COVID-19 Molecular Test - Flights To Canada Essai Moléculaire Relatif À La COVID-19 - Vols À Destination Du Canada

AR04331
FOR PUBLIC CONSULTATION POUR CONSULTATION PUBLIQUE

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paragraphe 8(1) qu’elle présente ne sont pas liés à la CO-

VID-19.
COVID-19 Molecular Test — Essai moléculaire relatif à la

Flights to Canada COVID-19 — vols à destination
du Canada
Application Application
11 (1) Sections 12 to 17 apply to a private operator or air 11 (1) Les articles 12 à 17 s’appliquent à l’exploitant pri-
carrier operating a flight to Canada departing from any vé et au transporteur aérien qui effectuent un vol à desti-
other country and to every person boarding an aircraft nation du Canada en partance de tout autre pays et à
for such a flight. chaque personne qui monte à bord d’un aéronef pour le
vol.
Non-application Non-application
(2) Sections 12 to 17 do not apply to persons who are not (2) Les articles 12 à 17 ne s’appliquent pas aux personnes
required under an order made under section 58 of the qui ne sont pas tenues de présenter la preuve qu’elles ont
Quarantine Act to provide evidence that they received a obtenu un résultat à un essai moléculaire relatif à la CO-
result for a COVID-19 molecular test. VID-19 en application d’un décret pris au titre de l’article
58 de la Loi sur la mise en quarantaine.
Notification Avis
12 A private operator or air carrier must notify every 12 L’exploitant privé ou le transporteur aérien avise
person who intends to board an aircraft for a flight that chaque personne qui a l’intention de monter à bord d’un
the private operator or air carrier operates that the per- aéronef pour un vol qu’il effectue qu’elle peut se voir re-
son may be denied permission to board the aircraft if fuser de monter à bord si elle ne peut présenter la preuve
they are unable to provide evidence that they received a qu’elle a obtenu un résultat à un essai moléculaire relatif
result for a COVID-19 molecular test. à la COVID-19.
Evidence — result of test Preuve — résultat de l’essai

13 (1) Before boarding an aircraft for a flight, every per- 13 (1) Avant de monter à bord d’un aéronef pour un vol,
son must provide to the private operator or air carrier chaque personne est tenue de présenter à l’exploitant pri-
operating the flight evidence that they received either vé ou au transporteur aérien qui effectue le vol la preuve
qu’elle a obtenu, selon le cas :
(a) a negative result for a COVID-19 molecular test
that was performed on a specimen collected no more a) un résultat négatif à un essai moléculaire relatif à la
than 72 hours before the aircraft’s initial scheduled de- COVID-19 qui a été effectué sur un échantillon prélevé
parture time; or dans les soixante-douze heures précédant l’heure de
départ de l’aéronef prévue initialement;
(b) a positive result for such a test that was performed
on a specimen collected at least 14 days and no more b) un résultat positif à un tel essai qui a été effectué
than 180 days before the aircraft’s initial scheduled de- sur un échantillon prélevé au moins quatorze jours et
parture time. au plus cent quatre-vingts jours précédant l’heure de
départ de l’aéronef prévue initialement.
Evidence — location of test Preuve — lieu de l’essai

(2) For the purposes of subsection (1), the COVID-19 (2) Pour l’application du paragraphe (1), l’essai molécu-
molecular test must have been performed in a country or laire relatif à la COVID-19 doit être effectué dans un pays
territory that is not listed in Schedule 1. ou territoire qui ne figure pas à l’annexe 1.
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Evidence — elements Preuve — éléments

14 Evidence of a result for a COVID-19 molecular test 14 La preuve d’un résultat à un essai moléculaire relatif
must include à la COVID-19 comprend les éléments suivants :
(a) the person’s name and date of birth; a) les prénom, nom et date de naissance de la per-
sonne;
(b) the name and civic address of the laboratory that
administered the test; b) le nom et l’adresse municipale du laboratoire qui a
effectué l’essai;
(c) the date the specimen was collected and the test
method used; and c) la date à laquelle l’échantillon a été prélevé et le
procédé utilisé;
(d) the test result.
d) le résultat de l’essai.
False or misleading evidence Preuve fausse ou trompeuse

15 A person must not provide evidence of a result for a 15 Il est interdit à toute personne de présenter la preuve
COVID-19 molecular test that they know to be false or d’un résultat à un essai moléculaire relatif à la COVID-19,
misleading. la sachant fausse ou trompeuse.
Notice to Minister Avis au ministre

16 A private operator or air carrier that has reason to 16 L’exploitant privé ou le transporteur aérien qui a des
believe that a person has provided evidence of a result for raisons de croire qu’une personne lui a présenté la
a COVID-19 molecular test that is likely to be false or preuve d’un résultat à un essai moléculaire relatif à la
misleading must notify the Minister as soon as feasible of COVID-19 qui est susceptible d’être fausse ou trompeuse
the person’s name and contact information and the date informe le ministre dès que possible des prénom, nom et
and number of the person’s flight. coordonnées de la personne ainsi que la date et le numé-
ro de son vol.
Prohibition Interdiction
17 A private operator or air carrier must not permit a 17 Il est interdit à l’exploitant privé ou au transporteur
person to board an aircraft for a flight that the private aérien de permettre à une personne de monter à bord
operator or air carrier operates if the person does not d’un aéronef pour un vol qu’il effectue si la personne ne
provide evidence that they received a result for a présente pas la preuve qu’elle a obtenu un résultat à un
COVID-19 molecular test in accordance with the require- essai moléculaire relatif à la COVID-19 selon les exi-
ments set out in section 13. gences prévues à l’article 13.
Vaccination — Flights Departing Vaccination – vols en partance

from an Aerodrome in Canada d’un aérodrome au Canada
17.1 (1) Sections 17.2 to 17.18 apply to all of the follow- 17.1 (1) Les articles 17.2 à 17.18 s’appliquent aux per-
ing persons: sonnes suivantes :
(a) a person boarding an aircraft for a flight that an a) la personne qui monte à bord d’un aéronef pour un
air carrier operates departing from an aerodrome list- vol qu’un transporteur aérien effectue en partance
ed in Schedule 2; d’un aérodrome visé à l’annexe 2;
(b) a person entering a restricted area at an aero- b) la personne qui accède à une zone réglementée
drome listed in Schedule 2 from a non-restricted area d’un aérodrome visé à l’annexe 2 à partir d’une zone
to board an aircraft for a flight that an air carrier oper- non réglementée dans le but de monter à bord d’un
ates; aéronef pour un vol qu’un transporteur aérien effec-
tue;
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(c) an air carrier operating a flight departing from an c) le transporteur aérien qui effectue un vol en par-
aerodrome listed in Schedule 2; tance d’un aérodrome visé à l’annexe 2;
(d) a screening authority at an aerodrome listed in d) l’administration de contrôle à un aérodrome visé à

Schedule 2. l’annexe 2.
(2) Sections 17.2 to 17.18 do not apply to any of the fol- (2) Les articles 17.2 à 17.18 ne s’appliquent pas aux per-
lowing persons: sonnes suivantes :
(a) a child who is less than 12 years and four months a) l’enfant âgé de moins de douze ans et quatre mois;
of age;
b) le membre d’équipage;
(b) a crew member;
c) la personne qui accède à une zone réglementée
(c) a person entering a restricted area at an aero- d’un aérodrome visé à l’annexe 2 à partir d’une zone
drome listed in Schedule 2 from a non-restricted area non réglementée dans le but de monter à bord d’un
to board an aircraft for a flight operated by an air car- aéronef pour un vol qu’un transporteur aérien effec-
rier tue :
(i) only to become a crew member on board anoth- (i) dans le seul but d’agir à titre d’un membre
er aircraft operated by an air carrier, d’équipage à bord d’un autre aéronef exploité par
un transporteur aérien,
(ii) after having been a crew member on board an
aircraft operated by an air carrier, or (ii) après avoir agi à titre d’un membre d’équipage
à bord d’un aéronef exploité par un transporteur
(iii) to participate in mandatory training required aérien,
by an air carrier in relation to the operation of an
aircraft, if the person will be required to return to (iii) afin de suivre une formation obligatoire sur
work as a crew member; l’exploitation d’un aéronef exigée par un transpor-
teur aérien si elle devra retourner au travail à titre
(d) a person who arrives at an aerodrome from any de membre d’équipage;
other country on board an aircraft in order to transit
to another country and remains in a sterile transit d) la personne qui arrive à un aérodrome à bord d’un
area, as defined in section 2 of the Immigration and aéronef en provenance d’un autre pays en vue d’y
Refugee Protection Regulations, of the aerodrome un- transiter vers un autre pays et qui demeure, jusqu’à
til they leave Canada; son départ du Canada, dans l’espace de transit isolé
au sens de l’article 2 du Règlement sur l’immigration
(e) a person who arrives at an aerodrome on board an et la protection des réfugiés de l’aérodrome;
aircraft following the diversion of their flight for a
safety-related reason, such as adverse weather or an e) la personne qui arrive à un aérodrome à bord d’un
equipment malfunction, and who boards an aircraft aéronef à la suite du déroutement de son vol pour une
for a flight not more than 24 hours after the arrival raison liée à la sécurité, comme le mauvais temps ou
time of the diverted flight. un défaut de fonctionnement de l’équipement, et qui
monte à bord de l’aéronef pour un vol au plus tard
vingt-quatre heures après l’arrivée du vol dérouté.
Notification Avis
17.2 An air carrier must notify every person who in- 17.2 Le transporteur aérien avise chaque personne qui a
tends to board an aircraft for a flight that the air carrier l’intention de monter à bord d’un aéronef pour un vol
operates that qu’il effectue de ce qui suit :
(a) they are prohibited from boarding the aircraft un- a) il lui est interdit de monter à bord de l’aéronef, à
less they are a fully vaccinated person or a person re- moins qu’elle ne soit une personne entièrement vacci-
ferred to in paragraph 17.3(2)(a) or (b) or any of sub- née ou qu’elle ne soit une personne visée au para-
paragraphs 17.3(c)(i) to (iv) or (d)(i) to (vi); graphe 17.3(2);
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(b) they will be required to provide to the air carrier b) elle sera tenue de présenter au transporteur aérien
evidence of COVID-19 vaccination demonstrating that la preuve de vaccination contre la COVID-19 démon-
they are a fully vaccinated person or evidence that trant qu’elle est une personne entièrement vaccinée ou
they are a person referred to in paragraph 17.3(2)(a) or la preuve qu’elle est une personne visée au paragraphe
(b) or any of subparagraphs 17.3(c)(i) to (iv) or (d)(i) 17.3(2);
to (vi); and
c) si elle soumet une demande visée à l’article 17.4,
(c) if they submit a request referred to in section 17.4, elle doit le faire dans le délai prévu au paragraphe
they must do so within the period set out in subsection 17.4(3).
17.4(3).
Prohibition — person Interdiction — personne

17.3 (1) A person is prohibited from boarding an air- 17.3 (1) Il est interdit à toute personne de monter à
craft for a flight or entering a restricted area unless they bord d’un aéronef pour un vol ou d’accéder à une zone
are a fully vaccinated person. réglementée sauf si elle est une personne entièrement
vaccinée.
Exception Exception — étranger

(2) Subsection (1) does not apply to (2) Le paragraphe (1) ne s’applique pas aux personnes
suivantes :
(a) a foreign national, other than a person registered
as an Indian under the Indian Act, who is boarding a) l’étranger qui n’est pas inscrit à titre d’Indien sous
the aircraft for a flight to an aerodrome in Canada if le régime de la Loi sur les indiens et qui monte à bord
the initial scheduled departure time of that flight is d’un aéronef pour un vol à destination d’un aérodrome
not more than 24 hours after the departure time of a au Canada si l’heure de départ prévue initialement est
flight taken by the person to Canada from any other au plus tard vingt-quatre heures après l’heure de dé-
country; part du vol qu’elle a pris en partance de tout autre
pays à destination du Canada;
(b) a person who has received a result for a COVID-19
molecular test described in paragraph 13(1)(a) or (b) b) l’étranger qui a obtenu un résultat à un essai molé-
and who is a foreign national boarding an aircraft for a culaire relatif à la COVID-19 visé aux alinéas 13(1)a)
flight to a country other than Canada or to an aero- ou b) et qui monte à bord d’un aéronef pour un vol à
drome in Canada for the purpose of boarding an air- destination de tout autre pays ou à destination d’un
craft for a flight to a country other than Canada; aérodrome au Canada dans le but de monter à bord
d’un autre aéronef pour un vol à destination de tout
(c) a person who has received a result for a COVID-19 autre pays,
molecular test described in paragraph 13(1)(a) or (b)
and who is c) la personne qui a obtenu un résultat à un essai mo-
léculaire relatif à la COVID-19 visé aux alinéas 13(1)a)
(i) a person who has not completed a COVID-19 ou b) et qui, selon le cas :
vaccine dosage regimen due to a medical con-
traindication and who is entitled to be accommo- (i) n’a pas suivi un protocole vaccinal complet
dated on this basis under applicable legislation by contre la COVID-19 en raison d’une contre-indica-
being permitted to enter the restricted area or to tion médicale et qui a droit à une mesure d’adapta-
board an aircraft without being a fully vaccinated tion pour ce motif, aux termes de la législation ap-
person, plicable, lui permettant de monter à bord d’un
aéronef pour un vol ou d’accéder à une zone régle-
(ii) a person who has not completed a COVID-19 mentée [sans être une personne entièrement vacci-
vaccine dosage regimen due to a sincerely held reli- née],
gious beliefs and who is entitled to be accommodat-
ed on this basis under applicable legislation by be- (ii) n’a pas suivi un protocole vaccinal complet
ing permitted to enter the restricted area or to contre la COVID-19 en raison d’une croyance reli-
board an aircraft without being a fully vaccinated gieuse sincère et qui a droit à une mesure d’adapta-
person, tion pour ce motif, aux termes de la législation ap-
plicable, lui permettant de monter à bord d’un
aéronef pour un vol ou d’accéder à une zone
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(iii) a person who is boarding an aircraft for a flight réglementée [sans être une personne entièrement
for the purpose of attending an appointment for an vaccinée],
essential medical service or treatment,
(iii) monte à bord de l’aéronef pour un vol afin de
(iv) a competent person who is at least 18 years old se rendre à un rendez-vous pour obtenir des ser-
and who is boarding an aircraft for a flight for the vices ou traitements médicaux essentiels,
purpose of accompanying a person referred to in
subparagraph (iii), if the person needs to be accom- (iv) est une personne âgée d’au moins dix-huit ans
panied because they qui monte à bord de l’aéronef pour un vol afin d’ac-
compagner la personne visée au sous-alinéa (iii) si
(A) are under the age of 18 years, cette personne a besoin d’être accompagnée pour
une des raisons suivantes:
(B) have a disability, or
(A) elle est âgée de moins de dix-huit ans,
(C) need assistance to communicate; or
(B) elle est handicapée,
(d) a person who has received a result for a COVID-19
molecular test described in paragraph 13(1)(a) or (b) (C) elle a besoin d’aide pour communiquer.
and who is boarding an aircraft for a flight for a pur-
pose other than an optional or discretionary purposes, d) la personne qui a obtenu un résultat à un essai mo-
such as tourism, recreation or leisure, and who is léculaire relatif à la COVID-19 visé aux alinéas 13(1)a)
ou b) et qui monte à bord d’un aéronef pour un vol à
(i) a person who entered Canada at the invitation of des fins autres que de nature optionnelle ou discré-
the Minister of Health for the purpose of assisting tionnaire telles que le tourisme, les loisirs ou le diver-
in the COVID-19 response, tissement et qui est, selon le cas :
(ii) a person who is permitted to work in Canada as (i) entrée au Canada à l’invitation du ministre de la
a provider of emergency services under paragraph Santé afin de participer aux efforts de lutte contre
186(t) of the Immigration and Refugee Protection la COVID-19,
Regulations and who entered Canada for the pur-
pose of providing those services, (ii) autorisée à travailler au Canada afin d’offrir des
services d’urgence en vertu de l’alinéa 186t) du Rè-
(iii) a person who has been issued a permanent res- glement sur l’immigration et la protection des ré-
ident visa under subsection 139(1) of those Regula- fugiés et qui est entrée au Canada afin d’offrir de
tions and who is tels services,
(A) a person whom the Immigration and (iii) une personne qui s’est vu délivrer un visa de
Refugee Board has determined to be a Conven- résident permanent en application du paragraphe
tion refugee under subsection 107(1) of the Im- 139(1) de ce règlement et, qui selon le cas :
migration and Refugee Protection Act, or
(A) s’est vu reconnaître, par la Commission de
(B) a person in similar circumstances to those of l’immigration et du statut de réfugié, la qualité
a Convention refugee within the meaning of sub- de réfugié au sens de la Convention [en applica-
section 146(1) of those Regulations, tion du paragraphe 107(1) de la Loi sur l’immi-
gration et la protection des réfugiés],
(iv) an accredited person,
(B) est dans une situation semblable à celle d’un
(v) a person holding a D1, O1 or C1 visa who en- réfugié au sens de la Convention au sens du pa-
tered Canada to take up a post and become an ac- ragraphe 146(1) de ce règlement;
credited person, or
(iv) est une personne accréditée,
(vi) a diplomatic or consular courier.
(v) est titulaire d’un visa D1, O1 ou C1 qui est en-
trée au Canada pour occuper un poste et devenir
une personne accréditée,
(vi) est un courrier diplomatique ou consulaire.
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Persons referred to in any of subparagraphs Personne visée à l’un des sous-alinéas 17.3(2)c)(i) à
17.3(2)(c)(i) to (iv) (iv)
17.4 (1) An air carrier must issue a document to a per- 17.4 (1) Le transporteur aérien délivre un document à
son referred to in any of subparagraphs 17.3(2)(c)(i) to une personne visée à l’un des sous-alinéas 17.3(2)c)(i) à
(iv) who intends to board an aircraft for a flight that the (iv) qui a l’intention de monter à bord d’un aéronef pour
air carrier operates or that is operated on the air carrier’s un vol effectué par le transporteur aérien ou pour son
behalf under a commercial agreement if compte en application d’une entente commerciale si :
(a) in the case of a person referred to in any of sub- a) dans le cas d’une personne visée aux sous-alinéas
paragraphs 17.3(2)(c)(i) to (iii), the person submits a 17.3(2)c)(i), (ii) ou (iii), une demande a été soumise au
request in respect of that flight to the air carrier in ac- transporteur aérien par la personne ou pour son
cordance with subsections (2) and (3) or such a re- compte, conformément aux paragraphes (2) et (3), à
quest is submitted on their behalf; l’égard du vol qu’il effectue;
(b) in the case of a person referred to in subparagraph b) dans le cas d’une personne visée aux sous-alinéas
17.3(2)(c)(i) or (ii), the air carrier is obligated to ac- 17.3(2)c)(i) ou (ii), le transporteur aérien a l’obliga-
commodate the person on the basis of a medical con- tion, aux termes de la législation applicable, de
traindication or a sincerely held religious belief under prendre des mesures d’adaptation en raison d’une
applicable legislation by issuing the document; and contre-indication médicale ou d’une croyance reli-
gieuse sincère en délivrant le document;
(c) in the case of a person referred to in subparagraph
17.3(2)(c)(iv), the person who needs accompaniment c) dans le cas d’une personne visée au sous-alinéa
submits a request to the air carrier in respect of that 17.3(2)c)(iv), une demande a été soumise au transpor-
flight in accordance with subsections (2) or (3) or such teur aérien par la personne qui a besoin d’être accom-
a request is submitted on their behalf. pagnée ou pour son compte, conformément aux para-
graphes (2) et (3), à l’égard du vol qu’il effectue.
Request — contents Éléments de la demande

(2) The request must be signed by the requester and in- (2) La demande est signée par le demandeur et com-
clude the following: prend les éléments suivants :
(a) the person’s name and address and, if the request a) les prénom, nom et son adresse de résidence de la
is made by someone else on the person’s behalf, that personne et, s’il y a lieu, du demandeur;
person’s name and address;
b) la date et le numéro du vol ainsi que les aéro-
(b) with respect to the flight, the date, the aerodrome dromes de départ et d’arrivée;
of departure, the aerodrome of arrival and the flight
number; c) dans le cas d’une personne visée au sous-alinéa
17.3(2)c)(i) :
(c) in the case of a person described in subparagraph
17.3(2)(c)(i), (i) un document délivré par le gouvernement d’une
province ou un certificat médical signé par un mé-
(i) a document issued by the government of a decin ou un infirmier praticien autorisé à pratiquer
province confirming that the person cannot com- au Canada attestant que la personne ne peut pas
plete a COVID-19 vaccination regimen due to a suivre un protocole vaccinal complet contre la CO-
medical condition or a medical certificate signed by VID-19 en raison de sa condition médicale,
a medical doctor or nurse practitioner who is li-
censed to practice in Canada certifying that the per- (ii) le numéro du permis d’exercice délivré au mé-
son cannot complete a COVID-19 vaccination regi- decin ou à l’infirmier praticien par un organisme
men due to a medical condition, and qui réglemente la profession de médecin ou d’infir-
mier praticien;
(ii) the licence number issued by a professional
medical licensing body to the medical doctor or d) dans le cas d’une personne visée au sous-alinéa
nurse practitioner; 17.3(2)c)(ii), une déclaration sous serment ou une af-
firmation solennelle de la personne devant une per-
sonne nommée à titre de commissaire aux serments
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(d) in the case of a person described in subparagraph au Canada attestant qu’elle n’a pas suivi un protocole
17.3(2)(c)(ii), a statement sworn or affirmed by the vaccinal complet contre la COVID-19 en raison d’une
person before a person appointed as a Commissioner croyance religieuse sincère et décrivant de quelle ma-
of Oaths in Canada attesting that the person has not nière cette croyance religieuse l’empêche de suivre le
completed a COVID-19 vaccination regimen due to a protocole vaccinal complet;
sincerely held religious belief, including a description
of how the belief renders them unable to complete e) dans le cas d’une personne visée au sous-alinéa
such a regimen; and 17.3(2)c)(iii), un document qui comprend:
(e) in the case of a person described in subparagraph (i) la signature d’un médecin ou d’un infirmier pra-
17.3(2)(c)(iii), a document that includes ticien autorisé à pratiquer au Canada,
(i) the signature of a medical doctor or nurse prac- (ii) le numéro du permis d’exercice délivré au mé-
titioner who is licensed to practice in Canada, decin ou à l’infirmier praticien par un organisme
qui réglemente la profession de médecin ou d’infir-
(ii) the licence number issued by a professional mier praticien,
medical licensing body to the medical doctor or
nurse practitioner, (ii) la date et l’endroit des services ou traitements
médicaux essentiels,
(iii) the date of the appointment for the essential
medical service or treatment and the location of the (iii) la date de la signature du document par le mé-
appointment, decin ou l’infirmier praticien,
(iv) the date on which the document was signed, (iv) si la personne a besoin d’être accompagnée par
and une personne visée au sous-alinéa 17.3(2)c)(iv), les
prénom, nom et les coordonnées de la personne vi-
(v) if the person needs to be accompanied by a per- sée au sous-alinéa 17.3(2)c)(iv) ainsi que la raison
son referred to in subparagraph 17.3(2)(c)(iv), the pour laquelle l’accompagnement est nécessaire.
name and contact information of that person and
the reason that the accompaniment is needed.
Timing of request Soumission de la demande

(3) The request must be submitted to the air carrier: (3) La demande doit être soumise au transporteur aérien
au plus tard :
(a) in the case of a person referred to in subparagraph
17.3(2)(c)(i) or (ii), 21 days before the day on which a) dans le cas d’une personne visée aux alinéas
the flight is initially scheduled to depart; and 17.3(2)c)(i) ou (ii), vingt-et-un jours avant l’heure de
départ de l’aéronef prévue initialement;
(b) in the case of a person referred to in subparagraph
17.3(2)(c)(iii) or (iv), 14 days before the day on which b) dans le cas d’une personne visée aux 17.3(2)c)(iii)
the flight is initially scheduled to depart. ou (iv), quatorze jours avant l’heure de départ de l’aé-
ronef prévue initialement.
Content of document Contenu du document

(4) The document referred to in subsection (1) must in- (4) Le document visé au paragraphe (1) indique, à la
dicate that the air carrier has verified that the person is a fois :
person referred to in any of subparagraphs 17.3(2)(c)(i)
to (v) and must include, in respect of the flight for which a) que le transporteur aérien a vérifié que la personne
the document is issued, the date, the aerodrome of de- est une personne visée à l’un des sous-alinéas
parture, the aerodrome of arrival and the flight number. 17.3(2)c)(i) à (iv);
b) la date et le numéro du vol à l’égard duquel le do-

cument a été délivré ainsi que les aérodromes de dé-
part et d’arrivée.
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Record keeping Tenue de registre

17.5 (1) An air carrier must keep a record of the follow- 17.5 (1) Le transporteur aérien consigne dans un re-
ing information: gistre les renseignements ci-après :
(a) the number of requests that the air carrier has re- a) le nombre de demandes reçues à l’égard de chaque
ceived in respect of each exception referred to in sub- exception visée à l’un des sous-alinéas 17.3(2)c)(i) à
paragraph 17.3(2)(c)(i) to (iv); (iv);
(b) the number of documents issued under subsection b) le nombre de documents délivrés en application du
17.4(1); and paragraphe 17.4(1);
(c) the number of requests that the air carrier denied. c) le nombre de demandes que le transporteur aérien
a refusées.
Retention Conservation
(2) An air carrier must retain the record for a period of at (2) Le transporteur aérien conserve le registre pendant
least 12 months after the day on which the record was au moins douze mois après la date de sa création.
created.
Ministerial request Demande du ministre

(3) The air carrier must make the record available to the (3) Il met le registre à la disposition du ministre à la de-
Minister on request. mande de celui-ci.
Copies of requests Copies des demandes

17.6 (1) An air carrier must keep a copy of a request for 17.6 (1) Le transporteur aérien conserve une copie de
a period of at least 90 days after the day on which the air chaque demande qu’il reçoit pendant au moins quatre-
carrier issued a document under subsection 17.4(1) or re- vingt-dix jours après la délivrance du document visé au
fused to issue the document. paragraphe 17.4(1) ou le refus de le délivrer.

(2) The air carrier must make the copy available to the (2) Il met les copies à la disposition du ministre à la de-
Request for evidence — air carrier Demande de présenter la preuve — transporteur

aérien
17.7 Before permitting a person to board an aircraft for 17.7 Le transporteur aérien qui effectue le vol est tenu
a flight that the air carrier operates, the air carrier must de demander à chaque personne avant de monter à bord
request that the person provide de l’aéronef de présenter, selon le cas :
(a) evidence of COVID-19 vaccination demonstrating a) la preuve de vaccination contre la COVID-19 dé-
that they are a fully vaccinated person; montrant qu’elle est une personne entièrement vacci-
née;
(b) evidence that they are a person referred to in para-
graph 17.3(2)(a); or b) la preuve qu’elle est visée à l’alinéa 17.3(2)a);
(c) evidence that they are a person referred to in para- c) la preuve qu’elle est visée à l’alinéa 17.3(2)b) ou à
graph 17.3(2)(b) or any of subparagraphs 17.3(c)(i) to l’un des sous-alinéas 17.3(2)c)(i) à (v) ou d)(i) à (vi) et
(iv) or (d)(i) to (vi) and that they have received a result qu’elle a obtenu un résultat à un essai moléculaire re-
for a COVID-19 molecular test. latif à la COVID-19,
Request for evidence — screening authority Demande de présenter la preuve — administration de

contrôle
17.8 Before permitting a certain number of persons, as 17.8 Avant de permettre à certaines personnes choisies
specified by the Minister and selected on a random basis, de façon aléatoire dont le nombre est déterminé par le
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to enter a restricted area, the screening authority must ministre d’accéder à la zone réglementée, l’administra-
request that each of those persons, when they present tion de contrôle est tenue de demander à chacune de ces
themselves for screening at a passenger screening check- personnes, lorsqu’elles se présentent à un point de
point, provide the evidence referred to in paragraph contrôle des passagers pour un contrôle, de présenter la
17.7(1)(a), (b) or (c). preuve visée aux alinéas 17.7(1)a), b) ou c).
Provision of evidence Présentation de la preuve

17.9 A person must, at the request of an air carrier or a 17.9 Toute personne est tenue de présenter, sur de-
screening authority, provide to the air carrier or screen- mande du transporteur aérien ou de l’administration de
ing authority the evidence referred to in paragraph contrôle, la preuve visée aux alinéas 17.7(1)a), b) ou c).
17.7(1)(a), (b) or (c).
Evidence of vaccination — elements Preuve de vaccination — éléments

17.10 (1) Evidence of COVID-19 vaccination must be 17.10 (1) La preuve de vaccination contre la COVID-19
evidence issued by the government or the non-govern- est délivrée par le gouvernement ou l’entité non gouver-
mental entity that is authorized to issue it in the jurisdic- nementale qui a la compétence pour la délivrer sur le ter-
tion in which the vaccine was administered and must ritoire où le vaccin contre la COVID-19 a été administré
contain the following information: et comprend les renseignements suivants :
(a) the name of the person who received the vaccine; a) les prénom et nom de la personne qui a reçu le vac-
cin;
(b) the name of the government or of the non-govern-
mental entity; b) le nom du gouvernement ou de l’entité non gouver-
nementale;
(c) the brand name or any other information that
identifies the vaccine that was administered; and c) la marque nominative ou tout autre renseignement
permettant d’identifier le vaccin qui a été administré;
(d) the dates on which the vaccine was administered
or, if the evidence is one document issued for both d) les dates auxquelles le vaccin a été administré ou,
doses and the document specifies only the date on dans le cas où la preuve est un document unique qui
which the most recent dose was administered, that est délivré pour deux doses et qui ne mentionne que la
date. date à laquelle la dernière dose a été administrée, cette
date.
Evidence of vaccination — translation Preuve de vaccination — traduction

(2) The evidence of COVID-19 vaccination must be in (2) La preuve de vaccination contre la COVID-19 doit
English or French and any translation into English or être en français ou en anglais et, s’il s’agit d’une traduc-
French must be a certified translation. tion en français ou en anglais, celle-ci est certifiée
conforme.
Evidence of COVID-19 molecular test — result Preuve de l’essai moléculaire COVID-19 — résultat
17.11 (1) A result for a COVID-19 molecular test is a re- 17.11 (1) Le résultat d’un essai moléculaire relatif à la
sult described in paragraph 13(1)(a) or (b). COVID-19 est un résultat visé aux alinéas 13(1)a) ou b).
Evidence of COVID-19 molecular test — elements Preuve du résultat de l’essai moléculaire COVID-19 —
éléments
(2) Evidence of a result for a COVID-19 molecular test (2) La preuve d’un résultat à un essai moléculaire relatif
must include the elements set out in paragraphs 14(a) to à la COVID-19 comprend les éléments prévus aux alinéas
(d). 14a) à d).
Person referred to in paragraph 17.3(2)(a) Personne visée à l’alinéa 17.3(2)a)

17.12 (1) Evidence that the person is a person referred 17.12 (1) La preuve qu’une personne est visée à l’alinéa
to in paragraph 17.3(2)(a) means a passport or other 17.3(2)a) comprend un passeport ou autre titre de voyage
travel document issued by their country of citizenship or délivré par son pays de citoyenneté ou de nationalité,
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nationality and a travel itinerary or boarding pass that l’itinéraire de voyage ou la carte d’embarquement qui dé-
shows that the initial scheduled departure time of the montre que l’heure de départ de l’aéronef prévue initiale-
person’s flight to an aerodrome in Canada is not more ment pour le vol à destination d’un aérodrome au Canada
than 24 hours after the departure time of a flight taken by est au plus tard vingt-quatre heures après l’heure de dé-
the person to Canada from any other country. part du vol que la personne a pris en partance de tout
autre pays à destination du Canada.
Person referred to in paragraph 17.3(2)(b) Personne visée à l’alinéa 17.3(2)b)

(2) Evidence that the person is a person referred to in (2) La preuve qu’une personne est visée à l’alinéa
paragraph 17.3(2)(b) means a passport or other travel 17.3(2)b) comprend un passeport ou autre titre de voyage
document issued by their country of citizenship or na- délivré par son pays de citoyenneté ou de nationalité, ou
tionality and a travel itinerary or boarding pass that qui n’ont pas de pays de citoyenneté ou de nationalité de
shows that the person is boarding an aircraft for a flight tout autre pays délivré à la personne et l’itinéraire de
to a country other than Canada or to an aerodrome in voyage ou la carte d’embarquement qui démontre que le
Canada for the purpose of boarding an aircraft for a flight vol de la personne est à destination de tout autre pays ou
to a country other than Canada. à destination d’un aérodrome au Canada dans le but de
monter à bord d’un autre aéronef pour un vol à destina-
tion de tout autre pays,.
Person referred to in any of subparagraphs Personne visée à l’un des sous-alinéas 17.3(2)c)(i) à
17.3(2)(c)(i) to (iv) (iv)
(3) Evidence that the person is a person referred to in (3) La preuve qu’une personne est visée à l’un des sous-
any of subparagraphs 17.3(2)(c)(i) to (iv) means a docu- alinéas 17.3(2)b)(i) à (iv) est le document délivré par le
ment issued by an air carrier under subsection 17.4(1) in transporteur aérien, en application du paragraphe
respect of the flight for which the person is boarding the 17.4(1), à l’égard du vol pour lequel la personne monte à
aircraft or entering the restricted area. bord de l’aéronef ou accède à la zone réglementée.
Person referred to in subparagraph 17.3(2)(d)(i) Personne visée au sous-alinéa 17.3(2)d)(i)

(4) Evidence that the person is a person referred to in (4) La preuve qu’une personne est visée au sous-alinéa
subparagraph 17.3(2)(d)(i) means a document from the 17.3(2)d)(i) est un document délivré par le ministre de la
Minister of Health that indicates that the person was Santé indiquant que la personne s’est fait demander
asked to enter Canada for the purpose of assisting in the d’entrer au Canada afin de participer aux efforts de lutte
COVID-19 response. contre la COVID-19.
Person referred to in subparagraph 17.3(2)(d)(ii) Personne visée au sous-alinéa 17.3(2)d)(ii)

(5) Evidence that the person is a person referred to in (5) La preuve que la personne est visée au sous-alinéa
subparagraph 17.3(2)(d)(ii) means a document from a 17.3(2)d)(ii) est un document délivré par un gouverne-
government or non-governmental entity that indicates ment ou une entité non gouvernementale indiquant que
that the person was asked to enter Canada for the pur- la personne s’est fait demander d’entrer au Canada afin
pose of providing emergency services under paragraph d’offrir des services d’urgences en vertu de l’alinéa 186t)
186(t) of the Immigration and Refugee Protection Regu- du Règlement sur l’immigration et la protection des ré-
lations. fugiés.
Person referred to in subparagraph 17.3(2)(d)(iii) Personne visée au sous-alinéa 17.3(2)d)(iii)

(6) Evidence that the person is a person referred to in (6) La preuve qu’une personne est visée au sous-alinéa
subparagraph 17.3(2)(d)(iii) means a document issued by 17.3(2)d)(iii) est un document délivré par le ministère de
the Department of Citizenship and Immigration that con- la Citoyenneté et de l’Immigration confirmant que la per-
firms that the person is a person who has been issued a sonne s’est vu délivrer un visa de résident permanent en
permanent resident visa under subsection 139(1) of the application du paragraphe 139(1) du Règlement sur l’im-
Immigration and Refugee Protection Regulations and migration et la protection des réfugiés et qu’elle, selon le
that the person is cas :
(a) a person whom the Immigration and Refugee a) s’est vu reconnaître, par la Commission de l’immi-
Board has determined to be a Convention refugee gration et du statut de réfugié, la qualité de réfugié au
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under subsection 107(1) of the Immigration and sens de la Convention [en application du paragraphe
Refugee Protection Act; or 107(1) de la Loi sur l’immigration et la protection des
réfugiés];
(b) a person in similar circumstances to those of a
Convention refugee within the meaning of subsection b) est dans une situation semblable à celle d’un réfu-
146(1) of those Regulations. gié au sens de la Convention au sens du paragraphe
146(1) de ce règlement.
Person referred to in any of subparagraph Personne visée aux sous-alinéas 17.3(2)d)(iv), (v) ou
17.3(2)(d)(iv) to (vi) (vi)
(7) Evidence that the person is a person referred to in (7) La preuve qu’une personne est visée aux sous-alinéas
any of subparagraphs 17.3(2)(d)(iv) to (vi) means a DI, 17.3(2)d)(iv), (v) ou (vi) comprend un visa DI, O1 ou C1
O1 or C1 visa and a document confirming that the person et un document confirmant que la personne monte à
is boarding an aircraft for a flight for a purpose related to bord de l’aéronef pour un vol pour des fins liées aux af-
diplomatic or consular affairs. faires diplomatiques ou consulaires.
False or misleading information Information fausse ou trompeuse

17.13 (1) A person must not submit a request referred 17.13 (1) Il est interdit à toute personne de fournir de
to in section 17.4 that contains information that they l’information dans le cadre d’une demande visée à l’ar-
know to be false or misleading. ticle 17.4, la sachant fausse ou trompeuse.

(2) A person must not provide evidence that they know (2) Il est interdit à toute personne de présenter une
to be false or misleading. preuve, la sachant fausse ou trompeuse.
Notice to Minister — information Avis au ministre

17.14 (1) An air carrier that has reason to believe that a 17.14 (1) Le transporteur aérien qui a des raisons de
person has submitted a request referred to in section 17.4 croire qu’une personne lui a fourni de l’information dans
that contains information that is likely to be false or mis- le cadre d’une demande visée à l’article 17.4 susceptible
leading must notify the Minister of the following not d’être fausse ou trompeuse informe le ministre, au plus
more than 72 hours after the air carrier received the retard soixante-douze heures après la réception de la de-
quest: mande, de ce qui suit :
(a) the person’s name and contact information; a) des prénom et nom de la personne ainsi que de ses
coordonnées,
(b) the date and number of the person’s flight; and
b) de la date et du numéro de son vol;
(c) the reason the air carrier believes that the infor-
mation is likely to be false or misleading. c) les raisons pour lesquelles le transporteur aérien
croit que l’information est susceptible d’être fausse ou
trompeuse.
Notice to Minister — evidence

(2) An air carrier or screening authority that has reason (2) Le transporteur aérien ou l’administration de
to believe that a person has provided evidence that is contrôle qui a des raisons de croire qu’une personne lui a
likely to be false or misleading must notify the Minister présenté une preuve susceptible d’être fausse ou trom-
of the following not more than 72 hours after the provi- peuse informe le ministre, au plus tard soixante-douze
sion of the evidence: heures après la présentation de la preuve, de ce qui suit :
(a) the person’s name and contact information; a) des prénom et nom de la personne ainsi que de ses
coordonnées,
b) de la date et du numéro de son vol;
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(c) the reason the air carrier or screening authority c) les raisons pour lesquelles le transporteur aérien
believes that the evidence is likely to be false or ou l’administration de contrôle croit que la preuve est
misleading. susceptible d’être fausse ou trompeuse.
Prohibition — air carrier Interdiction — transporteur aérien

17.15 An air carrier must not permit a person to board 17.15 Il est interdit au transporteur aérien de permettre
an aircraft for a flight that the air carrier operates if the à une personne de monter à bord d’un aéronef pour un
person does not provide the evidence they are required to vol qu’il effectue lorsque la personne ne présente pas la
provide under section 17.9. preuve exigée par l’article 17.9.
Prohibition — screening authority Interdiction – administration de contrôle

17.16 (1) A screening authority must not permit a per- 17.16 (1) Il est interdit à l’administration de contrôle de
son to enter a restricted area if the person does not pro- permettre l’accès à une zone réglementée à une personne
vide the evidence they are required to provide under sec- qui ne présente pas la preuve exigée par l’article 17.9.
tion 17.9.
Notification to air carrier Avis au transporteur aérien

(2) If a screening authority denies a person entry to a re- (2) L’administration de contrôle qui refuse à une per-
stricted area, the screening authority must notify the air sonne l’accès à une zone réglementée en avise le trans-
carrier operating the flight that the person has been de- porteur aérien qui effectue le vol et lui fournit les prénom
nied entry and provide the person’s name and flight et nom de cette personne et le numéro de son vol.
number to the air carrier.
Air carrier requirements Exigences du transporteur aérien

(3) An air carrier that has been notified under subsection (3) Le transporteur aérien avisé, en application du para-
(3) must ensure that the person is escorted to a location graphe (3), veille à ce que la personne soit escortée jus-
where they can retrieve their checked baggage, as de- qu’à l’endroit où elle peut récupérer ses bagages enre‐
fined in section 3 of the Canadian Aviation Security Reg- gistrés, au sens de l’article 3 du Règlement canadien de
ulations, 2012, if applicable. 2012 sur la sûreté aérienne, le cas échéant.
Record keeping — air carrier Tenue de registre — transporteur aérien

17.17 (1) An air carrier must keep a record of the fol- 17.17 (1) Le transporteur aérien consigne dans un re-
lowing information in respect of a person each time the gistre les renseignements ci-après à l’égard d’une per-
person is denied permission to board an aircraft under sonne chaque fois qu’elle s’est vu refuser de monter à
subsection 17.15(1): bord d’un aéronef pour un vol en application du para-
graphe 17.15(1):
(a) the person’s name and contact information, in-
cluding the person’s home address, telephone number a) les prénom et nom de la personne ainsi que ses co-
and email address; ordonnées, y compris son adresse de résidence, son
numéro de téléphone et son adresse de courriel;
(b) the date and flight number;
b) la date et le numéro du vol;
(c) the reason why the person was denied permission
to board the aircraft; and c) le motif pour lequel la personne s’est vu refuser de
monter à bord de l’aéronef;
(d) whether the person had been issued a document
under subsection 17.4(1) in respect of the flight. d) si la personne s’est vu délivrer un document, en ap-
plication du paragraphe 17.4(1), à l’égard du vol.
(2) The air carrier must retain the record for a period of (2) Il conserve le registre pendant au moins douze mois
at least 12 months after the date of the flight. après la date du vol.
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Record keeping — screening authority Tenue de registre — administration de contrôle

17.18 (1) A screening authority must keep a record of 17.18 (1) L’administration de contrôle consigne dans
the following information in respect of a person each un registre les renseignements ci-après à l’égard d’une
time the person is denied entry to a restricted area under personne chaque fois qu’elle s’est vu refuser l’accès à une
subsection 17.16(1): zone réglementée en application du paragraphe 17.16(1):
(a) the person’s name; a) les prénom et nom de la personne;
(b) the date and flight number; and b) la date et le numéro du vol;
(c) the reason why the person was denied entry to the c) le motif pour lequel la personne s’est vu refuser
restricted area. l’accès à la zone réglementée.
(2) The screening authority must retain the record for a (2) Elle conserve le registre pendant au moins douze
period of at least 12 months after the day on which it was mois après la date de sa création.
created.

(3) The screening authority must make the record avail- (3) Elle met le registre à la disposition du ministre à la
able to the Minister on request. demande de celui-ci.
[17.19 reserved] [17.19 réservé]
Policy Respecting Mandatory Politique à l’égard de la

Vaccination vaccination obligatoire
17.20 Sections 17.21 to 17.25 apply to 17.20 Les articles 17.21 à 17.25 s’appliquent :
(a) the operator of an aerodrome listed in Schedule 2; a) à l’exploitant d’un aérodrome visé à l’annexe 2;
(b) an air carrier operating a flight departing from an b) au transporteur aérien qui effectue un vol en par-
aerodrome listed in Schedule 2, other than an air car- tance d’un aérodrome visé à l’annexe 2, à l’exception
rier who operates a commercial air service under Sub- de l’exploitant d’un service aérien commercial visé à la
part 1 of Part VII of the Regulations; and sous-partie 1 de la partie VII du Règlement;
(c) NAV CANADA. c) à NAV CANADA.
Definition of relevant person Définition de personne concernée

17.21 (1) For the purposes of sections 17.22 to 17.25, 17.21 (1) Pour l’application des articles 17.22 à 17.25,
relevant person, in respect of an entity referred to in personne concernée s’entend, à l’égard d’une entité vi-
section 17.20, means a person whose duties involve an ac- sée à l’article 17.20, de toute personne dont les tâches
tivity described in subsection (2) and who is concernent une activité visée au paragraphe (2) et qui, se-
lon le cas :
(a) an employee of the entity;
a) est un employé de l’entité;
(b) an employee of the entity’s contractor or agent or
mandatary;
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(c) a person hired by the entity to provide a service; b) est un employé d’un entrepreneur ou d’un manda-
taire de l’entité;
(d) the entity’s lessee or an employee of the entity’s
lessee, if the property that is subject to the lease is part c) est embauchée par l’entité pour offrir un service;
of aerodrome property; or
d) est un locataire de l’entité ou un employé d’un loca-
(e) a person permitted by the entity to access aero- taire de l’entité, si les lieux faisant l’objet du bail font
drome property or, in the case of NAV CANADA, a lo- partie des terrains de l’aérodrome;
cation where NAV CANADA provides civil air naviga-
tion services. e) a l’autorisation de l’entité pour accéder aux terrains
de l’aérodrome ou, dans le cas de NAV CANADA, à un
emplacement où celle-ci fournit des services de navi-
gation aérienne civile.
Activities Activités
(2) For the purposes of subsection (1), the activities are (2) Pour l’application du paragraphe (1), les activités
sont :
(a) conducting or directly supporting activities that
are related to commercial flight operations — such as a) la conduite d’activités qui sont liées à l’exploitation
aircraft refuelling services, aircraft maintenance and des vols commerciaux — telles que les services de ravi-
repair services, baggage handling services, supply ser- taillement des aéronefs, les services d’entretien et de
vices for the operator of an aerodrome, an air carrier réparation d’aéronefs, les services de manutention des
or NAV CANADA, runway and taxiway maintenance bagages, les services d’approvisionnement fournis à
services or de-icing services — and that take place on l’exploitant d’un aérodrome, à un transporteur aérien
aerodrome property or at a location where NAV ou à NAV CANADA, les services d’entretien des pistes
CANADA provides civil air navigation services; et des voies de circulation et les services de dégivrage
— qui se déroulent aux terrains de l’aérodrome ou à
(b) interacting in-person on aerodrome property with un emplacement où NAV CANADA fournit des ser-
a person who intends to board an aircraft for a flight; vices de navigation aérienne civile, et le soutien direct
à de telles activités;
(c) engaging in tasks, on aerodrome property or at a
location where NAV CANADA provides civil air navi- b) l’interaction en présentiel aux terrains de l’aéro-
gation services, that are intended to reduce the risk of drome avec quiconque a l’intention de monter à bord
transmission of the virus that causes COVID-19; and d’un aéronef pour un vol;
(d) accessing a restricted area at an aerodrome listed c) l’exécution, aux terrains de l’aérodrome ou à un
in Schedule 2. emplacement où NAV CANADA fournit des services
de navigation aérienne civile, de tâches qui ont pour
but de réduire le risque de transmission du virus de la
COVID-19;
d) l’accès à une zone réglementée d’un aérodrome visé

à l’annexe 2.
Comprehensive policy — operators of aerodromes Politique globale — exploitant d’un aérodrome

17.22 (1) The operator of an aerodrome must establish 17.22 (1) L’exploitant d’un aérodrome établit et met en
and implement a comprehensive policy respecting œuvre une politique globale à l’égard de la vaccination
mandatory COVID-19 vaccination in accordance with obligatoire contre la COVID-19 qui est conforme au para-
subsection (2). graphe (2).
Policy — content Politique — contenu

(2) The policy must (2) La politique de vaccination doit :
(a) require that as of November 15, 2021, a person a) exiger que, à compter du 15 novembre 2021, toute
who is 12 years and four months of age or older be a personne âgée de douze ans et quatre mois ou plus
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fully vaccinated person before accessing aerodrome soit une personne entièrement vaccinée pour pouvoir
property, other than a person accéder aux terrains de l’aérodrome, sauf :
(i) who intends to board an aircraft for a flight that (i) si elle a l’intention de monter à bord d’un aéro-
an air carrier operates, nef pour un vol qu’un transporteur aérien effectue,
(ii) who does not intend to board an aircraft for a (ii) si elle n’a pas l’intention de monter à bord d’un
flight and who is accessing aerodrome property for aéronef et accède aux terrains de l’aérodrome à des
leisure purposes or to accompany a person who in- fins de loisirs ou pour accompagner une personne
tends to board an aircraft for a flight, qui a l’intention de monter à bord d’un aéronef
pour un vol,
(iii) who is the holder of an employee identification
document issued by a department or departmental (iii) si elle est titulaire d’une pièce d’identité d’em-
corporation listed in Schedule 3 or a member iden- ployé délivrée par un ministère ou un établissement
tification document issued by the Canadian Forces, public visé à l’annexe 3 ou d’une pièce d’identité de
or membre délivrée par les Forces canadiennes,
(iv) who is delivering equipment or providing ser- (iv) qui effectue, dans une zone réglementée, la
vices within the restricted area of the aerodrome fourniture d’équipements ou de services qui sont
that are critical to aerodrome operations; essentiels aux activités de l’aérodrome;
(b) despite paragraph (a), allow a person who is sub- b) malgré l’alinéa a), permettre à la personne assujet-
ject to the policy and who is not a fully vaccinated per- tie à la politique qui n’est pas une personne entière-
son to access aerodrome property if the person ment vaccinée d’accéder aux terrains de l’aérodrome
la personne :
(i) has not completed a COVID-19 vaccine dosage
regimen due to a medical contraindication or a sin- (i) n’a pas suivi un protocole vaccinal complet
cerely held religious belief, or contre la COVID-19 en raison d’une contre-indica-
tion médicale ou d’une croyance religieuse sincère,
(ii) received the first dose of a COVID-19 vaccine
dosage regimen before November 15, 2021; (ii) a reçu sa première dose du protocole vaccinal
contre la COVID-19 avant le 15 novembre 2021;
(c) provide for a procedure for verifying evidence pro-
vided by a person referred to in paragraph (b) that c) prévoir une procédure permettant de vérifier la
demonstrates that the person preuve présentée par la personne visée à l’alinéa b) dé-
montrant qu’elle:
regimen due to a medical contraindication or their (i) n’a pas suivi un protocole vaccinal complet
sincerely held religious beliefs, or contre la COVID-19 en raison d’une contre-indica-
(d) provide for a procedure for issuing to a person
whose evidence has been verified under the procedure d) prévoir une procédure permettant de délivrer un
referred to in paragraph (c) a document confirming document à la personne dont la preuve a été vérifiée,
that they are a person referred to in subparagraph en application de la procédure visée à l’alinéa c), qui
(b)(i) or (ii); confirme qu’elle est une personne visée aux sous-ali-
néas b)(i) ou (ii);
(e) provide for a procedure that ensures that a person
subject to the policy provides, on request, the follow- e) prévoir une procédure permettant de veiller à ce
ing evidence before accessing aerodrome property: que la personne assujettie à la politique présente sur
demande la preuve ci-dessous avant d’accéder aux ter-
(i) in the case of a fully vaccinated person, the evi- rains de l’aérodrome :
dence of COVID-19 vaccination referred to in sec-
tion 17.10, and
23
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(ii) in the case of a person referred to in paragraph (i) dans le cas d’une personne entièrement vacci-
(d), the document issued to the person under that née, la preuve de vaccination contre la COVID-19
procedure; décrite à l’article 17.10,
(f) provide for a procedure that allows a person to (ii) dans le cas d’une personne visée à l’alinéa d), le
whom sections 17.31 to 17.40 apply — other than a document qui lui a été délivré en application de la
person referred to in subsection 17.34(2) — who is a procédure;
fully vaccinated person or a person referred to in sub-
paragraph (b)(i) or (ii) and who is unable to provide f) prévoir une procédure permettant à la personne as-
the evidence referred to in paragraph (e), to temporar- sujettie aux articles 17.31 à 17.40, à l’exception de celle
ily access aerodrome property if they provide a decla- visée au paragraphe 17.34(2), qui est une personne en-
ration confirming that they are a fully vaccinated per- tièrement vaccinée ou une personne visée aux sous-
son or that they have been issued a document under alinéas b)(i) ou (ii) et qui n’est pas en mesure de pré-
the procedure referred to in paragraph (d); senter la preuve visée à l’alinéa e) d’accéder
temporairement aux terrains de l’aérodrome si elle
(g) provide for a procedure that ensures that a person présente une déclaration confirmant qu’elle est une
referred to in paragraph (d) is tested for COVID-19 at personne entièrement vaccinée ou qu’elle s’est vu déli-
least twice every week; vrer un document en application de la procédure visée
à l’alinéa d);
(h) provide for a procedure that ensures that a person
who receives a positive result for a COVID-19 test, oth- g) prévoir une procédure permettant de veiller à ce
er than a COVID-19 molecular test, under the proce- que la personne visée à l’alinéa d) se soumette à un es-
dure referred to in paragraph (g) receives a result for a sai relatif à la COVID-19 au moins bihebdomadaire-
COVID-19 molecular test; ment;
(i) provide for a procedure that ensures that a person h) prévoir une procédure permettant de veiller à ce
who receives a positive result for a COVID-19 molecu- que la personne qui a reçu un résultat positif à un es-
lar test under the procedure referred to in paragraph sai relatif à la COVID-19, autre qu’un essai moléculaire
(g) or (h) is prohibited from accessing aerodrome relatif à la COVID-19, en application de la procédure
property for a period of 14 days after the result was re- visée à l’alinéa g), obtienne un résultat d’un essai mo-
ceived or until the person is not exhibiting any of the léculaire relatif à la COVID-19;
symptoms referred to in subsection 8(1), whichever is
later; and i) prévoir une procédure permettant de veiller à ce
que la personne qui a reçu un résultat positif à un es-
(j) provide for a procedure that ensures that a person sai moléculaire relatif à la COVID-19 en application de
referred to in paragraph (i) is exempt from the rela procédure visée aux alinéas g) ou h) ne puisse accé-
quirement referred to in paragraph (g) for a period of der aux terrains de l’aérodrome pour la période de
180 days after the person received a positive result for quatorze jours suivant la réception du résultat ou jus-
a COVID-19 molecular test. qu’à ce qu’elle ne présente pas des symptômes prévus
au paragraphe 8(1), selon la plus tardive des éventuali-
tés;
j) prévoir une procédure permettant de veiller à ce

que la personne visée à l’alinéa i) soit exemptée de
l’exigence visée à l’alinéa g) pour la période de cent
quatre-vingts jours suivant la réception d’un résultat
positif à un essai moléculaire relatif à la COVID-19.
Medical contraindication Contre-indication médicale

(3) For the purposes of subparagraph (2)(c)(i) and para- (3) Pour l’application du sous-alinéa 2(c)(i) et de l’alinéa
graph (2)(d), the policy must provide for a procedure for (2)d), la politique doit prévoir que le document confir-
issuing to a person a document confirming that they did mant la raison pour laquelle une personne n’a pas suivi
not complete a COVID-19 vaccine dosage regimen on the un protocole vaccinal complet contre la COVID-19 n’est
basis of a medical contraindication only if they provide a délivré à la personne pour le motif d’une contre-indica-
medical certificate from a medical doctor or nurse practi- tion médicale que si elle soumet un certificat médical
tioner who is licensed to practice in Canada certifying d’un médecin ou d’un infirmier praticien autorisé à
24
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that the person cannot complete a COVID-19 vaccination pratiquer au Canada attestant que la personne ne peut
regimen due to a medical condition and specifying pas suivre un protocole vaccinal complet contre la CO-
whether the condition is permanent or temporary. VID-19 en raison d’une condition médicale et précisant si
cette condition est permanente ou temporaire.
Religious belief Croyance religieuse

issuing to a person a document confirming that they did mant la raison pour laquelle une personne n’a pas suivi
not complete a COVID-19 vaccine dosage regimen on the un protocole vaccinal complet contre la COVID-19 n’est
basis of their sincerely held religious belief only if they délivré à la personne pour le motif d’une la croyance reli-
submit an attestation, sworn by them, that they have not gieuse sincère de la personne que si elle fournit une dé-
completed a COVID-19 vaccination regimen due to their claration sous serment attestant qu’elle n’a pas suivi un
sincerely held religious beliefs. protocole vaccinal complet contre la COVID-19 en raison
de sa croyance religieuse sincère.
Canadian Human Rights Act Loi canadienne sur les droits de la personne
graph (2)(d), in the case of an employee of the operator of (2)d), dans le cas de l’employé de l’exploitant d’un aéro-
an aerodrome or a person hired by the operator of an drome ou de la personne qui est embauchée par l’exploi-
aerodrome to provide a service, the policy must provide tant de l’aérodrome pour offrir un service, la politique
for a procedure for issuing to the employee or person a doit prévoir que le document confirmant la raison pour
document confirming that they did not complete a laquelle il n’a pas suivi de protocole vaccinal complet
COVID-19 vaccine dosage regimen on the basis of their contre la COVID-19 n’est délivré en raison d’une
sincerely held religious beliefs only if the operator of the croyance religieuse sincère que si l’exploitant de l’aéro-
aerodrome is obligated to accommodate them on the ba- drome a l’obligation de prendre des mesures d’adapta-
sis of this ground under the Canadian Human Rights Act tion pour ce motif aux termes de la Loi canadienne sur
by issuing such a document. les droits de la personne en délivrant un tel document.
Applicable legislation Législation applicable

graph (2)(d), in the following cases, the policy must pro- (2)d), dans les cas ci-après, la politique doit prévoir que
vide for a procedure for issuing to the employee a docu- le document confirmant la raison pour laquelle le proto-
ment confirming that they did not complete a COVID-19 cole vaccinal complet contre la COVID-19 n’a pas été sui-
vaccine dosage regimen on the basis of their sincerely vi n’est délivré en raison de la croyance religieuse sincère
held religious beliefs only if they would be entitled to que si la personne a droit à une telle une mesure d’adap-
such an accommodation on the basis of this ground un- tation pour ce motif aux termes de la législation appli-
der applicable legislation: cable :
(a) in the case of an employee of the operator of an a) le cas d’un employé d’un entrepreneur ou d’un
aerodrome’s contractor or agent or mandatary; and mandataire de l’exploitant d’un aérodrome;
(b) in the case of an employee of the operator of an b) le cas d’un l’employé d’un locataire de l’exploitant
aerodrome’s lessee, if the property that is subject to d’un aérodrome, si les lieux faisant l’objet du bail font
the lease is part of aerodrome property. partie des terrains de l’aérodrome.
Comprehensive policy — air carriers and NAV Politique globale — transporteur aérien et NAV
CANADA CANADA
17.23 Section 17.24 does not apply to an air carrier or 17.23 L’article 17.24 ne s’applique pas au transporteur
NAV CANADA if that entity aérien ou à NAV CANADA, si cette entité :
(a) establishes and implements a comprehensive poli- a) d’une part, établit et met en œuvre une politique
cy respecting mandatory COVID-19 vaccination in ac- globale à l’égard de la vaccination obligatoire contre la
cordance with paragraphs 17.24(2)(a) to (i) and sub- COVID-19 qui est conforme aux alinéas 17.24(2)a) à i)
sections 17.24(3) to (6); and et aux paragraphes 17.24(3) à (6);
25
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Draft Ébauche
(b) has procedures in place to ensure that while a rele- b) d’autre part, possède des procédures permettant de
vant person is carrying out their duties related to com- veiller à ce que la personne concernée lors de l’exécu-
mercial flight operations, no in-person interactions tion de ses tâches liées à l’exploitation de vols com-
occur between the relevant person and an unvaccinat- merciaux n’ait aucune interaction en personne avec
ed person who has not been issued a document under toute personne non-vaccinée qui ne s’est pas vu déli-
the procedure referred to in 17.24(2)(d) and who is vrer un document en application de l’alinéa 17.24(2)d)
et qui est :
(i) an employee of the entity,
(i) un employé de l’entité,
(ii) an employee of the entity’s contractor or agent
or mandatary, (ii) un employé d’un entrepreneur ou d’un manda-
taire de l’entité,
(iii) a person hired by the entity to provide a ser-
vice, or (iii) une personne qui est embauché par l’entité
pour offrir un service,
(iv) the entity’s lessee or an employee of the enti-
ty’s lessee, if the property that is subject to the lease (iv) un locataire de l’entité ou un employé d’un lo-
is part of aerodrome property. cataire de l’entité, si les lieux faisant l’objet du bail
fait partie des terrains de l’aérodrome.
Targeted policy — air carriers and NAV CANADA Politique ciblée — transporteur aérien et NAV
CANADA
17.24 (1) An air carrier or NAV CANADA must estab- 17.24 (1) Le transporteur aérien ou NAV CANADA éta-
lish and implement a targeted policy respecting manda- blit et met en œuvre une politique ciblée à l’égard de la
tory COVID-19 vaccination in accordance with subsec- vaccination obligatoire contre la COVID-19 qui est
tion (2). conforme au paragraphe (2).

(a) require that as of November 15, 2021, a relevant a) exiger que, à compter du 15 novembre 2021, toute
person, other than the holder of an employee identifi- personne concernée, à l’exception du titulaire d’une
cation document issued by a department or depart- pièce d’identité d’employé délivrée par un ministère
mental corporation listed in Schedule 3 or a member ou un établissement public visé à l’annexe 3 ou d’une
identification document issued by the Canadian pièce d’identité de membre délivrée par les Forces ca-
Forces, be a fully vaccinated person before accessing nadiennes, soit une personne entièrement vaccinée
aerodrome property or, in the case of NAV CANADA, a pour pouvoir accéder aux terrains de l’aérodrome ou,
location where NAV CANADA provides civil air navi- dans le cas de NAV CANADA, à un emplacement où
gation services; NAV CANADA fournit des services de navigation aé-
rienne civile;
(b) despite paragraph (a), allow a relevant person who
is subject to the policy and who is not a fully vaccinat- b) malgré l’alinéa a), permettre à la personne concer-
ed person to access aerodrome property or, in the case née assujettie à la politique qui n’est pas une personne
of NAV CANADA, a location where NAV CANADA entièrement vaccinée d’accéder aux terrains de l’aéro-
provides civil air navigation services, if the relevant drome ou, dans le cas de NAV CANADA, à un empla-
person cement où NAV CANADA fournit des services de navi-
gation aérienne civile si la personne :
sincerely held religious beliefs, or contre la COVID-19 en raison d’une contre-indica-
26
AR04349
Draft Ébauche
(c) provide for a procedure for verifying evidence pro- c) prévoir une procédure permettant de vérifier la
vided by a relevant person referred to in paragraph (b) preuve présentée par la personne concernée visée à
that demonstrates that the relevant person l’alinéa b) démontrant qu’elle:
(i) has not completed a COVID-19 vaccine dosage (i) n’a pas suivi un protocole vaccinal complet
regimen due to a medical contraindication or their contre la COVID-19 en raison d’une contre-indica-
sincerely held religious beliefs, or tion médicale ou d’une croyance religieuse sincère,
(ii) received the first dose of a COVID-19 vaccine (ii) a reçu sa première dose du protocole vaccinal
dosage regimen before November 15, 2021; contre la COVID-19 avant le 15 novembre 2021;
(d) provide for a procedure for issuing to a relevant d) prévoir une procédure permettant de délivrer un
person whose evidence has been verified under the document à la personne concernée dont la preuve a
procedure referred to in paragraph (c) a document été vérifiée, en application de la procédure visée à l’ali-
confirming that they are a relevant person referred to néa c), qui confirme qu’elle est une personne concer-
in paragraph (b); née visée aux sous-alinéas b)(i) ou (ii);
(e) provide for a procedure that ensures that a rele- e) prévoir une procédure permettant de veiller à ce
vant person subject to the policy provides, on request, que la personne concernée assujettie à la politique
the following evidence before accessing aerodrome présente sur demande la preuve ci-dessous avant d’ac-
property: céder aux terrains de l’aérodrome :
(i) in the case of a fully vaccinated person, the evi- (i) dans le cas d’une personne entièrement vacci-
dence of COVID-19 vaccination referred to in sec- née, la preuve de vaccination contre la COVID-19
tion 17.10, and décrite à l’article 17.10 ,
(ii) in the case of a relevant person referred to in (ii) dans le cas d’une personne concernée visée à
paragraph (d), the document issued to the relevant l’alinéa d), le document qui lui a été délivré en ap-
person under that procedure; plication de la procédure;
(f) provide for a procedure that ensures that a rele- f) prévoir une procédure permettant de veiller à ce
vant person referred to in paragraph (d) is tested for que la personne concernée visée à l’alinéa d) se sou-
COVID-19 at least twice every week; mette à un essai relatif à la COVID-19 au moins biheb-
domadairement;
(g) provide for a procedure that ensures that a rele-
vant person who receives a positive result for a g) prévoir une procédure permettant de veiller à ce
COVID-19 test, other than a COVID-19 molecular test, que la personne concernée qui a reçu un résultat posi-
under the procedure referred to in paragraph (f) re- tif à un essai relatif à la COVID-19, autre qu’un essai
ceives a result for a COVID-19 molecular test; moléculaire relatif à la COVID-19, en application de la
procédure visée à l’alinéa f), obtienne un résultat d’un
(h) provide for a procedure that ensures that a rele- essai moléculaire relatif à la COVID-19;
vant person who receives a positive result for a
COVID-19 molecular test under the procedure re- h) prévoir une procédure permettant de veiller à ce
ferred to in paragraph (f) or (g) is prohibited from ac- que la personne concernée qui a reçu un résultat posi-
cessing aerodrome property for a period of 14 days af- tif à un essai moléculaire relatif à la COVID-19 en ap-
ter the result was received or until the relevant person plication de la procédure visée aux alinéas f) ou g) ne
is not exhibiting any of the symptoms referred to in puisse accéder aux terrains de l’aérodrome pour la pé-
subsection 8(1), whichever is later; riode de quatorze jours suivant la réception du résultat
ou jusqu’à ce qu’elle ne présente plus des symptômes
(i) provide for a procedure that ensures that a relevant prévus au paragraphe 8(1), selon la plus tardive des
person referred to in paragraph (h) is exempt from the éventualités;
requirement referred to in paragraph (d) for a period
of 180 days after the relevant person received a posi- i) prévoir une procédure permettant de veiller à ce
tive result for a COVID-19 molecular test; que la personne visée à l’alinéa h) soit exemptée de
l’exigence visée à l’alinéa f) pour une période de cent
(j) set out procedures for reducing the risk that a rele- quatre-vingts jours suivant la réception d’un résultat
vant person will be exposed to the virus that causes positif à un essai moléculaire relatif à la COVID-19;
27
AR04350
Draft Ébauche
COVID-19 due to an in-person interaction occurring j) prévoir une procédure visant à réduire le risque
on aerodrome property or at a location where NAV d’exposition au virus qui cause la COVID-19 pour les
CANADA provides civil air navigation services with an personnes concernées à la suite des interactions en
unvaccinated person who has not been issued a docu- personne, aux terrains de l’aérodrome ou à un empla-
ment under the procedure referred to in paragraph (d) cement où NAV CANADA fournit des services de navi-
and who is a person referred to in subparagraph gation aérienne civile, avec des personnes non-vacci-
17.23(b)(i), (ii), (iii) or (iv), which may include proto- nées ne s’étant pas vu délivrer un document en
cols related to application de l’alinéa d) et qui sont visées à l’un des
sous-alinéas 17.23b)(i) à (iv), procédure pouvant com-
(i) the vaccination of persons, other than relevant prendre des protocoles à l’égard :
persons, who access aerodrome property or a loca-
tion where NAV CANADA provides civil air naviga- (i) de la vaccination des personnes, autres que les
tion services, personnes concernées, qui accèdent aux terrains de
l’aérodrome ou à un emplacement où NAV
(ii) physical distancing and the wearing of masks, CANADA fournit des services de navigation aé-
and rienne civile,
(iii) reducing the frequency and duration of in-per- (ii) de la distanciation physique et du port du
son interactions; masque,
(k) establish a procedure for collecting the following (iii) de la restriction et de la durée des interactions
information with respect to an in-person interaction en personne;
related to commercial flight operations between a rele-
vant person and a person referred to in subparagraph k) établir une procédure pour colliger les renseigne-
17.23(b)(i), (ii), (iii) or (iv) who is unvaccinated and ments ci-après à l’égard des interactions en personne
has not been issued a document under the procedure découlant de l’exploitation de vols commerciaux entre
referred to in paragraph (d) or whose vaccination sta- une personne concernée et une personne qui est visée
tus is unknown: à l’un des sous-alinéas 17.23b)(i) à (iv) qui n’est pas
vaccinée et qui ne s’est pas vu délivrer un document en
(i) the time, date and location of the interaction, application de l’alinéa d) ou une personne dont le sta-
and tut de vaccination est inconnu :
(ii) contact information for the relevant person and (i) la date, l’heure et l’endroit de l’interaction,
the other person;
(ii) les coordonnées de la personne concernée et de
(l) establish a procedure for recording the following l’autre personne;
information and submitting it to the Minister on re-
quest: l) établir une procédure afin de consigner et de trans-
mettre, à la demande du ministre, les renseignements
(i) the number of relevant persons who are subject suivants :
to the entity’s policy,
(i) le nombre de personnes concernées qui sont vi-
(ii) the number of relevant persons who require ac- sées par la politique de l’entité,
cess to a restricted area,
(ii) le nombre de personnes concernées qui doivent
(iii) the number of relevant persons who accéder aux zones réglementées de l’aérodrome,
(A) are fully vaccinated persons, (iii) le nombre de personnes concernées qui :
(B) have received the first dose of a COVID-19 (A) sont entièrement vaccinées,
vaccine dosage regimen, and
(B) ont reçu leur première dose du protocole
(C) are unvaccinated persons, vaccinal contre la COVID-19,
(iv) the number of hours during which relevant (C) ne sont pas vaccinées,
persons were unable to fulfill their duties related to
commercial flight operations due to COVID-19,
28
AR04351
Draft Ébauche
(v) the number of relevant persons who have been (iv) le nombre d’heures au cours desquelles les per-
issued a document under the procedure referred to sonnes concernées n’ont pu accomplir leurs tâches
in paragraph (d), the reason for issuing the docu- liées à l’exploitation de vols commerciaux à cause
ment and a confirmation that the relevant persons de la COVID-19,
have submitted evidence of COVID-19 tests in ac-
cordance with the requirements referred to in para- (v) le nombre de personnes concernées qui se sont
graphs (f) and (g), faites délivrer un document en application de l’ali-
néa d), la raison invoquée, et une confirmation que
(vi) the number of relevant persons who refuse to ces personnes ont soumis une preuve d’un essai re-
comply with a requirement referred to in paragraph latif à la COVID-19 conformément aux exigences
(a), (f), (g) or (h), prévues aux alinéas f) et g),
(vii) the number of relevant persons who were de- (vi) le nombre de personnes concernées qui ont re-
nied entry to a restricted area because of a refusal fusé de se conformer aux exigences prévues aux ali-
to comply with a requirement referred to in para- néas a), f), g) ou h),
graph (a), (f), (g) or (h),
(vii) le nombre de personnes concernées qui se
(viii) the number of persons referred to in subpara- sont vu refuser l’accès à une zone réglementée à
graphs 17.23(b)(i) to (iv) who are unvaccinated and cause de leur refus de se conformer aux exigences
who have not been issued a document under the prévues aux alinéas a), f), g), ou h),
procedure referred to in paragraph (d), or whose
vaccination status is unknown, who have an in-per- (viii) le nombre de personnes visées à l’un des
son interaction related to commercial flight opera- sous-alinéas 17.23b)(i) à (iv) qui sont non-vaccinées
tions with a relevant person and a description of et qui ne se sont pas fait délivrer un document en
any procedures implemented to reduce the risk that application de l’alinéa d), ou dont le statut de vacci-
a relevant person will be exposed to the virus that nation est inconnu qui interagissent en personne
causes COVID-19 due to such an interaction, and avec des personnes concernées découlant de l’ex-
ploitation de vols commerciaux, de même qu’une
(ix) the number of instances in which the air carri- description des procédures mises en place afin de
er or NAV CANADA, as applicable, is made aware réduire le risque, pour les personnes concernées,
that a person with respect to whom information d’exposition au virus de la COVID-19, à la suite de
was collected under paragraph (k) received a posi- ces interactions,
tive result for a COVID-19 test, the number of rele-
vant persons tested for COVID-19 as a result of this (ix) le nombre d’occasions où le transporteur aé-
information, the results of those tests and a de- rien ou NAV CANADA, selon le cas, a été informé
scription of any impacts on commercial flight oper- qu’une personne dont les renseignements ont été
ations; and colligés en application de l’alinéa k) a reçu un résul-
tat positif pour essai relatif à la COVID-19, le
(m) require the air carrier or NAV CANADA, as appli- nombre de personnes concernées soumises à un es-
cable, to keep the information referred to in paragraph sai relatif à la COVID-19 découlant de cette infor-
(l) for a period of at least 12 months after the date that mation, les résultats de ces essais et l’incidence sur
the information was recorded. l’exploitation de vols commerciaux;
m) exiger que le transporteur aérien ou NAV

CANADA, selon le cas, conserve les renseignements
visés à l’alinéa l) pour une période d’au moins de
douze mois après la date à laquelle ils ont été colligés.

(3) For the purposes of subparagraph (2)(c)(i) and para- (3) Pour l’application du sous sous-alinéa 2(c)(i) et de
graph (2)(d), the policy must provide for a procedure for l’alinéa (2)d), la politique doit prévoir que le document
issuing to a relevant person a document confirming that confirmant la raison pour laquelle une personne concer-
they did not complete a COVID-19 vaccine dosage regi- née n’a pas suivi un protocole vaccinal complet contre la
men on the basis of a medical contraindication only if COVID-19 n’est délivré à la personne pour le motif d’une
they provide a medical certificate from a medical doctor contre-indication médicale que si elle soumet un certifi-
or nurse practitioner who is licensed to practice in cat médical d’un médecin ou d’un infirmier praticien
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Canada certifying that the relevant person cannot com- autorisé à pratiquer au Canada attestant que la personne
plete a COVID-19 vaccination regimen due to a medical ne peut pas suivre un protocole vaccinal complet contre
condition and specifying whether the condition is perma- la COVID-19 en raison d’une condition médicale et préci-
nent or temporary. sant si cette condition est permanente ou temporaire.

issuing to a relevant person a document confirming that mant la raison pour laquelle une personne concernée n’a
they did not complete a COVID-19 vaccine dosage regi- pas suivi un protocole vaccinal complet contre la CO-
men on the basis of their sincerely held religious belief VID-19 n’est délivré à la personne pour le motif de la
only if they submit an attestation, sworn by them, that croyance religieuse sincère de la personne que si elle
they have not completed a COVID-19 vaccination regi- fournit une déclaration sous serment attestant qu’elle n’a
men due to their sincerely held religious beliefs. pas suivi un protocole vaccinal complet contre la CO-
VID-19 en raison de sa croyance religieuse sincère.
graph (2)(d), in the case of an employee of an entity or a (2)d), dans le cas de l’employé d’une entité ou de la per-
relevant person hired by an entity to provide a service, sonne qui est embauchée par une entité pour offrir un
the policy must provide for a procedure for issuing to the service, la politique doit prévoir que le document confir-
employee or relevant person a document confirming that mant la raison pour laquelle le protocole vaccinal com-
they did not complete a COVID-19 vaccine dosage regi- plet contre la COVID-19 n’a pas été suivi n’est délivré en
men on the basis of their sincerely held religious beliefs raison de la croyance religieuse sincère que si l’entité a
only if the entity is obligated to accommodate the rele- l’obligation de prendre des mesures d’adaptation pour ce
vant person on the basis of this ground under the Cana- motif aux termes de la Loi canadienne sur les droits de la
dian Human Rights Act by issuing such a document. personne en délivrant un tel document.

graph (2)(d), in the following cases, the policy must pro- (2)d), dans les cas ci-après, la politique doit prévoir que
vide for a procedure for issuing to the employee a docu- le document confirmant la raison pour laquelle le proto-
ment confirming that they did not complete a COVID-19 cole vaccinal complet contre la COVID-19 n’a pas été sui-
vaccine dosage regimen on the basis of their sincerely vi n’est délivré en raison de la croyance religieuse sincère
held religious beliefs only if they would be entitled to que si la personne concernée a droit à une telle mesure
such an accommodation on the basis of this ground un- d’adaptation pour ce motif aux termes de la législation
der applicable legislation: applicable :
(a) in the case of an employee of an entity’s contractor a) le cas d’un employé d’un entrepreneur ou d’un
or agent or mandatary; and mandataire d’une entité;
(b) in the case of an employee of an entity’s lessee, if b) le cas de l’employé d’un locataire d’une entité, si les
the property that is subject to the lease is part of aero- lieux faisant l’objet du bail font partie des terrains de
drome property. l’aérodrome.
Ministerial request — policy Demande du ministre — politique

17.25 (1) The operator of an aerodrome, an air carrier 17.25 (1) L’exploitant d’un aérodrome, le transporteur
or NAV CANADA must make a copy of the policy referred aérien ou NAV CANADA met une copie de la politique vi-
to in section 17.22, 17.23 or 17.24, as applicable, available sée aux articles 17.22, 17.23 ou 17.24, selon le cas, à la dis-
to the Minister on request. position du ministre à sa demande.
Ministerial request — implementation Demande du ministre — mise en œuvre

(2) The operator of an aerodrome, an air carrier or NAV (2) L’exploitant d’un aérodrome, le transporteur aérien
CANADA must make information related to the ou NAV CANADA met l’information à l’égard de la mise
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implementation of the policy referred to in section 17.22, en œuvre de la politique visée aux articles 17.22, 17.23 ou
17.23 or 17.24, as applicable, available to the Minister on 17.24, selon le cas, à la disposition du ministre à sa de-
request. mande.
[17.26 to 17.29 reserved] [17.26 à 17.29 réservés]
Vaccination — Aerodromes in Vaccination – aérodromes au

Canada Canada
17.30 (1) Beginning on November 15, 2021 at 3:00:59 17.30 (1) Le 15 novembre 2021, les articles 17.31 à 17.40
a.m. Eastern standard time, sections 17.31 to 17.40 apply s’appliquent aux personnes suivantes :
to all of the following persons:
a) sous réserve de l’alinéa c), la personne qui accède à
(a) subject to paragraph (c), a person entering a re- une zone réglementée d’un aérodrome visé à l’annexe
stricted area at an aerodrome listed in Schedule 2 2 à partir d’une zone non réglementée pour un motif
from a non-restricted area for a reason other than to autre que celui de monter à bord d’un aéronef pour un
board aircraft for a flight; vol;
(b) a crew member entering a restricted area at an b) le membre d’équipage qui accède à une zone régle-
aerodrome listed in Schedule 2 from a non-restricted mentée d’un aérodrome visé à l’annexe 2 à partir d’une
area to board an aircraft for a flight operated by an air zone non réglementée dans le but de monter à bord
carrier under Subpart 3, 4 or 5 of Part VII of the Regu- d’un aéronef pour un vol effectué par un transporteur
lations; aérien visé aux sous-parties 3, 4 ou 5 de la partie VII
du Règlement;
(c) a person entering a restricted area at an aero-
drome listed in Schedule 2 from a non-restricted area c) la personne qui accède à une zone réglementée
to board an aircraft for a flight d’un aérodrome visé à l’annexe 2 à partir d’une zone
non réglementée dans le but de monter à bord d’un
(i) only to become a crew member on board anoth- aéronef pour un vol :
er aircraft operated by an air carrier under Subpart
3, 4 or 5 of Part VII of the Regulations, (i) dans le seul but d’agir à titre d’un membre
d’équipage à bord d’un autre aéronef exploité par
(ii) after having been a crew member on board an un transporteur aérien visé aux sous-parties 3, 4 ou
aircraft operated by an air carrier under Subpart 3, 5 de la partie VII du Règlement,
4 or 5 of Part VII of the Regulations, or
(ii) après avoir agi à titre d’un membre d’équipage
(iii) to participate in mandatory training required à bord d’un aéronef exploité par un transporteur
by an air carrier in relation to the operation of an aérien visé aux sous-parties 3, 4 ou 5 de la partie
aircraft operated under Subpart 3, 4 or 5 of Part VII VII du Règlement,
of the Regulations, if the person will be required to
return to work as a crew member; (iii) afin de suivre une formation obligatoire exigée
par un transporteur aérien sur l’exploitation d’un
(d) a screening authority at an aerodrome where per- aéronef exploité en application des sous-parties 3, 4
sons other than passengers are screened or can be ou 5 de la partie VII du Règlement si elle devra re-
screened; tourner au travail à titre de membre d’équipage;
(e) the operator of an aerodrome listed in Schedule 2. d) l’administration de contrôle à un aérodrome où le

contrôle des personnes autres que des passagers est
effectué ou peut être effectué;
e) l’exploitant d’un aérodrome visé à l’annexe 2.
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of age;
b) la personne qui arrive à un aérodrome à bord d’un
(b) a person who arrives at an aerodrome on board an aéronef à la suite du déroutement de son vol pour une
aircraft following the diversion of their flight for a raison liée à la sécurité, comme le mauvais temps ou
safety-related reason, such as adverse weather or an un défaut de fonctionnement de l’équipement, et qui
equipment malfunction, and who enters a restricted accède à une zone réglementée dans le but de monter
area to board an aircraft for a flight not more than 24 à bord d’un aéronef pour un vol au plus tard vingt-
hours after the arrival time of the diverted flight; quatre heures après l’arrivée du vol dérouté;
(c) a member of emergency response provider person- c) le membre du personnel des fournisseurs de ser-
nel who is responding to an emergency; vices d’urgence qui répond à une urgence;
(d) a peace officer who is responding to an emergen- d) l’agent de la paix qui répond à une urgence;
cy;
e) le titulaire d’une pièce d’identité d’employé délivrée
(e) the holder of an employee identification document par un ministère ou un établissement public visé à
issued by a department or departmental corporation l’annexe 3 ou d’une pièce d’identité de membre délivré
listed in Schedule 3 or a member identification docu- par les Forces canadiennes;
ment issued by the Canadian Forces; or
f) la personne qui effectue, dans une zone réglemen-
(f) a person who is delivering equipment or providing tée, la fourniture d’équipements ou de services qui
services within the restricted area of the aerodrome sont essentiels aux activités de l’aérodrome.
that are critical to aerodrome operations.
17.31 (1) A person must not enter a restricted area of 17.31 (1) Il est interdit à toute personne d’accéder à
an aerodrome unless they are a fully vaccinated person. une zone réglementée d’un aérodrome sauf si elle est une
personne entièrement vaccinée.
Exception Exception
(2) Subsection (1) does not apply to a person who has (2) Le paragraphe (1) ne s’applique pas à la personne qui
been issued a document under the procedure referred to s’est fait délivrer un document en application des alinéas
in paragraph 17.22(2)(d) or 17.24(2)(d). 17.22(2)d) ou 17.24(2)d).

17.32 A person must provide to a screening authority or 17.32 Toute personne est tenue de présenter sur de-
the operator of an aerodrome, on their request, mande de l’administration de contrôle ou de l’exploitant
de l’aérodrome la preuve suivante :
(a) in the case of a fully vaccinated person, the evi-
dence of COVID-19 vaccination referred to in section a) dans le cas d’une personne entièrement vaccinée, la
17.10, and preuve de vaccination contre la COVID-19 décrite à
l’article 17.10,
(b) in the case of a person who has been issued a doc-
ument under the procedure referred to in paragraph b) dans le cas d’une personne qui s’est vu délivrer un
17.22(2)(d) or 17.24(2)(d), the document issued to the document en application des alinéas 17.22(2)d) ou
person. 17.24(2)d), le document qui lui a été délivré.
Request for evidence Demande de présenter la preuve

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themselves for screening at a non-passenger screening personnes, lorsqu’elles se présentent à un point de
checkpoint or a passenger screening checkpoint, provide contrôle des non-passagers pour un contrôle ou à point
the evidence referred to in paragraph 17.32(a) or (b). de contrôle des passagers, de présenter la preuve visée
aux alinéas 17.32a) ou b).
Declaration Déclaration
17.34 (1) A person who is a fully vaccinated person or 17.34 (1) La personne qui n’est pas en mesure de pré-
has been issued a document under the procedure re- senter la preuve, suite à une demande en application de
ferred to in paragraph 17.22(2)(d) and who is unable, fol- l’article 17.33, et qui est une personne entièrement vacci-
lowing a request to provide evidence under section 17.33, née ou qui s’est fait délivrer un document en application
to provide the evidence, may de l’alinéa 17.22(2)d) peut, selon le cas :
(a) sign a declaration confirming that they are a fully a) signer une déclaration confirmant qu’elle est une
vaccinated person or that they have been issued a doc- personne entièrement vaccinée ou qu’elle s’est vu s’est
ument under the procedure referred to in paragraph fait délivrer un document en application de l’alinéa
17.22(2)(d); or 17.22(2)d);
(b) if the person has signed a declaration under para- b) si elle a signé une déclaration en application de
graph (a) no more than seven days before the day on l’alinéa a) dans les sept jours précédant la demande de
which the request to provide evidence is made, pro- présenter de la preuve, présenter la déclaration signée.
vide that declaration.
Exception Exception
(2) Subsection (1) does not apply to the holder of a docu- (2) Le paragraphe (1) ne s’applique pas au titulaire d’un
ment of entitlement that expires within seven days after document d’autorisation qui expire dans les sept jours
the day on which the request to provide evidence under suivant la demande de présenter la preuve en application
section 17.33 is made. de l’article 17.33.
Notification to aerodrome operator Avis à l’exploitant de l’aérodrome

(3) If a person signs a declaration referred to in para- (3) Lorsque la personne signe la déclaration visée à l’ali-
graph (1)(a), the screening authority must notify the op- néa (1)a), l’administration de contrôle avise l’exploitant
erator of the aerodrome as soon as feasible of the per- de l’aérodrome dès que possible des prénom et nom de la
son’s name and the number or identifier of the person’s personne ainsi que du numéro ou de l’identifiant de son
document of entitlement. document d’autorisation.

(4) A person who signed a declaration under paragraph (4) La personne qui a signé une déclaration en applica-
(1)(a) must provide the evidence referred to in paragraph tion de l’alinéa (1)a) présente la preuve visée aux alinéas
17.32(a) or (b) to the operator of the aerodrome within 17.32a) ou b) à l’exploitant de l’aérodrome dans les sept
seven days after the day on which the declaration is jours suivant la signature de la déclaration.
signed.
Suspension of restricted area access Suspension de l’accès à la zone réglementée

(5) An operator of an aerodrome must ensure that the (5) L’exploitant de l’aérodrome veille à ce que l’accès à la
restricted area access of a person who does not provide zone réglementée de la personne qui ne présente pas la
the evidence within seven days as required under subsec- preuve dans le délai prévu au paragraphe (4) soit suspen-
tion (4) is suspended until the person provides the evi- du jusqu’à ce qu’elle la présente.
dence.
Record keeping — suspension Tenue de registre — suspensions

17.35 (1) The operator of the aerodrome must keep a 17.35 (1) L’exploitant de l’aérodrome consigne dans un
record of the following information in respect of a person registre les renseignements ci-après à l’égard d’une
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each time the restricted area access of the person is sus- personne chaque fois qu’elle s’est vu suspendre l’accès à
pended under subsection 17.34(5): la zone réglementée en application du paragraphe
17.34(5) :
(a) the person’s name;
a) les prénom et nom de la personne;
(b) the number or identifier of the person’s document
of entitlement; b) le numéro ou l’identifiant de son document d’auto-
risation;
(c) the date of the suspension; and
c) la date de la suspension;
(d) the reason for the suspension.
d) le motif de la suspension.
(2) The operator must retain the record for a period of at (2) Il conserve le registre pendant au moins douze mois
least 12 months after the day on which the record was après la date de sa création.
created.

(3) The operator of the aerodrome must make the record (3) Il met le registre à la disposition du ministre à la de-
available to the Minister on request. mande de celui-ci.
17.36 (1) A screening authority must deny entry to a re- 17.36 (1) Si une personne ne présente pas la preuve de-
stricted area if a person, following a request to provide mandée en application de l’article 17.33 ou la déclaration
evidence under section 17.33, does not provide the evi- signée conformément au paragraphe 17.34(1), selon le
dence or, if applicable, does not sign or provide a declara- cas, l’administration de contrôle lui refuse l’accès à la
tion under subsection 17.34(1). zone réglementée.
Notification to aerodrome operator Avis à l’exploitant de l’aérodrome

(2) If a screening authority denies entry to a restricted (2) L’administration de contrôle qui refuse l’accès à une
area it must notify the operator of the aerodrome as soon zone réglementée en application du paragraphe (1) avise
as feasible of the person’s name and, if applicable, the l’exploitant de l’aérodrome et lui fournit dès que possible
number or identifier of the person’s document of entitle- les prénom et nom de la personne ainsi que, le cas
ment. échéant, le numéro ou l’identifiant du document d’autori-
sation de la personne.

17.37 A person must not provide evidence that they 17.37 Il est interdit à toute personne de présenter une
know to be false or misleading. preuve, la sachant fausse ou trompeuse.

17.38 A screening authority or the operator of an aero- 17.38 L’administration de contrôle ou l’exploitant de
drome that has reason to believe that a person has pro- l’aérodrome qui a des raisons de croire qu’une personne
vided evidence that is likely to be false or misleading lui a présenté une preuve, susceptible d’être fausse ou
must notify the Minister of the following not more than trompeuse informe le ministre, au plus tard soixante-
72 hours after the provision of the evidence: douze heures après la présentation de la preuve, de ce qui
suit :
a) des prénom et nom de la personne,
of entitlement, if applicable; and b) du numéro ou de l’identifiant du document d’auto-
risation de la personnel;
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(c) the reason the screening authority or the operator c) des raisons pour lesquelles l’administration de
of an aerodrome believes that the evidence is likely to contrôle ou l’exploitant de l’aérodrome croit que la
be false or misleading. preuve est susceptible d’être fausse ou trompeuse.
Record keeping — denial of entry Tenue de registre — refus d’accès

time the person is denied entry to a restricted area under personne chaque fois qu’elle s’est vu refuser l’accès à la
subsection 17.36(1): zone réglementée en application du paragraphe 17.36(1) :
(b) the number or identifier of the person’s document b) le numéro ou l’identifiant de son document d’auto-
of entitlement, if applicable; risation, le cas échéant;
(c) the date on which the person was denied entry and c) la date et l’endroit du refus d’accès à la zone régle-
the location; and mentée;
(d) the reason why the person was denied entry to the d) le motif pour lequel la personne s’est vu refuser
period of at least 12 months after the day on which the mois après la date de sa création.
record was created.

