Canada Gazette, Part I, Volume 154, Number 9: ORDERS IN COUNCIL
February 29, 2020
(Erratum)
GOVERNMENT HOUSE
Order of Merit of the Police Forces
P.C. 2000-1390 August 24, 2000
Notice is hereby given that in the Saturday, April 7, 2001, issue of the Canada Gazette, Part I, Vol. 135, No. 14, section 8 of the Constitution of the Order of Merit of the Police Forces should have been written as follows on page 1195:
8. The Committee shall:
- (a) perform the duties referred to in subsections 10(2) and (3); and
- (b) advise the Governor General on any other matters that may be referred to it.
PUBLIC HEALTH AGENCY OF CANADA
QUARANTINE ACT
Minimizing the Risk of Exposure to COVID-19 Coronavirus Disease in Canada Order
P.C. 2020-70 February 17, 2020
Whereas the Governor in Council is of the opinion that
- (a) there is an outbreak of a communicable disease, namely COVID-19 coronavirus disease, in certain foreign countries;
- (b) the introduction or spread of the disease would pose an imminent and severe risk to public health in Canada;
- (c) the entry of persons who have recently been in those foreign countries may introduce or contribute to the spread of the disease in Canada; and
- (d) no reasonable alternatives to prevent the introduction or spread of the disease are available;
Therefore, Her Excellency the Governor General in Council, on the recommendation of the Minister of Health, pursuant to section 58 of the Quarantine Act footnote a, makes the annexed Minimizing the Risk of Exposure to COVID-19 Coronavirus Disease in Canada Order.
Minimizing the Risk of Exposure to COVID-19 Coronavirus Disease in Canada Order
Interpretation
1 The following definitions apply in this Order.
- Chief Public Health Officer means the Chief Public Health Officer appointed under subsection 6(1) of the Public Health Agency of Canada Act. (administrateur en chef)
- quarantine facility means a place that is designated as a quarantine facility under section 7 of the Quarantine Act or that is deemed to be designated as a quarantine facility under subsection 8(2) of that Act. (installation de quarantaine)
Requirements
2 (1) Any person who arrives in Canada, directly or indirectly from a foreign country in which there is an outbreak of COVID-19 coronavirus disease, by means of a flight that is organized by the Government of Canada or a foreign government for the purpose of transporting persons from the foreign country who have or may have been exposed to that disease, and who enters Canada must
- (a) board any means of transportation provided by the Government of Canada for the purpose of transporting them to a quarantine facility chosen by the Chief Public Health Officer, including at any time during the 14-day period referred to in paragraph (b);
- (b) remain at the quarantine facility until the expiry of the 14-day period that begins on the day on which they arrive at the quarantine facility; and
- (c) while the person remains at the quarantine facility, undergo any health assessments that a quarantine officer requires.
Transfer
(2) If the Chief Public Health Officer determines that it is necessary to transfer a person who remains at a quarantine facility under subsection (1) to another quarantine facility, the 14-day period referred to in paragraph (1)(b) is calculated from the day on which they arrived at the first quarantine facility to which they were transported after their arrival in Canada.
Non-application — paras. 2(1)(a) and (b)
3 (1) The requirements referred to in paragraphs 2(1)(a) and (b) do not apply to
- (a) a person who is taken to a health care facility that is outside the quarantine facility referred to in paragraph 2(1)(a), for the duration of their stay at the health care facility;
- (b) a person who, during their stay at a health care facility that is outside the quarantine facility referred to in paragraph 2(1)(a),
- (i) becomes the subject of a provincial or local public health order that is inconsistent with those requirements, or
- (ii) is diagnosed with COVID-19 coronavirus disease;
- (c) a person to whom the Minimizing the Risk of Exposure to 2019-nCoV Acute Respiratory Disease in Canada Order footnote 1 applies;
- (d) a person for whom those requirements are inconsistent with another requirement imposed on them under the Quarantine Act; or
- (e) a person if the Chief Public Health Officer determines that the person does not pose a risk of significant harm to public health.
