Launched in early April, a petition calling for the adoption of a COVID-zero strategy has already gathered more than 4,000 signatures in Canada. The initiative ZeroCovidCanada.org was started by experts, doctors and citizens from across the country, including Quebecois engineer Stéphane Bilodeau and Albertan biologist Malgorzata Gasperowicz, who are members of the international coalition Endcoronavirus.org. This organization is holding a Global Day of Action for Zero Covid on April 10. In Quebec, this strategy is suported by the group COVID-Stop.
The ZeroCovidCanada collective is calling on the federal and provincial governments to replace their pandemic mitigation strategy with a focus on completely eliminating SARS-CoV-2. The petition is addressed to Prime Minister Justin Trudeau, Minister of Health Patty Hajdu, the provincial premiers, and Theresa Tam, the chief public health officer of Canada. You can sign the petition by following this link.
Canada must adopt Zero-Covid to avert catastrophic deaths and long-term health problems
We are a national group of researchers, physicians, engineers, activists, lawyers, educators, and concerned citizens. We are alarmed that Canada is facing a third, much more dangerous wave of the COVID-19 pandemic everywhere except the Atlantic provinces and the North. SARS-CoV-2 variants are quickly taking over, causing daily new cases to surge.
Current mitigation strategies have failed: thousands of Canadians have died, and many people are suffering from long-term health problems and financial instability. We strongly urge the federal and provincial governments to immediately adopt a COVID-zero strategy with the goal of eliminating SARS-CoV-2 from Canada, just as the Atlantic provinces and the Territories have successfully done. It is imperative that we prevent even more tragic and unnecessary illness and death. Furthermore, the SARS-CoV-2 variants have dramatically increased pandemic risks. These variants are much more transmissible, harmful, deadly, and/or can better evade the immune response. Variants have increased the incidence of severe outcomes and death for children and young adults. They are now present in large numbers in multiple Canadian provinces, and their growth is not under control.
COVID-19 is a dangerous, poorly understood disease that can be fatal for people of all ages, including children. Many survivors that needed acute care in hospital were later readmitted to hospital, developed new diseases, or died within a few months after their release from hospital. Even if not fatal, COVID-19 can sometimes cause symptoms that persist for many months, a condition termed long COVID. Children are not immune to long COVID. The UK is finding that approximately 10 per cent of children who recover from COVID-19 continue to struggle for many months with debilitating symptoms including gastrointestinal issues, rashes, COVID toes, loss of smell, and heart palpitations. The long-term health consequences present significant future costs for both individuals as well as society.
Vaccines are critical life-saving tools, but on their own, they cannot resolve the pandemic. Canada has begun to vaccinate the elderly, essential workers, and medically vulnerable people, but not enough people have been vaccinated. There are currently not enough doses, so Canada’s vaccination roll-out is slow. The national vaccination effort is also compromised by letting the virus spread in high numbers. Ultimately, we face too many uncertainties with immune-response evading variants. The basic reproduction number (R0) of the original variant and especially of the new variants is likely too high, so that even with 70 per cent of the population vaccinated, the herd immunity threshold may not be reached.
Canada’s current mitigation strategy has failed
Canada’s mitigation strategy — tolerating a limited number of cases that will not overwhelm hospitals — resulted in the second wave and has led to the deaths of 23,000 Canadians from a preventable disease. The belief that this is our “new normal” and we must “learn to live with the virus,” central to Canada’s current mitigation strategy, has caused great harm to children and families. Trying to keep schools open during a pandemic has proven to be highly disruptive for children and families. COVID outbreaks in schools have a profound effect on the mental health of children as children and families are infected and/or have to isolate.
A mitigation strategy is also highly inequitable. It ignores the vulnerable position of families, essential workers, marginalized communities, and those living in congregate care. First Nations communities and many ethnic minorities disproportionately experience the negative impacts of the pandemic. They more often live in multi-generational households, and children attending a school with an outbreak or in-school transmission put their elderly family members at great risk. These children do not have the option to keep separate from their grandparents because they are dependent on them for childcare. Women similarly suffer disproportionate impacts from the pandemic, whether due to loss of income, increased responsibility for family care, or increased incidences of gender-based violence.
