“People will find a way around. You can say, ‘Stop all direct flights,’ but that doesn’t stop all travel,” Dr. Isaac Bogoch, an infectious disease specialist based out of Toronto General Hospital, told Global News.
“If someone wants to get from Point A to Point B, they will find a way to do that. If there’s not a direct route, there will be alternative routes. This is just human nature.”
This week, Air Canada extended a suspension of its flights between Canada and the Chinese cities of Beijing and Shanghai until March 27. The airline first halted flights to the cities after the federal government issued a travel advisory in late January, urging Canadians to avoid all non-essential travel to mainland China because of the viral COVID-19 outbreak. The same recommendations have been in place for weeks.
Dozens of other nations have implemented travel-related measures since the outbreak began in late December, including outright bans.
Canada, at this point, has not taken that route. The advisory currently in place is not a ban.
“The decision to travel is your choice, and you are responsible for your personal safety abroad,” it reads.
So while Air Canada has chosen to suspend its service to China, it’s not a requirement. It’s left airlines that offer service between Canada and China with a choice — to fly or to not fly.
Coronavirus outbreak: WHO says cases with no China travel history could be the ‘spark that becomes a bigger fire’
As of Feb. 14, a number of international airlines are still operating between Canada and China throughout February, March and April. Hainan Airlines offered non-stop flights between Toronto and Beijing. China Eastern offered some non-stop trips between Toronto or Vancouver and Shanghai. And Air China had some non-stop flights between Vancouver and Beijing available.
Travel bans and quarantines are an age-old answer to stop the spread of the disease, but it’s exactly what the World Health Organization (WHO) has advised against since the outbreak began. The agency’s general-director, Tedros Adhanom Ghebreyesus, called the bans unnecessary and said they fan fear and stigma “with little public health benefit.”
“This is still and foremost an emergency for China,” he said.
Of the more than 64,000 cases, 99 per cent are in China. Of the 1,384 deaths, all but two are inside China.
Banning travel from an affected country is an oversimplified response to a complex situation, said Bogoch, and it “can do more harm than good.”
Bogoch pointed to the 2009 outbreak of H1N1, which became a pandemic. Many countries banned travel from North America, its believed country of origin, despite the WHO saying there was “no rationale” for it.
Novel coronavirus outbreak: Travel restrictions rise with death outside China
“At best, it slowed down the spread of infection by two to four weeks. It certainly did not prevent this from turning into an epidemic,” Bogoch said.
The measures also come with huge economic consequences.
One study found that the travel restrictions related to H1N1 contributed to a 40 per cent decline in air travel to and from Mexico but did relatively little to stave off the disease.
While simply stopping flights may, by definition, have the ability to reduce new cases to certain regions, it’s not foolproof, said Jason Kindrachuk, a professor of emerging viruses at the University of Manitoba.
“While there is sustained human-to-human transmission in China, we have not seen this outside of the region. What this suggests is that self-monitoring by passengers coming from these regions has worked quite well,” he said.
During the 2014 West African Ebola outbreak, travel bans actually made stopping the outbreak more difficult. The closed borders pinched a country already ill-equipped to cope with a rapidly spreading disease by “compromising connectivity to the region, mobilization of resources to the affected area and sustained response operations,” according to one study.
“The long-term ramifications of travel bans on both relations and economic tolls may outweigh any potential benefit from a travel ban,” Kindrachuk said. “Now, it’s also a question of how extensive a ban would be needed to even capture all potential cases, considering that there are increasing numbers across Asia at this point.”
Is it safe to travel during the coronavirus outbreak?
With no Canadian travel ban in place and other airlines offering non-stop flights, why would Air Canada opt to keep China-bound flights grounded until March?
Optics play a huge role, Bogoch believes.
“Obviously, to the general public, the optics are favourable when we say we’re not having any more travel to that particular area,” he said.
“People say, ‘Well, this epidemic is existing on the other side of the world. If we simply stop air travel to that part of the world, we won’t import cases.’ It’s just not that simple.”
