1. Preventing transmission
The section on PREVENTING TRANSMISSION includes information on key public health measures that aim to prevent the further spread of the disease. It details how countries are advising the general public and people who (might) have the disease to prevent further spread, as well as measures in place to test and identify cases, trace contacts, and monitor the scale of the outbreak.
1.1 Health communication
On January 20, 2020, Canada’s Chief Public Health Officer (Dr. Theresa Tam) and Deputy Chief Public Health Officer (Dr. Howard Njoo) held their first media briefing on the novel coronavirus (PHAC, 2020a). The announcement conveyed that there was a low risk of the virus spreading to or within Canada but precautions were being taken at the Vancouver, Toronto, and Montreal airports (Gunn, 2020). These included screening questions at electronic kiosks for all incoming international travellers, handouts with information for arriving travellers, new signage in French, English, and Chinese, and available staff from the Public Health Agency of Canada (PHAC) (Tam, 2020b). This information was relayed on social media, where Dr. Tam continued to inform Canadians to follow travel notices (see Section 6), monitor symptoms while travelling abroad, maintain hand hygiene and respiratory etiquette, and regularly visit the COVID-19 page of the Government of Canada website for updated information (Tam, 2020a). On January 30, Dr. Tam and other public health officials began urging Canadians to avoid stigmatizing individuals of Asian descent and issuing warnings about false information related to COVID-19 (Vogel, 2020).
To date, updates and public health messaging continue to be provided through briefings, social media, a mobile app, a dedicated information telephone line, and the federal COVID-19 website. The website currently includes information on the transmission of COVID-19, prevention and risks of contracting the disease, travel restrictions and exemptions, symptoms and treatment, financial supports, etc. (PHAC, 2020n). Recommendations are provided for social distancing, hand and respiratory hygiene, personal protective equipment, and travel. The Government of Canada website also includes a page on “Awareness Resources” for public education and dissemination. These include audio clips, videos, infographics, and information sheets on COVID-19 (PHAC, 2020j). The first of these resources was published on February 21, 2020, and the page is regularly updated (PHAC, 2020j). On April 2, 2020, Canada launched the “Canada COVID-19 app” to provide Canadians with the latest information on COVID-19 and allow them to check their symptoms (Canada, 2020a). On April 30, 2020, Canada announced additional digital tools for COVID-19 communication (Health Canada, 2020d). These include a web-based email service that provides subscribers with information related to the pandemic and an app, “ArriveCAN,” that allows travellers arriving to Canada to input their 14-day isolation or quarantine information upon arrival (Health Canada, 2020d).
On March 13, 2020, Canadian Prime Minister Justin Trudeau provided what would be his first daily video briefings to the country on COVID-19 (Tumilty, 2020a). The Prime Minister proceeded to deliver 26 consecutive days of briefings and, to date (i.e., at the time of writing), he has continued to provide daily updates from Ottawa, missing only a few days (e.g. Easter) (Grenier, 2020). Notably, on March 12, Prime Minister Trudeau announced that he was self-isolating after his wife developed symptoms of COVID-19 after returning from the United Kingdom; while self-isolating Prime Minister Trudeau delivered all media briefings from outside his Ottawa home, the Rideau Cottage (Connolly, 2020b). The Prime Minister has continued to deliver all but a handful of his daily media briefings from this location, unaccompanied by other officials (Connolly, 2020b).
As well, since March 19, 2020, PHAC has hosted daily news conferences, including Drs. Tam and/or Njoo, as well as the Federal Minister of Health (Honourable Patty Hajdu) and/or other ministers and Government of Canada officials, as appropriate to the daily agenda (Service Canada, 2016). In recent weeks, these press briefings have been held Monday through Saturday (Service Canada, 2016). On March 20, the federal government launched a CA$30 million advertising campaign, featuring Dr. Tam and other notable Canadians (e.g. athletes) to promote the importance of hand hygiene, physical distancing and other measures that every Canadian could do to prevent the spread of COVID-19; these advertisements (in English and French) appeared on television, radio, print and online mediums through March and April (The Canadian Press, 2020a).
