Quebec offering fourth COVID-19 dose to most vulnerable, keeping mask mandate until mid-April

Quebec public health is now recommending a fourth dose of the COVID-19 vaccine for older and more vulnerable Quebecers.

Dr. Luc Boileau, Quebec’s interim public health director, says that booster will be available beginning next week for people over the age of 80, for those living in high-risk settings and for some immunocompromised people.

This comes amid a rise in infections driven by the BA.2 subvariant.

But Boileau says that’s not changing the province’s plan to lift its mask mandate in most public places by mid-April, as originally anticipated. He says the mask mandate won’t be lifted sooner than April 15.

“We’re not surprised by the rise of cases in hospital, we’re not expecting those to be as high as they were two months ago and we’re following the situation very carefully,” he said at Wednesday’s press conference.

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Boileau says the more transmissible BA.2 subvariant makes up 50 per cent of all cases in Quebec, but he stopped short of calling it a sixth wave.

“It’s difficult for us to say if we’re in a sixth wave right now, it’s mostly after a few days or a couple of weeks that we can say that, ‘oh it was a wave.’ Now we’re only observing a few cases that are going up, but not necessarily for a period of two, three weeks.

“But obviously it’s a pattern that we were expecting to have more cases, but not necessarily a big wave.”

Quebecers eligible for a fourth shot of the COVID-19 vaccine can register with Clic Santé as of Tuesday. The vaccine campaign in CHSLDs and RPAs will begin that day as well.

“Outbreaks means isolation, and isolation for elderly people does have impacts as well,” said Dr. Jean Longtin, a microbiologist at Quebec’s health ministry. “So we are recommending this second booster shot as a way to prevent cases and complications as well as outbreaks for these people.”

Projections published Wednesday by l’Institut national d’excellence en santé et en services sociaux (INESSS) suggests an “upward trend in the number of new hospitalizations as well as the number of regular beds occupied by COVID patients” in the next two weeks. But ICU numbers are expected to remain relatively stable.

“Right now with the numbers changing, from our experience when you look at Europe, cases don’t necessarily transpose in hospitalization nor in ICU intensive care unit cases,” said Longtin. “But hospitals have been following this very closely as well as the ministry, just so to be sure that if the rise in cases does translate to a rise in hospital cases that they’re prepared to take care of these patients.”

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Boileau says officials don’t regret the recent lifting of health measures. He says they factored the new subvariant into their plans, as well as the province’s high rate of vaccinations and the availability of treatments like Paxlovid at pharmacies.

“We were confident that with those measures that are now out of the scope that there would have an impact on contacts and most probably an increase in (contagiousness) in cases, but not necessarily a sad story on the hospital situation,” said Boileau.

Dr. Marie-France Raynault, the senior strategic advisor for Quebec’s health ministry, says masks and boosters remain the answer.

“Infection rate is not rising in schools right now, it’s decreasing, so increasing rate is being seen in adults. That’s why we take our time to take off the mask mandate,” she said.

“Third dose of vaccine is important to reduce the transmission, so the mask is not the only measure, but the third dose of the vaccine is also very effective to reduce the transmission.”