TORONTO -- As cities across Canada search for explanations and areas of blame for the spread of COVID-19, one in particular faces the most pressing questions.
Montreal, the epicentre of the novel coronavirus in Canada, has seen more than 22,000 confirmed cases and about 2,300 deaths since the first presumptive case at the end of February. That鈥檚 more than one-third of all deaths in the country.
Why has the city been hit so hard? There鈥檚 still much to be determined, infectious disease specialist Matthew Oughton told CTV鈥檚 Your Morning on Tuesday.
鈥淭he entire final story has not yet been written,鈥 he said. But there are significant factors likely at play.
LONG-TERM CARE POPULATION
COVID-19 causes the most severe illness in people who are older with multiple health problems, a population group of which Montreal has many as the biggest city in the province.
鈥淲e have a higher proportion per capita of people in these long-term care facilities鈥 Oughton said.
Last week, Quebec Premier Francois Legault visited the city for the first time in the pandemic and said the Quebec society is to blame for what has happened in Montreal.
鈥淚 think the society failed,鈥 he told reporters.
Per capita, there are three times more elderly people in long-term care facilities in Quebec 鈥渢han anywhere else in the world,鈥 he said, adding that they have been underfunded and understaffed for years.
LARGE POPULATION HIT EARLY
Quebec has the earliest March break of any province, which Oughton said likely contributed to the city getting hit early and hard by COVID-19 weeks before quarantine and physical distancing measures were widespread.
鈥淲e got a large influx of disease early on,鈥 he said. 鈥淚 wouldn鈥檛 be surprised if there was community transmission earlier than we expected while we were still looking for it in the travelling population, but that鈥檚 going to remain to be proven.鈥
MOVING WORKERS
In efforts to quell the spread early on in long-term care facilities, the provincial government took an 鈥渁ll hands on deck鈥 approach, said Oughton, making the decision to move many workers from hospitals to those facilities, which are called CHSLDs in Quebec.
It was a 鈥渟hort-term fix,鈥 he said, but may have contributed to further spread.
鈥淚 believe that posed a risk to those workers who then might be coming back to their original places of work without having been properly quarantined,鈥 he said.
POOR NEIGHBOURHOODS
Another subset of the population that has been hit hard by COVID-19 are the poorer boroughs of the city.
鈥淚t really seems like this virus is 鈥榩rogrammed鈥 to take advantage of our society鈥檚 weakest and most vulnerable,鈥 said Oughton. Not only has the disease attacked elderly people and those with existing health problems, it appears to be targeting those are who 鈥渟ocioeconomically disadvantaged,鈥 a fact that hasn鈥檛 played to Montreal鈥檚 favour, said Oughton. The city has some of the poorest neighbourhoods in the country with some of the worst rates of child poverty.
鈥淭his really speaks to the importance of proper housing, good ventilation,鈥 said Oughton, 鈥渁ll these kinds of measures that we know are important determinants of health.鈥
Infographic by Mahima Singh