Requirement to establish and implement Exigence – établissement et mise en œuvre

17.40 The operator of an aerodrome must ensure that a 17.40 L’exploitant de l’aérodrome veille à ce que les do-
document of entitlement is only issued to a fully vacci- cuments d’autorisation soient seulement délivrés à des
nated person or a person who has been issued a docu- personnes entièrement vaccinées ou qui se sont faites dé-
ment under the procedure referred to in paragraph livrer un document en application de l’alinéa 17.22(2)d).
17.22(2)(d).
Masks Masque
18 (1) Sections 19 to 24 do not apply to any of the fol- 18 (1) Les articles 19 à 24 ne s’appliquent pas aux per-
(a) a child who is less than two years of age; a) l’enfant âgé de moins de deux ans;
(b) a child who is at least two years of age but less b) l’enfant âgé de deux ans ou plus, mais de moins de
than six years of age who is unable to tolerate wearing six ans, qui ne peut tolérer le port du masque;
a mask;
c) la personne qui fournit un certificat médical attes-
(c) a person who provides a medical certificate certify- tant qu’elle ne peut porter de masque pour des raisons
ing that they are unable to wear a mask for a medical médicales;
reason;
d) la personne qui est inconsciente;
(d) a person who is unconscious;
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(e) a person who is unable to remove their mask with- e) la personne qui est incapable de retirer son masque
out assistance; par elle-même;
(f) a crew member; f) le membre d’équipage;
(g) a gate agent. g) l’agent d’embarquement.
Mask readily available Masque à la portée de l’enfant

(2) An adult responsible for a child who is at least two (2) L’adulte responsable d’un enfant âgé de deux ans ou
years of age but less than six years of age must ensure plus, mais de moins de six ans, veille à ce que celui-ci ait
that a mask is readily available to the child before board- un masque à sa portée avant de monter à bord d’un aéro-
ing an aircraft for a flight. nef pour un vol.
Wearing of mask Port du masque

(3) An adult responsible for a child must ensure that the (3) L’adulte responsable d’un enfant veille à ce que celui-
child wears a mask when wearing one is required under ci porte un masque lorsque l’article 21 l’exige et se
section 21 and complies with any instructions given by a conforme aux instructions données par l’agent d’embar-
gate agent under section 22 if the child quement en application de l’article 22 si l’enfant :
(a) is at least two years of age but less than six years of a) est âgé de deux ans ou plus, mais de moins de six
age and is able to tolerate wearing a mask; or ans, et peut tolérer le port du masque;
(b) is at least six years of age. b) est âgé de six ans ou plus.
Notification Avis
the private operator or air carrier operates that the per- aéronef pour un vol qu’il effectue qu’elle est tenue de res-
son must pecter les conditions suivantes :
(a) be in possession of a mask before boarding; a) avoir un masque en sa possession avant l’embar-
quement;
(b) wear the mask at all times during the boarding
process, during the flight and from the moment the b) porter le masque en tout temps durant l’embarque-
doors of the aircraft are opened until the person enters ment, durant le vol et dès l’ouverture des portes de
the air terminal building; and l’aéronef jusqu’au moment où elle entre dans l’aéro-
gare;
(c) comply with any instructions given by a gate agent
or a crew member with respect to wearing a mask. c) se conformer aux instructions données par un
agent d’embarquement ou un membre d’équipage à
l’égard du port du masque.
Obligation to possess mask Obligation d’avoir un masque en sa possession

20 Every person who is at least six years of age must be 20 Toute personne âgée de six ans ou plus est tenue
in possession of a mask before boarding an aircraft for a d’avoir un masque en sa possession avant de monter à
flight. bord d’un aéronef pour un vol.
Wearing of mask — persons Port du masque — personne

21 (1) Subject to subsections (2) and (3), a private oper- 21 (1) Sous réserve des paragraphes (2) et (3), l’exploi-
ator or air carrier must require a person to wear a mask tant privé ou le transporteur aérien exige que toute per-
at all times during the boarding process and during a sonne porte un masque en tout temps durant l’embar-
flight that the private operator or air carrier operates. quement et durant le vol qu’il effectue.
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Exceptions — person Exceptions — personne

(2) Subsection (1) does not apply (2) Le paragraphe (1) ne s’applique pas dans les situa-
tions suivantes :
(a) when the safety of the person could be endangered
by wearing a mask; a) le port du masque risque de compromettre la sécu-
rité de la personne;
(b) when the person is drinking or eating, unless a
crew member instructs the person to wear a mask; b) la personne boit ou s’alimente, à moins qu’un
membre d’équipage ne lui demande de porter le
(c) when the person is taking oral medications; masque;
(d) when a gate agent or a crew member authorizes c) la personne prend un médicament par voie orale;
the removal of the mask to address unforeseen cir-
cumstances or the person’s special needs; or d) la personne est autorisée par un agent d’embarque-
ment ou un membre d’équipage à retirer le masque en
(e) when a gate agent, a member of the aerodrome se- raison de circonstances imprévues ou des besoins par-
curity personnel or a crew member authorizes the re- ticuliers de la personne;
moval of the mask to verify the person’s identity.
e) la personne est autorisée par un agent d’embarque-
ment, un membre du personnel de sûreté de l’aéro-
drome ou un membre d’équipage à retirer le masque
pendant le contrôle d’identité.
Exceptions — flight deck Exceptions — poste de pilotage

(3) Subsection (1) does not apply to any of the following (3) Le paragraphe (1) ne s’applique pas aux personnes
persons when they are on the flight deck: ci-après lorsqu’elles se trouvent dans le poste de pilo-
tage :
(a) a Department of Transport air carrier inspector;
a) l’inspecteur des transporteurs aériens du ministère
(b) an inspector of the civil aviation authority of the des Transports;
state where the aircraft is registered;
b) l’inspecteur de l’autorité de l’aviation civile de
(c) an employee of the private operator or air carrier l’État où l’aéronef est immatriculé;
who is not a crew member and who is performing
their duties; c) l’employé de l’exploitant privé ou du transporteur
aérien qui n’est pas un membre d’équipage et qui
(d) a pilot, flight engineer or flight attendant em- exerce ses fonctions;
ployed by a wholly owned subsidiary or a code share
partner of the air carrier; d) un pilote, un mécanicien navigant ou un agent de
bord qui travaille pour une filiale à cent pour cent ou
(e) a person who has expertise related to the aircraft, pour un partenaire à code partagé du transporteur aé-
its equipment or its crew members and who is re- rien;
quired to be on the flight deck to provide a service to
the private operator or air carrier. e) la personne qui possède une expertise liée à l’aéro-
nef, à son équipement ou à ses membres d’équipage et
qui doit être dans le poste de pilotage pour fournir un
service à l’exploitant privé ou au transporteur aérien.
Compliance Conformité
22 A person must comply with any instructions given by 22 Toute personne est tenue de se conformer aux ins-
a gate agent, a member of the aerodrome security per- tructions de l’agent d’embarquement, du membre du per-
sonnel or a crew member with respect to wearing a mask. sonnel de sûreté de l’aérodrome ou du membre d’équi-
page à l’égard du port du masque.
37
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Prohibition — private operator or air carrier Interdiction — exploitant privé ou transporteur aérien
person to board an aircraft for a flight that the private aérien de permettre à une personne, dans les cas ci-
operator or air carrier operates if après, de monter à bord d’un aéronef pour un vol qu’il ef-
fectue :
(a) the person is not in possession of a mask; or
a) la personne n’a pas de masque en sa possession;
(b) the person refuses to comply with an instruction
given by a gate agent or a crew member with respect to b) la personne refuse de se conformer aux instruc-
wearing a mask. tions de l’agent d’embarquement ou du membre
d’équipage à l’égard du port du masque.
Refusal to comply Refus d’obtempérer

24 (1) If, during a flight that a private operator or air 24 (1) Si, durant un vol que l’exploitant privé ou le
carrier operates, a person refuses to comply with an in- transporteur aérien effectue, une personne refuse de se
struction given by a crew member with respect to wear- conformer aux instructions données par un membre
ing a mask, the private operator or air carrier must d’équipage à l’égard du port du masque, l’exploitant privé
ou le transporteur aérien :
(a) keep a record of
a) consigne dans un registre les renseignements sui-
(i) the date and flight number, vants :
(ii) the person’s name, date of birth and contact in- (i) la date et le numéro du vol,
formation, including the person’s home address,
telephone number and email address, (ii) les prénom et nom de la personne ainsi que sa
date de naissance et ses coordonnées, y compris
(iii) the person’s seat number, and son adresse de résidence, son numéro de téléphone
et son adresse de courriel,
(iv) the circumstances related to the refusal to
comply; and (iii) le numéro du siège occupé par la personne,
(b) inform the Minister as soon as feasible of any (iv) les circonstances du refus;
record created under paragraph (a).
b) informe dès que possible le ministre de la création
d’un registre en application de l’alinéa a).
Retention period Conservation

(2) The private operator or air carrier must retain the (2) L’exploitant privé ou le transporteur aérien conserve
record for a period of at least 12 months after the date of le registre pendant au moins douze mois suivant la date
the flight. du vol.

(3) The private operator or air carrier must make the (3) L’exploitant privé ou le transporteur aérien met le re-
record available to the Minister on request. gistre à la disposition du ministre à la demande de celui-
ci.
Wearing of mask — crew member Port du masque — membre d’équipage

ator or air carrier must require a crew member to wear a tant privé ou le transporteur aérien exige que tout
mask at all times during the boarding process and during membre d’équipage porte un masque en tout temps du-
a flight that the private operator or air carrier operates. rant l’embarquement et durant le vol qu’il effectue.
Exceptions — crew member Exceptions — membre d’équipage

(2) Subsection (1) does not apply (2) Le paragraphe (1) ne s’applique pas aux situations
suivantes :
38
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(a) when the safety of the crew member could be en- a) le port du masque risque de compromettre la sécu-
dangered by wearing a mask; rité du membre d’équipage;
(b) when the wearing of a mask by the crew member b) le port du masque par le membre d’équipage risque
could interfere with operational requirements or the d’interférer avec des exigences opérationnelles ou de
safety of the flight; or compromettre la sécurité du vol;
(c) when the crew member is drinking, eating or tak- c) le membre d’équipage boit, s’alimente ou prend un
ing oral medications. médicament par voie orale.
Exception — flight deck Exception — poste de pilotage

(3) Subsection (1) does not apply to a crew member who (3) Le paragraphe (1) ne s’applique pas au membre
is a flight crew member when they are on the flight deck. d’équipage qui est un membre d’équipage de conduite
lorsqu’il se trouve dans le poste de pilotage.
Wearing of mask — gate agent Port du masque — agent d’embarquement

ator or air carrier must require a gate agent to wear a tant privé ou le transporteur aérien exige que tout agent
mask during the boarding process for a flight that the d’embarquement porte un masque durant l’embarque-
private operator or air carrier operates. ment pour un vol qu’il effectue.
Exceptions Exceptions
suivantes :
(a) when the safety of the gate agent could be endan-
gered by wearing a mask; or a) le port du masque risque de compromettre la sécu-
rité de l’agent d’embarquement;
(b) when the gate agent is drinking, eating or taking
oral medications. b) l’agent d’embarquement boit, s’alimente ou prend
un médicament par voie orale.
Exception — physical barrier Exception — barrière physique

(3) During the boarding process, subsection (1) does not (3) Le paragraphe (1) ne s’applique pas, durant l’embar-
apply to a gate agent if the gate agent is separated from quement, à l’agent d’embarquement s’il est séparé des
any other person by a physical barrier that allows the autres personnes par une barrière physique qui lui per-
gate agent and the other person to interact and reduces met d’interagir avec celles-ci et qui réduit le risque d’ex-
the risk of exposure to COVID-19. position à la COVID-19.
Deplaning Débarquement
27 (1) Section 28 does not apply to any of the following 27 (1) L’article 28 ne s’applique pas aux personnes sui-
persons: vantes :
a mask;
reason;
39
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(d) a person who is unconscious; e) la personne qui est incapable de retirer son masque
par elle-même;
(e) a person who is unable to remove their mask with-
out assistance; f) la personne qui est à bord d’un vol en provenance
du Canada et à destination d’un pays étranger.
(f) a person who is on a flight that originates in
Canada and is destined to another country.

child wears a mask when wearing one is required under ci porte un masque lorsque l’article 28 l’exige si l’enfant :
section 28 if the child
a) est âgé de deux ans ou plus, mais de moins de six
(a) is at least two years of age but less than six years of ans, et peut tolérer le port du masque;
age and is able to tolerate wearing a mask; or
b) est âgé de six ans ou plus.
(b) is at least six years of age.
Wearing of mask — person Port du masque — personne

28 A person who is on board an aircraft must wear a 28 Toute personne à bord d’un aéronef est tenue de por-
mask at all times from the moment the doors of the air- ter un masque en tout temps dès l’ouverture des portes
craft are opened until the person enters the air terminal de l’aéronef jusqu’au moment où elle entre dans l’aéro-
building, including by a passenger loading bridge. gare, notamment par une passerelle d’embarquement des
passagers.
Screening Authority Administration de contrôle

a mask;
reason;
e) la personne qui est incapable de retirer son masque
(e) a person who is unable to remove their mask with- par elle-même;
out assistance;
f) le membre du personnel des fournisseurs de ser-
(f) a member of emergency response provider person- vices d’urgence qui répond à une urgence;
nel who is responding to an emergency;
g) l’agent de la paix qui répond à une urgence.
(g) a peace officer who is responding to an emergency.

child wears a mask when wearing one is required under ci porte un masque lorsque le paragraphe 30(2) l’exige et
subsection 30(2) and removes it when required by a
40
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Draft Ébauche
screening officer to do so under subsection 30(3) if the l’enlève lorsque l’agent de contrôle lui en fait la demande
child au titre du paragraphe 30(3) si l’enfant :
Requirement — passenger screening checkpoint Exigence — point de contrôle des passagers

30 (1) A screening authority must notify a person who is 30 (1) L’administration de contrôle avise la personne
subject to screening at a passenger screening checkpoint qui fait l’objet d’un contrôle à un point de contrôle des
that they must wear a mask at all times during screening. passagers qu’elle doit porter un masque en tout temps
pendant le contrôle.

(2) Subject to subsection (3), a person who is the subject (2) Sous réserve du paragraphe (3), la personne qui fait
of screening referred to in subsection (1) must wear a l’objet du contrôle visé au paragraphe (1) est tenue de
mask at all times during screening. porter un masque en tout temps pendant le contrôle.
Requirement to remove mask Exigence d’enlever le masque

(3) A person who is required by a screening officer to re- (3) Pendant le contrôle, la personne enlève son masque
move their mask during screening must do so. si l’agent de contrôle lui en fait la demande.
Wearing of mask — screening officer Port du masque — agent de contrôle

(4) A screening officer must wear a mask at a passenger (4) L’agent de contrôle est tenu de porter un masque à
screening checkpoint when conducting the screening of a un point de contrôle des passagers lorsqu’il effectue le
person if, during the screening, the screening officer is contrôle d’une personne si, lors du contrôle, il se trouve à
two metres or less from the person being screened. une distance de deux mètres ou moins de la personne qui
fait l’objet du contrôle.
Requirement — non-passenger screening checkpoint Exigence — point de contrôle des non-passagers

31 (1) A person who presents themselves at a non-pas- 31 (1) La personne qui se présente à un point de
senger screening checkpoint to enter into a restricted contrôle des non-passagers pour passer dans une zone
area must wear a mask at all times. réglementée porte un masque en tout temps.

(2) Subject to subsection (3), a screening officer must (2) Sous réserve du paragraphe (3), l’agent de contrôle
wear a mask at all times at a non-passenger screening est tenu de porter un masque en tout temps lorsqu’il se
checkpoint. trouve à un point de contrôle des non-passagers.
suivantes :
(a) when the safety of the screening officer could be
endangered by wearing a mask; or a) le port du masque risque de compromettre la sécu-
rité de l’agent de contrôle;
(b) when the screening officer is drinking, eating or
taking oral medications. b) l’agent de contrôle boit, s’alimente ou prend un
médicament par voie orale.

32 Sections 30 and 31 do not apply to a person, includ- 32 Les articles 30 et 31 ne s’appliquent pas à la per-
ing a screening officer, if the person is two metres or less sonne, notamment l’agent de contrôle, qui se trouve à
from another person and both persons are separated by a deux mètres ou moins d’une autre personne si elle est
41
AR04364
Draft Ébauche
physical barrier that allows them to interact and reduces séparée de l’autre personne par une barrière physique
the risk of exposure to COVID-19. qui leur permet d’interagir et qui réduit le risque d’expo-
sition à la COVID-19.
Prohibition — passenger screening checkpoint Interdiction — point de contrôle des passagers

33 (1) A screening authority must not permit a person 33 (1) Il est interdit à l’administration de contrôle de
who has been notified to wear a mask and refuses to do permettre à une personne qui a été avisée de porter un
so to pass beyond a passenger screening checkpoint into masque et qui n’en porte pas de traverser un point de
a restricted area. contrôle des passagers pour se rendre dans une zone ré-
glementée.
Prohibition — non-passenger screening checkpoint Interdiction — point de contrôle des non-passagers

(2) A screening authority must not permit a person who (2) Il est interdit à l’administration de contrôle de per-
refuses to wear a mask to pass beyond a non-passenger mettre à une personne qui ne porte pas de masque de
screening checkpoint into a restricted area. traverser un point de contrôle des non-passagers pour se
rendre dans une zone réglementée.
Designated Provisions Textes désignés

Designation Désignation
34 (1) The provisions of this Interim Order set out in 34 (1) Les dispositions du présent arrêté d’urgence figu-
column 1 of Schedule 4 are designated as provisions the rant à la colonne 1 de l’annexe 4 sont désignées comme
contravention of which may be dealt with under and in dispositions dont la transgression est traitée conformé-
accordance with the procedure set out in sections 7.7 to ment à la procédure prévue aux articles 7.7 à 8.2 de la
8.2 of the Act. Loi.
Maximum amounts Montants maximaux

(2) The amounts set out in column 2 of Schedule 4 are (2) Les sommes indiquées à la colonne 2 de l’annexe 4
the maximum amounts of the penalty payable in respect représentent les montants maximaux de l’amende à
of a contravention of the designated provisions set out in payer au titre d’une contravention au texte désigné figu-
column 1. rant à la colonne 1.
Notice Avis
(3) A notice referred to in subsection 7.7(1) of the Act (3) L’avis visé au paragraphe 7.7(1) de la Loi est donné
must be in writing and must specify par écrit et comporte :
(a) the particulars of the alleged contravention; a) une description des faits reprochés;
(b) that the person on whom the notice is served or to b) un énoncé indiquant que le destinataire de l’avis
whom it is sent has the option of paying the amount doit soit payer la somme fixée dans l’avis, soit déposer
specified in the notice or filing with the Tribunal a re- auprès du Tribunal une requête en révision des faits
quest for a review of the alleged contravention or the reprochés ou du montant de l’amende;
amount of the penalty;
c) un énoncé indiquant que le paiement de la somme
(c) that payment of the amount specified in the notice fixée dans l’avis sera accepté par le ministre en règle-
will be accepted by the Minister in satisfaction of the ment de l’amende imposée et qu’aucune poursuite ne
amount of the penalty for the alleged contravention sera intentée par la suite au titre de la partie I de la Loi
and that no further proceedings under Part I of the Act contre le destinataire de l’avis pour la même contra-
will be taken against the person on whom the notice in vention;
respect of that contravention is served or to whom it is
sent; d) un énoncé indiquant que, si le destinataire de l’avis
dépose une requête en révision auprès du Tribunal, il
(d) that the person on whom the notice is served or to se verra accorder la possibilité de présenter ses élé-
whom it is sent will be provided with an opportunity ments de preuve et ses observations sur les faits
42
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Draft Ébauche
consistent with procedural fairness and natural justice reprochés, conformément aux principes de l’équité
to present evidence before the Tribunal and make rep- procédurale et de la justice naturelle;
resentations in relation to the alleged contravention if
the person files a request for a review with the Tri- e) un énoncé indiquant que le défaut par le destina-
bunal; and taire de l’avis de verser la somme qui y est fixée et de
déposer, dans le délai imparti, une requête en révision
(e) that the person on whom the notice is served or to auprès du Tribunal vaut aveu de responsabilité à
whom it is sent will be considered to have committed l’égard de la contravention.
the contravention set out in the notice if they fail to
pay the amount specified in the notice and fail to file a
request for a review with the Tribunal within the pre-
scribed period.
Repeal Abrogation
35 The Interim Order Respecting Certain Re- 35 L’Arrêté d’urgence no 45 visant certaines exi-
quirements for Civil Aviation Due to COVID-19, gences relatives à l’aviation civile en raison de
No. 45, made on November [XX], 2021, is rela COVID-19, pris le XX novembre 2021, est abro-
pealed. gé.
43
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Draft Ébauche
SCHEDULE 1 ANNEXE 1
(Subsection 13(2)) (paragraphe 13(2))
Countries and Territories Pays et territoires

Item Name Article Nom
1 India 1 Inde
2 Morocco 2 Maroc
44
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SCHEDULE 2 ANNEXE 2
(Subsections 1(1) and 17.1(1) and paragraphs 17.1(2)(c), 17.20(a) (paragraphes 1(1) et 17.1(1) et alinéas 17.1(2)c), 17.20a) et b),
and (b), 17.21(2)(d) and 17.30(1)(a) to (c) and (e)) 17.21(2)d) et 17.30(1)a) à c) et e))
Aerodromes Aérodromes
ICAO Location Indicateur
Name Indicator d’emplacement
Nom de l’OACI
Abbotsford International CYXX
Abbotsford (aéroport international) CYXX
Alma CYTF
Alma CYTF
Bagotville CYBG
Bagotville CYBG
Baie-Comeau CYBC
Baie-Comeau CYBC
Bathurst CZBF
Bathurst CZBF
Brandon Municipal CYBR
Brandon (aéroport municipal) CYBR
Calgary International CYYC
Calgary (aéroport international) CYYC
Campbell River CYBL
Campbell River CYBL
Castlegar (West Kootenay Regional) CYCG
Castlegar (aéroport régional de West CYCG
Charlo CYCL Kootenay)
Charlottetown CYYG Charlo CYCL
Chibougamau/Chapais CYMT Charlottetown CYYG
Churchill Falls CZUM Chibougamau/Chapais CYMT
Comox CYQQ Churchill Falls CZUM
Cranbrook (Canadian Rockies International) CYXC Comox CYQQ
Dawson Creek CYDQ Cranbrook (aéroport international des CYXC

Rocheuses)
Deer Lake CYDF
Dawson Creek CYDQ
Edmonton International CYEG
Deer Lake CYDF
Fort McMurray CYMM
Edmonton (aéroport international) CYEG
Fort St. John CYXJ
Fort McMurray CYMM
Fredericton International CYFC
Fort St. John CYXJ
Gander International CYQX
Fredericton (aéroport international) CYFC
Gaspé CYGP
Gander (aéroport international) CYQX
Goose Bay CYYR
Gaspé CYGP
Grande Prairie CYQU
Goose Bay CYYR
Greater Moncton International CYQM
Grande Prairie CYQU
Halifax (Robert L. Stanfield International) CYHZ
Halifax (aéroport international Robert L. CYHZ
Hamilton (John C. Munro International) CYHM Stanfield)
45
AR04368
Draft Ébauche

Nom de l’OACI
Îles-de-la-Madeleine CYGR
Hamilton (aéroport international John C. CYHM
Iqaluit CYFB Munro)
Kamloops CYKA Îles-de-la-Madeleine CYGR
Kelowna CYLW Iqaluit CYFB
Kingston CYGK Kamloops CYKA
Kitchener/Waterloo Regional CYKF Kelowna CYLW
La Grande Rivière CYGL Kingston CYGK
Lethbridge CYQL Kitchener/Waterloo (aéroport régional) CYKF
Lloydminster CYLL La Grande Rivière CYGL
London CYXU Lethbridge CYQL
Lourdes-de-Blanc-Sablon CYBX Lloydminster CYLL
Medicine Hat CYXH London CYXU
Montréal International (Mirabel) CYMX Lourdes-de-Blanc-Sablon CYBX
Mont-Joli CYYY Medicine Hat CYXH
Montréal (Montréal — Pierre Elliott Trudeau CYUL Moncton (aéroport international du Grand) CYQM
International)
Mont-Joli CYYY
Montreal (St. Hubert) CYHU
Montréal (aéroport international de Mirabel) CYMX
Nanaimo CYCD
Montréal (aéroport international Pierre-Elliott- CYUL
North Bay CYYB Trudeau)
Ottawa (Macdonald-Cartier International) CYOW Montréal (St-Hubert) CYHU
Penticton CYYF Nanaimo CYCD
Prince Albert (Glass Field) CYPA North Bay CYYB
Prince George CYXS Ottawa (aéroport international Macdonald- CYOW

Cartier)
Prince Rupert CYPR
Penticton CYYF
Québec (Jean Lesage International) CYQB
Prince Albert (Glass Field) CYPA
Quesnel CYQZ
Prince George CYXS
Red Deer Regional CYQF
Prince Rupert CYPR
Regina International CYQR
Québec (aéroport international Jean-Lesage) CYQB
Rivière-Rouge/Mont-Tremblant International CYFJ
Quesnel CYQZ
Rouyn-Noranda CYUY
Red Deer (aéroport régional) CYQF
Saint John CYSJ
Regina (aéroport international) CYQR
Sarnia (Chris Hadfield) CYZR
Rivière-Rouge/Mont-Tremblant (aéroport CYFJ
international)
46
AR04369
Draft Ébauche

Nom de l’OACI
Saskatoon (John G. Diefenbaker International) CYXE
Rouyn-Noranda CYUY
Sault Ste. Marie CYAM
Saint John CYSJ
Sept-Îles CYZV
Sarnia (aéroport Chris Hadfield) CYZR
Smithers CYYD
Saskatoon (aéroport international John G. CYXE
St. Anthony CYAY Diefenbaker)
St. John’s International CYYT Sault Ste. Marie CYAM
Stephenville CYJT Sept-Îles CYZV
Sudbury CYSB Smithers CYYD
Sydney (J.A. Douglas McCurdy) CYQY St. Anthony CYAY
Terrace CYXT St. John’s (aéroport international) CYYT
Thompson CYTH Stephenville CYJT
Thunder Bay CYQT Sudbury CYSB
Timmins (Victor M. Power) CYTS Sydney (J. A. Douglas McCurdy) CYQY
Toronto (Billy Bishop Toronto City) CYTZ Terrace CYXT
Toronto (Lester B. Pearson International) CYYZ Thompson CYTH
Toronto/Buttonville Municipal CYKZ Thunder Bay CYQT
Val-d’Or CYVO Timmins (Victor M. Power) CYTS
Vancouver (Coal Harbour) CYHC Toronto (aéroport de la ville de Toronto — Billy CYTZ
Bishop)
Vancouver International CYVR
Toronto (aéroport international Lester B. CYYZ
Victoria International CYYJ Pearson)
Wabush CYWK Toronto/Buttonville (aéroport municipal) CYKZ
Whitehorse (Erik Nielsen International) CYXY Val-d’Or CYVO
Williams Lake CYWL Vancouver (aéroport international) CYVR
Windsor CYQG Vancouver (Coal Harbour) CYHC
Winnipeg (James Armstrong Richardson CYWG Victoria (aéroport international) CYYJ

International)
Wabush CYWK
Yellowknife CYZF
Whitehorse (aéroport international Erik CYXY
Nielsen)
Williams Lake CYWL
Windsor CYQG
Winnipeg (aéroport international James CYWG

Armstrong Richardson)
Yellowknife CYZF
47
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SCHEDULE 3 ANNEXE 3
(Subparagraph 17.22(2)(a)(iii) and paragraphs 17.24(2)(a) and (sous-alinéa 17.22(2)a)(iii) et alinéas 17.24(2)a) et 17.30(2)e))
17.30(2)(e))
Departments and Departmen‐ Ministères et établissements

tal Corporations publics
Name Nom
Canada Border Services Agency Agence de la santé publique du Canada
Correctional Service of Canada Agence des services frontaliers du Canada
Department of Agriculture and Agri-Food Gendarmerie royale du Canada
Department of Fisheries and Oceans Ministère de l'Agriculture et de l'Agroalimentaire
Department of Health Ministère de l'Environnement
Department of National Defence Ministère des Pêches et des Océans
Department of the Environment Ministère des Transports
Department of Transport Ministère de la Défense nationale
Public Health Agency of Canada Ministère de la Santé
Royal Canadian Mounted Police Service correctionnel du Canada
48
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SCHEDULE 4 ANNEXE 4
(Subsections 34(1) and (2)) (paragraphes 34(1) et (2))

Column 1 Column 2 Colonne 1 Colonne 2
Designated Provision Maximum Amount of Penalty ($) Texte désigné Montant maximal de l’amende ($)
Individual Corporation Personne physique Personne morale
Subsection 2(1) 5,000 25,000 Paragraphe 2(1) 5 000 25 000

Subsection 3(1) 5,000 Paragraphe 3(1) 5 000
Section 4 5,000 25,000 Article 4 5 000 25 000
Section 5 5,000 25,000 Article 5 5 000 25 000
Section 9 5,000 25,000 Article 9 5 000 25 000
Section 10 5,000 Article 10 5 000
Section 12 5,000 25,000 Article 12 5 000 25 000
Section 16 5,000 25,000 Article 16 5 000 25 000
Section 17 5,000 25,000 Article 17 5 000 25 000
Section 17.2 25,000 Article 17.2 25 000
Subsection 17.3(1) 5,000 Paragraphe 17.3(1) 5 000
Section 17.7 25,000 Article 17.7 25 000
Section 17.8 25,000 Article 17.8 25 000
Section 17.9 5,000 Article 17.9 5 000
Subsection 17.13(2) 5,000 Paragraphe 17.13(2) 5 000 25 000
Section 17.15 25,000 Article 17.15 25 000
49
AR04372
Draft Ébauche

Section 17.32 5,000 Article 17.32 5 000
Section 17.33 25,000 Article 17.33 25 000
Section 17.37 5,000 Article 17.37 5 000
Section 17.38 25,000 Article 17.38 25 000
Section 17.40 25,000 Article 17.40 25 000
Section 19 5,000 25,000 Article 19 5 000 25 000
Section 23 5,000 25,000 Article 23 5 000 25 000
50
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51
AR04374
Ceci est la pièce « O » au soutien de

l’affidavit de MARIO BOILY
affirmé solennellement devant moi,
par moyen technologique
dans la ville de Saint-Rémi, province de Québec,
ce 22e jour d’avril 2022.
Anna Mrowczynski #237706

Commissaire à l’assermentation pour le Québec et l’extérieur du Québec
PROTECTED B / PROTÉGÉ B
AR04375
I Transport
Canada
Transports
Canada PROTECTED B
SAFETY AND SECURITY GROUP
CCM #: SUB-2021-000889
RDIMS #: 18102778
Memorandum to the Minister of Transport
Interim Order Respecting Certain Requirements for Civil Aviation Due to

COVID-19
For Approval
Purpose:
To seek your approval to repeal the Interim Order Respecting Certain Requirements
for Civil Aviation due to COVID-19 No. 46, and replace it with the Interim Order
Respecting Certain Requirements for Civil Aviation due to COVID-19, No. 47
(Annex A), which is recommended for signature on November 30, 2021.
Interim Order No. 47 reintroduces existing provisions of Interim Order No. 46 and
introduces the second phase of the federal vaccination mandate for all air
passengers.
Background:
As the Minister, you have the authority to make an Interim Order pursuant to
subsection 6.41(1) of the Aeronautics Act to deal with a significant risk (direct or
indirect) to aviation safety or the safety of the public.
On March 17, 2020, the initial Interim Order to Prevent Certain Persons from
Boarding Flights to Canada due to COVID-19 was made in relation to international
and transborder flights. Since then, a number of subsequent Interim Orders have
been made to expand requirements (e.g., health checks and notification of border
entry restrictions, mandate face covering requirements for passengers and
non-passengers) and introduce more recent ones such as pre-departure COVID-19
testing and notification requirements for air carriers to inform travellers that they
must submit a suitable quarantine plan, as well as information and evidence relating
to their COVID-19 vaccination status.
On August 13, 2021, Ministers announced that the Government of Canada would
require that all federal public service employees be vaccinated, that federally-
regulated employers develop vaccine plans for their employees to ensure safety in the
workplace, and that all commercial air travellers, passengers on interprovincial
trains, and passengers on large marine vessels with overnight accommodations be
vaccinated to support the safe restart of the economy.
A vaccination mandate for the federally regulated transportation sector will enhance
the safety of Canada’s transportation system by creating an environment where those
responsible for the continued operation of the system and the passengers needed to
realize recovery will be protected from the worst of the disease.
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On October 30, 2021, at 03:01 AM EDT, Interim Order No. 43 came into force and it
included the following elements as part of the implementation phase 1:
 A requirement for all aerodrome operators, air carriers, and NAV Canada to
establish a policy respecting mandatory vaccination for their respective
organizations;
 A requirement that all air passengers over the age of 12 years and 4 months on
board a commercial flight departing from one of the 82 specified Canadian
airports be fully vaccinated or have proof of a valid COVID-19 molecular test
result, unless they meet one of the limited exceptions (e.g., children until 12 years
and 4 months, transiting passengers, international to domestic travellers and
foreign crew members); and
 Subsequently, a separate set of exemptions were approved by the Director
General of Aviation Security under subsection 5.9(2) of Aeronautics Act to
manage the roll out and implementation of the mandatory vaccination policy for
air passengers who are travelling to or from Canada’s remote communities.
Interim Order No. 44 included the remaining elements of phase 1 of the vaccination
mandate relating to non-passengers. Effective November 15, 2021, CATSA (where
present) or alternatively the aerodrome operators became responsible for the
verification of non-passengers (i.e., employees) entering the restricted area of the
airport. Non-passengers who are not in possession of their proof of vaccination
would not be allowed to enter the restricted area, unless they have an
accommodation from their employer (and carrying a standardized form from their
employer as proof).
Implementation Phases
Phase 2 – Effective November 30, 2021

The transition period established with the implementation of phase 1 will end and
vaccination will become a universal requirement for air travel within or departing
Canada, with limited and specific exceptions:
 Medical inability to be vaccinated;
 Essential medical care;
 Those with sincerely held religious beliefs;
 Foreign nationals (non-residents) departing Canada;
 Travel required in support of national interests;
 Travel to or from remote communities; or
 Cases of emergency travel.
Analysis and Considerations:
Interim Order No. 46 will reintroduce existing provisions of Interim Order No. 45
and will introduce phase 2 of the federal COVID-19 vaccination mandate, which will
now require that all individuals seeking to board an aircraft for a flight within or
departing Canada or entering the restricted area at a specified Canadian airport
(schedule 2) be fully vaccinated, with minimal exceptions (e.g. medical inability,
essential medical care, sincerely held religious beliefs, foreign nationals departing
Canada). A few additional exceptions were also included to allow for foreign
nationals to leave Canada or to facilitate essential domestic travel for certain cohorts
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of foreign nationals, such as individuals assisting in the COVID-19 response; a

provider of emergency services under paragraph 186 (t) of the Immigration and
Refugee Protection Regulations; resettled refugees or new permanent residents; and
accredited diplomats, or diplomatic or consular couriers. If an individual meets one
of the exceptions within the Interim Order, to board a flight in Canada or outbound,
they must provide proof of a valid COVID-19 molecular test result as well as
appropriate documentation, either provided by their air carrier (medical, religious,
or essential medical travel exceptions), or specific evidence that they meet one of the
additional exceptions. For ease of reference, a detailed chart on who can travel and
under what authority has been included at Annex B.
Limited Exceptions – Operator Administered

In order for unvaccinated individuals to be provided with an exception due to
medical inability to be fully vaccinated, strongly held religious beliefs or to access
essential medical care (patient and escort if needed), passengers will need to make a
request using standardized forms to their air carrier at least 2-3 weeks before their
planned travel. Transport Canada has developed detailed guidance to help support
air carriers in the administration and issuance of these exceptions. These exceptions
are temporary (one return tip) and are air carrier specific.
Under section 5.9(2) of the Aeronautics Act, a set of transition exemptions are also
being implemented to account for the fact that the finalized operator forms will only
be available on November 30th. Until December 13, 2021, operators will have
flexibility to approve an unvaccinated individual to board (and an escort, if needed) if
they present medical information in a format other than the prescribed forms. This
would allow an unvaccinated individual to attend an appointment for essential
medical services or treatment schedule, or a person with a medical inability to
become fully vaccinated, to travel before December 13, 2021. Air carriers, however,
will still need to make sure the information provided meets the spirit of the exception
laid out in the Interim Order and report to Transport Canada when used.
Limited Exceptions – TC Administered

In addition, as part of phase 2, Transport Canada has established a domestic
National Interest Exemption Program (NIEP), where Transport Canada will
administer on a case-by-case basis applications for exemptions from the vaccination
mandate for: travel in Canada’s national interest and/or in support of critical
infrastructure need; urgent and/or time sensitives cases; and authorization for
compelling situations where there is no vaccination alternative. The department will
also seek approval, in the near future, from the Minister to authorize the Director
General responsible for the COVID Recovery Team to issue exemptions in support of
the NIE process. These authorities are currently limited to the Director General of
Aviation Security and the Director General of Civil Aviation under section 5.9(2) of
the Aeronautics Act.
International to Domestic Connecting Travel

As part of phase 2, unvaccinated foreign nationals permitted to enter Canada under
the Public Health Agency of Canada’s (PHAC) Orders-in-Council will continue to be
allowed onward domestic travel to complete their journey and connect as required to
reach their final destination as long as it’s within 24 hours of their flight into Canada.
While, unvaccinated Canadians and existing permanent residents are permitted
entry into Canada, they will not be permitted to take a connecting flight, or
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alternatively a train, to their final destination. They will need to find alternative
arrangements upon their arrival in Canada.
Travel from Remote Communities

For travellers to and from remote communities, the current interim measures, which
are managed by separate exemptions under subsection 5.9(2) of the Aeronautics Act,
will remain in place until at least January 2022, while the department engages with
key stakeholders, industry, affected communities and provinces and territories on
the policy. After November 30, passengers from remote communities can continue to
rely on proof of a valid COVID-19 test result, including the use of the Government of
Canada-provided rapid molecular test.
Other Amendments:
Additional amendments were made to provisions introduced through previous

Interim Orders, to ensure precision with the overall policy intent as well as alignment
with the PHAC’s recently updated Orders-In-Council:
 Removed the provisions related to the denial of boarding and/or entry into
the restricted area for a period of 72 hours if the individual fails to provide
proof of vaccination or a valid test result when asked by the air carrier or
screening authority.
 A COVID-19 molecular test result can not longer be used as an alternative to
proof of vaccination, it is only to be used in the case of an excepted or
exempted person.
 Three additional airports have been added to the list of specified airports
found at Schedule 2 of the Interim Order, this includes: Mirabel; St. Hubert;
and Coal Harbour (Vancouver).
Communications:
Your decision to establish Interim Order No. 47 and the elements of phase 2 of the
mandatory vaccination policy was part of the Government’s platform commitments
during the 2021 election. While the implementation comes following two
announcements, one on August 13 and another on October 6, 2021, it is still expected
that this will generate increased media interest. A responsive communications
approach is recommended. New and existing Media Lines and Questions & Answers
on the department’s COVID-19 air measures would be used should the department
receive media calls.
Stakeholder Assessment:
Discussions have been held with domestic and international air carriers, as well as
Canadian airports, several times a week since March 13, 2020, to inform them of the
direction of the Government. Transport Canada is also in constant communication
with other government departments to ensure a coordinated approach to mitigating
COVID-19.
Prior to implementation, Transport Canada conducted consultations with Industry

and relevant stakeholders to inform the mandatory vaccination policy for both air
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passengers and the comprehensive policy respecting mandatory vaccination for

aerodromes, air carriers and NAV Canada. This was done through both regular and
ad hoc calls with industry and stakeholders, as well as secretarially.
Industry is generally supportive of the federal vaccine mandate. The key issues
flagged during consultation processes included concerns around the timeline, the
impact on the availability of labour, potential demonstrations by those opposed to
the initiative and the need to develop a more flexible approach for remote
communities.
Legal Assessment:
Next Steps:
Transport Canada will continue to work closely with federal partners and industry to
ensure a smooth implementation of the Interim Order provisions.
Recommendation:
It is recommended that you make the attached Interim Order No. 47 (Annex A).
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____________________________ ____________________________
Deputy Minister of Transport Associate Deputy Minister of
Transport
2021-11-27
Date:________________
____ I approve ____ I do not approve ____ See Comments
_______________________________ 30 November 2021

Date:________________
Minister of Transport
Attachments:
Annex A: Interim Order Respecting Certain Requirements for Civil Aviation Due to
COVID-19, No. 47
Annex B: Travel Chart – “Who Can Travel by Air as of November 30, 2021 –
Domestic and Outbound Travel”
Annex C:
Annex D: Tabling Letter for the House of Commons
Annex E: Tabling Letter for the Senate
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PROTECTED B PROTÉGÉ B
Whereas the annexed Interim Order Respecting Cer‐ Attendu que l’Arrêté d’urgence no 47 visant certaines
tain Requirements for Civil Aviation Due to COVID-19, exigences relatives à l’aviation civile en raison de la
No. 47 is required to deal with a significant risk, di‐ COVID-19, ci-après, est requis pour parer à un risque
rect or indirect, to aviation safety or the safety of the appréciable — direct ou indirect — pour la sûreté aé‐
public; rienne ou la sécurité du public;
Whereas the provisions of the annexed Order may be Attendu que l’arrêté ci-après peut comporter les
contained in a regulation made pursuant to sections mêmes dispositions qu’un règlement pris en vertu
4.71a and 4.9b, paragraphs 7.6(1)(a)c and (b)d and sec‐ des articles 4.71a et 4.9b, des alinéas 7.6(1)a)c et b)d et
tion 7.7e of the Aeronautics Actf; de l’article 7.7e de la Loi sur l’aéronautiquef;
And whereas, pursuant to subsection 6.41(1.2)g of Attendu que, conformément au paragraphe 6.41(1.2)g
that Act, the Minister of Transport has consulted with de cette loi, le ministre des Transports a consulté au
the persons and organizations that that Minister con‐ préalable les personnes et organismes qu’il estime
siders appropriate in the circumstances before mak‐ opportun de consulter au sujet de l’arrêté ci-après,
ing the annexed Order;
Therefore, the Minister of Transport, pursuant to sub‐ À ces causes, le ministre des Transports, en vertu du
section 6.41(1)g of the Aeronautics Actf, makes the an‐ paragraphe 6.41(1)g de la Loi sur l’aéronautiquef,
nexed Interim Order Respecting Certain Require‐ prend l’Arrêté d’urgence no 47 visant certaines exi‐
ments for Civil Aviation Due to COVID-19, No. 47. gences relatives à l’aviation civile en raison de la CO‐
VID-19, ci-après.
Ottawa,30 November , 2021 Ottawa, le 30 novembre 2021
Le ministre des Transports,
Omar Alghabra
a a
S.C. 2004, c. 15, s. 5 L.C. 2004, ch. 15, art. 5
b b
S.C. 2014, c. 39, s. 144 L.C. 2014, ch. 39, art. 144
c c
S.C. 2015, c. 20, s. 12 L.C. 2015, ch. 20, art. 12
d d
S.C. 2004, c. 15, s. 18 L.C. 2004, ch. 15, art. 18
e e
S.C. 2001, c. 29, s. 39 L.C. 2001, ch. 29, art. 39
f f
R.S., c. A-2 L.R., ch. A-2
g g
S.C. 2004, c. 15, s. 11(1) L.C. 2004, ch. 15, par. 11(1)
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Interim Order Respecting Certain Require‐ Arrêté d’urgence no 47 visant certaines exi‐
ments for Civil Aviation Due to COVID-19, gences relatives à l’aviation civile en raison
No. 47 de la COVID-19
Interpretation Définitions et interprétation

Definitions Définitions
1 (1) The following definitions apply in this Interim Or- 1 (1) Les définitions qui suivent s’appliquent au présent
der. arrêté d’urgence.
accredited person means a foreign national who holds administration de contrôle La personne responsable du
a passport that contains a valid diplomatic, consular, offi- contrôle des personnes et des biens à tout aérodrome visé
cial or special representative acceptance issued by the à l’annexe du Règlement sur la désignation des aéro-
Chief of Protocol for the Department of Foreign Affairs, dromes de l’ACSTA ou à tout autre endroit désigné par le
Trade and Development. (personne accréditée) ministre au titre du paragraphe 6(1.1) de la Loi sur l’Ad-
ministration canadienne de la sûreté du transport aé-
aerodrome property means, in respect of an aerodrome rien. (screening authority)
listed in Schedule 2, any air terminal buildings, restricted
areas or facilities used for activities related to aircraft op- agent de contrôle Sauf à l’article 2, s’entend au sens de
erations that are located at the aerodrome. (terrains de l’article 2 de la Loi sur l’Administration canadienne de la
l’aérodrome) sûreté du transport aérien. (screening officer)
aerodrome security personnel has the same meaning agent de la paix S’entend au sens de l’article 3 du Rè-
as in section 3 of the Canadian Aviation Security Regu- glement canadien de 2012 sur la sûreté aérienne.
lations, 2012. (personnel de sûreté de l’aérodrome) (peace officer)
air carrier means any person who operates a commercial COVID-19 La maladie à coronavirus 2019. (COVID-19)
air service under Subpart 1, 3, 4 or 5 of Part VII of the
Regulations. (transporteur aérien) document d’autorisation S’entend au sens de l’article 3
du Règlement canadien de 2012 sur la sûreté aérienne.
Canadian Forces means the armed forces of Her (document of entitlement)
Majesty raised by Canada. (Forces canadiennes)
essai moléculaire relatif à la COVID-19 Essai de dépis-
COVID-19 means the coronavirus disease 2019. (CO‐ tage ou de diagnostic de la COVID-19 effectué par un la-
VID-19) boratoire accrédité, y compris l’essai effectué selon le
procédé d’amplification en chaîne par polymérase (ACP)
COVID-19 molecular test means a COVID-19 screening ou d’amplification isotherme médiée par boucle par
or diagnostic test carried out by an accredited laboratory, transcription inverse (RT-LAMP). (COVID-19 molecu‐
including a test performed using the method of poly- lar test)
merase chain reaction (PCR) or reverse transcription
loop-mediated isothermal amplification (RT-LAMP). étranger Personne autre qu’un citoyen canadien ou un
(essai moléculaire relatif à la COVID-19) résident permanent; la présente définition vise égale-
ment les apatrides. (foreign national)
document of entitlement has the same meaning as in
section 3 of the Canadian Aviation Security Regulations, exploitant d’un aérodrome S’agissant d’un aérodrome
2012. (document d’autorisation) où des activités liées à l'aviation civile sont exercées, la
personne responsable de l’aérodrome, y compris un em-
foreign national means a person who is not a Canadian ployé, un mandataire ou un représentant autorisé de
citizen or a permanent resident and includes a stateless cette personne. (operator of an aerodrome)
person. (étranger)
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AR04383
non-passenger screening checkpoint has the same Forces canadiennes Les forces armées de Sa Majesté le-
meaning as in section 3 of the Canadian Aviation Securi- vées par le Canada. (Canadian Forces)
ty Regulations, 2012. (point de contrôle des non-pas‐
sagers) personnel de sûreté de l’aérodrome S’entend au sens
de l’article 3 du Règlement canadien de 2012 sur la sûre-
operator of an aerodrome means the person in charge té aérienne. (aerodrome security personnel)
of an aerodrome where activities related to civil aviation
are conducted and includes an employee, agent or man- personne accréditée Étranger titulaire d’un passeport
datary or other authorized representative of that person. contenant une acceptation valide qui l’autorise à occuper
(exploitant) un poste en tant qu’agent diplomatique ou consulaire, ou
en tant que représentant officiel ou spécial, délivrée par
passenger screening checkpoint has the same mean- le chef du protocole du ministère des Affaires étrangères,
ing as in section 3 of the Canadian Aviation Security du Commerce et du Développement. (accredited per‐
Regulations, 2012. (point de contrôle des passagers) son)
peace officer has the same meaning as in section 3 of point de contrôle des non-passagers S’entend au sens
the Canadian Aviation Security Regulations, 2012. de l’article 3 du Règlement canadien de 2012 sur la sûre-
(agent de la paix) té aérienne. (non-passenger screening checkpoint)
Regulations means the Canadian Aviation Regulations. point de contrôle des passagers S’entend au sens de
(Règlement) l’article 3 du Règlement canadien de 2012 sur la sûreté
aérienne. (passenger screening checkpoint)
restricted area has the same meaning as in section 3 of
the Canadian Aviation Security Regulations, 2012. Règlement Le Règlement de l’aviation canadien. (Reg‐
(zone réglementée) ulations)
screening authority means a person responsible for the terrains de l’aérodrome À l’égard de tout aérodrome vi-
screening of persons and goods at an aerodrome set out sé à l’annexe 2, les aérogares, les zones réglementées et
in the schedule to the CATSA Aerodrome Designation les installations destinées aux activités liées à l’utilisation
Regulations or at any other place designated by the Min- des aéronefs et qui sont situés à l’aérodrome. (aero‐
ister under subsection 6(1.1) of the Canadian Air Trans- drome property)
port Security Authority Act. (administration de
contrôle) transporteur aérien Exploitant d’un service aérien com-
mercial visé aux sous-parties 1, 3, 4 ou 5 de la partie VII
screening officer, except in section 2, has the same du Règlement. (air carrier)
meaning as in section 2 of the Canadian Air Transport
Security Authority Act. (agent de contrôle) zone réglementée S’entend au sens de l’article 3 du Rè-
glement canadien de 2012 sur la sûreté aérienne. (re‐
stricted area)
Interpretation Interprétation
(2) Unless the context requires otherwise, all other (2) Sauf indication contraire du contexte, les autres
words and expressions used in this Interim Order have termes utilisés dans le présent arrêté d’urgence s’en-
the same meaning as in the Regulations. tendent au sens du Règlement.
Conflict Incompatibilité
(3) In the event of a conflict between this Interim Order (3) Les dispositions du présent arrêté d’urgence l’em-
and the Regulations or the Canadian Aviation Security portent sur les dispositions incompatibles du Règlement
Regulations, 2012, the Interim Order prevails. et du Règlement canadien de 2012 sur la sûreté aé-
rienne.
Definition of mask Définition de masque

(4) For the purposes of this Interim Order, a mask (4) Pour l’application du présent arrêté d’urgence,
means any mask, including a non-medical mask, that masque s’entend de tout masque, notamment un
meets all of the following requirements:
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AR04384
(a) it is made of multiple layers of tightly woven mate- masque non médical, qui satisfait aux exigences
rials such as cotton or linen; suivantes :
(b) it completely covers a person’s nose, mouth and a) il est constitué de plusieurs couches d’une étoffe
chin without gaping; tissée serrée, telle que le coton ou le lin;
(c) it can be secured to a person’s head with ties or ear b) il couvre complètement le nez, la bouche et le men-
loops. ton sans laisser d’espace;
c) il peut être solidement fixé à la tête par des at-

taches ou des cordons formant des boucles que l’on
passe derrière les oreilles.
Masks — lip reading Masque — lecture sur les lèvres

(5) Despite paragraph (4)(a), the portion of a mask in (5) Malgré l’alinéa (4)a), la partie du masque située de-
front of a wearer’s lips may be made of transparent mate- vant les lèvres peut être faite d’une matière transparente
rial that permits lip reading if qui permet la lecture sur les lèvres si :
(a) the rest of the mask is made of multiple layers of a) d’une part, le reste du masque est constitué de plu-
tightly woven materials such as cotton or linen; and sieurs couches d’une étoffe tissée serrée, telle que le
coton ou le lin;
(b) there is a tight seal between the transparent mate-
rial and the rest of the mask. b) d’autre part, le joint entre la matière transparente
et le reste du masque est hermétique.
Definition of fully vaccinated person Définition de personne entièrement vaccinée

(6) For the purposes of this Interim Order, a fully vacci‐ (6) Pour l’application du présent arrêté d’urgence, per‐
nated person means a person who completed, at least sonne entièrement vaccinée s’entend de la personne
14 days before the day on which they access aerodrome qui a suivi un protocole vaccinal complet contre la CO-
property or a location where NAV CANADA provides civil VID-19 au moins quatorze jours avant l’accès aux ter-
air navigation services, a COVID-19 vaccine dosage regi- rains de l’aérodrome ou à un emplacement où NAV
men if CANADA fournit des services de navigation aérienne ci-
vile, si :
(a) in the case of a vaccine dosage regimen that uses a
COVID-19 vaccine that is authorized for sale in a) dans le cas d’un protocole vaccinal précisant un
Canada, vaccin contre la COVID-19 qui est autorisé pour la
vente au Canada :
(i) the vaccine has been administered to the person
in accordance with its labelling, or (i) soit le vaccin a été administré à la personne
conformément à son étiquetage,
(ii) the Minister of Health determines, on the rec-
ommendation of the Chief Public Health Officer ap- (ii) soit le ministre de la Santé, sur recommanda-
pointed under subsection 6(1) of the Public Health tion de l’administrateur en chef de la santé pu-
Agency of Canada Act, that the regimen is suitable, blique nommé en application du paragraphe 6(1) de
having regard to the scientific evidence related to la Loi sur l’Agence de la santé publique du Canada
the efficacy of that regimen in preventing the intro- conclut que le protocole vaccinal est approprié
duction or spread of COVID-19 or any other factor compte tenu des preuves scientifiques relatives à
relevant to preventing the introduction or spread of son efficacité pour prévenir l’introduction ou la
COVID-19; or propagation de la COVID-19 ou de tout autre fac-
teur pertinent à cet égard;
(b) in all other cases,
b) dans tout autre cas :
(i) the vaccines of the regimen are authorized for
sale in Canada or in another jurisdiction, and (i) d’une part, les vaccins du protocole vaccinal
sont autorisés pour la vente soit au Canada, soit
dans un pays étranger,
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AR04385
(ii) the Minister of Health determines, on the rec- (ii) d’autre part, le ministre de la Santé, sur recom-
ommendation of the Chief Public Health Officer ap- mandation de l’administrateur en chef de la santé
pointed under subsection 6(1) of the Public Health publique nommé en application du paragraphe 6(1)
Agency of Canada Act, that the vaccines and the de la Loi sur l’Agence de la santé publique du
regimen are suitable, having regard to the scientific Canada conclut que ces vaccins et le protocole vac-
evidence related to the efficacy of that regimen and cinal sont appropriés compte tenu des preuves
the vaccines in preventing the introduction or scientifiques relatives à leur efficacité pour prévenir
spread of COVID-19 or any other factor relevant to l’introduction ou la propagation de la COVID-19 ou
preventing the introduction or spread of COVID-19. de tout autre facteur pertinent à cet égard.
Interpretation — fully vaccinated person Interprétation — personne entièrement vaccinée

(7) For greater certainty, for the purposes of the defini- (7) Pour l’application de la définition de personne en‐
tion fully vaccinated person in subsection (6), a tièrement vaccinée au paragraphe (6), il est entendu
COVID-19 vaccine that is authorized for sale in Canada que ne constitue pas un vaccin contre la COVID-19 auto-
does not include a similar vaccine sold by the same man- risé pour la vente au Canada le vaccin similaire qui est
ufacturer that has been authorized for sale in another ju- vendu par le même fabricant et qui a été autorisé pour la
risdiction. vente dans un pays étranger.
Notification Avis
Federal, provincial and territorial measures Mesures fédérales, provinciales ou territoriales
2 (1) A private operator or air carrier operating a flight 2 (1) L’exploitant privé ou le transporteur aérien qui ef-
between two points in Canada or a flight to Canada de- fectue un vol entre deux points au Canada ou un vol à
parting from any other country must notify every person destination du Canada en partance de tout autre pays
boarding the aircraft for the flight that they may be sub- avise chaque personne qui monte à bord de l’aéronef
ject to measures to prevent the spread of COVID-19 tak- pour le vol qu’elle peut être visée par des mesures visant
en by the provincial or territorial government with juris- à prévenir la propagation de la COVID-19 prises par l’ad-
diction where the destination aerodrome for that flight is ministration provinciale ou territoriale ayant compétence
located or by the federal government. là où est situé l’aérodrome de destination du vol ou par
l’administration fédérale.
Suitable quarantine plan Plan approprié de quarantaine

(2) A private operator or air carrier operating a flight to (2) L’exploitant privé ou le transporteur aérien qui effec-
Canada departing from any other country must notify ev- tue un vol à destination du Canada en partance de tout
ery person before the person boards the aircraft for the autre pays avise chaque personne, avant qu’elle ne monte
flight that they may be required, under an order made à bord de l’aéronef pour le vol, qu’elle pourrait être te-
under section 58 of the Quarantine Act, to provide, be- nue, aux termes de tout décret pris en vertu de l’article 58
fore boarding the aircraft, to the Minister of Health, a de la Loi sur la mise en quarantaine, de fournir, avant de
screening officer or a quarantine officer, by the electronic monter à bord de l’aéronef, au ministre de la Santé, à
means specified by that Minister, a suitable quarantine l’agent de contrôle ou à l’agent de quarantaine, par le
plan or, if the person is not required under that order to moyen électronique que ce ministre précise, un plan ap-
provide the plan and the evidence, their contact informa- proprié de quarantaine ou, si le décret en cause n’exige
tion. The private operator or air carrier must also notify pas qu’elle fournisse ce plan, ses coordonnées. L’exploi-
every person that they may be liable to a fine if this re- tant privé ou le transporteur aérien avise chaque per-
quirement applies to them and they fail to comply with it. sonne qu’elle peut encourir une amende si cette exigence
s’applique à son égard et qu’elle ne s’y conforme pas.
Vaccination Vaccination
fore boarding the aircraft or before entering Canada, to de la Loi sur la mise en quarantaine, de fournir, avant de
81100-3-96-46 4 2021-11-26 (18:57)

AR04386
the Minister of Health, a screening officer or a quaran- monter à bord de l’aéronef ou avant qu’elle n’entre au
tine officer, by the electronic means specified by that Canada, au ministre de la Santé, à l’agent de contrôle ou
Minister, information related to their COVID-19 vaccina- à l’agent de quarantaine, par le moyen électronique que
tion and evidence of COVID-19 vaccination. The private ce ministre précise, des renseignements sur son statut de
operator or air carrier must also notify every person that vaccination contre la COVID-19 et une preuve de vacci-
they may be denied permission to board the aircraft and nation contre la COVID-19. L’exploitant privé ou le trans-
may be liable to a fine if this requirement applies to them porteur aérien avise chaque personne qu’elle peut se voir
and they fail to comply with it. refuser de monter à bord de l’aéronef et qu’elle peut en-
courir une amende si cette exigence s’applique à son
égard et qu’elle ne s’y conforme pas.
False confirmation Fausse confirmation

(4) A private operator or air carrier operating a flight be- (4) L’exploitant privé ou le transporteur aérien qui effec-
tween two points in Canada or a flight to Canada depart- tue un vol entre deux points au Canada ou un vol à desti-
ing from any other country must notify every person nation du Canada en partance de tout autre pays avise
boarding the aircraft for the flight that they may be liable chaque personne qui monte à bord de l’aéronef pour le
to a monetary penalty if they provide a confirmation re- vol qu’elle peut encourir une amende si elle fournit la
ferred to in subsection 3(1) that they know to be false or confirmation visée au paragraphe 3(1), la sachant fausse
misleading. ou trompeuse.
(5) The following definitions apply in this section. (5) Les définitions qui suivent s’appliquent au présent
article.
quarantine officer means a person designated as a
quarantine officer under subsection 5(2) of the Quaran- agent de contrôle S’entend au sens de l’article 2 de la
tine Act. (agent de quarantaine) Loi sur la mise en quarantaine. (screening officer)
screening officer has the same meaning as in section 2 agent de quarantaine Personne désignée à ce titre en
of the Quarantine Act. (agent de contrôle) vertu du paragraphe 5(2) de la Loi sur la mise en qua-
rantaine. (quarantine officer)
Confirmation Confirmation
3 (1) Before boarding an aircraft for a flight between 3 (1) Avant de monter à bord d’un aéronef pour un vol
two points in Canada or a flight to Canada departing entre deux points au Canada ou un vol à destination du
from any other country, every person must confirm to the Canada en partance de tout autre pays, chaque personne
private operator or air carrier operating the flight that est tenue de confirmer à l’exploitant privé ou au trans-
they understand that they may be subject to a measure to porteur aérien qui effectue le vol qu’elle comprend qu’elle
prevent the spread of COVID-19 taken by the provincial peut être visée par des mesures visant à prévenir la pro-
or territorial government with jurisdiction where the des- pagation de la COVID-19 prises par l’administration pro-
tination aerodrome for that flight is located or by the fed- vinciale ou territoriale ayant compétence là où est situé
eral government. l’aérodrome de destination du vol ou par l’administration
fédérale.

(2) A person must not provide a confirmation referred to (2) Il est interdit à toute personne de fournir la confir-
in subsection (1) that they know to be false or misleading. mation visée au paragraphe (1), la sachant fausse ou
trompeuse.
81100-3-96-46 5 2021-11-26 (18:57)

AR04387
Exception Exception
(3) A competent adult may provide a confirmation re- (3) L’adulte capable peut fournir la confirmation visée au
ferred to in subsection (1) on behalf of a person who is paragraphe (1) pour la personne qui n’est pas un adulte
not a competent adult. capable.
4 A private operator or air carrier operating a flight be- 4 Il est interdit à l’exploitant privé ou au transporteur
tween two points in Canada or a flight to Canada depart- aérien qui effectue un vol entre deux points au Canada ou
ing from any other country must not permit a person to un vol à destination du Canada en partance de tout autre
board the aircraft for the flight if the person is a compe- pays de permettre à une personne de monter à bord de
tent adult and does not provide a confirmation that they l’aéronef pour le vol si la personne est un adulte capable
are required to provide under subsection 3(1). et ne fournit pas la confirmation exigée par le paragraphe
3(1).
Foreign Nationals Étrangers

5 A private operator or air carrier must not permit a for- 5 Il est interdit à l’exploitant privé ou au transporteur
eign national to board an aircraft for a flight that the pri- aérien de permettre à un étranger de monter à bord d’un
vate operator or air carrier operates to Canada departing aéronef pour un vol qu’il effectue à destination du
from any other country. Canada en partance de tout autre pays.
Exception Exception
6 Section 5 does not apply to a foreign national who is 6 L’article 5 ne s’applique pas à l’étranger dont l’entrée
permitted to enter Canada under an order made under au Canada est permise en vertu de tout décret pris en
section 58 of the Quarantine Act. vertu de l’article 58 de la Loi sur la mise en quarantaine.
Health Check Vérification de santé

7 Sections 8 to 10 do not apply to either of the following 7 Les articles 8 à 10 ne s’appliquent pas aux personnes
persons: suivantes :
(a) a crew member; a) le membre d’équipage;
(b) a person who provides a medical certificate certi- b) la personne qui fournit un certificat médical attes-
fying that any symptoms referred to in subsection 8(1) tant que les symptômes visés au paragraphe 8(1)
that they are exhibiting are not related to COVID-19. qu’elle présente ne sont pas liés à la COVID-19.
Health check Vérification de santé

8 (1) A private operator or air carrier must conduct a 8 (1) L’exploitant privé ou le transporteur aérien est te-
health check of every person boarding an aircraft for a nu d’effectuer une vérification de santé en posant des
flight that the private operator or air carrier operates by questions à chaque personne qui monte à bord d’un aéro-
asking questions to verify whether they exhibit any of the nef pour un vol qu’il effectue pour vérifier si elle présente
following symptoms: l’un ou l’autre des symptômes suivants :
(a) a fever; a) de la fièvre;
(b) a cough; b) de la toux;
(c) breathing difficulties. c) des difficultés respiratoires.
81100-3-96-46 6 2021-11-26 (18:57)

AR04388
Notification Avis
(2) A private operator or air carrier must notify every (2) L’exploitant privé ou le transporteur aérien avise
person boarding an aircraft for a flight that the private chaque personne qui monte à bord d’un aéronef pour un
operator or air carrier operates that the person may be vol qu’il effectue qu’elle peut se voir refuser de monter à
denied permission to board the aircraft if bord dans les cas suivants :
(a) they exhibit a fever and a cough or a fever and a) elle présente de la fièvre et de la toux ou de la fièvre
breathing difficulties, unless they provide a medical et des difficultés respiratoires, à moins qu’elle four-
certificate certifying that their symptoms are not relat- nisse un certificat médical attestant que ses symp-
ed to COVID-19; tômes ne sont pas liés à la COVID-19;
(b) they have, or have reasonable grounds to suspect b) elle a la COVID-19 ou elle a des motifs raisonnables
that they have, COVID-19; de soupçonner qu’elle l’a;
(c) they have been denied permission to board an air- c) elle s’est vu refuser de monter à bord d’un aéronef
craft in the previous 14 days for a medical reason re- dans les quatorze derniers jours pour une raison mé-
lated to COVID-19; or dicale liée à la COVID-19;
(d) in the case of a flight departing in Canada, they are d) dans le cas d’un vol en partance du Canada, elle fait
the subject of a mandatory quarantine order as a re- l’objet d’un ordre de quarantaine obligatoire du fait
sult of recent travel or as a result of a local or provin- d’un voyage récent ou d’une ordonnance de santé pu-
cial public health order. blique provinciale ou locale.
(3) Every person boarding an aircraft for a flight that a (3) La personne qui monte à bord d’un aéronef pour un
private operator or air carrier operates must confirm to vol qu’un exploitant privé ou un transporteur aérien ef-
the private operator or air carrier that none of the follow- fectue confirme à celui-ci qu’aucune des situations sui-
ing situations apply to them: vantes ne s’applique :
(a) the person has, or has reasonable grounds to sus- a) elle a la COVID-19 ou elle a des motifs raisonnables
pect that they have, COVID-19; de soupçonner qu’elle l’a;
(b) the person has been denied permission to board b) elle s’est vu refuser de monter à bord d’un aéronef
an aircraft in the previous 14 days for a medical reason dans les quatorze derniers jours pour une raison mé-
related to COVID-19; dicale liée à la COVID-19;
(c) in the case of a flight departing in Canada, the per- c) dans le cas d’un vol en partance du Canada, elle fait
son is the subject of a mandatory quarantine order as l’objet d’un ordre de quarantaine obligatoire du fait
a result of recent travel or as a result of a local or d’un voyage récent ou d’une ordonnance de santé pu-
provincial public health order. blique provinciale ou locale.
False confirmation — obligation of private operator or Fausse confirmation — obligation de l’exploitant privé
air carrier ou du transporteur aérien
(4) The private operator or air carrier must advise every (4) L’exploitant privé ou le transporteur aérien avise la
person that they may be liable to a monetary penalty if personne qu’elle peut encourir une amende si elle fournit
they provide answers, with respect to the health check or des réponses à la vérification de santé ou une confirma-
a confirmation, that they know to be false or misleading. tion qu’elle sait fausses ou trompeuses.
False confirmation — obligations of person Fausse confirmation — obligations de la personne

(5) A person who, under subsections (1) and (3), is sub- (5) La personne qui, en application des paragraphes (1)
jected to a health check and is required to provide a con- et (3), subit la vérification de santé et est tenue de donner
firmation must la confirmation est tenue :
(a) answer all questions; and a) d’une part, de répondre à toutes les questions;
81100-3-96-46 7 2021-11-26 (18:57)

AR04389
(b) not provide answers or a confirmation that they b) d’autre part, de ne pas fournir de réponses ou une
know to be false or misleading. confirmation qu’elle sait fausses ou trompeuses.
Exception Exception
(6) A competent adult may answer all questions and pro- (6) L’adulte capable peut répondre aux questions ou
vide a confirmation on behalf of a person who is not a donner une confirmation pour la personne qui n’est pas
competent adult and who, under subsections (1) and (3), un adulte capable et qui, en application des paragraphes
is subjected to a health check and is required to give a (1) et (3), subit la vérification de santé et est tenue de
confirmation. donner la confirmation.
Observations — private operator or air carrier Observations — exploitant privé ou transporteur

aérien
(7) During the boarding process for a flight that the pri- (7) Durant l’embarquement pour un vol qu’il effectue,
vate operator or air carrier operates, the private operator l’exploitant privé ou le transporteur aérien observe
or air carrier must observe whether any person boarding chaque personne montant à bord de l’aéronef pour voir si
the aircraft is exhibiting any symptoms referred to in elle présente l’un ou l’autre des symptômes visés au para-
9 A private operator or air carrier must not permit a per- 9 Il est interdit à l’exploitant privé ou au transporteur
son to board an aircraft for a flight that the private opera- aérien de permettre à une personne de monter à bord
tor or air carrier operates if d’un aéronef pour un vol qu’il effectue dans les cas sui-
vants :
(a) the person’s answers to the health check questions
indicate that they exhibit a) les réponses de la personne à la vérification de san-
té indiquent qu’elle présente :
(i) a fever and cough, or
(i) soit de la fièvre et de la toux,
(ii) a fever and breathing difficulties;
(ii) soit de la fièvre et des difficultés respiratoires;
(b) the private operator or air carrier observes that, as
the person is boarding, they exhibit b) selon les observations de l’exploitant privé ou du
transporteur aérien, la personne présente au moment
(i) a fever and cough, or de l’embarquement :
(ii) a fever and breathing difficulties; (i) soit de la fièvre et de la toux,
(c) the person’s confirmation under subsection 8(3) (ii) soit de la fièvre et des difficultés respiratoires;
indicates that one of the situations described in para-
graphs 8(3)(a), (b) or (c) applies to that person; or c) la confirmation donnée par la personne aux termes
du paragraphe 8(3) indique que l’une des situations vi-
(d) the person is a competent adult and refuses to an- sées aux alinéas 8(3)a), b) et c) s’applique;
swer any of the questions asked of them under subsec-
tion 8(1) or to give the confirmation under subsection d) la personne est un adulte capable et refuse de ré-
8(3). pondre à l’une des questions qui lui sont posées en ap-
plication du paragraphe 8(1) ou de donner la confir-
mation visée au paragraphe 8(3).
Period of 14 days Période de quatorze jours

10 A person who is not permitted to board an aircraft 10 La personne qui s’est vu refuser de monter à bord
under section 9 is not permitted to board another aircraft d’un aéronef en application de l’article 9 ne peut monter
for a period of 14 days after the denial, unless they pro- à bord d’un autre aéronef, et ce, pendant une période de
vide a medical certificate certifying that any symptoms quatorze jours après le refus, à moins qu’elle fournisse un
referred to in subsection 8(1) that they are exhibiting are certificat médical attestant que les symptômes visés au
not related to COVID-19.
81100-3-96-46 8 2021-11-26 (18:57)

AR04390
paragraphe 8(1) qu’elle présente ne sont pas liés à la CO-

VID-19.

du Canada
vol.
Notification Avis
son may be denied permission to board the aircraft if fuser de monter à bord de l’aéronef si elle ne peut présen-
they are unable to provide evidence that they received a ter la preuve qu’elle a obtenu un résultat à un essai molé-
result for a COVID-19 molecular test. culaire relatif à la COVID-19.

than 72 hours before the flight’s initial scheduled de- COVID-19 qui a été effectué sur un échantillon prélevé
parture time; or dans les soixante-douze heures avant l’heure prévue
initialement de départ du vol;
than 180 days before the flight’s initial scheduled de- sur un échantillon prélevé au moins quatorze jours et
parture time. au plus cent quatre-vingts jours avant l’heure prévue
initialement de départ du vol.

(2) For the purposes of subsection (1), the COVID-19 (2) Pour l’application du paragraphe (1), l’essai molécu-
molecular test must have been performed in a country or laire relatif à la COVID-19 doit être effectué dans un pays
territory that is not listed in Schedule 1. ou territoire qui ne figure pas à l’annexe 1.
81100-3-96-46 9 2021-11-26 (18:57)

AR04391

sonne;
procédé utilisé;


the person’s name and contact information and the date avise le ministre dès que possible des prénom, nom et co-
and number of the person’s flight. ordonnées de la personne ainsi que la date et le numéro
de son vol.
ments set out in section 13. gences prévues à l’article 13.

tue;
81100-3-96-46 10 2021-11-26 (18:57)

AR04392
(c) an air carrier operating a flight departing from an c) le transporteur aérien qui effectue un vol en par-
aerodrome listed in Schedule 2; tance d’un aérodrome visé à l’annexe 2;
(d) a screening authority at an aerodrome listed in d) l’administration de contrôle à un aérodrome visé à

Schedule 2. l’annexe 2.
of age;
(b) a crew member;
rier tue :
(i) only to become a crew member on board anoth- (i) dans le seul but d’agir à titre de membre d’équi-
er aircraft operated by an air carrier, page à bord d’un autre aéronef exploité par un
transporteur aérien,
aircraft operated by an air carrier, or (ii) après avoir agi à titre de membre d’équipage à
bord d’un aéronef exploité par un transporteur aé-
(iii) to participate in mandatory training required rien,
(d) a person who arrives at an aerodrome from any de membre d’équipage;
other country on board an aircraft in order to transit
to another country and remains in a sterile transit d) la personne qui arrive à un aérodrome à bord d’un
area, as defined in section 2 of the Immigration and aéronef en provenance d’un autre pays en vue d’y
Refugee Protection Regulations, of the aerodrome un- transiter vers un autre pays et qui demeure, jusqu’à
til they leave Canada; son départ du Canada, dans l’espace de transit isolé
au sens de l’article 2 du Règlement sur l’immigration
(e) a person who arrives at an aerodrome on board an et la protection des réfugiés de l’aérodrome;
aircraft following the diversion of their flight for a
safety-related reason, such as adverse weather or an e) la personne qui arrive à un aérodrome à bord d’un
equipment malfunction, and who boards an aircraft aéronef à la suite du déroutement de son vol pour une
for a flight not more than 24 hours after the arrival raison liée à la sécurité, comme le mauvais temps ou
time of the diverted flight. un défaut de fonctionnement de l’équipement, et qui
Notification Avis
operates that qu’il effectue qu’elle est tenue de respecter les conditions
suivantes :
(a) they must be a fully vaccinated person or a person
referred to in any of paragraphs 17.3(2)(a) to (c) or any a) être une personne entièrement vaccinée ou être vi-
of subparagraphs 17.3(2)(d)(i) to (iv) or (e)(i) to (vii); sée à l’un des alinéas 17.3(2)a) à c) ou à l’un des sous-
alinéas 17.3(2)d)(i) à (iv) et e)(i) à (vii);
81100-3-96-46 11 2021-11-26 (18:57)

AR04393
(b) they must provide to the air carrier evidence of b) présenter au transporteur aérien la preuve de vac-
COVID-19 vaccination demonstrating that they are a cination contre la COVID-19 établissant qu’elle est une
fully vaccinated person or evidence that they are a per- personne entièrement vaccinée ou la preuve qu’elle est
son referred to in any of paragraphs 17.3(2)(a) to (c) or visée à l’un des alinéas 17.3(2)a) à c) ou à l’un des
any of subparagraphs 17.3(2)(d)(i) to (iv) or (e)(i) to sous-alinéas 17.3(2)d)(i) à (iv) et e)(i) à (vii);
(vii); and
c) si la personne présente une demande visée à l’ar-
(c) if they submit a request referred to in section 17.4, ticle 17.4, présenter la demande dans le délai prévu au
they must do so within the period set out in subsection paragraphe 17.4(3).
17.4(3).

vaccinée.

suivantes :
the aircraft for a flight to an aerodrome in Canada if le régime de la Loi sur les Indiens et qui monte à bord
not more than 24 hours after the departure time of a au Canada si l’heure prévue initialement de départ du
flight taken by the person to Canada from any other vol est au plus tard vingt-quatre heures après l’heure
country; de départ du vol qu’il a pris en partance de tout autre
(b) a permanent resident who is boarding the aircraft
for a flight to an aerodrome in Canada if the initial b) le résident permanent qui monte à bord d’un aéro-
scheduled departure time of that flight is not more nef pour un vol à destination d’un aérodrome au
than 24 hours after the departure time of a flight taken Canada si l’heure prévue initialement de départ du vol
by the person to Canada from any other country for est au plus tard vingt-quatre heures après l’heure de
the purpose of entering Canada to become a perma- départ du vol qu’il a pris en partance de tout autre
nent resident; pays à destination du Canada dans le but d’entrer au
Canada afin de devenir résident permanent;
(c) a foreign national who has received a result for a
COVID-19 molecular test described in paragraph c) l’étranger qui a obtenu un résultat à un essai molé-
13(1)(a) or (b) and who is boarding an aircraft for a culaire relatif à la COVID-19 visé aux alinéas 13(1)a)
flight to a country other than Canada or to an aero- ou b) et qui monte à bord d’un aéronef pour un vol à
drome in Canada for the purpose of boarding an air- destination de tout autre pays que le Canada ou pour
craft for a flight to a country other than Canada; un vol à destination d’un aérodrome au Canada dans
le but de monter à bord d’un autre aéronef pour un vol
(d) a person who has received a result for a COVID-19 à destination de tout autre pays;
molecular test described in paragraph 13(1)(a) or (b)
and who is d) la personne qui a obtenu un résultat à un essai mo-
léculaire relatif à la COVID-19 visé aux alinéas 13(1)a)
(i) a person who has not completed a COVID-19 ou b) et qui, selon le cas :
traindication and who is entitled to be accommo- (i) n’a pas suivi de protocole vaccinal complet
dated on that basis under applicable legislation by contre la COVID-19 en raison d’une contre-indica-
81100-3-96-46 12 2021-11-26 (18:57)

AR04394
(ii) a person who has not completed a COVID-19 aéronef pour un vol ou d’accéder à une zone régle-
vaccine dosage regimen due to a sincerely held reli- mentée sans être une personne entièrement
gious belief and who is entitled to be accommodat- vaccinée,
ed on that basis under applicable legislation by be-
ing permitted to enter the restricted area or to (ii) n’a pas suivi de protocole vaccinal complet
board an aircraft without being a fully vaccinated contre la COVID-19 en raison d’une croyance reli-
person, gieuse sincère et qui a droit à une mesure d’adapta-
tion pour ce motif, aux termes de la législation ap-
(iii) a person who is boarding an aircraft for a flight plicable, lui permettant de monter à bord d’un
for the purpose of attending an appointment for an aéronef pour un vol ou d’accéder à une zone régle-
essential medical service or treatment, or mentée sans être une personne entièrement vacci-
née,
(iv) a competent person who is at least 18 years old
and who is boarding an aircraft for a flight for the (iii) monte à bord d’un aéronef pour un vol afin de
purpose of accompanying a person referred to in se rendre à un rendez-vous pour obtenir des ser-
subparagraph (iii) if the person needs to be accom- vices ou traitements médicaux essentiels,
panied because they
(iv) est une personne capable âgée d’au moins dix-
(A) are under the age of 18 years, huit ans qui monte à bord d’un aéronef pour un vol
afin d’accompagner la personne visée au sous-ali-
(B) have a disability, or néa (iii) si cette personne a besoin d’être accompa-
gnée pour l’une des raisons suivantes :
(C) need assistance to communicate; or
(A) elle est âgée de moins de dix-huit ans,
(e) a person who has received a result for a COVID-19
molecular test described in paragraph 13(1)(a) or (b) (B) elle a un handicap,
and who is boarding an aircraft for a flight for a pur-
pose other than an optional or discretionary purpose, (C) elle a besoin d’aide pour communiquer,
such as tourism, recreation or leisure, and who is
e) la personne qui a obtenu un résultat à un essai mo-
(i) a person who entered Canada at the invitation of léculaire relatif à la COVID-19 visé aux alinéas 13(1)a)
the Minister of Health for the purpose of assisting ou b) et qui monte à bord d’un aéronef pour un vol à
in the COVID-19 response, des fins autres que de nature optionnelle ou discré-
tionnaire telles que le tourisme, les loisirs ou le diver-
(ii) a person who is permitted to work in Canada as tissement et qui, selon le cas :
a provider of emergency services under paragraph
186(t) of the Immigration and Refugee Protection (i) est entrée au Canada à l’invitation du ministre
Regulations and who entered Canada for the pur- de la Santé afin de participer aux efforts de lutte
pose of providing those services, contre la COVID-19,
(iii) a person who entered Canada not more than 90 (ii) est autorisée à travailler au Canada afin d’offrir
days before the day on which this Interim Order des services d’urgence en vertu de l’alinéa 186t) du
came into effect and who, at the time they sought to Règlement sur l’immigration et la protection des
enter Canada, réfugiés et est entrée au Canada afin d’offrir de tels
services,
(A) held a permanent resident visa issued under
subsection 139(1) of the Immigration and (iii) est entrée au Canada dans les quatre-vingt-dix
Refugee Protection Regulations, and jours précédant la date d’entrée en vigueur du pré-
sent arrêté et au moment qu’elle cherchait à entrer
(B) was recognized as a Convention refugee or a au Canada, elle était à la fois :
person in similar circumstances to those of a
Convention refugee within the meaning of sub- (A) titulaire d’un visa de résident permanent dé-
section 146(1) of the Immigration and Refugee livré aux termes du paragraphe 139(1) du Règle-
Protection Regulations, ment sur l’immigration et la protection des réfu-
giés,
(iv) a person who has been issued a temporary resi-
dent permit within the meaning of subsection 24(1)
81100-3-96-46 13 2021-11-26 (18:57)

AR04395
of the Immigration and Refugee Protection Act (B) reconnue comme réfugié au sens de la
and who entered Canada not more than 90 days be- Convention ou était dans une situation sem-
fore the day on which this Interim Order came into blable à celle d’un réfugié visé au paragraphe
effect as a protected temporary resident under sub- 146(1) de ce même règlement;
section 151.1(2) of the Immigration and Refugee
Protection Regulations, (iv) est titulaire d’un permis de séjour temporaire
au sens du paragraphe 24(1) de la Loi sur l’immi-
(v) an accredited person, gration et la protection des réfugiés et qui est en-
trée au Canada dans les quatre-vingt-dix jours pré-
(vi) a person holding a D1, O1 or C1 visa who en- cédant la date d’entrée en vigueur du présent arrêté
tered Canada to take up a post and become an ac- à titre de résident temporaire protégé aux termes
credited person, or du paragraphe 151.1(2) du Règlement sur l’immi-
gration et la protection des réfugiés,
(vii) a diplomatic or consular courier.
(v) est une personne accréditée,
(vi) est titulaire d’un visa D1, O1 ou C1 et est entrée

au Canada pour occuper un poste et devenir une
personne accréditée,
(vii) est un courrier diplomatique ou consulaire.
Persons — subparagraphs 17.3(2)(d)(i) to (iv) Personne visée à l’un des sous-alinéas 17.3(2)d)(i) à
(iv)
son referred to in any of subparagraphs 17.3(2)(d)(i) to une personne visée à l’un des sous-alinéas 17.3(2)d)(i) à
behalf under a commercial agreement if compte en application d’une entente commerciale dans
les cas suivants :
(a) in the case of a person referred to in any of sub-
paragraphs 17.3(2)(d)(i) to (iii), the person submits a a) la personne est visée aux sous-alinéas 17.3(2)d)(i) à
request to the air carrier in respect of that flight in ac- (iii) et une demande a été présentée par cette per-
cordance with subsections (2) and (3) or such a re- sonne ou pour son compte conformément aux para-
quest is submitted on their behalf; graphes (2) et (3) au transporteur aérien à l’égard du
vol;
17.3(2)(d)(i) or (ii), the air carrier is obligated to ac- b) la personne est visée aux sous-alinéas 17.3(2)d)(i)
commodate the person on the basis of a medical con- ou (ii) et le transporteur aérien a l’obligation, aux
traindication or a sincerely held religious belief under termes de la législation applicable, de prendre une
applicable legislation by issuing the document; and mesure d’adaptation en raison d’une contre-indication
médicale ou d’une croyance religieuse sincère et il la
(c) in the case of a person referred to in subparagraph prend en délivrant le document;
17.3(2)(d)(iv), the person who needs accompaniment
submits a request to the air carrier in respect of that c) la personne est visée au sous-alinéa 17.3(2)d)(iv) et
flight in accordance with subsections (2) and (3) or une demande a été présentée à l’égard du vol au trans-
such a request is submitted on their behalf. porteur aérien par la personne qui a besoin d’être ac-
compagnée ou pour son compte conformément aux
paragraphes (2) et (3).
Request — contents Contenu de la demande

clude the following: prend les renseignements suivants :
a) les prénom, nom et adresse de résidence de la per-

sonne et, si la demande a été faite en son nom par une
81100-3-96-46 14 2021-11-26 (18:57)

AR04396
(a) the person’s name and home address and, if the autre personne, les prénom, nom et adresse de rési-
request is made by someone else on the person’s dence de la personne qui a fait la demande;
behalf, that person’s name and home address;
b) les date et numéro du vol ainsi que les aérodromes
(b) the date and number of the flight as well as the de départ et d’arrivée;
aerodrome of departure and the aerodrome of arrival;
c) dans le cas d’une personne visée au sous-alinéa
(c) in the case of a person described in subparagraph 17.3(2)d)(i) :
17.3(2)(d)(i),
(i) soit un document délivré par le gouvernement
(i) a document issued by the government of a d’une province attestant que la personne ne peut
province confirming that the person cannot com- pas suivre un protocole vaccinal complet contre la
plete a COVID-19 vaccination regimen due to a COVID-19 en raison de sa condition médicale,
medical condition, or
(ii) soit un certificat médical signé par un médecin
(ii) a medical certificate signed by a medical doctor ou un infirmier praticien autorisé à pratiquer au
or nurse practitioner who is licensed to practise in Canada attestant que la personne ne peut pas
Canada certifying that the person cannot complete suivre un protocole vaccinal complet contre la CO-
a COVID-19 vaccination regimen due to a medical VID-19 en raison de sa condition médicale et le nu-
condition and the licence number issued by a pro- méro du permis d’exercice délivré au médecin ou à
fessional medical licensing body to the medical doc- l’infirmier praticien par un organisme qui régle-
tor or nurse practitioner; mente la profession de médecin ou d’infirmier pra-
ticien;
(d) in the case of a person described in subparagraph
17.3(2)(d)(ii), a statement sworn or affirmed by the d) dans le cas d’une personne visée au sous-alinéa
person before a person appointed as a commissioner 17.3(2)d)(ii), une déclaration sous serment ou une af-
of oaths in Canada attesting that the person has not firmation solennelle de la personne faites devant une
completed a COVID-19 vaccination regimen due to a personne nommée à titre de commissaire aux ser-
sincerely held religious belief, including a description ments au Canada attestant qu’elle n’a pas suivi de pro-
of how the belief renders them unable to complete tocole vaccinal complet contre la COVID-19 en raison
such a regimen; and d’une croyance religieuse sincère et décrivant de
quelle manière cette croyance religieuse l’empêche de
(e) in the case of a person described in subparagraph suivre le protocole vaccinal complet;
17.3(2)(d)(iii), a document that includes
e) dans le cas d’une personne visée au sous-alinéa
(i) the signature of a medical doctor or nurse prac- 17.3(2)d)(iii), un document qui comprend :
titioner who is licensed to practise in Canada,
(i) la signature d’un médecin ou d’un infirmier pra-
(ii) the licence number issued by a professional ticien autorisé à pratiquer au Canada,
medical licensing body to the medical doctor or
nurse practitioner, (ii) le numéro du permis d’exercice délivré au mé-
decin ou à l’infirmier praticien par un organisme
(iii) the date of the appointment for the essential qui réglemente la profession de médecin ou d’infir-
medical service or treatment and the location of the mier praticien,
appointment,
(iii) l’endroit où le service ou traitement médical
(iv) the date on which the document was signed, essentiel sera reçu et la date du rendez-vous,
and
(iv) la date de la signature du document,
(v) if the person needs to be accompanied by a per-
son referred to in subparagraph 17.3(2)(d)(iv), the (v) si la personne a besoin d’être accompagnée par
name and contact information of that person and une personne visée au sous-alinéa 17.3(2)d)(iv), les
the reason that the accompaniment is needed. prénom, nom et coordonnées de cette personne
ainsi que la raison pour laquelle l’accompagnement
est nécessaire.
81100-3-96-46 15 2021-11-26 (18:57)

AR04397
Timing of request Moment de la demande

(3) The request must be submitted to the air carrier (3) La demande doit être présentée au transporteur aé-
rien au plus tard, selon le cas :
17.3(2)(d)(i) or (ii), 21 days before the day on which a) dans le cas d’une personne visée aux sous-alinéas
the flight is initially scheduled to depart; and 17.3(2)d)(i) ou (ii), vingt et un jours avant la date pré-
vue initialement de départ du vol;
17.3(2)(d)(iii) or (iv), 14 days before the day on which b) dans le cas d’une personne visée aux sous-alinéas
the flight is initially scheduled to depart. 17.3(2)d)(iii) ou (iv), quatorze jours avant la date pré-
vue initialement de départ du vol.
Special circumstances Circonstances spéciales

(4) In special circumstances, an air carrier may issue the (4) Dans des circonstances spéciales, en réponse à une
document referred to in subsection (1) in response to a demande présentée après le délai prévu au paragraphe
request submitted after the period referred to in subsec- (3), le transporteur aérien peut délivrer le document visé
tion (3). au paragraphe (1).

