La santé

COVID updates, April 15: Montrealers urged to avoid swamped hospital ERs – Montreal Gazette

Health officials offer advice on reducing risk at holiday gatherings amid sixth wave.

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Updated throughout the day on Friday, April 15. Questions/comments: ariga@postmedia.com

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Top updates

  • Montrealers urged to avoid swamped hospital ERs
  • Tough two weeks ahead for Quebec ERs dealing with COVID-19, influenza, sick staff
  • Coronavirus persisting in feces offers clues to the cause of long COVID
  • Health officials offer advice on reducing risk at holiday gatherings amid sixth wave
  • Note: Updated COVID numbers are not available
  • Beware of pandemic fatigue – the BA.2 sub-variant remains dangerous, experts say
  • Quebec saw a ‘significant’ increase in cases last week, CIRANO research centre estimates
  • Aislin: Navigating the sixth wave
  • Ontario’s top doctor to recommend extending mask mandate for hospitals, transit
  • Regulations have ended, but many Montreal students still wear masks in class
  • ‘Parents need to be informed’: Montreal mother warns of rare post-COVID syndrome
  • Canada’s greenhouse gas emissions fell during first year of pandemic
  • Long COVID: The invisible public health crisis fuelling labour shortages
  • Shanghai turns residences into COVID isolation facilities, sparking protest
  • Quebec COVID guide: Vaccinations, testing
  • Sign up for our free nightly coronavirus newsletter

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4 p.m.

Thanks for reading

Note that our blog and newsletter will not be published on Monday due to the holiday.

But both will return on Tuesday. One of my colleagues will be taking over as I’ll be off on Tuesday and Wednesday

You can follow all our coverage via the coronavirus page.

My previous COVID-19 live blogs are available here.


3:35 p.m.

Montrealers urged to avoid swamped hospital ERs

Quebec did not publish updated statistics about the COVID-19 situation in the province today because of the Easter holiday.

However, there was fresh evidence that the pandemic continues to wreak havoc in the province’s hospitals.

This morning, Montreal’s public health department urged residents to avoid hospital emergency rooms because they are swamped.

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Hours later, health authorities in the Outaouais region in western Quebec suspended all visits to hospitals until further notice as several health institutions in the region deal with outbreaks of COVID-19.

The news comes a day after Health Minister Christian Dubé said the next two weeks will be difficult in the province’s emergency rooms.

Many people who live in seniors’ residences are expected to go to ERs in the coming days due to COVID, the flu or other reasons.

“Often these people if they are sick we are unable to send them back to residences right away so it causes overcrowding,” Dubé said.

Hospitals are also struggling because 13,000 health workers are absent due to COVID

In a notice posted online today, the Centre intégré de santé et de services sociaux de l’Outaouais said it pausing visits “to ensure the protection of our most vulnerable users, health care workers and the population.”

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It said caregivers will be able to continue to visit loved ones to assist them. Visits for humanitarian reasons also remain possible. However, caregivers and people who want to visit for humanitarian reasons cannot enter hospitals if they have symptoms, the health authority said.

These are the hospitals affected:

  • Hôpital de Gatineau
  • Hôpital de Hull
  • Hôpital de Papineau
  • Hôpital de Maniwaki
  • Hôpital de Shawville
  • Hôpital de Wakefield
  • Hôpital Pierre-Janet

On Thursday, the head of Quebec’s emergency medicine doctors association warned that the next two weeks will be difficult.

Hospitals are dealing with a “perfect storm” of issues – influxes of COVID and influenza patients in the midst of a severe labour shortage, Association des specialistes en medecine d’urgence president Dr. Gilbert Boucher told The Canadian Press.

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“For two or three weeks now, there has been a lot more viruses,” he said. “(Gastroenteritis) has been around for four to six weeks, the influenza is hitting us a little bit, but there are a lot of little viruses right now.”

He said “it’s kind of a perfect storm – we haven’t seen those volumes of patients for almost two years… It’s very difficult and the next two weeks are going to be fairly tough.”

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2:50 p.m.

Chinese truckers left stranded for days at highway exit by hardline COVID curbs

From the Reuters news agency:

Earlier this month Chinese truck driver Dong Zhigang finished a job in the coastal city of Nantong and began what should have been a four-hour journey north to his home village in Lianyungang, Jiangsu province. On Friday, nine sticky days in his cab later, he still had not made it home.

Like many Chinese truckers, Dong, 30, had fallen victim to some of the country’s recent hardline anti-COVID measures and disruption as local authorities scramble to maintain China’s zero-COVID policy.

