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.
4) The figures would appear to justify Quebec’s decision to shut restaurants and bars. But the chart below doesn't list outbreaks in cinemas or concert halls, which also closed. The next category affected is retail: boutiques, big-box stores, green grocers and pharmacies.
5) What stands out in the list is #COVID19 outbreaks are occurring among workers in pharmacies, where people go to purchase their medications. Workers have also fallen ill in hotels and motels, raising the possibility guests might be exposed to the highly contagious #coronavirus.
6) In light of the new data, perhaps the Quebec government should devise new restrictions and measures for pharmacies, hotels and motels, which are staying open during the #pandemic. The chart also helps explain why Quebec decided to close gyms in red zones on Thursday.
7) In addition, the government must start looking at what extra safeguards it could implement quickly in the city's schools, which are reporting the second highest number of #COVID19 outbreaks after the workplace, as well as how to better protect workers and children in daycares.
8) Meanwhile, Montreal posted 290 #COVID19 cases on Thursday, slightly down from the 300-to-400 range earlier this week. However, the seven-day average remains alarmingly high: 169.35 infections per million population. (Please see the chart below.)
9) At the neighborhood level, the city centre is still dominating with new #COVID19 cases, as the chart below indicates. The north and east ends of Montreal are also hard hit. What’s noteworthy is that Dorval, Lachine and LaSalle appear to be far less affected. I don't know why.
10) Although the Quebec City areas has declared a marked increase in #COVID19 deaths in the past week with 19, the number of fatalities is starting to creep up again in Montreal. The city added three more to a death toll that’s soared to 3,490. End of thread. Please stay safe.

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More from @Aaron_Derfel

10 Oct
1) Premier François Legault expressed guarded optimism on Friday that Quebec has “reached some level of stabilization” in #COVID19 cases. But a provincial health institute issued dire projections for Montreal’s intensive-care units. In this thread, I will review those forecasts.
2) This is what the institute had to say: “For the regions of Montreal, Laval, the Laurentians, Lanaudière and the Montérégie, projections suggest hospital capacity will be reached at the end of the next month and even more quickly with regard to intensive-care beds.”
3) Health Minister Christian Dubé tweeted his concerns about hospital capacity but didn't address the faster potential impact on the Montreal region’s ICUs. I’ve spoken with the chiefs of two Montreal ICUs, and they say they’re very worried their ICUs could soon be overwhelmed. Image
Read 10 tweets
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
7 Oct
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.
Read 12 tweets
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
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
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

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