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Aaron Derfel

7 Oct, 12 tweets, 6 min read

1) Quebec is now beset with more than 500 #COVID19 outbreaks as the province posted a record 1,364 infections on Tuesday amid an upswing in hospitalizations and deaths. In this thread, I will assess whether the second wave in the #pandemic may prove more dangerous than the first.

2) Certainly, the potential is there for a more dangerous second wave. That’s because unlike the shutdown of the first wave, schools have reopened, and many businesses are still operating. At the same time, Quebec’s health-care system is stretched to the limit as never before.

3) And as the weather grows colder, more people will congregate indoors, providing the opportunity for the contagious #coronavirus to spread more easily. In November, the annual flu season will be upon us, raising the prospect of a Twindemic — #COVID19 coupled with the flu.

4) In order to head off a potential Twindemic, experts have recommended Quebec make the flu vaccine available to everyone for free. Quebec has decided against that plan. Australia’s flu season was very mild. Let’s hope this augurs well for North America this fall and winter.

5) On Tuesday, Health Minister Christian Dubé addressed a tougher press corps, urging Quebecers to stay at home during the upcoming Thanksgiving Day weekend. He expressed concern about rising #COVID19 deaths and hospitalizations, and the fact this is happening all over Quebec.

6) If left unchecked, the #coronavirus has the potential to cause a lot more deaths than the 66 observed in the past seven days. Will the second wave prove deadlier than the first? So far, the virus is circulating mostly among younger Quebecers who are less likely to die.

7) Perhaps the greater danger is to Quebec’s acute-care health network, which the government worked so hard to protect during the first wave. Hospital ER overcrowding has become a massive problem, as the chart below conveys. A few outbreaks have started to erupt in hospitals.

8) Health-care staff are exhausted and there are 1,600 fewer nurses across the province than during the first wave. Cancer treatments are at risk of being put off again. There is no more give in the system should #COVID19 hospitalizations and outbreaks ramp up.

9) The worse-case scenario of overwhelmed hospitals may not be too far off, health workers fear. The government must prepare Quebecers for more drastic action, including the last resort of closing more businesses and maybe even schools. Quebecers deserve to know what’s at stake.

10) Montreal declared 442 more #COVID19 cases Tuesday, according to the rising orange line in the chart below. The city’s seven-day average jumped to 174 infections per million population, up from 160 on Monday. Are the current #pandemic restrictions enough to stop this spread?

11) No district in the city has been spared from the #coronavirus. The city’s hot spots are found in its centre, the north end and the east end, as the chart below makes clear. The transmission is mostly at the community level, but there are signs of spread among health workers.

12) In conclusion, Montreal added three #COVID19 fatalities to a death toll that has soared to 3,487. The last time the city recorded as many deaths in a day was more than three weeks ago. We must all steel ourselves for what could come. End of thread. Please stay safe everyone.

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More from @Aaron_Derfel

Aaron Derfel

@Aaron_Derfel

9 Oct

1) Montreal health authorities released for the first time Thursday a breakdown of #COVID outbreaks in the workplace, revealing that most have occurred in restaurants, bars, gyms and hotels. In this thread, I'll try to explain what this means for the city's #pandemic's response.

2) Public health officials are scrambling to contain more than 130 #COVID19 outbreaks in the metropolis: at least 51 in the workplace, 42 in schools, 18 in daycare centres and more than a dozen in health-care institutions that include public and private eldercare homes.

3) The breakdown by authorities lists 25 outbreaks affecting restaurants, bars, gyms, hotels, motels and temporary employment agencies as of Oct. 7. It’s clear that some workers in restaurants and bars, which closed to customers on Oct. 1, are still reeling from #COVID19.

Read 10 tweets

Aaron Derfel

@Aaron_Derfel

8 Oct

1) In the span of a week, the number of #COVID19 hospitalizations in Montreal has more than doubled — from 61 to 125 — stretching the already-thin resources of the city’s health-care system. In this thread, I will return to the subject of Montreal’s fragile hospitals.

2) Authorities have set aside 1,000 out of the city’s 5,000 hospital beds for #pandemic cases. At the rate #COVID19 is spreading, Premier François Legault calculated on Wednesday that the province could be hit with as many as 1,600 new hospitalizations within a month’s time.

3) Montreal hospital emergency rooms are again starting to admit patients with #COVID19. ER nurses at the Lakeshore General Hospital are treating up to two COVID patients per shift. The chart below by the McGill University Health Centre from shows a recent COVID spike in its ERs.

Read 10 tweets

Aaron Derfel

@Aaron_Derfel

6 Oct

1) More than a month after the school year started, Quebec will require high school students in red zones to wear masks in class as of Thursday. But that won’t be mandated for primary school children. In this thread, I will argue why children in this age group should wear masks.

2) Dr. Richard Massé, a public health advisor to the government, acknowledged that “there is some transmission (of the #coronavirus) in primary schools, but it’s much more limited than what we see in secondary schools.” Massé did not cite any statistics to back up his assertion.

3) In the absence of stats from the government, let me provide some #COVID19 figures by age group drawn from the Montreal public health department from Aug. 25, just before the start of the school year, until the most recent date available, Oct. 4. The stats are quite revealing.

Read 16 tweets

Aaron Derfel

@Aaron_Derfel

5 Oct

1) On the eve of Quebec’s announcement Monday that it will impose new restrictions in the #pandemic, a quarter of the province’s schools on Sunday night have declared at least one case of #COVID19 among students and staff. In this thread, I will revisit the topic of schools.

2) As of 9:44 p.m., 767 of the province's 3,000 schools have at least one infection, according to covidecolesquebec.org. On the island of Montreal, 10 schools have reported at least five cases each. But authorities last week confirmed at least 30 school outbreaks in the city.

3) However, the extent of the #COVID contagion in schools is not fully known because authorities aren't systematically screening students, as they are in Germany. Even in classes where a student has tested positive, not every pupil is screened. It differs from school to school.

Read 10 tweets

Aaron Derfel

@Aaron_Derfel

3 Oct

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.

Read 17 tweets

Aaron Derfel

@Aaron_Derfel

3 Oct

1) As the daily number of #COVID19 infections crossed the thousand-case threshold in Quebec on Friday — the highest since the peak of the first wave — it’s clear the province is now fighting a multi-front war on the #pandemic. In this thread, I will elaborate on those fronts.

2) Let’s start with a surge in #COVID19 outbreaks in long-term care centres (CHSLDs) and seniors’ residences (RPAs) across the province. Clusters have been identified in more than 30 such facilities, with two dozen infections confirmed in the past 24 hours among the elderly.

3) The hardest-hit nursing homes are in Chaudière-Appalaches, the Capitale-Nationale, Outaouais and the Gaspé — regions largely spared during the #pandemic’s first wave. Eldercare centres have also been affected in the Eastern Townships, the Laurentians, Laval and Montreal.

Read 11 tweets

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