Quebec is using long-term care homes to house COVID-19 patients who aren't residents

Regional health agencies in Quebec are asking public long-term care homes to establish "hot zones" to accommodate COVID-19 patients who don't live in those facilities.

But some staff and family members, scarred by treatment of residents during the first wave, worry the move could lead to cross-contamination and more outbreaks inside the home.

"Why would you let them in where there's so many vulnerable people?" said an employee of a long-term care home in Châteauguay. CBC News agreed not to publish the person's name because they fear professional repercussions.

The employee said at least four COVID-19 patients from the community were already admitted over the weekend to a hot zone established in what used to be a day centre at the Centre d'hébergement de Châteauguay.

The employee believed the decision wasn't in the best interest of patients at the home.

"We're doing all this business to keep COVID-19 out of the building, and now we're bringing it inside," they said.

The local health agency didn't respond to a request to confirm the news, but other health networks are confirming they're setting up red zones in long-term care homes for patients from the community.

Family members say safety at risk

One such zone is being set up at the Maimonides Geriatric Centre in Côte-St-Luc.

Maimonides was hit with a major outbreak of the novel coronavirus during the first wave, but currently has no infected residents.

Josée Di Sano's mother, Maria Di Clemente, has Alzheimer's disease and lives at the centre. Her mother contracted COVID-19 and has since recovered, but family was barred from visiting her for two months while she was ill.

"We finally have no one with COVID-19 in the centre and now they're going to be accepting COVID-positive people?" Di Sano said.

"We can't go through a second wave. Our loved ones can't afford to do that."

Health agency explains

Barbra Gold, director of the support program for the autonomy of seniors at the health board for the CIUSSS Centre-Ouest Montréal, explained the decision in a letter to families of Maimonides residents.

"Our responsibility at the CIUSSS is to vulnerable seniors across our territory," Gold said in the letter.

She explained that the hot zones at the homes would be expanded for patients who do not require hospitalization, but need "a greater level of care than what is being offered at their current location."

The patients would be people who live on the territory covered by the health board and live at places, such as seniors' residences, intermediate-care homes or people who recovered in hospital but aren't yet strong enough to go home.

Gold wasn't available for an interview.

The health network in Laval confirmed to CBC it's doing the same thing.

Judith Goudreau, a spokesperson for the Laval health network, said the hot zones set up in long-term care homes are designed to be "completely independent" from the rest of the home, with separate doors and equipment.

The CIUSSS du Nord-de-l'Île-de-Montréal said it was also opening red zones for non-residents in CHSLDs, the French-language acronym for public long-term care homes in Quebec.

Some health agencies not on board

Other health agencies are taking a different approach.

The CIUSSS du Centre-Sud-de-l'Île-de-Montréal and the CIUSSS de l'Est-de-l'Île-de-Montréal announced Tuesday they would open a facility together at the former Hôtel-Dieu hospital.

The centre will accommodate COVID-19 patients from private seniors' residences and other facilities, rather than sending them to CHSLDs.

The West Island health board told CBC it wouldn't accept COVID-19 patients from the wider community at its long-term care homes, and would also look for other "non-traditional" sites to accommodate them.

Health Minister Christian Dubé said Tuesday he asked public health officials to look into all infection control measures at CHSLDs to ensure patients were being kept safe.

It can be done safely, expert says

Christopher Labos, a Montreal cardiologist with a degree in epidemiology, said he believes opening red zones in CHSLDs for non-residents can be safe, as long as it's done correctly.

He said hot zones are already in place and working well in many hospitals.

"I don't think it's an inherently dangerous strategy, depending on how it's implemented," Labos said.

"You have to be able to keep these patients separate and you have to make sure the people working in one zone don't work in the other, and that you don't share equipment."

Those measures need to be in place to avoid cross-contamination, he said.

"The question becomes: Do you have enough personnel and can you logistically make it happen?"