As doors reopen, should you go?

Risk assessment new reality of global travel

The European Union has deemed travellers from Canada safe to enter EU countries. But just because you can, should you?

The EU agreed Tuesday to relax temporary restrictions on non-essential travel for 14 countries as of July 1, including Canada, but not the United States, where COVID-19 infections are surging in several states.

Top infectious diseases expert Anthony Fauci warned Tuesday that cases in the U.S. could reach 100,000 a day “if this does not turn around.”

Canada fulfilled the 27-member EU bloc’s criteria for a safe — or, perhaps more accurately, safer — country, including a “stable or decreasing trend of new cases” over the last 14 days compared to the previous 14 days, as well as the nation’s overall response to COVID-19, including testing and contact tracing, and the reliability of its data.

The shortlist of endorsed countries will be reviewed and updated every two weeks. The recommendations aren’t legally binding: EU member states can reopen their borders, or not, to whichever countries they choose.

Denmark and Ireland, for example, are not taking part in the recommendation’s adoption.

The lifting of European travel restrictions comes as Air Canada and Westjet are set to drop social-distancing seating and resume filling middle seats, a move that has unnerved B.C. Health Minister Adrian Dix.

“What I’d like to hear from Transport Canada, from Health Canada is do they agree with this,” Dix told a new conference on Monday.

But it’s not just about the flight. Travelling is so much more.

“Can this be done safely? The real answer is, ‘look, in this era, there is going to be nothing that’s without risk — everything is going to be tied to some element of risk,” said Toronto infectious disease scientist Dr. Isaac Bogoch. “People are going to have to make their own risk assessment to determine if this is worth it for them or their family, or not.”

The federal government is still recommending Canadians avoid all non-essential travel outside of the country. With few exceptions, anyone entering or returning to Canada is required to self-quarantine for 14 days, whether or not they have symptoms of COVID-19. Maximum penalties for failing to comply carry a fine of up to $750,000, imprisonment for six months, or both.

Even travelling inside the country remains a challenge with public health restrictions and periods of quarantine. Visitors to Prince Edward Island, for example, must fill out an online declaration form ahead of their trip, bring a copy with them, and be prepared for health screening at point of entry. New Brunswick is also limiting non-essential travel, and requires visitors to quarantine for 14 days.

People with no or few symptoms can spread COVID-19 while still infectious. “So, unless you are going to screen every traveller immediately before each trip, then mass transit of any form comes with an inherent degree of risk,” said Dr. Matthew Oughton, an attending physician in the Jewish General Hospital’s division of infectious diseases in Montreal.

Airlines have committed to pre-boarding temperature checks, health screenings and masking policies. But the data suggest only smaller numbers of people actually show up with fever as their first symptom of COVID-19. There is also pre-symptomatic transmission.

“Even though I could screen completely negative and have a normal temperature today, I could be infectious and coughing and febrile tomorrow,” said Dr. Zain Chagla, an associate professor of medicine in infectious disease at Mcmaster University.

If the symptom screening does pick up a couple of people, well, fine, that’s helpful, Chagla said. “But it might still miss 70 to 80 per cent of people that might have COVID.”

In addition, while he would hope people would behave ethically, “if you’re paying a lot of money for a transatlantic flight, there’s a negative incentive for people to lie on those symptom screens, and get on the plane.”

According to the U.S. Centers for Disease Control and Prevention, most viruses don’t spread easily on flights because of the way air is circulated and filtered.

“But we know with this virus, even with good air exchanges, closed contacts and droplets are still a mode of transmission,” Chagla said.

He believes travel should be restricted to immediate or urgent reasons, not necessarily pleasure. “We pose less of a threat to Europe. That doesn’t mean Europe doesn’t pose more of a threat to the average traveller,” he said.