidelines — announced a day after Premier François Legault confirmed a return to in-person schooling — include a set of measures for the entire province that can be tweaked at specific schools depending on vaccine coverage and the epidemiological situation in the region.

COVID-19 updates, July 28: As cases rise, Quebec’s vaccination campaign is losing steam
Dubé urges Quebecers to get 2nd dose ASAP as positivity rate increases. More than 920,000 people have registered for province’s vaccine lottery.

COVID-19 updates, April 13: Montreal schools, non-essential businesses may close ‘in coming weeks’ – Legault
With variants spreading and more young people getting infected in Quebec, don’t expect life to return to normal before June 24, premier warns.

11 April
COVID-19: Quebec reports 1,535 new cases as government brings back 8 p.m. curfew in Montreal, Laval
Provincial officials announced on Thursday they would move the nightly curfew in both cities by 90 minutes as of Sunday as a preventive measure amid rising COVID-19 infections across the province

7 April
Montreal bracing for third wave as COVID-19 cases linked to variants increase in the city
The Quebec government announced new COVID-19 restrictions on Tuesday for the provinces red and orange zones, aimed at curbing the spread of cases linked to variants.
The new measures coming into effect in Montreal include the closure of gyms, the return to hybrid learning for high school students in grades 9, 10 and 11, and reducing the maximum capacity in places of worship to 25 people.

29 March
Quebec officially in third wave of COVID-19 (video)
It was not the news Quebecers wanted to hear. After months of back and forth on tightening and easing sanitary restrictions, the province has officially entered the third wave of the COVID-19 pandemic. As Global’s Phil Carpenter explains, with the rise in variant infections, Quebec is trying to find a balance with what can and cannot stay open.

That was nice, but it didn’t last long!
16 March
Curfew pushed back to 9:30 p.m. in Quebec’s red zones
Premier François Legault announced the change on Tuesday, saying the situation is improving in Quebec despite the threat of variants and a possible third wave.
He said people have been requesting the curfew be pushed back as days are getting longer. However, the premier warned, people cannot hold private gatherings with friends and family.
“We can take an evening walk but indoor gatherings are still forbidden,” Legault said.
Legault announced the loosening of several measures, including allowing theatres and show venues in red zones to reopen on March 26. Audiences of up to 250 people will be allowed but they will need to wear procedural masks and remain distanced.
The premier said the vaccination campaign is getting into full swing and officials expect everyone over the age of 65 to be vaccinated by mid-April.
Everybody who wants a vaccine will be able to get it by June 24, he said, but that does not mean that public health restrictions can be immediately lifted.

4 February
Here’s what’s reopening in Quebec as of Feb. 8
The Quebec government has given the green light for non-essential businesses to reopen, including personal care services.
The current 8 p.m. to 5 a.m. curfew will remain in place in red zones.
Non-essential businesses (including personal care services) will be permitted to open all over Quebec, with limited capacity. Malls have also received permission to open, but will be supervised to avoid gatherings in common areas.
CEGEP and university students all over Quebec will be able to slowly return to in-person classes, where they will have to wear procedural masks. The government said more details will be announced in the coming days.
Museums have also been given the green light to reopen across the province, including planetariums, insectariums, the Biodôme and other such attractions, provided that health measures are in place.

6 January
Quebec imposes curfew, tightens lockdown restrictions as coronavirus health crisis deepens
(Global) In his first address of the New Year on Wednesday, Quebec Premier François Legault announced a tightening of lockdown measures aimed at bringing the second wave of the novel coronavirus in the province under control.
Under the new rules, an overnight curfew will be put in place from 8 p.m. to 5 a.m. beginning on Saturday, Jan. 9. until Feb. 8.
People will not be allowed out of their homes during those hours unless they are going to work, Legault said.
Quebec thus becomes the first province in the country to impose a curfew during the pandemic.
Much of Quebec, including Montreal and Quebec City, has been under partial lockdown since October, when bars, restaurant dining rooms, gyms and entertainment venues were closed. In December, Legault closed all “non-essential” retail stores and extended the winter break for elementary and high school students, and ordered office workers to work remotely.
All grocery stores and corner stores will be required to close at 7:30 p.m. to respect the curfew, except those with gas stations which will be allowed to stay open longer. Pharmacies will also be allowed under the new rules to remain open after 8 p.m.
Legault also ordered the closure of “non-essential” manufacturers, as well as a shut down of construction sites.
Churches and other places of worship have also been ordered to close.
Grade school students will be allowed to resume in-person classes on Jan. 11, as previously planned. High school students will continue with online learning for an extra week, with a return to school scheduled for Jan. 18.
(CBC) As part of the announcement, Quebec also revealed an updated, more optimistic vaccination timeline.
The province expects to vaccinate 250,000 people by early February, when Legault plans to lift some of the lockdown measures.
Those include all those living in long-term care homes and more than half the province’s health-care workers.
By the middle of February, Quebec expects to begin vaccinating people over 80 in the general population.

