The sub-variant XBB.1.5, which spread like wildfire in the United States, begins to spread in Quebec. It accounted for 2.4% of cases between December 25 and 31, according to the National Institute of Public Health of Quebec (INSPQ), which released new data on Wednesday. Twenty cases have been identified.
Inès Levade, clinical specialist in medical biology at the Quebec Public Health Laboratory at the INSPQ, expects this percentage to increase. “The question is more: will it increase as quickly as in the United States? ” she says.
According to the United States Centers for Disease Control and Prevention (CDC), 28% of cases of COVID-19 that were detected there last week were attributable to XBB.1.5. Following the collection of new data, the CDC revised down the 40% estimate first reported in the media. “In the northeastern United States, it’s gone to a little over 70%,” adds M.me Levade.
It remains to be seen whether the XBB.1.5 — part of the Omicron family — will supplant the variants already present in Quebec. During the holiday season, BQ.1.1 dominated (65% of infections).
“For several months, we have been dealing with a kind of soup of variants, indicates Inès Levade. We are quite cautious about predictions, about what we observe in another country and if it can happen here. You can never really be sure. She cites as an example the first line of XBB, which “took over” in other countries, but never took root in Quebec. XBB remained below 1% of cases in the province.
The INSPQ is however closely monitoring XBB.1.5, the first case of which in the province was detected towards the end of November.
According to the World Health Organization (WHO), it is the most contagious subvariant to date. It combines mutations that would give it “a great ability to evade our antibodies, the first line of defense of the immune system”, as well as a “greater ability to bind to the receptor of the cells it infects”, specifies Mme Levade.
“He doesn’t seem any more virulent,” she continues. It doesn’t seem to trigger a more severe disease. Despite this, if it is transmitted much more, it is still annoying, in the sense that we would have more cases and therefore more hospitalizations, potentially. »
A network already under pressure
The Quebec health network remains under pressure. On Wednesday afternoon, the average occupancy rate on a stretcher in the emergency room was around 130%, according to Index Santé. The Suroît Hospital (Salaberry-de-Valleyfield), the Royal Victoria Hospital (Montreal) and the Lanaudière Regional Hospital Center (Saint-Charles-Borromée) recorded rates of around 200%.
According to the Dr Guillaume Lacombe, vice-president of the Association of specialists in emergency medicine of Quebec, many patients needing to be hospitalized are stuck in the emergency room, for lack of beds available on the floors. He reports that around 2 p.m. Wednesday, “50 to 70% of patients on stretchers in the emergency room in Greater Montreal” were “waiting for a bed upstairs”. “It’s catastrophic,” he said. The lack of staff is glaring.
Asked about this during a press scrum on Wednesday, the Minister of Health, Christian Dubé, recalled that the crisis unit had made recommendations to reduce the pressure on emergencies. This cell held a meeting on Wednesday, sources confirmed to the To have to.
But what can be done in the short term to improve the situation? “It’s not so much new measures, but implementing those that have been suggested to us,” replied Minister Dubé.
Since December 19, hospitals in the greater Montreal area must implement an “overcapacity protocol” so that the floors accommodate more patients when the emergency room is overflowing. A directive has been sent on this subject to the CEOs of health establishments.
In a scrum, the minister acknowledged that this measure had not been implemented everywhere. He added that those who have not implemented their overcapacity plan “often do not act for lack of will”. “They may not have the resources or the expertise to do it,” he said.
Christian Dubé says he asked Assistant Deputy Minister Daniel Desharnais, head of the crisis unit, to check “why” certain hospitals do not have recourse to overcapacity and “how we can help them”.
As for the XBB.1.5 sub-variant, Christian Dubé indicated that “so far, there is no concern”.
In its latest update, the National Institute for Excellence in Health and Social Services (INESSS) predicts “a slight decrease in new hospitalizations” of patients with COVID-19 over the next two weeks. The number of occupied hospital beds will stabilize at around 2150 (confidence interval between 1990 and 2326), as will the number of intensive care beds (57, with a confidence interval between 53 and 62).
However, INESSS points out that “this week’s projections are fraught with uncertainties, because the decline observed during the holiday season may be linked in part to certain delays in data entry”.