Non-application — P.C. 2020-0059
(2) The Minimizing the Risk of Exposure to 2019-nCoV Acute Respiratory Disease in Canada Order does not apply to any person who arrives by aircraft at Canadian Forces Base Trenton, directly or indirectly from Hubei province, China, on or after the day on which this Order is made.
Choice of quarantine facility
4 In choosing a quarantine facility for the purposes of this Order, the Chief Public Health Officer must consider the following factors:
- (a) the risk to public health posed by COVID-19 coronavirus disease;
- (b) the feasibility of controlling access to and egress from the quarantine facility;
- (c) the capacity of the quarantine facility;
- (d) the feasibility of isolating persons; and
- (e) any other factor that the Chief Public Health Officer considers relevant.
Powers and obligations
5 For greater certainty, this Order does not affect any of the powers and obligations set out in the Quarantine Act.
Effective period
6 This Order has effect for the period beginning on the day on which it is made and ending on April 30, 2020.
EXPLANATORY NOTE
(This note is not part of the Order.)
Proposal
The Order in Council, entitled Minimizing the Risk of Exposure to COVID-19 Coronavirus Disease in Canada Order, has been made pursuant to section 58 of the Quarantine Act.
Objective
The objective of this Order is to protect the health of exposed travellers as well as the health and safety of the general public from the COVID-19 coronavirus disease outbreak through heightened oversight of all individuals arriving to Canada from areas with a high contagion risk, as part of the Government of Canada’s action to bring Canadians home.
Background
COVID-19 coronavirus disease was first detected in Wuhan, China, in December 2019. The disease is caused by a new strain of virus never before seen in humans. As such, information about the virus, how it causes disease, who it affects, and how to appropriately treat or prevent illness has been limited and based on best practices approaches to coronaviruses at large. Originally seen to be a local and contained outbreak, COVID-19 coronavirus disease has now affected many countries across the globe. The science around the virus is still in its infancy. On January 30, 2020, the World Health Organization (WHO) declared an outbreak of what is now known as COVID-19 coronavirus disease to be a Public Health Emergency of International Concern (PHEIC).
There is an outbreak of a communicable disease in a foreign country
The COVID-19 coronavirus disease is caused by a novel coronavirus capable of causing severe illness, named the Severe Acute Respiratory Syndrome coronavirus 2 (SARS-CoV-2). It is part of a family of viruses that includes Middle East Respiratory Syndrome coronavirus (MERS-CoV) and Severe Acute Respiratory Syndrome coronavirus (SARS-CoV). Coronaviruses are mainly responsible for mild upper respiratory tract infections; common signs of infection include respiratory symptoms, fever, cough, shortness of breath and breathing difficulties. The novel coronavirus has clearly demonstrated that it can cause severe, life-threatening respiratory disease. In more severe cases, infection can cause pneumonia, severe acute respiratory syndrome, kidney failure and death.
The number of persons infected with the virus continues to rise, with 27 countries/regions outside of mainland China reporting cases. The majority of cases continue to be in Hubei Province, China. As of February 14, 2020, there are 66 492 confirmed cases of COVID-19 globally, including 1 523 deaths. This is up six-fold from the earlier January 31, 2020, numbers used to support the Minimizing the Risk of Exposure to 2019-nCoV Acute Respiratory Disease in Canada Order. Cases of the disease have been detected in numerous countries across the world, although to date they have been primarily associated with the Pacific Ocean Rim area. Canada needs to do its part to help prevent further transmission of the disease. Some patients have successfully recovered and have been discharged from care. However, as human transmission involving large numbers of patients is possible, it is important to mitigate the health risks associated with people who have been in direct contact with the virus through intervention and proper care.
The introduction or spread of the disease would pose an imminent and severe risk to public health in Canada
Patients with the novel coronavirus disease present with symptoms that may include fever, malaise, dry cough, shortness of breath, and damage to the lungs. Current data suggests that approximately 15% of cases are severe or critical in nature. Older individuals and those with a weakened immune system or underlying medical condition have been seen to be at a higher risk of severe disease. The time from exposure to onset of symptoms is currently estimated to be up to 14 days, with an average of 5 days. Current treatment is supportive and aimed at relief of symptoms and treatment of associated medical complications. There are no specific treatments for COVID-19 coronavirus disease, and there is no preventative vaccine currently available.
