QUEBEC CITY -- The refusal of some health-care workers to be vaccinated could lead to a breakdown in services in the health-care network, according to Health Minister Christian Dubé, who says he wants to do everything possible to avoid this scenario.

Hence the government's decision to make vaccinations against COVID-19 mandatory for health-care workers, a position that the Minister justified Thursday to a parliamentary committee. He recalled how tens of thousands of workers who interact with vulnerable people, in both the public and private sectors, are still not vaccinated — making the health-care system more fragile every day.

On Aug. 26 and 27, a parliamentary commission is taking stock of the government's decision to impose vaccinations on all health-care workers in contact with patients for more than 15 minutes by Oct.15. It will also assess the possibility of extending this obligation to other categories of workers, including teachers and daycare workers. A total of 17 stakeholders and experts are expected to give their opinion.

Health-care workers who refuse the vaccine despite Quebec's decree will no longer be able to carry out their duties and will be offered an indefinite leave of absence, without pay. And if refusals remain numerous, the impact on the network — especially on patients waiting for surgery — will soon be felt, Dubé warned.

"The worst news we can give to Quebecers is that if many people in the network leave, we will be forced to cut back on surgeries once again. That will be our choice, and it's not our first choice, and that's why we're giving our employees until Oct. 15 to do so," said Dubé, in response to questions from Vincent Marissal, a Québec Solidaire MNA.

In the spring, no less than 140,000 surgeries had to be postponed due to the excessive pressure on the network caused by patients with COVID-19. During the first waves of the pandemic, the network had to offload up to 40% of planned surgeries at certain times.

"We don't want to go there," Dubé commented in a press conference after his testimony to the committee. 

"We've seen it in previous waves — when you're short-staffed, what do you do? Unfortunately, we cut surgeries, we cut services that are essential. It is certain that if many people leave, there will be an impact," he said.

In the public health network alone, it is estimated that some 30,000 workers have still not received their two doses of the vaccine. Taking the private sector into account, there could be as many as 50,000 unvaccinated health-care workers. And one infected caregiver "can wreak havoc," said Dubé. 

Since the Delta variant took hold in Quebec, daily infections have been rising, as have hospitalizations — a phenomenon that is likely to worsen as the school year begins in the coming days, said the Minister.

"We know that September will be extremely difficult for the network," said Dubé, who described the current situation as "very worrisome."

At the height of the pandemic last year, the health network was missing 12,000 employees, for a variety of reasons. Currently, the situation is less severe, but it is estimated that more than 2,500 employees are absent from work for reasons relating to COVID-19, including more than 130 workers absent because they have contracted the virus and more than 1,500 for preventative reasons. 

Arruda: it's the children's turn

The National Director of Public Health, Dr. Horacio Arruda, expressed confidence that children aged zero to 12 years will be vaccinated in the short term. There is currently no licensed vaccine available to this age group, as the current vaccine applies to those age 12 and up. 

When asked how he hopes to get 95 per cent of the population vaccinated — the threshold he has set for achieving herd immunity — Dr. Arruda said he is focusing on children.

He said it is only a matter of months before the COVID-19 vaccine is suitable for the province's youngest.

"The vaccination of toddlers, five to 11-year-olds [...] will bring us to levels of herd immunity that will probably prevent the virus from spreading," said the doctor, in response to questions from Liberal MNA Marie Montpetit.

He said that a licensed vaccine for children aged five to 11 should be available as early as October, and a vaccine for toddlers (zero to four-years) should be ready by January.

Public Health is already in contact with the school system to plan the vaccination of children, he said.

On the subject of making the vaccine mandatory for teachers and school network personnel, Dr. Arruda affirmed that "we are not there yet".

--This story was first reported in French by The Canadian Press on Aug. 26.