Letter to the Government of Canada Regarding Tightening Measures on Coronavirus

The Issue

Introduction and current situation

As a Canadian citizen, I am deeply concerned about our government’s lackluster response to the novel coronavirus disease (COVID-19) pandemic which originated from China since the end of 2019. On January 30th 2020, the World Health Organization (WHO) declared the Public Health Emergency of International Concern over the coronavirus pandemic and also confirmed human-to-human transmission. As of February 21st, there were over 77,600 reported cases of contracted patients with over 2,350 reported deaths over the coronavirus around the world, with most of the cases officially reported by the National Health Commission of the People’s Republic of China. As of February 21st, there are 3 confirmed cases in Ontario and 6 in British Columbia.

Canada’s current responses

The Government of Canada raised the travel alert to level 3 (avoid non-essential travels) to mainland China [1] and level 4 (avoid all travels) to Hubei Province, China [2].

According to the latest updates from Public Health Agency of Canada [2]:

For the next 14 days of travellers returning from mainland China excluding Hubei Province to
- monitor their health and avoid crowded public spaces
- isolate themselves and contact local public health authorities ASAP if symptoms develops
For the next 14 days of travellers returning from Hubei Province, China to
- limit their contact with others mainly by stay at home to self-isolate and avoid visitors
- contact local public health authority within 24 hours of arriving in Canada
- contact local public health authorities ASAP if symptoms develops

The Canada Border Services Agency [3]:

Has put signages at airport arrival areas to raise traveller awareness and guide them
Added additional screening questions for travellers to declare voluntarily whether they have been in the Province of Hubei, China in the past 14 days
Has been referring travellers experiencing flu-like symptoms to the Public Health Agency of Canada staff for further health screening

Canadians being evacuated from Wuhan, China are undergoing mandatory 14 days quarantine at military base upon arriving in Canada. The quarantined Diamond Princess cruise ship with about 3,700 passengers and crew aboard has over 600 confirmed cases as of February 21st. After the 14 days mandatory quarantine period onboard, our government is offering evacuation of non-infected Canadians on board with a condition of mandatory 14 days quarantine at military base upon arriving in Canada.