The Government of Canada has made available translated COVID-19 health resources and videos in several Indigenous languages on the website of Indigenous Services Canada (ISC) (Canada, 2020bc). Also on the ISC website is a public service announcement about COVID-19 translated to 20 different Indigenous languages (Canada, 2020c). Other COVID-19 information for Indigenous Peoples are provided by regional bodies, such as the First Nations Health Authority (FNHA) in British Columbia (FNHA, 2020); with wide variations in the information available across jurisdictions as reported by the Union of British Columbia Indian Chiefs, a political body representing numerous First Nations in British Columbia (Union of British Columbia Indian Chiefs, 2020). Resources and protocols are also communicated via regional Indigenous governing bodies such as local Band Councils where many First Nations websites list current updates and may direct visitors to the Band Council’s Facebook page for more informal community-specific updates regarding COVID-19 (Eabametoong First Nation, n.d.; Pictou Landing First Nations, n.d.; Six Nations Of The Grand River, n.d.; Sweetgrass First Nation, n.d.).
In addition to information for the public, PHAC provides information for provincial and territorial (PT) public health authorities and health care professionals, including guidance on measures to mitigate the spread of COVID-19 (PHAC, 2020i). While many public health orders are within the purview of provincial, territorial and municipal (PTM) authorities, PHAC has released several official statements regarding specific issues of public health importance throughout the pandemic. For example, on April 7, 2020, PHAC released an official statement regarding the use of non-medical masks by the public (PHAC, 2020o). It announced that, while wearing a non-medical mask has not been proven to protect the person wearing it, non-medical masks could be an additional measure to protect others (PHAC, 2020o). In the meantime, PHAC recommended that medical masks should be conserved for health care workers (PHAC, 2020o). On April 14, 2020, the Government of Canada announced that all travellers arriving in Canada will be required to wear a non-medical mask to proceed to their final destination, where they will be required to self-isolate (PHAC, 2020r). As of April 20, 2020, individuals will not be able to travel by air in Canada without wearing a face covering (Transport Canada, 2020b).
Further, the federal government has communicated that those aged 65 and over and with compromised immune systems and/or underlying medical conditions pose the highest risk to more severe outcomes from COVID-19 (PHAC, 2020m). Deaths in long-term care and seniors’ homes have accounted for three-quarters of COVID-19-related deaths in the country, to date (Hsu et al., 2020). While the provision of long-term care services is generally the responsibility of PT governments, PHAC has strongly advised organizations supporting these populations to work with staff to limit their work to a single facility, support staff to allow them to avoid working if symptomatic, discontinue any planned outings for residents, follow the recommendations for infection prevention and control and to not allow visits or non-essential on-site services at their facilities (except under compassionate or special circumstances), (PHAC, 2020u). Notably, throughout the pandemic, the Canadian Armed Forces have worked with provinces, such as Quebec and Ontario, to deploy personnel to long-term care homes to address staffing shortages and support enhanced infection prevention and control procedures (Canada, 2020o); several medical professionalorganizations have called on federal, provincial and territorial governments to undertake public inquiries investigating the systemic issues in long-term care facilities that have been highlighted by the pandemic (Ontario Long Term Care Association, 2020).
In a statement issued by Dr. Tam on August 31, the federal government acknowledged International Overdose Awareness Day, recognizing that current public health measures designed to reduce the spread of COVID-19 may increase isolation and increase barriers to people to access the supports they need (PHAC, 2020ag). In this statement it was confirmed that an average of 435 new cases of COVID-19 are being reported daily during the most recent seven days (PHAC, 2020ag).
Specific provincial and territorial measures are reported by the North American Observatory on Health Systems and Policies on their dedicated COVID-19 page (https://ihpme.utoronto.ca/research/research-centres-initiatives/nao/covid19/).
See full reference list under ‘Key links and articles: Full list of references’.