At Laval's Cité-de-la-Santé Hospital, Dr. Joseph Dahine says all eight patients in his intensive care unit with COVID-19 on Friday were unvaccinated or not adequately vaccinated.
Their average age is around 40 years old.
"They're sick, they have very damaged lungs, they require ventilator support, most of them are intubated," said Dahine, an intensive care specialist at the hospital, which was operating at 131 per cent as of Saturday afternoon.
An unabated staffing shortage has left many emergency rooms in regions like Montreal, Laval, Montérégie, the Laurentians and the Lanaudière swamped and operating well above capacity as patients flood hospitals, prompting some of them to curtail hours of operation, reduce services or even shut their doors altogether.
But while the ER situation is reminiscent of previous waves of the pandemic, the demographic of patients hospitalized with COVID-19 has changed amid the fourth.
Public health data indicate that people in younger age groups, especially those who aren't vaccinated, are accounting for more hospitalizations this time around compared to the first three waves where the older population made up the large majority of the province's COVID-19 patients.
Last month, which signalled the start of the fourth wave according to many experts, people between 40 and 49 made up the majority of hospitalizations, followed second by people aged 50 to 59.
People between 20 and 29 years old also reached a higher percentage of hospitalizations — 8.9 per cent — than they did during any other wave.
"If you think it's bad now, wait until later because the numbers are rising up and they will continue to increase as long as people continue to increase their social contacts," said Dahine, adding that vaccination is the only way to curb the trend.
Delta changed the game, says ICU doctor
So what changed in the fourth wave? "One word: delta," said Dahine.
"It's very contagious. It finds a way, that variant, to find the people who are vulnerable. Who's vulnerable? The unvaccinated. Who's unvaccinated? Those who choose not to get vaccinated and kids."
As of Saturday, Quebec's vaccination rate among the eligible population stood at 88 per cent for one dose and 82 per cent for both doses. Those who are in the 18-39 age group are still lagging when it comes to receiving two vaccine doses, collectively sitting under the 75 per cent provincial benchmark.
Public health officials have said people who are not adequately vaccinated are 39 times more at risk of being hospitalized with COVID-19 and 46 times more at risk of ending up in the ICU.
Dr. François Marquis, an intensive care chief at Maisonneuve-Rosemont Hospital in Montreal, also says the kinds of patients in his hospital has changed.
"They are younger, not vaccinated or partially vaccinated," he said, adding that the only fully vaccinated people that are admitted in his ICU are taking "severe immunosuppressive therap[ies]."
In a tweet Friday, Health Minister Christian Dubé said all new intensive care cases were among people who were not vaccinated and urged the stragglers to get immunized to relieve pressure on the hospitals.
Public sector missing 4,000 nurses
Earlier this week, president and CEO of the CIUSSS du Centre-Sud-de-l'Île-de-Montréal, Sonia Bélanger, took stock of the situation in Montreal's health-care system.
"In hospitals, it is unfortunately the unvaccinated people who risk overwhelming the health and social services network in the coming weeks," said Bélanger.
...the unvaccinated people who risk overwhelming the health and social services network -Sonia Bélanger, president of the CIUSSS du Center-Sud-de-l'Île-de-Montréal
Quebec Premier François Legault said this week that the public sector is missing about 4,000 nurses. He said the government is looking at any and all options to entice nurses who have left the public sector to return.
In four weeks, the shortage could get even worse, as health-care workers who are not adequately vaccinated will be subject to suspensions without pay.
"If I had one message to get across so we can get through this fourth wave," Dubé said earlier this week, "it's that those who aren't vaccinated, please do so."