Examples of why it’s insufficient and ineffective and slow response

Dr. Anne Schuchat, principal deputy director of the US Centers for Disease Control and Prevention (CDC) indicated concerns of underreported cases from the daily stats from China’s National Health Commission [4]
While the consensus internationally is that the incubation period ranges from 2-10 days, and 99% of cases are less than 14 days, research published by prominent Chinese epidemiologist Zhong Nanshan suggests that the incubation period may last up to 24 days [5]. The US CDC has indicated that asymptomatic infections were reported [6].
There are currently no specialized drugs known to cure the disease, no vaccine to prevent infection, and quarantine is the best measure for outbreak prevention.
The fatality rate does not seem to be as low as 2% that the consensus believed to be as the Chinese film director Chang Kai and his sister died on Feb 14, with his wife in critical condition in Wuhan, after nursing his late parents who were infected with the coronavirus and passed away in the end of January [7]. This is suggesting that 4 of 5 members (80%) in the same family have died from the coronavirus, where the fatality rate can be much higher than expected when not treated properly at a hospital due to healthcare system being overwhelmed, and that self-isolation at home is not a great option.
Shigeru Omi, the chief director of the Japan Community Health Care Organisation indicated that 70% of those testing positive of the passengers and crew tested on the Diamond Princess are not showing any symptoms at all [8]. As of February 17th, 1700 of the 3700 passengers and crew have been tested since the quarantine began, indicating that the 454 confirmed cases [9] is over 26% being infected on board of a cruise ship which started after the later confirmed case of an 80 year old man from Hong Kong disembark the Diamond Princess in Hong Kong. This 80 year old man from Hong Kong only travelled to Shenzhen for a few hours before flying to Tokyo to board the Diamond Princess which is believed to be how he contracted the coronavirus and later infected the rest of the passengers on the Diamond Princess.[10]
There are no on the spot rapid turnaround time testing coronavirus infection with accurate detection. Fever is no indication of possible infection. While, the cheap, abundant, and generally accurate nucleic acid amplification test with throat swabs proves to be very inaccurate for the coronavirus as Professor Wang Chen, an expert in critical diseases and director of the Chinese Academy of Medical Sciences, indicated that “even patients who definitely have the disease only come back positive 30-50% of the time” [11]
More than a dozen countries including US, Australia, New Zealand, Taiwan, Singapore, Philippines, Vietnam, Malaysia, Indonesia, North Korea, Russia have barred entry of non-citizens arriving with travel history in China in the last 14 days. While the EU is considering similar travel restrictions. As of February 19th, South Korea and Japan (excluding Diamond Princess), which followed WHO advice to not impose travel bans have the most confirmed cases outside of China, with new cases overwhelmingly being community transmissions than imported cases, and they are very difficult to track [4].
Wuhan mayor Zhou Xianwang indicated about 5 million residents left Wuhan before the lockdown was put in place to curb the spread of the coronavirus on January 23rd [12]. During the Lunar New Year, there were about 415 million people traveling within mainland China in 2019, and this year this number was expected to be similar or more if not for the disruption due to the current coronavirus outbreak and regional lockdowns. Aside from voluntarily declaration through screening, there are no effective ways for foreign governments to identify whether people entering their countries arriving from mainland China had been in Wuhan, or the Hubei province in the last 14 days.
Most of Hubei province has been under lock down since January 24th due to being the epicentre of the coronavirus outbreak where there are over 59,000 confirmed cases and over 1,700 deaths as of February 17th. Yet, Canada’s Chief Public Health Office Dr. Theresa Tam indicated that travellers from China arriving in major Canada airports screening still shows about 70-80 people entering Canada from Hubei each day, as reported by the Globe and Mail on February 11th [13].
The Canadian Federation of Nurses Unions is warning that the federal public health agency’s guidelines to protect front-line health-care workers from outbreaks of diseases like the novel coronavirus are inadequate, especially science have not settled on whether the coronavirus can be spread through air rather than through droplets [14].
China is the epicentre of this coronavirus pandemic and is implementing travel restrictions within its country between cities and provinces; they clearly know what action they should be taking in the situation. However, WHO is asking the rest of the world to not impose travel restrictions in and out of China due to racism and economy. The world is only imposing travel restriction to personal travelling with China but not goods transportation to minimize economic and supply chain impact nor discrimination.
Businesses in different Chinese communities across the nation are suffering significantly drop in business as much as 70% for restaurants and close to dry up for travel/cruise related businesses. Reports suggests that much of these are due to discrimination [15] or misinformation [16], but in majority of the cases, 80%+ of these businesses’ customer base are of Chinese ethnicity background and the increase in deliveried orders clearly point out discrimination is most likely not the problem; while the misinformation piece is debateable whether these customers are receving misinformation from their families and friends back home or the state of China is giving mininformation to the world.

We demand following responses from our government

Given the current measures from our different levels of government and ministries, it seems to me that Canada is assuming the coronavirus will spread into Canada, so we are more focused on reacting to such over preventing the spread locally, helping the world by containing it in the current pandemic areas, and help them recover from it.

I demand tighter measurements to reduce imported cases into Canada and reduce risk of community outbreaks of the coronavirus in Canada. We need to safeguard our already stretched healthcare resources from further heavy burdens may be caused by these potential local outbreaks, which is already hardly maintaining its current healthcare standards to all local Canadians, as follows:

To avoid any racism and xenophobia type of discrimination, and further avoid of such discrimination that started to rise in our local communities in Canada,
- the Government of Canada should suspend entry into Canada of visitors of all foreign nationals, who have travel history in pandemic areas such as China (an possibly other regions as the outbreak progress) within the last 28 days
- Increase the transparency and speed of updates of detailed information about the coronavirus and outbreak
If the Diamond Princess cruise ship is considered a pandemic region that needs evacuation and mandatory quarantine, the Government of Canada should require all Canadian citizens returning from other pandemic regions like China undergo the same measure of mandatory quarantine at a military base or other facilities with proper support, as self-isolation and quarantine at home does not work unless the person lives alone, and extending the quarantine period to 28 days due to possible longer incubation period.
The Public Health Agency of Canada which was created in the wake of the SARS outbreak in 2003, should step up its measures against the worldwide coronavirus emergency and safeguard medical supplies to our frontline healthcare workers
Hong Kong being the region outside of Canada with the most Canadian citizens resides in, estimated about 300,000. The Government of Canada should push the Hong Kong government to do more to reduce the risks of spreading coronavirus outbreak from mainland China, namely tightening entry control of non-Hong Kong residents who have recent travel history in pandemic areas to reduce import cases and better mandatory local quarantine protocols, as Canada do not have the resources to evacuate 300,000 citizens from Hong Kong and put them under mandatory quarantine should Hong Kong import more cases from mainland China or undergo widespread community transmission.
After accessing and reserving our resources and capacity for local needs, instead of requiring more for possible local outbreaks, our nation will be able to offer some resources to help other regions who are undergoing outbreaks to help contain this global health emergency and reduce further spreading.

