Canada Gazette, Part I, Volume 155, Number 50: ORDERS IN COUNCIL

December 11, 2021

PUBLIC HEALTH AGENCY OF CANADA

QUARANTINE ACT

Minimizing the Risk of Exposure to COVID-19 in Canada Order (Prohibition of Entry into Canada — Specified Countries)

P.C. 2021-967 November 27, 2021

Whereas the Governor in Council is of the opinion, based on the declaration of a pandemic by the World Health Organization, that there is an outbreak of a communicable disease, namely coronavirus disease 2019 (COVID-19), in the majority of foreign countries;

Whereas the Governor in Council is of the opinion that the introduction or spread of COVID-19 would pose an imminent and severe risk to public health in Canada;

Whereas the Governor in Council is of the opinion that the entry of persons into Canada who have recently been in a foreign country may introduce or contribute to the spread in Canada of COVID-19 or of new variants of the virus causing COVID-19 that pose risks that differ from those posed by other variants but that are equivalent or more serious;

And whereas the Governor in Council is of the opinion that no reasonable alternatives to prevent the introduction or spread of COVID-19 are available;

Therefore, Her Excellency the Governor General in Council, on the recommendation of the Minister of Health, pursuant to section 58 of the Quarantine Act footnote a, makes the annexed Minimizing the Risk of Exposure to COVID-19 in Canada Order (Prohibition of Entry into Canada — Specified Countries).

Minimizing the Risk of Exposure to COVID-19 in Canada Order (Prohibition of Entry into Canada — Specified Countries)

Definitions

Definitions

1 The following definitions apply in this Order.

Chief Public Health Officer
has the same meaning as in section 2 of the Public Health Agency of Canada Act. (administrateur en chef)
foreign national
has the same meaning as in subsection 2(1) of the Immigration and Refugee Protection Act. (étranger)
Omicron variant
means the SARS-CoV-2 variant B.1.1.529, designated as a variant of concern and named Omicron by the World Health Organization. (variant Omicron)
Quarantine Order
means the Minimizing the Risk of Exposure to COVID-19 in Canada Order (Quarantine, Isolation and Other Obligations). (Décret visant la quarantaine)

Application

Application

2 This Order applies in addition to the prohibitions and requirements set out in the Minimizing the Risk of Exposure to COVID-19 in Canada Order (Prohibition of Entry into Canada from the United States), Minimizing the Risk of Exposure to COVID-19 in Canada Order (Prohibition of Entry into Canada from any Country Other than the United States) and the Quarantine Order.

Prohibition

Prohibition

3 (1) A foreign national is prohibited from entering Canada if, within a period of 14 days before the day on which they seek to enter Canada, they were in a country where, as determined by the Chief Public Health Officer,

Factors

(2) For the purposes of subsection (1), the Chief Public Health Officer must consider the following factors:

Non-application

4 Section 3 does not apply to

Powers and Obligations

Quarantine Act

5 For greater certainty, this Order does not affect any of the powers and obligations set out in the Quarantine Act.

Cessation of Effect

January 31, 2022

6 This Order ceases to have effect at 00:01:00 Eastern Standard Time on January 31, 2022.

Coming into Force

Day made

7 This Order comes into force at 11:59:59 p.m. Eastern Standard Time on the day on which it is made.

EXPLANATORY NOTE

(This note is not part of the Order.)

Proposal

This Order in Council, entitled Minimizing the Risk of Exposure to COVID-19 in Canada Order (Prohibition of Entry into Canada — Specified Countries), is made pursuant to section 58 of the Quarantine Act.

This Order applies to foreign nationals arriving from countries identified as having an outbreak or at risk of having an outbreak of the SARS-CoV-2 variant B.1.1.529 (Omicron). This Order is in addition to Orders in Council P.C. 2021-961 and P.C. 2021-962 and P.C. 2021-963, which came into force on November 21, 2021.

The new Order is complemented by the Minimizing the Risk of Exposure to COVID-19 in Canada Order (Quarantine, Isolation and Other Obligations) [the Quarantine Order] made under the Quarantine Act, which imposes testing, isolation, quarantine, and other requirements to prevent the introduction or spread of COVID-19.

This Order will be in effect from 23:59:59, EST, on the day on which it is made, until 00:01:00 EST, on January 31, 2022.

Objective

This Order maintains Canada’s focus on reducing the introduction and further spread of COVID-19 and new variants by decreasing the risk of importing cases from outside the country.

