Jeffery Hale staff say more should have been done to contain COVID-19 outbreak in palliative care unit

Some employees at Jeffery Hale Hospital in Quebec City say the hospital's administration did not do enough to protect staff and patients from contracting COVID-19. 

An employee — who CBC has agreed not to name — told Radio-Canada visitors were still allowed to see symptomatic patients in the hospital's palliative care unit until Monday, and a number of those patients were not tested for the virus because they were already receiving end-of-life care.

Seven patients and eight employees at the hospital have tested positive for the novel coronavirus, and 50 are in precautionary self-isolation, according to Dr. François Desbiens, the director of public health for Quebec City. 

But the concerned employee told Radio-Canada not enough was done as early as it should have been. They said staff asked management for extra protective equipment and asked that other palliative care unit residents be tested, but they were told not to do the tests because they were already considered to be at the end of their lives.

"Certainly in palliative care it is different, because patients are at the end of life, and their families want to have contact," that employee told Radio-Canada. "But from the outset, knowing we were leaving the doors open, there should have been necessary protection in place for visitors."

The employee said another employee started showing symptoms, and some staff were sent home as a precaution, but remaining staff were not told which resident had received an infected visitor and continued to care for the patient as usual. Then other people started having symptoms. 

Staff expressed concerns to management, union says

The union representing health-care workers in the region confirmed employees had expressed concerns to management that palliative care patients were not being tested for COVID-19.

"It's as though someone said, 'They're in palliative care anyway, so we don't have to test them,' but we're saying they should have been tested regardless, because it's important for staff and families to have that information," said Patricia Lajoie, president of the Syndicat des professionnelles en soins du CIUSSS de la Capitale-Nationale. 

She said she doesn't think controls on visits to the palliative care unit were put in place, even after people had been alerted someone who had circulated on the floor had tested positive. 

"Effectively, measures to control visitors were put in place [Monday]," she said. "From what I've been told, from what I know, prior to that, visitor access was not controlled."

"For example," she said, "there have been patients in palliative care who received seven or eight visitors at a time." 

Lajoie said things have improved since Monday. 

"There is a lot of concern, but things are in hand," she said. "When we spoke to people today, materials were in place, and there were clear directives." 

Lajoie told Radio-Canada she would not comment on staff requests for extra protective equipment, because hospitals across the province are trying to avoid a shortage.

Other staff members issue a letter of response

Nearly two dozen staff members signed a three-page letter in response to the anonymous employee's claims, stating COVID-19 tests were administered in the unit because a staff member had tested positive, and residents had mild symptoms. 

It also states none of the patients who tested positive had received visitors since increased government safety measures were put in place in mid-March and said the claims testing was withheld from end-of-life patients is false.

"A person at the end of life was even tested — and was negative — because there could have been confusion with end-of-life symptoms," the letter reads.

CIUSSS says safety measures are in place 

In an email to Radio-Canada, CIUSSS de la Capitale-Nationale spokesperson Vincent
Lamontagne said patients with symptoms were tested for COVID-19 quickly after a member of the staff tested positive, except for those who were at the end of life. 

"In those cases, it is up to a doctor to determine whether fever and respiratory symptoms are due to an infection or imminent death," he wrote. 

He said strict infection control measures were already in place in the unit, because flu-like symptoms had been present for several days. 

Desbiens of public health said all preventative infection control measures are in place: visitation has been limited — save for those who are receiving visitors for "humanitarian reasons" — and residents who have tested positive are grouped together to avoid infecting personnel. 

He said the hospital is still able to maintain its services despite the number of staff in isolation. 

"Everyone who potentially could have been exposed to positive cases has been contacted within the scope of the epidemiological investigation," he said. "People who have not been contacted should not worry."

In an email to Radio-Canada, regional health agency spokesperson Mathieu Boivin said end-of-life patients with symptoms of COVID-19 are still tested for the virus.