Canadian advisory panel recommends ending hotel quarantine program and creating system to “validate proof of vaccination”

On May 27, 2021, the COVID-19 Testing and Screening Expert Advisory Panel released a report calling for the end to the mandatory hotel quarantine program which is currently required for international travellers entering Canada. The report also suggests that the government should implement a system to “validate proof of vaccination for arriving travellers as soon as possible.”

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The federal advisory panel that provides recommendations to the Canadian Federal government on COVID-19 testing and screening has recommended that the government put an end to the mandatory hotel quarantine program which is currently required for international travellers entering Canada. 

The Public Health Agency of Canada states that “Canada has some of the strictest travel and border measures in the world.”

Those travel restrictions include, 

“Travellers are required to complete a pre-arrival molecular test, as well as tests on arrival and later during their mandatory 14-day quarantine. Travellers must submit their travel information through ArriveCAN, including their contact information, 14-day travel history, and symptom self-assessment. Air travellers must also submit proof of having reserved and paid for their mandatory stay at a government-authorized hotel while they await the results of their on-arrival test. Travellers who do not follow these measures face significant penalties.”

The report from the COVID-19 Testing and Screening Expert Advisory Panel is recommending, instead of the mandatory 3-day hotel quarantine stay, international travellers should instead be allowed to come up with their own quarantine plans which should be presented to officials when entering Canada.

The report says that the mandatory three-day hotel quarantine program is flawed in several ways and says that “the role of border measures is to mitigate risk, recognizing that it’s impossible to eliminate risk completely”.

The panel emphasises that “Border measures must be simple, easy to understand, equitable and consider both benefits and harms”.

“The current requirement for all air travellers to quarantine in government-authorized accommodations should be discontinued.”

Adding, “However, travellers subject to quarantine must provide a suitable quarantine plan for approval and then adhere to this plan. If the traveller does not have a suitable quarantine plan, they should be required to adhere to an alternative one (for example, in designated quarantine facilities).”

The report also suggests that the government should implement a system to “validate proof of vaccination for arriving travellers as soon as possible.”

Between February 21 to 22, 2021 and March 24 to 25, 2021, of the 112,498 tests from land and air travellers, only 1,359 tests came back positive. 

“At land borders, 0.3% (70 cases) of the 25,855 non-exempt travellers tested positive for SARS-CoV-2. For air travel, 1.5% (1,289 cases) of the 86,613 non-exempt travellers tested positive for SARS-CoV-2.”

The report says that,

“Previous border measures were insufficient to prevent the importation of the B.1.1.7 VoC, which is now the dominant strain in Ontario and British Columbia. As well, P.1 is gaining ground in British Columbia.”

“It is important to note that by the time a variant is identified as being “of concern,” it is highly likely to be present in many countries around the world.”

Adding, “excessive or ‘targeted’ focus on travellers arriving from a single country is likely to provide a false sense of reassurance and not materially impact the presence of a VoC (variant of concern) in Canada.”

The report also discusses the downsides of border measures. 

“Border measures also come at a cost to the economy and to the movement of Canadians. For example, airlines are reporting operating at significantly lower capacity compared to the previous year.” 

Adding, “As the roll-out of vaccination programs advances domestically and internationally, the volume of travel will likely increase. A new balance will need to be found with modified testing and quarantine requirements. However, some border measures are likely to be required for the foreseeable future.”

The panel emphasizes the need for border measures to be “based on data from the scientific literature and the Public Health Agency of Canada and experiences to date,”. 

The panel recommends pre-departure testing, arrival testing, quarantine and quarantine exit testing at this time. 

Currently to enter Canada, the government requires a PCR test, and does not accept rapid antigen tests (RATs). 

However, the panel says that modeling shows “pre-departure rapid antigen tests (RATs) conducted close to departure (24 hours or less) may be as effective at identifying positive cases as PCR tests collected within 72 hours before departure”.

The panel also discussed 7-day quarantines with exit testing in the report. “Depending on the level of compliance, a 7-day quarantine with testing may be more effective than a 14-day quarantine without testing.”

Suggesting that, “Requiring a test at day 7 of quarantine to facilitate exit may prove to be an incentive and thus increase compliance, resulting in more robust surveillance.”

The report also discusses “several issues related to mandatory government-authorized accommodation” which they deem “worthy of consideration”.

Those issues include travellers who choose to pay a fine of up to $3,000 rather than staying in the government-authorized accommodation, suggesting that “these travellers may or may not be adhering to quarantine”.

Another issue with the mandatory hotel quarantines they discuss are the “significant administrative costs and resources devoted to managing hotel quarantine that cannot be used for other issues related to the pandemic response.”

The report also discusses the issue with the high price tag travellers are facing while staying in the mandatory quarantine hotels (up to $2,000 CAD per person). 

Other issues discussed include the discrepancy between the quarantine rules between the land and air border, and the fact that “3 days is inconsistent with the incubation period of SARS-CoV-2”. 

“Given the current Canadian context, the Panel recommends a strong focus on adherence to quarantine rather than modifying the hotel quarantine program to become more like those in place in New Zealand and Australia.”

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