There have been at least 1,300 flights that have either landed or taken off in Canada since the start of September with potential COVID-19 exposures on board, according to information provided by the Public Health Agency of Canada (PHAC).
This includes at least 200 flights during the past two weeks, including five flights from the U.K., where a new strain of the novel coronavirus is spreading rapidly.
It’s not clear how many people may have been exposed to the virus on board these flights, and whether all of the passengers were travelling for essential reasons, but public health experts are warning that the urge to be physically close to the people we care about most this holiday season could end up causing more harm than good.
As much as it may hurt, they say, all non-essential travel and family gatherings should be avoided to prevent a spike in infections at the start of the new year.
“This year more than any other year in my life, we need physical affection. We need the company of family and friends,” said Colin Furness, an infectious disease specialist and epidemiologist at the University of Toronto.
“Yet this is the one Christmas season, the one holiday season, where it’s exceedingly dangerous to do so.”
In the summer, when the number of new daily COVID-19 infections was declining, restrictions were eased in many parts of the country and life seemed to regain a sense of normalcy.
But as the number of new cases grew rapidly in the fall, lockdowns and tighter restrictions reemerged from coast to coast to coast.
At present, the federal government is recommending Canadians avoid all non-essential travel — including trips within Canada to visit friends and family — while many provinces and territories have rules in place that either limit the size of or prohibit public and household gatherings.
In Alberta and B.C., for example, people are prohibited from gathering with anyone who doesn’t live in the same household. The same goes for all of southern Quebec and several of the most populated regions of southern Ontario, including Peel, York, Toronto, Hamilton and Windsor-Essex.
There are a few exceptions for people who live alone, are in committed relationships or are single parents, but, generally, the guidance from public health officials is don’t go anywhere you don’t need to.
“My sincere advice to people is to say really, really be careful about what you think is OK, about what you think you might be able to get away with. Because the way it’s looking, there may not be a hospital bed in January,” Furness said.
“No one wants to have a holiday season that ends in tragedy.”
Furness is also concerned about the public messaging around travel restrictions and what is and isn’t allowed.
He said attempts by politicians to keep non-essential businesses open and to persuade people that if they acted in a certain way maybe the holidays would be spared have resulted in frustration and a lack of clarity when it comes to what works best to prevent the spread of COVID-19.
“We should have been messaged all the way back from when schools opened in September: by the way, this is going to be a different Christmas, take a few months to get used to that,” he said.
Furness said infectious diseases don’t care about politics and that the only way to reduce the spread of these types of diseases is to dramatically reduce contacts and to take whatever other measures are necessary when out in public.
He thinks more consistent messaging from government leaders would have made it easier for people to accept that this year is different than any other.
“The discourse has been open,” he said. “Let’s let businesses flourish. Let’s open all the way up until we get right to the edge of the precipice where we’re about to completely lose control and then all of a sudden, let’s shut everything down.
“This is lurching from one extreme to another. I think that is a huge problem. It wears people out. It wears people down.”
How risky is travel?
There are risks to holiday visits that go beyond the act of getting together with friends and family.
How you get to your destination plays a significant role in determining these risks.
The safety of flying has been a topic of significant public scrutiny since the start of the pandemic, especially in the early months when public health guidance still didn’t require passengers to wear masks.
And while the risk of contracting COVID-19 on a flight is generally considered by public health experts to be very low, several studies have documented likely transmission on board passenger flights, including a suspected superspreader event during a 13-hour flight from London to Hanoi in early March.
Researchers have been careful to point out that these studies were conducted prior to mandatory masking requirements and other safety measures imposed by airlines and many countries around the world.
Meanwhile, a recent study from the U.S. Department of Defense that used mannequins to simulate breathing while wearing a mask on a plane found that it would take 54 hours of exposure to contract COVID-19 on a commercial flight. The big caveat with this study is that it doesn’t account for the fact that people may take off their masks to eat and drink during a flight, and may not wear them properly.
“If we look at countries that did a really good job with the pandemic, if we look at countries that don’t have COVID now or regions in Canada that don’t, they all have one thing in common, and that is that they managed travel and they blocked it. They prevented it. They kept COVID out,” Furness said.
“COVID travels on airplanes, it travels in cars. It doesn’t swim or walk or fly on its own. So when you’re trying to control a global pandemic and you’re allowing a lot of travel back and forth, you’re creating a very dangerous situation.”
Overall, the number of COVID-19 infections in Canada linked to international travel is low, representing roughly one per cent of total cases. Early on in the pandemic, however, international travel was a significant factor in how the virus spread within Canada.
Between March 1 and Dec. 1, there were at least 2,000 flights that either arrived in or departed from Canada with cases of COVID-19 on board, according to data provided PHAC.
The data shows a significant increase in the number of potential exposures on commercial flights during the fall.
In March, the number of potential exposures on flights in Canada was 251. By May, when air travel slowed to a trickle, this number shrank to just 30. By October it had increased to 342.