Coronaviruses are spread among humans through the inhalation of airborne infectious respiratory droplets (when an infected individual coughs or sneezes) or through contact with objects or surfaces contaminated by infectious droplets. Human-to-human transmission is the main driving force of the current COVID-19 coronavirus disease outbreak. This novel coronavirus disease has the demonstrated ability to spread if introduced to the general population given lack of immunity, and cause widespread illness.
The entry of members of a certain class of persons into Canada may introduce or contribute to the spread of the communicable disease in Canada
COVID-19 has demonstrated to date that it can cause widespread illness if not properly contained. To date, Canada has managed to prevent the spread of the virus through isolation measures. The Government of Canada, in choosing to repatriate Canadians with a higher risk of exposure to the virus, recognizes the need to prevent the unnecessary introduction of the illness to the broader Canadian population.
The Government of Canada is finalizing plans to repatriate Canadian citizens who have been sequestered on board the Diamond Princess cruise ship with a known outbreak of COVID-19 coronavirus disease. As of February 14, 2020, there were 67 new diagnoses aboard alone, with more than 280 already being treated. This means that the remaining individuals still on board have a significantly higher risk of developing the disease than others who may have had no or limited exposure to an infected individual. The individuals on board the ship include older adults, some of whom may have other illnesses, who have been demonstrated to be more impacted by the virus. The flight returning travellers to Canada will also include personnel (employed or contracted) from other Government of Canada departments who, despite proper use of appropriate personal protective equipment that will lessen their risk of contracting the virus, may also need to stay in quarantine if they are exposed during the course of their duties supporting the repatriation of Canadians on this flight.
Based on the life cycle of the virus, when passengers disembark in Canada they may continue to be asymptomatic, but infected, for two weeks, as they could have been exposed immediately prior to boarding the aircraft or in flight. There have been a significant number of newly reported cases in passengers and crew up to the 10th day post-implementation of quarantine, which is past the average incubation period.
This effort is the fourth such repatriation of Canadian citizens from abroad in response to the COVID-19 outbreak overseas, with three different groups of Canadians having previously been repatriated from Hubei Province, China, as per the previous Order in Council entitled Minimizing the Risk of Exposure to 2019-nCoV Acute Respiratory Disease in Canada Order. The present Order in Council aims to enable the Government to manage risks for future potential efforts that may be undertaken to repatriate Canadians from other areas of outbreak.
No reasonable alternatives to prevent the introduction or spread of the disease are available
The Canada Border Services Agency (CBSA) is carrying out enhanced screening of all travellers who have been in Hubei Province, China, in the past 14 days. Travellers who are feeling sick or unwell are assessed for symptoms, including fever, cough and difficulty breathing. Public Health Agency of Canada (PHAC) officers assist the CBSA in the screening assessment and then completion of a health assessment that includes gathering information on travel history, exposure risk, and signs and symptoms of illness. At-risk travellers who exhibit symptoms are sent for immediate medical assessment and care as appropriate. At-risk travellers without symptoms are requested to self-isolate for the 14-day period, report to a local public health authority (LPHA) within 24 hours and monitor their well-being. Information is provided on what to observe and who to contact in case symptoms develop. Recently, a form has been developed to allow for identification and follow-up of all travellers from Hubei who present at ports of entry in Canada. This form is provided to travellers by the CBSA, who then submits the completed form to the PHAC to be shared with the provinces and territories. This will enable the LPHA to follow up with each traveller and ensure they have reported within 24 hours as suggested.
For the limited number of cases in Canada, self-isolation has worked thanks to the excellent civic duty and care exercised by returning Canadians (e.g. initial Toronto, Ontario, cases) and effective contact tracing and follow up by local health authorities. However, the science on the virus is continuously evolving and governments must flexibly adapt their measures to contain the spread of the disease.
