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What you need to know about COVID-19: September 18, 2020
The European Union has deemed travellers from Canada safe to enter EU countries. But just because you can, should you?
The EU agreed Tuesday to relax temporary restrictions on non-essential travel for 14 countries as of July 1, including Canada, but not the United States, where COVID-19 infections are surging in several states to the horror of observers, including top infectious diseases expert Anthony Fauci, who warned Tuesday that cases in the U.S. could reach 100,000 a day “if this does not turn around.”
Canada fulfilled the 27-member EU bloc’s criteria for a safe — or, perhaps more accurately, safer —country, including a “stable or decreasing trend of new cases” over the last 14 days compared to the previous 14 days, as well as the nation’s overall response to COVID-19, including testing and contact tracing, and the reliability of its data.
The shortlist of endorsed countries will be reviewed and updated every two weeks. The recommendations aren’t legally binding — EU member states can reopen their borders, or not, to whichever countries they choose. Denmark and Ireland, for example, are not taking part in the recommendation’s adoption.
The lifting of European travel restrictions comes as Air Canada and WestJet are set to drop social-distancing seating and resume filling middle seats, a move that has unnerved B.C. Health Minister Adrian Dix. “What I’d like to hear from Transport Canada, from Health Canada is do they agree with this,” Dix told a new conference on Monday.
But it’s not just about the flight. Travelling is so much more. “Can this be done safely? The real answer is, ‘look, in this era, there is going to be nothing that’s without risk — everything is going to be tied to some element of risk,” said Toronto infectious disease scientist Dr. Isaac Bogoch. “People are going to have to make their own risk assessment to determine if this is worth it for them or their family, or not.”
We pose less of a threat to Europe. That doesn’t mean Europe doesn’t pose more of a threat to the average traveller
The Canadian government is still recommending Canadians avoid all non-essential travel outside of the country. With few exceptions, anyone entering or returning to Canada, whether by air, land or sea, is required to self-quarantine for 14 days, whether or not they have symptoms of COVID-19. Maximum penalties for failing to comply carry a fine of up to $750,000, imprisonment for six months, or both. “Spot checks will be conducted by the Government of Canada to verify compliance,” the Public Health Agency of Canada states on its website.
Even travelling inside the country remains a challenge with public health restrictions and periods of quarantine. Visitors to Prince Edward Island, for example, must fill out an online declaration form ahead of their trip, bring a physical copy with them, and be prepared for health screening at point of entry. New Brunswick is also limiting non-essential travel, and requires visitors to quarantine for 14 days.
People with no or few symptoms can spread COVID-19 while still infectious. “So, unless you are going to screen every traveller immediately before each trip, then mass transit of any form comes with an inherent degree of risk,” said Dr. Matthew Oughton, an attending physician in the Jewish General Hospital’s division of infectious diseases in Montreal.
Airlines have committed to pre-boarding temperature checks, health screenings and masking policies. But the data suggest only smaller numbers of people actually show up with fever as their first symptoms of COVID-19. There is also pre-symptomatic transmission.
“Even though I could screen completely negative and have a normal temperature today, I could be infectious and coughing and febrile tomorrow,” said Dr. Zain Chagla, an associate professor of medicine in infectious disease at McMaster University.
If the symptom screening does pick up a couple of people, well, fine, that’s helpful, Chagla said. “But it might still miss 70 to 80 per cent of people that might have COVID.”
In addition, while he would hope people would behave ethically, “if you’re paying a lot of money for a transatlantic flight, there’s a negative incentive for people to lie on those symptom screens, and get on the plane.”
According to the U.S. Centers for Disease Control and Prevention, most viruses don’t spread easily on flights, because of the way air is circulated and filtered. There are frequent air exchanges; most of the air gets cleaned up relatively quickly, Chagla said.
“But we know with this virus, even with good air exchanges, close contacts and droplets are still a mode of transmission, “ Chagla said. The people next to you are the most contagious, not so much four or five rows down.
“Certainly there can be transmission of infection,” said Bogoch, who helped create guidelines for safer flying during the pandemic for the World Health Organization and International Air Transportation Association. But good epidemiological data from SARS-CoV-2 and other coronaviruses, including SARS, suggest, “There’s less transmission than you would think.”
Still, the risks continue once off the plane, including the burden of infection on the ground. “What are the control efforts in that destination city or country? What do you plan on doing there? Are you just staying in your hotel or interacting with the world around you?” Bogoch said.
Chagla believes travel should be restricted to matters that are immediate or urgent, not necessarily pleasure. “We pose less of a threat to Europe. That doesn’t mean Europe doesn’t pose more of a threat to the average traveller,” he said.
There’s a gamble every time you spend a day out of Canada
The sheer process of getting from point A to point B, he said, particularly transatlantic travel, is a potentially toxic, high-touch slalom (the door handle of the taxi to the airport, touchscreen check-in kiosks, common washrooms, concessions). Line ups to drop off bags, line ups at security, line ups to board the plane, line ups at customs. “All of those things are high, high risk for COVID, particularly as they tend to occur in fairly poorly ventilated settings,” Chagla said.
“We’re talking about masking more and more today — this is a setting where you would be stupid not to wear a mask. You probably should be wearing your mask from the second you walk into the airport to the second you walk out of the airport on the other side.”
Masks do need to come off to eat and drink, particularly during a transatlantic flight, but it does expose people to respiratory droplets.
What can people do to keep themselves safer? Sanitize hands frequently. Once the plane lands, wait to make sure aisles are clear before squeezing to get out of the exist as fast as possible. Other people have been handling your bags; once collected, wipe down the handles and wash hands after handling. Always maintain distancing in lines. Careful of high-touch surfaces in hotels, like remote controls and door handles. Wipe them down with Lysol or other wipes.
Two weeks is also a long time in the context of COVID, Chagla said. “If you’re planning on travelling you have to be willing that your plans may get completely thrown out of whack, you might be diverted. If there’s a local crisis, you may not be able to get the airport. And god forbid that something happens in Canada where Canada gets restricted again, you might get stuck in that country.
“There’s a gamble every time you spend a day out of Canada.”
Copyright Postmedia Network Inc., 2020