Policy responses for Canada - HSRM


Policy responses for Canada

1.2 Physical distancing

As regions within Canada experienced a decline in the number of COVID-19 cases in May 2020, some PTs eased limits on gatherings. Many regions took a staged approach to re-opening, whereby increasingly larger gathering sizes were permitted; the specifics of these approaches have varied across PTs. For example, on May 15, 2020, Alberta announced that their ban on outside gatherings would increase to allow no more than 50 people, while indoor gatherings would remain restricted to no more than 15 people (Government of Alberta, 2020c, p. 63). In contrast, since April 30, Newfoundland and Labrador has permitted two households to interact without physical distancing, which they’ve referred to as the “double-bubble” and allowed for the size of social gatherings (with physical distancing) to increase from a maximum of five to ten people (CBC News & April 30, 2020).

Re-Imposition of Stricter Measures: Physical distancing
In the Fall of 2020, as daily case numbers started to rise again, many regions re-imposed limits on gatherings. For example, Ontario reduced gathering limits to 10 people at an indoor event and 25 at an outdoor event in September, from the previous respective 50 and 100 person limits (Ontario, 2020l). Similarly, British Columbia suspended all events and social gatherings  in November (British Columbia, 2020h).

Specific PTl 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’.

Physical distancing measures were largely determined at a provincial, territorial, and municipal (PTM) level in response to timing and intensity of the virus activity (PHAC, 2020d).

Initially, at the federal level, the Public Health Agency of Canada (PHAC) developed a guide on community-based measures for provincial and territorial (PT) public health authorities for mitigating the spread of COVID-19 (PHAC, 2020d). It is not clear when this guide was first published but it was most updated on March 25, 2020 (PHAC, 2020d). It provided the following recommendations for social/physical distancing, defined as measures taken to minimize close contact with other individuals in the community: avoid crowded places, avoid non-essential travel, maintain a 2-meter physical separation from individuals not in your household, avoid physical contact-based greetings (e.g. handshakes), high-risk individuals are encouraged to stay home unless necessary, and limit the number of individuals gathering in one place (as per PT regulations) (PHAC, 2020d). 

The Government of Canada has recommended that everyone practice physical distancing of at least 2 arms lengths, or approximately 2 meters, from others (PHAC, 2020t). All Canadians are advised to stay at home, avoid all non-essential trips, not gather in groups, limit contact with those at higher risk (older adults and those in poor health), and keep their distance (PHAC, 2020n). Household contacts do not need to distance from each other unless they are sick, have travelled in the last 14 days, or are recommended to self-isolate for other reasons (PHAC, 2020n).

Decisions around school closures, workplace and community-setting closures, and mass-gathering events are based on risk assessments conducted at the PT level (PHAC, 2020d). On March 16, PHAC initially recommended in-person gatherings of more than 50 attendees be cancelled or postponed (National Post Staff, 2020), and that individuals maintain at least two metres distance between one another, where possible (PHAC, 2020n). Vulnerable populations – those aged 65 and over, with compromised immune systems, and with other underlying medical conditions – were told to re-consider attending any gatherings (PHAC, 2020n). On February 10, PHAC released guidance on when to cancel postpone, or restrict large gatherings, recommending a risk assessment be taken with relevant health authorities and measures be taken to reduce transmission; however, PTM jurisdictions are responsible for legislating and enforcing specific measures to prevent mass gatherings (PHAC, 2020n).

Although Canada was seeing a slow and steady rise in hospitalizations and intensive care admissions, on April 16, Prime Minister Trudeau cautioned that physical distancing restrictions will not be relaxed until measures are in place for “massive” testing and contact tracing (O’Kane et al., 2020). However, many infectious disease experts cautioned that Canada did not currently have testing or contact tracing capacities that would be necessary to support successful reopening strategies (Crowe, 2020b). Health Minister Hajdu agreed that, although Canada had made many improvements over the course of the pandemic, further improvements would be necessary to support successful reopening strategies (ibid). On May 11, 2020, as the number of new cases continued to decline across Canada, Dr. Theresa Tam underscored that the successful reopening of schools and business will continue to rely heavily on testing, contact tracing, and other infection control efforts, such as physical distancing and hand and respiratory hygiene (Rabson, 2020). On May 22, 2020, Prime Minister Trudeau announced that Canada plans to adopt a contact tracing mobile app to help manage the spread of COVID-19; Ontario would be the first province to pilot the app (date to be determined, initial estimated launch date: July 2, 2020) (Tunney, 2020c). Further, to support contact tracing needs, Statistics Canada has trained 1,700 new employees and existing public service employees to perform up to 23,600 contact tracing calls per day, as of May 2020 (Aiello, 2020).

In June 2020, Inuit Tapiriit Kanatami (ITK), a national organization that represents the interests of Inuit in Canada, published a report regarding the potential impacts of COVID-19 on Inuit Nunangat (the Inuit homeland encompassing 51 communities across the Inuvialuit Settlement Region (Northwest Territories), Nunavut, Nunavik (Northern Quebec), and Nunatsiavut (Northern Labrador) in part explaining that the PHAC recommendations for physical distancing is difficult, and potentially impossible, for many who live in Inuit Nunangat due to the overcrowded housing conditions and high proportion of homelessness (Inuit Tapiriit Kanatami, 2020).

On July 2, a statement from Dr. Tam reminded individuals across Canada to avoid the “three C’s” as much as possible to prevent the spread of COVID-19 (PHAC, 2020ac): (1) closed spaces (and especially those with poor ventilation), (2) crowded places, and (3) close contact where  two metres physical distance from others cannot be maintained (PHAC, 2020ac).

As regions within Canada experienced a decline in the number of new COVID-19 cases, some provinces and territories made decisions ease limits on gatherings (see Transition Measures: Physical distancing); however, in the second wave of the COVID-19 pandemic, many of these stricter measures have been put back in place (see Re-Imposition of Stricter Measures: Physical Distancing)

Specific PT 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’.