(5) The document referred to in subsection (1) must in- (5) Le document visé au paragraphe (1) comprend les
clude éléments suivants :
(a) a confirmation that the air carrier has verified that a) la confirmation que le transporteur aérien a vérifié
the person is a person referred to in any of subpara- que la personne est visée à l’un des sous-alinéas
graphs 17.3(2)(d)(i) to (iv); and 17.3(2)d)(i) à (iv);
(b) the date and number of the flight as well as the b) les date et numéro du vol ainsi que les aérodromes
aerodrome of departure and the aerodrome of arrival. de départ et d’arrivée.

ing information: gistre les renseignements suivants :
(a) the number of requests that the air carrier has re- a) le nombre de demandes reçues par le transporteur
ceived in respect of each exception referred to in sub- aérien à l’égard de chaque exception visée à l’un des
paragraphs 17.3(2)(d)(i) to (iv); sous-alinéas 17.3(2)d)(i) à (iv);
a refusées.
(2) An air carrier must retain the record for a period of at (2) Il conserve le registre pendant au moins douze mois
created.

81100-3-96-46 16 2021-11-26 (18:57)

AR04398

a period of at least 90 days after the day on which the air chaque demande présentée pendant au moins quatre-
carrier issued a document under subsection 17.4(1) or re- vingt-dix jours après la date de délivrance du document
fused to issue the document. visé au paragraphe 17.4(1) ou celle du refus de le délivrer.


aérien
17.7 Before permitting a person to board an aircraft for 17.7 Avant de permettre à une personne de monter à
a flight that the air carrier operates, the air carrier must bord de l’aéronef pour un vol qu’il effectue, le transpor-
request that the person provide teur aérien est tenu de demander à la personne de pré-
senter, selon le cas :
(a) evidence of COVID-19 vaccination demonstrating
that they are a fully vaccinated person; a) la preuve de vaccination contre la COVID-19 éta-
blissant qu’elle est une personne entièrement vacci-
(b) evidence that they are a person referred to in para- née;
graph 17.3(2)(a) or (b); or
b) la preuve qu’elle est visée aux alinéas 17.3(2)a) ou
(c) evidence that they are a person referred to in para- b);
graph 17.3(2)(c) or any of subparagraphs 17.3(2)(d)(i)
to (iv) or (e)(i) to (vii) and that they have received a re- c) la preuve qu’elle est visée à l’alinéa 17.3(2)c) ou à
sult for a COVID-19 molecular test. l’un des sous-alinéas 17.3(2)d)(i) à (iv) et e)(i) à (vii) et
qu’elle a obtenu un résultat à un essai moléculaire re-
latif à la COVID-19.
Request for evidence — screening authority Demande de présenter la preuve — administration de

contrôle
to enter a restricted area, the screening authority must ministre d’accéder à une zone réglementée, l’administra-
themselves for screening at a passenger screening check- personnes, lorsqu’elles se présentent à un point de
point, provide the evidence referred to in paragraph contrôle des passagers pour un contrôle, de présenter la
17.7(a), (b) or (c). preuve visée aux alinéas 17.7a), b) ou c).

17.9 A person must, at the request of an air carrier or a 17.9 Toute personne est tenue de présenter, sur de-
screening authority, provide to the air carrier or screen- mande du transporteur aérien ou de l’administration de
ing authority the evidence referred to in paragraph contrôle, la preuve visée aux alinéas 17.7a), b) ou c).
17.7(a), (b) or (c).

evidence issued by a non-governmental entity that is au- est délivrée par une entité non gouvernementale ayant la
thorized to issue the evidence of COVID-19 vaccination in compétence pour la délivrer dans le territoire où le vaccin
the jurisdiction in which the vaccine was administered, contre la COVID-19 a été administré, par un gouverne-
by a government or by an entity authorized by a government ou par une entité autorisée par un gouvernement et
ment, and must contain the following information: comprend les renseignements suivants :
(a) the name of the person who received the vaccine;
81100-3-96-46 17 2021-11-26 (18:57)

AR04399
(b) the name of the government or of the entity; a) les prénom et nom de la personne qui a reçu le vac-
cin;
identifies the vaccine that was administered; and b) le nom du gouvernement ou de l’entité;
(d) the dates on which the vaccine was administered c) la marque nominative ou tout autre renseignement
or, if the evidence is one document issued for both permettant d’identifier le vaccin qui a été administré;
doses and the document specifies only the date on
which the most recent dose was administered, that d) les dates auxquelles le vaccin a été administré ou,
date. dans le cas où la preuve est un document unique qui
est délivré pour deux doses et qui ne mentionne que la
date à laquelle la dernière dose a été administrée, cette
date.

conforme.
sult described in paragraph 13(1)(a) or (b). COVID-19 est un résultat visé aux alinéas 13(1)a) ou b).
éléments
(d). 14a) à d).
Person — paragraph 17.3(2)(a) Personne visée à l’alinéa 17.3(2)a)

17.12 (1) Evidence that the person is a person referred 17.12 (1) La preuve qui établit qu’une personne est vi-
to in paragraph 17.3(2)(a) must be sée à l’alinéa 17.3(2)a) comprend les éléments suivants :
(a) a travel itinerary or boarding pass that shows that a) un itinéraire de voyage ou une carte d’embarque-
the initial scheduled departure time of the flight to an ment qui indique que l’heure prévue initialement de
aerodrome in Canada is not more than 24 hours after départ du vol à destination d’un aérodrome au Canada
the departure time of a flight taken by the person to est au plus tard vingt-quatre heures après l’heure de
Canada from any other country; and départ du vol que la personne a pris en partance de
tout autre pays à destination du Canada;
(b) their passport or other travel document issued by
their country of citizenship or nationality. b) un passeport ou autre titre de voyage de la per-
sonne délivré par son pays de citoyenneté ou de natio-
nalité.
Person — paragraph 17.3(2)(b) Personne visée à l’alinéa 17.3(2)b)

(2) Evidence that the person is a person referred to in (2) La preuve qui établit qu’une personne est visée à l’ali-
paragraph 17.3(2)(b) must be néa 17.3(2)b) comprend les éléments suivants :
the departure time of the flight taken by the person to est au plus tard vingt-quatre heures après l’heure de
81100-3-96-46 18 2021-11-26 (18:57)

AR04400
(b) a document entitled “Confirmation of Permanent b) un document délivré par le ministère de la Citoyen-
Residence” issued by the Department of Citizenship neté et de l’Immigration intitulé « Confrmation de ré-
and Immigration that confirms that the person be- sidence permanente » qui confirme que la personne
came a permanent resident on entry to Canada after est devenue résident permanent à son entrée au
the flight taken by the person to Canada from any oth- Canada après le vol qu’elle a pris en partance de tout
er country. autre pays à destination du Canada.
Person — paragraph 17.3(2)(c) Personne visée à l’alinéa 17.3(2)c)

paragraph 17.3(2)(c) must be néa 17.3(2)c) comprend les éléments suivants :
the person is boarding an aircraft for a flight to a ment qui indique que la personne monte à bord d’un
country other than Canada or to an aerodrome in aéronef pour un vol à destination de tout autre pays
Canada for the purpose of boarding an aircraft for a que le Canada ou qu’elle monte à bord d’un aéronef
flight to a country other than Canada; and pour un vol à destination d’un aérodrome au Canada
dans le but de monter à bord d’un autre aéronef pour
(b) their passport or other travel document issued by un vol à destination de tout autre pays;
their country of citizenship or nationality.
b) un passeport ou autre titre de voyage de la per-
nalité.
Person — subparagraphs 17.3(2)(d)(i) to (iv) Personne visée à l’un des sous-alinéas 17.3(2)d)(i) à
(iv)
(4) Evidence that the person is a person referred to in (4) La preuve qui établit qu’une personne est visée à l’un
any of subparagraphs 17.3(2)(d)(i) to (iv) must be a docu- des sous-alinéas 17.3(2)d)(i) à (iv) est le document déli-
ment issued by an air carrier under subsection 17.4(1) in vré par le transporteur aérien en application du para-
respect of the flight for which the person is boarding the graphe 17.4(1) à l’égard du vol pour lequel la personne
aircraft or entering the restricted area. monte à bord de l’aéronef ou accède à la zone réglemen-
tée.
Person — subparagraph 17.3(2)(e)(i) Personne visée au sous-alinéa 17.3(2)e)(i)

(5) Evidence that the person is a person referred to in (5) La preuve qui établit qu’une personne est visée au
subparagraph 17.3(2)(e)(i) must be a document issued by sous-alinéa 17.3(2)e)(i) est un document délivré par le
the Minister of Health that indicates that the person was ministre de la Santé indiquant que la personne s’est fait
asked to enter Canada for the purpose of assisting in the demander d’entrer au Canada afin de participer aux ef-
COVID-19 response. forts de lutte contre la COVID-19.
Person — subparagraph 17.3(2)(e)(ii) Personne visée au sous-alinéa 17.3(2)e)(ii)

subparagraph 17.3(2)(e)(ii) must be a document from a sous-alinéa 17.3(2)e)(ii) est un document délivré par un
government or non-governmental entity that indicates gouvernement ou une entité non gouvernementale qui
that the person was asked to enter Canada for the pur- indique que la personne s’est fait demander d’entrer au
pose of providing emergency services under paragraph Canada afin d’offrir des services d’urgences en vertu de
186(t) of the Immigration and Refugee Protection Regu- l’alinéa 186t) du Règlement sur l’immigration et la pro-
lations. tection des réfugiés.
Person — subparagraph 17.3(2)(e)(iii) Personne visée au sous-alinéa 17.3(2)e)(iii)

subparagraph 17.3(2)(e)(iii) must be a document issued sous-alinéa 17.3(2)e)(iii) est un document délivré par le
by the Department of Citizenship and Immigration that ministère de la Citoyenneté et de l’Immigration qui
confirms that the person has been recognized as a Con- confirme que la personne s’est vu reconnaître comme ré-
vention refugee or a person in similar circumstances to fugié au sens de la Convention ou était dans une situation
81100-3-96-46 19 2021-11-26 (18:57)

AR04401
those of a Convention refugee within the meaning of sub- semblable à celui-ci au sens du paragraphe 146(1) du Rè-
section 146(1) of the Immigration and Refugee Protec- glement sur l’immigration et la protection des réfugiés.
tion Regulations.
Person — subparagraph 17.3(2)(e)(iv) Personne visée au sous-alinéa 17.3(2)e)(iv)

subparagraph 17.3(2)(e)(iv) must be a document issued sous-alinéa 17.3(2)e)(iv) est un document délivré par le
confirms that the person entered Canada as a protected confirme que la personne et qu’elle est entrée au Canada
temporary resident under subsection 151.1(2) of the Im- à titre de résident temporaire protégé aux termes du pa-
migration and Refugee Protection Regulations. ragraphe 151.1(2) du Règlement sur l’immigration et la
protection des réfugiés.
Person — subparagraph 17.3(2)(e)(v) Personne visée au sous-alinéa 17.3(2)e)(v)

subparagraph 17.3(2)(e)(v) must be their passport con- sous-alinéa 17.3(2)e)(v) est le passeport de la personne
taining a valid diplomatic, consular, official or special contenant une acceptation valide l’autorisant à occuper
representative acceptance issued by the Chief of Protocol un poste en tant qu’agent diplomatique ou consulaire, ou
for the Department of Foreign Affairs, Trade and Devel- en tant que représentant officiel ou spécial, délivrée par
opment. le chef du protocole du ministère des Affaires étrangères,
du Commerce et du Développement.
Person — subparagraph 17.3(2)(e)(vi) Personne visée au sous-alinéa 17.3(2)e)(vi)

subparagraph 17.3(2)(e)(vi) must be the person’s DI, O1 sous-alinéa 17.3(2)e)(vi) est le visa DI, O1 ou C1 de la
or C1 visa. personne.
Person — subparagraph 17.3(2)(e)(vii) Personne visée au sous-alinéa 17.3(2)e)(vii)

subparagraph 17.3(2)(e)(vii) must be sous-alinéa 17.3(2)e)(vii) :
(a) in the case of a diplomatic courier, the official doc- a) dans le cas d’un courrier diplomatique, le docu-
ument confirming their status referred to in Article 27 ment officiel attestant sa qualité mentionné à l’article
of the Vienna Convention on Diplomatic Relations, as 27 de la Convention de Vienne sur les relations diplo-
set out in Schedule I to the Foreign Missions and In- matiques, telle qu’elle figure à l’annexe I de la Loi sur
ternational Organizations Act; and les missions étrangères et les organisations interna-
tionales;
(b) in the case of a consular courier, the official docu-
ment confirming their status referred to in Article 35 b) dans le cas d’un courrier consulaire, le document
of the Vienna Convention on Consular Relations, as officiel attestant sa qualité mentionné à l’article 35 de
set out in Schedule II to that Act. la Convention de Vienne sur les relations consulaires,
telle qu’elle figure à l’annexe II de la Loi sur les mis-
sions étrangères et les organisations internationales.
False or misleading information Renseignements faux ou trompeurs

17.13 (1) A person must not submit a request referred 17.13 (1) Il est interdit à toute personne de présenter
to in section 17.4 that contains information that they une demande visée à l’article 17.4 qui comporte des ren-
know to be false or misleading. seignements, les sachant faux ou trompeurs.

81100-3-96-46 20 2021-11-26 (18:57)

AR04402
Notice to Minister — information Avis au ministre — renseignements

person has submitted a request referred to in section 17.4 croire qu’une personne lui a présenté une demande visée
that contains information that is likely to be false or mis- à l’article 17.4 qui comporte des renseignements suscep-
leading must notify the Minister of the following not tibles d’être faux ou trompeurs en avise le ministre, au
more than 72 hours after receiving the request: plus tard soixante-douze heures après la réception de la
demande et l’avis comprend les éléments suivants :
(a) the person’s name and contact information;
a) les prénom, nom et coordonnées de la personne;
b) les date et numéro de son vol;
croit que ces renseignements sont susceptibles d’être
faux ou trompeurs.
Notice to Minister — evidence Avis au ministre — preuve

(2) An air carrier or screening authority that has reason (2) Le transporteur aérien ou l’administration de
to believe that a person has provided evidence that is contrôle qui a des raisons de croire qu’une personne lui a
likely to be false or misleading must notify the Minister présenté une preuve susceptible d’être fausse ou trom-
of the following not more than 72 hours after the provi- peuse en avise le ministre, au plus tard soixante-douze
sion of the evidence: heures après la présentation de la preuve et l’avis com-
prend les éléments suivants :
(c) the reason the air carrier or screening authority
believes that the evidence is likely to be false or mis- c) les raisons pour lesquelles le transporteur aérien
leading. ou l’administration de contrôle croit que la preuve est
susceptible d’être fausse ou trompeuse.

Prohibition — screening authority Interdiction – administration de contrôle

17.16 (1) A screening authority must not permit a per- 17.16 (1) Il est interdit à l’administration de contrôle de
son to enter a restricted area if the person does not pro- permettre l’accès à une zone réglementée à une personne
vide the evidence they are required to provide under sec- qui ne présente pas la preuve exigée par l’article 17.9.
tion 17.9.
Notification to air carrier Avis au transporteur aérien

(2) If a screening authority denies a person entry to a re- (2) L’administration de contrôle qui refuse à une per-
stricted area, the screening authority must notify the air sonne l’accès à une zone réglementée en avise le trans-
carrier operating the flight that the person has been de- porteur aérien qui effectue le vol et lui fournit les prénom
nied entry and provide the person’s name and flight et nom de cette personne et le numéro de son vol.
number to the air carrier.
Air carrier requirements Exigences du transporteur aérien

(3) An air carrier that has been notified under subsection (3) Le transporteur aérien avisé, en application du para-
(2) must ensure that the person is escorted to a location graphe (2), veille à ce que la personne soit escortée
81100-3-96-46 21 2021-11-26 (18:57)

AR04403
where they can retrieve their checked baggage, as de- jusqu’à l’endroit où elle peut récupérer ses bagages en‐
fined in section 3 of the Canadian Aviation Security Reg- registrés, au sens de l’article 3 du Règlement canadien
ulations, 2012, if applicable. de 2012 sur la sûreté aérienne, le cas échéant.

person is denied permission to board an aircraft for a sonne chaque fois qu’elle s’est vu refuser de monter à
flight under section 17.15: bord d’un aéronef pour un vol en application de l’article
17.15:
cluding the person’s home address, telephone number a) les prénom, nom et coordonnées de la personne, y
and email address; compris son adresse de résidence, son numéro de télé-
phone et son adresse de courriel;
b) les dates et numéro du vol;

Record keeping — screening authority Tenue de registre — administration de contrôle

time the person is denied entry to a restricted area under personne chaque fois qu’elle s’est vu refuser l’accès à une
(b) the date and flight number; and b) les dates et numéro du vol;
(c) the reason why the person was denied entry to the c) le motif pour lequel la personne s’est vu refuser
period of at least 12 months after the day on which it was mois après la date de sa création.
created.

81100-3-96-46 22 2021-11-26 (18:57)

AR04404


lon le cas :
mandatary; b) est un employé d’un entrepreneur ou d’un manda-
(c) a person hired by the entity to provide a service;
c) est embauchée par l’entité pour offrir un service;
lessee, if the property that is subject to the lease is part d) est un locataire de l’entité ou un employé d’un loca-
of aerodrome property; or taire de l’entité, si les lieux faisant l’objet du bail font
partie des terrains de l’aérodrome;
(e) a person permitted by the entity to access aero-
drome property or, in the case of NAV CANADA, a lo- e) a l’autorisation de l’entité pour accéder aux terrains
cation where NAV CANADA provides civil air naviga- de l’aérodrome ou, dans le cas de NAV CANADA, à un
tion services. emplacement où celle-ci fournit des services de navi-
sont :
are related to commercial flight operations — such as a) la conduite d’activités qui sont liées à l’exploitation
aircraft refuelling services, aircraft maintenance and des vols commerciaux — telles que les services de ravi-
repair services, baggage handling services, supply ser- taillement des aéronefs, les services d’entretien et de
vices for the operator of an aerodrome, an air carrier réparation d’aéronefs, les services de manutention des
or NAV CANADA, runway and taxiway maintenance bagages, les services d’approvisionnement fournis à
services or de-icing services — and that take place on l’exploitant d’un aérodrome, à un transporteur aérien
aerodrome property or at a location where NAV ou à NAV CANADA, les services d’entretien des pistes
CANADA provides civil air navigation services; et des voies de circulation et les services de dégivrage
— qui se déroulent aux terrains de l’aérodrome ou à
(b) interacting in-person on aerodrome property with un emplacement où NAV CANADA fournit des ser-
a person who intends to board an aircraft for a flight; vices de navigation aérienne civile, et le soutien direct
à de telles activités;
81100-3-96-46 23 2021-11-26 (18:57)

AR04405
(c) engaging in tasks, on aerodrome property or at a b) l’interaction en présentiel aux terrains de l’aéro-
location where NAV CANADA provides civil air navi- drome avec quiconque a l’intention de monter à bord
gation services, that are intended to reduce the risk of d’un aéronef pour un vol;
transmission of the virus that causes COVID-19; and
c) l’exécution, aux terrains de l’aérodrome ou à un
(d) accessing a restricted area at an aerodrome listed emplacement où NAV CANADA fournit des services
in Schedule 2. de navigation aérienne civile, de tâches qui ont pour
COVID-19;

à l’annexe 2.


(a) require that, as of November 15, 2021, a person a) exiger que, à compter du 15 novembre 2021, toute
who is 12 years and four months of age or older be a personne âgée de douze ans et quatre mois ou plus
fully vaccinated person before accessing aerodrome soit une personne entièrement vaccinée pour pouvoir
property, unless they are a person accéder aux terrains de l’aérodrome, sauf dans les cas
suivants :
(i) who intends to board an aircraft for a flight that
an air carrier operates, (i) elle a l’intention de monter à bord d’un aéronef
pour un vol qu’un transporteur aérien effectue,
(ii) who does not intend to board an aircraft for a
flight and who is accessing aerodrome property for (ii) elle n’a pas l’intention de monter à bord d’un
leisure purposes or to accompany a person who in- aéronef et accède aux terrains de l’aérodrome à des
tends to board an aircraft for a flight, fins de loisirs ou pour accompagner une personne
qui a l’intention de monter à bord d’un aéronef
(iii) who is the holder of an employee identification pour un vol,
document issued by a department or departmental
corporation listed in Schedule 3 or a member iden- (iii) elle est titulaire d’une pièce d’identité d’em-
tification document issued by the Canadian Forces, ployé délivrée par un ministère ou un établissement
or public visé à l’annexe 3 ou d’une pièce d’identité de
membre délivrée par les Forces canadiennes,
(iv) who is delivering equipment or providing ser-
vices within the restricted area of the aerodrome (iv) elle effectue, dans une zone réglementée, la
that are urgently needed and critical to aerodrome fourniture d’équipements ou de services essentiels
operations; aux activités de l’aérodrome et pour lesquels il y a
un besoin urgent;
(b) despite paragraph (a), allow a person who is sub-
ject to the policy and who is not a fully vaccinated per- b) malgré l’alinéa a), permettre à la personne assujet-
son to access aerodrome property if the person tie à la politique qui n’est pas une personne entière-
ment vaccinée d’accéder aux terrains de l’aérodrome si
(i) has not completed a COVID-19 vaccine dosage celle-ci :
regimen due to a medical contraindication or their
sincerely held religious belief, or (i) n’a pas suivi un protocole vaccinal complet
contre la COVID-19 en raison d’une contre-indica-
(ii) received the first dose of a COVID-19 vaccine tion médicale ou de sa croyance religieuse sincère,
dosage regimen before November 15, 2021;
81100-3-96-46 24 2021-11-26 (18:57)

AR04406
(c) provide for a procedure for verifying evidence pro- (ii) a reçu sa première dose du protocole vaccinal
vided by a person referred to in paragraph (b) that contre la COVID-19 avant le 15 novembre 2021;
demonstrates that the person
c) prévoir une procédure permettant de vérifier la
(i) has not completed a COVID-19 vaccine dosage preuve présentée par la personne visée à l’alinéa b)
regimen due to a medical contraindication or their établissant qu’elle :
sincerely held religious belief, or
(i) n’a pas suivi de protocole vaccinal complet
(ii) received the first dose of a COVID-19 vaccine contre la COVID-19 en raison d’une contre-indica-
dosage regimen before November 15, 2021; tion médicale ou de sa croyance religieuse sincère,
(d) provide for a procedure for issuing to a person (ii) a reçu sa première dose du protocole vaccinal
whose evidence has been verified under the procedure contre la COVID-19 avant le 15 novembre 2021;
referred to in paragraph (c) a document confirming
that they are a person referred to in subparagraph d) prévoir une procédure permettant de délivrer à la
(b)(i) or (ii); personne dont la preuve a été vérifiée en application
de l’alinéa c), un document qui confirme qu’elle est vi-
(e) provide for a procedure that ensures that a person sée aux sous-alinéas b)(i) ou (ii);
subject to the policy provides, on request, the follow-
ing evidence before accessing aerodrome property: e) prévoir une procédure permettant de veiller à ce
que la personne assujettie à la politique présente sur
(i) in the case of a fully vaccinated person, the evi- demande la preuve ci-après avant d’accéder aux ter-
dence of COVID-19 vaccination referred to in sec- rains de l’aérodrome :
tion 17.10, and
(i) dans le cas d’une personne entièrement vacci-
(ii) in the case of a person referred to in paragraph née, la preuve de vaccination contre la COVID-19
(d), the document issued to the person under the visée à l’article 17.10,
procedure referred to in that paragraph;
(ii) dans le cas d’une personne visée à l’alinéa d), le
(f) provide for a procedure that allows a person to document qui lui a été délivré en application de cet
whom sections 17.31 to 17.40 apply — other than a alinéa;
person referred to in subsection 17.34(2) — who is a
fully vaccinated person or a person referred to in sub- f) prévoir une procédure permettant à la personne as-
paragraph (b)(i) or (ii) and who is unable to provide sujettie aux articles 17.31 à 17.40, à l’exception de celle
the evidence referred to in paragraph (e) to temporari- visée au paragraphe 17.34(2), qui est une personne en-
ly access aerodrome property if they provide a declara- tièrement vaccinée ou une personne visée aux sous-
tion confirming that they are a fully vaccinated person alinéas b)(i) ou (ii) et qui n’est pas en mesure de pré-
or that they have been issued a document under the senter la preuve visée à l’alinéa e) d’accéder
procedure referred to in paragraph (d); temporairement aux terrains de l’aérodrome si elle
présente une déclaration confirmant qu’elle est une
(g) provide for a procedure that ensures that a person personne entièrement vaccinée ou qu’elle s’est vu déli-
referred to in paragraph (d) is tested for COVID-19 at vrer un document en application de la procédure visée
least twice every week; à l’alinéa d);
(h) provide for a procedure that ensures that a person g) prévoir une procédure permettant de veiller à ce
who receives a positive result for a COVID-19 test, oth- que la personne visée à l’alinéa d) se soumette à un es-
er than a COVID-19 molecular test, under the proce- sai relatif à la COVID-19 au moins deux fois par se-
dure referred to in paragraph (g) receives a result for a maine;
COVID-19 molecular test;
h) prévoir une procédure permettant de veiller à ce
(i) provide for a procedure that ensures that a person que la personne qui a reçu un résultat positif à un es-
who receives a positive result for a COVID-19 molecu- sai relatif à la COVID-19, autre qu’un essai moléculaire
lar test under the procedure referred to in paragraph relatif à la COVID-19, en application de la procédure
(g) or (h) is prohibited from accessing aerodrome visée à l’alinéa g), obtienne un résultat d’un essai mo-
property for a period of 14 days after the result was re- léculaire relatif à la COVID-19;
ceived or until the person is not exhibiting any of the
81100-3-96-46 25 2021-11-26 (18:57)

AR04407
symptoms referred to in subsection 8(1), whichever is i) prévoir une procédure permettant de veiller à ce
later; and que la personne qui a reçu un résultat positif à un es-
sai moléculaire relatif à la COVID-19 en application de
(j) provide for a procedure that ensures that a person la procédure visée aux alinéas g) ou h) ne puisse accé-
referred to in paragraph (i) is exempt from the re- der aux terrains de l’aérodrome pour la période de
quirement referred to in paragraph (g) for a period of quatorze jours suivant la réception du résultat ou jus-
180 days after the person received a positive result for qu’à ce qu’elle ne présente pas des symptômes prévus
a COVID-19 molecular test. au paragraphe 8(1), selon la plus tardive des éventuali-
tés;
j) prévoir une procédure permettant de veiller à ce

que la personne visée à l’alinéa i) soit exemptée de
l’exigence visée à l’alinéa g) pour la période de cent
quatre-vingts jours suivant la réception d’un résultat
positif à un essai moléculaire relatif à la COVID-19.

(3) For the purposes of subparagraph (2)(c)(i) and para- (3) Pour l’application du sous-alinéa (2)(c)(i) et de l’ali-
graph (2)(d), the policy must provide that a document is néa (2)d), la politique doit prévoir que le document
to be issued to a person confirming that they did not confirmant qu’une personne n’a pas suivi de protocole
complete a COVID-19 vaccine dosage regimen on the ba- vaccinal complet contre la COVID-19, pour le motif de
sis of a medical contraindication only if they provide a contre-indication médicale, n’est délivré à la personne
medical certificate from a medical doctor or nurse practi- que si celle-ci soumet un certificat médical délivré par un
tioner who is licensed to practise in Canada certifying médecin ou un infirmier praticien autorisé à pratiquer au
that the person cannot complete a COVID-19 vaccination Canada qui atteste que la personne ne peut pas suivre de
regimen due to a medical condition and specifying protocole vaccinal complet contre la COVID-19 en raison
whether the condition is permanent or temporary. d’une condition médicale et qui précise si cette condition
est permanente ou temporaire.

to be issued to a person confirming that they did not confirmant qu’une personne n’a pas suivi de protocole
complete a COVID-19 vaccine dosage regimen on the ba- vaccinal complet contre la COVID-19, pour le motif de
sis of their sincerely held religious belief only if they sub- croyance religieuse sincère de la personne, n’est délivré à
mit a statement sworn or affirmed by them attesting that la personne que si celle-ci fournit une déclaration sous
they have not completed a COVID-19 vaccination regi- serment ou une affirmation solennelle attestant qu’elle
men due to their sincerely held religious belief. n’a pas suivi de protocole vaccinal complet contre la CO-
VID-19 en raison de sa croyance religieuse sincère.
graph (2)(d), in the case of an employee of the operator of néa (2)d), dans le cas de l’employé de l’exploitant d’un
an aerodrome or a person hired by the operator of an aérodrome ou de la personne qui est embauchée par l’ex-
aerodrome to provide a service, the policy must provide ploitant d’un aérodrome pour offrir un service, la poli-
that a document is to be issued to the employee or person tique doit prévoir que le document confirmant qu’une
confirming that they did not complete a COVID-19 vac- personne n’a pas suivi de protocole vaccinal complet
cine dosage regimen on the basis of their sincerely held contre la COVID-19, pour le motif de croyance religieuse
religious belief only if the operator of the aerodrome is sincère de l’employé ou de la personne, n’est délivré à la
obligated to accommodate them on that basis under the personne que si l’exploitant d’un aérodrome a l’obliga-
Canadian Human Rights Act by issuing such a docu- tion de prendre une telle mesure d’adaptation pour ce
ment. motif aux termes de la Loi canadienne sur les droits de la
personne.
81100-3-96-46 26 2021-11-26 (18:57)

AR04408

graph (2)(d), in the following cases, the policy must pro- néa (2)d), dans les cas ci-après, la politique doit prévoir
vide that a document is to be issued to the employee con- que le document confirmant qu’une personne n’a pas sui-
firming that they did not complete a COVID-19 vaccine vi de protocole vaccinal complet contre la COVID-19,
dosage regimen on the basis of their sincerely held reli- pour le motif de croyance religieuse sincère de la per-
gious belief only if they would be entitled to such an ac- sonne, n’est délivré à la personne que si celle-ci a droit à
commodation on that basis under applicable legislation: une telle mesure d’adaptation pour ce motif aux termes
de la législation applicable :
(a) in the case of an employee of the operator of an
aerodrome’s contractor or agent or mandatary; and a) le cas de l’employé d’un entrepreneur ou d’un man-
dataire de l’exploitant d’un aérodrome;
(b) in the case of an employee of the operator of an
aerodrome’s lessee, if the property that is subject to b) le cas de l’employé d’un locataire de l’exploitant
the lease is part of aerodrome property. d’un aérodrome, si les lieux faisant l’objet du bail font
partie des terrains de l’aérodrome.
CANADA CANADA
cordance with paragraphs 17.24(2)(a) to (i) and sub- COVID-19 qui est conforme aux alinéas 17.24(2)a) à i)
ed person who has not been issued a document under toute personne non-vaccinée qui ne s’est pas vu déli-
the procedure referred to in paragraph 17.24(2)(d) and vrer un document en application de l’alinéa 17.24(2)d)
who is et qui est :
(i) an employee of the entity, (i) un employé de l’entité,
(ii) an employee of the entity’s contractor or agent (ii) un employé d’un entrepreneur ou d’un manda-
or mandatary, taire de l’entité,
(iii) a person hired by the entity to provide a ser- (iii) une personne qui est embauché par l’entité
vice, or pour offrir un service,
(iv) the entity’s lessee or an employee of the enti- (iv) un locataire de l’entité ou un employé d’un lo-
ty’s lessee, if the property that is subject to the lease cataire de l’entité, si les lieux faisant l’objet du bail
is part of aerodrome property. fait partie des terrains de l’aérodrome.
CANADA
81100-3-96-46 27 2021-11-26 (18:57)

AR04409

(a) require that, as of November 15, 2021, a relevant a) exiger que, à compter du 15 novembre 2021, toute
person, other than the holder of an employee identifi- personne concernée, à l’exception du titulaire d’une
cation document issued by a department or depart- pièce d’identité d’employé délivrée par un ministère
mental corporation listed in Schedule 3 or a member ou un établissement public visé à l’annexe 3 ou d’une
identification document issued by the Canadian pièce d’identité de membre délivrée par les Forces ca-
Forces, be a fully vaccinated person before accessing nadiennes, soit une personne entièrement vaccinée
aerodrome property or, in the case of NAV CANADA, a pour pouvoir accéder aux terrains de l’aérodrome ou,
location where NAV CANADA provides civil air navi- dans le cas de NAV CANADA, à un emplacement où
gation services; NAV CANADA fournit des services de navigation aé-
rienne civile;
person cement où NAV CANADA fournit des services de navi-
gation aérienne civile si celle-ci :
sincerely held religious belief, or contre la COVID-19 en raison d’une contre-indica-
tion médicale ou de sa croyance religieuse sincère,
(c) provide for a procedure for verifying evidence pro-
vided by a relevant person referred to in paragraph (b) c) prévoir une procédure permettant de vérifier la
that demonstrates that the relevant person preuve présentée par la personne concernée visée à
l’alinéa b) établissant qu’elle :
regimen due to a medical contraindication or their (i) n’a pas suivi de protocole vaccinal complet
sincerely held religious belief, or contre la COVID-19 en raison d’une contre-indica-
tion médicale ou de sa croyance religieuse sincère,
(d) provide for a procedure for issuing to a relevant
person whose evidence has been verified under the d) prévoir une procédure permettant de délivrer à la
procedure referred to in paragraph (c) a document personne concernée dont la preuve a été vérifiée en
confirming that they are a relevant person referred to application de l’alinéa c), un document qui confirme
in subparagraph (b)(i) or (ii); qu’elle est visée aux sous-alinéas b)(i) ou (ii);
(e) provide for a procedure that ensures that a rele- e) prévoir une procédure permettant de veiller à ce
vant person subject to the policy provides, on request, que la personne concernée assujettie à la politique
the following evidence before accessing aerodrome présente sur demande la preuve ci-dessous avant d’ac-
property: céder aux terrains de l’aérodrome :
(i) in the case of a fully vaccinated person, the evi- (i) dans le cas d’une personne entièrement vacci-
dence of COVID-19 vaccination referred to in sec- née, la preuve de vaccination contre la COVID-19
tion 17.10, and visée à l’article 17.10,
(ii) in the case of a relevant person referred to in (ii) dans le cas d’une personne visée à l’alinéa d), le
paragraph (d), the document issued to the relevant document qui lui a été délivré en application de cet
person under the procedure referred to in that alinéa;
paragraph;
81100-3-96-46 28 2021-11-26 (18:57)

AR04410
COVID-19 at least twice every week; mette à un essai relatif à la COVID-19 au moins deux
fois par semaine;
COVID-19 test, other than a COVID-19 molecular test, que la personne concernée qui a reçu un résultat posi-
under the procedure referred to in paragraph (f) re- tif à un essai relatif à la COVID-19, autre qu’un essai
ceives a result for a COVID-19 molecular test; moléculaire relatif à la COVID-19, en application de la
procédure visée à l’alinéa f), obtienne un résultat d’un
(h) provide for a procedure that ensures that a rele- essai moléculaire relatif à la COVID-19;
vant person who receives a positive result for a
COVID-19 molecular test under the procedure re- h) prévoir une procédure permettant de veiller à ce
ferred to in paragraph (f) or (g) is prohibited from ac- que la personne concernée qui a reçu un résultat posi-
cessing aerodrome property for a period of 14 days af- tif à un essai moléculaire relatif à la COVID-19 en ap-
ter the result was received or until the relevant person plication de la procédure visée aux alinéas f) ou g) ne
is not exhibiting any of the symptoms referred to in puisse accéder aux terrains de l’aérodrome pour la pé-
subsection 8(1), whichever is later; riode de quatorze jours suivant la réception du résultat
ou jusqu’à ce qu’elle ne présente plus des symptômes
(i) provide for a procedure that ensures that a relevant prévus au paragraphe 8(1), selon la plus tardive des
person referred to in paragraph (h) is exempt from the éventualités;
requirement referred to in paragraph (f) for a period
of 180 days after the relevant person received a posi- i) prévoir une procédure permettant de veiller à ce
tive result for a COVID-19 molecular test; que la personne visée à l’alinéa h) soit exemptée de
l’exigence visée à l’alinéa f) pour une période de cent
(j) set out procedures for reducing the risk that a rele- quatre-vingts jours suivant la réception d’un résultat
vant person will be exposed to the virus that causes positif à un essai moléculaire relatif à la COVID-19;
COVID-19 due to an in-person interaction, occurring
on aerodrome property or at a location where NAV j) prévoir des procédures visant à réduire le risque
CANADA provides civil air navigation services, with d’exposition au virus qui cause la COVID-19 pour les
an unvaccinated person who has not been issued a personnes concernées à la suite des interactions en
document under the procedure referred to in para- personne, aux terrains de l’aérodrome ou à un empla-
graph (d) and who is a person referred to in any of cement où NAV CANADA fournit des services de navi-
subparagraphs 17.23(b)(i) to (iv), which procedures gation aérienne civile, avec des personnes non-vacci-
may include protocols related to nées ne s’étant pas vu délivrer un document en
application de l’alinéa d) et qui sont visées à l’un des
(i) the vaccination of persons, other than relevant sous-alinéas 17.23b)(i) à (iv), procédures pouvant
persons, who access aerodrome property or a loca- comprendre des protocoles à l’égard :
tion where NAV CANADA provides civil air naviga-
tion services, (i) de la vaccination des personnes, autres que les
personnes concernées, qui accèdent aux terrains de
(ii) physical distancing and the wearing of masks, l’aérodrome ou à un emplacement où NAV
and CANADA fournit des services de navigation aé-
rienne civile,
(iii) reducing the frequency and duration of in-per-
son interactions; (ii) de la distanciation physique et du port du
masque,
(k) establish a procedure for collecting the following
information with respect to an in-person interaction (iii) de la restriction et de la durée des interactions
related to commercial flight operations between a rele- en personne;
vant person and a person referred to in any of sub-
paragraphs 17.23(b)(i) to (iv) who is unvaccinated and k) établir une procédure pour colliger les renseigne-
has not been issued a document under the procedure ments ci-après à l’égard des interactions en personne
referred to in paragraph (d) or whose vaccination sta- découlant de l’exploitation de vols commerciaux entre
tus is unknown: une personne concernée et une personne qui est visée
à l’un des sous-alinéas 17.23b)(i) à (iv) qui n’est pas
vaccinée et qui ne s’est pas vu délivrer un document en
81100-3-96-46 29 2021-11-26 (18:57)

AR04411
(i) the time, date and location of the interaction, application de l’alinéa d) ou une personne dont le sta-
and tut de vaccination est inconnu :
the other person;
(l) establish a procedure for recording the following l’autre personne;
quest: l) établir une procédure afin de consigner et de trans-
(iii) the number of relevant persons who accéder aux zones réglementées de l’aérodrome,
(A) are fully vaccinated persons, (iii) le nombre de personnes concernées qui :
(B) have received the first dose of a COVID-19 (A) sont entièrement vaccinées,
vaccine dosage regimen, and
(B) ont reçu leur première dose du protocole
(C) are unvaccinated persons, vaccinal contre la COVID-19,
(iv) the number of hours during which relevant (C) ne sont pas vaccinées,
commercial flight operations due to COVID-19, (iv) le nombre d’heures au cours desquelles les per-
sonnes concernées n’ont pu accomplir leurs tâches
(v) the number of relevant persons who have been liées à l’exploitation de vols commerciaux à cause
issued a document under the procedure referred to de la COVID-19,
in paragraph (d), the reason for issuing the docu-
ment and a confirmation that the relevant persons (v) le nombre de personnes concernées qui se sont
have submitted evidence of COVID-19 tests in ac- vu délivrer un document en application de l’alinéa
cordance with the requirements referred to in para- d), la raison invoquée, et une confirmation que ces
graphs (f) and (g), personnes ont soumis une preuve d’un essai relatif
à la COVID-19 conformément aux exigences pré-
(vi) the number of relevant persons who refuse to vues aux alinéas f) et g),
comply with a requirement referred to in paragraph
(a), (f), (g) or (h), (vi) le nombre de personnes concernées qui ont re-
fusé de se conformer aux exigences prévues aux ali-
(vii) the number of relevant persons who were de- néas a), f), g) ou h),
nied entry to a restricted area because of a refusal
to comply with a requirement referred to in para- (vii) le nombre de personnes concernées qui se
graph (a), (f), (g) or (h), sont vu refuser l’accès à une zone réglementée à
cause de leur refus de se conformer aux exigences
(viii) the number of persons referred to in subpara- prévues aux alinéas a), f), g), ou h),
graphs 17.23(b)(i) to (iv) who are unvaccinated and
who have not been issued a document under the (viii) le nombre de personnes visées à l’un des
procedure referred to in paragraph (d), or whose sous-alinéas 17.23b)(i) à (iv) qui sont non-vaccinées
vaccination status is unknown, who have an in-per- et qui ne se sont pas vu délivrer un document en
son interaction related to commercial flight opera- application de l’alinéa d), ou dont le statut de vacci-
tions with a relevant person and a description of nation est inconnu qui interagissent en personne
any procedures implemented to reduce the risk that avec des personnes concernées découlant de l’ex-
a relevant person will be exposed to the virus that ploitation de vols commerciaux, de même qu’une
causes COVID-19 due to such an interaction, and description des procédures mises en place afin de
réduire le risque, pour les personnes concernées,
81100-3-96-46 30 2021-11-26 (18:57)

AR04412
(ix) the number of instances in which the air carri- d’exposition au virus qui cause la COVID-19, à la
er or NAV CANADA, as applicable, is made aware suite de ces interactions,
that a person with respect to whom information
was collected under paragraph (k) received a posi- (ix) le nombre d’occasions où le transporteur aé-
tive result for a COVID-19 test, the number of rele- rien ou NAV CANADA, selon le cas, a été informé
vant persons tested for COVID-19 as a result of this qu’une personne dont les renseignements ont été
information, the results of those tests and a de- colligés en application de l’alinéa k) a reçu un résul-
scription of any impacts on commercial flight oper- tat positif pour essai relatif à la COVID-19, le
ations; and nombre de personnes concernées soumises à un es-
sai relatif à la COVID-19 découlant de cette infor-
(m) require the air carrier or NAV CANADA, as appli- mation, les résultats de ces essais et l’incidence sur
cable, to keep the information referred to in paragraph l’exploitation de vols commerciaux;
(l) for a period of at least 12 months after the date that
the information was recorded. m) exiger que le transporteur aérien ou NAV
CANADA, selon le cas, conserve les renseignements
visés à l’alinéa l) pour une période d’au moins de
douze mois après la date à laquelle ils ont été colligés.

to be issued to a relevant person confirming that they did confirmant qu’une personne concernée n’a pas suivi de
not complete a COVID-19 vaccine dosage regimen on the protocole vaccinal complet contre la COVID-19, pour le
basis of a medical contraindication only if they provide a motif de contre-indication médicale, n’est délivré à la
medical certificate from a medical doctor or nurse practi- personne que si celle-ci soumet un certificat médical déli-
tioner who is licensed to practise in Canada certifying vré par un médecin ou un infirmier praticien autorisé à
that the relevant person cannot complete a COVID-19 pratiquer au Canada qui atteste que la personne ne peut
vaccination regimen due to a medical condition and spec- pas suivre de protocole vaccinal complet contre la CO-
ifying whether the condition is permanent or temporary. VID-19 en raison d’une condition médicale et qui précise
si cette condition est permanente ou temporaire.

to be issued to a relevant person confirming that they did confirmant qu’une personne concernée n’a pas suivi de
not complete a COVID-19 vaccine dosage regimen on the protocole vaccinal complet contre la COVID-19, pour le
basis of their sincerely held religious belief only if they motif de croyance religieuse sincère de la personne, n’est
submit a statement sworn or affirmed by them attesting délivré à la personne que si celle-ci fournit une déclara-
that they have not completed a COVID-19 vaccination tion sous serment ou une affirmation solennelle attestant
regimen due to their sincerely held religious belief. qu’elle n’a pas suivi de protocole vaccinal complet contre
la COVID-19 en raison de sa croyance religieuse sincère.
graph (2)(d), in the case of an employee of an entity or a néa (2)d), dans le cas de l’employé de l’exploitant d’un
relevant person hired by an entity to provide a service, aérodrome ou de la personne concernée qui est embau-
the policy must provide that a document is to be issued to chée par l’exploitant d’un aérodrome pour offrir un ser-
the employee or the relevant person confirming that they vice, la politique doit prévoir que le document confir-
did not complete a COVID-19 vaccine dosage regimen on mant qu’une personne n’a pas suivi de protocole vaccinal
the basis of their sincerely held religious belief only if the complet contre la COVID-19, pour le motif de croyance
entity is obligated to accommodate the relevant person religieuse sincère de l’employé ou de la personne, n’est
on that basis under the Canadian Human Rights Act by délivré à la personne que si l’exploitant d’un aérodrome a
issuing such a document. l’obligation de prendre une telle mesure d’adaptation
pour ce motif aux termes de la Loi canadienne sur les
droits de la personne.
81100-3-96-46 31 2021-11-26 (18:57)

AR04413

graph (2)(d), in the following cases, the policy must pro- néa (2)d), dans les cas ci-après, la politique doit prévoir
vide that a document is to be issued to the employee con- que le document confirmant qu’une personne n’a pas sui-
firming that they did not complete a COVID-19 vaccine vi de protocole vaccinal complet contre la COVID-19,
dosage regimen on the basis of their sincerely held reli- pour le motif de croyance religieuse sincère de la per-
gious belief only if they would be entitled to such an ac- sonne, n’est délivré à la personne que si celle-ci a droit à
commodation on that basis under applicable legislation: une telle mesure d’adaptation pour ce motif aux termes
de la législation applicable :
(a) in the case of an employee of an entity’s contractor
or agent or mandatary; and a) le cas de l’employé d’un entrepreneur ou d’un man-
dataire d’une entité;
(b) in the case of an employee of an entity’s lessee, if
the property that is subject to the lease is part of aero- b) le cas de l’employé d’un locataire d’une entité, si les
drome property. lieux faisant l’objet du bail font partie des terrains de
l’aérodrome.


CANADA must make information related to the imple- ou NAV CANADA met l’information à l’égard de la mise
mentation of the policy referred to in section 17.22, 17.23 en œuvre de la politique visée aux articles 17.22, 17.23 ou
or 17.24, as applicable, available to the Minister on re- 17.24, selon le cas, à la disposition du ministre à sa de-
quest. mande.

Canada Canada
17.30 (1) Sections 17.31 to 17.40 apply to all of the fol- 17.30 (1) Les articles 17.31 à 17.40 s’appliquent aux per-
(a) subject to paragraph (c), a person entering a re- a) sous réserve de l’alinéa c), la personne qui accède à
stricted area at an aerodrome listed in Schedule 2 une zone réglementée d’un aérodrome visé à l’annexe
from a non-restricted area for a reason other than to 2 à partir d’une zone non réglementée pour un motif
board aircraft for a flight operated by an air carrier; autre que celui de monter à bord d’un aéronef pour un
vol effectué par un transporteur aérien;
(b) a crew member entering a restricted area at an
aerodrome listed in Schedule 2 from a non-restricted b) le membre d’équipage qui accède à une zone régle-
area to board an aircraft for a flight operated by an air mentée d’un aérodrome visé à l’annexe 2 à partir d’une
carrier under Subpart 3, 4 or 5 of Part VII of the Regu- zone non réglementée dans le but de monter à bord
lations; d’un aéronef pour un vol effectué par un transporteur
aérien visé aux sous-parties 3, 4 ou 5 de la partie VII
(c) a person entering a restricted area at an aero- du Règlement;
drome listed in Schedule 2 from a non-restricted area
to board an aircraft for a flight
81100-3-96-46 32 2021-11-26 (18:57)

AR04414
(i) only to become a crew member on board anoth- c) la personne qui accède à une zone réglementée
er aircraft operated by an air carrier under Subpart d’un aérodrome visé à l’annexe 2 à partir d’une zone
3, 4 or 5 of Part VII of the Regulations, non réglementée dans le but de monter à bord d’un
aéronef pour un vol :
aircraft operated by an air carrier under Subpart 3, (i) dans le seul but d’agir à titre d’un membre
4 or 5 of Part VII of the Regulations, or d’équipage à bord d’un autre aéronef exploité par
un transporteur aérien visé aux sous-parties 3, 4 ou
(iii) to participate in mandatory training required 5 de la partie VII du Règlement,
aircraft operated under Subpart 3, 4 or 5 of Part VII (ii) après avoir agi à titre d’un membre d’équipage
of the Regulations, if the person will be required to à bord d’un aéronef exploité par un transporteur
return to work as a crew member; aérien visé aux sous-parties 3, 4 ou 5 de la partie
VII du Règlement,
(d) a screening authority at an aerodrome where per-
sons other than passengers are screened or can be (iii) afin de suivre une formation obligatoire exigée
screened; par un transporteur aérien sur l’exploitation d’un
aéronef exploité en application des sous-parties 3, 4
(e) the operator of an aerodrome listed in Schedule 2. ou 5 de la partie VII du Règlement si elle devra re-
tourner au travail à titre de membre d’équipage;
d) l’administration de contrôle à un aérodrome où le

of age;
cy;
f) la personne qui effectue dans une zone réglementée
(f) a person who is delivering equipment or providing la fourniture d’équipements ou de services qui sont es-
services within the restricted area of the aerodrome sentiels aux activités de l’aérodrome et pour lesquels il
that are urgently needed and critical to aerodrome op- y a un besoin urgent.
erations.
81100-3-96-46 33 2021-11-26 (18:57)

AR04415
17.31 (1) A person must not enter a restricted area of 17.31 (1) Il est interdit à toute personne d’accéder à
an aerodrome unless they are a fully vaccinated person. une zone réglementée d’un aérodrome sauf si elle est une
personne entièrement vaccinée.
Exception Exception
been issued a document under the procedure referred to s’est vu délivrer un document en application des alinéas

d’un aérodrome la preuve suivante :
17.10; and preuve de vaccination contre la COVID-19 visée à l’ar-
ticle 17.10;
17.22(2)(d) or 17.24(2)(d), the document issued to the document en application de l’alinéa 17.22(2)d) ou
person. 17.24(2)d), ce document.

17.34 (1) If a person who is a fully vaccinated person or 17.34 (1) La personne qui n’est pas en mesure de pré-
who has been issued a document under the procedure re- senter la preuve, en réponse à une demande faite en ap-
ferred to in paragraph 17.22(2)(d) is unable, following a plication de l’article 17.33 et qui est une personne entiè-
request to provide evidence under section 17.33, to pro- rement vaccinée ou qui s’est vu délivrer un document en
vide the evidence, the person may application de l’alinéa 17.22(2)d) peut, selon le cas :
vaccinated person or that they have been issued a doc- personne entièrement vaccinée ou qu’elle s’est vu déli-
ument under the procedure referred to in paragraph vrer un document en application de l’alinéa 17.22(2)d);
17.22(2)(d); or
b) si elle a signé une déclaration en application de
(b) if the person has signed a declaration under para- l’alinéa a) dans les sept jours précédant la demande de
graph (a) no more than seven days before the day on présenter la preuve, présenter la déclaration signée.
which the request to provide evidence is made, pro-
Exception Exception
81100-3-96-46 34 2021-11-26 (18:57)

AR04416
Notification to aerodrome operator Avis à l’exploitant d’un aérodrome

erator of the aerodrome as soon as feasible of the per- d’un aérodrome dès que possible des prénom et nom de
son’s name and the number or identifier of the person’s la personne ainsi que, le cas échéant, du numéro ou de
document of entitlement, if applicable. l’identifiant de son document d’autorisation.

17.32(a) or (b) to the operator of the aerodrome within 17.32a) ou b) à l’exploitant d’un aérodrome dans les sept
signed.

(5) An operator of an aerodrome must ensure that the (5) L’exploitant d’un aérodrome veille à ce que l’accès à
restricted area access of a person who does not provide la zone réglementée de la personne qui ne présente pas la
dence.

17.35 (1) The operator of the aerodrome must keep a 17.35 (1) L’exploitant d’un aérodrome consigne dans
record of the following information in respect of a person un registre les renseignements ci-après à l’égard d’une
17.34(5) :
of entitlement, if applicable; b) le numéro ou l’identifiant de son document d’auto-
risation, le cas échéant;
created.

17.36 (1) A screening authority must deny a person en- 17.36 (1) Si une personne ne présente pas la preuve de-
try to a restricted area if, following a request to provide mandée en application de l’article 17.33 ou la déclaration
signée conformément au paragraphe 17.34(1), selon le
81100-3-96-46 35 2021-11-26 (18:57)

AR04417
evidence under section 17.33, the person does not pro- cas, l’administration de contrôle lui refuse l’accès à la
vide the evidence or, if applicable, does not sign or pro- zone réglementée.
vide a declaration under subsection 17.34(1).

(2) If a screening authority denies entry to a restricted (2) L’administration de contrôle qui refuse l’accès à une
area it must notify the operator of the aerodrome as soon zone réglementée en application du paragraphe (1) avise
as feasible of the person’s name and, if applicable, the l’exploitant d’un aérodrome et lui fournit dès que pos-
number or identifier of the person’s document of entitle- sible les prénom et nom de la personne ainsi que, le cas
ment. échéant, le numéro ou l’identifiant du document d’autori-
sation de la personne.


17.38 A screening authority or the operator of an aero- 17.38 L’administration de contrôle ou l’exploitant d’un
drome that has reason to believe that a person has pro- aérodrome qui a des raisons de croire qu’une personne
vided evidence that is likely to be false or misleading lui a présenté une preuve susceptible d’être fausse ou
must notify the Minister of the following not more than trompeuse en avise le ministre, au plus tard soixante-
72 hours after the provision of the evidence: douze heures après la présentation de la preuve et l’avis
comprend les éléments suivants :
of entitlement, if applicable; and b) le numéro ou l’identifiant du document d’autorisa-
tion de la personne, le cas échéant;
(c) the reason the screening authority or the operator
of an aerodrome believes that the evidence is likely to c) les raisons pour lesquelles l’administration de
be false or misleading. contrôle ou l’exploitant d’un aérodrome croit que la
preuve est susceptible d’être fausse ou trompeuse.

record was created.
81100-3-96-46 36 2021-11-26 (18:57)

AR04418


17.40 The operator of an aerodrome must ensure that a 17.40 L’exploitant d’un aérodrome veille à ce que les
document of entitlement is only issued to a fully vacci- documents d’autorisation ne soient délivrés qu’à des per-
nated person or a person who has been issued a docu- sonnes entièrement vaccinées ou qui se sont vu délivrer
ment under the procedure referred to in paragraph un document en application de l’alinéa 17.22(2)d).
17.22(2)(d).
Masks Masque
a mask;
reason;
out assistance;
f) le membre d’équipage;
(f) a crew member;
g) l’agent d’embarquement.
(g) a gate agent.


81100-3-96-46 37 2021-11-26 (18:57)

AR04419
Notification Avis
quement;
gare;



tions suivantes :
81100-3-96-46 38 2021-11-26 (18:57)

AR04420

tage :
fectue :

(i) les dates et numéro du vol,
81100-3-96-46 39 2021-11-26 (18:57)

AR04421
(ii) the person’s name, date of birth and contact in- (ii) les prénom et nom de la personne ainsi que sa
formation, including the person’s home address, date de naissance et ses coordonnées, y compris
telephone number and email address, son adresse de résidence, son numéro de téléphone
(iii) the person’s seat number, and
(iii) le numéro du siège occupé par la personne,
comply; and (iv) les circonstances du refus;
(b) inform the Minister as soon as feasible of any b) informe dès que possible le ministre de la création
record created under paragraph (a). d’un registre en application de l’alinéa a).

the flight. du vol.

ci.


suivantes :
(a) when the safety of the crew member could be en-
dangered by wearing a mask; a) le port du masque risque de compromettre la sécu-
rité du membre d’équipage;
(b) when the wearing of a mask by the crew member
could interfere with operational requirements or the b) le port du masque par le membre d’équipage risque
safety of the flight; or d’interférer avec des exigences opérationnelles ou de
compromettre la sécurité du vol;
(c) when the crew member is drinking, eating or tak-
ing oral medications. c) le membre d’équipage boit, s’alimente ou prend un


81100-3-96-46 40 2021-11-26 (18:57)

AR04422
suivantes :

persons: vantes :
a mask;
reason;
out assistance;
f) la personne qui est à bord d’un vol en provenance
(f) a person who is on a flight that originates in du Canada et à destination d’un pays étranger.


mask at all times from the moment the doors of the ter un masque en tout temps dès l’ouverture des portes
81100-3-96-46 41 2021-11-26 (18:57)

AR04423
aircraft are opened until the person enters the air termi- de l’aéronef jusqu’au moment où elle entre dans l’aéro-
nal building, including by a passenger loading bridge. gare, notamment par une passerelle d’embarquement des
passagers.

a mask;
reason;
out assistance;

subsection 30(2) and removes it when required by a l’enlève lorsque l’agent de contrôle lui en fait la demande
screening officer to do so under subsection 30(3) if the au titre du paragraphe 30(3) si l’enfant :
child


81100-3-96-46 42 2021-11-26 (18:57)

AR04424




suivantes :

from another person and both persons are separated by a deux mètres ou moins d’une autre personne si elle est sé-
physical barrier that allows them to interact and reduces parée de l’autre personne par une barrière physique qui
the risk of exposure to COVID-19. leur permet d’interagir et qui réduit le risque d’exposition
à la COVID-19.

glementée.

81100-3-96-46 43 2021-11-26 (18:57)

AR04425


Notice Avis
whom it is sent will be provided with an opportunity ments de preuve et ses observations sur les faits repro-
consistent with procedural fairness and natural justice chés, conformément aux principes de l’équité procé-
to present evidence before the Tribunal and make rep- durale et de la justice naturelle;
scribed period.
81100-3-96-46 44 2021-11-26 (18:57)

AR04426
Repeal Abrogation
No. 46, made on November 26, 2021, is repealed. la COVID-19, pris le 26 novembre 2021, est abrogé.
81100-3-96-46 45 2021-11-26 (18:57)

AR04427
SCHEDULE 1 ANNEXE 1
(Subsection 13(2)) (paragraphe 13(2))
Countries and Territories Pays et territoires

Item Name Article Nom
1 Botswana 1 Afrique du Sud
2 Eswatini 2 Botswana
3 India 3 Eswatini
4 Lesotho 4 Inde
5 Morocco 5 Lesotho
6 Mozambique 6 Maroc
7 Namibia 7 Mozambique
8 South Africa 8 Namibie
9 Zimbabwe 9 Zimbabwe
81100-3-96-46 46 2021-11-26 (18:57)

AR04428
SCHEDULE 2 ANNEXE 2
Nom de l’OACI
Alma CYTF
Alma CYTF
Bagotville CYBG
Bagotville CYBG
Baie-Comeau CYBC
Baie-Comeau CYBC
Bathurst CZBF
Bathurst CZBF
Campbell River CYBL
Campbell River CYBL

Rocheuses)
Deer Lake CYDF
Dawson Creek CYDQ
Deer Lake CYDF
Fort McMurray CYMM
Fort St. John CYXJ
Fort McMurray CYMM
Fort St. John CYXJ
Gaspé CYGP
Goose Bay CYYR
Gaspé CYGP
Grande Prairie CYQU
Goose Bay CYYR
Grande Prairie CYQU
81100-3-96-46 47 2021-11-26 (18:57)

AR04429

Nom de l’OACI
Iqaluit CYFB Munro)
Mont-Joli CYYY Lourdes-de-Blanc-Sablon CYBX
Montréal International (Mirabel) CYMX Medicine Hat CYXH
International)
Mont-Joli CYYY
Montréal (St. Hubert) CYHU
Nanaimo CYCD

Cartier)
Prince Rupert CYPR
Penticton CYYF
Quesnel CYQZ
Prince George CYXS
Prince Rupert CYPR
Quesnel CYQZ
Rouyn-Noranda CYUY
Saint John CYSJ
international)
81100-3-96-46 48 2021-11-26 (18:57)

AR04430

Nom de l’OACI
Rouyn-Noranda CYUY
Saint John CYSJ
Sept-Îles CYZV
Smithers CYYD
Bishop)

International)
Wabush CYWK
Yellowknife CYZF
Nielsen)
Williams Lake CYWL
Windsor CYQG

Yellowknife CYZF
81100-3-96-46 49 2021-11-26 (18:57)

AR04431
SCHEDULE 3 ANNEXE 3
17.30(2)(e))

Name Nom
Correctional Service of Canada Agence des services frontaliers du Canada
Department of Agriculture and Agri-Food Gendarmerie royale du Canada
Department of Fisheries and Oceans Ministère de la Défense nationale
Department of Health Ministère de la Santé
Department of National Defence Ministère de l'Agriculture et de l'Agroalimentaire
Department of the Environment Ministère de l'Environnement
Department of Transport Ministère des Pêches et des Océans
Public Health Agency of Canada Ministère des Transports
81100-3-96-46 50 2021-11-26 (18:57)

AR04432
SCHEDULE 4 ANNEXE 4


Section 4 5,000 25,000 Article 4 5 000 25 000
Section 5 5,000 25,000 Article 5 5 000 25 000
Section 9 5,000 25,000 Article 9 5 000 25 000
Section 12 5,000 25,000 Article 12 5 000 25 000
Section 16 5,000 25,000 Article 16 5 000 25 000
Section 17 5,000 25,000 Article 17 5 000 25 000
Section 17.2 25,000 Article 17.2 25 000
Section 17.7 25,000 Article 17.7 25 000
Section 17.8 25,000 Article 17.8 25 000
Section 17.9 5,000 Article 17.9 5 000
Section 17.15 25,000 Article 17.15 25 000
81100-3-96-46 51 2021-11-26 (18:57)

AR04433

Section 17.32 5,000 Article 17.32 5 000
Section 17.33 25,000 Article 17.33 25 000
Section 17.37 5,000 Article 17.37 5 000
Section 17.38 25,000 Article 17.38 25 000
Section 17.40 25,000 Article 17.40 25 000
Section 19 5,000 25,000 Article 19 5 000 25 000
Section 23 5,000 25,000 Article 23 5 000 25 000
81100-3-96-46 52 2021-11-26 (18:57)

AR04434

81100-3-96-46 53 2021-11-26 (18:57)

AR04435
UNAUTHORIZED DISCLOSURE PROHIBITED
Who can travel by air effective November 30, 2021?
Cohorts (Unvaccinated Individuals) Authorized Entry TC Aviation Interim Order #47

(Minimizing the Risk of
Exposure to COVID-19 International to Domestic Flights Outbound Flight to International
in Canada Orders-in- Domestic Connection to / Transborder Destination
Council) Final Destination
Person who transits through Canada and remains in Yes
N/A N/A N/A
the sterile transit area until they leave Canada 17.1(2)(d)
Flight diversion for a safety-related reason, and who
Yes Yes
boards an aircraft for a flight not more than 24 hours N/A N/A
17.1(2)(e) 17.1(2)(e)
after the arrival time of the diverted flight
Canadian citizens, Permanent Residents and No
Individuals registered under the Indian Act No
No
TC Domestic National TC Domestic National
Right of Entry TC Domestic National Interest
Interest Exemption Interest Exemption
Exemption Process
Process - Extenuating Process
Circumstances Only
 Prisoner transfers, extraditions cases, persons in Yes
custody N/A N/A AVSEC Exemption Yes
#C2021-154
 A child or a person that is not competent being Yes
relocated by a Federal, Provincial or Territorial N/A N/A AVSEC Exemption No
(FPT) government or agency #C2021-151
 An individual who requires urgent medical care Yes
(patient and escort(s)) N/A N/A AVSEC Exemption No
#C2021-165
 An individual travelling between remote Yes
communities and transiting through a specified N/A N/A AVSEC Exemption No
aerodrome (i.e. milk run) #C2021-151
Page 1 of 4
Version 1.1
AR04436

 An individual travelling to a remote community Yes
after having completed a mandatory N/A N/A AVSEC Exemption No
quarantine required by a territorial authority #C2021-151
 Remote communities (self-test kits) Yes
AVSEC Exemptions
N/A N/A No
#C2021-152
#C2021-153
 Essential medical services or treatments that Yes
Yes
are required prior to December 13, 2021. N/A N/A AVSEC Exemption
See previous column
#C2021-168
 Individuals with medical contraindication who Yes
Yes
need to travel prior to December 13, 2021 N/A N/A AVSEC Exemption
See previous column
#C2021-166
 Medical contraindication, sincere religious
Yes
belief, essential medical service or treatment Yes
N/A N/A 17.3(2)(d)(i), (ii), (iii), or
and guardian. These exceptions may also 17.3(2)(d)(i), (ii), (iii), or (iv)
(iv)
apply to foreign nationals.
Canadian citizens, Permanent Residents and No
Individuals registered under the Indian Act who reside
outside of Canada, including those entering through TC Domestic National No
the PHAC compassionate program. Right of Entry Interest Exemption No TC Domestic National Interest
Process as part of Exemption Process
Extenuating
Circumstances
New Permanent Residents Must meet entry Yes No No
requirements 17.3(2)(b)
(note 24 hour time limit)
Newly Resettled Refugees Must meet entry Yes Yes No
requirements See next column 17.3(2)(e)(iii)
Page 2 of 4
Version 1.1
AR04437

(non-discretionary
purpose ONLY)
Foreign nationals: Must meet entry Yes No Yes
requirements 17.3(2)(a) TC Domestic National 17.3(2)(c)
 Essential Services (note 24 hour time limit) Interest Exemption
 Foreign Workers Process
 Foreign Crews
 Athletes
 Immediate and Extended Family Members
 International Students
 Compassionate Program
Foreign Diplomats / Accredited Foreign Must meet entry Yes Yes Yes
Representatives requirements See next column 17.3(2)(e)(v), (vi), or (vii) 17.3(2)(c)
(non-discretionary
purpose ONLY)
 Families of foreign diplomats Must meet entry Yes No Yes
 Families of accredited foreign representatives requirements 17.3(2)(a) TC Domestic National 17.3(2)(c)
 Unaccredited foreign delegation members (note 24 hour time limit) Interest Exemption
Process
Person who entered Canada at the invitation of the Must meet entry Yes Yes Yes
Minister of Health for the purpose of assisting requirements See next column 17.3(2)(e)(i) 17.3(2)(c)
in the COVID-19 response (non-discretionary
purpose ONLY)
Person who is permitted to work as a provider of Must meet entry Yes Yes Yes
emergency services under Immigration and Refugee requirements See next column 17.3(2)(e)(ii) 17.3(2)(c)
Protection Regulations (non-discretionary
purpose ONLY
Page 3 of 4
Version 1.1
AR04438

Foreign nationals who have a contraindication to a Must meet entry Yes No Yes
COVID-19 vaccine dosage regimen, where the requirements 17.3(2)(a) These individuals must 17.3(2)(c)
evidence that demonstrate their contraindication was (note 24 hour time limit) obtain domestic
obtained outside of Canada. evidence of their
contraindication in
accordance with the TC
Interim Order and follow
the process to obtain an
exemption from the air
carrier.
Crew members (on duty) Right of Entry Yes Yes Yes
or 17.1(2)(b) 17.1(2)(b) 17.1(2)(b)
Note, however, that domestic crew members are Must meet entry
subject to the restricted area regulations and air requirements (as
carrier policies regarding mandatory vaccination. applicable)
Crew members (off duty – travelling as passengers Right of Entry Yes Yes Yes
(CARs 701, 703, 704 and 705)): or 17.1(2)(c) 17.1(2)(c) 17.1(2)(c)
Must meet entry
 only to become a crew member on board requirements (as
another aircraft operated by an air carrier, applicable)
 after having been a crew member on board an
aircraft operated by an air carrier, or
 to participate in mandatory training required by
an air carrier in relation to the operation of an
aircraft, if the person will be required to return to
work as a crew member.
Page 4 of 4
Version 1.1
AR04439
Solicitor-Client Privilege
November 25, 2021
Interim Order Respecting Certain Requirements for Civil Aviation Due to COVID-19
1
AR04440
November 25, 2021
2
AR04441
November 25, 2021
3
UNCLASSIFIED / NON CLASSIFIÉ
AR04442
Minister of Transport Ministre des Transports
Ottawa, Canada K1A 0N5
Greffier de la Chambre des communes / Clerk of the House of Commons

Chambre des communes / House of Commons
Ottawa, Ontario
Monsieur Charles Robert, Mr. Charles Robert,
Vous trouverez ci-joint, pour dépôt à la Enclosed for tabling in the House of
Chambre des communes, en vertu du Commons, pursuant to subsection
paragraphe 6.41 (5) de la Loi sur 6.41 (5) of the Aeronautics Act and for
l’Aéronautique, et renvoi au Comité referral to the Standing Committee on
permanent des transports, de l’infrastructure Transport, Infrastructure and Communities,
et des collectivités, une copie dans les deux is a copy in both official languages of the
langues officielles de l’Arrêté d’urgence nº 47 Interim Order Respecting Certain
visant certaines exigences relatives à l’aviation Requirements for Civil Aviation Due to
civile en raison de la COVID-19. COVID-19, No. 47.
Veuillez agréer, Monsieur, l’expression de Yours Sincerely,

mes sentiments les meilleurs.
Omar Alghabra,
C.P., député / P.C., M.P.
Ministre des Transports / Minister of Transport
P.j. / Enclosures
Canada
AR04443
Greffier du Sénat / Clerk of the Senate

Sénat / Senate
Ottawa, Ontario
Monsieur Gérald Lafrenière, Mr. Gérald Lafrenière,
Vous trouverez ci-joint, pour dépôt au Sénat, en Enclosed for tabling in the Senate, pursuant to
vertu du paragraphe 6.41 (5) de la Loi sur subsection 6.41 (5) of the Aeronautics Act, is a
l’Aéronautique, une copie dans les deux langues copy in both official languages of the Interim
officielles de l’Arrêté d’urgence nº 47 visant Order Respecting Certain Requirements for Civil
certaines exigences relatives à l’aviation civile en Aviation Due to COVID-19, No. 47
raison de la COVID-19.
Veuillez agréer, Monsieur, l’expression de mes Yours Sincerely,

sentiments les meilleurs.
Omar Alghabra,
P.j. / Enclosures
Canada
AR04444
Ceci est la pièce « P » au soutien de


AR04445
Unauthorized Disclosure Prohibited
Divulgation non autorisée interdite
AVIATION SECURITY EXEMPTION EXEMPTION SUR LA SÛRETÉ

NO. C2022-008 AÉRIENNE
Aerodrome Operators – Mandatory NO C2022-008
Vaccination Policy Exploitants d’aérodromes – Politique à
l’égard de la vaccination obligatoire
Whereas the Director General, Aviation Attendu que le directeur général, Sûreté
Security, is of the opinion that it is in the aérienne, estime que l’intérêt public le justifie
public interest and not likely to adversely et que la sécurité ou la sûreté aérienne ne
affect aviation safety or security to exempt the risque pas d’être compromise du fait
aerodrome operators listed under Schedule 1 d’exempter les exploitants d’aérodromes
of the Interim Order Respecting Certain énumérés à l’annexe 1 de l’Arrêté d’urgence
Requirements for Civil Aviation Due to visant certaines exigences relatives à
COVID-19 (Interim Order), from paragraph l’aviation civile en raison de la COVID-19
17.22(2)(a). (l’Arrêté d’urgence), de l’alinéa 17.22(2)a).
Therefore, the Director General, Aviation Par conséquent, en vertu du paragraphe 5.9(2)
Security, pursuant to subsection 5.9(2) of the de la Loi sur l’aéronautique, le directeur
Aeronautics Act, hereby makes the following général, Sûreté aérienne, émet l’Exemption sur
Aviation Security Exemption No. la sûreté aérienne no C2022-008, ci-après.
C2022-008.
APPLICATION APPLICATION
1. This exemption applies to the aerodrome 1. La présente exemption s’applique aux

operators listed under Schedule 1 of the exploitant d’aérodromes énumérés à l’annexe 1
Interim Order, where an employee of the de l’Arrêté d’urgence, et un employé des
lessees listed in Schedule 1 of this exemption, locataires énumérés à l’annexe 1 de cette
who works on the aerodrome property outside exemption, qui travaille sur les terrains de
of the restricted area, does not meet the l’aérodrome à l’extérieur de la zone
definition of a fully vaccinated person as per règlementée, et qui ne satisfait pas à la
the Interim Order. définition d’une personne entièrement
vaccinée sous l’Arrêté d’urgence.
PURPOSE OBJECTIF
2. The purpose of this exemption is to allow 2. L’objectif de l’exemption est de permettre

an individual referred to in section 1 of this à une personne visée à l’article 1 de cette
exemption to access the aerodrome property, exemption d’accéder aux terrains de
but not the restricted area, of the aerodromes l’aérodrome mais pas la zone règlementée des
listed under Schedule 1 of the Interim Order, aérodromes énumérés à l’annexe 1 de l’Arrêté
while completing a COVID-19 vaccine dosage d’urgence, tout en complétant un protocole
regime. vaccinal complet contre la COVID-19.
CONDITIONS CONDITIONS
3. The operator of an aerodrome is exempt 3. L’exploitant d’un aérodrome est exempté

from the requirements set out in paragraph des exigences énoncées à l’alinéa 17.22(2)a) de
17.22(2)(a) of the Interim Order, provided l’Arrêté d’urgence, pourvu que :
that:
C2022-008 1/3
AR04446
(a) the individual referred to in section 1 a) la personne visée à l’article 1 fournit au

provides the lessee responsible for their contracteur responsable pour sa présence sur
presence on aerodrome property, proof les terrains de l’aérodrome, une preuve qu’elle
that they received their first dose prior to a reçu sa première dose avant le
January 14, 2022, and proof that they 14 janvier 2022 et la preuve qu’elle a reçu sa
received their second dose by March 26, deuxième dose d’ici le 26 mars 2022;
2022; and
(b) the individual meets the definition of a b) la personne satisfait à la définition d’une
fully vaccinated person, as per the personne entièrement vaccinée, sous l’Arrêté
Interim Order, by April 9, 2022; d’urgence, d’ici le 9 avril 2022;
(c) The individual referred to in section 1 c) la personne visée à l’article 1 n’a pas accès à
does not have access to the restricted la zone règlementée; et
area of an aerodrome; and
(d) The individual referred to in section 1 is d) la personne visée à l’article 1 n’est pas un
not a crew member, as defined by the membre d’équipage au sens du Règlement de
Canadian Aviation Security Regulations, l’aviation canadien.
2012.
EFFECTIVE PERIOD VALIDITÉ
4. This exemption is in effect on the day it is 4. La présente exemption entre en vigueur à

signed until the earliest of the following: compter de sa date de signature et le demeure
jusqu’à la première des éventualités suivantes :
(a) 23:59 ET on April 9, 2022; a) 23 h 59 HE, 9 avril 2022;
(b) the day on which any of the conditions set b) la date où l’une des conditions énoncées
out in this exemption is dans la présente exemption est enfreinte; ou
breached; or
(c) the day on which this exemption is repealed c) sa date d’abrogation par écrit par le
in writing by the Director General or by a directeur général, ou par la personne assumant
person fulfilling the duties of the Director ses fonctions, si elle ou il estime que son
General if she or he is of the opinion that it is application ne répond plus à l’intérêt public ou
no longer in the public interest or that it is que la sécurité ou la sûreté aérienne risque
likely to adversely affect aviation safety or d’être compromise.
security.
Acting Director General, Aviation Security for the Minister of Transport Canada
Directeur général par intérim, Sûreté aérienne pour le ministre des Transports
C2022-008 2/3
AR04447
Schedule 1/Annexe 1
FedEx
United Parcel Service (UPS)
C2022-008 3/3
AR04448
Ceci est la pièce « Q » au soutien de


AR04449
I Transport
Canada
Transports
Canada
PROTECTED B
CCM #: SUB-2022-000906
RDIMS #: 18296152

COVID-19
For Approval
Purpose:
for Civil Aviation due to COVID-19, No. 53, and replace it with the Interim Order
(Annex A), which is recommended for signature on February 10, 2022.
Interim Order No. 54 reintroduces existing provisions of Interim Order No. 53 and
updates language to broaden its application to all COVID-19 variants, improves
alignment with the Public Health Agency of Canada’s Order in Council, and provides
greater clarity for accommodated employees who test positive for COVID-19.
These provisions are necessary to address significant (direct and indirect) risks to
aviation safety, or the safety of the public. In particular, continuation of the
vaccination mandate for the federally regulated transportation sector enhances the
safety of Canada’s transportation system and supports the recovery of the air sector
by ensuring those responsible for the continued operation of the system, and their
passengers are protected from severe outcomes of COVID-19.
Background:
been made to expand requirements and introduce pre-departure COVID-19 testing
and notification requirements for air carriers to inform travellers that they must
submit a suitable quarantine plan, as well as information and evidence relating to
their COVID-19 vaccination status.
In late 2021, new provisions were added to require specified airport operators, air
carriers and NAV Canada to establish vaccination policies and to require that all
passengers boarding a commercial flight in Canada or leaving Canada be fully
vaccinated with very few exceptions. Most recently, some requirements were
amended to ensure alignment with the Public Health Agency of Canada’s (PHAC)
Emergency Orders. This included: amendments to the denial of boarding period or
denial of access to an aerodrome property for a period to 10 days, and the positive
test result provision to 10 days to 180 days. It also added the requirement for foreign
crew members to be fully vaccinated when entering the restricted area of a specified
Page 1
AR04450
PROTECTED B
CCM #: SUB-2021-000906
RDIMS #: 18256164
aerodrome, given that all foreign crew members must be fully vaccinated to enter
Canada.
Interim Order No. 54 updates the language under subsection 13(2) to refer to the
Minister of Health, rather than the Chief Public Health Officer, to align with recent
changes in the OIC. In addition, the Interim Order no longer specifically references
the Omicron variant, but instead references any variant of COVID-19 to ensure the
Interim Order is relevant as the epidemiological situation evolves, including the
potential for new variants of concern
In addition, the 10-day waiting period for accommodated employees who test
positive for COVID-19 has been removed and replaced with requirements that these
employees follow the period of isolation set out by the public health authority of the
province or territory in which the aerodrome is located. . This change means
accommodated employees will be treated the same way as vaccinated employees who
develop COVID, and aligns the process for accommodated employees with processes
in place for the Federal public service.
The measures being proposed for the Interim Order are the result of continuous
work with partner departments and agencies, notably the Public Health Agency of
Canada to ensure the safety of the aviation transportation system.
Informed by public health recommendations, the vaccination mandate for the

federally regulated transportation sector, has been critical to ensure the safety of
passengers, crew, and those employees responsible for the continued operation of the
aviation system.
The measures included in the Interim Order Respecting Certain Requirements for
Civil Aviation Due to COVID-19 are continuously informed by public health advice,
based on scientific evidence available at the time, including the efficacy, availability,
and uptake of vaccines, and the evolving epidemiological situation in Canada and
abroad.
As we have seen with its evolution from the Alpha variant to Delta and then Omicron,
the COVID-19 virus changes rapidly, and its viral evolution is inherently
unpredictable. The vaccine mandate remains essential in the face of highly
transmissible variants. Public health data shows that Omicron is more transmissible
than previous variants of concern and that, while it has shown lower severity, it can
still cause serious illness. Public health advice indicates that COVID-19 vaccines
provide an additional layer of protection, particularly against severe illness and
hospitalization. Public health advice also indicates that a third mRNA vaccine
booster dose increases protection against symptomatic illness.
In light of the information to date and available data, public health officials continue
to support the effectiveness and importance of Transport Canada’s vaccine mandate.
It continues to be necessary to ensure a high rate of vaccination, with very minimal
exceptions, across the travelling population for the full benefits of the vaccine to be
realized and to minimize the risks of COVID-19. The vaccine mandate helps prevent
serious illness due to Omicron, which in turn protects aviation system workers and
Page 2
AR04451
PROTECTED B
CCM #: SUB-2021-000906
RDIMS #: 18256164
passengers from the most serious outcomes of COVID-19, thereby fortifying aviation
safety and security.
Communications:
Your decision to establish Interim Order No. 54 and the proposed changes are not
expected to generate media interest. A responsive communications approach is
recommended. Existing media lines and questions and answers on the department’s
COVID-19 measures would be updated should the department receive media calls.
COVID-19.
Prior to implementation, Transport Canada hosted a call with industry and relevant
stakeholders to inform them of the amendments to the Interim Order.
While they are supportive of the Government’s approach to mitigate the spread of
COVID, stakeholders and travellers may continue to be frustrated with the existing
travel restrictions
Legal Assessment:
Next Steps:
Page 3
AR04452
PROTECTED B
CCM #: SUB-2021-000906
RDIMS #: 18256164
Recommendation:
____________________________ ____________________________
Transport
2022-02-10
Date:________________
____ I approve
X ____ I do not approve ____ See Comments
_______________________________ Date:________________
2022-02-10
Attachments:
Annex A: Interim Order Respecting Certain Requirements for Civil Aviation Due
to COVID-19, No. 54
Annex B:
Annex C: Tabling Letter for the House of Commons
Annex D: Tabling Letter for the Senate
Page 4
AR04453
VID-19, ci-après.
Ottawa, Feb. 10 , 2022 Ottawa, le 10 février 2022
Omar Alghabra
a a
S.C. 2004, c. 15, s. 5 L.C. 2004, ch. 15, art. 5
b b
S.C. 2014, c. 39, s. 144 L.C. 2014, ch. 39, art. 144
c c
S.C. 2015, c. 20, s. 12 L.C. 2015, ch. 20, art. 12
d d
S.C. 2004, c. 15, s. 18 L.C. 2004, ch. 15, art. 18
e e
S.C. 2001, c. 29, s. 39 L.C. 2001, ch. 29, art. 39
f f
R.S., c. A-2 L.R., ch. A-2
g g
S.C. 2004, c. 15, s. 11(1) L.C. 2004, ch. 15, par. 11(1)
81100-3-96-53 2022-02-08 (09:39)

AR04454

accredited person means a foreign national who holds administrateur en chef L’administrateur en chef de la
a passport that contains a valid diplomatic, consular, offi- santé publique, nommé en application du paragraphe
cial or special representative acceptance issued by the 6(1) de la Loi sur l’Agence de la santé publique du
Chief of Protocol for the Department of Foreign Affairs, Canada. (Chief Public Health Officer)
Trade and Development. (personne accréditée)
administration de contrôle La personne responsable du
aerodrome property means, in respect of an aerodrome contrôle des personnes et des biens à tout aérodrome visé
listed in Schedule 1, any air terminal buildings or re- à l’annexe du Règlement sur la désignation des aéro-
stricted areas or any facilities used for activities related to dromes de l’ACSTA ou à tout autre endroit désigné par le
aircraft operations or aerodrome operations that are lo- ministre au titre du paragraphe 6(1.1) de la Loi sur l’Ad-
cated at the aerodrome. (terrains de l’aérodrome) ministration canadienne de la sûreté du transport aé-
rien. (screening authority)
aerodrome security personnel has the same meaning
as in section 3 of the Canadian Aviation Security Regu- agent de contrôle Sauf à l’article 2, s’entend au sens de
lations, 2012. (personnel de sûreté de l’aérodrome) l’article 2 de la Loi sur l’Administration canadienne de la
sûreté du transport aérien. (screening officer)
air carrier means any person who operates a commercial
air service under Subpart 1, 3, 4 or 5 of Part VII of the agent de la paix S’entend au sens de l’article 3 du Rè-
Regulations. (transporteur aérien) glement canadien de 2012 sur la sûreté aérienne.
(peace officer)
Canadian Forces means the armed forces of Her
Majesty raised by Canada. (Forces canadiennes) COVID-19 La maladie à coronavirus 2019. (COVID-19)
Chief Public Health Officer means the Chief Public document d’autorisation S’entend au sens de l’article 3
Health Officer appointed under subsection 6(1) of the du Règlement canadien de 2012 sur la sûreté aérienne.
Public Health Agency of Canada Act. (administrateur (document of entitlement)
en chef)
essai moléculaire relatif à la COVID-19 Essai de dépis-
COVID-19 means the coronavirus disease 2019. (CO‐ tage ou de diagnostic de la COVID-19 effectué par un la-
VID-19) boratoire accrédité, y compris l’essai effectué selon le
procédé d’amplification en chaîne par polymérase (ACP)
COVID-19 molecular test means a COVID-19 screening ou d’amplification isotherme médiée par boucle par
or diagnostic test carried out by an accredited laboratory, transcription inverse (RT-LAMP). (COVID-19 molecu‐
including a test performed using the method of poly- lar test)
merase chain reaction (PCR) or reverse transcription
loop-mediated isothermal amplification (RT-LAMP). étranger S’entend au sens du paragraphe 2(1) de la Loi
(essai moléculaire relatif à la COVID-19) sur l’immigration et la protection des réfugiés. (foreign
national)
document of entitlement has the same meaning as in
section 3 of the Canadian Aviation Security Regulations, exploitant d’un aérodrome S’agissant d’un aérodrome
2012. (document d’autorisation) où des activités liées à l'aviation civile sont exercées, la
81100-3-96-53 1 2022-02-08 (09:39)

AR04455
foreign national has the same meaning as in subsection personne responsable de l’aérodrome, y compris un em-
2(1) of the Immigration and Refugee Protection Act. ployé, un mandataire ou un représentant autorisé de
(étranger) cette personne. (operator of an aerodrome)
non-passenger screening checkpoint has the same Forces canadiennes Les forces armées de Sa Majesté le-
meaning as in section 3 of the Canadian Aviation Securi- vées par le Canada. (Canadian Forces)
ty Regulations, 2012. (point de contrôle des non-pas‐
sagers) personne accréditée Étranger titulaire d’un passeport
contenant une acceptation valide qui l’autorise à occuper
operator of an aerodrome means the person in charge un poste en tant qu’agent diplomatique ou consulaire, ou
of an aerodrome where activities related to civil aviation en tant que représentant officiel ou spécial, délivrée par
are conducted and includes an employee, agent or man- le chef du protocole du ministère des Affaires étrangères,
datary or other authorized representative of that person. du Commerce et du Développement. (accredited per‐
(exploitant) son)
passenger screening checkpoint has the same mean- personnel de sûreté de l’aérodrome S’entend au sens
ing as in section 3 of the Canadian Aviation Security de l’article 3 du Règlement canadien de 2012 sur la sûre-
Regulations, 2012. (point de contrôle des passagers) té aérienne. (aerodrome security personnel)
peace officer has the same meaning as in section 3 of point de contrôle des non-passagers S’entend au sens
the Canadian Aviation Security Regulations, 2012. de l’article 3 du Règlement canadien de 2012 sur la sûre-
(agent de la paix) té aérienne. (non-passenger screening checkpoint)
Regulations means the Canadian Aviation Regulations. point de contrôle des passagers S’entend au sens de
(Règlement) l’article 3 du Règlement canadien de 2012 sur la sûreté
the Canadian Aviation Security Regulations, 2012. Règlement Le Règlement de l’aviation canadien. (Reg‐
(zone réglementée) ulations)
screening authority means a person responsible for the terrains de l’aérodrome À l’égard de tout aérodrome vi-
screening of persons and goods at an aerodrome set out sé à l’annexe 1, les aérogares, les zones réglementées et
in the schedule to the CATSA Aerodrome Designation les installations destinées aux activités liées à l’utilisation
Regulations or at any other place designated by the Min- des aéronefs ou à l’exploitation d’un aérodrome et qui
ister under subsection 6(1.1) of the Canadian Air Trans- sont situées à l’aérodrome. (aerodrome property)
port Security Authority Act. (administration de
contrôle) transporteur aérien Exploitant d’un service aérien com-
mercial visé aux sous-parties 1, 3, 4 ou 5 de la partie VII
screening officer, except in section 2, has the same du Règlement. (air carrier)
meaning as in section 2 of the Canadian Air Transport
Security Authority Act. (agent de contrôle) variant préoccupant Tout variant du coronavirus du
syndrome respiratoire aigu sévère 2 (SRAS-CoV-2) dési-
variant of concern means a variant of severe acute res- gné comme un variant préoccupant par l’Organisation
piratory syndrome coronavirus 2 (SARS-CoV-2) that is mondiale de la santé. (variant of concern)
designated as a variant of concern by the World Health
Organization. (variant préoccupant) zone réglementée S’entend au sens de l’article 3 du Rè-
glement canadien de 2012 sur la sûreté aérienne. (re‐
stricted area)
81100-3-96-53 2 2022-02-08 (09:39)

AR04456
rienne.

meets all of the following requirements: masque non médical, qui satisfait aux exigences sui-
vantes :
(a) it is made of multiple layers of tightly woven mate-
rials such as cotton or linen; a) il est constitué de plusieurs couches d’une étoffe
tissée serrée, telle que le coton ou le lin;
(b) it completely covers a person’s nose, mouth and
chin without gaping; b) il couvre complètement le nez, la bouche et le men-
ton sans laisser d’espace;
(c) it can be secured to a person’s head with ties or ear
loops. c) il peut être solidement fixé à la tête par des at-

coton ou le lin;

vile, si :
vente au Canada :
ommendation of the Chief Public Health Officer, (ii) soit le ministre de la Santé, sur recommanda-
that the regimen is suitable, having regard to the tion de l’administrateur en chef conclut que le pro-
scientific evidence related to the efficacy of that reg- tocole vaccinal est approprié compte tenu des
imen in preventing the introduction or spread of preuves scientifiques relatives à son efficacité pour
COVID-19 or any other factor relevant to prévenir l’introduction ou la propagation de la
81100-3-96-53 3 2022-02-08 (09:39)

AR04457
preventing the introduction or spread of COVID-19; COVID-19 ou de tout autre facteur pertinent à cet
or égard;
(b) in all other cases, b) dans tout autre cas :
(i) the vaccines of the regimen are authorized for (i) d’une part, les vaccins du protocole vaccinal
sale in Canada or in another jurisdiction, and sont autorisés pour la vente soit au Canada, soit
dans un pays étranger,
ommendation of the Chief Public Health Officer, (ii) d’autre part, le ministre de la Santé, sur recom-
that the vaccines and the regimen are suitable, hav- mandation de l’administrateur en chef conclut que
ing regard to the scientific evidence related to the ces vaccins et le protocole vaccinal sont appropriés
efficacy of that regimen and the vaccines in pre- compte tenu des preuves scientifiques relatives à
venting the introduction or spread of COVID-19 or leur efficacité pour prévenir l’introduction ou la
any other factor relevant to preventing the intro- propagation de la COVID-19 ou de tout autre fac-
duction or spread of COVID-19. teur pertinent à cet égard.