He got as far as a highway exit leading to his village before he was told by officials that to enter he would need to do 14 days of centralized quarantine costing at least 240 RMB per day followed by a further seven days of home quarantine.

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“We could not afford this,” the father-of-two told Reuters, referring to the group of four to five truckers he waited with.

Dong had a negative COVID test result that day and had not been to any medium or high-risk areas. But the officials were in no mood for discussion.

He said he was told: “I don’t care where you have come from.”

Locals provided the drivers with two takeaway meals a day but there were no toilet or shower facilities.

On Thursday evening a group of over a dozen police in riot gear including several SWAT officers told Dong and his fellow drivers that they had to leave their spot immediately or they would be fined and would lose their driving licenses.

The officers said they did not care where the drivers went, according to Dong. So the group acquiesced and moved to another exit further up the highway.

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Later, a village official contacted the group and said they could count their days parked by the highway towards their 14 days in centralized quarantine, thus greatly reducing their costs.

Dong, desperate to get home to complete urgent work on the farm, agreed to go, and on Friday he was waiting to enter quarantine. But at least one member of the group, surnamed Wang, told Reuters he would stay put.

Hundreds of toll stations at exits from highways and highway service stations have been shut across the country this month, official data has shown.

“I’d drive for seven or eight hours without a break,” Dong said. “There was nowhere to get off the highway.”

After a government push earlier this week to open up routes, this number has dropped in many areas. But as of midnight on Thursday, 91 toll station highway exits and 44 highway service stations in Jiangsu province remained closed, government data showed.

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Jiangsu’s government did not immediately respond to a Reuters request for comment on this or on Dong’s long wait.

While COVID-related requirements vary widely across China, many localities have been taking increasingly cautious approaches recently.

Dong said that his order numbers and earnings had dropped by half since the start of March due to the impact of the COVID policies he had encountered.


1:10 p.m.

Coronavirus persisting in feces offers clues to the cause of long COVID

From the Bloomberg news agency:

COVID-19 patients can harbour the coronavirus in their feces for months after infection, researchers found, stoking concern that its persistence can aggravate the immune system and cause long COVID symptoms.

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In the largest study tracking SARS-CoV-2 RNA in feces and COVID symptoms, scientists at California’s Stanford University found that about half of infected patients shed traces of the virus in their waste in the week after infection and almost 4 per cent of patients still emit them seven months later.

The researchers also linked coronavirus RNA in feces to gastric upsets and concluded that SARS-CoV-2 likely directly infects the gastrointestinal tract, where it may hide.

“It raises the question that ongoing infections in hidden parts of the body may be important for long COVID,” said Ami Bhatt, a senior author of the study published online Tuesday in the journal Med, and an associate professor of medicine and genetics at Stanford.

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The lingering virus might directly invade cells and damage tissues or produce proteins that are provoking the immune system, she said in an interview.

No one knows yet what causes the constellation of post-COVID symptoms, often termed long COVID, that afflict from 5 per cent to 80 per cent of people after a SARS-CoV-2 infection.

At least four different biological mechanisms may lead to distinct conditions or subtypes of long Covid, said Akiko Iwasaki, a professor of immunobiology and molecular, cellular, and developmental biology at Yale University.

“Long COVID is likely multiple different diseases,” Iwasaki said last week in an interview in her lab in New Haven, Connecticut. In one of these forms, persistent SARS-CoV-2 may trigger a damaging immune response that leads to ailments that could be quelled with drugs that target the virus, she said.

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“I have heard anecdotally of people recovering from long COVID after antivirals or monoclonals,” said Iwasaki, who wants to collaborate on clinical studies of potential therapies. “I’m really excited at the possibility of testing direct antivirals and monoclonal antibodies” against long COVID, she said.


12:30 p.m.

Health officials offer advice on reducing risk at holiday gatherings amid sixth wave

Amid the sixth wave of COVID-19, Quebec is seeing a rise in cases and hospitalization that is not expected to abate for at least two weeks.

With Easter, Passover, Ramadan and the Indian festival of Vaisakhi, to name a few, April is a month of religious observance and a time for people to gather, celebrate and feast.

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René Bruemmer looked at how Quebecers can reduce their risks at holiday gatherings.

Here’s what’s open and closed on the long weekend in Montreal

Health Canada is promoting a pandemic “risk calculator” that helps people make informed decisions about getting together with others.

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The federal health department notes that in higher-risk situations Canadians can run “kitchen or bathroom exhaust fans continuously at low speed and with open windows to improve ventilation” in homes.

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The Quebec government has published a guide to “living with the virus,” focusing on symptoms, self-isolation, masks and vaccination.


