COVID-positive travellers fell through cracks, quarantine hotel system flawed: AG report

The Public Health Agency of Canada struggled to enforce COVID-19 restrictions at the border through the first half of 2021, resulting in failures to contact positive COVID-19 cases and uncertainty over whether those required to be tested or stay in a hotel quarantine actually did so, according to the Auditor General.

In a new report issued Thursday, Auditor General Karen Hogan identified “significant gaps” in the Public Health Agency of Canada (PHAC)’s administration of emergency travel measures that came into effect in early 2021.

Specifically, she called out major shortcomings with the enforcement of the requirement for incoming travellers to take a COVID-19 test 72 hours before arriving Canada, and the introduction of required quarantine hotel stays for returning travellers awaiting test results.

Not all air and land travellers actually completed their mandatory COVID-19 tests when coming back from international locations, Hogan found.

“We found gaps in the verification of mandatory COVID-19 tests for incoming travellers: 14 per cent of travellers did not complete an on-arrival test, and 26 per cent did not complete a post-arrival test,” reads the report.

Further, according to the performance audit:

• Between February and June 2021, PHAC was either missing or unable to match 30 per cent of COVID-19 test results to incoming travellers;
• The agency was responsible for verifying travellers completed their COVID-19 tests and was to follow up with these who had positive results to inform them of the need to isolate, however 14 per cent of positive travellers (1,156) were not contacted;
• Due to not having records of stays or an automated system to track them, for 75 per cent of travellers who flew into Canada, the agency didn’t know whether those who were required to stay at quarantine hotels actually did so; and
• PHAC did not reliably track whether air travellers who had been notified of positive COVID-19 tests had stayed at a government-authorized hotel as required.

These measures were supposed to limit the importation of COVID-19 and its variants into this country. In Hogan’s view, despite some improvements, PHAC has largely fallen short on its responsibility to direct the implementation of border control measures as they have evolved over the last 20 months.

Notably, while the requirement for a negative test result has remained in place since it’s been enacted, the hotel quarantine stay requirement ended in August 2021, but has recently come back into wider use for certain incoming travellers amid fears over the Omicron variant.

“With travel increasing and new variants continuing to emerge, the agency needs to improve the way it manages and enforces border control measures that are meant to limit the introduction of the COVID-19 virus and its variants into Canada,” said Hogan during a press conference unveiling her report.

“I’m concerned that the department and agencies are unable to show us whether or not these border measures are effective border measures.”

Asked whether she would draw the conclusion that Canadians’ health was put at risk by the patchwork border enforcement, Hogan hesitated to make such a link. She said that in the case of failing to contact positive cases, it was her understanding that the lab that completed the test “likely” would have reached out to those individuals.

“We don't have enough information in order to be able to determine a causal link between the spread of the virus and individuals coming into the country. There's so much more information about health-related matters that the agency doesn't have, and that we don't have,” Hogan said.

“But, when there is no evidence for us to be able to determine whether or not the person was reached, all we can tell you is that they didn't monitor and enforce the requirements properly.”

Responding to the report, the federal government acknowledged that its border response has been “far from perfect,” but said there have been improvements to its tracking and record keeping and further actions will be taken.

Health Minister Jean-Yves Duclos also said that regardless of if PHAC was able to, the test providers would have informed travellers of their results and those without had their quarantine periods extended. However, he couldn't guarantee 100 per cent of travellers being contacted going forward.

"Such a system doesn't exist, however, a good and improving system is better than no system at all," he said.

SOME IMPROVEMENT FROM LAST AUDIT

Hogan did note that despite continued shortcomings, PHAC has improved its verification of traveller compliance with mandatory quarantine orders over the course of the pandemic.

The performance audit picked up where a previous study left off, looking at whether PHAC had made improvements in enforcing the evolving range of border measures.

The previous report issued in March found that PHAC “underestimated” the potential impact of COVID-19 and was unprepared to respond as a result. It also highlighted shortcomings in how the Canada Border Services Agency (CBSA) and PHAC applied and followed up on border restrictions, which impacted the federal government’s overall efforts to control the virus’ spread.

The March audit covered the agencies’ response from Jan. 1, 2020 to June 30, 2020, and Thursday’s report focused on what was going on at the border between July 1, 2020 and June 30, 2021.

• Read more: Public health agency was unprepared, led to lacking early pandemic response, AG says

In March, Hogan reported that lacking a pre-existing national plan for mandatory quarantine, PHAC attempted to follow-up with incoming travellers, but was unaware whether 66 per cent of those ordered to complete a 14-day quarantine, actually did. Even when people were flagged for being a risk for breaking the rules, there wasn’t always follow-up.

At the time, PHAC agreed with recommendations to improve its practices to better verify whether travellers actually complied with the restrictions the federal government has imposed.

As of her latest findings, the agency has improved its tracking of incoming travellers, seeing the percentage of untracked incoming travellers dropping to 37 per cent during the window of time this audit was focused on.

This improvement was tied to beginning to collect travellers’ contact information electronically through the ArriveCAN application, rather than on paper as it was previously being done.

Although we found that the percentage had dropped… this is not a success story,” said Hogan on Thursday. “The Agency’s inability to confirm whether more than one-third of travellers complied with quarantine orders remains a significant problem.”

Hogan said she hopes that that more lessons will be learned from this audit and applied going forward, since these measures are currently being relied on and without the ability to track compliance, the government would have a hard time knowing whether the border measures it has imposed are effective.

“The findings in the Auditor General’s report reveal a pattern of incompetence, with severe gaps in the application of policies. The report that makes clear that this Liberal government has once again failed to take action on lessons learned,” said Conservative health critic Luc Berthold in a statement.

According to the report, from the outset of the pandemic in March 2020 to August 2021, PHAC has spent $614 million to administer border measures, including:

• $65 million for 14-day quarantine orders;
• $342 million for COVID-19 testing orders;
• $7 million to operate government-authorized hotels; and
• $200 million to house incoming travellers at designated quarantine facilities.

As for how effective the compliance regime has been in issuing fines for those found to be breaking the Quarantine Act requirements, PHAC did not know what the outcome was for 59 per cent of priority referrals to law enforcement for follow-ups.

“That’s still too much, way too much,” Duclos said.

Further, the auditor general found that “ticketing of travellers for non-compliance was dependent on the enforcement regime in each province and territory, and in some jurisdictions, no tickets were issued.”

According to the audit, between December 2020 and June 2021, the only provinces that issued tickets were British Columbia, Manitoba, and Ontario. The total amount collected was more than $21 million.

In response to these compliance findings, the federal government noted Thursday that since border restrictions have been in place, officials have made more than 7 million compliance verification calls, and made 500,000 visits to confirm travellers were quarantining at home.

“We agree that we need to be constantly vigilant in our approach to border measures,” Duclos said.

“One of the key lessons we have learned is that we have to respond quickly as new information becomes available. We have seen this most recently in the border measures we have introduced to reduce the risk of importation and transmission of the Omicron variant of concern.”