How BC Could Get to COVID Zero

Last Thursday, pandemic writer Andrew Nikiforuk’s call for tough measures to eliminate COVID-19 cases in Canada began its ascent to becoming one of The Tyee’s most widely read and shared pieces since the pandemic began.

Nikiforuk argued current mitigation strategies haven’t worked, and Canada faces increasing damage as new variants arrive during a brutal winter of rising cases, mounting deaths and confusing and demoralizing public health measures.

Instead, stringent lockdowns and travel restrictions should be introduced until active cases are dramatically reduced or eliminated in regions, he wrote. Then the regions — Green Zones —would reopen with effective test-and-trace programs to prevent a recurrence.

But when asked by The Tyee Friday, B.C.’s provincial health officer Dr. Bonnie Henry said eliminating the virus entirely wasn’t a realistic goal for the province.

“I think what has been expressed, including in your paper, around COVID Zero is likely not a reality for a jurisdiction such as ours, where we have so many land borders and ways that people move in and out of this province,” Henry responded, noting the biggest risk is “so much essential travel” from the United States.

“And that is a reality of where we are geographically in the world, and where we are in our socio-economic interactions in the world.”

But an expert in global pandemic management says a lack of will and understanding of new COVID-19 variants, not geography, are preventing B.C. from trying for zero.

“I’m surprised she said that; I don’t think it’s the case,” said Kelley Lee of Simon Fraser University. “We never even considered that strategy.”

And with 18 cases of more transmissible COVID-19 variants associated with the United Kingdom and South Africa, Lee says the opportunity to protect the province from a deadlier third wave may be evaporating.

“Two weeks ago I was arguing… the window of opportunity to move on new variants would be closing,” she said. “We’re two weeks since then, and I do wonder, is it possible now to get on top of this?”

Lee has been mapping global border controls implemented since the pandemic began, from pre-travel controls to post-arrival quarantine requirements.

The countries that fared the best, including those with extensive land borders and trade like Vietnam and Thailand, had stringent, mandatory and supervised quarantines for all travellers.

In fact, the way countries dealt with arriving travellers appears to be emerging as the most important aspect of travel-related infection control, Lee said.

“In an ideal world, you may not need travel restrictions if you have really good testing, screening and quarantine.”

But in Canada, an absence of data about travel-related COVID-19 cases has led to relatively lax interprovincial and international travel rules, Lee said.

“The association between COVID-19 and travel is indisputable. We didn’t have these new variants a few weeks ago,” she said.

The most recent numbers available from Statistics Canada show 51,385 non-residents entering the province and 39,185 Canadians returning to B.C. from abroad in November alone. “Those are huge numbers for one month, when those new variants were emerging,” said Lee.

It may not be fair to compare Canada to island countries like New Zealand and Australia that have been lauded for their proactive responses, Lee said.

But there are things B.C. could do, like implementing a mandatory 14-day quarantine for inter-provincial travellers as Manitoba, Atlantic-bubble provinces and the territories have.

Lee is also skeptical that all the essential travel is actually essential.

She’d like to see shipments of food and medicine continue through fewer points of entry into the province, and a halt to shipments of non-essential goods.

Hotels could also be mandated to cancel booking for out-of-region travellers, particularly in emerging hotspots like Whistler.

Lee said accepting travel-related infections as unavoidable is like failing to put up mosquito screens on a home near a swamp.

“What we’ve done is put screens on some doors, and we’re not applying the right screens at the right places,” said Lee. “It’s kind of like we haven’t even tried.”

Relatively lax travel restrictions can also undermine support for other measures like social distancing and avoiding gatherings, said David Clough, an assistant professor at the Sauder School of Business at the University of British Columbia.

Protecting the border might be the only way to keep even B.C.’s “balanced approach” to non-essential business and activities.

“The areas where the guidance is a bit ambiguous is travel restrictions and preventing the new variants from reaching different areas,” he said. “The most efficient approach would be re-implementing travel restrictions within the province and keeping the balanced approach by protecting borders.”

Clough says the approach so far has worked relatively well from an economic perspective.

But B.C. would need to step up supports for businesses and workers if tougher measures are needed.

“If they are to consider another strict lockdown, I would expect they ought to be considering similar kinds of economic help to what we saw in the spring,” said Clough.

Governments should be providing information on what lies ahead, he said, including contingency plans if vaccine rollouts are delayed or expedited. That would increase public confidence and give businesses fair warning of possible future lockdowns.

Most businesses right now are just able to “tread water,” and Clough gets the sense people’s “patience is getting tested because of ambiguity around travel restrictions.”

Valorie Crooks, an expert in health-related travel at SFU, says when people travel they not only bring their transmission risk, but also inaccurate assumptions about the danger of transmission based on their lives elsewhere.

“You may under or overestimate the risk,” said Crooks. “It’s one of the reasons we need to limit travel as much as we can.”

Crooks would like to see the province step up its current travel advisory warnings to an order, making exceptions for people travelling for essential work or medical care.

Lee said B.C. hasn’t collected enough data on travel-related transmission and that could lead to bad decisions.

“But we’re in a situation now where I would say, ‘Buckle up.’ We’re going to get lots of transmission and really going to have to lock down.”