MONTREAL -- Workers at the Douglas psychiatric hospital say they’re angry to hear about an outbreak of COVID-19 at their facility.

What makes them angry, they say, is that they already knew about it—but only in bits and pieces, days after the fact, and largely through workplace gossip.

The opaque, “top-down” updates meant many staff didn’t understand the extent of the outbreak, nor did one of their biggest unions, despite its daily meetings with the hospital director.

“We’re the last to know,” said one employee at the Douglas, who didn’t want to be identified for fear of repercussions at work. 

“People are starting to crack.”

Staff are increasingly stressed by the feeling they’re working in the dark, unable to help prevent more infections, the employee said, less than two weeks before Premier François Legault has proposed to begin reopening the local economy.

As of Thursday, there are 22 staff members and 16 patients confirmed to be infected by COVID-19 at the Douglas Mental Health University Institute, which is in Verdun. 

It’s unclear how the outbreak began. It was “community transmission,” said the health authority that governs the Douglas, the CIUSSS de l’Ouest-de-l’Île-de-Montréal.

Some staff heard another explanation. Many had been asked to transfer temporarily to severely understaffed long-term care homes. Some at the Douglas were later told that colleagues brought the virus back with them aftern not being given time, for various reasons, to self-isolate at home between jobs. 

The CIUSSS did not respond to a question about protocols for staff moving between facilities.

NEWS A WEEK LATE

Whatever its origins, the outbreak first began more than a week ago—long before most staff heard there was a problem.

Four nurses working in the Douglas’ emergency room tested positive around April 21, said Elizabeth Rich, who represents them at the FIQ healthcare workers’ union. Several other nurses then asked to be tested, but they weren't given tests, she said. (The health authority didn’t explain why this was, but it said in a statement it will ensure that all patients and staff at the Douglas are tested in the coming days.)

It was only a week later, on April 27, that many staff in other units learned about any of this. They weren’t told directly, but were simply notified there was a staff shortage in the emergency room and that people would need to be brought from other units to help out.

This kind of request “happens all the time. No one bats an eye,” said the staff member who spoke to CTV News. However, in this case, the bigger news trickled out “through the grapevine.”

Finally, there were some conference calls, including one on April 29, confirming the Douglas had positive cases. But management still didn’t say how many.

“I heard five to six,” said the employee that same afternoon. “But I've also heard a total of nine. So I'm not sure.” A few hours later, the hospital authority confirmed to the press that the number of staff infected was in fact 22, plus the 16 patients. 

UNIONS LIMITED IN TRACKING OUTBREAKS

Even the unions, which have been getting daily tallies of infected workers, can’t easily track the situation at individual hospitals, said Rich. 

That’s because they get their daily totals broken down by type of worker—nurses, orderlies, social workers and so on—rather than by facility.

This is for privacy reasons, she says. The union, which represents workers at multiple facilities, is not supposed to know which individual people are infected, and to know their job description plus where they work would risk outing them.

However, many of the infected people do tell her directly, or their close coworkers ask for help getting a test, Rich said.

“People are scared because their colleagues are falling down [infected], and they’ve been working with them,” she said.

People have been alerting colleagues to their positive tests, said the Douglas employee. “We're friends, we text,” the person said. On the other hand, that means other staff are “not going to know unless someone has friends and gets insider info.”

A GROWING LOAD IN PSYCHIATRIC CARE

While they’re not dealing with legions of patients on ventilators, there have been other sources of stress unique to the Douglas, said the employee.

It’s very difficult to limit contact because almost no one is bedridden, with many patients and staff walking between units. “In this hospital, people are active,” said the source. 

Patients sometimes need to be suddenly restrained—for example, if someone is experiencing psychosis and could hurt himself or herself—and there’s little time for extra gear or precautions in those urgent moments. 

More than that, Montreal will likely soon see a new wave of psychological distress, said the employee.

“The biggest issue, and what the Douglas is preparing for, is psychosocial support for…the people who will probably lose loved ones to the disease, people who will be overworked, overwhelmed.”

That includes the Douglas staff themselves. Their anxiety is coming to a head this week, between the outbreak and the news of Montreal’s imminent deconfinement.

“People are yelling…in the meetings,” the person said. “They're rightfully afraid, because this isn't going to end on May 18th or May 11th or whenever we open up. We're going to get more and more and more cases, more of our colleagues that are sick.”