Too soon to say Quebec’s in a sixth COVID wave, health director says

Despite some signs Quebec is following Europe, public health director says it’s too soon to say if the province is starting its sixth wave.

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Those on the front lines in Quebec hospitals are seeing signs that look a lot like the beginnings of Quebec’s sixth wave of COVID-19, as the ultra-contagious BA.2 sub-variant now makes up half of confirmed cases.

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But Quebec’s interim public health director, Luc Boileau, says a steady rise in COVID-19 cases was expected with the loosening of public health restrictions and should not be assumed to be the beginning of a sixth wave.

“The expectations are that it’s going to go up, but not necessarily as a wave, so let’s wait before talking about a sixth wave,” said a seemingly relaxed and confident Boileau at a news conference in Quebec City Wednesday afternoon.

Boileau announced that Quebec will be making fourth doses of the vaccine available to certain vulnerable Quebecers — residents in long-term care or seniors’ homes, those over 80, and those with compromised immune systems, for example — as of Tuesday. But he described this as a precautionary measure, as Quebec data does not yet confirm that immunity wanes significantly after three doses.

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Data released Wednesday by the Institut national d’excellence en santé et en service sociaux (INESSS) showed that new COVID-19 hospitalizations actually went down slightly, for the ninth week in a row, in mid-March. But INESSS projects that trend will turn over the next two weeks.

And on Tuesday, new confirmed cases topped 2,000 in one day, hitting 2,111, for the first time since mid-February.

Boileau confirmed he wrote to Quebec’s health system administrators on Tuesday to warn them to prepare for more hospitalizations, but again, he insisted this trend was expected when the government made its plan to relax measures.

He said he has not advised the government to delay its plan to lift the mask mandate (everywhere except on public transit), on April 15. And speaking to reporters this morning, Premier François Legault said he had no intention to do so.

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“Quebec has always been very prudent with its decisions, I think, and with what’s happening in Europe and with the data we have here we hope to maintain this prudence,” Boileau said. “We judge it useful to maintain mask-wearing for now, without changing the previously announced date of mid-April. We would have liked the landscape to stay very positive so we could lift it earlier, but let’s be reasonable and keep it at the 15th of April and we should be OK.”

Meanwhile, Judy Morris, president of Association of emergency physicians of Quebec, said her members report observing many of the signs that heralded previous waves.

More and more hospital staff members are beginning to call in sick and to test positive, she said. Certain units have gone back to systematic testing, and training sessions and meetings are moving to online. Hospital emergency wards are beyond full again, with occupation rates of 150 to 200 per cent in hospitals on the island of Montreal and 100 to 150 per cent in the Laurentians, for example.

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“We really have the impression we are experiencing the same things,” that preceded previous waves, she said, “so, it would be a good thing to take measures now to try to control it a bit … maybe not drastic measures, but people have to act accordingly.”

She said the number of true positive cases is probably much, much higher than the 2,111 cases confirmed by PCR in Quebec’s labs. She would like to see the government expand testing now and maintain mask mandates for as long as is feasible.

She said hospitals are ready for the sixth wave, but it’s really the public that needs to get back into pandemic mode.

“In the hospitals, we are used to this now and our protocols haven’t changed, but it’s more up to everybody to pay attention if we don’t want the number of cases to explode,” Morris said. “It is really up to Mr. and Mrs. Everyone to be careful, to wear their masks even if some are fed up with them, and if they have the slightest cold symptoms they should not visit older people in long-term care … all that management really belongs to the community.”

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She has concerns that a new surge in cases will cause more cancellations of surgeries and treatments that can save lives.

Dr. Matthew Oughton, an infectious diseases specialist at the Jewish General Hospital, said he has the feeling he is looking at the tip of an iceberg and wondering how much is below the surface of the water. He said it doesn’t make sense to try to set a firm date for the removal of mask mandates at this point.

“I would have preferred that we say, ‘For now we are going to keep mask mandates. We are going to wait and see how things evolve. Stay tuned.’ “

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