[Canada] Canadian Politics Redux

[Malthus]

Question: are there any good analyses as to why Quebec is faring so much worse than Ontario through this pandemic?

My impression is that it is more or less a matter of luck, but I don't really know. As far as I know, both provinces enacted more or less similar measures, and god knows the Ontario provincial government is not markedly more competent than the Quebec provincial government. Both Toronto and Montreal are pretty significant hubs for travel, but maybe Montreal has more volume?

[Rex Francorum]

Just my 2 cents:

Earlier spring break in Quebec that made it possible for people to travel abroad and bring back the virus.
Lack of human resources in nursing care establishments (which is why the government needed badly the millitary medical corps)
Employes from the nursing cares working at more than one establishment. 
Also a possibility: Percentage of elder population in nursing care is more important than in other provinces. I heard that on CBC but I can't find a source to confirm it.

[Grey Fox]

Faring much worse is a misnomer, we fared much worse but now it is going very well once the LTC home situation was stabilized.

Like Rex says, the LTC way of employment really hurt us. 50% of public LTCs employees are temp & work in more than 1 establishment. They transported Covid-19 across multiple LTCs. As for the private LTCs, employees simply deserted them.

[Malthus]

Yeah, we had the same issues in Ontario with nursing homes - my wife's brother's wife worked in two old age homes, and was required to quit one.

I just wondered because I was looking over stats and noticed there was a huge difference between Ontario and Quebec, and wondered what was causing it. Both provinces are pretty comparable - both have a heavily populated part, with one really major city, and the polices both followed were roughly the same, as far as I know.

There is no question Quebec was hit harder. As of today, Quebec has 55k cases and 5.5k deaths, while Ontario has 35k cases and 2.6k deaths - yet the population of Ontario is considerably higher, 14.2 million vs 8.5 million. Both provinces are in the downward curve.

It just seemed surprising to me, I would have figured they should be roughly the same. Unless there is some good explanation for the difference I have to assume a lot of it is just random chance.

[Grey Fox]

The deaths it's the LTC situation.

The cases it's our earlier spring break. Everyone was back at school for 4 day before they were shut down & then the LTCs kept it alive in the health care system.

[viper37]

Yeah, we had the same issues in Ontario with nursing homes - my wife's brother's wife worked in two old age homes, and was required to quit one.

I just wondered because I was looking over stats and noticed there was a huge difference between Ontario and Quebec, and wondered what was causing it. Both provinces are pretty comparable - both have a heavily populated part, with one really major city, and the polices both followed were roughly the same, as far as I know.

There is no question Quebec was hit harder. As of today, Quebec has 55k cases and 5.5k deaths, while Ontario has 35k cases and 2.6k deaths - yet the population of Ontario is considerably higher, 14.2 million vs 8.5 million. Both provinces are in the downward curve.

It just seemed surprising to me, I would have figured they should be roughly the same. Unless there is some good explanation for the difference I have to assume a lot of it is just random chance.

On top of what Rex and GF said:

lots of people working in LTCs seemed to think the rules didn't apply to them.

Healthcare governance is a mess.  It's been that way for years.

The latest reforms only exacerberated the problem by removing an important layer: a director of LTC on site, answering to an higher organisation in the department.  Those that had that fared a lot of better, sometime with no cases at all.

Also, the Quebec health public director is not in the same management unit as regional public health directorate, so they don't answer to him... that complicates matters a lot.

In short:

• no one is answerable to anyone, there was a shortage of staff, those that stayed ignored the security directives (wash your hands, wear mask and cover-all, change them in between rooms, etc, etc),
  
• some staff deserted their post either taking their vacations or claiming a danger to their health (very astute excuse to use, since in times of pandemic everything is slowed down, by the time their case would have been processed&analyzed and they might be forced to come back to work, the worst would be over and they would still keep their indemnity of 90% net salary during their offtime);  I have zero sympathy for them. There was already a shortage of manpower.
  
