In the midst of an explosion in the number of cases and hospitalizations of COVID-19, more than 700 tests have been accumulating since last Thursday at the CIUSSS du Center-Sud-de-l’Île-de-Montréal (CCSMTL) after the breakage of a screening machine. Medical staff believe the laboratory is “hanging by a thread”, putting the health of patients and employees at risk.
Hundreds of tests have been piling up in the fridges since one of the machines used to perform PCR tests broke down at the Verdun Hospital. The situation is critical at this laboratory, which is also responsible for analyzing the tests at Notre-Dame Hospital and the CHSLDs in the Sud-Ouest / Verdun (SOV) sector.
“We’re not even going to have finished the tests from December 31st to January 3rd. It is not COVID tests in the community or of people with a cold that we screen for. They are patients of hospitals and CHSLDs, very vulnerable people. Like yesterday, we were sent specimens that have not yet been passed through the machine. Is the information I take out 3 days later relevant, especially if it is an outbreak? », Asks, discouraged, an employee of the Verdun laboratory.
“The lab now only works by a thread. We have two old machines that break down every week. Dozens of representations have been made by our microbiologists to replace them, but we always come up against an end of inadmissibility ”, indicates an executive of the Verdun hospital who agreed to confide in the Duty confidentially, as did all other employees who testified, since he prohibited them from speaking to the media.
“We asked the CHUM to do our tests while our machine was broken and the answer was no because they too have a backlog. Our tests are piling up but nothing is happening, ”he explains.
The CCSMTL did not wish to comment on the situation at the Verdun Hospital laboratory, passing the buck to Optilab-CHUM which manages all the laboratories of the CHUM cluster, including that of Verdun. The CHUM has indicated that the defective device will be repaired during the week.
Constant prioritization of patients
The Verdun laboratory’s COVID-19 screening problems are forcing emergency personnel to turn to back-up solutions such as the use of a machine that processes only 7 tests at a time in 1 hour 30 minutes.
“Currently, it works at arm’s length with the rapid machine to prioritize the patients that we want to go upstairs, that we want to get into intensive care, those who must have surgery. It also has an impact on the staff who must be tested, ”indicates a CIUSSS executive who also specifies that outpatients must wait up to 5 days for their results.
“The operating room procedure is very different when it comes to a COVID positive patient. The duration of the operation is doubled, ”explains an emergency doctor at the Verdun Hospital.
The doctor also stresses the importance of testing all patients who are admitted to the hospital within a reasonable time to avoid possible outbreaks.
“I absolutely have to test a patient to send him to intensive care for a heart attack. If I send her to a cold bed [zone sans COVID] and that we receive a positive test later, it’s full of people that we have just infected, ”he says.
The situation at the Verdun hospital laboratory has also prevented, since December 31, the performance of other types of tests.
“Our lab is not doing anything else at the moment. Usually, when a patient is admitted to the hospital, we don’t just get tested for COVID. We test you to find out if you do not have resistant bacteria, such as the famous MRSA. In Verdun, we no longer do this. We no longer have the ability to do both. It’s risk management, ”says a hospital executive.
Obsolete machines
The molecular diagnostic instrument that is lacking in the Verdun hospital laboratory is an M2000. It was acquired by the hospital more than ten years ago, before being managed by Optilab-CHUM following the reform of the health system.
“It’s an old machine that is not made to continually roll through a pandemic. When COVID-19 started, it was already nearing the end of its technical life. We asked for another device but they bought us the same junk food. They don’t even make those devices anymore. They constantly break, each in turn, ”says one employee of the laboratory discouraged. “The latter works well, only one repair has been listed so far,” Optilab – CHUM insisted on clarifying.
Even if it runs at full speed, 24 hours a day, the M2000 only provides 360 tests per day and takes over 7 hours to get a result.
At the end of 2020, when its equipment broke down, the Verdun Hospital laboratory asked Optilab-CHUM to replace it with a new generation of more efficient machine. “There were Alinity machines available in Quebec. We had requested one but it was refused. The Optilab cluster in Montérégie bought them all to supply their hospitals. It’s much more modern, you can constantly fill it with tubes. They give the results in 1 hour 30 minutes. Why didn’t we get it? Good question ! We are not far from being the largest CIUSSS in Quebec, however, ”he laments.
Optilab-CHUM informed the Duty that “this decision rests with the Ministry of Health and Social Services. The COVID test kits on Abbott’s next-generation devices were not yet available at the time of the replacement request, ”he said.
The Verdun laboratory also had at its disposal even before the start of the pandemic two individual test devices giving the result in 15 minutes. But it was only this week that he received the authorization to finally be able to use them for screening for COVID-19, according to our sources.
“It was proposed to have one in the emergency room. It is made for that. But this is not yet the case… ”, indicates an employee of the laboratory.
“What is unfortunate is that in the midst of a pandemic, the laboratory would have the capacity to process a large number of tests if it was adequately equipped,” says a hospital executive. “Instead, we’re skating in the middle of a pandemic! », Deplores an employee of the laboratory.