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.