• no one in authority on site.  It's not required for daily operations, but when there's a problem, you need someone giving orders and making sure they are obeyed.  If one director has 12 healthcare units to supervise, he can't visit them all day long during a week.  Especially if all under intense stress.  The government has already proposed to create smaller units for retirees, "Houses of the elderlys" could be an approximate translation.  Smaller structures with individual rooms/small appartments.  4 different people and their families/support sharing a single bathroom in times of pandemic is a recipe for disaster.  The govt has said this process will be accelerated, and has also hinted at changes in the organisation of our healthcare governance.  For once, we haven't put a fringing doctor in charge of the Department, an accountant is there, so maybe, at last, things will improve.
  

[Malthus]

I'm certain that the bad practices at nursing homes contributed significantly to the situation. I guess my question is why they affected Quebec so much worse than Ontario, which had, as far as I know, similar problems with nursing home practices.

[viper37]

I'm certain that the bad practices at nursing homes contributed significantly to the situation. I guess my question is why they affected Quebec so much worse than Ontario, which had, as far as I know, similar problems with nursing home practices.

Lack of direct supervision.  Someone in charge needs to be there.  When the army arrived, they had to reprimand people not wearing their (medical) masks in hot zones.

Some LTCs fared better, with zero cases.  They all had in common a direct supervisor on site, someone on site who could direct employees through all the security measures, like mandated testing before entering the building.

The smaller units, private and public also fared better than the bigger ones.

Like GF said, we apparently have a lot more elderlys in LTCs (and other non individual residential units) than other provinces.  Could explain that.

What I found is this (in French, but just look at the table):
Link[/urk]
Quebec has 343 LTCs infected.
Ontario had 24 LTCs infected.EDIT:duh!  This article dates from April 14.  Might as well have been last year...  None of these numbers are accurate. <sigh>

I am trying to find the total number of LTCs (CHSLD is the official designation here) but I can't find it, I only have the number of "beds".   It says a total of 37 468 for Quebec, among which 83% are in the public sector.  However, this figure is incomplete, as there are "non conventionned LTCs", meaning they are 100% private, with minimal government oversight, like the "infamous" Heron Centre in Montreal.

For Ontario, I got 79 000 beds from this [url=https://www.oltca.com/OLTCA/Documents/Reports/TILTC2019web.pdf]document.

It's also unclear if any of these figures includes private retirement homes with smallish appartments (like a regular appartment, but with a collective kitchen instead).

Could be that Ontario is under reported and Quebec over-reported.  Not all dead patients were tested for covid-19 before they passed away in their LTCs.  The numbers include everyone who was in contact with an infected person and developped flu-like symptoms.

Conclusion:
I can't make head or tails of any of these stats.  No wonder the Prime Minister pushed on his bureaucrats to constantly give him more info, if that's the level of data they have, we can't govern at all like this.  Knowing the number of beds is irrelevant if you don't know how many are occupied or not, and which ones are infected.

I guess we will have to wait on our respective inquiry boards to determine what was going on in there.  Maybe we'll have some useful info.[/url]

[Admiral Yi]

Hey Frenchies, how do you say "Indian" in Quebec?

[saskganesh]

indien?

[Duque de Bragança]

Not sure if Amérindien really caught traction in Québec or rather francophone Canada for that matter.
Membre des Premières Nations really sounds as administrative jargon. Viper and Oexmelin will know more about it.
https://www.btb.termiumplus.gc.ca/tpv2alpha/alpha-fra.html?lang=fra&srchtxt=INDIAN&i=&index=ent&codom2nd_wet=1
Indien still exists, but not so much used.

PS : I assume you are talking about American natives.

[Grey Fox]

Sask is right, the French word for Indian is Indien. Les Indiens de Cleveland.

[Zoupa]

Lots of folks say autochtones.

[Valmy]

PS : I assume you are talking about American natives.

Yes though it is the same word still, is it not?

Anyway it recently came to my attention that the American Indians call themselves Indians on this side of the border so I went back to calling them that. But boy is it confusing with so many people from India around. Stupid Columbus.

[crazy canuck]

If you ever come North best to revert to not using that term.