Canada Gazette, Part I, Volume 154, Number 13: ORDERS IN COUNCIL

March 28, 2020

DEPARTMENT OF HEALTH

FOOD AND DRUGS ACT

Order Approving the Interim Order Respecting the Importation and Sale of Medical Devices for Use in Relation to COVID-19

P.C. 2020-176 March 24, 2020

Her Excellency the Governor General in Council, on the recommendation of the Minister of Health, pursuant to paragraph 30.1(2)(a) footnote a of the Food and Drugs Act footnote b, approves the Interim Order Respecting the Importation and Sale of Medical Devices for Use in Relation to COVID-19, made by the Minister of Health on March 18, 2020.

EXPLANATORY NOTE

(This note is not part of the Order.)

The Order approves the Interim Order Respecting the Importation and Sale of Medical Devices for Use in Relation to COVID-19 made by the Minister of Health on March 18, 2020. Without this approval, the Interim Order would, in accordance with paragraph 30.1(2)(a) of the Food and Drugs Act, cease to have effect 14 days after it was made. As a result of this approval, the Interim Order will, in accordance with paragraphs 30.1(2)(b) to (d) of the Food and Drugs Act, cease to have effect on the day on which it is repealed, on the day on which regulations having the same effect come into force or one year after the day on which the Interim Order is made, whichever is earliest.

PUBLIC HEALTH AGENCY OF CANADA

QUARANTINE ACT

Minimizing the Risk of Exposure to COVID-19 Coronavirus Disease in Canada Order (Prohibition of Entry into Canada)

P.C. 2020-157 March 18, 2020

Whereas the Governor in Council is of the opinion that

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 c, makes the annexed Minimizing the Risk of Exposure to COVID-19 Coronavirus Disease in Canada Order (Prohibition of Entry into Canada).

Minimizing the Risk of Exposure to COVID-19 Coronavirus Disease in Canada Order (Prohibition of Entry into Canada)

Definition of immediate family member

1 In this Order, immediate family member, in respect of a person means

Prohibition

2 Any foreign national, as defined in subsection 2(1) of the Immigration and Refugee Protection Act, is prohibited from entering Canada if they arrive by means of an aircraft from a foreign country.

Non-application

3 Section 2 does not apply to

Powers and obligations

4 For greater certainty, this Order does not affect any of the powers and obligations set out in the Quarantine Act.

Effective period

5 This Order has effect for the period beginning at noon Eastern Daylight Time on March 18, 2020 and ending at noon Eastern Daylight Time on June 30, 2020.

EXPLANATORY NOTE

(This note is not part of the Order.)

Proposal

This Order in Council, entitled Minimizing the Risk of Exposure to COVID-19 Coronavirus Disease in Canada Order (Prohibition of Entry into Canada), is made pursuant to section 58 of the Quarantine Act.

Objective

The objective of this Order is to protect the health and safety of the public from the COVID-19 coronavirus disease outbreak by banning entry of foreign nationals travelling to Canada by air from all countries with the exception of persons travelling from the United States who have been in that country or Canada for at least 14 days. The measure would not apply to specified exceptions such as immediate family members of Canadian citizens, Indigenous peoples of Canada, persons authorized by consular services for purposes of reuniting with immediate family, air crews, diplomats, persons invited to Canada to assist with Canada’s COVID-19 response, persons on military flights or other Canadian military support, certain refugees, French citizens from Saint-Pierre and Miquelon, those whose presence is in the national interest and travellers arriving in Canada in transit to a third country.

This Order works in conjunction with a counterpart notice to airmen (NOTAM) under the Aeronautics Act to require air carriers on flights to Canada to deny boarding to passengers who are not Canadian citizens or permanent residents, with the exception of persons travelling from the United States who have been in that country or Canada for at least 14 days.

Background

COVID-19 coronavirus disease was first detected in Wuhan, China, in December 2019. The disease is caused by a new strain of coronavirus never before seen in humans. Therefore, 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 outbreak, COVID-19 coronavirus disease has now affected the majority of countries across the globe. The science around the virus is still in its infancy. 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) on January 30, 2020, and a pandemic on March 11, 2020. Within the last week, the number of travel-related cases of COVID-19 in Canada has escalated and the number of global cases has increased and spread to over 150 countries. Immediate action to reduce the health impacts to Canada through enhanced border measures is required.

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). Common signs of infection include respiratory symptoms, fever, cough, shortness of breath and breathing difficulties.

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 its lack of immunity, and cause widespread illness.

Outside of China, Italy is reporting the most cases, followed by Iran, South Korea, Spain, and France. As of March 15, 2020, there are 156 000 confirmed cases of COVID-19 globally, including 5 758 deaths. Some patients have successfully recovered and have been discharged from care. However, human transmission involving large numbers of patients continues to be possible.

