'Several breaches' of COVID-19 protocol at Lakeshore General Hospital expose patients to delta variant

An internal memo obtained by some media outlets including CBC News has revealed that multiple patients in the emergency room of Lakeshore General Hospital on Montreal's West Island were exposed to COVID-19 in recent days due to "several breaches" in protocol by staff. 

Last week, it was revealed that an unvaccinated nurse working in the ER had tested positive for COVID-19, and at least one patient in contact with that nurse had developed symptoms.

The memo, written by Marjorie Blanchette, an infection control counsellor with the CIUSSS de l'Ouest-de-l'Île-de-Montréal suggests a more widespread problem.

"Several breaches of protocols were also noted in the past few days in the ER, leading to multiple exposures of varying duration in several areas of the ER,"  Blanchette said in the health authority's memo dated Aug. 28. 

The breaches occurred between Aug. 20 and Aug. 26. Most of them involved staff or patients not wearing proper personal protective equipment (PPE). 

The memo also said several COVID-positive patients were present in the ER last week.

"Symptomatic and positive COVID-19 users spent several hours in the emergency room (waiting room, stretcher, outpatients and non-ambulatory) from August 20 to 26, 2021.  They were unvaccinated and had no history of the disease," Blanchette said in the memo.

The memo said those users were infected with the delta variant.

Health authority beefs up measures

Hélène Bergeron-Gamache, a spokesperson for the health authority, told CBC in an email that the patient who developed symptoms after coming in contact with the unvaccinated, COVID-19-positive nurse last week has so far tested negative.

"For now, he is negative as are all employees and patients with whom the nurse has been in contact," Bergeron-Gamache said.

She added that the hospital has issued a "high surveillance notice" to all staff which should increase infection control measures.

"Reminders to this effect have been sent to all staff and COVID agents have been deployed to the hospital to ensure respect and compliance with the wearing of PPE and good practices in infection prevention and control," she said.

She noted that 89 per cent of all staff of the CIUSSS have received at least one dose of a COVID-19 vaccine and 84 per cent have received two doses.

Staff burnt out across the province

Doctors and nurses groups say the problem isn't limited to the Lakeshore.

They say the pandemic has exacerbated chronic staff shortages, and now overworked staff are tired and more prone to mistakes.

"We are missing a lot of staff. It's not necessarily a breach of protocol. They're so busy," said Kristina Hoare, a spokesperson for the union representing nurses at the Lakeshore.

"Compared to the other waves we have much less personnel available on hand. We've lost a lot of personnel at all the hospitals across the province. And it affects us," Judy Morris, president of the Association des médecins d'urgence du Québec, told CBC News.

"People are tired. Some some staff are forced to do overtime. And that has a huge impact. They get tired. They might be less concentrated on what they're doing," Morris said.

More patients in hallways increases risk

Gilbert Boucher, president of the Association des spécialistes en médecine d'urgence du Québec, said overcrowding is also playing a role.

Boucher says the delta variant is bringing more patients to ERs, and those patients are usually unvaccinated.

"There's patients everywhere. It's overflowing everywhere. That means there's more patients in corridors," Boucher said.

"We need to empty those corridors because those are really high-risk places for patients and for staff."

Boucher said he expects the situation to get worse.

"It's going to be a tough fall: return to school, return to work, return to the city with a big explosion of people in corridors with the delta. It doesn't look good," he said.

He said some ERs may have to close.

Both Boucher and Morris said the best way to head that off would be for as many as people to be fully vaccinated