Investigators look into catastrophic outbreak that infected all residents of TMR seniors' home, killing 70

Public health, as well ashealth and workplace safety investigators, don't know exactlyhow all226 residents and some 148 employees ofa private seniors' home in the Town of Mount Royal became infected with COVID-19 a catastrophic outbreak that has killed at least 70 residents.

Quebec Public Health Director Dr. Horacio ArrudasaidThursday that theCHSLD Vigi Mont-Royal appears not to have been managed with the level of infection prevention controls in place at hospitals.

With too few employeeson duty, the seniors' home may not have been kept as clean as it should have been,or people may even have been dining together, contributing to the spread of the novel coronavirus, he said.

It is possible a faulty ventilation system was a source of transmission.

With staff getting infected despite wearing appropriate personal protective equipment, thehealth agency that oversees the home,the CIUSSS Centre-Ouest-de-l'le-de-Montral, conducted an air-quality study, and experts found virus particles in the air insome rooms.

Could ventilations systems be a factor?

An infectious disease specialist at Sainte-Justine Hospital,Caroline Quach, saidstudies done elsewhere have found particles, known as virus RNA,in the air of patients' rooms although not in ventilation systems but whether those airborne particles arecapable of infecting people is inconclusive.

Air filtration is important for filtering out all kinds of diseasesand allergens, said Arruda, but it is"perhaps a very low factor in transmission" of COVID-19.

Dr. Mylne Drouin, the public health director for the Montreal region, agreed with Arruda. However, she saidthere is still much to learn about the spread of COVID-19 in long-term care homes and hospitals.

Ventilation may be one factor, Drouin said, but a multitude of possibilities for the spread of the coronavirus make it hard to control outbreaks like the one at Vigi Mont-Royal.

Dr. Ccile Tremblay, a microbiologist and infectious disease specialist at the Centre hospitalier de l'Universit de Montral, told CBC News that ventilation systems havelittle to do with the transmission of COVID-19, as the diseaseis mainly spread through droplets.

However, the virus can stay suspended in the air a "little longer" in a closed environment that lacks adequateair circulation, she said.

Staff, military now in hazmat-like gear

Even without conclusive studies about how ventilation systems affect the spread of COVID-19, theCIUSSS Centre-Ouest-de-l'le-de-Montralordered tests of the air quality at the TMR residence, due to problems with the ventilation system there dating back to late April.

"We were concerned that our staff members deployed to Vigi Mont-Royal had contracted the virusdespite wearing the appropriate personal protective equipment," said CIUSSS spokesperson Carl Thriault.

Quebec's workplace health and safety board, the CNESST, has launched its owninvestigation into the home, wherestaff and military personnel are now wearing equipment not usually required inlong-term care homes.

That protective gear includes waterproof gowns, N95 masks, visors, hoods, gloves that end at theelbows and shoe covers. Workers continue to wear it,despite the fact that inspectors have nowsaid the air quality is now safe.

The home is owned by Vigi Sant, a company that operates 15 long-term care homes in Quebec. The company's assistant director, Jean Hbert, said a crew was sent to repair the ventilation system on April 30 the day after the health board raised concerns.

Some 50 Vigi-Sant employees have returned to work after testing negative, Hbert said, and every precaution has been taken to ensure their safety and to protect residents.

Air quality was tested Wednesday and was found to be excellent, he said, and the facility is being disinfected to meet standards set by public health authorities. He said all staff have been provided the proper personal protective equipment, as well.

FIQseeks court order to ensure nurses' safety

Quebec's largest nurses' federation,the Fdration interprofessionnelle de la sant du Qubec (FIQ), disagrees withHbert's assessment.

"People were [testing] positive at a phenomenal speed," saidSonia Mancier, president of the FIQwing representing private-sector nurses.

Mancier saidshe believes the disorganization at Vigi Sant, including the mixing of hot and cold zones, encouraged the spread of the virus in several of the company's homes.She is also concerned about similar problems with ventilation systems at other homes owned by the company.

For example, 96 per cent of residents of CHSLD Vigi Dollard-des-Ormeaux, alsoowned by Vigi Sant, have tested positive, and 66 of them have died,according to internal documents obtained by Radio-Canada.

That same investigation shows 116 employees of that West Island facility also became infected.

The CIUSSS de l'Ouest-de-l'le-de-Montral sent a team of workers to Vigi Dollard-des-Ormeaux, and a spokesperson saidthe situation is difficultbut stable.

Other documents addressed to Quebec's minister responsible for seniors, Marguerite Blais, and obtained by Radio-Canadashow there are two otherhomes owned by Vigi Santwith "significant" outbreaks:Vigi Pierrefondsand Vigi Reine-lizabeth.

Earlier this week, theFIQobtained a court order from theQuebec Superior Courtto compel Vigi Santto carry out air-quality inspections at Vigi Dollard-des-Ormeaux and Vigi Reine-lizabeth and to provide protective equipment to all employees.

Even before the judge ordered the air testing on Wednesday, Vigi Sant said under oath that it had appointed three expert firms to carry out tests. The judge demanded that the results be sent to the union.