1) The #pandemic in Montreal has begun to spread from long-term care centres and seniors’ residences into acute-care hospitals as the city reported its second biggest single-day increase in #COVID deaths on Wednesday. In this thread, I will try to explain what’s going on.

2) A week ago, the Jewish General Hospital reported about 75 hospitalizations. This morning, the designated #COVID treatment centre is up to 120 hospitalizations. The vast majority are people from long-term care centres.

3) The #COVID patient population at the Jewish General has also shifted. About two weeks ago, the patients were 20 to 30 years younger. Tonight, many of the patients at the hospital are the elderly who are wearing oxygen masks to help them breathe.

4) The nursing homes, or CHSLDs, are sending these patients to hospitals not because they’re overwhelmed — which clearly, they are — but because these vulnerable individuals need more care. They don’t necessarily need to be in the intensive care unit, but they do need oxygen.

5) At the same time, some hospitals are struggling to contain outbreaks on their floors. In the most serious example, #COVID has swept through Sacré-Coeur Hospital, which has been described as Dickensian for its lack of private rooms. Among the infected: cancer patients.

6) The pressure is still being felt in the city’s ERs, too. Tonight, four emergency rooms are overcrowded, and two others are approaching full capacity. The ERs are dealing with mostly non-COVID admissions, but they’re also getting patients infected with the #coronavirus.

7) Meanwhile, the crisis is growing worse in Montreal’s CHSLDs and seniors’ residences (RPAs). Twenty-nine of these facilities are coded red, hit with the most serious outbreaks, up from 23 less than a week earlier. More residents than ever are infected with #COVID.

8) At the same time, the number of #COVID deaths jumped by 64 to 647. To put that number in context, Montreal has now declared more deaths than the tolls in each of the following nations: Indonesia (635), Ecuador (537), Romania (524) and Austria (510).

9) Montreal’s #COVID mortality rate per million population is now 331.7. Greater Boston’s is 297 and Toronto’s 46. In that context, it’s understandable why Premier @francoislegault called on Ottawa today to dispatch 1,000 soldiers to assist in the CHSLDs in Montreal and Laval.

10) In yet another sign of how the crisis is spreading beyond CHSLDs, the number of people who’ve died from #COVID in Montreal hospitals increased by 16 since yesterday to 22. There’s no doubt that the city’s already over-taxed health system is being pressured as never before.

11) Dr. Mylène Drouin, the city’s top health officer, updated Montrealers last Thursday. Given that the number of new #COVID cases surged on Wednesday, its second highest ever, perhaps tomorrow might be a good time to give us all an update. End of thread and please stay safe.