On March 13, 2020, the Government put an official global travel advisory into effect advising against non-essential travel outside Canada until further notice.

The introduction or spread of the disease would pose an imminent and severe risk to public health in Canada

COVID-19 has been clearly demonstrated to cause severe, life-threatening respiratory disease. Patients with COVID-19 present with symptoms that may include fever, malaise, dry cough, shortness of breath, and damage to the lungs. In more severe cases, infection can cause pneumonia, severe acute respiratory syndrome, kidney failure and death. Current data suggests that approximately 16% 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.

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. Global efforts are focused on containment of the outbreak and the prevention of further spread. To date, Canada has managed to prevent the spread of the virus through isolation measures. This Order recognizes that it is no longer possible to pinpoint specific hot zones from which to protect Canadians. There is widespread infection reported by many countries and many countries do not have sufficient capacity to detect cases. If widespread disease occurs in Canada, the health system can easily be overwhelmed, further increasing negative health impacts. This has recently been demonstrated in Italy, a G7 country with a similar health care system.

To date, the vast majority of Canadian cases are linked to international travel (e.g. China, Iran, Egypt, Italy, Spain). Blocking foreign nationals from entering Canada would reduce the risk of further introductions and spread of COVID-19 in this country.

No reasonable alternatives to prevent the introduction or spread of the disease are available

As part of the Canada Border Services Agency’s (CBSA) enhanced screening, all travellers who are feeling sick or unwell are assessed for symptoms including fever, cough and difficulty breathing. Public Health Agency of Canada officers assist the CBSA in the screening assessment and then completion of a health assessment that includes gathering information on exposure risk, and signs and symptoms of illness. All travellers are requested to self-isolate for a 14-day period, monitor their well-being and follow up with local public health authorities if symptoms occur. Information is provided on what to observe and who to contact in case symptoms develop.

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.

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. Targeted measures that only prohibit travel from limited countries would no longer be effective given that COVID-19 is now a pandemic. Furthermore, there are limits on the enforceability of measures such as voluntary isolation. By rigorously limiting incoming foreign nationals, Canada is taking the robust precautionary measure to limit the chance of unintentional new exposures from outside its borders. Exceptions to this rule are made for practical reasons, for example, permitting controlled travel across the United States border to allow for continued supply chain provisions through Canada’s major trading partner. These actions will contribute to how Canada is applying layers of public health measures to reduce the risk of COVID-19. This is an ongoing situation and exemptions will be closely monitored to align with public health requirements.

With this Order, Canada is taking an approach similar to but more comprehensive than that taken by the United States.

Implications

Aviation industry; other industries

The yearly pre-tax profits of the Canadian airline industry each year are about CAN$1.5 billion. The air transportation sector represents thousands of industry jobs. In addition, thousands of jobs support the aviation industry.

The Air Transport Association of Canada, while voicing support of the Government’s actions to curb the spread of COVID-19, has also expressed concerns regarding the sustainability of Canadian air carriers.

There will likely also be economic impacts resulting from this measure on other affected businesses. This public health measure is being taken in an effort to minimize the potentially devastating economic and health impacts already in evidence around the globe.

Key impacts for travellers

All foreign nationals on flights to Canada other than transborder flights, and any foreign national on a transborder flight who has resided outside the United States and Canada in the last 14 days, would be prohibited entry into Canada. The measure would not apply to specified exceptions such as immediate family members of Canadian citizens, Indigenous peoples of Canada, persons authorized by consular services for purposes of reuniting with immediate family, air crews, diplomats, persons invited to Canada to assist with Canada’s COVID-19 response, persons on military flights or other Canadian military support, certain refugees, French citizens from Saint-Pierre and Miquelon, those whose presence is in the national interest and travellers arriving in Canada in transit to a third country.

Failure to comply with this Order and other related measures under the Quarantine Act are offences under the Act. The maximum penalties are a fine of up to $1,000,000 or imprisonment for three years, or both.

Consultation

Because there are numerous points of entry into Canada for international air carriers, the Government of Canada has engaged key stakeholders (provinces and territories, airlines and airports) to align efforts and advance implementation plans.

The Government has also engaged the G7 leaders on its plans to prohibit the entry of most foreign nationals into Canada, and has consulted the U.S. Administration on the Order to facilitate its application on transborder flights as it pertains to screening people getting on U.S. flights.

As part of its commitment to support the International Health Regulations, Canada will also be notifying the World Health Organization of this action.

Departmental contact

George Samiotis
Public Health Agency of Canada
Telephone: 343‑542‑6031
Email: george.samiotis@canada.ca