Hospitals told to ramp up surgeries as outbreaks ease
Montreal hospitals have been ordered by the Quebec Health Ministry to ramp up their elective surgeries in the next few weeks amid tentative signs COVID-19 outbreaks may be tapering off in nursing homes.
However, this must be orchestrated very carefully, because hundreds of acute-care nurses, who normally work in hospitals, are still on reassignment tending to the infected residents of longterm care centres, where many of the regular staff have been on sick leave. The acute-care nurses need to return to hospitals for the planned ramp-up in operations.
Those plans could still be derailed if authorities discover new outbreaks in nursing homes (CHSLDS) or in communities like Montreal North. It’s for this reason that Premier François Legault announced on Friday the public health department will be distributing masks to residents of Montreal North and other so-called hot zones.
The premier also cited the lack of staffed beds in Montreal hospitals as the main reason the government has postponed reopening schools until the end of August. What’s more, some hospitals, like the Montreal General and the Lakeshore General, are struggling with outbreaks on their own wards while emergency rooms are becoming increasingly overcrowded.
Yet for the first time since the COVID -19 crisis erupted in Montreal, several trends have emerged suggesting the pandemic may have started weakening in Canada’s epicentre.
“Things are definitely looking up, no question,” a senior health manager told the Montreal Gazette.
First, there’s the COVID -19 death rate in Montreal. The city reported 28 deaths on Friday, the lowest number in nearly a month. And that figure includes deaths from previous days. It’s now taking 16 days for the number of deaths to double in the city. On May 2, the doubling took 10 days.
A chart released on Friday by the Institut national de santé publique du Québec shows the province actually reported only 10 deaths on Thursday, and the trend is clearly downward, with no deaths reported in people’s homes.
The number of COVID-19 hospitalizations appears to be plateauing in the 1,800 range. But perhaps the most welcome news may be found in Montreal’s network of CHSLDS, which for weeks was beset by uncontrollable outbreaks and a soaring death toll.
The number of new cases in CHSLDS across the province declined on Thursday to 46, from 48 the day before, according to the government’s latest update. In Montreal, some CHSLD outbreaks are on the verge of being contained. For example, although the CHSLD Vigi Pierrefonds has declared 17 deaths, only one resident was reported infected on Thursday, down from 19 at the peak of its outbreak.
Nonetheless, authorities must remain vigilant. There could be no better proof of the contagious nature of the coronavirus than the fact that four Canadian Forces personnel have contracted COVID -19 while caring for CHSLD residents. That’s one of the reasons all workers are being tested in these institutions, including acute-care nurses.
At the Jewish General Hospital, a designated COVID-19 treatment centre, more than 100 nurses were loaned out to assist in CHSLDS. Their absence at the Côte-des-neiges hospital has meant surgeons have had to reduce the number of operations to 20 per cent of the normal volume. All orthopedic surgery has been postponed during the pandemic.
“All the hospitals have a challenge with their nurses being in long-term care facilities,” Dr. Lawrence Rosenberg, in charge of the Jewish General, said in an interview, explaining that many work in operating rooms and recovery units.
It’s the same story at Maisonneuve-rosemont and Sacré-coeur hospitals, which have reassigned nurses to understaffed CHSLDS. Still, the government is confident that some nurses can now return to hospitals.
“That’s going to start happening in the next week or two, but it won’t happen with the flip of a switch,” said Rosenberg, executive director of Montreal’s centre-west health authority.
“From a morale point of view, it’s great, because everybody wants to come back. But we’re worried about how to start up the hospital again.”
Hospitals have been instructed to provide the health ministry with detailed plans on how they will ramp up their elective surgeries, amid concerns some people at home whose operations have been delayed might develop serious health problems.
Meanwhile, nine patients were being treated for COVID-19 in the Jewish General’s intensive-care unit on Friday, down from a high of 28 four weeks ago. At the Mcgill University Health Centre, 95 patients were being treated for the respiratory illness, down from a peak of 123 only eight days ago — yet another positive trend.
However, as demonstrated by the growing outbreak at northend Bordeaux jail — where 89 inmates have tested positive, up from 14 only three weeks ago — a positive trend can quickly turn negative if everyone lowers their guard.