St. Joe's unit for premature infants has a staff outbreak of COVID-19

St. Joseph's Healthcare Hamilton has tested one baby and mother for COVID-19 and is the process of contacting two other families whose babies may have been exposed, following an outbreak of the virus in its Special Care Nursery.

Three staff members who work in the unit that cares for premature babies have tested positive for COVID-19, according to Dr. David Russell, interim chief of staff at St. Joe's.

"It's absolutely clear this is a very unsettling time for parents," said Russell. "It's unsettling time for staff as well, but especially for parents."

No babies or parents in the unit are symptomatic so far and all are being closely monitored, stated a media release from the public health officials and the hospital Monday.

The mother and baby that have been tested so far did not test positive for COVID-19, said Russell.

The first staff member tested positive on March 31, he explained. That person worked in an administrative role and didn't have contact with any babies. Two other staff members were tested and their results came back negative.

Then, a healthcare worker who had contact with three infants tested positive Friday evening, said Russell.

A second staff member who they had also come into contact with tested positive Sunday morning too.

"As far as we know this is an outbreak among staff rather than an outbreak among patients or families," Russell said, adding a "large number" of staff working in the unit at the same time have been tested and the majority of their results have come back and are negative.

The doctor said it's impossible to say whether the staff members with COVID-19 picked it up in the community or at the hospital but, "to be entirely safe, and be as careful as possible, we assumed all of the contacts came from a healthcare setting."

Russell noted all of the staff members who have since become confirmed cases of coronavirus did not show any symptoms at work.

"This is the difficult part of this particular infection — you can be highly-contagious and asymptomatic."

The two workers who did have contact with babies and their families were wearing protective masks, stated public health in the release.

12 babies staying in nursery

The nursery provides care for babies "who need extra support and monitoring," including those that are born up to two months prematurely or have other health concerns including a need for respiratory support or intravenous therapy, says the St. Joe's website.

A 2013 video produced by St. Joe's about the unit describes it as a "safe place" where a team of healthcare professionals make sure babies are cared for.

The video includes a registered nurse who says "infection control is [of the] utmost importance," and notes parents are asked to wash their hands before touching their baby and when entering or leaving the nursery.

The city says the unit will continue to take in infants born at St. Joe's who require care.

Russell said the nursery is a 15-bassinet unit and 12 babies are currently being cared for there.

The infants who may have been exposed to COVID-19 have been placed in a segregated area.

Respiratory support is the most common reason for babies to require care in the nursery, said Russell, but none of the patients staying there now need help breathing.

"The level of illness in the patients we currently have is on the low side with very good prognosis. Although we we could have very sick babies in there, we currently don't."

A Chinese study seems to indicate babies, including those in neo-natal units, recover from the virus. Russell said that work was based on only a few cases and scientists still have much learn about COVID-19.

"I don't think you can generalize and say that therefore babies will be fine if they get this," he said. "We just don't have the evidence to say that right now."

Midwives say COVID-19 another 'layer of concern'

Susie Martin, a registered midwife with The Hamilton Midwives, said all of the hospital deliveries her organization is involved in happen at St. Joe's. Staff with the Special Care Nursery sometimes attend with them if a birth is considered higher-risk. 

"This is a time of great uncertainty for all birthing people and all families anticipating new babies," she said. "So we really feel for them as this will be one more layer of concern."

Midwives rely on the hospital to outfit them with personal protective equipment, the supply of which has become strained across the province.

"To have feelings of risk for yourself going to work is not a comfortable place," said Martin.

"But ... the hospital is taking things very seriously, taking all of the steps they can take to keep the staff and the clients safe."

The Hamilton Midwives are working with St. Joe's to discharge clients who are well enough early and to set up a system so they can return and safely complete their 24-hour blood work.

They're also creating a new position of a designated midwife to support community midwives by providing the hospital care for clients, as a way to conserve resources including PPE.

"We are really working hard on this," said Martin. "We're trying to do our best so that the clients get the best experience and obviously the safest experience so they are in good hands at St. Joe's."

St. Joe's to sit down with parents

The hospital is continuing to allow parents to visit their babies in the nursery, but they have to pass rigorous screening that includes questions about symptoms, travel and a laser thermometer to check their temperature.

St. Joe's also intends to have one-on-one sessions with parents to answer their questions.

"I think that parents would be alarmed by this and very concerned and wonder if it's safe to continue their care here," said Russell.  "We have a dedicated plan with physicians, nursing staff ... to sit down individually with each parent and explain to them what we know ... [and] how we're monitoring how their baby is doing."