#COVID-19: Comparing provinces with other countries 21 October Update

Apart from overall large increases in infections in most jurisdictions, and corresponding increases in death rates in some, overall country and jurisdiction ranking largely unchanged.

Deaths per million: no change
 
Infections per million: Sweden now higher than UK (so much for herd immunity), Japan ahead of Atlantic Canada
 
Weekly:
 
 

#COVID-19: Comparing provinces with other countries 14 October Update

No changes in relative ranking as overall rate of infections climbs in most jurisdictions:

Weekly:
 
 

#COVID-19: Comparing provinces with other countries 7 October Update

Highlights:

Deaths per million: USA now ahead of UK

Infections per million: France and Quebec ahead of Sweden, Japan ahead of Atlantic Canada

Weekly:
 
 

#COVID-19: Comparing provinces with other countries 30 September Update

Highlights:

Deaths per million:Canada less Quebec now ahead of Germany

Infections per million: Ontario now ahead of Germany, Canada less Quebec ahead of Philippines

Weekly:

Monthly Comparison (September 2-30 increase percent):
Infections: British Columbia and Prairies in top 5 jurisdictions with highest increases
Deaths: No provinces in top 5 in terms of increased death rates but British Columbia, Alberta and Prairies in top 10
The Globe has an editorial highly critical of the Ford government:

The German language probably has a word for the state of being surprised by the unsurprising, unprepared for the expected, and caught off guard by the danger you were on guard against. English does not have such a word. But when this pandemic is over, we are going to have to come up with one.

We’ll need it to describe what appears to be happening right now, in Canada.

Governments from coast to coast knew a second wave was coming. It was as predictable as fall. It was as expected as the rising of the sun. It was as surprising as the first snowfall – timing and severity uncertain; occurrence inevitable.

And yet, somehow, many governments have reacted like someone who forgot to set the alarm clock. Leading the parade of those surprised by the unsurprising is Premier Doug Ford’s Ontario government.

On Monday, Ontario reported 700 new cases of COVID-19, a new single-day record. Also on Monday, Ontario casinos reopened their doors to gamblers.

They say timing is everything in comedy and politics. In pandemics, too.

Also on Monday, the Ford government announced that, in response to the second wave, it would be hiring 3,700 more frontline health care workers. It’s a move that should have been made in May or June, not late September.

Still on Monday: Ontario reported processing more than 41,000 tests, but had a backlog of 49,586 waiting to be analyzed. By Tuesday, the backlog was nearly 55,000. The province, like many parts of the country, has recently seen enormous lineups at testing centres; lineups that are – how is this surprising? – driven by the predictable and predicted combination of rising infection rates and people needing to get tested to allow a safe return to school.

Yet again on Monday: The Ottawa Citizen obtained a memo showing that provincial health bureaucrats ordered a reduction in testing in some areas, owing to labs being overwhelmed. It’s another unsurprising result of too little test-processing capacity meeting growing demand for tests.

As of Tuesday afternoon, the pinned tweet at the top of Health Minister Christine Elliott’s Twitter feed still said: “It’s never been more important to get tested for #COVID19.” She’s right. The more people who get tested, the more often, the better. That should include lots of people who have no symptoms. But if everyone takes that advice to heart in the current system, where there are not enough tests or facilities to process them, Grade 3 math points to the inevitability of a surprisingly unsurprising outcome.

For anyone who remembers what Ontario went through last spring, that outcome looks all too familiar. We have lived this movie before.

Yes, Ontario is conducting several times more daily tests than it did back in April. Yes, Ontario has the second-highest provincial testing rate (Alberta is tops). There has been progress. There just hasn’t been enough.

With case numbers rising, as in the spring, and testing not keeping pace, as in the spring, this looks a lot like a sequel. The script has a disturbing amount of consistency. If it were run through plagiarism-detection software, someone would be getting an “F.”

