Quebec public health director says 'all options are on the table' in face of 6th wave

Roughly two weeks before the province is expected to lift nearly all masking requirements, Quebec's interim public health director says he's not ruling out maintaining the mandate and even possibly reimposing some health measures as COVID-19 cases surge again.

"All options are on the table," said Dr. Luc Boileau in an interview on Radio-Canada's Première Heure Thursday morning. 

But at a news scrum Thursday, Quebec Health Minister Christian Dubé told reporters "there is no reason for the moment [... ] to change the strategy."

On Wednesday afternoon, the province's public health institute (INSPQ) officially confirmed that Quebec is in its sixth wave of the pandemic, citing indicators such as the high positivity rate, the number of sick health-care workers and the number of hospitalizations, driven by the highly contagious BA.2 variant.

The key indicators have been on the rise since mid-March, and health officials believe they'll ramp up in the days and weeks ahead.

"The month of April will be difficult," said Boileau, adding cases will likely drop off come May. He said it's time people understand the importance of this wave and most of all, the habits to follow. 

"When we have COVID-19, the virus stays contagious for 10 days. Not five days — 10," he said.

Boileau said, in accordance with public health guidelines, people should strictly protect themselves for the first five days and then remain vigilant for the following five by wearing a mask and keeping a distance of two metres from others.

"Resume some activities, but don't go to parties, dinners, or see lots of people or the grandparents," he said. 

Boileau said he's counting on the good sense of Quebecers to be careful and to reduce their contacts.

"If we are able to see this change in behaviour and attitude in this wave, it will help us all."

He said he is also watching the evolution of the situation closely and plans to make his recommendation to the government regarding the continued use of masks in public places next week. 

More restrictive measures not part of the plan: Dubé

Speaking to reporters Thursday, Dubé said that while the government is concerned about the rise in cases and hospitalizations, the situation was expected.

He said what wasn't anticipated, however, was the pace at which the BA.2 variant would spread. In the last few days, it has become the dominant strain in the province, accounting for 50 per cent of infections. 

"Our biggest concern for the health-care network is that we already have more than 10,000 people missing from the health-care system because of COVID," said Dubé, although they are not necessarily infected with the virus.

Despite this, he said he is not worried about breaks in service as employees can now come back to work after five days of isolation, which "will help a lot to be able to reduce the pressure on our employees."

Dubé said the effect of the BA.2 subvariant is felt predominantly in regions such as the North Shore, Abitibi-Témiscamingue, Quebec City and the Gaspé. 

"This is because these are regions that were not as hard hit by Omicron. So these are people who have less natural protection or immunity against Omicron than in the Montreal region," he said.  

While Dubé is encouraging people in the regions as well as residents of seniors' residences to be extra cautious, he says there is no plan to add restrictions in Quebec. 

"People have to learn to live with the virus," he said. 

The sixth wave comes as Dubé kicks off consultations today on his bill to put an end to the health emergency.

In response to opposition criticism that he was trying to retain too many emergency powers, Dubé introduced amendments and a new title to the bill Thursday, to reflect the "temporary and transitional" measures the government wants to maintain.

One of the amendments would explicitly extend measures such as the authorization for health professionals like dental hygienists and veterinarians to administer COVID-19 vaccines, and allow for distance-learning in schools, among other measures.

It would allow also the government to maintain masking provisions until Dec 31 at the latest. However, a spokesperson for the the minister clarified that the measure would be maintained until "Dr. Boileau has a new recommendation on this matter."

When he first introduced the bill, Dubé had emphasized that the rules that would be extended until the end of the year were "operational" measures, not those that would affect the broader population, such as masking.

When asked Thursday by a reporter if he "sees the irony" that there is a debate to terminate the public health emergency at the same time the INSPQ is confirming a sixth wave, Dubé responded "no, the opposite." 

"Let's make sure that today we clarify how we want to remove the measures. But we need transition measures [...] to make sure we can act."

Dr. Gaston De Serres, an epidemiologist at INSPQ, says while the increase in cases will be much smaller than what the province saw over the holiday period in December, its severity will depend on the behaviour of the population.

"There needs to be an understanding that it's not because the government is not mandating restrictions that people should not restrict themselves in the number of contacts they have," De Serres told CBC Montreal's Daybreak.

The INSPQ anticipates that if the number of contacts people have during this wave is similar to what Quebec experienced before Christmas, the surge will be substantial.

"We don't know how high this wave will be," he said.