I acknowledge the above suggested measures will not completely stop the coronavirus from spreading into Canada, but should reduce and delay the spread into Canada significantly better than current measures in buying more time for Canada to prepare for any future possible outbreaks. Furthermore, the suggested measures once implemented to minimize more imported cases, and in the absence of local community transmission cases, this will build more trust within the various Chinese communities across the nation and their trust in visiting local businesses be restored once incubation period ends after the suggested measured implemented.

References:

Christie ChanPetition Starter

Media inquiries

This petition had 515 supporters

The Issue

Introduction and current situation

Canada’s current responses

The Government of Canada raised the travel alert to level 3 (avoid non-essential travels) to mainland China [1] and level 4 (avoid all travels) to Hubei Province, China [2].

According to the latest updates from Public Health Agency of Canada [2]:

For the next 14 days of travellers returning from mainland China excluding Hubei Province to
- monitor their health and avoid crowded public spaces
- isolate themselves and contact local public health authorities ASAP if symptoms develops
For the next 14 days of travellers returning from Hubei Province, China to
- limit their contact with others mainly by stay at home to self-isolate and avoid visitors
- contact local public health authority within 24 hours of arriving in Canada
- contact local public health authorities ASAP if symptoms develops

The Canada Border Services Agency [3]:

Has put signages at airport arrival areas to raise traveller awareness and guide them
Added additional screening questions for travellers to declare voluntarily whether they have been in the Province of Hubei, China in the past 14 days
Has been referring travellers experiencing flu-like symptoms to the Public Health Agency of Canada staff for further health screening

