Photo: Marie-France Coallier The Duty
A woman has donned gloves and a mask to take the bus to Parc – Extension.
The transmission of community is amplified in the metropolis. Every day between 200 and 300 new cases of COVID-19 associated with the transmission in “open environment or unknown” on the island of Montreal these last few days, while the average for the month of April was approximately 175. Conversely, the transmission in NURSING homes, hospitals and among health care workers is declining. These values obviously depend on the rate of screening in their evolution, for each of the groups.
For the first time Wednesday, the regional Directorate of public health (DRSP) of Montréal made public a detailed report of the epidemic of coronavirus in its territory. We distinguish between cases depending on the context of exposure : in a closed setting (hospitals, CHSLDS, intermediate resources, private residences for seniors, rehabilitation centre), in the open or unknown, or among employees of the health.
Since may 3, the majority of the cases are from a transmission in an open environment, or unknown. Thus, despite the confinement to the home of a good portion of the population, most of the cases newly-identified COVID-19 result of exposure at home, at the grocery store, in the street, or elsewhere in society.
The number of new cases arising of a transmission in a closed setting is in decline since the beginning of the month. In April, there were, on average, approximately 160 new cases per day associated with this type of transmission. For the last week appearing in the balance of the DRSP (from 5 to 11 may), the daily average is closer to 100. Among the health workers, the number of cases detected each day has increased from an average of 95, in April, to less than fifty.
How do you explain the increase in the number of cases related to exposure in community ? According to the press officer of the executive committee of Montreal, Laurence Houde-Roy, the increase in the number of screening tests for the past week, particularly thanks to the mobile clinics, would be part of the reasons.
“It is certain that the transmission of community in the neighborhoods we are concerned with,” she says in a written response. That is why we are distributing masks in the neighborhoods and want to help [governments ‘ financial] in this sense. We also want to continue to exercise caution regarding the process of déconfinement. “
The dashboard on the evolution of the coronavirus in Quebec, in Canada and in the world
In the report of the DRSP, we can see an increase in the transmission in a community of Montréal-Nord and Rivière-des-Prairies–Pointe-aux-Trembles — which are the two boroughs with the largest number of cases of COVID-19 per 100 000 inhabitants. The transmission in the health care workforce is also considerable. Respectively, 24 % and 27 % of positive diagnosis involve the caregivers in these two boroughs, whereas this rate is 19 % for the entire island.
According to the epidemiologist, Nimâ Machouf, the increase in the transmission of community in these districts as elsewhere, is surely of outbreaks in medical settings.
“The epidemic community, it is the result of the CHSLD. The transmission belt, it is the workers health. It is the same epidemic. An employee of the health can contaminate a close, and if he works at the grocery store, people will be exposed, ” she said.
Dr. Machouf believes that the increase in the transmission community comes with a few weeks of lag compared to the health system. And if the transmission in a closed environment decreases, this is because many residents of NURSING homes have been tested and that the measures applied in those homes ” are good “.
More widely in the community, ” there is too much transmission is done yet “, she believes.
“We really need a big push, test, many people detect as soon as possible all the positive cases, and confine them to the house,” adds this specialist in public health. With 2003 deaths as of Monday night, more than 960 per 100 000 inhabitants, the island of Montreal is one of the cities most affected in the world by the pandemic.
Even if the re-opening of certain businesses is scheduled for may 25 in the metropolis, a new report seems likely.
“If the situation does not improve, we will not re-open. Therefore, we need to see an improvement “, said on Wednesday the prime minister, François Legault, during the daily press conference. For the first time since the beginning of the crisis, he will be coming to Montreal on Thursday and Friday. He must meet with the mayor of Montreal, Valerie Plant, and the public Health authorities.
Type of transmission
The middle of likely exposure of the case of COVID-19 is not part of the data made public on a daily basis by the national Institute of public health of Quebec. Until recently, the public health Agency of Canada (PHAC) gave this information in his review of the epidemiological daily, but this is no longer the case now. The vast majority of cases contained in this balance sheet, at the end of April, however, were of unknown origin.
In Ontario, the chief medical officer of health, David Williams, said last week that 55 % of new cases were related to forms of transmission in the community, and that the rest originated from nursing homes for seniors.
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