Faced with the surge in cases of COVID-19 linked to the Omicron variant and the alarming increase in hospitalizations, François Legault should announce the return of the mandatory curfew throughout Quebec. A radical measure that would come into force for three weeks, from Friday.
According to information obtained by Press, François Legault was quite reluctant to go ahead with this measure, already used at the beginning of 2021, but the Minister of Health, Christian Dubé, the chief of staff of Mr. Legault, Martin Koskinen, and specialists in the Public health were clearly in favor.
At the end of the week, Public Health asked for “more time” to see the direction the pandemic would take. Four days later, the finding is clear: with 13,149 cases, Quebec shatters a new record, and the 804 hospitalizations recorded on Wednesday – a jump of 102 compared to the day before – show that the hospital system has reached its limit before it quits. ‘we do not enact mass postponements of interventions for other diseases.
These announcements should be formalized by the Prime Minister in a press briefing this Thursday, at 5 p.m. or 6 p.m., we learned, internally.
The deadline for meeting on the public highway was not set Wednesday evening; there was talk of a 9 p.m. or 10 p.m. to 5 a.m. curfew.
Quebec resorted to this same measure in January 2021, when it assessed that the pandemic could no longer be controlled. The curfew then came into effect at 8 p.m.
Restaurants and family bubble
The government is also considering decreeing the complete closure of restaurants. Public health specialists observe that outbreaks occur mainly among kitchen workers and waiters, rather than among customers. Unlike last year, however, “non-essential” businesses will not have to close their doors entirely. They have already been subject since last week to limits on the number of customers they can accommodate. Already last week, Quebec asked employers to return to telework.
At the same time, Quebec is expected to announce that the maximum number of people for a rally will be further reduced. Since December 26, we must limit ourselves to 6 people.
Friday, François Legault would ask people to limit themselves to their family bubble, as at the beginning of the year.
The start of the school year, which had been postponed to January 10, would be postponed again. We are now talking about January 17 for all levels, can we understand.
There will be no regionalization of the measures: all of Quebec will live under the same system.
In the fog
But the echoes obtained from Public Health quickly made it clear that decisions are now made based on intuition rather than on a formal scientific basis. With the proliferation of rapid tests, Quebec has lost control over the assessment of the number of cases, which are not necessarily reported.
PHOTO SARAH MONGEAU-BIRKETT, PRESS ARCHIVES
The Dr Horacio Arruda, Prime Minister François Legault and Minister Christian Dubé, on December 16
Difficult, in these conditions, to locate sources of outbreak, to know precisely where to strike. Two important meetings, Tuesday evening and Wednesday afternoon, did not give the team of Dr Horacio Arruda as to the direction to take. As usual, the meetings ended without a clear conclusion, without even the national director of public health giving the impression that he had a firm opinion on the measures to be adopted.
Among specialists, opinions differ in the face of the impossibility of accurately assessing the impact of the curfew to curb the spread of the disease, for example.
Hospitalizations jump
The idea of imposing a curfew resurfaces as the number of hospitalized patients is up 81% over one week. Of 804 people on Wednesday, 122 were in intensive care. Initially, 700 beds had been reserved for infected patients network-wide.
The load shedding is well and truly initiated in hospitals, says Dr.r Gilbert Boucher, emergency physician at the Montreal Heart Institute. “For each case of COVID-19 that we see, it is someone who does not have his services,” he says.
All our beds are already full and we cannot afford to leave these patients in the corridors of our emergency rooms.
The Dr Gilbert Boucher, emergency physician at the Montreal Heart Institute
The situation is not going to improve anytime soon, warns the Dr Butcher. “At the moment, with 100 [nouveaux patients] per day, it’s unfortunate, but it’s going to be like last year at the beginning of January, when the hospital system [traitait] only COVID-19, ”he said.
It will be necessary to proceed to new offloads “as and when hospitalizations will increase”, also estimates the DD Judy Morris, President of the Quebec Association of Emergency Physicians.
According to the Dr Boucher, Quebec still sees only the “tip of the iceberg” of cases due to the Omicron variant.
In early December 2020, Quebec asked health establishments to reduce the activities of their operating theaters by 50%.
Proportion of hospitalizations truly linked to COVID-19
However, these statistics must be qualified: the DD Morris says he treats patients who go to the hospital for another condition, but who test positive for COVID-19. These patients are then counted in the statistics of patients with the coronavirus.
The care trajectory for these patients is not expected to be as long as in previous waves.
The DD Judy Morris, President of the Quebec Association of Emergency Physicians
The DD Morris nevertheless describes the rise in cases as “worrying”.
It is necessary to distinguish patients hospitalized due to COVID-19 from those admitted for another reason and then declared positive, admitted the Minister of Health and Social Services, Christian Dubé, Tuesday during a press briefing. . “We have to do it systematically to get a fair picture of the situation,” he added.
Outbreaks in CHSLDs
During this time, outbreaks are increasing in CHSLDs. As of December 28, seven CHSLDs were in the red zone, more than 25% of residents being infected with COVID-19, according to the Quebec government. These establishments are located in the regions of Montreal, Lanaudière, Mauricie and Montérégie. In the Chaudière-Appalaches region, the Saint-Raphaël CHSLD is in the orange zone: 15% of its residents are declared positive.
Some private seniors’ residences (RPAs) are struggling with outbreaks. At the Le Saint-Guillaume residence in Beauce, 14% of residents are affected by COVID-19. At CHSLD Marguerite-Rocheleau in Longueuil, more than half of the residents are affected by the virus, or 59% of them.
To date, 77% of residents in CHSLDs and 84% of those in RPA are considered to be adequately vaccinated and have received a booster dose, indicate the latest data from the Institut de santé publique du Québec (INSPQ).
Dreaded staff shortage
The numerous cases of COVID-19 in CHSLDs risk causing a shortage of staff, who will have to isolate themselves after being infected with the coronavirus, underlines the DD Sophie Zhang, co-chair of the community of practice of physicians in CHSLDs.
This potentially creates service disruptions in several areas. This is the great danger that awaits us with the outbreaks that we see everywhere.
The DD Sophie Zhang, co-chair of the Community of practice of physicians in CHSLDs
The DD Zhang fears that he will no longer be able to provide basic care to residents in this context. The measure announced Tuesday by Minister Christian Dubé to shorten the isolation of asymptomatic workers is justified in these “exceptional circumstances”, according to the doctor. Provided that “all workers” wear N95 masks, she says.
Omicron variant still worrisome, says DD Zhang. “But we have reasons to be a little less worried than before, given that the residents are triply vaccinated for the vast majority,” she argues. Less severe illness is expected. ”
With the collaboration of Lila Dussault and Ariane Lacoursière, Press