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cases Surge

As Cases Surge, Pandemic Restrictions Again Descend on Quebec – The New York Times

Politicians in Quebec and neighboring Ontario, Canada’s two most populous provinces, are blaming a rise in cases on people dropping their guard.

Credit…Paul Chiasson/The Canadian Press, via Associated Press

Dan BilefskyIan Austen

MONTREAL — There has been a veneer of normalcy in Montreal.

Couples hunched over steak-frites and poutine at popular neighborhood bistros. Young people thronging comedy shows and CrossFit classes in parks. Shopping sprees, even if armed with masks and sanitizers.

But this week the sense that regular life was gradually returning was upended when Quebec, faced with a resurgence of coronavirus cases, became Canada’s first province to reintroduce tough shutdown measures — including closing restaurants, cinemas, and theaters, and forbidding household visits to friends or family, with some exceptions.

“The situation has become critical,” Quebec’s premier, François Legault, said on Monday evening, lamenting that people had relaxed their vigilance and prioritized fun. “If we don’t want our hospitals to be submerged, if we want to limit the number of deaths, we must take strong action.”

Alarm has also shaken Ontario where some cities are again posting record case numbers, and some new, modest restrictions have been imposed, including shutting down strip bars and banning alcohol sales after 11 p.m.

Epidemiologists attributed the growing numbers of case to inadequate contact tracing; an unwillingness to shut down schools and businesses; and people letting their guards down. For example, the karaoke bar, Bar Kirouac, in Quebec City, was linked to 72 cases of Covid-19, according to Quebec health officials.

The relapse has underlined how even Canada, a country with universal health care and a generally disciplined, rule-bound population, remains vulnerable to the coronavirus.

On Tuesday, Ottawa, the national capital, reported 105 cases — its highest number of new cases in one day since the beginning of the pandemic. It now has the highest number of active cases since late April.

Quebec, Canada’s epicenter throughout the pandemic, reported 750 new cases on Monday, helping to bring the total number in the province to 73,450. In total, 5,833 people have died in Quebec; the entire country has seen 9,289 deaths.

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Credit…Blair Gable/Reuters

Canadians have until recently taken some satisfaction in the country’s approach to containing the virus. Most provinces moved swiftly in March to shut down schools and businesses. The border with the United States was closed and some provinces limited travelers from other parts of Canada — a restriction that still is in effect.

By spring and through the summer, many of those measures were significantly relaxed in most parts of the country.

In contrast to the hard-hit United States, where President Trump has repeatedly clashed with governors over how to manage the pandemic, partisan and regional grievances in Canada have been largely set aside.

Premier Jason Kenney of Alberta, a conservative who has often sparred with premiers in more liberal provinces, offered surplus masks, gloves and ventilators to Quebec, Ontario and British Columbia.

Without exception, political leaders have also deferred to physicians, scientists and public health experts to inform the country’s approach.

While Prime Minister Justin Trudeau has recently been buffeted by scandal, he has been generally credited for his authoritative handling of the pandemic. Early on, he set an example when he became the first leader of a major industrialized country to go into self-isolation, when his wife, Sophie Grégoire Trudeau, tested positive for the virus.

His government has since offered billions of dollars in financial support for businesses and workers hit by the virus to limit economic harm.

But David Buckeridge, an assistant professor and public health surveillance researcher at McGill University in Montreal, said that in Quebec, the provincial government did not act fast enough this time around.

“There’s so much pressure to maintain the economy that the government was a little slow to act decisively and close businesses,” Professor Buckeridge said. He said certain types of businesses like bars should never have been reopened.

He also said that although Mr. Legault blamed the rise in cases on private social gatherings, the province’s poor record at contact tracing made it impossible to confirm that. Mr. Legault’s analysis, he suggested, may be motivated by economic rather than medical considerations.

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Credit…Paul Chiasson/The Canadian Press, via Associated Press

Health officials and epidemiologists said Quebec’s party culture has helped make it the pandemic troublemaker, compared with other provinces like British Columbia and those on Canada’s Atlantic coast, where the numbers of cases per capita have been significantly lower.

Speaking on Sunday night on a popular television show, “Tout le monde en parle,” Quebec’s health minister, Christian Dubé, said, “We like to party.”

In Montreal, parks in recent weeks have hosted dense clusters of young people attending performance nights or sunning themselves. As winter looms, and with the city’s usual diet of summer festivals canceled because of the pandemic, there has been a particular urge to have fun. The authorities say private underground house parties have also helped fan the outbreak.

In Quebec, revelers enjoy mimicking Celine Dion, a native daughter, at karaoke nights. But earlier this month, after the outbreak at Bar Kirouac in Quebec City, health authorities suspended karaoke evenings throughout the province.

They noted that the projection of respiratory droplets when people sing and the sharing of microphones had made singing nights potentially deadly.

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Credit…Graham Hughes/The Canadian Press, via Associated Press

Under Quebec’s new rules, which will go into effect on Thursday, people will be forbidden to invite houseguests with the exception of individuals who require a caregiver, child care or maintenance services. Museums, bars and libraries will be closed. Churches, synagogues and mosques will be limited to 25 people.

People gathering outside will also be expected to remain two meters, or about 6.6 feet, apart. However, schools, which have been buffeted by dozens of cases of coronavirus, will remain open, as will gyms, hotels and hair salons.

The new restrictions will be imposed for 28 days and apply to three regions in Quebec, including Montreal.

In Ontario last weekend, a group of mostly young motorists poured into a resort community and commandeered its streets for illegal racing. Most of the crowd members were not wearing masks or socially distancing. Overwhelmed, police sealed off the town.