Notification Avis

81100-3-96-53 4 2022-02-08 (09:39)

AR04458
fore boarding the aircraft or before entering Canada, to de la Loi sur la mise en quarantaine, de fournir, avant de
the Minister of Health, a screening officer or a quaran- monter à bord de l’aéronef ou avant qu’elle n’entre au

article.
fédérale.
81100-3-96-53 5 2022-02-08 (09:39)

AR04459

trompeuse.
Exception Exception
3(1).

Exception Exception


81100-3-96-53 6 2022-02-08 (09:39)

AR04460
Notification Avis
they have, COVID-19; de soupçonner qu’elle l’a;
craft in the previous 10 days for a medical reason re- dans les dix derniers jours pour une raison médicale
lated to COVID-19; or liée à la COVID-19;
an aircraft in the previous 10 days for a medical reason dans les dix derniers jours pour une raison médicale
related to COVID-19; liée à la COVID-19;
81100-3-96-53 7 2022-02-08 (09:39)

AR04461

jected to a health check and is required to provide a et (3), subit la vérification de santé et est tenue de donner
confirmation must la confirmation est tenue :
Exception Exception

aérien
the aircraft is exhibiting any symptoms referred to in elle présente l’un ou l’autre des symptômes visés au para-
vants :
81100-3-96-53 8 2022-02-08 (09:39)

AR04462
Period of 10 days Période de dix jours

vide a medical certificate certifying that any symptoms dix jours après le refus, à moins qu’elle fournisse un cer-
referred to in subsection 8(1) that they are exhibiting are tificat médical attestant que les symptômes visés au para-
not related to COVID-19. graphe 8(1) qu’elle présente ne sont pas liés à la CO-
VID-19.

du Canada
vol.
Notification Avis
they are unable to provide evidence that they received a ter la preuve qu’elle a obtenu un résultat à un essai molé-
result for a COVID-19 molecular test. culaire relatif à la COVID-19.

parture time; or dans les soixante-douze heures avant l’heure prévue
than 180 days before the flight’s initial scheduled de- sur un échantillon prélevé au moins dix jours et au
parture time. plus cent quatre-vingts jours avant l’heure prévue ini-
tialement de départ du vol.
81100-3-96-53 9 2022-02-08 (09:39)

AR04463
Location of test — outside Canada Lieu de l’essai — extérieur du Canada

(1.1) The COVID-19 molecular test referred to in para- (1.1) L’essai moléculaire relatif à la COVID-19 visé à
graph (1)(a) must be performed outside Canada. l’alinéa (1)a) doit être effectué à l’extérieur du Canada.

(2) For the purposes of paragraph (1)(a) and subsection (2) Pour l’application de l’alinéa (1)a) et du paragraphe
(1.1), the COVID-19 molecular test must not have been (1.1), l’essai moléculaire relatif à la COVID-19 ne doit pas
performed in a country where, as determined by the Min- être effectué dans un pays, selon ce que conclut le mi-
ister of Health, there is an outbreak of a variant of con- nistre de la Santé, qui est aux prises avec l’apparition
cern or there are reasonable grounds to believe that there d’un variant préoccupant ou dont il y a des motifs raison-
is an outbreak of that variant. nables de croire qu’il est aux prises avec l’apparition d’un
tel variant.
Evidence — alternative testing protocol Preuve — protocole d’essai alternatif

13.1 Despite subsections 13(1) and (1.1), a person re- 13.1 Malgré les paragraphes 13(1) et (1.1), avant de
ferred to in section 2.22 of the Order entitled Minimizing monter à bord d’un aéronef pour un vol, la personne vi-
the Risk of Exposure to COVID-19 in Canada Order sée à l’article 2.22 du Décret visant la réduction du risque
(Quarantine, Isolation and Other Obligations) must, be- d’exposition à la COVID-19 au Canada (quarantaine,
fore boarding an aircraft for a flight, provide to the pri- isolement et autres obligations) présente à l’exploitant
vate operator or air carrier operating the flight evidence privé ou au transporteur aérien qui effectue le vol la
of a COVID-19 molecular test that was carried out in ac- preuve qu’elle a obtenu un résultat à un essai moléculaire
cordance with an alternative testing protocol referred to relatif à la COVID-19 effectué conformément à un proto-
in that section. cole d’essai alternatif visé à cet article.

sonne;
procédé utilisé;


the person’s name and contact information and the date avise le ministre dès que possible des prénom, nom et co-
and number of the person’s flight. ordonnées de la personne ainsi que la date et le numéro
de son vol.
81100-3-96-53 10 2022-02-08 (09:39)

AR04464
ments set out in section 13 or 13.1. gences prévues aux articles 13 ou 13.1

tue;
(c) an air carrier operating a flight departing from an
aerodrome listed in Schedule 1. c) le transporteur aérien qui effectue un vol en par-
tance d’un aérodrome visé à l’annexe 1.
of age;
(b) a crew member;
rier tue :
(i) only to become a crew member on board anoth- (i) dans le seul but d’agir à titre de membre d’équi-
er aircraft operated by an air carrier, page à bord d’un autre aéronef exploité par un
transporteur aérien,
aircraft operated by an air carrier, or (ii) après avoir agi à titre de membre d’équipage à
bord d’un aéronef exploité par un transporteur aé-
(iii) to participate in mandatory training required rien,
de membre d’équipage;
81100-3-96-53 11 2022-02-08 (09:39)

AR04465
(d) a person who arrives at an aerodrome from any d) la personne qui arrive à un aérodrome à bord d’un
other country on board an aircraft in order to transit aéronef en provenance d’un autre pays en vue d’y
to another country and remains in a sterile transit transiter vers un autre pays et qui demeure, jusqu’à
area, as defined in section 2 of the Immigration and son départ du Canada, dans l’espace de transit isolé
Refugee Protection Regulations, of the aerodrome un- au sens de l’article 2 du Règlement sur l’immigration
til they leave Canada; et la protection des réfugiés de l’aérodrome;
(e) a person who arrives at an aerodrome on board an e) la personne qui arrive à un aérodrome à bord d’un
aircraft following the diversion of their flight for a aéronef à la suite du déroutement de son vol pour une
safety-related reason, such as adverse weather or an raison liée à la sécurité, comme le mauvais temps ou
equipment malfunction, and who boards an aircraft un défaut de fonctionnement de l’équipement, et qui
for a flight not more than 24 hours after the arrival monte à bord de l’aéronef pour un vol au plus tard
time of the diverted flight. vingt-quatre heures après l’arrivée du vol dérouté.
Notification Avis
suivantes :
(b) they must provide to the air carrier evidence of
COVID-19 vaccination demonstrating that they are a b) présenter au transporteur aérien la preuve de vac-
fully vaccinated person or evidence that they are a per- cination contre la COVID-19 établissant qu’elle est une
son referred to in any of paragraphs 17.3(2)(a) to (c) or personne entièrement vaccinée ou la preuve qu’elle est
any of subparagraphs 17.3(2)(d)(i) to (iv) or (e)(i) to visée à l’un des alinéas 17.3(2)a) à c) ou à l’un des
(vii); and sous-alinéas 17.3(2)d)(i) à (iv) et e)(i) à (vii);
(c) if they submit a request referred to in section 17.4, c) si la personne présente une demande visée à l’ar-
they must do so within the period set out in subsection ticle 17.4, présenter la demande dans le délai prévu au
17.4(3). paragraphe 17.4(3).

vaccinée.

suivantes :
81100-3-96-53 12 2022-02-08 (09:39)

AR04466
(c) a foreign national who is boarding an aircraft for a
flight to a country other than Canada or to an aero- c) l’étranger qui monte à bord d’un aéronef pour un
drome in Canada for the purpose of boarding an air- vol à destination de tout autre pays que le Canada ou
craft for a flight to a country other than Canada and pour un vol à destination d’un aérodrome au Canada
who has received either dans le but de monter à bord d’un autre aéronef pour
un vol à destination de tout autre pays et qui a obtenu,
(i) a negative result for a COVID-19 molecular test selon le cas :
that was performed on a specimen collected no
more than 72 hours before the flight’s initial sched- (i) un résultat négatif à un essai moléculaire relatif
uled departure time, or à la COVID-19 qui a été effectué sur un échantillon
prélevé dans les soixante-douze heures avant
(ii) a positive result for such a test that was per- l’heure prévue initialement de départ du vol,
formed on a specimen collected at least 10 days and
no more than 180 days before the flight’s initial (ii) un résultat positif à un tel essai qui a été effec-
scheduled departure time; tué sur un échantillon prélevé au moins dix jours et
au plus cent quatre-vingts jours avant l’heure pré-
(d) a person who has received a result for a COVID-19 vue initialement de départ du vol;
molecular test described in subparagraph (c)(i) or (ii)
and who is d) la personne qui a obtenu un résultat à un essai mo-
léculaire relatif à la COVID-19 visé au sous-alinéa c)(i)
(i) a person who has not completed a COVID-19 ou (ii) et qui, selon le cas :
traindication and who is entitled to be accommo- (i) n’a pas suivi de protocole vaccinal complet
dated on that basis under applicable legislation by contre la COVID-19 en raison d’une contre-indica-
(ii) a person who has not completed a COVID-19 mentée sans être une personne entièrement vacci-
vaccine dosage regimen due to a sincerely held reli- née,
gious belief and who is entitled to be accommodat-
ed on that basis under applicable legislation by be- (ii) n’a pas suivi de protocole vaccinal complet
ing permitted to enter the restricted area or to contre la COVID-19 en raison d’une croyance reli-
board an aircraft without being a fully vaccinated gieuse sincère et qui a droit à une mesure d’adapta-
person, tion pour ce motif, aux termes de la législation ap-
plicable, lui permettant de monter à bord d’un
(iii) a person who is boarding an aircraft for a flight aéronef pour un vol ou d’accéder à une zone régle-
for the purpose of attending an appointment for an mentée sans être une personne entièrement vacci-
essential medical service or treatment, or née,
(iv) a competent person who is at least 18 years old (iii) monte à bord d’un aéronef pour un vol afin de
and who is boarding an aircraft for a flight for the se rendre à un rendez-vous pour obtenir des ser-
purpose of accompanying a person referred to in vices ou traitements médicaux essentiels,
subparagraph (iii) if the person needs to be accom-
panied because they (iv) est une personne capable âgée d’au moins dix-
huit ans qui monte à bord d’un aéronef pour un vol
(A) are under the age of 18 years, afin d’accompagner la personne visée au sous-ali-
néa (iii) si cette personne a besoin d’être accompa-
(B) have a disability, or gnée pour l’une des raisons suivantes :
(C) need assistance to communicate; or (A) elle est âgée de moins de dix-huit ans,
(B) elle a un handicap,
81100-3-96-53 13 2022-02-08 (09:39)

AR04467
(e) a person who has received a result for a COVID-19 (C) elle a besoin d’aide pour communiquer;
molecular test described in subparagraph (c)(i) or (ii)
and who is boarding an aircraft for a flight for a pur- e) la personne qui a obtenu un résultat à un essai mo-
pose other than an optional or discretionary purpose, léculaire relatif à la COVID-19 visé au sous-alinéa c)(i)
such as tourism, recreation or leisure, and who is ou (ii) et qui monte à bord d’un aéronef pour un vol à
des fins autres que de nature optionnelle ou discré-
(i) a person who entered Canada at the invitation of tionnaire telles que le tourisme, les loisirs ou le diver-
the Minister of Health for the purpose of assisting tissement et qui, selon le cas :
in the COVID-19 response,
(i) est entrée au Canada à l’invitation du ministre
(ii) a person who is permitted to work in Canada as de la Santé afin de participer aux efforts de lutte
a provider of emergency services under paragraph contre la COVID-19,
186(t) of the Immigration and Refugee Protection
Regulations and who entered Canada for the pur- (ii) est autorisée à travailler au Canada afin d’offrir
pose of providing those services, des services d’urgence en vertu de l’alinéa 186t) du
Règlement sur l’immigration et la protection des
(iii) a person who entered Canada not more than 90 réfugiés et est entrée au Canada afin d’offrir de tels
days before the day on which this Interim Order services,
came into effect and who, at the time they sought to
enter Canada, (iii) est entrée au Canada dans les quatre-vingt-dix
jours précédant la date d’entrée en vigueur du pré-
(A) held a permanent resident visa issued under sent arrêté d’urgence et au moment qu’elle cher-
subsection 139(1) of the Immigration and chait à entrer au Canada, elle était à la fois :
Refugee Protection Regulations, and
(A) titulaire d’un visa de résident permanent dé-
(B) was recognized as a Convention refugee or a livré aux termes du paragraphe 139(1) du Règle-
person in similar circumstances to those of a ment sur l’immigration et la protection des réfu-
Convention refugee within the meaning of sub- giés,
section 146(1) of the Immigration and Refugee
Protection Regulations, (B) reconnue comme réfugié au sens de la
Convention ou était dans une situation sem-
(iv) a person who has been issued a temporary resi- blable à celle d’un réfugié visé au paragraphe
dent permit within the meaning of subsection 24(1) 146(1) de ce même règlement,
of the Immigration and Refugee Protection Act
and who entered Canada not more than 90 days be- (iv) est titulaire d’un permis de séjour temporaire
fore the day on which this Interim Order came into au sens du paragraphe 24(1) de la Loi sur l’immi-
effect as a protected temporary resident under sub- gration et la protection des réfugiés et qui est en-
section 151.1(2) of the Immigration and Refugee trée au Canada dans les quatre-vingt-dix jours pré-
Protection Regulations, cédant la date d’entrée en vigueur du présent arrêté
d’urgence à titre de résident temporaire protégé
(v) an accredited person, aux termes du paragraphe 151.1(2) du Règlement
sur l’immigration et la protection des réfugiés,
(vi) a person holding a D-1, O-1 or C-1 visa who en-
tered Canada to take up a post and become an ac- (v) est une personne accréditée,
credited person, or
(vi) est titulaire d’un visa D-1, O-1 ou C-1 et est en-
(vii) a diplomatic or consular courier. trée au Canada pour occuper un poste et devenir
(iv)
un vol effectué par le transporteur aérien ou pour son
81100-3-96-53 14 2022-02-08 (09:39)

AR04468
air carrier operates or that is operated on the air carrier’s compte en application d’une entente commerciale dans
behalf under a commercial agreement if les cas suivants :
(a) in the case of a person referred to in any of sub- a) la personne est visée à l’un des sous-alinéas
paragraphs 17.3(2)(d)(i) to (iii), the person submits a 17.3(2)d)(i) à (iii) et une demande a été présentée par
request to the air carrier in respect of that flight in ac- cette personne ou pour son compte conformément aux
cordance with subsections (2) and (3) or such a re- paragraphes (2) et (3) au transporteur aérien à l’égard
quest is submitted on their behalf; du vol;
(b) in the case of a person referred to in subparagraph b) la personne est visée aux sous-alinéas 17.3(2)d)(i)
17.3(2)(d)(i) or (ii), the air carrier is obligated to ac- ou (ii) et le transporteur aérien a l’obligation, aux
commodate the person on the basis of a medical con- termes de la législation applicable, de prendre une
traindication or a sincerely held religious belief under mesure d’adaptation en raison d’une contre-indication
applicable legislation by issuing the document; and médicale ou d’une croyance religieuse sincère et il la
prend en délivrant le document;
(c) in the case of a person referred to in subparagraph
17.3(2)(d)(iv), the person who needs accompaniment c) la personne est visée au sous-alinéa 17.3(2)d)(iv) et
submits a request to the air carrier in respect of that une demande a été présentée à l’égard du vol au trans-
flight in accordance with subsections (2) and (3) or porteur aérien par la personne qui a besoin d’être ac-
such a request is submitted on their behalf. compagnée ou pour son compte conformément aux

(a) the person’s name and home address and, if the a) les prénom, nom et adresse de résidence de la per-
request is made by someone else on the person’s be- sonne et, si la demande a été faite en son nom par une
half, that person’s name and home address; autre personne, les prénom, nom et adresse de rési-
dence de la personne qui a fait la demande;
(b) the date and number of the flight as well as the
aerodrome of departure and the aerodrome of arrival; b) les date et numéro du vol ainsi que les aérodromes
de départ et d’arrivée;
17.3(2)(d)(i), c) dans le cas d’une personne visée au sous-alinéa
17.3(2)d)(i) :
(i) a document issued by the government of a
province confirming that the person cannot com- (i) soit un document délivré par le gouvernement
plete a COVID-19 vaccination regimen due to a d’une province attestant que la personne ne peut
medical condition, or pas suivre de protocole vaccinal complet contre la
COVID-19 en raison de sa condition médicale,
(ii) a medical certificate signed by a medical doctor
or nurse practitioner who is licensed to practise in (ii) soit un certificat médical signé par un médecin
Canada certifying that the person cannot complete ou un infirmier praticien autorisé à pratiquer au
a COVID-19 vaccination regimen due to a medical Canada attestant que la personne ne peut pas
condition and the licence number issued by a pro- suivre de protocole vaccinal complet contre la CO-
fessional medical licensing body to the medical doc- VID-19 en raison de sa condition médicale et le nu-
tor or nurse practitioner; méro du permis d’exercice délivré au médecin ou à
l’infirmier praticien par un organisme qui régle-
(d) in the case of a person described in subparagraph mente la profession de médecin ou d’infirmier pra-
17.3(2)(d)(ii), a statement sworn or affirmed by the ticien;
person before a person appointed as a commissioner
of oaths in Canada attesting that the person has not d) dans le cas d’une personne visée au sous-alinéa
completed a COVID-19 vaccination regimen due to a 17.3(2)d)(ii), une déclaration sous serment ou une af-
sincerely held religious belief, including a description firmation solennelle de la personne faites devant une
personne nommée à titre de commissaire aux
81100-3-96-53 15 2022-02-08 (09:39)

AR04469
of how the belief renders them unable to complete serments au Canada attestant qu’elle n’a pas suivi de
such a regimen; and protocole vaccinal complet contre la COVID-19 en rai-
son d’une croyance religieuse sincère et décrivant de
(e) in the case of a person described in subparagraph quelle manière cette croyance religieuse l’empêche de
17.3(2)(d)(iii), a document that includes suivre le protocole vaccinal complet;
(i) the signature of a medical doctor or nurse prac- e) dans le cas d’une personne visée au sous-alinéa
titioner who is licensed to practise in Canada, 17.3(2)d)(iii), un document qui comprend :
(ii) the licence number issued by a professional (i) la signature d’un médecin ou d’un infirmier pra-
medical licensing body to the medical doctor or ticien autorisé à pratiquer au Canada,
nurse practitioner,
(ii) le numéro du permis d’exercice délivré au mé-
(iii) the date of the appointment for the essential decin ou à l’infirmier praticien par un organisme
medical service or treatment and the location of the qui réglemente la profession de médecin ou d’infir-
appointment, mier praticien,
(iv) the date on which the document was signed, (iii) l’endroit où le service ou traitement médical
and essentiel sera reçu et la date du rendez-vous,
(v) if the person needs to be accompanied by a per- (iv) la date de la signature du document,
son referred to in subparagraph 17.3(2)(d)(iv), the
name and contact information of that person and (v) si la personne a besoin d’être accompagnée par
the reason that the accompaniment is needed. une personne visée au sous-alinéa 17.3(2)d)(iv), les
prénom, nom et coordonnées de cette personne
est nécessaire.



81100-3-96-53 16 2022-02-08 (09:39)

AR04470

a refusées.
created.




aérien
sult for a COVID-19 molecular test. l’un des sous-alinéas 17.3(2)d)(i) à (iv) et e)(i) à (vii) et
qu’elle a obtenu un résultat à un essai moléculaire re-
latif à la COVID-19.
81100-3-96-53 17 2022-02-08 (09:39)

AR04471

17.9 A person must, at the request of an air carrier, pro- 17.9 Toute personne est tenue de présenter au transpor-
vide to the air carrier the evidence referred to in para- teur aérien, sur demande de celui-ci, la preuve visée aux
graph 17.7(a), (b) or (c). alinéas 17.7a), b) ou c).

cin;
(b) the name of the government or of the entity;
b) le nom du gouvernement ou de l’entité;
identifies the vaccine that was administered; and c) la marque nominative ou tout autre renseignement
permettant d’identifier le vaccin qui a été administré;
(d) the dates on which the vaccine was administered
or, if the evidence is one document issued for both d) les dates auxquelles le vaccin a été administré ou,
doses and the document specifies only the date on dans le cas où la preuve est un document unique qui
which the most recent dose was administered, that est délivré pour deux doses et qui ne mentionne que la
date. date à laquelle la dernière dose a été administrée, cette
date.

conforme.
sult described in subparagraph 17.3(2)(c)(i) or (ii). COVID-19 est un résultat visé aux sous-alinéas
17.3(2)c)(i) ou (ii).
éléments
(d). 14a) à d).

81100-3-96-53 18 2022-02-08 (09:39)

AR04472
(b) their passport or other travel document issued by b) un passeport ou autre titre de voyage de la per-
their country of citizenship or nationality. sonne délivré par son pays de citoyenneté ou de natio-
nalité.

the departure time of the flight taken by the person to est au plus tard vingt-quatre heures après l’heure de
(b) a document entitled “Confirmation of Permanent
Residence” issued by the Department of Citizenship b) un document délivré par le ministère de la Citoyen-
and Immigration that confirms that the person be- neté et de l’Immigration intitulé « Confirmation de ré-
came a permanent resident on entry to Canada after sidence permanente » qui confirme que la personne
the flight taken by the person to Canada from any oth- est devenue résident permanent à son entrée au
er country. Canada après le vol qu’elle a pris en partance de tout
autre pays à destination du Canada.

nalité.
(iv)
tée.

81100-3-96-53 19 2022-02-08 (09:39)

AR04473


tion Regulations.

confirms that the person entered Canada as a protected confirme que la personne est entrée au Canada à titre de
temporary resident under subsection 151.1(2) of the Im- résident temporaire protégé aux termes du paragraphe
migration and Refugee Protection Regulations. 151.1(2) du Règlement sur l’immigration et la protection
des réfugiés.


subparagraph 17.3(2)(e)(vi) must be the person’s D-1, sous-alinéa 17.3(2)e)(vi) est le visa D-1, O-1 ou C-1 de la
O-1 or C-1 visa. personne.

subparagraph 17.3(2)(e)(vii) must be sous-alinéa 17.3(2)e)(vii) est :
tionales;
ment confirming their status referred to in Article 35
81100-3-96-53 20 2022-02-08 (09:39)

AR04474
of the Vienna Convention on Consular Relations, as b) dans le cas d’un courrier consulaire, le document
set out in Schedule II to that Act. officiel attestant sa qualité mentionné à l’article 35 de
la Convention de Vienne sur les relations consulaires,



faux ou trompeurs.

(2) An air carrier that has reason to believe that a person (2) Le transporteur aérien qui a des raisons de croire
has provided evidence that is likely to be false or mislead- qu’une personne lui a présenté une preuve susceptible
ing must notify the Minister of the following not more d’être fausse ou trompeuse en avise le ministre, au plus
than 72 hours after the provision of the evidence: tard soixante-douze heures après la présentation de la
preuve et l’avis comprend les éléments suivants :
(c) the reason the air carrier believes that the evi-
dence is likely to be false or misleading. c) les raisons pour lesquelles le transporteur aérien
croit que la preuve est susceptible d’être fausse ou
trompeuse.

81100-3-96-53 21 2022-02-08 (09:39)

AR04475

17.15 :

[17.18 and 17.19 reserved] [17.18 et 17.19 réservés]


lon le cas :
mandatary;
81100-3-96-53 22 2022-02-08 (09:39)

AR04476
(c) a person hired by the entity to provide a service; b) est un employé d’un entrepreneur ou d’un manda-
lessee, if the property that is subject to the lease is part c) est embauchée par l’entité pour offrir un service;
of aerodrome property; or
d) est un locataire de l’entité ou un employé d’un loca-
(e) a person permitted by the entity to access aero- taire de l’entité, si les lieux faisant l’objet du bail font
drome property or, in the case of NAV CANADA, a lo- partie des terrains de l’aérodrome;
cation where NAV CANADA provides civil air naviga-
tion services. e) a l’autorisation de l’entité pour accéder aux terrains
de l’aérodrome ou, dans le cas de NAV CANADA, à un
emplacement où celle-ci fournit des services de navi-
sont :
are related to aerodrome operations or commercial a) la conduite d’activités qui sont liées à l’exploitation
flight operations — such as aircraft refuelling services, de l’aérodrome ou des vols commerciaux — telles que
aircraft maintenance and repair services, baggage les services de ravitaillement en carburant des aéro-
handling services, supply services for the operator of nefs, les services d’entretien et de réparation des aéro-
an aerodrome, an air carrier or NAV CANADA, fire nefs, les services de manutention des bagages, les ser-
prevention services, runway and taxiway maintenance vices d’approvisionnement fournis à l’exploitant d’un
services or de-icing services — and that take place on aérodrome, à un transporteur aérien ou à NAV
aerodrome property or at a location where NAV CANADA, les services de prévention des incendies, les
CANADA provides civil air navigation services; services d’entretien des pistes et des voies de circula-
tion et les services de dégivrage — qui se déroulent sur
(b) interacting in-person on aerodrome property with les terrains de l’aérodrome ou à un emplacement où
a person who intends to board an aircraft for a flight; NAV CANADA fournit des services de navigation aé-
rienne civile, ainsi que le soutien direct à de telles acti-
(c) engaging in tasks, on aerodrome property or at a vités;
location where NAV CANADA provides civil air navi-
gation services, that are intended to reduce the risk of b) l’interaction en présentiel sur les terrains de l’aéro-
transmission of the virus that causes COVID-19; and drome avec quiconque a l’intention de monter à bord
d’un aéronef pour un vol;
(d) accessing a restricted area at an aerodrome listed
in Schedule 1. c) l’exécution, sur les terrains de l’aérodrome ou à un
emplacement où NAV CANADA fournit des services
COVID-19;

à l’annexe 1.


(2) The policy must (2) La politique de vaccination doit, à la fois :
81100-3-96-53 23 2022-02-08 (09:39)

AR04477
(a) require that a person who is 12 years and four a) exiger que toute personne âgée de douze ans et
months of age or older be a fully vaccinated person be- quatre mois ou plus soit une personne entièrement
fore accessing aerodrome property, unless they are a vaccinée pour pouvoir accéder aux terrains de l’aéro-
person drome, sauf dans les cas suivants :
(i) who intends to board an aircraft for a flight that (i) elle a l’intention de monter à bord d’un aéronef
an air carrier operates, pour un vol qu’un transporteur aérien effectue,
(ii) who does not intend to board an aircraft for a (ii) elle n’a pas l’intention de monter à bord d’un
pour un vol,
document issued by a department or departmental (iii) elle est titulaire d’une pièce d’identité d’em-
(iv) who is delivering equipment or providing ser- (iv) elle livre des équipements ou fournit des ser-
vices within a restricted area that are urgently vices dans une zone réglementée, lesquels sont es-
needed and critical to aerodrome operations and sentiels aux activités de l’aérodrome et dont on a un
who has obtained an authorization from the opera- besoin urgent, et a obtenu une autorisation préa-
tor of the aerodrome before doing so; lable de l’exploitant d’un aérodrome pour ce faire;
son to access aerodrome property if the person has not ment vaccinée d’accéder aux terrains de l’aérodrome si
completed a COVID-19 vaccine dosage regimen due to celle-ci n’a pas suivi de protocole vaccinal complet
a medical contraindication or their sincerely held reli- contre la COVID-19 en raison d’une contre-indication
gious belief; médicale ou de sa croyance religieuse sincère;
vided by a person referred to in paragraph (b) that preuve présentée par la personne visée à l’alinéa b)
demonstrates that the person has not completed a établissant qu’elle n’a pas suivi de protocole vaccinal
COVID-19 vaccine dosage regimen due to a medical complet contre la COVID-19 en raison d’une contre-
contraindication or their sincerely held religious be- indication médicale ou de sa croyance religieuse sin-
lief; cère;
(d) provide for a procedure for issuing to a person d) prévoir une procédure permettant de délivrer à la
whose evidence has been verified under the procedure personne dont la preuve a été vérifiée aux termes de la
referred to in paragraph (c) a document confirming procédure visée à l’alinéa c), un document qui
that they are a person referred to in paragraph (b); confirme qu’elle est visée à l’alinéa b);
(e) provide for a procedure that ensures that a person e) prévoir une procédure permettant de veiller à ce
subject to the policy provides, on request, the follow- que la personne assujettie à la politique présente sur
ing evidence before accessing aerodrome property: demande la preuve ci-après avant d’accéder aux ter-
rains de l’aérodrome :
(i) in the case of a fully vaccinated person, the evi-
dence of COVID-19 vaccination referred to in sec- (i) dans le cas d’une personne entièrement vacci-
tion 17.10, and née, la preuve de vaccination contre la COVID-19
visée à l’article 17.10,
(ii) in the case of a person referred to in paragraph
(d), the document issued to the person under the (ii) dans le cas d’une personne visée à l’alinéa d), le
procedure referred to in that paragraph; document qui lui a été délivré en application de cet
alinéa;
81100-3-96-53 24 2022-02-08 (09:39)

AR04478
(f) provide for a procedure that allows a person to f) prévoir une procédure permettant à la personne as-
whom sections 17.31 to 17.40 apply — other than a sujettie aux articles 17.31 à 17.40, à l’exception de celle
person referred to in subsection 17.34(2) — who is a visée au paragraphe 17.34(2), qui est une personne en-
fully vaccinated person or a person referred to in para- tièrement vaccinée ou une personne visée à l’alinéa b)
graph (b) and who is unable to provide the evidence et qui n’est pas en mesure de présenter la preuve visée
referred to in paragraph (e) to temporarily access à l’alinéa e) d’accéder temporairement aux terrains de
aerodrome property if they provide a declaration con- l’aérodrome si elle présente une déclaration confir-
firming that they are a fully vaccinated person or that mant qu’elle est une personne entièrement vaccinée
they have been issued a document under the proce- ou qu’elle s’est vu délivrer un document en application
dure referred to in paragraph (d); de la procédure visée à l’alinéa d);
(g) provide for a procedure that ensures that a person g) prévoir une procédure permettant de veiller à ce
referred to in paragraph (d) is tested for COVID-19 at que la personne visée à l’alinéa d) se soumette à un es-
least twice every week; sai relatif à la COVID-19 au moins deux fois par se-
maine;
(h) provide for a procedure that ensures that a person
who receives a positive result for a COVID-19 test tak- h) prévoir une procédure permettant de veiller à ce
en under the procedure referred to in paragraph (g) is qu’il soit interdit à la personne qui reçoit un résultat
prohibited from accessing aerodrome property until positif à un essai relatif à la COVID-19 réalisé confor-
the end of the period for which the public health au- mément à la procédure visée à l’alinéa g) d’accéder
thority of the province or territory in which the aero- aux terrains de l’aérodrome jusqu’à la fin de la période
drome is located requires them to isolate after receiv- d’isolement exigée, à la suite de la réception d’un ré-
ing a positive result or until the person is not sultat positif, par l’autorité sanitaire de la province ou
exhibiting any of the symptoms referred to in subsec- du territoire où est situé l’aérodrome ou jusqu’à ce
tion 8(1), whichever is later; and qu’elle ne présente plus de symptômes visés au para-
graphe 8(1), selon la plus tardive de ces éventualités;
(i) provide for a procedure that ensures that a person
referred to in paragraph (h) who undergoes a i) prévoir une procédure permettant de veiller à ce
COVID-19 molecular test is exempt from the proce- que la personne visée à l’alinéa h) qui se soumet à un
dure referred to in paragraph (g) for a period of 180 essai moléculaire relatif à la COVID-19 soit exemptée
days after the person received a positive result from de la procédure visée à l’alinéa g) pour la période de
that test. cent quatre-vingts jours suivant la réception d’un ré-
sultat positif à cet essai.

(3) For the purposes of paragraphs (2)(c) and (d), the (3) Pour l’application des alinéas (2)c) et d), la politique
policy must provide that a document is to be issued to a doit prévoir que le document confirmant qu’une per-
person confirming that they did not complete a sonne n’a pas suivi de protocole vaccinal complet contre
COVID-19 vaccine dosage regimen on the basis of a med- la COVID-19, pour le motif de contre-indication médi-
ical contraindication only if they provide a medical cer- cale, ne soit délivré à la personne que si celle-ci soumet
tificate from a medical doctor or nurse practitioner who un certificat médical délivré par un médecin ou un infir-
is licensed to practise in Canada certifying that the per- mier praticien autorisé à pratiquer au Canada qui atteste
son cannot complete a COVID-19 vaccination regimen que la personne ne peut pas suivre de protocole vaccinal
due to a medical condition and specifying whether the complet contre la COVID-19 en raison d’une condition
condition is permanent or temporary. médicale et qui précise si cette condition est permanente
ou temporaire.

COVID-19 vaccine dosage regimen on the basis of their la COVID-19, pour le motif de croyance religieuse sincère
sincerely held religious belief only if they submit a state- de la personne, ne soit délivré à la personne que si celle-
ment sworn or affirmed by them attesting that they have ci fournit une déclaration sous serment ou une affirma-
tion solennelle attestant qu’elle n’a pas suivi de protocole
81100-3-96-53 25 2022-02-08 (09:39)

AR04479
not completed a COVID-19 vaccination regimen due to vaccinal complet contre la COVID-19 en raison de sa
their sincerely held religious belief. croyance religieuse sincère.
(5) For the purposes of paragraphs (2)(c) and (d), in the (5) Pour l’application des alinéas (2)c) et d), dans le cas
case of an employee of the operator of an aerodrome or a de l’employé de l’exploitant d’un aérodrome ou de la per-
person hired by the operator of an aerodrome to provide sonne qui est embauchée par l’exploitant d’un aérodrome
a service, the policy must provide that a document is to pour offrir un service, la politique doit prévoir que le do-
be issued to the employee or person confirming that they cument confirmant qu’une personne n’a pas suivi de pro-
did not complete a COVID-19 vaccine dosage regimen on tocole vaccinal complet contre la COVID-19, pour le mo-
the basis of their sincerely held religious belief only if the tif de croyance religieuse sincère de l’employé ou de la
operator of the aerodrome is obligated to accommodate personne, ne soit délivré à la personne que si l’exploitant
them on that basis under the Canadian Human Rights d’un aérodrome a l’obligation de prendre une telle me-
Act by issuing such a document. sure d’adaptation pour ce motif aux termes de la Loi ca-
nadienne sur les droits de la personne.

(6) For the purposes of paragraphs (2)(c) and (d), in the (6) Pour l’application des alinéas (2)c) et d), dans les cas
following cases, the policy must provide that a document ci-après, la politique doit prévoir que le document confir-
is to be issued to the employee confirming that they did mant qu’une personne n’a pas suivi de protocole vaccinal
not complete a COVID-19 vaccine dosage regimen on the complet contre la COVID-19, pour le motif de croyance
basis of their sincerely held religious belief only if they religieuse sincère de la personne, n’est délivré à la per-
would be entitled to such an accommodation on that ba- sonne que si celle-ci a droit à une telle mesure d’adapta-
sis under applicable legislation: tion pour ce motif aux termes de la législation appli-
cable :
CANADA CANADA
cordance with paragraphs 17.24(2)(a) to (h) and sub- COVID-19 qui est conforme aux alinéas 17.24(2)a) à h)
ed person who has not been issued a document under toute personne non vaccinée qui ne s’est pas vu déli-
who is et qui est :
81100-3-96-53 26 2022-02-08 (09:39)

AR04480
(iii) a person hired by the entity to provide a ser- (iii) une personne qui est embauchée par l’entité
CANADA

(a) require that a relevant person, other than the a) exiger que toute personne concernée, à l’exception
holder of an employee identification document issued du titulaire d’une pièce d’identité d’employé délivrée
by a department or departmental corporation listed in par un ministère ou un établissement public visé à
Schedule 2 or a member identification document is- l’annexe 2 ou d’une pièce d’identité de membre déli-
sued by the Canadian Forces, be a fully vaccinated vrée par les Forces canadiennes, soit une personne en-
person before accessing aerodrome property or, in the tièrement vaccinée pour pouvoir accéder aux terrains
case of NAV CANADA, a location where NAV de l’aérodrome ou, dans le cas de NAV CANADA, à un
CANADA provides civil air navigation services; emplacement où NAV CANADA fournit des services
de navigation aérienne civile;
person has not completed a COVID-19 vaccine dosage cement où NAV CANADA fournit des services de navi-
regimen due to a medical contraindication or their gation aérienne civile si celle-ci n’a pas suivi de
sincerely held religious belief; protocole vaccinal complet contre la COVID-19 en rai-
son d’une contre-indication médicale ou de sa
(c) provide for a procedure for verifying evidence pro- croyance religieuse sincère;
vided by a relevant person referred to in paragraph (b)
that demonstrates that the relevant person has not c) prévoir une procédure permettant de vérifier la
completed a COVID-19 vaccine dosage regimen due to preuve présentée par la personne concernée visée à
a medical contraindication or their sincerely held reli- l’alinéa b) établissant qu’elle n’a pas suivi de protocole
gious belief; vaccinal complet contre la COVID-19 en raison d’une
contre-indication médicale ou de sa croyance reli-
(d) provide for a procedure for issuing to a relevant gieuse sincère;
person whose evidence has been verified under the
procedure referred to in paragraph (c) a document d) prévoir une procédure permettant de délivrer à la
confirming that they are a relevant person referred to personne concernée dont la preuve a été vérifiée aux
in paragraph (b); termes de la procédure visée à l’alinéa c), un docu-
ment qui confirme qu’elle est visée à l’alinéa b);
(e) provide for a procedure that ensures that a rele-
vant person subject to the policy provides, on request, e) prévoir une procédure permettant de veiller à ce
the following evidence before accessing aerodrome que la personne concernée assujettie à la politique
property: présente sur demande la preuve ci-dessous avant d’ac-
céder aux terrains de l’aérodrome :
dence of COVID-19 vaccination referred to in sec-
tion 17.10, and
81100-3-96-53 27 2022-02-08 (09:39)

AR04481
(ii) in the case of a relevant person referred to in (i) dans le cas d’une personne entièrement vacci-
paragraph (d), the document issued to the relevant née, la preuve de vaccination contre la COVID-19
person under the procedure referred to in that visée à l’article 17.10,
paragraph;
(ii) dans le cas d’une personne visée à l’alinéa d), le
(f) provide for a procedure that ensures that a rele- document qui lui a été délivré en application de cet
vant person referred to in paragraph (d) is tested for alinéa;
COVID-19 at least twice every week;
f) prévoir une procédure permettant de veiller à ce
(g) provide for a procedure that ensures that a rele- que la personne concernée visée à l’alinéa d) se sou-
vant person who receives a positive result for a mette à un essai relatif à la COVID-19 au moins deux
COVID-19 test under the procedure referred to in fois par semaine;
paragraph (f) is prohibited from accessing aerodrome
property until the end of the period for which the pub- g) prévoir une procédure permettant de veiller à ce
lic health authority of the province or territory in qu’il soit interdit à la personne concernée qui reçoit un
which the aerodrome is located requires them to iso- résultat positif à un essai relatif à la COVID-19 réalisé
late after receiving a positive test result or until the conformément à la procédure visée à l’alinéa f) d’accé-
relevant person is not exhibiting any of the symptoms der aux terrains de l’aérodrome jusqu’à la fin de la pé-
referred to in subsection 8(1), whichever is later; riode d’isolement exigée, à la suite de la réception d’un
résultat positif, par l’autorité sanitaire de la province
(h) provide for a procedure that ensures that a rele- ou du territoire où est situé l’aérodrome ou jusqu’à ce
vant person referred to in paragraph (g) who under- qu’elle ne présente plus de symptômes visés au para-
goes a COVID-19 molecular test is exempt from the graphe 8(1), selon la plus tardive de ces éventualités;
procedure referred to in paragraph (f) for a period of
180 days after the relevant person received a positive h) prévoir une procédure permettant de veiller à ce
result from that test; que la personne visée à l’alinéa g) qui se soumet à un
essai moléculaire relatif à la COVID-19 soit exemptée
(i) set out procedures for reducing the risk that a rele- de la procédure visée à l’alinéa f) pour une période de
vant person will be exposed to the virus that causes cent quatre-vingts jours suivant la réception d’un ré-
COVID-19 due to an in-person interaction, occurring sultat positif à cet essai;
on aerodrome property or at a location where NAV
CANADA provides civil air navigation services, with i) prévoir des procédures visant à réduire le risque
an unvaccinated person who has not been issued a d’exposition au virus qui cause la COVID-19 pour les
document under the procedure referred to in para- personnes concernées à la suite des interactions en
graph (d) and who is a person referred to in any of personne, sur les terrains de l’aérodrome ou à un em-
subparagraphs 17.23(b)(i) to (iv), which procedures placement où NAV CANADA fournit des services de
may include protocols related to navigation aérienne civile, avec des personnes non
vaccinées ne s’étant pas vu délivrer un document aux
(i) the vaccination of persons, other than relevant termes de la procédure visée à l’alinéa d) et qui sont
persons, who access aerodrome property or a loca- visées à l’un des sous-alinéas 17.23b)(i) à (iv), ces pro-
tion where NAV CANADA provides civil air naviga- cédures pouvant comprendre des protocoles à l’égard :
tion services,
(i) de la vaccination des personnes, autres que les
(ii) physical distancing and the wearing of masks, personnes concernées, qui accèdent aux terrains de
and l’aérodrome ou à un emplacement où NAV
CANADA fournit des services de navigation aé-
(iii) reducing the frequency and duration of in-per- rienne civile,
son interactions;
(ii) de la distanciation physique et du port du
(j) establish a procedure for collecting the following masque,
information with respect to an in-person interaction
related to commercial flight operations between a rele- (iii) de la restriction et de la durée des interactions
vant person and a person referred to in any of sub- en personne;
paragraphs 17.23(b)(i) to (iv) who is unvaccinated and
has not been issued a document under the procedure j) établir une procédure pour colliger les renseigne-
referred to in paragraph (d) or whose vaccination sta- ments ci-après à l’égard des interactions en personne
tus is unknown: découlant de l’exploitation de vols commerciaux entre
81100-3-96-53 28 2022-02-08 (09:39)

AR04482
(i) the time, date and location of the interaction, une personne concernée et une personne qui est visée
and à l’un des sous-alinéas 17.23b)(i) à (iv) qui n’est pas
vaccinée et qui ne s’est pas vu délivrer de document
(ii) contact information for the relevant person and aux termes de la procédure visée à l’alinéa d) ou une
the other person; personne dont le statut de vaccination est inconnu :
(k) establish a procedure for recording the following (i) la date, l’heure et l’endroit de l’interaction,
quest: (ii) les coordonnées de la personne concernée et de
l’autre personne;
(i) the number of relevant persons who are subject
to the entity’s policy, k) établir une procédure afin de consigner et de trans-
(ii) the number of relevant persons who require ac- suivants :
(iii) the number of relevant persons who are fully sées par la politique de l’entité,
vaccinated persons and those who are not,
(iv) the number of hours during which relevant accéder aux zones réglementées de l’aérodrome,
commercial flight operations due to COVID-19, (iii) le nombre de personnes concernées qui sont
entièrement vaccinées et de celles qui ne le sont
(v) the number of relevant persons who have been pas,
issued a document under the procedure referred to
in paragraph (d), the reason for issuing the docu- (iv) le nombre d’heures au cours desquelles les per-
ment and a confirmation that the relevant persons sonnes concernées n’ont pu accomplir leurs tâches
have submitted evidence of COVID-19 tests taken liées à l’exploitation de vols commerciaux à cause
in accordance with the procedure referred to in de la COVID-19,
paragraph (f),
(v) le nombre de personnes concernées qui se sont
(vi) the number of relevant persons who refuse to vu délivrer un document aux termes de la procé-
comply with a requirement referred to in paragraph dure visée à l’alinéa d), la raison invoquée, et une
(a), (f) or (g), confirmation que ces personnes ont soumis une
preuve d’un essai relatif à la COVID-19 réalisé
(vii) the number of relevant persons who were de- conformément à la procédure visée à l’alinéa f),
nied entry to a restricted area because of a refusal
to comply with a requirement referred to in para- (vi) le nombre de personnes concernées qui ont re-
graph (a), (f) or (g), fusé de se conformer aux exigences prévues aux ali-
néas a), f) ou g),
(viii) the number of persons referred to in subpara-
graphs 17.23(b)(i) to (iv) who are unvaccinated and (vii) le nombre de personnes concernées qui se
who have not been issued a document under the sont vu refuser l’accès à une zone réglementée à
procedure referred to in paragraph (d), or whose cause de leur refus de se conformer aux exigences
vaccination status is unknown, who have an in-per- prévues aux alinéas a), f) ou g),
son interaction related to commercial flight opera-
tions with a relevant person and a description of (viii) le nombre de personnes visées à l’un des
any procedures implemented to reduce the risk that sous-alinéas 17.23b)(i) à (iv) qui sont non vaccinées
a relevant person will be exposed to the virus that et qui ne se sont pas vu délivrer un document aux
causes COVID-19 due to such an interaction, and termes de la procédure visée à l’alinéa d), ou dont le
statut de vaccination est inconnu qui interagissent
(ix) the number of instances in which the air carri- en personne avec des personnes concernées décou-
er or NAV CANADA, as applicable, is made aware lant de l’exploitation de vols commerciaux, de
that a person with respect to whom information même qu’une description des procédures mises en
was collected under paragraph (j) received a posi- place afin de réduire le risque, pour les personnes
tive result for a COVID-19 test, the number of rele- concernées, d’exposition au virus qui cause la CO-
vant persons tested for COVID-19 as a result of this VID-19, à la suite de ces interactions,
81100-3-96-53 29 2022-02-08 (09:39)

AR04483
information, the results of those tests and a de- (ix) le nombre d’occasions où le transporteur aé-
scription of any impacts on commercial flight oper- rien ou NAV CANADA, selon le cas, a été informé
ations; and qu’une personne dont les renseignements ont été
colligés aux termes de la procédure visée à l’alinéa
(l) require the air carrier or NAV CANADA, as appli- j) a reçu un résultat positif à un essai relatif à la CO-
cable, to keep the information referred to in paragraph VID-19, le nombre de personnes concernées sou-
(k) for a period of at least 12 months after the date mises à un tel essai découlant de cette information,
that the information was recorded. les résultats de ces essais et l’incidence sur l’exploi-
tation de vols commerciaux;
l) exiger que le transporteur aérien ou NAV CANADA,

selon le cas, conserve les renseignements visés à l’ali-
néa k) pour une période d’au moins douze mois après
la date à laquelle ils ont été colligés.

relevant person confirming that they did not complete a sonne concernée n’a pas suivi de protocole vaccinal com-
COVID-19 vaccine dosage regimen on the basis of a med- plet contre la COVID-19, pour le motif de contre-indica-
ical contraindication only if they provide a medical cer- tion médicale, n’est délivré à la personne que si celle-ci
tificate from a medical doctor or nurse practitioner who soumet un certificat médical délivré par un médecin ou
is licensed to practise in Canada certifying that the rele- un infirmier praticien autorisé à pratiquer au Canada qui
vant person cannot complete a COVID-19 vaccination atteste que la personne ne peut pas suivre de protocole
regimen due to a medical condition and specifying vaccinal complet contre la COVID-19 en raison d’une
whether the condition is permanent or temporary. condition médicale et qui précise si cette condition est
permanente ou temporaire.

COVID-19 vaccine dosage regimen on the basis of their plet contre la COVID-19, pour le motif de croyance reli-
sincerely held religious belief only if they submit a state- gieuse sincère de la personne, n’est délivré à la personne
ment sworn or affirmed by them attesting that they have que si celle-ci fournit une déclaration sous serment ou
not completed a COVID-19 vaccination regimen due to une affirmation solennelle attestant qu’elle n’a pas suivi
their sincerely held religious belief. de protocole vaccinal complet contre la COVID-19 en rai-
son de sa croyance religieuse sincère.
case of an employee of an entity or a relevant person de l’employé de l’exploitant d’un aérodrome ou de la per-
hired by an entity to provide a service, the policy must sonne concernée qui est embauchée par l’exploitant d’un
provide that a document is to be issued to the employee aérodrome pour offrir un service, la politique doit prévoir
or the relevant person confirming that they did not com- que le document confirmant qu’une personne n’a pas sui-
plete a COVID-19 vaccine dosage regimen on the basis of vi de protocole vaccinal complet contre la COVID-19,
their sincerely held religious belief only if the entity is ob- pour le motif de croyance religieuse sincère de l’employé
ligated to accommodate the relevant person on that basis ou de la personne, n’est délivré à la personne que si l’ex-
under the Canadian Human Rights Act by issuing such a ploitant d’un aérodrome a l’obligation de prendre une
document. telle mesure d’adaptation pour ce motif aux termes de la
Loi canadienne sur les droits de la personne.
81100-3-96-53 30 2022-02-08 (09:39)

AR04484

cable :
l’aérodrome.


quest. mande.

Canada Canada
board an aircraft for a flight operated by an air carrier; autre que celui de monter à bord d’un aéronef pour un
carrier under Subpart 1, 3, 4 or 5 of Part VII of the zone non réglementée dans le but de monter à bord
Regulations; d’un aéronef pour un vol effectué par un transporteur
aérien visé aux sous-parties 1, 3, 4 ou 5 de la partie VII
to board an aircraft for a flight
81100-3-96-53 31 2022-02-08 (09:39)

AR04485
(i) only to become a crew member on board anoth- c) la personne qui accède à une zone réglementée
er aircraft operated by an air carrier under Subpart d’un aérodrome visé à l’annexe 1 à partir d’une zone
1, 3, 4 or 5 of Part VII of the Regulations, non réglementée dans le but de monter à bord d’un
aéronef pour un vol :
aircraft operated by an air carrier under Subpart 1, (i) dans le seul but d’agir à titre d’un membre
3, 4 or 5 of Part VII of the Regulations, or d’équipage à bord d’un autre aéronef exploité par
un transporteur aérien visé aux sous-parties 1, 3, 4
(iii) to participate in mandatory training required ou 5 de la partie VII du Règlement,
aircraft operated under Subpart 1, 3, 4 or 5 of Part (ii) après avoir agi à titre d’un membre d’équipage
VII of the Regulations, if the person will be re- à bord d’un aéronef exploité par un transporteur
quired to return to work as a crew member; aérien visé aux sous-parties 1, 3, 4 ou 5 de la partie
VII du Règlement,
(d) a screening authority at an aerodrome where per-
sons other than passengers are screened or can be (iii) afin de suivre une formation obligatoire exigée
screened; par un transporteur aérien sur l’exploitation d’un
aéronef exploité en application des sous-parties 1,
(e) the operator of an aerodrome listed in Schedule 1. 3, 4 ou 5 de la partie VII du Règlement si elle devra
retourner au travail à titre de membre d’équipage;

of age;
cy;
f) la personne qui livre des équipements ou fournit
(f) a person who is delivering equipment or providing des services dans une zone réglementée, lesquels sont
services within a restricted area that are urgently essentiels aux activités de l’aérodrome et dont on a un
needed and critical to aerodrome operations and who besoin urgent, et qui a obtenu une autorisation préa-
has obtained an authorization from the operator of the lable de l’exploitant d’un aérodrome pour ce faire.
aerodrome before doing so.
81100-3-96-53 32 2022-02-08 (09:39)

AR04486
17.31 (1) A person must not enter a restricted area un- 17.31 (1) Il est interdit à toute personne d’accéder à
less they are a fully vaccinated person. une zone réglementée sauf si elle est une personne entiè-
rement vaccinée.
Exception Exception

ticle 17.10;

17.22(2)(d); or
Exception Exception
81100-3-96-53 33 2022-02-08 (09:39)

AR04487

son’s name, the date on which the declaration was signed cette personne ainsi que de la date à laquelle elle a signé
and, if applicable, the number or identifier of the per- la déclaration et, le cas échéant, du numéro ou de l’iden-
son’s document of entitlement. tifiant de son document d’autorisation.

signed.

dence.

17.34(5) :
created.

evidence under section 17.33, the person does not signée conformément au paragraphe 17.34(1), selon le
81100-3-96-53 34 2022-02-08 (09:39)

AR04488
provide the evidence or, if applicable, does not sign or cas, l’administration de contrôle lui refuse l’accès à la
provide a declaration under subsection 17.34(1). zone réglementée.

(2) If a screening authority denies a person entry to a re- (2) L’administration de contrôle qui refuse l’accès à une
stricted area, it must notify the operator of the aero- personne à une zone réglementée avise l’exploitant d’un
drome as soon as feasible of the person’s name, the date aérodrome dès que possible des prénom et nom de cette
on which the person was denied entry and, if applicable, personne ainsi que de la date à laquelle l’accès lui a été
the number or identifier of the person’s document of en- refusé et, le cas échéant, du numéro ou de l’identifiant de
titlement. son document d’autorisation.

restricted area access of a person who was denied entry la zone réglementée de la personne qui s’en est vu refuser
under subsection (1) is suspended until the person pro- l’accès en application du paragraphe (1) soit suspendu
vides the requested evidence or the signed declaration. jusqu’à ce qu’elle présente la preuve demandée ou la dé-
claration signée.



81100-3-96-53 35 2022-02-08 (09:39)

AR04489
record was created.


17.22(2)(d).
Masks Masque
a mask;
reason;
out assistance;
(f) a crew member;
(g) a gate agent.


81100-3-96-53 36 2022-02-08 (09:39)

AR04490
Notification Avis
quement;
gare;



tions suivantes :
81100-3-96-53 37 2022-02-08 (09:39)

AR04491


tage :
fectue :

81100-3-96-53 38 2022-02-08 (09:39)

AR04492
(i) the date and flight number, a) consigne dans un registre les renseignements sui-
vants :
(ii) the person’s name, date of birth and contact in-
formation, including the person’s home address, (i) les dates et numéro du vol,
telephone number and email address,
(ii) les prénom et nom de la personne ainsi que sa
(iii) the person’s seat number, and date de naissance et ses coordonnées, y compris
son adresse de résidence, son numéro de téléphone
(iv) the circumstances related to the refusal to et son adresse de courriel,
comply; and
(iii) le numéro du siège occupé par la personne,
(b) inform the Minister as soon as feasible of any
record created under paragraph (a). (iv) les circonstances du refus;


the flight. du vol.

ci.


suivantes :


81100-3-96-53 39 2022-02-08 (09:39)

AR04493
suivantes :

persons: vantes :
a mask;
reason;
out assistance;

81100-3-96-53 40 2022-02-08 (09:39)

AR04494

passagers.

a mask;
reason;
out assistance;

child

81100-3-96-53 41 2022-02-08 (09:39)

AR04495





suivantes :

à la COVID-19.

glementée.
81100-3-96-53 42 2022-02-08 (09:39)

AR04496



Notice Avis
81100-3-96-53 43 2022-02-08 (09:39)

AR04497

scribed period.
Repeal Abrogation
No. 53, made on January 28, 2022, is repealed. la COVID-19, pris le 28 janvier 2022, est abrogé.
81100-3-96-53 44 2022-02-08 (09:39)

AR04498
SCHEDULE 1 ANNEXE 1
Nom de l’OACI
Alma CYTF
Alma CYTF
Bagotville CYBG
Bagotville CYBG
Baie-Comeau CYBC
Baie-Comeau CYBC
Bathurst CZBF
Bathurst CZBF
Campbell River CYBL
Campbell River CYBL

Rocheuses)
Deer Lake CYDF
Dawson Creek CYDQ
Deer Lake CYDF
Fort McMurray CYMM
Fort St. John CYXJ
Fort McMurray CYMM
Fort St. John CYXJ
Gaspé CYGP
Goose Bay CYYR
Gaspé CYGP
Grande Prairie CYQU
Goose Bay CYYR
Grande Prairie CYQU
81100-3-96-53 45 2022-02-08 (09:39)

AR04499

Nom de l’OACI
Iqaluit CYFB Munro)
International)
Mont-Joli CYYY
Nanaimo CYCD

Cartier)
Prince Rupert CYPR
Penticton CYYF
Quesnel CYQZ
Prince George CYXS
Prince Rupert CYPR
Quesnel CYQZ
Rouyn-Noranda CYUY
Saint John CYSJ
international)
81100-3-96-53 46 2022-02-08 (09:39)

AR04500

Nom de l’OACI
Rouyn-Noranda CYUY
Saint John CYSJ
Sept-Îles CYZV
Smithers CYYD
Bishop)

International)
Wabush CYWK
Yellowknife CYZF
Nielsen)
Williams Lake CYWL
Windsor CYQG

Yellowknife CYZF
81100-3-96-53 47 2022-02-08 (09:39)

AR04501
SCHEDULE 2 ANNEXE 2
17.30(2)(e))

Name Nom
Canadian Security Intelligence Service Agence des services frontaliers du Canada
Correctional Service of Canada Gendarmerie royale du Canada
Department of Agriculture and Agri-Food Ministère de la Défense nationale
Department of Employment and Social Development Ministère de l'Agriculture et de l'Agroalimentaire
Department of Fisheries and Oceans Ministère de la Santé
Department of Health Ministère de la Sécurité publique et de la Protection civile
Department of National Defence Ministère de l’Emploi et du Développement social
Department of Public Safety and Emergency Preparedness Ministère des Pêches et des Océans
Department of Transport Ministère des Transports
Public Health Agency of Canada Service canadien du renseignement de sécurité
81100-3-96-53 48 2022-02-08 (09:39)

AR04502
SCHEDULE 3 ANNEXE 3

Maximum Amount of Penalty ($) Texte désigné Montant maximal de l’amende ($)
Designated Provision Individual Corporation Personne physique Personne morale

Section 4 5,000 25,000 Article 4 5 000 25 000
Section 5 5,000 25,000 Article 5 5 000 25 000
Section 9 5,000 25,000 Article 9 5 000 25 000
Section 12 5,000 25,000 Article 12 5 000 25 000
Section 13.1 5,000 Article 13.1 5 000
Section 16 5,000 25,000 Article 16 5 000 25 000
Section 17 5,000 25,000 Article 17 5 000 25 000
Section 17.2 25,000 Article 17.2 25 000
Section 17.7 25,000 Article 17.7 25 000
Section 17.9 5,000 Article 17.9 5 000
Section 17.15 25,000 Article 17.15 25 000
81100-3-96-53 49 2022-02-08 (09:39)

AR04503

Section 17.32 5,000 Article 17.32 5 000
Section 17.33 25,000 Article 17.33 25 000
Section 17.37 5,000 Article 17.37 5 000
Section 17.38 25,000 Article 17.38 25 000
Section 17.40 25,000 Article 17.40 25 000
Section 19 5,000 25,000 Article 19 5 000 25 000
Section 23 5,000 25,000 Article 23 5 000 25 000
81100-3-96-53 50 2022-02-08 (09:39)

PROTECTED B SOLICITOR-CLIENT PRIVILEGE - PROTÉGÉ B SECRET PROFESSIONNEL DES AVOCATS
AR04504
February 8, 2022
1
AR04505
February 8, 2022
2
AR04506
February 8, 2022
3
AR04507
February 8, 2022
4
AR04508

Ottawa, Ontario

Omar Alghabra,
P.j. / Enclosures
Canada
AR04509
January 31, 2022


Sénat / Senate
Ottawa, Ontario
certaines exigences relatives à l’aviation civile en Aviation Due to COVID-19, No. 54.

Omar Alghabra,
P.j. / Enclosures
Canada
AR04510
Ceci est la pièce « R » au soutien de


AR04511
I Transport
Canada
Transports
Canada
PROTECTED B
CCM #: SUB-2022-000913
RDIMS #: 18342101

COVID-19
For Approval
Purpose:
for Civil Aviation due to COVID-19, No. 55, and replace it with the Interim Order
(Annex A), which is recommended for signature on February 28, 2022.
Interim Order No. 56 reintroduces existing provisions of Interim Order No. 55,
introduces changes to existing provisions regarding pre-departure testing, and
introduces the use of self-administered molecular tests. The changes to the pre-
departure testing requirements allow for a negative antigen test result taken one
calendar day before departure. Lastly additional changes provide greater clarity for
accommodated employees who test positive for COVID-19.
The interim order is necessary to address significant (direct and indirect) risks to
aviation safety, or the safety of the public. In particular, continuation of the
vaccination mandate for the federally regulated transportation sector enhances the
safety of Canada’s transportation system and supports the recovery of the air sector
by ensuring those responsible for the continued operation of the system, and their
passengers are protected from severe outcomes of COVID-19.
Background:
been made to expand requirements and introduce pre-departure COVID-19 testing
and notification requirements for air carriers to inform travellers that they must
submit a suitable quarantine plan, as well as information and evidence relating to
their COVID-19 vaccination status.
In late 2021, new provisions were added to require specified airport operators, air
carriers and NAV Canada to establish vaccination policies and to require that all
passengers boarding a commercial flight in Canada or leaving Canada be fully
vaccinated with very few exceptions. Most recently, some requirements were
amended to ensure alignment with the Public Health Agency of Canada’s (PHAC)
Emergency Orders. This included: amendments to the denial of boarding period or
denial of access to an aerodrome property for a period to 10 days, and the positive
Page 1
AR04512
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CCM #: SUB-2022-000913
RDIMS #: 18342101
test result provision to 10 days to 180 days. It also added the requirement for foreign
crew members to be fully vaccinated when entering the restricted area of a specified
aerodrome, given that all foreign crew members must be fully vaccinated to enter
Canada.
In order to align with the Government of Canada’s approach to lightening border

measures as part of the transition of the pandemic response, the Interim Order now
allows for the use of a negative antigen test to fulfill pre-departure and entry
requirements in lieu of molecular tests. The tests must be on a specimen collected no
more than one calendar day before departure. Evidence provided by PHAC (See
attached rationale Annex F) indicates that antigen tests can detect most cases with
high viral load. These are the individuals who are the most likely to be infectious.
The inclusion of antigen tests applies to pre-departure entry requirements for

travellers, both vaccinated and unvaccinated, coming to Canada, and to exempted
and excepted unvaccinated travellers on domestic or outbound flights. Valid
molecular test results will continue to be accepted. In addition, allowances have also
been made to accept observed and verified self-administered antigen and molecular
tests to fulfill these same requirements. It’s important to note that in order to prove a
previous COVID-19 infection, the Government of Canada will continue to only accept
a positive molecular test result. These changes were required in order to align with
the Public Health Agency of Canada’s Order in Councils, which come into effect on
February 28, 2022 at 00:01 AM EST.
Under subsections 17.22(h) and 17.24(g), which applies to accommodated

employees, the reference to symptoms referred to under section 8(1) was removed.
Instead, accommodated employees are now instructed to follow local health
guidelines when making determinations on when they can return to work. This
change ensures that the Interim Order is able to appropriately reflect municipal,
provincial or territorial health requirements as they continue to evolve.
Lastly the exceptions relating to unvaccinated foreign nationals departing Canada

have been maintained in the Interim Order following the decision by government to
extend this allowance until at least August 31, 2022. This means that unvaccinated
foreign nationals will be able to continue to board a flight departing Canada, so long
as they have a valid test result. Doing so will allow for enough time for adjustments to
be made to the PHAC entry exemptions to catch up with vaccine mandate for
domestic travel, recognizing that decision making on entry exemptions is still on-
going. This will also help ensure that foreign nationals that are obligated to leave
Canada at the end of their authorized stay can do so, and would allow those subject
to removal orders to depart Canada without any special exemptions, which if issued
may be viewed as arbitrary to the overall policy.
The measures being proposed for the Interim Order are the result of continuous
work with partner departments and agencies, notably the Public Health Agency of
Canada to ensure the safety of the aviation transportation system.
Informed by public health recommendations, the vaccination mandate for the

federally regulated transportation sector, has been critical to ensure the safety of
Page 2
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passengers, crew, and those employees responsible for the continued operation of the
aviation system.
The measures included in the Interim Order Respecting Certain Requirements for
Civil Aviation Due to COVID-19 are continuously informed by public health advice,
based on scientific evidence available at the time, including the efficacy, availability,
and uptake of vaccines, and the evolving epidemiological situation in Canada and
abroad.
As we have seen with its evolution from the Alpha variant to Delta and then Omicron,
the COVID-19 virus changes rapidly, and its viral evolution is inherently
unpredictable. The vaccine mandate remains essential in the face of highly
transmissible variants. Public health data shows that Omicron is more transmissible
than previous variants of concern and that, while it has shown lower severity, it can
still cause serious illness. Public health advice indicates that COVID-19 vaccines
provide an additional layer of protection, particularly against severe illness and
hospitalization. Public health advice also indicates that a third mRNA vaccine
booster dose increases protection against symptomatic illness.
In light of the information to date and available data, public health officials continue
to support the effectiveness and importance of Transport Canada’s vaccine mandate.
It continues to be necessary to ensure a high rate of vaccination, with very minimal
exceptions, across the travelling population for the full benefits of the vaccine to be
realized and to minimize the risks of COVID-19 in the transportation sector. The
vaccine mandate helps prevent serious illness due to Omicron, which in turn protects
aviation system workers and passengers from the most serious outcomes of COVID-
19, thereby fortifying aviation safety and security.
The situation is evolving rapidly and as evidence is becoming available, an

assessment is made as to whether to recommend an adjustment to subsequent
measures.
Communications:
Your decision to establish Interim Order No. 56 and the proposed changes are not
expected to generate media interest. The expansion approved pre-departure testing
methods, including self administered tests and the use of rapid antigen tests has
already been publicly announced. The extension of provisions relating to
unvaccinated foreign nationals may generate some media attention.
Communications products are being developed separately for this issue. A responsive
communications approach is recommended. Existing media lines and questions and
answers on the department’s COVID-19 measures would be updated should the
department receive media calls.
COVID-19.
Page 3
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Prior to implementation, Transport Canada hosted a call with industry and relevant
stakeholders to inform them of the amendments to the Interim Order.
While they are supportive of the Government’s approach to mitigate the spread of
COVID, stakeholders and travellers may continue to be frustrated with the existing
travel restrictions
Legal Assessment:
Next Steps:
Recommendation:
Page 4
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RDIMS #: 18342101
____________________________ ____________________________
Transport
2022-02-26
Date:________________
____ I approve
X ____ I do not approve ____ See Comments
_______________________________ Date:________________
2022-02-28
Attachments:
Annex A: Interim Order Respecting Certain Requirements for Civil Aviation Due
to COVID-19, No. 56
Annex B:
Annex C:
Annex D: Tabling Letter for the House of Commons
Annex E: Tabling Letter for the Senate
Annex F: Rapid Antigen Test Rationale from the Public Health Agency of Canada
Page 5
AR04516
VID-19, ci-après.
Ottawa, Feb. 28th , 2022 Ottawa, le 28 février 2022
Omar Alghabra
a a
S.C. 2004, c. 15, s. 5 L.C. 2004, ch. 15, art. 5
b b
S.C. 2014, c. 39, s. 144 L.C. 2014, ch. 39, art. 144
c c
S.C. 2015, c. 20, s. 12 L.C. 2015, ch. 20, art. 12
d d
S.C. 2004, c. 15, s. 18 L.C. 2004, ch. 15, art. 18
e e
S.C. 2001, c. 29, s. 39 L.C. 2001, ch. 29, art. 39
f f
R.S., c. A-2 L.R., ch. A-2
g g
S.C. 2004, c. 15, s. 11(1) L.C. 2004, ch. 15, par. 11(1)
81100-3-96-55 2022-02-25 (13:57)

AR04517

accredited person means a foreign national who holds administrateur en chef L’administrateur en chef de la
a passport that contains a valid diplomatic, consular, offi- santé publique, nommé en application du paragraphe
cial or special representative acceptance issued by the 6(1) de la Loi sur l’Agence de la santé publique du
Chief of Protocol for the Department of Foreign Affairs, Canada. (Chief Public Health Officer)
Trade and Development. (personne accréditée)
administration de contrôle La personne responsable du
aerodrome property means, in respect of an aerodrome contrôle des personnes et des biens à tout aérodrome visé
listed in Schedule 1, any air terminal buildings or re- à l’annexe du Règlement sur la désignation des aéro-
stricted areas or any facilities used for activities related to dromes de l’ACSTA ou à tout autre endroit désigné par le
aircraft operations or aerodrome operations that are lo- ministre au titre du paragraphe 6(1.1) de la Loi sur l’Ad-
cated at the aerodrome. (terrains de l’aérodrome) ministration canadienne de la sûreté du transport aé-
rien. (screening authority)
aerodrome security personnel has the same meaning
as in section 3 of the Canadian Aviation Security Regu- agent de contrôle Sauf à l’article 2, s’entend au sens de
lations, 2012. (personnel de sûreté de l’aérodrome) l’article 2 de la Loi sur l’Administration canadienne de la
sûreté du transport aérien. (screening officer)
air carrier means any person who operates a commercial
air service under Subpart 1, 3, 4 or 5 of Part VII of the agent de la paix S’entend au sens de l’article 3 du Rè-
Regulations. (transporteur aérien) glement canadien de 2012 sur la sûreté aérienne.
(peace officer)
Canadian Forces means the armed forces of Her
Majesty raised by Canada. (Forces canadiennes) COVID-19 La maladie à coronavirus 2019. (COVID-19)
Chief Public Health Officer means the Chief Public document d’autorisation S’entend au sens de l’article 3
Health Officer appointed under subsection 6(1) of the du Règlement canadien de 2012 sur la sûreté aérienne.
Public Health Agency of Canada Act. (administrateur (document of entitlement)
en chef)
essai antigénique relatif à la COVID-19 Essai immu-
COVID-19 means the coronavirus disease 2019. (CO‐ nologique de dépistage ou de diagnostic de la COVID-19
VID-19) qui, à la fois :
COVID-19 antigen test means a COVID-19 screening or a) détecte la présence d’un antigène viral indicatif de
diagnostic immunoassay that la COVID-19;
(a) detects the presence of a viral antigen indicating b) est autorisé pour la vente ou la distribution au
the presence of COVID-19; Canada ou dans un pays étranger dans lequel il a été
obtenu;
(b) is authorized for sale or distribution in Canada or
in the jurisdiction in which it was obtained; c) si l’essai est auto-administré, est observé et dont le
résultat est vérifié :
(c) if the test is self-administered, is observed and
whose result is verified
81100-3-96-55 1 2022-02-25 (13:57)

AR04518
(i) in person by an accredited laboratory or testing (i) en personne par un laboratoire accrédité ou un
provider, or fournisseur de services d’essais,
(ii) in real time by remote audiovisual means by the (ii) à distance, en temps réel, par un moyen audio-
accredited laboratory or testing provider that pro- visuel par le laboratoire accrédité, ou le fournisseur
vided the test; and de services d’essais, qui a fourni l’essai;
(d) if the test is not self-administered, is performed by d) s’il n’est pas auto-administré, est effectué par un
an accredited laboratory or testing provider. (essai laboratoire accrédité ou par un fournisseur de services
antigénique relatif à la COVID-19) d’essais. (COVID-19 antigen test)
COVID-19 molecular test means a COVID-19 screening essai moléculaire relatif à la COVID-19 Essai de dépis-
or diagnostic test, including a test performed using the tage ou de diagnostic de la COVID-19, notamment l’essai
method of polymerase chain reaction (PCR) or reverse effectué selon le procédé d’amplification en chaîne par
transcription loop-mediated isothermal amplification polymérase (ACP) ou d’amplification isotherme médiée
(RT-LAMP), that par boucle par transcription inverse (RT-LAMP), qui :
(a) if the test is self-administered, is observed and a) s’il est auto-administré, est observé et dont le résul-
whose result is verified tat est vérifié :
(i) in person by an accredited laboratory or testing (i) en personne par un laboratoire accrédité ou un
provider, or fournisseur de services d’essais,
(ii) in real time by remote audiovisual means by the (ii) à distance, en temps réel, par un moyen audio-
accredited laboratory or testing provider that pro- visuel par le laboratoire accrédité, ou le fournisseur
vided the test; or de services d’essais, qui a fourni l’essai;
(b) if the test is not self-administered, is performed by b) s’il n’est pas auto-administré, est effectué par un
an accredited laboratory or testing provider. (essai laboratoire accrédité ou par un fournisseur de services
moléculaire relatif à la COVID-19) d’essais. (COVID-19 molecular test)
document of entitlement has the same meaning as in étranger S’entend au sens du paragraphe 2(1) de la Loi
section 3 of the Canadian Aviation Security Regulations, sur l’immigration et la protection des réfugiés. (foreign
2012. (document d’autorisation) national)
foreign national has the same meaning as in subsection exploitant d’un aérodrome S’agissant d’un aérodrome
2(1) of the Immigration and Refugee Protection Act. où des activités liées à l'aviation civile sont exercées, la
(étranger) personne responsable de l’aérodrome, y compris un em-
ployé, un mandataire ou un représentant autorisé de
non-passenger screening checkpoint has the same cette personne. (operator of an aerodrome)
meaning as in section 3 of the Canadian Aviation Securi-
ty Regulations, 2012. (point de contrôle des non-pas‐ Forces canadiennes Les forces armées de Sa Majesté le-
sagers) vées par le Canada. (Canadian Forces)
operator of an aerodrome means the person in charge fournisseur de services d’essais S’entend :
of an aerodrome where activities related to civil aviation
are conducted and includes an employee, agent or man- a) d’une personne qui peut fournir des essais de dé-
datary or other authorized representative of that person. pistage ou de diagnostic de la COVID-19 en vertu de la
(exploitant) loi du pays dans lequel elle fournit ces essais;
passenger screening checkpoint has the same mean- b) de l’organisation, tel un fournisseur de télésanté ou
ing as in section 3 of the Canadian Aviation Security une pharmacie, qui peut fournir des essais de dépis-
Regulations, 2012. (point de contrôle des passagers) tage ou de diagnostic de la COVID-19 en vertu de la loi
du pays dans lequel elle fournit ces essais et qui em-
ploie ou engage une personne visée à l’alinéa a). (test‐
ing provider)
81100-3-96-55 2 2022-02-25 (13:57)

AR04519
peace officer has the same meaning as in section 3 of personne accréditée Étranger titulaire d’un passeport
the Canadian Aviation Security Regulations, 2012. contenant une acceptation valide qui l’autorise à occuper
(agent de la paix) un poste en tant qu’agent diplomatique ou consulaire, ou
en tant que représentant officiel ou spécial, délivrée par
Regulations means the Canadian Aviation Regulations. le chef du protocole du ministère des Affaires étrangères,
(Règlement) du Commerce et du Développement. (accredited per‐
son)
the Canadian Aviation Security Regulations, 2012. personnel de sûreté de l’aérodrome S’entend au sens
(zone réglementée) de l’article 3 du Règlement canadien de 2012 sur la sûre-
té aérienne. (aerodrome security personnel)
screening authority means a person responsible for the
screening of persons and goods at an aerodrome set out point de contrôle des non-passagers S’entend au sens
in the schedule to the CATSA Aerodrome Designation de l’article 3 du Règlement canadien de 2012 sur la sûre-
Regulations or at any other place designated by the Min- té aérienne. (non-passenger screening checkpoint)
ister under subsection 6(1.1) of the Canadian Air Trans-
port Security Authority Act. (administration de point de contrôle des passagers S’entend au sens de
contrôle) l’article 3 du Règlement canadien de 2012 sur la sûreté
screening officer, except in section 2, has the same
meaning as in section 2 of the Canadian Air Transport Règlement Le Règlement de l’aviation canadien. (Reg‐
Security Authority Act. (agent de contrôle) ulations)
testing provider means terrains de l’aérodrome À l’égard de tout aérodrome vi-

sé à l’annexe 1, les aérogares, les zones réglementées et
(a) a person who may provide COVID-19 screening or les installations destinées aux activités liées à l’utilisation
diagnostic testing services under the laws of the juris- des aéronefs ou à l’exploitation d’un aérodrome et qui
diction where the service is provided; or sont situées à l’aérodrome. (aerodrome property)
(b) an organization, such as a telehealth service transporteur aérien Exploitant d’un service aérien com-
provider or pharmacy, that may provide COVID-19 mercial visé aux sous-parties 1, 3, 4 ou 5 de la partie VII
screening or diagnostic testing services under the laws du Règlement. (air carrier)
of the jurisdiction where the service is provided and
that employs or contracts with a person referred to in variant préoccupant Tout variant du coronavirus du
paragraph (a). (fournisseur de services d’essais) syndrome respiratoire aigu sévère 2 (SRAS-CoV-2) dési-
gné comme un variant préoccupant par l’Organisation
variant of concern means a variant of severe acute res- mondiale de la santé. (variant of concern)
piratory syndrome coronavirus 2 (SARS-CoV-2) that is
designated as a variant of concern by the World Health zone réglementée S’entend au sens de l’article 3 du Rè-
Organization. (variant préoccupant) glement canadien de 2012 sur la sûreté aérienne. (re‐
stricted area)
rienne.
81100-3-96-55 3 2022-02-25 (13:57)

AR04520

meets all of the following requirements: masque non médical, qui satisfait aux exigences sui-
vantes :
(a) it is made of multiple layers of tightly woven mate-
rials such as cotton or linen; a) il est constitué de plusieurs couches d’une étoffe
tissée serrée, telle que le coton ou le lin;
(b) it completely covers a person’s nose, mouth and
chin without gaping; b) il couvre complètement le nez, la bouche et le men-
ton sans laisser d’espace;
(c) it can be secured to a person’s head with ties or ear
loops. c) il peut être solidement fixé à la tête par des at-

coton ou le lin;

vile, si :
vente au Canada :
ommendation of the Chief Public Health Officer, (ii) soit le ministre de la Santé, sur recommanda-
that the regimen is suitable, having regard to the tion de l’administrateur en chef conclut que le pro-
scientific evidence related to the efficacy of that reg- tocole vaccinal est approprié compte tenu des
imen in preventing the introduction or spread of preuves scientifiques relatives à son efficacité pour
COVID-19 or any other factor relevant to prevent- prévenir l’introduction ou la propagation de la CO-
ing the introduction or spread of COVID-19; or VID-19 ou de tout autre facteur pertinent à cet
égard;
(b) in all other cases,
b) dans tout autre cas :
(i) the vaccines of the regimen are authorized for
sale in Canada or in another jurisdiction, and
81100-3-96-55 4 2022-02-25 (13:57)

AR04521
(ii) the Minister of Health determines, on the rec- (i) d’une part, les vaccins du protocole vaccinal
ommendation of the Chief Public Health Officer, sont autorisés pour la vente soit au Canada, soit
that the vaccines and the regimen are suitable, hav- dans un pays étranger,
ing regard to the scientific evidence related to the
efficacy of that regimen and the vaccines in pre- (ii) d’autre part, le ministre de la Santé, sur recom-
venting the introduction or spread of COVID-19 or mandation de l’administrateur en chef conclut que
any other factor relevant to preventing the intro- ces vaccins et le protocole vaccinal sont appropriés
duction or spread of COVID-19. compte tenu des preuves scientifiques relatives à
leur efficacité pour prévenir l’introduction ou la
propagation de la COVID-19 ou de tout autre fac-
teur pertinent à cet égard.

Notification Avis

flight that they may be required, under an order made à bord de l’aéronef pour le vol, qu’elle pourrait être
81100-3-96-55 5 2022-02-25 (13:57)

AR04522
under section 58 of the Quarantine Act, to provide, be- tenue, aux termes de tout décret pris en vertu de l’article
fore boarding the aircraft or before entering Canada, to 58 de la Loi sur la mise en quarantaine, de fournir, avant
the Minister of Health, a screening officer or a quaran- de monter à bord de l’aéronef ou avant qu’elle n’entre au

article.
fédérale.

trompeuse.
81100-3-96-55 6 2022-02-25 (13:57)

AR04523
Exception Exception
3(1).

Exception Exception


81100-3-96-55 7 2022-02-25 (13:57)

AR04524
Notification Avis
they have, COVID-19; de soupçonner qu’elle l’a;
craft in the previous 10 days for a medical reason re- dans les dix derniers jours pour une raison médicale
lated to COVID-19; or liée à la COVID-19;
an aircraft in the previous 10 days for a medical reason dans les dix derniers jours pour une raison médicale
related to COVID-19; liée à la COVID-19;

jected to a health check and is required to provide a con- et (3), subit la vérification de santé et est tenue de donner
firmation must la confirmation est tenue :
81100-3-96-55 8 2022-02-25 (13:57)

AR04525
Exception Exception

aérien
the aircraft is exhibiting any of the symptoms referred to elle présente l’un ou l’autre des symptômes visés au para-
in subsection (1). graphe (1).
vants :
Period of 10 days Période de dix jours

vide a medical certificate certifying that any symptoms
referred to in subsection 8(1) that they are exhibiting are
not related to COVID-19.
81100-3-96-55 9 2022-02-25 (13:57)

AR04526
dix jours après le refus, à moins qu’elle fournisse un cer-

tificat médical attestant que les symptômes visés au para-
graphe 8(1) qu’elle présente ne sont pas liés à la CO-
VID-19.
COVID-19 Tests — Flights to Essais relatif à la COVID-19 —

Canada vols à destination du Canada
vol.
Quarantine Act to provide evidence that they received a obtenu le résultat d’un essai moléculaire relatif à la CO-
result for a COVID-19 molecular test or a COVID-19 anti- VID-19 ou d’un essai antigénique relatif à la COVID-19
gen test. en application d’un décret pris au titre de l’article 58 de la
Loi sur la mise en quarantaine.
Notification Avis
they are unable to provide evidence that they received a ter la preuve qu’elle a obtenu le résultat d’un essai molé-
result for a COVID-19 molecular test or a COVID-19 anti- culaire relatif à la COVID-19 ou d’un essai antigénique
gen test. relatif à la COVID-19.

parture time; dans les soixante-douze heures avant l’heure prévue
(b) a negative result for a COVID-19 antigen test that
was performed on a specimen collected no more than b) un résultat négatif à un essai antigénique relatif à
one day before the flight’s initial scheduled departure la COVID-19 qui a été effectué sur un échantillon pré-
time; or levé au plus tard un jour avant l’heure prévue initiale-
ment de départ du vol ;
(c) a positive result for a COVID-19 molecular test
that was performed on a specimen collected at least 10 c) un résultat positif à un essai moléculaire relatif à la
days and no more than 180 days before the flight’s ini- COVID-19 qui a été effectué sur un échantillon prélevé
tial scheduled departure time. au moins dix jours et au plus cent quatre-vingts jours
avant l’heure prévue initialement de départ du vol.
81100-3-96-55 10 2022-02-25 (13:57)

AR04527
Location of test — outside Canada Lieu de l’essai — extérieur du Canada

(1.1) The COVID-19 tests referred to in paragraphs (1.1) Les essais relatifs à la COVID-19 visés aux alinéas
(1)(a) and (b) must be performed outside Canada. (1)a) et b) doivent être effectués à l’extérieur du Canada.

(2) For the purposes of paragraphs (1)(a) and (b) and (2) Pour l’application des alinéas (1)a) et b) et du para-
subsection (1.1), the COVID-19 molecular test or graphe (1.1), l’essai moléculaire relatif à la COVID-19 ou
COVID-19 antigen test must not have been performed in l’essai antigénique relatif à la COVID-19 ne doit pas être
a country where, as determined by the Minister of effectué dans un pays, selon ce que conclut le ministre de
Health, there is an outbreak of a variant of concern or la Santé, qui est aux prises avec l’apparition d’un variant
there are reasonable grounds to believe that there is an préoccupant ou dont il y a des motifs raisonnables de
outbreak of such a variant. croire qu’il est aux prises avec l’apparition d’un tel va-
riant.
Evidence — alternative testing protocol Preuve — protocole d’essai alternatif

13.1 Despite subsections 13(1) and (1.1), a person re- 13.1 Malgré les paragraphes 13(1) et (1.1), avant de
ferred to in section 2.22 of the Order entitled Minimizing monter à bord d’un aéronef pour un vol, la personne vi-
the Risk of Exposure to COVID-19 in Canada Order sée à l’article 2.22 du Décret visant la réduction du risque
(Quarantine, Isolation and Other Obligations) must, be- d’exposition à la COVID-19 au Canada (quarantaine,
fore boarding an aircraft for a flight, provide to the pri- isolement et autres obligations) présente à l’exploitant
vate operator or air carrier operating the flight evidence privé ou au transporteur aérien qui effectue le vol la
of a COVID-19 molecular test or a COVID-19 antigen test preuve qu’elle a obtenu le résultat d’un essai moléculaire
that was carried out in accordance with an alternative relatif à la COVID-19 ou d’un essai antigénique relatif à la
testing protocol referred to in that section. COVID-19 effectué conformément à un protocole d’essai
alternatif visé à cet article.
Evidence — molecular test Preuve — essai moléculaire

14 (1) Evidence of a result for a COVID-19 molecular 14 (1) La preuve du résultat d’un essai moléculaire rela-
test must include tif à la COVID-19 comprend les éléments suivants :
(a) the name and date of birth of the person from a) les prénom, nom et date de naissance de la per-
whom the specimen was collected for the test; sonne de laquelle l’échantillon a été prélevé;
(b) the name and civic address of the accredited labo- b) le nom et l’adresse municipale du laboratoire ac-
ratory or the testing provider that performed or ob- crédité, ou du fournisseur de services d’essais, qui a ef-
served the test and verified the result; fectué ou observé l’essai et qui a vérifié le résultat;
(c) the date the specimen was collected and the test c) la date à laquelle l’échantillon a été prélevé et le
method used; and procédé utilisé;
(d) the test result. d) le résultat de l’essai.
Evidence — antigen test Preuve — essai antigénique

(2) Evidence of a result for a COVID-19 antigen test must (2) La preuve du résultat d’un essai antigénique relatif à
include la COVID-19 comprend les éléments suivants :
(a) the name and date of birth of the person from a) les prénom, nom et date de naissance de la per-
whom the specimen was collected for the test; sonne de laquelle l’échantillon a été prélevé;
(b) the name and civic address of the accredited labo- b) le nom et l’adresse municipale du laboratoire ac-
ratory or the testing provider that performed or ob- crédité, ou du fournisseur de services d’essais, qui a ef-
served the test and verified the result; fectué ou observé l’essai et qui a vérifié le résultat;
(c) the date the specimen was collected and the test c) la date à laquelle l’échantillon a été prélevé et le
method used; and procédé utilisé;
81100-3-96-55 11 2022-02-25 (13:57)

AR04528
(d) the test result. d) le résultat de l’essai.

