Just over one month ago, amid a lull in Quebec’s COVID-19 infection rates, the province’s leading public health official, Dr. Horacio Arruda, used a colourful metaphor to describe the threat posed by more contagious variants of the virus.
“We are right now in a period of calm seas,” he said. “But underneath there are sharks, and those sharks are the variants.”
Despite the warning, the government decided to authorize swimming in these shark-infested waters.
In the ensuing weeks, rules were relaxed across much of the province. The Quebec City area and the Outaouais were among the regions reclassified as orange zones. Restaurant dining rooms and gyms were reopened. There was hope in the air.
Even in Montreal — a perennial trouble spot — extracurricular school activities and large religious gatherings were permitted again. Older high-school students were told to go back to full-time, in-person classes.
But on Tuesday, Premier François Legault played the role of Chief Brody in the movie Jaws. Get out of the water, he told the province.
At a news conference in Montreal, he announced he was cancelling the small freedoms recently granted to residents of the greater Montreal area: gyms will close, extracurriculars will stop, religious services will be capped at 25 people max.
Last week, he announced a series of harsher measures for the Quebec City area and the Outaouais, where cases have grown at exponential rates.
Controlling the variants
Epidemiologists and other health experts had warned the government in March it was making a high-odds bet by lifting measures even though the variants were clearly gaining ground.
The normally staid public health research institute the INSPQ said bluntly on March 26 that the provincial measures in place “were insufficient to control the variants.”
But Arruda, Legault and Health Minister Christian Dubé — le trio, as the francophone press calls them — insisted the moves were justified because hospitalizations were continuing to decrease at the same time as elderly Quebecers were being vaccinated.
In an interview with La Presse last week, Arruda spelled out, with surprising candour, the province’s strategy to a younger journalist.
“If I have 2,000 [new] cases [a day] in Quebec, but we don’t have significant hospitalizations or deaths, we can live with that,” he said.
“Because older people are protected, we will, of course, have people your age who will find themselves in intensive care and die, which is horrible. But is it better if you close everything, and people break the rules in secret?”
Avoiding Ontario’s fate
At the moment, Quebec is averaging 1,200 cases per day, and so far, hospitalizations haven’t returned to the critical levels seen around Christmas.
Legault said Tuesday he hoped by taking action now, before hospitalizations rise quickly, he can avoid the situation facing Ontario, where intensive care units are hitting capacity and many schools are set to close to in-person learning again.
“It’s a matter of days, or at most, weeks,” he said, before Quebec’s hospital numbers begin to tick upward.
The new measures announced Tuesday, along with those introduced last week, bring more coherence to the government’s message. The added restrictions reflect the danger of a virus that has been turbo-charged by variants.
“It was the right thing to do. We needed to be more proactive,” said Dr. Cécile Tremblay, an infectious disease specialist at the Université de Montréal health centre, following Legault’s announcement.
“The models showed we risked having an exponential growth in cases if we kept the measures as they were before.”
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But the abrupt pivot — from downplaying the dangers of the third wave to re-imposing lockdown measures — has exposed the government to criticism that its public health approach is haphazard. And there are signs its credibility has been damaged.
On the one hand, the government faced protests last week in several Montreal-area schools where students and parents wanted more, not fewer, public health measures in place.
On the other hand, its flip-flop caused whiplash, bitterness and confusion in and around Quebec City. Over the weekend, police there received more than double their usual number of calls about illegal gatherings.
The new rules
Legault wouldn’t admit he had made a mistake by lifting measures last month. “We won’t stop ourselves from providing freedom when we’re able to do so, or closing things again when it’s necessary,” he said.
Throughout the pandemic, the premier has made clear the government’s priority is protecting the health-care network, as opposed to eliminating the virus outright (which was the stated goal of the Atlantic provinces, for example).
Arruda’s comments to La Presse last week only made it apparent what the trade-offs are.
It is a bargain the public has found reasonable to date. Freedom was maximized for the least vulnerable — school-aged children — and progressively reduced for the most vulnerable, especially the elderly.
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Some in long-term care homes were effectively confined to their rooms for months on end as the virus circulated widely in the community. In turn, they were first up when vaccines became available.
But the more contagious variants of COVID-19 have upended the terms of the bargain. The old methods for containing transmission are no longer enough to prevent the virus from spreading like wildfire, and vaccines can’t be rolled out fast enough to prevent younger people from ending up in hospital.
With the measures announced over the last week, the Legault government signalled it is no longer just talking about these new realities of the pandemic — it has started to adjust to them as well.