We know that 12,000 cases, that 13,000 cases, that 15,000 cases per day, that does not say all: the screening capacity of Quebec is overwhelmed. We know that the daily count only gives an overview of the current slaughter. What is reliable is the positivity rate.
The positivity rate is the percentage of positive cases among Quebecers tested on a given day.
It is currently 24%.
One in four Quebecers!
In short, the barn is on fire.
The barn is on fire and the question arises, urgently: what do we do now?
I’m not talking about the past. The past is of course made up of missed opportunities. I spoke about this recently about the rapid tests and the administration of the third dose (1).
I also think, like analyst Patrick Déry (2), that Horacio Arruda has had his day at the head of our Public Health.
Too often he says things that are contradicted by scientists. He gets tangled up in his explanations at a press conference. The Dr Arruda is ripe for new challenges.
But what do we do now?
While the barn is on fire?
We had nearly 13,000 cases on Tuesday. “Service disruptions” are not just occurring in the healthcare network. All sections of society suffer from it, because workers are infected. In the United States, ditto: there is no official lockdown, but a kind of semi-lockdown in some places, because too many workers are in isolation (3).
In Quebec, we won’t tell you too loudly, but the Sûreté du Québec is currently covering the rear of municipal police forces which are hit by numerous outbreaks. It’s an example. This kind of disruption in service currently affects all parts of our society.
Perfect, then, for the health sector… what do we do?
The government has made its nest. Minister Christian Dubé announced it yesterday: health workers who have received a positive test, but who are asymptomatic, may be called upon to continue working. He spoke of a “paradigm shift”.
For a paradigm shift, that is all.
In the United States, the Centers for Disease Control and Prevention (CDC), the federal public health agency, has just shortened the isolation period for positive people to five days. It is also a paradigm shift. I note that it is disputed, however. But the Dr Anthony Fauci supports the CDC in the name of a principle: “Perfection cannot be the enemy of good. “(4)
The Quebec government has therefore opened the door for health care workers – under conditions to be determined – to return to work if they are positive and asymptomatic.
I also note that the government took its advice for this “new paradigm” from a committee of experts. There are groups and physicians such as the microbiologist Karl Weiss, the ethicist Marie-Eve Bouthillier, the geriatrician David Lussier, the College of Physicians, the National Institute of Excellence in Health and Social Services as well as the intensivist. Joseph Dahine …
In view of the present situation, it is a lesser evil if the other option is a disruption of service.
Or, even, no service.
Take the case, not entirely fictitious, of a hospital with seven obstetricians and gynecologists. Four are in isolation. There are three left, for the moment, to ensure the deliveries …
What do we do if the other three doctors test positive? Are we stopping childbirth in this hospital?
You broke your leg while skiing. Would you rather be operated on tonight by a surgeon who has tested positive and is asymptomatic… or in – maybe – a week, a week and a half, by a surgeon who is not infected?
I add to the equation that I pose in front of you, dear reader: an untreated leg fracture can sometimes lead to serious and irremediable complications.
So what’s your answer?
Mine: now, please, even if the surgeon is positive and asymptomatic.
Fortunately, I have my third dose: my chances of developing complications are minimal. Even double dosed, if infected, have minimal risk of complications.
Anyway, at a 24% positivity rate, I can also catch the virus from anyone who comes to help me – relatives and caregivers – because I’m bedridden.
La Santé is a vast archipelago that includes state-of-the-art university hospitals and small “intermediate resources”, where caregivers look after young autistic people and old women with Alzheimer’s disease. This archipelago works with workers who, because of the Omicron variant, are infected like the rest of society: at high speed…
I find it hard to see what the solution is, failing to send to the front some infected soldiers, but not symptomatic, who treat and work alongside a majority of vaccinated people.
We leave the seniors in CHSLDs in their backyard while three attendants do the job of seven?
We feed autistic intermediate resources half of the time because two of the three employees are in isolation… but not sick?
Do we stop giving birth to women?
I think that with certain beacons, while the barn is on fire, this “new paradigm” of infected but not sick workers that we send to the front is a lesser evil.
I note that the Federation of Specialist Physicians of Quebec (FMSQ) supports this approach.
I also note, unsurprisingly, that the unions – hello FIQ, CSN, CSQ and company! – reject it en bloc (5). This rejection of major unions is completely in line with the union approach since the start of the pandemic, an approach that I have been denouncing since the spring of 2020: detestable (6) and divorced from reality (7).
Do you see the irony here?
The unions who fought tooth and nail so that their unvaccinated members can continue to work without being sanctioned (and who have never publicly condemned these irresponsible) are now moved, hand on heart, that health workers asymptomatic can be sent to the fire while the barn is on fire …
Not confusing: the unions have harsher words for the government than for their anti-tax comrades whose “right” they have defended to work without giving a damn about patients and colleagues.
All this without providing a concrete solution.
Uh, what can I say, comrades?
I prefer not to say anything, I could say bad words, the boss prefers that I refrain from saying it during the holidays.
I’ll just say: LOL.