The Pandemic at Hôpital Maisonneuve-Rosemont: Taking Stock of the Situation
5 August 2020
Dr. Marquis and members of his team at a patient’s bedside
Hôpital Maisonneuve-Rosemont (HMR) is one of the institutions that treated the most patients suffering from COVID-19 in Quebec. What conclusions can be drawn? Interview with Dr. François Marquis, Chief of Intensive Care at the HMR.
What can we learn from the management of the pandemic at the HMR?
François Marquis: We can be satisfied. We overcame the crisis thanks in particular to the exceptional mobilization of our staff in the field. When everyone is trying to find solutions, we can do anything!
What were the high points?
F. M.: I am proud to be part of the great Hôpital Maisonneuve-Rosemont family. If there is one thing that this pandemic clearly demonstrates, it is the importance and extraordinary power of solidarity.
Everyone at HMR put their shoulders to the wheel and showed tremendous solidarity. Doctors came to help us in intensive care. Others went to lend a hand in the CHSLDs. Researchers at our Research Centre mobilized, adapting their laboratories to perform COVID tests in less than two weeks. Many worked behind the scenes, I am thinking in particular of the Supply Department personnel, who performed miracles to ensure that we did not run out of masks or protective equipment.
Did the HMR manage to maintain its essential services?
F. M.: It took enormous effort and prowess from all, but we did.., It was crucial because patients undergoing cell therapy or chemotherapy, for example, simply cannot wait. For them, it is their last chance of overcoming their illness. We started working faster, with more patients needing more care, in a ward that was already in crisis. The fact that there was no COIVD outbreak in oncology, and only one nosocomial infection in the Intensive Care Unit, bears witness to the extraordinary discipline and sense of responsibility shown by our teams.
Did the pandemic also highlight deficiencies at HMR?
F. M.: The Hospital was built in 1954 and the dilapidated condition of most of the wards, including the main one, is a major problem, particularly for dealing with infectious and contagious diseases.
Nonetheless, HMR remains the go-to health care institution in the East End of Montreal, and beyond. Today, HMR treats one out of every ten Quebecers, from all over Quebec and beyond.
While the new buildings built in recent years have significantly improved the situation, the main pavilion continues to deteriorate. This has been going on for some time. We are coping with it, but the pandemic really highlighted the shortcomings.
Open areas, narrow corridors, lack of air circulation, lack of single rooms and the impossibility of carrying out certain alterations to existing buildings make patient isolation very complicated. In addition, there is a lack of air conditioning, humidity issues in some rooms, and other problems that have a significant impact on the provision of care as well as on the safety of patients and staff. Most sections of the hospital had to be transformed, with the addition of partitions, protective airlocks and independent ventilation systems, to deal with the crisis.
Thankfully, the entire HMR family responded?
F. M.: Absolutely. We saw it with our nurses, but the doctors also answered the call. They came from different departments of the hospital to help with the management of patients.
The community also expressed its solidarity in tangible ways. Restaurant owners and their customers offered meals to HMR employees. Contractors provided expertise and equipment to adapt the Hospital’s facilities. At the individual level, each of us did his part to help the HMR by making the decision to follow Public Health guidelines and by making donations.
How did you reconcile the pandemic with everyday life?
F. M.: It was difficult. We tend to forget that the HMR was not dealing only with the pandemic and that it’s Emergency Department welcomes close to 80,000 people each year.
Some activities, non-urgent surgeries for example, were postponed while the hospital was successful in maintaining essential surgeries, cellular therapies, and chemotherapies.
It should be noted that maintaining a functional cold unit is demanding in terms of human and material resources. We cannot duplicate our intensivists, nurses and respiratory therapists to cover both cold AND hot areas. It is essential that these patients be distributed to avoid contagion, so some staff dedicated themselves to COVID-19 cases and others to “regular” patients. We have also been resourceful in training nurses, for example. An example that underscores the importance of training and of having the needed equipment on hand.
That is why I often say that the old high-fidelity simulation dummy was the first victim of COVID. Indeed, we used it so much to train staff that it broke down. Fortunately, it is one of the essential pieces of equipment that will be replaced soon thanks to the Together for the HMR Fund.
Was cancer confined as well?
F. M.: No. It didn’t take a break. Another issue kept the HMR on alert. That of our CAR-T hematology program: a cutting-edge cell therapy. White blood cells are taken from the patient (T cells), genetically modified to make them more aggressive towards cancer cells, multiplied and then injected back into the patient.
These patients are complex cases. For these patients, it is their last chance to overcome their illness. And during this forced break, their illness only progressed.
| Without your support, the HMR and its teams would not have been ready to face this pandemic. Without your generosity, the Intensive Care Unit staff would not have had the equipment or access to the training required to adapt to the situation in a timely manner.
Your solidarity has made a difference in the past, it makes the difference today in the face of the pandemic, and it will make the difference again tomorrow. |
