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SARS-CoV-19 -- China's Gift to the World, Transmitted Country-to-Country in Global Linkage

"We instituted the enhanced screening focused initially on China and then as it moved into Europe and Iran."
"In March, we in very quick succession told people not to go on cruises, issued a global travel  health notice, because you can't actually tell which country the virus will come from, followed by the succession of border measures."
Dr.Theresa Tam, Chief Public Health Officer, Canada

"We remain concerned that access from visitors from the United States continues to be allowed [into Canada]."
"It's our strong message that visitors from the United States not come to British Columbia."
Adrian Dix, B.C.Health Minister, March

When it became increasingly obvious that Canada would not be immune to the swift inroads of infections from the SARS-CoV-2 virus, which surfaced in Wuhan, China, and whose viral infection rate, and transmission human-to-human of the new zoonotic was denied by Beijing, the federal government in Ottawa moved first to impose travel restrictions on China, but the last of the border restrictions to be put in place was for the United States, with mutual agreement.

Infamously, the Chinese Communist Party bristled with outrage at other countries closing their borders with China, calling the decision 'racist'. Ironically, when Chinese travellers returned to China after the Chinese New Year, bringing new cases of  COVID-19 back with them from Italy, Spain, France and Britain, Beijing moved to exclude visitors from those countries.

And while the Canadian government claimed that it was instituting screening and isolation, none of it was formal, but merely suggestions that people do so. In the event, Canada moved tardily in comparison with many other countries to restrict international travel from China, beginning with airport screening relying on passengers to disclose whether they were experiencing virus symptoms and would commit to self-isolating.

Flights from China were suspended by Air Canada in February, with the government recommending people not travel to China, in early January. It took until March 18 when travellers from China were banned, and then sweeping global restrictions were imposed and international visitors barred from Canada altogether, with only Canadian citizens and permanent residents permitted to return.

Still, there was no closure of the U.S. border -- with a view to keeping essential goods between the two trading partners flowing. The continued open border between British Columbia and Washington State, which had become a focal point for an infection breakout, worried B.C. Minister of Health Adrian Dix, and he went out of his way to 'disinvite' Americans from travelling to British Columbia under the circumstances of their infection breakout.

By April 17, Ontario had identified 1,201 cases of COVID in people who had returned from some kind of international travel, five of whom had travelled from China, whereas 404 related to people travelling from the United States. The United Kingdom accounted for 126 cases, Mexico for 68 and Spain for 49 cases, rounding up the top destinations that gave Canadians with coronavirus infections they returned to Canada with.

Iran and Italy represent two other hot spots for the virus, both more heavily represented as sources for the virus than China; 19 cases attributed to Iran and seven from Italy. the United States gave Quebec 373 cases, with none at all from China, while travellers from France brought 151 cases back with them and 121 originated in Puerto Rico, and 117 in Austria. Alberta had one single case from China and 36 percent of their cases from he U.S.

According to data from Statistics Canada, the U.S., U.K. and China represented the top three destinations for travellers to Canada in 2018. Dr.Tam emphasized that curbs on travel from Iran arrived before Iran even reported it had any cases, reflecting that Canada had health data implicating Iran with a virus problem while Iran itself continued to deny it had any cases internally.

In the final analysis, all of the cases in Canada's early days of the novel coronavirus resulted from travelling, but as travel restrictions were enacted and Canadians returned home, travel-contact and infection began to represent a reduced part of the infection picture. On April 1 in Ontario, 695 cases connected to travel were identified. Three weeks later, 1,395 cases were identifiedc a period during which case numbers increased five-fold.

A body is removed after several residents died of the coronavirus disease (COVID-19) at the Eatonville Care Centre in Toronto, Ontario, Canada April 14, 2020. Reuters