Vaccine Rollout Brings Hope to Maimonides

Dec. 17, 2020

By JANICE ARNOLD

MONTREAL—Every December, Beverly Spanier has organized a Hanukkah party for her friends. That celebration, held in a favourite restaurant or hotel, continued even after she moved into Maimonides Geriatric Centre five years ago.

Planning the party was a project the retired high school teacher worked on for weeks in advance. A paraplegic, she got to the site via the city’s adapted transit service.

That, of course, did not happen this year. Spanier, 75, has not left Maimonides since the pandemic began in March except for three hospital visits. In fact, she has been confined to her room for the past nine months, save for some time in its garden during the summer.

Beverly Spanier
Beverly Spanier

For the first months of the pandemic, all visitors, including paid caregivers on whom Spanier relied, were barred from Maimonides, and remain restricted.

For Spanier, Hanukkah has been limited to looking at the menorah in a municipal park from her fifth-floor window.

When Maimonides was selected as the first site in Montreal for the Pfizer/BioNTech vaccine rollout, she didn’t hesitate to consent. On the afternoon of Dec. 14, Spanier was among the first of the first in Canada – and indeed the world – to be inoculated.

Maimonides, a long-term care institution in Cote Saint-Luc, and a Quebec City nursing home, Centre d’Hébergement St. Antoine, received the first vaccine shipments to Quebec. The highly anticipated cargo landed at Mirabel Airport north of Montreal on the evening of Dec. 13.

Maimonides took delivery of two boxes of 972 doses each, and 150 residents and staff received their first shot on Dec. 14. Almost 95 percent of Maimonides’s approximately 350 residents have agreed to be inoculated, as have, at time of writing, 40 percent of its roughly 500 employees, according to CIUSSS West-Central Montreal, the regional health authority that administers Maimonides.

Surplus doses from this initial batch will be made available to workers at other health care facilities in the local network.

The day after the first of her two shots, Spanier said she felt fine, with only a little redness at the injection site on her arm. Although she has much faith in medicine – her late brother was a doctor – Spanier was nervous about any adverse reaction and wondered if Maimonides had sufficient medical support on standby should a problem arise.

(CIUSSS officials reassured the public that it does have a trained team in place and precautions, such as a “crash cart,” to treat anaphylactic shock.)

“It is miraculous how the scientists and pharmaceutical industry have been able to produce an effective vaccine in such a short time, but you do worry,” Spanier said. “We are still, in a sense, in the midst of an experiment.”

On balance, she realizes that her risk of catching COVID is far greater than any associated with the vaccine. The consequences for Spanier, who has respiratory issues, could be fatal.

She also has a sense of responsibility toward society. “I think that we all have to do what we can to overcome this terrible disease and allow the world to return to normal.”

The psychological toll of the pandemic has been brutal, she said.

Maimonides has been hard hit by the coronavirus, twice. In the first wave, a third of residents were infected and 39 died, according to government information. It took the assistance of the Canadian Armed Forces and, after that, the Canadian Red Cross to help overwhelmed staff get the outbreak under control.

In early October, Maimonides was proud to announce there were no more active cases. But within weeks, the numbers went from zero to over 50 and, after trying to care for the sick in an isolated ward, transferred many to hospital.

On Dec. 16, Maimonides site coordinator Jennifer Clarke made public that, in the second wave, a total of 88 residents have had COVID and 19 have died. There are currently nine active cases, she reported.

Spanier compares her life to being on a “battleground,” with its fear, disruption and grief.

“We are a community here. I knew some of the people who died, or know someone who knew them,” she said. Her hope today is tinged with solemnity because she can’t forget the havoc the virus wreaked.

Much hoopla surrounded the rollout at Maimonides, with Quebec Health Minister Christian Dubé and federal Health Minister Patty Hajdu on hand for a ceremony held outside the building just before the first shot was administered to resident Gloria Lallouz, 78.

The politicians hailed it as a historic occasion. Hajdu, who did not hide her tears, said, “I see this as the first step toward the light.”

Spanier is more cautious. The first battle to be won is ending the pandemic, but the definition of victory in the long term, she believes, is changing society’s disregard for the institutionalized frail elderly.