Examples of why it’s insufficient and ineffective and slow response

Dr. Anne Schuchat, principal deputy director of the US Centers for Disease Control and Prevention (CDC) indicated concerns of underreported cases from the daily stats from China’s National Health Commission [4]
While the consensus internationally is that the incubation period ranges from 2-10 days, and 99% of cases are less than 14 days, research published by prominent Chinese epidemiologist Zhong Nanshan suggests that the incubation period may last up to 24 days [5]. The US CDC has indicated that asymptomatic infections were reported [6].
There are currently no specialized drugs known to cure the disease, no vaccine to prevent infection, and quarantine is the best measure for outbreak prevention.
The fatality rate does not seem to be as low as 2% that the consensus believed to be as the Chinese film director Chang Kai and his sister died on Feb 14, with his wife in critical condition in Wuhan, after nursing his late parents who were infected with the coronavirus and passed away in the end of January [7]. This is suggesting that 4 of 5 members (80%) in the same family have died from the coronavirus, where the fatality rate can be much higher than expected when not treated properly at a hospital due to healthcare system being overwhelmed, and that self-isolation at home is not a great option.
Shigeru Omi, the chief director of the Japan Community Health Care Organisation indicated that 70% of those testing positive of the passengers and crew tested on the Diamond Princess are not showing any symptoms at all [8]. As of February 17th, 1700 of the 3700 passengers and crew have been tested since the quarantine began, indicating that the 454 confirmed cases [9] is over 26% being infected on board of a cruise ship which started after the later confirmed case of an 80 year old man from Hong Kong disembark the Diamond Princess in Hong Kong. This 80 year old man from Hong Kong only travelled to Shenzhen for a few hours before flying to Tokyo to board the Diamond Princess which is believed to be how he contracted the coronavirus and later infected the rest of the passengers on the Diamond Princess.[10]
There are no on the spot rapid turnaround time testing coronavirus infection with accurate detection. Fever is no indication of possible infection. While, the cheap, abundant, and generally accurate nucleic acid amplification test with throat swabs proves to be very inaccurate for the coronavirus as Professor Wang Chen, an expert in critical diseases and director of the Chinese Academy of Medical Sciences, indicated that “even patients who definitely have the disease only come back positive 30-50% of the time” [11]
More than a dozen countries including US, Australia, New Zealand, Taiwan, Singapore, Philippines, Vietnam, Malaysia, Indonesia, North Korea, Russia have barred entry of non-citizens arriving with travel history in China in the last 14 days. While the EU is considering similar travel restrictions. As of February 19th, South Korea and Japan (excluding Diamond Princess), which followed WHO advice to not impose travel bans have the most confirmed cases outside of China, with new cases overwhelmingly being community transmissions than imported cases, and they are very difficult to track [4].
Wuhan mayor Zhou Xianwang indicated about 5 million residents left Wuhan before the lockdown was put in place to curb the spread of the coronavirus on January 23rd [12]. During the Lunar New Year, there were about 415 million people traveling within mainland China in 2019, and this year this number was expected to be similar or more if not for the disruption due to the current coronavirus outbreak and regional lockdowns. Aside from voluntarily declaration through screening, there are no effective ways for foreign governments to identify whether people entering their countries arriving from mainland China had been in Wuhan, or the Hubei province in the last 14 days.
Most of Hubei province has been under lock down since January 24th due to being the epicentre of the coronavirus outbreak where there are over 59,000 confirmed cases and over 1,700 deaths as of February 17th. Yet, Canada’s Chief Public Health Office Dr. Theresa Tam indicated that travellers from China arriving in major Canada airports screening still shows about 70-80 people entering Canada from Hubei each day, as reported by the Globe and Mail on February 11th [13].
The Canadian Federation of Nurses Unions is warning that the federal public health agency’s guidelines to protect front-line health-care workers from outbreaks of diseases like the novel coronavirus are inadequate, especially science have not settled on whether the coronavirus can be spread through air rather than through droplets [14].
China is the epicentre of this coronavirus pandemic and is implementing travel restrictions within its country between cities and provinces; they clearly know what action they should be taking in the situation. However, WHO is asking the rest of the world to not impose travel restrictions in and out of China due to racism and economy. The world is only imposing travel restriction to personal travelling with China but not goods transportation to minimize economic and supply chain impact nor discrimination.
Businesses in different Chinese communities across the nation are suffering significantly drop in business as much as 70% for restaurants and close to dry up for travel/cruise related businesses. Reports suggests that much of these are due to discrimination [15] or misinformation [16], but in majority of the cases, 80%+ of these businesses’ customer base are of Chinese ethnicity background and the increase in deliveried orders clearly point out discrimination is most likely not the problem; while the misinformation piece is debateable whether these customers are receving misinformation from their families and friends back home or the state of China is giving mininformation to the world.

We demand following responses from our government

To avoid any racism and xenophobia type of discrimination, and further avoid of such discrimination that started to rise in our local communities in Canada,
- the Government of Canada should suspend entry into Canada of visitors of all foreign nationals, who have travel history in pandemic areas such as China (an possibly other regions as the outbreak progress) within the last 28 days
- Increase the transparency and speed of updates of detailed information about the coronavirus and outbreak
If the Diamond Princess cruise ship is considered a pandemic region that needs evacuation and mandatory quarantine, the Government of Canada should require all Canadian citizens returning from other pandemic regions like China undergo the same measure of mandatory quarantine at a military base or other facilities with proper support, as self-isolation and quarantine at home does not work unless the person lives alone, and extending the quarantine period to 28 days due to possible longer incubation period.
The Public Health Agency of Canada which was created in the wake of the SARS outbreak in 2003, should step up its measures against the worldwide coronavirus emergency and safeguard medical supplies to our frontline healthcare workers
Hong Kong being the region outside of Canada with the most Canadian citizens resides in, estimated about 300,000. The Government of Canada should push the Hong Kong government to do more to reduce the risks of spreading coronavirus outbreak from mainland China, namely tightening entry control of non-Hong Kong residents who have recent travel history in pandemic areas to reduce import cases and better mandatory local quarantine protocols, as Canada do not have the resources to evacuate 300,000 citizens from Hong Kong and put them under mandatory quarantine should Hong Kong import more cases from mainland China or undergo widespread community transmission.
After accessing and reserving our resources and capacity for local needs, instead of requiring more for possible local outbreaks, our nation will be able to offer some resources to help other regions who are undergoing outbreaks to help contain this global health emergency and reduce further spreading.

References:

Christie ChanPetition Starter

Media inquiries

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This petition had 515 supporters

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Public Health Agency of Canada

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Petition created on February 26, 2020