As COVID restrictions drop, what happens next in Québec?

“Better days are coming,” interim public health director Luc Boileau said this week. Not everyone is so certain, and many argue some restrictions should continue in order to protect the vulnerable.

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Almost two years to the day after COVID first forced the province to lock down, Quebec is opening up again.

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As of Saturday, most health restrictions are being eased. Restaurants and bars can open at full capacity. Dancing is permitted. Karaoke patrons are free to belt out Livin’ on a Prayer.

The Bell Center will welcome 20,000 raucous fans as the Habs host the Seattle Kraken Saturday, the first time in three months the arena will be filled to the rafters. While masks are still required, vaccine passports are no longer mandatory, meaning the unvaxxed can mingle freely with their vaccinated brethren.

Premier François Legault announced in early February that restrictions could soon be dropped because public health projections indicated doing so wouldn’t overload hospitals — and, he noted, much of the public was “fed up.”

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Quebec is following in the footsteps of other provinces and much of Europe, often a bellwether of things to come here.

The virus is still circulating and thousands are infected daily, interim public health director Luc Boileau stressed on Thursday. But modeling projections predict that even with relaxed health measures, Quebec should not come anywhere near the peak of the Omicron wave, which was linked to the death of 1,500 people in January alone.

“Better days are coming,” Boileau said.

Not everyone is so certain. Many argue some restrictions should continue in order to protect the vulnerable from unnecessary hospitalizations, suffering and death.

“As a family physician, and as a parent, I am irate,” Ottawa doctor Nili Kaplan-Myrth wrote in an opinion piece this week in reaction to the news Ontario is dropping most mask mandates as of March 21. “In just the last few days, we have had call after call from entire families sick with COVID-19. Young children and their grandparents who are struggling with high fevers, exhaustion, brain fog, some so short of breath that they cannot get through a sentence. … Our politicians are spinning a tale that the pandemic is over. It is not.”

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According to a report presented in early March by the Institut national de santé publique du Québec (INSPQ), the gradual easing of health restrictions should not lead to a spike in cases on the same level as in January, in part because of the large number of people infected during that surge.

Researchers believe roughly one in three people in the Greater Montreal area contracted Omicron between Dec. 1 and Jan. 31, when case counts were raging as high as 90,000 a day according to INSPQ estimates and an average of 50 people infected with the disease were dying daily.

With high rates of infection and vaccination providing immunity against severe illness, modeling projections under the “optimistic” scenario predict cases, hospitalizations and deaths will continue to drop through March. Under the “pessimistic” scenario, every day we will see between 10,000 and 20,000 cases, anywhere from 30 to 160 people will be admitted to hospitals, and between three and 20 people will die.

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Scientists cautioned that the prognostications could be knocked off course by several elements: the wanting efficacy of vaccinations, the introduction of new variants, and possible outbreaks among the vulnerable living in long-term care centers and those lacking immunity.

“What our modeling shows is that, yes, there will be some higher levels of transmission,” said Gaston De Serres, epidemiologist at the INSPQ. “But these levels are not reaching a point where they will have a huge impact on hospitals.”

Even with Quebec’s high vaccination rate, stopping all transmission will never be possible, De Serres said, and a balance needs to be struck between living with the virus and moving on with “all the other things we want to do with our lives.”

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“We have to face something that is quite difficult to grasp, which is that the virus is here to stay and we have used the vaccines pretty much to the maximum extent that we can,” De Serres said. “Is the virus receding as quickly as it would have if we kept all the public health measures in place? The answer is probably not. But those measures are very costly in terms of the socioeconomic aspects of our lives, and in education.”

Dr. André Veillette, director of the molecular oncology research unit at the Montreal Clinical Research Institute, predicts numbers will rise as social contacts increase. According to projections published this week by the Institut national d’excellence en santé et en services sociaux (INESSS), the daily number of Quebec hospitalizations is expected to “stabilize” over the next two weeks, at about 68 a day. In recent projections, the INESSS forecast decreases in hospitalizations.

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Veillette argues public health is moving too quickly in removing some restrictions, particularly mask-wearing in classrooms, at the expense of those vulnerable to infection, like the aged, immunocompromised and those suffering from chronic medical conditions. “What’s the effect on the economy, or on the children, of waiting a few more weeks?” he said.

With the Quebec election coming, the government is bowing to the will of those tired of restrictions, Veillette said.

“Right now we have a high level of vaccinations and health measures, and we’re still losing 25 people a day. Imagine what will happen when vaccine immunity wanes and health measures are dropped,” he said. “They want to move on because people are tired, but there is a risk associated with that. People will die because of that.”

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Veillette fears that, despite the government’s plea for Quebecers to take personal responsibility and observe the measures necessary to protect themselves and others, many will take the loosening of restrictions as a signal “they can do anything they want.”

“And that’s very sad.”

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