1) NEW: In this thread, I try to explain why the increase in Montreal’s #COVID19 cases today, 106, was so much lower than in previous days. This is of vital importance as Montreal’s epidemic is the worst of any Canadian metropolis, and people are hoping to see a big improvement.

2) The last thing I want to do is give people false hope, and I'm warning against jumping to conclusions. Here is a partial answer. We don’t have figures for Montreal, but provincially the number of #COVID19 tests plummeted since yesterday.

3) Quebec reported 2,322 new tests on April 1, compared with 7,226 tests on March 31. Credit for those numbers goes to colleague Amélie Daoust-Boisvert, ( @amelieboisvert) who has done an amazing job compiling Quebec’s #COVID19 data – even better than the government itself!

4) Could the much lower increase in #COVID19 cases be attributed solely to problems in testing? I put the question to a senior health department official, who told me: “There’s a backlog in the testing because there’s a shortage of test reagent.”

5) “So is today’s count a red herring?” I asked. The official, who agreed to speak on condition of anonymity, responded: “It might be, but then again, the ( #COVID19) social isolation measures may also be kicking in.”

6) Montreal’s chief public health officer would later confirm at a news conference today that “we’re facing many delays in the laboratories…and we’re expecting new ( #COVID19) cases that will be added in the coming days.”

7) So everyone needs to brace for a one-day or two-day surge in #COVID19 cases in Montreal once the bottleneck in testing is cleared. Other jurisdictions have faced similar shortages with testing reagents. Let us hope Quebec can stay on top of this.

8) Dr. Mylène Drouin, the city’s public health officer, noted that despite a spate of 13 #COVID19 outbreaks in some of Montreal’s long-term care centres, “there is some good news.”

9) “In the last four or five days, we have observed a certain stability in the number of new ( #COVID) cases. That number has not doubled or tripled,” Drouin said, comparing Montreal’s epidemic with perhaps what has gone on tragically in Italy and other countries.

10) I would now like to focus on another chart I created that is slightly different than the chart in the first tweet of this thread. The chart below is a basic logarithmic graph that epidemiologists like to use. Notice the blue line representing cumulative #COVID cases.

11) See how that blue line in the new chart below of cumulative #COVID cases appears to curve ever so slightly, compared with the skyrocketing blue line in my first chart? Perhaps this is what Dr. Drouin was referring to when she said “we’ve observed a certain stability.”

12) A lot of people have been focusing on #COVID acute-care hospitalization rates. Obviously, they’re important, but the bigger problem now is the city’s 13 outbreaks in long-term care centres and 14 deaths to date of the elderly.

13) It’s a very sad reality that fatal outbreaks of superbugs like #MRSA and #Cdifficile occur far too often in long-term care centres, and now it’s #COVID19 that is hitting nursing homes. Authorities really need to contain these 13 outbreaks and prevent others from flaring up.

14) Meanwhile, 132 people are hospitalized for #COVID19 in Montreal. We don’t have the figure for Tuesday because public health didn't hold a news conference then. But on Sunday, Drouin reported 83 hospitalizations. So there’s been an increase of 49 in the past three days.

15) At the Jewish General Hospital, the only hospital to provide daily updates, the number of #COVID hospitalizations remained at 60 as of Wednesday night, the same as the day before.

16) Dr. Lawrence Rosenberg, in charge of the JGH, said this about his #COVID numbers: “I think it’s better than they thought it was going to be, but as I told you yesterday, we’ll really know better towards the end of the week or into the weekend which way things are trending."

17) It’s safe to conclude at this stage Montreal is still in the throes of the #COVID pandemic. Both the CHSLD outbreaks and the climbing hospitalization rates mean we can’t lower our guard. Some people should keep this in mind before gathering in parks. End of thread. Keep safe!