The recent emergence internationally of several Variants of Concern has made reinforcing border controls to prevent COVID importation even more urgent. The #CanadianShield report recommends to: “Significantly strengthen internal and, especially, international borders to prevent COVID transmission while maintaining trade and service flows.”
Sign the Variants of Concern (VOC) petition by virologists, epidemiologists, doctors and public health officials
Petition en françaisSee some of who have already signed
Highly infectious variants of the SARS-CoV-2 virus which causes COVID-19 (known as Variants of Concern, or VOCs) are circulating internationally. Several have been identified, with a naming strategy still being decided, including B.1.1.7 (identified in the UK) as well as variants identified in South Africa (501Y.V2) and Brazil (P.1). Others may exist and more could emerge.
Variants of Concern represent a clear and present danger to Canada’s health security and economic well-being. For example, the B.1.1.7 variant is estimated to be 30-60% more transmissible than current circulating strains based on current epidemiology data. It quickly became the dominant strain across the UK and Ireland, causing massive increases in COVID-19 cases, overwhelming hospitals and forcing both countries into difficult new lockdowns. Modelling for the U.S. Center for Disease Control suggests that B.1.1.7 could become the dominant variant in the U.S. in March.
The Ontario Science Table advises that B.1.1.7 “could drive much higher case counts, ICU occupancy and mortality if community transmission occurs.” If B.1.1.7 or another highly transmissible VOC becomes dominant in Canada, it could cause hundreds of thousands of additional COVID cases and thousands of additional deaths. Very stringent, long lockdowns (beyond what Canadians are already experiencing) could be required to control it, causing tens of billions of dollars in additional economic damage.
While vaccine deployment will eventually add to our defenses against current circulating SARS-CoV-2 strains, and presumably VOCs, the accelerated transmission rate associated with B.1.1.7 coupled with delays in vaccine acquisition and distribution raise significant concerns for the viability of current, overstretched pandemic controls in Canada.
Existing travel and border protocols have not prevented the importation of these new variants into Canada. Cases of variants B.1.1.7 and 501Y.V1 have now been confirmed in several provinces. It is highly concerning that, in a number of cases, their path into Canada remains unknown.
There is a brief window to prevent the scenario that is unfolding in the UK. Without immediate additional action by the Federal government, Canada faces a very significant risk of an escalated new, variant driven COVID wave. Delays in significantly reducing the risk of importation could be ruinous.
Several other jurisdictions, with more rigorous approaches to border control than Canada, have successfully limited the importation of VOCs. These include Taiwan, Australia, New Zealand and South Korea. They are succeeding due to tight travel restrictions alongside domestic measures (notably strict quarantine requirements) adopted earlier and applied more strongly than current Canadian policy.
Drawing upon these demonstrable successes and adjusting for Canadian realities (e.g. our land-border with the U.S.), we recommend the following 9 immediate actions by the Federal government:
Given the very high stakes involved, it is better to act very strongly now and have the ability to relax constraints in the future versus not to be tough enough and lose forever the chance of shielding Canadians from the onslaught of new higher-transmission variants.
If the Federal government is not able to enact protective measures immediately, provincial governments should implement them without delay. A prudent response would be to enact protections against entry of VOCs into Canada by this week’s end.
In addition, provincial and federal governments should continue to coordinate on critical domestic actions to identify and eliminate VOCs already in Canada. Genomic sequencing of non-travel COVID cases should be expanded, and appropriate screening surveillance protocols developed, to identify VOCs already in the community. Inter-provincial travel should be restricted to essential activities in order to limit the geographic spread of VOCs until baseline surveillance is established and current data reviewed.
Canadians will support decisive action. In a recent poll, 87% of Canadians supported banning international travel until there were reduced numbers of COVID cases, with strong majorities across all regions, age groups, and party affiliations. In another poll, 65% of Canadians said they would ban international travel altogether.
These actions are not easy. However, they are not nearly as difficult as the restrictions already in place in many provinces. Compared to stay-at-home orders for 15 million Canadians plus nightly curfews for 8 million more, addressing deadly COVID outbreaks in hundreds of long-term care homes, or curtailing entire business sectors, stopping flights to holiday destinations and requiring all arriving passengers to have additional COVID tests is not unreasonable. Certainly, these restrictions are not as severe as the implications of not implementing them, if Canada then experienced a severe VOC COVID surge.
These actions will be difficult for our hard-hit airlines who have just announced a new round of cuts and are struggling to ensure pre-boarding testing of passengers. There is a strong case for sectoral support, as has been provided in other countries. However, these considerations should not block or delay painful but necessary actions to protect the health of Canadians and the viability of our fragile health systems.
These recommendations will protect Canadians from further importations of VOCs that have already been identified. They will also protect Canadians from the importation of future VOCs that have yet to be detected.
