COVID-19: Appearance before the Parliamentary Standing Committee on Health (February 3, 2020)—Questions and answers

No – there are no direct flights from Hubei to Canada, these measures are being put in place at Montreal, Vancouver and Toronto Pearson international airports due to the high likelihood that travellers on connecting flights from Hubei will be arriving in Canada at one of these 3 airports.

The CBSA processed just under 2 million travellers from China to Canada in 2019 – this equates to roughly 5,500 travellers from China arriving a day. Of which, just over 18,000 travelled from Wuhan and another 345 from other airports in the Hubei Province.

The CBSA works closely with PHAC to prevent the introduction and spread of communicable diseases into Canada through the administration of the Quarantine Act at all ports of entry into Canada.

PHAC is responsible for advising the CBSA of any required enhanced measures to be implemented at the Canadian border to help prevent the spread of serious infectious diseases into Canada.

The CBSA works to implement and operationalize the measures PHAC recommends.

Standard border measures

The CBSA relies on outward signs of an illness, which may not always be evident, or on the honesty of the traveller, which is not always there. Unless the person is visibly ill, border services officers must accept the traveller's word on whether or not they have been in Wuhan or whether or not they are feeling ill or unwell.

Signage and information

Airports: Provides a valuable mechanisms to inform travellers of their responsibility to advise a CBSA officer if they are feeling ill or unwell.

Airlines: Airlines are an important partner in preventing the spread of infectious diseases and have an obligation to advise if they have sick passengers on board before arrival in Canada. This allows the Public Health Agency of Canada to put in place appropriate measures for ill passengers before the aircraft land.

Screening questions

A moderately reliable tool to help identify a targeted population. Screening questions work well on the condition that travellers respond accurately and truthfully.

Targeting

Works very well to track those travellers that have the full travel itinerary in their passenger name record (PNR). This would allow the CBSA to identify potentially impacted travellers and flag their arrival to have the traveller automatically referred for further examination. This would ensure that regardless of the traveller's response to a screening question (if still implemented at the time) they are referred for further screening where appropriate.

The CBSA collects Passenger Name Record (PNR) data under the authority of the Customs Act and uses this data for the detection of terrorism and serious transnational crime. In light of a potential pandemic situation, the Agency will use this data to identify individuals whose journeys originated in China. This is deemed to be reasonably necessary to protect life, health, and safety of individuals in accordance with Customs Act paras. 107(3)(a) and 107(4)(e).

Thermal scanners

Labour intensive process. Would rely on PHAC to check the temperature of all passengers arriving from affected countries.

During the Severe Acute Respiratory Syndrome (SARS) outbreak in 2003, more than 6.5 million screening transactions occurred at Canadian airports including inbound and outbound travellers. Of these, 2.3 million travellers were screened using thermal scanners. Despite this intensive screening effort, no cases of SARS were detected using this method.

• International travellers arriving at the Montreal, Toronto Pearson and Vancouver international airports will be asked the screening question
• Travellers will either be asked the question on an electronic kiosk (Primary Inspection Kiosks, Automated Border Clearance or NEXUS kiosks) or by a border services officer directly

The question that will be asked to travellers arriving in Canada at Toronto, Montreal and Vancouver international airports is: "Have you been in Hubei, China in the past 14 days?"

Travellers who have visited the Hubei province who answer "Yes" to the screening question are referred for further examination.

A CBSA officer will then ask the traveller if they feel sick or unwell and, if yes, ask additional questions about their symptoms. For example, are you experiencing fever, cough or difficulty breathing?

If a traveller feels sick or unwell, the CBSA will refer the individual to PHAC.
All travellers that do not display symptoms of concern will receive a handout from the CBSA officer with instructions about monitoring their health for symptoms of concern for the next 14 days, and to call a health care professional if they become ill. The phone numbers for public health authorities in each province and territory may also be included in the handout.

The handout instructs travellers to call their health care provider or local public health authority tell them of their symptoms and that they were travelling in the province of Hubei, China if they develop fever, cough, or difficulty breathing in the next 14 days.

After the traveller scans their QR code, they will be prompted to respond to the additional health screening question on the Primary Inspection Kiosk.

After completing the initial processing, the CBSA officer would refer the traveller to a PHAC quarantine officer.

The health referral to a quarantine officer takes precedence over immigration, customs or food, plant and animal processing.

It is only once the traveller is cleared by the quarantine officer, the traveller would be processed for immigration, customs or FPA concerns in accordance with existing procedures.

Should a situation occur where the quarantine officer determines that a traveller is required to go to the hospital for a medical examination or treatment, the immigration, food, plant and animal or customs processing would be deferred until the traveller is cleared by medical staff and / or PHAC.

No. Travellers that are visibly ill, feeling ill and having visited the province of Hubei are referred to PHAC, as per procedure.

CBSA officers make decisions based on the information available to them at the time a traveller seeks entry into Canada.

Should a traveller arrive at a port of entry seriously and visibly ill and in need of immediate medical attention, emergency medical services will be contacted.

While it would be inappropriate for me to speak to specific cases, I can tell you that travellers who respond "Yes" to the screening question are referred for further screening and examination.

If a traveller does not appear ill, or does not disclose that they have any symptoms or potential illness, they are provided a handout instructing them what to do if they feel ill over the next 14 days.

