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Aaron Derfel

13 Oct, 9 tweets, 6 min read

1) Two Montreal schools announced over the long weekend that they're closing for two weeks after #COVID19 outbreaks. Quebec also reported an upswing of 20 hospitalizations Monday. In this thread, I'll try to explain why the province is in for a long haul during this second wave.

2) Collège Pasteur and Loyola High School will close for 14 days, marking at least the third private educational institution to shut in Montreal during the #pandemic. It’s worth noting private schools have acted more prudently to close than public ones.
montrealgazette.com/news/local-new…

3) In addition to schools, covidecolesquebec.org has begun tracking #COVID19 in daycares, reporting Monday at least 11 affected in the province. The rise in cases corresponds with Montreal demographic data showing a marked percentage increase among children up to the age of 4.

4) Although the province posted 843 new #COVID19 cases Monday, down by nearly a hundred from the day before, net hospitalizations are still trending upward. What’s more, Quebec added a dozen more fatalities to its #pandemic death toll that has soared to nearly 6,000 to date.

5) In Montreal, the city declared 274 #COVID19 infections, up from 227 the previous day, and despite a drop in testing. Please see the orange line in the chart below. This still suggests a plateauing, but it’s a very high one and no one knows how long it will stay at that level.

6) At the neighborhood level, #COVID19 remains stubbornly high in the central health district of Côte-des-Neiges, downtown Métro, Parc-Extension and Outremont, which is still observing a spike in cases. See the chart below. Again, this suggests the second wave has staying power.

7) With #COVID19 cases still up, the risk of hospitalizations is ever present. At the Jewish General, the ICU chief told me he’s more worried about the impact of a second wave than the first one because medical activities are no longer being ramped down. montrealgazette.com/news/local-new…

@cdube_sante

8) Meanwhile, Health Minister Christian Dubé tweeted Sunday he will make a technical change to the way #COVID19 hospitalization numbers are being reported in response to a Montreal physician's recommendation. Does this mean @cdube_sante is open to more changes in releasing data?

9) Perhaps Dubé should respond to a petition by prominent Canadian scientists that’s garnered 700 names in less than 24 hours. The petition is calling for the public release of far more information to keep Quebecers safer in the #pandemic. End of thread.
change.org/p/fran%C3%A7oi…

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More from @Aaron_Derfel

Aaron Derfel

@Aaron_Derfel

14 Oct

1) Although Quebec observed its fourth daily decline in new #COVID19 cases on Tuesday, the pandemic is beginning to take a toll on the acute-care hospital system, schools and the workplace. In this thread, I will examine those impacts in the provincial capital and in Montreal.

2) After treating relatively few #COVID19 patients in August and September, the McGill University Health Centre is now grappling with a resurgence, as the chart below makes clear. Total hospitalizations have crept up to 21, along with intensive-care stays at six.

3) In the provincial capital, the CHU de Québec hospital network announced Tuesday afternoon that it has no choice but to proceed with délastage, purposely ramping down as many as 300 elective surgeries and 6,000 appointments per week because of an influx of 61 #COVID19 patients.

Read 10 tweets

Aaron Derfel

@Aaron_Derfel

11 Oct

1) Montreal and much of the rest of Quebec are at a deceptive point in the second wave, as new #COVID19 cases have apparently plateaued in the city. In this thread, I will caution against jumping to conclusions and will call for the public release of more data in the #pandemic.

2) First, the good news: the number of net #COVID19 hospitalizations in the province has declined for the first time in almost two weeks. Quebec did not report any deaths in the past 24 hours. In Montreal, the city posted 227 cases Sunday, the lowest daily number since Sept. 23.

3) At the neighborhood level, the health district of Petite-Patrie—Villeray reported six #COVID19 cases, the lowest since Sept. 24. Other boroughs also declared much fewer infections. Keep in mind, though, that the government chart below frequently undercounts.

Read 9 tweets

Aaron Derfel

@Aaron_Derfel

10 Oct

1) This past Wednesday, Montreal health authorities disclosed a major #COVID19 outbreak at a seniors’ residence in the Quartier Latin that's infected at least 28 people, hospitalized six and killed one. Yet these stats still haven’t been listed in the provincial records. Why not?

2) Dr. Mylène Drouin publicized the outbreak at the Soleil Manoir Plaza to warn that a growing number of so-called mobile elderly are falling ill with #COVID19 in seniors’ residences as opposed to long-term care centres. She explained there was a lag in transmitting the data.

3) But four days later, the Soleil Manoir outbreak — which would appear to be the worst in the province — has still not appeared in the government’s updates, resulting in an undercount of at least 28 cases in the latest daily tally. Undercounts are a problem elsewhere, too.

Read 8 tweets

Aaron Derfel

@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.

Read 10 tweets

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

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