In Ontario, the pandemic situation was described as "out of control" on Monday, while in the United States a top official delivered an apocalyptic warning. But in Quebec, where coronavirus variants are surging and restrictions have recently been eased, the government is holding steady.
Thus far, Premier François Legault and his top officials have ignored criticism from health-care experts and expressed confidence that Quebec's vaccination campaign will mean it can thread the needle: avoid tightening public health restrictions while keeping hospitalizations relatively low.
"What we look at is the increase in hospitalizations," Legault said during his weekly briefing on Tuesday. "Every weekend I see the projections and in those we could see two things: an increase in cases and an increase of the number of hospitalizations — but within the capacity we can handle."
The Legault government's more singular focus on hospitalizations and intensive care unit occupancy centres around the assumption that outbreaks and rising case counts in the now-declared third wave won't have the same urgency as in previous waves.
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With variants on the rise, Legault said, an increase in cases was expected. He said the government is keeping a constant eye on hospitalization numbers, region by region.
He warned of even tighter restrictions if trends worsen, but for now sees no reason to adjust restrictions.
Quebec's situation 'different,' Legault says
That approach comes even as concerns are multiplying elsewhere and new measures are introduced.
In Ontario, variants make up a clear majority of new infections and hospitalizations and ICU occupancy have risen significantly. Dr. Peter Juni, a top scientific advisor for the province, said Monday there is "no way out" of a dire situation without a lockdown.
On Monday, with new infections gathering speed, British Columbia imposed a three-week "circuit breaker"-style lockdown.
In the United States, where vaccination efforts are substantially ahead of those in Quebec, the director of the Centers for Disease Control and Prevention warned Monday of "impending doom."
Legault said Quebec's situation is different.
"Our situation is now better," he said. "Our measures are tougher, including the curfew at 9:30. All the restaurants, for 60 per cent of Quebec, in red zones, are closed. We have to take that into consideration when we compare to other provinces or the United States."
Following a path
Some are not reassured by the government's moves, however. In recent days various experts and groups, including the Collège des médecins du Québec and the Quebec order of nurses have asked the government to reconsider the relaxation of restrictions.
"The measures are exactly what will allow Quebec to follow the path that other countries and our neighbouring province of Ontario are going through right now," said Maude Laberge, a professor at Université Laval and a researcher in population health. "Meaning: exponential growth of cases and eventually of hospitalizations."
Because many of the most vulnerable people have been vaccinated, she said, "the delay between the growth in cases and hospitalizations is going to be increased, but that doesn't mean it's not going to happen."
Prativa Baral, an epidemiologist and doctoral candidate at Johns Hopkins Bloomberg School of Public Health, said at this stage the government should slow down its efforts to relax restrictions.
Baral acknowledged that to preserve "mental health and emotional development and social development and so on," schools should stay open.
"But other things, like opening up theatres and opening up houses of worship for 250 people, that to me seems a little premature," she said.
"The virus doesn't really care if you're there for prayer or for theatre — what it really sees is a crowd of people and 250 people indoors is just asking the virus to spread faster."
The government's task is made more complex by increasingly fragmented public opinion.
There are parents very upset about their children going to school and others who feel the opposite. Some people want more restrictions and the virus stamped out entirely, while others feel that their liberties have been trampled for too long.
And there are those who, buoyed by rampant disinformation campaigns, have embraced conspiracy theories that dispute the severity of the disease and dismiss the facts of packed hospitals and high death tolls.
On Tuesday, Legault reiterated a common request — for the public to follow the rules — and noted that "the problem is not the rules in place but the people who don't follow them."
But a few days earlier, he acknowledged that if restrictions were too strict, people might stop following them altogether.
"Regarding measures, we need to have a balance," he said. "If we want the population to follow the measures we have in place, we need to have a balance."