“We are very close to a point of no return,” Dubé says of Quebec hospitals

The province is scrambling to find another 1,000 health care staff to send to hospitals as COVID-19 admissions continue to rise.

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With hundreds more COVID-19 patients expected to be admitted to Quebec hospitals this week, health experts continue to say the province must do more to curb the spread of the virus.

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At a press conference on Tuesday, Health Minister Christian Dubé said Quebec is struggling to find 1,000 health workers to send to hospitals as they are reaching a breaking point with the continued spread of the variant. Omicron.

“The weekend ahead will be the most difficult,” Dubé said Tuesday, as COVID-19 hospitalizations reached 2,742 in Quebec, including 255 in intensive care.

Although Dubé suspects that roughly half of the COVID-19 hospitalizations in Quebec (outside of intensive care) are among patients admitted for reasons other than the virus (who subsequently tested positive), he said projections suggest that hospitalizations for COVID-19 specifically could hit 2,500 in the next few days.

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“We are very close, within a week, to reaching a level that is very difficult,” Dubé said, explaining that another 1,000 hospitalizations would bring the situation to the highest alert level, causing unmanageable disruptions. “We are very close to a point of no return.”

For Dr. Donald Vinh, infectious disease specialist and medical microbiologist at McGill University Health Center, the distinction between patients admitted to the hospital for COVID and those admitted with COVID is “a bit of a distraction.” .

“You still need the same amount of dedicated rooms, staff and equipment,” he said. “The virus does not care if it is with COVID or despite COVID: the person has COVID and is potentially transmissible to other people, including a threat to healthcare workers. … You don’t want a nurse who cares for a COVID-positive patient to go to an old woman who doesn’t have COVID and take care of her, because we know that’s what led to COVID in the other waves. “

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At the MUHC, the strain of COVID-19 can be felt throughout the building. On Tuesday, Vinh said he was heading to a meeting to discuss rationing of care in his work area.

“We are at that point,” he said.

In Vinh’s department, rationing care means deciding which immunocompromised COVID-positive patients who do not respond well to vaccines will receive preventive treatment with monoclonal antibodies to prevent the virus from progressing to a serious or life-threatening state, he said.

“We can catch them early and give them to them, but of course we don’t have enough to do that for everyone,” Vinh said, explaining that hospitals receive about 10 to 20 doses per week and that the MUHC has delivered eight in the last two days. only. “How do we approach that? These are the kinds of conversations we are having. “

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While the province bases its pandemic response on hospitalization metrics and intensive care numbers, treatments like those Vinh provides to immunocompromised patients occur before those cases require a hospital bed.

“There are both ascending and descending issues outside of hospitalizations,” he said. “Hospitalizations are a current metric that the government is focusing on, understandably, because that’s the hole in the boat right now. Except the other problems on the ship are that the wood is rotting and there is no dock in sight. ”

Quebec’s acting director of public health, Dr. Luc Boileau, who has headed the Institut national d’excellence en santé et services sociaux (INESSS) until now, said he anticipates the peak of the fifth wave will hit Quebec soon, but that he can’t confirm he has yet.

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“We really hope that we will see a slowdown in transmission soon,” he said.

But with the return to school looming for students and back to work for their teachers, Dr. André Veillette, an immunologist at the Montreal Institute for Clinical Research, said reaching the peak may take longer than expected.

“The bottom line is that we don’t know,” he said. “I think (going back to school and work) will have an effect. They may not be immediate, they may take a few weeks. So we have to do everything possible now ”.

For Veillette, there should be more emphasis on wearing N95 masks, physical distancing, rapid tests, better ventilation, and giving Quebec adults their boosters and children their second dose as soon as possible.

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“The risk is that it will take until March for everyone over 18 to get vaccinated and by then the damage from this wave will be done,” he said. “I think that if we want to prevent people from getting sick, we must vaccinate them as soon as possible. It should have been done in November, even in October ”.

Echoing Veillette, Vinh called for similar measures and a more consistent approach to managing the pandemic in Quebec.

“We cannot have limiting restrictions and curfews, but inconsistent messages about masks, inconsistent messages about the quality of the masks that are required, not addressing the need to improve ventilation, an astonishingly delayed and continuous release of third doses,” he said. Vinh. “On the one hand, the message is that everyone gets their dose, on the other hand, it is that everyone still does not get their dose.”

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