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An Unprecedented Public Health Challenge
For this report, an interview
took place with Dr. Jean-Pierre Trépanier, Director of Public
Health for the CISSS of Laval
and Dr. Olivier Haeck, microbiologist/infectious disease specialist and Officer of Prevention and Infection
Control (PCI) at the CISSS of Laval.
“We’ve started a marathon, but we don’t know yet whether it’s going to be a triathalon or an Iron- man” – Dr. Jean-Pierre Trépanier.
At 43 years old, Dr. Trépanier has already amassed more than 20 years of experience in the health and social services sector. As the Director of Public Health for the CISSS of Laval over the past four years, his career started out amidst the H1N1 pandemic. When it comes to a public health crisis or infectious disease outbreak, he has been around the bend! That said, COVID-19 has proved to be the biggest challenge he has encountered to date.
As for Dr. Haeck, he has worked as a microbiologist/infectious disease specialist since 2007, and as Officer of Prevention and Infection Control (PCI) at the CISSS of Laval since 2012, a role that has taken on unprecedented proportions since the start of the COVID-19 pandemic.
“We’re dealing with a super virus. It’s extremely contagious, has a prolonged incubation period (one to 14 days – much longer than most viral infections) and has a mortality rate five to 10 times higher than the seasonal flu,” says Dr. Haeck. Adding to the complexity is the fact that there is no medicine available, neither for the treatment or prevention of the disease. “Though we had experience with SARS in 2003 in Toronto, and a brief experience with a Middle East Coronavirus outbreak in 2015 in South Korea, the vaccine development research wasn’t very advanced when this pandemic started,” adds Dr. Haeck. “And given that this vaccine will potentially be administered to billions of people, we have to take the time needed to ensure that it’s effective AND safe!”
War Time Teams
For the 10 500 CISSS employees, the effort put forth mendous. The Public Health t comprising of about employees and 15 doctors, a working seven days a wee from 8 amto 8 pm, researching, analysing data and producing statistics that the entire city of Laval is eagerly following when it comes to the number of cases per sector. “It’s an amazing team that’s dedicate and incredibly involved, despi the challenges. They definit have their moments of doub uncertainty, of concerns…It’ mal—we all do!” says Dr. Trép For the prevention and infections team, consistin microbiologists/infectious lists and a dozen devoted c a constant battle against an Their role: to interpret the d Institut national de Santé publique du Québec (INSPQ) into concrete applications on the ground in 32 establishments across the CISSS of Laval. Since March, there has been the addition of the private CHSLD’s, intermediate care, elderly residences and other home care resources across the territory of Laval.
“My role is based in science and communication. I have to support and guide the advisory board in decision-making,” says Dr. Haeck—
“Ça va bien aller”
Like many guardian angels, the two doctors have stopped counting the number of hours they are putting in since the beginning of the crisis. Both are fathers and have been working seven days a week for 12 to 14 hours per day. They are determined and dedicated, but both hope to feel the winds of change.
“We call it COVID-19 because the virus was detected in 2019, but for us, the situation started to become alarming near the end of January,” says Dr. Trépanier. “We began the year with COVID on our radar, and it never left!” Dr. Haeck adds: “At the beginning, we had hoped that the disease would stay in China, but when we saw the situation in Italy, we knew we would have to prepare for when it arrived here.”
At the time of writing this report, we don’t know what the future holds. They both hope that a vaccine will be discovered as soon as possible. Until then, they will continue their relentless work while thinking about all the elderly in care homes, the courageous healthcare workers and the thousands of unemployed—everyone who is affected whether directly or indirectly.
“One thing is clear to me, we have to remain steadfast, because together will get out of this. Out of this crisis will come positive changes for everyone,” says Dr. Haeck.
At The Heart of Solidarity
Everyone is saying it; one of the positive aspects of this crisis is witnessing the population mobilize. Fondation Cité de la Santé has had a front-row seat to this phenomenon for the past 40 years. The foundation has contributed to the improvement of care and services offered at the hospital as well as at the other 31 establishments across the CISSS of Laval. We take care of our people. Now, more than ever.
The foundation launched a COVID-19 emergency fund from the very beginning of the crisis, guided by three financing principles: support for the most vulnerable population during the pandemic, purchase of essential medical equipment and support for health care workers. Several individuals and businesses have contributed to miracles, both big and small:
1. The acquisition of electronic tablets for seniors in care homes
As soon and the confinement began, the foundation purchased and distributed 31 tablets in five public CHSLD in order for seniors to communicate with their loved ones, as visits aren’t permitted. This initiative garnered merit and was then extended to other sectors, such as the intensive care unit at the hospital and private senior homes. A donation from Telus of 40 additional tablets allowed many more seniors to connect with their loved ones.
2. The purchase of entertainment kits and portable DVD players at Centre jeunesse
Children newly admitted to the Centre jeunesse must be in confinement in their rooms for 14 days. To break the isolation and allow for some fun, the foundation purchased 12 portable DVD players, some games and art material.
3. Easter chocolate distribution at community organizations
For Easter, thanks to the contribution from Chocolats Favoris and Mondoux Confiserie, the foundation distributed more than 4000 chocolates at a dozen community organizations across Laval who work with women who are victims of violence, recent immigrants or families from vulnerable communities.
4. The acquisition of two portable ultrasound scanners at the hospital’s emergency ward
These two new portable ultrasound scanners at the emergency ward allow for patients to receive their ultrasounds directly in the COVID-19 unit, which limits the risk of spreading the virus and speeds up procedures.
