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April 2, 2021

PM Justin Trudeau, MoH Patty Hajdu, CPHO Dr. Theresa Tam, Provincial Premiers, MoHs and CMOHs, PHAC, Government of Canada

Re: 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-CoV2 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 Zero Covid strategy with the goal of eliminating SARS-CoV2 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-CoV2 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 later needed to be readmitted to hospital, developed new diseases, or died within a few months after their release from hospital. Even when 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% 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 of getting infected with the virus 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% 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. Indigenous, racialized, and other marginalized communities 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 Zero Covid strategy works and is sustainable.

There is tremendous urgency for Canada and each province to immediately enact a Zero Covid strategy to stop all chains of community transmission as rapidly as possible.

Measures for Canada to Achieve Zero Covid

  • 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 Zero Covid 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. Zero Covid regions may form a quarantine-free travel bubble with other Zero Covid 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 Zero Covid Strategy

The necessity of a Zero Covid strategy is clear. It prevents disease, hospitalization, and death, and it allows communities and businesses to thrive. The Zero Covid 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 Zero Covid strategy can fully account for the complexity, uncertainty, and potential for irreversible, catastrophic loss from Covid. 

Canada must aim for Zero Covid today and protect all Canadians from further harm. It is unethical to permit the harm of some Canadians — often the most vulnerable — when Zero Covid is possible and is clearly beneficial for all of us. We call on Canadian leaders to take strong action to protect the safety and well-being of all Canadians.

Sincerely,

Stephane Bilodeau, Engineer, PhD, FEC

Dr. Malgorzata Gasperowicz, Developmental Biologist

Dr. Maria Infante, PhD in 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

*On May 7th the third sentence in this paragraph was edited from the following: “First Nations communities and many ethnic minorities disproportionately experience the negative impacts of the pandemic.” This was done to use more inclusive and appropriate language.

Supporting Organizations

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Why Zero Covid

Because I care about others and want them to be protected as much as possible, in particular those who have put themselves at great risk to help the rest of us meet our essential needs.

This is the strategy that has worked in other countries (Australia, New Zealand, Thailand, etc.) and in Atlantic Canada. Mitigation does not work, and is far more costly in terms of life, physical health, and mental health.

I value all lives.

I want the death and suffering to stop, I want the yo-yoing between opening too early and having to lock down to stop, I want the instability for children and workers to stop, I want the opportunity for the virus to mutate into new variants to stop, I want health care workers to have a well-deserved reprieve, and after more than a year, I want my children to be able to play with their friends and I want to be able to see my extended family.

Prevention of disease spread and chronic short and long term effects of same. Short term (social/economic) pain for long term gain.

With proper govt support this approach along with vaccinations will give us the hope we need at this time.

I want a Zero Covid strategy in Canada to save lives and the economy.

It's the only approach that makes sense from a health, equity, economic, and ethics perspective.

To avoid preventable chronic illness and death. For equity. For economic certainty and stronger economic recovery. For better mental health. To stop new variants of concern from emerging.

The current strategy of close down then open up, then close down again is clearly not working. We need to have a consistent and comprehensive plan for our country to mitigate and remove the threat of COVID-19.

We as a country have failed the public. We are now in a very dangerous time in the pandemic and proper measures are needed that must be coordinated with all provinces.

I don't want any more people to die.

I am concerned about the unknown long term effect of Covid on children and youth. Our provincial government's strategy has failed in BC.

I want a Zero Covid strategy to get off this roller coaster of stores open, stores closed. I want to go see a concert or as sporting event and we will not get to that unless there is no Covid

I want to see a Zero Covid strategy in Canada because I don’t want any more deaths and I don’t want politicians playing politics with our lives.

Any strategy short of this is willful negligence causing death.

I want life to go back to normal without excessive suffering. I had to quit my job because Vancouver won’t do anything to stop the spread.

Signatures of those that agree that the Federal and Provincial Governments should immediately begin a Zero Covid strategy with the target of eliminating SARSCoV2 and variants

Supporting Statements

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