11:25 a.m

Note: Updated COVID numbers not available

Note that updated statistics about the pandemic situation in Quebec are not available.


11:20 a.m.

Beware of pandemic fatigue – the BA.2 sub-variant remains dangerous, experts say

From La Presse Canadienne:

Despite the public’s weariness over health measures and oft-repeated advice about protection measures, the BA.2 sub-variant poses a very real threat that must “absolutely” be taken seriously, experts warn.

“BA.2 is a significant health risk, in the same way as BA.1 was a few months ago” when thousands died in Canada, warns CoVaRR-Net, a network of interdisciplinary researchers that helps the federal government develop strategies to address the threat posed by new and emerging variants of SARS-CoV-2.

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BA.2 is highly transmissible (more than BA.1, the first sub-variant of Omicron, dominant from December to February) because it can infect and spread more easily in our cells.

Due to this high transmissibility and rapid spread, which is occurring as public health measures are being reduced, the CoVaRR-Net website reads, “BA.2 is fueling the sixth wave of the pandemic and increasing both the risks to the health of Canadians and the need to take thoughtful and appropriate protective measures.”

Although one may have the impression that the BA.1 and BA.2 subvariants are more benign than the Delta variant and that the health risks associated with COVID-19 are decreasing or have passed, CoVaRR-Net notes: “BA.2 remains a serious threat that causes serious illness, hospitalizations and deaths among Canadians every day.”

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“I think there is a weariness with COVID and people underestimate the impact BA.2 can have on health,” said Denis Leclerc, a virologist from Quebec City’s Centre de recherche du CHU de Québec, a member of CoVaRR-Net.

The usual instructions remain in place over the Easter long weekend, when many family gatherings will take place, Leclerc said.

The vaccines we currently have to fight COVID-19 will never be able to eradicate it since they train the immune system to recognize the now-famous spike protein on its surface, experts say.

It is this protein that mutates and gives the virus its new identities, allowing it to at least partially escape counterattacks.

To be able to hope to defeat the virus once and for all, we must change our strategy, Leclerc said.

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“We absolutely have to start thinking about the emergence of new vaccines that will be better suited to the strains that are circulating now, a bit like we do with the flu virus,” he said.

To protect people, the flu vaccine contains four different strains of the flu virus. Scientists will have to think about developing vaccines that will contain several different proteins to be sure to give people a broader spectrum of protection against coronaviruses.

It is with this in mind that Leclerc and his colleagues are working on the development of a vaccine that would teach the immune system to recognize a protein called nucleocapsid.

Without this protein, the researcher explained, the coronavirus would be unable to replicate. It is therefore unthinkable, in an evolutionary and survival context, for this protein to end up mutating.

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The vaccine from the Quebec company Medicago – which was approved in Canada but rejected by the World Health Organization because of the company’s link to the tobacco company Philip Morris – partly targets the nucleocapsid.

“It will give us vaccines that will provide protection against all the strains that may emerge, said Leclerc said. “There’s a lot of proof of concept (…) on the use of nucleocapsids in vaccination, but it’s not something that has been commercialized or used on a large scale in humans.

However, he added, “It is an approach that is really worth exploiting because, in the end, this is what would get us out of this pandemic.”


10:20 a.m.

Quebec saw ‘significant’ increase in cases last week, CIRANO research centre says

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The CIRANO research centre, which has released weekly estimates of case numbers in Quebec since PCR testing was restricted, today said there was a “statistically significant” jump in infections last week.

You can read the report here.

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10 a.m.

Aislin: Navigating the sixth wave

Aislin, April 16, 2022
Aislin, April 16, 2022 Photo by Aislin /Montreal Gazette

9:50 a.m.

Ontario’s top doctor to recommend extending mask mandate for hospitals, transit

From The Canadian Press:

Ontario’s chief medical officer of health will recommend that the province extend remaining mask mandates — in settings such as hospitals, long-term care and public transit — as new COVID-19 modelling suggests a tenuous plateau in transmission.

Dr. Kieran Moore will be submitting that proposal to the government, for a four-week extension beyond the current expiry date of April 27, he told The Canadian Press in an interview Thursday.

“I think that will get us down the epidemic curve to further protect those that are living and working in those vulnerable sectors,” he said.

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His office is also able to further extend that mandate, even during the upcoming election period, if need be, Moore said.

Premier Doug Ford said earlier in the day that he would have “no problem” extending the remaining mask mandates beyond the end of the month if that is Moore’s recommendation.