The number of potential exposures on board flights in Canada in November was 504, according to PHAC.
This upward trend appears to be continuing in December, based on publicly available data. The government website tracking potential exposures on board flights also shows at least five flights from London, U.K. to Toronto, Montreal and Vancouver since Dec. 6.
On Dec. 20, the federal government suspended all inbound flights from the U.K. because of a new strain of COVID-19 that researchers have said could be more contagious than the strain most countries are currently dealing with. Many other countries around the world have also blocked flights from the U.K.
It’s not clear how many passengers may have been exposed to COVID-19 on board the five flights from the U.K. to Canada in the past two weeks. PHAC does not track the number of people on each flight and the information provided publicly only indicates the rows where passengers may have been exposed.
A spokesperson for Air Canada, which operated four of the U.K. to Canada flights with possible exposures in the past two weeks, said it’s also important to note that just because a flight is flagged for possible exposure doesn’t mean someone who was infected with the virus was on the plane. The person could have contracted the virus after the flight and then test positive. Because it’s often unclear exactly when and where transmission occurs, health officials notify the public of a potential exposure on board the flight as a precaution.
Air Canada also said flights that result in potential exposure notifications being issued represent less than one per cent of all the flights the airline operates.
The airline industry, meanwhile, has advocated for fewer restrictions on international travel, saying widespread bans on air travel have hurt the industry and prevented healthy people from visiting.
Airlines, including Canadian airlines, have implemented strict safety measures to prevent the transmission of COVID-19 on board flights. This includes mandatory masking rules and enhanced sanitization of aircraft and other spaces in airports, plus health screening prior to boarding, such as asking passengers if they feel ill or have a cough or fever, and checking temperatures.
The airline industry and public health experts, including Canada’s chief public health officer, Dr. Theressa Tam, have also said air filtration systems on commercial flights makes it very unlikely that the coronavirus will circulate on board planes.
It’s not only flying
The risks associated with travel aren’t just about flying. Getting to the airport or your final destination also creates opportunity for the virus to spread.
Dr. Craig Jenne, an infectious disease specialist at the University of Calgary, says interactions with people before, during and after travel are just as likely, if not more likely, to lead to possible exposure to COVID-19.
“Unless absolutely necessary, travel really needs to be avoided,” Jenne said.
“The health-care system across Canada, Alberta, Manitoba, Ontario, Quebec, is stressed. There’s no room for additional patients, no ICU space. So we have to do what we can to lower infection in the community. And one way is to limit travel.”
Jenne said there are other factors aside from your own personal risk that need to be considered when contemplating travel.
While a person may feel fine and have no symptoms of COVID-19, that doesn’t necessarily mean they aren’t infected, he said.
Depending on where they’re travelling, an asymptomatic person — someone who is infected with COVID-19 but shows no symptoms — could unknowingly introduce the virus to a community with very few or no confirmed cases, Jenne said. And because communities with fewer cases generally have fewer restrictions in place, the introduction of the virus to these places could have significant consequences.
“We’ve seen, unfortunately, the Atlantic bubble sort of burst in the last few weeks, where cases from outside those provinces get in,” Jenne said. “We do see that in the North, where a handful, one or two cases entering a very low-risk area begin to spread rapidly.”
Other methods of transportation
Transport Canada has issued requirements and recommendations for all federally regulated travel industries, including the rail system.
Since the start of the pandemic, Via Rail has implemented measures to prevent the transmission of COVID-19 on board trains, including upgrading air filtration systems and limiting availability of seats to create space for physical distancing.
In its Quebec City-to-Windsor corridor — which represents 97 per cent of all passenger volume — Via Rail has limited seat capacity to 58 per cent, according to a statement from the company. All other routes have been limited to half capacity.
Between March 1 and Dec. 1, there were 31 possible exposures of COVID-19 on board Via Rail trains, according to PHAC.
The company said it takes the safety of its passengers and staff seriously and that it follows all guidelines and recommendations made by the government and public health officials to avoid possible transmission. The company also said it reports any possible exposure to the responsible health authorities.
Other means of transportation people may use during the holiday season include public transit.
Both Jenne and Furness say this increases the risk of possible exposure to COVID-19 because it expands the number of “anonymous” contacts who may or may not have the virus.
Furness is particularly concerned for marginalized and racialized communities who rely on public transit more often and who are less likely to be able to work from home during the pandemic. He says research has shown that these communities have been affected by COVID-19 more severely than the general population, with higher infection and mortality rates.
For this reason alone, he said, it’s incumbent upon people who have the ability to choose not to travel for work or leisure to stay at home if they can.
If people decide not to do this, the start of the new year could be disastrous, he said.
“If a significant proportion of those in this privileged category use their agency to engage in risky behaviour, we all lose,” Furness said.
“And so that’s my real concern. People who have the ability to stay isolated and choose not to do so, That is going to determine whether our health-care system breaks.”