Awareness of the need to isolate individuals with known exposure to a high-risk contagion area (e.g. epicentre of outbreak, enclosed close quarters in a site with high rates of illness) has evolved as public health officials are now better informed of the potential risks of the virus. The travellers in question have been sequestered in an area with a high concentration of cases and generally represent a vulnerable population. Their risk of exposure and potential illness is increased relative to other travellers from less exposed areas. It is now known that the virus may be transmissible from infected individuals with mild symptoms and that vulnerable populations are more susceptible to serious illness, and there is no vaccine currently available. Through isolation of individuals with a higher risk of contracting or carrying the disease, Canada is in line with WHO and other health authority recommendations for containment of COVID-19.
Given the high risk to individual health once exposed and the increased vulnerable population risk, it is appropriate to have the repatriated Canadians cared for in an environment that supports their well-being for a period of up to 14 days, while protecting the general population from unnecessary exposure. Ongoing monitoring of travellers’ health allows for a more immediate and prepared response should a traveller become ill, which in turn increases the likelihood of a smooth recovery. Given the evolving scientific evidence on this virus, it is in the best interest of Canadian public health, both for the travellers and the general public, to provide medically supervised observation for this group of Canadians for the duration of the incubation period.
With this Order, Canada is aligning the objectives of its approach with those of its international counterparts in the United States, who have instigated a similar repatriation. Australia, New Zealand, and the United Kingdom are considering similar options.
Implications
Key obligations for travellers
Canadian Forces Health Services medical personnel will conduct a pre-boarding assessment of all implicated Diamond Princess travellers, will accompany the travellers on the flight, and will monitor all on board for onset of any symptoms of respiratory illness throughout the approximately 13-hour duration of the flight. No travellers who have tested positive for COVID-19 or who have any symptoms will be allowed to board the plane.
CFB Trenton, a designated Canadian entry point, will be the point at which Canadians repatriated from the Diamond Princess cruise are considered to have officially entered the country (unless formally deplaned elsewhere in Canada due to illness). At this point, the Order will obligate all individuals to remain under medical supervision for up to 14 days at a quarantine facility designated by the Chief Public Health Officer of Canada. For those anticipated to return via the Diamond Princess cruise repatriation effort, the quarantine facility designated under section 7 to the Quarantine Act will be the NAV CENTRE, Cornwall, Ontario, Canada. They will be monitored for signs and symptoms of COVID-19 coronavirus disease for the duration. Travellers who exhibit symptoms of COVID-19 coronavirus disease on arrival or during the 14 days following will be issued an order to undergo a medical examination and will receive appropriate medical care as required.
Travellers will be afforded consideration of their personal needs to the extent reasonable within the quarantine facilities’ capabilities, but always in accordance with the Canadian Charter of Rights and Freedoms. For example, with the Diamond Princess repatriation, the NAV CENTRE has built-in accessibility considerations for an older population (elevators, etc.).
Failure to comply with this Order and other related measures under the Quarantine Act are offences under the Quarantine Act. The maximum penalties are a fine of up to $750,000 or imprisonment for six months, or both.
Consultation
As the representative of the host province, the Ontario public health authority has been consulted on the Order. The PHAC will continue to collaborate with provinces and territories on the implementation of the Order and address any forthcoming challenges or concerns.
Departmental contact
George Samiotis
Director
Office of Border and Travel Health
Public Health Agency of Canada
Telephone: 343‑542‑6031
Email: george.samiotis@canada.ca
PUBLIC HEALTH AGENCY OF CANADA
QUARANTINE ACT
Minimizing the Risk of Exposure to COVID-19 Coronavirus Disease in Canada Order (Persons Not on Government Flight)
P.C. 2020-71 February 19, 2020
Whereas the Governor in Council is of the opinion that
- (a) there is an outbreak of a communicable disease, namely COVID-19 coronavirus disease, in certain foreign countries;
- (b) the introduction or spread of the disease would pose an imminent and severe risk to public health in Canada;
- (c) the entry into Canada of persons who have recently been in those foreign countries may introduce or contribute to the spread of the disease in Canada; and
- (d) no reasonable alternatives to prevent the introduction or spread of the disease are available;
Therefore, Her Excellency the Governor General in Council, on the recommendation of the Minister of Health, pursuant to section 58 of the Quarantine Act footnote b, makes the annexed Minimizing the Risk of Exposure to COVID-19 Coronavirus Disease in Canada Order (Persons Not on Government Flight).
