Canada’s international borders are the frontline against future importation of SARS-CoV-2 and its variants.
As researchers in global health, we have analyzed the effective use of cross-border measures internationally during the COVID-19 pandemic through the Pandemics and Borders Project. At this critical stage of the COVID-19 response, our findings point to the urgent need to address the gaps in border management to prevent another resurgence of the virus in the fall.
Modelling studies show that herd immunity — estimated to be at least 90 per cent of total population vaccinated given highly transmissible variants — will be difficult to reach, despite Canada’s progress in mass vaccination.
The federal government announced that hotel quarantine requirements will end on July 5 for fully vaccinated returning citizens and residents. This will be only the first phase of easing travel restrictions over the coming months.
Travel-related risks need to be carefully managed, balancing growing pressure to reopen with the race to get Canadians vaccinated. How well this is accomplished will determine whether Canada is set on a path towards recovery or a fourth wave.
Ongoing gaps in Canada’s border management
Federal officials have repeatedly touted Canada’s border measures during COVID-19 as among the most stringent in the world. Yet the third wave of variant-driven infections, hospitalizations and lockdowns across the country, and growing risks from the Delta variant first detected in India, suggest otherwise.
Unlike Taiwan, Thailand, Vietnam, South Korea, Australia, New Zealand and many other jurisdictions, Canada’s mandatory testing and hotel quarantine measures were only introduced in January and February 2021. By that point, significant and repeated virus importation had already occurred.
Canadian policy remains inconsistent for travellers arriving by air versus land. A Public Safety Canada briefing note from March 10, 2021, reported only seven per cent of travellers entering via land crossings are subject to quarantine requirements. Broad exemptions include cross-border students, technicians working on vaguely defined critical infrastructure, public officials and other categories of arrivals.
Beyond the three-day hotel quarantine for air arrivals, the 14-day quarantine for non-exempt travellers has been largely self-monitored and sporadically enforced.
Most concerning, data collection and analysis has been incomplete, failing to provide accurate risk assessment evidence to inform border management. Government officials have often claimed fewer than two per cent of total SARS-CoV-2 infections in Canada are associated with international travel. This figure has been used to justify arguments against improved border measures.
Gaps and lags in contact tracing and reporting from provincial authorities, combined with exemptions and inconsistencies in testing and quarantine, means this figure is unreliable and inadequate for policy decisions.
Further doubts about available data arise from Public Health Agency of Canada reporting that show more than 45 per cent of all exposures in Canada are from an “unknown source.”
To appropriately assess risks, methods must go beyond these partial counts. They must model risks of community transmission from infected travellers — especially those with a high-transmission variant — who may remain unidentified and/or come in contact with the wider population.
Why effective border management matters now
Border management grounded in sound risk assessment is particularly critical now. Canadians await opportunities to travel more freely to international destinations, and there are growing questions about how and when the Canada-U.S. border may reopen to non-essential travel.
However, vast discrepancies in global vaccine access and distribution mean high levels of infection and transmission worldwide. More variants will likely emerge, some highly transmissible and virulent, some potentially vaccine evasive. If the latter is imported into Canada in the coming weeks, as previous variants were, this has the potential to undermine gains made through vaccination. The result would be another cycle of lockdowns, shuttered businesses and school closures.
Easing travel restrictions safely
Easing measures requires some doable fixes that, if done right, lay the foundation for the phasing in an immunization-based border management system. Here are four recommendations from our Pandemics and Borders Project:
Better communication is needed. Public officials and journalists have often used terms such as “travel bans” and “border closures,” yet hundreds of thousands of travellers have arrived in Canada each month. As Canada eases travel restrictions, we recommend reframing the issue as risk-based border management. The clear task is to align who can travel across Canadian borders, and under what conditions, with the evolving science concerning COVID-19 vaccines.
Now is the time to prevent, rather than react to, a potential fourth wave. Taking action after a highly transmissible variant is already within our borders has proven too slow and ineffective. Prevention means plugging existing holes in the system and then gradually easing restrictions starting with fully vaccinated travellers.
Prioritize effective testing and self-quarantine. Testing and quarantine have been criticized by some for restricting freedom and imposing undue burdens on travellers. But options can be unobtrusive, encourage vaccination and ultimately prevent a fourth wave in Canada. This requires better alignment with best practices worldwide.
Strengthen risk assessment. Risk assessment is essential to identifying existing weaknesses in the testing and quarantine protocols for international and domestic travellers. Public access to appropriately detailed and standardized data should also be improved. Without better data collection, reporting and analysis of travel-related risks, we are largely flying in the dark.
As mass vaccination continues at home and abroad, and Canadians anticipate easing of travel restrictions, strengthening border management and risk assessment should be key parts of Canada’s strategy for reopening its borders.
Julianne Piper is funded by the New Frontiers in Research Fund for her work on the Pandemics and Borders Project
Benoît Gomis receives funding from the New Frontiers in Research Fund through the Pandemics and Borders Project.
Kelley Lee receives research funding from the Canadian Institutes of Health Research and New Frontiers in Research Fund.
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This content was originally published by The Conversation. Original publishers retain all rights. It appears here for a limited time before automated archiving. By The Conversation