'Keep it closed': Second wave of COVID-19 could wreak havoc if U.S. border opens, epidemiologist says

Talks between Canada and the United States seem to be heading towards extending the suspension on non-essential travel between the neighbouring countries due to the ongoing COVID-19 pandemic.

The shutdown is now expected to last through at least June 21, and as some U.S. states and Canadian provinces reboot their economies, it has left many wondering when it will be safe to cross the borders.

A leading Canadian epidemiologist thinks the longer the wait, the better.

“I would keep it closed for as long as possible until the Americans have their act together...the Americans don’t have their house in order, they really just don’t,” said Dr. Gerald Evans, Chair and Medical Director of Infection Prevention & Control at Kingston Health Sciences Centre.

The border closures went into place on March 21, which still allowed for the flow of trade and goods to continue, but barred any travel which was deemed non-essential. The two countries re-upped the agreement on April 18 and it was set to expire on May 21.

The tale of COVID-19 in the two countries has been drastically different. In the U.S., there’s been more than double the total number of cases and deaths per population of one million. Globally, the U.S. has the most deaths caused by COVID-19.

America opened ‘too quickly,’ expert says

“I think from the Canadian perspective the big problem is opening the border too soon to the usual traffic would be a mistake because here we haven’t had the same degree of disease activity,” said Dr. Evans.

In some states like Iowa, Wyoming and North Dakota, the governors never issued a stay-at-home order, while most states have allowed for the reopening of retail businesses. In very few states, there were state-wide directives regarding lockdowns in place, and in North Carolina they continued to allow mass religious gatherings.

“I think the Americans have gone to opening up their economy and society in general much too quickly,” said Dr. Evans.

TOPSHOT - Demonstrators take part in an "American Patriot Rally," organized on April 30, 2020, by Michigan United for Liberty on the steps of the Michigan State Capitol in Lansing, demanding the reopening of businesses. - Michigan's stay-at-home order declared by Democratic Governor Gretchen Whitmer is set to expire after May 15. (Photo by JEFF KOWALSKY / AFP) (Photo by JEFF KOWALSKY/AFP via Getty Images)
Demonstrators take part in an "American Patriot Rally," on the steps of the Michigan State Capitol in Lansing, demanding the reopening of businesses. (Getty)

Evans' line of thinking is matched by Dr. Anthony Fauci, the director of the National Institute of Allergy and Infectious Diseases and member of the White House Coronavirus Task Force who told Congress this past Tuesday that re-opening too soon could lead to a second, potentially larger spike.

“If some areas, cities, states or what have you jump over those various checkpoints and prematurely open up without having the capability of being able to respond effectively and efficiently, my concern is that we will start to see little spikes that might turn into outbreaks,” Fauci said. “The consequences could be really serious.”

Dr. Evans is quick to point out that if physical distancing and good hygiene is not being practiced in the U.S. then that second wave could wreak more havoc than the initial.

“The risk in that second wave is exactly what Dr. Fauci said, you have to reintegrate social distancing which will further setback an economic opening that is sustainable,” he said.

In Dr. Evans’ view, if Canada does open its border to Americans, it could have a huge impact on the Canadian health system. He also added that travel and open borders were what led to the initial mass spread of COVID-19.

“The movement of those Americans who may be infected could cause a resurgence in Canada which results in us having the same problem and having to close everything again,” he said.

Slow and steady

While P.E.I, the Northwest Territories, Nunavut and Yukon combined have less than 100 total cases, premiers in all the provinces and territories are taking segmented and mild-mannered approaches to reopening society. There are still limits on gatherings, physical distancing is still being recommended and the concept of a slow reopening is music to Dr. Evans’ ears.

“We’re doing a much more deliberate and planned reopening of society, we’re taking it a month at a time, limiting what can go on, but the problem is it could be messed up if we allow a big influx of Americans,” said Dr. Evans.

Dr. Evans fears if borders are reopened and tourism restarts as normal or even at fifty percent, it could result in the virus being spread quickly.

“If we open the borders like normal we’re going to have numbers of people who will travel to Canada to visit family or friends or to be tourists, if we’re not doing the right things, it could end badly,” said Dr. Evans.

A second wave as a result of reopening the borders is a major concern for Dr. Evans, especially if Canada reopens to a country that has poorly handled the pandemic.

“Everyone needs to put it in perspective that we need to get on top of this virus and prevent a resurgence,” he said.

Mixed messages

While both Dr. Fauci and Dr. Evans are on the same page, U.S. President Donald Trump has been insisting governors “liberate” their people and cheering on the reopening of businesses. The inconsistent messaging from top officials in the White House Coronavirus Task Force has led to conflict and confusion resulting in a large partisanship divide.

“Here political leaders and medical people are saying there’s no rush, where in the U.S. you’re getting mixed messages about liberating states,” said Nelson Wiseman, a professor of Political Science and Director of the Canadian Studies program at the University of Toronto.

According to Wiseman, the same cannot be said about Canada where the pandemic hasn’t been as politicized and Prime Minister Justin Trudeau has allowed Dr. Theresa Tam to carry the load, especially on health directives.

“You’re getting conflicting messages from the U.S. and the president is saying something else — you never hear Trudeau not being consistent with Dr. Tam,” he said.

A recent poll conducted for CNN shows Dr. Fauci’s trustworthiness at 72%, whereas only half as many of the Americans surveyed (36%) trusted Trump’s advice on the pandemic. In contrast, a poll by Ipsos showed very favourable numbers for PM Trudeau’s handling, which sits at 72%.

“Fauci’s ratings are way higher than the president’s where if you look here, the ratings for Dr. Tam and Trudeau are about the same, there’s not the same partisanship here,” he said.

Part of the favourability for Trudeau and Canada’s handling of the pandemic by Canadians is tied into the fact that nearly 67% of Canadians surveyed believe the country needs to have the ability to vaccinate against COVID-19 before opening society and the economy again. Dr. Evans feels the government is keen to continue listening to the health professionals due to current public perception.

“Right now the politicians are on the side of scientists and medicine principally because political pressure from the public is we don’t want people dying,” he said.

While Dr. Evans thinks Canadian politicians can stave off pressures from a small minority for the time being, he understands public perception could soon change.

“There’ll be pressure, there’s no question about it and as time goes by it will increase and that may influence what the politicians eventually do,” he said.

Wiseman points to how leaders in the countries, specifically Ontario Premier Doug Ford’s handling of COVID-19 protestors versus Trump’s handling of an armed militia which stormed the Michigan capitol building explains the disparity in attitudes.

“When people protested at Queens Park the premier called them yahoos, whereas in the States the president said they’re ‘fine people,’” he said.

Dr. Evans believes Canadians’ trust in the public healthcare system is one of the things working in healthcare officials’ favour and has led to them adhering to their advice.

“We see division in the States because Americans tend to be more distrustful of their government and health systems,” said Dr. Evans.