How the West Island's Lakeshore General learned from COVID-19 outbreaks within its aging walls

In March, just as Quebec declared a public health emergency to try to thwart the spread of the novel coronavirus,staff at the only hospital serving Montreal's West Island received a phone call from the provincial government. They were asked to step up and prepare their regionalhospital to become aCOVID-designated centre.

Within two weeks, the Lakeshore General Hospital transformed itsshort-term stay unit into an intensive care unit for COVID-positive patients.

Hospital leadership readily admittheir buildingwas not the ideal place to deal with an infectious disease, especially not one that spreads as easily as COVID-19.

"The hospital performed to the best it could, but not necessarily always to the very best standard,"said Dr. Rolf Loertscher, a nephrologist and head of the hospital's specialized medicine department.

"In an old structure, it is limited what can be done."

They did their best to make made significant improvements, he said, learning hard lessons along the way about how the virus behaves.

A spokesperson for Quebec's Health Ministry said Lakeshore was chosenbecause COVID patients in the western part of Montreal needed a hospital ready to receive them.

But Lakeshore was built in the 1960s, withadditionsin the early 2000s, and unlike Montreal's newsuperhospitals with their layouts designed to prevent the spread of infectious diseases, the Lakeshore still has wings where four patients share a room.

One of those areas is thegeneral medical ward, locatedin a wing built in 1963.

On a tour of the hospital with CBC News,Loertscheracknowledged that ward was the site of one of the Lakeshore's outbreaks meaning patients who entered the hospital for reasons other than COVID-19 ended up being infected with the virus.

The hospital responded by renovating the floor on the spot. Itbuilt new walls, to convertrooms with four beds into single rooms.

The small, crowded nursing station was also expanded so that nurses could remain physicallydistanced, as much as possible.

"Ever since that was put in place, there's been no further transmission of COVID to patients,"Loertschersaid.

WATCH: A behind-the-scenes look at Lakeshore General Hospital

A behind-the-scenes look at Lakeshore General Hospital during a pandemic

4 years ago

Duration 2:44

Hit with two separate COVID-19 outbreaks, staff learned from mistakes and adapted in an old building with limited resources.

Dialysis posed heightened risks

The hemodialysisunit was another problem spot.

Dialysis can take up to four hours, three times a week. Before the pandemic, patients would sit for the entire treatment in a shared, open space. '

Somepatients came fromlong-term care homes, not knowing they were sick,and unfortunatelyended up spreading the infection.

The unit responded by creating two dialysis treatment beds specifically for patients at risk of having COVID-19. They surrounded the beds with closed plastic bubbleswith zippered doors which sealed tight.

At the time, it still wasn't clear how exactly the virus was spreadand how important it was to have proper air ventilation.

Two nurses who were tending to those patients ended up sick with COVID-19.

The hospital adapted yet again, this time installingfloor-to-ceiling plexiglass around the beds in the unit, in order to create negative pressure rooms with ventilation systems.

Since then, they've had no moremore transmission of COVID-19 in the dialysis unit.

The nurses who caught COVID-19 have recovered and are now back at work.

Many regular dialysis patients ended up falling ill, and roughly half of thoseinfected with the coronavirus died. The hospital said it knows of only two patients who caught the disease while in the dialysis unit. One of them recovered and one died, but from a cause unrelated to COVID-19.

Latest expertise, but not the resources

Lakeshore General Hospital is a teaching hospital associated with McGill University, whereLoertscheris an associate professor of medicine.

Loertscher said it's important to understand that while the medical staffwere on top of the latest expertise on the disease, applying that to the realities of a regionalhospital with limited resources is an entirely different ball game.

"When it comes down to the little nitty gritty ... you read the bigger report, but then when it has to be translated into action, you're really still starting from scratch," he said.

Paul Brunet,head of the QuebecCouncil for the Protection of Patients, said it's good the hospital is adapting, but it's not anideal situation.

"Even though they're trying, and we have to give them [credit], it is not the best place or the best way to securely treat patients. Especially with the risk of infection and risk of COVID spreading."

He said while having patients behindplexiglasslowers the risk of spreading infection, it's far fromperfect.

That point is not lost onLoertscher, who agrees ideally, major renovations are the answer. He said he hopes the government will recognize the need to invest in a hospital with enormous potential, a place he calls"a diamond in the rough."

"If there is an effort made to make it into what it should be, to serve the population an aging population and a growing population then investments have to be made."

He said the LakeshoreGeneral Hospital shouldcontinue todeliver community-level care, but ofa very high quality.

While the hospital looks to its future and prepares for the possibility of a second wave of COVID-19, it's also building a new annex a negative pressure modular complex with space for 24 stretchers.

The extension has been under construction for about 10 weeks and isexpected to open in the next few days.

Loertscherhopes they can continue to modernize and update the hospital, with more financial support from the provincial government.

A spokesperson for Quebec's Health Ministry said the level of care available at the Lakeshoreduring the pandemic was appropriate.