2020

19 December
Health-care workers say COVID-19 second wave has pushed the network to the brink of collapse
Nurses, doctors and support staff have been working extended hours with little or no vacations for more than nine months and experts fear the worst of COVID-19’s second wave hasn’t even come yet.
“There are many emergency rooms that are functioning at overcapacity without any reserve or any ability to compensate for the increased numbers that we expect,” said emergency medicine specialist Dr. Mitch Shulman.

Updated 16 December
Quebec schools, offices, non-essential businesses to close until Jan. 11 to help curb spread of 2nd wave
Most retailers will be shut down between Dec. 25 and Jan. 11, doing away with in-person Boxing Day shopping. The rest of the restrictions are also expected to be lifted Jan. 11.
Grocery stores, pharmacies, banks, hardware stores and pet stores will be allowed to remain open. Big box stores will be allowed to open but will be restricted to selling essential goods, such as groceries and pharmacy products.
Provincially run liquor stores and cannabis stores will also remain open.
Dentists, optometrists and other health services will be allowed to stay open, but hair salons, spas and manicurists will have to close starting Dec. 25.
For the period of time between Dec. 17 and Jan. 11, the province’s yellow zones will be upgraded to orange and orange zones to red with restaurant dining rooms, gyms, museums and theatres shutting down as a result.
… In another change, people living alone in red zones will be allowed to join one family’s bubble. Currently, they are only allowed to receive a single visitor.

20 November
Brownstein: Legault’s COVID holiday gift a disaster waiting to happen
We should be doing what we’ve been told to do up until now from Dec. 24-27: limit all social contacts.
Quebec has outlined its guidelines for the holidays. Here’s what the experts say

15 November
$100 million investment in home care is a big relief for many seniors
Three days after deploring the Legault government’s lack of significant investment in home care in Minister Girard’s economic update, the Réseau FADOQ applauds Quebec’s injection of $100 million to improve the supply of home care services.
The country’s largest seniors’ organization believes this announcement will help repair the break in the continuum of care caused by the health crisis.
“There has been a big disruption in the continuum of care since the beginning of the pandemic. Our members have seen a significant decline in their home care service. In the current context, this recurrent funding from the Québec government will put a balm on the nightmare experienced by many seniors,” says the president of the Réseau FADOQ, Gisèle Tassé-Goodman.

23 October
Quebec health system headed for massive burnout in pandemic, expert warns
“What we’re going to see is all the indirect impacts of COVID-19 that have been lasting for so long,” Dr. Joanne Liu says as Quebec is poised to declare a tally of more than 100,000 cases.

24 September
Quebec’s long-term care homes are about to be put to another test, and the cracks are already showing
Evidence is beginning to mount that CHSLDs and seniors’ residences could see a repeat of the spring
Benjamin Shingler, Sean Gordon
The movement of staff between hot zones, filled with COVID-19 infections, and cold zones was one reason CHSLDs were so devastated by the coronavirus.
Four days ago the CHSLD in Maria, on the Gaspé peninsula, declared a COVID-19 outbreak. On Thursday, regional health authorities issued a cry for help, imploring locals to apply for work cleaning, cooking and caring for patients at the centre.
The appeal, designed to ease the pressure on exhausted staff, came the same day the provincial ombudsman issued a report excoriating the Quebec government for ignoring repeated warnings about the fraying elder care system.
And it landed only hours after the release of a pair of investigations into mass infections at two other CHSLDs that found alarming administrative and other shortcomings.
Four private seniors’ residences — two in Quebec City and two in neighbouring Chaudière-Appalaches — are considered by the province to be at the ‘critical’ stage, meaning more than 25 per cent of their residents have COVID-19. Another 35 are ‘under surveillance’ because they have reported multiple active cases.
In her annual report, Quebec Ombudsman Marie Rinfret said the failings of the province’s network of long-term care homes should have been corrected long ago.
The government has also recruited nearly 10,000 new patient attendants, about 7,000 of whom are already working in the system. The rest are still in training courses.

15 June
Quebec to allow indoor gatherings of 50 people, children to be closer together
Larger gatherings allowed and cinemas can reopen on June 22
Dr. Horacio Arruda, the province’s public health director, made the announcement Monday, explaining that this new regulation will allow movie theatres and performance spaces to reopen, with special measures in place.
In places with seating, and specifically where no one is talking, people will be expected to stay 1.5 metres away from one another, Arruda said. That includes university classrooms and movie theatres.
In larger gathering areas where there is a lot of circulation, including in restaurants, Quebecers will still be expected to keep two metres apart.

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