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Montreal well being authority takes inventory of pandemic response

By Frank S. Crawford

  1. news
  2. Local News

First wave highlighted the greatest weaknesses in our public health system, while the third wave showed it at its best, Mylène Drouin says.

dr Myléne Drouin, head of Montreal's public health authority, speaks with reporters alongside Dr. Luc Boileau, Quebec's director of public health, in June 2022. dr Myléne Drouin, head of Montreal’s public health authority, speaks with reporters alongside Dr. Luc Boileau, Quebec’s director of public health, in June 2022. Photo by John Mahoney /Montreal Gazette

The first wave of the COVID-19 pandemic that infiltrated Montreal’s seniors residences in the spring of 2020, killing thousands of the city’s elderly population, highlighted the greatest weaknesses in our public health system.

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The third wave that came roughly a year later showed Montreal’s system at its best, when contact tracing to suppress outbreaks and vaccination campaigns targeting the most vulnerable allowed the region to limit hospitalizations and avoid the mass shutdowns that affected places like Quebec City and Toronto.

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These were among the low and high points of the pandemic cited by Montreal public health director Dr. Mylène Drouin on Tuesday as she presented journalists with an overview of the city’s emergency response to the coronavirus outbreak.

The regional health authority released a report outlining its measures, titled: “Outlook on the COVID-19 pandemic in Montreal: Towards an efficient and equitable response to future health emergencies.”

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At the same time, Drouin weighed in on whether the province should re-institute a mask mandate, as proposed this week by Quebec’s College of Physicians and many epidemiologists given the recent rise in multiple types of viruses and the fragility of the hospital system.

Drouin stopped short of calling for a mask mandate, instead issuing a “strong recommendation” that anyone with symptoms wear them, and that schools and workplaces give masks to any person or student showing symptoms.

Anyone in a closed indoor setting for a long period of time should wear them as well, she said.

“I would say we should make sure people have access and make it a social norm,” she said. “And make sure people that do have symptoms do wear their masks wherever they go.”

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It’s estimated 10 per cent of schoolchildren are exhibiting symptoms of viruses and should be wearing masks in schools in the Montreal region, she said.

“I think the approach will be to protect the vulnerable population — elders, people with chronic diseases, and children under one who are more at risk of viruses,” she said. “Making sure they have their shots, but to avoid closing settings like we have in the last two years.”

The first wave of the pandemic exposed Montreal’s deficiencies in terms of testing capacities, supplies of protective equipment and staffing of health care institutions and seniors residences, Drouin said.

“The first wave was catastrophic for the elderly in residences,” she said. “One of the things that we must remember from that period is that we have to avoid having deaths of people alone in places when we limited visitors. Those are things that we would not do in the same way.”

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Widespread vaccination programs targeting the elderly in residences, along with strong protective measures, were among the main things that helped save lives later. But the elder population also told health authorities they have to be more supple in their definition of what constitutes a “care provider” to make sure the measures put in place don’t end up isolating them and causing other issues.

During the third wave, the alpha variant of COVID-19 came to Quebec between January and April of 2021. Prepared by what they had seen in Europe and earlier waves, Montreal’s public health team put in place an aggressive contact tracing system that limited outbreaks in schools and workplaces, Drouin said.

At the same time, the public health department vaccinated the most vulnerable first, and targeted two Montreal communities identified as at risk for outbreaks. It showed that 15,000 targeted doses could be instrumental in doing a much wider spread, she said.

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While schools and sports were allowed to remain open in Montreal, places like Quebec and Toronto and other provinces in Canada experienced mass closures.

Public health authorities learned as well to pay more attention to the collateral damage sanitary measures could inflict on certain segments, where the cure could be worse than the possible disease.

Studies showed that instances of family abuse rose significantly during imposed curfews, and that the unhoused were particularly impacted, which allowed Montreal to get exemptions for people living on the street.

The pandemic also highlighted social inequalities, in which many families who found themselves out of work were no longer able to buy food. Federal and provincial aid programs were instituted to fill those needs.

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For future emergency plans, health experts have to work on balancing the effects of health measures with negative side effects, particularly on vulnerable communities, Drouin said.

Health departments must work with community organizations and increase the number of social workers and epidemiologists on the ground to determine how to best serve those areas, and how to get reliable information out into the community that will be trusted.

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  1. Montreal's public health director, Mylène Drouin, has been at odds with some of the mandates coming from Quebec's public health department, in particular when the province decided it would impose a second curfew on the population at the beginning of 2022.

    Montreal faced different pandemic challenges than the rest of Quebec

  2. A woman keeps her Covid-19 face mask at the ready as she walks in Montreal in 2021.

    Quebec College of Physicians recommends everyone wear masks in public spaces

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Frank S. Crawford 1026 posts 0 comments

Mother's maiden name is Wilson, Love to write about Montreal and the life I have here! Amazing city with amazing food! I love to write and so I give time to this website!

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