With COVID-19 on the rise, Quebecers lack tools to manage risk, doctors say

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With several hospital emergency rooms over capacity and the public left to manage their own risk, upward trends in COVID-19 indicators again cause concern in Quebec.

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At a news conference last week, public health director Dr. Luc Boileau urged Quebecers to remain vigilant in the face of the surge, but said there are no immediate plans to reinstate restrictions. He cited projections suggesting hospitalizations could peak at around 1,600 over the next few weeks, as well as the reduction in the severity of COVID-19 cases among younger people who have been vaccinated.

The rise in hospitalizations, fueled by newer variants, comes as experts warn it could be a tough summer for Montreal emergency rooms as the number of people visiting hospitals reaches pre-pandemic levels and Staff shortages continue across the network as a result of vacations. and COVID-19 (6,347 health workers are absent due to the virus, the government said Monday).

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Dr. Judy Morris, president of the Quebec Association of Emergency Physicians, said in an interview Monday that while hospitalizations for COVID-19 have been difficult for the network in the past two years, they often occurred when there was periods of significant closures throughout the province. .

“So what we’re worried about right now is everything else is fully open, and that’s fine, but we’re seeing visits going back to pre-COVID times, and now the fear is adding (COVID-19) hospitalizations,” said. “If it goes up, it will put additional pressure on the health care network, especially given that we have so many beds closed over the summer.”

On Friday, the last day for which data is available, Quebec announced that 1,294 people were hospitalized with COVID-19 in Quebec, including 42 in intensive care. Hospitalizations have been on the rise since mid-June. At the same time, according to Index Santé, Quebec’s emergency rooms are currently operating in 114 percent capacity on average.

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Morris said that since surgeries and other procedures had to be canceled even before emergency rooms exceeded capacity, a wave of COVID-19 this summer could mean an even more significant effect on the health care network. In the coming days, he said, it will be important to follow the data and “adjust accordingly.”

“I would really like us to follow the advice of infectious disease specialists and public health specialists who are not politicians and get real advice,” he said. “What would be better for the population right now given that the disease is on the rise?”

Dr. Matthew Oughton, an infectious disease specialist at the Jewish General Hospital, said that for people to manage their own risk amid the pandemic, which is the approach the government has taken, they need timely and accurate information about the presence of the virus in their communities.

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“And that’s the conflict that I see right now,” he said. “We don’t have enough data for people to make informed decisions. We have many avenues where there is limited data, but not in real time that allows people to get a more accurate and up-to-date view.”

Lagging indicators such as hospitalizations are not helpful, and neither are case numbers when testing is restricted to priority communities, Oughton explained.

Months after a pilot project ended, Quebec has finally resumed sewage testing, which Oughton said would give people living in those areas a general idea of ​​COVID-19 trends. But data available online It’s about two weeks ago.

“For something that spreads, transmits, and can be infectious within a few days, 12 days is simply too long to allow people to make accurate and informed decisions today,” Oughton said. “So it’s one thing to say ‘personal responsibility,’ but I think that comes with an obligation to provide information that enables people to make informed decisions.”

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The Health Ministry did not respond to the Montreal Gazette when asked if it plans to update how it shares wastewater data.

In the meantime, Morris and Oughton advise Quebecers to stay up to date on vaccinations to protect themselves.

Oughton said that, more generally than just in Quebec, he expects future improvements to our systems for disease prevention and mitigation, which he said should include ventilation and air filtration in places like schools.

He said that we are currently underestimating the virus and compared it to house fires.

“Home fires are a fact of life, unfortunately,” he said. “But just because they’re close doesn’t mean you don’t do anything about it. It still institutes policies to make sure buildings are built to a certain code to reduce the chance of fires and reduce the damage they cause. You still have laws about having some kind of active monitoring with smoke detectors and stuff.”

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“You can’t eliminate all the causes of fires all the time, but you can do things to keep people safe as much of the time as possible and reduce the damage when a fire does happen, and I think we should look at managing SARS- CoV-2 in a similar way.”

With files from Jesse Feith and René Bruemmer of the Montreal Gazette.

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