COVID-19: The Omicron wave, more deadly than the previous two

The 5and wave, inflated by Omicron, has had more casualties to date than the 3and and 4and waves united, and took in its disastrous wake more than 1,700 Quebecers in less than two months.

At a time when Quebec is loosening the grip of health measures and when hospitalizations are declining, little is said about the people who succumb in the current wave. However, the figures show that the wave dominated by the Omicron variant is proving to be one of the deadliest since the start of the pandemic.

In just 57 days, the current tide of infections has resulted in the deaths of 1,704 people, says the National Institute of Public Health of Quebec (INSPQ), and appears to have dethroned the Delta variant in terms of casualties. In absolute numbers, this 5and wave – still ongoing – is already almost three times more deadly than the 3and wave (spring 2021) and five times more than the 4and (Fall 2021). In January 2022, the peak of daily deaths (79) even exceeded that observed (70) at the height of the 2and wave (January 2021).

Quebec remained marked by the magnitude of the wave that decimated CHSLDs and seniors’ residences in 2020. That linked to Omicron seems to mow down out of sight, especially people living at home. “This number of deaths is explained by the number of infections which has exploded and which has exceeded that of other waves. The death rate is lower, but absolutely there is more. We still have to analyze the profile of the people who were affected and what variant was involved, ”explains the DD Rodica Gilca, medical advisor at INSPQ and coordinator of an ongoing study on COVID-related mortality.

For now, the very high contagiousness of Omicron, combined with intense and sustained community transmission in December and January, is known to have hit seniors living in their homes, who have so far been spared. However, the INSPQ does not yet have data on the vaccination status of people who have died since the start of the 5and wave.

But we observe that 81% of people with COVID who died in December were living at home, as well as 64% of those who died during the month of January. The very old accounted for the vast majority of these deaths, but twice as many people in their 50s and three times as many in their 60s have died since December than during the 4and wave.

What role could access to the third dose of vaccine have played in this new wave of deaths?

The Dr Réjean Hébert, geriatrician who was Minister of Health under the last PQ government and who described the fate reserved for seniors in CHSLDs as “ageicide” during the 1D wave, once again launches a cry of alarm. “Another 1,700 dead. I am overwhelmed by this carelessness. It seems that we have developed a tolerance for the death of elders, and that all that matters now is not to prevent deaths, but to save the health system! »

The latter believes that the delays in granting the third dose to seniors living at home could partly explain this disastrous picture. “The strategies deployed to give the first and second dose to seniors at home were not as well organized for the third dose. Appointments are centralized and difficult to access. Fifty thousand people over the age of 70 in Montreal have still not received their third dose,” he says.

The Montreal Regional Public Health Department could not confirm this figure on Wednesday, and does not yet have detailed data by borough on vaccination coverage linked to the booster dose. But the INSPQ reports a vaccination rate reaching 80% for the booster dose among Montrealers over 70 who live in the community. This is nevertheless the lowest rate recorded in Quebec, after Nunavik (77%), followed by Laval (83%) and Mauricie (84%).

fatal everywhere

“We would like to have more information on the profile of the people who are currently dying, advances the Dr Hoang Duong, internist at Le Gardeur Hospital and president of the Association of Internal Medicine Specialists of Quebec. In those who are hospitalized or in intensive care, there is a very significant overrepresentation of unvaccinated people, as well as of the youngest immunocompromised. »

The situation is no different in Ontario, as it is elsewhere in the world. In the neighboring province, January was the third deadliest month since the start of the pandemic with more than 1,000 deaths, says Public Health Ontario. A situation due to the dazzling number of people infected, and whose repercussions would have been much worse in the absence of a high vaccination rate. In the past five weeks, more people have contracted COVID-19 in Ontario than since the start of the pandemic.

In France, public health authorities have also just declared that Omicron now causes more deaths than the Delta variant, given the large number of people infected and hospitalized.

In the United States, COVID-related mortality has increased even further with the Omicron surge, which has led to more deaths than were attributed last fall to the Delta variant. The United States currently has the highest death rate from COVID-19 among the wealthiest countries on the planet, the New York Times.

In Quebec, says the DD Gilca, if it is clear that the 5and wave is more deadly, it is still difficult to measure the proportion of deaths attributable to the Omicron variant, which became predominant (80%) at the end of December. “The Delta variant was still circulating in December. So people may have died from the Delta variant as late as early January. Afterwards, it is assumed that the majority of deaths must have been due to Omicron,” she says.

Given the changes in PCR testing policies, it is impossible to say precisely at this time the true number of infections due to Omicron, and therefore the mortality rate associated with these infections, adds the DD Rodica Gilca. But according to her, it is below 1%. At the start of the epidemic in Quebec, the mortality rate had reached 10%, then dropped to around 1% at the end of the 1D wave and at the beginning of the 2and.

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