Chaudière-Appalaches: Portrait of a region coloured in orange

If you look at the provincial government's colour-coded COVID-19 map, it's the large swath of orange just south of Quebec City.

But while the sprawling region is orange in its entirety, public health officials in Chaudière-Appalaches are focusing their efforts to beat back spiking COVID-19 case numbers narrowly.

Specifically, the spotlight is on seniors' residences.

One of the main factors behind the region's move to orange has been the worsening situation in privately run old age homes — résidences pour personnes agées (RPAs).

"The current epidemiology in Chaudière-Appalaches shows seniors' homes are the places where the risk is highest," said Dr. Liliana Romero, the region's public health director. "We have multiple outbreaks. We had three deaths this past weekend. We need stiffer measures if we hope to stop the virus from entering these residences."

In other words, it's past the point of trying to attack the problem by coaxing or threatening the wider community to take public health measures more seriously.

More than 100 new cases since Friday

Chaudière-Appalaches reported a record daily high of 50 new confirmed COVID-19 cases on Monday, adding to the 55 over the weekend. Those are big numbers for an area with an overall population of just over 400,000.

And the outbreaks are not geographically concentrated:

• Four new cases at a residence in Lévis.
• Eight active cases among residents and five among staff at a home in Saint-Nazaire-de-Dorchester.
• Two residences in Thetford Mines dealing with outbreaks.
• A residence in Saint-Georges-de-Beauce with 12 cases.

The Saint-Georges residence also recently recorded one death. The town's mayor, Claude Morin, told Quebec AM last week the infection may have originated with a construction crew working outside the building.

It's a handy illustration of why public health officials are trying to nip the coronavirus bud among younger, healthier people, who represent a majority of this month's positive tests. 

In all, four RPAs in the region now report at least a quarter of their clientele is infected with coronavirus. Romero's immediate response has been to tighten regulations in extended care and old age homes.

"Visits are going to be limited. Every visitor will have to fill out a questionnaire, they'll have to wear a surgical mask at all times, and they will be supervised so they don't end up spreading the illness," she said.

It's not a ban, exactly. Close family and caregivers will still be able to see their loved ones, she stressed, but there will be hoops to jump through.

'We're in the midst of dropping the ball'

The situation is also worsening in Quebec City.

The regional Heart and Lung Institute confirmed it is dealing with an outbreak. The municipality also smashed its previous single-day total of new infections on Saturday.

Take the provincial capital's numbers and combine them with its neighbour across the St. Lawrence, and you have something that looks a lot like the epicentre of the gathering second pandemic wave.

"I always like it when we're at the top of the list, but in this case we're first because we're the worst," said Quebec City Mayor Régis Labeaume, before catching himself. "Actually, yesterday and today we're second. Our neighbours are the worst."

Labeaume is not one to mince words, and in looking at what's happening in his city and environs, he's reached a bleak conclusion.

"Honestly, I think we're in the midst of dropping the ball. And dropping it hard," he said. "If this continues, my feeling is we're headed for red. And red is the wall. So we're headed straight for the wall."

Like Chaudière-Appalaches, the Quebec City region is trying to put out multiple small fires in a diffuse area; officials there have identified 40 separate mini-outbreaks, Labeaume said.

Though the main ravages of the initial COVID wave took place among the elderly and chronically ill, he pointed out that storyline is no longer operative.

"The virus is among us," he said, "and I think we need to wake up."