Published:November 3, 2021

-Global News

The decision by Quebec and Ontario to not make COVID-19 vaccines mandatory for health-care workers has drawn sharp criticism from doctors in those provinces, who say the move is not backed by science.

Both provincial governments announced Wednesday that they will not require health-care staff — hospital workers in Ontario and current health-care employees in Quebec — to be fully vaccinated against COVID-19, pointing to the negative impact of such a mandate on the health-care system.

Experts say this puts both health-care workers and patients at an increased risk amid the fourth wave of COVID-19.

Dr. Naheed Dosani, a palliative care physician and health equity lead at Kensington Health in Toronto, called it an “unfortunate” decision that is prioritizing the freedom of unvaccinated health-care workers over the safety of sick patients.

“This goes against science,” he told Global News.

“This is really unfortunate news and really surprising, especially considering that policies like vaccine mandates for health workers have the potential to keep vulnerable patients who are accessing health care in places like hospitals safe,” he said.

Ontario has mandated COVID-19 vaccination for long-term care workers, with a deadline of Nov. 15 for staff to get immunized.

Despite the decision to not make it a mandatory policy across the province by the government, several Ontario hospitals have already implemented their own mandates and have seen roughly two per cent of staff placed on unpaid leave or terminated because of the policies.

Meanwhile, Quebec had planned to suspend unvaccinated workers as of Nov. 15 after pushing that deadline multiple times.

Health Minister Christian Dube said Wednesday the province was backtracking on that policy to avoid losing thousands of unvaccinated employees, which would have “devastating consequences” for the health-care system.

Dr. Donald Vinh, an infectious disease specialist and a medical microbiologist at the McGill University Health Centre (MUC), said Quebec’s government has dug itself into a hole by making such a move, which could backfire.

“I worry that it’s not the science that is guiding the policy decision-making,” he told Global News

“Health-care workers who are inadequately vaccinated will find themselves at higher risk of needing to be hospitalized,” he added.

“That not only puts their own health in danger, but that actually risks or threatens the staffing issues that are recognized by the government.”

Dr. Michael Warner, director of critical care at Michael Garron Hospital in Toronto, said this was a “bad decision” that will endanger patients and increase risk of absenteeism due to COVID-19.

While vaccination will no longer be mandatory for current health-care employees in Quebec, Dubé said that all new hires will have to be vaccinated.

Unvaccinated staff will be obliged to get tested for COVID-19 three times a week, and those who don’t comply will be suspended without pay.

A COVID-19 vaccine mandate in British Columbia that went into effect last month has already put more than 3,000 unvaccinated health-care workers on unpaid leave, many of whom could face being fired from their job if they don’t get at least one dose before the Nov. 15 deadline.

Ontario Premier Doug Ford pointed to the experience of B.C. and Quebec as well as “real-world evidence” in Ontario in making the decision to not mandate vaccines for hospital workers.

“This is a complex issue,” Ford said in statement on Wednesday.

“But when the impact of the potential departure of tens of thousands of health-care workers is weighed against the small number of outbreaks that are currently active in Ontario’s hospitals, I am not prepared to jeopardize the delivery of care to millions of Ontarians.”

Given the risks of potential layoffs, Kerry Bowman, a professor of bioethics and global health at the University of Toronto, said this was a “practical decision” and the timing was “fairly reasonable” given the overall pandemic situation in the province.

“The advantage is … there won’t be significant disruptions to health-care delivery because by losing — even if it’s one or two per cent of their staff, it will affect health-care delivery.”

However, Bowman added that this decision would upset many patients and families who would be concerned about getting treatment from unvaccinated staff.

Inconsistent messaging

Meanwhile, there is also concern about the inconsistent public health messaging.

The federal government has already enforced a mandatory COVID-19 policy for all federal workers. The government announced Wednesday that over 95 per cent of public service employees are fully vaccinated.

When parliament resumes on Nov. 22, all MPs will have to be fully vaccinated to enter the House of Commons.

COVID-19 vaccines are also compulsory for senators, staff and visitors if they want to access the Senate.

Dosani questioned the double standards.

“The ridiculousness of this policy is that our politicians — for example, an MP — will be entering the House of Commons and be vaccinated, but you could be going into a hospital or a health-care facility and your health worker won’t be vaccinated.

“How does that make sense?” he asked.

Dosani said such discrepancies contribute to vaccine hesitancy and resistance.

“This is another example of inconsistent messaging which has detrimental implications on our ability to showcase for the public that vaccines are our way out of this pandemic.”