1) The number of #COVID19 cases in Montreal has been dropping much faster than the rate of hospitalizations and deaths, suggesting this is partly the result of the dramatic decrease in screening. In this thread, I will try to explain the risks of performing fewer tests.

2) Since Dr. @ArrudaHoracio announced on May 1 a ramp-up in #COVID testing with a daily goal of 14,000, the province has achieved it on only three dates, the last of which was on May 27. This is far from the “disciplined” #pandemic approach Premier @francoislegault favors.

3) Under guidance by the World Health Organization to reopen from lockdowns, “stopping the spread of #COVID19 requires finding and testing all suspected cases.” Has Quebec truly been following this guideline as it rushes ahead with reopening?

4) Ideally, a jurisdiction should at least maintain its #COVID testing levels as it reopens: first, to spot any potential flare-ups, and second, to ensure whether the loosening of confinement measures is not backfiring. Clearly, Quebec is not doing this.

5) In neighboring Ontario, the government has been increasing its testing numbers, even though it’s observing a decline in cases. Please see the chart below, courtesy of Dr. Jennifer Kwan, @jkwan_md, who’s been doing a terrific job tracking the #pandemic in Ontario.

6) Ontario’s testing approach should give the public and government the confidence to reopen from its lockdown. Yet Ontario appears to be reopening more gradually and prudently than Quebec even though Quebec has been much harder hit in the #pandemic.

7) On Wednesday, Montreal posted 58 new #COVID cases, up from 40 the day before. (See below.) This is occurring even though the province has been carrying out fewer tests. Montreal’s current seven-day average of cases dropped by 54% from the previous seven-day average.

8) By comparison, the number of #COVID hospitalizations dropped by 36% in the past 14 days, as the chart below shows. This is fantastic news, but it’s worth pointing out that the number of detected #COVID cases is falling at a faster rate than hospitalizations.

9) There’s no doubt the decline in #COVID cases is the result of the progress of three months’ worth of confinement measures, for which Quebecers should be praised. But it would be naïve to assume it’s only because of the lockdown and not also because of fewer tests.

10) Meanwhile, Montreal posted 22 #COVID fatalities on Wednesday. (See the dark blue line below.) By comparison, the Ontario declared 12 new deaths for the whole province. Montreal’s current seven-day average in deaths declined by 11.5% from its previous seven-day average.

11) At the neighborhood level (please see the chart below), in Villeray–Saint-Michel–Parc-Extension, a #COVID hot spot acknowledged by Dr. Mylène Drouin Tuesday, the borough reported a dozen new cases, up from eight the day before.

12) Although Dr. Drouin said that fewer people with #COVID are showing up in the city’s emergency rooms, the ERs are nonetheless terribly overcrowded, making it hard to separate infected patients from those who aren’t. (See below.)

13) On Friday, Montreal’s public health department will discontinue its five #COVID testing buses, the same day city's shopping malls reopen. I recommend authorities send those buses instead to the parking lots of those shopping malls. End of thread. Wear masks in public.