1) Since last week, the #COVID19 positivity rate in the Montreal borough of Saint-Léonard has jumped to 20.9% (!) from 18.1%, underscoring how the #coronavirus is running rampant in the city. Will the four-week curfew announced Wednesday succeed in breaking this second wave?
2) Before answering that question, it’s worth focusing on the rising #COVID19 hospitalizations in Montreal and across the province. At the McGill University Health Centre (see the chart below), the number of such hospitalizations has been surging in an almost vertical line.
3) Quebec-wide, intensive-care stays due to #COVID19 are fast approaching the peak of the first wave, with a total of 202 disclosed on Wednesday. (The record stands at 222 on May 6). This is in addition to all the other non-COVID patients who are in ICUs. See the chart below.
4) Despite the fact that non-essential businesses have been closed for nearly two weeks, the number of workplace #COVID19 outbreaks soared by 55 to 659 since Tuesday. The curfew is intended to reduce social contacts. But it does not address workplace transmission.
5) Outbreaks in health-care institutions like hospitals and long-term care centres ramped up by eight to 463. ER overcrowding remains a major problem, and there aren't nearly enough health workers to treat the influx of #COVID19 patients. Kidney transplants have been suspended.
6) School outbreaks plummeted by 155 to 139 on Wednesday. That’s understandable, given that schools closed on Dec. 17. But elementary schools will reopen on Monday. The curfew doesn’t address school transmission. On Friday, we’ll learn more about Quebec’s plans for schools.
7) Meanwhile, Montreal posted its highest seven-day average Wednesday, a rate of 44.54 cases per 100,000 residents. The metropolis counted 846 #COVID19 cases, up from 790 the day before, but down from the 1,200-range earlier in the week. See the chart below.
8) At the neighborhood level, community transmission of the #coronavirus remains disturbingly high in four boroughs, notably in Villeray—Saint-Michel—Parc-Extension and Côte-des-Neiges—Notre-Dame-de-Grâce. This is where the curfew will help.
9) And certainly, keeping non-essential businesses closed for another four weeks will no doubt help reduce community transmission. But will that be enough, given that so many #COVID19 outbreaks have been occurring in the manufacturing sector?
10) Ultimately, the goal of the new measures is to break the second wave that includes #COVID19 deaths. The province declared another 47 such fatalities Wednesday. Montreal’s death toll rose by 16 to 3,923. My gut tells me more measures may be needed. End of thread. Stay safe.

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More from @Aaron_Derfel

9 Jan
1) A Quebec public health advisor suggested Friday installing portable air purifiers in schools might produce the opposite effect, inadvertently causing the #coronavirus to spread in the air among students. In this thread, I will fact-check this assertion by Dr. Richard Massé.
2) This is what Dr. Massé had to say on the subject: “The committee also found that if they’re not installed properly they can create air movement that promotes the transmission of aerosols.” Upon what scientific basis did the committee reach this decision?
3) The answer to that question can be found in the scientific references listed in the back of the study by the Institut national de santé publique du Québec. The INSPQ cited a South Korean study which warns the “installation of air purifiers may cause new problems.” Image
Read 11 tweets
8 Jan
1) In the past two days, #COVID19 outbreaks in the workplace have jumped by 70 across Quebec, raising questions about the government’s decision to spare the manufacturing industry from its latest lockdown announcement. In this thread, I will re-examine the government's decision.
2) On Nov. 21, the government reported a total of 64 outbreaks in manufacturing, 53 in stores and 26 in construction. In the last update on workplace outbreaks on Dec. 23, the government disclosed that #COVID19 clusters in manufacturing nearly tripled to 187.
3) Outbreaks in stores nearly tripled, too, with a total of 151, according to the Institut national de santé publique du Québec (INSPQ). And #COVID19 clusters in construction nearly doubled to 60. Yet the Premier has exempted manufacturing and construction from the new lockdown.
Read 10 tweets
6 Jan
1) On the eve of Quebec’s announcement of a total lockdown for at least three weeks, the province posted a staggering single-day increase of 31 #COVID19 outbreaks in health-care institutions. In this thread, I will focus on what the lockdown will mean for these facilities.
2) In the short-term at least, it’s doubtful the lockdown will ease the tremendous pressure that hospitals and long-term care centres are under, with #COVID19 outbreaks flaring up, workers getting sick and hospitalizations rising.
3) In the first wave, Premier François Legault announced a lockdown on March 13, and waited nearly three months to declare the lifting of restrictions in Montreal. The big question is whether a lockdown of three to four weeks will be sufficient this time around.
Read 10 tweets
3 Jan
1) On Dec. 10, Montreal crossed the threshold by Harvard University experts for stay-at-home orders. But Quebec waited until Dec. 17 to send schoolchildren home. On Dec. 25, it shut businesses. The city posted 648 #COVID19 cases Dec. 10. By Sunday, it was more than double: 1,300.
2) The latest figures show #COVID19 is now surging far faster in Montreal than any other region in the province. The metropolis’s seven-day rolling average rose to 43.88 cases per 100,000 residents Sunday, well above Harvard’s 25-case threshold.
3) Provincially, Quebec set a record 2,869 #COVID19 cases Sunday, as well as a record 1,225 hospitalizations. Of that number, a record 179 patients were being treated in rapidly crowding intensive-care units across the province.
Read 9 tweets
2 Jan
1) With #COVID19 cases and hospitalizations soaring in Montreal and across the province, public health experts are beginning to openly question the Legault government’s semi-lockdown plan over the holidays. In this thread, I will examine the continuing problems with that plan.
2) What worries epidemiologist Benoît Mâsse is that cases have ratcheted up despite the fact that schools closed on Dec. 17. “I sincerely expected to see a reduction in new infections around Dec. 28 or 29,” Mâsse told Presse Canadienne.
3) Yet from Dec. 27 to Dec. 30, Quebec posted four days of rising #COVID19 cases, culminating in a record 2,819 on Dec. 30. The number of intensive-care stays climbed to 165 amid 1,175 hospitalizations and a growing number of infected health workers.
Read 10 tweets
2 Jan
1) Intensive-care units and emergency rooms in Montreal are beginning to fill up with a combination of #COVID19 patients and those with other medical problems, front-line workers told me on New Year's Day. In this short thread, I will explain this serious and growing problem.
2) “It is getting more challenging to find beds, that is for sure,” a veteran ER physician told me. “But I have yet to have a patient stuck so far. It is coming, though.” During the first wave, some overcrowded Montreal hospitals sent some #COVID19 patients to regional centres.
3) But in this second wave, those regional hospitals are full of their own #COVID19 patients. With cases and hospitalizations still rising and absenteeism increasing among health-care workers (because they’re getting sick), the acute-care system is now at the breaking point.
Read 8 tweets

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