Public health authorities in Quebec City are urging people to wear a mask if they find themselves unable to maintain at least one metre of distance from others during Pope Francis's visit this week.

"The virus is everywhere," said Dr. Jacques Girard, medical assistant to the Capitale-Nationale region's director of public health.

"COVID-19 is still with us and we need to be very careful."

Hundreds of Indigenous community members and delegates were already gathered in Sainte-Anne-de-Beaupré, northeast of the province's capital, on Tuesday morning in anticipation of the Pope's arrival.

He will hold a mass at the basilica there on Thursday, with flocks of people arriving by shuttles. Some 1,600 people are expected to attend the mass inside and another 10,000 will be outdoors.

The mass will also be broadcast on the Plains of Abraham in Quebec City, where organizers expect a total of 140,000 people.

But before he even arrives at the basilica, there will be thousands of people gathered in the province's capital with hopes of seeing the Pope on Wednesday as he visits the city and delivers a speech at the Citadelle.

People of all ages are expected to be attending the appearances, with a substantial number likely to to be seniors who are more at risk of developing complications from COVID-19, explained Girard.

"We always highlight the importance of collective responsibility and individual responsibility," said Girard.

"We feel it's not a trivial situation."

In Quebec City, community transmission is very high, and the region has not yet reached the peak of the wave, Girard said. People with COVID-19 symptoms should not attend the gatherings, he said.

He encourages people to use rapid testing but "any symptoms, I wouldn't take any chance."

Among those who will be avoiding the festivities is none other than Quebec City Mayor Bruno Marchand who announced on Twitter Tuesday that he has tested positive for COVID-19.

"I will respect the isolation prescribed by public health," he said on Twitter. "Acting mayor Catherine Vallières-Roland will take my place as part of the activities surrounding the Pope's visit."

Those who are particularly vulnerable to the virus, such as seniors or those with medical conditions, should wear a mask even when outside, Girard said. However, masks will not be made mandatory by the regional health authority, the CIUSSS de la Capitale-Nationale.

"We have thought about this, but actually, we think we could also rely on individual responsibility," he said.

"It's important for the people to feel they have a role to play in fighting COVID-19."

The health authority is distributing masks and providing hand sanitizer at the basilica and at certain shuttle access points.

"Since the buses will be more crowded than usual, we would like people to have a mask close to them and possibly wear it if ever it isn't possible to maintain a reasonable distance, at least one metre," said Girard.

Pope Francis spoke about the importance of grandparents and the elderly as thousands gathered for a public mass at Edmonton's football stadium Tuesday, a day after the pontiff apologized for abuses committed at Catholic-run residential schools.

Francis prayed for "a future in which the history of violence and marginalization suffered by our Indigenous brothers and sisters is never repeated.''

"Young and old, grandparents and grandchildren, all together. Let us move forward together, and together, let us dream.''

About 65,000 free tickets were available for the mass at Commonwealth Stadium but many rows of seats were empty, particularly in the upper decks. Organizers estimated there were about 50,000 in attendance.