The recent increase in infections and hospitalizations is being felt in CHSLDs and private residences for seniors (RPA) in Quebec, where the number of deaths linked to COVID-19 has been increasing for two weeks. The situation calls for great vigilance in these establishments, warn doctors.
Posted at 5:00 a.m.
“We are all tired, but despite this pandemic fatigue, we really must not lower our guard against the virus”, affirms the Dr Quoc Nguyen, geriatrician at the University of Montreal Hospital Center (CHUM).
According to data compiled by The Press, Quebec has recorded 42 deaths in CHSLDs in the past two weeks. This is three times more than what we had recorded the previous two weeks, or 14. Approximately 1,855 cases of COVID-19 are also still considered active in Quebec CHSLDs. In RPA, we observe the same trend: 43 deaths have been recorded in the last 14 days, against 29 in the previous two weeks, an increase of 48%.
On average, we currently deplore four deaths per day in CHSLDs and four others in RPAs. At home, the situation seems less acute, but still worrying. The number of deaths linked to COVID-19 rose from 92 to 113 in the space of two weeks, which represents an increase of 22%. There are nine deaths a day on average at home. The deaths that have occurred over the past two weeks concern people whose average age remains high, around 83 years old.
Officially, the cases have been decreasing for almost two weeks in Quebec, but the data from the PCR tests indicate that it is first of all the youngest who explain this downward trend. Those aged 60 and over took longer to register a decline, which only materialized a few days ago. This delay in the most vulnerable group could explain the fact that hospitalizations continue to increase so long after the number of cases has dropped. It generally takes between seven and ten days after a drop in cases to observe a decrease in hospitalizations.
‘No warning sign’
Despite several outbreaks still active, “we see no sign of alarm letting us believe for the moment that this wave will be more deadly than the previous one in the network”, specifies the co-president of the Community of practice of doctors in CHSLDs. (CPMC), the DD Sophie Zhang, who nevertheless calls for vigilance, too.
Between December and January, during the fifth wave propelled by the arrival of the Omicron variant, the CIUSSS du Centre-Sud-de-l’Île-de-Montréal had recorded a mortality rate of 4.4% among residents declared positive from 17 CHSLDs. “It’s a mortality rate that is low compared to the past, so that’s encouraging. We will have the figures for this wave at the end of it, and we hope that it will be maintained, ”supports the DD Zhang.
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“The main risk, for us, would be that everyone catches it, or at least that we have an infection rate close to 100%, if community transmission remains high. We would then have death figures that would jump, and the most fragile would leave first, ”she maintains in the same breath.
According to Quoc Nguyen, the limits imposed on screening necessarily make it more difficult to assess the situation.
What is different this time is that before, we had access to PCR tests in the general population. There, we have the rapid tests, but it is based on the goodwill of everyone, so it is certain that we are less equipped to protect the most vulnerable.
Quoc Nguyen, geriatrician at the CHUM
The two experts agree: the network will not return to the draconian restrictive measures that have been taken in recent months in CHSLDs and RPAs, these having “a cost” sometimes very high for the mental health of users. Protecting them, by wearing the mask at all times, getting their booster dose and monitoring their symptoms, “remains the key”, they say.
Moreover, the administration of the fourth doses in CHSLDs made it possible to relaunch the vaccination campaign. Quebec administers an average of 30,000 doses per day, five times more than a month ago. To date, 5.8% of Quebecers have received four doses. More than a quarter (28%) of Quebecers aged 70 and over received a fourth dose.
Increase in hospitalizations
In the health network, we observed an increase of 100 hospitalizations on Wednesday. To date, 2,381 patients therefore remain hospitalized in connection with the virus, of which 101 are still in intensive care, a figure that has remained stable. At the moment, the 2,382 people currently hospitalized represent an increase of 16% over one week. In intensive care, the increase is 22% over one week. Quebec also reported 2,330 new cases on Wednesday, bringing the daily average to 2,347. The trend is thus down 24% over one week. Moreover, the proportion of positive PCR screening tests for COVID-19 remains very high, at 14.5%. In terms of vaccination, the Quebec campaign is picking up a bit. More than 33,660 additional doses were administered on Tuesday.
Henri Ouellette-Vézina and Pierre-André Normandin, The Press