“If any good has come out of this, it is that light has been shed on what is happening in chronic care places. We can’t just dump people, and the resources have to back that up. One orderly for 35 patients at night is not feasible anymore.”

Families Protest Possible Admission of COVID Patients to Nursing Homes

Oct. 28, 2020

By JANICE ARNOLD

MONTREAL— Families of residents of the long-term care institutions Maimonides Geriatric Centre and Jewish Eldercare Centre, which were hard-hit by COVID this spring and summer, are pleading with health officials to halt a plan to admit outside patients with the virus to recuperate in those facilities.

Jewish Edlercare

“My initial reaction was, ‘What are they thinking?’” Helen Adam, president of the users’ committee at Maimonides, told the CJR. At the outbreak’s worst, one-third of Maimonides’s 380 residents were infected and 39 would die, in addition to the staff members who tested positive. It took reinforcement by members of the Canadian Armed Forces and then the Red Cross to get the situation under control.

Eldercare had an even more difficult time from the outset of the pandemic in March, and lost more residents.

On Oct. 19, CIUSSS West-Central Montreal, the government health agency that administers Maimonides and Eldercare, informed families that there were no longer any COVID cases among residents and that the “hot zones” at both sites would, if necessary, accommodate certain people with the virus who live in the geographic territory served by the CIUSSS.

The email, signed by Barbra Gold, director of the CIUSSS’s Support Program for the Autonomy of Seniors, states that these beds would be for “COVID-positive patients who are medically stable (do not require hospitalization) but require a greater level of care than what is being offered at their current locations, such as private seniors’ residences, intermediate resources or those recovered in hospital who are not strong enough to go home.”

To date, no such transfers have been made and Gold noted that “every effort” is being made to keep such patients where they are. She added, “We are confident that this approach will not compromise the health and well-being of our residents and is in the best interest of the community we serve.”

Adam said families are flabbergasted that after waging such a lengthy battle to contain the virus – which included stopping visits for months and moving residents to different rooms and makeshift spaces to separate the infected from those who were not – the two institutions are now being opened to ill people from the community.

At Maimonides, the hot zone is located in part of the uppermost seventh floor. Adam said she is fearful that staff will inevitably move to other areas of the building despite the best intentions.

“I think Quebec has gone out of its mind. They try one thing one week and another the next. Now it looks like they are setting us up as an adjunct to the hospitals. People are so scared and confused,” said Adam.

Asked by the CJR to respond, the CIUSSS emailed a statement that those with COVID will be moved “only as a last resort” and with extra precautions.

“If and when any COVID-positive individuals arrive at the facility, they will not come into contact with uninfected residents. They will be put into designated hot zones that are separated by permanent walls from the other residents and the other units,” it said.

“They and the staff who care for them will also use designated elevators that will be unavailable to other residents and personnel. As well, they will receive care from dedicated members of the staff—in other words, the COVID-positive person or their health care provider should not have any contact with the other residents, caregivers or health care teams at Maimonides or Jewish Eldercare.”

West-Central Montreal adds that, “like every CIUSSS throughout the province, we are required to provide residents in our area with emergency spaces in a non-traditional site, such as a long-term care centre.”

This is not reassuring to Maimonides resident Beverly Spanier. The retired high school teacher is afraid of another COVID outbreak and has little confidence in the institution’s ability to deal with it.

“This is supposed to be our home, not a hospital,” she said, still traumatized by the upheaval that took place earlier this year. “We’ve already been through hell. I don’t want to live in a war zone again.”

In a letter to Premier Francois Legault, the users’ committee says a “highly vulnerable population” is being put at risk and suggests an alternative. “There are many virtually empty hotels, who would probably welcome the work. Why not use them?

“We appeal to you M. Legault to rethink this directive.”

The committee has also reached out to the Conseil pour la protection des malades, a group defending the rights of users of the health care system.

Adam’s mother, who lived for six years at Maimonides, died in May, but not of COVID. Adam thinks many residents’ passing, including her mother’s, was due to the loneliness and stress caused by the pandemic restrictions. She did not see her mother in person from mid-March until just before her death when she was allowed to visit on compassionate grounds.

She does not want that to happen again to any other residents or their relatives.

By the official count, more than 6,100 people in Quebec have died of COVID, the great majority of them residents of nursing homes or seniors’ facilities.