Quebecers in soon-to-be orange zones rejoice, but experts say province is moving too quickly

The dining room in Katie Rioux's Quebec City restaurant has been closed since the fall, and she expected her business would remain a takeout-only operation for weeks to come, if not longer.

On Wednesday, though, the owner of Café Krieghoff received some unexpected good news.

Premier François Legault announced he was scaling back health restrictions in several regions, allowing Rioux and countless other restaurant owners to serve customers sitting inside for the first time in five months.

"Honestly, we could not have gotten better news than this," said Rioux, who also promised to do her part to ensure Quebec City does not go back to being a red zone. 

"As restaurant owners, we will do everything we can. I think the population is also on our side."

However, some public health experts say the Quebec government's decision to roll back restrictions to this extent is too hasty. 

Following March break, the Quebec City region will be joined by the Eastern Townships, Mauricie-et-Centre-du-Québec and Chaudières-Appalaches as the latest to be downgraded from red to orange zones.

In these regions, gyms and show venues will be allowed to reopen, houses of worship will be able to take in as many as 100 people at a time. The government is also dropping the requirement that all primary school students must wear a medical grade mask. The nightly curfew remains, but will kick in at 9:30 p.m. instead of 8 p.m.

"I would have preferred to wait until at least one week after the holiday week, because then we would be able to see the impact of the vacation on the increase of cases everywhere in Quebec," said Dr. Cécile Tremblay, a microbiologist and infectious diseases specialist at the Centre hospitalier de l'Université de Montréal.

"We know that people from Montreal travel to other regions, and we won't know the result of that until two weeks from now."

The race between variants and vaccines

Legault's announcement came a day after Health Minister Christian Dubé and Public Health Director Dr. Horacio Arruda held a news conference of their own, during which they warned Quebecers about the growing spread of coronavirus variants.

"The ocean is calm at the moment ... but underneath there are sharks," Arruda said, "and I'll tell you what those sharks are: they're the variants."

The decision to remove restrictions in places outside of the greater Montreal area seems to reflect data showing that variants are gaining more ground in Montreal than elsewhere in the province.

On Wednesday, Legault said spikes in cases and hospitalizations were expected in and around Montreal, and those projections played a major role in the government's most recent announcement.

But Prativa Baral, an epidemiologist with the Johns Hopkins Bloomberg School of Public Health, says the province is squandering a golden opportunity to deal a crushing blow to the virus. 

With more and more Quebecers set to get vaccinated, Baral says the government should focus on its inoculation campaign while limiting contacts as much as possible, in an effort to keep the spread of variants under control.

"For us to be loosening restrictions now, is too premature. We don't want to be reactive, we want to be proactive for once," Baral said.

"At this point, it's more of a virus versus vaccine race, and we really want to make sure that we're pushing the vaccine segment to win, as opposed the variant segment."

The province's latest projections for the spread COVID-19 appear to reinforce the importance of winning that race.

According to the mathematical modelling published by the Institut national de santé publique du Québec (INSPQ) on Thursday, lowering the province's collective guard could provoke a rapid spike in new infections that could reach between 3,000 and 4,000 cases per day.

It also seems possible, perhaps even likely given the presence of infectious variants, that Quebec will experience a third wave.

Sticking with the low-socialization and low-contact measures that were in place from January and February might not entirely prevent another peak this spring in terms of daily infections, but it could keep hospitalization numbers and fatalities low.

Marc Brisson, the director of the Université Laval mathematical modelling group that conducts the INSPQ's COVID-19 forecasts, said the model doesn't account for the government's latest announcement, but does include increased inter-regional travel and social contacts from March break.

"If we can accelerate vaccination ... and follow public health guidelines, then at that point our model is saying we could stay at a number of cases that would be relatively stable. However, if vaccination slows down and there's more contact, then a third wave is predicted," he said.

There is some good news in the projections, however.

The model supports the government's contention that there are two distinct epidemiological realities in Quebec: greater Montreal, and the rest of the province.

The fact there is lower community spread outside the province's largest urban agglomeration means it's less likely the variant strains will spread.

"The race is how many vulnerable people we can protect with vaccination and ... can that variant infect the most vulnerable among us?" he said.

The key, Brisson concluded, is continued adherence to public health measures, which "would buy time for the vaccine to take its effect."