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Controlling COVID-19 variants requires stricter travel measures, expert says

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Summary

Global health policy expert wonders why it took Canada so long to take action on travel measures


SFU expert says researchers left 'scratching their heads' at numbers informing feds' decision-making process on travel


Expert says speed is of the essence when dealing with an outbreak


With new travel measures being implemented in Canada, a global health policy expert is wondering why it took the federal government so long to get serious about stopping people from bringing COVID-19 and its variants to this country.

In the coming weeks, more recently-announced COVID-19 travel measures will take effect, requiring international travellers be tested for the coronavirus upon arrival and quarantine in a government-designated hotel for three days — at their own cost — while they await results, before completing the remainder of the already mandated two-week isolation period.

This new requirement is in addition to those requiring travellers show a negative PCR test before boarding a flight to Canada. It also comes as Canadian airlines cancel flights to Mexico and the Caribbean until April 30 as part of an agreement with the federal government.

However, Kelley Lee, a professor in Global Health Policy at Simon Fraser University, told Kitchener Today with Brian Bourke that researchers have been left “scratching their heads” at the numbers informing the federal government’s decision-making process, arguing that those figures are “likely to under-represent travel related COVID-19 cases.”

Prime Minister Justin Trudeau has pointed to statistics saying fewer than two per cent of COVID-19 cases are being linked to Canadians returning to the country, adding that number stands as proof travel measures had been working.

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Prior to new travel measures, Canadians arriving at, for example, Pearson International Airport in Toronto would be screened for COVID-19 and told to receive a COVID-19 test if they experienced symptoms. Otherwise, that traveler was allowed to begin their 14-day quarantine at home. This system, Lee said, relies on travellers to come forward if they do have symptoms – though there are many points in between that may not result in someone getting tested for the virus.

“They might be asymptomatic, they might decide, ‘Okay, I’ll just ride it out for 14 days,’ or they might just ignore it,” said Lee, who is also the Canada Research Chair in Global Health Governance at SFU. “So, we’re not systematically testing everyone that’s coming in the way that we will be doing as of Thursday. We’re not following up on everyone who comes through.”

Lee said there are several ways a traveller may impact other people, such as a visit to a coffee shop or a trip in a taxi after leaving the airport. Those individuals impacted or infected along the way would not be counted in travel-related case statistics, though Lee argues they should be, as their infections are a result of travel.

“We’re not counting a lot of the cases coming in – if you’re not counting something, you can’t know the real risk,” she added.

While previously implemented rules require travellers to Canada to show a negative COVID-19 test taken within 72 hours of boarding their flight, Lee said a negative test doesn’t guarantee you’re negative – as the virus can show up days later.

“I think this kind of ‘we’re preventing the virus from getting on airplanes because we’re testing people three days before’ is really untrue,” said Lee. “We know that, since January 7th, something like 160 positive cases of COVID were confirmed on flights coming in. Obviously, the system isn’t fool-proof.”

On the soon-to-be implemented, mandatory testing and three-day quarantine for travellers, Lee said the measure is easy to criticize in retrospect. She said Canadian officials and researchers continue to learn more about the COVID-19 virus, though other countries have already put travel measures in place that are much stronger than those here. Lee noted what’s been learned from our research is that speed is of the essence when dealing with an outbreak, especially one of global proportions – and while it may be costly to restrict borders, you want to move fast in testing and quarantine to secure your borders.

“That doesn’t mean you have to do that forever – and it also doesn’t mean that’s all you do, because that would be the wrong thing. You’re buying yourself time – a few days, a few weeks – you really want to put into place all the domestic public health measures that need to go with good infection control,” Lee explained.

“That’s where countries fell down – they thought ‘all we need to do is restrict travel from Wuhan or wherever, and put our feet on our desk’, and that was the big mistake that a lot of countries made – that borders are somehow going to magically keep the virus out…”

While Trudeau has stood behind the restrictions, Lee said Canada has had millions of people coming in and out of the country, with “patchy” virus screening and a quarantine program that’s “very much an honour system.”

Related video: Trudeau announces strict measures for all international flight passengers

“The virus has come in – it didn’t swim here. The new variants didn’t walk here. They came here by travellers, and now we need to get a hold of them in the community, but we also have to keep new variants from coming in.” said Lee. “If you’re fighting a fire, you don’t want someone throwing matches behind you (…) so this is the kind of strategy now – to really reduce to a minimum non-essential travel and screen all travelers, essential and non-essential, as they come in.

“Better late than never, but there’s still more we could do to tighten it up,” she added.

When asked where the reluctance to put in stricter measures could have come from, Lee said, like most countries, Canada has found itself in a situation it’s never been in before. Being a heavily dependent trading economy, Lee said it’s a “huge thing” to secure our perimeter while limiting movement of people and trade. In trying to do both, Lee said the federal government deployed “half measures” in trying to screen people while keeping the economy going.

“We’ve seen many countries doing that, and we see the prices being paid,” she said.

Lee admits that a full shutdown like what was seen in Australia and New Zealand is significantly harder to carry out in Canada, though certainly not impossible. A firm response early in the pandemic would have meant establishing Canada as a “safe space”, said Lee, allowing Canadians to live their lives in a very different way compared to current efforts of suppressing the virus and riding out “semi-lockdowns”.

Lee also argued that the federal and provincial governments should consider some limitation on inter-provincial travel, as any method that stops people from moving around and interacting with others will limit the spread of COVID-19. Lee believes the federal government has only left people with “advice” – and while they may not be able to force people to stay in one place, they can make it expensive or inconvenient.

“That way, we could have reduced the spread of these new variants. (…) we had that opportunity to prevent them, but now that they’re in, we see them across the country – that’s because people are moving across the country,” said Lee. “I know people are generally following the rules. There’s that proportion of people that don’t think that applies to them – they need to be incentivized to not go on holiday at this time.”

A widespread shut down would likely end up in the courts, Lee noted, admitting the issue would be “politically tricky” – though she said that measure may need to be re-examined in the case a worse pandemic were to appear in the future.

A recent proposal from the B.C. government to ban or otherwise restrict interprovincial travel was scrapped after Premier John Horgan sought a  review of legal options.

“The review of our legal options made it clear we can’t prevent people from travelling to British Columbia. We can impose restrictions on people travelling for non-essential purposes if they are causing harm to the health and safety of British Columbians,” a statement from Horgan’s office said last month.

Other experts have also said a non-essential travel ban would likely violate the Constitution, but that the courts may allow for one.

Looking to countries that have successfully kept the spread of COVID-19 under control like Vietnam, Thailand and Rwanda, Lee said those countries with fewer resources have managed to pull together through community efforts and a sense of responsibility. Lee said there may be lessons to be learned from these communities coming out of the pandemic.

“Individualistic countries are tending to suffer more because they’re less likely to be compliant with what needs to be done in a collective sense,” said Lee. “In Canada, we do have a community spirit, but maybe as a whole, we’re so diverse as a country that it’s maybe more difficult to have a national strategy.”