Minimizing the Risk of Exposure to COVID-19 Coronavirus Disease in Canada Order (Persons Not on Government Flight)
Definition of Chief Public Health Officer
1 In this Order, Chief Public Health Officer means the Chief Public Health Officer appointed under subsection 6(1) of the Public Health Agency of Canada Act.
Persons entering Canada
2 (1) Any person who meets either of the following conditions and who enters Canada must comply with the requirements set out in subsection (2):
- (a) the person was in a foreign country in which there is, or was, an outbreak of COVID-19 coronavirus disease and was offered the opportunity to leave the country on a flight organized by the Government of Canada or a foreign government but did not board the flight; or
- (b) the person was on board, in a foreign country, a means of transportation in which there is, or was, an outbreak of COVID-19 coronavirus disease but was not offered the opportunity to leave the country on a flight organized by the Government of Canada or a foreign government.
Requirements
(2) For the purposes of subsection (1), the requirements are:
- (a) to disclose the facts referred to in paragraph (1)(a) or (b), as the case may be, to a screening officer at the entry point; and
- (b) if a screening officer or quarantine officer determines that the person is not exhibiting symptoms of COVID-19 coronavirus disease,
- (i) to remain in isolation, in accordance with instructions provided by a quarantine officer and at a place determined by the Chief Public Health Officer, until the expiry of the 14-day period that begins on the day on which the person enters Canada, and
- (ii) within 24 hours after entering Canada, to contact the public health authority specified by a quarantine officer, in the manner specified by the quarantine officer.
Factors to be considered
(3) In determining a place for the purposes of subparagraph (2)(b)(i), the Chief Public Health Officer must consider the following factors:
- (a) the risk to public health posed by COVID-19 coronavirus disease;
- (b) the feasibility of isolating the person at the place;
- (c) the proximity of the place to the entry point; and
- (d) any other factor that the Chief Public Health Officer considers relevant.
Additional requirements
3 A person who is required to remain in isolation must
- (a) in the time and manner specified by the public health authority that they are required to contact under subparagraph 2(2)(b)(ii),
- (i) measure their body temperature,
- (ii) record the measurements, and
- (iii) report the measurements to the authority;
- (b) answer any questions about their body temperature or symptoms that they are asked by an official of the public health authority; and
- (c) if they develop any symptom of COVID-19 coronavirus disease, immediately report the symptom to the public health authority and follow any instructions provided by the authority.
Non-application — medical emergency
4 (1) The requirement for a person to remain in isolation does not apply for the duration of any medical emergency that requires them to visit a health care facility.
Non-application — other grounds
(2) The requirement to remain in isolation, as well as the requirements set out in section 3, do not apply to a person if
- (a) during their stay at a health care facility, the person
- (i) becomes the subject of a provincial or local public health order that is inconsistent with those requirements, or
- (ii) is diagnosed with COVID-19 coronavirus disease;
- (b) those requirements are inconsistent with another requirement imposed on the person under the Quarantine Act; or
- (c) the Chief Public Health Officer determines that the person does not pose a risk of significant harm to public health.
Powers and obligations
5 For greater certainty, this Order does not affect any of the powers and obligations set out in the Quarantine Act.
Effective period
6 This Order has effect for the period beginning on the day on which it is made and ending on April 30, 2020.
EXPLANATORY NOTE
(This note is not part of the Order.)
Proposal
The Order in Council, entitled Minimizing the Risk of Exposure to COVID-19 Coronavirus Disease in Canada Order (Persons Not on Government Flight), has been made pursuant to section 58 of the Quarantine Act.
