On October 1st, Canada will no longer require proof of COVID vaccination to enter the country. Canada is also dropping its requirement that unvaccinated travelers quarantine. Canada is one of the last developed, Western countries to remove its travel related COVID restrictions. Most European countries did this towards the beginning of the year, starting with France and Italy. England dropped most of its restrictions shortly thereafter. In June, the US rescinded its requirement that all travelers on flights into the US show a negative COVID test prior to boarding. However, according to the CDC’s website, non-US citizens and non-permanent residents are still required to show that they are fully vaccinated before flying into the US. This only applies to air travel into the US.
In retrospect, it is unclear how much any of these restrictions helped to slow the spread of COVID which still moved through every country in the world and did so quite rapidly. It makes a lot of sense to be removing these restrictions now. First, the Omicron variants, while more readily spread, are also much less virulent. Second, most people are now immune to varying degrees either from vaccination, prior infection or both. The result is that we have been seeing a dramatic decrease in the number of hospitalizations and COVID related deaths throughout the US and the rest of the world. This conclusion is also supported by the observation that there has been a significant reduction, both locally and nationally, of people wearing masks in public spaces. This has resulted in an increase in positive test results, but again, has not resulted in a proportional increase in either hospitalizations or deaths.
The California Department of Public Health (CDPH), recently updated its advisories, most notably dropping the mandate that healthcare facilities screen all visitors for COVID vaccination status, require a negative test if they are unvaccinated and screen for COVID symptoms. The updated advisory also backs off on most of the remaining mask mandates, such as for homeless shelters, correctional facilities and public transportation. The new advisory continues to require masks in what the CDPH considers “high-risk” areas that include hospitals, clinics and nursing homes. Masks will still be required by all who enter those areas, visitors and staff alike. These advisories continue to urge people to wear masks in crowded public areas and also urges all people who are at high-risk to continue to wear masks in all public settings. It should be noted that these advisories continue to be based on the level of spread in a particular community.
While it is fair to say that the public health response in California helped to reduce the impact of COVID upon our already overstressed healthcare system, there is room now for debate as to whether continuing any further restrictions makes sense. Central to the arguments from the very start has been the balance of public health concerns with individual freedoms. These are difficult decisions to make and our experience with the COVID pandemic has hopefully given us some insight into how to better manage societal expectations of public health’s role in protecting us and individual’s own expectations of how such decisions impact them personally.
Miller Report for the Week of Sep 26th, 2022; by William Miller, MD
You can access all previous Miller Reports online at www.WMillerMD.com.
Dr. Miller is a practicing hospitalist and the Chief of Staff at Adventist Health Mendocino Coast hospital in Ft. Bragg, California. The views shared in this weekly column are those of the author and do not necessarily represent those of the publisher or of Adventist Health.