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home / 世界杯决赛2022

omicron presents unique challenges for quebec's hospitals

covid variant appears less severe than delta, but hospitalizations are surging and an exhausted health network is more overburdened than ever.

by aaron derfel

jan 5 2022
read time 4 minute read
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hospitals across quebec are grappling with a new phenomenon in the latest covid-19 wave: how to categorize adult patients who test positive for the coronavirus, but who have mild or no symptoms and whose primary diagnosis for admission was a medical condition other than the pandemic illness.
in previous waves, such patients were few and far between. but since the omicron variant swept the province last month, as many as 30 per cent of patients are admitted not for covid, but for something else — say, appendicitis or a urinary tract infection — and test positive only once they’re in hospital.
what’s more, quebec hospitalizations for covid as a primary diagnosis are much shorter than in the past, suggesting that while omicron may be a lot more contagious, it’s not as severe — a trend that has been observed in south africa where the variant emerged.
but physicians are quick to caution that the data are preliminary, with hospitalizations rising fast in an exhausted health network that’s more overburdened than ever. the fifth wave is also affecting the pediatric population differently, with hospitalizations among quebec children up to the age of nine now at their highest level since the start of the pandemic.
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“what we’re seeing with omicron is that it’s much more contagious than the delta (variant), but at the same time people who are infected with omicron, as a group, tend to be less sick than those caught with delta,” said dr. françois marquis, chief of intensive care at maisonneuve-rosemont hospital.
“most of the patients in our icu right now are delta patients, while most patients being admitted on the wards are basically all omicron. at this point, a big majority of them don’t require critical care.”
at the jewish general, one in two patients admitted to hospital don’t have covid as their primary diagnosis, dr. lawrence rosenberg, executive director of the centre-west health authority, told the montreal gazette.
“they’re not as sick as people who we admitted in the previous waves and they don’t stay in hospital as long,” rosenberg said. “we’re not really being inundated with icu patients. all of this bodes well and speaks to the efficacy of the vaccination program.”
still, quebec reported the biggest single-day increase in hospitalizations on tuesday since the beginning of the pandemic: 196, raising the total to 1,592. however, icu stays inched up by four to 185. the province’s icu capacity is 319 beds.
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hospitals are now weighing the possibility of stopping the practice of transferring every asymptomatic covid patient with a different primary diagnosis to a covid ward and instead keeping them in their original ward with extra precautions. the government is also considering publishing a new category of hospitalizations to distinguish patients who have covid as their primary diagnosis from those testing positive as a secondary diagnosis.
at first glance, the latest wave seems eerily similar to the one last january. on jan. 3 last year, quebec recorded a tally of 1,294 hospitalizations, of which 188 were icu stays. but that’s where the similarities end.
on the same date in 2021, the health ministry declared 2,546 new covid cases. on tuesday, the province posted 14,494 cases, and that figure is probably a vast underestimate because many quebecers are self-testing and the government is not tabulating those results.
moreover, the seven-day average number of covid deaths stood at 31 on jan. 3 last year, compared with an average of almost 13 in the past seven days.
the difference in pediatric hospitals is also striking. on jan. 3 last year, quebec reported one new hospitalization in the zero-to-9 age demographic. on tuesday, the province counted 15 new hospitalizations in children up to the age of nine. to date, 56 per cent of quebec’s population aged five to 11 has received one covid vaccine dose — a rate that’s far below what’s needed to counter omicron.

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these pediatric statistics might help explain why montreal’s public health department on monday announced it was overriding a provincial daycare directive that children and educators who come in contact with someone known to be infected with covid no longer have to isolate for 10 days. quebec backtracked on the directive on tuesday.

omicron is also distinguishing itself from previous waves in the number of breakthrough infections among those who’ve received two vaccine doses. nearly 78 per cent of the new cases tuesday arose in those who were administered two shots. in the past 28 days, 62 per cent of those hospitalized were doubly vaccinated.
marquis and rosenberg have each observed some quebecers who got the booster and who nonetheless tested positive for covid. but they stressed that the vaccines are highly effective in reducing hospitalizations, averting icu stays and preventing death.
rosenberg was cautiously optimistic the omicron wave might peak in the next couple of weeks — a prediction some u.s. experts have made. but marquis warned quebec’s health network could also become overwhelmed very quickly.
“it’s the law of the big numbers,” he explained. “omicron is so incredibly contagious that it’s probably going to sweep through canada from coast to coast. you just don’t want to get it at the same time as everyone else.”

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aderfel@postmedia.com
twitter.com/aaron_derfel

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