Effective border management plays key role in battle against COVID-19

By Jeff Hodson

Canada needs better data and improved decision-making tools if it is to be able to apply a risk-based approach to border management including the use of travel restrictions, according to a world-leading expert on global health governance.

Kelley Lee, a professor in SFU’s Faculty of Health Sciences, says mitigating risks from all travel – from local to global – is critical for Canada to get right if it is to navigate successfully through the COVID-19 pandemic.

“There is now overwhelming evidence that travel and COVID-19 are intimately connected and will continue to be,” says Lee.  “We must deal with community transmission and continue to vaccinate at speed.  However, it’s also repeated reintroductions of the virus into populations through travel, including variants of concern, that can undermine and potentially undo these efforts.”

For the past 16 months, Lee has been one of the country’s most sought-after media commentators on issues relating to the World Health Organization (WHO), along with travel and border management during the pandemic. She receives half a dozen media requests a week and has appeared in publications like the New York Times and Rolling Stone. She was recently named co-winner of SFU’s media newsmaker of the year.

SFU’s Canada Research Chair in Global Health Governance, Lee will be speaking at 6 p.m. on June 1 in a  President’s Faculty Lecture entitled, ‘Pandemics and borders: How to manage travel restrictions more effectively.’ The event, hosted by SFU Public Square is free, but requires registration.

In the lecture, Lee will review the past 16 months with an eye on how COVID-19 has been managed in terms of travel restrictions and border.  The work of the Pandemics and Borders Project team, which she leads, informed the findings of a recent WHO International Health Regulations Review Committee report that recommended countries move to a risk-based approach to managing borders.

“While many people are now talking about easing travel measures, we can’t really open up again unless we have a solid system in place to assess and mitigate risk.  We need to act from a position of strength.”

Compared to many countries, Canada was slower to introduce the kinds of travel measures proven to be effective.

For example, early on in the pandemic, travellers were asked to check for symptoms, allowing asymptomatic and pre-symptomatic arrivals with COVID-19 to enter the country. Better testing and mandatory hotel quarantine requirements were introduced in 2021. However, a large proportion of the 1 million international arrivals each month into Canada remain exempt from these measures. There are also inconsistencies between land and air arrivals that create loopholes and workarounds. Many non-exempt travelers, for example, are diverting to land crossings to avoid the three-day hotel quarantine.

“We have had, and continue to have, a lot of people coming into Canada that aren’t required to be quarantined or tested. It is no leap of imagination that this is how variants have got in,” says Lee. “It’s no surprise we got variants in B.C.  We’re now vaccinating quickly but, at one point, the variants were outpacing the vaccinations.  We are now beginning to pull ahead of current variants but more are waiting in the wings.”

Lee, however, says her work is not to cast blame, but to support policymakers with risk-based data and tools to make better decisions on border management.

“These last 16 months have been unprecedented and we discovered there was no rule book or evidence base to use when it came to border management. It’s been very challenging for those who have had the responsibility to put into place measures and adapt them over time.”

In addition to her research and teaching work at SFU, Lee is participating in almost a dozen groups seeking to address weaknesses in global health surveillance systems, redefining what a national security threat in a health context looks like, and exploring the potential for a global pandemic treaty to increase collective action on preventing or responding to the next pandemic.

As to the future, Lee says travel, like many previously familiar things, will initially feel different. She predicts travel will open up again gradually, starting with people who can demonstrate a degree of immunity to the virus through previous infection or vaccination. But, she adds, this future remains uncertain while the virus continues to pummel countries around the world.  Canadians may be vaccinated in large numbers soon but the majority of countries around the world will not be.

Her hope, she adds, is that Canada will invest in creating more robust system of managing health risks at borders. Investment is needed to put into place best practices in data collection, as the foundation of effective disease surveillance among travellers, and then linking risk assessment using such data to border management.

“There’s a lot of work to be done to enable us to travel safely again.  But it will happen.  Most Canadians still want to be closely connected with the rest of the world.”

With files from Sharon Mah