(BRENDAN KERGIN / iNFOnews.ca)

Interior Health experts are exploring several hypotheses into outbreaks at Royal Inland Hospital including whether COVID-19 cases could have spread through an exposure within its emergency department.

The Kamloops hospital currently has four outbreaks: in Unit 5N, a stroke and rehab unit, Unit 5S, a general medical floor, Unit 7N, a general medical ward specializing in renal and cardiac patients and Unit 6S, a surgical ward.

Three people have died in relation to the outbreaks. Of the 56 cases across the four outbreaks, 47 are fully immunized, four are partially immunized and five are unimmunized, according to Interior Health.

READ MORE: 3rd death linked to COVID-19 outbreaks in Kamloops hospital

Dr. Carol Fenton, medical health officer with Interior Health, said the outbreaks are being treated as separate until the genome sequencing data of the virus is available.

“The lab that does those at the provincial level is very busy so we’re still waiting for some we’ve requested even from October. We usually get those as a retrospective,” she said.

Until then, the leading medical microbiologist is investigating several hypotheses including: a breach in PPE among a staff member with COVID-19; a positive case was travelling around the hospital exposing other people; exposure from a positive visitor, which is why visitors at the hospital have been restricted until that theory is ruled out; or an exposure event in the emergency department because it’s been very busy lately, Fenton said.

“We have people spending a fair amount of time in (the emergency room) while they’re waiting for a bed upstairs and then going to different units so if they were exposed in emergency and then were admitted to these different units, that would explain why we have multiple units affected. So that’s why it’s a possible hypothesis but we need to not make assumptions and we can’t rule out any given hypothesis until we have evidence,” she said.

A vast majority of the hospital cases have been asymptomatic or very mildly symptomatic and have only been found as a result of the investigation into the COVID-19 outbreaks, she said.

Most of the cases are also double vaccinated. The vaccine provides roughly 80 to 85% effectiveness in preventing infection entirely but that still leaves 15 to 20% of people that can get infected but those cases are mild, she said.

“It could be that the people who are sick enough to be in hospital are more likely to be in that 15 to 20% for whom the vaccine is not going to prevent the virus entirely,” she said. “There are people in this group who have died, but it’s really hard to say when this person was sick enough to be in the hospital to begin with and they were fully vaccinated and we just happened to find COVID, how much the COVID contributed."

“I am concerned that we’ve had this much spread in the hospital which warrants this full investigation because we can’t have breaches in our PPE, we need the hospital to be a safe place to be. I am reassured, however, that the people who are fully vaccinated do have that level of protection and we are just seeing really mild or incidental cases… we’re not seeing unexpected ICU admissions or deaths in this group and so for me, that’s really assessing the vaccine is working while we continue to investigate.”

Recently, a nurse on stress leave at RIH said she wants the province to do more to improve the current work situation at the hospital, which she said is dangerous.

“I feel like it makes it more stressful that we cannot safely voice our concerns about our working conditions,” she said. “I have gone home in tears from emotion and mental injuries, we are not doing okay. The worst feeling is to go home after giving only the bare necessities to patients. That is not why we became nurses.”

READ MORE: Nurse on stress leave wants province to increase staffing at interior hospitals

Tracey Rannie, executive director at Royal Inland Hospital, said the hospital is experiencing staffing challenges but “there’s a lot of folks working on recruitment and retention and the staff work hard every day to provide safe patient care.”

Interior Health is facing challenges across all jurisdictions. There is a centralized recruitment team that helps streamline the hiring process, she said.

Since Jan. 1, RIH has hired nearly 200 nurses and 41 student nurses. More LPNs will also be added following Sprott Shaw's nurse graduation in late November, according to Interior Health.

Due to the COVID-19 outbreaks, non-urgent surgeries have been postponed to redeploy staff in other areas of the hospital, Rannie said.

“The goal is to get the services back online as soon as possible,” she said. "We’re monitoring daily… it’s always a difficult decision when we have to postpone surgeries.”

She couldn’t speak to patient-specific concerns, but patients are being monitored and urgent services are continuing.

Recently, a computer system was not working correctly so staff were asked to stay past their 12-hour shift, she said.

“Sometimes nurses will stay over a 12-hour shift to assist with patient care,” but Rannie said nurses are not required to stay unless in an emergency situation or to confirm who is present at shift change.

“And that’s a very rare occurrence,” she said.

Recently temporary closures of medical centres in neighbouring communities have not increased demand at the Kamloops hospital, she said.

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