Transcription – English – Dr. York Hsiang

08. York Hsiang1.mp4: Video automatically transcribed by Sonix

08. York Hsiang1.mp4: this mp4 video file was automatically transcribed by Sonix with the best speech-to-text algorithms. This transcript may contain errors.

York Hsiang:
Thank you for allowing me to speak at the citizens hearing. My name is York Hsiang. In my professional life, I was a vascular surgeon as well as a professor of surgery. I have lost both of those positions as a result of the mandates. But I'm not really here to talk about my professional life and the impact that the mandates have had on me. But something I think is much more important that the impact of the mandates on my personal life. I have a mother and she is now very old. She has never told me her actual date of birth, but I am estimating it is probably about 98 this year. My mother was admitted to a nursing home in November 2019 as a result of a fracture of her hip, which resulted in her no longer being able to walk. I was very pleased to have found this nursing home since it's close to where I live. I thought that she was getting appropriate care. Not only could I visit her at any time, but any one of her friends or other relatives could come and visit her at any time. And life there was quite good. The impact of COVID, though, has really changed things quite a bit. Initially in 2020, at the beginning of COVID, when nobody really knew what was happening, there were restrictions primarily on the number of visitors who could come and see her. And so the nursing home only allowed one designated visitor, which happened to be me.

York Hsiang:
And I continue to see her, although I would need to now make appointments to see her specifically. Whenever I went to see her, I couldn't go by the front door. I had to go by the back door. In fact, all of the visitors had to go by the back door, had to be screened with a number of questions, as well as temperature checks. And then we'd have to mask and gown up to see my mother specifically for only a short period of time. That situation worsened as a result of the outbreaks and a number of nursing homes, including my mother's, where we were no longer able to see our relatives for an extended period of time. In fact, I believe that the clients were more or less confined to their rooms and their meals were brought to that. And this went on for, I suspect, for a number of weeks. I am not certain how long this lasted, but at the end of it, this was now in 2021. Vaccines became available and at the time, because of my mother's age, I agree that she was at high risk for developing COVID and recommended that she go ahead and have the COVID vaccinations. As a result of that, the policy within the nursing home also changed that visitors not only did you have to make appointments and you could only have one designated person to come and see your relative, but they now required that whoever was going to come and visit your relative had to be vaccinated.

York Hsiang:
In my situation, I have natural immunity and that is usually not allowed as a substitute for vaccination because of my mother's situation of perhaps prolonged confinement. I understand that she started to act out, in the words of the nurses or nursing care aides at that home, and as a result, the physicians sedated her. I have only been able to see my mother since the rollout of the vaccines three times in person. Each time has been associated with an overdose of sedation, and at a period where the nursing staff feel that my mother was pre terminal, was I allowed to see her for a brief sanctioned visit and that she was overdosed? And I would simply say to the nurses, you're just overdosing my mother with sedatives. And each time this is associated with a change in physicians. And so there have been three physicians associated with each one of those overdose episodes. And I think each one of the physicians are not aware of the dosing requirements for a very elderly, small Asian lady. So after seeing my mother briefly letting the nursing staff know that it's simply just over sedation, they would hold her sedation and with. And 24 hours she was back to her normal self. Once she was back to her normal self though they denied me entrance to see her again.

York Hsiang:
And so I have only been able to contact her by telephone or by Zoom. I think that this is a terrible policy and that with natural immunity I don't feel that I am a risk at all to my mother or to any of the other clients or staff in the long term care facility. I think this is very cruel that in her last remaining time she has I cannot see her as frequently as I like. And I think that the worst part of it is that as a result of the confinement and the lack of exposure to familiar faces, my mother's dementia has deteriorated significantly to the point now that she can only recognise myself in one brother. She has no other memory recollection and this is quite different than when she initially went into the long term care facility. So that essentially is my story. My story is that I feel that the mandates have been overdone. Elsewhere in society, there are lifting of mandates and we in British Columbia, we are no longer need to wear masks. We can now travel within the country if we're unvaccinated. But this mandate of requiring all visitors long term care homes to be vaccinated simply does not make sense. And I think it is extremely cruel to those relatives who can't see their loved ones. Thank you.

Trish Wood:
Yeah. I mean, you have you have kind of two stories, right? One of them is about the vaccine and your inability to go in and care for your mother. But the other one, too, is that her care doesn't seem to be that good if she's being overdosed. Right in that way. Right. So and do forgive me for mispronouncing your name. I'm sorry about that, but but do you feel that if you had seen her more that the the the overdoses would have been happening less because you would have been able to monitor her? Is that your frustration?

