Four dead, 50 infected at Maimonides care home; authorities outline protocol changes
MONTREAL -- A care home for the elderly in Cote-Saint-Luc is in the midst of a serious COVID-19 outbreak a few months after being hit hard in the first wave.
Fifty people so far have tested positive for the virus this fall at the Maimonides care home as of Monday night, and four have died, according to a letter sent to residents' families.
"On behalf of all of us we wish to offer our sincere condolences to the families" of those who died, the home's administrators wrote.
The outbreak began when one resident was infected by a caregiver from outside the facility who was positive but asymptomatic, said Jennifer Clarke, Maimonides's site coordinator. That could mean either a family member or a paid caregiver.
Family members of the residents say they fear the situation is a repeat of the spring and they want alarms pulled now, with major action to stem the outbreak.
"We are fearing for the lives of our loved ones," said Joyce Shanks, the daughter of a Maimonides resident.
"We’re asking the government for help. We’re saying 'Send the Red Cross now, send the SWAT team now.'"
But the home released more details on Tuesday to try to reassure the families that the situation now is not the same.
"Improved practices in infection control have been implemented, given the increase in knowledge about the novel coronavirus that has emerged since the pandemic began," wrote Dr. Lawrence Rosenberg, the CEO of the health authority for West-Central Montreal, which runs Maimonides, in a statement Tuesday.
CHANGES SINCE THE FIRST WAVE
Rosenberg's statement elaborated on some of the details the administrators told family members in their Monday letter.
They had said that patients who test positive are being relocated to the seventh floor of the building. On Tuesday, Rosenberg clarified that members of nursing staff do not move between care units, and they don't move from any "hot zone" to any other part of the building.
Staff in hot zones have their own elevators and lounge that they don't share with other workers, he said.
In a second measure, all members of staff and registered caregivers -- whether paid or family -- are required to wear protective equipment and are monitored for compliance.
Third, there is a new testing regime, Rosenberg wrote. On-site testing is available, and when any outbreak occurs, all staff and residents are tested.
Staff are encouraged to get tested weekly, regardless of known outbreaks, and the on-site testing has been set up -- not just at Maimonides but at all of the West-Central long-term care homes -- to ease that process.
Every person who enters the building is also screened for symptoms, Rosenberg wrote.
The CIUSSS hopes an addition will soon be added to that regime, he said. They're about to submit a proposal for a rapid-testing pilot project to Quebec's health ministry.
ALMOST TWO DOZEN STAFF SELF-ISOLATING
In the letter to residents' families, Maimonides made it clear the outbreak is far from over -- most of the 50 people who have tested positive are still fighting their infections.
"We are pleased to report that seven residents have now recovered and have been transferred back to their units," said the letter.
Right now, there are 39 active cases. Of those, all are being treated on-site, on the seventh floor, except for one patient who has been taken to the Jewish General Hospital.
But the outbreak has also hit staff hard, at least in terms of the need to self-isolate. There are 22 staff members "from a cross section of departments" who are currently quarantining at home, along with seven "caregivers," said the administrators.
That's also a red flag for some relatives about how things could go from here.
"Things are spiraling out of control at Maimonides in terms of staffing," said Morris Azouz, whose 92-year-old mother lives at the home.
When he visits, he said, he often finds himself helping her.
"I had one [orderly] tell me just today that they don’t know what they would do if the family members and the caregivers were not there to help out," he said.
Azouz said not enough has changed at the home since the first wave, when it also had a bad outbreak, with at least 77 people positive and at least 12 dead.
In his statement Tuesday, Rosenberg said that while "staffing is an ongoing challenge," there's "no shortage" of orderlies right now.
Quebec's new class of thousands of orderlies, rapidly trained over the summer, has helped, with 70 of them assigned to Maimonides, Rosenberg said. Nurses are a bigger problem.
"Having as many nurses on hand as we would like is always difficult," he said, but the CIUSSS is generally able to help.
MEMORIES OF THE SPRING
At the time, families with loved ones living there were very upset about the protocols in place, especially around the transfer of patients between different floors.
A new wave of worries arose, with echoes of that time, last month, when it was announced that Maimonides and other care homes would need to be prepared to care for COVID-19 patients from outside the facility if the hospitals overflowed. Doing so is a ministerial order.
However, Rosenberg said Tuesday that this hasn't happened yet -- it's not a factor in the current outbreak.
"At this time, no one has been transferred from the community to the hot zone at Maimonides," he wrote.
He and the home's administrators, in both their letters, said that representatives of the public health department came for a visit on Friday afternoon.
"They visited each floor and reviewed all aspects of our operations and procedures," said the letters to families.
"The initial feedback was very positive and encouraging, and we will share their findings with you once we receive them."
Rosenberg said that while public health's official report hasn't been released yet, "they have already spoken to us and given their approval for the measures we put in place."
He also said they recommended "several relatively minor improvements" that were put in place, so "overall, Public Health is satisfied with our approach."
Rosenberg also wrote that he would "keep the lines of communication open" and issue further statements when needed.
--With files from CTV News' Andrew Brennan