COVID-19 molecular test or a COVID-19 antigen test that du résultat d’un essai moléculaire relatif à la COVID-19
they know to be false or misleading. ou à un essai antigénique relatif à la COVID-19, la sa-
chant fausse ou trompeuse.

a COVID-19 molecular test or a COVID-19 antigen test preuve du résultat d’un essai moléculaire relatif à la CO-
that is likely to be false or misleading must notify the VID-19 ou d’un essai antigénique relatif à la COVID-19
Minister as soon as feasible of the person’s name and qui est susceptible d’être fausse ou trompeuse avise le
contact information and the date and number of the per- ministre dès que possible des prénom, nom et coordon-
son’s flight. nées de la personne ainsi que de la date et du numéro de
son vol.
provide evidence that they received a result for a présente pas la preuve qu’elle a obtenu le résultat d’un
COVID-19 molecular test or a COVID-19 antigen test in essai moléculaire relatif à la COVID-19 ou d’un essai anti-
accordance with the requirements set out in section 13 or génique relatif à la COVID-19 selon les exigences prévues
13.1. aux articles 13 ou 13.1.

tue;
(c) an air carrier operating a flight departing from an
aerodrome listed in Schedule 1. c) le transporteur aérien qui effectue un vol en par-
tance d’un aérodrome visé à l’annexe 1.
of age;
81100-3-96-55 12 2022-02-25 (13:57)

AR04529
(b) a crew member; b) le membre d’équipage;
(c) a person entering a restricted area at an aero- c) la personne qui accède à une zone réglementée
to board an aircraft for a flight operated by an air car- non réglementée dans le but de monter à bord d’un
rier aéronef pour un vol qu’un transporteur aérien effec-
tue :
(i) only to become a crew member on board anoth-
er aircraft operated by an air carrier, (i) dans le seul but d’agir à titre de membre d’équi-
page à bord d’un autre aéronef exploité par un
(ii) after having been a crew member on board an transporteur aérien,
aircraft operated by an air carrier, or
(ii) après avoir agi à titre de membre d’équipage à
(iii) to participate in mandatory training required bord d’un aéronef exploité par un transporteur aé-
by an air carrier in relation to the operation of an rien,
aircraft, if the person will be required to return to
work as a crew member; (iii) afin de suivre une formation obligatoire sur
l’exploitation d’un aéronef exigée par un transpor-
(d) a person who arrives at an aerodrome from any teur aérien si elle devra retourner au travail à titre
other country on board an aircraft in order to transit de membre d’équipage;
to another country and remains in a sterile transit
area, as defined in section 2 of the Immigration and d) la personne qui arrive à un aérodrome à bord d’un
Refugee Protection Regulations, of the aerodrome un- aéronef en provenance d’un autre pays en vue d’y
til they leave Canada; transiter vers un autre pays et qui demeure, jusqu’à
son départ du Canada, dans l’espace de transit isolé
(e) a person who arrives at an aerodrome on board an au sens de l’article 2 du Règlement sur l’immigration
aircraft following the diversion of their flight for a et la protection des réfugiés de l’aérodrome;
safety-related reason, such as adverse weather or an
equipment malfunction, and who boards an aircraft e) la personne qui arrive à un aérodrome à bord d’un
for a flight not more than 24 hours after the arrival aéronef à la suite du déroutement de son vol pour une
time of the diverted flight. raison liée à la sécurité, comme le mauvais temps ou
un défaut de fonctionnement de l’équipement, et qui
Notification Avis
suivantes :
(b) they must provide to the air carrier evidence of
COVID-19 vaccination demonstrating that they are a b) présenter au transporteur aérien la preuve de vac-
fully vaccinated person or evidence that they are a per- cination contre la COVID-19 établissant qu’elle est une
son referred to in any of paragraphs 17.3(2)(a) to (c) or personne entièrement vaccinée ou la preuve qu’elle est
any of subparagraphs 17.3(2)(d)(i) to (iv) or (e)(i) to visée à l’un des alinéas 17.3(2)a) à c) ou à l’un des
(vii); and sous-alinéas 17.3(2)d)(i) à (iv) et e)(i) à (vii);
(c) if they submit a request referred to in section 17.4, c) si la personne présente une demande visée à l’ar-
they must do so within the period set out in subsection ticle 17.4, présenter la demande dans le délai prévu au
17.4(3). paragraphe 17.4(3).
81100-3-96-55 13 2022-02-25 (13:57)

AR04530

vaccinée.

suivantes :
(c) a foreign national who is boarding an aircraft for a
flight to a country other than Canada or to an aero- c) l’étranger qui monte à bord d’un aéronef pour un
drome in Canada for the purpose of boarding an air- vol à destination de tout autre pays que le Canada ou
craft for a flight to a country other than Canada and pour un vol à destination d’un aérodrome au Canada
who has received either dans le but de monter à bord d’un autre aéronef pour
un vol à destination de tout autre pays et qui a obtenu,
(i) a negative result for a COVID-19 molecular test selon le cas :
more than 72 hours before the flight’s initial sched- (i) un résultat négatif à un essai moléculaire relatif
uled departure time, à la COVID-19 qui a été effectué sur un échantillon
prélevé dans les soixante-douze heures avant
(ii) a negative result for a COVID-19 antigen test l’heure prévue initialement de départ du vol,
more than one day before the flight’s initial sched- (ii) un résultat négatif à un essai antigénique relatif
uled departure time, or à la COVID-19 qui a été effectué sur un échantillon
prélevé au plus tard un jour avant l’heure prévue
(iii) a positive result for a COVID-19 molecular test initialement de départ du vol,
that was performed on a specimen collected at least
10 days and no more than 180 days before the (iii) un résultat positif à un essai moléculaire relatif
flight’s initial scheduled departure time; à la COVID-19 qui a été effectué sur un échantillon
prélevé au moins dix jours et au plus cent quatre-
(d) a person who has received a result for a COVID-19 vingts jours avant l’heure prévue initialement de
molecular test or a COVID-19 antigen test described in départ du vol;
subparagraph (c)(i), (ii) or (iii) and who is
d) la personne qui a obtenu le résultat d’un essai mo-
(i) a person who has not completed a COVID-19 léculaire relatif à la COVID-19 ou d’un essai antigé-
vaccine dosage regimen due to a medical con- nique relatif à la COVID-19 visé aux sous-alinéas c)(i),
traindication and who is entitled to be accommo- (ii) ou (iii) et qui, selon le cas :
dated on that basis under applicable legislation by
being permitted to enter the restricted area or to
81100-3-96-55 14 2022-02-25 (13:57)

AR04531
board an aircraft without being a fully vaccinated (i) n’a pas suivi de protocole vaccinal complet
person, contre la COVID-19 en raison d’une contre-
indication médicale et qui a droit à une mesure
(ii) a person who has not completed a COVID-19 d’adaptation pour ce motif, aux termes de la législa-
vaccine dosage regimen due to a sincerely held reli- tion applicable, lui permettant de monter à bord
gious belief and who is entitled to be accommodat- d’un aéronef pour un vol ou d’accéder à une zone
ed on that basis under applicable legislation by be- réglementée sans être une personne entièrement
ing permitted to enter the restricted area or to vaccinée,
board an aircraft without being a fully vaccinated
person, (ii) n’a pas suivi de protocole vaccinal complet
contre la COVID-19 en raison d’une croyance reli-
(iii) a person who is boarding an aircraft for a flight gieuse sincère et qui a droit à une mesure d’adapta-
for the purpose of attending an appointment for an tion pour ce motif, aux termes de la législation ap-
essential medical service or treatment, or plicable, lui permettant de monter à bord d’un
(iv) a competent person who is at least 18 years old mentée sans être une personne entièrement vacci-
and who is boarding an aircraft for a flight for the née,
purpose of accompanying a person referred to in
subparagraph (iii) if the person needs to be accom- (iii) monte à bord d’un aéronef pour un vol afin de
panied because they se rendre à un rendez-vous pour obtenir des ser-
vices ou traitements médicaux essentiels,
(A) are under the age of 18 years,
(iv) est une personne capable âgée d’au moins dix-
(B) have a disability, or huit ans qui monte à bord d’un aéronef pour un vol
afin d’accompagner la personne visée au sous-ali-
(C) need assistance to communicate; or néa (iii) si cette personne a besoin d’être accompa-
gnée pour l’une des raisons suivantes :
(e) a person who has received a result for a COVID-19
molecular test or a COVID-19 antigen test described in (A) elle est âgée de moins de dix-huit ans,
subparagraph (c)(i), (ii) or (iii) and who is boarding an
aircraft for a flight for a purpose other than an option- (B) elle a un handicap,
al or discretionary purpose, such as tourism, recre-
ation or leisure, and who is (C) elle a besoin d’aide pour communiquer;
(i) a person who entered Canada at the invitation of e) la personne qui a obtenu le résultat d’un essai mo-
the Minister of Health for the purpose of assisting léculaire relatif à la COVID-19 ou d’un essai antigé-
in the COVID-19 response, nique relatif à la COVID-19 visé aux sous-alinéas c)(i),
(ii) ou (iii) et qui monte à bord d’un aéronef pour un
(ii) a person who is permitted to work in Canada as vol à des fins autres que de nature optionnelle ou dis-
a provider of emergency services under paragraph crétionnaire telles que le tourisme, les loisirs ou le di-
186(t) of the Immigration and Refugee Protection vertissement et qui, selon le cas :
Regulations and who entered Canada for the pur-
pose of providing those services, (i) est entrée au Canada à l’invitation du ministre
de la Santé afin de participer aux efforts de lutte
(iii) a person who entered Canada not more than 90 contre la COVID-19,
days before the day on which this Interim Order
came into effect and who, at the time they sought to (ii) est autorisée à travailler au Canada afin d’offrir
enter Canada, des services d’urgence en vertu de l’alinéa 186t) du
Règlement sur l’immigration et la protection des
(A) held a permanent resident visa issued under réfugiés et est entrée au Canada afin d’offrir de tels
subsection 139(1) of the Immigration and services,
Refugee Protection Regulations, and
(iii) est entrée au Canada dans les quatre-vingt-dix
(B) was recognized as a Convention refugee or a jours précédant la date d’entrée en vigueur du pré-
person in similar circumstances to those of a sent arrêté d’urgence et au moment qu’elle cher-
chait à entrer au Canada, elle était à la fois :
81100-3-96-55 15 2022-02-25 (13:57)

AR04532
Convention refugee within the meaning of sub- (A) titulaire d’un visa de résident permanent dé-
section 146(1) of the Immigration and Refugee livré aux termes du paragraphe 139(1) du Règle-
Protection Regulations, ment sur l’immigration et la protection des réfu-
giés,
(iv) a person who has been issued a temporary resi-
dent permit within the meaning of subsection 24(1) (B) reconnue comme réfugié au sens de la
of the Immigration and Refugee Protection Act Convention ou était dans une situation sem-
and who entered Canada not more than 90 days be- blable à celle d’un réfugié visé au paragraphe
fore the day on which this Interim Order came into 146(1) de ce même règlement,
effect as a protected temporary resident under sub-
section 151.1(2) of the Immigration and Refugee (iv) est titulaire d’un permis de séjour temporaire
Protection Regulations, au sens du paragraphe 24(1) de la Loi sur l’immi-
gration et la protection des réfugiés et qui est en-
(v) an accredited person, trée au Canada dans les quatre-vingt-dix jours pré-
cédant la date d’entrée en vigueur du présent arrêté
(vi) a person holding a D-1, O-1 or C-1 visa who en- d’urgence à titre de résident temporaire protégé
tered Canada to take up a post and become an ac- aux termes du paragraphe 151.1(2) du Règlement
credited person, or sur l’immigration et la protection des réfugiés,
(vii) a diplomatic or consular courier. (v) est une personne accréditée,
(vi) est titulaire d’un visa D-1, O-1 ou C-1 et est en-
trée au Canada pour occuper un poste et devenir
(iv)
behalf under a commercial agreement if compte en application d’une entente commerciale dans
les cas suivants :
(a) in the case of a person referred to in any of sub-
paragraphs 17.3(2)(d)(i) to (iii), the person submits a a) la personne est visée à l’un des sous-alinéas
request to the air carrier in respect of that flight in ac- 17.3(2)d)(i) à (iii) et une demande a été présentée par
cordance with subsections (2) and (3) or such a re- cette personne ou pour son compte conformément aux
quest is submitted on their behalf; paragraphes (2) et (3) au transporteur aérien à l’égard
du vol;
17.3(2)(d)(i) or (ii), the air carrier is obligated to ac- b) la personne est visée aux sous-alinéas 17.3(2)d)(i)
commodate the person on the basis of a medical con- ou (ii) et le transporteur aérien a l’obligation, aux
traindication or a sincerely held religious belief under termes de la législation applicable, de prendre une
applicable legislation by issuing the document; and mesure d’adaptation en raison d’une contre-indication
médicale ou d’une croyance religieuse sincère et il la
(c) in the case of a person referred to in subparagraph prend en délivrant le document;
17.3(2)(d)(iv), the person who needs accompaniment
submits a request to the air carrier in respect of that c) la personne est visée au sous-alinéa 17.3(2)d)(iv) et
flight in accordance with subsections (2) and (3) or une demande a été présentée à l’égard du vol au trans-
such a request is submitted on their behalf. porteur aérien par la personne qui a besoin d’être ac-
compagnée ou pour son compte conformément aux
81100-3-96-55 16 2022-02-25 (13:57)

AR04533

(a) the person’s name and home address and, if the a) les prénom, nom et adresse de résidence de la per-
request is made by someone else on the person’s be- sonne et, si la demande a été faite en son nom par une
half, that person’s name and home address; autre personne, les prénom, nom et adresse de rési-
dence de la personne qui a fait la demande;
(b) the date and number of the flight as well as the
aerodrome of departure and the aerodrome of arrival; b) les date et numéro du vol ainsi que les aérodromes
de départ et d’arrivée;
17.3(2)(d)(i), c) dans le cas d’une personne visée au sous-alinéa
17.3(2)d)(i) :
(i) a document issued by the government of a
province confirming that the person cannot com- (i) soit un document délivré par le gouvernement
plete a COVID-19 vaccination regimen due to a d’une province attestant que la personne ne peut
medical condition, or pas suivre de protocole vaccinal complet contre la
COVID-19 en raison de sa condition médicale,
(ii) a medical certificate signed by a medical doctor
or nurse practitioner who is licensed to practise in (ii) soit un certificat médical signé par un médecin
Canada certifying that the person cannot complete ou un infirmier praticien autorisé à pratiquer au
a COVID-19 vaccination regimen due to a medical Canada attestant que la personne ne peut pas
condition and the licence number issued by a pro- suivre de protocole vaccinal complet contre la CO-
fessional medical licensing body to the medical doc- VID-19 en raison de sa condition médicale et le nu-
tor or nurse practitioner; méro du permis d’exercice délivré au médecin ou à
l’infirmier praticien par un organisme qui régle-
(d) in the case of a person described in subparagraph mente la profession de médecin ou d’infirmier pra-
17.3(2)(d)(ii), a statement sworn or affirmed by the ticien;
person before a person appointed as a commissioner
of oaths in Canada attesting that the person has not d) dans le cas d’une personne visée au sous-alinéa
completed a COVID-19 vaccination regimen due to a 17.3(2)d)(ii), une déclaration sous serment ou une af-
sincerely held religious belief, including a description firmation solennelle de la personne faites devant une
of how the belief renders them unable to complete personne nommée à titre de commissaire aux ser-
such a regimen; and ments au Canada attestant qu’elle n’a pas suivi de pro-
tocole vaccinal complet contre la COVID-19 en raison
(e) in the case of a person described in subparagraph d’une croyance religieuse sincère et décrivant de
17.3(2)(d)(iii), a document that includes quelle manière cette croyance religieuse l’empêche de
suivre le protocole vaccinal complet;
(i) the signature of a medical doctor or nurse prac-
titioner who is licensed to practise in Canada, e) dans le cas d’une personne visée au sous-alinéa
17.3(2)d)(iii), un document qui comprend :
(ii) the licence number issued by a professional
medical licensing body to the medical doctor or (i) la signature d’un médecin ou d’un infirmier pra-
nurse practitioner, ticien autorisé à pratiquer au Canada,
(iii) the date of the appointment for the essential (ii) le numéro du permis d’exercice délivré au mé-
medical service or treatment and the location of the decin ou à l’infirmier praticien par un organisme
appointment, qui réglemente la profession de médecin ou d’infir-
mier praticien,
(iv) the date on which the document was signed,
and (iii) l’endroit où le service ou traitement médical
essentiel sera reçu et la date du rendez-vous,
(v) if the person needs to be accompanied by a per-
son referred to in subparagraph 17.3(2)(d)(iv), the (iv) la date de la signature du document,
name and contact information of that person and
the reason that the accompaniment is needed.
81100-3-96-55 17 2022-02-25 (13:57)

AR04534
(v) si la personne a besoin d’être accompagnée par

une personne visée au sous-alinéa 17.3(2)d)(iv), les
prénom, nom et coordonnées de cette personne
est nécessaire.




a refusées.
created.
81100-3-96-55 18 2022-02-25 (13:57)

AR04535




aérien
sult for a COVID-19 molecular test or a COVID-19 l’un des sous-alinéas 17.3(2)d)(i) à (iv) et e)(i) à (vii) et
antigen test. qu’elle a obtenu le résultat d’un essai moléculaire rela-
tif à la COVID-19 ou d’un essai antigénique relatif à la
COVID-19.

17.9 A person must, at the request of an air carrier, pro- 17.9 Toute personne est tenue de présenter au transpor-
vide to the air carrier the evidence referred to in para- teur aérien, sur demande de celui-ci, la preuve visée aux
graph 17.7(a), (b) or (c). alinéas 17.7a), b) ou c).

cin;
(b) the name of the government or of the entity;
b) le nom du gouvernement ou de l’entité;
81100-3-96-55 19 2022-02-25 (13:57)

AR04536
(c) the brand name or any other information that c) la marque nominative ou tout autre renseignement
identifies the vaccine that was administered; and permettant d’identifier le vaccin qui a été administré;
(d) the dates on which the vaccine was administered d) les dates auxquelles le vaccin a été administré ou,
or, if the evidence is one document issued for both dans le cas où la preuve est un document unique qui
doses and the document specifies only the date on est délivré pour deux doses et qui ne mentionne que la
which the most recent dose was administered, that date à laquelle la dernière dose a été administrée, cette
date. date.

conforme.
Result of COVID-19 test Résultat d’un essai COVID-19

17.11 (1) A result for a COVID-19 molecular test or a 17.11 (1) Le résultat d’un essai moléculaire relatif à la
COVID-19 antigen test is a result described in subpara- COVID-19 ou d’un essai antigénique relatif à la CO-
graph 17.3(2)(c)(i), (ii) or (iii). VID-19 est un résultat visé aux sous-alinéas 17.3(2)c)(i),
(ii) ou (iii).
Evidence — molecular test Preuve — essai moléculaire

(2) Evidence of a result for a COVID-19 molecular test (2) La preuve du résultat d’un essai moléculaire relatif à
must include the elements set out in paragraphs 14(1)(a) la COVID-19 comprend les éléments prévus aux alinéas
to (d). 14(1)a) à d).
Evidence — antigen test Preuve — essai antigénique

(3) Evidence of a result for a COVID-19 antigen test must (3) La preuve du résultat d’un essai antigénique relatif à
include the elements set out in paragraphs 14(2)(a) to la COVID-19 comprend les éléments prévus aux alinéas
(d). 14(2)a) à d).

(b) their passport or other travel document issued by
their country of citizenship or nationality. b) un passeport ou autre titre de voyage de la per-
nalité.

est au plus tard vingt-quatre heures après l’heure de
81100-3-96-55 20 2022-02-25 (13:57)

AR04537
the departure time of the flight taken by the person to départ du vol que la personne a pris en partance de
Canada from any other country; and tout autre pays à destination du Canada;
(b) a document entitled “Confirmation of Permanent b) un document délivré par le ministère de la Citoyen-
Residence” issued by the Department of Citizenship neté et de l’Immigration intitulé « Confirmation de ré-
and Immigration that confirms that the person be- sidence permanente » qui confirme que la personne
came a permanent resident on entry to Canada after est devenue résident permanent à son entrée au
the flight taken by the person to Canada from any oth- Canada après le vol qu’elle a pris en partance de tout
er country. autre pays à destination du Canada.

nalité.
(iv)
tée.



81100-3-96-55 21 2022-02-25 (13:57)

AR04538
tion Regulations.

confirms that the person entered Canada as a protected confirme que la personne est entrée au Canada à titre de
temporary resident under subsection 151.1(2) of the Im- résident temporaire protégé aux termes du paragraphe
migration and Refugee Protection Regulations. 151.1(2) du Règlement sur l’immigration et la protection
des réfugiés.


subparagraph 17.3(2)(e)(vi) must be the person’s D-1, sous-alinéa 17.3(2)e)(vi) est le visa D-1, O-1 ou C-1 de la
O-1 or C-1 visa. personne.

subparagraph 17.3(2)(e)(vii) must be sous-alinéa 17.3(2)e)(vii) est :
tionales;
ment confirming their status referred to in Article 35 b) dans le cas d’un courrier consulaire, le document
of the Vienna Convention on Consular Relations, as officiel attestant sa qualité mentionné à l’article 35 de
set out in Schedule II to that Act. la Convention de Vienne sur les relations consulaires,


81100-3-96-55 22 2022-02-25 (13:57)

AR04539

faux ou trompeurs.

(2) An air carrier that has reason to believe that a person (2) Le transporteur aérien qui a des raisons de croire
has provided evidence that is likely to be false or mislead- qu’une personne lui a présenté une preuve susceptible
ing must notify the Minister of the following not more d’être fausse ou trompeuse en avise le ministre, au plus
than 72 hours after the provision of the evidence: tard soixante-douze heures après la présentation de la
preuve et l’avis comprend les éléments suivants :
(c) the reason the air carrier believes that the evi-
dence is likely to be false or misleading. c) les raisons pour lesquelles le transporteur aérien
croit que la preuve est susceptible d’être fausse ou
trompeuse.


17.15 :
81100-3-96-55 23 2022-02-25 (13:57)

AR04540
(d) whether the person had been issued a document d) si la personne s’est vu délivrer un document, en ap-
under subsection 17.4(1) in respect of the flight. plication du paragraphe 17.4(1), à l’égard du vol.

[17.18 and 17.19 reserved] [17.18 et 17.19 réservés]


lon le cas :
mandatary; b) est un employé d’un entrepreneur ou d’un manda-
(c) a person hired by the entity to provide a service;
c) est embauchée par l’entité pour offrir un service;
lessee, if the property that is subject to the lease is part d) est un locataire de l’entité ou un employé d’un loca-
of aerodrome property; or taire de l’entité, si les lieux faisant l’objet du bail font
partie des terrains de l’aérodrome;
(e) a person permitted by the entity to access aero-
drome property or, in the case of NAV CANADA, a lo- e) a l’autorisation de l’entité pour accéder aux terrains
cation where NAV CANADA provides civil air naviga- de l’aérodrome ou, dans le cas de NAV CANADA, à un
tion services. emplacement où celle-ci fournit des services de navi-
sont :
81100-3-96-55 24 2022-02-25 (13:57)

AR04541
(a) conducting or directly supporting activities that a) la conduite d’activités qui sont liées à l’exploitation
are related to aerodrome operations or commercial de l’aérodrome ou des vols commerciaux — telles que
flight operations — such as aircraft refuelling services, les services de ravitaillement en carburant des aéro-
aircraft maintenance and repair services, baggage nefs, les services d’entretien et de réparation des aéro-
handling services, supply services for the operator of nefs, les services de manutention des bagages, les ser-
an aerodrome, an air carrier or NAV CANADA, fire vices d’approvisionnement fournis à l’exploitant d’un
prevention services, runway and taxiway maintenance aérodrome, à un transporteur aérien ou à NAV
services or de-icing services — and that take place on CANADA, les services de prévention des incendies, les
aerodrome property or at a location where NAV services d’entretien des pistes et des voies de circula-
CANADA provides civil air navigation services; tion et les services de dégivrage — qui se déroulent sur
les terrains de l’aérodrome ou à un emplacement où
(b) interacting in-person on aerodrome property with NAV CANADA fournit des services de navigation aé-
a person who intends to board an aircraft for a flight; rienne civile, ainsi que le soutien direct à de telles acti-
vités;
(c) engaging in tasks, on aerodrome property or at a
location where NAV CANADA provides civil air navi- b) l’interaction en présentiel sur les terrains de l’aéro-
gation services, that are intended to reduce the risk of drome avec quiconque a l’intention de monter à bord
transmission of the virus that causes COVID-19; and d’un aéronef pour un vol;
(d) accessing a restricted area at an aerodrome listed c) l’exécution, sur les terrains de l’aérodrome ou à un
in Schedule 1. emplacement où NAV CANADA fournit des services
COVID-19;

à l’annexe 1.


(2) The policy must (2) La politique de vaccination doit, à la fois :
(a) require that a person who is 12 years and four a) exiger que toute personne âgée de douze ans et
months of age or older be a fully vaccinated person be- quatre mois ou plus soit une personne entièrement
fore accessing aerodrome property, unless they are a vaccinée pour pouvoir accéder aux terrains de l’aéro-
person drome, sauf dans les cas suivants :
(i) who intends to board an aircraft for a flight that (i) elle a l’intention de monter à bord d’un aéronef
an air carrier operates, pour un vol qu’un transporteur aérien effectue,
(ii) who does not intend to board an aircraft for a (ii) elle n’a pas l’intention de monter à bord d’un
pour un vol,
document issued by a department or departmental (iii) elle est titulaire d’une pièce d’identité d’em-
81100-3-96-55 25 2022-02-25 (13:57)

AR04542
(iv) who is delivering equipment or providing ser- (iv) elle livre des équipements ou fournit des ser-
vices within a restricted area that are urgently vices dans une zone réglementée, lesquels sont es-
needed and critical to aerodrome operations and sentiels aux activités de l’aérodrome et dont on a un
who has obtained an authorization from the opera- besoin urgent, et a obtenu une autorisation préa-
tor of the aerodrome before doing so; lable de l’exploitant d’un aérodrome pour ce faire;
son to access aerodrome property if the person has not ment vaccinée d’accéder aux terrains de l’aérodrome si
completed a COVID-19 vaccine dosage regimen due to celle-ci n’a pas suivi de protocole vaccinal complet
a medical contraindication or their sincerely held reli- contre la COVID-19 en raison d’une contre-indication
gious belief; médicale ou de sa croyance religieuse sincère;
vided by a person referred to in paragraph (b) that preuve présentée par la personne visée à l’alinéa b)
demonstrates that the person has not completed a établissant qu’elle n’a pas suivi de protocole vaccinal
COVID-19 vaccine dosage regimen due to a medical complet contre la COVID-19 en raison d’une contre-
contraindication or their sincerely held religious be- indication médicale ou de sa croyance religieuse sin-
lief; cère;
(d) provide for a procedure for issuing to a person d) prévoir une procédure permettant de délivrer à la
whose evidence has been verified under the procedure personne dont la preuve a été vérifiée aux termes de la
referred to in paragraph (c) a document confirming procédure visée à l’alinéa c), un document qui
that they are a person referred to in paragraph (b); confirme qu’elle est visée à l’alinéa b);
(e) provide for a procedure that ensures that a person e) prévoir une procédure permettant de veiller à ce
subject to the policy provides, on request, the follow- que la personne assujettie à la politique présente sur
ing evidence before accessing aerodrome property: demande la preuve ci-après avant d’accéder aux ter-
rains de l’aérodrome :
(ii) in the case of a person referred to in paragraph
(d), the document issued to the person under the (ii) dans le cas d’une personne visée à l’alinéa d), le
procedure referred to in that paragraph; document qui lui a été délivré en application de cet
alinéa;
(f) provide for a procedure that allows a person to
whom sections 17.31 to 17.40 apply — other than a f) prévoir une procédure permettant à la personne as-
person referred to in subsection 17.34(2) — who is a sujettie aux articles 17.31 à 17.40, à l’exception de celle
fully vaccinated person or a person referred to in para- visée au paragraphe 17.34(2), qui est une personne en-
graph (b) and who is unable to provide the evidence tièrement vaccinée ou une personne visée à l’alinéa b)
referred to in paragraph (e) to temporarily access et qui n’est pas en mesure de présenter la preuve visée
aerodrome property if they provide a declaration con- à l’alinéa e) d’accéder temporairement aux terrains de
firming that they are a fully vaccinated person or that l’aérodrome si elle présente une déclaration confir-
they have been issued a document under the proce- mant qu’elle est une personne entièrement vaccinée
dure referred to in paragraph (d); ou qu’elle s’est vu délivrer un document en application
de la procédure visée à l’alinéa d);
(g) provide for a procedure that ensures that a person
referred to in paragraph (d) is tested for COVID-19 at g) prévoir une procédure permettant de veiller à ce
least twice every week; que la personne visée à l’alinéa d) se soumette à un es-
sai relatif à la COVID-19 au moins deux fois par se-
(h) provide for a procedure that ensures that a person maine;
who receives a positive result for a COVID-19 test tak-
en under the procedure referred to in paragraph (g) is h) prévoir une procédure permettant de veiller à ce
prohibited from accessing aerodrome property until qu’il soit interdit à la personne qui reçoit un résultat
the end of the period for which the public health
81100-3-96-55 26 2022-02-25 (13:57)

AR04543
authority of the province or territory in which the positif à un essai relatif à la COVID-19 réalisé confor-
aerodrome is located requires them to isolate after re- mément à la procédure visée à l’alinéa g) d’accéder
ceiving a positive result; and aux terrains de l’aérodrome jusqu’à la fin de la période
d’isolement exigée, à la suite de la réception d’un ré-
(i) provide for a procedure that ensures that a person sultat positif, par l’autorité sanitaire de la province ou
referred to in paragraph (h) who undergoes a du territoire où est situé l’aérodrome;
COVID-19 molecular test is exempt from the proce-
dure referred to in paragraph (g) for a period of 180 i) prévoir une procédure permettant de veiller à ce
days after the person received a positive result from que la personne visée à l’alinéa h) qui se soumet à un
that test. essai moléculaire relatif à la COVID-19 soit exemptée
de la procédure visée à l’alinéa g) pour la période de
cent quatre-vingts jours suivant la réception d’un ré-
sultat positif à cet essai.

COVID-19 vaccine dosage regimen on the basis of a med- la COVID-19, pour le motif de contre-indication médi-
ical contraindication only if they provide a medical cer- cale, ne soit délivré à la personne que si celle-ci soumet
tificate from a medical doctor or nurse practitioner who un certificat médical délivré par un médecin ou un infir-
is licensed to practise in Canada certifying that the per- mier praticien autorisé à pratiquer au Canada qui atteste
son cannot complete a COVID-19 vaccination regimen que la personne ne peut pas suivre de protocole vaccinal
due to a medical condition and specifying whether the complet contre la COVID-19 en raison d’une condition
condition is permanent or temporary. médicale et qui précise si cette condition est permanente
ou temporaire.

COVID-19 vaccine dosage regimen on the basis of their la COVID-19, pour le motif de croyance religieuse sincère
sincerely held religious belief only if they submit a state- de la personne, ne soit délivré à la personne que si celle-
ment sworn or affirmed by them attesting that they have ci fournit une déclaration sous serment ou une affirma-
not completed a COVID-19 vaccination regimen due to tion solennelle attestant qu’elle n’a pas suivi de protocole
their sincerely held religious belief. vaccinal complet contre la COVID-19 en raison de sa
croyance religieuse sincère.
case of an employee of the operator of an aerodrome or a de l’employé de l’exploitant d’un aérodrome ou de la per-
person hired by the operator of an aerodrome to provide sonne qui est embauchée par l’exploitant d’un aérodrome
a service, the policy must provide that a document is to pour offrir un service, la politique doit prévoir que le do-
be issued to the employee or person confirming that they cument confirmant qu’une personne n’a pas suivi de pro-
did not complete a COVID-19 vaccine dosage regimen on tocole vaccinal complet contre la COVID-19, pour le mo-
the basis of their sincerely held religious belief only if the tif de croyance religieuse sincère de l’employé ou de la
operator of the aerodrome is obligated to accommodate personne, ne soit délivré à la personne que si l’exploitant
them on that basis under the Canadian Human Rights d’un aérodrome a l’obligation de prendre une telle me-
Act by issuing such a document. sure d’adaptation pour ce motif aux termes de la Loi ca-
nadienne sur les droits de la personne.

81100-3-96-55 27 2022-02-25 (13:57)

AR04544
cable :
CANADA CANADA
cordance with paragraphs 17.24(2)(a) to (h) and sub- COVID-19 qui est conforme aux alinéas 17.24(2)a) à h)
ed person who has not been issued a document under toute personne non vaccinée qui ne s’est pas vu déli-
who is et qui est :
(iii) a person hired by the entity to provide a ser- (iii) une personne qui est embauchée par l’entité
CANADA

(a) require that a relevant person, other than the a) exiger que toute personne concernée, à l’exception
holder of an employee identification document issued du titulaire d’une pièce d’identité d’employé délivrée
by a department or departmental corporation listed in par un ministère ou un établissement public visé à
81100-3-96-55 28 2022-02-25 (13:57)

AR04545
Schedule 2 or a member identification document is- l’annexe 2 ou d’une pièce d’identité de membre déli-
sued by the Canadian Forces, be a fully vaccinated vrée par les Forces canadiennes, soit une personne en-
person before accessing aerodrome property or, in the tièrement vaccinée pour pouvoir accéder aux terrains
case of NAV CANADA, a location where NAV de l’aérodrome ou, dans le cas de NAV CANADA, à un
CANADA provides civil air navigation services; emplacement où NAV CANADA fournit des services
de navigation aérienne civile;
person has not completed a COVID-19 vaccine dosage cement où NAV CANADA fournit des services de navi-
regimen due to a medical contraindication or their gation aérienne civile si celle-ci n’a pas suivi de
sincerely held religious belief; protocole vaccinal complet contre la COVID-19 en rai-
son d’une contre-indication médicale ou de sa
(c) provide for a procedure for verifying evidence pro- croyance religieuse sincère;
vided by a relevant person referred to in paragraph (b)
that demonstrates that the relevant person has not c) prévoir une procédure permettant de vérifier la
completed a COVID-19 vaccine dosage regimen due to preuve présentée par la personne concernée visée à
a medical contraindication or their sincerely held reli- l’alinéa b) établissant qu’elle n’a pas suivi de protocole
gious belief; vaccinal complet contre la COVID-19 en raison d’une
contre-indication médicale ou de sa croyance reli-
(d) provide for a procedure for issuing to a relevant gieuse sincère;
person whose evidence has been verified under the
procedure referred to in paragraph (c) a document d) prévoir une procédure permettant de délivrer à la
confirming that they are a relevant person referred to personne concernée dont la preuve a été vérifiée aux
in paragraph (b); termes de la procédure visée à l’alinéa c), un docu-
ment qui confirme qu’elle est visée à l’alinéa b);
(e) provide for a procedure that ensures that a rele-
vant person subject to the policy provides, on request, e) prévoir une procédure permettant de veiller à ce
the following evidence before accessing aerodrome que la personne concernée assujettie à la politique
property: présente sur demande la preuve ci-dessous avant d’ac-
céder aux terrains de l’aérodrome :
(ii) in the case of a relevant person referred to in
paragraph (d), the document issued to the relevant (ii) dans le cas d’une personne visée à l’alinéa d), le
person under the procedure referred to in that document qui lui a été délivré en application de cet
paragraph; alinéa;
COVID-19 at least twice every week; mette à un essai relatif à la COVID-19 au moins deux
fois par semaine;
COVID-19 test under the procedure referred to in qu’il soit interdit à la personne concernée qui reçoit un
paragraph (f) is prohibited from accessing aerodrome résultat positif à un essai relatif à la COVID-19 réalisé
property until the end of the period for which the pub- conformément à la procédure visée à l’alinéa f) d’accé-
lic health authority of the province or territory in der aux terrains de l’aérodrome jusqu’à la fin de la pé-
which the aerodrome is located requires them to iso- riode d’isolement exigée, à la suite de la réception d’un
late after receiving a positive test result; résultat positif, par l’autorité sanitaire de la province
ou du territoire où est situé l’aérodrome;
(h) provide for a procedure that ensures that a rele-
vant person referred to in paragraph (g) who
81100-3-96-55 29 2022-02-25 (13:57)

AR04546
undergoes a COVID-19 molecular test is exempt from h) prévoir une procédure permettant de veiller à ce
the procedure referred to in paragraph (f) for a period que la personne visée à l’alinéa g) qui se soumet à un
of 180 days after the relevant person received a posi- essai moléculaire relatif à la COVID-19 soit exemptée
tive result from that test; de la procédure visée à l’alinéa f) pour une période de
cent quatre-vingts jours suivant la réception d’un ré-
(i) set out procedures for reducing the risk that a rele- sultat positif à cet essai;
vant person will be exposed to the virus that causes
COVID-19 due to an in-person interaction, occurring i) prévoir des procédures visant à réduire le risque
on aerodrome property or at a location where NAV d’exposition au virus qui cause la COVID-19 pour les
CANADA provides civil air navigation services, with personnes concernées à la suite des interactions en
an unvaccinated person who has not been issued a personne, sur les terrains de l’aérodrome ou à un em-
document under the procedure referred to in para- placement où NAV CANADA fournit des services de
graph (d) and who is a person referred to in any of navigation aérienne civile, avec des personnes non
subparagraphs 17.23(b)(i) to (iv), which procedures vaccinées ne s’étant pas vu délivrer un document aux
may include protocols related to termes de la procédure visée à l’alinéa d) et qui sont
visées à l’un des sous-alinéas 17.23b)(i) à (iv), ces pro-
(i) the vaccination of persons, other than relevant cédures pouvant comprendre des protocoles à l’égard :
persons, who access aerodrome property or a loca-
tion where NAV CANADA provides civil air naviga- (i) de la vaccination des personnes, autres que les
tion services, personnes concernées, qui accèdent aux terrains de
l’aérodrome ou à un emplacement où NAV
(ii) physical distancing and the wearing of masks, CANADA fournit des services de navigation aé-
and rienne civile,
(iii) reducing the frequency and duration of in-per- (ii) de la distanciation physique et du port du
son interactions; masque,
(j) establish a procedure for collecting the following (iii) de la restriction et de la durée des interactions
information with respect to an in-person interaction en personne;
related to commercial flight operations between a rele-
vant person and a person referred to in any of sub- j) établir une procédure pour colliger les renseigne-
paragraphs 17.23(b)(i) to (iv) who is unvaccinated and ments ci-après à l’égard des interactions en personne
has not been issued a document under the procedure découlant de l’exploitation de vols commerciaux entre
referred to in paragraph (d) or whose vaccination sta- une personne concernée et une personne qui est visée
tus is unknown: à l’un des sous-alinéas 17.23b)(i) à (iv) qui n’est pas
vaccinée et qui ne s’est pas vu délivrer de document
(i) the time, date and location of the interaction, aux termes de la procédure visée à l’alinéa d) ou une
and personne dont le statut de vaccination est inconnu :
the other person;
(k) establish a procedure for recording the following l’autre personne;
quest: k) établir une procédure afin de consigner et de trans-
(iii) the number of relevant persons who are fully accéder aux zones réglementées de l’aérodrome,
vaccinated persons and those who are not,
(iii) le nombre de personnes concernées qui sont
entièrement vaccinées et de celles qui ne le sont
pas,
81100-3-96-55 30 2022-02-25 (13:57)

AR04547
(iv) the number of hours during which relevant (iv) le nombre d’heures au cours desquelles les per-
persons were unable to fulfill their duties related to sonnes concernées n’ont pu accomplir leurs tâches
commercial flight operations due to COVID-19, liées à l’exploitation de vols commerciaux à cause
de la COVID-19,
(v) the number of relevant persons who have been
issued a document under the procedure referred to (v) le nombre de personnes concernées qui se sont
in paragraph (d), the reason for issuing the docu- vu délivrer un document aux termes de la procé-
ment and a confirmation that the relevant persons dure visée à l’alinéa d), la raison invoquée, et une
have submitted evidence of COVID-19 tests taken confirmation que ces personnes ont soumis une
in accordance with the procedure referred to in preuve d’un essai relatif à la COVID-19 réalisé
paragraph (f), conformément à la procédure visée à l’alinéa f),
(vi) the number of relevant persons who refuse to (vi) le nombre de personnes concernées qui ont re-
comply with a requirement referred to in paragraph fusé de se conformer aux exigences prévues aux ali-
(a), (f) or (g), néas a), f) ou g),
(vii) the number of relevant persons who were de- (vii) le nombre de personnes concernées qui se
nied entry to a restricted area because of a refusal sont vu refuser l’accès à une zone réglementée à
to comply with a requirement referred to in para- cause de leur refus de se conformer aux exigences
graph (a), (f) or (g), prévues aux alinéas a), f) ou g),
(viii) the number of persons referred to in subpara- (viii) le nombre de personnes visées à l’un des
graphs 17.23(b)(i) to (iv) who are unvaccinated and sous-alinéas 17.23b)(i) à (iv) qui sont non vaccinées
who have not been issued a document under the et qui ne se sont pas vu délivrer un document aux
procedure referred to in paragraph (d), or whose termes de la procédure visée à l’alinéa d), ou dont le
vaccination status is unknown, who have an in-per- statut de vaccination est inconnu qui interagissent
son interaction related to commercial flight opera- en personne avec des personnes concernées décou-
tions with a relevant person and a description of lant de l’exploitation de vols commerciaux, de
any procedures implemented to reduce the risk that même qu’une description des procédures mises en
a relevant person will be exposed to the virus that place afin de réduire le risque, pour les personnes
causes COVID-19 due to such an interaction, and concernées, d’exposition au virus qui cause la CO-
VID-19, à la suite de ces interactions,
(ix) the number of instances in which the air carri-
er or NAV CANADA, as applicable, is made aware (ix) le nombre d’occasions où le transporteur aé-
that a person with respect to whom information rien ou NAV CANADA, selon le cas, a été informé
was collected under paragraph (j) received a posi- qu’une personne dont les renseignements ont été
tive result for a COVID-19 test, the number of rele- colligés aux termes de la procédure visée à l’alinéa
vant persons tested for COVID-19 as a result of this j) a reçu un résultat positif à un essai relatif à la CO-
information, the results of those tests and a de- VID-19, le nombre de personnes concernées sou-
scription of any impacts on commercial flight oper- mises à un tel essai découlant de cette information,
ations; and les résultats de ces essais et l’incidence sur l’exploi-
tation de vols commerciaux;
(l) require the air carrier or NAV CANADA, as appli-
cable, to keep the information referred to in paragraph l) exiger que le transporteur aérien ou NAV CANADA,
(k) for a period of at least 12 months after the date selon le cas, conserve les renseignements visés à l’ali-
that the information was recorded. néa k) pour une période d’au moins douze mois après
la date à laquelle ils ont été colligés.

COVID-19 vaccine dosage regimen on the basis of a med- plet contre la COVID-19, pour le motif de contre-indica-
ical contraindication only if they provide a medical cer- tion médicale, n’est délivré à la personne que si celle-ci
tificate from a medical doctor or nurse practitioner who soumet un certificat médical délivré par un médecin ou
is licensed to practise in Canada certifying that the un infirmier praticien autorisé à pratiquer au Canada qui
81100-3-96-55 31 2022-02-25 (13:57)

AR04548
relevant person cannot complete a COVID-19 vaccination atteste que la personne ne peut pas suivre de protocole
regimen due to a medical condition and specifying vaccinal complet contre la COVID-19 en raison d’une
whether the condition is permanent or temporary. condition médicale et qui précise si cette condition est
permanente ou temporaire.

COVID-19 vaccine dosage regimen on the basis of their plet contre la COVID-19, pour le motif de croyance reli-
sincerely held religious belief only if they submit a state- gieuse sincère de la personne, n’est délivré à la personne
ment sworn or affirmed by them attesting that they have que si celle-ci fournit une déclaration sous serment ou
not completed a COVID-19 vaccination regimen due to une affirmation solennelle attestant qu’elle n’a pas suivi
their sincerely held religious belief. de protocole vaccinal complet contre la COVID-19 en rai-
son de sa croyance religieuse sincère.
case of an employee of an entity or a relevant person de l’employé de l’exploitant d’un aérodrome ou de la per-
hired by an entity to provide a service, the policy must sonne concernée qui est embauchée par l’exploitant d’un
provide that a document is to be issued to the employee aérodrome pour offrir un service, la politique doit prévoir
or the relevant person confirming that they did not com- que le document confirmant qu’une personne n’a pas sui-
plete a COVID-19 vaccine dosage regimen on the basis of vi de protocole vaccinal complet contre la COVID-19,
their sincerely held religious belief only if the entity is ob- pour le motif de croyance religieuse sincère de l’employé
ligated to accommodate the relevant person on that basis ou de la personne, n’est délivré à la personne que si l’ex-
under the Canadian Human Rights Act by issuing such a ploitant d’un aérodrome a l’obligation de prendre une
document. telle mesure d’adaptation pour ce motif aux termes de la
Loi canadienne sur les droits de la personne.

cable :
l’aérodrome.

81100-3-96-55 32 2022-02-25 (13:57)

AR04549

quest. mande.

Canada Canada
board an aircraft for a flight operated by an air carrier; autre que celui de monter à bord d’un aéronef pour un
carrier under Subpart 1, 3, 4 or 5 of Part VII of the zone non réglementée dans le but de monter à bord
Regulations; d’un aéronef pour un vol effectué par un transporteur
aérien visé aux sous-parties 1, 3, 4 ou 5 de la partie VII
to board an aircraft for a flight c) la personne qui accède à une zone réglementée
d’un aérodrome visé à l’annexe 1 à partir d’une zone
(i) only to become a crew member on board anoth- non réglementée dans le but de monter à bord d’un
er aircraft operated by an air carrier under Subpart aéronef pour un vol :
1, 3, 4 or 5 of Part VII of the Regulations,
(i) dans le seul but d’agir à titre d’un membre
(ii) after having been a crew member on board an d’équipage à bord d’un autre aéronef exploité par
aircraft operated by an air carrier under Subpart 1, un transporteur aérien visé aux sous-parties 1, 3, 4
3, 4 or 5 of Part VII of the Regulations, or ou 5 de la partie VII du Règlement,
(iii) to participate in mandatory training required (ii) après avoir agi à titre d’un membre d’équipage
by an air carrier in relation to the operation of an à bord d’un aéronef exploité par un transporteur
aircraft operated under Subpart 1, 3, 4 or 5 of Part aérien visé aux sous-parties 1, 3, 4 ou 5 de la partie
VII of the Regulations, if the person will be re- VII du Règlement,
quired to return to work as a crew member;
(iii) afin de suivre une formation obligatoire exigée
(d) a screening authority at an aerodrome where per- par un transporteur aérien sur l’exploitation d’un
sons other than passengers are screened or can be aéronef exploité en application des sous-parties 1,
screened; 3, 4 ou 5 de la partie VII du Règlement si elle devra
retourner au travail à titre de membre d’équipage;
(e) the operator of an aerodrome listed in Schedule 1.
81100-3-96-55 33 2022-02-25 (13:57)

AR04550
of age;
cy;
f) la personne qui livre des équipements ou fournit
(f) a person who is delivering equipment or providing des services dans une zone réglementée, lesquels sont
services within a restricted area that are urgently essentiels aux activités de l’aérodrome et dont on a un
needed and critical to aerodrome operations and who besoin urgent, et qui a obtenu une autorisation préa-
has obtained an authorization from the operator of the lable de l’exploitant d’un aérodrome pour ce faire.
aerodrome before doing so.
17.31 (1) A person must not enter a restricted area un- 17.31 (1) Il est interdit à toute personne d’accéder à
less they are a fully vaccinated person. une zone réglementée sauf si elle est une personne entiè-
rement vaccinée.
Exception Exception

ticle 17.10;
81100-3-96-55 34 2022-02-25 (13:57)

AR04551

17.22(2)(d); or
Exception Exception

son’s name, the date on which the declaration was signed cette personne ainsi que de la date à laquelle elle a signé
and, if applicable, the number or identifier of the per- la déclaration et, le cas échéant, du numéro ou de l’iden-
son’s document of entitlement. tifiant de son document d’autorisation.

signed.

dence.
81100-3-96-55 35 2022-02-25 (13:57)

AR04552

17.34(5) :
created.

evidence under section 17.33, the person does not pro- signée conformément au paragraphe 17.34(1), selon le
vide the evidence or, if applicable, does not sign or pro- cas, l’administration de contrôle lui refuse l’accès à la
vide a declaration under subsection 17.34(1). zone réglementée.

(2) If a screening authority denies a person entry to a re- (2) L’administration de contrôle qui refuse l’accès à une
stricted area, it must notify the operator of the aero- personne à une zone réglementée avise l’exploitant d’un
drome as soon as feasible of the person’s name, the date aérodrome dès que possible des prénom et nom de cette
on which the person was denied entry and, if applicable, personne ainsi que de la date à laquelle l’accès lui a été
the number or identifier of the person’s document of en- refusé et, le cas échéant, du numéro ou de l’identifiant de
titlement. son document d’autorisation.

restricted area access of a person who was denied entry la zone réglementée de la personne qui s’en est vu refuser
under subsection (1) is suspended until the person pro- l’accès en application du paragraphe (1) soit suspendu
vides the requested evidence or the signed declaration. jusqu’à ce qu’elle présente la preuve demandée ou la dé-
claration signée.

81100-3-96-55 36 2022-02-25 (13:57)

AR04553


record was created.


17.22(2)(d).
81100-3-96-55 37 2022-02-25 (13:57)

AR04554
Masks Masque
a mask;
reason;
out assistance;
(f) a crew member;
(g) a gate agent.


Notification Avis
quement;
gare;
81100-3-96-55 38 2022-02-25 (13:57)

AR04555
(c) comply with any instructions given by a gate agent c) se conformer aux instructions données par un
or a crew member with respect to wearing a mask. agent d’embarquement ou un membre d’équipage à



tions suivantes :

tage :
81100-3-96-55 39 2022-02-25 (13:57)

AR04556
fectue :

(ii) the person’s name, date of birth and contact in- (i) les dates et numéro du vol,
formation, including the person’s home address,
telephone number and email address, (ii) les prénom et nom de la personne ainsi que sa
date de naissance et ses coordonnées, y compris
(iii) the person’s seat number, and son adresse de résidence, son numéro de téléphone
comply; and (iii) le numéro du siège occupé par la personne,
(b) inform the Minister as soon as feasible of any (iv) les circonstances du refus;
record created under paragraph (a).

the flight. du vol.
81100-3-96-55 40 2022-02-25 (13:57)

AR04557

ci.


suivantes :


suivantes :

81100-3-96-55 41 2022-02-25 (13:57)

AR04558
persons: vantes :
a mask;
reason;
out assistance;


passagers.

a mask;
81100-3-96-55 42 2022-02-25 (13:57)

AR04559
(c) a person who provides a medical certificate certify- c) la personne qui fournit un certificat médical attes-
ing that they are unable to wear a mask for a medical tant qu’elle ne peut porter de masque pour des raisons
reason; médicales;
(d) a person who is unconscious; d) la personne qui est inconsciente;
(e) a person who is unable to remove their mask with- e) la personne qui est incapable de retirer son masque
out assistance; par elle-même;
(f) a member of emergency response provider person- f) le membre du personnel des fournisseurs de ser-
(g) a peace officer who is responding to an emergency. g) l’agent de la paix qui répond à une urgence.

child





81100-3-96-55 43 2022-02-25 (13:57)

AR04560

suivantes :

à la COVID-19.

glementée.



81100-3-96-55 44 2022-02-25 (13:57)

AR04561
Notice Avis
scribed period.
Repeal Abrogation
No. 55, made on February 23, 2022, is repealed. la COVID-19, pris le 23 février 2022, est abrogé.
81100-3-96-55 45 2022-02-25 (13:57)

AR04562
SCHEDULE 1 ANNEXE 1
Nom de l’OACI
Alma CYTF
Alma CYTF
Bagotville CYBG
Bagotville CYBG
Baie-Comeau CYBC
Baie-Comeau CYBC
Bathurst CZBF
Bathurst CZBF
Campbell River CYBL
Campbell River CYBL

Rocheuses)
Deer Lake CYDF
Dawson Creek CYDQ
Deer Lake CYDF
Fort McMurray CYMM
Fort St. John CYXJ
Fort McMurray CYMM
Fort St. John CYXJ
Gaspé CYGP
Goose Bay CYYR
Gaspé CYGP
Grande Prairie CYQU
Goose Bay CYYR
Grande Prairie CYQU
81100-3-96-55 46 2022-02-25 (13:57)

AR04563

Nom de l’OACI
Iqaluit CYFB Munro)
International)
Mont-Joli CYYY
Nanaimo CYCD

Cartier)
Prince Rupert CYPR
Penticton CYYF
Quesnel CYQZ
Prince George CYXS
Prince Rupert CYPR
Quesnel CYQZ
Rouyn-Noranda CYUY
Saint John CYSJ
international)
81100-3-96-55 47 2022-02-25 (13:57)

AR04564

Nom de l’OACI
Rouyn-Noranda CYUY
Saint John CYSJ
Sept-Îles CYZV
Smithers CYYD
Bishop)

International)
Wabush CYWK
Yellowknife CYZF
Nielsen)
Williams Lake CYWL
Windsor CYQG

Yellowknife CYZF
81100-3-96-55 48 2022-02-25 (13:57)

AR04565
SCHEDULE 2 ANNEXE 2
17.30(2)(e))

Name Nom
Canadian Security Intelligence Service Agence des services frontaliers du Canada
Correctional Service of Canada Gendarmerie royale du Canada
Department of Agriculture and Agri-Food Ministère de la Défense nationale
Department of Employment and Social Development Ministère de l'Agriculture et de l'Agroalimentaire
Department of Fisheries and Oceans Ministère de la Santé
Department of Health Ministère de la Sécurité publique et de la Protection civile
Department of National Defence Ministère de l’Emploi et du Développement social
Department of Public Safety and Emergency Preparedness Ministère des Pêches et des Océans
Department of Transport Ministère des Transports
Public Health Agency of Canada Service canadien du renseignement de sécurité
81100-3-96-55 49 2022-02-25 (13:57)

AR04566
SCHEDULE 3 ANNEXE 3


Section 4 5,000 25,000 Article 4 5 000 25 000
Section 5 5,000 25,000 Article 5 5 000 25 000
Section 9 5,000 25,000 Article 9 5 000 25 000
Section 12 5,000 25,000 Article 12 5 000 25 000
Section 13.1 5,000 Article 13.1 5 000
Section 16 5,000 25,000 Article 16 5 000 25 000
Section 17 5,000 25,000 Article 17 5 000 25 000
Section 17.2 25,000 Article 17.2 25 000
Section 17.7 25,000 Article 17.7 25 000
Section 17.9 5,000 Article 17.9 5 000
Section 17.15 25,000 Article 17.15 25 000
81100-3-96-55 50 2022-02-25 (13:57)

AR04567

Section 17.32 5,000 Article 17.32 5 000
Section 17.33 25,000 Article 17.33 25 000
Section 17.37 5,000 Article 17.37 5 000
Section 17.38 25,000 Article 17.38 25 000
Section 17.40 25,000 Article 17.40 25 000
Section 19 5,000 25,000 Article 19 5 000 25 000
Section 23 5,000 25,000 Article 23 5 000 25 000
81100-3-96-55 51 2022-02-25 (13:57)

AR04568
February 24, 2022
1
AR04569
February 24, 2022
2
AR04570
February 24, 2022
3
AR04571
February 24, 2022
4
AR04572
February 24, 2022
5
AR04573
February 24, 2022
6
*
1 1 Department
AR04574 of Justice Ministère de la Justice
Canada Canada
PROTECTED B SOLICITOR-CLIENT PRIVILEGE - VO
Prairie Regional Office (Winnipeg) Bureau régional des Prairies (Winnipeg)
National Litigation Sector Secteur national du contentieux
601-400 St. Mary Avenue 400, avenue St. Mary, pièce 601
Winnipeg, MB R3C 4K5 Winnipeg (Manitoba) R3C 4K5
MEMORANDUM / NOTE DE SERVICE
TO / DEST:
FROM / ORIG:
SUBJECT / OBJET:
ATTACHMENTS /
ATTACHMENTS:
Comments/Remarque
Do not write in this space / Ne pas écrire dans cet espace
AR04575
-2-
AR04576
-3-
AR04577
-4-
AR04578
-5-
AR04579
-6-
AR04580
-7-
AR04581
-8-
AR04582

Ottawa, Ontario

Omar Alghabra,
P.j. / Enclosures
Canada
AR04583

Sénat / Senate
Ottawa, Ontario
certaines exigences relatives à l’aviation civile en Aviation Due to COVID-19, No. 56.

Omar Alghabra,
P.j. / Enclosures
Canada
PROTECTED B - CABINET CONFIDENCES / PROTÉGÉ B - RENSEIGNEMENT CONFIDENTIELS DU CABINET
AR04584
Rapid Antigen Test Rationale from the Public Health Agency of Canada
Testing capabilities advanced significantly in early 2021. Over 197 countries and territories require a
negative pre-travel COVID-19 test or medical certificate as a condition of entry into their jurisdictions.
The United States (US), for instance, currently requires that all travellers arriving by air to the US have
evidence of a negative pre-departure molecular or antigen test no more than one day prior to boarding a
flight to the US, irrespective of vaccination status. The US does not currently require testing for entry at
the land border.
Antigen tests have a lower sensitivity than molecular tests for detecting COVID-19 over the duration of
infection, and are less likely to detect asymptomatic infections. However, evidence indicates that rapid
antigen tests (RATs) can detect most cases with high viral load, who are the most likely to be infectious.
This, coupled with broad international availability of RATs, high domestic vaccination rates, and the
improving epidemiological situation in Canada supports adoption of RATs for the purposes of pre-arrival
testing of travellers seeking to enter Canada. Accepting RATs under some circumstances brings Canada’s
border and travel measures into closer alignment with those of many other countries, including the US and
many G7 allies, which either do not have pre-entry testing requirements in effect or accept evidence from
RATs to meet pre-entry testing requirements. Additionally, recognizing negative RAT results for Canada’s
pre-entry test requirement reduces the barriers to travel, given the higher cost and difficulty of acquiring
molecular tests in some jurisdictions.
Available science demonstrates that, as is the case with many other viruses, a person may continue to obtain
a positive molecular test result up to 180 days after their infection, even though they are no longer
considered infectious. Positive molecular test results of previously infected individuals, for tests performed
up to 180 days prior, should not be considered as evidence of a new infection posing risk, but rather that a
person has recovered from a prior COVID-19 infection. Since a positive test result may inadvertently
prevent a recovered patient from entering Canada, acceptable proof of prior infection from an asymptomatic
traveller is accepted as an alternative to a negative pre-arrival test, and as an alternative to the requirement
to test upon arrival. Requiring that prior positive test results be obtained at least 10 days before the initial
scheduled departure (by air) or arrival time (by land) allows for the time needed to become non-infectious,
thus preventing those persons who may be infectious from travelling and possibly transmitting COVID-19
upon travel to Canada. Due to the possibility of a false positive result from a rapid antigen test, a positive
molecular test result will continue to be required as proof of a previous COVID-19 infection.
1/1
AR04585
Ceci est la pièce « S » au soutien de


AR04586
1*1 Transport
Canada
Transports
Canada
GUIDANCE MATERIAL FOR INDUSTRY

REMOTE POLICY
Federal Vaccination Mandate

Guidance regarding COVID-19 self-test kits for passengers
travelling to and from remote locations
This guidance material is intended to provide recommendations and guidance on the operationalization of Transport
Canada’s Interim Order, Interim Order Respecting Certain Requirements for Civil Aviation due to COVID-19.
Important Caveat: Nothing in this guidance document supersedes any requirement or

obligation outlined in Transport Canada’s Interim Order. It is meant to complement
this legal document and provide recommendations and guidance on how to
understand and carry out the requirements.
1
Canada
AR04587
1*1 Transport
Canada
Transports
Canada
Document Outline:
Sections Annexes
Section 1 – General Annex A – Health Canada testing protocol for Lucira Check It
Section 2 – Guidance for gateway COVID-19 testing kits
aerodromes Annex B – Health Canada user guidance on Lucira Check it
Section 3 – Guidance for air carriers COVID-19 testing kits
transporting passengers transiting Annex C – Template for self-test – negative result
from or going to remote locations Annex D – List of public health contacts at gateway airports
Section 4 – 24/7 Guidance for air Annex E – Template for self-test – no kits available
operators and aerodromes
Section 1 - General
Purpose
For people living in remote communities, air travel is often the only link to essential services, usually
provided in urban centres. Testing capacity being more difficult to access in these communities, the
national vaccination mandate for travellers includes specific accommodations to address their situation
and ensure that they will be able to travel to obtain these essential services while maintain the health
benefits of the national policy.
In order to alleviate the burden on these travellers, Health Canada will provide approved molecular
COVID-19 testing kits that individuals can self-administer if they board a flight at an airport specified in
the Transport Canada Interim Order Respecting Certain Requirements for Civil Aviation due to COVID-
19. As for other tests, the results will be valid for 72 hours, and the travellers will be able to use them if
they transfer to other flights or return to their communities within that time period.
2
Canada
AR04588
1*1 Transport
Canada
Transports
Canada
Section 2 -Guidance for gateway aerodromes
Transport Canada has gathered contact information for aerodromes which have been identified as
gateways through which remote community travellers transit on their way to receive essential
services, or from which they board to return home. As such, these gateways are where travellers who
may not have a proof of vaccination or valid COVID-19 test result would most likely benefit from being
provided with a self-test kit.
Lucira Check It COVID-19 Test Kits (the test kits) have been distributed by Health Canada, and are being
used since the new mandate came into force on October 30th.
Gateway aerodrome operators should:
 Inform air operators with flights to/from remote locations that self-test kits are available should
they be required;
 Provide the self-test kits to the air operators upon request; and
 Inform Health Canada at contact.us.screening.kits.contactez.nous.trousse.depistage@hc-
sc.gc.ca should they need more kits, taking into account the time necessary for delivery.
Health Canada has provided clear guidance on how best to administer and resource testing areas for
passengers within an aerodrome (Annex A). Wherever feasible, these guidelines should be applied to
ensure effective administration and analysis for the tests.
Specifically outlined in these guidelines is that, aerodromes should work with air operators to provide
travellers with a location where they can administer the self-test. Ideally, such a location will offer
privacy, as well as:
 a garbage receptacle;
 a marker;
 paper towels or tissues;
 a way to measure time (e.g. a clock), and
 a mirror.
In order for the test to be valid, it will need to remain undisturbed on a hard, flat surface for 30
minutes, and it will therefore be important that such a surface be available next to the testing location.
3
Canada
AR04589
1*1 Transport
Canada
Transports
Canada
Section 3 - Guidance for air carriers transporting passengers transiting from or

going to remote locations
As part of the Transport Canada Interim Order Respecting Certain Requirements for Civil Aviation due to
COVID-19, air carriers are required to confirm that passengers boarding a flight at a specified airport
are vaccinated, have a valid COVID-19 test, or are exempt according to one of the provisions of the
Interim Order.
If travellers to or from remote locations cannot confirm one of the above, they may be offered the
option to use a COVID-19 self-test kit, which will satisfy the same requirements as a laboratory test for
requirements of the Interim Order.
The specific application of this alternative approach is outlined in exemptions (C2021-129 and C2021-
131) that have been issued to all air operators servicing remote communities and travellers to and
from these locations.
Along with the self-test kits, Health Canada have provided a testing protocol, training material, and
infographic for users. These documents will be made available in multiple indigenous languages by
Indigenous Services Canada. Copies of this material are found at Annex B. Should you require this
information in other languages, please send a request to TC.AviationSecurity-
Sureteaerienne.TC@tc.gc.ca.
Air carriers should contact the aerodrome operator in order to obtain test kits.
If a traveller indicates they want to avail themselves of the self-test option, air operators should:
 Explain to the traveller that they can be offered a self-test kit, and, after self-administering it,
be allowed to board if they present a negative test result to the operator.
 Offer a self-test kit as well as instructions (Annex B).
 Direct the passenger to a location where they can administer the self-test. Ideally, such a
location will offer privacy as well as:
o a garbage receptacle;
o a marker;
o paper towels or tissues;
o a way to measure time (e.g. a clock), and
o a mirror.
 In order for the test to be valid, it will need to remain undisturbed on a hard, flat surface for 30
minutes, and it will therefore be important that such a surface be available next to the testing
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location. Please note that more detailed information on testing is available through Health
Canada guidance material (Annex A).
 When the traveller has completed the self-test, they should present the result to the air
operator. It will show one of the three following results:
Results
E Invalid Result O Negative Result

£) Ready Dane Request another kit Q Heady Dane © You may proceed
COVID- 19 and repeat the test COVID- 19 with travel.
•O Negative
Positive again.
O Positive
• Negative
A record of this
result will be valid
for 72 hours.
E Positive Result
O Heady Done © COVID -19 was detected. Stay calm, and please ensure you notify
COVID-19 airline operators immediately. You may not proceed with travel.
•O Negative
Positive
You must follow directions from airport staff, airline staff and local public
health authorities.
1. Invalid Result:
 A second test is offered by the air operator.

 If the second test is also invalid, the air operator must contact the local public health authority
(Annex D) for direction regarding further testing.
 The traveller cannot proceed with travel until the local public health authority provides
direction.
2. Negative Result:
 The operator will complete the form attached in Annex C (or another document containing the
same data elements) and hand it to the traveller.
 The operator informs the traveller that this document will be valid for 72 hours and should be
kept for further flights within that period.
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3. Positive Result
 The operator should provide the traveller with a medical face mask and a space to isolate away
from others.
 The operator must contact local public health authorities for further public health direction and
case management, including for the traveller’s companions and close contacts, potentially
including other travellers.
 See Annex D for a list of contacts for the jurisdiction of each gateway airport.
 We are awaiting additional information in this area from the Public Health Agency of Canada.
As per Interim Order requirements, the air operator will need to inform TC (at TC.AviationSecurity-
Sureteaerienne.TC@tc.gc.ca) of any denials of boarding within 72 hours. In addition, the number of
negative and invalid tests should be communicated to TC at the same address on a weekly basis.
Health Canada does not require tests be disposed of as biohazard, but air operators and aerodromes
should confirm local requirements with the appropriate authorities.
If no self-test kits are available at the aerodrome, travellers will be allowed to board as per exemption
C2021-131, and informed that they will need to be tested the next time they board a flight at a
specified airport. The air operator should complete and give the traveller a document saying that they
have not been tested but are allowed to travel under the exemption (Annex E). In addition, the air
operator should contact the aerodrome authority immediately in order for more kits to be sent.
As the tests are valid for persons 14 years of age and older, persons aged between 12 and 4 months
and 14 will also need to be issued the form under Annex E. They will not have to be administered the
self-test, but will still be allowed to board.
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Section 4 - 24/7 contact information
24/7 Guidance for air operators and aerodromes:
Transport Canada Aviation Operations Centre:
 1-877-992-6853 or 613-992-6853
 operations.aviation@tc.gc.ca
Transport Canada Situation Centre:

 1-888-857-4003
24/7 Guidance for passengers:
 1-800 O-Canada (1-800-622-6232)
Contact Information:
Question on this Guidance or the Annexes within should be directed to:

 TC.AviationSecurity-Sureteaerienne.TC@tc.gc.ca
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Annex A: Health Canada testing protocol for Lucira Check It COVID-19 testing
kits
Guidance for airline and airport operators/test kit administrators to serve unvaccinated travellers from
northern, remote, and isolated communities.
Purpose
This testing protocol for Lucira Check It COVID-19 Test Kit (Lucira Check It) outlines the approach for its
use by unvaccinated passengers travelling to and from northern, remote, and isolated (NRI)
communities, who will require confirmation of a negative COVID-19 molecular test prior to travelling
from “gateway” airports identified in Schedule A.
This Testing Protocol is specific to the use of Lucira Check It in this context and should not be used to
inform use of this or other test(s) in other situations or settings.
Eligibility
As of October 30, 2021, a traveller aged 12 and over will have three options that would allow them to
travel by air domestically:
1. Provide proof of vaccination (all travellers in Canada)

2. Provide proof of a molecular test:
a. Obtain a negative molecular test result taken within 72hrs of travel from an existing and
verified community-based testing program (all travellers in Canada)
b. Show a positive molecular test result taken 14-180 days before travel from an existing
and verified community-based testing program (all travellers in Canada)
c. Obtain a negative self-administered molecular test result through a test provided by air
operator (those flying to / from remote communities only)
3. Complete a 14-day quarantine under public health requirements prior to travel
Recognizing that there are challenges to vaccination, as well as limited access to COVID-19 testing, in
NRI communities, this protocol supports an interim approach for unvaccinated travellers from NRI
communities to meet the testing requirement identified above (2b).
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Guiding Principles
Testing is not an alternate to vaccination. Vaccination offers the most effective protection from
COVID-19 to individuals and communities. A test for COVID-19 reflects the individual’s status at the
time of the test. Even with a negative test result, all travellers, including those from NRI communities
are strongly encouraged to follow all public health preventive practices including:
 self-monitoring for symptoms and staying home when sick;

 completing required symptom screening protocols before arriving at the airport;
 maintaining at least two meters of physical distance from others at the airport;
 always wearing a non-medical mask indoors, even when physical distancing can be maintained;
 wearing a non-medical mask outdoors when physical distancing cannot be maintained; and
 washing hands or using hand sanitizer with at least 70% alcohol content.
Transport Canada has determined, for the period October 30 to November 29, 2021, that:
 To realize the health benefits of federal vaccine policy for domestic travel, travellers on flights
from “gateway” airports, or on flights to NRI airports, will need to provide proof of vaccination,
proof of having undergone a 14-day quarantine under public health requirements prior to
travel, or a valid COVID-19 molecular test.
 Unvaccinated travellers will be encouraged to access, where capacity is available, community-
based molecular COVID-19 testing.
 However, to ensure all travellers coming from, or transiting to, NRI communities have access to
molecular testing, the Government of Canada will provide self-administered Lucira Check It
COVID-19 molecular test kits to Canadian Air Operators that transport travellers to and from
Gateway communities, (Schedule A), at no charge.
 At Gateway airports, airline operators will provide these test kits, along with clear Health
Canada approved instructions, to all travellers that do not have proof of vaccination, proof of
quarantine, or proof of valid COVID-19 molecular tests, prior to checking in for any flight to
remote communities or to southern destinations.
 Limited additional testing kits will be provided to operators at southern airports for travellers
beginning their multi-flight transit back to a remote community.
 Airline operators will provide travellers with documentation of their negative Lucira Check It
test result, which will allow unvaccinated travellers to board any connecting flights without
need for another test result for 72hrs (e.g., the test result could allow traveller to board
multiple flights).
The Lucira Check It is a single-use molecular amplification test authorized for over-the-counter use. The
disposable test kit consists of one nasal swab, a sample vial that contains the elution buffer (test
solution), a test unit that contains the reagents for target amplification and an electronic readout,
batteries and a disposal bag. Lucira Check It provides test results in approximately 30 minutes.
Travellers will also be given a medical face mask and sanitizing wipe.
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COVID-19 Testing of Unvaccinated Travellers from Northern/Remote/Isolated Communities
Wherever possible, unvaccinated travellers from NRI communities are encouraged to access local
molecular COVID-19 testing in their communities prior to travel. Travel for essential purposes may
allow community based molecular testing at no cost to the traveller.
Recognizing that access to testing is often limited in NRI communities, travellers departing from NRI
communities will not be required to provide proof of vaccination or a negative molecular COVID-19
test, until reaching a connecting Gateway airport. Prior to departing the NRI community, travellers
should be clearly informed by air operators of the requirement to take a self-administered test at the
gateway airport as well as the consequences of positive test results or of refusing to test, i.e., they will
not be permitted to travel onward unless they test negative.
Upon arrival at Gateway airports, travellers from NRI communities who are scheduled to board
connecting flights to other airports must present themselves to the airline operator (or their
designated representative) at the check-in gate to provide
 proof of their vaccination status,

 proof of having undergone a 14-day quarantine under public health requirements prior to
travel
 proof of a positive molecular COVID-19 test result between 14-180 days before departure, or
 proof of a negative COVID-19 molecular test taken within the previous 72 hours.
Where Lucira tests are available at the gateway airport, travellers without such proof will be required
to undertake and have a negative result on a self-administered molecular test for COVID-19 before
further travel.
The airline operator will provide self-administered test kits to the traveller, to self-administer on site
along with a mask and a sanitizing wipe. Once the traveller shows the result to the operator they will
receive documentation that includes the traveller’s name, date, type of test, and result (see
“Administering the Lucira Check It Self-test). They can use this form as proof of a negative test result
for the flight and potentially subsequent flights, if the test was conducted within 72 hours of the
scheduled departure time.
Refusal to undertake the self-administered test could result in denial of boarding for onward travel
beyond that point. Airline operators should be prepared to engage with individuals who may refuse
testing.
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Administering the Lucira Check It Self-test
Role of the Airport Operator
 Order and receive Lucira Check It tests, and maintain inventory (see section Acquiring Lucira
Check It Tests)
 Store tests according to manufacturers’ guidelines (see section Test Storage)
 Make tests available to airline operators
 Provide designated testing area (see “Administering the Test”)
 Follow guidance provided for federally regulated operators in terms of personal protective
equipment required for handling the test and disinfecting surfaces.
Role of the Airline Operator
 Provide a test, mask, sanitizing wipe and Health Canada approved instructions to travellers that
require tests
 Record the “Test Kit #” found on the box provided to each passenger (required in the event of a
recall or passenger does not report back the result)
 Direct the traveller to assemble and administer the test
o A permanent marker should be available in the dedicated testing space to enable
travellers to write their names on the side of the test.
o Remind the passenger that the name written on the test kit should be the same as the
name on any identification used for travel purposes
 Infographics should be available (see Schedule B) to direct the traveller in administering the test
o Airline operator should be available to answer questions about the administration of the
test to the best of their knowledge.
 Read the results after the test is finished and complete a form (provided by Transport Canada)
which will include:
o Traveller first and last name (the name written on the test kit should be the same as the
name on any identification used for travel purposes)
o Location of test (i.e., which airport)
o Date
o Time
o Type of test (Lucira Check It COVID-19 Test Kit)
o Result
Note: Where possible, it is recommended that airline operators walk over to the traveller’s test device
to note the results so that the traveller does not have to carry the test device.
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Role of the Traveller
 Use a permanent marker to write your name (the same name as on identification used for travel
purposes) on the side of the test kit
 Clean hands, clean the testing area before use (hand sanitizer is sufficient)
 Assemble and administer the self-test following the Health Canada approved instructions (see Schedule
B)
 Clean testing area after use, and clean hands again (hand sanitizer is sufficient)
 When the test is complete, show the airline operator the results
 Obtain documentation for travel from the airline operator, demonstrating proof of the molecular test
result
 Once the results have been recorded, dispose of the test kit according to the directions provided in the
airport.
Usage of Testing Kits
The test must always be used at ambient temperatures of between 15-30°C / 59-86°F. Storage and use
at lower (e.g., 5°C) or higher (e.g., 45°C) temperatures can give invalid results.
Airport or airline operators should provide designated spaces for administering the test, awaiting
results and isolating any positive cases (see Schedule E).
Administering Testing
The test must be placed on a hard flat surface (e.g., table) for administration and cannot be moved
once the test is initiated. The testing space should allow for adequate distancing (i.e., 2 meters) from
other people during the testing stream.
The designated space for testing should allow for traveller privacy as many will be uncomfortable
swabbing or performing the test in a public setting or be concerned about being recognized as
unvaccinated.
Finally, space should be provided to ensure that the test is not disturbed or moved for up to 30
minutes until the result appears.
Provision should be made for appropriate cleaning and disinfection of the self-testing area/station
before and after each traveller using the station according to guidelines for federally regulated sectors.
The local public health authority should be consulted regarding the most appropriate disposal of the
materials generated in the self-testing area and overall cleaning recommendations for the airport (see
Schedule C for provincial and territorial health authorities).
Recommended equipment to facilitate testing includes tables and chairs, barriers (to separate
travellers administering the test), mirrors (for participant to use while swabbing), disinfectant wipes (or
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spray and paper towel), hand sanitizer, gloves, paper towels, pens, markers, large garbage and/or
biohazard waste bins. Medical face masks and a sanitizing wipe must be given to every traveller who is
given a test kit so that it’s available for participants who test positive.
Airports establishing testing within the airport are encouraged to consult the Creative Destruction Lab
Rapid Screening Consortium (CDL RSC) for support in establishing the testing programs. CDL RSC is a
non-profit organization working to develop innovative systems to implement rapid screening programs
across Canada. The following resources are available:
 Screening site set-up (materials, station layout)

 Screening site operations (sample collection and analysis, waiting for results, waste
management, communicating results
 Regulatory operations (regional/provincial public health guidelines)
Testing Instructions
Airline operators should verify that test kits are sealed and that the packaging is intact before giving
them to a traveller. Prior to using the kit, the traveller should verify if any test kit components appear
damaged or open. If there is any damage, the traveller should report the damage and obtain a
replacement from the airline operator (or their representative).
For definitive and detailed instructions regarding use of Lucira Check It, please follow the full
instructions for use as well as the package insert that comes with the test and includes the following
key information on page 2:
 Set up test
 Swab both nostrils
 Stir swab and run test
 Do not move the test until it has provided the result
 Read results
Training resources
 Lucira Check It package insert

 Lucira Check It full instructions for use
 Lucira Check It video
A simplified infographic has been developed to support use of the test by participants in an airport
setting (see Schedule B).
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Considerations
 Leave kit components sealed in foil pouch until just before use.
 Proper sample collection and sample handling are essential for correct results.
 Do not touch swab tip when handling swab sample.
 Do not use any kit components with visible damage.
 Do not use the kit components after their expiration date.
 Choose a level location to do this test where you can let the test sit undisturbed for 30 minutes.
 All kit components are single use items. Do not use with multiple specimens.
 Dispose of kit components and test samples according to all local regulations.
 Do not move the test kit while waiting for results
Waste Disposal
The instructions for use for Lucira Check It indicate that once completed, the unit should be placed in
plastic disposal bag provided and disposed of in trash. The manufacturer has confirmed that batteries
can be removed and used for other purposes prior to disposal.
In some jurisdictions, COVID-19 self-test kits, PPE and contaminated material are considered a
biohazard and must be disposed in an appropriate biohazard container. Similarly, batteries may be
considered hazardous waste and should be disposed of based on the regulations in that jurisdiction.
The airline operator/airports should consult with their local public health authority to confirm
requirements in their jurisdiction and then follow the directions provided.
Interpreting Test Results
Negative test result
 A negative result means COVID-19 (SARS-CoV-2) was not detected in the traveller’s swab
sample.
 The airline operator will record the result on a Transport Canada form required for onward
travel and is valid for up to 72 hours.
 The traveller may proceed with onward travel by air.
 The traveller must continue to follow all local public health measures.
Positive test result (see Schedule E)
 A positive result means COVID-19 (SARS-CoV-2) was potentially detected in the traveller’s swab
sample. Although they may not have any symptoms, they may be infectious and could
potentially spread the virus.
 The traveller CANNOT proceed with onward travel by air.
 The traveller must not repeat the test to try to obtain a negative result.
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 The traveller must wear the medical face mask they were given at the airport and be directed
to a pre-determined isolation space within the airport to safely isolate away from others.
 The local public health authority must be contacted (see Schedule E) for further direction
regarding confirmatory testing, isolation, and further management etc.
 The local public health authority must be consulted for advice regarding the management and
onward air travel of the traveller’s companions and close contacts (potentially including other
travellers on prior flights), as they may also be required to self-isolate at a provincial/territorial
isolation centre or other site designated by public health and undergo further testing. In
addition, the local public health authority must be consulted on proper waste disposal of tests
and PPE (see Waste Disposal & Storage).
 Airport and airline operators may access the 24/7 system from Transport Canada for support.
Invalid test result
 An invalid result means that the test could not detect whether the traveller’s swab sample
contained COVID-19 (SARS-CoV-2).
 The traveller must:

o re-read and confirm understanding of the instructions on the test kit
o repeat the rapid test using a new test kit obtained from the air operator (air operator
to provide additional support or supervision to traveller as needed).
 If the second test is also invalid, the traveller CANNOT proceed with onward travel by air prior
to clarification of additional testing or other requirements confirmed by the local public health
authority. No confirmation of testing travel document can be provided to the traveller.
 The air operator must contact the local public health authority for direction regarding further
testing.
Traveller Agreement
Before leaving an NRI community, unvaccinated travellers should be advised that they will need to
undertake testing at the gateway airport for onward travel or a return flight if they are unvaccinated or
if they do not have a negative molecular COVID-19 test result taken within 72 hours of departure.
Should they undergo testing at the gateway airport and receive a positive result, they will not be able
to travel further and will be required to isolate in the gateway community based on local public health
guidance.
Health Canada recommends that travellers are provided with the necessary information to ensure they
understand the risks and impacts of a positive result as well as how their personal information is stored
and their privacy protected. Travellers should provide their agreement to testing at the gateway
airport prior to departing an NRI airport to travel to the gateway airport, and prior to receiving the test.
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Acquiring Lucira Check It Tests
Health Canada has placed the first order of tests, which will be sent directly to gateway airports.
Volumes were estimated based on current travel numbers and estimated needs. Further shipments
will follow to ensure there is sufficient supply to meet the demand.
Airports should maintain an inventory tracker which should include lot numbers and expiry dates.
Airports should also confirm regularly that the inventory will meet expected need plus a surplus and
inform HC as soon as possible if the inventory is low. Shipping times will vary across Canada but are
expected to be lengthier for remote and/or northern locations.
Airports should reorder for tests from HC by sending number of rapid tests requested, name and
coordinates of the shipping contact person, full delivery address as well as name of gateway airport to:
contact.us.screening.kits.contactez.nous.trousse.depistage@hc-sc.gc.ca.
Receiving tests
Airport operators are required to complete the following once they receive the tests:
 Review the packing slip for the expected quantity and ensure this matches the quantity
received
 Keep the packing slip in a secure file
 Inspect boxes and kits for any major exterior damage
 Record the number of kits received and store by expiry date (note the 6 month expiry on Lucira
Check It)
 Keep shipments together and place kits to be used first on more accessible shelves (e.g., first to
expire)
 Follow the manufacturer’s test specifications for storage conditions (must be stored between
15-30°C / 59-86°F at all times)
Damaged Tests
To report rapid tests that have been damaged in transit, please notify Health Canada
contact.us.screening.kits.contactez.nous.trousse.depistage@hc-sc.gc.ca immediately and provide
photos, along with product details and count, as well as the suspected cause or source of the damage.
Please indicate to HC if you need the damaged tests to be replaced immediately. You may then set
aside the damaged supply and follow HC instructions.
If any issues are detected by or reported to Transport Canada regarding medical devices, including
Testing Devices for COVID-19 distributed by Health Canada Testing Secretariat, please report the issues
to nessregulatory-reglementationrnsu@phac-aspc.gc.ca. A form is included in Schedule D that will
need to be completed and submitted to the email address above.
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Test Storage
Test kits must always be stored at an ambient temperature (15-30°C / 59-86°F).
Reporting Use of Tests
Usage must be reported to Transport Canada Regional Points of Contact on a weekly basis. Transport
Canada will provide additional guidance for airline operators, which will include reporting on number
of tests used as well as negative, positive and invalid results. In addition, airports will be asked to
monitor remaining test resources and report to Transport Canada in this regard.
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Schedule A – Gateway Airports

Province / Territory Airport Airport Code
Yukon Whitehorse CYXY

Northwest Territories Yellowknife CYZF
Nunavut Iqaluit CYFB
Deer Lake CYDF
Gander CYQX
Goose Bay CYYR
Newfoundland and Labrador
St Anthony CYAY
St. John’s CYSJ
Wabush-Labrador CYWK
Nova Scotia Halifax CYHZ
Chibougamau CYMT
La Grande Rivière CYGL
Mont Joli CYYY
Montréal CYUL
Quebec
Québec CYQB
Rouyn-Noranda CYUY
Sept-Îles CYZV
Val d'Or CYVO
Hamilton CYHM
Kingston CYGK
London CYXU
North Bay CYYB
Ontario Ottawa CYOW
Sudbury CYSB
Thunder Bay CYQT
Timmins CYTS
Toronto (Pearson) CYYZ
Brandon CYBR
Manitoba Thompson CYTH
Winnipeg CYWG
Prince Albert CYPA
Saskatchewan Regina CYQR
Saskatoon CYXE
Calgary CYYC
Alberta Edmonton CYEG
Fort McMurray CYMM
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Grande Prairie CYQU

Lethbridge CYQL
Medicine Hat CYXH
Red Deer CYQF
Campbell River CYBL
Comox CYQQ
Dawson Creek CYDQ
Fort St. John CYXJ
Kelowna CYLW
Nanaimo CYCD
Prince George CYXS
British Columbia
Prince Rupert CYPR
Quesnel CYQZ
Smithers CYYD
Terrace CYXT
Vancouver CYVR
Victoria CYYJ
Williams Lake CYWL
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Schedule B – Infographic for Participant Use
Lucira Check It COVID-19 Test Kit

Instructions
Read all instructions before you start.
Test kit contents Before you start
Clean hands Write your name on the test
Do the test on a flat surface. Find a place where you will not be disturbed because the device must
not move during the 30 minutes of the test. Please ask for assistance if you have difficulty with these
instructions. You may find having a mirror helpful.
l Set up your test

Gently
'
Check that Do not open

Open packages Insert two green light Remove Do not the swab until
1and 2 AA batteries turns on the seal push down ready to use
2 Swab nostrils
<S
-v
nostrils
Do not put down Swab tip is fully inside nose. You may feel discomfort
3 Stir swab in vial
All the Throw out

way down the swab
Continued on the next page
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Continued
l
'
4 Run the test
Wait 30 minutes
_
i t
Qt », —
>
<OVI D -19
o
4
Ip P&s ttlve
READi
' NsgiatNe
READY light should Do NOT When finished, Follow airline

-
COVID l?
Q Paail rv» blink within 5 seconds. move the test show your airline staff instructions
O
If not, press down operator the to dispose of the
harder on vial result test kit
Results

O Ready Done Q Request another kit Q Ready Done O You may proceed
COVID -19 and repeat the test COVID-19 with travel.
O Positive O Positive
again. A record of this
O Negative O Negative result will be valid
for 72 hours.
E Positive Result
0 Ready DoneQ COVID-19 was detected. Stay calm, and please ensure you notify
COVID -19 .
airline operators immediately You may not proceed with travel.
O Positive
O Negative
health authorities.
I*I Government
of Canada
Qouvemement
du Canada Canada
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Schedule C – Provincial/territorial Public Health Contact Information
P/T Public Health Contact Information

BC Telephone number: 811
Website: www.bccdc.ca/covid19
AB Telephone number: 811
Website: www.myhealth.alberta.ca
SK The public health point of contact for all SK key gateway airports (Prince Albert,
Regina, and Saskatoon) is 811.
Website: www.saskhealthauthority.ca
SK’s Positive Self-Test Results Guide: https://www.saskatchewan.ca/-
/media/files/coronavirus/testing/t2p-positiveresultsguide.pdf
MB Telephone number: 1 866 626 4862
Website: https://manitoba.ca//covid19/
ON Telephone number: 1 866 797 0000
Website: www.ontario.ca/coronavirus
QC Telephone number: 1 877 6444 4545
Website: www.quebec.ca/en/coronavirus
PEI Telephone number: 811
Website: www.princeeedwardisland.ca/covid19
NL Telephone number: 811 or 1 888 709 2929
Website: www.gov.nl.ca/covid-19
NS Telephone number: 811
Website: www.novascotia.ca/coronavirus
NB Telephone number: 811
Website: www.gnb.ca/publichealth
YT Telephone number: 811
Website: www.Yukon.ca/covid-19
Contact Yukon Communicable Disease Control
Email: ycdcsurveillance@yukon.ca
NT Telephone number: 811
Website: www.gov.nt.ca/covid-19
The local Yellowknife public health number to call is 1-867-445-3192 to report
positive COVID cases. It is not 24/7 so please leave a message.
Email for YK CovidTeam is YK_CovidTeam@gov.nt.ca as a back-up.
NU Telephone number: 1 888 975 8601
Website: www.gov.nu.ca/health
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Schedule D - Form for Issues with Lucira Check It

Issue Notification Form for Medical Devices including Testing Devices for COVID-19 Distributed by the Health
Canada Testing Secretariat or the Public Health Agency of Canada (PHAC)
If any issues are detected with medical devices including Testing Devices for COVID-19 distributed by Health
Canada Testing Secretariat or PHAC, please report the issues to the PHAC at nessregulatory-
reglementationrnsu@phac-aspc.gc.ca
Medical Device, including Personal Protective Equipment
Product Name:
Product Description:
Model Number: Lot/Batch Number:
Manufactured on:
Serial number/UPC/Bar Code: Expiry Date:
Manufacturer of the Product
Manufacturer Name: Address (if known):
Date product was received (yyyy-mm-dd):
Issue
Who identified the issue (e.g. health care professional, logistics, end user etc.)
Date Issue occurred or was noticed (yyyy-mm- Number of products affected:

dd):
Were affected products located in the same Were similarly affected products found in other
lot/batch (Yes or No): lots/batches (Yes or No):
Has the product been further distributed (yes or

no):
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Description of Issue (required):
Do you have any supporting documentation, labels or pictures? (Y/N)
e.g. picture of the damage/defect or of the product label
Please attach supporting documentation, labels or pictures to the email.
Point of Contact
Province/Territory:
Contact Name (first name, last name):
Title:
Email:
Cell Phone (including area code): Work Phone (including area code):
Contact for this issue (if different than above)
First name: Last name:
Email:
Cell Phone (including area code): Work Phone (including area code):
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General Notice
The Public Health Agency of Canada may share any information and material provided in, and
submitted in relation to, this form with, and for the use by, other Government of Canada entities
including departments, agencies and organizations, as well as third parties.
Privacy Notice
The personal information you provide to the Public Health Agency of Canada will be used by the
COVID-19 PPE Strategy Team under the Medical Device Regulations and Food and Drugs Act and
handled in accordance with the Privacy Act.
Why are we collecting your personal information?

We require your personal information to assess the nature of the report and to monitor problems with
medical devices [(such as personal protective equipment (PPE), test kits, etc] that it has distributed.
Personal information may be used to conduct follow-up; to monitor the safety and efficacy of
distributed medical devices and PPE; for compliance and enforcement activities; to request safety and
efficacy information from the manufacturers, health care professionals / practitioners / facilities and
other users of marketed medical devices for the purpose of post-market surveillance of medical
devices, to report to senior management, or to complete a trend analysis.
Will we use or share your personal information for any other reason?
PHAC will share your information with Health Canada and manufacturers of the identified medical
devices when required for the purposes of, for example, following up with Health Canada or
manufacturers when a product safety or quality concern is observed.
What are your rights?

