Montreal region could see spike in COVID-19 hospitalizations over holidays, INSPQ says

The Montreal region may be kicking off the new year with a repeat of early 2022 when it comes to COVID-19-related hospitalizations.

That's the worst-case projection by Quebec's institute of public health (INSPQ) which teamed up with the Université Laval to model three possible scenarios for the coming months.

While the increase in gathering over the holidays plays a role in the expected spike in hospitalizations, the BQ.1 and BQ.1.1 variants and their subvariants may also be a driving force, the INSPQ said in a report published Monday.

Preliminary data shows that vaccine or previous infection immunity is less effective against these variants and subvariants.

At the beginning of December, approximately half of the cases in Quebec were due to the BQ.1 and BQ.1.1 variants, the INSPQ says, and the proportion of cases caused by these subvariants is increasing rapidly not only in the province, but around the world.

Best-case scenario: the impact on hospitals will be limited, the INSPQ says.

Baseline scenario: BQ.1 and BQ.1.1 exhibit more immunity escape than the BA.4 and BA.5 Omicron variants, causing an upsurge in cases and new hospitalizations during the holidays, with the peak being similar to that of the spring and summer of 2022.

Pessimistic scenario: BQ.1 and BQ.1.1 has an even greater level of immunity escape, causing more infections. While data indicates symptoms aren't more severe, the increase in cases could cause the number of new, Montreal-area hospitalizations to jump to more than 150 per day in January 2023.

In this case, the number of hospitalizations could reach the peak of the Omicron wave of January 2022.

By comparison, there are currently about 200 new hospitalizations per day in the entire province. As of Dec. 10, there were nearly 2,000 Quebecers hospitalized for COVID-19. 

At this time last year, it was fewer than 300.

The rise in hospitalizations due to COVID-19 comes at a time when hospitals across the country are already under strain due to a spike in other respiratory viruses.

In the report, INSPQ associate vice-president Éric Litvak said that even in the baseline scenario, an upsurge in hospilizations is expected.

"It is important to pay particular attention to the protection of the elderly or vulnerable during this period," he said.

Just last week, public health authorities asked Quebecers to get back into their old pandemic habits ahead of the holiday season to limit the pressure on the province's health-care network.

"It's tough right now," said Dr. Luc Boileau, Quebec's director of public health, at a news conference.

"If people don't agree to change their habits … it's going to be busy."