5. Increasing recognition for health care workers
Dr. Joseph Dahine, internist and intensive care specialist at the hospital, contacted the foundation to launch a fund dedicated to the support of CHSLD workers. The funds raised will go to highlight and recognize these workers once the crisis has slightly lifted and they will need extra support.
The Laval community has also responded to the needs by offering its time. Sophie Bouchard, Chief of Coordination of Volunteer Resources and Spiritual Care at the CISSS de Laval has seen this firsthand. “At the pique of the crisis, we were receiving 15-20 emails per day from volunteers who wanted to help! People are so generous, and it’s very touching to see this,” says Bouchard. “There are even some volunteers that I needed to slow down because they were putting their own physical or mental health at risk, but still they wanted to do more. They are so devoted!”
At the time of this report, there are currently 150 volunteers and more than 2000 candidacies received on Je contribue.
The Faces Behind the Battle at the CISSS of Laval
In a situation like this, every action counts and each person is important. From the stretcher carrier to the lab technician to the ambulance paramedic to the social worker, each of the 10 500 employees has a key role to play in our community’s battle against this pandemic. They are ALL our guardian angels.
Jennie Laguerre, Special Educator
Jennie Laguerre has been working with children living with an autism spectrum disorder at the CISSS of Laval for the past four years. Before the pandemic, she worked directly in the homes of children under the age of five who don’t yet have their diagnosis but have developmental delays.
By mid-April, it had already been two weeks that her day-to-day had been turned upside down. She now works the night shift, for the first time in her life, with six youth who are at the Unité Le Jardin located at 310 boul. Cartier. This new unit welcomes youth with severe special needs such as intellectual disabilities or autism. “It’s definitely very different for me! These youth really need a lot of stability, routine and organization so in the context of the current situation, they are quite fragile and become easily disorganized,” says Laguerre. “It’s very demanding and you have to take it one day at a time, even one hour at a time!” Despite all of this, how does she stay positive and keep her morale up? “You have to find ways to keep the balance and manage stress. Music helps me a lot, as well as spirituality and reflection,” she says. “You can’t neglect your health and spirit. I call my family and friends regularly. We have to continue to live and take care of ourselves. We’ll get there, together.” If you weren’t already a fan of Laguerre’s devotion, you might want to know that in addition to her essential role, she even found time to compose and record a rap song to encourage youth to “spread the message, not the virus” on YouTube. You can view it here: youtu.be/ufU6E0gbZc8
Caroline Donais, Nurse
Caroline Donais is a councillor at the Bureau de gestion intégrée de la qualité et des risques à la Direction de la qualité, de l’évaluation, de la performance et de l’éthique (DQEPE). A nurse by profession, she has had many roles in her 19-year career before moving toward risk management. She never thought that COVID-19 would throw her full force into the category of “other related tasks”.
When several employees began testing positive at CHSLD Ste-Dorothée, she volunteered to work as the site coordinator for the evening shift.
A Striking Experience
“I have never worked in a CHSLD in my career before this,” says Donais. “I’ve changed more diapers in the past two weeks than in my entire life!” says the mother of three. “It has to be said. What we’re experiencing right now is completely unheard of. The CHSLD’s were designed to be care facilities, not intensive care units! And then there’s the constant rate of death weighing very heavily on the staff who support these elderly patients, who know their habits and their families…we’re not ready to face this—no one is!”
At the time of this report, reinforcement has arrived at the CHSLD. Occupational therapists, physiotherapists, doctors, special education teachers, volunteers…And every one of them has risen to the occasion, working in an unfamiliar environment for the most part, in a very difficult situation! “We are all links in the chain,” says Donais. “Every action counts and every effort put forth is important.”
Cynthia Yenikomshian, Nurse
Cynthia has been a nurse at Cité-de-la-Santé Hospital for 15 years. She has worked in the mobile teams and in the overwhelmed emergency ward, where she met her husband, Jean-Sébastien Deslongchamps, who has been an orderly beneficiary attendant for 17 years. Since the beginning of the crisis, Yenikomshian and Deslongchamps made the decision to voluntarily ‘place’ their three daughters to avoid contaminating them because they knew their workload would be intense, and they weren’t wrong!
A Different Kind of Intervention
Yenikomshian says that the way she has to interact with patients has changed drastically since the pandemic started. “For example, the other day a woman arrived who was very unwell. A few minutes later, she was in cardiac arrest. Normally, we would have all run towards her to start procedures, but with COVID-19, we have to protect ourselves: we get dressed, we put on our equipment and then we intervene,” she explains.
Contact with COVID-19 patients is already restricted to the minimum, as they are placed on stretchers surrounded by plastic barriers in a negative pressure environment. “We’ve installed monitors, like baby monitors, and we try to talk to them that way so we don’t have to enter their space as often…it’s very sad!” says Yenikomshian.
Though she has seen the impact that confinement has had on the pandemic’s evolution, Yenikomshian is looking forward to the gradual deconfinement. She is especially looking forward to seeing her daughters up close, and not through a screen! It would seem that the strength and solidarity of her team is what is keeping her afloat. “Honestly, if we weren’t as steadfast and united, I don’t think I would make it,” she says. “But this challenge, we’re all living it together, and that makes all the difference! There are also so many small gestures from the community that do us good: Tim Hortons coffee, the meals provided, the guard of honour from the police force…We just can’t give up!”
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