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Aaron Derfel

10 Oct, 10 tweets, 5 min read

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.

4) In the chart below, #COVID19 is projected to breach the capacity of Montreal ICUs by mid-November. A fraction of Quebecers testing positive this week will be hospitalized in the coming days, and smaller percentage will be treated in ICUs. But the system can take only so much.

5) During the first wave, Montreal hospitals were able to ramp down surgeries and other clinical activities, easing pressure on the ICUs to accommodate and treat #COVID19 patients. But during this second wave, most hospitals can no longer ramp down as many elective surgeries.

6) On the island of Montreal, authorities have set aside 1,000 out of 5,000 hospital beds for #COVID19 patients. Of that number, only 150 have been reserved for ICU #COVID19 patients. But that allocation of beds was made before Friday’s ICU projections and may have to be revised.

7) Meanwhile, Montreal posted 345 new #COVID19 cases Friday, up from 290 the day before, as the orange line in the chart below indicates. The city’s rolling seven-day average dipped to a still-concerning 168.52 infections per million population from 169.35 the previous day.

8) At the neighborhood level, the city’s centre health district of Côte-des-Neiges, downtown Métro, Parc-Extension and Outremont reported 40 #COVID19 cases, half as many as five days ago. Efforts may be proving successful in reducing transmission in Outremont’s Hasidic community.

9) But public health authorities are scrambling to contain at least 130 active #COVID19 outbreaks in an epidemiological version of whack-a-mole. Positive #coronavirus results have been observed in at least 156 Montreal schools, according to covidecolesquebec.org.

10) And the metropolis declared three more #COVID19 deaths Friday and 10th in a week, as the chart below shows. The city’s pandemic death toll has climbed to 3,493, greater than Australia (897), Japan (1,616) and Hungary (913) combined. The end. Enjoy a safe, happy Thanksgiving.

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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

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

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

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