Commentary, Opinion

Quebec’s hospital vaccine mandate deadline extensions highlight a crumbling health care system

Quebec recently extended its deadline for the mandatory vaccination of all health care workers until Nov. 15. Additionally, the province announced that all people over the age of 13 would need to show proof of vaccination or their vaccine passport before entering health care facilities for non-essential reasons, such as visiting those in care. Quebec’s Health Minister Christian Dubé’s decision to extend the vaccine mandate deadline overlaps with the implementation of a mandatory vaccine passport to enter health care settings. Although both the mandate and the extension have brought the government under fire, the extension is the best possible option considering the circumstances. 

Dubé’s approach may seem confusing, since visitors are being asked to get vaccinated, while the people caring for those who are most vulnerable to COVID-19 are not. Those who oppose vaccination mandates applauded the extension, while many workers saw the decision as a compromise that undermines the government’s authority. Indeed, vaccine mandates have received backlash across the province, recently escalating to a legal challenge to the order. However, if Dubé had maintained his original deadline, the health care system would have lost around 22,000 workers who are currently unvaccinated—a figure that represents around 4 per cent of the province’s total health care workers. Although the percentage seems slim, it is enough to make the whole system crumble

Quebec’s health care system has been on the edge of failure for months: Emergency rooms are closing due to exhausted and burnt out workers, and COVID-19 wings are consistently overwhelmed. Workers have reported forced overtime work, with a nurse clocking in four 16-hour shifts back to back at one point. The loss of 22,000 nurses and doctors would be catastrophic and would result in the loss of 600 beds and 35 operating rooms province-wide. The province cannot afford to take that risk. The Quebec government holds responsibility for guaranteeing safe, reliable, and quality medical care to the population—and despite Dubé’s promises of “mammoth changes,” the situation remains critical. Taking this into account, enforcing the original deadline would have been a huge mistake. The fact that the provincial government had to choose between the short term and the long term safety of Quebecers, however, reveals a weak system with deep-rooted issues like understaffing and inhumane working conditions. 

The optics of Dubé’s decision are not ideal but the optics do not matter as much when the foundations of the system are at risk. There is a risk that the general population, and more importantly the unvaccinated staff, will not take the government’s threats seriously anymore. Furthermore, it seems like Quebec is ceding to a tiny sector of the population who is refusing to comply with public health recommendations. Nonetheless, that tiny sector could be responsible for a severe health crisis. Additionally, it is estimated that 80 per cent of the Quebec population is adequately protected against the virus. Although the vaccine does not completely eliminate the risk of infection and death, it does have the power to reduce it to a manageable level. But because the risk is not zero, especially for people who are dealing with other health issues, the government should continue the implementation of simultaneous measures like mandatory testing and increased vaccine information campaigns, and should also add new measures like limiting the access to non-essential areas like cafeterias as a way to both curb the spread of the virus and incentivize the unvaccinated staff. 

Fundamentally, the Quebec government must not grant any more extensions on this Nov. 15 deadline. Patients’ lives are at risk and should not be compromised any longer. If the idea of a vaccine mandate is no longer plausible, then new implementations of regular testing must be put in place immediately. Dubé has been firm about his intention to enforce the deadline, and the fact that, since Wednesday’s announcement, 1000 healthcare workers have gotten vaccinated, is proof that his approach is working. The cost-benefit analysis that the government is doing is brutal. It seems like officials are having to sacrifice safety for stability, and the consequences eventually fall back onto the general population. But considering the bleak situation we are in, the government is choosing the least harmful option. 

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