This Order prohibits entry of foreign nationals into Canada, with very limited exceptions, based on their 14-day travel history from any country identified as having an outbreak or at risk of having an outbreak of the SARS-CoV-2 variant B.1.1.529 (Omicron). The prohibition on entry applies to fully vaccinated and unvaccinated travellers. The Chief Public Health Officer (CPHO) will identify countries impacted by the Order on a list informed by epidemiologic data and public health criteria. All changes to existing border measures pursuant to the Order are described under the “Implications” section. The new Order is in effect until January 31, 2022.

Background

COVID-19

COVID-19 is caused by a novel coronavirus capable of causing severe illness, named Severe Acute Respiratory Syndrome coronavirus 2 (SARS-CoV-2). Although it is part of a family of viruses that includes Middle East Respiratory Syndrome coronavirus (MERS-CoV) and Severe Acute Respiratory Syndrome coronavirus (SARS-CoV), SARS-CoV-2 is more contagious than SARS-CoV and MERS-CoV.

COVID-19 was first detected in Wuhan, China, in December 2019. The disease is caused by a new strain of coronavirus never before seen in humans. Information about the virus, how it causes disease, whom it affects, and how to appropriately treat or prevent illness has been developing over the past two years.

SARS-CoV-2, the virus that causes COVID-19, spreads from an infected person to others through respiratory droplets and aerosols when an infected person breathes, coughs, sneezes, sings, shouts, or talks. The droplets vary in size, from large droplets that fall to the ground rapidly (within seconds or minutes) near the infected person, to smaller droplets, sometimes called aerosols, which linger in the air in some circumstances.

COVID-19 has been clearly demonstrated to be a severe, life-threatening respiratory disease. Patients with COVID-19 present symptoms that may include fever, malaise, dry cough, shortness of breath, and damage to the lungs. In more severe cases, infection can cause pneumonia, severe acute respiratory syndrome, kidney failure and death. Older individuals and those with a weakened immune system or an underlying medical condition are at a higher risk of severe disease. The time from exposure to onset of symptoms is currently estimated to be up to 14 days, with a median of 5 to 6 days. The time period in which an individual with COVID-19 can transmit the virus is said to be at a maximum of 10 days after symptom onset for immunocompetent people who have COVID-19.

The World Health Organization (WHO) declared an outbreak of what is now known as COVID-19 to be a Public Health Emergency of International Concern on January 30, 2020, and a pandemic on March 11, 2020. COVID-19 has demonstrated that it can cause widespread illness if not contained. The WHO continues to provide technical guidance and advice to countries for containing the pandemic, including identification of cases and recommendations for measures to prevent further spread. Since September 2020, multiple countries have detected SARS-CoV-2 variants whose mutations may increase pathogenicity and/or transmissibility, and potentially reduce vaccine effectiveness; these are referred to as variants of concern. The introduction of the new variants of concern of the virus causing COVID-19, which are more transmissible, has further worsened the negative health impacts of COVID-19.

Testing

Testing capabilities have advanced significantly over the past several months. Over 197 countries and territories require a negative pre-travel COVID-19 test or medical certificate as a condition of entry into their jurisdictions. The United States, for instance, currently requires that all travellers arriving by air to the United States have evidence of a negative pre-departure molecular or antigen test no more than three days prior to boarding a flight to the United States for fully vaccinated travellers and no more than one day prior to boarding for unvaccinated travellers.

COVID-19 molecular testing, such as polymerase chain reaction (PCR) tests and reverse transcription loop-mediated isothermal amplification (RT-LAMP) tests, has a higher sensitivity for detecting COVID-19 over the duration of infection, and it is also able to detect most symptomatic and asymptomatic infections. An antigen test is more likely to miss a COVID-19 infection compared to a molecular test, such as a PCR test. Therefore, molecular tests are more accurate for use in pre-departure screening.

Available science demonstrates that, as is the case with many other viruses, a person may continue to obtain a positive molecular test result up to 180 days after their infection, even though they are no longer considered infectious. Positive test results of previously infected individuals, for tests performed up to 180 days prior, should not be considered as evidence of a new infection posing risk, but rather that a person has recovered from a prior COVID-19 infection. Since a positive test result may inadvertently prevent a recovered patient from entering Canada, acceptable proof of prior infection from an asymptomatic traveller is generally accepted to board a flight to Canada. This will remain in place for Canadian citizens, permanent residents of Canada and persons registered as an Indian under the Indian Act. The approach may need to be re-evaluated as evidence emerges about the new Omicron variant.

