Number of COVID-19 cases in nursing homes rising
The number of nursing homes battling COVID-19 outbreaks in Quebec went up on Thursday, as did the number of cases within their walls.
Yet the grim numbers hide a positive element that gives CHSLD operators something to be hopeful about.
“Most of them are asymptomatic,” Yves Vincelette, the clinical counsellor at CHSLD Château Westmount, said of the increasing number of residents who are testing positive for novel coronavirus at his private long-term care facility.
“The second wave seems to be less deadly. People don't seem to have symptoms as much as we saw in the first wave. I talk with other centres and they say the same thing. A lot of the residents are much less symptomatic than in the first wave. So it's a good thing.”
On Thursday, the nursing home in Westmount remained near the top of the government's “critical” list of CHSLDS across the province, with the single largest day-to-day spike: 18 new cases. That brought the tally at Château Westmount to 45 cases in this second wave of the pandemic, which represents 42 per cent of its beds. The residence has had five deaths from COVID-19.
The government list released on Thursday also indicated that 65 CHSLDS around the province were now managing an outbreak, up from 61 the day before. The number of infections in CHSLDS was up by 87 from the previous day, with a tally of 673 cases across CHSLDS.
The situation in six of the residences, including Château Westmount and CHSLD du Manoir de l'ouest de l'île in Pierrefonds, which had 10 new cases and two more deaths since the previous day, is considered “critical.”
The Pierrefonds residence remained at the top of the list with 59 residents infected, representing 78 per cent of its beds. The other CHSLDS in the critical category were Villa-bonheur in Granby, Saint Brigid's Home in Quebec City, CHSLD Paul- Gilbert in Lévis and Centre Hébergement Andrée-perreault in Saint-hyacinthe.
However, the government's colour-coded list doesn't offer certain nuances, such as the number of residents who have recovered. Vincelette said 18 residents at Château Westmount have recovered from COVID-19 since the outbreak began at the facility just under a month ago.
The number of active cases was in fact down to 43 on Thursday, he said, because some residents finished their 10-day isolation. (The government's daily list is based on the previous day's numbers.) One other resident was on their last day of isolation on Thursday, Vincelette added. And by Monday, another five residents are supposed to be out of isolation, he said.
But progress is tenuous and uncertain for CHSLDS given the high level of community transmission during this second wave of the pandemic, Vincelette acknowledged.
“We had zero cases for nine months,” he said. “That's why it's very frustrating. We managed to go through the first wave with zero cases.”
The outbreak at the facility seems to trace to an employee who works on the second floor where the residents with dementia live, he said. That worker got the virus through community transmission and unknowingly brought it into the facility, he said.
The problem for any CHSLD is that dementia patients have a tendency to wander and touch, Vincelette said. If the virus infiltrates among those residents, it becomes a major outbreak, he said.
“Since there's a lot of community-acquired transmission right now, the risk that people get infected outside is very high,” Vincelette said. “And, unfortunately, that's what happened. The worker who tested positive on the second floor is probably our vector.”
Château Westmount has had strict measures since March, he said, such as requiring employees to change into a fresh uniform upon arriving for work and not allowing them to bring personal belongings to the residents' floors.
“Employees weren't even allowed to bring a coffee cup on the floor to diminish the risk of transmission,” Vincelette said.
But because Quebec was in a lockdown during the first wave, community transmission wasn't such a threat, he said.
Now, 12 of the facility's 160 employees have tested positive for COVID-19, Vincelette said. Five were traced to community transmissions, he said.
Vincelette said the local CIUSSS and Montreal public health agency are “a big help.” They've suggested the facility start isolating residents on affected floors in their rooms, all of which are single occupancy at Château Westmount, since mov
ing residents around to create hot zones increases the risk of propagation.
The facility has also started screening for COVID-19 every three or four days instead of weekly, he said.
“It's frustrating that it spread like that,” Vincelette said, “even though everyone is working very hard to stop the spread.”