After 100 days of fight against the COVID-19, where is Quebec?

Après 100 jours de luttre contre la COVID-19, où se situe le Québec?

Photo: Valérian Mazataud The Duty
There is a very large concentration of NURSING homes and retirement homes on the islands of Montréal and Laval, where the epidemic has hit hardest. Daphnee Phillips, a resident of the neighborhood, lays a wreath of flowers in front of the CHSLD Heron in Dorval.

It is in the long term that will win the war, but the battle of the first 100 days of the health emergency puts Québec in an unenviable position in the ranking world in the fight against the pandemic.

After more than three months, the mortality rate per million inhabitants is always the Quebec summit of the pyramid of the developed countries, where the disease, all proportions kept, has claimed the most lives.

Quebec has succeeded in its goal first, the one to iron out the famous curve, an image that became viral last April, thanks to the vigorous demonstrations of the gestural of the national director of public health, Dr. Horacio Arruda. At the same time, countries such as Italy, Spain, the United Kingdom, and later the State of New York lived a roller-coaster ride, with scenes of heart-wrenching from the emergency overrun.

But after 100 days, the death toll counted among the population of Québec has just tarnish his overall performance, with a more black than many other countries.

With a cumulative rate of mortality of 614 deaths per million inhabitants in the 14 June, in Québec, is more has now been surpassed by Belgium (837 deaths per million) and is leaving behind States where we had cried out the blaze such as Spain (580) Italy (570) or France (453). The balance sheet quebec is far heavier than that of Sweden (500), one of the few countries not to have applied any containment is strict, and is much heavier than that of the United States (362), despite the disaster experienced in New York.

“We can always say that it is not worse than other countries, because some of them do perhaps not all deaths, which is true. But even bulking up the figures of mortality of certain countries of 25 %, it remains in the head of the pack, ” says Robert Choinière, demographer and former chief of scientific affairs at the Institut national de santé publique du Québec (INSPQ). France has revised the data since April to add all the deaths occurring in long-term care facilities (the equivalent of our NURSING homes) and at home, ” adds the expert, at the origin of a site, comparing the data from Quebec’s health to those of OECD countries.

 

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For an equivalent population in Quebec (about 8 million inhabitants), countries such as Switzerland (1956 deaths), Austria (688 people), or Israel (300 deaths) are much less deaths than the province of Quebec (more than 5340 people), note the demographer. “Our figures are higher than countries like Portugal or Greece,” says Mr. Choinière. Two countries that are home to a higher proportion of seniors than the province of Quebec.

The crisis of the CHSLD

Without the outbreak lived in NURSING homes, Quebec would have been champion in its management of the pandemic, were defended this week in their balance sheets, the prime minister François Legault and Dr. Horacio Arruda.

Indeed, without this, the balance sheet would have been different, ” insists Mr. Choinière. Nevertheless, even after the death in a CHSLD striped of its balance sheet total, the Quebec reportedly said at June 14, a cumulative rate of 218 deaths per million inhabitants, a table worse than Ontario (175 deaths per million), Portugal, Germany, Denmark or Austria. But it would compare favourably with the Swiss, and would have done better than Ireland, the netherlands and the United States.

“But this is a non-sense to say that, since NURSING homes are part of our population, and it is the case elsewhere also. One can always claim that the systems are different, but if you look at just the Canada, with similar systems, we see that the gap is huge with other provinces, including British Columbia, which was struck earlier, ” says the demographer.

The current situation

In recent weeks, the demographer, has added new players to its comparative graphs, including Belgium and the State of New York, because there was ” more countries where the situation was comparable in Quebec.”

“Now, we must compare the us States to find comparable. It seems to follow more the curve of the States of the american northeast, ” he says.

Even if the epidemic is experiencing a lull since may, and that the number of new cases and deaths declined (all the same 132 last week), the mortality rate in the eyes of the population continues to be higher in Quebec than in Europe, except the Uk and Sweden.

An urban epidemic

Everywhere, the COVID first hit the dense cities and the metropolitan region of Montréal has not been spared. A reality that has to say to health authorities that there were two realities in Quebec, an epidemic, active in Montreal, and a quasi-lull in the regions.

However, if one compares the health region of Montreal and Laval to those of other cities, the portrait is not more glorious. With a cumulative rate of 1539 deaths per million inhabitants, the metropolis of Quebec does not compare for a moment that the Lombardy (the rate of 1631 deaths/million), the Italian region encompassing the city of Milan that has become the epicenter of the pandemic in Italy.

In comparison, Toronto, the largest city in Canada, has a rate four times lower, with 352 deaths/million.

“In America, if we compare Montreal to cities of the same size as Chicago, or even Boston, we had more mortality. In Paris or London which are cities much more dense, there were more than two times less mortality, ” says the demographer.

A situation that can be explained because of the very large concentration of NURSING homes and residences for seniors on the island of Montréal and Laval, where the epidemic has hit hardest. Hard to say if the proportion of living environments for seniors is also high in these other urban areas. For the moment, the city of New York remains the sad champion of all the cities, with a rate of 2622 deaths of the COVID per million inhabitants.

And the future ?

According to Dr. Marie-France Raynault, professor emeritus of public health at the University of Montreal, the Quebec situation is “under control” at the present time. The famous reproductive rate of the virus (R0), the number of infections generated by a person, was 0.9. “The event of ten days ago (Black Lives Matter) gave us cold sweats, but it seems since there is no resurgence of the case to date. It was reported less than an infection by a new case, so I am optimistic. And until now, the déconfinement gave reason for optimistic ! “

Data INSPQ, Worldometers. info, Ourworldindata.com Johns Hopkins University,

Comparisons-sante-quebec.ca

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