Vaccination

Another technological development assisting in pandemic control measures is the advent of new vaccines against COVID-19. The COVID-19 vaccines are very effective at preventing severe illness, hospitalization and death from COVID-19. They also decrease symptomatic and asymptomatic infection, including against the Delta variant, and they will also decrease SARS-CoV-2 transmission, although this effectiveness varies depending on the COVID-19 vaccine product received and may decrease with time since vaccination. Evidence from COVID-19 border testing for the July to October 2021 period indicated that unvaccinated travellers are five times more likely to test positive than travellers who have received a complete course of Government of Canada recognized vaccines at least 14 days prior to arrival.

Globally, 51% of the world population has received at least one dose, and 40% is fully vaccinated with a COVID-19 vaccine, as of November 9, 2021. While 65.7% of people in high-income countries have been fully vaccinated, only 4.2% of people in low-income countries have received at least one dose. Vaccine accessibility remains a challenge especially for children and adolescents. As of November 11, 2021, over 30.0 million Canadians (78.4% of the total population) have received at least one dose, and more than 28.6 million (74.7% of the total population) are fully vaccinated.

The Government of Canada seeks to align, alongside domestic vaccination-related border measures, exemptions available for international and domestic requirements. In terms of domestic measures, on August 13, 2021, the Government of Canada announced its intent to require COVID-19 vaccination for federal employees and domestic travellers. As of October 30, the Government of Canada requires employers in the federally regulated air, rail, and marine transportation sectors to establish vaccination policies for their employees.

Also effective October 30, air passengers departing from Canadian airports, travellers on VIA Rail and Rocky Mountaineer trains, and travellers 12 years of age and older on non-essential passenger vessels on voyages of 24 hours or more, such as cruise ships, need to be vaccinated or show a valid COVID-19 molecular test within 72 hours of travel. By November 30, all domestic travellers must be fully vaccinated, with very limited exceptions to address specific situations such as emergency travel, and those medically unable to be vaccinated.

Canada’s current list of accepted vaccines includes five of eight vaccines on the WHO Emergency Use Listing (EUL).

Despite the proven efficacy of vaccines, the Omicron variant has been reported to have a high number of concerning mutations, including mutations to the spike protein, which is the target of vaccines, as well as in locations thought to be potential drivers of transmissibility. The concerns and potential risks of these mutations are that this variant of concern may be able to spread faster than previous variants (e.g. Delta), vaccines may have decreased effectiveness, immunity from past infections may be less robust, and that the variant may be less susceptible to current treatments. Therefore, foreign nationals entering Canada from a country with an outbreak or at risk of having an outbreak of the Omicron variant may pose a substantive risk to public health regardless of their vaccination status.

Other measures

Even at current levels of vaccination coverage, core public health and personal protective measures, such as limiting travel and contacts in public places, continue to be important for managing the growth of COVID-19 cases, protecting the vulnerable, and reducing the risk of overwhelming health care capacity.

Wearing masks in public places is an effective public health measure to prevent the transmission of COVID-19. Evidence suggests that mask use decreases transmission in the community when adherence levels are good and when masks are worn in accordance with public health guidance.

COVID-19 situation globally

The cumulative number of COVID-19 cases reported globally is now over 250 million and the number of deaths exceeds 5 million. For the week of November 1 to 7, 2021, the global number of new cases reported was over 3.1 million, a 1% increase as compared to the previous week. The increases in transmission appear to be driven by the circulation of more transmissible variants of concern, easing of domestic public health measures coupled with increased social mixing and low global vaccine coverage. According to the WHO weekly report, as of November 9, 2021, four of the six regions reported a decline (regions of the Americas, South-East Asia, Western Pacific, and the Eastern Mediterranean), while the other two (Europe and Africa) reported an increase in cases over the last week. The region of Europe reported the highest increase in case reporting (+7%), with 1.9 million new cases (209 per 100 000 population), representing 63% of the cases reported in the last week.

Despite efforts to extend vaccination coverage, many countries across all six WHO Regions continue to experience surges in COVID-19 cases among predominantly unvaccinated groups. As of November 9, 2021, the countries reporting the highest number of cases in the previous seven days were the United States (510 968 new cases; 3% decrease), the Russian Federation (281 305 new cases; 3% increase), the United Kingdom (252 104 new cases; 12% decrease), Turkey (197 335 new cases; 8% increase), and Germany (169 483 new cases; 29% increase).

In many countries, the spread of more contagious variants of concern has contributed to increased transmission. In the winter of 2020–2021, variants of the virus, which are more transmissible, detected in the United Kingdom, South Africa, Brazil and India have spread to many countries around the globe, including Canada and the United States. Globally, cases of the B.1.1.7 (Alpha) variant have been reported in 194 countries, territories or areas (hereafter countries);141 countries have reported cases of the B.1.351 (Beta) variant; 92 countries have reported cases of the P.1 (Gamma) variant; and 174 countries have reported cases of the B.1.617 (Delta) variant. Of 814 165 sequences uploaded to GISAID with specimens collected in the last 60 days 810 946 (99.6%) were Delta, 1 163 (0.1%) Gamma, 400 (<0.1%) Alpha, 23 (<0.1%) Beta, and 0.2% comprised other circulating variants (including variants of concern C.37 [Lambda] and B.1.621 [Mu]).