More transmissible variants render the current mitigation strategy even more precarious. It is unrealistic to think it is possible to have a small amount of B.1.1.7 spreading slowly. As soon as restrictions are relaxed, the virus spreads quickly. So, we can either aim to eliminate the virus completely or risk igniting a wildfire all over again. In sharp contrast to Canada’s mitigation strategy, New Zealand, Australia, Vietnam, Laos, Taiwan, Atlantic Canada and the Territories clearly demonstrate that a COVID-zero strategy works and is sustainable.
There is tremendous urgency for Canada and each province to immediately enact a COVID-zero strategy to stop all chains of community transmission as rapidly as possible.
Measures for Canada to achieve COVID-zero
● Adopt an explicit goal of COVID elimination and clearly communicate it to Canadians.
● Implement international and interprovincial travel restrictions by mandating supervised quarantine for all travellers. Provide priority vaccination and rapid tests for commercial truck drivers and essential workers who travel regularly between provinces and countries. Create out-of-home supported isolation hotels for incoming travelers to ensure they do not bring new cases into the community.
● Order a strict, enforced, and financially supported lockdown immediately. The federal government needs to continue to provide strong financial support for businesses and people including paid sick/isolation leave. Close all non-essential businesses during the lockdown. Restaurants and bars should be open for take-out only.
● In-school transmission of COVID shows that schools are currently not safe for children. In-person learning should transition to online learning immediately. Small in-person classes should be provided for essential workers and for children who would experience significant developmental harm from not being at school.
● Fund an aggressive Test/Trace/Isolate capacity to prevent chains of transmissions.
● Provide clear guidance for Infection Prevention and Control (IPC) for Public Health and employers to follow airborne precautions to protect against COVID.
● Provide N95 respirators to health care workers, staff and residents in care homes, patients in hospitals, teachers in schools, and other frontline workers.
● Provide the general public with N95 respirators, free of charge. Develop a fund to assist employers and community building owners to improve air filtration and ventilation.
The COVID-zero strategy is best done on a region-by-region basis. Once at zero community cases, a region with well-managed borders can cautiously loosen restrictions and can return to relative normalcy. COVID-zero regions may form a quarantine-free travel bubble with other COVID-zero regions, as the Atlantic provinces have done. While travel related cases or community flare-ups might still appear, they are manageable via quarantine facilities, local restrictions, and comprehensive testing and tracing.
Canada must aim for a COVID-zero strategy
The necessity of a COVID-zero strategy is clear. It prevents disease, hospitalization, and death, and it allows communities and businesses to thrive. The COVID-zero strategy eliminates the continuous "yo-yo" between restrictions and relaxation, providing economic and social stability. When cases are low, outbreaks can be eliminated quickly with Test/Trace/Isolate strategies.
Canadians expect the federal government to provide leadership in its Covid-19 response. We expect science-based policy and a recognition that public health is a shared responsibility with provincial governments. Inadequate public health measures that ignore the science of airborne transmission and pandemic dynamics leave Canadians of all ages vulnerable to infection, harm, and death. Numerous outbreaks in care homes, hospitals, schools, workplaces, prisons, and shelters are evidence that Canada’s current mitigation strategy needs to change. Canadians also expect the federal government to heed the recommendations of The SARS Commission, which identified the precautionary principle as the single most important lesson in addressing the great uncertainty and risk of harm from any future novel contagious disease. Only a COVID-zero strategy can fully account for the complexity, uncertainty, and potential for irreversible, catastrophic loss from COVID.
Canada must aim for COVID-zero today and protect all Canadians from further harm. It is unethical to permit the harm of some Canadians — often the most vulnerable — when COVID-zero is possible and is clearly beneficial for all of us. We call on Canada’s leaders to take strong action to protect the safety and well-being of all Canadians.
The main instigators of the petition
Stephane Bilodeau, Engineer, PhD, FEC
Dr. Malgorzata Gasperowicz, Developmental Biologist
Dr. Maria Infante, PhD Resource Management and Environmental Studies
Karl Parkinson, Software Engineer, BSc
Joshua A. Farden
Jennifer Tomaszewski, Retired Lawyer, Activist
Conor A Ruzycki, PhD Candidate & Killam Scholar in Mechanical Engineering, University of Alberta
Aaron Paquette, Author
Jonathan Mesiano-Crookston, BScH Biochem, JD
Dr. Tehseen Ladha, MD, MPH, FRCPC, Assistant Professor, Department of Pediatrics, University of Alberta
Dr. Joe Vipond, Clinical Assistant Professor, Department of Emergency Medicine, University of Calgary, co-founder Masks4Canada
Dr. Darren Markland, MD, FRCPC