September 30, 2023

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Covid-19 subtype XBB.1.5 arrives in Quebec

The Subvariant XBB.1.5, which It spread like wildfire in America, begins to spread in Quebec. It accounted for 2.4% of cases between December 25 and 31, according to Quebec’s National Institute of Public Health (INSPQ), which released new data on Wednesday. Twenty cases have been identified.

Inès Levade, clinical specialist in clinical biology at the Quebec Public Health Laboratory at INSPQ, expects this percentage to increase. “The question remains: 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 COVID-19 What was discovered there last week was XBB.1.5. Following new data collection, the CDC lowered the 40% estimate originally reported in the media. “In the northeastern United States, it’s a little over 70%,” says giving up

Whether it replaces XBB.1.5, part of the Omicron family, remains to be seen. Variations Quebec already has. During the holiday season, BQ.1.1 predominated (65% of infections).

“For months, we have been dealing with a kind of soup, notes Inès Levade. We are very careful about predictions, what we observe in another country and whether it will happen here. You can never be sure. She cites the first line of XBB as an example, which is the other “took” in the countries, but never took root in Quebec.XBB was less than 1% of the province.

However INSPQ is closely monitoring XBB.1.5, the first case of which was detected in the province in late November.

According to the World Health Organization (WHO), it is the most infectious to date. It combines mutations that give it “a better ability to evade our antibodies, the immune system’s first line of defense,” as well as “a greater ability to bind to receptors on the cells it infects,” giving up

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“He doesn’t look more aggressive,” she continues. It doesn’t seem to trigger more severe disease. However, if it spreads more, it’s still annoying, meaning we’ll have more cases and therefore more hospitalizations. »

An already stressed network

The Quebec health network is under pressure. By Wednesday afternoon, according to Index Sande, the average stretcher occupancy in the emergency room was 130%. Suroît Hospital (Salaberry-de-Valleyfield), Royal Victoria Hospital (Montreal) and Lanaudière Regional Hospital Center (Saint-Charles-Borromée) recorded rates of around 200%.

According to DR Guillaume Lacombe, vice-president of Quebec’s Association of Emergency Medicine Specialists, said many patients who need to be admitted to hospital are stuck in the emergency room because there are no beds on the floors. By 2 p.m. Wednesday, he reports, “50 to 70% of patients on stretchers in the emergency room in Greater Montreal” were “up there waiting for a bed.” “It’s a disaster. The staffing shortage is stark.

Asked about this during a journalist scrum on Wednesday, Health Minister Christian Dubey recalled that the crisis unit had made recommendations to ease pressure on emergencies. The cell held a meeting on Wednesday, sources confirmed want.

But what can be done in the short term to improve the situation? “These are not so much new measures, but implementation of those recommended to us,” replied Minister Dubey.

Beginning December 19, hospitals in the greater Montreal area A “high capacity protocol” should be implemented So floors can accommodate more patients when the emergency room is full. An order has been sent to the CEOs of the health institutions in this regard.

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In a scrum, the minister admitted that the measure was not implemented everywhere. Those who don’t implement a high-skill program “often don’t act out of desire,” he said. “They may not have the resources or the expertise to do that,” he said.

Christian Dubey says he has asked Assistant Deputy Minister Daniel Desharnais, head of the crisis unit, to check “why” some hospitals are overcapacity and “how we can help them”.

As for the XBB.1.5 sub-variant, Christian Dubay noted “no worries so far”.

In its latest update, the National Agency for Health and Social Services (INESSS) predicted a “slight decrease in new hospitalizations” of patients with COVID-19 over the next two weeks. The number of hospital beds occupied is about 2150 (confidence interval between 1990 and 2326), the number of intensive care beds (with confidence interval between 57, 53 and 62) will be confirmed.

However, INESSS points out that “this week’s projections are fraught with uncertainties, as the decline observed during the holiday season may be associated with some delays in data input.”

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