Breaking News: Maimonides Sends COVID Patients to Hospital to Curb Outbreak

Dec. 1, 2020

By JANICE ARNOLD

MONTREAL – A rapidly worsening COVID outbreak at Maimonides Geriatric Centre has been brought under temporary control by transferring infected residents to hospital, but family members say more needs to be done to prevent a recurrence.

On Nov. 29, 20 residents were taken by ambulance from the Cote Saint-Luc long-term care facility’s “hot zone.” Two acutely ill residents were brought to the Jewish General Hospital and the rest to Hotel Dieu Hospital, which has a unit dedicated to less severely ill patients from nursing and seniors’ homes.

Maimonides’s hot zone for active cases, located on its uppermost seventh floor, is closed for now.

The move was made after some relatives held a demonstration outside Maimonides on Nov. 26, fearing the facility had lost control of the viral spread. They claimed infection prevention measures were inadequate, that a shortage of nursing and support staff was resulting in repeated movement between cold, warm and hot zones, and that infected residents were not getting the medical treatment they needed.

They appealed to Premier Francois Legault to take immediate action.

Active cases went from zero to over 50 in a couple of weeks, the most at any long-term care home in the province at that point, although not the highest per capita rate. Eight residents had previously been sent to hospital. Ten residents have died, while others recovered.

In addition, more than 20 staff members and about a dozen registered caregivers – either family members or workers privately hired – have tested positive and had to quarantine at home.

Maimonides was hard hit by COVID in the first wave, when one-third of residents had the virus and 39 succumbed to it, according to Quebec government statistics. Members of the Canadian Armed Forces and later the Canadian Red Cross were brought in.

During this second wave, administrators had insisted the situation was in hand, that stringent infection prevention measures were in place, and that staffing overall met government requirements, until relatives raised their voices ever louder that this was not what they observed. They received support from Cote Saint-Luc Mayor Mitchell Brownstein and local Member of the National Assembly, David Birnbaum.

In a Nov. 29 public message under the heading “Mission accomplished!” Barbra Gold, an official of CIUSSS West-Central Montreal, the regional health authority that manages Maimonides, confirmed that the residents’ transfer to hospital had been completed that day.

“We hope that this temporary closing of our hot zone will break the cycle of infection in our facility,” she stated.

Gold said that 10 other residents with active COVID who had been in the hot zone remain at Maimonides, explaining, “our medical team determined they could be safely returned to their rooms (in other areas).”

Caregivers are not allowed to visit the residents at Hotel Dieu, she said, but an effort is being made to set up FaceTime calls. They were accompanied to Hotel Dieu by the nurses and orderlies who had tended to them at Maimonides. The CIUSSS has arranged for kosher food to be available there.

Gold added that a virtual town hall with families is being planned to address concerns.

The day before, Gold communicated that an evaluation of Maimonides’s COVID isolation unit by public health authorities, infectious disease specialists and the institution’s health care professionals had been conducted. A “contributing factor” to the virus’s rapid spread, they believe, was “a high density of very contagious individuals in a relatively small area that has not been built to accommodate them.” That seventh-floor wing was sealed off with plastic sheeting.

Another CIUSSS official, associate chief executive officer Francine Dupuis, told the media that the ventilation system may have been another factor. She also said the origin of the outbreak was traced to a caregiver, who was asymptomatic and later tested positive.

The Family Advocacy Committee, which staged the demonstration, is now calling for mandatory weekly testing of all employees and visitors to Maimonides. Its chair, Joyce Shanks, whose 92-year-old father is a resident, deplored that testing is now voluntary and only required when a positive case occurs in a unit.

The committee would also like to see the return of the Red Cross or of the health department’s “swat team,” which shores up staff when an outbreak reaches a critical level.

The CIUSSS says that, as of Dec. 7, all registered caregivers at Maimonides and other CHSLD under its jurisdiction, which includes the Jewish Eldercare Centre, must be tested every two weeks, either on-site or at any testing centre in the province. Written proof of a negative result must be shown or they will be barred. Maimonides has an on-site clinic three days a week, and Eldercare twice a week.

Since the second wave began, the 320-bed Eldercare has had total of 17 cases among its residents of which 10 are now active, attending physician Dr. Mark Karanofsky reported. Two residents have died. Two positive staff are currently isolating at home. Karanofsky himself came down with COVID in late October and has recovered.

COVID Rips Through Jewish Retirement Home

Nov. 12, 2020

By LILA SARICK

Coronavirus has ripped through a Toronto Jewish retirement home, infecting all but one of the residents and leading to the deaths of several elderly patients.

147 Elder Street, a retirement home that cares for seniors with dementia, has seen 45 of its 46 residents test positive for the virus, with one test still pending.

147 Elder Street, North York, Ontario (source: 147elder.com)

Seven residents have died, since the outbreak started in mid-October and six residents are currently in hospital, Krista Samborsky, director of resident and family relations, wrote in an email sent to family members on Nov. 11.

According to a report posted Nov. 9 by Toronto Public Health, 25 staff at the retirement home have also tested positive for the virus.

“This is a devastating virus that is severely impacting us right now,” Samborsky wrote to families. “While loss of life is a natural part of 147 Elder Street, our team is impacted particularly deeply by these events.”

The home, located in a predominantly Jewish neighbourhood in North York, advertises that it serves “the Jewish and general community.”

The source of the virus’s spread has not been pinpointed, but “in all likelihood it is a combination of factors, combined with the high transmission rate of the virus in the community, the prevalence of dementia in our home and our high staffing ratios,” the email to families stated.

The home did not have any COVID cases during the first wave of the pandemic. Since this outbreak started, staff from Humber River Hospital’s Infection Prevention and Control (IPAC) Team have been at the home daily to review operations and make recommendations. The hospital has also sent doctors and nurses to the home to treat residents, Samborsky said in an email to the CJR.

The home has increased staffing and has added more personal support workers than usual. Staff compensation has been increased to retain staff, and accommodation has been offered to employees who are not comfortable going home due to the health status of their families, Samborsky said.

Sue-Ann Levy, whose 91-year-old father lives at 147 Elder and has been diagnosed with COVID, said the home had taken every precaution to keep residents safe since the beginning of the pandemic.

“I think they did everything they possibly could to keep it (COVID) out and in my view, unfortunately it was just dumb luck,” Levy told the CJR.

In the early days of the pandemic in the spring, the home required caregivers to work at only one facility, before the province mandated it. Visitors were carefully screened and had to have a negative COVID test and wear full protective gear before entering the facility, Levy said.

Since the outbreak, the home has conducted testing regularly and involved Humber River Hospital early on.

Levy, a columnist with the Toronto Sun, said she has written stories about families with loved ones in long-term care where they hear nothing from the home for four or five days, a situation she calls “unacceptable.”

In her case, she and her brother have received two emails and two phone calls a day about their father.

The home operates on a model that encourages residents not to isolate in their rooms, which has been “wonderful” for her outgoing father, Levy said.

“But that kind of formula leads to a very quick spread and unfortunately, that’s probably what has happened,” she said.

Residents are now isolated in private rooms. While family visits have been suspended, the home was working with authorities to allow one designated caregiver per resident to enter, Samborsky said, 

Levy said she plans on visiting her father this Friday, with a negative COVID test in hand. “My dad has dementia, as does everyone else, and they feel it would be good emotionally for him,” she said.

The toll at the home has been sobering, but not unexpected, Levy added.

“I said this all along throughout the summer, having covered all this, that if it got into a dementia facility, it would be a nightmare and now, we’re living it.”