Outbreaks of COVID-19 have been declared on two units at Edmonton’s Misericordia Community Hospital.
Eight patients and three health-care workers linked to the outbreaks have tested positive for the coronavirus, Alberta Health Services said Thursday. There are currently 29 health-care workers in isolation, AHS added.
The outbreaks were declared on two medical units on the seventh floor of the hospital: 7 East and 7 West, according to Dr. Owen Heisler, chief medical officer with Covenant Health, which operates the facility. Heisler said the units are general medicine units, not intensive care units.
AHS added the outbreaks were declared on the units on Oct. 5 and 6 respectively.
Contact tracing continues and AHS said the situation is being monitored closely.
“We’ve started an extensive prevalence screening, so we’re screening everyone thinking that some of these may still be asymptomatic as well. So it would not be unexpected that we would find one or two more (cases) before we are sure where we are,” Heisler said.
As of Thursday morning, the emergency department at the hospital in west Edmonton remained open. Visits to the two affected units have been temporarily restricted for the health and safety of patients and staff. AHS asked families to meet virtually with their loved ones.
“We continue to manage through our zone emergency operations committee looking at all sites’ capacity and directing patients to where the resources are,” said Dr. David Zygun, the Edmonton zone medical director with AHS.
“We have not seen a significant effect of this outbreak on flow. But as you can imagine, it is something that we follow continuously and are able to react to. Right now, we are not at risk of closing the services at the Misericordia but we do maintain vigilance.”
Enhanced screening measures among patients and health-care workers on the units have been implemented, AHS said.
“The hospital has increased infection prevention and control measures on the units to further ensure the continued safety of all patients and health-care workers,” AHS said in a media release.
All patients on the units have been tested for the coronavirus, AHS said, as well as all staff who have either worked on or have been present on those units, even if they are not showing symptoms.
Second time outbreak declared at hospital
This is the second time an outbreak has been declared at the hospital. The first COVID-19 outbreak was declared at the Misericordia in late June.
The first death linked to the outbreak was recorded on June 25.
The hospital closed to incoming patients on July 8 as part of the facility’s response to the outbreak and began a phased reopening in mid-August when the outbreak was declared over.
In total, 58 cases of COVID-19 and 11 deaths were linked to the outbreak over the summer.
AHS and Covenant Health said an epidemiological report was completed after the initial outbreak this summer and several lessons were learned. Zygun said “many factors” led to the first outbreak and a number of measures have since been implemented at the hospital that health officials believe will help contain the new outbreaks.
“Closer monitoring of how staff moves around within the building, so we know with sign-in sheets who comes in and out of each and every room,” Heisler said. “We have enhanced cleaning protocols as we go forward, much quicker involvement of the entire team including AHS, the medical officer of health. Closer cohorting of staff so that staff don’t move between the different units as quickly. Greater prevalence of screening, so screening wider than we did before.”
Zygun said a PPE coach was also brought in to ensure staff are donning and doffing personal protective equipment appropriately.
“We certainly heard about our staff’s fatigue with PPE and the challenges of maintaining that,” Zygun said. “We’ve developed a program to support our staff.”
With the additional measures in place, Heisler said they believe they will be able to contain the outbreak within the hospital. However, both doctors said they will not be certain of that until two incubation periods of the virus — or 28 days — pass.
“Where we would be concerned is if it we saw these rapidly expanding or in other units, but we are watching for that,” Zygun said. “I am happy with the containment at this point in time, but I won’t be satisfied that it is over until we wait at least two incubation periods.
“We’re certainly not 100 per cent comfortable for at least the four weeks until we can be confident and then take the wards off outbreak.”
At the beginning of September, several people who work at the Misericordia were self-isolating as a precaution after they attended an “off-site social event” after which at least one attendee tested positive for COVID-19, according to a spokesperson for Covenant Health.
Zygun said Thursday it is “safe to eliminate” the incident as the cause of this outbreak because more than two incubation periods of the virus have passed. Health officials say the coronavirus has an incubation period of 14 days.
“Given that was more than two incubation periods, I don’t see it’s likely of any linkage to that,” Zygun said.
Staff are feeling ‘decimated,’ union says
Cam Westhead with the United Nurses of Alberta said the union has spoken to staff on site, who admit they are nervous but still prepared to do whatever it takes to keep Albertans safe.
“We’ve talked to staff at the site and they are feeling nervous about what’s going on, but they are professional staff and they’ve been through this before,” he said.
“This is a part of the job that nurses signed up for. We took the training and it’s a matter of pride for nurses to do everything they can to care for patients in these difficult circumstances.”
Westhead said one of the biggest safety precautions was to ensure staff have the PPE they need to do their jobs.
“When you’re taking care of sick patients, staff need to be protected, so we’ve been assured that there’s adequate PPE available there for them.”
Westhead also said staff are feeing “decimated — emotionally and physically” — and the union is doing what it can to support members with peer support, as well as employee and family assistance should they require additional help.
“They do have a lot of confidence that they’re going to get through this together.”
Ongoing COVID-19 outbreaks
Zygun also noted that health officials, unfortunately, expect COVID-19 outbreaks to continue unless community transmission of the virus can be contained.
“The transmission of COVID will continue until we get that control in the community, so it’s very important that we all do our part to try to reduce the transmission,” he said.
“We obviously have to have patients coming in and out, we have visitors, we have staff that are coming in and out of our facilities all the time. Vigilance will be very important to maintain, especially over this upcoming long weekend.”
The most recent data released from Alberta Health Thursday afternoon showed 2,097 active cases of COVID-19 in Alberta, with 1,251 of those in the Edmonton zone.
There were 77 people in hospital with COVID-19 on Wednesday afternoon, 13 of whom were being treated in intensive care.