In light of the very high contagiousness of the BA.2 variant, Quebec should take up the torch of prevention and expand access to the fourth dose of vaccine against COVID-19. Especially since the latest data show that more than a third of people who have died of the disease since December were under 80 years old.
At least that’s what the D defends.D Cécile Tremblay, professor in the Department of Microbiology, Immunology and Infectiology at the University of Montreal, who judges that there is a significant “discordance” between what Quebec advocates with regard to the fourth dose and what is observed on field.
“We are really behind the times. Limiting vaccination to people aged 80 and over and to immunocompromised people sends the message that people under 80 are not at risk. As we can see, the risk remains high among those over 60 years of age. With such a contagious variant, all those who have comorbidity factors should be able to get this fourth dose, “says Dr.D Tremblay.
His comments are consistent with the portrait of deaths linked to the different waves of the COVID-19 pandemic recently published by the Institut national de santé publique du Québec (INSPQ). If 62.4% of people killed by the virus in the last three months (during the fifth wave) were 80 years old or older, almost a third (32.5%) were aged 60 to 79, and 4.9 % from 20 to 59 years old.
Risk factors
This same report suggests that the presence of comorbidity factors, which includes some thirty health problems and chronic diseases, increases the risk of dying from COVID-19 by four to eight times, regardless of age. infected people. However, according to the INSPQ, about 1.1 million Quebecers aged 25 and over have more than two.
However, vaccination greatly reduces the risk for these more vulnerable people. A study from the US Centers for Disease Control and Prevention (CDC) measured that a booster dose passed the maximum protection against the risk of hospitalization due to COVID (five months after the second dose) from 50% to more than 90%. However, this protection decreased to 78% four months later, hence the recommendation of the American organization that it is necessary to advocate the granting of a fourth dose to those over 50 years of age.
It is up to the Quebec Committee on Immunization to decide whether to expand access to the fourth dose to people 60 and older, or even to those 50 and older, admits Dr.D Tremblay. But, according to her, “a whole pool of the population does not have sufficient immunity” at present.
Fourth dose administration campaigns have begun in CHSLDs and seniors’ residences. However, data from February and March show that a large majority of deaths (70% in March) occurred among people living in their homes.
More than a hundred people in their fifties have died since the start of the fifth wave, more than during any other period. Since the start of the pandemic, this wave is also the one that has killed the most people aged 40 to 49 (23) and 20 to 29 (5).
The “too vulnerable” health system
Given the extraordinary number of caregivers absent due to COVID-19, the infectious disease specialist said last week that he feared that this sixth wave would be as deleterious to the health network as the fifth. She still doesn’t give up.
“There is a lack of a clear public message that would reiterate the instructions for wearing a mask and isolating. All we hear is that the vaccination clinics are closing. We feel that the government wants to please people. We are not talking about this sixth wave. People interpret this as if the pandemic was over”, deplores the one who also judges that Quebec must maintain at all costs the compulsory wearing of the mask as long as the current wave is raging.
There were more than 11,140 workers absent from the health network on Monday, including more than 7,000 on sick leave due to COVID-19, a level comparable to that reached at the end of December 2021, before the peak of the fifth wave. . A situation that announces the resumption of power cuts and which will have repercussions on thousands of patients still waiting for treatment or an operation.
“We can clearly see that we cannot counter the current transmission just by telling people to manage their personal risk themselves. Our health care system is too vulnerable. It’s magical thinking. We also have a collective responsibility to protect the most disadvantaged, and the government has a responsibility to keep the population informed and up to date on the situation,” said Dr.D Tremblay.
More so, she believes, the risk of long-lasting COVID also remains in the blind spot of government discourse. The first studies on this subject estimate that 20% to 30% of infected people suffer from longer-term symptoms. “Even young people are struggling with persistent pulmonary, neurological or cardiac symptoms. We have to stop trivializing this and saying that COVID is a flu. »
Without advocating a return to restrictive measures, the DD Tremblay believes that Quebec must take up the torch quickly, relaunch prevention and expand access to a fourth dose of vaccine without further delay. And limit, if necessary, access to certain high-risk closed places until this sixth wave has subsided.