Quebec has consistently been the hardest hit province in Canada throughout the COVID-19 pandemic, totalling 42,183 cases and 3,483 deaths as of Sunday.

While other provinces in Canada begin to slowly lift restrictions, Quebec is struggling to flatten the curve; the province continues to report an excess of 700 new cases every day. The daily death toll has ranged from 50 to 142 deaths over the past week.

May 16 #COVID19 #Canada update. Explore the data on our (@ishaberry2) dashboard below.👇https://t.co/tvi5Muem7e pic.twitter.com/I1AaEKsFcI

— Jean-Paul R. Soucy (@JPSoucy) May 16, 2020

Quebec has a number of social distancing measures in place, including limiting public gatherings and temporarily closing down non-essential businesses (e.g. hair salons, restaurants, day camps) — but even with the government restricting daily interaction, the caseload continues to rise.

Some of Quebec's early exponential growth in cases is simply a result of unfortunate timing; schools in Quebec let out two weeks earlier than schools in other provinces, which resulted in an increased number of international travellers returning from the United States and Europe — potentially carrying the virus back to Canada.

But the province's cases can be attributed to more than bad luck; it also has to do with population density.

Roughly half of Quebec's COVID-19 cases are situated in Montreal, which had one of the highest population densities per square kilometre in Canada in 2016, ranking second only to Vancouver; this sort of packed geographical layout makes it difficult for people to maintain proper social distancing.

The city has introduced pedestrian corridors to encourage more spacing between residents, but the corridors weren't implemented until mid-April, when Montreal already had an excess of 7,000 cases.

Nouveau corridor piétonnier rue Jarry à Montréal. pic.twitter.com/wFieH9FVDH

— Benoit Audet (@audetbe) May 8, 2020

Similarly, Montreal had the highest rate of shared dwellings in Canada in 2016, with apartments and flats in a duplex making up 58.4 per cent of all dwellings in the city.

In fact, the study highlights that all five urban centres in the province of Quebec ranked highly for the largest share of apartment dwellings, with about half of the province's population living in some form of shared accommodation.

These conditions could potentially contribute to the caseload; with hundreds of people touching the same shared surfaces in apartment buildings (e.g. elevator buttons, door handles), it's difficult to control the spread of the virus — even if people are staying indoors.

What’s happening in Montreal? “Being able to socially distance is a sign of privilege”: One neighbourhood sector has almost twice the population density of NYC’s densest borough. “It’s hard to apply those rules in Montreal North.” https://t.co/0CSM9CCtBi

— J.J. Gould (@jjgould) May 13, 2020

But Quebec isn't just suffering a large caseload; the province's death toll continues to rise as well, with COVID-19 claiming the lives of almost 3,500 people in Quebec.

Over 90 per cent of those deaths can be attributed to Quebec's elderly population (70 years or older), who are more likely to suffer health complications after contracting the virus.

And while the high death rate among an elderly population is somewhat expected, Canadian medical experts believe that the high death rate in continuing care homes can also be partially attributed to the failure to ensure an adequate supply of personal protective equipment (PPE), a lack of directives, and health care aides working in several care homes simultaneously — thereby unwittingly spreading the virus across facilities.

Canada's high number of #COVID19 deaths in continuing care is a national tragedy. What could we have done to prevent them? https://t.co/hmMnbRvxeP @HolroydJm @AndreasLaupacis #cdnhealth #cdnpoli pic.twitter.com/9DB62TAyrc

— CMAJ (@CMAJ) May 14, 2020

The Quebec government has now deployed Canadian soldiers to assist in long-term care facilities in order to meet those staffing challenges, but the virus had already impacted at least 75 per cent of facilities in the province before those measures were taken.

Fortunately, Quebec is making some strides toward flattening the curve, with 11,458 people now recovered — just under a quarter of the province's total number of cases.

Quebec plans to gradually reopen some intraprovincial travel, retail services and outdoor non-contact sports later this month. Elementary schools outside of Montreal have also resumed, although provincial officials say that those in the Montreal area won't resume until September.