COVID-19 could kill between 1,200 and 9,000 by end of month, Quebec public health officials warn

Public health experts with the Quebec government are projecting between 1,200 and 9,000 people could die of COVID-19 by the end of the month, although they also believe the current trajectory for mortalities is toward the lower end of that range.

The forecasting models were released Tuesday amid public pressure on political leaders, both in Canada and abroad, to be transparent about why drastic isolation and physical-distancing measures are necessary.

Quebec outlined two scenarios about what could happen by April 30.

One is optimistic: it projects 29,212 confirmed cases, with as many as 1,404 people in hospital at once and 1,263 deaths.

The other scenario is pessimistic: 59,845 confirmed cases, with as many as 3,208 people hospitalized at one time and 8,860 deaths. In this scenario, Quebec would not have enough beds in intensive care units to treat the more severe cases. 

In both scenarios. Quebec health officials project COVID-19 cases will peak on April 18

So far, 150 deaths in Quebec have been attributed to COVID-19, slightly higher than what is projected by the optimistic forecast. There are now 583 people in hospital, slightly lower than the optimistic forecast.

Quick action spared Quebec the worst, adviser says

Richard Massé, a senior public health adviser to the government who presented the projections, said because the government took swift action at the outset of the crisis, the real figures are unlikely to approach the worst-case scenario.

Most countries around the world have taken broadly similar physical-distancing measures, he said. Quebec, though, moved to put them in place soon after the first cases were detected. 

"When there is a delay in implementing measures, the situation is painful," said Massé, using Italy as an example. "We had the vision and capacity to act sooner here."  

Legault was not present for the release of the projections, but in his daily briefing earlier Tuesday, the premier suggested he wanted Quebecers to interpret the numbers with stoicism.

"I don't want people to be alarmed by the pessimistic scenario," he said. "Obviously, when you see the number of deaths projected, that can appear worrying."

Horacio Arruda, the province's top public health official, also said earlier today that Quebec is "closer to the optimistic scenario than the pessimistic one."

Arruda said April will be a critical month for determining whether that remains true.

Quebec compared to European countries

Public health officials in Quebec had been reluctant to release projections, citing the huge amount of uncertainty involved in the calculations. Premier François Legault, however, insisted they be made public.

What was released, in the end, was a simple projection based on what happened in European countries with similar health-care systems after they surpassed 10 cases.

The pessimistic scenarios were drawn from the experience of Italy and Spain. More than 17,000 and 13,000 people have died in those two countries, respectively. Germany and Portugal served as models for the optimistic scenario.

The value of the projections, said Massé, is in giving the government an indication of how many hospital beds and, critically, intensive care beds, will be needed when the greatest number of people are ill with COVID-19.

Some medical professionals were disappointed Quebec didn't provide a more sophisticated model that included estimates of asymptomatic transmission or the virus's presence in the general population.

Cécile Tremblay, an infectious disease specialist at the Centre hospitalier de l'Université de Montréal, said the projections nevertheless demonstrate that Quebec is still more than a week away from hitting its peak number of new cases.  

"That should give us pause in terms of those people who want to relax the precautions. We're still in the in the midst of this epidemic, and we're not yet there in terms of thinking of the plateauing and eventually, coming down," Tremblay said. 

Over the weekend, Legault extended the closure of non-essential business in the province until May 4.

Massé said it is still too early to determine whether that is a realistic date by which the government might begin relaxing physical-distancing measures.

"We have to move forward carefully," he said. "We're looking at how and when to do it so that we protect people and make sure the curve doesn't increase again."