On November 24, 2021, the Omicron variant was first reported to WHO from South Africa. The epidemiological situation in South Africa has been characterized by three distinct peaks in reported cases, the latest of which was predominantly the Delta variant. In recent weeks, infections have increased steeply, coinciding with the detection of Omicron. As of November 25, 2021, South Africa was reporting the rate of new daily cases per 100 000 over the last seven days being 1.7, with 2 465 cases (4.1 cases per 100 000 persons). These daily case numbers represent a 260% increase compared to two weeks prior suggesting early evidence of increased transmissibility of the Omicron variant. Current COVID-19 PCR diagnostics continue to detect this variant. Preliminary evidence suggests an increased risk of reinfection with this variant, as compared to other variants of concern. Based on the evidence presented indicative of a detrimental change in COVID-19 epidemiology, WHO has designated Omicron as a variant of concern.

The WHO has published an interim guidance document providing national authorities with a step-by-step approach to decision-making for calibrating risk mitigation measures and establishing policies to allow for safe international travel, but currently, there is no internationally accepted standard for establishing travel thresholds or assessing a country’s COVID-19 risk. At this time, it is the view of the Government of Canada that travel continues to present a risk of importing cases, including cases of new variants of the virus that causes COVID-19, and increases the potential for onward community transmission of COVID-19. With inequities globally with regard to vaccine access, efforts to prevent and control the spread of COVID-19 and variants of concern continue.

COVID-19 situation in Canada

Canada is experiencing a fourth wave, driven by the Delta variant, with an increase in national case reporting over the last week though there is regional variability. The number of people experiencing severe and critical illness has declined slightly in recent weeks but remains elevated. A complete two-dose series of a COVID-19 vaccine provides moderately good protection against infection and very good protection against severe illness; achieving high (complete) vaccination coverage across the population is essential to reduce opportunities for Delta to spread. As of November 10, 2021, over 89.6% of the eligible Canadian population has received at least one dose of COVID-19 vaccine (77.7% of the total population) and over 85.3% are fully vaccinated (74% of the total population).

As of November 1, 2021, there have been 368 043 cases involving variants of concern in Canada reported via the national case surveillance system. The B.1.617.2 (Delta) variant, first identified in India, is proving to have the highest transmissibility rates of all variants of concern and has become the dominant variant of concern reported in Canada. The Delta variant is now identified in most provinces and territories. New variants, including C.37 (Lambda) and B.1.621 (Mu), were detected at the Canadian border in August 2021, and are being monitored.

Measures limiting travel into Canada have significantly reduced the number of travel-related COVID-19 cases. Canada has seen a 74% decrease in the number of travellers arriving from the United States in October 2021 compared to October 2019, and a 58% decrease among international travellers arriving from all other countries for the same period. However, when comparing October 2021 to October 2020, there has been a 79% increase in the number of travellers arriving from the United States, and a 260% increase among international travellers arriving from all other countries due to the gradual easing of Canada’s border restrictions.

However, the rate of importation also increased in March and April 2021, driven by a number of factors, including the introduction of mandatory Canadian border testing measures that increased case detection; a worsening global situation; as well as an increase in the number of imported cases from India and Pakistan. Following the April 22, 2021, implementation of a notice to airmen (NOTAM) that restricted direct flights from India and Pakistan and a Transport Canada interim order that required indirect travellers from these countries to obtain a negative COVID-19 test from a third country, the rate of case importation into Canada decreased in May and remained relatively stable throughout June. In recognition of high rates of COVID-19 cases originating from Morocco, a NOTAM was introduced for this country on August 29, 2021. As the respective COVID-19 situations have improved, Transport Canada has lifted the bans, with the last ban on direct international flights from any one country lifted as of October 29, 2021. Additional public health measures remain in place for persons travelling to Canada directly from India.

The introduction of post-border testing has led to improved case detection and the current number of reported imported cases is therefore likely a closer approximation of the true estimate of imported cases than what was reported prior to the implementation of routine post-border testing in February 2021.

Evidence demonstrates that a combination of pre-departure and post-arrival testing will facilitate detection of persons with COVID-19 arriving in Canada. Identification of cases will further permit genetic sequencing and the identification of variants of concern to support public health efforts to contain COVID-19 spread.

