“We cannot rule out” an overrun of hospital capacities in the coming weeks despite the tightening of health instructions announced on Monday and despite the acceleration of vaccination with the third dose, provides the National Institute of Public Health (INSPQ) in its most recent modeling.
As for the National Institute of Excellence in Health and Social Services (INESSS), in its update of December 20, it provides for “a rapid increase in the number of new hospitalizations and COVID bed occupancy rates over the years. next three weeks ”. His forecasts do not take into account the health instructions for Monday.
“It is certain that if citizens pay attention to the measures and modify their behavior, the figures could be modified”, declared the President and CEO of INESSS, Luc Boileau, at Duty.
The forecasts of his teams suggest that by January 9, around 1,200 current beds and 300 intensive care beds will be occupied in hospitals. This corresponds to 80% of the beds used in January 2021.
INESSS and INSPQ projections were made public on Wednesday. They were eagerly awaited, since they played an important role in the choice of new health measures to be announced by Quebec at the end of the afternoon.
Quebec “fragile”
Forecasts by INSPQ experts were updated on Wednesday. In these, the scientists note that Quebec was in a “fragile” situation when the Omicron variant arrived, during the fall.
According to government experts, the increase in hospitalizations observed since November can be explained by two factors: the increase in social contacts during the fall and the gradual decrease in the protection offered by the two doses of vaccines. At the beginning of December, the proportion of people vaccinated with a third dose was only 4%, recalls the INSPQ.
To date, “the combination of a strong adherence of the population to the measures, the acceleration of the vaccination with the third dose, the screening and the isolation could attenuate the transmission of Omicron in Quebec”, notes the report. “However, given the uncertainty regarding the severity of Omicron, we cannot exclude an overrun of hospital capacities, even with the measures announced on December 20 and the acceleration of the vaccination with a third dose”, they qualify. right away.
The INSPQ notes in passing that the data concerning the characteristics of the Omicron variant “are very uncertain and limited for the moment, particularly concerning its severity”. Uncertainties about the rate of vaccination and the population’s adherence to health measures also call for caution in interpreting the data, experts argue.
Gaston De Serres, epidemiologist at the INSPQ, recalled in an interview the importance of health instructions to slow the increase in hospitalizations. “If we do not apply very strictly the measures currently being taken to try to reduce contact, we will be in a very, very difficult situation,” he insists.
225 hospitalizations per day
The most pessimistic scenario studied by experts (wanting Omicron to be similar in severity to Delta) suggests that the measures announced on Monday and the third dose would “not be enough to reduce hospitalizations below a peak of 100 new hospitalizations per day in Greater Montreal ”in January. Depending on whether vaccine escape is high or low (i.e. whether the vaccines protect us poorly or well against the variant), the number of daily hospitalizations could approach 200 or exceed 225, respectively.
The only scenario that could avoid the “January 2021 peak” – with a peak of 150 new hospitalizations on January 2 – is that the Omicron has an “average transmissibility” (whether it is 1.5 to 1.7 times more transmissible than Delta), although the vaccine offers a reduced rate of protection (high vaccine escape rate). This scenario takes into account the measures announced on Monday.
On the other hand, even if the vaccine protected the population well (low vaccine escape rate), a high transmissibility of Omicron (two to three times more transmissible than the Delta variant) would not make it possible to avoid this peak in hospitalizations.
“Indeed, there is no good scenario”, summarized Cécile Tremblay, microbiologist infectious disease at the Center hospitalier universitaire de Montréal (CHUM) “In the most optimistic scenario, the situation in January would be similar to that of last year. If we consider the average scenario, this should encourage all citizens to comply with the measures to the letter and to get their third dose as quickly as possible. The most pessimistic scenario implies that drastic measures must be taken quickly. “
In the opinion of Nathalie Grandvaux, director of the Laboratory for Research on the Host Response to Viral Infections at the CHUM, the government “has no choice but to go with the scenario which takes into account that Omicron is as severe as the Delta ”. We must therefore anticipate the worst-case scenario, according to her. She nevertheless hopes that complete containment will be avoided. “Yes, there is the health system, but there is mental health,” she says. It is not an easy decision. “