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“We don’t have enough data for people to make informed decisions,” said Dr. Matthew Oughton, an infectious disease specialist at Jewish General Hospital.
Judy Morris, President of the Association of Emergency Physicians of Quebec. Photo by Pierre Obendrauf/Montreal Gazette
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As various hospital emergency departments exceed capacity and the public is left to manage its own risk, upward trends in COVID-19 indicators are once again causing concern in Quebec.
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At a news conference last week, Public Health Director Dr. Luc Boileau urged Quebecers to remain vigilant amid the surge, but said there were no immediate plans to return to restrictions. He cited forecasts that hospitalizations could peak around 1,600 in the next few weeks, as well as the reduced burden of COVID-19 cases among younger people who have been vaccinated.
The increase in hospitalizations, fueled by the newer options, comes as experts warn it could be a tough summer for Montreal emergency rooms as the number of people visiting hospitals reaches pre-pandemic levels and staff shortages persist across the network, both as a result of the holidays and COVID-19 (6,347 health workers are absent due to the virus, the government said on Monday).
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Dr. Judy Morris, president of the Quebec Association of Emergency Physicians, said in an interview Monday that while hospitalizations due to COVID-19 have been difficult for the network over the past two years, they often occur when there are periods of significant closures across the province.
“So what we’re worried about right now is that everything else is fully open — and everything is fine — but we’re seeing visits going back to pre-Covid times, and now the fear is adding (COVID-19) hospitalizations,” said she. “If it goes up, it will put further strain on the health network, especially as we have so many beds closed for the summer.”
On Friday, the latest day for which data is available, Quebec announced that 1,294 people had been hospitalized with COVID-19 in Quebec, including 42 in intensive care. Hospitalizations have been increasing since mid-June. At the same time, according to Index Santé, emergency departments in Quebec are currently operating at an average of 114 percent capacity.
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Morris said that because surgeries and other procedures had to be canceled even before emergency rooms exceeded capacity, a wave of COVID-19 this summer could mean an even more significant effect on the health network. In the coming days, she said, it will be important to follow the data and “adjust accordingly.”
“I really wish we would follow the advice of infectious disease specialists and public health specialists who are not political and get the real advice,” she said. “What would be best for the population right now given that the disease is on the rise?”
Dr Matthew Otten, an infectious disease specialist at the Jewish General Hospital, said that for people to manage their own risk amid the pandemic – which is the approach the government has taken – they need timely and accurate information about the presence of the virus in their communities.
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“And that’s the conflict I see right now,” he said. “We don’t have enough data for people to make informed decisions.” We have a lot of avenues where there is limited data, but not in real time, which allows people to get a more accurate and up-to-date view.”
Lagging indicators such as hospitalizations are not helpful, nor are case numbers when testing is limited to priority communities, Oughton explained.
Months after the pilot project ended, Quebec has finally resumed wastewater testing, which Oughton says will give people living in those areas a general idea of COVID-19 trends. But the available online data is from about two weeks ago.
“For something that spreads, transmits and can be contagious within a matter of days, 12 days is just too long for us to be able to allow people to make accurate, informed decisions today,” Oughton said. “So it’s one thing to say ‘personal responsibility,’ but I think that comes with an obligation to provide information that allows people to make informed decisions.”
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The Ministry of Health did not respond to a Montreal Gazette question about whether it plans to update how it shares wastewater data.
In the meantime, Morris and Oughton are advising Quebecers to keep up with vaccinations to protect themselves.
Oughton said that more generally than just in Quebec, he hopes there will be improvements in our disease prevention and mitigation systems, which he says should include ventilation and air filtration in places like schools.
He said we are currently underestimating the virus and likened it to house fires.
“House fires are a fact of life, unfortunately,” he said. “But just because they’re around doesn’t mean you’re not doing anything for them. You still put policies in place to make sure buildings are built to a certain code to reduce the likelihood of fires and to reduce the damage that fires cause. You still have laws for things like active surveillance with smoke detectors and so on.
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“You can’t eliminate all the causes of fires all the time, but you can do things to keep people safe as much of the time as possible and reduce the damage when a fire does occur, and I think you should consider managing SARS-CoV-2 in a similar way.”
With files from Jesse Feit and Renee Brummer of the Montreal Gazette.
kthomas@postmedia.com
twitter.com/katelynthomas
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