• The Quarantine Act requires travellers at a port of entry to report to a CBSA Border Services Officer if they are ill upon arrival
• Every traveller entering Canada has a key role to play in protecting Canada
  • By properly declaring, travellers are helping the CBSA obtain the information needed to help prevent the introduction and spread of serious infectious diseases into Canada

• CBSA officers are trained to observe and assess for signs of illness
• If there are any indications that a traveller may be ill, they may be referred to PHAC for further health screening

• The CBSA may provide a mask to an ill traveller or those in direct proximity when deemed necessary
• I would defer to PHAC on the question of widespread distribution of masks to travellers

• The protocols and procedures in place, as advised by PHAC, are being followed
• Upon arrival, all travellers are being asked the health screening question of whether they had travelled to the province of Hubei, China within the past 14 days
• There is a mandatory referral to a PHAC quarantine officer if a traveller responds positively

• None
• The Quarantine Act authorizes screening officers, in this case the CBSA officer, to isolate a traveller until a detailed assessment can be conducted by a PHAC Quarantine Officer

• Once a potentially ill traveller is identified, measures are in place to isolate them from comingling with other travellers
• At the earliest opportunity ill travellers are directed to a dedicated area and are processed away from others to reduce the risk of potential transmission
• The traveller will be provided a surgical mask to wear along with alcohol based hand sanitizer early in the process

Have you visited the province of Hubei, China in the past 14 days?

• Absolutely not
• All travellers coming into Canada are required to report to the CBSA
• In addition, all international travellers are required to answer the same health screening question regardless of their travel history

• Generally speaking, all Canadian citizens have the right to re-renter Canada
• From a Customs Act perspective, there is no authority to restrict the entry of individuals for medical reasons
• Beyond that, I would refer you to the Department of Justice

• There is a 14 day incubation period for the 2019 novel coronavirus, so screening travellers before they disembark an airplane is a limited measure
• Health screening upon arrival alone is not a guarantee against the possible spread of the virus
  • It is one tool, amongst many, in the Government of Canada's response strategy

• As the situation evolves, so too will our operational posture
  • The CBSA continues to work with PHAC to ensure the appropriate enhanced screening measures are in place using a risk based approach
• The Government of Canada implemented enhanced screening at the Vancouver, Montreal and Toronto Pearson international airports on January 22 due to the fact that over 97% of travellers from China arrive either directly or indirectly at one of these 3 airports
• While the risk to Canadians remains low, effective February 1, the CBSA expanded its screening measures to other major airports across the country
• Screening measures were expanded to these airports due to the volume of travellers they receive along with the potential for travellers from China transiting though other counties to these airports
• The Government of Canada is confident of the enhanced screening measures in place and will continue to protect the health and safety of Canadians

• In addition to the enhanced border measures in place, the CBSA has more than 40 liaison officers (LOs) operating out of 36 international offices
• LOs have a range of reporting, interdiction, investigative and liaison responsibilities which included working with airline authorities to manage risks and threats at the earliest and farthest point possible from our physical border

  [Reference: CBSA has one regional director and an International network manager in Beijing, and one LO in Hong Kong. There are currently 2 vacant LO positions in Beijing and Shanghai]

• National Health Commission statistics in China (does not include overseas) as of January 31:
  • 17,205 confirmed cases, including 2,110 in critical condition
  • 361 deaths
  • 475 people have been released from hospital
  • 21,558 remain as suspected cases
• Total number of confirmed cases in Hong Kong: 15; Macao: 8; Taiwan: 10
• The first overseas death from 2019-nCoV occurred on February 1 in the Philippines

• Japan
• South Korea
• Singapore
• Australia
• Kuwait
• Hong Kong
• Jordan
• New Zealand
• Russia (Chinese tour groups)
• Israel
• Azerbaijan
• United States of America
• Philippines
• Oman

I will defer this question to colleagues at PHAC.

• The Public Health Agency of Canada is leading the Government of Canada's response to the novel coronavirus, and is providing the departments and agencies with advice and guidance accordingly
• The CBSA is in regular communication with its international partners, including the United States Customs and Border Protection, and the measures implemented at international airports across the country are in line with our global partners
• The CBSA is prepared should the situation escalate and other enhanced border measures are deemed appropriate and required by PHAC

• The rules governing entry into the U.S. are set and enforced by the U.S. Customs and Border Protection (CBP)
• We are in constant communication with our US counterparts on their policy and program stance so we can understand how it will apply to Canadians
• Our Government has been clear that Canadian citizens have the right to expect that their treatment at the border will be professional, consistent, and respectful

• While it would be the U.S. to confirm their data, as of this morning we are hearing that a total of 21 travellers were denied entry as a result of the US–China measures
• Most of the incidents were at land ports of entry (9 of 10), while one occurred at Vancouver International Airport
• The travellers were a mix of Canadian citizens, permanent residents and foreign nationals transiting through Canada

• The CBSA has been using a specialized cleaning solution to sanitize countertops and other frequently touched areas in the CBSA hall and the arrivals area (PHAC assessment rooms and other frequently touched surfaces)
• The responsibility of maintaining and cleaning communal areas and primary inspection kiosks (PIK and NEXUS) falls under the airport authority
  • We have received confirmation that this is happening on a regular basis throughout the day

• Currently, the CBSA has an administrative deferral of removal (ADR) to the province of Hubei, China
• An ADR is a temporary measure put in place when immediate action is needed to defer removals in situations of humanitarian crisis
• All removals to Hubei province in China are temporarily deferred except for the removal of persons who are inadmissible under IRPA subsection:
  • 34(1): security grounds
  • 35(1): grounds of violating human or international rights
  • 36(1): grounds of serious criminality or 36(2) - grounds of criminality
  • 37(1): grounds of organized criminality
  • referred to in section F of Article 1 of the 1951 United Nations Refugee Convention; or
    • where an individual informs the Minister in writing that they consent to their removal to a country or place to which a stay of removal applies