The comments came as Ontario’s COVID-19 Science Advisory Table shared its latest modelling, noting that the province is “well into wave six of the pandemic” spurred by the infectious BA.2 Omicron subvariant, waning immunity and the lifting of most public health measures.

Wastewater signals suggest COVID-19 transmission may have peaked in Ontario, but the advisers said it’s unclear if the apparent crest will be followed by an increase, a decrease or a continued plateau after the long weekend.

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Science table member Dr. Fahad Razak, an internist in Toronto, described the recent plateau as a “significant period of uncertainty” in the trajectory of the sixth wave, which he said “didn’t have to get this high” if protections like masks were still in place.

“We feel highly uncertain that we are at the peak. It’s possible, but we’ll know a lot more within a week,” he said.

Razak said at the moment, around 100,000 people appear to be acquiring new infections every day. He recommended people limit gatherings, meet outdoors if possible and consider high-risk individuals as they head into the long weekend, which has the potential to accelerate spread if many people gather indoors without masks.

“Please be cautious, because even if we are at the peak right now of the sixth wave, it’s a very high peak. Getting us to a downward trajectory as fast as possible has value and we may very well rise after this weekend again,” he said.

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The new modelling suggests hospitalizations and ICU admissions will continue rising, with timing and height of the peak uncertain. But the group noted that it’s unlikely they will reach levels seen earlier this year during the fifth wave.

Estimates for hospital occupancy range from just over 2,500 hospitalized patients to around 4,000, possibly peaking in the middle of May.

As for ICU occupancy, the group presented a range of scenarios from around 375 people in intensive care due to the virus or close to 650 people.


9:40 a.m.

Regulations have ended, but many Montreal students still wear masks in class

Amid a rising COVID-19 case count, the situation on masking in Montreal-area classrooms remains very much a mixed bag. The Quebec government dropped its mandatory mask regulations for elementary and high school classrooms as of March 7 in most regions, but many students are continuing to wear them.

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In some schools, however, it appears parents and their children have adopted a fatalistic attitude in the face of a dogged sixth wave.

Read our full story, by René Bruemmer.


9:40 a.m.

‘Parents need to be informed’: Montreal mother warns of rare post-COVID syndrome

Stephanie Peillon’s daughter Rebecca was hospitalized for six weeks last year. Doctors believed she was most likely suffering from a rare post-COVID condition called multisystem inflammatory syndrome in children (MIS-C).
Stephanie Peillon’s daughter Rebecca was hospitalized for six weeks last year. Doctors believed she was most likely suffering from a rare post-COVID condition called multisystem inflammatory syndrome in children (MIS-C). Photo by John Mahoney /Montreal Gazette

A year ago this week, Stephanie Peillon’s daughter was finally discharged from the hospital after a six-week stay and two stints in intensive care.

Though she never tested positive for COVID-19, doctors believed Rebecca, then 12 years old, was most likely suffering from a rare, post-COVID syndrome called multisystem inflammatory syndrome in children.

Ever since, Peillon has urged the Quebec government to raise awareness about the syndrome and warn the public about its risks. Yet, despite nearly a year of letters and phone calls, she has made little progress.

Read our full story, by Jesse Feith.


9:40 a.m.

Canada’s greenhouse gas emissions fell during first year of pandemic

Canada’s greenhouse gas emissions plummeted to their lowest level in almost three decades in 2020 as pandemic restrictions kept cars off the road and grounded airplanes for months on end.

Read our full story.


9:40 a.m.

Long COVID: The invisible public health crisis fuelling labour shortages

Long COVID is a disaster in the making for businesses and economies, potentially sidelining significant numbers of people when employers are already struggling to hire

Read our full story.


9:40 a.m.

Shanghai turns residences into COVID isolation facilities, sparking protest

Police officers wearing hazmat suits detain a man, as residents protest over neighbouring residential compounds being turned into COVID-19 isolation facilities, in Pudong, Shanghai, China, in this screen grab from a video reported to be April 14, 2022.
Police officers wearing hazmat suits detain a man, as residents protest over neighbouring residential compounds being turned into COVID-19 isolation facilities, in Pudong, Shanghai, China, in this screen grab from a video reported to be April 14, 2022. Photo by VIDEO OBTAINED BY REUTERS /via REUTERS

Shanghai is converting residential buildings into quarantine centers to house a mounting number of COVID-19 cases, but the move is sparking anger and protest from neighbors worried they are being put at increased risk of infection.

Read our full story.


9:15 a.m.

Quebec COVID guide: Vaccinations, testing

Vaccinations

Testing


8:30 a.m.

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ariga@postmedia.com

Read my previous live blogs here.


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