York Hsiang:
I would say so. I would say that two points here. One is that I believe that after the first overdose happened, had I been able to see my mother on a regular basis, I would frequently go in and assess for the nursing records what exactly what other medications is my mother receiving? And the other aspect of it is that her dementia rapidly changed to a much worse situation. I think this is irreversible, and I think that that also could have been prevented.

Trish Wood:
I'm going to throw to the panel now. I'm sure they have questions for you. Thank you.

David Ross:
Thanks. Dr. Student, erm, wrong one, Dr. Hsiang. Sorry for your for your comments. On the face of your story, it appears that lots has been done wrong in the nursing home. In your view, what have they done that is right.

York Hsiang:
I think that they have continued to care for the clients and the best way that they know of. I think that initially some of the policies are probably, I would say, could not be faulted because at the beginning of the pandemic, I think restricting the number of visitors is probably appropriate. I think vaccinating the. A very elderly knowing that the very elderly have a higher risk of dying from COVID is also well done.

David Ross:
And so in terms of what they've done wrong is, in your view, I guess, or where where the policies have have been suboptimal, I guess we could say it that way at best. Is there anyone there that's prepared to discuss these things? Or are you just kind of talking to a to a to a hand?

York Hsiang:
Oh, no, no, no, no. I don't think there's anyone there is prepared to discuss it, because I have actually written to the director in that long term care facility explaining my situation that I have been allowed to see my mother when she is pre terminal only. I do have natural immunity. I will not be at risk, but they are only following the policy guidelines as set by the Ministry of Health and they are in no situation that they could actually question this. They don't have any training in any of these matters. I would say, if anything, it's very similar to probably what other speakers have been talking about. There has been no evaluation of the policies that they have implemented and whether they are reasonable or not.

David Ross:
So I'm starting to see a pattern here. And I know we're only a half a dozen witnesses in, but it seems like those who are communicating the policies and administrating and enforcing the policies are not prepared to talk about them.

York Hsiang:
That is correct. That's that, unfortunately, is my assessment of the situation. You have implemented this policy. The policy has been around for quite a while. Why don't you evaluate the effectiveness of your policy?

David Ross:
And would you and I'm trying not to lead you with this, but would it be a reasonable expectation to think that that people in positions of authority who enforce policies should be accountable to explain the policies so that people can can understand them and. In other words, if you make a decision to stand by it, to be accountable.

York Hsiang:
I think that would be ideal. But I don't think that that would work. And I think that what you need is you need a separate body to oversee the policies. This has been a great experiment on a worldwide basis with very little actual evaluation of any of the policies since. You could run a series of very useful policy evaluations, essentially research into how effective these have been. But I think that that can only come from an independent body. It cannot the police cannot police themselves, is what I'm saying.

David Ross:
But I guess we're where I'm going with this is I'm I'm I guess and maybe this comes more from my own perspective is that if people are are are. Her feeling like they need to enforce a policy that they ought to be accountable to. To give an account of why they are enforcing it and to take responsibility for enforcing it rather than say, well, somebody else is making me do this.

York Hsiang:
Oh, I agree. There needs to be a policy evaluation. But the people who have implemented the policy, I think that they are no, they are clearly biased in their recommendations. And if you ask them to evaluate their own policies, I think that you will get a biased answer.

Trish Wood:
Okay. Thank thank you very much. It's time to to wrap up with this.

Speaker4:
One quick question. Real quick question. I appreciate it. Maybe you've elaborate on this, but evaluation is kind of after the fact. If you were in charge of that nursing home yourself right from the beginning. What would you do differently at the front end? Not not even at the back end that would maybe have alleviated this situation.

York Hsiang:
I think that probably at the very beginning, with so little information being known, I think that their plans to limit the number of visitors was correct. I think that knowing that confinement of these elderly clients, probably all of whom have dementia and knowing that that would only worsen the dementia, I think that's very cruel to them. I think that obviously now with a large retrospective look at everything, there were alternative treatments that never made the headlines. But going forward, I think that knowing that there are a number of alternative treatments which surprisingly work in different situations, this may also be something to be considered.

Speaker4:
Okay.

Trish Wood:
Okay. Thank you very much for your your evidence. It's the long term care and assisted living story is a very, very important one. Thank you from Vancouver.

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