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People walk along a street in Old Montreal following a news conference on Dec. 30, by Quebec Premier Francois Legault where he announced the closure of restaurant dining rooms and a curfew beginning on Dec. 31 at 10 p.m.Graham Hughes/The Canadian Press

Quebec is bringing in the toughest COVID-19 restrictions in the country – including a curfew that will start in time for New Year’s Eve, an end to indoor dining and a ban on gatherings in personal homes – as cases of the Omicron variant of the virus keep surging.

Other jurisdictions across Canada are introducing less stringent measures as they work to blunt a wave of COVID-19 infections that doctors and politicians warn could strain the medical system.

Ontario, Quebec and Alberta are delaying by a few days students’ return to schools next month. And Ontario is limiting the use of polymerase chain reaction (or PCR) COVID-19 tests, even though that will artificially reduce the official tally of daily cases. The provincial government is framing this as a way to protect scarce testing resources.

Nova Scotia pledged to increase its capacity to administer booster shots, while Prince Edward Island urged residents to keep New Year’s celebrations as small as possible. And Ontario announced it would start giving fourth COVID-19 vaccine doses to vulnerable people, such as long-term care home residents.

What’s happening for New Year’s Eve 2021 (and what’s not) across Canada

During an early evening briefing in Quebec, Premier François Legault pleaded with health care professionals to continue showing up to work.

“We are in a storm, and this storm is at its peak right now,” he said, speaking in French. “I cannot believe that over the upcoming weeks we’re going to leave Quebeckers without care. We really do need you. Please, if you are able to come and help your colleagues, please, we do really need you.”

The Premier announced the curfew at the same briefing. He said it will be in place as of Friday evening and will run from 10 p.m. to 5 a.m. each day, with fines ranging as high as $6,000 for violators. There will be exceptions for people whose jobs require them to be out, he said.

Quebec had a curfew earlier in the pandemic. It was a rare policy in North America, and the move was controversial. Mr. Legault acknowledged to reporters that it was hard to prove that the previous curfew had been effective at slowing the spread of the virus, but he suggested the province has no choice but to act.

“Right now the situation is so serious that we cannot allow ourselves to not add everything to our toolbox that we can,” he said.

Sally Otto, a University of British Columbia mathematical biologist who has done COVID-19 modelling, said a global review of COVID-19 public-health measures found restricting gatherings, both large and small, was the most effective way of curbing the spread of the virus. She added that curfews and making protective equipment more widely available were also found to substantially reduce transmission rates.

Quebec and Ontario are farther along in their Omicron outbreaks, she said, but she noted that the intensity of the latest wave caught many provincial authorities off guard.

“Every province is scrambling,” Dr. Otto said.

On Thursday, Quebec reported another daily record of 14,188 COVID-19 cases. Experts across jurisdictions have been warning that the real numbers are likely higher than official counts, because the results of many rapid COVID-19 tests done at home are not being added to formal tallies.

Ontario will further muddy the waters by restricting the use of PCR tests, which had previously been used by many to confirm the results of at-home rapid antigen tests. The province will now reserve the sensitive lab-based tests for people who are at elevated risk of harm from the virus. The move is being billed as a way of preventing the PCR system from being overwhelmed by a surge in mild infections, as vaccinated people catch Omicron.

Kieran Moore, Ontario’s chief medical officer of health, acknowledged that this would bring down official case numbers, which are largely based on the results of PCR tests. But he told a media briefing that the province could track the progress of the pandemic in other ways, including by testing health care workers in high-risk settings.

“This is not to cover up,” Dr. Moore said, noting that COVID-19 transmission in Ontario is widespread. “That’s absolutely going to be the ongoing risk in our communities for the next six to eight weeks, so we’ll have a rapid ascent in cases and then a slow, steady decline.”

Ontario government delays return to school until Jan. 5

Ontario has said it is limiting capacity at sporting venues to 50 per cent, or 1,000 people, whichever is lower. Meanwhile, Quebec announced Thursday that it is completely stopping indoor sports, concerts, in-home gatherings and attendance at places of worship. Indoor dining at restaurants remains acceptable in Ontario, although at reduced capacity. In Quebec, it’s now banned outright.

Quebec, Ontario and Alberta all said Thursday they are pushing back the dates when primary and secondary students will return from their winter breaks – by a week in Quebec and Alberta, and two days in Ontario.

At the same time, several provinces are acting to make it easier for asymptomatic people who have tested positive for the virus to rejoin society. Ontario joined Saskatchewan Thursday in lowering from 10 days to five the isolation period for anyone in the general public who is twice-vaccinated, provided they are feeling better and mask up outside their homes.

This summer, British Columbia changed its rules in a similar way, but decided on seven days of isolation. Most provinces are still following the Public Health Agency of Canada’s current guidance that asymptomatic people should wait at least 10 days after testing positive before leaving their homes.

The explosion of COVID-19 cases, driven by the Omicron variant, is raising alarms across the country. Even if the variant proves relatively mild for most who catch it, experts warn, the sheer volume of cases could still overwhelm the medical system.

In Quebec, modelling by the Institut national d’excellence en santé et en services sociaux, a research institute that reports to the government, suggests the numbers of hospitalizations over the next three weeks could surpass those in previous COVID-19 waves in the province.

The institute’s report says about 1 per cent of new cases result in hospitalizations.

Asked if there was reason to believe Ontario would be on a different trajectory, Dr. Moore noted his province had moved sooner than Quebec to approve booster vaccines.

“I am anxious, though – I’m not going to tell a lie – about the impact potentially of a significant number of individuals needing care,” he said.

“Because Omicron is much more transmissible, it is expected that the number of hospitalizations and impacts on the health care system will be significant.”

With a report from The Canadian Press

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