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

Doctors and nurses say staff burnout and overcrowding at ERs are making it more difficult to apply COVID-19 safety protocols

Internal memo reveals several patients exposed to delta variant in ER after staff didn't follow procedures

A modular addition to the ER Lakeshore General Hospital designed to improve patient safety is scheduled to open this spring.
An internal memo obtained by CBC News says there were several breaches of protocol in recent days, leading to patients being exposed to the COVID-19 delta variant. (Jean-Claude Taliana/CBC)

An internal memo obtained by some media outlets including CBCNews 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'le-de-Montralsuggests 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'smemo 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," Blanchettesaid in the memo.

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

Health authoritybeefs up measures

Hlne 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 nurselast 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 COVIDagents have been deployed to the hospital to ensure respectand compliance with the wearing of PPE and good practices in infection prevention and control," she said.

She notedthat 89per cent of all staff ofthe CIUSSShave receivedat 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 waveswe 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 mdecins d'urgence du Qubec, told CBC News.

Judy Morris with Quebec's Association of ER doctors said staff are exhausted and that makes them more prone to making errors when it comes to COVID-19 protocols. (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 spcialistes en mdecine d'urgence du Qubec, said overcrowdingis also playing a role.

Gilbert Boucher, president of Quebec's Assocation of Specialist ER doctors said overcrowding in ERs means more patients end up in hallways, where social distancing is harder to maintain. (CBC News)

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 incorridors," 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