Should Canada aim for #CovidZero?

What would a #CovidZero strategy look like?

A handful of places, including Northern Canada and the Atlantic provinces, have sustained relatively low or no community transmission of SARS-COV-2 through a combination of strategies:

• Strict enforcement of borders, quarantines and physical distancing;

• Aggressive testing, contact tracing and isolation of cases;

• Clear public health messaging and political commitment;

• Meaningful supports for people affected by pandemic measures.

The countries most successful at curbing COVID-19 aim to eliminate, not manage outbreaks. Now some doctors want Canada to do the same.

Image courtesy of iStock.com/skynesher

For example, Nunavut banned nearly all travel by non-residents and required returning residents to quarantine for 14 days outside of the territory at the government’s expense. Until early November, Nunavut was one of the few jurisdictions in the world that had zero community transmission of SARS-CoV-2 since the beginning of the pandemic.

Meanwhile, countries like Australia and New Zealand that enforced longer, disciplined shutdowns to quash outbreaks are now enjoying fewer restrictions on daily life and much lower infection rates than Canadians. Some experts estimate that it may take Canada several months of strict lockdowns while also boosting testing and contact tracing to achieve the same results.

How does this differ from proposed “circuit breaker” shutdowns?

The “circuit breaker” approach adopted by some European countries doesn’t attempt to eliminate COVID-19 from communities. Rather, it relies on repeated, short-term shutdowns to curb outbreaks to a manageable level. At least one Canadian modelling study suggests this approach balances protecting health systems with mitigating economic and social fallout. But proponents of #CovidZero say rolling shutdowns are confusing for the public and only prolong the pain of the pandemic.

What are the challenges to #CovidZero in Canada?

Critics question whether eliminating COVID-19 in Canada would be practically or politically feasible without a vaccine. Most jurisdictions that have successfully suppressed community transmission of SARS-CoV-2 are islands or otherwise remote. Some, like New Zealand and Taiwan, never allowed outbreaks to get out of hand in the first place, making it easier to stay on top of new cases. Others have resorted to measures that critics say are too “draconian.”

For example, Australia stamped out a major outbreak in Victoria by imposing a strict 112-day lockdown. As of Nov. 27, Victoria has reported zero new cases of COVID-19 for 28 consecutive days, down from peaks rivalling Ontario’s current daily cases per capita.

But getting to zero involved curfews, a ban on travel more than 5 kilometres from home, and a one-hour limit on outdoor exercise. There were heavy fines for breaking the rules and mass arrests of anti-lockdown protestors. In one case, authorities forced 3000 people living in public housing to remain in their units under guard. “None of that can, will or should happen in Canada,” contends National Post commentator Chris Selley.

What’s the political and public appetite for tougher pandemic measures?

The provinces hit hardest by the second wave are led by right-of-centre governments that are ideologically ill-suited to adopting a #CovidZero approach. And early cross-partisan support for public health measures has fractured over time, with growing differences in mask usage and public trust between right-leaning and left-leaning Canadians.

Even so, recent polls show that most Canadians still support tougher measures than those currently adopted, including a four-week shutdown of non-essential businesses. “When you ask the vast majority of Canadians, they do believe that we should be taking pretty strong measures when it comes to trying to shut things down in order to get us through this pandemic,” Ipsos CEO of Public Affairs Darrell Bricker told Global News.

What’s the risk of staying the current course?

Chief Public Health Officer Dr. Theresa Tam warned in mid-November that Canada would soon see more than 10 000 new cases of COVID-19 a day if provinces failed to bend the upward trend in new infections. “You can only imagine if we got to that level that the pressure on the health care system would be huge,” she said. Some hospitals were already postponing elective surgeries.

Prime Minister Justin Trudeau urged provincial and territorial premiers to take stronger action to curb outbreaks before Ottawa faces “impossible decisions” allocating COVID-19 resources. “We may at some point have to choose between helping one region or another,” Trudeau said.