Time is of the essence. Every day increases the risk of further importation of the new variants, and their establishing a widespread presence in Canada. Hesitation could be fatal to thousands of Canadians, to our economic recovery, and to Canada’s overall fight against COVID.
We call on the Federal government, and in particular:
to act decisively and immediately in implementing these urgent recommendations.
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Some of those who have already signed
Dr. Jeff KwongProfessor, Department of Family and Community Medicine and the Dalla Lana School of Public Health, University of Toronto
Professor Caroline ColijnCanada 150 Research Chair in Mathematics for Infection, Evolution and Public Health, Simon Fraser University
Professor Christopher CottonProfessor of Economics Jarislowsky-Deutsch Chair in Economic & Financial Policy
Ms Marion CroweFirst Nations Health Administrator CEO
Dr. Christopher McCabeExecutive Director and CEO, Institute of Health Economics
Professor Ashleigh TuiteAssistant Professor, Dalla Lana School of Public Health, University of Toronto
Ms. Tasha AyindeAssociate Director, Faculty of Medicine and Health Sciences, McGill University
Dr. Andrew MorrisInfectious Diseases Specialist, Sinai Health and University Health Network, and Professor, Department of Medicine, University of Toronto
Jean-Paul SoucyStudying for a Doctoral degree in infectious disease epidemiology at the Dalla Lana School of Public Health, University of Toronto
Mr. Brett HouseDeputy Chief Economist, Scotiabank
Dr. Jaspreet KhanguraDepartment of Emergency Medicine, University of Alberta Emergency Physician & Clinical Instructor
Dr. David FismanPhysician, Epidemiologist (and Lead of the Institute for Pandemic's Centre for Pandemic Readiness at the Dalla Lana School of Public Health)
Professor Kelley LeeProfessor, Health Sciences, Canada Research Chair Tier I, Simon Fraser University
Dr. Jason KindrachukVirologist, Assistant Professor, Canada Research Chair – University of Manitoba
Dr. Lynora M SaxingerInfectious DIseases, University of Alberta co-Chair COVID-19 Scientific Advisory Group, Alberta Health Services
Dr. Amy L. Greer, MSc, PhDCanada Research Chair in Population Disease Modelling and Associate Professor, University of Guelph
Dr. Robyn LeeInfectious disease and genomic epidemiologist Adjunct Professor, Infectious Disease and Genomic Epidemiology, Dalla Lana School of Public Health, University of Toronto
Dr. Karen GrépinUniversity of Hong Kong Associate Professor
Miss Lyana PatrickAssistant Professor, Health Sciences, Simon Fraser University
Mrs Lucy HenryInternational Health Research Manager Director, Research in Health
Dr. Rupert KaulInfectious Disease Physician Division Director of Infectious Diseases, University of Toronto
Dr. Kamyab GhatanInfection Prevention and Control IPAC Officer
Dr Selina LiuDivision of Endocrinology & Metabolism, Department of Medicine, Western University Assistant Professor
Ms Wendy SomervilleInfection Control Practitioner Coordinator, IPAC program McGill Faculty of Dentistry
Dr. Mona LoutfyInfectious Diseases Specialist, Women's College Hospital Professor, University of Toronto
Dr Yvonne YauMedical Microbiologist Assistant Professor, University of Toronto
Dr Lindsay CohenPhysician Emergency Medicine Physician
Dr. Gerald A. EvansInfectious Disease Specialist, Kingston Health Sciences Centre Professor & Chair, Division of Infectious Disease, Dept. of Medicine, Queen's University
Dr. Benoît DuguayFull Professor PhD, MBA
Mme Gabrielle ViensPropriétaire entreprise Directrice des affaires
Dr. Vivian WelchSchool of Epidemiology and Public Health, University of Ottawa Associate
Tania St-AmourAgente adminstrative Réseau de la santé
Dr Leyla AsadiInfectious Diseases Physician PhD student, University of Alberta
M. Doucet NormandPréposé aux bénéficiaires PAB Unité Covid en CHSLD
Dr Marzieh AbedpourDardashti Family Doctor MD FCFP
Dr Catherine PoundPhysician MD, MSc
Dr Tina WhittyAnesthesiology Doctor
M. Sébastien GagnéInfirmier clinicien M
Dr Anne-Marie NicolAcademic Researcher Associate Professor
Dr. Malgorzata GasperowiczDevelopmental Biologist, General Associate, University of Calgary PhD
Dr. Diego G. BassaniAssociate Professor, Department of Paediatrics & Dalla Lana School of Public Health PhD
Professor William HsiaoUniversity Professor Associate Professor, Faculty of Health Science, Simon Fraser University
