Quebec emergency room doctors warn conditions “out of control” due to surge of COVID and other respiratory infections

With the onset of winter, Quebec’s emergency rooms are overflowing, endangering the health and lives of Quebecers. A major driver of the increased burden on hospitals is a surge in COVID-19 cases.

This is a repeat of the situation experienced in November and December 2022. According to the government’s Index Santé website, the province’s overall emergency-room (ER) occupancy rate has exceeded 100 percent on every single day since Nov. 12. On Tuesday, the average rate across the province was 131 percent. In Laval, Quebec’s third-largest city, it was 182 percent and in the nearby Lanaudière region, 171 per cent.

Patients often wait for hours, sometimes even days, on stretchers awaiting care. [Photo: FIQ/Twitter]

ER doctors wrote to Health Minister Christian Dubé last Friday to warn that conditions in emergency rooms across the province are “out of control.” “Overcrowding in the emergency department leads to daily mortality,” says the letter, which was written by Dr. Marie-Maud Couture, the president of the Regroupement des Chefs d’Urgence du Québec (Association of Emergency Rooms Chiefs), and supported by the hundreds of doctors and residents who comprise the Association des spécialistes en médecine d’urgence du Québec (Quebec Association of Specialists in Emergency Medicine).

“Congestion in emergency departments leads to mortality, recently estimated at one excess death for every 82 patients admitted,” wrote Dr. Couture. “This statistic does not take into account indirect deaths, i.e. people who present late despite having an urgent medical condition, for fear of waiting more than 24 hours in a waiting room, and sometimes even for fear of being a ‘nuisance.’”

The immediate cause of the current overcrowding crisis is the “triple epidemic” of respiratory viruses that is hitting the province. As in 2022, influenza, COVID-19 and respiratory syncytial virus (RSV) are infecting Quebecers en masse.

According to the Institut national de santé publique du Québec (INSPQ), some 130,000 Quebecers contract a respiratory virus every day.

COVID-19 is believed to be responsible for a third of these infections, although official figures (4,987 new cases for the week ending November 26) continue to seriously underestimate the number of cases. This is because they are based on PCR tests, which are accessible to only a small minority of people. These incomplete official figures and voluntary declarations of positive rapid tests have been steadily increasing since the end of September.

As of last week, 2,200 people were hospitalized with COVID-19, a number that exceeds what was seen in 2020 and 2021 before the arrival of the Omicron wave. This shows that the policy of mass infection adopted by the ruling class at the time has allowed the disease to take hold permanently, with a very high baseline.

COVID-19 also continues to kill. The 70 people who died between November 26 and December 2 in Quebec brought the official count of COVID deaths since 2020 to 19,084. At the end of November, Statistics Canada published its annual report on life expectancy in Canada. For the third year in a row, life expectancy in the country has fallen, from 82.3 years in 2019 to 81.3 in 2022.

The Statscan report also revealed that COVID-19 caused more deaths in the country last year than in any other year of the pandemic. With over 19,700 deaths attributable to it in 2022, COVID-19 is now the third leading cause of death in the country, responsible for around 6 percent of all deaths. In Quebec and Ontario, the two most populous provinces, mortality caused by COVID-19 increased by 38 percent in 2022 as compared to 2021.

The right-wing Coalition avenir Québec (CAQ) government, with the complicity of the corporate-controlled media outlets and the federal Liberal government, is doing everything in its power to prevent the public from becoming aware of the immense dangers it faces. Its aim is to continue pursuing a deliberate policy of mass infection.

The COVID-19 health emergency was lifted in Quebec on June 1, 2022, and all measures, including the mandatory wearing of masks in healthcare centers, were eliminated. Even tracking the evolution of COVID-19 has become almost impossible due to the lack of data.

In the most recent example, on December 6 the INSPQ discreetly announced on its website that data on hospitalizations linked to COVID had also become imprecise with the end of the obligation for hospitals to record specific information. In particular, it will no longer be possible to know the number of COVID patients hospitalized in intensive care units.

Government and media propaganda downplaying the dangers associated with COVID has also led to a collapse in the number of Quebecers keeping their COVID vaccinations up to date. As of the middle of December, barely 900,000 people, or around 14 percent of the population, had received a booster dose designed to combat the Omicron XBB.1.5 sub-variant since the vaccination campaign began in October.

The data are just as alarming for the most vulnerable people, the only ones for whom the government and INSPQ officially recommend the vaccine. Vaccination rates are 39.1 percent for those over 60 and 45.8 percent for people aged 70-79. Of those 80 and over barely half, 50.5 percent, have received the latest booster.

Quebec Public Health Director Dr. Luc Boileau has warned of a “cocktail of COVID-19 and flu for Christmas,” even while downplaying the dangers. He is urging those over 70 to get vaccinated, and recommends that those with symptoms wash their hands and wear a mask. Quebec Premier François Legault appointed Boileau as the province’s “interim” public health director in Jan. 2022, as the government was moving to eliminate all mitigation measures amid the Omicron wave, and later made his posting “permanent,” precisely because of Boileau’s readiness to implement the government’s murderous profits-before-lives pandemic policy.

According to Dr. Boileau, cases of influenza—whose main strain this year is H1N1, which is particularly dangerous for children—are also rising sharply in Quebec. The test positivity rate has risen from 3.9 percent to almost 7.3 percent in the space of a week, and several adults with influenza are hospitalized in intensive care. Authorities fear that the situation will evolve in the same way as in Alberta, where the test positivity rate has risen from 3 percent to 33 percent in the space of a month.

The deeper causes of the ongoing crisis in emergency departments and, more generally, in the healthcare system, are also well known. They include the savage cuts made for decades by successive Parti Québécois and Quebec Liberal Party governments, and the intensification of capitalist austerity by the CAQ, which announced in its March budget an increase in healthcare spending below inflation when non-recurring, COVID-19-related expenses are deducted.

Meanwhile, Dubé’s “solutions” to the ER crisis are collapsing miserably one after the other. At the end of November, the only two full-time nurses in the first Specialized Nurse Practitioner (SNP) clinic resigned, citing “issues impacting the quality and safety of care,” including a lack of equipment.

The clinic was opened with great fanfare at the suggestion of the “crisis unit” set up by Dubé in December 2022, when emergency departments were in acute crisis. It was intended to relieve emergency departments and hospitals by treating less urgent cases.

Similarly, the Info-Santé line (811), where sick people are supposed to be able to talk to a professional and be directed to an alternative to ER care if their case is not too serious, is itself overwhelmed. People sometimes have to wait several hours to talk to someone.

In the first week of December, 42.3 percent of 811 callers hung up before getting any advice. Despite this, Dubé reiterated on Tuesday that people should avoid the ER if at all possible, encouraging sick people to self-diagnose the severity of their illness and decide if they have the “right” to seek ER treatment.

The crisis in the healthcare system and the indifference of the ruling class are a serious threat to the lives of Quebecers. Recently, the media revealed that two people died in the emergency room of the Anna-Laberge hospital in Châteauguay, near Montreal, on November 29 and 30.

Although the authorities have refused to give details of these tragic incidents on the pretext that administrative investigations are underway, it appears that one person died after waiting 12 hours, although he was supposed to see a doctor within 30 minutes of arrival according to the preliminary examination carried out in triage. The stretcher occupancy rate at Anna-Laberge Hospital was 184 percent.