Quebec's institute for public health (INSPQ) has declared a sixth wave of COVID-19 in the province — and some medical experts say the data show it was premature for the government to drop health measures.

Cases are surging, fueled by the Omicron BA.2 variant, and "an upward trend has begun," according to a report from the province's healthcare research institute (INESSS).

New cases hit 3,067 in the past 24 hours, creeping up to nearly a thousand more daily cases than one week ago. Hospitalizations were up 18% last week compared to the week before, and are now hovering around 150 new daily hospitalizations for the first time since the peak of the fifth wave in mid-January. The INESSS projects hospitalizations could reach approximately 200 per day — with a high number of regular and ICU beds occupied by COVID-19 patients — in the coming weeks.

Outbreaks in the health network

While the province has allocated more hospital beds for people with COVID-19, anticipating the surge, many of the workers who would normally attend to those patients have become sick themselves. Around 8,600 caregivers have contracted COVID-19 in recent weeks, with the health network seeing a 60% rise in the number of staff members who are infected.

"Our health care workers have not had a moment to breathe in the last two years and have not recuperated from the latest Omicron surge — and we are already starting our next wave. It’s disheartening," said epidemiologist and Johns Hopkins Bloomberg School of Public Health doctoral candidate Prativa Baral.

"The BA.2 variant is even more contagious than the previous Omicron variant that caused the massive wave over the winter and crippled our health care system. We’ve dropped restriction capacities, and there’s just a lot of virus circulating, so it's not surprising unfortunately that everyone is at a higher risk of being infected, including our health care workers."

No more mask mandate

As of this weekend, the government reaffirmed that mask mandates in public spaces would likely be removed by mid-April. Interim Public Health Director Luc Boileau said on Sunday that even during a sixth wave the government would not bring back the strict health measures issued during earlier waves.

"It's normal to have waves of this kind of infection… let’s try to live with it right now," said Boileau. "Every person has to act responsibly, according to their situation."

That didn't sit well with Montreal-based doctor Lisa Iannattone.

"After two years, we shouldn’t be approaching this reactively or playing chicken with hospital capacity. We still need collective measures, not as a restriction but as a protection," she said.

"If you’re a high-risk working parent, how can you avoid infection when your colleagues aren’t masking at work and your kids’ classmates aren’t masking at school? Waves are expected, particularly when measures are dropped, but living with the virus does not mean completely dropping the ball and normalizing mass and ongoing infection (and reinfection) over and over again."

For Iannattone, adapting to a world where the virus continues to circulate means taking steps to educate the public about effective mask use and airborne transmission of the virus.

"We will never go back to 2019"

Iannattone said more public education about how the virus spreads is needed so fewer expose themselves to infection unknowingly and unnecessarily.

"People are still wearing cloth masks or poorly fitted surgical masks. The simple act of swapping out a suboptimal mask for a respirator (KN95, KF94, or N95) can greatly decrease your risk of being infected," she said.

Improved ventilation and filtration in shared indoor spaces is also a must, she said.

"The same way we have standards for our drinking water, we need to have standards for our air quality," said Iannattone, citing preliminary data from schools in Italy that show ventilation upgrades in classrooms with six air changes per hour decreased the number of infections by 82%.

"Upgrading the ventilation in every school, office building, and restaurant won’t happen in a day, but it needs to get done so the sooner we start, the better."

Instead of lifting measures, the government should be investing in longer-term solutions, Baral affirmed.

"Failing to mention the airborne method of transmission for this virus and the appropriate ways of protection is misinformation. Not mentioning the risk of long COVID due to an infection is normalizing these waves of infection," said Baral.

"The reality is, we will never go back to 2019, but it doesn’t mean that our future has to be one with either mass infections or lockdowns. There are a lot of steps that can be taken in between these two extremes that would allow us to live, and do all the things we enjoy doing. Instead, governments around the world, including our own, are choosing to look the other way and pretend things are 'normal' when they clearly are not."