Faced with the increase in COVID-19 cases 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 take effect for three weeks, starting on Friday.
Posted on December 30, 2021 at 5:00 am
Updated at 9:20 am
According to the information obtained by La Presse, François Legault was quite reluctant to go ahead with this measure, already used in early 2021, but the Minister of Health, Christian Dubé, the chief of staff of Mr. Legault, Martin Koskinen, and the Public health specialists 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 breaks a new record, and the 804 hospitalizations recorded on Wednesday, a jump of 102 compared to the previous day, show that the hospital system reached its limit before leaving. “We do not enact massive postponements of interventions for other diseases.
These announcements must be formalized by the Prime Minister at a press conference this Thursday at 5 pm
The deadline for meeting on public roads was not set on Wednesday night; there was talk of a curfew from 9 pm or 10 pm to 5 am
Quebec had used the same measure in January 2021, when it assessed that the pandemic could no longer be controlled. The curfew went into effect at 8 p.m.
Restaurants and family bubble
The government is also considering decreeing the complete closure of restaurants. Public health specialists note that outbreaks occur primarily among kitchen workers and waiters, rather than customers. However, unlike last year, “non-essential” companies will not have to close their doors completely. They have already been subject since last week to limits on the number of clients they can accommodate. As early as last week, Quebec asked employers to return to telecommuting.
At the same time, Quebec is expected to announce that the maximum number of people for a rally will be further reduced. From December 26, we must limit ourselves to 6 people.
On Friday, François Legault asked people to limit themselves to their family bubble, like at the beginning of the year.
The start of the school year, which had been postponed until January 10, would be postponed again. Now we are talking about January 17 for all levels, do we understand?
There will be no regionalization of the measures: all of Quebec will live under the same system.
In the fog
But echoes from Public Health quickly made it clear that decisions are now made based on intuition and not on a formal scientific basis. With the proliferation of rapid tests, Quebec has lost control over the evaluation of the number of cases, which are not necessarily reported.
Difficult, under these conditions, to locate the sources of the outbreak, to know precisely where to attack. Two important meetings, on Tuesday night and Wednesday afternoon, did not give Dr. Horacio Arruda’s team a clear opinion on the direction to follow. As usual, the meetings ended without a clear conclusion, without even the national director of public health giving the impression of having a firm opinion on the measures to be taken.
Among specialists, opinions differ regarding the impossibility of accurately assessing the impact of the curfew to slow the spread of the disease, for example.
The idea of imposing a curfew resurfaces as the number of hospitalized patients has risen 81% in one week. Of 804 people on Wednesday, 122 were in intensive care. Initially, 700 beds had been reserved for infected patients across the network.
In fact, burden reduction has begun in hospitals, says Dr. Gilbert Boucher, an emergency room physician at the Montreal Heart Institute. “For every case of COVID-19 that we see, it is someone who does not have their services,” he says.
All of our beds are already full and we cannot afford to leave these patients in the corridors of our emergency rooms.
Dr. Gilbert Boucher, Montreal Heart Institute emergency room physician
The situation is not going to improve anytime soon, warns Dr. Boucher. “At the moment, with 100 [nouveaux patients] per day, it is unfortunate, but it will be like last year at the beginning of January, when the hospital system [traitait] just COVID-19, ”he said.
It will be necessary to make new downloads “as hospitalizations increase,” also estimates Dr. Judy Morris, president of the Association of emergency physicians of Quebec.
According to 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 facilities to reduce activities in their operating rooms by 50%.
Proportion of hospitalizations truly related to COVID-19
However, these statistics must be qualified: Dr. Morris says that she treats patients who go to the hospital for another condition, but who test positive for COVID-19. These patients are then counted in the coronavirus patient statistics.
The care trajectory of these patients is not expected to be as long as in previous waves.
Dr. Judy Morris, president of the Quebec Association of Emergency Physicians
However, Dr. Morris calls the increase in cases “worrisome.”
It is necessary to distinguish patients hospitalized for COVID-19 from those admitted for another reason and later declared positive, admitted the Minister of Health and Social Services, Christian Dubé, during a press conference on Tuesday. “We have to do it systematically to get a fair picture of the situation,” he added.
Outbreaks in CHSLD
During this time, outbreaks are increasing in the CHSLDs. As of December 28, seven CHSLDs were in the red zone, more than 25% of residents were infected with COVID-19, according to the Quebec government. These establishments are located in the Montreal, Lanaudière, Mauricie and Montérégie regions. In the Chaudière-Appalaches region, the Saint-Raphaël CHSLD is in the orange zone: 15% of its residents declare themselves positive.
Some private homes for the elderly (RPA) are fighting the 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 CHSLD residents and 84% of RPA residents are considered adequately vaccinated and have received a booster dose, according to the latest data from the Institut de santé publique du Québec (INSPQ).
Dreaded staff shortage
The many COVID-19 cases in CHSLD are at risk of causing a staff shortage, who will have to isolate themselves after becoming infected with the coronavirus, stresses Dr. Sophie Zhang, Co-Chair of the Community of Practice of Physicians at CHSLD.
This potentially creates service interruptions in various areas. This is the great danger that awaits us with the outbreaks that we see everywhere.
Dr. Sophie Zhang, Co-Chair, CHSLD Physician Community of Practice
Dr. Zhang fears that she will no longer be able to provide basic care to residents in this context. The measure announced on Tuesday by Minister Christian Dubé to shorten the isolation of asymptomatic workers is justified in these “exceptional circumstances”, according to the doctor. As long as “all workers” wear N95 masks, he says.
The Omicron variant remains a concern, says Dr. Zhang. “But we have reasons to be a little less worried than before, since the neighbors are triple vaccinated for the great majority,” he argues. A less serious illness is expected. ”
With the collaboration of Lila Dussault and Ariane Lacoursière, La Presse
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