Why do we Allow Canadian Nurses and Doctors to Commute Daily to Work From Windsor to Detroit when All Other Canadians are Required to Self Isolate for 14 Days, given that it is More Dangerous to visit Detroit today than it was to visit Wuhan, China at the end of January?

I find it perplexing that over one thousand Canadian nurses and doctors are working in Detroit hospitals and commuting daily from Windsor.  Why are we permitting Canadians to travel to a COVID-19 hotspot  and return daily  to infect Canadians?   Has no one learned anything from the mistakes that we made in January, February and March?   In those months we allowed people returning from China and other countries to self isolate.  It didn’t work.  Self isolation resulted in the community spread of the disease.  Permitting Canadian nurses and doctors to work in Detroit hospitals, and to commute daily from Windsor, can only result in the spread of the disease in Canada.

I don’t believe that anyone can question that the USA is a COVID-19 hotspot and Michigan is a COVID-19 hotspot.   The USA now leads the world in COVID-19 cases, and by next week will likely overtake Spain and Italy in the deaths column. In the USA only the states of New York and New Jersey have more confirmed cases and more deaths than Michigan.  As of April 8 the state of Michigan had reported 20,346 cases, 959 deaths, 5 recoveries and 3,856 in hospitals.   A majority of the cases in Michigan are in Metro Detroit, with the City of Detroit accounting for  5824 cases and 251 deaths.   Regrettably,  the cases and deaths in Detroit and in Michigan will only go up as they are adding over 1,000 confirmed cases each day.

It is worth noting that the United States evacuated its citizens from China, and that Canada evacuated Canadians from China, when there were similar total cases and total deaths to those now in Michigan.  The United States would never have sent  nurses and doctors to Wuhan and allowed them to return home weekly to the USA without isolating them for 14 days each time they returned.  Canada would never have sent our nurses and doctors to Wuhan and allowed them to return home weekly to Canada.  Why then are our nurses and doctors being allowed to commute daily  to Michigan? 

It is also worth noting that on January 31st President Trump imposed travel restrictions preventing foreign nationals from entering the U.S. if they had been in China within the previous two weeks.    There were about half as many confirmed cases in China (11,821) and about a third as many deaths in China (259)  at that point in time than there are now in Michigan.   The comparison is even more stark when you factor in that Detroit has a population of under 700,000, greater Detroit has a population of 4 million and  Michigan has a population of 10 million, while Wuhan has a population of 11 million and Hubei province has a population of 58.5 million.  Visiting Michigan today is six times more dangerous than it was to visit Wuhan, China at the end of January.

I am not objecting to Canadian health professionals working in the USA.  Canada should be proud that we can help our neighbour to the south in its time of need..   What I am objecting to is Canadian doctors and nurses failing to observe the requirement that they self isolate for fourteen days each time that they return to Canada.   If every other Canadian is required to self isolate, why aren’t people returning from the most infected country in the world required to self isolate?   Further, why are they permitted to return day after day from a COVID-19 hotspot, each day increasing their risk of contacting the disease and bringing it back to Canada?

A real concern is that nurses and doctors cannot live in Canada without coming into contact with Canadians.  Many of the health professionals that commute daily to the USA will be living in apartment buildings in Canada, in condominiums in Canada, in duplexes in Canada and in row housing in Canada.  Those that live in apartment buildings and in condominium towers will be sharing the elevators with other residents of those buildings.   The health professionals will also be buying gasoline for their cars in Canada, shopping for groceries in Canada, shopping for wine and beer in Canada, going to the drug stores in Canada, ordering in meals in Canada  and going for walks in Canada in their time off.   Those that smoke or vape will also be going to convenience stores in Canada to buy cigarettes and vaping products.  They have to come in contact with Canadians.  Do you really want to be the next person pumping gas after a nurse has filled her or his car with gas.  Do you want to be in grocery store with a person who has been working in a COVID-19 hotspot even where the nurse or doctor is standing six feet away?

At the start of the COVID-19 pandemic there were conflicting reports in the press as to whether those not showing symptoms were contagious.  We now know that asymptomatic spreading is the norm, with at least one study showing that it is possible that more people have been infected by those that do not show symptoms than have been infected by those that show symptoms.   We also now know that a significant number of those who are infected (anywhere from 18 to 30 percent) do not show symptoms.  Why then do we permit nurses and doctors who appear to be healthy to commute daily to and from the USA.  They are not being tested on a daily basis in the USA and many could be asymptomatic.  Do we not care about our border officers?   Do we not care about the Canadians that the health professionals will come into contact with? 

Another concern is that we now know that health professionals are among the groups most likely to become infected with COVID-19.   In Ottawa, there are over 400 confirmed cases, of  which one in ten is a health professional.    In Windsor roughly one-third of COVID-19 cases are health-care workers, with a number of those infected having worked at U.S. hospitals.  Do we really want our hospitals to be inundated with  health professionals who contacted the disease in the US and will want to be treated in Canada?

The simple solution is that those that work in the USA should be housed in the USA (at the expense of U.S. hospitals) for the duration of the COVID-19 crisis.   Further, Canadian nurses and doctors working at U.S. hospitals should not be allowed to return to Canada until they self isolate in the USA for a fourteen day period, and can provide a recent test for COVID-19 showing that they are not infected.

Christopher Brett