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People outside a COVID-19 testing site in Montreal on Jan. 15.Graham Hughes/The Canadian Press

January isn’t over, but with 1,144 COVID-19 deaths reported this month in Quebec, it’s already the fifth deadliest month of the COVID-19 pandemic in the province.

Two health experts say the high death toll is due, in part, to Quebec’s slow campaign to deliver booster doses to people 70 and older living outside institutional care.

“My hunch is that there is some sizable number of deaths and hospitalizations that could have been prevented if we had given our third dose earlier,” Dr. Quoc Dinh Nguyen, a gerontologist at Centre hospitalier de l’Universite de Montreal, said in an interview Tuesday.

As of Jan. 21, about 87 per cent of deaths linked to COVID-19 over the preceding 28 days involved people 70 and older. And unlike in previous waves, most of those who died were living at home instead of in long-term care homes or private seniors residences.

As well, of those people 70 and older who died in the current wave, 22 per cent were unvaccinated and 34.7 per cent had received a third dose of vaccine more than seven days before their deaths. The Health Department says 76 per cent of Quebecers 60 and over have received three doses of a COVID-19 vaccine and 94 per cent have received at least two.

Dr. Donald Vinh, an infectious disease specialist at the McGill University Health Centre, agrees with Nguyen. He said this month’s statistics – lower numbers of deaths in long-term care but higher numbers in the community – are the result of Quebec’s delayed third-dose vaccination campaign.

“There were vaccination teams that went into those institutions,” Vinh said in an interview Tuesday, referring to private seniors residences and to long-term care homes, known in Quebec as CHSLDs.

“So that was great – except if you were not institutionalized elderly,” he said. “If you were community-dwelling, that’s where the gap was.”

Quebec began administering third doses in long-term care centres in mid-October. The government didn’t make boosters available to people 80 and older living in the community until a month later, when the campaign to give third doses to long-term care and private seniors residents was coming to an end. Appointments for boosters only opened to people 70 and older in late November.

Older people who lived at home, Vinh said, may not have known they needed a third dose, or they may have struggled to make appointments.

According to data from Quebec’s public health institute, 66.4 per cent of those who died with COVID-19 this month lived in the community, up from 33.6 per cent in January 2021. In April and May 2020, the two deadliest months of the pandemic, less than 10 per cent of COVID-19 victims lived at home, and the majority of deaths reported involved people who lived in long-term care.

Another reason January has seen a surge in deaths is related to the explosion of cases in late December when officials reported more than 50,000 new cases over several days, Vinh said. That number didn’t include the positive results from rapid tests taken outside official testing centres.

“What the pandemic has shown us is that the rise of community cases precedes the rise in deaths,” Vinh said, adding that the province should have done more to slow the spread of the disease in late December.

“This spike in deaths is not surprising, given that it follows the spike in cases, but it is disappointing because it was preventable.”

Quebec has reported more deaths linked to COVID-19 than any other province, both since the beginning of the pandemic and over the past two weeks, according to federal government data. The province, which accounts for less than 23 per cent of Canada’s population, reported 45.5 per cent of all COVID-19 deaths reported in the whole country over the past two weeks.

Tara Moriarty, a University of Toronto professor who wrote a report for the Royal Society of Canada on mortality linked to the pandemic, said Quebec has a better – and faster – death-reporting system than other provinces. The province also tests more people for COVID-19 after death than almost any other province, she added.

In some parts of the country, she said, death statistics from the first wave are still being reported and she expects the death toll in other parts of the country to keep rising.

“I think it’s really crucial right now that across the country, everyone understands that what they’re seeing in Quebec very likely is, or will soon be, happening in their own province,” she said in a recent interview.

“I think that people need to watch Quebec and understand that that’s probably the reality of what’s happening”

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