Objective
The objective of this Order is to protect the health of travellers who have or may have been exposed to the COVID-19 coronavirus disease outbreak, as well as the health and safety of the general public through heightened oversight of all individuals arriving in Canada from an outbreak area (i.e. high contagion risk), but who have either declined the Government of Canada’s express action to bring Canadians home or are foreign nationals not eligible for the repatriation effort.
Background
COVID-19 coronavirus disease was first detected in Wuhan, China, in December 2019. The disease is caused by a new strain of virus never before seen in humans. As such, information about the virus, how it causes disease, who it affects, and how to appropriately treat or prevent illness has been limited and based on best practices approaches to coronaviruses at large. Originally seen to be a local and contained outbreak, COVID-19 coronavirus disease has now affected many countries across the globe. The science around the virus is still in its infancy. On January 30, 2020, the World Health Organization (WHO) declared an outbreak of what is now known as COVID-19 coronavirus disease to be a Public Health Emergency of International Concern (PHEIC).
There is an outbreak of a communicable disease in a foreign country
The COVID-19 coronavirus disease is caused by a novel coronavirus capable of causing severe illness, named the Severe Acute Respiratory Syndrome coronavirus 2 (SARS-CoV-2). It is part of a family of viruses that includes Middle East Respiratory Syndrome coronavirus (MERS-CoV) and Severe Acute Respiratory Syndrome coronavirus (SARS-CoV). Coronaviruses are mainly responsible for mild upper respiratory tract infections; common signs of infection include respiratory symptoms, fever, cough, shortness of breath and breathing difficulties. The novel coronavirus has been clearly demonstrated to cause severe, life-threatening respiratory disease. In more severe cases, infection can cause pneumonia, severe acute respiratory syndrome, kidney failure and death.
The number of persons infected with the virus continues to rise, with 28 countries/regions outside of mainland China reporting cases. The majority of cases continue to be in Hubei Province, China. As of February 17, 2020, there are 71 429 confirmed cases of COVID-19 globally, including 1 775 deaths. This is up six-fold from the earlier January 31, 2020, numbers used to support the Minimizing the Risk of Exposure to 2019-nCoV Acute Respiratory Disease in Canada Order. Cases of the disease have been detected in numerous countries across the world, although to date they have been primarily associated with the Pacific Ocean Rim area. Canada needs to do its part to help prevent further transmission of the disease. Some patients have successfully recovered and have been discharged from care. However, as human transmission involving large numbers of patients is possible, it is important to mitigate the health risks associated with people who have been in direct contact with the virus through intervention and proper care.
The introduction or spread of the disease would pose an imminent and severe risk to public health in Canada
Patients with the novel coronavirus disease present with symptoms that may include fever, malaise, dry cough, shortness of breath, and damage to the lungs. Current data suggests that approximately 15% of cases are severe or critical in nature. Older individuals and those with a weakened immune system or underlying medical condition have been seen to be at a higher risk of severe disease. The time from exposure to onset of symptoms is currently estimated to be up to 14 days, with an average of 5 days. Current treatment is supportive and aimed at relief of symptoms and treatment of associated medical complications. There are no specific treatments for COVID-19 coronavirus disease, and there is no preventative vaccine currently available.
Coronaviruses are spread among humans through the inhalation of airborne infectious respiratory droplets (when an infected individual coughs or sneezes) or through contact with objects or surfaces contaminated by infectious droplets. Human-to-human transmission is the main driving force of the current COVID-19 coronavirus disease outbreak. This novel coronavirus disease has the demonstrated ability to spread if introduced to the general population given lack of immunity, and cause widespread illness.
The entry of members of a certain class of persons into Canada may introduce or contribute to the spread of the communicable disease in Canada
COVID-19 has demonstrated to date that it can cause widespread illness if not properly contained. To date, Canada has managed to prevent the spread of the virus through isolation measures. The Government of Canada, in choosing to repatriate Canadians with a higher risk of exposure to the virus, recognizes the need to prevent the unnecessary introduction of the illness to the broader Canadian population.