On Tuesday Doug Ford, the Ontario premier, said he will introduce orders barring visitors from long-term care homes in three of the province’s most populous regions.

The resurgence of cases has disproportionately affected young people, a shift from the early days of the pandemic. Dr. David N. Fisman, a professor of epidemiology at the University of Toronto Dalla Lana School of Public Health, said that may not just be the result of irresponsible behavior but of other factors, including the opening of university dorms and the fact that young people work in shops and restaurants.

“Not many 60-year-old baristas and waiters here,” he said, saying that blaming renewed outbreaks on social gatherings and irresponsible youth had “become an escape hatch for the government in terms of any restrictions on businesses.”

Dr. Buckeridge said that Quebec’s new measures will take weeks to have any effect on infection rates, and that the province will likely have to go further.

“There are going to be a few 28-day periods unless we change what we’re doing in a meaningful way,” he said.

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Coronavirus Surge

Coronavirus surge in Lebanon compounds the misery in a battered country – The Washington Post

BEIRUT — An alarming spike in novel coronavirus cases since the devastating explosion at Beirut’s port is compounding Lebanon’s misery at a time when the country was already laid low by overlapping financial, economic and political crises.

Since around 2,700 tons of ammonium nitrate were ignited Aug. 4 by a still-unexplained blaze in a warehouse at the port, the total number of coronavirus infections has more than doubled — to 12,191 as of Saturday — prompting the government to order a partial lockdown that went into effect Friday.

The jump has been attributed in part to the mass panic that gripped Beirut in the aftermath of the blast, which wrecked three Beirut neighborhoods adjoining the port and inflicted damage and injuries for miles beyond. Tens of thousands of injured and traumatized people surged onto the streets without thought of wearing masks or social distancing.

For days after the explosion, dazed Beirutis abandoned all coronavirus precautions as they swarmed hospitals to seek treatment for their wounds or hunt for missing friends and relatives. Thousands descended on the stricken areas to help in the rescue and cleanup effort. A jump in coronavirus cases was widely predicted.

The estimated 300,000 made homeless took refuge with friends or relatives or moved into shelters, adding to the overcrowding. Three hospitals were destroyed, including one that had hosted a substantial number of Beirut’s coronavirus patients, further straining Lebanon’s capacity to care for an already rising number of cases.

But Lebanon may already have been heading for a coronavirus crisis even before the blast, health experts say. The country had won plaudits from the World Health Organization for containing the coronavirus in the earliest weeks of the pandemic, but numbers had already begun to rise.

“The blast is partially to blame, but it is not the blast alone. We clearly had an exponential rise before the blast,” said Firas Abiad, who manages Lebanon’s largest coronavirus facility, Rafik Hariri University Hospital.

On the morning of the explosion, he recalled, he tweeted about the risk that rising coronavirus numbers could soon overwhelm the country’s hospital-bed capacity.

The success of a nearly two-month lockdown caused many to relax their guard once the restrictions were lifted, he said.

Videos posted on social media showed Lebanese crowding onto beaches, into mountain resorts and into nightclubs. One depicted revelers openly mocking the threat posed by the virus by parading around a nightclub carrying a coffin.

Most significantly, travelers failed to follow — and the government failed to enforce — strict requirements at the airport for people arriving in the country. They include a mandatory coronavirus test on arrival, to be followed by a 48-hour quarantine until the results of the test are received.

There are multiple examples of people participating in weddings, funerals and parties and then receiving positive results, Abiad said.

Lebanon still lags behind many other countries in terms of the per capita number of infections, with about 1,700 cases per million people, compared with more than 17,000 in the United States, according to Lebanese government and Johns Hopkins University figures.

But the jump in recent days — from slightly more than 100 new infections a day a month ago to more than 600 a day since Thursday — suggests the virus may now be spinning out of control, infectious-disease experts say.

“The numbers are increasing very rapidly, and we are seeing signs of exponential growth,” said Ghina Mumtaz, an assistant professor of infectious diseases at the American University of Beirut. “When they start growing exponentially like this, they can get very high very quickly.”

Whether the latest partial and spottily imposed lockdown will work to curtail the spread is another question confronting Lebanon. The government has ordered most shops to close along with restaurants, cafes and bars. A strict 6 p.m.-to-6 a.m. curfew has shut down all nightlife in the capital.

But the restrictions are being loosely observed, mainly because even those Lebanese who have not been affected by the blast are already struggling to get by. The United Nations estimates that the poverty rate in Lebanon soared from 28 percent last year to 55 percent in May, three months before the blast. It is almost certainly higher now, U.N. officials say.

“We’re not as bad as some places in terms of numbers, except it’s hitting us here against a background of economic and financial collapse and the consequences of the blast,” said Souha Kanj, who heads the infectious-disease department at the American University hospital in Beirut. “In other countries having to deal with covid, it’s just that.”

“People are hurting financially and economically. Telling people you have to close your shops and businesses for two weeks is too much,” she said.

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COVID Surge

How the Covid-19 Surge Shifted to the South and West – The Wall Street Journal

Americans are seeing the coronavirus pandemic play out in two parts, as states that bore the brunt of cases in the early months of the pandemic have mostly contained the spread, while a new wave of infections is now threatening much of the rest of the country.

At the start of April, New York and New Jersey accounted for fully half of all cases nationwide. Those two states plus five others saw a combined rate of confirmed infections that was nearly eight times that of the rest of the country. But mitigation efforts that brought…

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