But the decision by Air Canada — or any of the dozens of international airlines that have chosen to suspend or reduce service to Beijing, Shanghai and, in some cases, Hong Kong — isn’t an overreaction to Ross Aimer, a former pilot and CEO of Aero Consulting Experts. Aimer said passenger demand to visit the countries should be considered, as it’s likely reduced dramatically.
“There are considerations for their own crew’s safety as well,” he said. “That’s become a big issue.”
Ultimately, the efforts to stop the spread lie at the heart of the outbreak, Bogoch said.
“And that’s what happening right now,” he said. “There are significant resources being poured into China and being utilized by China to essentially prevent further transmission of this virus.”
— With files from Reuters
© 2020 Global News, a division of Corus Entertainment Inc.
Passengers at 11 more Canadian airports face mandatory temperature checks – CTV News
Transport Canada is expanding mandatory temperature screening to all passengers in 11 additional airports across the country.
The department announced on Tuesday that temperature screening has begun at airports in St. John’s, N.L. Halifax, Quebec City, Ottawa, Toronto (Billy Bishop), Winnipeg, Regina, Saskatoon, Edmonton, Kelowna, B.C. and Victoria.
“Since the beginning of the pandemic, Canadians have come together, made sacrifices, and done their part to help limit the spread of the virus,” Transport Minister Marc Garneau said in a news release.
“Our government has expanded temperature screenings to major airports across the country to support these efforts and as another measure in our multi-layered approach to help protect the safety of the travelling public and air industry workers.”
This is an expansion of the temperature screening program that began on June 30 at four of Canada’s busiest airports: Montreal, Calgary, Vancouver and Toronto (Pearson).
Any passenger found to have an elevated temperature without a medical certificate with a reason for this elevation will not be allowed to continue their travel and will be told to book another flight at least 14 days later.
All employees who work within the restricted area of an airport will also be subject to temperature screening.
Feds announce plan to buy 7.9 million rapid COVID tests – CBC.ca
Public Services and Procurement Minister Anita Anand today announced a plan to buy roughly 7.9 million rapid point-of-care COVID-19 tests from U.S.-based Abbott Laboratories.
The purchase is meant to offer other testing options to Canadians at a time when the country’s testing apparatus is being severely strained, with coronavirus caseloads spiking in some regions.
To date, the vast majority of tests have been done at public health clinics, with samples then sent to laboratories for analysis — a process that can take days.
A point-of-care test could be administered by trained professionals in other settings. The molecular test Canada is looking to buy — the ID NOW — can produce results from a nasal swab in as little as 13 minutes.
While Canada has announced this purchase from a well-regarded U.S. firm, the test itself has not yet been approved by Health Canada for distribution.
“As with many of our agreements for equipment, tests and vaccines, we have pursued an advanced purchase agreement to secure Canada’s access to these tests conditional on Health Canada’s regulatory approval,” Anand said.
“These rapid tests will aid in meeting the urgent demands from provinces and territories to test Canadians and reduce wait time for results, which is key to reducing the spread of the virus.”
The U.S. Food and Drug Administration (FDA) first issued an emergency use authorization (EUA) to Abbott for the ID NOW device in March.
Since then, some researchers have said the device has led to false positives in a small number of cases. The FDA re-issued a revised EUA on Sept. 18, saying that the test should be administered within the first seven days of the onset of symptoms.
Anand said that, beyond the Abbott deal, Canada will proactively purchase other rapid tests in bulk to supply the country.
With tens of thousands of tests being done each day, the demand is high.
The announcement comes as Health Canada bureaucrats in charge of regulating new testing devices are defending the government’s response to this point.
Health experts — including Dr. David Naylor, the co-chair of the federal government’s COVID-19 task force — have for weeks been urging regulators to approve rapid testing to take the pressure off testing centres.
While other major Western countries such as the U.S. have authorized a number of point-of-care tests, Health Canada regulators have been slow to give the necessary approvals to deploy these devices.
Regulators approved Cepheid’s Xpert Xpress SARS-CoV-2 device in late March, a test that can be used in both lab and point of care settings.
The next approval for a point-of-care device — one that could be used in a doctor’s office or a walk-in clinic — only came last week.