The Government of Canada has finalized plans to repatriate Canadian citizens who have been sequestered on board the Diamond Princess Cruise Ship with a known outbreak of COVID-19 coronavirus disease. Individuals who return to Canada by means of a flight that is organized by the Government of Canada or another government — for the purpose of transporting persons from the foreign country who have or may have been exposed to that disease — will be subject to the Order in Council, Minimizing the Risk of Exposure to COVID-19 Coronavirus Disease in Canada. This Order sets out requirements for all individuals arriving in Canada from an area with an outbreak of COVID-19 (therefore presenting a high contagion risk) as part of the Government of Canada’s action to bring Canadians home. Upon arrival in Canada, these individuals will be subject to a mandatory quarantine at the NAV CENTRE in Cornwall, Ontario, of up to 14 days starting upon the date of arrival in Canada at the quarantine facility.
The basis of the repatriation from the Diamond Princess Cruise Ship is the continued increase in the numbers of individuals being infected on board, despite the implementation of quarantine measures. As of February 16, 2020, there are more than 349 confirmed cases already being treated from a population of approximately 3 700. This is an increase of over 70 new cases since February 14, 2020. This high number of new cases so close to the end of the 14-day quarantine period, for an illness with an average incubation of 5 days, suggests that the disease may have continued to spread on board the ship despite quarantine efforts. There have been a significant number of newly reported cases in passengers and crew up to the 10th day post-implementation of quarantine, which is past the average incubation period. The individuals on board have a significantly higher risk of developing the disease than others who may have had no or limited exposure to an infected individual. This group includes older adults, some of whom may have other medical conditions, a population that develops more severe illness. Based on the life cycle of the virus, when passengers from the Diamond Princess disembark in Canada they may continue to be asymptomatic, but infected, for two weeks as they could have been exposed prior to boarding the plane.
For this Order, Canadians on the ship may choose either to board the government-chartered plane to return to quarantine in Canada or to remain in Japan. However, travellers who have remained are considered to present the same risk to Canadian public health as those who chose to take the chartered flight and be quarantined at the NAV CENTRE in Cornwall, Ontario. As with the Canadians who have travelled home on the government-organized flight, when these travellers disembark in Canada they may continue to be asymptomatic, but infected, for two weeks. Unless they are determined by the Chief Public Health Officer of Canada to not pose a risk of significant harm to public health (e.g., if they have visited another low contagion area for a duration longer than the anticipated quarantine period in Canada and have not developed symptoms or tested positive for COVID-19 in that time period), these individuals should also be isolated upon their arrival in Canada.
To this end, the current Order requires travellers who choose to decline the government-chartered flight and return by their own means to Canada to remain in isolation at their point of entry in Canada for up to 14 days. The specific location for isolation will be determined by the Chief Public Health Officer of Canada in accordance with the provisions set out in the Order. This applies equally to foreign nationals who had been on board the same Diamond Princess Cruise Ship.
No reasonable alternatives to prevent the introduction or spread of the disease are available
The Canada Border Services Agency (CBSA) is carrying out enhanced screening of all travellers who have been in Hubei Province, China, in the past 14 days. Travellers who are feeling sick or unwell are assessed for symptoms, including fever, cough and difficulty breathing. Public Health Agency of Canada (PHAC) officers assist the CBSA in the screening assessment and then completion of a health assessment that includes gathering information on travel history, exposure risk, and signs and symptoms of illness. At-risk travellers who exhibit symptoms are sent for immediate medical assessment and care as appropriate. At-risk travellers without symptoms are requested to self-isolate for the 14-day period, report to a local public health authority (LPHA) within 24 hours and monitor their well-being. Information is provided on what to observe and who to contact in case symptoms develop. Recently, a form has been developed to allow for identification and follow-up of all travellers from Hubei who present at ports of entry in Canada. This form is provided to travellers by the CBSA, who then submits the completed form to the PHAC to be shared with the provinces and territories. This will enable the LPHA to follow up with each traveller and ensure they have reported within 24 hours as suggested.
