Cancer, dialysis patients infected as COVID-19 sweeps through Montreal's Sacré-Coeur hospital

COVID-19 has swept through five wards on four different floors at Montreal's Sacré-Cœur hospital, infecting 122 patients, including cancer patients and others with already weakened immune systems.

Health-care workers say small, shared rooms with no possibility of physical distancing have contributed to the spread of the novel coronavirus. A nurse who Radio-Canada agreed not to identify sent photographs that show three-patient rooms with beds less than a metre apart, separated only by curtains.

The CIUSSS du Nord-de-l'île-de-Montréal, which manages the hospital, says it is doing everything it can to isolate patients, keeping them one to a room wherever possible. The hospital has also opened eight overflow units for infected patients. 

Some of the outbreaks have occurred on wards with particularly vulnerable patients. The CIUSSS says there have been eight cases on the oncology ward, including six patients who were infected while in hospital. At least one of those patients has died of COVID-19. 

In the hemodialysis unit, 26 patients are infected, the CIUSSS has confirmed, and several of them are now in intensive care. Two of those patients have died.

Robert Charbonneau, president of Quebec's association of kidney specialists, said there are several hospitals in Montreal with coronavirus outbreaks on their hemodialysis wards, although Sacré-Coeur is the one that is hardest-hit.

"We know that in at least two or three hospitals, there are patients contaminated by COVID-19, and unfortunately some have already died," Charbonneau told Radio-Canada.

"The oncology and hemodialysis sectors, unfortunately, experienced an outbreak in early April,"  said CIUSSS spokesperson Marie-Hélène Giguère.

"Our priority is the health and safety of our patients and our staff. We always rigorously apply infection prevention and control protocols and always adjust to new guidelines."

The hospital is one of those designated to receive COVID-19 patients, said Health Minister Danielle McCann at the government briefing Wednesday. However, she said, those wards are hermetically sealed from the hospital's other vulnerable patients, such as those with cancer or kidney disease.

"In those services they have to organize the care — separated from COVID-19 patients," McCann said.

All patients masked

For more than a week, all patients on the hemodialysis unit at Sacré-Coeur have been wearing masks because physical distancing is impossible, said Dr. Stéphanie Raymond-Carrier, deputy director of the CIUSSS du Nord-de-l'île-de-Montréal.

She said all patients admitted to the unit have their temperatures taken, and they are segregated into different zones, depending on screening results.

"As the number of cases increases, all patients are screened because there may be asymptomatic ones," said Raymond-Carrier.

However, Sacré-Cœur's staff have not similarly been preventively tested for COVID-19 to eliminate the possibility of contagion, Radio-Canada has learned. Only employees who showed symptoms have been tested.

The CIUSSS du Nord-de-l'île-de-Montréal has been the second-hardest hit regional health agency on the island of Montreal, accounting for 2,095 COVID cases as of Monday. More than 500 of the agency's health-care workers have been infected.

Sacré-Cœur-de-Montréal, on Gouin Boulevard West in the borough of Ahuntsic-Cartierville, was constructed in 1926. It is a Université de Montréal-affiliated teaching hospital and one of Montreal's two main trauma centres, and is responsible for about 15,000 in-patient admissions every year.

Other institutions affected by outbreaks

Christian Merciari, a spokesperson for the CIUSSS de l'Est-de-l'Île-de-Montréal, which oversees Maisonneuve-Rosemont Hospital, said there are 13 hemodialysis patients under at that hospital care who have tested positive.

He said it is unfair to say the hospital has an outbreak, however.

There are other hospitals treating kidney patients with COVID-19, as well, including at the Centre hospitalier de l'Université de Montréal (CHUM), said nephrologist Dr. Jean-François Cailhier.

Outbreaks are also reported at the Verdun Hospital, Jean-Talon Hospital and Fleury Hospital, according to Radio-Canada.

The McGill University Health Centre (MUHC) has reported 18 dialysis patients have contracted COVID-19, Cailhier said — several of those from long-term care homes, known as CHSLDs.

"CHSLD outbreaks are a major problem for us in dialysis units, as we are trying to avoid spread in hemodialysis units," he said. "If we work in a CHSLD, we can no longer work in hemodialysis units, as we will risk contamination."

Cailhier is aware of at least four deaths of patients on hemodialysis wards in Montreal hospitals.

"All the nephrology teams are sitting on a time bomb," he said.