On Sept. 23, Health Canada approved for use in Canada the Hyris bCube — a portable device that its Guelph, Ont.-based distributor says can be used “wherever people are — anytime, anywhere.”
The regulator hasn’t yet approved any antigen tests — a different form of testing that can be easily deployed to high-risk workplaces and schools to help identify positive COVID-19 cases.
In fact, Health Canada only posted guidance for antigen device manufacturers to its website today, seven months into the pandemic.
The antigen tests — which, depending on the device, use matter collected from a nasal or throat swab — don’t require the use of a lab to generate results.
While much faster, these tests are considered by some to be less accurate than the “gold standard” — the polymerase chain reaction (PCR) testing process currently in use across Canada.
Antigen testing devices like Quidel Corporation’s Sofia 2 SARS, which received emergency authorization from the U.S. FDA in May, can produce results in less than 20 minutes. As of Tuesday, Quidel’s device was listed as “under review” by Health Canada.
Antigen tests have been used in thousands of U.S. long-term care homes for months.
Speaking to reporters on teleconference about Health Canada’s progress, Dr. Supriya Sharma, senior medical adviser to the department’s deputy minister, said she doesn’t think the authorization process has been slow to this point.
She said Canada’s regulatory regime is different from what’s in place in the U.S. and the department has been focused on approving lab-based PCR testing devices.
“I don’t think we’re slow. We’ve got staff working flat out,” she said. “There’s no file sitting on anyone’s desk not being looked at.”
Sharma said it’s difficult to state exactly when the Abbott test or an antigen test will be approved for use in Canada.
“Antigen testing is our number one priority and we are doing everything that we can to review these tests to ensure they are available to Canadians,” she said.
“We have increased the efficiency and we’re streamlining those review processes. We’re committed to getting a company a decision within 40 days,” she said, adding that the pre-pandemic process often would take months to complete.
She said regulators will not be rushed, citing the risk of approving a faulty test that tells people they’re clear of COVID-19 when they’re actually infected.
“A test that doesn’t meet this criteria could have devastating consequences for Canadians,” Sharma said.
When asked if the department was reluctant to approve new devices because of past missteps, Sharma conceded Health Canada’s early decision to authorize a device from Ottawa-based Spartan Bioscience — a test that later proved faulty — resulted in some “lessons learned” for regulators. In May, the National Microbiology Lab found problems with the test that made it unreliable.
While Canadian regulators have not yet given the green light, the World Health Organization (WHO) announced on Monday a plan to send 120 million COVID-19 antigen tests to low- and middle-income countries over the next six months to dramatically expand access to testing in places where PCR isn’t viable due to limited laboratory capacity.
The WHO touted these tests as “highly portable, reliable and easy to administer, making testing possible in near-person, decentralized healthcare settings.”
“High-quality rapid tests show us where the virus is hiding, which is key to quickly tracing and isolating contacts and breaking the chains of transmission,” Dr. Tedros Adhanom Ghebreyesus, the director general of the WHO, said in announcing the plan.
“The tests are a critical tool for governments as they look to reopen economies and ultimately save both lives and livelihoods.”
Asked about the WHO plan after a meeting with UN officials, Prime Minister Justin Trudeau told reporters Canada would rely on its own scientists to determine which devices should be used here at home.
WATCH: Trudeau is asked about rapid COVID-19 tests
“As much as we’d love to see those tests as quickly as possible, we’re not going to tell our scientists how to do their job and do that work. We are, however, ensuring that as soon as those approvals happen, we are ready to deliver these tests across the country,” he said.
Raywat Deonandan, an associate professor at the University of Ottawa and an expert in epidemiology, said that while antigen tests can be less sensitive than PCR tests, they can be useful for “reassurance” purposes.
“If someone needs a negative test to go back to work, we’ll use this,” Deonandan said in an interview.
“We need more creative tools on the table and this is one creative tool — again, with the caveat that it matters entirely how you use it, where you use it and by whom,” he said, adding that he believes antigen tests shouldn’t be a primary diagnostic tool.
