Whether Quebec’s “calculated risk” not to reinstate most health measures during the sixth wave was successful is up for debate

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The sixth wave of the COVID-19 pandemic, which Quebec tackled with fewer health restrictions than ever before, appears to have peaked.

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Six weeks after authorities officially pronounced it had begun, the numbers of cases are trending down and hospitalizations in the province have stabilized, health experts said.

Over the weekend, the number of patients hospitalized with COVID-19 dropped for two straight days, the first time since March 20 the numbers had decreased. (Tuesday’s net increase of 64 patients, however, reinforced epidemiologists’ warnings that Quebecers are by no means out of the woods). Official case counts have been dropped since April 7.

Whether Quebec’s “calculated risk” not to reinstate most health measures during the sixth wave was successful is up for debate. On one hand, the province still hit a high of 2,410 patients in hospital with COVID-19 last week, and several hundred people died. As of Tuesday, the province was averaging 28 deaths per day, a grim reminder of the human toll the disease still has the power to inflict even when most infections result in minor symptoms.

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On the other, much of society was able to resume life as normal and the economy to reboot. And Quebec’s increase in infections and vaccinations, epidemiologists note, could serve to create a type of “community immunity” that could protect it next fall from the harsher consequences now playing out in places like China.

The province’s handling of the sixth wave was unique in its relative lack of health restrictions, with the exception of wearing masks in public spaces, noted Gaston De Serres, an epidemiologist with the Institut national de santé publique du Québec (INSPQ), the province’s research institute. Previous waves saw lockdowns and imposed social distancing used to limit infections.

“The drop in cases this time arrived because the virus (and vaccinations) have touched many people, and so the virus is having more difficulty finding vulnerable people that it can infect.”

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Quebec’s imposition of severe restrictions last December during the fifth wave to block the first surge of the Omicron variant likely spared it from far greater hospitalizations and deaths, De Serres said. That wave also infected millions, and convinced many others to get their booster shot, giving them better protection in March and April.

Increased immunity and indications the new BA.2 sub-lineage of Omicron circulating resulted in mainly minor symptoms among the immunized, allowed the government to take its calculated risk. At the same time, the Coalition Avenir Québec, under pressure to ease restrictions as other provinces and countries had done, stressed measures could be imposed if conditions worsened, and warned citizens they still needed to exercise caution by avoiding large, unmasked gatherings and to self -test and stay home if symptomatic.

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To date, Easter and Passover weekend doesn’t seem to have made a large impact, De Serres said. Hospitalizations seem to have crested before overloading the health system. The deaths from COVID-19 are a reflection of what society is willing to accept, I have noted. Luc Boileau, Quebec’s interim health director, said in March that while the only acceptable number of deaths in theory is zero, that would be impossible for COVID-19 in the same way as it’s impossible for the flu. “There are too many constraints to be put in a society to get there,” he said. “And it’s a situation that is not necessarily acceptable, but that is a normal situation.”

Quebec’s decision to allow more widespread infections during the 6th wave could protect the province next fall, when scientists predict another COVID-19 wave is all but inevitable. Dr. Doug Manuel, senior scientist at the Ottawa Hospital Research Institute and a member of Ontario’s COVID-19 science advisory table, referred to it in a recent interview with the National Post as “building community immunity,” in which a relatively stable number of infections pass through populations until enough immunity is created to end the pandemic.

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The counterpoint is places like China, which tried to suppress outbreaks altogether, and has been forced to shut down Shanghai, population 25 million, for more than a month because few residents have developed immunity through infections or effective vaccines.

“We lived a painful wave with deaths and hospitalizations in Quebec, but hopefully that will allow us to have a situation that is much easier to manage in the future,” De Serres said. “Because the virus will be with us for decades to come.”

As to the near future, if the virus stays similar to what it is now, it should stay manageable, De Serres said. “But if we have one that changes radically during the summer, it could be difficult.

“Predictions are difficult, because the changes are unpredictable,” he said. “What is predictable is there will be changes.”

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