Thread by @Aaron_Derfel

1) For three days in late June, Montreal reported no new cases of #COVID19 — a stunning turnaround in the #pandemic. But for the past three days this fall, the metropolis’s daily tally has averaged 362 cases. What went wrong? In this thread, I will offer possible explanations.

2) First, let me reiterate it’s highly unlikely, as Quebec’s public health officer suggested Sept. 26, the province has been hit harder by a second wave than elsewhere in Canada because of a more “invasive” and “lethal” #coronavirus strain. Other provinces have this strain, too.

3) Second, it was not inevitable that Quebec should be so hard hit during the second wave, especially given its tragic experience with the first one. British Columbia, after observing an increase in August, has managed to lower its incidence rate recently. See the chart below.

4) Policy analyst Patrick Déry (@Patrickdery) has published a perceptive commentary today on what could be considered Quebec’s missteps leading to the second wave. In this thread, I would like to make some additional observations. plus.lapresse.ca/screens/627899…

5) On June 25, Quebec announced bars could reopen despite solid evidence from other countries that these drinking establishments are among the riskiest venues in a #pandemic for the transmission of the #coronavirus for a slew of obvious reasons.

6) This announcement was also misinterpreted by many younger Quebecers that it was okay to drink alcohol in groups outside of bars, too. Within days, Quebec witnessed #COVID19 outbreaks not only in bars, first on the South Shore and then in Montreal, but at house parties as well.

7) There’s been some second-guessing about the recent decision to close bars again. It’s therefore instructive to review what occurred in Quebec's bars over the summer and into the fall. In mid-July, authorities were investigating #COVID exposures in at least 14 bars in Montreal.

8) The negative news surrounding bars led to massive lineups for #COVID tests. Health Minister Christian Dubé declined to close bars but imposed restrictions on them. This led to a drop-off in bar business. But in August, a massive outbreak erupted in a Quebec City karaoke bar.

9) The superspreading karaoke bar outbreak was subsequently blamed for six hospitalizations, one death, and the seeding of #COVID19 clusters in no fewer than six schools and a long-term care centre. So what would have happened had Quebec not reopened bars so early in the summer?

10) The short answer is there would have been fewer #COVID19 cases. While the Ontario Medical Association warned against reopening bars, Quebec’s medical authorities were silent on the matter. Some have argued that had bars remained closed, private parties would have flourished.

11) My response to that argument is that private parties would have occurred anyway, but the government’s announcement on June 25 that it was acceptable to drink again in bars inadvertently sent the wrong message to some people that you could also drink at house parties.

12) Compounding matters, Quebec announced that it would increase the size of public gatherings from 50 to 250 people as of Aug. 2, despite the #COVID19 resurgence caused by the bar outbreaks and house parties, and despite grave concerns raised by physicians.

13) Almost two weeks after that announcement, 2,500 people gathered on Mount-Royal for a dance party, with no #SocialDistancing and most people not wearing masks. Outbreaks were later traced to outdoor salsa dances in parks, to large wedding receptions, even to a bar mitvah.

14) What would have happened had Quebec not boosted public gatherings by five-fold? There would have been fewer #COVID19 outbreaks and less community transmission of the #coronavirus. Those two announcements, more than anything else, set the stage for Quebec’s second wave.

15) The lessons to be learned is Quebec can’t be too careful when it comes to this insidious #pandemic, that the government must follow the best practices of other jurisdictions around the world and steer clear of the worst ones. It must be guided by the precautionary principle.

16) Meanwhile, Quebec posted 1,107 #COVID19 cases Saturday, the second day of more than a thousand infections. The province has observed a net increase of 224 #pandemic hospitalizations in the past four weeks. A hundred more Quebecers have died during this same period.

17) Montreal’s seven-day average jumped to 156.66 #COVID19 cases per million population from 147.02 the day before. See the rising orange line in the chart below. Despite grim news, there’s hope. Act prudently by practicing #PhysicalDistancing and wearing a mask. End of thread.