More than 1,300 outbreaks have hit hospitals and CHSLDs in Quebec, many of which have caused patient deaths. No less than 2,630 CHSLD residents are currently infected. Is it still safe to visit hospitals and end-of-life settings?
According to the most recent data from the Direction régionale de la Santé publique de Montréal, no less than 4,156 cases of infection linked to 263 active outbreaks have been reported in hospitals and CHSLDs in the metropolis and in other living and care environments. public.
The most recent outbreak report from the Institut national de santé publique du Québec (INSPQ) reported, as of January 26, more than 1,324 active outbreaks underway in general and long-term care hospitals, in slight however, has been falling since January 17. This remains the highest outbreak threshold reported in healthcare settings since September 2020.
“We were recently told of the case of an elderly lady, living in a residence, who had to be hospitalized in Saint-Eustache, where she contracted COVID. After 10 days, her condition degenerated, and she went to die at her residence,” laments Ms.and Paul G. Brunet, President of the Council for the Protection of the Sick. “Do we still manage hot and cold areas in hospitals well? ” he asks.
Several experts agree that the high contagiousness of the Omicron variant poses daunting challenges in preventing COVID infections in hospital settings, but say that shouldn’t put people off who really need to go there.
“A variant like Omicron, in an environment where vulnerable people are concentrated, exposed to close contact, is the ideal combination for a perfect storm,” says Régis Blais, professor at the School of Public Health at the University. from Montreal.
“You shouldn’t say ‘don’t go to the hospital any more’. But those who can should think of an alternative, like a family doctor,” he says.
With Omicron, patients admitted to hospital for other diagnoses are at risk of catching COVID-19, but the vast majority will not have serious consequences, says Dr.D Marie-Pascale Pomey, professor at the School of Public Health at the University of Montreal. “It is important not that people who really need it avoid the hospital and expose themselves to more serious complications. »
According to this, Omicron continues to “walk around” in hospitals and CHSLDs, despite the application of very strict infection prevention measures.
“Rather, it is unvaccinated patients and very vulnerable populations, such as the immunocompromised or the very elderly, who are at risk and who must be protected by changing ways of doing things. At the same time, infection prevention measures are very heavy, and this weighs on the efficiency and morale of the staff. It’s quite a headache, ”she concedes.
Currently, “headwinds” are blowing as to tolerance of Omicron circulation within hospitals, adds this public health specialist. Given its lesser danger for patients in general, some would like to relax certain preventive measures to increase the capacity of hospitals to treat more patients requiring care other than COVID-19.
The INSPQ also notes that the outbreak figures are not an accurate indicator of the number of nosocomial COVID cases (contracted in hospitals), because some patients are infected there without an outbreak being involved.
A summit in CHSLDs
In CHSLDs, the most recent status report from the Ministry of Health and Social Services counts some 2,630 active cases and 297 deaths linked to outbreaks among elderly residents in 278 of these facilities. In seniors’ residences (RPA), some 5,117 active cases and 96 deaths linked to ongoing outbreaks in 546 residences have been reported.
“Having third doses has protected CHSLD residents from death and serious consequences better than in previous years, but there will always be vulnerable seniors for whom Omicron will pass through the defenses”, also advances Professor Régis Blais.
“It is certain that the current wave is dazzling. It reminds us of the first wave, but there are a lot fewer deaths, and the cases are down now, ”insists the DD Sophie Zhang, deputy head of accommodation at the CIUSSS Centre-Sud.
“Any infection has serious consequences for very vulnerable residents, so even if Omicron is less serious, a COVID-19 infection is not trivial,” she acknowledges.
Moreover, the latter considers that there is no reason that justifies avoiding general hospitals for the population requiring care. “For those who go to outpatient clinics and are triple vaccinated, there is no reason to see that as a danger. As for the hospitalized people, if they are there, it is because the seriousness of their condition justified it. The reality is that there is a risk of contracting COVID, but it is often a lower risk than that of not being treated. »