1) As COVID hospitalizations trend downward in Québec — dipping by 31 to 1,758 Saturday — everyone is wondering what will happen as the province continues lifting public health protections with the BA.2 sub-variant on the rise. In this thread, I will try to answer that question.
2) First, it’s worth noting the Omicron variant had the hardest impact on hospitalizations in Québec than at any other point in the pandemic. In contrast, although Omicron caused a wave of hospitalizations in South Africa (where it was first detected), past ones there were worse. 
3) Omicron has also produced the second highest wave of #COVID deaths in Québec. Again in contrast, although Omicron caused a wave of death in South Africa, previous waves there were higher. So what explains the difference between Québec and South Africa?
4) One likely explanation is Québec's population is much older than South Africa’s, with 20.3% above the age of 65, compared with a rate of 5.5% in South Africa. This sheds light on why South Africa’s Omicron hospitalizations also started falling sooner and faster than in Québec.
5) As the chart below suggests, although #COVID hospitalizations are clearly trending downward in Québec, the wave of hospitalizations will likely extend much longer than in South Africa. What also must be considered is the utter fragility of Québec's health-care system.
6) At the same time, Québec faces the prospect of the proliferation of the Omicron sub-variant BA.2, now occurring to the greatest extent in South Africa. The province’s public health director, Luc Boileau, has estimated up to 15% of new #COVID cases in Montréal arose from BA.2.
7) But there might be a glimmer of hope, again coming from South Africa. A pre-print study published on Thursday by researchers from Johannesburg found that BA.2 was not associated with an increase in clinical severity compared with Omicron. medrxiv.org/content/10.110…
8) What’s more, Dr. Luc Boileau estimated two weeks ago that at least two million Québecers contracted #Omicron, including one million since the start of this year. This suggests that perhaps there might be a certain degree of immunity among the province's population.
9) However, there is also research out of Japan last week warning that BA.2 may well be more pathogenic than Omicron — that is to say, in its ability to cause sickness. And Québec’s population is much older than South Africa’s.
10) Denmark’s population is considered among Europe's healthiest, with 20.16% over 65, similar in this regard to Québec. Denmark, much further ahead in its BA.2-driven wave than Québec, is still reporting a high rate of COVID hospitalizations but they're starting to go down.
11) Denmark’s experience and not South Africa’s suggests that Québec’s current wave of #COVID hospitalizations and deaths might either be prolonged as a result of BA.2 or the province might be hit with another (possibly smaller) wave in the coming weeks or even months.
12) Complicating all of this is Québec’s decision to end all public health protections on March 14 as well as the province’s much lower booster vaccination rate than Denmark's. The upshot: We’re still not out of the woods yet by a long shot. End of thread.
13) ADDENDUM: For another in-depth perspective on what’s to come, especially at the national level with a focus on Ontario, please read this brilliant analysis by the phenomenal @egpayne of the @OttawaCitizen: ottawacitizen.com/news/local-new…
14) ADDENDUM: @LussiD just pointed out correctly that masks will still have to be worn in Québec on March 14 in public places like stores and schools, but the vaccine passport and other measures will end. My apologies for not stating this explicitly.
• • •
Missing some Tweet in this thread? You can try to
force a refresh
