Montreal Public Health Director Recommends ‘Suppressive Approach’ As COVID-19 Cases Rise

Dr. Mylène Drouin said limiting contacts, wearing masks and other similar measures are imperative to flatten the curve.

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Amid a spike in COVID-19 cases before the holidays, Montreal’s public health director Dr. Mylène Drouin urges people to limit their contacts.

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Public health hopes to delay the rapid expansion of the Omicron variant from taking over Delta for as long as possible to avoid undue pressure on the healthcare system in the city, especially as it continues to deal with a wave of cases of Delta, Drouin said at a news conference Wednesday.

This means that repressive measures must be observed, such as limiting contacts and continuing to wear masks. Drouin also mentioned the possibility of adjusting capacities in public spaces.

“Those are preventive measures, so the sooner you put them in place, the sooner they will take effect and reduce the risk,” he said, adding that the last thing he wants is for the government to have to reimplement more drastic measures.

The city has seen an increase in the number of daily cases for seven consecutive weeks, with 844 cases reported Wednesday, and public health predicts that the trend will continue as the Delta and Omicron variants continue to spread. Montreal’s positivity rate for COVID-19 is currently around eight percent.

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“The current situation is not really what we were planning or hoping for two weeks before Christmas, and I think it forces us to be more agile and resilient in the face of the Omicron situation,” Drouin said, adding that he might feel differently about the meetings. if the city the increase in the number of daily cases had remained stable.

“But for two or three days, we have seen an exponential increase and, in that context, our contact tracing is not enough, vaccination will not be enough, we have to add a global reduction of contacts,” he said.

As of Wednesday, 95 confirmed and suspected cases of the Omicron variant had been detected in Montreal, 50 percent of which came from travelers (primarily from the US, with some from Europe and Africa). Public health will better understand how present Omicron is within days of receiving screening results.

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The median age of Omicron cases in Montreal is 32, and 90 percent of them were people who were fully vaccinated, Drouin said. Eighty percent have symptoms, but so far there have been no hospitalizations or deaths. The cases were detected in a community center, two elementary schools, two universities, a nursery, a gym and a sports team.

“We know that right now it is mainly in young populations, so it is not yet known what will happen if the Omicron variant is introduced, for example, in places where we have older populations,” he said, adding that the measures will be added in environments of medical care and residences for the elderly.

“That’s why we ask people to get their third dose, if indicated, as soon as possible,” he said.

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Sonia Bélanger, director of the CIUSSS du Center-Sud-de-l’Île-de-Montréal said hospitalizations are relatively stable for now, but she expects an increase. Wednesday’s report had 113 people hospitalized in Montreal, including 34 in intensive care.

The head of intensive care at Maisonneuve-Rosemont hospital, Dr. François Marquis, for his part, said it is difficult to predict the impact that Omicron will have on hospitalizations, especially during vacations, which are usually very busy. He noted that many variables must be considered: the variant, the festive gatherings (and whether or not people will be careful when they get together); the fact that children are currently being vaccinated; and that many people are receiving reinforcements.

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“So when a lot of this comes together, it’s incredibly difficult for us to try to see what’s going to happen,” Marquis said. “Which of these variables will be the prevalent one?” Which will have the greatest effect? “

“We are very vigilant, which means we all know that (Omicron is) there,” he added. “It’s just a matter of time, Omicron will blow up at some point in Quebec.”

Marquis said his hospital never stopped being “ready to restart everything” after dealing with waves one to four of the pandemic.

“We are trying not to use isolation chambers, we make sure we have open communication channels between hospitals and critical care specialists,” he said. “We always knew the holidays were coming and we have known for many weeks that Omicron is crawling to Canada.”

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Marquis said reducing contact during the holidays will play an important role, but he believes the government’s approach, which allows gatherings of 20 people but reserves the right to change that rule at any time, makes sense.

“You have to find a middle ground between what is physical health and mental health,” he said. “If you are strictly thinking about contagion… 20 (people in a meeting) is a little too much, like too much. Now this is not a unique variable, people need to see their families, so it is a balancing act and it is very difficult to put a number on it. “

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