While antigen tests can be less accurate, they’re also cheap to produce and easy to administer. That means they can be used multiple times to ensure a more accurate reading — not unlike a home pregnancy test.
“The advantage of these types of tests is that you can do them frequently,” said Ashleigh Tuite, an assistant professor at the University of Toronto and an infectious disease researcher.
“You could do it the day that you were going to visit the person who you cared about and it would basically tell you at that point in time, are you infectious? That’s incredibly powerful information.
“It just makes common sense — use every tool you have.”
COVID-19 in Canada will get worse before it gets better, and here's why – CBC.ca
Cases of COVID-19 will likely continue to climb in Canada’s most populous provinces for a while even if people start to hunker down, experts say, because of the nature of the infection.
Epidemiologists look at the effective reproductive number of COVID-19, which describes how many other people an infected person will pass the coronavirus onto on average.
Public health experts like to see the value significantly below one so cases don’t snowball and spread out of control.
The effective reproductive number of COVID-19 in Canada continues to hover at 1.4, the Public Health Agency of Canada reported on Friday. That means for every 10 people who test positive for COVID-19, they’ll likely infect 14 others who then pass it on to 20 others and so on.
Christopher Labos, a physician in Montreal with an epidemiology degree, said the effective reproductive number also varies depending on the population in which a virus is spreading.
“If nothing changes, certainly it’ll keep rising and may even surpass a number of cases we had before,” Labos said.
The doubling time depends on how contagious someone is, the likelihood they’ll contact and infect another susceptible person and the frequency of contact.
But Labos said there’s another important factor: individual changes in behaviour.
WATCH | Flattening Canada’s COVID-19 curve again:
“We probably will see rising case numbers in the next few days, maybe in the next few weeks. But if we take action now and control stuff, we might see this virus plateau before the end of the year. And that’s really what we’re trying to hope for.”
To that end, Quebec’s premier announced on Monday partial shutdowns in areas with high case counts, namely Montreal, Quebec City and Chaudière-Appalaches, south of the provincial capital.
“We see that our hospitals are in a fragile situation,” Premier François Legault said.
As of Thursday for 28 days, visiting those in other households won’t be allowed (with exceptions), restaurants will be serving delivery and takeout only and other gathering places such as bars, concert halls, cinemas, museums and libraries in the affected regions will close, he said
To explain why, Legault said protecting people in school communities, hospitals and long-term care homes is a priority.
Sacrifices required to change course
“None of this is a given. We can change the outcome,” Labos said. “It simply requires us to sacrifice a little bit.”
Nicola Lacetera, a behavioural economist at the University of Toronto, first studied compliance with physical distancing during the start of the pandemic in Italy. He found that the more frequently governments extended lockdown dates, the more disappointed the public tended to get, which could lessen co-operation.
“People say, ‘Well, I don’t know anybody who has COVID,'” Lacetera said. “From a statistical point of view, it makes no sense. But people tend to over-weigh what’s closer to them, like having known someone who got COVID.”
When the public can’t see the health consequences of COVID-19 directly in their daily lives then Lacetera said making hygiene, distancing and wearing masks more of a habit, alongside consistent messaging from different levels of government and communicating the science, could help.
Ontario’s Chief Medical Officer of Health, Dr. David Williams, suggested “targeted” measures are under consideration. His Toronto counterpart, Dr. Eileen de Villa, called for new limits in restaurants on Monday, such as reducing the number of patrons from 100 to 75 and requiring establishments to collect contact information from those attending.
De Villa also said the extent of spread of the infection in the city means the concept of the bubble or a social circle “no longer reflects the circumstances in which we live.”
Jacob Wharton-Shukster said his Toronto restaurant would stay open until 2 a.m. before the pandemic. He voluntarily chose to close at 11 p.m. after watching what can happen elsewhere in the world late at night when people have been drinking alcohol.
“The numbers are doubling from last week, and this is all reasonably foreseeable,” he said. ” We would have had to have taken a mitigation strategy a month ago to see any result now.”
Epidemiologists agree, saying the effects of measures only become apparent two weeks down the road because of the lag when someone is newly infected, develops symptoms, gets tested and receives the result.
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