Dr. François Desbiens leaves the direction de santé publique de la Capitale-Nationale
Trichloroethylene (TCE) in the water of Shannon, the crisis of legionnaire’s disease, red dust in Limoilou, pandemic COVID-19… The past 20 years at the helm of the public health in the National Capital have not been easy for Dr. François Desbiens, who will leave his post Monday to take on a new challenge at the Institut national de santé publique du Québec (INSPQ), where he served as vice-president of scientific affairs. Balance sheet.
Dr. François Desbiens started his mandate of director of public health in the National Capital in September 2000, after having led that of Chaudière-Appalaches during the seven and a half years, and, just before, that of the North Shore, where he began his career as a community health specialist.
As early as November, just a few weeks after his arrival at Quebec, the team of Dr. Desbiens has been requested when the TCE, a solvent used on the Valcartier military base, has been discovered in drinking water wells of the citizens of Shannon.
“In two weeks, it was necessary to analyze the situation, make recommendations of non-potable water use, discuss with the ministry of the Environment and the City to find an alternative source of drinking water […]. We then did some studies on a ten years to try to highlight health problems that the TEC would have been able to cause,” recalls Dr. Desbiens.
The collective action brought made it all the way to the Court of appeal, which was expanded last January to the scope of the judgment condemning the federal government, the Société immobilière Valcartier and General Dynamics to compensate the residents of Shannon affected by the contamination of the groundwater with TCE.
For the Dr. Desbiens, the folder has been “very busy, very long, very present for 10-12 years”, pretty stressful too, “because people were concerned and that one could not always reassure them”, because they have all the answers.
Then, in the summer of 2012, the director of public health in the National Capital has been facing “one of the largest outbreaks of legionnaires’ disease in North America and in a difficult race against the clock to find the cooling tower responsible for transmitting the bacterium, which has no fewer than 14 people out of a total of 182 people infected.
“At the time, there was no directory of cooling towers, no regulations to compel owners to declare their tower, not a regulatory obligation to register maintenance of the towers… So when it occurred, it was necessary to make an appeal to all to join the owners of large buildings” and taking samples in the towers, said Dr. Desbiens.
The tower guilty, the Complex Place Jacques Cartier, the property of CSQ, has been identified only in September, more than two months after the first cases of legionellosis were reported to public health. Again, there has been collective action (against the CSQ, chemical State, and Trane, the ministry of Health, the CIUSSS of the Capitale-Nationale and Dr. François Desbiens as the director of public health), which concluded in December 2018 by an agreement out of court.
And then came, in October 2012, the episode of the famous red dust from the trans-shipment of ore to the port of Quebec. Another class action, which has had its outcome seven years later, while the Stevedoring Quebec has been ordered to pay nearly$ 1.7 Million to the citizens affected by this episode of dust of iron oxide. The folder has served in public health, which has undertaken an extensive study on the air pollution in the central districts of Quebec. Its conclusion is expected by June 2021.
Throughout, the team of public health in the National Capital has worked on “folders [plus] regular,” says Dr. Desbiens, citing in particular the approval of the plan of sustainable development of the City of Québec, the memory on the legalisation of cannabis and the report on social inequalities in health. “We have documented the fact that health problems are more concentrated in our lower classes. It has been impactful for the region, which has been well received,” recalls the specialist in public health.
COVID-19: the National capital ready for a second wave?
The doctor had to leave the direction de santé publique de la Capitale-Nationale at the beginning of the month of April to join the team of the INSPQ, but he had to stay a few more weeks, the time that the first wave of COVID-19 passes.
“The pandemic plan that we had, it was for the H1N1 vaccine, for influenza, for which we know that we can develop a vaccine within eight months, that we have antivirals to be effective, intervention tools. There, our pandemic plan, we had to update to a virus against which we have no antiviral drugs, no medicine effective, no vaccine… All we can do, what are the supportive care and primary prevention,” says Dr. Desbiens, who had to mobilize all the resources of the public health in the fight to the COVID-19.
The tragedy experienced in residential environments for seniors of Quebec was deeply saddened, ” he said. “When it [the virus] enters an environment where there are vulnerable people who have three or four hours-care, it is very difficult to regain control. To a place, we thought we would have to deal with an outbreak of gastro, so this is the protocol gastro that has been applied, but it was finally the COVID who was disguised as the gastro, we realized this 10 days later […]. Even when you’re super strict on the measurements, you can be outsmart by this virus, in the way that he behaves,” explains Dr. Desbiens.
The difficulty of properly wearing personal protective equipment, the transmission of asymptomatic or pre-symptomatic, the lack of personnel, the movement of employees to an accommodation centre or an area to another, are all factors that have contributed to the outbreaks, according to Dr. Desbiens. “But there is a lack of staff, and if staff does not move, there are treatments that do not”, says the doctor, pleased with the decision of the government Legault to quickly train 12 000 employees and enhance the working conditions in NURSING homes.
“It will allow you to have human resources dedicated to it, who will not have to move, which will be able to ensure a continuity of care… It is perfect as a solution,” judge he.
The successor(e) Dr. François Desbiens, which will ensure the interim until the position is filled on a permanent basis, in the fall, will be known(e) at the beginning of the next week. Dr. Desbiens is pleased with the current lull, which will allow his team to take a vacation “well deserved vacation” this summer. “The structure is well established with good leadership,” said the doctor, who believes that his team is ready to face a second wave, “after having learned from the first”.
“I have the impression that we will be able to contain, and that we will be able to have an approach of containment a target, close only the media [such as businesses and schools] where there are outbreaks instead of close”, sees it.
But the management of the pandemic still remains “a big challenge”, admits Dr. Desbiens, who hopes not to see the same level of intensity in the fall”. In this regard, he wishes that the population complies with the preventive measures “with the same rigour”.
“We took good habits, our businesses have reconfigured their practices to limit the opportunities for transmission, but I know that this is not followed 100% by the citizens, yet too few of them to wear the mask in public places where the distancing physics of two meters is difficult to meet, grieves the Dr. Desbiens.
“It is a fantastic tool to limit the spread of droplets by people can be carriers without knowing it – you wear a mask, you want me to protect them, I put them one, I am protecting you -but people have not yet taken the habit to wear it. This is the challenge in anticipation of the second wave,” said the doctor, who wished to have it “go further” by making awareness campaigns.
“It is necessary to promote, explain why it takes the wear, and if it is demonstrated that with promotion, we do not reach our goals, we could move to the second step” in making the mask-wearing mandatory, particularly in public transport, ” said Dr. Desbiens.
“I have the impression that we will be able to contain, and that we will be able to have an approach of containment a target, close only the media [such as businesses and schools] where there are outbreaks instead of close ”
Dr. François Desbiens, director of public health of the National Capital
If it was up to him, the borders of canada-u.s. remain closed after July 21, “because the american side, there is no decay” case of COVID-19. The doctor recalls that “these are the trips during the week of spring break, which have helped inoculate the virus in Quebec.”
At the end of the interview, Dr. François Desbiens wished to express its gratitude to “all the managers and all the staff of the department of public health”. “During these 20 years, I have had the privilege of working with people of experience, amazing people, motivated by the well-being of the population”, he stressed.