You have the right to access and request a correction and/or notation to your personal information.
You also have a right to complain to the Privacy Commissioner of Canada if you feel your personal
information has been handled improperly. For more information about these rights, or about how we
handle your personal information, please contact Regulatory Affairs and Quality Assurance:
nessregulatory-reglementationrnsu@phac-aspc.gc.ca.
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Schedule E: Positive Case management
Annex to follow
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Annex B: Health Canada user guidance on Lucira Check It COVID-19 testing kits
Lucira Check It COVID-19 Test Kit

Instructions
Read all instructions before you start.
Test kit contents Before you start
£ Clean hands Write your name on the test
Do the test on a flat surface. Find a place where you will not be disturbed because the device must
not move during the 30 minutes of the test. Please ask for assistance if you have difficulty with these
instructions. You may find having a mirror helpful.
l Set up your test

Gently
(T]gEp|
Check that Do not open
Open packages Insert two green light Remove Do not the swab until
1and 2 AA batteries turns on the seal push down ready to use
2 Swab nostrils
Do not put down Swab tip is fully inside nose. You may feel discomfort
3 Stir swab in vial
All the Throw out

way down the swab
Continued on the next page
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Continued
l
'
4 Run the test
Wait 30 minutes
_
i t
Qt », —
>
<OVI D -19
o
4
Ip P&s ttlve
READi
' NsgiatNe
READY light should Do NOT When finished, Follow airline

-
COVID l?
Q Paail rv» blink within 5 seconds. move the test show your airline staff instructions
O
If not, press down operator the to dispose of the
harder on vial result test kit
Results

O Ready Done Q Request another kit Q Ready Done O You may proceed
COVID -19 and repeat the test COVID-19 with travel.
O Positive O Positive
again. A record of this
O Negative O Negative result will be valid
for 72 hours.
E Positive Result
0 Ready DoneQ COVID-19 was detected. Stay calm, and please ensure you notify
COVID -19 .
airline operators immediately You may not proceed with travel.
O Positive
O Negative
health authorities.
I*I Government
of Canada
Qouvemement
du Canada Canada
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Annex C: Federal Vaccine Mandate – Passenger Self-Test – Negative Result

<<Insert Air Carrier Logo and Address here>>
Section 1: Traveller Details
Full name Date of birth
Section 2: Test information
Test Type Lucira Check It COVID-19 Molecular Test Kit

Test Result NEGATIVE
Date test administered (DD/MM/YY)
Time test administered (HH:MM)
Section 3: Privacy and Information Sharing
The personal information in this form may be provided to Transport Canada for the purpose of audit
and enforcement. The Minister of Transport may collect this personal information pursuant to the
Aeronautics Act. In the event that any personal information is provided to Transport Canada, it will only
be used and disclosed by Transport Canada in accordance with the Privacy Act. The personal
information collected is described in the relevant personal information bank. Under the provisions of the
Privacy Act, individuals have the right of access to correction of and protection of their personal
information. Instructions for obtaining personal information are provided in Info Source, a copy of which
is available in major public and academic libraries or online at http://infosource.gc.ca.
IMPORTANT NOTICE:
A person who provides information to an air carrier that is known to be false or misleading may be
subject to an administrative monetary penalty or other enforcement action, including prosecution under
the Criminal Code.
During travel, each traveller must carry with them the necessary proof to demonstrate, upon
request, compliance with the Interim Order or its exemptions.
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Annex D: List of public health contacts at gateway airports
Government of Canada:
 1-833-784-4397 or visit www.canada.ca/coronavirus.
Provincial and territorial:
Alberta: British Columbia: 811 Manitoba:

811 1-888-315-9257
New Brunswick: 811 Newfoundland and Labrador: Northwest Territories:
811 or 1-888-709-2929 811
Nova Scotia: Nunavut: Ontario:
811 1-888-975-8601 1-866-797-0000
Prince Edward Island: Quebec: Saskatchewan:
811 1-877-644-4545 811
Yukon:
811
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Annex E: Federal Vaccine Mandate – Passenger Self-Test – No Test Available

<<Insert Air Carrier Logo and Address here>>
Section 1: Passenger Details
Full name Date of birth
Section 2: Air Operator Confirmation
I hereby confirm that the passenger named above should have been given a Lucira Check It COVID-19
molecular test but that none are currently available at the aerodrome OR that the passenger named
above is between 12 and 4 months and 14 years of age.
Full name
Signature
Date
(DD/MM/YY)
Aerodrome
The personal information in this form may be provided to Transport Canada for the purpose of audit
and enforcement. The Minister of Transport may collect this personal information pursuant to the
Aeronautics Act. In the event that any personal information is provided to Transport Canada, it will only
be used and disclosed by Transport Canada in accordance with the Privacy Act. The personal
information collected is described in the relevant personal information bank. Under the provisions of the
Privacy Act, individuals have the right of access to correction of and protection of their personal
is available in major public and academic libraries or online at http://infosource.gc.ca.
IMPORTANT NOTICE:
A person who provides information that is known to be false or misleading may be subject to an
administrative monetary penalty or other enforcement action, including prosecution under the Criminal
Code. During travel, each traveller must carry with them the necessary proof to demonstrate,
upon request, compliance with the Interim Order or its exemptions.
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GUIDANCE MATERIAL FOR AIR OPERATORS

Guidance for Air Operators in managing travellers departing
from a Canadian aerodrome
This guidance material is intended to provide recommendations and guidance on the operationalization of Transport
Canada’s Interim Order, Interim Order Respecting Certain Requirements for Civil Aviation due to COVID-19.

this legal document and provide recommendations and guidance on how to
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Contents
Section 1 – General ....................................................................................................................................3
Section 2 – Summary Operational Models – Phase 1 ..................................................................4
Section 3 - Obligations of Air Operators...........................................................................................6
Section 4 - Exceptions/Accommodations to the Federal Vaccination Mandate ..........10
Section 5 - Air Operator assistance .................................................................................................13
Annex A – List of Specified Airports in Canada ....................................................................................................14

Annex B – Sample Email to Travellers .................................................................................................................17
Annex C – Sample Confirmation Template ..........................................................................................................18

Annex D – Sample Letter to Traveller..................................................................................................................21
Annex E – Template Letter for Foreign Crew .......................................................................................................22

Annex F – Sample ArriveCAN Receipt..................................................................................................................23
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Section 1 – General
Purpose
The purpose of this guidance document is to outline the requirements under the Transport Canada Interim
Order related to Phase 1 of the federal vaccination mandate as it pertains to the management of air travellers.
These provisions are expected to come into force on October 30 at 03:01 EDT. Advice, guidance, and sample
templates are included to support air operators in the implementation of this part of the federal vaccination
mandate as applicable. The information in this document concerns travellers departing a Canadian airport
(domestic, transborder or international flight). The requirements for inbound international travellers under the
Transport Canada Interim Order are not expected to change; note that entry eligibility, pre-departure testing,
digital submission, and other border conditions must continue in accordance with Public Health Agency of
Canada’s Orders in Council.
This document complements the other guidance material that has been prepared to accompany the COVID-19
response measures. These are available here: COVID-19 measures, updates, and guidance for aviation issued by
Transport Canada.
With respect to Phase 2 (expected to come into force beginning on November 30, 2021), further guidance will
be provided shortly.
What is the Federal Vaccination Mandate?

The pandemic has had a devastating impact on Canada’s transportation sector, public health measures have
been critical to combatting the spread of the virus. However, additional measures are needed to ensure the
safety and security of Canada’s transportation system and facilitate the resumption of safe air travel. A
requirement for travellers and crew to be vaccinated in federally regulated air, rail, and marine sectors enhances
the safety of the Canadian aviation system, and builds Canadians’ confidence to resume travel, while still
adhering to public health measures.
Application: Which travellers fall under the Federal Vaccination Mandate?
The Federal Vaccine mandate applies to all of the following travellers:

 All travellers 12 years and 4 months of age and older*, boarding any flight from a specified airport
(Annex A) in Canada;
AND
 All travellers flying on a commercial passenger aircraft (CAR Subparts 701 (outbound), 703, 704 and 705)
operated as per the above, including both scheduled and charter flights.
*Note: A 4 month grace period is allowed under the Interim Order in order to ensure that children
turning 12 years of age have adequate time to become fully vaccinated. Travellers that are younger than
12 years and 4 months old do not fall within the regulatory scope of the Interim Order and should not to
be denied boarding if not fully vaccinated.
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Non-applicability: Passengers on board military flights, medevac flights, those on private aircraft (Canadian
Aviation Regulations – or CAR - subpart 604), or an aerial work flight operated under CAR 702 do not fall within
the regulatory scope of the traveller provisions. Additionally, this does not apply to passengers coming inbound
to Canada from an international last point of departure and travelling onward to another international location.
Finally this would not apply in the cases where an aircraft is diverted (for example due to adverse weather,
mechanical issues, or others) to a specified airport. However, effective November 15, 2021, operators should
note that Transport Canada will be prohibiting anyone from entering the restricted area of a specified airport
(Annex A) unless they are fully vaccinated, or meet the exception criteria laid out in Section 4.
Section 2 – Summary Operational Models – Phase 1

The following provides a summary of the different operational approaches that can be considered by air
operations in the implementation of the Federal Vaccination Mandate requirements as it pertains to travellers.
The following models outline, at a high level, various approaches that can be implemented to meet the
requirements, specifically as they relate to the verification requirement of proof documentation. It should be
noted that additional details related to the verification of proof documents is available in the
SUPPLEMENTARY BULLETIN - INTERIM ORDER RESPECTING CERTAIN REQUIREMENTS FOR CIVIL
AVIATION DUE TO COVID-19.
Air Passenger Flow - Model #1

October 31 to November 29
• Air Carrier notifies Passenger about requirements
• Traveller confirms* that they are:
• Eligible to travel (fully vaccinated; valid COVID-19 molecular test; or meets specified
BEFORE exemption)
• Prepared, with supporting documents, to demonstrate their eligibility during travel
TRAVEL
• CATSA officer: verifies** that travellers have documents proving eligibility by checking required
data elements
• Traveller without proof of vaccination, test or meeting an exemption, barred from entering to
AT CATSA catch their flight and referred to air carrier for any further action.
SCREENING CATSA reports possible fraudulent documents to TC for enforcement action
CHECKPOINT
• Air Carrier verifies** that travellers (aged 12 year +4 months) have documents proving
eligibility, checking required date elements
• Verification location: can be in advance of travel, at the check-in counter or at the boarding gate
• Air Carrier denies_boarding to anyone without valid proof, no re-booking for 72 hours
PRIOR TO OR AT
• Air Carrier reports possible fraudulent documents to TC for enforcement action
BOARDING GATE • Traveller fined for false declarations
* See Traveller Confirmation template (Annex C)

* " Verification pursuant to TC Aviation Operational Bulletin - SUPPLEMENTARY BULLETIN INTERIM ORDER RESPECTING
CERTAIN REQUIREMENTS FOR CIVIL AVIATION DUE TO COVID-19.
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Air Passenger Flow - Model # 2

Advanced notification, but no CATSA Screening
• Air Carrier notifies Passenger about requirements

• Traveller confirms that they are:
• Eligible to travel (fully vaccinated; valid COVID-19 molecular test; or meets specified
exemption)
BEFORETRAVE • Prepared, with supporting documents to demonstrate their eligibility during travel.
Air Carrier verifies” that travellers have documents proving eligibility by checking required
•
data elements
• Verification location: can be in advance of travel, at the check-in counter or boarding gate
• Air Carrier denies_ boarding to anyone without valid proof, no re-booking for 72 hours
PRIOR TO OR AT • Air Carrier reports possible fraudulent documents to TC for enforcement action
BOARDING GATE • Traveller fined for false declarations
* See Traveller Confirmation template ( Annex C)

•‘Verification pursuant to TC Aviation Operational Bulletin - SUPPLEMENTARY BULLETIN - INTERIM ORDER RESPECTING
Air Passenger Flow - Model # 3

No advanced confirmation
Air Carrier notifies traveller verbally* about requirements on the day of travel
•
Traveller confirms at the time of travel that they have supporting documents, to
•
demonstrate their eligibility during travel .
PRIOR TO OR AT • Air Carrier verifies** for all travellers aged 12 year +4 months proving eligibility by checking
required data elements
BOARDING GATE • Air Carrier denies.boarding to anyone without valid proof, no re-booking for 72 hours
• Air Carrier reports possible fraudulent documents to TC for enforcement action
• Travellers fined for false declarations
•This model is intended generally for smaller operators, and for airports at which CATSA is not present.
• * Verification pursuant to TC Aviation Operational Bulletin - SUPPLEMENTARY BULLETIN INTERIM ORDER RESPECTING
-
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Section 3 - Obligations of Air Operators

Transport Canada is taking a performance-based approach to attain the ultimate objectives of the Federal
Vaccination Mandate for air travellers. This will allow air operators – of all sizes - to decide how best to
operationalize and achieve the requirements of the mandate, in accordance with their business model.
Summary of Air Operator Obligations in Phase 1 of the Federal Vaccination Mandate pertaining to
travellers:
1) Notify travellers of the vaccination mandate requirements and what it means for them;
2) Implement a process for travellers to confirm their eligibility to board a flight from a specified
airport;
3) Implement a process to verify eligibility documents consistent with Operational Bulletin -
SUPPLEMENTARY BULLETIN - INTERIM ORDER RESPECTING CERTAIN REQUIREMENTS FOR
CIVIL AVIATION DUE TO COVID-19. Operators will be required to provide details of their
notification, confirmation and verification procedure to Transport Canada upon request;
4) Deny boarding to travellers who refuse to confirm eligibility or that do not provide documentation to
support that eligibility;
5) Where relevant, establish a process to manage any traveller that CATSA has re-directed back to the
air operator should the traveller fail to provide proof of eligibility at the screening check point and is
denied entry into the restricted area; and
6) Notify Transport Canada if they believe a traveller is providing false information/documentation
within 72 hours;
7) Maintain records of any denials of boarding and provide the information to Transport Canada within
72 hours.
The following outlines the requirements for PHASE 1 that must be in place by October 30, 2021 pertaining to
the management of outbound travellers from a Canadian aerodrome on the specified list in Annex A.
 Notification Requirement: Air Operators are required to notify affected travellers departing a Canadian
aerodrome on the list in Annex A that they:
(1) are not allowed to board an aircraft unless they confirm the following:
 they are fully vaccinated; or
 they have a valid COVID-19 molecular test result; or
 they meet an exception.
(2) must have and carry with them proof of their eligibility, to be provided to the air operator,
CATSA or Transport Canada upon request; and
(3) may be liable to a monetary penalty if they knowingly provide false or misleading
information.
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Please refer to Annex B, which provides a sample of a notification email that can be sent to travellers to
inform them of the vaccination mandate.
 Confirmation Process: Air operators are required to implement a traveller confirmation process which
would enable all travellers to confirm :
(1) that they have been fully vaccinated per Canada’s standard; OR
(2) that they have a valid COVID-19 molecular test result; OR
(3) that they meet a limited exception.
Please see Annex C for a sample confirmation template that air operators can use to meet this
requirement.
This confirmation process can be done in any manner that the air operator chooses, as long as the
requirements noted in the Operational Bulletin - SUPPLEMENTARY BULLETIN - INTERIM ORDER
RESPECTING CERTAIN REQUIREMENTS FOR CIVIL AVIATION DUE TO COVID-19 are met. The
various models were also proposed in Section 2. However, Transport Canada strongly recommends that
this confirmation be done digitally, well in advance of the traveller physically entering any of the
specified airports. This will ensure a smoother travel journey and less logistical issues for the air
operator (e.g. rebooking flights, baggage reconciliation, etc.). If this is not feasible, air operators can do
the confirmation process verbally at the boarding gate. In all cases, whether done digitally or verbally at
the gate, every passenger must make the confirmation (that they are fully vaccinated, OR have a valid
COVID-19 molecular test result OR meet an exception).
Retention requirements: There is currently no regulatory requirement for retention of documented

evidence of the passenger confirmation (e.g., retention of digital or paper template for each traveller).
However, it will be up to each air operator to be able to demonstrate their confirmation process is being
managed to account for all affected travellers. Where information is retained, it must be done so
according to The Personal Information Protection and Electronic Documents Act (PIPEDA).
 Verification of Proof Documents: Air operators are required to develop and implement a random
verification process to verify the proof that the traveller:
(1) has been fully vaccinated per Canada’s standard; OR
(2) has a valid COVID-19 molecular test result; OR
(3) meets a limited exception.
The proportion of traveller eligibility documents that operators must verify will vary in accordance with
the selected operation model. In addition, operators should note that the percentage of random
verification will be set according to the Operational Bulletin - SUPPLEMENTARY BULLETIN - INTERIM
ORDER RESPECTING CERTAIN REQUIREMENTS FOR CIVIL AVIATION DUE TO COVID-19.
Air operators should note that over the course of Phase 1, the percentage of random verification will be
rapidly increased. Air operators need to work rapidly towards automated verification ahead of the
traveller journey where possible, leveraging the secure pan-Canadian, standardized proof of vaccination
that will be available in all provinces and territories shortly. CATSA random verification is being
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implemented as an interim measure only, and operators will be required to incorporate this into their
operating models.
Verification - Elements for the proof of vaccination
Types of acceptable proof of vaccination include:
 Paper;
 Digital; and
 For travellers connecting from an international to domestic flight, an ArriveCAN receipt with
immunization status denoted or their boarding pass (see Section 5).
Air Operators are required to verify the following elements, for all travellers 12 years and 4 months of
age and older:
 Full name (family name and given names) of the person who received the vaccine;
 The name of the government / non-government entity who issued the proof document;
 The type and manufacturer of the vaccine. It must be one of the following, or an acceptable
combination of:
o Pfizer-BioNTech Comirnaty (tozinameran, BNT162b2) – 2 doses
o Moderna Spikevax (mRNA-1273) – 2 doses
o AstraZeneca Vaxzevria/COVISHIELD (ChAdOx1-S, AZD – 2 doses
o Janssen/Johnson & Johnson (Ad26.COV2.S) – 1 dose
 The date the traveller received their last dose. This date must be at least 14 full days prior to
their date of travel. For example, if the last dose was administered on Thursday July 1, then
Friday July 16 would be the first day that the traveller would meet the 14 day condition)
Example:
Eligible to Fly
Received full
dose of
vaccine
s
•
14 FULL davs have passed ( Julv 2 - 15 inclusive )

July
12 3 4 5 6 7 8 9 10 11 12 13 14 15 16
Note: the proof of vaccination must have been issued in English or French or a certified translation is
required if it was issued in a language other than English or French.
Federal Proof of Identification and Provincial Proof of Vaccination

There may be circumstances in which the name on the proof of identification does not match the name
on the provincial or territorial proof of vaccination. For example, in the Province of Quebec a female’s
name at birth may appear on the proof of vaccination, while their married name may appear on a
federal identification document such as a passport. Other examples includes those from remote or
Indigenous communities where formal identification can be more challenging to obtain. Please note that
the air operator, in these cases, has flexibility to accept a proof of vaccination that does not perfectly
match a traveller’s identification documents, so long as the traveller is able to establish their vaccination
credential through other means (e.g., health card or letter from Indigenous community leader).
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Verification Elements for the COVID-19 molecular test (in lieu of proof of vaccination)
A COVID-19 molecular test is defined within Transport Canada’s Interim Order as a COVID-19 screening
or diagnostic test carried out by an accredited laboratory, including a test carried out by the method of
polymerase chain reaction (PCR) or reverse transcription loop-mediated isothermal amplification (RT-
LAMP). For a list of tests that are considered molecular tests, please consult the “Accepted Types of
Tests” section that can be found on the following webpage: https://travel.gc.ca/travel-covid/travel-
restrictions/flying/covid-19-testing-travellers-coming-into-canada.
Air operators would need to verify that the following elements are included in the COVID-19 molecular
test result for unvaccinated travellers age 12 (and 4 months) and older:
 If the test result is negative, it must be dated within 72 hours of the traveller’s
scheduled departure time at a specified Canadian aerodrome;
 If the test result is positive, it must be dated at least 14 days before but not more than
180 days prior to the traveller’s scheduled departure at a specified Canadian aerodrome
(e.g., the traveller would be eligible to travel on day 15 after their test was
administered, since 14 days have passed). This accounts for those that had contracted
COVID-19, have recovered, but may still be testing positive due to lingering amounts of
the virus in their system.
Reporting to Transport Canada: False or Misleading Information

If the air operator suspects that the traveller has provided false or misleading information as it relates to
either the proof of vaccination document or the COVID-19 molecular test result, the operator is to notify
Transport Canada within 72 hours. The following information is to be included:
 the person’s name
 contact information (home address, telephone number, email address)
 date and flight number
 description of the potential non-compliance issue
 Providing proof of Eligibility Process to Transport Canada – Air operators must select an operational
verification model in accordance with Operational Bulletin - SUPPLEMENTARY BULLETIN - INTERIM
ORDER RESPECTING CERTAIN REQUIREMENTS FOR CIVIL AVIATION DUE TO COVID-19. Upon
request, operators will be required to indicate the model selected and demonstrate how their process is
meeting the minimum threshold for verifying travellers’ proof of eligibility documents.
 Liaise with CATSA – Air operators must establish a process for CATSA to be able to re-direct travellers
back to the air operator should they fail to meet the requirements at the screening check point and are
denied access to the restricted area of an airport.
 Denial of Boarding – Air operators are required to deny boarding to any traveller who:
(1) refuses to confirm that they are fully vaccinated, have a valid COVID-19 molecular test result or
that they meet an exception; or
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(2) who fails to provide their proof of vaccination, evidence of a valid COVID-19 molecular test
result, or proof that they meet an exception, when requested.
Notification of 72 hour window: Should a traveller be denied boarding due to failure to comply to a
requirement under the Interim Order pertaining to the Federal Vaccination Mandate, the air operator is
to inform the traveller that they are not able to board another flight from any of the specified Canadian
aerodromes for 72 hours, and that Transport Canada will be notified. Please see Annex D for a sample
letter that can be issued to the traveller to make this notification.
Air operators must also keep a record of any denials of boarding due to lack of proof of vaccination or
valid COVID-19 molecular test result. Records are to be sent to Transport Canada within 72 hours
following the incident. The air operator must keep these records for at least 12 months.
The records must include:

 Person’s name;
 Date of Birth;
 Contact Information (home address, telephone number and email address);
 Date and flight number; and
 Circumstances related to the refusal to comply.
Section 4 - Exceptions/Accommodations to the Federal

Vaccination Mandate
During Phase 1 (October 30, 2021 to November 29, 2021), there are a few limited exceptions to the requirement
for a traveller to be either fully vaccinated or have a valid COVID-19 molecular test. These exceptions are noted
directly with the Interim Order:
1) Foreign Flight Crew: during phase 1 (from October 30, 2021 to November 29, 2021), foreign flight crew
are exempt from having to be fully vaccinated, when deadheading or repositioning on a different airline.
Additionally, if foreign flight crew are travelling to take mandatory training they are also part of this
exception. To be considered for this exception foreign crew must show their airline ID, be in uniform,
or have documentation from their employer (i.e. air operator) confirming that they are in fact foreign
flight crew or travelling to become crew. Please see Annex E or a letter that can be used to identify
foreign crew members in these specific cases.
2) International to Domestic Travel: In some cases, travellers who arrive in Canada from an international
or transborder last point of departure may have pre-departure tests that have expired or may not have
proof of vaccination based on the Public Health Agency of Canada entry requirements, as outlined in the
Orders in Council. For these travellers, both vaccinated and unvaccinated, if their itinerary can
demonstrate continuous travel (same 24 hour period as their international inbound flight), they will be
allowed to use: (1) their boarding pass (from their inbound journey); or (2) their ArriveCAN receipt as an
alternative form of proof on the domestic leg of their journey in lieu of proof of vaccination or a COVID-
19 molecular test result that meets the required criteria.
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Proof documents that can be used:

1) ArriveCAN receipt: For those travellers with an ArriveCAN receipt, air operators can verify
that the traveller has a receipt as their proof since their vaccination status is indicated on
the receipt. Additionally, they will have already shown their valid COVID-19 molecular test
result in order to fly to Canada, as well as on arrival, and undergone testing upon arrival as
determined by Border Officials. See Annex F for sample ArriveCAN receipts.
OR
2) Boarding Pass: Air operators can verify that the traveller’s boarding pass indicates that the
last leg of their flight inbound to Canada is within 24 hours of their scheduled departure
time of their domestic flight.
For example: a traveller flying from London, England at 06:00 arriving in Toronto at 12:00,
and then connecting to a flight from Toronto to Ottawa at 17:00, would be allowed onward
travel and would simply need to show their boarding pass as proof since their inbound flight
was at 06:00, and their connecting domestic flight is at 17:00 (within 24 hours).
In addition to the exceptions noted within the Interim Order, Transport Canada is also issuing the following
exemptions (e.g., outside of the Interim Order). Please note that official details are available in each specific
exemption document that is available in Transport Canada’s Secure Supply Chain Information Management
System (SSCIMS). Should you require access to SSCIMS, please contact the Aviation Security inbox:
TC.AviationSecurity-Sureteaerienne.TC@tc.gc.ca.
1. Inmates / Deportations / Extraditions – In the case where an inmate or person subject to an

extradition or deportation order needs to board a flight at a specified airport (see Annex A for the list of
specified airports), they could be exempted from the requirement to be fully vaccinated or to present a
COVID-19 molecular test result as a last resort, after they refused to confirm that they are fully
vaccinated or have done a molecular COVID-19 test. They must follow all other COVID-19 measures that
are in place such as: must be asymptomatic; wearing a facemask, and confirming that they: do not have
or suspect they have COVID-19; have not been denied boarding in the past 14 days for a medical reason
related to COVID-19; and are not currently supposed to be quarantining based on the direction of local
or provincial health orders. If they refuse to provide the confirmation themselves, their escort will
provide the information to the air operator that they are an inmate/subject to an extradition or
deportation order, have refused vaccination and/or a COVID-19 molecular test result, and confirmed to
the air operator what they are refusing to confirm to be allowed on board. For specific details please
refer to Aviation Security exemption No. C2021-125 - Boarding of persons in Canadian Correctional
Service, Canadian Border Services or Law Enforcement Agency/ police force custody, including
inmates and those subject to an extradition or deportation order, who have not been vaccinated and
who refuse to submit to molecular COVID-19.
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2. Other exemptions – the following cohorts of travellers are considered exempt from the requirement to
be fully vaccinated or provide a COVID-19 molecular test result, due to the contextual circumstances.
These include:
 Child custody arrangements - where children are travelling and are unvaccinated, without a
COVID-19 test result, per the arrangement set out in a custody agreement.
 Medical emergencies for remote communities – in the event of a life threatening situation, a
traveller from a remote community will be exempt from the requirement to be fully vaccinated
or to provide a pre-departure COVID-19 test result. A medical document outlining the situation
will be required from a licensed medical practitioner.
 Exemption for 14 day directed quarantine – in the instance where a traveller must adhere to a
14 day quarantine prior to entering a specific province or territory (e.g., Nunavut), they are
exempt from the requirement to be fully vaccinated or having to present a COVID-19 molecular
test result since they will have quarantined for a sufficient period of time to significantly reduce
the possibility of exposing others to COVID-19.
 Exemption when passengers do not disembark the aircraft (for remote communities) – if
travellers from a remote community are on a flight that makes stops at specified airports, but
the travellers do not disembark from the plane, they are not required to show proof of
vaccination or have a valid COVID-19 molecular test result to board their flight.
For more details, please see Aviation Security Exemption C2021-128 - Specific cohorts of individuals
who have not been vaccinated and who do not have a COVID-19 molecular test result
3. Remote Communities (self – administered testing procedure) – During Phase 1 (October 30, 2021 to
November 29, 2021), an exemption will be provided to those travelling to and from remote
communities that are unvaccinated and not able to present a valid COVID-19 molecular test result in
order to obtain essential services, obtain medical care, or for social welfare reasons. These travellers will
be authorized to take a rapid self-administered COVID-19 molecular test at the airport, prior to any
onward domestic travel, or when they are returning to their remote community. The air operators will
be required to attest that they have seen the negative COVID-19 molecular test result and they will
provide the traveller with a document that indicates the test result will be valid for 72 hours. If the test
result is positive, they are to be denied boarding. For more details, please see Aviation Security
Exemption C2021-129 – Individuals from a remote community in Canada who have not been
vaccinated and who do not have a COVID-19 molecular test result when boarding a flight operated
within Canada – When using COVID-19 rapid self-administered molecular tests and the Guidance for
Industry regarding COVID-19 self-test kits for passengers travelling to and from remote locations, that is
available on SSCIMS.
4. Remote Communities (lack of availability of test kits) – in the instance where a traveller is travelling to
or from a remote community, and is not fully vaccinated or in possession of a COVID-19 molecular test
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result, and no rapid test kits are available at the airport, they are exempt and can continue their journey.
For more details, please see Aviation Security Exemption C2021 – 131 Individuals from a remote
community in Canada who have not been vaccinated and who do not have a COVID-19 molecular test
result when boarding a flight operated within Canada – When no COVID-19 rapid self-administered
molecular tests are available and the Guidance for Industry regarding COVID-19 self-test kits for
passengers travelling to and from remote locations, that is available on SSCIMS.
5. Data Elements for Proof of Vaccination – for the first 14 days following the implementation of the
Interim Order No. 43, an exemption will be in place to allow air operators to board travellers if they
show proof of vaccination from their respective province or territory (or designated entity who issued
the proof of vaccination), even if their proof of vaccination does not contain all of the necessary data
elements as required by the Interim Order (i.e. name, issuing body, type of vaccine, and date the final
dose of the regimen was administered). This is to allow for travellers adjusting to the new vaccination
mandate and for a transition period as provinces and territories make the new Canadian proof of
vaccination available. In the event that traveller presents a proof of vaccination, but without all the
required data elements, the air operator is not required to deny boarding of the individual on any flight
leaving Canada for the 72-hour period. The air operators will be required to record these instances and
provide this information to Transport Canada, as per the specifications in the exemption document. For
more details, please refer to Aviation Security Exemption C2021-130 - Individuals with a Proof of
Vaccination that does not have all of the necessary data elements.
Section 5 - Air Operator assistance

There following are different ways to seek assistance from Transport Canada as the requirements under the
federal vaccination mandate are being operationalized.
Circumstance Contact Information
General air operator questions Aviation Security inbox: TC.AviationSecurity-Sureteaerienne.TC@tc.gc.ca

(non-urgent)
Urgent issue happening on the Contact the Transport Canada Situation Centre:
ground and your Air Operator’s
1-888-857-4003
HQ/Support Center doesn't have an
answer
Where to direct your travellers for Service Canada: 1-800-O-CANADA (1-800-622-6232)

information or to ask questions
This link can also be provided to direct travellers to Service Canada:
https://www.canada.ca/en/contact/contact-1-800-o-canada.html
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Annex A – List of Specified Airports in Canada

List of Specified Airports
# Airport Name ICAO
1 Abbotsford CYXX
2 Alma CYTF
3 Bagotville CYBG
4 Baie-Comeau CYBC
5 Bathurst CZBF
6 Brandon CYBR
7 Calgary International CYYC
8 Campbell River CYBL
9 Castlegar CYCG
10 Charlo CYCL
11 Charlottetown CYYG
12 Chibougamau / Chapis CYMT
13 Chruchill Falls CZUM
14 Comox CYQQ
15 Cranbrook CYXC
16 Dawson Creek CYDQ
17 Deer Lake CYDF
18 Edmonton International CYEG
19 Fort McMurray CYMM
20 Fort St. John CYXJ
21 Fredericton International CYFC
22 Gander International CYQX
23 Gaspé CYGP
24 Goose Bay CYYR
25 Grand Prairie CYQU
26 Greater Moncton International CYQM
27 Halifax (Robert L. Stanfield International) CYHZ
28 Hamilton CYHM
29 Iles-de-la-Madeleine CYGR
30 Iqaluit CYFB
31 Kamloops CYKA
32 Kelowna CYLW
33 Kingston CYGK
34 Kitchener / Waterloo Regional CYKF
35 La Grande Rivière CYGL
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36 Lethbridge CYQL
37 Lloydminster CYLL
38 London CYXU
39 Lourdes-de-Blanc-Sablon CYBX
40 Medicine Hat CYXH
41 Mont-Joli CYYY
42 Montreal-Pierre Elliott Trudeau International Airport CYUL
43 Nanaimo CYCD
44 North Bay CYYB
45 Ottawa (Macdonald-Cartier International) CYOW
46 Penticton CYYF
47 Prince Albert CYPA
48 Prince George CYXS
49 Prince Rupert CYPR
50 Québec International (Jean Lesage International) CYQB
51 Quesnel CYQZ
52 Red Deer Regional CYQF
53 Regina CYQR
54 Rivière-Rouge (Mont-Tremblant International) CYFJ
55 Rouyn-Noranda CYUY
56 Saint John CYSJ
57 Sarnia (Chris Hadfield) CYZR
58 Saskatoon (John G. Diefenbaker International) CYXE
59 Sault Ste. Marie CYAM
60 Sept-Îles CYZV
61 Smithers CYYD
62 St. Anthony CYAY
63 St. John’s International CYYT
64 Stephenville CYJT
65 Sudbury CYSB
66 Sydney CYQY
67 Terrace CYXT
68 Thompson CYTH
69 Thunder Bay CYQT
70 Timmins CYTS
71 Toronto (City Centre) CYTZ
72 Toronto (Lester B/ Pearson International) CYYZ
73 Toronto/Buttonville Municipal CYKZ
74 Val-d’Or CYVO
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75 Vancouver International CYVR

76 Victoria International CYYJ
77 Wabush CYWK
78 Whitehorse International CYXY
79 Williams Lake CYWL
80 Windsor CYQG
81 Winnipeg (James Armstrong Richardson International) CYWG
82 Yellowknife CYZF
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Annex B – Sample Email to Travellers
Subject: Federal Vaccine Mandate – all travellers must be vaccinated to board a plane at Canadian airports
Hello,
Thank you for booking your flight with [insert name of air operator].
As announced by the Government of Canada, as of October 30, 2021 all travellers 12 years and 4 months of age
and older that are departing a Canadian Airport, for travel within Canada or abroad, must be fully vaccinated in
order to enter the restricted area of an airport and subsequently to board their flight, with limited exceptions.
To be considered fully vaccinated, you must have been vaccinated with one of the Public Health Agency of
Canada’s approved vaccine regimens. Please refer to the following link: COVID-19 Vaccines: Authorized
vaccines - Canada.ca for more information.
Proof of vaccination will be required during your travel journey, so be sure to have your documentation readily
available. The documentation can be digital or in a paper form; however, you are encouraged to have a paper
copy as a back-up to your digital proof. If you do not have proof of vaccination you risk being denied boarding.
Please note that for the brief transition period, between October 30, 2021 and November 29, 2021, travellers
are permitted to provide proof of a valid COVID-19 molecular test result in lieu of proof of vaccination.
In all cases, travellers must either confirm that they are either a) fully vaccinated; b) have a valid COVID-19
molecular test result; or c) meet a limited exception.
Travellers who knowingly provide false or misleading information may be subject to a monetary penalty.
[Note: air operators to determine how they will ask travellers to confirm they are eligible to travel, in
accordance with the models set out in Operational Bulletin - SUPPLEMENTARY BULLETIN - INTERIM ORDER
RESPECTING CERTAIN REQUIREMENTS FOR CIVIL AVIATION DUE TO COVID-19]
Please visit the travel.gc.ca website for more details.
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Annex C – Sample Confirmation Template

<<Insert Company Logo here>> PROTECTED A (when complete)
<<Insert Air Carrier Address here>>

Federal Vaccine Mandate – Passenger Confirmation Template
Under Transport Canada requirements, travellers must confirm their eligibility to board a flight from a
specified airport in Canada (Interim Order Respecting Certain Requirements for Civil Aviation Due to
COVID-19). Travellers must have the appropriate documents to prove this eligibility prior to
entering the secure area of the airport and/or boarding a flight.
Section 1: Routing/Traveller Details
Flight number Date of departure
Complete the table below with the names of all travelers, aged 12 (+ 4 months) and older, travelling
under the same reservation and flight number:
Name of Traveller: Name of Traveller:
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Your privacy is important to us. Please note that [name of air carrier/company name] will handle your
personal information in accordance with applicable privacy legislation. The personal information in this
form may be provided to and used by Transport Canada for the purpose of audit and enforcement. The
Minister of Transport may collect this personal information pursuant to the Aeronautics Act and the
Interim Order Respecting Certain Requirements for Civil Aviation Due to COVID-19. In the event that
any personal information is provided to Transport Canada, it will only be used and disclosed by
Transport Canada in accordance with the Privacy Act. The personal information collected, as well as its
use, disclosure and retention is described in the personal information bank entitled TC PPU 015 and
other applicable personal information banks which are published on Transport Canada’s Info Source
page. Given that the applicable Personal Information Banks are currently being modified and/or
developed, please visit the following website for more information: [X]. Under the provisions of the
Privacy Act, individuals have the right of access to, correction of and protection of their personal
is available in major public and academic libraries or online at http://infosource.gc.ca. Individuals who
wish to exercise their right to complaint under the Privacy Act about the handling of their personal
information may do so by filing a complaint with the Office of the Privacy Commissioner. For more
detailed information on how [name of air carrier/company name] processes your personal information,
please visit [name of air carrier/company name’s] privacy policy at [link to air carrier/company name’s
privacy policy].
Section 3: Confirmation and Acknowledgement by a Traveller 16 years of age and older.
I, , hereby confirm the information contained in Section 1
is accurate, and acknowledge that:
(1) The traveller(s) listed in Section 1 are fully vaccinated in accordance with the Interim Order; and will
carry valid proof or
(2) The traveller(s) listed in Section 1 have evidence of valid1 COVID-19 molecular test results prior to
their initial scheduled aircraft departure time; or
(3) The traveller(s) fall under one of the exempt categories:
a. international traveller authorized to enter Canada under an order made under section 58 of the
Quarantine Act and who boards an aircraft for a flight in Canada within 24 hours of the time of
departure of their inbound flight to Canada; or
1 A valid test can be either a: a) a negative result for a COVID-19 molecular test that was performed on a specimen
collected no more than 72 hours before the aircraft’s initial scheduled departure time; or b) a positive result for such a
test that was performed on a specimen collected at least 14 days and no more than 180 days before the aircraft’s
initial scheduled departure time.
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b. an individual who is a foreign crew member of a commercial passenger aircraft and who is
boarding a flight only to become such a crew member, repositioning or to conduct mandatory
training required by their employer.
IMPORTANT NOTICE:
A person who provides information to an air carrier that is known to be false or misleading may be
subject to an administrative monetary penalty or other enforcement action, including prosecution under
the Criminal Code.
During travel, each traveller must carry with them the necessary proof to demonstrate, upon
request, compliance with the above-noted Interim Order.
------------------------------------------------------------- ----------------
Signature of Traveller Date
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Annex D – Sample Letter to Traveller

The following can be used to notify the traveller that they are not able to board a plane / enter the restricted
area of an airport within Canada for 72 hours since they have failed to comply with one or more provisions
under the Transport Canada Interim Order related to Federal Vaccination Mandate.
[Letterhead of Air Operator]
[Insert Date of Letter]
RE: Note for Traveller – unable to board a flight from a Canadian Airport for 72 hours
To [insert traveller’s name],
Please be advised that since you have failed to comply with one or more of the following provisions
under the Transport Canada Interim Order, you are not allowed to board a flight or to enter the
restricted area of an airport in Canada for the next 72 hours from the time of your originally scheduled
flight:
1) Failure to confirm eligibility to board;
2) Failure to show proof documents for one of the following:
 Proof of being fully vaccinated; OR
 Proof of a valid COVID-19 molecular test result; OR
 Proof that an exception applies.
Transport Canada has been notified of your failure to comply with one or more of the requirements.
Should you have any further questions, please consult travel.gc.ca for more information on the
requirements to board a flight at a Canadian airport, or for general information on travel restrictions
related to COVID-19.
Thank you,
[Appropriate contact info for Air Operator]
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Annex E – Template Letter for Foreign Crew

The following letter can be used to identify foreign crew in the instances that they are repositioning or travelling to
attend training. Alternatively other means such as air operator ID will also be accepted.
*************************************************************************************
[Letterhead of Air Operator]
[Insert Date of Letter]
Re: Confirmation of Air Crew Members
To Whom It May Concern,
This letter is to confirm that [Name on Crew Identification] is a member of the air crew of [Name of Air Operator] by
virtue of their position as [Crew Member’s Title]. The person is travelling on active duty, or is traveling to or within
Canada to begin active duty (i.e. repositioning to become crew or are travelling to attend training).
Please process them under any relevant exceptions related to the Federal Vaccination Mandate for air crew during
Phase 1 (October 30, 2021 to November 29, 2021):
 Being exempt from the requirement to present proof of vaccination; and

 Being exempt from the requirement to provide a COVID-19 molecular test result;
They are considered an essential worker, crucial to the movement of goods and people and their travel is associated
with this work.
Should you require any additional information, please do not hesitate to contact me at the coordinates listed below.
Thank you,
[Name of Supervisor/Manager]
[Telephone Number of Supervisor/Manager]
[Email of Supervisor/Manager]
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Annex F – Sample ArriveCAN Receipt
Mobile Receipt: Printed from the website:

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Printed Receipt:
Your ArriveCAN receipt

Show your receipt prior to boarding your flight, and to the Border Services Officer upon entry. Your receipt will also be emailed to you .
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Please print this page and bring it with you when you travel.
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AR04642
<<Insert Company Logo here>> <<Insert privacy caveat here>> (when complete)
<<Insert Air Carrier Address here>>
Federal Vaccine Mandate – Passenger Confirmation Template
Under Transport Canada requirements, travellers must confirm their eligibility to board a flight
from a specified airport in Canada (Interim Order Respecting Certain Requirements for Civil
Aviation Due to COVID-19). Travellers must have the appropriate documents to prove this
eligibility prior to entering the secure area of the airport and/or boarding a flight.
Section 1: Routing/Traveller Details
Flight number Date of departure
Complete the table below with the names of all travelers, aged 12 (+ 4 months) and older,
travelling under the same reservation and flight number:
Your privacy is important to us. Please note that [name of air carrier/company name] is subject
to applicable privacy legislation with respect to the handling of your personal information. The
personal information in this form may be provided to and used by Transport Canada for the
purpose of audit and enforcement. The Minister of Transport may collect this personal
information pursuant to the Aeronautics Act and the Interim Order Respecting Certain
Requirements for Civil Aviation Due to COVID-19. In the event that any personal information is
provided to Transport Canada, it will only be used and disclosed by Transport Canada in
accordance with the Privacy Act. The personal information collected, as well as its use,
disclosure and retention is described in the personal information bank entitled TC PPU 015 and
other applicable personal information banks which are published on Transport Canada’s Info
Source page. Given that the applicable Personal Information Banks are currently being
modified and/or developed, please visit the following website for more information: COVID-19
Boarding flights, trains and cruise ships in Canada. Under the provisions of the Privacy Act,
individuals have the right of access to, correction of and protection of their personal
information. Instructions for obtaining personal information are provided in Info Source, a copy
of which is available in major public and academic libraries or online at http://infosource.gc.ca.
Individuals who wish to exercise their right to complaint under the Privacy Act about the
handling of their personal information may do so by filing a complaint with the Office of the
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Privacy Commissioner. For more detailed information on how [name of air carrier/company
name] processes your personal information, please visit [name of air carrier/company name’s]
privacy policy at [link to air carrier/company name’s privacy policy].
Section 3: Confirmation and Acknowledgement by a Traveller 16 years of age and older.
I, , hereby confirm the information contained in

Section 1 is accurate, and acknowledge that:
(1) The traveller(s) listed in Section 1 are fully vaccinated in accordance with the Interim Order;
and will carry valid proof or
(2) The traveller(s) listed in Section 1 have evidence of valid1 COVID-19 molecular test results
prior to their initial scheduled aircraft departure time; or
(3) The traveller(s) fall under one of the exempt categories:
a. international traveller authorized to enter Canada under an order made under section
58 of the Quarantine Act and who boards an aircraft for a flight in Canada within 24
hours of the time of departure of their inbound flight to Canada; or
b. an individual who is a foreign crew member of a commercial passenger aircraft and who
is boarding a flight only to become such a crew member, repositioning or to conduct
mandatory training required by their employer.
IMPORTANT NOTICE:
A person who provides information to an air carrier that is known to be false or misleading may
be subject to an administrative monetary penalty or other enforcement action, including
prosecution under the Criminal Code.
During travel, each traveller must carry with them the necessary proof to demonstrate,
upon request, compliance with the above-noted Interim Order.
------------------------------------------------------------- ----------------
Signature of Traveller Date
1A valid test can be either a: a) a negative result for a COVID-19 molecular test that was performed on a
specimen collected no more than 72 hours before the aircraft’s initial scheduled departure time; or b) a
positive result for such a test that was performed on a specimen collected at least 14 days and no more than
180 days before the aircraft’s initial scheduled departure time.
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GUIDANCE MATERIAL FOR OPERATORS OF AN

AERODROME, AIR OPERATORS &
& NAV CANADA

Guidance on the requirements for implementation of a Policy
Respecting Mandatory Vaccination
This guidance material is intended to provide recommendations and guidance on the operationalization of
Transport Canada’s Interim Order, Interim Order Respecting Certain Requirements for Civil Aviation Due to COVID-
19, No 43.

these legal documents and provide recommendations and guidance on how to
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Purpose of this Guidance Document
The purpose of this guidance document is to outline the requirements under the Transport Canada
Interim Order No. 43 related to the Federal Vaccination Mandate as it pertains to the implementation of
a policy respecting mandatory vaccination. Advice, guidance, and sample templates are included to
facilitate the implementation.
What is the Federal Vaccination Mandate?

While the pandemic has had a devastating impact on Canada’s transportation sector, public health
measures have been critical to preventing the spread of COVID-19. Additional measures are needed to
ensure the safety and security of Canada’s transportation system and facilitate the resumption of safe
travel. A requirement for employers in the federally regulated air, rail, and marine transportation
sectors to establish vaccination policies for their employees to enhance the safety of the Canadian
aviation system, and help give Canadians the confidence to resume travel, while still adhering to public
health measures.
Policy Respecting Mandatory Vaccination

Operators of an aerodrome at specified aerodromes (see Annex A) are required to establish an
aerodrome-wide comprehensive policy respecting mandatory COVID-19 vaccination by November 15,
2021. Aerodrome-wide policies are needed to ensure the safe operation of the aviation system,
recognizing that relevant employees (e.g. employees critical to support this function) must be
adequately protected.
NAV CANADA and air carriers (CAR subpart 703, 704, 705) with operations at specified aerodromes (see
Annex A) are required to establish and implement a policy respecting mandatory vaccination by
November 15, 2021, to ensure all relevant employees are protected from COVID-19. This is imperative in
order to ensure that these companies take into account the various risks associated with all of their
operations and how the various workflows and employees interact with each other. NAV CANADA and
air carriers should review the provisions related to implementing either the comprehensive or targeted
policies and the subsequent implications on their operations. Targeted vaccination policies apply to
relevant employees only (but with additional measures required for segregation and reporting, whereas
a comprehensive policy apply to all employees, regardless of their location/site and the nature of their
work.
As a basic guideline for establishing and administering company vaccination policies, employers are
encouraged to refer to the Treasury Board Framework for the Implementation of the Policy on COVID-19
Vaccination for the Core Public Administration:
https://www.canada.ca/en/government/publicservice/covid-19/vaccination-public-service/framework-
implementation-policy-covid-19-vaccination-cpa-including-rcmp.html
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Key Dates:
The following key dates apply to comprehensive and targeted mandatory vaccination policies.
Date Requirement
October 30, 2021  Vaccination Policies required to be in place
 All [relevant] employees must have received their first vaccine dose, and
November 15, those who are not fully vaccinated must have an accommodation
2021 approved their employer.
 [Relevant] employees who are not fully vaccinated to be tested* at least
twice per week until they are fully vaccinated
January 24, 2022  All [relevant] employees must be fully vaccinated, unless exempt from
requirement
 Companies must remove aerodrome access privileges for [relevant]
January 25, 2022 employees who remain unvaccinated and who are not exempt from the
requirement to be vaccinated
Section 2 - Application
The following entities are required to implement a Policy Respecting Mandatory Vaccination:
 Operators of aerodromes on the specific list (see Annex A);
 Air carriers who operate at aerodromes listed on Annex A; and
 NAV CANADA at locations where NAV CANADA provides civil air navigation services.
Note: Air carriers and NAV CANADA have the option to implement a comprehensive mandatory
vaccination policy, or have a targeted policy respecting mandatory COVID-19 vaccination,
focused on relevant employees (defined below), with mandatory reporting requirements.
The term ‘’relevant employees’’ means:
1. an employee of the regulated entity;

2. an employee of a contractor or an agent of the regulated entity ;
3. an individual hired by the regulated entity to provide a service;
4. a tenant or an employee of the entity’s tenant, if the property that is subject to the tenancy
is part of aerodrome property;
5. an individual permitted by the regulated entity to access a specified aerodrome or, in the
case of NAV CANADA, a location at which NAV CANADA conducts operations related to
commercial flights.
AND
a. conducting or directly supporting operations that are related to commercial flights — such
as aircraft refueling services, aircraft maintenance and repair services, baggage handling,
supply services for the operator of an aerodrome, an air carrier or NAV CANADA, runway
and taxiway maintenance services or de-icing services — and that take place in aerodrome
property or a location at which NAV CANADA conˇ ducts operations related to civil air
navigation services;
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b. interacting in-person in aerodrome property with a person who intends to board an aircraft
for a flight;
c. engaging in tasks intended to reduce the risk of transmission of the virus that causes COVID-
19, in relevant aerodrome property or a location at which NAV CANADA conducts
operations related to civil air navigation services; and
d. accessing the restricted area of an aerodrome listed in Annex A.
The term ‘’aerodrome property’’ means any air terminal buildings, restricted areas or facilities used for
activities related to aircraft operations that are located at the aerodrome.
The requirement to have a Policy Respecting Mandatory Vaccination (Comprehensive or Targeted) is not
applicable to: cargo operators, secure supply chain participants, private operators (CAR subpart 604),
general aviation, aerial work (CAR subpart 702). Operators will, however, need to verify whether their
employees/contractors working in the restricted area of an aerodrome listed in (Annex A)would need to
be vaccinated as a result of the future measures (Interim Order #44 – measures for restricted area
management expected to come into force on November 15, 2021) or as indicated under an aerodrome
policy.
Section 3 – Requirements of the Comprehensive Policy

Respecting Mandatory Vaccination
As outlined in Transport Canada’s Interim Order, operators of aerodromes are required to have a
comprehensive vaccination policy established by November 15 th, which includes the requirement for
mandatory vaccination of all relevant employees, unless exempt. Air carriers and NAV CANADA can
choose to implement a comprehensive mandatory vaccination policy, or can instead implement a
targeted policy respecting mandatory COVID-19 vaccination, which includes reporting requirements (at
least once a week and upon request).
The comprehensive vaccination policy must include the following elements, as outlined in the Interim
Order:
 General Requirement: A requirement for all relevant employees to be fully vaccinated by
November 15, 2021, following the Public Health Agency of Canada’s standard, unless they meet
the requirements for an exemption.
 Granting exemptions: general guidance for granting (or denying) an exemption is noted below
(e.g., medical, religious or first dose exemptions). Please refer to Annex B for specific
considerations when assessing exemption requests.
o Is the form complete (e.g., no empty required fields)?
o Is the request form that was submitted the proper form that the employee should have
used (e.g. what is pointed to in the aerodrome vaccination policy)?
o For medical exemptions, does it indicate that the signing authority is a doctor or nurse
practitioner? For example, it is not a chiropractor, physiotherapist or other medical
professional that is seemingly not in a position to diagnose the medical condition, to the
best of the knowledge of the employer.
o For religious exemptions, the commissioner of oaths is seemingly valid (e.g., there is an
official-looking stamp on the form).
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o For the first dose exemption, the date on the form that specifies the first dose is before
November 15, 2021.
 Issuing exemptions: The Interim Order requires that employers provide for a procedure to grant
exemptions from the requirement to be fully vaccinated in very limited circumstances, namely if
the person has not completed a COVID-19 vaccination regime due to a medical contraindication
the person’s sincerely held religious beliefs, or if they are only partially vaccinated (e.g., have
received one dose of a two dose vaccine regimen). This includes explaining how the employee
will receive their approved exemption form and instructions to ensure they are in possession of
Part 2 of the exemption form (See Annex C for medical exemption form, Annex D for the
religious exemption form and Annex E for the first dose exemption form) at all times when
passing through a screening checkpoint or access point, as this is their official proof of
exemption.
Please refer to Annex B for specific considerations around issuing exemptions.
 Testing protocols for exempt employees: A process for ensuring those that are granted an
exemption follow the associated testing protocols, which involves being testing twice a week or
showing proof of a valid positive test result that is at least 14 days but not more than 180 days
old. Employees need to be aware of where and when they are to report for testing and how the
results will be communicated, in addition to steps to take should they test positive.
 COVID-19 molecular testing: A process to ensure if an employee tests positive for COVID-19
using any test other than a COVID-19 molecular test (e.g., if a rapid antigen test was used) that
they must then obtain a COVID-19 molecular test result to confirm the diagnosis (as molecular
tests have been proven to be the most accurate at diagnosing COVID-19).
 Accessing aerodrome property: A process for ensuring that any employee who obtains a
positive COVID-19 molecular test result is not allowed on relevant aerodrome property (any air
terminal buildings, restricted areas or facilities used for activities related to aerodrome
operations that are located at the aerodrome) for at least 14 days (unless they are still exhibiting
symptoms, which means they are not allowed on aerodrome property until the symptoms are
gone even if this is beyond 14 days since testing positive).
 Exemption following positive test result: A process for ensuring that once an employee tests
positive for COVID-19 using a molecular test, has waited at least 14 days and is no longer
symptomatic, they will be exempt from the at least twice a week testing requirements until they
get to day 180 following their initial positive molecular test result (as their positive test is valid
until that time as lingering amounts of the virus could remain in their system despite having
recovered and not being contagious). A process will need to be in place to flag that once the 180
days is complete, the at least twice a week testing resumes.
Section 3 – Requirements for Targeted Mandatory

Vaccination Policy (Relevant Employees)
Air operators and NAV CANADA have the option to implement a targeted policy respecting mandatory
COVID-19 vaccination, which will ensure that all relevant employees are vaccinated (instead of a
comprehensive policy respecting mandatory COVID-19 vaccination that is company-wide) before
accessing aerodrome property. Supplemental elements in their policy, including a weekly reporting
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requirement, must be added to ensure the relevant employees are not exposed to the risk of COVID-19
in their respective organizations by other employees.
This will allow for employees who are not directly in the aerodrome environment (e.g., working in a call-
centre in another city, individuals conducting virtual training sessions with employees) or interacting in
person with those working on aerodrome property to have a separate set of policies that are applicable
to them, given the operational context.
Note: even if air operators or NAV CANADA choose to implement a targeted policy respecting
mandatory COVID-19 vaccination to meet the regulatory requirement, Transport Canada still strongly
encourages having a vaccination policy for non-relevant employees.
The targeted policy respecting mandatory COVID-19 vaccination, must include the following elements
(same requirements for the comprehensive policy respecting mandatory COVID-19 vaccination that
were described above), as outlined in Transport Canada’s Interim Order; however, the policy applies to
relevant employees only. While the full definition is included above, this generally means employees
that work in the aerodrome on aerodrome property, including those who require access to the
restricted area.
 General requirement: A requirement for all relevant employee to be fully vaccinated by

November 15, 2021, following the Public Health Agency of Canada’s standard, before accessing
aerodrome property.
 Granting exemptions: A process for granting (or denying) an exemption for relevant employees
based on the exemptions noted below (e.g., medical, religious or first dose exemptions).
 Issuing exemptions: A process for issuing the exemption to a relevant employee that confirms
(or denies) the exemption. This includes explaining how the relevant employees will receive
their approved exemption form and instructions to ensure they are in possession of Part 2 of the
form at all times when passing through a screening checkpoint.
 Testing protocols for exempt employees: A process for ensuring those that are granted an
exemption follow the associated testing protocols, which involves being tested at least twice a
week or showing proof of a valid positive test result that is at least 14 days but not more than
180 days old.
 COVID-19 molecular testing: A process to ensure if a relevant employee tests positive for
COVID-19 using any test other than a COVID-19 molecular test (e.g., if a rapid antigen test was
used) that they must then obtain a COVID-19 molecular test result to confirm the diagnosis (as
molecular tests have been proven to be the most accurate at diagnosing COVID-19).
 Accessing aerodrome property: A process for ensuring that all relevant employee who obtains a
positive COVID-19 molecular test result is not allowed on aerodrome property (any air terminal
buildings, restricted areas or facilities used for activities related to aircraft operations that are
located at the aerodrome) for 14 days (unless they are still exhibiting symptoms, which means
they are not allowed on aerodrome property until the symptoms are gone even if this is beyond
14 days since testing positive).
 Exemption following positive test result: A process for ensuring that once any relevant
employee tests positive for COVID-19 using a molecular test, has waited 14 days and is no longer
symptomatic, they will be exempt from the at least twice a week testing requirements until they
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get to day 180 following their initial positive molecular test result (as their positive test is valid
until that time as lingering amounts of the virus may remain in their system despite having
recovered and not being contagious).
The following additional elements (i.e. those that go above and beyond the requirements of the
comprehensive policy respecting mandatory COVID-19 vaccination) must also be included in the
targeted policy respecting mandatory COVID-19 vaccination:
 Reducing the exposure risk: A process for reducing the risk that an unvaccinated employee who
has not been granted an exemption may expose a relevant employee to COVID-19 due to an in-
person interaction. These risk mitigation measures may include:
o broader vaccination policies beyond relevant employees;
o wearing masks;
o physical distancing; and
o limiting or reducing the duration of in-person meetings.
Other best practices that may be considered to reduce the exposure risk of COVID-19 can be
found here: Public Health Agency of Canada– How business and employees can stay safe while
operating during COVID-19.
 Contact Tracing - establish a procedure for collecting the following information with respect to
an in-person interaction related to commercial flight operations between a relevant employee
and an employee who is unvaccinated and has not been granted an exemption under paragraph
or whose vaccination status is unknown. The following information needs to be collected:
o the time, date and location of the interaction, and
o contact information for the relevant person and the other person.
While contact tracing can be challenging, it is absolutely essential in limiting the spread of
COVID-19. Further information on contact tracing is available here: Updated: Public health
management of cases and contacts associated with COVID-19 - Canada.ca
 Reporting Requirements - procedures to collect the following information and to provide this
information to the Minister upon request are required. Note: this information must be retained
for 12 months.
o The number of instances in which an air operator / NAV CANADA was made aware that
a relevant employee tested positive for COVID-19 due to an in-person interaction with
an unvaccinated (non-exempt) employee, the number of relevant employees tested as a
result of this instance, the results of those additional relevant employee COVID-19 tests,
and a description of any impact on commercial flight operations.
o The total number of relevant employees (e.g. those that meet the definition noted in
the Interim Order and included above).
o The total number of relevant employees that require access to the restricted area
(include any relevant employees who require access for any reason, even if for brief
periods, to conduct their duties).
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o The number of relevant employees that are:

 1) fully vaccinated (as per the PHAC standard for Canada);
 2) that have received the first dose of a COVID-19 vaccine (when 2 doses are
required to be deemed fully vaccinated); and
 3) are unvaccinated.
o The number of hours during which relevant employees were unable to fulfill their duties
related to commercial flights due to COVID-19. This would include a relevant employee
that is unvaccinated and did not meet an exemption, therefore they are not able to
access the airport property to conduct their duties.
o The number of relevant persons who have been granted an exemption (e.g., medical,
religious or first dose exemption).
o The number of relevant employees who refuse to comply with the following provisions
of the policy respecting mandatory vaccination: the requirement to be fully vaccinated
or to have an approved exemption, to get tested at least twice a week if an exemption
applies, to obtain a molecular COVID-19 test to get an official diagnosis if they test
positive using a non-molecular COVID-19 test, and to not access aerodrome property for
at least 14 days (and beyond if necessary, until asymptomatic) following a positive
COVID-19 molecular test result.
o The number of relevant employees who were denied boarding, due to a refusal to
comply with the following provisions of the policy respecting mandatory vaccination:
the requirement to be fully vaccinated or to have an approved exemption, to get tested
at least twice a week if an exemption applies, to obtain a molecular COVID-19 test to get
an official diagnosis if they test positive using a non-molecular COVID-19 test, and to not
access aerodrome property for at least 14 days (and beyond if necessary, until
asymptomatic) following a positive COVID-19 molecular test result.
o The number of unvaccinated employees who have not been granted an exemption (e.g.,
medical, religious or first dose exemptions) or whose vaccination status is unknown that
interact in-person with relevant employees with respect to commercial flight
operations. These mitigation measures that are required to reduce the exposure risk of
COVID-19 due to in-person interactions between unvaccinated employees and relevant
employees may also be requested.
o The number of instances in which an air operator / NAV CANADA was made aware that
a relevant employee tested positive for COVID-19 due to an in-person interaction with
an unvaccinated (non-exempt) employee, the number of relevant employees tested as a
result of this instance, the results of those additional relevant employee COVID-19 tests,
and a description of any impact on commercial flight operations.
How reporting will work: the required data will be reported to Transport Canada via a multi-modal
portal. More details will follow on this shortly.
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Transport
Canada
Transports
Canada
ANNEX A – List of Specified Airports in Canada

# Airport Name ICAO
1 Abbotsford CYXX
2 Alma CYTF
3 Bagotville CYBG
4 Baie-Comeau CYBC
5 Bathurst CZBF
6 Brandon CYBR
7 Calgary International CYYC
8 Campbell River CYBL
9 Castlegar CYCG
10 Charlo CYCL
11 Charlottetown CYYG
12 Chibougamau / Chapis CYMT
13 Chruchill Falls CZUM
14 Comox CYQQ
15 Cranbrook CYXC
16 Dawson Creek CYDQ
17 Deer Lake CYDF
18 Edmonton International CYEG
19 Fort McMurray CYMM
20 Fort St. John CYXJ
21 Fredericton International CYFC
22 Gander International CYQX
23 Gaspé CYGP
24 Goose Bay CYYR
25 Grand Prairie CYQU
26 Greater Moncton International CYQM
27 Halifax (Robert L. Stanfield International) CYHZ
28 Hamilton CYHM
29 Iles-de-la-Madeleine CYGR
30 Iqaluit CYFB
31 Kamloops CYKA
32 Kelowna CYLW
33 Kingston CYGK
34 Kitchener / Waterloo Regional CYKF
35 La Grande Rivière CYGL
36 Lethbridge CYQL
37 Lloydminster CYLL
38 London CYXU
39 Lourdes-de-Blanc-Sablon CYBX
40 Medicine Hat CYXH
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Transport
Canada
Transports
Canada
41 Mont-Joli CYYY
42 Montreal-Pierre Elliott Trudeau International Airport CYUL
43 Nanaimo CYCD
44 North Bay CYYB
45 Ottawa (Macdonald-Cartier International) CYOW
46 Penticton CYYF
47 Prince Albert CYPA
48 Prince George CYXS
49 Prince Rupert CYPR
50 Québec International (Jean Lesage International) CYQB
51 Quesnel CYQZ
52 Red Deer Regional CYQF
53 Regina CYQR
54 Rivière-Rouge (Mont-Tremblant International) CYFJ
55 Rouyn-Noranda CYUY
56 Saint John CYSJ
57 Sarnia (Chris Hadfield) CYZR
58 Saskatoon (John G. Diefenbaker International) CYXE
59 Sault Ste. Marie CYAM
60 Sept-Îles CYZV
61 Smithers CYYD
62 St. Anthony CYAY
63 St. John’s International CYYT
64 Stephenville CYJT
65 Sudbury CYSB
66 Sydney CYQY
67 Terrace CYXT
68 Thompson CYTH
69 Thunder Bay CYQT
70 Timmins CYTS
71 Toronto (City Centre) CYTZ
72 Toronto (Lester B/ Pearson International) CYYZ
73 Toronto/Buttonville Municipal CYKZ
74 Val-d’Or CYVO
75 Vancouver International CYVR
76 Victoria International CYYJ
77 Wabush CYWK
78 Whitehorse International CYXY
79 Williams Lake CYWL
80 Windsor CYQG
81 Winnipeg (James Armstrong Richardson International) CYWG
82 Yellowknife CYZF
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Annex B – Considerations around issuing employee exemptions to the

Vaccination Policy
Further considerations – Medical Exemption:

It is important to stay abreast of National Advisory Committee on immunization (NACI)
guidance on COVID-19 vaccines, which is based on current evidence:
https://www.canada.ca/en/public-health/services/immunization/national-advisory-committee-
on-immunization-naci/recommendations-use-covid-19-vaccines/summary-october-22-
2021.html
At present, the Medical Exemption form tracks three specific categories under which to make a
certified request for exemption on medical grounds, namely if the individual:
1) Has a medical contraindication to full vaccination against COVID-19 with mRNA vaccine
(Pfizer-BioNTech or Moderna vaccines) based on recommendation of the National
Advisory Committee on Immunization (as follows based on NACI advice as of September
10, 2021), and whether the condition is permanent or time limited and in effect until a
certain date:
 History of anaphylaxis after previous administration of an mRNA COVID-19 vaccine

 Confirmed allergy to polyethylene glycol (PEG) which is found in the Pfizer-BioNTech
and Moderna COVID-19 vaccines
(Note that if the patient is allergic to tromethamine which is found in Moderna, they
can receive the Pfizer-BioNTech product)
2) Has a medical reason for delay of full vaccination against COVID-19 as described by the
National Advisory Committee on Immunization (as follows based on NACI advice as of
September 10, 2021), and how long that reason is in effect:
 A History of myocarditis/pericarditis following the first dose of an mRNA vaccine
 Due to an immunocompromising condition or medication, waiting to vaccinate
when immune response can be maximized (i.e., waiting to vaccinate when
immunocompromised state / medication is lower)
(Note: Consideration should be given to benefit/risk when vaccination is delayed)
3) Has a medical reason precluding full vaccination against COVID-19 not covered above, a
description of the reason, and whether that reason is permanent or time-limited and in
effect until a certain date.
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Further Considerations – Religious Grounds:

Leaders and members of a number of religions (e.g., Islam, Roman Catholicism, Judaism, Greek
Orthodox, Mennonites, Jehovah’s Witnesses, Christian Science) have released public
statements indicating their support for the COVID-19 vaccine specifically in the interest of
public health.
Nevertheless, an individual may hold a strongly held religious belief that prevents full
vaccination.
As an additional reference, the Government of Canada has provided guidance with respect to
how it will evaluate requests for accommodation on the ground of religion, as follows:
https://www.canada.ca/en/government/publicservice/covid-19/vaccination-public-
service/framework-implementation-policy-covid-19-vaccination-cpa-including-rcmp.html
Each request is to be evaluated on a case-by-case basis. Managers should consider the
information provided by the employee to substantiate the request for accommodation based
on religion. The information must clearly demonstrate the following three elements:
a) That the belief is religious in nature:
 Religion typically involves a particular and comprehensive system of faith and worship
as well as the belief in a divine, superhuman or controlling power (e.g., “I don’t believe
in vaccination” would not in itself be a reason).
 It does not apply to beliefs, convictions or practices that are secular, socially based or
only conscientiously held; nor does it protect false empirical beliefs about the
development, the contents, effects, or purpose of the vaccines.
 Note: it is not necessary for the employee to prove that the religious belief is objectively
recognized as valid by other members of the same religion or that it is required by
official religious dogma or is in conformity with the position of religious officials (e.g.,
confirmation by a priest, rabbi, imam or other spiritual leader).
b) That the belief prevents full vaccination
 The information provided by the employee must demonstrate how the religious belief
prevents vaccination.
 It is not sufficient for the employee to say they have a certain religious belief and they
cannot be vaccinated. They must explain how vaccination would conflict with their
religious belief in a way that is not trivial or insubstantial (i.e. being vaccinated conflicts
with the employee’s genuine connection with the divine).
c) That it is sincerely held:
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 Where the employee provides a sworn affidavit, this can be a sign of the sincerity of the
belief since this becomes a record with legal standing. Swearing a false affidavit is a
serious offence and would constitute breach of the company/operator’s Values and
Ethics Code (often a Term and Condition of Employment) and could result in disciplinary
action up to and including termination. The seriousness with which an affidavit is sworn
before a Commissioner of Oaths is a safeguard of the accuracy of the information
contained within.
 Factors that indicate whether the belief is sincere could include: the overall credibility of
the employee’s statement as well as the consistency of the belief with the employee’s
other current religious practices (it is, however, inappropriate to rigorously focus on
past religious practices since these can evolve over time).
One the rigorous assessment is complete, and the employee has provided acceptable
attestations, the company can complete part 2 of the relevant exemption forms so that
CATSA or the airport authority is not required to verify proof of vaccination for those being
exempted for one of the following reasons: medical, religious, or partially vaccinated.
Further Consideration - First Dose Exemption

If an employee provides proof that they have received the first dose of a two dose vaccine
regimen of a Public Health Agency of Canada approved vaccine, by November 15, 2021, they
should be considered for this exemption.
Please refer to the following link for more information: https://www.canada.ca/en/health-
canada/services/drugs-health-products/covid19-industry/drugs-vaccines-
treatments/vaccines.html
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Annex C – Medical Exemption Form

MEDICAL EXEMPTION REQUEST FORM
The person requesting a medical exemption must submit a completed copy of this form in its entirety. All pages
must be reviewed and completed by the person to be exempted and/or requester, as well as the required
medical doctor or nurse practitioner. The employer evaluating this request must do so in accordance with its
legal duty to accommodate under the applicable legislation.
PART I OF MEDICAL EXEMPTION
Person To Be Exempted
Please provide the following concerning the person for which a medical exemption is requested:
First Name: __________________________ Last Name: __________________________
Home Address: ________________________________________
Requester’s Information
If the requester is different than the person to be exempted, please complete the following:
Mailing Address: ________________________________________
Provincial / Territorial Government

In some cases, a provincial or territorial government may issue a credential to the effect that an individual cannot be
vaccinated. The employer can accept this credential code instead of a medical doctor or nurse practitioner attestation. If
this situation applies, the person requesting the exemption must select the check box below and present their provincial or
territorial credential to their employer for verification.
 The person requesting a medical exemption is in possession of a provincial or territorial government issued
credential (e.g. QR code) confirming that the person cannot be vaccinated. The employer must verify the
credential prior to granting a medical exemption.
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Medical Doctor Or Nurse Practitioner

Medical Statement
I, _______________________________ am a licensed Physician/Nurse Practitioner in the province / territory

of ___________________________. I hereby certify that ________________________________ (indicate one
of the following):
 1) Has a medical contraindication to full vaccination against COVID-19 with mRNA vaccine (Pfizer-BioNTech or
Moderna vaccines) based on recommendation of the National Advisory Committee on Immunization (as follows based
on NACI advice as of September 10, 2021):

 Confirmed allergy to polyethylene glycol (PEG) which is found in the Pfizer-BioNTech and Moderna
COVID-19 vaccines
(Note that if the patient is allergic to tromethamine which is found in Moderna, they can receive the
Pfizer-BioNTech product)
This medical reason is (please indicate only one)

 Permanent
 Time limited and will be in effect until _______________________
 2) Has a medical reason for delay of full vaccination against COVID-19 as described by the National Advisory
Committee on Immunization (as follows based on NACI advice as of September 10, 2021):
 Due to an immunocompromising condition or medication, waiting to vaccinate when immune
response can be maximized (i.e., waiting to vaccinate when immunocompromised state /
medication is lower)
This medical reason will be in effect until ___________________________
 3) Has a medical reason precluding full vaccination against COVID-19 (not covered above) as described below (for
privacy reasons, only include information related to why the medical reason precludes vaccination):
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________

 Permanent
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Signature: ______________________________________
Date: _______________________________
Name: ________________________________
Telephone number:______________________________
License number: __________________ Province/Territory: _____________________________
Requester’s Attestation
The following is to be completed by or on behalf of the person requesting a medical exemption:
I hereby certify that I am/or the person for which a request is made is unable to be vaccinated due to a medical
condition:
Signature: ______________________________ Full Name: ________________________________
Date: ________________________________ Location: ________________________________
False Or Misleading Information

It is an offence under section 366 of the Criminal Code to make a false document, knowing it to be false.
As per the applicable Interim Order Respecting Certain Requirements for Civil Aviation Due to COVID-19, a person who
provides information to a carrier that is known to be false or misleading may also be subject to an administrative
monetary penalty or other enforcement action, including prosecution.
Personal Information
Personal information you provide in this form will be used for the purposes of determining the qualification of the person
identified on this form for medical exemption from the requirements of the applicable Interim Order Respecting Certain
Requirements for Civil Aviation Due to COVID-19. This information may also be shared with Transport Canada for the sole
purpose of audit or enforcement.
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PART 2 OF EXEMPTION
Important Notice: Only Part 2 of this exemption is to be provided by the employee, upon request, to the Airport
Authority, the Canadian Air Transport Security Authority (CATSA) or Transport Canada. Should additional
information be required by Transport Canada, a government official will contact the Employer* directly.
Confirmation of Exemption by
Employer*
Employer* Record Number: ____________
This is to confirm that _______________________________ (full name of the exempted person),

RAIC/RAP/Temp pass #:___________________________, has an exemption from the mandatory vaccination
requirements under the Transport Canada Interim Order Respecting Certain Requirements for Civil Aviation Due to
COVID-19.
Signature: ___________________________ Full Name: ________________________________
Title: ______________________________ Organization: _______________________________
Phone number (day): ________________________________
Date: ________________________________ Location: _______________________________
* Part 2 is to be completed by the employer or an organization responsible to validate the exemption

request in accordance with the applicable airport-wide mandatory vaccination policy.
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Annex D – Religious Exemption Form
RELIGIOUS EXEMPTION REQUEST FORM
The person requesting a religious exemption must submit a completed copy of this form in its entirety. All
pages must be reviewed and completed by the person to be exempted and/or requester, as well as by the
required commissioner for taking oaths. The employer evaluating this request must do so in accordance with its
legal duty to accommodate under the applicable legislation.
PART I OF RELIGIOUS EXEMPTION
Please provide the following concerning the person for which a religious exemption is requested:
Home Address: ________________________________________
Affidavit - Religious Belief
Please provide the requested information concerning your religious belief. Note, leaders and members of a
number of religions (e.g., Islam, Roman Catholicism, Judaism, Greek Orthodox, Mennonites, Jehovah’s
Witnesses, Christian Science) have released public statements indicating their support for the COVID-19
vaccine specifically in the interest of public health.
Affidavit of ___________________________________ (name)
I, ________________________________ (full name), currently employed as ________________________ (position) at
__________________________________ (organization), MAKE OATH OR SOLEMNLY AFFIRM AND SAY AS FOLLOWS:
1. The requirements of the Vaccination Policy for _______________________________ (organization) conflicts

with my sincerely held religious belief or practice that prohibits me from receiving the COVID-19 vaccine.
2. The nature of this sincerely held religious belief or practice is as follows (please describe the reasons why your
religious belief prohibits you from receiving the COVID-19 vaccine):
_________________________________________________________________________________
_________________________________________________________________________________
_________________________________________________________________________________
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_________________________________________________________________________________
_________________________________________________________________________________
_________________________________________________________________________________
_________________________________________________________________________________
_________________________________________________________________________________
_________________________________________________________________________________
Signature: _______________________________ Full Name: __________________________________

Date: _________________________________ Location: ____________________________________
Signature of Commissioner Of Oaths
The following is to be completed by a commissioner of oaths:

SWORN OR SOLEMNLY AFFIRMED before me at: ________________________________ (Municipality)
in ________________________________ (Province, State, or Country) on _________________ (Date)
Signature: ________________________________ Full Name: ________________________________
It is an offence under section 131 of the Criminal Code to make a false statement under oath or solemn affirmation, by
affidavit, solemn declaration or deposition or orally, knowing that the statement is false. It is further an offence
under section 366 of the Criminal Code to make a false document, knowing it to be false.
As per the applicable Interim Order Respecting Certain Requirements for Civil Aviation Due to COVID-19, a person who
provides information to a carrier that is known to be false or misleading may also be subject to an administrative
monetary penalty or other enforcement action, including prosecution.
Personal information you provide in this form will be used for the purposes of determining the qualification of
the person identified on this form for religious exemption from the requirements of the applicable Interim Order
Respecting Certain Requirements for Civil Aviation Due to COVID-19. This information may also be shared with
Transport Canada for the sole purpose of audit or enforcement.
Canada
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AR04664
Canada Canada
->&
PART 2 OF EXEMPTION
Employer*

RAIC/RAP/Temp pass #:___________________________, has an exemption from the mandatory
vaccination requirements under the Transport Canada Interim Order Respecting Certain Requirements for Civil
Aviation Due to COVID-19.
Signature: ________________________________ Full Name:

________________________________
Title: ________________________________ Organisation:

_______________________________
Phone number (day): ________________________________
Date: ________________________________
Location: ________________________________
* Part 2 is to be completed by the employer or an organization responsible to validate the exemption request in
accordance with the applicable airport-wide mandatory vaccination policy.
Canada
20
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Canada Canada
Annex E – Partially Vaccinated Exemption Form

PARTIALLY VACCINATED EXEMPTION REQUEST FORM
The person must review and submit a completed copy of this form in its entirety, requesting an exemption on
the ground that they have received a first vaccine dose PRIOR to November 15, 2021 and are waiting to receive
the second. Alternatively, the person requesting the exemption may have had their final dose but has not yet
completed the 14 days period in order to be considered fully vaccinated prior to November 15, 2021.The
employer evaluating this request must do so in accordance with its legal duty to accommodate under the
applicable legislation.
PART I OF FIRST DOSE EXEMPTION
Please provide the following concerning the person for which the exemption is requested:
Home Address: ________________________________________
Vaccine Doses
Please provide the requested information concerning the vaccine doses you have received to-date and that you
intend to receive in the near future. Note, the second vaccine dose must be received no later than January 24,
2022, and the failure to do so will result in the suspension of your Restricted Area Identity Card.
Date of first vaccine dose received: __________________________

Anticipated (or actual) date of second vaccine dose: __________________________
Expected date of being fully vaccinated (14 days after final dose): ________________________
As per the applicable Interim Order Respecting Certain Requirements for Civil Aviation Due to COVID-19, a
person who provides information to a carrier that is known to be false or misleading may also be subject to an
administrative monetary penalty or other enforcement action, including prosecution.
Canada
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*i
Canada Canada
Personal information you provide in this form will be used for the purposes of determining the qualification of
the person identified on this form for exemption from the requirements of the Interim Order Respecting Certain
Requirements for Civil Aviation Due to COVID-19 on the ground that they have received a first vaccine dose and
are awaiting the second. This information may also be shared with Transport Canada for the sole purpose of
audit or enforcement.
>$-
PART 2 OF EXEMPTION
Employer*

RAIC/RAP/Temp pass #:___________________________, has an exemption from the mandatory
vaccination requirements on the ground that they have received a first dose and is waiting to receive the second.
Signature: ________________________________ Full Name:

________________________________
Title: ________________________________ Organisation:

_______________________________
Phone number (day): ________________________________
Date: ________________________________ Location: ________________________________
* Part 2 is to be completed by the employer or an organization responsible to validate the exemption request in
accordance with the applicable airport-wide mandatory vaccination policy.
Canada
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TAB 27
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Court File No. T-145-22

FEDERAL COURT
BETWEEN:
NABIL BEN NAOUM
Demandeur
et
LE PROCUREUR GÉNÉRAL DU CANADA
Défendeur

AND BETWEEN:
L’HONORABLE MAXIME BERNIER
Demandeur
et
Défendeur

AND BETWEEN:
THE HONOURABLE A. BRIAN PECKFORD, LEESHA NIKKANEN,
KEN BAIGENT, DREW BELOBABA, NATALIE GRCIC,
AND AEDAN MACDONALD
Applicants
and
ATTORNEY GENERAL OF CANADA
Respondent
AR04669

AND BETWEEN:
SHAUN RICKARD AND KARL HARRISON
Applicants
and
Respondent
AFFIDAVIT OF ELIZABETH HARRIS

Department of Justice Canada
Prairie Regional Office (Winnipeg)
601 – 400 St. Mary Avenue
Winnipeg, MB R3C 4K5
Fax: (204) 983-3636
Per: Sharlene Telles-Langdon, Mariève Sirois-Vaillancourt, Robert Drummond,

Pascale-Catherine Guay, Raymond Lee, James Elford, Mahan Keramati,
Virginie Harvey, Sarah Chênevert-Beaudoin, Michaël Fortier
Tel: (
Email:
Counsel for the Respondent

AR04670

FEDERAL COURT
BETWEEN:
NABIL BEN NAOUM
Demandeur
et
Défendeur

AND BETWEEN:
Demandeur
et
Défendeur

AND BETWEEN:
AND AEDAN MACDONALD
Applicants
and
Respondent
AR04671

AND BETWEEN:
Applicants
and
Respondent
AFFIDAVIT OF ELIZABETH HARRIS
I, Elizabeth Harris, Scientific Director of the Testing Directorate in the Infectious Disease
Prevention and Control Branch of Public Health Agency of Canada, of 130 Colonnade Road, in
the City of Ottawa, in the Province of Ontario, SOLEMNLY DECLARE THAT:
1. I am currently the Scientific Director of the Testing Directorate (Directorate) in the

Infectious Disease Prevention and Control Branch of the Public Health Agency of Canada
(PHAC), which establishes pilot programs and testing initiatives. I have been in this role since
March 2021. As part of my duties in that role, I am responsible for overseeing the production and
dissemination of all products produced by the Testing Directorate. This includes all reports and ad
hoc analysis requests. In close collaboration with partners both within and outside of PHAC, I am
responsible for resolving any data issues identified by our team, as well as develop and oversee
the implementation of epidemiologically-sound improvements and modifications to the border
testing program. Finally, I am responsible for ensuring that Senior Management are regularly
briefed and are made aware in a timely fashion of any changes in trends as they relate to border
testing. I am an epidemiologist by training. I hold both a Masters of Science in Epidemiology
conferred by the University of Toronto in 2001 and a PhD in Infectious Disease Epidemiology
conferred by the London School of Hygiene and Tropical Medicine (UK) in 2010. I have worked
as a public health epidemiologist at the regional, provincial and federal levels for over 20 years. I
have extensive experience in pandemic public health response, having been part of Ontario’s
SARS Epi-Team in 2003 and PHAC’s H1N1 Task Force in 2009/2010. I have attached a copy of
my current curriculum vitae as Exhibit “A”.
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2. As a result of my current position, I have personal knowledge of the facts deposed to in

this affidavit except as follows. As part of my responsibilities, I necessarily receive information
gathered by others within PHAC, other federal government departments and agencies working
with PHAC, or others outside the Government of Canada. In the case of the matters described
within this affidavit, this necessarily includes information received from the Canada Border
Services Agency (CBSA) and service providers, which I explain more fully below. Where in this
affidavit I state that I received information gathered by others in conducting my work functions, I
confirm that I trust the accuracy of that information and believe it to be true based on the
professional conduct and ability of those providing that information. Where I otherwise state my
knowledge is based on information and belief, I have stated the source of my information and
believe the same to be true.
3. COVID-19 is the disease caused by the severe acute respiratory syndrome coronavirus 2
(SARS-CoV-2) and can be a severe, life-threatening respiratory disease. It was first detected in
China, in December 2019 and spread rapidly throughout the globe. The World Health Organization
(WHO) declared a global COVID-19 pandemic in March 2020. I am informed by counsel and do
believe that other individuals will be providing affidavits or experts’ reports on behalf of the
Attorney General of Canada within these proceedings, which more fully explain the nature of the
virus, the disease, and the effects of vaccination. For shorthand, I will refer to the SARS-CoV-2
virus as COVID-19 within this affidavit.
A. The Testing Directorate
4. PHAC is a federal agency created by the Public Health Agency of Canada Act. It supports
the federal Minister of Health as part of the Health Portfolio. Its mandate includes the prevention
and control of infectious diseases, preparation for and response to public health emergencies, and
strengthening intergovernmental collaboration on public health and facilitating national
approaches to public health policy and planning.
5. The Directorate is a unit within PHAC which establishes pilot programs and testing
initiatives. Along with the National Microbiology Laboratory, also within PHAC, it provides
epidemiological recommendations on best testing protocols. Among its roles during the COVID-
3
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19 pandemic, the Directorate has been tracking the rates at which individuals entering Canada
from abroad were found to be infected with COVID-19.
B. Testing Requirements for Entry into Canada
6. Since January 2021, individuals entering Canada and otherwise not exempted (Travellers),
have been required to follow certain border testing measures. Attached as Exhibit “B” is a copy
of an October 27, 2021 report prepared by PHAC’s Testing Directorate for the
Federal/Provincial/Territorial Technical Advisory Committee (TAC) entitled “Findings from
Canada’s COVID-19 Border Surveillance.” Page 4 of that report sets out some of the history of
the testing required of Travellers entering Canada. I discuss this report in more detail later in my
affidavit.
7. Beginning on January 7, 2021, all Travellers entering Canada by air were required to
provide proof of a negative pre-departure COVID-19 molecular test (e.g.polymerase chain reaction
(PCR) test) prior to boarding a flight to Canada. As of February 15, 2021, that same requirement
applied to Travellers entering Canada by land. On February 28, 2022, the requirement for pre-
departure testing was expanded to include pre-departure antigen test within 24 hours of a
Traveller’s scheduled arrival into Canada, as an alternative to COVID-19 molecular testing. On
April 1, 2022, the requirement for pre-departure testing was dropped for fully vaccinated
Travellers only; at the time of this affidavit, unvaccinated or partially vaccinated Travellers must
still comply with the pre-departure test requirement.
8. Pre-departure testing, though valuable in limiting importation of COVID-19 from infected

persons, cannot fully eliminate the risk of a person being infected since not every COVID-19
infection is detectable with a single test. This is due to the sensitivity of the test itself, the
incubation period of COVID-19, and the fact that some individuals might become infected after
the pre-departure test is taken.
9. Beginning on February 21, 2021, Travellers entering Canada by air or land were required
to take an on-arrival PCR test (Day 1 Test) as well as a PCR test on the tenth day after arrival to
determine if they were infected with COVID-19. On April 22, 2021, the second post arrival PCR
test was shifted to the eighth day after arrival (Day 8 Test). As such, between April 22, 2021 and
4
AR04674
July 5, 2021, all Travellers had to complete a Day 1 Test and a Day 8 Test to determine if they
were infected with COVID-19.
10. From July 5, 2021 to August 9, 2021, fully vaccinated Travellers were required to complete
only a Day 1 Test. As I set out below, at that time a fully vaccinated person was an individual who
had completed a full course of vaccinations of a COVID-19 vaccine approved by Health Canada
more than 14 days earlier. As of November 30, 2021, the Government of Canada expanded the
list of vaccines accepted at the border in determining who is considered a fully vaccinated
traveller, to include additional vaccines granted Emergency Use Listing by the WHO and which
have been approved by the Minister of Health as qualifying for the purposes of entry to Canada.
Since August 9, 2021, only a certain number of randomly selected fully vaccinated Travellers were
required to take a Day 1 Test. As of this affidavit, all other non-exempt Travellers are required to
complete a Day 1 and a Day 8 Test.
c. Gathering of Data
11. In the paragraphs that follow, where I refer to the positivity rate, I refer to the percentage
of tests indicating a positive result of COVID-19 out of all tests administered for a particular data
set of Travellers.
12. The data the Directorate uses to determine the positivity rate among Travellers comes from
two sources. The CBSA provides information about Travellers’ arrival date and COVID-19
vaccine status and the service providers that administer and process the COVID-19 tests under
contract with the Government of Canada provide information about test results.
13. Prior to and after entering Canada, Travellers are required to provide various information
in the ArriveCan computer application which information is collected by the CBSA. The
information required includes contact information and travel details, a quarantine plan if necessary,
as well as any information about a Traveller’s COVID-19 vaccine status including the name of the
vaccines and the numbers of doses they had received. Currently, Travellers are not prompted to
advise if they have received third or further doses of a vaccine. I have been informed by officials
at CBSA that a Traveller’s proof of vaccination is confirmed through an optical character
recognition program. The CBSA will also collect information about a Traveller through the
5
AR04675
desktop ContactTrace application at some points of entry and completed paper forms a Traveller
normally provides CBSA at a point of entry into Canada.
14. The CBSA will compile those data into a package and provide it to PHAC. This
information is then transferred into the Quarantine Case Management System (QCMS). The
Directorate is then provided access to some, but not all, of the data in QCMS.
15. As noted above, Travellers who are not fully vaccinated are currently required to take a
Day 1 Test and a Day 8 Test. A certain number of randomly selected fully vaccinated Travellers
are also required to take a Day 1 Test. During peak traveller periods, some Travellers may be
provided with test kits which they administer themselves under the remote (virtual) supervision of
a service provider staff member, and book a prepaid courier pickup to deliver the completed test
kit to service providers. At the ten major Canadian airports receiving international flights, Day 1
Tests can be provided onsite. At other airports, and at land border crossings, Travellers required
to take tests are provided test kits which they administer themselves, again under the remote
supervision of a laboratory service provider staff member, and book a prepaid courier pickup to
deliver the completed test kit to service providers.
16. Once the service providers receive the results of those tests, they provide those results
directly to PHAC through an application programming interface which I understand to be a method
of automatic near real-time transmission of test results upon completion.
17. Once the test results are received from service providers, they are merged with the
information received from CBSA about that Traveller. The linkage between the test results and the
information from CBSA may not be perfect as a result of some inconsistent or incomplete
information. For example, an individual Traveller may not provide the same name when entering
information in ArriveCan and when providing information to a service provider. Notwithstanding
such imperfection, the Directorate considers the resulting information reliable given (1) the high
proportion of records adequately matched (95.5% between July 5, 2021 and February 12, 2022)
and (2) the lack of a consistent pattern in percent positivity amongst those who are unmatched.
18. The combined data are then accessible to my team which we can then analyze for various
purposes, including determining the rates of positivity among Travellers entering Canada.
6
AR04676
D. Analysis
19. Based on data extracted on September 16, 2021, the Directorate prepared a brief deck
entitled “Counts of cases and travellers using ALL TESTS for ALL countries” comparing the rates
of positive tests among different groups of Travellers based on their vaccination status. A copy of
that report is attached as Exhibit “C”.
20. PHAC does not have data in respect of Travellers’ vaccination status before July 2021. To
the best of my knowledge, CBSA was not systematically collecting this information before that
date.
21. For the purposes of that report, we defined the COVID-19 vaccination status of Travellers
entering Canada as follows:
a. Unvaccinated Travellers were individuals who had no record of having received

any vaccine for COVID-19;
b. Fully vaccinated Travellers were individuals who had completed a course of

vaccines for COVID-19 approved by Health Canada at least 14 days before arrival;
c. Partially vaccinated Travellers were individuals who had started but not completed
a course of vaccines for COVID-19 approved by Health Canada or who had
completed that course less than 14 days before arrival;
d. WHO-approved vaccinated Travellers were individuals who had completed a

course of vaccines for COVID-19 approved by the WHO, but not approved by
Health Canada, at least 14 days before arrival;
e. WHO-approved partially vaccinated Travellers were individuals who had started,

but not completed a course of vaccines for COVID-19 approved by the WHO, but
not approved by Health Canada, or who had completed that course less than 14
days before arrival;
f. Other vaccinated Travellers were individuals who had received a course of vaccines
not approved by either Health Canada or the WHO; and
7
AR04677
g. The records of certain Travellers were not reconciled and therefore their
vaccination status was unknown.
The latter two categories were not included in the analysis set out in the deck.
22. For clarification, I repeat that since November 30, 2021, the definition of a fully vaccinated
person would include individuals who completed a course of WHO-approved vaccines approved
for border crossing by the Minister of Health.
23. The data indicated that during the period between July 5, 2021 and August 8, 2021,
unvaccinated Travellers arriving in Canada had a positivity rate of 0.59% based on Day 1 tests. In
contrast, partially vaccinated Travellers had a positivity rate of 0.38%, while fully vaccinated
Travellers had a positivity rate of only 0.17% based on a Day 1 Test. In other words, the positivity
rate among unvaccinated Travellers was nearly three-and-a-half times that among fully vaccinated
Travellers.
24. As of August 9, 2021, fully vaccinated Travellers were no longer required to take a Day 1
Test on a universal basis. Instead, they were subject to a Mandatory Random Testing (MRT)
Program by which only a random selection of fully vaccinated Travellers would be required to
complete a Day 1 Test. As such, the absolute numbers of vaccinated Travellers tested for COVID-
19 on arrival decreased after this date; however, as the MRT program was designed to test a
statistically representative sample of fully vaccinated Travellers and the Travellers were randomly
selected, the Directorate considered the results as likely reflecting the positivity rates of all fully
vaccinated Travellers entering Canada at that time.
25. The data indicated that during the period between August 9, 2021 and September 11, 2021,
unvaccinated Travellers arriving in Canada had a positivity rate of 1.06% based on Day 1 tests. In
contrast, partially vaccinated Travellers had a positivity rate of 0.73% while fully vaccinated
Travellers had a positivity rate of only 0.23% based on Day 1 tests. The positivity rate among
unvaccinated Travellers was over four-and-a-half times that among fully vaccinated Travellers.
26. I am informed by counsel and do believe that Jennifer Little of Transport Canada will
explain in her affidavit both that Transport Canada received this deck from PHAC in September
2021 and how Transport Canada used the information contained in this deck.
8
AR04678
27. As noted above, on October 27, 2021, PHAC presented a report prepared by the Directorate
attached as Exhibit “B” entitled “Findings from Canada’s COVID-19 Border Surveillance.” to the
Federal/Provincial/Territorial Technical Advisory Committee (TAC). The purpose of that report
was to explain the then-existing border testing requirement for Travellers, present key findings
from the Directorate’s analysis of border testing data, and to raise possible changes to the border
testing requirements.
28. As part of that report, rates of COVID-19 positivity among Travellers arriving from
February 21 to July 3, 2021 were presented for air and land. This demonstrated that test positivity
among air Travellers peaked in mid-April at approximately 2.5%; positivity rates dropped
considerably thereafter. Throughout this period, the positivity rates at land remained on average
between 0.1% and 0.3%.
29. As above, PHAC did not have information about Travellers’ vaccination status before July
2021. Once that information was available, the data from July to October 2021 indicated that
Travellers who were considered un-vaccinated were five times more likely to test positive for
COVID-19 than Travellers who were considered to be fully vaccinated.
30. I am informed by counsel and do believe that Jennifer Little of Transport Canada will
explain in her affidavit both that Transport Canada received this deck in October 2021 and how
Transport Canada used the information contained in this deck.
E. Recent Analyses
31. PHAC has been continuing to receive and analyze data in respect of COVID-19 positivity
rates for Travellers since the deck attached as Exhibit “C” was generated and provided to Transport
Canada.
32. I attach as Exhibit “D” a deck prepared on March 21, 2022 for the purpose of this affidavit
and which sets out the results of subsequent data collection and analysis. The data in this deck are
presented slightly differently from those in the deck attached as Exhibit “C” in that (a) the data
from unvaccinated and partially vaccinated Travellers are grouped together and compared against
the data from fully vaccinated Travellers and (b) vaccination status is derived differently and
9
AR04679
considers the Border Services Officer’s final decision as to whether someone qualifies as fully
vaccinated.
33. The emergence of the Omicron variant of COVID-19 in November 2021 coincided with a
shift of positivity rates among arriving Travellers. Of note, and as set out on page two of Exhibit
“D”, the positivity rates rose markedly in both vaccinated and unvaccinated/partially vaccinated
Travellers beginning in late November 2021. The positivity rate for both groups peaked in early
January 2022 at which point, there was a 21.4% Day 1 positivity rate in unvaccinated or partially
vaccinated Travellers while there was a 9.29% Day 1 positivity rate among fully vaccinated
Travellers.
34. Since the first week of January 2022, the positivity rates among all Travellers has decreased
up to the time of analysis shown. During the week of February 20, 2022, there was a 2.41% Day
1 positivity rate among unvaccinated or partially vaccinated Travellers and a 1.42% Day 1
positivity rate among fully vaccinated Travellers. The chart below is taken from page two of
Exhibit “D”, and demonstrates both the number of tests administered and the positivity rate in each
group.
Test Positivity in International Travellers , by Vaccination Status

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Week of Arrival into Canada

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% Positivity (Overall) - Fully Vaccinated Travellers % Positivity (Overall) - Unvaccinated/Partially Vaccinated Travellers
10
AR04680
35. The data have also allowed the Directorate to determine the comparative ratios of positive
test results between fully vaccinated Travellers and unvaccinated/partially vaccinated Travellers
since July 5, 2021. While the exact ratios have varied from week to week, certain trends were
evident. From July 5, 2021 to November 27, 2021, the Day 1 positivity rate among
unvaccinated/partially vaccinated Travellers was generally four to five times that among fully
vaccinated Travellers. Since the emergence of the Omicron variant in November 2021 the
positivity rate among unvaccinated/partially vaccinated Travellers was generally two times that
among fully vaccinated Travellers. This later ratio has remained stable since December 2021.
These ratios are set out in detail on pages 3 and 4 of Exhibit “D”.
36. I make this affidavit bona fide in support of the Attorney General of Canada’s position in
these matters and for no other purpose.
AND I HAVE SIGNED by

technological means in the City of
Ottawa, in the Province of Ontario, this
22nd day of April, 2022.
ELIZABETH HARRIS
Affirmed before me by technological means in

the City of Saint-Rémi, in the Province of
Québec, this 22nd day of April, 2022.

