How far should Canada go to contain the future spread of COVID-19?

Failing to stop the spread of SARSCoV-2 has led to efforts to reduce the spread through prolonged lockdowns, school closures and a scramble to implement effective virus testing, tracing and reporting. Failing to stop or contain the virus has also led to thousands of deaths — primarily the elderly and those with pre-existing medical conditions. As provinces start reopening, mask wearing, handwashing, physical distancing and sanitization will be the measures used to prevent virus spread.

Should we be considering other measures in response to a second wave or future pandemics? Countries like Taiwan, Singapore, South Korea, Iceland and New Zealand were able to stop the spread of SARS-CoV-2 virus with few deaths and shorter or no lockdowns and school closures. They contained subsequent outbreaks as they appeared and New Zealand has eradicated the virus completely.

1. They closed their borders early on and introduced mandatory quarantines for visitors — severely restricting the movement of individuals. This happened on March 15 in New Zealand.

2. They got testing up and running quickly, testing those with and without symptoms. It was reported that by May 17, Iceland had tested 15.5 per cent of is population for the virus.

3. They implemented immediate tracking and tracing of cases. Taiwan also monitored all individuals following testing so they could follow up with individuals who tested negative for the virus but went on to show symptoms of infection.

4. They took quarantine seriously. Those quarantined were monitored — in some cases via their cellphone GPS data — to ensure they were following quarantine orders.

5. They used existing information sources to identify individuals with risk characteristics for infection or negative health effects if they were to be infected (e.g. those over 70, with existing chronic medical conditions, or history of travel to countries with an outbreak). China ranked citizens into red, yellow, and green risk groups and created corresponding rules for mobility.

Successful containment and surveillance are linked. Countries that were able to stop the virus spreading relied heavily on modern information technology, the use of personal data, and compliance of their citizens. For Canada to take a similar approach, Canadians would need to accept greater surveillance and monitoring, increased government control of personal information and suspension of some individual rights.

Think about being required to download a phone app and using it to report symptoms, track your location and transmit that information to the local public health unit. Think about testing positive for COVID-19, relocating to a quarantine facility, reporting on your health and having this information shared with different levels of government. You could expect a letter from government identifying you at-risk for virus infection and requesting you to self-isolate and report your location to public health for a period of time.

At the same time, many countries such as Canada are queasy about monitoring and surveillance of individuals. Privacy watchdogs warn us against relinquishing rights, freedoms and control of information during this public health crisis for fear that this information will be kept on file. Allowing governments and health officials access into our lives and personal information to address a health risk has the potential to undermine some of the central principles of our liberal democracy.

It is very clear — pandemics can be contained through the use of information technology, restrictions on mobility and population compliance. Although Canada might be unable to use the same strategies as Taiwan, Singapore and New Zealand, less-invasive, voluntary technologies are available — like anonymous symptom tracking. Or we could consider more stringent monitoring among higher risk groups, like long-termcare home staff and residents. Google and Apple have collaborated to develop a free, voluntary phonebased contact-tracing software than can alert individuals who have been in contact with a person (who also has the software on their phone) who subsequently tests positive for the virus. The recent release of this software provides Canada with an opportunity to gauge the public’s appetite for phone-based tracking in health emergencies.

The long-term human and economic cost of our blunt response to reducing the spread of SARSCoV-2 may be far greater than direct health impact of the virus itself. Containment is the goal and now is the time to have a debate about the methods available to achieve this.