For the limited number of cases in Canada, self-isolation has worked thanks to the excellent civic duty and care exercised by returning Canadians (e.g. initial Toronto, Ontario, cases) and effective contact tracing and follow up by local health authorities. However, the science on the virus is continuously evolving and governments must flexibly adapt their measures to contain the spread of the disease.
Awareness of the need to isolate individuals with known exposure to a high-risk contagion area (e.g. epicentre of outbreak, enclosed close quarters in a site with high rates of illness) has evolved as public health officials are now better informed of the potential risks of the virus. The travellers impacted by this Order will have been sequestered in an area with a high concentration of cases and generally represent a vulnerable population. Their risk of exposure and potential illness is increased relative to other travellers from less exposed areas. It is now known that the virus may be transmissible from infected individuals with mild symptoms and that vulnerable populations are more susceptible to serious illness, and there continues to be no vaccine currently available. Through mandatory isolation of individuals with a higher risk of contracting or carrying the disease, Canada is in line with WHO and other health authority recommendations for containment of COVID-19.
Given the high risk to individual health once exposed and the increased vulnerable population risk, it is appropriate to have the repatriated Canadians isolated in an environment that supports their well-being for a period of up to 14 days, while protecting the general population from unnecessary exposure. Ongoing monitoring of travellers’ health allows for a more immediate and prepared response should a traveller become ill, which in turn increases the likelihood of a smooth recovery. Given the evolving scientific evidence on this virus, it is in the best interest of Canadian public health, both for the travellers and the general public, to provide medical supervision for this group of Canadians for the duration of the incubation period.
With this Order, Canada is aligning the objectives of its approach with those of its international counterparts in the United States, who have instigated similar measures. Australia, New Zealand, and the United Kingdom are considering similar options.
Implications
Key obligations for travellers
Travellers who have tested positive for COVID-19 should at no point board a plane. Prior to leaving the Diamond Princess, travellers will be required to follow the Japanese health authority’s formal screening release process.
The Order will apply to people in foreign countries where there is an outbreak of COVID-19 who were offered, but did not board, a government-organized charter to Canada. The Order will also be applicable to people on a conveyance where there is an outbreak of COVID-19, such as the Diamond Princess, who were offered a government-organized charter to Canada. The Order will obligate all affected individuals to disclose those facts to a screening officer. Travellers will be required to remain in isolation in a location close to the point of entry for up to 14 days from the time of their arrival. They will be required to self- monitor for signs and symptoms of COVID-19 coronavirus disease for the duration and report immediately to a specified public health authority if they develop symptoms of COVID-19. Travellers who exhibit symptoms of COVID-19 coronavirus disease on arrival or during the following 14 days will be issued an order to undergo a medical examination and will receive appropriate medical care as required.
When designating a quarantine facility for isolation, the Chief Public Health Officer will afford travellers consideration of their personal needs to the extent reasonable within the government’s capabilities, but always in accordance with the Canadian Charter of Rights and Freedoms.
Travellers who choose not to return on the chartered flight but to remain in Japan for a full 14-day isolation period following their release from the Diamond Princess may, at the discretion of the Chief Public Health Officer of Canada, be considered eligible for entry in Canada without being subject to the Order if they can demonstrate they are no longer considered to present a high risk of infection (e.g. followed appropriate isolation measures, have negative PCR testing for the virus).
Failure to comply with this Order and other related measures under the Quarantine Act are offences under the Quarantine Act. The maximum penalties are a fine of up to $750,000 or imprisonment for six months, or both.
Consultation
As there are multiple potential points of entry, the provincial public health authorities have been consulted on the Order. The PHAC will continue to collaborate with provinces and territories on the implementation of the Order and address any forthcoming challenges or concerns.
Departmental contact
George Samiotis
Director
Office of Border and Travel Health
Public Health Agency of Canada
Telephone: 343‑542‑6031
Email: george.samiotis@canada.ca