Commissioner for Oaths for Québec and for
outside Québec
11
AR04681
This is Exhibit “A” referred to in the

Affidavit of Elizabeth Harris
affirmed before me by technological means
in the City of Saint-Rémi, in the Province of Québec,
this 22nd day of April, 2022.

Commissioner for Oaths for Québec and for outside of Québec
AR04682
Dr. Elizabeth Rolland-Harris

Education
Doctor of Philosophy, Infectious Disease Epidemiology, London School of Hygiene and Tropical
Medicine, London (UK), 2010
Master of Science, Epidemiology, University of Toronto, Toronto, ON (Canada), 2001
Bachelor of Arts (Honours), Geography, Queen’s University, Kingston, ON (Canada), 1998
Professional Experience
Scientific Director, COVID Testing Directorate, Infectious Disease Prevention and Control
Branch, Public Health Agency of Canada, Ottawa (Canada), March 2021-Present
• Lead a team implementing and evaluating border testing for COVID-19
Acting Director, Global Health and Guidelines Division, Centre for Chronic Disease Prevention
and Health Equity, Public Health Agency of Canada, Ottawa (Canada), October 2020-March 2021
Acting Senior Manager, Global Health and Guidelines Division, Centre for Chronic Disease
Prevention and Health Equity, Public Health Agency of Canada, Ottawa (Canada), February 2020-
October 2020
• Director/Senior Manager to epidemiologist/subject-matter expert team responsible for
providing scientific leadership and support of Canadian Task Force on Preventive Health
Care clinical guidelines development and dissemination
Manager, Global Health and Guidelines Division, Centre for Chronic Disease Prevention and
Health Equity, Public Health Agency of Canada, Ottawa (Canada), October 2019-February 2020
• Manager to epidemiologist/subject-matter expert team responsible for providing scientific
leadership and support of Canadian Task Force on Preventive Health Care clinical guidelines
development and dissemination
Senior Epidemiologist (Secondment), H1N1 Task Force, Public Health Agency of Canada, Ottawa
(Canada), 2009-2010
• Seconded by DND to provide epidemiological expertise to PHAC response to H1N1
Senior Epidemiologist, Force Health Protection, Department of National Defence, Ottawa

(Canada), June 2006-October 2019
• Managing a multi-site team of epidemiologists and support staff
• Provided epidemiological leadership on multiple cross-cutting military health files
Lead Epidemiologist (Secondment), SARS Team, Ontario Ministry of Health and Long-Term Care,
Toronto (Canada), 2003
• Seconded by KFL&A Public Health to support Ontario’s provincial response to SARS
Public Health Epidemiologist, PHRED Program, KFL&A Public Health, Kingston (Canada), 2002-
2005
• Public Health Epidemiologist for the KFL&A Public Health Unit
AR04683
Research Associate, Department of Emergency Medicine, Queen’s University, Kingston

(Canada), 2001-2002
• Managed all aspects of injury-related surveillance programs and multi-site randomized
clinical trials
Selected Peer-Reviewed Publications

• Lunney M, Ronksley PE, Weaver R, Barnieh L, Blue D, Avey M, Rolland-Harris E,
Khan FM, Pang JXQ, Rafferty E, Scory TD, Svenson LW, Rodin R, Tonelli M. COVID-19
infection among international travelers: a prospective analysis. BMJ Open.
2021;11:e050667.
• Rolland-Harris E, Simkus K, Weeks M. Burden of Cancer mortality in the Canadian

Armed Forces, 1976-2012: A Retrospective Cohort Study. Cancer Epidemiology,
Biomarkers & Prevention. 2019;28(8):1364-9.
• Rolland-Harris E. Beyond Counting Numbers: Evolution of the Canadian Armed

Forces Suicide Surveillance Capacity. Military Medicine. 2019;184(3/4):37.
• Rolland-Harris E, VanTil L, Zamorski M, Boulos D, Reicker A, Masoud H, Trudeau R,

Weeks M, Simkus K. The Canadian Forces Cancer and Mortality Study II: A
Longitudinal Record-Linkage Study Protocol. CMAJ Open. 2018;6(4):619-27.
• Rolland-Harris E, Weeks M, Simkus K, VanTil L. Overall mortality of Canadian

Armed Forces personnel enrolled 1976-2012. Occupational Medicine. 2018.
68(1):32-7.
• Rolland-Harris E, Vachon J, Kropp R, Frood J, Morris K, Pelletier L, Rodin R.

Hospitalization of Pregnant Women with Pandemic A/H1N1 2009 in Canada.
Epidemiology and Infection. 2012;140(7):1316-27.
• Rolland-Harris E, Mangtani M, Moore KM. Who uses Telehealth? Setting a usage

baseline for the early identification of pandemic influenza activity. Telemedicine
and e-Health. 2012;18(2):153-7.
• Rolland-Harris E, Tepper M. Letter to the Editor: Cost-effectiveness of Ontario’s

pandemic vaccine program. Vaccine, 2011;29(22):3829.
• Jouvet P, Hutchison J, Pinto R, Menon K, Rodin R, Choong K, Kesselman M,

Veroukis S, Dugas MA, Santschi M, Guerguerian AM, Witchington D, Alsaati B, Joffe
A, Drews T, Skippen P, Rolland E, Kumar A, Fowler R. Critical Illness in Children with
Influenza A/H1N1 2009 infection in Canada. Pediatric Critical Care Medicine,
2010;11(5):603-9.
2/2
AR04684
This is Exhibit “B” referred to in the


I + IAR04685
Public Health
Agency of Canada
Agence de la sant£
publique du Canada Canada
Findings from Canada’s COVID-19 Border Surveillance
Presentation to TAC
October 27, 2021
AR04686
Purpose
• Describe testing requirements for international travellers entering Canada
• Present key findings from COVID-19 border testing data
• Discuss potential testing program changes for feedback

– Whether to modify pre-departure test requirements for fully vaccinated travellers
– Whether antigen tests should be accepted for pre-departure tests
– Whether to continue Day 8 testing for unvaccinated travellers
– Whether to implement mandatory randomized testing for unvaccinated travellers and phase it
out for fully vaccinated travellers
2
AR04687
Why Canada tests international travellers for COVID-19
• COVID-19 border testing is a public health measure Pillars of Canada’s COVID-19

implemented to protect the health and safety of Canadians Border Measures
during the pandemic
– Prevent infected travellers from travelling into Canada Entry Restrictions
– Detect and isolate infected travellers arriving in Canada
Global Travel Advisory
– Monitor prevalence of COVID-19 in travellers to Canada
Public health measures during

• Each case detected among international travellers can
travel
prevent new chains of transmission in Canadian
communities Traveller Vaccination Status
• Supports Provincial and Territorial efforts to control Testing (pre- and post-arrival)
disease outbreaks, and protect health care capacity and
vulnerable populations Quarantine and Isolation Orders
• Positive specimens are sent for genomic sequencing for
Variants of Interest and Concern
3
AR04688
Canada Border Testing Program Changes

Implementation of post- Day 8 testing and 14-day
All incoming arrival testing on Day 1 quarantine requirement
commercial (Arrival Test) and on Day dropped for fully vaccinated
Majority of incoming passenger flights to Discretionary entry
commercial 10 of the 14-day travellers only * into Canada is
Canada restricted to 4 mandatory quarantine
passenger flights to Day 1 and Day 8 testing granted to fully
largest airports for non-exempt
Canada restricted to 4 (including Sun requirement for partially or vaccinated
largest airports travellers entering non-vaccinated travellers international travellers
destinations, US) Canada by air or land. remains unchanged
September 7,
March 18, 2020 February 3, 2021 February 21, 2021
July 5, 2021 2021
January 7, 2021 February 15, 2021 April 22, 2021 August 9, 2021
Discretionary entry into Canada is
Implementation of 72- Pre-Arrival PCR test for Shift from Day 10 to granted to fully vaccinated US travellers
hour pre-departure land border travellers Day 8 post-arrival
Programmatic shift to Mandatory
PCR testing required testing Random Testing for vaccinated travellers
requirement for air Day 1 testing only
travellers requirement remains Day 1 and Day 8 testing requirement for
unchanged partially or non-vaccinated travellers
remains unchanged
* Fully vaccinated is defined as having received all required doses of a

Health Canada approved vaccine, more than 14 days prior to arrival
into Canada
4
AR04689
COVID-19 Border Testing: February 21 to July 3, 2021
Positivity Dropped in May and June

• All Non-exempt travellers tested for COVID-19 pre-departure, on arrival and at Day 10/8 (+ Quarantine*14
days)
• Of all positive tests, 55% were detected on Day 1 test and 45% detected on Day 10/8 test
• COVID-19 positivity peaked in April (2% of tests from air travellers)

– Surge detected in positivity on direct flights from India and Pakistan
– After implementation of NOTAM on April 22, test positivity for air travellers entering Canada dropped to
0.3% in May
Air (%) Land (%) Overall (%)
• By June, positivity at land border was 0.1% February 1.3 0.3 1.0
– Epidemiological improvement in United States March 1.7 0.3 1.4
– Likely that many returning Canadian travellers April 2.0 0.3 1.4
(e.g. snowbirds) are fully vaccinated May 0.3 0.2 0.3
June 0.3 0.1 0.3
5
AR04690
Positivity (%) by Mode of Entry from February 21 to July 3, 2021

% Positivity by Mode of Entry
80,000 3.5
3
Number of Resulted Tests
60,000
2.5
% Positivity
2
40,000
1.5
1
20,000
0.5
0 0
Air % positivity Land % positivity Week of Arrival

6
AR04691
Current Testing Requirements* for Non-Exempt Travellers Entering Canada
All travellers:
72-hour pre-entry/departure PCR test
or proof of positive test (within 14 to 180 days)
Fully vaccinated
Partially/Non-vaccinated
with HC-approved vaccines
Required to complete an arrival PCR

test if they are selected for Mandatory Requirement to undergo
Randomized Testing (MRT) upon entry COVID-19 PCR test at arrival
to Canada (Day 1) and on Day 8 of their
No Day 8 test nor 14-day quarantine 14-day quarantine period
requirement
PCR tests detect COVID infections earlier and later in the cycle of infection in a
traveller, are substantially more accurate than rapid antigen testing, and provide
genetic material required to sequence to identify Variants of Concern
*As of Aug 9, 2021
7
AR04692
Move to Mandatory Randomized Testing (MRT) for Fully Vaccinated Travellers

• Given the low level of positive tests for vaccinated travellers, the high rate of vaccinated Canadians,
and limited supply of tests and space at points of entry, since August 9, 2021 fully vaccinated travellers are
subject to MRT
– At present, 5,625 vaccinated travellers are tested each day, for a 90% statistical significance
– PHAC is currently growing the sample size to 9,100 a day to reach 95% statistical significance
• MRT provides epidemiological intelligence and rapid and actionable evidence for policy decision-making
and response
– 9% of eligible, fully vaccinated travellers who arrived into Canada from August 9th to October 9th, completed a Day 1
test under the MRT program
• This approach represents a step change from the previous population-wide monitoring approach for all
travellers, whether vaccinated or not, acknowledging that:
– Increasing traveller volumes are stressing the system’s ability to test all incoming travellers
– Vaccinated travellers represent a lower risk of importation than unvaccinated travellers
– Additional fail-safes in the system (including pre-departure testing) also provide additional layers of
protection against importation
8
AR04693
COVID-19 Border Testing: July to October, 2021

Unvaccinated Travellers 5x More Likely to Test Positive
• Early July, Border Testing Program begins tracking travellers by vaccination status
– Fully vaccinated: 2 doses of HC-approved vaccine
– Unvaccinated: Traveller did not report a single dose of any vaccine
– Not recognized as fully vaccinated: unvaccinated, partially vaccinated, partially/fully vaccinated with a non-HC-
approved vaccine
– All travellers not recognized as fully vaccinated are subject to 14-day quarantine and Day 1 & 8 tests
Since the launch of MRT, Day 1 test positivity:
Unvaccinated: 0.99%
Fully Vaccinated: 0.21%
• United States 4th Wave (August to current) had impacts on Day 1 test positivity of land border travellers:
– Not recognized as fully vaccinated test positivity peaked at 1.49% (September 5-11)
– Fully vaccinated test positivity peaked at 0.21% (September 5-11)
– Not recognized as fully vaccinated more affected by US 4th wave (7x more likely to test positive than
vaccinated)
9
AR04694

With pre-departure testing in place, Sinopharm/Sinovac vaccines test positive at
similar rates to HC-approved vaccines
• Canada considers fully vaccinated travellers to have received a full series (or mix) of Health Canada
approved vaccines: Moderna, Pfizer, AstraZeneca and Janssen
• WHO approved vaccines include Health Canada approved vaccines, but also Sinopharm and Sinovac
• Border Testing Surveillance has observed a gradient in test result positivity
Day 1 Positivity Day 8 Positivity

Unvaccinated 0.81 1.13
Partially vaccinated (HC-approved) 0.48 0.90
Partially vaccinated (Sinopharm/Sinovac) 0.09 0.41
Fully Vaccinated (Sinopharm/Sinovac) 0.14 0.33

Fully Vaccinated (HC-approved) 0.18 N/A
10
AR04695

Fully Vaccinated now comprise vast majority of non-exempt travellers
Border Crossings, by Vaccination Status
400,000
Number of Border Crossings
300,000
200,000
100,000
0
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PUBLIC HEALTH A G EN CY O F C A N A D A > 11

AR04696
Pre-departure test
Effective Tool to Prevent Entry of Infected Travellers
• Pre-departure molecular test required for both unvaccinated and fully vaccinated non-exempt
travellers within 72 hours of travel to Canada
• Canada’s Border Testing Program does not have data on impact of pre-departure test
– Travellers who receive positive result do not report it – they delay trip to Canada by at least 14
days
• Border testing surveillance approach includes the pre-departure test in program design, modeling
assumptions and risk analysis of importation
• Canada sees relatively low importation of COVID-19 due in part to pre-departure test
– Removal of pre-departure test requirement would increase importation (difficult to quantify impact)
– Permitting other types of tests (e.g. antigen) may also increase importation (difficult to quantify impact)
12
AR04697
Upcoming Changes to Border Testing Program

• Re-open more airports to international flights
– It is proposed that self-swab kits will be distributed to unvaccinated travellers in smaller airports with limited
international traffic
– MRT- TBD whether sufficient travel volume to merit running program there (5-10 kits/day); PHAC will still be
testing connecting travellers going to ALL jurisdictions in Canada
• Temporary swab stations located at high-traffic land border crossing will close before winter
• MRT sample size to be enhanced to 9,100 tests/day

– On-site testing at four major airports to continue
• Changes occurring during evolving context

– Transport Canada mandate requiring vaccination to travel on air, rail (Via), marine
– Pent up demand for international travel
– Possible waning immunity and booster doses
– Consideration of other vaccines accepted for international travel
13
AR04698
U.S. Border Re-opening – Implications

• US land border re-opening for discretionary travel on November 8, 2021
– Proof of vaccination required for all travellers, will be verified through secondary screening
– No pre-departure test requirement will be established for land border travellers
– Essential workers need to be vaccinated by January 2022 (e.g. truckers)
– US will accept all WHO-approved vaccines and mixed doses among fully vaccinated travellers
• Direct flights to US
– Proof of vaccination required to board flight
– Pre-departure test requirement remains in effect (PCR or antigen)
• Implications for Canada

– New volume pressure at Canadian land border crossings as travellers return
– Volumes increasing as immunity starts to wane in winter
– MRT sample size will be stable as traveller volumes increase
– Travellers may favour land travel over air travel due to US’ differentiated pre-departure test approach
– Stakeholders calling for Canada to remove pre-departure test requirement or to accept antigen pre-
departure tests
14
AR04699
Questions for consideration – Modifications to current testing regime

• Should pre-departure test be modified or removed?
– Reduce cost and logistical burden on travellers
– Increases importation; are PT systems sufficiently resilient; vulnerable populations
– Option to remove for some modes of entry or for brief trips (e.g. day trip travel)
– Option to accept Antigen pre-departure tests, which would reduce costs for traveller, but reduce
reliability for traveller (false positives) and increase importation (false negatives)
• Should unvaccinated travellers continue with Day 8 test?

– Given high population immunity through vaccination, is a two test border testing regime sufficient (e.g.
pre-departure test and Day 1 test)
– Would reduce case detection; recall >45% of positive tests are currently detected on Day 8 test
• Should MRT scope change?

– Option to do MRT for both fully vaccinated and unvaccinated travellers; no longer test all unvaccinated
travellers on Day 1
– Option to phase out MRT for fully vaccinated travellers, if so when?
– Volumes of unvaccinated travellers will decline precipitously in months ahead
15
AR04700
Annex
16
Managing
AR04701 volumes: opening additional airports
FY 2019-20
Rank Airport
International Passengers % of total
1 Toronto Pearson (T1) 8,932,503 25.5%
“Big 4” 2 Vancouver 6,761,587 19.3%
airports 3 Montreal 6,587,514 18.8%
4 Toronto Pearson (T3) 6,581,897 18.8%
remained 5 Calgary 2,783,243 7.9%
open 6 Edmonton 705,209 2.0%
7 Ottawa 554,139 1.6%
8 Toronto Billy Bishop 451,036 1.3%
Next six 9 Winnipeg 346,002 1.0%
reopened 10 Halifax 331,454 0.95%
fall 2021 11 Quebec City 313,428 0.89%
12 Hamilton 170,319 0.49%
13 Victoria 126,078 0.36%
Airports 14 Saskatoon 98,696 0.28%
proposed 15 Kelowna 71,690 0.20%
16 Regina 48,139 0.14%
to reopen 17 London 34,756 0.10%
18 Abbotsford 30,934 0.09%
19 Moncton 22,653 0.06%
<2% of
20 St. John's NL 22,548 0.06%
total air
volume 21 Windsor 11,314 0.03%
TBD Harbour Air (Vancouver) TBD TBD
Other Airports 62,756 0.18%
Grand Total 35,047,895 100%
17
AR04702
Turn-Around Times (TAT)

• TAT is the time from specimen collection to reporting of the test result
• Availability of testing on-site or near to the border crossing improves TAT:
– On-site testing = Day 1 Air = Median TAT 17 hours
– Near to border crossing = Day 1 Land (Swab Island) = Median TAT 55 hours
– At-home testing = Day 1 Air, Day 1 Land (Not Swab Island), Day 8 Land = Median TAT 82-83 hours
Air Land
Day 1 Day 8 Day 1 Day 1 Day 8
Weeks 30-32 (Sep 12-Oct 2) (Swab Island) (Not Swab Island)
Total 87,594 53,117 17,293 5,492 3,483
Median (hrs) 17h 82h 55h 83h 83h
% reported within 48 hrs 98.2% 18.8% 44.1% 22.0% 18.9%
• ‘Air’ includes tests from travellers arriving at YVR, YYC, YYZ and YUL
• ‘Day 1 (Swab Island)’ includes tests from travellers arriving at any of the 16 land ports of entry where testing stations are available nearby
18
AR04703
This is Exhibit “C” referred to in the


METHODS for Table 1
AR04704
Counts of cases and travellers using ALL TESTS for ALL countries
• Data extracted: Sept 16, 2021
• Dates of arrival & collection dates used: July 5-Sept 11 2021
• Both Day 1 and Day 8 tests used: Day 1 or 8 label as for HPOC slides
• Vaccination groups are mutually exclusive, n=7 and are based on ArriveCAN/CBSA or vaccine record
1. Unvaccinated: no record of ANY vaccine at all
2. Fully vaccinated: complete schedule of Health Canada-approved shots & arrival date is at least 14 days after last
shot
3. Partially vaccinated: Incomplete doses (1 dose only from 2-dose HC-approved shots) or 2-dose HC-approved
shots but <14 days since last shot upon arrival
4. WHO-approved vaccines, fully vaccinated: 2 shots of Sinopharm or Sinovac AND no record of any HC-approved
shots
5. WHO-approved vaccines, partially vaccinated: 1 shot only of Sinopharm or Sinovac AND no record of any HC-
approved shots
6. Other vaccines: received any non-HC, non-WHO approved shots (eg, Bharat Biotech, etc. Not shown in Table 1)
7. Unknown vaccination status: unreconciled test records (not shown in Table 1)
*If a traveller has received both WHO-approved and HC-approved vaccine, the status of the HC-approved vaccine will
be used to categorize them
1
Positivity by week of arrival in all tests in all countries
AR04705
Table 1: Breakdown of cases by week of arrival & vaccination status

Fully Vaccinated
DAY 1 DAY 8
(HC-approved) *Week 24 includes Aug 8,
WHO-approved, corresponding to Phase 1 (before
WHO-approved, WHO-approved, WHO-approved, fully Mandatory Random Testing (MRT)
Unvaccinated Partially vaccinated Unvaccinated Partially vaccinated partially Overall
Week of Arrival partially vaccinated fully vaccinated vaccinated **Week 25 starts Aug 9 (MRT
vaccinated
implementation)
Phase 1
***The most recent week’s results are
Week 20 (Jul 5-10) 87/31,474 incomplete as test results are still
10/4,538 (0.22%) 0/81 (0%) 1/954 (0.1%) 100/16,596 (0.6%) 6/2,403 (0.25%) 0/79 (0%) 4/868 (0.46%) 34/41,419 (0.08%)
(0.28%) incoming
Week 21 (Jul 11-17) 112/23,353 Positive Test Results / (Positive +
20/7,874 (0.25%) 0/201 (0%) 4/1,861 (0.21%) 157/17,133 (0.92%) 21/3,922 (0.54%) 1/196 (0.51%) 4/1,774 (0.23%) 45/48,217 (0.09%)
(0.48%) Negative Tests Results) from tests
142/23,162 conducted during the specified date
Week 22 (Jul 18-24) 26/9,454 (0.28%) 0/455 (0%) 5/1,882 (0.27%) 152/16,858 (0.9%) 19/3,587 (0.53%) 3/442 (0.68%) 8/1,795 (0.45%) 80/56,661 (0.14%)
(0.61%) range (% Positive – rounded to one
230/24,508 decimal spot)
Week 23 (Jul 25-31) 47/11,723 (0.4%) 1/439 (0.23%) 2/1,933 (0.1%) 257/17,776 (1.45%) 35/3,704 (0.94%) 0/405 (0%) 13/1,832 (0.71%) 116/67,796 (0.17%)
(0.94%) Data are preliminary and subject to
327/49,232 change
Week 24 (Aug 1-8)* 73/12,886 (0.57%) 0/319 (0%) 0/1,581 (0%) 371/24,782 (1.5%) 42/3,313 (1.27%) 5/318 (1.57%) 3/1,547 (0.19%) 213/77,833 (0.27%)
(0.66%)
898/151,729 176/46,475 1,037/93,145 9/1,440
Total Phase 1 1/1,495 (0.07%) 12/8,211 (0.15%) 123/16,929 (0.73%) 32/7,816 (0.41%) 488/291,926 (0.17%)
(0.59%) (0.38%) (1.11%) (0.62%)
Phase 2
Week 25 (Aug 9- 316/39,151

14)** 31/3,229 (0.96%) 0/321 (0%) 5/1,922 (0.26%) 337/27,610 (1.22%) 39/2,247 (1.74%) 2/329 (0.61%) 7/1,915 (0.37%) 34/15,149 (0.22%)
(0.81%)
Week 26 (Aug 15- 402/36,431
21)*** 32/4,692 (0.68%) 0/564 (0%) 3/3,238 (0.09%) 323/27,167 (1.19%) 34/3,351 (1.01%) 3/550 (0.55%) 6/3,242 (0.19%) 46/17,156 (0.27%)
(1.1%)
Week 27 (Aug 22- 303/24,152
28)*** 43/6,418 (0.67%) 0/685 (0%) 7/3,654 (0.19%) 220/20,004 (1.1%) 45/4,361 (1.03%) 2/656 (0.3%) 5/3,555 (0.14%) 56/23,223 (0.24%)
(1.25%)
Week 28 (Aug 29- 217/19,144
Sept 04)*** 32/4,900 (0.65%) 1/575 (0.17%) 5/3,465 (0.14%) 175/13,998 (1.25%) 30/2,930 (1.02%) 3/525 (0.57%) 9/3,140 (0.29%) 50/21,158 (0.24%)
(1.13%)
Week 29 (Sept 05- 181/14,494
Sept 11)*** 29/3,737 (0.78%) 2/668 (0.3%) 2/3,291 (0.06%) 20/2,084 (0.96%) 3/479 (0.63%) 0/100 (0%) 1/552 (0.18%) 29/16,989 (0.17%)
(1.25%)
1,419/133,372 167/22,976 22/15,570 1,075/90,863 10/2,160
Total Phase 2 3/2,813 (0.11%) 151/13,368 (1.13%) 28/12,404 (0.23%) 215/93,675 (0.23%)
(1.06%) (0.73%) (0.14%) (1.18%) (0.46%)
TOTAL (PHASE 1 2,317/285,101 343/69,451 34/23,781 2,112/184,008 19/3,600
&2) 4/4,308 (0.09%) 274/30,297 (0.9%) 60/20,220 (0.3%) 703/385,601 (0.18%)
(0.81%) (0.49%) (0.14%) (1.15%) (0.53%)
2
AR04706
This is Exhibit “D” referred to in the


I + IAR04707
Public Health
Agency of Canada
Agence de la sant£
publique du Canada Canada
Information for Affidavit

CBTP - Fully vaccinated vs. Unvaccinated/partially vaccinated international travellers, by week of arrival (October 31, 2021 – February 26, 2022)
AR04708
• With the emergence of the Omicron variant in late November 2021, and its subsequent spread across the globe, test positivity among both unvaccinated/partially vaccinated and fully
vaccinated international travellers increased, peaking at 19.85% and 9.29% in the first week of January 2022. Since then, test positivity for both traveller groups has steadily decreased, to
2.38% and 1.42% for the week ending February 26th, 2022.
• Although test positivity remains higher among unvaccinated/partially vaccinated compared to fully vaccinated international travellers, the test positivity ratio between these two traveller
groups has decreased.
Test Positivity in International Travellers, by Vaccination Status Test Positivity Ratio
(Unvaccinated/Partially Vaccinated vs. Fully Vaccinated
Number of Resulted Tests from International Travellers
160,000 30.0 5
International Travellers)
140,000
4
120,000
Test Positivity Ratio

20.0
Test Positivity (%)

Arriving into Canada
100,000 I\ 3
\
80,000 / \
\
/ \
60,000 / 2
\
10.0
/ \
40,000 / N
v, 1
%
20,000
0 0.0
0
\ 'b <0 1 \°> 'b <b o> *£>
\ N’o

Total Tests (Overall) - Fully Vaccinated Travellers Total Tests (Overall) - Unvaccinated/Partially Vaccinated Travellers
% Positivity (Overall) - Fully Vaccinated Travellers % Positivity (Overall) - Unvaccinated/Partially Vaccinated Travellers
2
CBTP - Fully vaccinated vs. Unvaccinated/partially vaccinated international travellers, by test day (July 5, 2021 – February 26, 2022)
AR04709
• From July to November 2021, unvaccinated/partially vaccinated travellers (cumulative Day 1 + Day 8 test positivity) were 4.7 times more likely to test positive than fully vaccinated
travellers. This is likely due to the effectiveness of vaccines against circulating strains and the recentness of vaccination (i.e. the majority of fully vaccinated Canadian travellers received
their second dose in Summer/Fall 2021).
• With the emergence of the Omicron variant in late November 2021, we observed a sudden and sustained decrease in the effectiveness of vaccination against infection among international
travellers. Between November 28th, 2021 and February 26th, 2022 unvaccinated/partially vaccinated travellers were 2.0 times more likely to test positive than fully vaccinated travellers.
Fully Vaccinated
Unvaccinated/Partially Vaccinated International Travellers International Travellers
(Unvaccinated/Partially Vaccinated
Period of Arrival into Canada Day 1 Day 8 Overall Overall vs. Fully Vaccinated International Travellers)
Total Phase 1 (Jul 5-Aug 8) 987/165,908 (0.59%) 1,198/119,398 (1.00%) 2,185/285,306 (0.77%) 571/324,877 (0.18%) 4.4
Total Phase 2 (Aug 9-Sep 9) 1,542/154,688 (1.00%) 1,396/132,605 (1.05%) 2,938/287,293 (1.02%) 208/102,756 (0.20%) 5.1
Total Phase 3 (Sep 10-Nov 27) 1,015/169,133 (0.60%) 1,004/137,301 (0.73%) 2,019/306,434 (0.66%) 556/341,249 (0.16%) 4.0
Phase 3a
December 2021 (Nov 28-Dec 31)* 2,362/72,625 (3.25%) 2,621/44,879 (5.84%) 4,983/117,504 (4.24%) 11,160/443,610 (2.52%) 1.7
January 2022 (Jan 1-29)* 9,100/53,460 (17.02%) 4,040/29,127 (13.87%) 13,140/82,587 (15.91%) 36,562/490,742 (7.45%) 2.1
Week 50 onwards
Week 50 (Jan 30-Feb 5) 555/6,700 (8.28%) 148/3,582 (4.13%) 703/10,282 (6.84%) 3,326/99,632 (3.34%) 2.0
Week 51 (Feb 6-12) 362/6,455 (5.61%) 111/3,125 (3.55%) 473/9,580 (4.94%) 2,275/97,924 (2.32%) 2.1
Week 52 (Feb 13-19) 233/6,740 (3.46%) 46/1,942 (2.37%) 279/8,682 (3.21%) 1,656/103,319 (1.60%) 2.0
Week 53 (Feb 20-26) 161/6,691 (2.41%) 3/188 (1.60%) 164/6,879 (2.38%) 1,388/97,625 (1.42%) 1.7
Total Phase 3a (Nov 28-Feb 26) 12,773/152,671 (8.37%) 6,969/82,843 (8.41%) 19,742/235,514 (8.38%) 56,367/1,332,852 (4.23%) 2.0
*Slide 4 contains a weekly breakdown for the period of November 28, 2021 to January 29, 2022.
• Data are preliminary and subject to change. The most recent weeks’ results are incomplete as test results are still incoming
• Positive Test Results / (Positive + Negative Tests Results) from tests conducted during the specified date range (% Positive – rounded to one decimal spot)
• Includes all Modes of Entry: Air, Land and Unknown
• Vaccine status was only collected in QCMS from July 5th, 2021 onwards. Therefore data from travellers who arrived before July 5th are excluded.
• Source: Public Health Agency of Canada Quarantine Case Management System (QCMS) 20220302
PUBLIC H E A L T H A G E N C Y O F C A N A D A > 3
CBTP - Fully vaccinated vs. Unvaccinated/partially vaccinated international travellers, by test day (November 28, 2021 – February 26, 2022)
AR04710
• The test positivity ratio between partially/non-vaccinated and fully vaccinated international travellers has remained two-fold and stable since the Omicron variant emerged in late
November 2021. Although the ratio decreased in comparison to the pre-Omicron period, there remains evidence that vaccination is protective against infection among international
travellers arriving into Canada.
Fully Vaccinated
Partially/Non-Vaccinated International Travellers International Travellers
(Partially/Non-Vaccinated
Week of Arrival into Canada Day 1 Day 8 Overall Overall vs. Fully Vaccinated International Travellers)
Week 41 (Nov 28-Dec 4) 87/11,784 (0.74%) 71/9,945 (0.71%) 158/21,729 (0.73%) 181/56,201 (0.32%) 2.3
Week 42 (Dec 5-11) 69/9,186 (0.75%) 82/6,622 (1.24%) 151/15,808 (0.96%) 244/72,101 (0.34%) 2.8
Week 43 (Dec 12-18) 172/14,082 (1.22%) 284/8,253 (3.44%) 456/22,335 (2.04%) 802/94,374 (0.85%) 2.4
Week 44 (Dec 19-25) 640/20,121 (3.18%) 877/10,318 (8.50%) 1,517/30,439 (4.98%) 2,884/112,391 (2.57%) 1.9
Week 45 (Dec 26-Jan 1) 1,696/20,330 (8.34%) 1,592/11,423 (13.94%) 3,288/31,753 (10.35%) 8,898/128,959 (6.90%) 1.5
Week 46 (Jan 2-8) 4,305/20,364 (21.14%) 1,911/10,954 (17.45%) 6,216/31,318 (19.85%) 13,469/144,955 (9.29%) 2.1
Week 47 (Jan 9-15) 2,380/14,981 (15.89%) 961/7,747 (12.40%) 3,341/22,728 (14.70%) 10,215/125,409 (8.15%) 1.8
Week 48 (Jan 16-22) 1,335/8,475 (15.75%) 580/4,757 (12.19%) 1,915/13,232 (14.47%) 6,584/101,857 (6.46%) 2.2
Week 49 (Jan 23-29) 778/6,762 (11.51%) 303/3,987 (7.60%) 1,081/10,749 (10.06%) 4,445/98,105 (4.53%) 2.2
Week 50 (Jan 30-Feb 5) 555/6,700 (8.28%) 148/3,582 (4.13%) 703/10,282 (6.84%) 3,326/99,632 (3.34%) 2.0
Week 51 (Feb 6-12) 362/6,455 (5.61%) 111/3,125 (3.55%) 473/9,580 (4.94%) 2,275/97,924 (2.32%) 2.1
Week 52 (Feb 13-19) 233/6,740 (3.46%) 46/1,942 (2.37%) 279/8,682 (3.21%) 1,656/103,319 (1.60%) 2.0
Week 53 (Feb 20-26) 161/6,691 (2.41%) 3/188 (1.60%) 164/6,879 (2.38%) 1,388/97,625 (1.42%) 1.7
Total 12,773/152,671 (8.37%) 6,969/82,843 (8.41%) 19,742/235,514 (8.38%) 56,367/1,332,852 (4.23%) 2.0
• Data are preliminary and subject to change. The most recent weeks’ results are incomplete as test results are still incoming
• Positive Test Results / (Positive + Negative Tests Results) from tests conducted during the specified date range (% Positive – rounded to one decimal spot)
• Includes all Modes of Entry: Air, Land and Unknown
• Source: Public Health Agency of Canada Quarantine Case Management System 20220302
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TAB 28
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FEDERAL COURT
BETWEEN:
NABIL BEN NAOUM
Demandeur
et
Défendeur

AND BETWEEN:
Demandeur
et
Défendeur

AND BETWEEN:
AND AEDAN MACDONALD
Applicants
and
Respondent
AR04713

AND BETWEEN:
Applicants
and
Respondent
AFFIDAVIT OF MICHAEL DEJONG

Fax: (204) 983-3636

Tel: (
Email:

AR04714

FEDERAL COURT
BETWEEN:
NABIL BEN NAOUM
Demandeur
et
Défendeur

AND BETWEEN:
Demandeur
et
Défendeur

AND BETWEEN:
AND AEDAN MACDONALD
Applicants
and
Respondent
AR04715

AND BETWEEN:
Applicants
and
Respondent
AFFIDAVIT OF MICHAEL DEJONG
I, MICHAEL DEJONG, Director General of Rail Safety at Transport Canada, at 427

Laurier Avenue West, of the City of Ottawa, in the Province of Ontario, AFFIRM THAT:
1. I am the Director General of Rail Safety at Transport Canada. I have been in this position
since July 2020. In my current position, I am responsible for developing and implementing
policies and regulations, and administering the Railway Safety Act, RSC, 1985, c 32 (4th Supp). In
this context, I am responsible for managing COVID-19 regulatory responses and oversight as they
relate to the rail sector. Prior to being the Director General of Rail Safety, I was the Director
General of Multi-Modal and Road Safety Programs, from August 2017 to July 2020. In that
position I was responsible for developing and implementing regulations regarding motor vehicle
safety, and for coordinating a multi-modal approach to regulatory development, training, and
enforcement. Prior to holding that position, from 2015 to 2017, I was the Senior Director, Policy
and Program Development, Emergency Management at Public Safety Canada, where I was
responsible for advancing a cohesive, national approach to emergency management. I have
attached a copy of my current curriculum vitae as Exhibit “A” to this affidavit.
2. As a result of my current position, I have personal knowledge of the facts deposed to in

this affidavit except as follows. As part of my responsibilities as the Director General of Rail
Safety, I necessarily receive information prepared by various groups within Transport Canada and
other federal government departments or agencies working with Transport Canada. Where in this
affidavit I state that I received information gathered by others in conducting my work functions, I
confirm that I trust the accuracy of that information and believe it to be true based on the
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professional conduct and ability of those providing that information. Where I otherwise state my
knowledge is based on information and belief, I believe the same to be true.
A. Transport Canada – Rail Safety sector
3. The Minister of Transport (Minister) oversees a diverse portfolio that undertakes activities
and implements programs in support of key objectives related to the transportation system under
Federal jurisdiction. This includes overseeing the federal government’s transportation regulatory
and oversight department, Transport Canada. Under the Railway Safety Act, Parliament has given
the Minister broad powers, including delegation powers, to develop policies and regulate railways
and supervise all matters connected with railways. Transport Canada oversees rail safety and has
the power to protect people (public, passengers, and railway company employees), property, and
the environment by ensuring railways operate in compliance with the regulatory framework
governing rail safety. Railway companies are responsible for the safety of their own operations.
4. The Minister is responsible for the Rail Safety Program. The Rail Safety Program of
Transport Canada 1) develops and administers risk-based oversight plans for railways by
conducting audits and inspections of railway companies; 2) issues notices and orders to address
specific safety threats identified by inspectors; 3) takes enforcement action as required, including
issuing administrative monetary penalties when necessary; and 4) issues Ministerial Orders (MOs)
and Emergency Directives in the interest of safe railway operations or to respond to immediate
threats.
B. Regulatory framework – Rail Safety Act
5. The Railway Safety Act sets out requirements for anyone operating a federally regulated
railway or operating on the tracks of a federally regulated railway. This includes federal and local
railway companies operating on federally regulated tracks (e.g., provincially regulated short lines,
passenger railway, or tourist trains), road authorities (organizations that manage public roads in
Canada), and private authorities (businesses or people that privately own paths, trails, and roads
crossing railway tracks) who share ownership of grade crossings across Canada.
6. Under section 32.01 of the Railway Safety Act, the Minister may order a company to stop
any activity that may constitute a threat to safe railway operations or to follow a specified
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procedure. Under subsection 4(4) of the Railway Safety Act, in determining whether railway
operations are safe, the Minister must have regard not only to the safety of persons and property
transported by railways, but also to the safety of other persons and other property. As part of this
mandate, the Minister, or a Minister’s delegate, may issue an order requiring vaccination in the
interest of safe railway operations, having regard not only to the safety of persons transported by
railways but also to the safety of other persons.
7. Under section 36 of the Railway Safety Act, the Minister may order that a company provide
information or documents that they consider necessary for the purpose of ensuring compliance
with the act, regulations, rules, orders, standards, MOs, and emergency directives. Under section
45, the Minister may authorize any person to exercise any of the Minister’s powers and duties
under the Railway Safety Act.
8. Pursuant to section 45 of the Railway Safety Act, the Minister has authorized me, Director
General of Rail Safety, to make MOs that are necessary in the interest of safe railway operations.
I have attached the authorization document as Exhibit “B” to this affidavit. This includes orders
requiring proof of vaccination for passengers and mandatory vaccination for railway company
employees, described in detail below.
C. Impact of COVID-19 on the rail sector
9. The COVID-19 pandemic has had an unprecedented impact on the health of Canadians and
severe impacts on the Canadian economy and transportation sector, including rail.
10. The rail sector is essential to Canadians and the Canadian economy. Freight rail services
are a critical component of export supply chains for coal, potash, grain, forest products, chemicals,
and automobiles. Freight rail services are also a critical component of the import supply chain.
They are the primary means of transporting consumer goods and intermediate goods via containers
from Canadian ports to urban centres. Practically all of the chlorine supplied for drinking water
treatment travels by rail. Intercity passenger rail services provide an important alternative to air
and road modes of travel, especially in the densely populated corridor between Windsor and
Quebec City. Passenger rail also provides the only means of access for some remote and isolated
communities in Northern Quebec, Labrador, and Northern Manitoba.
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11. In 2019, prior to the pandemic, approximately 5 million passenger trips were taken by rail,
on VIA and Rocky Mountaineer. Passenger service on VIA Rail has experienced a significant
drop in activity following the start of the pandemic, declining to 10 percent of its pre-pandemic
level in the weeks after March 2020. Freight rail service has experienced a lesser decline given its
role in supporting essential economic activity.
12. Since the outset of the pandemic, Transport Canada has duly considered, and as necessary
acted on, the guidance of the Public Health Agency of Canada (PHAC), Health Canada, other
government departments and agencies, and global institutions (such as the World Health
Organization) to implement measures to protect those working in, and using, the federally-
regulated transportation sector, as well as the Canadian public in general.
13. To date, consistent with other transportation modes, Transport Canada has issued 19 MOs
requiring intercity passenger railway companies (e.g. VIA Rail) to conduct health checks for
COVID-19 symptoms and deny boarding to symptomatic passengers.
14. Transport Canada has provided guidance to intercity passenger railway companies and
federal railway companies on wearing of masks, physical distancing, and enhanced hygiene
protocols. This guidance complemented the railway companies’ own rigorous health checks and
safety protocols applicable to their employees, to which Transport Canada was privy. Throughout
the pandemic, my team and I have been in constant communication with railway companies
regarding the measures in place and their experiences.
15. Transport Canada has also issued a series of exemptions to medical certification
requirements, training and qualification requirements, and inspection frequencies and intervals set
out in various rules and regulations of the rail safety regime to reduce in-person contact and lessen
the risk of transmission. Most recently, it has issued MOs requiring vaccination of passengers and
railway company employees.
16. Amtrak, the U.S. national passenger railway service is the only passenger railway
company that provides service between Canada and the U.S. It ceased cross-border rail operations
with the Canada-U.S. border was closed to travel for discretionary purposes on March 21, 2020.
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It has yet to resume service. Freight rail traffic between Canada and the U.S., as an essential
service, has remained in operation since the start of the pandemic.
D. Reliance on PHAC data to develop a vaccination mandate for the federally regulated
transportation sector
17. PHAC serves as the overall Government of Canada lead for responding to the pandemic,
including by providing the relevant data and research used to inform decision-making around
public health measures at the federal level.
18. Canada’s vaccination mandate for the federally regulated transport sector has been
informed by public health considerations provided by PHAC, based on the scientific evidence
available at the material times, including information on the efficacy, availability, and uptake of
vaccines; the evolving domestic and international epidemiological situation; and the effectiveness
of public health and other measures – including in the transport sector – to keep the system and
the public safe.
19. Transport Canada’s COVID Recovery Team provides an essential leadership and
coordination role in the overall development of Transport Canada’s COVID-19 vaccination
mandate. In particular, the COVID Recovery Team directly received and considered all the public
health information that PHAC provided to guide decision makers and shared some of the
information, which I will discuss later in my affidavit, with modal Directors General, including
myself. I am informed by counsel and verily believe that Ms. Jennifer Little, Director General of
COVID Recovery, will provide affidavit evidence regarding the COVID Recovery Team and the
information it received.
20. In July 2021, PHAC broadly advised that the fourth wave of COVID-19 was underway in
Canada, being driven by the Delta variant of concern (VOC). On August 13, 2021, the
Government of Canada announced that a federal vaccination mandate would be implemented for
the federally regulated air, rail, and marine transportation sectors. It further announced that the
vaccination requirement would extend to travellers, including all commercial air travellers,
passengers on interprovincial trains (specifically, VIA Rail and the Rocky Mountaineer), and
passengers on larger marine vessels with overnight accommodations, such as cruise ships.
Following this announcement Transport Canada began developing its vaccination policies.
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21. Transport Canada’s COVID Recovery Team, and the development of the multi-modal
vaccination mandate guidance, relied on public health rationale that PHAC provided to support
multiple federal government departments’ decision making and which describes the benefits of
COVID-19 vaccination. Attached as Exhibit “C” to this affidavit is a PHAC document titled
Draft public health considerations related to the implementation of COVID-19 vaccine
requirements for the federal workforce, which I also received and considered. The PHAC public
health considerations document is marked “draft” as it is an evergreen document that PHAC
continues to update. PHAC provided an initial version on August 17, 2021. In response to
questions that arose during the policy development process, PHAC provided an updated version
of these considerations on or about August 31, 2021. Although marked “draft”, the August 31,
2021 document is the version of the public health considerations that informed Transport Canada’s
mandate for federally regulated transportation sectors and passengers.
22. In this document, PHAC highlighted key scientific evidence related to COVID-19 and
COVID-19 vaccines, including that:
i) The fourth wave of COVID-19 has started in Canada and will most likely be driven by
the Delta VOC;
ii) The Delta VOC is much more contagious than other SARS-CoV2 viruses that have
circulated in Canada; it spreads faster and increases risk of hospitalizations;
iii) SARS-CoV2 is known to be more transmissible in indoor crowded spaces, including

workplaces;
iv) Vaccines are very effective at preventing severe illness, hospitalization, and death from
COVID-19, including against the Alpha and Delta VOC;
v) People who are fully vaccinated with a COVID-19 vaccine are less likely to have
symptomatic COVID-19 disease or asymptomatic SARS-CoV-2 infection compared to
unvaccinated individuals;
vi) COVID-19 vaccines prevent transmission in two ways – by decreasing infection and by
potentially decreasing transmission from vaccinated individuals who become infected.
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There is some evidence that COVID-19 vaccines reduce the risk of transmission of
COVID-19 by vaccinated individuals who are infected;
vii) The benefits of vaccination outweigh any safety risks; and
viii) Vaccines are critical to improving the functioning of society and to achieving
widespread immunity.
23. According to a September 24, 2021 statement by the Chief Public Health Officer of
Canada, the majority of COVID-19 cases, hospitalizations, and fatal outcomes in Canada were
among those individuals who were unvaccinated. This information, which I also received and
considered, informed Transport Canada’s development of the vaccination mandate for federally
regulated transportation sectors and passengers. I have not attached a copy of the Statement from
the Chief Public Health Officer of Canada, 24 September 2021 to my affidavit because I am
informed by counsel and verily believe that it is attached to Jennifer Little’s affidavit as Exhibit
“D”.
24. In addition to considering the evidence demonstrating that vaccination was an important
layer of protection for the safety and security of the federally regulated transportation sectors and
passengers, I also worked with the Director General of COVID Recovery to identify challenges
regarding the implementation of a vaccination mandate. Based on the public health information
and these consultations with the modes, the COVID Recovery Team prepared a presentation for
decision makers, which I also received and considered. I have not attached a copy of this
presentation to my affidavit because I am informed by counsel and verily believe that it is attached
to Jennifer Little’s affidavit as Exhibit “E”.
25. Based on information provided by PHAC, at that time, I was informed and verily believed
that vaccination was a critical and very effective tool to reduce the risk of COVID-19 for
Canadians, to protect safe railway operations, to reduce the risk of future outbreaks, and to sustain
broader public health.
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E. Development of a vaccination policy for the rail sector
26. The primary objective of Transport Canada’s vaccination mandate is to ensure the safety
and security of the transportation system, the health and safety of passengers and transportation
employees, and the safety of the public. Recognizing that people travel for a range of essential
and non-essential purposes, Transport Canada’s vaccination policy approach was designed to meet
multiple objectives, including: safety for employees and travellers; allowing for essential domestic
and international travel; transportation of essential goods without disruption to supply chains;
keeping exceptions to a minimum while allowing for accommodations for residents of remote
communities and those travelling for specified essential or urgent reasons, such as to receive
medical care or to respond to emergencies; being feasible for operators to implement; being
enforceable; and moving incrementally to greater compatibility between the international and
domestic travel regimes.
27. Throughout the development and implementation of its vaccination policy, the Rail Safety
Sector worked with government departments, industry stakeholders (e.g. the Railway Association
of Canada, Canadian National Railway (Compagnie des Chemins de fer nationaux du Canada),
Canadian Pacific Railway (Chemin de fer canadien Pacifique), and VIA Rail), labour
representative (e.g United Steelworkers Canada (Syndicat des Metallos), Teamsters Canada Rail
Conference, and Unifor), Indigenous Groups, provinces and territories, the
Federal/Provincial/Territorial Rail Safety Working Group, and international partners to inform its
operational planning.
28. Following the Government’s August 13, 2021 announcement and continuing to the present
time, members of my team and I held a series of multilateral and bilateral meetings with these
stakeholders and sought their input on the specific elements of the proposed mandates. The
consultations were both iterative and comprehensive. On my instructions, the Rail Safety Program
provided federal railway companies (e.g. the Railway Association of Canada, Canadian National
Railway, Canadian Pacific Railway, VIA Rail), employee representatives, and labour
organizations (e.g United Steelworkers Canada (Syndicat des Metallos), Teamsters Canada Rail
Conference, Unifor) with two engagement documents outlining Transport Canada’s proposed
vaccination mandates for passengers and employees, in order to facilitate these discussions. These
documents set out detailed information on the proposed approach, record keeping requirements,
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and potential exceptions to the mandatory requirements of the mandates. I have attached the
documents as Exhibit “D” Federal Vaccination Mandate – Railway Passengers, and Exhibit “E”
Federal Vaccination Mandate – Railway Employees, to this affidavit.
29. Members of my team and I conducted particularly extensive consultations with the largest
freight and passenger railway companies (e.g. the Railway Association of Canada, Canadian
National Railway, Canadian Pacific Railway, and VIA Rail) to better understand the impacts of
the proposed mandates on their operations. We considered their feedback and incorporated it into
the final MOs. These consultations were both scheduled and ad hoc in nature, as issues arose, and
could occur several times per week.
30. In addition, throughout October and November 2021 (the months leading up to the issuance
of the initial vaccination mandate MOs) and thereafter, members of my team and I conducted in-
depth, extensive, and frequent consultations with VIA Rail on the potential impact of the mandates
on the company’s service to remote and northern communities, and the unique considerations to
be taken into account. This includes VIA Rail’s Winnipeg to Churchill route and the connecting
service it provides to communities serviced by the Keewatin Railway Company in Northern
Manitoba.
31. We also drew from the approach that Transport Canada was developing for air travel to
these communities. Transport Canada conducted extensive consultations with public health
authorities and stakeholders of these communities given that air travel is often the only link to
obtaining medical, health, and other social services. The engagement helped ensure a consistent
approach between the modes.
32. The discussions with VIA Rail informed the approach to remote communities described in
the MO regarding vaccination of passengers. A consultation draft of the MO, attached as Exhibit
“F” to this affidavit, was shared with representatives of VIA Rail on October 9, 2021 to assist with
our discussions.
33. Members of my team and I continue to have ongoing dialogue with industry stakeholders
and labour organization, via bi-weekly scheduled meetings and on an ad hoc basis. The
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implementation of the mandatory vaccination policies has been quick in order to provide safe
environment for passengers and employees.
F. Vaccination mandate for rail passengers
34. On October 29, 2021 as the Minister’s delegate, I issued MO No. 21-08 setting out a
vaccination mandate for rail passengers. On November 29, 2021, the MO was repealed and
replaced with MO No. 21-09, which adopted its predecessor, removed the transition provisions,
and set out exceptions and accommodation. On January 15, 2022, MO No. 21-09 was repealed
and replaced with MO No. 21-09.1, which adopted its predecessor, and adjusted acceptable
COVID-19 test results to include positive tests taken at least 10 days, instead of 14 days, prior.
On February 28, 2022, MO. No. 21-09.1 was repealed and replaced with MO No. 21-09.2, which
adopted its predecessor, and allowed for the use of antigen tests in addition to molecular tests. MO
No. 21-09.2 will be in place until it is revoked by the Minister of Transport.
35. Pursuant to the MOs, as of October 30, 2021, all rail passengers over 12 years and 4 months
of age were required to provide proof of vaccination credentials, as defined in the MO,
demonstrating they were fully vaccinated, or proof of a COVID-19 PCR molecular test result.
36. An individual is considered “fully vaccinated” if they have received the full series of a
COVID-19 vaccine authorized by Health Canada, or any combination of such vaccines, and they
received their final dose of the COVID-19 vaccine at least 14 days ago. This definition is subject
to change.
37. MO No. 21-08 set out a transition period between October 30, 2021 and November 30,
2021, where travellers who were not fully vaccinated could provide the result of a COVID-19
molecular test taken within 72 hours of travel, including proof of a positive COVID-19 molecular
test performed 10-180 days prior to show they are no longer infectious. Since November 30, 2021,
the COVID-19 molecular test option has only been available for travellers who are not vaccinated
in very limited circumstances, set out below.
38. Railway companies must refuse boarding, or if verification is done while the train is already
in movement, require removal at the next stop, of any person who fails to provide an acceptable
proof of vaccination credential, or acceptable COVID-19 test result, if applicable.
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39. Transport Canada has provided railway companies with guidance materials setting out
recommendations for the operationalization of vaccination mandates for passengers. The
document addresses recommended format of proof of vaccination credential, how and when to
verify proof of vaccination credential or molecular test results, privacy considerations. Attached
as Exhibit “G” to my affidavit is a document titled “Guidance Material for Railway Companies:
Rail Safety’s Vaccination Mandate for Passengers”.
G. Vaccination mandate for rail employees
40. On October 29, 2021, I issued MO No. 21-07 requiring that railway companies ensure
vaccination of employees in the interest of safe railway operations. On November 29, 2021, the
MO was repealed and replaced with MO No. 21-07.1, which adopted its predecessor, and included
clarifications to the Order including a definition of “employee”. On January 15, 2022, MO No.
21-07.1 was repealed and replaced with MO No. 21-07.2, which adopted its predecessor, and
adjusted acceptable COVID-19 test results to include positive tests taken at least 10 days, instead
of 14 days, prior. On February 28, 2022, MO No. 21-07.2 was repealed and replaced with MO
No. 21-07.3, which adopted its predecessor, and allowed for the use of antigen tests in addition to
PCR tests. MO No. 21-07.3 will be in place until it is revoked by the Minister of Transport.
41. Consistent with the requirement of section 32.01 of the Railway Safety Act, the purpose of
these MOs is to take every precaution necessary to ensure safe railway operations in the context
of the ongoing COVID-19 pandemic. Safe railway operations involve the safety of persons and
property transported by railways as well the safety of other persons and other property. The best
available scientific evidence indicates that vaccines are effective at preventing severe illness,
hospitalization, and death from COVID-19. The availability of skilled employees who can safely
carry out their railway responsibilities is essential to the overall safety of Canada’s railway system.
By reducing the frequency and severity of the COVID-19 illness amongst railway employees,
vaccines have helped protect the health of skilled employees and thereby minimized disruptions
and interruptions impacting the safe and fluid operations of the railway system.
42. The current MO mandates railway companies to follow a set of “prescriptive obligations”.
Railway companies are required to verify that every operating employee who is not on leave and
does not fall within a limited exception, has a proof of vaccination credential before they enter any
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place, or board any equipment, owned or controlled by the railway company. Operating employees
are persons in a safety critical position, as defined by the Rules Governing Safety Critical
Positions, which I have attached as Exhibit “H” to this affidavit. They directly engage in the
operations of trains in the main track or yard service, or engage in rail traffic control. They present
greater risk as a result of being in close proximity with one another and travelling between
communities, thus increasing the risk of spreading the virus with other railway company
employees, and others. To mitigate the risks that non-operating employees pose, railway
companies must implement a testing regimen to monitor for the presence of COVID-19 for all
employees who enter onto the premises, at any company location frequented by operating
employees.
43. Even prior to the MO being announced, some railway companies, including Canadian
National Railway, had taken early initiative and implemented their own, company-wide
vaccination policies that were more expansive than these prescriptive obligations. These initiatives
helped inform the development of the MO, along with consultations with industry stakeholders.
Given the highly transmissible nature of COVID-19 and its variants, and the potential for railway
employees to work in close proximity with one another, a company-wide vaccination approach
was deemed the most effective in realizing Transport Canada’s policy objectives. Based on my
observations and discussions with labour representatives, there are many circumstances in which,
by the nature of their work, railway employees, including those who do maintenance and repair
(and who are not categorized as operating employees), work in close proximity with one another,
without the ability to socially distance. For instance, these employees may have to travel together,
attend job briefings, or work closely to resolve certain issues with machinery. Therefore, as an
alternative to complying with the prescriptive obligations, the MO provides railway companies
with the option to implement a “company-wide vaccination policy” for all employees. In general,
under this alternative option, railway companies would follow an approach similar to the public
service: develop and implement a company-wide vaccination policy for all employees who are not
on leave, including operating employees, contractors, and suppliers who enter onto company
premises. MO 21-07.2 defines “employee” as persons employed by a railway company, and
includes:
a. persons who are directly employed by the railway company; and
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b. persons who are not directly employed by the railway company who enter onto
company premises, have contact with other employees and are:
i. directly employed by an entity that is the railway company’s contractor,

agent, or mandatary;
ii. hired by the railway company to provide service;
iii. suppliers of the railway company.
44. Railway companies that adopt a company-wide policy are subject to fewer testing and
reporting obligations than those that opt for the prescriptive obligations option. These testing
obligations were being used specifically to mitigate the risk posed by possibly unvaccinated non-
operating employees. With respect to companies that adopt a company-wide policy, the risk posed
by non-operating employees is mitigated through vaccination.
45. Under both options, railway companies must set out a fixed period of time for employees
to become fully vaccinated (i.e. in accordance with the wait times between vaccines, and between
the last shot and being fully vaccinated) and criteria for when and how employees who fall under
an exception will be accommodated. Additionally, policies must lay out the consequences of non-
compliance, which include, as a minimum sanction, leave without pay in the case of employees
directly employed by the railway companies, and termination of compensation in the case of
individuals who are not directly employed by the railway companies, such as contractors and
suppliers.
46. Transport Canada has provided railway companies with guidance material that set out
recommendations on the operationalization of vaccination mandate for employees. Attached as
Exhibit “I” to my affidavit is a document titled Guidance Material for Railway Companies: Rail
Safety’s Vaccination Mandate for Employees. The document sets out recommendations for
verification processes, granting exceptions, accommodations, privacy considerations and best
practices.
47. Railway companies are overwhelmingly opting for the company-wide vaccination policy,
creating the broadest coverage possible. By mid-March 2022, railway companies were reporting
on average that more than 95 percent of their employees were fully vaccinated.
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H. Exceptions to the vaccination requirements and accommodations
48. The MOs set out limited exceptions to the requirement that passengers and employees must
be fully vaccinated. These exceptions are consistent between the various modes of travel.
49. Passengers who are unvaccinated due to a medical contraindication or sincerely held
religious belief, passengers travelling for the purpose of attending an appointment for an essential
medical service or treatment, and passengers who fall under a limited national interest category
are among some those who fall under an exception. Travellers over 12 years and 4 months, who
are claiming an exception must make a temporary exception request to the railway company prior
to their travel and demonstrate that they qualify for a specific exception. They must then provide
an acceptable proof of a COVID-19 test result, as defined in the MO, at the time of boarding.
50. Residents of remote communities, for whom passenger rail services are the primary means
of access to their communities, are also exempt from the requirement to be vaccinated. Instead,
they provide evidence of a negative COVID-19 molecular test result or COVID-19 antigen test
result that is taken prior to boarding a train. In passenger rail, this exception applies to residents
of Northern Manitoba who travel on Via Rail’s between Winnipeg and Churchill or the service to
access the paseenger services of Keewatin Railway Company. Overall, the exception for residents
of remote communities applies to less than 2% of air, rail, and marine passenger trips in a year.
51. The exceptions for railway company employees are more limited. Employees may obtain
an exception from being fully vaccinated on the basis of a medical contraindication or sincerely
held religious belief. Employees must demonstrate these grounds by providing to their employer
a medical certificate or sworn attestation, respectively.
52. Railway companies must verify that employees who are not yet fully vaccinated, or those
who fall under an exception, provide an acceptable proof of a COVID-19 test result every 72 hours.
This was later updated on February 28, 2022 in MO 21-07.3 to allow for the use of rapid antigen
tests every 24 hours for employees subject to an exception.
53. Railway companies must have in place any other accommodation measures as set out in
local public health guidance for passengers and employees who fall under an exception.
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I. Privacy, oversight, and enforcement
54. Transport Canada oversees and reviews railway companies’ processes to ensure
effectiveness of approach in meeting the overall objectives. It oversees compliance by means of
inspections and review of records and will use a range of enforcement tools, including letters of
non-compliance and Administrative Monetary Penalties.
55. Railway companies must report to Transport Canada, at least once per week, on various
aspects of their vaccination policies and implementation. Transport Canada utilizes railway
company reports to confirm compliance with the MO, to ensure that it is attaining its intended
goals, to focus its oversight and inspections on the companies and locations of greatest risk, and
to ensure that the exception provisions are not undermining the objectives of the MO.
56. Railway companies that adopt a company wide vaccination policy must report to Transport
Canada each week via electronic means on the number of employees who are partially or fully
vaccinated, have been granted a medical or religious exception from being fully vaccinated, and
are on leave without pay for refusal to comply with the measures.
57. Railway companies that opted to comply with the prescriptive obligations in the MO must
keep daily records of the number of employees who are partially or fully vaccinated, who have
been subject to sanctions, who fall under an exception, and whether any delays were incurred due
to crewing issues. The greater testing and reporting obligations associated with this option
reflected the need for higher degrees of control and scrutiny to decrease risk associated with the
comingling of vaccinated and unvaccinated employees at company locations.
58. Passenger railway companies are required to also report weekly on passenger volumes, the
number of exception requests made and granted, the number of denied boardings and the reasons
for the denials, and any suspicious patterns detected, including identification of fraudulent
documents.
59. Railway companies must ensure that the personal information of passengers and employees
are created, collected, retained, used, disclosed, stored, and disposed of in a manner that respects
the provisions set out in applicable legislation. Railway companies must ensure that data related
to personal information can only be accessed on a need-to-know basis.
16
AR04730
60. Railway companies must also advise their employees and passengers that providing false
statements or documents, may constitute offences under the Criminal Code of Canada.
J. Emergence of the Omicron VOC
61. Transport Canada’s policy development, including the decision I made to issue the initial
rail MOs, were made when the Delta VOC was the predominate variant circulating globally and
based on the scientific evidence then known. On November 26, 2021, the World Health
Organization announced the designation of Omicron as a new SARS-CoV-2 VOC. As of January
4, 2022, publicly available public health information indicated that the Omicron VOC was the
dominant variant circulating in Canada. The Omicron VOC was not a factor in my decision
making process in implementing the MOs in issue.
62. Transport Canada is continuing to monitor the evolving evidence and data with respe to
Omicron and continues to seek guidance from PHAC. In light of the Omicron VOC, the
government of Canada is currently reviewing all federal vaccination mandates, based on the
relevant, emerging, currently available scientific evidence, to assess whether changes to the
vaccination requirements are warranted, including to assess whether changes to the vaccination
requirements are warranted in upcoming MOs, with any appropriate transition period. Discussions
are ongoing at the most senior levels of government. The science is complicated and there are
many competing factors to consider.
63. To support the vaccination mandate policy review, PHAC has provided a document titled
Vaccine science to inform COVID-19 vaccination planning and policy (2.0), dated February 28,
2022, based on its ongoing monitoring of the emerging scientific literature, which I also received
and considered. I have not attached this document to my affidavit because I am advised by counsel
and verily believe that it is attached to Jennifer Little’s affidavit at Exhibit “W”. In this document,
PHAC advised that evidence shows that two doses of a vaccine initially provides 50-60%
protection against infection, symptomatic disease, and transmission of Omicron, but that this
wanes to near zero after six months. A third dose provides increased protection. PHAC further
advised that vaccines continue to provide good protection against severe outcomes and
hospitalization.
17
AR04731
64. The vaccination requirements within the rail sector have helped to protect rail sector
employees from severe outcomes associated with contracting COVID-19. According to
information contained in Exhibit “J” which I received and considered, as of April 19, 2022, based
on reporting current at that time, the percentage of rail employees unable to work due to COVID-
19 was 0.88%. The relatively low figure has meant that operators are able to safely function
throughout the Omicron wave without disruption to the movement of people and essential goods.
65. The vaccination requirement also continues to provide some protection against infection,
symptomatic disease, and transmission of Omicron among individuals who received their second
doses more recently, protecting both transportation workforces and passengers.
66. I continue to be of the view that mandatory vaccination is a critical and effective tool to
protect the health and safety of individuals who work in the rail transportation sector, and those
who use it, and therefore that the measures implemented through the MOs are necessary in the
interest of safe railway operations, having regard not only to the safety of persons transported by
railways, but also to the safety of other persons.
67. Transport Canada will continue to apply the precautionary principle of acting on the best
available information, including with respect to the Omicron VOC, to protect the health and safety
of passengers and employees of the transportation sector. Any decision to modify or remove the
COVID-19 vaccination mandate, or other protective measures, will be based on the
epidemiological situation in Canada and abroad, the emergence of new variants of concern, advice
from PHAC, and other considerations relevant to the implementation modifications to the
vaccination mandate.
18
AR04732
K. Conclusion
AND I HAVE SIGNED by technological

means in the City of Ottawa, in the Province of
Ontario, this 22nd day of April, 2022.
Michael DeJong
____________________________________
MICHAEL DEJONG
AFFIRMED before me by technological

means, in the City of Saint-Rémi, in the
Province of Québec, this 22nd day of April,
2022.
____________________________________
Commissioner for Oaths for Québec and
for outside Québec
19
AR04733

Affidavit of MICHAEL DEJONG

AR04734
Michael DeJong
Michael.DeJong@tc.gc.ca
427 Laurier Ave. W
Ottawa, ON
K1A 0N5
613-866-0022
Bilingual (ECE)
Security Clearance: Secret
EDUCATION
Masters of Arts, Economics, Queen’s University

Bachelor of Arts, Economics, International Trade, Co-op, University of Waterloo
EMPLOYMENT
Director General, Rail Safety, EX-03

Transport Canada, 2020 - Present
 Lead complex and high profile regulatory and oversight initiatives relating to rail
safety, such as mitigating the risks of uncontrolled movements and strengthening
grade crossing safety;
 Design and deliver policies, regulatory measures and Ministerial Orders to mitigate
the impact of the COVID-19 pandemic, including Ministerial Orders on mandatory
vaccine requirements for railway employees and passengers;
 Exercise leadership during emergencies involving railway operations, such as the
wildfires in Lytton BC, and the devastating floods in BC;
 Coordinate the delivery of a national oversight program for rail safety, including
inspections and safety management system audits;
 Implement measures in response to the Auditor General’s findings on rail safety, and
recommendations from the Transportation Safety Board, such as the national rollout
of enhanced train control technologies;
 Build partnerships with all levels of government, the private sector, labour
organizations and U.S. counterparts on rail safety regulations and rule-making
initiatives; and
 Manage the Directorate’s personnel and budget.
Director General, Multi-Modal and Road Safety Programs, EX-03

Transport Canada, 2017 - 2020
 Exercise leadership with respect to road safety programs in Canada, including with
respect to policy and program measures to mitigate distracted driving and impaired
driving;
 Lead a coordinated approach to mitigating the spread of COVID-19 through the
transportation sector, including development of strategic advice and
recommendations, and development of guidance and analysis (e.g. use of personal
AR04735
protective equipment; development of testing capacity; development of COVID-19

guidance for industry);
 Chair the Canadian Council of Motor Transport Administrators, which is composed
of federal/provincial/territorial representatives, and bringing together representatives
from industry and non-government organizations;
 Administer the Motor Vehicle Safety Act, including recalls and defect investigations;
 Coordinate the forward regulatory agenda for Transport Canada, including surge
capacity, centralized cost-benefit analysis, and liaison with Treasury Board
Secretariat;
 Oversight of the Centre for Enforcement Expertise, which provides case management
and surge capacity for major enforcement cases in Transport Canada;
 Lead the design and delivery of technical training of inspectors across aviation,
marine and rail personnel;
 Coordinate corporate reporting and planning across the safety and security group
within Transport Canada;
 Build partnerships with all levels of government, the private sector, non-government
organizations and labour organizations;
 Manage the Directorate’s personnel and budget.
Senior Director, Policy and Program Development, EX-02

Public Safety Canada, 2015 - 2017
 Lead complex and high profile policy initiatives relating to emergency management
(e.g. address the impacts of post-traumatic stress disorder on first responders);
 Build partnerships with all levels of government, the private sector, non-government
organizations and first responders, including coordination of the interdepartmental
and intergovernmental emergency management governance mechanisms;
 Design horizontal and intergovernmental emergency management programs (e.g.
National Disaster Mitigation Program)
 Coordinate policy and program development activities (e.g. Emergency Management
Action Plan, Heavy Urban Search and Rescue) among federal departments,
provinces/territories and the private sector;
 Engage international partners, especially the Department of Homeland Security, on
emergency management initiatives;
 Chair interdepartmental and international working groups (e.g. Canada-United States
Interoperability Working Group); and
 Act on behalf of the Director General as required, and manage the Division’s
personnel and budget.
Director, Critical Infrastructure Policy, EX-01

Public Safety Canada, 2011 - 2015
 Lead multi-dimensional and sensitive policy initiatives relating to critical
infrastructure and national security (e.g. National Strategy and Action Plan for
Critical Infrastructure);
 Develop partnerships with the private sector and all levels of government, including
coordination of the sector networks and National Cross Sector Forum;
AR04736
 Coordinate risk management activities, including site assessments, plans and

exercises among federal departments, provinces/territories and the private sector;
 Foster international partnerships on critical infrastructure and border traffic disruption
management;
 Co-chair the Federal/Provincial/Territorial Critical Infrastructure Working Group;
 Chair the Public Safety Portfolio Critical Infrastructure Intelligence and Information
Sharing Working Group; and
 Act on behalf of the Director General as required, and manage the Directorate’s
personnel and budget.
Director, Critical Infrastructure Partnerships, EC-08

Public Safety Canada, 2010-2011
 Provide strategic analysis and advice to senior management on complex and
controversial issues, such as the evacuation of Canadian from Lebanon, and the
Canada-United States Agreement on Emergency Management Cooperation;
 Engage regional partners and cross border stakeholders on the development of the
Canada-United States Border Traffic Disruption Plan;
 Coordinate a Portfolio approach to critical infrastructure intelligence sharing;
 Deliver major projects (e.g. transition notes, medium term planning) for the National
Security Branch; and
 Manage the Division’s personnel and budget.
Senior Policy Analyst, Critical Infrastructure Policy, EC-05-EC-07

Public Safety Canada, 2006-2010
 Lead major policy initiatives (e.g. Canada-US Action Plan for Critical Infrastructure);
 Develop private sector partnerships, including sector networks;
 Prepare Cabinet documents (e.g. Canada-United States Agreement on Emergency
Management Cooperation);
 Navigate the legislative process for Bill C-12, the Emergency Management Act.
Analyst, Financial Institutions Division, Finance Canada, 2006

 Prepare drafting instructions for the 2006 Financial Institution Legislation Review;
 Write briefing material, including Cabinet documents, to support the coming into
force of the Financial Institution Governance Bill.
Policy Analyst , Social Development Policy, Privy Council Office, 2005

 Coordinate with federal departments/agencies and write briefing material on complex
issues, including the Official Languages Action Plan, and Democratic Renewal; and
 Provide strategic analysis and recommendations to senior management on high
profile issues, such as the social economy framework, and reform of the expenditure
management system.
Economist, Aboriginal Affairs Division, HRSDC, 2004

 Research the labour market outcomes of Aboriginal Canadians and provide strategic
analysis to the Director and Director General; and
AR04737
 Refine and operate an economic model that distributes funding among stakeholders.
Program Analyst, Justice and Solicitor General Division, TBS, 2004

 Write briefing material and make recommendations to Treasury Board Ministers on
matters relating to Correctional Services Canada, the National Parole Board, and the
Office of the Correctional Investigator.
Policy Analyst, Regulatory Affairs, Privy Council Office, 2002-2003

 Prepare briefing notes and develop policy advice on smart regulation, the National
Health Care Council, and SIN Card Regulations.
Trade Analyst, Canadian International Trade Tribunal, 2000-2001

 Analyze and interpret trade statistics and the use of trade remedy measures.
Communications Support Officer, Environment Canada, 1999-2000

 Write media advisories and press releases on climate change.
AR04738


AR04739
1*1 Transport
Canada
Transports
Canada ORIGINAL - ORIGINALE
NO. N®- 161782

AUTHORIZATION
MINISTER OF TRANSPORT
TO
WHOM IT MAY CONCERN
Itoie: - March 10, 2016

licscripaov.: - Pursuant to section 45 of the Railway Safety Act,
authorises any person whose position is set out m
Column 4 of the attached schedule to carry out
powers and duties described in Column 3 in relation
to a provision of the Act set out in Column 2.
o>
^s|
oo
f>0
DEPTL REFERENCE - REFERENCE DU MINISTERE
FILE NO.- N’ DU DOSSIER
MEMORANDA - NOTES
The Authorisation signed on April 30, 2015 and registered under No. J 6 I471 is hereby cancellui.
AR04740
AUTHORIZATION / AUTORISATION
1.1, Marc Gameau, Minister of Transport, 1 . Je soussigne, Marc Gameau, ministre des
pursuant to section 45 of the Railway Safety Transports , en vertu de T article 45 de la Loi
Act (“Act”), authorize any person whose sur la securite ferroviaire ( « Loi »), autorise
position is set out in Column 4 of an item of les personnes dont le poste est enonce a la
the attached Schedule to carry out powers colonne 4 d’un article de T annexe ci-jointe,
and duties described in Column 3 of the h exercer les pouvoirs et les fonctions
item in relation to a provision of the Act set decrites a la colonne 3 de Particle a l ’egard
out in Column 2 of the item. d’une disposition de la Loi enoncee a la
colonne 2 de Particle.
2.1 authorize any person to do anything that 2. J’autorise tout fonctionnaire de

is described in column 3 of an item in Transports Canada qui est tenu de remplacer
relation to any provision of the Act set out temporairement une personne dont le poste
in column 2 of the item, where the person is est enonce a la colonne 4 de Particle, ou qui
an official of Transport Canada who is se voit temporairement attribuer par un
required to temporarily replace a person superviseur les pouvoirs et les fonctions de
whose position is set out in column 4 of that ce poste, a faire tout ce qui est decrit dans la
item or who is required to temporarily carry colonne 3 a l ’egard d’une disposition de la
out the duties of that position by an official Loi enoncee a la colonne 2 de Particle,
that has supervisory responsibility.
3. This Authorization remains in force until 3 . La presente autorisation demeure en

it has been withdrawn by me in writing. vigueur jusqu’a ce que je Pannule par ecrit.
4. The Authorization signed on April 30, 4. L’ autorisation en date du 30 avril 2015 et

2015 and registered under number 161471 enregistree sous lenumero 161471 au
in the Legal Registry of the Department of Services des documents juridiques du
Transport is hereby cancelled. ministere des Transports est annulee.
Dated at Ottawa, Ontario, Fait a Ottawa (Ontario)

this t O day of HareW 20\(o. Le MAR 1 0 2016 20 .
^
Ministefof Transp rt/Ministre des Transports
AR04741
Schedule
Authorizations under the Railway Safety Act
Column 1 Column 2 Column 3 Column 4

Item Provision Description of Power and limitations Authorized person
1 4( 1 ) Declare, by order, an association or organization to be a Deputy Minister

relevant association or organization in relation to a Associate Deputy Minister
railway company. Assistant Deputy Minister, Safety and Security
Associate Assistant Deputy Minister, Safely and Security
Director General, Rail Safety
Director General. Intcrmodal Surface, Security and Emergency Preparedness
2 4( 5 )
V
Approve, in writing, electronic or other means of filing Deputy Minister
or sending notices and documents; fix conditions in Associate Deputy Minister
respect of those means; and, in the case of a corporation, Assistant Deputy Minister, Safety and Security
designate an office, other than a head office, to which a Associate Assistant Deputy Minister, Safety and Security
notice or document must be sent or with which it a Director General, Rail Safety
notice or document must be filed. Director General, Intcrmodal Surface, Security and Emergency Preparedness
3 6 Enter into agreements with the Agency to coordinate Deputy Minister

activities and to provide for procedures to be followed in Associate Deputy Minister
the event that conflicting interests arise between the
Department and the Agency in respect of those activities.
4 6. ! ( ! )( « ) Enter into agreements with provincial ministers Deputy Minister

responsible for transportation matters for the Associate Deputy Minister
administration, in relation to persons who operate
railways within the legislative authority of the province,
of any law respecting railway safety and security and the
safety aspects of railway crossings.
1
AR04742
Column I Column 2 Column 3 Column 4

Item Provision Description or Power and limitations Authorized person
5 6.1( 1 )( a ) Amend the schedules of Rail Safety Inspection Services Deputy Minister
Agreements listing the federal inspectors who will Associate Deputy Minister
conduct inspections under the Agreement, specifying the Assistant Deputy Minister, Safety and Security
railways to which the Agreement applies and setting out Associate Assistant Deputy Minister, Safety and Security
the applicable per diem rates. Director General, Rail Safety
6 6. mm Enter into agreements with provincial ministers Deputy Minister

responsible for transportation matters for the Associate Deputy Minister
administration, in relation to persons who operate
railways within the legislative authority of the province,
of any law respecting matters relating to the protection
of the environment to which the Act applies.
:
7 6.1 ( 2 ) Designate anybody established under an Act of
Parliament, or any person or class of persons employed
Deputy Minister V
Associate Deputy Minister
in the federal public administration, to administer the
law in accordance with an agreement made under
subsection 6.1( 1 ).
8 6.2 Enter into agreements with provincial authorities to Deputy Minister

authorize the provincial authorities to regulate the Associate Deputy Minister
matters referred to in subsection 6.1( 1 ) in relation to a
railway in the same manner and to the same extent os it
may regulate a railway within the authorities’
jurisdiction.
9 7( 2 )(a ) By order, require a railway company to formulate Deputy Minister

engineering standards governing any matters referred to Associate Deputy Minister
in subsection 7( I ) that arc specified in the order or to Assistant Deputy Minister, Safety and Security
revise its engineering standards governing those matters. Associate Assistant Deputy Minister, Safety and Security
10 7< 2 )(6 ) Specify, in the order referred to in paragraph 7( 2 )( a ), the Deputy Minister
period to file the formulated or revised standards with Associate Deputy Minister
the authorized person for approval. Assistant Deputy Minister, Safety and Security
Associate Assistant Deputy Minister, Safety and Security
2
AR04743

II 9( 1 ) Where the authorized person is satisfied that an objection Deputy Minister

to a proposed railway work filed under subsection 8( 2) is Associate Deputy Minister
frivolous or vexatious or that the proposed railway work Assistant Deputy Minister, Safety and Security
to which the objection relates is in the public interest, Associate Assistant Deputy Minister, Safety and Security
send a notice to that effect to the person who filed the Director General, Rail Safely
objection.
12 9( 2 ) Send copy of notice under subsection 9( I ) to the Deputy Minister

proponent. Associate Deputy Minister
Assistant Deputy Minister, Safety and Security
Director General, Rail Safely
13 10( 3 )(o ) Approve a proposed railway work, by notice, cither Deputy Minister
absolutely or on such terms as are specified in the notice, Associate Deputy Minister V
if the authorized person is satisfied that ( he work is Assistant Deputy Minister, Safely and Security
consistent with safe railway operations and notify the Associate Assistant Deputy Minister, Safety and Security
proponent and an}’ objecting party that the authorized Director General, Rail Safety
person approves the work .
14 10( 3 )( A )( i ) Refuse to approve a proposed railway work, by notice, Deputy Minister

if the authorized person is not satisfied that the work is Associate Deputy Minister
consistent with safe railway operations, and inform the .
Assistant Deputy Minister Safety and Security
proponent and any objecting party why the authorized Associate Assistant Deputy Minister, Safety and Security
person is not satisfied and refuses to approve the work . Director General, Rail Safety
15 I 0(3 )( h )( ii ) By notice, direct the proponent to file with the Deputy Minister
authorized person and any objecting party, within the Associate Deputy Minister
period specified in the notice, such further particulars Assistant Deputy Minister, Safety and Security
relating to a proposed railway work as arc specified in Associate Assistant Deputy Minister, Safety and Security
the notice. Director General, Rail Safety
16 10( 4 ) Approve a proposed railway work that has been Deputy Minister
undertaken without the required approval having first Associate Deputy Minister
been given. Assistant Deputy Minister, Safety and Security
3
AR04744

17 10( 5 ) Engage any person or organization having expertise in Deputy Minister
.
matters of safe railway operations to furnish advice in Associate Deputy Minister
deciding whether to approve a proposed railway work. Assistant Deputy Minister Safety and Security
18 I 0( 8 )( 6) If the authorized person determines that it is not feasible Deputy Minister

to consider a request for approval of a proposed railway Associate Deputy Minister
work within 60 days, specify an additional period and Assistant Deputy Minister, Safety and Security
notify the proponent and any objecting party of that Associate Assistant Deputy Minister, Safety and Security
period. Director General, Rail Safety
19 12( 4 ) If is satisfied that an application for a grant in respect of Deputy Minister

a proposed railway work has been duly made and that Associate Deputy Minister
the safety of railway operations will be enhanced by the Assistant Deputy Minister, Safety and Security V
carrying out of the proposed railw ay work, authorize the Associate Assistant Deputy Minister, Safety and Security
making of a grant for the purpose of defraying a part of
the construction or alteration cost of that w ork..
Deputy Minister
20 12( 4 ) If satisfied that an application for a grant in respect of a
proposed railway work has been made and that the safety Assistant Deputy Minister, Safety and Security
of railway operations will be enhanced by carrying out
that work, authorize the making of a grant for the
purpose of defraying a part of the construction or
alteration cost of that work, were the work is under
$500,000.
21 12( 5) Attach terms and conditions to a grant in respect of a Deputy Minister

proposed railway work as the authorized person deems Associate Deputy Minister
advisable, including requirements to provide the Assistant Deputy Minister, Safety and Security
authorized person with evidence of expenditure on the Associate Assistant Deputy Minister, Safety and Security
work. .
Director General Rail Safety
4
AR04745

22 12.1 ( 1 ) Enter into an agreement with a person who has rights Deputy Minister
under Part III of Ihe Canada Transportation Act , or Associate Deputy Minister
otherwise, relating to a road crossing to close the Assistant Deputy Minister, Safety and Security
crossing in the interest of safe railway operations. .
Associate Assistant Deputy Minister Safety and Security
23 14( 1 ) If satisfied that a program, study, project or work is Deputy Minister

likely to promote, or make a contribution to, safe railway Associate Deputy Minister
operations, authorize the making of a grant for the Assistant Deputy Minister, Safely and Security
purpose of defraying the whole or pari of the cost . Associate Assistant Deputy Minister, Safety and Security
24 14( 1 ) If satisfied that a program, study, project or work is Deputy Minister

likely to promote, or make a contribution to, safe railway Associate Deputy Minister
operations, authorize the making of a grant for the Assistant Deputy Minister, Safely and Security
purpose of defraying the whole or part of the cost that is Associate Assistant Deputy Minister, Safety and Security V
under $500,000. Director General, Rail Safely
25 14( 2 ) Attach terms and conditions to a grant as the authorized Deputy Minister
person deems advisable, including requirements to Associate Deputy Minister
provide the authorized person with evidence of Assistant Deputy Minister, Safety and Security
expenditure on the program , study, project or work. Associate Assistant Deputy Minister, Safety and Security
26 17.4( 1 ) Issue a railway operating certificate authorizing a person Deputy Minister

to operate and maintain a railway company, or to operate Associate Deputy Minister
railway equipment on a railway, if satisfied that the Assistant Deputy Minister, Safety and Security
prescribed conditions for obtaining a certificate have Associate Assistant Deputy Minister, Safety and Security
been met . Director General, Rail Safety
27 17.4( 2 ) Specify terms and conditions on a railway operating Deputy Minister

certificate that the authorized person considers Associate Deputy Minister
appropriate. Assistant Deputy Minister, Safety and Security
Director General. Rail Safely
s
AR04746