More unsurprisingly surprising findings:

The most recent data from Toronto Public Health, as reported by the CBC, show that most people testing for COVID-19 don’t get results for at least two days. And nearly half of those who test positive are not followed up by contact tracers within 24 hours. Both of those numbers are well below the targets that need to be met for a program of heavy testing and contact tracing – which the province is supposed to have, but doesn’t – to be able to quickly find infected people before they infect others, and even more quickly track down anyone they may have infected.

In an effort to speed things up, the Ford government last week gave the green light for some pharmacies to begin administering tests to some asymptomatic individuals. The province also intends to hire more contact tracers. The mystery is why it didn’t do that months ago.

And last week, the province began rolling out plans for its response to the pandemic’s second wave. But this is like announcing in January that, in response to recent snowfalls, you plan to put out a tender for snowplows. It’s a bit late in the game.

And CBC has an analysis of what went wrong in Quebec:

A little over a month ago, Health Minister Christian Dubé congratulated Quebecers for their hard work at containing the spread of the coronavirus.

It was a Tuesday, Aug. 25, and the province had registered just 94 new cases of COVID-19 in the previous 24 hours.

“We have really succeeded at controlling the transmission of COVID,” Dubé said at a news conference in Montreal.

It was a statement of fact, but the ground had already started to shift. In the weeks that followed, transmission increased. At first it grew slowly, then exponentially.

On Monday, the government implicitly acknowledged it has again lost control of the virus. The province is reimposing lockdown measures on Quebec’s two biggest cities, starting Oct. 1.

Until Oct. 28, Quebecers won’t be able to entertain friends or families at home. Bars, restaurant dining rooms, theatres and cinemas will also be closed.

“The situation has become critical,” Premier François Legault said Monday evening. “If we don’t want our hospitals to be submerged, if we want to limit the number of deaths, we must take strong action.”

The new measures will bring abrupt changes to the lives of millions of Quebecers. They will also prompt questions about how the public health situation could have deteriorated so quickly.

This story tries to trace how Quebec again lost control of the spread of COVID-19.

At first, a stern warning

As Dubé addressed reporters on that Tuesday in late August, public health officials in Quebec City were busy trying to track down patrons of Bar Kirouac, a watering hole in the working-class Saint-Sauveur neighbourhood.

A karaoke night at the bar ultimately led to 72 cases and the activity being banned in the province.

There were also numerous reports by then of young people holding massive house parties and flouting physical distancing recommendations. One of them, in Laval, led to a small outbreak.

On Aug. 31, as Quebec’s daily average of new cases neared 152 cases, Legault delivered a stern warning.

“There has been a general slackening in Quebec,” Legault said. “It’s important to exercise more discipline.”

Legault and his health minister threatened stiffer punishments for those who disobeyed public-health rules, but stopped short of imposing new restrictions.

Private gatherings identified as the culprit

In late August, public health officials were attributing the rise in infections to Quebecers returning home from vacations around the province, as opposed to the start of school.

Though Quebec’s back-to-school plan wasn’t met with widespread criticism, some experts expressed concern about the large class sizes and the lack of physical distancing guidelines for students.

The government also ignored advice that it should make masks mandatory inside the classroom.

But the first weeks of the school year went relatively smoothly. By the start of Labour Day weekend, only 46 out of the province’s 3,100 schools had reported a case of COVID-19. Importantly, there were no major outbreaks.

The problem was elsewhere. Outside schools, in the community at large, cases continued to rise. On Sept. 8, the province was averaging 228 cases per day.

By now public health officials had identified private gatherings as the main culprit behind the increase.Montreal’s regional director of public health, Dr. Mylène Drouin, was among those who urged more caution when hanging out with friends and family.

“Yes, we can have social activities, but we have to reduce contacts to be able to reduce secondary transmission,” Drouin said on Sept. 9.

Warning signs

In an effort to spell out the consequences of the increase in cases, the Quebec government unveiled a series of colour-coded alert levels.

Areas coded green would see few restrictions; yellow zones would see more enforcement of existing rules; orange zones would be the target of added restrictions; and red zones would see more widespread closures of non-essential activities.

