Putting entire Canadian city under quarantine to contain virus inconceivable, unenforceable: expert

By | January 24, 2020

Placing an entire city under quarantine to prevent the spread of a virus is inconceivable, unenforceable and ineffective — and in Canada would be against the law, experts say.

Steven Hoffman, a professor of global health, law and political science at York University, said he was shocked when he heard China had shut down Wuhan, a city of 11 million people that is the epicentre of a new coronavirus outbreak.

“It’s totally unprecedented in public health,” Hoffman said. “It reminds me of what we might see in movies.”

The virus, which is from the same family of viruses that cause the common cold, has so far sickened close to 600 people in China and killed at least 17. Other countries, including the United States, have reported cases of the illness in recent days.

Canadian public health officials have said several people in two provinces — Quebec and British Columbia — are under observation for signs they may have contracted a coronavirus from China, but no confirmed cases have been reported.

Wuhan and the nearby cities of Huanggang and Ezhou — home to a total of 18 million people — were locked down on Thursday in an unprecedented effort to contain the deadly new virus.

Hoffman said such an extreme quarantine measure would never occur in Canada for a number of reasons.

“In Canada, such a broad, unspecific quarantine measure like this would certainly violate our Canadian Charter of Rights and Freedoms because it would be a restriction on people’s rights that are not justifiable,” he said. “In the Canadian context, it’s inconceivable.”

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He pointed to the federal Quarantine Act that gives the government the authority to isolate someone who is a risk to the public.

During the SARS outbreak, which killed 44 people in Canada 17 years ago, those who had the illness were quarantined in health-care facilities, Hoffman said, while those who came in direct contact with an infected person were in quarantine at their homes.

Plus, travel bans do not work, he said, because people who want to get out will find a way, which undermines the whole idea of a quarantine.

People queue to receive treatment at the fever outpatient department at the Wuhan Tongji Hospital in Wuhan, China, Jan. 22, 2020. cnsphoto via Reuters

“But from a scientific perspective, the travel ban in China is really intriguing,” he said. “If people are compliant and if there’s way to enforce it and to provide food to 20 million people, maybe it could work — I guess we’ll find out soon.”

Meanwhile, the World Health Organization said Thursday the outbreak in China was not yet a global health emergency, but cautioned that the decision “should not be taken as a sign that WHO does not think the situation is serious or that we’re not taking it seriously.”

Large-scale quarantines are rare around the world, because of concerns about infringing on people’s liberties.

“To my knowledge, trying to contain a city of 11 million people is new to science,” said Gauden Galea, the WHO’s representative in China. “It has not been tried before as a public health measure. We cannot at this stage say it will or it will not work.”

If there’s way to enforce it and to provide food to 20 million people, maybe it could work

Daniel Kollek, an emergency physician and a professor at McMaster University with a focus on disaster response research, scoffed at the idea of overarching travel bans, be it in China or Canada.

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“People are shedding the virus before they’re sick — this is after the horse has bolted,” he said. “If you truly have contained everyone with illness and lock them down, you can shut it off. But that’s not feasible, so this kind of isolation doesn’t have any value.”

One of the challenges provinces such as Ontario would be faced with in the case of an outbreak is hospital overcrowding, he said.

“Hospitals are overcrowded, emergency departments are overcrowded and we can’t get people into isolation rooms because they’re already occupied,” he said. “If you can’t isolate a patient, than the risk of communicating disease to other people is obviously higher.”

A health care worker outside the SARS assessment staff entrance at York Central Hospital in Richmond Hill, Ont., Apr. 21, 2003. Peter Redman/National Post/File

But Ontario’s Minister of Health Christine Elliott said current overcrowding in hospitals won’t be an issue.

“We have specific measures that will be in place,” Elliott said. “Anyone who is being tested in the future will be placed in isolation and that staff will be given the necessary protective equipment.”

Dr. Barbara Yaffe, Ontario’s associate chief medical officer of health, said they’ll be focused on both quarantine, should someone be infected with the coronavirus, and active surveillance, which means the local public health unit checks in with those who may have been exposed every day.

“With SARS our lessons learned were that full quarantine wasn’t really that necessary, it was more active surveillance is what we ended up doing toward the end and making sure the person doesn’t spread it any further,” she said.

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— with files from Allison Jones


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