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Infectious disease experts worried about impact of Quebec’s COVID-19 Christmas plan

People wear face masks as they walk along a street in Montreal, Saturday, Nov. 21, 2020, as the COVID-19 pandemic continues in Canada and around the world. THE CANADIAN PRESS/Graham Hughes

Quebec Premier François Legault wants to grant his province a mini-reprieve from pandemic restrictions for a four-day window over Christmas, leaving some medical experts baffled by his plan — and worried for the repercussions it could have on the rest of Canada.

Not only could those limited Christmas gatherings lead to widespread infections to start the new year, experts say, the decision also adds to confusion due to mixed messaging.

Legault’s plan, announced Thursday, allows gatherings of up to 10 per day from Dec. 24 to 27 and asks people to self-isolate for seven days before and after their events. However, Quebec public health officials clarified on Friday that the plan could change if the situation in the province worsens.

Further adding to rule confusion, Prime Minister Justin Trudeau cast doubt on the hope of a “normal Christmas” on Friday, while Dr. Theresa Tam, Canada’s chief public health officer, said that Legault’s plan could work, at least in theory.

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READ MORE: Quebec reports 1,189 new cases of COVID-19, 32 additional deaths

Tam said gatherings could be made safer with masks and physical distancing, but the crux of the plan would be limiting interactions before the holiday events.

“If we bend the curve fast in the next weeks, well, let’s just see what happens before the Christmas vacation,” Tam said.

Dr. Don Sheppard, the founder and director of the McGill Interdisciplinary Initiative in Infection and Immunity (MI4), strongly opposes Legault’s plan.

While Sheppard agrees that limiting interactions is our best bet to drive transmission down, he doesn’t think a seven-day quarantine period is enough.

The recommended 14-day time frame for self-isolation has been fairly consistent since the pandemic began, and Sheppard isn’t sure why Legault is deviating from that.

“The premier seems to have been consumed by the holiday spirit and he’s offering a holiday sale: 50 per cent off isolation,” Sheppard said.

“I’m extremely disappointed in (the plan). It fails to follow the science. It’s dangerous and it puts us at risk of a massive spike when we can least afford it.”

READ MORE: Doctors give mixed reviews to Quebec’s plan to relax gathering limits for Christmas

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Quebec reported 1,259 new COVID cases Friday and 32 more deaths, and Legault said earlier this week that restrictions could be tightened in the province’s red zones.

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Sheppard believes people are “losing faith” in the government’s public health guidelines because of that inconsistent messaging.

Dr. Christopher Labos, a Montreal-based physician, understands why some would be confused.

While Labos concedes that the broad principles of fighting the spread of COVID-19 _ keeping physical distance, wearing masks, washing hands — have stayed the same across the country, the daily ins and outs of living through a pandemic vary.

Some of that is to be expected, he said, given that parts of the country, and even regions within provinces, aren’t facing as dire a situation as others.

Still, he added, Canadians would benefit from more uniform messaging.

“People start to think: why are some things allowed in Quebec and not in Ontario, even though case numbers are more or less the same?” Labos said. “So it is confusing.”

Labos was surprised to hear of Legault’s Christmas plan because it doesn’t jell with the government’s own COVID-19 modelling that shows how cases could skyrocket in the coming months.

Tam said on Friday that Canada could see up to 20,000 new COVID cases per day by late December if the current trajectory holds up.

Trudeau also urged Canadians to limit their contacts.

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Click to play video: 'Coronavirus: Quebec to allow gatherings from Dec. 24-27, schools move to online learning before winter break'
Coronavirus: Quebec to allow gatherings from Dec. 24-27, schools move to online learning before winter break

“It’s right to give people hope that they can gather at Christmas, but so much depends upon what we are doing right now,” he said. “We all want to try to have as normal a Christmas as possible, even though a normal Christmas is quite frankly right out of the question.”

Many provinces and territories have recently implemented stricter restrictions, which officials hope will positively impact the dire projections, and Tam said it’s important to not “release the brakes rapidly.”

Labos says introducing relaxed measures, even for a short period, could be dangerous. And he worries people won’t follow instructions to self-isolate in the days before and after their gatherings, as Legault has asked.

“They will interpret the premier’s message as ‘it’s OK to gather over Christmas.’ So they’ll get together and we’ll have a spike in cases,” he said. “It’s pretty clear that if we don’t improve what we’re doing, we’re going to have significantly more cases come January.

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“And the real danger there is that it risks overwhelming the health-care system. We’re going to start running out of beds, we might have to start cancelling elective procedures again. There’s a lot of downstream effects.”

Mixed messaging over Christmas was put on display elsewhere in Canada earlier this week when Dr. David Williams, Ontario’s top doctor, said he was hopeful the entire province would be in the lower-risk “green zone” by Christmas.

The comment was met with sharp criticism online and Health Minister Christine Elliott backed away from that stance the following day.

Jean-Paul Soucy, an infectious disease epidemiologist at the University of Toronto, says those types of conflicting messages aren’t useful.

“What we don’t want is to have rapid public disagreements between various officials,” Soucy said. “If we clearly communicate that we’re asking people to make a sacrifice — and now that sacrifice has an end date with a vaccine on the horizon — I think that would be much more clear and unifying.”

Sheppard said the news of two successful vaccine clinical trials in the last two weeks should make things easier, both for the government to deliver the message and for people to digest it.

“If you really want to care for your family at Christmas, stay away from them and plan for a safe Christmas next year where everybody gets to come to the table because they’re still with you,” he said.

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“That’s got to be the message we get out.”

Click to play video: 'Quebec Jewish community says it’s excluded from Quebec’s Christmas break COVID-19 measures'
Quebec Jewish community says it’s excluded from Quebec’s Christmas break COVID-19 measures

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