When the scheme was announced on Sept. 8, Quebec City was classified yellow. Montreal was classified green.

At this point, though, health experts were already concerned that more was needed to curb the spread of the virus.”It is important to intensify these measures,” Dr. Cécile Tremblay, an infectious disease specialist with the Université de Montréal hospital network, said after the alert levels were announced.

The warning signs were starting to multiply.

Officials in Montreal were investigating 20 outbreaks at workplaces on Sept. 9; a week later that number had risen to 30. Long lines were also forming outside testing centres, filled with anxious parents and their children.

And more stories were circulating of private gatherings where the 10-person limit was ignored, angering the health minister.

He told reporters about a dinner with 17 people at a restaurant in Montérégie, which led to 31 cases. A corn roast in the Lower St. Lawrence, he said, resulted in 30 cases.

“To me, that’s unacceptable,” Dubé said on Sept. 15.”If people won’t understand from these examples then, I’m sorry, but they’ll never understand.”

He moved Montreal, and four other regions, into the yellow zones and banned bars from serving food after midnight. The province was averaging 338 new cases per day.

Second wave arrives

The warnings from the government did not curb the spread of the virus. By mid-September, authorities were reporting more cases in closed settings.

On Sept. 17, Herzliah High School in Montreal became the first school in the province to say it was shutting down for two weeks to deal with an outbreak. At least 400 other schools were also dealing with active cases of COVID-19.

Cases accumulated too in private seniors homes (known as RPAs), a major source of concern for public officials given the vulnerability of the residents to COVID-19.There were only 39 cases in RPAs at the start of the month, and 157 by Sept. 20.

On that day the government announced it was moving Montreal, Quebec City and the Chaudière-Appalaches region into the orange zone, the second-highest alert level. Private gatherings were capped at six people.

The province was by then averaging 501 new cases per day. The second wave had begun, according Quebec’s public health director, Horacio Arruda.

Red zone

Over the last week, Quebec’s health system has shown signs of strain as authorities race to contain the spread of the virus.

Drouin, the Montreal public health director, admitted on Sept. 21 that her contact-tracing teams were swamped by the demand.

Until now, the increase in cases had not been accompanied by a corresponding surge in hospitalizations. Most of the new cases were concentrated in younger people.But the number of hospitalized COVID-19 patients in Quebec has increased by 45 per cent in the last seven days. Hospital staff are starting to get stretched. Several thousand health-care workers are in preventive isolation.

“We’re feeling the second wave,” Dr François Marquis, the head of intensive care at Montreal’s Maisonneuve-Rosemont hospital. “We were apprehensive about it, but now it’s a reality.”

On Monday, Quebec reported 750 new cases of COVID-19. Montreal and Quebec City were classified as red zones later that evening.

Source: How Quebec went from COVID-19 success story to hot spot in 30 days

#COVID-19: Comparing provinces with other countries 23 September Update

Highlights:

Deaths per million: Philippines ahead of British Columbia

Infections per millionIndia ahead of  Canada, Prairies ahead of Pakistan

#COVID-19: Comparing provinces with other countries 9 September Update

Highlights:

Deaths per million: USA now higher than Sweden, Australia now higher than Atlantic Canada

Infections per million: France now higher than UK, India now higher than Germany and Ontario, British Columbia now higher than Canada less Quebec


#COVID-19: Comparing provinces with other countries 26 August Update and Globe editorial on Quebec’s handling of the pandemic

Changes of interest include Alberta now has a higher number of infections per million than Ontario, with India and the Philippines having higher infection rates than Canada less Quebec.
India’s death rate per million now exceeds Canada less Quebec.


Lastly, a good Globe and Mail editorial on the failures of the Quebec government in managing the pandemic (Quebec’s COVID-19 death toll is Canada’s highest, and one of the worst in the world. No, that’s not fake news):

There is no province in Canada that has done a perfect job of limiting the spread of the COVID-19 virus. But there is one province that stands out as having done the least perfect job of all, and that is Quebec.