A certain proportion of travellers will require the use of clinical resources for care. In addition, infected travellers can cause secondary transmission to household members or in the community. If travellers are to continue to enter Canada, it is important to reduce the risk of travellers introducing cases of COVID-19, including new variants of concern into Canada as much as possible. Based on current review of international experience with new variants, maintaining measures that leverage the availability of testing technologies, combined with aggressive vaccination programs, can help further reduce the introduction and spread of COVID-19 or new variants of concern in Canada.

Government of Canada response to COVID-19 pandemic

The Government of Canada’s top priority is the health and safety of Canadians. To limit the introduction and spread of COVID-19 in Canada, the Government of Canada has taken unprecedented action to implement a comprehensive strategy with layers of precautionary measures.

Between February 3, 2020, and November 21, 2021, 70 emergency orders were made under the Quarantine Act to minimize the risk of exposure to COVID-19 in Canada — to reduce the risk of importation from other countries, to repatriate Canadians, and to strengthen measures at the border to reduce the impact of COVID-19 in Canada. Some provinces and territories have implemented their own restrictions. Together, these measures have been effective in reducing the number of travel-related cases.

Changes to international travel restrictions and advice are based on national and international evidence-based risk assessments. The Government of Canada recognizes that entry prohibitions, mandatory quarantine requirements, vaccination programs, and testing protocols place significant burdens on the Canadian economy, Canadians, and their immediate and extended families.

With more transmissible variants of the virus that causes COVID-19 in countries around the world, the Government of Canada continues to take a data-driven, scientific evidence and precautionary approach to its border measures for travellers entering Canada. At the current time, no cases of the Omicron variant have been identified in Canada; however, with the rapidly evolving international situation and cases being identified in many countries, detection in Canada can be expected. To minimize the risk of introduction or spread of this new immune-escape variant into the country, the Government of Canada is taking immediate measures to prevent entry from high-risk countries.

Implications

In response to the identification of the Omicron variant, the Government of Canada is putting in place additional measures to prevent new importation and secondary transmission of Omicron in Canada.

The new Order prohibits the entry of foreign nationals regardless of vaccination status, with some limited exceptions, if in the 14 days prior to entering Canada they were in a country identified as having an outbreak or at risk of having an outbreak of the Omicron variant. The new Order will be in addition to the existing Orders in Council, P.C. 2021-961, P.C. 2021-962, and P.C. 2021-963, made pursuant to section 58 of the Quarantine Act.

The countries affected by this order will be identified by the CPHO and included in a list informed by epidemiological data and public health criteria. The list will be made publicly available. Countries may be added to or removed from the list based on evolving scientific information.

The limited exceptions from this Order include foreign nationals who were in airborne or marine transit at the time the country was added to the list of Omicron-affected countries. Such travellers will be permitted entry into Canada but remain subject to the requirements of the Quarantine Order to quarantine or isolate as appropriate, undergo post-border testing measures and comply with any other applicable obligations. In addition, any person or any person in a class of persons whose presence in Canada, as determined by the Minister of Health, is in the national interest is permitted entry into Canada.

Foreign nationals travelling for any purpose will continue to be denied entry into Canada under existing Quarantine Act orders if they have COVID-19, have reasonable grounds to suspect they have COVID-19 or are exhibiting signs and symptoms of COVID-19. The enforcement of the prohibition on entry for foreign nationals who arrive exhibiting COVID-19 symptoms, despite having appeared healthy prior to boarding an aircraft or vessel, may be deferred to the extent required to maintain public health and ensure the safety of the commercial transportation system.

This Order does not apply to Canadian citizens, permanent residents, protected persons and persons registered as an Indian under the Indian Act, who have been to a country affected by, or at risk of being affected by Omicron in the past 14 days before arriving in Canada. However, such persons remain subject to the requirements of the Quarantine Order.

The new Order will be in effect until 00:01:00 EST on January 31, 2022.

Penalties

Failure to comply with this Order and other related measures under the Quarantine Act is an offence under the Act. The maximum penalties are a fine of up to $1,000,000 or imprisonment for three years, or both. Non-compliance is also subject to fines under the federal Contraventions Act.

Consultation

The Government of Canada has engaged provinces and territories to coordinate efforts and implementation plans. In addition, given linkages to departmental mandates and other statutory instruments, there has been consultation across multiple government agencies, including the Canada Border Services Agency; Transport Canada; and Global Affairs Canada.

Contact

Kimby Barton
Public Health Agency of Canada
Telephone: 613‑960‑6637
Email: kimby.barton@phac-aspc.gc.ca