Question Period Note: ADJUSTING PUBLIC HEALTH MEASURES

How is the Government adjusting public health measures to address the current situation in Canada?

• The recent increase in the number of COVID-19 cases in Canada is concerning.

• Even a single person with mild symptoms can start a chain reaction of exposures and infections, both at private gatherings and in public settings.

• We can all do our part to reduce the impact and severity of the resurgence of COVID-19 activity in Canada by:

o Following public health guidelines, including recommendations on hand washing, wearing non-medical masks, and staying home when sick;
o Practising physical distancing; and
o Avoiding gatherings with people outside of our immediate household.

• We are continually evaluating the impact of relaxing and reintroducing public health measures, in collaboration with our provincial and territorial partners, based on the most recent evidence and the current epidemiological situation.

• We continue to use all evidence and models available on an ongoing basis to help us identify which combinations of public health measures are most effective to help us control the pandemic.

Public health measures (PHM) are the non-pharmaceutical interventions implemented by federal/provincial/territorial and local public health authorities to control COVID-19 transmission. Measures focus on helping individuals to protect themselves and others, such as personal hygiene, physical distancing, and self-monitoring. Public health organizations also aim to prevent transmission by undertaking testing programs to detect and isolate cases, tracing people exposed to cases and quarantining them so they cannot transmit COVID-19 to others. Community measures such as public education campaigns, restrictions on gatherings and school and workplace measures, help to protect groups and the community at large.

With limited options for treatments and no vaccine available at this time, core PHM (case detection, contact tracing and efforts of individuals such as personal hygiene and self-isolating when sick) will need to be sustained in order to maximize our ability as a society to control the spread of the virus over the long term. Public health authorities will need to continue to rapidly identify and respond to new cases and outbreaks to reduce community-spread, prevent large increases in case numbers and associated hospitalizations. It is important to consider how to reduce the impact of seasonal respiratory infections, so that public health resources and health care system capacity are not overwhelmed when dealing with COVID-19 cases occurring at the same time.

A series of models are being used to identify the potential impact of different combinations of control measures on infection rates in the Canadian population. On an ongoing basis, these models help to identify which combinations of public health measures, applied with what intensity, are most likely to reinforce pandemic control.

PHAC is continually evaluating the impact of PHM on the number of cases reported through surveillance systems, and is adjusting guidance as needed in collaboration with provincial and territorial partners. Community-based PHM are most effective when implemented as early as possible in response to epidemiological triggers of concern (e.g. increases in unlinked cases). Therefore, preparations include being ready to re-implement restrictive community PHM by the provinces and territories or at the municipal public health level. It is important to remember that it takes about two weeks before the impact of PHM can be seen in our surveillance data. This is because of the time lapse between when a person is infected, when they are tested and subsequently reported to PHAC as a confirmed case.

Holiday gatherings and celebrations
Holiday celebrations typically include indoor gatherings of families and friends, crowded parties, and travel, both domestic and international. During the holiday season, public health messaging will promote measures that Canadians can take to reduce their risk and prevent the spread of COVID-19. Mental health supports and resources will also be promoted. Advice should always be considered with the advice of local public health authorities rather than as a replacement.

Provincial/territorial measures
On August 28, 2020, Quebec updated the required isolation period for individuals who have COVID-19, or who came into contact with a confirmed case. Quebec’s instructions now dictate that individuals can end their isolation period when they meet all of the following conditions:

• 10 days have passed since symptoms started;
• The individual has not had a fever for at least 48 hours, without using fever medication; and
• Symptoms have improved for at least 24 hours, except for cough and loss of smell, which can last longer.

On July 3, 2020, the Atlantic travel bubble came into effect. For Atlantic Canada residents, travel within Nova Scotia, New Brunswick, Prince Edward Island and Newfoundland and Labrador was permitted without the requirement to self-isolate. Everyone who travelled from outside Atlantic Canada into the bubble (including post-secondary students and those travelling through Atlantic Canada to another destination) were required to self-isolate for 14 days when they arrived, or for the duration of their stay if it was less than 14 days. If a person from the region travelled outside Atlantic Canada they also were required to self-isolate for 14 days from the day they returned, even if they did not have symptoms. Effective November 24, 2020 until at least December 7, 2020, Newfoundland and Labrador and Prince Edward Island temporarily suspended their participation in the Atlantic bubble to curb the spread of COVID-19 in the region. As of November 26, Nova Scotia has advised its population to avoid non-essential travel to other Atlantic provinces. Effective November 27, New Brunswick reverted back to the original 14-day isolation rule for anyone from anywhere travelling into the province.

SYNOPSIS
The Public Health Agency of Canada (PHAC), along with provincial and territorial partners, is continually evaluating and adjusting the response based on the most recent evidence and the current epidemiological situation.
IF PRESSED ON PROVINCIAL/TERRITORIAL-SPECIFIC MEASURES

• Provinces and territories develop guidance and public health measures for their own jurisdictions which may differ, reflecting differences in the pandemic across the country and between regions within provinces and territories.

• Given the recent increase in cases in Canada, we are seeing some health authorities respond accordingly by reinstating stricter public health measures, and providing tailored public messaging based on local circumstances.

• Each province and territory will continue to make plans according to their COVID-19 transmission realities.
IF PRESSED ON HOLIDAY GATHERINGS

• The holidays are traditionally a time for Canadians to gather with family and friends, near and far.

• This holiday season will be different, but we can still stay socially connected to one another, even if we stay physically distant.

• To help reduce the spread of COVID-19, Canadians should keep holiday gatherings and celebrations within their immediate household.

• Celebrating with people outside your immediate household brings additional risk.

• Those who plan to gather with people outside their immediate household should:

o Check with their local public health authority to find out about gathering size limits and event cancellations;

o Keep gatherings as small as possible;

o Limit non-essential travel and activities 14 days prior to the gathering, to help reduce the risk of exposure; and

o Plan lower-risk activities, such as outdoor or virtual celebrations, or drop off gift exchanges.

• No matter how you plan to celebrate the holiday season, show kindness and respect to others by:

o Maintaining a physical distance;
o Wearing a non-medical mask; and
o Staying home and away from others if you have symptoms of COVID-19.

IF PRESSED ON WINTER/MOVING INDOORS

• We know that weather, holidays and other activities traditionally bring people indoors more often this time of year.

• As provinces and territories continue to adjust public health measures, we have to think about the risks associated with different settings and activities.

• Canadians are used to adding layers of clothing for protection against the elements.

• This year, we also encourage Canadians to use multiple layers of protection against the virus, in the form of public health measures.