Up to 8500 people dead, 34 000 people are hospitalized, 2.6 million Quebecers infected ; the forecasts made by the ministry of Health in its plan to fight the pandemic are frightening. To cope with this, 24 ways of fighting against a dangerous virus and save the most lives possible have been provided.
Our Bureau of investigation has peeled the approximately 125 pages of the plan of the ministry of Health and social Services. This plan was developed in 2006 to deal with an influenza pandemic, and is the basis of the intervention strategy in the face of the sars coronavirus.
We present to you a summary of the 24 major measures that it contains in the following two pages.
Some are already in place for a few days. Other measures may never be deployed or even be postponed to later, as the mass vaccination, in the absence of a vaccine currently available.
The ministry is currently working on an appendix to this basic plan, with specific measures at the COVID-19, which should be ready in the next few days.
Quebec also has another plan prepared by the Organization of civil security. This document aims to coordinate the work of several ministries and the office of the prime minister. It provides information on who does what in case of a pandemic, and on strategies of communication with the population. It also provides for measures of support to municipalities and other partners in the region.
MEASURE ALREADY IN PLACE OR IN DEPLOYMENT
MEASURE NOT YET IMPLEMENTED
1. Real-time monitoring new cases
During the pandemic, a centralized system allows to quickly detect new cases. The ministry can thus identify the affected populations and target groups that are most at risk. It can also deploy resources in a region that is particularly affected. Thus it is that in the last few days, each new case was quickly reported in the media.
2. Disseminate simple steps
Wash hands and avoid touching their eyes, nose or mouth, or cough on the inside of his arm. Such simple steps can help limit transmission of the virus. The authorities are going to communicate this message to repeat.
3. Drugs… in the meantime the vaccine
Lack of vaccine, antivirals are one of the only defenses against a virus. Despite their limitations, they can be used with larger patients. One of the problems, at this time, could be the lack of effective treatments. If the demand explodes, the priority groups will be identified and treated in priority. It is the public health Agency of Canada that will determine who are the priority groups.
4. The vaccine… when it will be available
The vaccine is the best way to protect the population. But there is currently no vaccine against the COVID-19. A campaign like the one against H1N1 influenza, however, is not planned for the moment, but it figures in the plans of Québec.
5. Limit gatherings
Quebec has begun to limit public gatherings, as we have seen in several countries. Gatherings of less than 250 people are now banned. This measure can help to slow down the transmission at the beginning of a pandemic, as well as some measures of protection at the border. However, it is Ottawa that decides on the actions at the border, including their closure.
6. Up to one million consultations
The ministry envisages that up to one million patients could consult a family doctor. To avoid overloading the network and treat people the more sick, the public health recommends the sick to stay home and care home. The only people that will be the subject of closer follow-up with support at home.
7. Volunteer to help the sick
The support service at home health centres will be quickly overwhelmed. Community-based organizations or non-profit as well as an army of volunteers could be mobilised to help the sick people at home and assess if their condition deteriorates to the point of requiring hospitalization.
8. The phone to the rescue
The Info-Santé service will be the point of contact for patients at home. The demand for this service is already very strong. Another phone service will be put in place to do a first sorting, and thus avoid saturating the 811. This is what has been done yesterday with the announcement of a new telephone line, the 1-877-644-4545.
9. Ambulances overwhelmed
The paramedics are called to play an important role. The request may explode during the pandemic. Equipment additional protection should be used by the paramedics. We also have plans to put in place a structure to manage the movement between hospitals and validate whether a patient should be transferred or not. A plan should also be put in place to deal with a shortage of staff.
10. Keep the hospitals open
To face an explosion of demand, designated clinics for the pandemic, are put in place, like the yard tight to the entrance of the hospital. Institutions will be required to suspend certain activities in order to devote to the pandemic. It could also increase the number of beds in the intensive care unit and add equipment, such as respirators. Doctors and nurses first-line may also be called as reinforcements.
11. Priority to the most sick
Antivirals can be used in the event of an influenza pandemic. In the case of the COVID-19, some treatments may be prescribed. Given the possible scarcity of antiviral drugs, the department will establish an order of priority, according to the vulnerability of patients and the severity of the pandemic.
12. The care of patients outside of hospital rooms
The health network could quickly be saturated with patients. The ministry is therefore considering opening up sites non-traditional. It could be hotels, for example. There may also be inpatients within the hospital, but in places such as gyms, meeting rooms, etc., The institutions will need to ensure they have the equipment available for these sites.
13. Dispose of dead bodies
If the pandemic hits significantly, and cause a lot of deaths, the morgues, the hospitals may not be enough. It will therefore be necessary to quickly dispose of the remains and work closely with the staff of the funeral home.
14. Coordinate psychological services
Each region will need to be able to offer psychological resources in coordination with the ministry.
15. Dealing with stress, anxiety and depression
A pandemic will increase the level of anxiety in the population. It could also increase the cases of depression, burnout and even post-traumatic stress disorder. The elderly, young people in trouble or already suffering from mental health problems will be more vulnerable. The health workers will also be the subject of a psychological follow-up tight.
16. To reassure the population
Given the demand for psychological care, information sessions or follow-up via the telephone line, Info-Social, may be necessary. The authorities will also ask the family to get involved in order to reassure the patients at home.
17. Help people to self-evaluate
The population will be informed on the ways of self-assessment in terms of psychological health issues and find ways to autotraiter. It is one of the ways to avoid the panic.
18. Avoid rumours
The lack of information contributes to the wildest rumours. The leaders of the network are therefore called upon to communicate the information they have to retain a sense of trust among their employees. If a question arises, you should respond as quickly as possible.
19. Web Sites for the pandemic
Quebec has set up websites to inform people on the progress of the pandemic and the measures to be taken. Since the ice storm of 1988, the elected officials and deputies are also better equipped to play a role of disseminator of information.
20. Get everyone involved
All the government departments, hospitals, employers ‘ organizations, trade unions and social groups will have to be involved in the fight against the pandemic.
21. Inform citizens
A crisis team is in place to ensure well-informed population. In the time of a pandemic, however, it is the executive Council, the department of the prime minister, who takes the leadership of the communications.
22. Replace up to 20 000 workers absent
The ministry’s plans provide that up to 20 000 workers of the health network could be affected at the same time. In total, up to 81 000 people could be affected during the weeks of a pandemic. Each institution must therefore provide for this shortage. As a last resort, you could even make use of human resources alternatives, people from outside of the network to fulfill some of the tasks. These volunteers could be retired, students, members of the public service, for example. Volunteers may also be called as reinforcements.
23. Secure drugs
In the event of a pandemic, the department may purchase without competitive tendering of medicines, masks and other equipment. The storage of medicines will be in places controlled by the department. Because of their scarcity, security measures should be taken to ensure the distribution of drugs and vaccines.
24. Computer systems reliable
To collect and disseminate data regarding the pandemic, the department believes it is essential to have computer systems that are reliable. The telephone network will also be put to the test.