As of Tuesday, Quebec had recorded 724 confirmed cases of COVID-19 per 100,000 people. The national average is 332 per 100,000. The province with the next highest rate, Alberta, stood at 295 on Tuesday.

The same gaps exist in the number of deaths per capita. Quebec has had 67 deaths per 100,000 people – one of the highest death rates in the world, and well above Italy, Spain or the United States. The next highest province, Ontario, is at 19 deaths per 100,000.

It may not be entirely fair to compare across jurisdictions, but Quebec Premier François Legault has invited such scrutiny by resorting to divisive tactics to distract from the painful reality of the crisis in his province.

Last week, he once again accused the veteran health reporter at The Gazette, Montreal’s English-language daily newspaper, of being biased. It was the third time he has claimed that Aaron Derfel is trying to undermine his government with false reporting.

The Premier also said that, if anglophones in Quebec are more worried about catching COVID-19 than francophones, as at least one poll suggests, it must be because they are spending their time reading Mr. Derfel’s tweets and watching CNN and other American news channels.

Attacking journalists and taking cheap shots at a minority group is no way to address a crisis that has claimed the lives of more than 5,700 Quebeckers. Columnists in the province’s French-language newspapers have rightfully pilloried Mr. Legault for trying to shoot the messenger.

Mr. Legault’s tactic has backfired in another way, too, by shining a spotlight on his government’s handling of the crisis. It’s fair to say the Premier has not had a good pandemic.

Not that it’s entirely his government’s fault. Quebec had the misfortune of scheduling its annual school spring break in late February, a week ahead of the rest of the country. Many Quebeckers holidayed in the United States and Europe just as the pandemic was picking up steam. Some experts believe Quebec’s early spike in cases was mostly bad luck.

But the curve of new cases continued to climb after lockdown was imposed in March. And Quebec’s outbreaks in long-term care homes were bigger, longer and deadlier than anywhere else in Canada.

The government’s most glaring misstep occurred on June 24, a provincial holiday, when Quebec’s public-health agency announced it would no longer release data about new cases and deaths on a daily basis – a practice common around the world – and would instead only make them public once a week.

The surprise decision came after Horacio Arruda, Quebec’s chief public-health officer, attended a provincial cabinet meeting at which the issue was discussed, raising concerns that Dr. Arruda had yielded to demands from the Legault government.

Dr. Arruda denied there was any political interference. But three days later, after much criticism from epidemiologists and francophone commentators, the decision was reversed.

In the midst of all that, Mr. Legault demoted his health minister, Danielle McCann, and replaced her with Treasury Board president Christian Dubé.

Firing your lead minister in the middle of a major crisis is never a good look, but Mr. Legault was reportedly fed up with the endless bad news battering his government.

The government has also come under fire for reopening bars in late June, causing a fresh spike in cases, and for raising the maximum number of people at an indoor public gathering to 250 from 50 as of Aug. 3, a move that has backfired in European countries and many American states.

This week it’s the government’s back-to-school plan that is drawing fire. Unlike most other provinces, Quebec students will not have to wear masks or physically distance in classrooms. And parents will not have the option of keeping their children at home to learn remotely, unless they provide a “valid medical note.”

Mr. Legault is not the only premier facing tough questions about their handling of the COVID-19 pandemic. But he’s the only one trying to make a farce of this tragedy, by blaming a reporter for reporting the news.

Source: https://www.theglobeandmail.com/opinion/editorials/article-quebecs-covid-19-death-toll-is-canadas-highest-and-one-of-the-worst/

#COVID-19: Comparing provinces with other countries 19 August Update

Latest update. As UK revised the number of deaths by about 5,000, Quebec now has the highest death rate per million. Overall infection and death numbers continue to increase given the impact of some of the opening up measures.

#COVID-19: Comparing provinces with other countries 12 August Update

Latest update. No major change in ranking although numbers in some of the hardest hit countries continue to increase.

 

#COVID-19: Comparing provinces with other countries 5 August Update

Latest update, along with chart for infections. Recent uptick in infections can be expected to lead to an uptick in deaths. No major change in ranking.