insight & evidence

COVID-19: The Border Dilemma

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How to Let People In, While Keeping the Virus Out

COVID-19 presents a particular challenge at our border, the 49th Parallel which is the longest undefended border in the world. The Border Dilemma, a paper created by Peter Nicholson and Jeff Larsen, describes a path where we can let people in while keeping COVID-19 out.

The following is a short excerpt from the paper – please download The Border Dilemma: How to let people in, while keeping the virus out to read the full strategy.

EXCERPT…

Prelude

As summer heats up and social distancing requirements are relaxed, there is an excitement that we can return to “normal”.  But at best we are talking about a “new normal”, and at worst we risk a second wave of COVID-19 and re-imposed restrictions or a lock-down.  The conventional wisdom is coalescing around a testing and tracing strategy to reopen the economy and society while preventing a second wave.  This approach has been described in different terms as “Hammer and Dance” and “Whac-a-Mole”, or fighting a forest fire.  In the latter analogy, you first control the blaze and then focus on spotting and snuffing out the sparks the moment they appear. 

In our Test, Trace, Repeat paper we describe this as part of a comprehensive strategy to reopen more safely in the context of Nova Scotia, although it is equally applicable to other jurisdictions. But the Achilles heel of this strategy is the border.  Why?

The threat of re-introducing COVID-19 comes when infected individuals travel and reignite the fire of community transmission.  This creates a frustrating dilemma for places that have eliminated the virus – in order to reopen internally there must be strict border controls to mitigate the risk of re-introducing the virus.  New Zealand is a case in point. They eliminated the virus within their border and were able to completely restore pre-COVID status—social gatherings, concerts, sporting events and all economic activity—but with mandatory 14-day supervised quarantine at government “isolation hotels” for all travellers, including returning residents.  In addition, those in quarantine receive (RT-PCR) tests for the virus on the third and twelfth days of their 14-day isolation period.  

New Zealand also provides a lesson with respect to the risk at borders.  Two women from the UK were given compassionate leave to exit quarantine on their sixth day and before results of their test were known. They unknowingly entered the country, creating a risk of igniting community transmission.  New Zealand’s rigorous approach to testing and tracing will likely contain the virus so that doesn’t happen, demonstrating the effectiveness of a Whack-a-Mole (WaM) strategy.  But it also shows that until we have a vaccine, vigilance at the border is critical if we want to be open within the border.

This is an important lesson for Canada.  In provinces where the daily number of new cases has been reduced to zero, or close to it, for at least two weeks—e.g. as Manitoba, Nova Scotia, Newfoundland and Labrador, New Brunswick, and PEI have already achieved – we can basically reopen everything without any social distancing restrictions provided we have a focused strategy to identify and immediately squelch the virus through enhanced border restrictions based on more detailed information complemented with a testing procedure.  It is important to realize that the international and interprovincial border restrictions in Canada are much less rigorous than those that are enforced in New Zealand.

The federal government requires 14-day honour-system self-isolation for those coming from foreign jurisdictions, as do the Atlantic provinces for those entering from provinces outside the Atlantic group.  Other provinces do not have restrictions or requirements for travel from other provinces.  Because these approaches are not monitored or supervised (except in rare cases), they are likely too lax to prevent the virus from entering and spreading in our communities.  On the other hand, a supervised quarantine like New Zealand’s is likely too restrictive and would eventually become impractical in the many months before a vaccine is widely available.

So how do we remove social distancing restrictions within our borders; permit more travel from outside; while also ensuring more safety and confidence?

The following paper describes a path where we can do this.  We prepared it on our own initiative, and it is not a government document. It is put forward informally for discussion and refinement. Since this draft was completed, the Atlantic Provinces have announced that they will form a “bubble”, effective July 3, that allows residents of those provinces to travel among them without a requirement for two-week self-isolation. The ideas advanced in our paper may provide a framework for allowing removal of all restrictions within Atlantic Canada…

TO CONTINUE READING, DOWNLOAD THE BORDER DILEMMA: HOW TO LET PEOPLE IN, WHILE KEEPING THE VIRUS OUT

About the author

Policy Wonks

The Policy Wonks are Dr. Peter Nicholson and Jeff Larson.

By Policy Wonks
insight & evidence