Professor Jean-Christophe Bélisle-PiponBioethicist Assistant Professor, Faculty of Health Sciences, Simon Fraser University
Dr. Cindy HolmesSocial Work Assistant Professor, University of Victoria
Dr. Susan EriksonProfessor, Faculty of Health Sciences, Simon Fraser University Professor
Dr. Farha HussainFamily physician MD CCFP
Dr. Christine FroelichMD, FRCPC Associate Clinical Professor, University of Alberta
Dr. Nicole BechardPediatric Resident Dr
Dr. Jill AlstonPhysician Geriatrician
Dr. Rajinder CheemaFamily Physician MD
Dr. Joanne VaughanMD Doctor
Dr. Jan McPheeFamily medicine Physician
Dr. Lillian BarthaMD Doctor
Dr. Giorgia TropiniResident physician MSc MD
Dr. Jo Ling FooMedicine Family physician
Dr. Richard IngramPhysician, University of Calgary, Alberta
Dr. Zainab AbbasFamily physician Dr
Dr. Ian SempowskiPhysician , Associate Professor MD CCFP (EM)
Dr. Emily ChingMedical physician Dr
Ms. Antonia BentonNurse practitioner
Dr. Jesse ShapiroEvolutionary microbiologist Associate professor, McGill University
Professor Ronald LabonteProfessor and Distinguished Research Chair, Globalization and Health School of Epidemiology and Public Health, University of Ottawa
Dr. Shraddha PaiPh.D. Research Scientist, Genomics and Bioinformatics Independent Investigator, Ontario Institute for Cancer Research
Dr. Kashif PirzadaEmergency Physician and Co-chair of Masks4Canada Assistant Clinical Professor, McMaster University
Dr John ChallisOC University Professor University Professor Emeritus, University of Toronto: Adjunct Professor Simon Fraser University
Dr. Joe VipondEmergency Physician MD CCFP(EM)
Dr. Amy TanPhysician, Adj Associate Professor
Dr. Tehseen LadhaPediatrician Assistant professor
Dr Srinivas MurthyPhysician Health Research Foundation and Innovative Medicines Canada Chair in Pandemic Preparedness Research
Dr. Kate TrebussPhysician Resident, Care of the Elderly
Dr. Cherelyn LakustaMD, FRCPC Clinical Assistant Professor, University of Calgary
Dr. Noah IversClinician Scientist Canada Research Chair, Implementation of Evidence-based Practice
Dr. Larissa MatukasMedical Microbiologist and Infectious Diseases Specialist Head, Division of Microbiology, St. Michael’s Hospital, Unity Health Toronto and Associate Professor, Department of Laboratory Medicine and Pathobiology, University of Toronto
Dr. Dick ZoutmanInfectious Diseases & Medical Microbiology Specialist Professor, Queen's University and University of Toronto
Ms. Isha BerryEpidemiologist PhD Candidate
Dr. Stirling BryanAcademic Professor of Health Economics, UBC Professor, Faculty of Health Sciences, Simon Fraser University Professor
Dr. Linda L. SmithMD CCFP FCFP Physician Assistant Clinical Professor
Dr. Howard OvensEmergency Physician Professor, Dept. of Family and Community Medicine, University of Toronto
Professor Olena HankivskyProfessor School of Public Policy Simon Fraser University
Dr. Jeff RoundHealth Economist Director of Economics, Institute of Health Economics
Dr. Maya GislasonAssistant Professor Simon Fraser University
Dr. Malcolm SteinbergUniversity Instructor Director Public Health Practice
Dr. Rachel McGovernLecturer, Health Sciences, Simon Fraser University; Medical Writer Limited Term Lecturer
Dr. Diego SilvaBioethics Lecturer
Dr. Leonie BeauchampPathologiste
Dr. Rina LeeMD Cardiologist
Dr. Mandy SchwartzFamily physician CCFP
Dre. Pascale LafortuneMedecin Madame
Dr. Claudine Storness-BlissObstetrics and Gynecology Physician
Mr. Kevin ReinhardtPsychologist Director of Clinical Services
Dre. Annie GagnonFamily physician
Miss Nancy SaulnierHospitalist Dre
Dr. Edith HuiFamily Physician MD
Mrs. Bernadette CouturePrimary Care Nurse Practitioner RN, MScN
Ms. Roojin HabibiResearcher Doctoral Candidate, Osgoode Hall Law School
Dr. Sonja HansenPhysician Family Medicine
Dr. Christine GibsonMedical Doctor
Mr. Geoff BoydRetired Researcher Peer Specialist
Dr Jeremy GrimshawPhysician scientist Professor and Senior Scientist
Dr Tim HillsonEye Physician and Surgeon Assistant Clinical Professor, McMaster University
Dr. Mark LechnerFaculty of Health Sciences, SFU University Lecturer
Dre. Cloe TrottierMD Doctor
Dr Richa AgnihotriPhysician Paediatrician
Dr Nitin WadhawanPhysician MD CCFP
Dr Jennifer LushFamily physician University Plaza Family Practice
Ms. Daphne BroadhurstRegistered Nurse Clinical Nurse Specialist