On the eve of new tax cuts, is the government groping for lack of data? precise to follow the evolution of the pandemic? Overview of the tools available with Roxane Borgès Da Silva, associate professor at the Montreal School of Public Health (ESPUM), Benoît Mâsse, epidemiologist at ESPUM, and Dr.r André Veillette, teacher at the Montreal Clinical Research Institute.
Hospital admissions were up again on Monday. Is it a good idea to continue to ease health measures?
Benoit Masse : For the past two to three weeks, we’ve been sailing a little blind. We only have data on the cases of health care workers, cases in CHSLDs and other living environments, but not the general portrait, for lack of universal access to PCR tests. In the UK, daily polls by age strata are taken from the population, which gives a better idea of the number of daily infections. It would be useful to know if the curve of infections is increasing and if it matches that of hospitalizations.
Aren’t the number of hospitalizations and the number of deaths good barometers of the progression of the virus in the population?
Benoit Masse : It’s a bit like driving a car whose steering wheel takes two weeks to turn. It’s hard to navigate like that. With Omicron, everything can change quite quickly. If we only rely on hospitalizations, we will always be two weeks late.
Since January 5, screening (reserved for priority clienteles) no longer gives an accurate portrait of the number of infections in Quebec. How to better follow the evolution of the pandemic?
Roxane Borges Da Silva : It is important to have an idea of the total number of people infected, it is the only way to measure the severity of the virus and its impact on hospitals. Without this data, we are in a delicate situation. But we can extrapolate from the number of cases among essential workers. For the period from January 25 to January 1er February, the latest assessment carried out using the CIRANO group’s barometer estimated the number of cases per day at 26,000, detected either by PCR test or by rapid test. With self-reports, there would have been 42,000 cases per day. Our network amplifier approach estimates that the number of daily infections would vary between 23,000 and 26,000, while an average of 3,324 cases per day is officially declared to the INSPQ.
André Veillette : Wastewater analysis would be a good way to continue to closely monitor the evolution of the pandemic, for a derisory cost. We already have all the research teams in place, but Quebec has stopped funding them. We can only rely on hospitalizations. Currently, many people with COVID have been admitted to hospital for other things.
Benoit Masse : The government also stopped funding the CONNECT study last summer, which revealed the average number of contacts in the population through regular surveys. It allowed us to make sharper projections to estimate the expected number of cases. We no longer have those tools.
All in all, are we deconfining too quickly?
André Veillette : We try to balance the risks. There is no scientific recipe for deconfinement. There will be an inevitable rise in cases. As the general population is no longer screened, it will be necessary to keep an eye on high-risk activities. And above all, push on the third dose!
Roxane Borges Da Silva : Given the current low social acceptability of the restrictions, we have no choice. You have to give people hope, but go very gradually and quickly assess the repercussions on the increase in cases. Several factors weigh in the balance: the epidemiological situation, the virulence of the virus, social acceptability, the risks of civil disobedience, etc. This balance is precarious, and the acceptability of the restrictions is slim at present.
Several European countries are deconfining. Is Quebec well prepared to go further?
Roxane Borges Da Silva : The fact that we are late in granting the third dose (47% in Quebec, against 55% in the United Kingdom), that makes us more vulnerable. We must relaunch the campaigns for the third dose. Perhaps do like France, by making greater use of artists and influencers to stimulate the population’s adherence to the third dose. The relief will result in an increase in cases, and given the fragility of our health system, still with level 5 load shedding in our hospitals, it is still the people who are waiting for care or an operation. which will suffer the effects of load shedding.
Benoit Masse : It’s hard to predict how people will react to these cuts. Those who have just been infected will perhaps be less reluctant to expose themselves, while others will remain cautious. The number of cases will also depend on that. But there is still time to catch up on the dose. We have to if we want to deconfine more. In the middle of the transmission period, I would tell people to get that third dose as soon as possible. Waiting for the vaccine against Omicron or this or that vaccine is not a good option. Knowing the number of people who have actually been infected recently would also help us to determine the share of people who are immune in the population and the speed at which we are going to get out of this 5and wave.
André Veillette : For us to be able to deconfine further, this third dose is crucial, since it increases the protection threshold from 60% to 90%. The most direct way to encourage people to get that third dose is to require it to keep the vaccine passport valid and to extend that passport to other places. And in order for people to get it, you have to decrease the interval between doses.
Is the vaccine passport still effective, as more than half of the population has not yet received its third dose?
Roxane Borges Da Silva : The vaccine passport is still effective, because even with two doses, people have a lower viral load and are less contagious. The other reason that militates for the maintenance of the passport is that unvaccinated people really should not end up in closed and frequented places. [où le passeport est exigé], where they are at risk of catching the virus. The passport also aims to prevent these people from being contaminated.