Analysis: COVID-19 cases rising again among eldercare residents

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Premier François Legault spoke a lot on Tuesday about the increase in hospitalizations among younger Quebecers, including those in their 20s and 30s.

Although this has been true with the arrival of the new variants, Quebec has also reported a 50-per-cent increase in the past two weeks in the number of active COVID-19 cases among residents of eldercare homes.

The Health Ministry has identified what it deems are critical outbreaks in two long-term care centres — one in Chaudière-Appalaches and the other in the Montérégie — as well as in two more in private seniors’ residences, both in the COVID-19 hot spot of Chaudière-Appalaches.

More than half of the nearly 40 clusters in eldercare homes in the province are concentrated in Chaudière-Applaches, the Capitale Nationale and the Outaouais — regions where the more transmissible variants are driving the third wave.

There is also a smattering of eldercare cases in the Montérégie, Laurentians and Montreal.

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In total, there are 175 active cases across Quebec, up from a low of 117 on March 29. In addition, 130 Quebecers who at least 80 years old are currently hospitalized with COVID-19, or 20 per cent of all admissions.

Dr. Quoc Dinh Nguyen, a geriatrician and researcher at the Centre hospitalier de l’université de Montréal, said that he, too, has noticed the uptick in cases and urged the government to administer second doses to eldercare residents as quickly as possible.

“Clearly, this is a reflection of what is happening in communities with high transmission and what we hope is that it doesn’t take on a life of its own, as it did during the first wave,” Nguyen said, alluding to the mass deaths in the province’s long-term care centres (CHSLDs) last spring.

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“I don’t want to say that the strategy of delaying the vaccines was right or wrong,” he added. “But I will say that now that we are vaccinating those who are 60 and over, I think there’s a strong argument for giving second doses in CHSLDs, especially in regions that see high community transmission.

“You could sleep much more easily knowing that people have received the two doses, especially since there are not that many CHSLD residents in Quebec. It’s about 40,000. And we’re vaccinating about 50,000 people a day in the province.”

Nguyen also recommended rapid second doses in private seniors’ residences (RPAs) in COVID-19 hot zones, especially since dining halls have reopened in these facilities.

On Tuesday, Health Minster Christian Dubé announced Quebec will expand the vaccine rollout to include all essential workers outside Montreal, along with those with chronic illnesses who receive medical treatment in hospital. But Dubé did not mention eldercare residents.

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Quebec took a different approach than Ontario early on in its rollout, delaying the second dose of the Pfizer and Moderna vaccines for three months to administer as many shots as possible. In contrast, Ontario gave second doses to most residents in long-term care by the end of February.

“The rollout of COVID-19vaccines in Ontario’s long-term care (LTC) homes has substantially reduced SARS-CoV-2 infections, COVID-19 hospitalizations, and deaths among LTC residents and health care workers,” the province’s science table advisory group concluded on March 8.

“Completing and maximizing the uptake of the full COVID-19 vaccine series according to recommended schedules will maximize the safety and well-being of Ontario’s LTC residents and staff.”

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Nguyen said there are good reasons to give second doses to the elderly, as they usually don’t mount as strong an immune response as younger healthy adults, and they are usually suffering from a number of medical conditions.

“We have data for COVID that in nursing home residents, even after two doses, their response is at least 10 or 20 per cent less strong than the immune response of health-care workers,” Nguyen noted.

Early in Quebec’s rollout, the families of residents of the Maimonides Geriatric Centre pleaded with the government not to delay the second shots, even going so far as to challenge the decision in court. The residents got their second doses last month.

The question is: what will the government do now for the rest of Quebec’s eldercare population?

aderfel@postmedia.com

Twitter.com/Aaron_Derfel

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