Anatomy of an outbreak at GNGH
It took less than a day for COVID-19 to infect 21 people at hospital
It took less than a day for the novel coronavirus to invade the Niagara Falls hospital, sicken at least 21 people, trigger two outbreak declarations and remind the region that even as the COVID-19 curve flattens, the virus remains as dangerous as ever.
“It certainly shows us that we cannot let our guard down and we have to remain vigilant,” said Derek McNally, Niagara Health vice-president of clinical services and chief nursing executive.
The hospital system had designated St. Catharines hospital the region’s COVID-19 “hot zone.” Built in 2013 with outbreak control in mind, the facility was the logical choice to treat Niagara residents suffering the worst of the virus.
McNally said all Niagara Health sites follow the same infection control protocols, but the aged infrastructure in Welland hospital and Greater Niagara General Hospital in Niagara Falls makes those efforts more difficult.
Still, it was hoped the virus could be contained in St. Catharines hospital. In the event a patient elsewhere had the virus, they would be moved to St. Catharines. But a single staff case discovered Friday upended those plans, and now the Niagara
Falls hospital is working to keep a lid on the spread of the virus.
McNally said a hospital staffer who works in the GNGH Trillium ward, where patients with chronic illness are treated, tested positive for COVID-19 on Friday. That single test was enough for the hospital to declare an outbreak in the ward. It is not known where exactly the worker was exposed, but an investigation by public health determined it was somewhere in the community.
Knowing how easily the coronavirus spreads, McNally said staff and patients that person was in contact with were tested. Because they were hospital staff and patients, the tests were regarded as urgent and processed quickly by labs. As the positive tests rolled in, the hospital continued its contact tracing and determined a staffer who was in contact with the first infected worker was also on Unit D in the hospital. A new wave of tests was conducted and by Saturday afternoon an outbreak was declared in that unit. As of Saturday, eight Niagara Health staff and 13 patients tested positive.
“It is a very fast-moving situation,” said McNally. “It all happens within a day or less.”
The hospital system had an infection control plan ready to go in the event the nightmare scenario of a COVID-19 outbreak in a hospital outside of St. Catharines.
When the first case was found, McNally said the plan was immediately put into action. The hospital had to know how many people were exposed, how many had the virus and where it might be spreading.
Enhanced cleaning measures were put into place on both wards. McNally said given the number of infected staff and patients, it was not safe to move them to St. Catharines. So, to prevent further spread of the virus, he said, “wards within the wards” were established in both impacted units.
All the infected patients are in these segregated areas. Staff assigned to those areas cannot work elsewhere in the hospital, and equipment used to treat the patients is not used on other patients.
The staff who tested positive are isolating at home, McNally said.
“The situation is very unfortunate,” said McNally. “Hopefully, we are able to contain it and this will be resolved quickly.”
There have been three COVID-19 outbreaks at St. Catharines hospital, two of which have been declared over.
The COVID-19 crackdown at GNGH is part of an effort to prevent the kind of outbreaks seen in long-term care homes, which have become Niagara’s pandemic hot spots.
Given the close quarters in medical facilities such as hospitals and long-term care homes, and the fact residents and patients often have other serious health problems, a COVID-19 outbreak can be disastrous.
Residents in three homes in particular — Lundy Manor in Niagara Falls along with Seasons Retirement Community and Royal Rose Place in Welland — represent 30 per cent of Niagara’s 523 COVID-19 cases and more than 82 per cent of all the 53 known local deaths related to the virus.
Due to their proximity to infected people, health-care workers — including doctors, nurses, paramedics, personal support workers and related support staff — are at a greater risk than most other people. According to recent Niagara public health data, health-care workers represent more than 20 per cent of all COVID-19 cases in the region, most of them workers at long-term care homes.
There have been no reported COVID-19 related deaths of health-care workers in Niagara since the pandemic began.