As the number of new daily COVID-19 cases in Quebec continues to creep upwards, health officials are cautioning the public to heed government restrictions and not slack off on physical distancing measures.
After recording 205 new cases Sunday — the highest number the province had seen in more than three months,Quebec reported an additional 216 new cases on Monday.
That means the province now has a seven-day moving average of 20.4 cases per million inhabitants. Quebec's health authorities had previously said they hoped to keep that number below 20 cases per million.
Dr. Caroline Quach, an infectious disease specialist, said that while the increase may in part be connected to growing testing numbers and contact tracing strategies, it is still a major concern.
"It's a few days now that this increase in the number of cases has been bothering us. It's already been more than a week that we're above 100 cases and it's been a few days that we've been above 170," said Quach.
"There's starting to be an upward trend."
Thursday saw the highest number of COVID-19 tests carried out since the beginning of the pandemic, with 20,219 people tested.
But with summer vacation wrapping up and the long weekend coming to a close, Quach fears the increase in cases may also be related to people growing more lax toward the rules, especially when it comes to limits on private gatherings.
While the province increased the limit on public gatherings to 250 earlier this summer, private gatherings are still capped at 10 people or less.
"It's the last long weekend of the summer so probably they want to see each other, and stick close and act as though nothing is happening. But there's nothing that says you won't be symptomatic tomorrow and have exposed people over the weekend," said Quach.
"We still need to be carful. It's exhausting but we don't have a choice."
Quach noted the cases are no longer concentrated in Montreal but spread throughout different regions.
For instance, 61 of the new cases recorded Monday were in Montreal, but Quebec City was not very far behind with 51 new cases. Montreal remains the region with the highest number of cases, with 30,148 cases reported since the start of the pandemic.
She said that while some may be tempted to blame this increase on the reopening of schools, many of the cases found in schools so far are the result of community spread.
"These are cases that were acquired in the community, whether they be linked to outbreaks we've seen or through their home contacts," she said.
The idea of a potential lockdown for certain regions has been floating around in recent days, and Quach believes that, if the numbers continue to trend upward, that might be something the government should look at implementing.
"To be able to control those places where the measures currently in place — wearing a mask, physical distancing, 10 people per home — aren't able to control transmission, it's possible they'll be obliged to enter confinement again," she said.
Last week, Premier François Legault warned Quebecers that he will be forced to re-impose lockdown measures if they don't start obeying public-health rules more diligently.
In a tweet Sunday, Health Minister Christian Dubé added that this latest increase in cases means the province is dealing with significant community spread and urged Quebecers to follow public health guidelines diligently.
Deaths remain low
Dr. Matthew Cheng, an infectious disease specialist at the MUHC and a researcher for the World Health Organization's COVID-19 treatment trials, said there is a silver lining to the latest numbers.
Despite the number of cases increasing, the number of hospitalizations and patients in the intensive care unit have remained relatively low.
"The number of hospitalizations is remaining relatively steady and that's probably because we're seeing a shift in the demographic of patients who are being infected," said Cheng.
"Currently what we're seeing are young adults who may not have followed the public health regulations and rules, and that were often seen to be having parties or other things indoors."
Cheng said he is bracing for the possibility that, if cases continue to trend upward, there could be more community spread and it may lead to more hospitalizations eventually.