28 17.4( 3 ) Vary the terms and conditions of a company’s railway Deputy Minister
operating certificate, on application by the company. Associate Deputy Minister
Assistant Deputy Minister, Safely and Security
.
29 17.4( 5 ) Suspend or cancel a company’s railway operating Deputy Minister
certificate if the company has ( a) ceased to meet any of Associate Deputy Minister
the prescribed conditions for obtaining the certificate; (b ) Assistant Deputy Minister, Safety and Security
contravened any provision of the Act or the regulations Associate Assistant Deputy Minister, Safely and Security
or any rule, order, standard or emergency directive made Director General. Rail Safety
under the Act; or (c ) requested its suspension or
cancellation.
30 17.5( 1 ) Notify the affected person or company of any decision Deputy Minister ' V
made under subsection 17.4( 1 ), ( 3 ) or ( 5 ). Associate Deputy Minister
31 19( 1 ) Order a company to formulate rules respecting any Deputy Minister
matter referred to in subsection 18( 1) or ( 2.1) or to revise Associate Deputy Minister
its rules respecting that matter; and specify the period in Assistant Deputy Minister, Safety and Security
which the formulated or revised rules is to be filed with Associate Assistant Deputy Minister, Safety and Security-
the authorized person for approval. Director General, Rail Safety-
.
Director General Intermodal Surface, Security and Emergency Preparedness
6
AR04747

Item Provision Description orPower and limitations Authorized person
32 19( 4 )(a ) Approve, by notice, either absolutely or on any terms Deputy Minister
and conditions ( hat the authorized person may specify in Associate Deputy Minister
authorized person is satisfied

—
the notice, the rules referred to in subsection 19( 1 ), if the
after considering
current railway practice, the views of the company and
the views of each relevant association or organization or
Director General , Intermodal Surface, Security and Emergency Preparedness
any railway company identified under subsection 19( 3 )
—
and any other factor that the authorized person considers
relevant that those rules are conducive to safe railway
operations by the company.
Provide the notice to the company, association,
organization or railway company identified under
subsection 19( 3 ).
3) !9(4 )( />) Refuse to approve, by notice, the rules referred to in Deputy Minister
—
subsection 19( 1 ), if the authorized person is not satisfied Associate Deputy Minister
after considering current railway practice, the views Assistant Deputy Minister, Safety and Security
of the company and the views or each relevant Associate Assistant Deputy Minister, Safely and Security
association or organization or any railway company Director General. Rail Safety
—
identified under subsection 19( 3 ) and any other factor Director General, Intermodal Surface, Security and Emergency Preparedness
that the authorized person considers relevant that
those rules are conducive to safe railway operations by
the company.
Provide the notice to the company, association,
organization or railway company identified under
subsection 19( 3 ).
34 19(4.2) Amend, on the basis of new information about the safety Deputy Minister
of the railway operations, any terms or conditions Associate Deputy Minister
specified under paragraph 19( 4 )( o) and provide a copy of Assistant Deputy Minister. Safety and Security
the amendments to each relevant association or Associate Assistant Deputy Minister, Safely and Security
organization, or any railway company, referred to in .
subsection 19( 4.1 ). Director General, Intermodal Surface, Security and Emergency Preparedness
7
AR04748

35 19< 5| In deciding whether to approve rules Tiled by a company, Deputy Minister

engage any person or organization having expertise in Associate Deputy Minister
matters relating to sale railway operations to furnish Assistant Deputy Minister, Safety and Security
advice in relation to the matter . .
Director General, Intermodal Surface, Security and Emergency Preparedness
Deputy Minister
36 19( 5.1 ) Specify the day on which rules approved by the
authorized person come into force, but, if the rules
replace any regulations, they may not come into force
.
earlier than the day on which the regulations arc Director General, Rail Safety
repealed .
37 W) By order, establish rules in respect of any matter referred Deputy Minister
to in subsection 18( 1 ) or ( 2.1 ) in relation to a company Associate Deputy Minister
that fails to flic rules pursuant to an order made under Assistant Deputy Minister, Safety and Security
subsection 19( 1 ). Associate Assistant Deputy Minister, Safety and Security
38 19( 7 ) By order, establish rules in respect of any matter referred Deputy Minister
to in subsection 18( I ) or ( 2.1 ) in relation to a company Associate Deputy Minister
that files rules pursuant to an order made under Assistant Deputy Minister, Safety and Security
subsection 19( 1 ) where the authorized person refuses, Associate Assistant Deputy Minister, Safely and Security
under subsection 19( 4 ), to approve those rules. Director General , Rail Safety
Director General , Intermodal Surface, Security and Emergency Preparedness
39 I 9( I 0 )< M Specify an additional period and notify the company if . Deputy Minister
before the expiration of the period mentioned in Associate Deputy Minister
.
paragraph I 9( 10 )(«) the authorized person determines Assistant Deputy Minister, Safely and Security
that, by reason of the complexity of the rules or the Associate Assistant Deputy Minister, Safety and Security
number of rules filed or for any other reason, it will not Director General, Rail Safely
be feasible to consider the rules within that period . Director General, Intermodal Surface, Security and Emergency Preparedness
8
AR04749

40 22( 2 )( «) IT, in the authorized person’s opinion, an exemption is in Deputy Minister

the public interest and is not likely to threaten safe Associate Deputy Minister
railway operations, he or she may, by notice, on any
terms and conditions that he or she specifies in the
-
-
notice, exempt a specified company, specified railway Director General, Rail Safety
equipment or a specified railway work from the Director General, Intcrmodal Surface, Security and Emergency Preparedness
application of a specified provision of regulations made
under subsection 18( 1 ) or ( 2.1) or of rules in force made
under section 19 or 20.
41 22(2 )( A ) .
If in the authorized person's opinion, an exemption is in Deputy Minister
-
the public interest and is not likely to threaten safe Associate Deputy Minister
-
railway operations, he or she may, by notice, on any Assistant Deputy Minister, Safety and Security
terms and conditions that he or she specifies in the Associate Assistant Deputy Minister, Safety and Security
notice, exempt a specified person from the application of Director General, Rail Safety
a specified provision of regulations made under Director General, Intcrmodal Surface, Security and Emergency Preparedness
subsection 18( 2).
42 22(7) Grant an application for an exemption made under Deputy Minister

subsection 22( 4 ) within sixty days after receiving it if, in Associate Deputy Minister
the authorized person’s opinion, the exemption is in the
public interest and is not likely to threaten safe railway - -
operations. Director General, Rail Safety
.
Director General, Intcrmodal Surface Security and Emergency Preparedness
43 22(7) Extend the time for granting an application made under Deputy Minister
-
subsection 22( 4 ) for an additional period of up to sixty Associate Deputy Minister
days . Assistant Deputy Minister, Safely and Security
Director General, Intcrmodal Surface, Security and Emergency Preparedness
44 22,l( 4 )(r;) Within twenty- one days after the filing of an objection Deputy Minister
under subsection 22.1( 3), confirm an objection filed Associate Deputy Minister
under that subsection, if the authorized person decides Assistant Deputy Minister, Safety and Security
that the exemption threatens safety. Associate Assistant Deputy Minister, Safety and Security
9
AR04750
.
45 «
22.1( 4 ) ) -
Within twenty one days alter the filing of an objection Deputy Minister
under subsection 22.1 ( 3 ) or within thirty-five days alter Associate Deputy Minister
receiving a notice under subsection 22.1( 1 ), impose Assistant Deputy Minister, Safety and Security
terms and conditions if the authorized person is of the Associate Assistant Deputy Minister, Safely and Security
opinion that the exemption without terms and conditions Director General, Rail Safety
is not in the public interest or is likely to threaten safety.
46 22.1 ( 4 )( c) Within thirty-five days after receiving the notice under Deputy Minister
subsection 22.1( 1 ), deny the exemption i f the authorized Associate Deputy Minister
person’s opinion is that the exemption is not in the .
public interest or that it is likely to threaten safely. Associate Assistant Deputy Minister, Safety and Security
Director General , Rail Safety
47 23.1 ( 2 ) Decide whether an areu meets the prescribed Deputy Minister
requirements. Associate Deputy Minister
V
4» 24 ( 1.1 ) Exempt any railway company or other person from the Deputy Minister
application of any regulation made under subsection Associate Deputy Minister
24( I ) on any terms and conditions that the authorized Assistant Deputy Minister, Safety and Security
person considers necessary', if, in the authorized person’s Associate Assistant Deputy Minister, Safety and Security
opinion, the exemption is in the public interest and is not Director General, Rail Safety
likely to threaten safely.
49 27( 1 ) Designate any person whom the authorized person Deputy Minister
considers qualified as a railway safety inspector for the Associate Deputy Minister
purposes of the Act and determine the matters, other than Assistant Deputy Minister, Safety and Security
rail security, in respect of which, and the restrictions and Associate Assistant Deputy Minister, Safety and Security
conditions under which, the person may exercise the Director General, Rail Safety
powers of a railway safety inspector.
10
AR04751

50 2711 ) Designate any person whom the authorized person Deputy Minister
considers qualified as a railway safely inspector for the Associate Deputy Minister
purposes of the Act and determine rail security matters Assistant Deputy Minister, Safety and Security
in respect of w hich, and the restrictions or conditions Associate Assistant Deputy Minister, Safety and Security
under which, the person may exercise the pow ers of a Director General, Intermodal Surface, Security and Emergency Preparedness
railway safely inspector. Director, Program Operations, Surface and Intermodal Security
5t Designate any person whom the authorized person Deputy Minister

considers qualified as a screening officer for the Associate Deputy Minister
purposes of the Act and determine the matters in respect Assistant Deputy Minister, Safely and Security
of w hich, and the restrictions or conditions under which, Associate Assistant Deputy Minister, Safety and Security
the person may exercise the powers of a screening Director General, Intermodal Surface, Security and Emergency Preparedness
officer. Regional Directors, Transportation Security
Director, Program Operations, Surface and Intermodal Security
52 27(3) Give u rillcn permission for a railway safety inspector to Deputy Minister
give testimony in any civil suit with regard to Associate Deputy Minister
information obtained by the inspector in the discharge of .
the inspector’s duties. Associate Assistant Deputy Minister, Safety and Security
53 27. U 1 ) Refuse to designate a person as a screening officer if the Deputy Minister

authorized person is of the opinion that the person is Associate Deputy Minister
incompetent, does not meet the qualifications or fulfill Assistant Deputy Minister, Safety and Security
the conditions required for the designation. Associate Assistant Deputy Minister, Safety and Security
Regional Directors, Transportation Security
27. t(i) Suspend, cancel or refuse to renew the designation of a Deputy Minister
person as a screening officer if the authorized person is Associate Deputy Minister
of the opinion that the person is incompetent or ceases to Assistant Deputy Minister, Safety and Security
meet the qualifications or fulfill the conditions required Associate Assistant Deputy Minister, Safety and Security
for the designation. Director General, Intermodal Surface, Security and Emergency Preparedness
Director, Program Operations, Surface and Inlcrmodal Security
H
AR04752

55 27.1 ( 2 ) Suspend or cancel the designation of a person as a Deputy Minister
screening officer if the authorized person is of the Associate Deputy Minister
opinion that, the person has committed an olTcncc within .
the meaning of section 41 . .
56 27.1( 3 ) Suspend the designation of a person as a screening Deputy Minister

officer if the authorized person is of the opinion that the Associate Deputy Minister
exercise by the person of the functions of a screening Assistant Deputy Minister, Safety and Security
officer constitutes, or is likely to constitute, an Associate Assistant Deputy Minister, Safety and Security
immediate threat to railway security. Director General, Intermodal Surface, Security and Emergency Preparedness
57 27.2( 1 ) Notify a person of the refusal to designate them as a Deputy Minister

screening officer or of the suspension, cancellation or Associate Deputy Minister
refusal to renew their designation. Assistant Deputy Minister, Safely and Security
.
58 «
27,5( 1 / ) Appeal a determination made under paragraph 27.4( 4 )( /> ) Deputy Minister
to the Transportation Appeal Tribunal of Canada. Associate Deputy Minister
Assistant Deputy Minister, Safely and Security
59 27.7( 2 ) On receipt of a request under subsection 27.7( I ). Deputy Minister
reconsider a decision made under section 27.1 (3), inform Associate Deputy Minister
the person affected of the decision, and apply sections Assistant Deputy Minister, Safety and Security
27.2 to 27.6 in respect of that decision , with any Associate Assistant Deputy Minister, Safety and Security
modifications that arc necessary.
12
AR04753

60 3 t .4 Confirm the order of a railway safety inspector Deputy Minister

designated for any matter other than security, or, by Associate Deputy Minister
order, alter or revoke the order if a matter, other than rail Assistant Deputy Minister, Safety and Security
security, is referred to the authorized person under Associate Assistant Deputy Minister, Safety and Security
subsection 31.1(4 ) or 31.2(3 ), or if the authorized person Director General, Rail Safety
on his or her own initiative decides to review the order.
6! 31.4 Confirm the order of a railw ay safety inspector Deputy Minister

designated for security, or, by order, alter or revoke the Associate Deputy Minister
order where a matter, related to rail security matters Assistant Deputy Minister, Safety and Security
only, is referred to the authorized person under Associate Assistant Deputy Minister, Safety and Security
subsection 31.1 ( 4 ) or 31.2( 3 ), or if the authorized person Director General , Inlermodal Surface, Security and Emergency Preparedness
on his or her own initiative decides to review the order.
1
62 32( 1 Mi / I By notice sent to the person responsible for a railway Deputy Minister
work, order the person to remove or modify the work , Associate Deputy Minister
where, in the authorized person 's opinion . Assistant Deputy Minister, Safety and Security
(a) a railway work the construction of which began Director General, Rail Safety
afier the coming into force of this section has not
been constructed in accordance with the
requirements imposed by or under the Act,
( b) any railway work has not been altered in
accordance with the requirements imposed by or
under the Act, or
>
< c any railway work is not being, or has not been,
maintained in accordance with the requirements
imposed by or under the Act .
63 32( 1 He ) Remove and destroy the work concerned and sell, give Deputy Minister
away or otherwise dispose of the materials contained in Associate Deputy Minister
the railway work, where a person fails to comply with an .
order made under paragraph 32( 1 ){</). Associate Assistant Deputy Minister, Safety and Security
.
Director General Rail Safely
64 Where the authorized person is of the opinion that a Deputy Minister
person has contravened a regulation made under section Associate Deputy Minister
24, by notice sent to the person, inform the person of ( hat Assistant Deputy Minister, Safely and Security
opinion and of the reasons for it . Associate Assistant Deputy Minister, Safety and Security
13
AR04754

65 32(3 )(« )( ii) Where Ihe authorized person is of the opinion that a Deputy Minister
person has contravened a regulation made under section
.
24 if the authorized person believes that, by reason of
that contravention, there exists in respect of particular
.
railway works an immediate threat to safe railway
operations, order the person to lake such action as is
necessary to remove the threat.
66 32(3 )(M(i) Where the authorized person is of the opinion that a Deputy Minister
person has contravened a regulation made under Associate Deputy Minister
section 24, by notice sent to the railway company
concerned, inform the railway company of that opinion
.
.
and of the reasons for it
67 32( 3 )(M(ii) Where the authorized person believes that, by reason of a Deputy Minister
person’s contravention of a regulation made under Associate Deputy Minister
section 24, there exists an immediate threat to safe Assistant Deputy Minister, Safety and Security
railway operations, order the railway company to ensure Associate Assistant Deputy Minister, Safely and Security
that specified railway works or specified railway
equipment not be used, or not be used otherwise than
under terms and conditions specified in Ihe notice, until
.
appropriate action to remove the threat has to the
authorized person’s satisfaction, been taken by the
person referred to in paragraph 32(3 )(n).
68 32(3.1) If the authorized person is of the opinion that the safety Deputy Minister
management system established by a company has Associate Deputy Minister
deficiencies that risk compromising railway safety, by Assistant Deputy Minister, Safety and Security
notice sent to the company, order the company to take Associate Assistant Deputy Minister, Safety and Security
the necessary corrective measures. Director General, Rail Safety
If the authorized person is of the opinion that a
6V 32( 3.2) Deputy Minister
company is implementing any part of its safely
management system in a manner that risks Associate Deputy Minister
compromising railway safety, by notice sent to the Assistant Deputy Minister, Safety and Security
company, order it to take the necessary corrective Associate Assistant Deputy Minister, Safety and Security
measures. Director General, Rail Safety
14
AR04755

If the authorized person is of the opinion that a railway
70 32( 3.21 ) operation poses a significant threat to the safety of Deputy Minister
persons or property or to the environment, by notice sent Associate Deputy Minister
to the person responsible for the railway operation, order Assistant Deputy Minister, Safety and Security
the person to take the necessary' corrective measures. Associate Assistant Deputy Minister, Safety and Security
If the authorized person considers it necessary in the
71 32.01 Deputy Minister
interests of safe railway operations, , by order sent to a
company, road authority or municipality, require the Associate Deputy Minister
company, road authority or municipality to slop any Assistant Deputy Minister, Safely and Security
activity that might constitute a threat to safe railway Associate Assistant Deputy Minister, Safety and Security
operations or to follow the procedures or lake the Director General, Rail Safely
corrective measures specified in the order, including
constructing, altering, operating or maintaining a railway
work.
72 32.1(3 ) Present evidence and make representations to the Deputy Minister
Transportation Appeal Tribunal of Canada in the context Associate Deputy Minister
of a review of an order made under section 32. Assistant Deputy Minister, Safely and Security
Associate Assistant Deputy Minister, Safe!} and Security
73 32.4 If a matter is referred back to the Minister under Deputy Minister
subsection 32.1(5) or 32.2( 3), confirm the order, or by Associate Deputy Minister
order, alter or revoke the order. Assistant Deputy Minister, Safely and Security
74 33( l )( n ) If the authorized person is of the opinion that there is on Deputy Minister
immediate threat to safe railway operations or the Associate Deputy Minister
security of railway transportation, by emergency Assistant Deputy Minister, Safely and Security
.
directive sent to a company, order it either absolutely or .
to the extent specified in the directive, to stop using the Director General, Rail Safety
kind of railway works or railway equipment or to stop .
Director General, Intcrmodal Surface Security and Emergency Preparedness
following the maintenance or operating practice that
poses the threat.
15
AR04756

75 33(! )( /> ) If the authorized person is of the opinion that there is an Deputy Minister
immediate threat to safe railway operations or the Associate Deputy Minister
security of railway transportation, by emergency Assistant Deputy Minister, Safety and Security
directive sent to a company, order it to follow a Associate Assistant Deputy Minister, Safety and Security
maintenance or operating practice specified in the Director General, Rail Safety
directive if the threat is posed by the company’s failure Director General, Intcrmodal Surface, Security and Emergency Preparedness
to follow that practice.
76 33( 4 ) By notice sent to the company, rescind an emergency Deputy Minister

directive, in which case the directive ceases to have Associate Deputy Minister
effect. Assistant Deputy Minister, Safety and Security
Associate Assistant Deputy Minister. Safety and Security
Director General. Rail Safely
Director General, lntermodal Surface. Security and Emergency Preparedness
77 33( 6 ) Before the expiration of the period during which an Deputy Minister
emergency directive has effect, by notice sent to the Associate Deputy Minister
company, renew the directive for a further specified Assistant Deputy Minister, Safety and Security
period commencing on the expiration of the previous Associate Assistant Deputy Minister, Safely and Security
period and not exceeding six months. .
.
Director General, lntermodal Surface Security and Emergency Preparedness
78 34 ( 2 ) By notice sent to the company or person, confirm an Deputy Minister
order contained in a notice served by a railway safety Associate Deputy Minister
inspector. Assistant Deputy Minister, Safety and Security
.
Director General, lntermodal Surface, Security and Emergency Preparedness
79 34 ( 3 ) File with the registrar of the court a certified copy of a Deputy Minister
ministerial order or directive so that the order or Associate Deputy Minister
directive becomes an order of the court. Assistant Deputy Minister, Safety and Security
.
.
Director General , lntermodal Surface Security and Emergency Preparedness
16
AR04757

80 34( 5 ) Enforce an order or directive by the authorized person’s Deputy Minister
own action. Associate Deputy Minister
Director General , Intcrmodal Surface, Security and Emergency Preparedness
81 36 Order that a company provide, in the form and within the Deputy Minister
period that the authorized person specifies, information
or documents considered necessary' for the purposes of
ensuring compliance with the Act and with the
.
Assistant Deputy Minister Safely and Security
regulations, rules, orders, standards and emergency Director General , Rail Safety
directives made under the Act. Director General, Intcrmodal Surface, Security and Emergency Preparedness
82 37( 1 HA ) Where the Governor in Council has made regulations Deputy Minister
respecting the filing with the Minister, including at the Associate Deputy Minister
request of the Minister of information records and Assistant Deputy Minister, Safety and Security
documents kept and preserved under regulations made Associate Assistant Deputy Minister, Safety and Security
under paragraph 37( 1 )( <? ), request the information Director General. Rail Safely
records and documents so preserved. Director General. Intcrmodal Surface, Security and Emergency Preparedness
83 39.1 ( 1 ) Formulate measures respecting the security of railway Deputy Minister
transportation. Associate Deputy Minister
84 39 1( 2 ) By notice in writing, require or authorize a railway Deputy Minister
company to carry out any security measures referred to Associate Deputy Minister
in subsection 39.1( 1 ). Assistant Deputy Minister, Safety and Security
.
Director General, Inlermodal Surface Security and Emergency Preparedness
85 39.1 ( 3 ) On any terms and conditions that the authorized person Deputy Minister
considers necessary, exempt any railway company or Associate Deputy Minister
other person from the application of a security measure, Assistant Deputy Minister, Safety and Security
if the authorized person is of the opinion that the Associate Assistant Deputy Minister, Safely and Security
exemption is in the public interest and is not likely to Director General, Intcrmodal Surface. Security and Emergency Preparedness
pose a security threat.
17
AR04758

Hem Provision Description of Power and limitations Authorized person
Kb 39.2( 1 Xa ) Authorize the disclosure of the substance of a security Deputy Minister

document that is labeled as a security document. Associate Deputy Minister
.
Director General, Inlermodal Surface, Security and Emergency Preparedness
87 39.2( 2 )( /> ) If a request is made for the production or discover)’ of a Deputy Minister
security document in any proceeding before a court or Associate Deputy Minister
other body having jurisdiction to compel its production Assistant Deputy Minister. Safety and Security
or discover) . make representations with respect to it. Associate Assistant Deputy Minister, Safety and Security
.
Director General Inlermodal Surface, Security and Emergency Preparedness
HK AWi By order, direct persons designated by the authorized Deputy Minister
person to conduct an inquiry in accordance with an)’ Associate Deputy Minister
regulations made pursuant to section 47, subject to the Assistant Deputy Minister, Safety and Security
Canadian Transportation Accident Investigation and Associate Assistant Deputy Minister, Safety and Security JW
Safety Board Act , and report the findings of the inquiry

to the authorized person in such manner and within such
period as the authorized person directs, if the authorized
person considers that any of the following raises, or may
raise, issues of public interest relating to safe railway
operations:
( « ) a proposed railway work set out in a plan filed with
the Minister under section 10,
( A ) rules filed with the Minister under section 19 or 20,
( c) any accident or incident associated with railway
works or with the operation of railway equipment, or
{ d ) any other matter relating to the operation or
maintenance of railway works or railway equipment.
89 40 ) 1 ( 1 ) Designate persons, or classes of persons, as enforcement Deputy Minister

officers. Associate Deputy Minister
18
AR04759

90 40.12 Establish the form and content of notices of violation. Deputy Minister
Director General, Inlermodal Surface, Security and Emergency Preparedness
91 40.19( 1 ) Appeal a determination made under section 40.18 to (he Deputy Minister
Transportation Appeal Tribunal of Canada within 30 Associate Deputy Minister
days. .
92 40.2 Obtain from the Transportation Appeal Tribunal of Deputy Minister
Canada or the member a certificate setting out the Associate Dcpul) Minister
amount of the penalty required to be paid by a person Assistant Deputy Minister, Safety and Security
who fails, within the time required, Associate Assistant Deputy Minister, Safely and Security
(a ) to pay the amount of a penally set out in a notice of Director General, Intcrmodal Surface, Security and Emergency Preparedness
violation or to file a request for a review under section
40.16;
( 6) to pay an amount determined under paragraph

40.18(6) or file an appeal under section 40.19; or
(c) to pay an amount determined under subsection

.
40.19( 4 )
93 44.1( 2) Make recommendations of procedures to deal with Depul)’ Minister

complaints concerning police constables, including how Associate Deputy Minister
the procedures are to be made public. Assistant Deputy Minister, Safety and Security
94 119( 5) By order, repeal a regulation or order referred to in Deputy Minister
-
subsection 119( 2) or 19 ( 2,2) or a by law referred to in Associate Deputy Minister
.
.
subsection 119( 4 ) Assistant Deputy Minister, Safety and Security
19
AR04760
Annexe
Pouvoirs en vertu de In Loisur la s£curit<* ferroviaire
Colonne 1 Colonne 2 Colonne 3 Colonne 4

Point Disposition Description des pouvoirs et ties limites Personne autorisec
1 4( 1 ) Classcr par amite unc association ou organisation conimc

organisation intercssee par rapport a une compagnic dc
-
Sous ministrc
Sous-ministrc dclcguc
chcmin dc fcr. .
Sous-ministrc adjoint Securitc ct surctc
-
Sous ministrc adjoint dclcguc, Sccuritc ct surctc
.
Dirccteur general, Securite ferroviaire
.
Dircctcur general Transport terrestre inlcrmodal Suretc et preparatifs
d’urgencc
2 4( 5 ) Approuver, par ecril, par message clcclronique, ou par lout Sous-ministrc

autre moyen, dc deposer ou d’envoyer dcs notifications ou la Sous-ministrc dclcgue
communication de documents, dc fixer des conditions Sous-minislre adjoint, Sccuritc ct surctc
conccmant ccs moyens, cl, dans Ic cas d'unc socictc, dc Sous-ministrc adjoint dclcguc, Sccuritc et suretc
.
designer un bureau, autre qu’un siege social oil pcuvcnl etre Dirccteur general, Sccuritc ferroviaire
envoyes les notifications ou la communication dc documents Dircctcur general Transport terrestre inlcrmodal, Surctc ct preparatifs
ou grace auquel Ic depot dc ccs demiers peut etre effcctue. d’urgencc
3 6 Conclurc avee I’Officc un accord prevoyant la coordination Sous-ministrc

dc Taction ct fixer les modalitcs dc rcglcmcnt des situations
de conflil pouvant en decouler,
-
Sous ministrc dclcgue
4 6.1( 1 ) Conclurc avee des ministres provinciaux charges des -

Sous ministrc
transports un accord rclalif a f application, a dcs cxploitants -
Sous ministrc dclcgue
dc chcmin de fcr assujettis a la competence legislative dc la
province cn cause, dc tout texte Icgislalif ayant trait a la
sccuritc ct a la suretc fcrroviaircs ct aux aspects dc sccuritc
dcs franchissemcnts fcrroviaircs.
5 6.1( 1 ) Modifier les annexes des Accords sur les services Sous-ministrc
d’inspcction sur la sccuritc ferroviaire cnumcrant les -
Sous ministrc dclcguc
inspectcurs fcdcraux qui cITcctucronl les inspections cn vertu Sous-ministrc adjoint, Sccuritc cl surctc
dc I’Accord, cn prccisant les chcmins dc fer auxqucls Sous-ministrc adjoint delegue, Securitc et suretc
s’applique f Accord et decrivant Ic tar ifjottrnaher Dircctcur general, Sccuritc ferroviaire
applicable.
1
AR04761
Colonne 1 Colonnc 2 Colonne 3 Colonne 4

Point Disposition Description lies pouvoirs et des limites Personne nutorisee
6 6.1( 1 ) Conclurc avcc des ministrcs provinciaux charges des Sous-minislre

transports un accord rclatif a I'application, a dcs exploilants -
Sous ministre delegue
de chemin dc fer assujeltis a la competence legislative dc la
province en cause, dc tout texte legislatif ayant trail a la
protection dc I'cnvironncmcnt, dans la mesure ou la Loi Ic
prevoit.
7 6.1( 2) Designer un organisme ctabli par une loi federate ou une Sous-ministre
personne ou une categoric de personnes teuvranl au sein de
[’administration pubiique federate pour appliqucr la loi
-
conformemcnl a cct accord conclu en vcriu du paragraphe

6.1( 1 ).
K 6.2 -
Sous ministre
-
Conclurc avcc toute autorite provinciate un accord aulorisant
-
ccllc ci a rcglcmcntcr les questions visccs au paragraphe
6.1( 1 ) concemanl leschemins dc feret 1’aulorite excrce cc
Sous minislre delegue
pouvoir dc la meme maniere ct dans la memc mesure que

cclui qu'ellc peut excrccra I’egard d’un chcmin dc fer
relevant de sa competence.
9 7(2) .
Par arrete enjoindre a une compagnie de chcmin dc fer soit -
Sous ministre
d’elablir dcs normes techniques concemant I’un dcs -
Sous ministre dclifguc
domaincs vises au paragraphe 7( 1), soit de modifier, d'unc .
Sous-ministre adjoint Securitc ct surctc
fa on particulicrc, dc tclles normes
^ . -
Sous ministre adjoint delegue, Securitc cl surctc
Direclcur general, Securitc ferroviaire
10 7( 2) Deposer, pour approbation, Ic texte des normes techniques Sous-ministre

aupres dc la personne autorisec, le tout dans un delai -
determine dans I’arrete vise au paragraphe 7( 2) . Sous-ministre adjoint, Securitc ct surctc
-
Sous ministre adjoint delegue, Securitc et surcte
Direclcur general, Securitc ferroviaire
2
AR04762
Colonne I Colonne 2 Colonne 3 Colonne 4

Point Disposition Description des pouvoirs et des limites Personne autorisec
II 9( 1 ) Lorsque la personne autorisec est convaincue, sur reception -
Sous ministre
de la copie visee au paragraphe 8(2), que I’opposition est Sous-ministrc delegue
manifestement infondee ou malveillante ou qu'elle vise unc -
Sous ministre adjoint, Sccurite ct surete
installation ferroviaire qui est d’intcret public, notific son
opinion a I ’opposant.
-
Sous ministrc adjoint delegue, Securite ct surete
Dircctcur general, Sccurite ferroviaire
12 9( 2 ) Envoie au promoteur unc copie de I ’avis de rejel vise au -

Sous ministre
paragraphe 9( I ). Sous-ministrc delegue
-
Sous ministrc adjoint, Sccurite el surete
Sous-ministre adjoint delegue, Securite ct surete
Dircctcur general, Securite ferroviaire
13 10( 3 )a ) Approuver les travaux projetes, ct nolificr au promoteur et Sous-ministrc

.
aux opposants avant I’cxpiration du delai d’examen, son Sous-ministrc delegue
approbation , assortic cvcntucllemcnt de conditions, s'il
decide que les ( ravaux projetes sonl compatibles avee la
-
Sous ministre adjoint, Securite et surete
Sous-ministrc adjoint delegue, Securite cl surete
securite ferroviaire. Dircctcur general, Sccurite ferroviaire
14 10(3)/ ) . Refuser d ’approuver les travaux projetes si la personne

autorisec decide que ces travaux ne sont pas compatibles
-
Sous ministre
-
Sous ministrc delegue
avec la sccurite ferroviaire et nolificr au promoteur el aux Sous-ministrc adjoint, Sccurite et surete
opposants son refus el ses motifs. Sous-ministrc adjoint delegue, Securite et surete
Directcur general , Securite ferroviaire
Sous-ministrc
—
15 I 0( 3 ) b ) Demander, par avis, au promoteur qu ’ il foumisse a la
.
—
personne autorisec ainsi qu’aux opposants , dans le
delai imparti certains renseignements supplemenlaires
-
Sous-ministre adjoint, Securite ct surete
concemant les travaux vises par la demande. Sous-ministrc adjoint delegue, Securite et surete
Directeur general, Securite ferroviaire
3
AR04763
Colonne I Cotonne 2 Colonne 3 Colonne 4

Point Disposition Description ties pouvoirs et des limites Person ne nutoris£e
16 10( 4 ) .
Approuver, de la meme manicrc les travaux deja entrepris. -
Sous minislre
Sous-ministrc dclegue
Sous-ministre adjoint, Sccuritc et surclc
- .
Sous ministrc adjoint dclegue Sccuritc cl surclc
Dirccleur general, Sccuritc ferroviairc
t7 10( 5 ) Rctcnir les services d ' associations spccialisccs ou d 'experts

en matiere dc sccuritc ferroviairc.
-
Sous ministre
Sous-ministrc dclegue
-
Sous ministrc adjoint, Sccuritc et surclc
-
Sous ministrc adjoint dclegue, Sccuritc cl surclc
.
Dircctcur general Securitc ferroviairc
18 10( 8 ) Lc dclai d’examen cst dc soixante jours suivant Ic depot dc la

demandc d’approbation: il peut toulcfois fairc I ’objet d’unc
-
Sous ministrc
-
Sous ministrc deleguc
prorogation, avant expiration, que la personne autoriscc Sous-ministrc adjoint, Sccuritc cl surclc
specific et nolific au promolcur et aux opposunls au motif
qu ’ il lui cst impossible dc proeeder a I ’cxamcn dans la
-
Sous ministrc adjoint dclegue, Sccuritc ct surclc
.
Dircctcur general Sccuritc ferroviairc
periode normalc.
19 12( 4 ) Auloriscr le versement d’ unc subvention dcstincc a couvrir Sous- ministrc

unc partic du cout dc realisation dcs travaux vises par la -
demandc a cct effet , si la personne autoriscc cst convaincuc - .
Sous minislre adjoint Sccuritc et surctc
-
que ccllc ci a etc regulierement faile ct que la realisation dc
ccs travaux accroitra la sccuritc ferroviairc.
Sous- ministrc adjoint deleguc, Sccuritc ct surctc
20 12( 4 ) Auloriscr Ic versement d ’une subvention destincc a couvrir Sous- ministrc

unc partic du cout dc realisation dcs travaux vises par la -
demandc a cct effet , s’ il s’elevc a moins dc 500 000 $, si la -
Sous minislre adjoint, Sccuritc ct surctc
-
personne autoriscc cst convaincuc que ccllc ci a etc
rcgulicrcmcnt faitc cl que la realisation dc ccs travaux
.
Sous-ministrc adjoint dclegue Sccuritc ct surctc
Dircctcur general, Sccuritc ferroviairc
accroitra la securitc ferroviairc.
21 12( 5 ) A (’appreciation dc la personne autoriscc, assortir dc -

Sous minislre
conditions Ic versement d ' une telle subvention ct notamment -
Sous minislre dclegue
cxiger la preuve dcs depenscs exposees . -
Sous ministre adjoint, Securitc et surclc
-
Sous ministrc adjoint dclegue, Sccuritc ct surcte
Directeur general, Securite ferroviairc
4
AR04764

Point Disposition Description des pouvoirs et des limites Personnc autorisee
22 12.1( 1 ) Cone lure, avec la personne qui, cn vertu de la partic III dc la -

Sous minislrc
Loi sur les transports au Canada ou aulrement, cst lilulairc
dc droils sur un franchissemcnt routicr, un accord cn vuc dc
--
Sous ministrc adjoint, Sccuritc ct surete
le I'ermer pour dcs motifs dc securite ferroviaire. Sous-ministrc adjoint delcguc, Securite ct surete
Dircctcur general, Securite ferroviaire
23 14( 1 ) Autoriser le versement d’unc subvention couvrant, mcmc cn Sous-ministre

partic, Ic cout dc realisation d ’ un projet lorsquc la personne -
Sous minislre delcguc
autorisee cst convaincuc que cc projel cst dc nature a -
Sous minislrc adjoint, Sccuritc ct surete
promouvoir la sccurile ferroviaire ou a y contribucr. -
Sous minislre adjoint delcguc, Securite et surete
24 14( 1 ) Autoriscr 1c versement d ' unc subvention couvrant, mcmc cn Sous-minislre

partic, Ic coul dc realisation d ' un projet lorsquc la personne Sous-ministrc delcguc
autorisee cst convaincuc que cc projet, si Ic coul s’eleve a Sous-ministrc adjoint, Sccurile ct surete
.
moins dc 500 000 $ esl dc nature a promouvoir la sccuritc Sous-ministrc adjoint delcguc - Sccuritc ct surete
,
ferroviaire ou a v contribucr. Dirccteur general, Sccurile ferroviaire
25 14( 2 ) A I ’appreciation dc la personne autorisee, assortir de -

Sous ministrc
conditions le versement d ’ unc subvention ct notamment
exiger la preuve dcs depenses exposees.
-
Sous-ministre adjoint, Securite et surete
-
Sous ministrc adjoint delcguc, Sccuritc cl surete
Dirccteur general, Sccurile ferroviaire
2b 17.4 ( 1 ) Delivrer un ccrtificat d ’cxploitalion dc chcmin dc fer -

Sous ministrc
autorisani son lilulairc a exploiter ou a entrclenir un chcmin
dc fer ou encore a exploiter du materiel ferroviaire sur un
-
Sous-ministrc adjoint, Securite et surete
chcmin dc fer si la personne autorisee est convaincuc que les -
Sous ministrc adjoint delcguc, Sccuritc cl surete
conditions rcglementaircs pour son obtention sont rcmplies. Dirccteur general, Sccurile ferroviaire
27 » 74( 2 ) Assujcttir le ccrtificat d ’exploitation dc chcmin de fer aux -

Sous ministrc
rnodaliles que la personne autorisee juge indiquccs. -
Sous ministrc delcguc
-
Sous ministre adjoint, Securite el surete
Sous-ministre adjoint delcguc, Securite ct surete
Dircctcur general , Securite ferroviaire
5
AR04765

Point Disposition Description des pouvoirs et des limitcs Personne nutorisee
28 17.4( 3 ) -
Sous minislrc
Modifier les modalites d’un certificat d ’cxploitation dc
-
chemin de fer sur demande d’ une compagnic.
-
-
Sous minislrc adjoint dclegue, Securite et surete
29 17.4( 5 ) Suspendre ou annuler un certificat d ’cxploitation de chemin Sous-ministrc
dc fer si, selon le cas, a ) la compagnie ne remplit plus I’unc -
Sous ministrc dclegue
ou I’aulre des conditions reglcmenlaires d’obtcntion du -
Sous ministrc adjoint, Securite cl surete
certificat; b ) la compagnic a contrevenu a une des
dispositions dc la presente loi ou des reglcmcnls ou a une
-
Sous ministrc adjoint deleguc, Securite et surete
regie, a un arrctc, a une normc ou a unc injonction
ministcricllc ctablis sous son regime, ou c) la compagnic le
demande.
30 17.5( 1 ) -
Sous ministre
Aviscr la personne ou la compagnic dc loute decision renduc
cn vertu des paragraphes 17.4( I ), ( 3) ou ( 5 ). --
Sous ministrc dclegue
Sous ministre adjoint. Securite et surete
-
Sous ministre adjoint dclegue, Securite cl surete
31 19( 1 ) Par arrete, enjoindre a unc compagnie soil d ’clablir des -

Sous ministrc
regies concemant 1’ un des domaincs vises aux paragraphes
18( 1 ) ou ( 2.1 ), soil dc modifier de tcllcs regies et d 'en
-
Sous ministre deleguc
-
deposer aupres d’elle, pour approbation, le texte original ou
.
modific dans un delai determine par la personne aulorisec.
-
Sous minislrc adjoint delegue, Securite et surete
.
Directeur general , Transport lerrestre inlcrmodal Surete et preparatifs
d’urgencc
6
AR04766

Point Disposition Description des pouvoirs et des limites Personne autorisee
32 19(4 ) Aussilot quc possible apres le depot du lexte, mats, cn tout Sous-ministre
etat de cause, avant ['expiration du delai d’c.xamen, decider si -
les regies dont le tcxlc a etc depose cn application du -
Sous ministre adjoint, Securite et suretc
paragraphe 19( 1 ) contribucnt ou non a la securite de
I 'exploilalion ferroviaire de la compagnic, apres avoir tenu
-
Sous ministrc adjoint delegue, Securite ct suretc
.
Dirccleur general, Securite ferroviaire
compie des usages cn la maticre, de I 'opinion de la Dircclcur general Transport terrestre intcrmodal, Suretc ct preparalifs
compagnic, dc toute organisation ou de loule compagnic de d’urgencc
chcmin de fer viscc au paragraphe 19( 3 ) et de lout point que
.
la personne autorisec juge utile, et notificr a ces demieres
dans le cas d’une decision positive, son approbation en en
precisant, Ic cas cchcanl, les conditions.
Notifier la compagnie, I ’organisalion ou loule compagnic dc
chcmin dc fer visee au paragraphe 19( 3 ).
33 19( 4 ) Aussilot que possible apres le depot du textc mais, en tout

.
etat de cause, avant I ’expiration du delai d ’cxamcn decider si
Sous-ministrc
--
-
les regies dont Ic textc a etc depose cn application du .
Sous ministrc adjoint Securite cl suretc
paragraphe !9( 1 ) contribuenl ou non a la securite dc Sous-ministre adjoint delegue, Securite ct surcle
I’cxploitation ferroviaire de la compagnie, apres avoir tenu .
Dirccteur general Securite ferroviaire
comptc des usages en la maticre, dc I 'opinion dc la .
Directcur general Transport terrestre intermodal, Surcle ct preparatifs
compagnie, dc toulc organisation ou de toute compagnic dc d ’urgence
chcmin de fer viscc au paragraphe 19( 3) ct de tout point que
la personne autorisec juge utile, ct notificr a ces demieres,
dans le cas d ’une decision negative, son refus et ses motifs.
Notificr la compagnie, I’organisation ou toute compagnie dc
chcmin dc fer visile au paragraphe 19( 3).
34 19(4.2 ) Modifier les conditions de ('approbation prccisccs au Sous-ministrc

paragraphe 19( 4 ), a la lumiere de nouveaux renseignements -
touchant la securite ferroviaire, ct fait parvenir. le cas
.
cchcant unc copie des modifications au.x organisations
-
Sous ministre adjoint, Securite et suretc
-
Sous ministre adjoint delegue, Securite et surcle
visecs a I’alinea 19 ( 4.1 )o ) ou a la compagnic dc chcmin de
.
Dirccleur general, Securite ferroviaire
fer visee a I 'alinen 19( 4.1 )b ). .
Dirccleur general Transport terrestre intermodal Suretc et preparalifs
d’urgence
7
AR04767
C'olonne 1 Colonne 2 Colonne 3 Cotonne 4

Point Disposition Description des pouvoirs et des limites Personnc nutorisee
19(5 ) Pour former sa decision d’approuver ou non les regies dont le Sous-ministre
tcxlc a ete depose par une compagnie, retenir les services Sous-ministrc delegue
d’associations specialisees ou d’experts en maliere de -
Sous ministre adjoint, Securite et surctc
securite fcrroviairc. -
Sous ministre adjoint delegue, Securite et surete
.
Directeur general Transport lerrestre inlcrmodal, Surete et preparatifs
d ’urgence
3b 19( 5.1 ) Decider de la date d’entrcc en vigucur des regies approuvecs -
Sous ministre
par la personnc autoriscc, mais si ccs regies remplaccnt un
reglemenl, cllcs entrent en vigueur au plus tot a la date
--
d 'abrogation du reglcmcnt qu'cllcs remplaccnt. -
Sous ministre adjoint delegue, Securite cl surete
.
Directeur general Transport terrestre intermodal, Surete et preparatifs
d’urgence
37 19( 7 ) Par arrete, etablir des regies a I ’egard de questions abordecs Sous-ministre
aux paragraphes 18( 1 ) ou ( 2.1 ) relativemcnt a une compagnie
qui omet de proceder au depot prevu dcs regies
-
.
Sous-ministre adjoint Securite el surctc
conformemcnt a un ordre cdicte en vertu du paragraphe
19( 1 ).
-
Directeur general, Transport lerrestre intermodal, Surete et preparatifs
d ' urgcnce
3K 19( 7) Par arrete, etablir dcs regies a I ’egard de questions abordecs -

Sous ministre
aux paragraphes 18( I ) ou ( 2.1 ) rclativemenl a une compagnie
qui a ete avisee du refus d 'approbalion par la personnc
--
autorisec, en vertu du paragraphe 19( 4 ) des regies dont cllc a Sous-ministre adjoint delegue, Securite et surctc
depose le texte conformemcnt a un ordre edicle en vertu du Directeur general, Securite ferroviaire
paragraphe 19( 1 ). .
d’urgence
39 19( 10) Proroger, avanl expiration, le delai d ’examen qui est de -

Sous ministre
soixanlc jours suivant le depot des regies pour une periodc
specifiee au paragraphe 19( 10), par notification a la
-
compagnie au motif qu’il lui est impossible de procedcr a -
Sous ministre adjoint delegue. Securite cl surete
I ’examcn dans le delai normal, nolamment en raison de la Directeur general, Securite ferroviaire
complexile de ces regies ou du nombre de regies deposecs .
aupres de lui . d’urgence
8
AR04768

Point Disposition Description des pouvoirs et des limites Personne nutorisee
4U 22( 2) Aux conditions quc la personne autoriscc fixe par avis a cet
effcl, soustrairc une compagnie ou dcs installations ou du
-
Sous ministrc
-
Sous ministrc deiegue
materiel ferroviaires a (’application d ’une disposition soil dcs -
Sous mimstre adjoint, Securite et surete
reglements pris sous le regime dcs paragraphes 18( I ) ou
( 2.1 ), soit des regies en vigueur sous le regime des articles 19
-
Sous ministre adjoint deiegue, Securite et surete
.
ou 20, si la personne aulorisee estime qu’il cst dans I’interet Directeur general Transport terrestre intcrmodal, Surete et preparatifs
public dc le fairc et que la securite ferroviaire nc risque pas d’ urgencc
d’etre compromise.
41 22( 2 ) Aux conditions que la personne autoriscc fixe par avis a cel Sous-ministrc
cITet. soustraire une personne a I’application d’unc -
disposition des reglements pris sous le regime du paragraphe
18( 2 ), si la personne autorisee estime qu’il cst dans I’interet
-
Sous ministrc adjoint, Securite et surete
Sous-ministrc adjoint deiegue, Securite et surete
public de le fairc et que la securite ferroviaire nc risque pas Directeur general, Securite ferroviaire
d 'etre compromise. Directeur general, Transport terrestre intcrmodal, Surete et preparatifs
d’urgencc
42 22(7) Dans les soixante jours suivant la reception d ’ une demande
-
d’exemption cn vertu du paragraphe 22( 4 ), agrccrcclle ci si
--
Sous ministrc
Sous ministre deiegue
-
-
la personne autoriscc estime qu’il cst dans I’intcret public de Sous ministre adjoint, Securite et surcle
le fairc et quc la securite ferroviaire ne risque pas d 'etre Sous ministrc adjoint deiegue, Securite et surete
compromise. .
Directeur general Securite ferroviaire
.
d’urgence
43 22( 7) Prolongcr le delai d’au plus soixante jours. --

Sous ministrc
--
Sous ministrc adjoint , Securite et surete
Sous ministre adjoint deiegue, Securite et surete
.
Directeur general Transport terrestre intermodal , Surete et preparatifs
d’urgcncc
9
AR04769

Point Disposition Description des pouvoirs et des limites Personnc autorisee
44 22.1( 4 )« ) Dans Ics vingl ct un jours suivant la reception dc 1’avis vise -

Sous ministrc
au paragraphe 22.1(3 ), maintenir I’opposition, si lapersonne
autorisee estime que I ’cxcmption compromet la securite
-
ferroviaire. -
45 22.1 ( 4 )A ) Dans Ics vingt ct un jours suivant Ic depot de 1’avis vise au Sous-ministrc
paragraphe 22.1 (3 ) ou dans les trente-cinq jours suivant la -
-
reception de I’avis vise au paragraphe 22.1 ( 1 ), assortir .
Sous ministrc adjoint Securite et surete
I ’cxcmption dcs conditions si la personnc autorisee estime .
Sous-ministrc adjoint delegue Securite et surete
qu ' ii esl dans I ’intercl public de le faire ou que la securite Directeur general, Securite ferroviaire
risque d ’etre compromise.
46 22.1( 4 )c) -
Dans les trente cinq jours suivant la reception de I’avis vise -
Sous ministrc
au paragraphe 22.1 ( 1 ), refuser I ’exemption si la personnc
autorisee estime qu’ ii cst dans I’intcrct public de le faire ou
--
.
Sous ministre adjoint Securite ct surete
que la securite ferroviaire risque d’etre compromise. .
Sous-ministrc adjoint delegue Securite et surete
.
47 23.1( 2 ) Statuer sur la conformitc de la partie du territoire avee les Sous-ministre
reglements. -
Sous-ministrc adjoint, Securite el surete
- .
Sous ministrc adjoint delegue Securite cl surete
,
4H 24( 1.1 ) Si la personnc autorisee estime qu ’ ii est dans I ' intcrct public Sous-ministrc
Sous-ministre delegue
--
de le faire et que la securite ferroviaire ne risque pas d ’etre
compromise, souslrairc, aux conditions que la personnc Sous ministre adjoint, Securite ct surete
autorisee juge utiles, loule compagnie de chemin dc fer ou Sous ministrc adjoint delegue, Sccurilc.et surete
toutc personnc a ( ’application d 'un reglemcnt pris sous Ic Directeur general, Securite ferroviaire
regime du paragraphe 24 ( 1 ).
10
AR04770

49 27( 1 ) Designer les personnes que la personne auloriscc cslimc

qualifiecs pour rcmplir les fonctions d’ inspcctcur de la
-
Sous ministre
Sous- minislre deleguc
securite fcrroviairc dans 1c cadre de la Loi, pour toutc -
question aulre que ccllcs concemant la surete ferroviaire. La
personne auloriscc doit, a I ’egard des inspeetcurs de la
-
Sous ministre adjoint deleguc, Sccurilc ct suretc
Directeur general, Securite fcrroviairc
securite ferroviaire, preciser leur champ de competence ainsi
que les modalites selon lesquclles ils cxerccnt leurs
functions.
50 27( 1 ) Designer les personnes que la personne auloriscc cslimc

qualifies pour remplir les fonclions d ’ inspecleur de la
--
Sous ministre
securite ferroviaire dans le cadre de la Loi, pour des
questions qui conccmenl la surele ferroviaire. Elle doit, a
--
Sous ministre adjoint, Securite ct suretc
Sous ministre adjoint delegue, Securite ct surete
*
I’egard des inspeetcurs de la securite ferroviaire, preciser leur .
Directeur general, Transport terrestre intcrmodal Surete et preparatifs
champ de competence ainsi que les modalites scion d ’urgcncc
lesquclles ils cxerccnt leurs fonctions. Directeur, Operations des programmes, Surete du transport terrestre et
intcrmodal
Sous-ministre
-
51 27( 1 ) Designer les personnes que la personne aulorisec eslimc
qualifiecs pour rcmplir les fonctions d 'agent de controlc dans Sous ministre deleguc
le cadre de la Loi. Bile doit, a I’egard des agents dc controlc, Sous-ministre adjoinL Securite et suretc
preciser leur champ de competence ainsi que les modalites
selon lesquclles ils cxerccnt leurs fonctions.
-
Sous ministre adjoint deleguc, Securite ct suretc
Directeur general , Transport terrestre intermodal, Suretc ct preparatifs
d’urgencc
Dircctcurs regionaux, Surete du transport
Directeur, Operations des programmes, Surete du transport terrestre cl
intcrmodal
Sous-ministre
--
52 27(3 ) Donncr unc autorisalion ecrilc a Tinspectcur dc reveler dans
unc action civile les rcnscigncments qu ’il a obtenus dans Sous ministre deleguc
.
I ’exercice de ses fonctions Sous ministre adjoint, Securite cl suretc
-
Sous ministre adjoint deleguc, Securite et surele
11
AR04771
Colonnc I Colonne 2 Colonne 3 Colonne 4

53 27.1 ( 1 ) Refuser de designer une personne a titre d’agent de conlrolc

si la personne autorisee cstimc quc 1’ intcrcssc cst inaptc ou
-
Sous ministrc
Sous-ministrc delegue
—
nc repond pas ou ne repond plus aux conditions de Sous-ministrc adjoint, Securite et surctc
delivrance ou de mainticn en elal de validile de la
designation.
-
Sous ministrc adjoint delegue, Sccuritc cl surctc
Dircclcur general, Transport terrestre intcrmodal, Surctc et preparalifs
d’urgence
Dirccteur regionaux, Surete du transport
Directeur, Operations des programmes. Surctc du transport terrestre et
intcrmodal
54 27.1( 1 ) Suspendre, annular ou refuser de rcnouveler la designation -
Sous ministrc
—
d ’un agent dc controlc, si la personne autorisee cstimc quc Sous-minislre delegue *
—
I’intercssc cst inaptc ou nc repond pas ou nc repond plus
aux conditions dc delivrance ou de mainticn en etnt de
-
Sous minislre adjoint, Securile et surete
-
Sous ministrc adjoint delegue, Securile et surete
validitc de la designation. .
Directeur general, Ttransport terrestre intcrmodal Surete el preparalifs
d ’ urgence
Dircctcurs regionaux, Surctc du transport
Directeur, Operations des programmes, Surctc du transport terrestre et
intcrmodal
55 27.1 ( 2 ) Suspendre ou annuler la designation de I’agent de conlrolc si -
Sous ministrc
la personne autorisee cstimc quc cclui-ci a commis unc
infraction, au sens dc Particle 41 .
-
Sous-ministrc adjoint, Securite el surctc
-
Sous ministrc adjoint delegue, Securile et surctc
Dircclcur general, Transport terrestre intcrmodal, Surete et preparalifs
d’urgcnce
Directeur, Operations des programmes, Surctc du transport terrestre cl
intcrmodal
56 27.1( 3 ) Suspendre la designation de I 'agent de controle si la personne
autorisee cstimc quc I’cxcrcicc, par lui , des fonctions d’agent
-
Sous ministrc
de controlc constitue un danger immediat ou probable pour la -
Sous ministrc adjoint, Sccuritc et surete
surete du transport fcrroviairc. -
Sous ministrc adjoint delegue, Securite cl surete
.
Directeur general Transport terrestre intcrmodal, Surctc ct preparalifs
d’ urgence
Dircctcurs regionaux. Surete du transport
Directeur, Operations des programmes, Surctc du transport terrestre et
intcrmodal
12
AR04772

Point Disposition Description des pouvoirs et des limites Pcrsonne autorisee
57 27.2( 1 ) Nolilier a I’intcrcssc sa decision dc suspendre, d 'annulcrou Sous-ministre

dc refuser de renouveler la designation dc I ’agenl de -
controle, ou de refuser dc designer une pcrsonne a litre
d ’agent dc controle.
- .
Sous ministre adjoint Securite ct surete
Sous-ministre adjoint delegue, Securite et surete
. .
Directeur general Transport terrestre inlcrmodal Surface et preparatifs
d’urgcncc
.
Directeur Operations des programmes, Surete du transport terrestre cl
inlcrmodal
58 27.5( 1 ) Paire appel au Tribunal d ' appel des transports du Canada dc
la decision rendue en vertu de I ’alinea 27.4(4 )6 ).
--
Sous ministre
Sous ministre dclegue
-- .
Sous ministre adjoint Sccurite ct surete
.
Sous ministre adjoint dclegue Sccurite ct surete
59 27.7 ( 2 ) Sur reception d’unc demande en vertu du paragraphe 27.7( I ), Sous-ministre
la pcrsonne autorisee doit proccdcr au reexamen dc la -
decision prise au litre du paragraphe 27.1 ( 3), informer -
I’intcresse de sa decision et appliquer les articles 27.2 a 27.6,
avec les adaptations ncccssaircs. a sa decision.
-
Sous ministre adjoint deleguc, Sccurite ct surete
60 31.4 Lors dc son examen au litre des paragraphes 31.1( 4 ) ou -

Sous ministre *
31.2( 3 ) ou de sa propre initiative, la pcrsonne autorisee
continue I ’ ordrc de I ’inspcclcur. pour toute question autre
-
Sous-ministre adjoint, Sccurite et surete
-
-
que cedes conccmant la surete ferroviaire, ou, par arrele, Sous ministre adjoint deleguc, Sccurite et surete
modiflc ou annule cclui ci. Directeur general, Sccurite ferroviaire
61 31.4 Lors de son examen au litre dcs paragraphes 31.1 ( 4 ) ou -

Sous ministre
31.2( 3 ) ou de sa propre initiative, confirmc 1 'ordrc dc -
I 'inspcctcur, pour des questions qui conccment la surete -
ferroviaire, ou, par arrele, modifie ou annule cclui-ci. -
.
Directeur general, Transport terrestre inlcrmodal Surete ct preparatifs
d’urgencc
13
AR04773
Colonno 1 Colonnc 2 Colonne 3 Colonnc 4

*2 32( 1 ) Par avis transmis uu rcsponsablc des installations

fcrroviaircs, ordonner a celui-ci dc les modifier ou dc les
Sous-ministrc
-
cnlever, si la personne autorisee estime que la construction - .
Sous ministrc adjoint Sccurite et surete
— entreprisc apres 1'entree en vigueur du present article — ,
la modification ou 1'enlrctien d’ installations fcrroviaircs ne
Sous-ministrc adjoint dcleguc, Sccurite ct surete
Dircclcur general, Sccurite ferroviairc
sont pas conformes a la Loi .
63 32( 1 ) Soil faire dclruirc, soil cnlever les installations fcrroviaircs et -
Sous ministre
proceder a la vente de leurs materiels et malcriaux ou prendre Sous-ministre dcleguc
loute autre mesure a leur cgurd. en cas d’inexccution de .
Sous-ministrc adjoint Sccurite et surete
I’ordre vise au paragraphe 32( 1). -
Sous ministre adjoint dcleguc, Sccurite et surete
Dircctcur general, Sccurite ferroviairc
64 32( 3 ) Transmettre, lorsquc la personne autorisee estime qu’il y a Sous-ministrc
eu violation d’un rcglcmcnt pris en application de Particle -
Sous ministre dcleguc
24, un avis au conlrcvcnant pour I’informer dc son opinion Sous-ministre adjoint, Sccurite et surete
et -
des motifs de cclle ci. Sous-ministrc adjoint dcleguc, Sccurite et surete
Directeur general, Sccurite ferroviairc
65 32(3 ) Si la personne autorisee estime qu’il y a cu violation d'un -
Sous ministrc
rcglcmcnt pris en vertu dc Particle 24 ct cllc cst convaincuc Sous-ministrc delegue
que la sccurite ferroviairc risque d’etre compromise dc fa?on -
Sous ministrc adjoint, Sccurite ct surete
imminente, a I’cgard dc certaines installations fcrroviaircs,
du fait dc cetlc violation, ordonner, par avis, au contrevcnant
-
Sous ministre adjoint delegue, Sccurite ct surete
de prendre les mesurcs pour ccarter ce risque.
66 32( 3 ) .
Transmettre lorsquc la personne autorisee estime qu’il y a eu Sous-ministre
violation d’un rcglcmcnt pris en vertu dc Particle 24, un avis Sous-ministrc delegue
a la compagnic de chemin de fer conccmcc pour I’informcr -
-
dc son opinion et des motifs dc cclle ci. Sous-ministre adjoint delegue, Sccurite ct surete
14
AR04774

Point Disposition Description des pouvoirs et des iimitcs Personnc autorisee
67 33131 Par avis, ordonner a la compagnie de clicmin de fcr, lorsquc -

Sous minislrc
la personnc autorisee cslime qu ’ il y a eu violation d’un -
Sous minislre delcguc
Sous-minislrc adjoint, Securitc et surete
-
reglemcnt pris en vertu de Particle 24 et elle cst convaincuc
que I 'exploitalion ferroviaire de ccllc ci risque d’etre
compromise de fa?on imminence a Pegard de certaines
-
Sous minislre adjoint delegue, Securitc et surete
.
installations ferroviaircs du fait de cctte violation,
d ’cmpecher toute utilisation d’installations ou de materiel
lerroviaires determines, ou de faire en sorte qu’ ils ne soient
utilises qu ’a certaines conditions, tant que le contrcvenant
n ’aura pas pris, scion elle, les mcsurcs appropriees.
611 mo Par avis, ordonner a la compagnie d’apporter les mesures

correctives necessaircs, si la personnc autorisee estime que le
-
Sous ministrc
systemc de gestion de la securitc ferroviaire elabli par une .
Sous-ministrc adjoint Securitc et surete
compagnie de chemin de for prcscnlc des lacuncs qui - .
Sous ministrc adjoint delegue Securitc et surete
risquent de compromettre la securitc ferroviaire. Direeteur general, Securite ferroviaire
6<> 32112 ) Si la personnc autorisee estime que la misc en oeuvre de Sous-ministre

toute partic du sysleme de gestion de la securite ctabli par Sous-ministre delcguc
une compagnie risque de compromettre la securite Sous--ministre adjoint, Securile et surete
ministre adjoint delegue. Securile et surete
.
ferroviaire, par avis Iransmis a la compagnie ordonner a Sous
cetle dcmierc d’apporter les mesures correctives necessaircs. Direeteur general, Securitc ferroviaire
70 m .2 o Si la personnc autorisee estime qu’ unc activilc exercee dans

le cadre de I’exploitalion ferroviaire cst une menace
--
Sous ministrc
Sous minislre delegue
importante a la securitc des personnes ou des biens ou a -
Sous minislre adjoint, Securile et surete
I ’cnvironnement, par avis Iransmis au rcsponsablc de -
Sous minislrc adjoint delegue, Securite et surete
-
l’activite, ordonner a celui ci de prendre les mesures Direeteur general, Securite ferroviaire
correctives necessaires.
15
AR04775

Point Disposition Description des pouvoirs et des limites Personne aulorisee
71 32.01 Si la personne aulorisee estime neccssaire pour la security -

Sous ministrc
ferroviaire, transmellrc un arrele a une compagnie, a une -
Sous ministrc delcgue
autorite responsable du service de voiric ou a une
municipality lui ordonnant dc mettre fin a toulc activity qui
-
Sous ministrc adjoint, Securite ct surete
Sous-ministrc adjoint delcgue, Sccuritc ct surctc
pourrait compromettre la securile ferroviaire ou de suivre Dircctcur general, Sccuritc ferroviaire
toutc procedure ou d ’apportcr les mesures correctives
necessaires precisees duns I’arrete, y compris dc conslruirc,
dc modifier, d 'cxploilcr ou d ’cntrclcnir des installations
ferroviaires.
72 32.1( 3 ) Presenter des elements de preuve ct des observations au -

Sous ministrc
Tribunal d ’appcl dcs transports du Canada dans Ic cadre Sous-ministrc delegue
d ’une revision d ’un ordre donne en vertu dc Particle 32. Sous-ministrc adjoint, Sccuritc et surctc
-
Sous ministrc adjoint delcgue, Sccuritc cl surete
Dirccteur general, Sccuritc ferroviaire
73 32.4 -
Confirmer I'ordrc ou , par arrele, annuler ou modifier cclui ci, -
Sous ministrc
lors dc son reexamen au titre des paragraphes 32.1( 5) ou
32.2( 3 ).
-
Sous ministrc delcgue
Sous-ministrc adjoint, Sccuritc ct surctc
-
Sous minislre adjoint delegue, Securile et surete
74 33( 1 ) En lui transmettant un avis d'injonction, enjoindre a la Sous-ministrc
compagnie conccmcc de mettre fin, totalcmcnt ou dans la Sous-ministrc delegue
mesurc prevue dans Pavis, a Putilisation d ' installations ou Sous-ministre adjoint Securile ct surete
,
de materiel ferroviaires d’un type determine, ou a toutc Sous-ministrc adjoint dcicguc, Sccuritc ct surctc
pratique conccmant leur entretien ou leur exploitation, qui, Dircctcur general, Security ferroviaire
scion la personne aulorisee, risqucnl dc compromettre dc .
Dirccteur general Transport terrestre intermodal, Surctc et preparatifs
fa on imminente la sccuritc ferroviaire. d ’ urgence
^
75 33( 1 ) En lui transmettant un avis d’injonction a la compagnie -
Sous ministre
-
concemcc, enjoindre ccllc ci dc mettre en ceuvrc unc ccrtaine
pratique concernant Pentrelicn ou I ’exploitation
-
.
Sous-ministre adjoint Security et surete
d’installations ou de matericls ferroviaires, lorsqu’unc
omission a cct egard comporte un risque de compromettre dc
- .
Sous ministre adjoint delcgue Security et surctc
.
Dirccteur general Security ferroviaire
fayon imminente la sccuritc ferroviaire.
d ’urgence
.
Dirccteur general Transport terrestre intermodal, Surete et preparatifs
16
AR04776

76 33( 4 ) Par avis Iransmis a la compagnie, annuler une injonclion, -

Sous minislrc
laqucllc eessc ausstlol d' avoir efTet. Sous-minislrc dclcguc
-
Sous ministrc adjoint, Securite et surctc
.
Sous-minislrc adjoint delegue Securilc et surete
Direclcur general, Securite ferroviairc
.
Direcleur general Transport terrestre intcrmodal, Surcte et preparatifs
d’urgcncc
77 33(6) .
Par avis transmis a la compagnie proroger une injonction par -
Sous ministrc
ailleurs validc d’au plus six mois. Sous-ministrc delegue
Sous-ministre adjoint, Securilc et surete
.
Sous-ministrc adjoint delegue Securilc et surete
Directeur general, Securilc ferroviairc
.
Directcur general Transport terrestre inlermodal, Surete cl preparatifs
d'urgcnce
78 34( 2) Par avis signifie a I’intcrcssc, confirmc I’ordre d’un -

Sous ministrc
inspecteur et lui conferc la meme valeur qu’un ordre pris par Sous-ministrc delegue
cllc. -
Sous-ministrc adjoint delegue, Securite cl surete
Directeur general, Securite ferroviairc
.
Directeur general Transport terrestre intcrmodal, Surete cl preparatifs
d’urgcnce
79 34( 3) Deposer une copie d’un ordre ou d’unc injonclion certifiee Sous-minislrc
conformc, aupres du greffier de la cour. L’ordrc ou -
Sous minislrc delegue
I’injonction deviennent alors assimiles a une ordonnancc .
Sous-minislre adjoint Securilc et surctc
judiciairc. -
Sous minislrc adjoint dclcguc, Securite et surcte
Direcleur general, Securite ferroviairc
. .
Directeur general Transport terrestre inlermodal Surete ct preparatifs
d’urgencc
17
AR04777

80 34 ( 5 ) Faire executer ses ordrcs ou scs injonclions. -

Sous ministre
Sous- ministre delegue
-
Sous minislre adjoint, Sccuritc ct surctc
-
Sous ministre adjoint deleguc, Securite et surctc
Dircctcur general Securite ferroviaire
,
.
Dircctcur general Transport terreslre intcrmodal, Surctc ct preparatifs
d 'urgcncc
81 36 -
Sous ministre
-
Dcmander, par arrclc, a unc compagnic dc lui foumir, en la
Sous ministre dclcguc
forme et dans le delai qui y sont prevus, lout renseignement
-
Sous ministre adjoint, Sccuritc cl surctc
ou document si la personne autorisee I ’cstimc ncccssairc
pour verifier Ic respect dc la Loi ct dc scs lextes -
Sous ministre adjoint dclcguc, Sccuritc ct surete
d’applicalion. Dircctcur general, Sccuritc ferroviaire
.
Dircctcur general Transport terrestre intcrmodal, Surctc cl preparatifs
d’ urgcnce
82 37( 1 )6 ) Dcmander certains rcnscigncmcnts, registres ou documents Sous-ministre

-
Sous ministre dclcguc
qui ont etc preserves, si Ic gouvemeur en conscil a regi 1c
-
depot aupres du ministre, a la demande dc cclui ci, des -
Sous ministre adjoint, Sccuritc ct surctc
Sous-ministre adjoint dclcguc, Sccuritc ct surete
renseignements, registres et documents gardes et conserves
Dircctcur general, Sccuritc ferroviaire
au litre des rcglemenls pris sous Ic regime dc I’alinea
37( 1 )a ). .
Dircctcur general Transport terrestre intcrmodal, Surete cl preparatifs
d ’ urgcncc
83 39.1 ( 1 ) -
i tablir des mesurcs pour assurer la surctc du transport Sous-minislre
Sous-ministre deleguc
ferroviaire.
- .
Sous minislre adjoint Securite et surctc
- .
Sous minislre adjoint dclcguc. Sccuritc ct surete
Dircctcur general Transport terrestre intcrmodal, Sflrcte et preparatifs
d’ urgence
84 39.1 ( 2 ) . -
Sous ministre
--
Par avis ccril obligcr ou autoriscr la compagnic dc chcmin
de fer a mcltrc en oruvre les mesures visces au paragraphe Sous ministre deleguc
39 1 ( 1 ) pour assurer la surete du transport ferroviaire. Sous ministre adjoint, Sccuritc cl surete
Sous-ministre adjoint dclcguc, Securite ct surctc
Dircctcur general, Transport terrestre intcrmodal, Surete et preparatifs
d’urgcncc
18
AR04778
Colonnc I Colonne 2 Colonne 3 Colonne 4

85 39.1(3 ) Si lo personne aulorisec estime qu ’ il cst dans I’ intcret public Sous-ministre

de le fairc et que la securite ferroviaire ne risque pas d'etre -
Sous minislrc delegue
compromise, soustraire, aux conditions que la personne -
Sous-ministre adjoint delegue, Securite et surete
autoriscc jugc utiles, toute compagnie dc chemin de Ter ou
toulc personne a (’application d’ unc mesurc dc surete du
transport ferroviaire. d’ urgcncc
.
Directeur general Transport terrestre inlermodal, Surete et preparatifs
86 39.2( 1 ) Auloriscr la divulgation de la leneur d’un texte rclatif a la -

Sous ministre
surete du transport ferroviaire qui est designe comme tel. Sous-ministre delegue
-
Sous ministre adjoint delegue, Securite cl surete
.
d’urgencc
87 39.2( 2 ) Presenter ses observations concemant le texte rclatif a la -

Sous ministre .*•
surete du transport dans le cas d’unc demande de production Sous-ministre delegue
ou de divulgation devant un tribunal ou tout autre organisme -
competent . -
. .
Directeur general Transport terrestre inlermodal Surete el preparatifs
d’ urgence
19
AR04779

88 40( 1 ) Ordonner, par arrcte. qu’unc enquctc soit tcnuc, dans )c cadre
rcglcmcnlairc fixe sous Ic regime dc [’article 47 ct sous
-
Sous ministrc
Sous-ministrc delegue
reserve dc la Loisur Ic Bureau canadien d’enquete stir les -
Sous ministrc adjoint, Securite et surcle
accidents dc transport et de la securite des transports , par les -
Sous ministrc adjoint delegue, Securite cl surctc
personnes que la personne auloriscc designe a cettc fin ct que
-
cellcs ci lui rcmcllent un rapport scion les modalites dc
temps et autres que la personne autorisee precise sur telle dcs
.
questions suivantes qui a son avis, soulevc ou cst susceptible
-
de soulevcr cllc memc dcs questions d’interct public liecs a
la securite ferroviairc :
a ) un projet d’ installations fcrroviaircs decril
dans un plan depose aupres dc lui en application dc
Particle 10;
b) les regies dcposccs aupres de lui en application des &
articles 19 ou 20;
c ) tout accident ou incident mettant en cause dcs
installations fcrroviaircs ou lie a I'cxploitation de materiel
ferroviairc;
/) toutc autre question lice a I’cxploitation ou a I’cntrcticn
(
d’installations ou de materiel fcrroviaircs.

89 40.11( 1 ) Designer, individuellcmcnl ou par categoric, les agents dc
I’autoritc.
--
Sous ministrc
-
Sous ministrc adjoint, Securite ct surcle
-
Sous ministrc adjoint delegue, Securite cl surcle
Directcur general, Securite ferroviairc
. .
Dircctcur general Transport terrestre intcrmodal Surctc cl preparatifs
d’urgencc
- -ministrc
---ministrc
90 40.12 Decider dc la forme ct de la teneur des proccs vcrbaux de Sous
violation. Sous ministrc delegue
Sous adjoint, Securite ct surctc
Sous ministrc adjoint delegue, Securite ct surctc
Dircctcur general, Securite ferroviairc
.
Dircctcur general Transport terrestre intcrmodal, Surete el preparatifs
d’urgencc
20
AR04780

91 40.19( 1 ) Deposer un uppcl au Tribunal d ’appel dcs transports du Sous --ministrc

--ministre adjoint. Securite et surete
Canada dc la decision rendue au litre Particle 40.18 dans un Sous ministre delegue
delai dc ( rente jours. Sous
40.2 -
--
92 Oblertir du Tribunal d’appel des transports du Canada ou du Sous ministre
. Sous ministre delegue
consciller, scion le cas un certificat indiquant la pcnalitc a
payer par Pintcressc si ce dernier, dans le delai requis : .
Sous ministre adjoint Securite et surete
a ) omet de payer la pcnalilc prevue dans le proces-vcrbal ou

-
Sous ministre adjoint delegue, Securite el surete
Direcleur general, Securite ferroviaire
de dcposcr une requite cn revision au litre de Particle 40.16;
d 'urgcnce
.
Direcleur general Transport tcrreslre intermodal, Surete ct preparatifs • i
b ) omet de payer la somme fixec cn vertu de Palinea 40.18b )

ou de deposer un appel au titre de Particle 40.19; ou
dr
« N*
c) omet de payer la somme fixee en vertu du paragraphe
40.19( 4 ),
93 44.1 ( 2 ) Formulcr des rccommandalions liees aux procedures pour Sous-ministre

rcgler les plaintcs conccmant les agents dc police, Sous- ministrc delegue
notamment cedes conccmant les moyens dc porter a la
connaissance du public Pexistence de la procedure.
-
Sous-ministrc adjoint delegue, Securite ct surete
.
Direcleur general Transport lerrestre intermodal, Surete et preparatifs
d ' urgcnce
94 119( 5 ) Par arrete, abroger les ordonnances et les reglements vises Sous-ministre
aux paragraphes 119( 2 ) el 119 ( 2.2) ainsi que les reglements -
adminislralifs vises au paragraphe 119( 4 ). -
Sous-ministrc adjoint delegue, Securite ct surete
21
AR04781


AR04782
Draft public health considerations related to the implementation of

COVID-19 vaccine requirements for the federal workforce
Version: August 17, 2021 with 2 addenda dated August 31st 2021
Prepared by: The Public Health Agency of Canada
The Government of Canada (GOC) announced on August 13th its intent to require COVID-19 vaccination
as early as the end of September across the federal public service. In addition, as soon as possible in the
Fall and no later than the end of October, the GOC will require employees in the federally regulated air,
rail, and marine transportation sectors to be vaccinated. The vaccination requirement will also extend to
certain travellers. This includes all commercial air travellers, passengers on interprovincial trains, and
passengers on large marine vessels with overnight accommodations, such as cruise ships. Further, the
GOC expects that Crown Corporations and other employers in the federally regulated sector will also
require vaccination for their employees. The government will work with these employers to ensure this
result1. As The GOC is currently exploring options for implementing these COVID-19 vaccine
requirements, the Public Health Agency of Canada (PHAC) has been asked to provide scientific and
public health evidence or considerations of relevance.
The COVID-19 pandemic has had an unprecedented impact on the health of Canadians. Reducing the
direct health impacts of COVID-19 and maintaining health care capacity with various public health
measures (closures, physical distancing and masking) has been extremely challenging and has affected a
larger range of health outcomes across populations in Canada.2 COVID-19 vaccines are a critical tool3
that will help bring an end to the crisis phase of the pandemic, resume societal functioning and achieve
widespread immunity in a safe way.
This document highlights key evidence in the areas of epidemiology, vaccine science and immunization
programs related to COVID-19 vaccine requirements. The strength of the evidence presented is
qualitatively labelled as strong, medium or weak.
Summary of key points:

 The fourth wave of COVID-19 has started in Canada and will most likely be driven by the Delta
variant. The majority of cases, hospitalisations and fatal outcomes are occurring among
unvaccinated people. The Delta variant is much more contagious than other SARS-CoV2 viruses that
have circulated in Canada; it spreads faster and increases risk of hospitalizations. SARS- CoV2 is
known to be more transmissible in indoor crowded spaces, including workplaces.
1
News release: https://www.newswire.ca/news-releases/government-of-canada-to-require-vaccination-of-federal-workforce-
and-federally-regulated-transportation-sector-818056331.html
2 From risk to resilience: An equity approach to COVID-19 – The Chief Public Health Officer of Canada’s Report on the State of
Public Health in Canada 2020 - Canada.ca

3 https://www.who.int/emergencies/diseases/novel-coronavirus-2019/covid-19-vaccines
1
AR04783
 Most recent modelling and forecasting studies indicate that with the current vaccination coverage
levels, although very good, the health care capacity could be exceeded during this wave. To
minimize this possibility, 80% or more of all eligible age groups would need to be fully vaccinated.
However, overall 2-dose coverage for the eligible general population in Canada is 71.3% and much
lower in the younger age groups (51% in the 18-29 year olds) as of mid-August 2021. Increasing the
coverage rate in the 18 to 39 year old group is a priority, as they are the group with the most cases
at this time. However, a strong resurgence of cases may not necessarily be associated with a sharp
increase in hospitalizations given high Canadian vaccine coverage in older age groups (who are more
likely to be hospitalized compared to younger age groups).
 COVID-19 vaccines are very effective (including against the Delta variant) the benefits outweigh any
safety risks. It is strongly recommended that all eligible Canadians receive a full course of vaccines as
soon as possible. Before we had vaccines, public health measures that were implemented to “flatten
the curves” were effective to preserve hospital capacity and save lives, but with some important
limits. Closings and physical distancing have major impacts on other health issues, children, the
economy and societal functioning and are not sustainable in the long term. Vaccines are a critical
tool to resume societal functioning and achieve widespread immunity in a safe way. Indeed, once
the vaccination campaign started for priority groups, deaths and severe outcomes in the most
vulnerable, including the elderly, have sharply declined.
 Vaccine uptake has plateaued and other countries are facing this challenge. To stimulate uptake, an
increasing number of countries as well as provinces and territories are implementing or
contemplating vaccine mandates or passports for specific sectors. The impact of these policies on
vaccine uptake will be better known as they roll out.
 For non COVID-19 vaccines, vaccine mandates exist and they can be effective to increase uptake.
This strategy is mostly effective for individuals that are complacent or not prioritizing vaccination in
their day to day life. Other strategies that are more dialogue based are effective to motivate vaccine
hesitant individuals. Combinations of strategies are most effective to optimize uptake.
 While COVID-19 vaccines are very effective, particularly against severe outcomes, no vaccine works
perfectly, and there is a percentage of the population who are vaccinated that will become infected.
The currently available vaccines are somewhat less effective against infection and symptomatic
disease for the Delta variant compared to the ancestral and Alpha strains. Therefore, until
widespread immunity is attained in the Canadian population, some additional public health
measures such as masking and reductions in contacts will still be needed at times, especially in
crowded indoor settings. These measures are also needed to protect people who do not respond as
well to vaccines, have contraindications and cannot receive them or who are not vaccinated. These
considerations are likely to have implications for occupational health.
Epidemiology (strong level of evidence unless indicated otherwise)

 The fourth wave of COVID-19 has started in Canada and it will be different than previous waves
because it is occurring in the context of the significant uptake in vaccination. While incidence rates
remain low after the end of the third wave, rates are starting to increase in British Columbia,
Alberta, Saskatchewan, Ontario, Quebec, and New Brunswick, following the relaxation of public
health measures. Incidence is highest, and increasing most rapidly, in the 20-39 years age group,
2
AR04784
which constitute an important proportion of the workforce. The Rt in Canada is now above 1.0,
indicating that transmission will continue to increase in the following weeks4.
 The B.1.617.2 (Delta) variant is now well established in Canada and will likely be the dominant strain
of the fourth wave. Most recent modelling and forecasting studies indicate that with the current
vaccination coverage levels, and predicted increases in contacts as reopening continues, the health
care capacity could be exceeded5 (medium level of evidence). This highlights the importance of
continuing efforts to increase vaccine uptake in Canada, with at least 80% of the all eligible age
groups fully vaccinated, given that the Delta variant is much more contagious than previous strains/
variants circulating in Canada and a complete two-dose series of COVID-19 vaccine provides
substantial protection against the variant28.
 The majority of SARS-CoV-2 cases in Canada are in unvaccinated people. Since December 14, 2020,
when the vaccination program began, 89.4% (n=554,523) of all cases were unvaccinated; An
additional 5.4% (n=32,845) were cases not yet protected from vaccination (within 14 days from the
first dose) and 4.7% (n=29,279) were partially vaccinated. Only 0.6% (n=3.457) of cases were fully
vaccinated. Among unvaccinated cases 10.7% (n=55,706) were asymptomatic, while 14.9%
(n=4.041) of partially vaccinated cases were asymptomatic and 28.1% (n=891) of fully vaccinated
cases were asymptomatic6.
 Being unvaccinated has become an important risk factor for hospitalization. Since May 1, 2021 the
COVID-19 hospitalization rates among unvaccinated populations are considerably higher than the
hospitalization rates for both partially and fully vaccinated populations (see Figure 1 in the Annex)
 Although mortality rates are currently low for all populations, mortality rates in unvaccinated
populations are higher than those that are partially and fully vaccinated.
 COVID-19 infections are also associated with the “long COVID-19” outcome. PHAC recently
published the initial findings for a living systematic review (studies published between January 2020
and January 2021) on the prevalence of long term effects in individuals diagnosed with COVID-197.
The prevalence of long term effects – persistence or presence of one or more symptoms at beyond
12 weeks – was (56% (95%CI: 34-75%). This particular estimate was based on a meta-analysis of
results from 4 studies (denominator=2412) and included non-hospitalized and hospitalized adults,
however the majority were hospitalized. While some studies suggest there is an association
between the severity of acute COVID-19 infection and the risk experiencing long COVID
manifestations, the evidence to date remains limited.
 An updated literature search was conducted in mid-April 2021, for which additional studies showing
prevalence of any symptom 12+ weeks after diagnosis met the inclusion criteria. The updated
prevalence estimate was 53% (95% CI of 41%-65%) and based on a meta-analysis of results from 14
studies (denominator=4511). Again, although the studies included non-hospitalized and hospitalized
individuals, the majority were hospitalized.
4
https://health-infobase.canada.ca/covid-19/epidemiological-summary-covid-19-cases.html
5
https://www.canada.ca/content/dam/phac-aspc/documents/services/diseases-maladies/coronavirus-disease-
covid-19/epidemiological-economic-research-data/update-covid-19-canada-epidemiology-modelling-20210730-
en.pdf
6
https://health-infobase.canada.ca/covid-19/epidemiological-summary-covid-19-cases.html#a9
7
Prevalence of long-term effects in individuals diagnosed with COVID-19: a living systematic review | medRxiv
3
AR04785
 These estimates do not allow for an analysis of Post COVID-19 condition by vaccination status.
Published studies reviewed were performed early in the pandemic, prior to mass vaccination
campaigns.
 Some new emerging limited evidence suggests that it is possible to get long COVID from a
breakthrough infection. However, the evidence is extremely limited at this point and the definition
of long COVID in terms of length of time after infection is not consistent in the different studies
referenced below (studies typically use 12 weeks the cut off point). One observational study in the
UK followed 1,102,192 vaccinated adults and identified 2,394 post-vaccination SARS-CoV-2
infections between Dec 8 2020 – May 1 2021. Preliminary results found that vaccinated older adults
(aged 60+) had fewer prolonged symptoms (>28 days) compared with those unvaccinated however
statistical significance was not reached (OR=0.72, 95% CI 0.51-1.00)8. In a study conducted in Israel
among 1497 fully vaccinated health care workers, 39 SARS-CoV-2 breakthrough infections were
documented. Most breakthrough cases were mild or asymptomatic, although 19% had persistent
symptoms (>6 weeks). The reported symptoms included a prolonged loss of smell, persistent cough,
fatigue, weakness, dyspnea, or myalgia. Nine workers (23%) took a leave of absence from work
beyond the 10 days of required quarantine; of these workers, 4 returned to work within 2 weeks.
One worker had not yet returned after 6 weeks9.
 It has been established that asymptomatic cases of COVID-19, particularly cases in the pre-
symptomatic phase of the infection, can transmit SARS-CoV-2. The contribution of these cases to the
overall transmission dynamics in an outbreak or community setting is very variable in studies and
appears reduced compared to the spread caused by symptomatic cases. Although some super
spreader asymptomatic cases have contributed to an important number of secondary cases, several
epidemiological investigations have reported that the majority of asymptomatic cases did not result
in onward transmission (strong level of evidence) 10, 11.
Delta variant (strong level of evidence)

 Genetic variations of viruses are common and expected. A variant of concern or VOC may be more
contagious, cause more severe illness or impact tests, treatments or vaccines12.
8
Post-vaccination SARS-CoV-2 infection: risk factors and illness profile in a prospective, observational community-
based case-control study | medRxiv
9
Covid-19 Breakthrough Infections in Vaccinated Health Care Workers | NEJM
10
Public Health Agency of Canada, Summary of the evidence on asymptomatic infections and transmission of
SARS-COV-2, June 5 2020.
11
Revue rapide de la littérature scientifique : proportion de personnes asymptomatiques, leur réponse
immunitaire et leur potentiel de transmission de la COVID-19 (inspq.qc.ca)
12 https://www.who.int/en/activities/tracking-SARS-CoV-2-variants/ (consulted August 12th)
4
AR04786
 Four Variants of Concern (VOCs) have been detected in Canada, the Delta variant is the most
contagious variant observed to date, spreading an estimated 50% faster than the Alpha variant13 14 15
 The number of cases with the Delta variant has increased more than 6-fold from early June to mid-
July and is the main strain detected in most affected provinces and territories. Unvaccinated cases of
Delta are over two times more likely to be hospitalized compared to unvaccinated Alpha cases16.
 A higher proportion of partially and fully vaccinated cases with Delta are hospitalized compared to
other VOCs and non-VOCs (see Figure 2 in the Annex).
 Presently, those who are unvaccinated are at greatest risk of infection and severe outcomes. Spread
in areas with low vaccination coverage presents an ongoing risk for emergence of, and replacement
by, new variants.
Vaccine coverage (strong evidence unless indicated otherwise)

 Overall 2-dose coverage for the eligible general population in Canada is 71.3%17, although lower
coverage is observed for 18-29 year olds (51.3%)18
 To minimize the impact of the fourth wave driven by Delta variant, modelling indicates that over
80% of all eligible age groups need to be fully vaccinated. Increasing the 2-dose coverage rate at
80% in the 18-39 year olds is of particular relevance to achieve this objective (medium level
evidence based on modelling).
 COVID-19 vaccination coverage throughout the Federal Public Service is currently unknown but
knowledge of some key sociodemographic characteristics such as geographical location and age
group19 permit inferences for vaccination coverage. For example, the average age for a Federal
Public Service employee is just over 43 years old and 2-dose coverage for this particular age group in
the general Canadian population is 67.5%. Furthermore, only 8% of Federal Public Service
employees are in the age group (60-69 year olds) for which 2-dose coverage (83.5%) is the highest.
In conclusion, 2-dose coverage for Federal Public Service employees could range from 51.3% to
73.1%, however this group may differ from the general population in some demographic
characteristics such as income, education level or gender distribution that are associated with higher
levels of vaccination.
13
https://assets.publishing.service.gov.uk/government/uploads/system/uploads/attachment_data/file/993879/Va
riants_of_Concern_VOC_Technical_Briefing_15.pdf
14
https://assets.publishing.service.gov.uk/government/uploads/system/uploads/attachment_data/file/1001359/V
ariants_of_Concern_VOC_Technical_Briefing_16.pdf
15
https://www.gov.uk/government/publications/investigation-of-sars-cov-2-variants-of-concern-variant-risk-
assessments
16 Detailed case information received by PHAC from provinces and territories
17 Little, N. (2021) COVID-19 Tracker Canada; Saskatchewan PHU; Statistic Canada – Population estimates 2021,
18 COVID-19 vaccination coverage in Canada - Canada.ca (Table 2, consulted August 12)
19 https://www.tbs-sct.gc.ca/ems-sgd/edb-bdd/index-eng.html#orgs/gov/gov/infograph/people
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Vaccine Science
NACI and Health Canada (HC) have different roles when it comes to vaccines. HC, as Canada’s regulator,
evaluates data from clinical trials, determining if the vaccine is safe and efficacious and if it should be
authorized for use in Canada. Authorization is based on specific schedules and conditions that took place
in clinical trials, as submitted by the manufacturer. HC does not dictate the practice of medicine or make
recommendations on how vaccines should be used in different age groups and sub-populations for
Public Health impact.
When developing recommendations, NACI assesses how to use vaccine for greatest benefit. To inform
its recommendations, NACI reviews the most up-to-date data from clinical trials and real world use;
COVID-19 epidemiology and risks for population subgroups; vaccine supply in Canada; ethical and equity
considerations. It is not uncommon for NACI to provide recommendations that are broader/narrower
than the conditions of use approved by HC regulator. NACI’s guidance is advisory in nature -
immunization program planning and delivery is a provincial/territorial (PT) responsibility and is based on
their unique needs and circumstances, including public health considerations, local epidemiology,
healthcare system capacity and vaccine management logistics.
Based on its review, NACI strongly recommends that all eligible Canadians be vaccinated with a full
series of a COVID-19 vaccine, with a preference for the mRNA vaccines20. The PHAC has continuously
recommended that all eligible Canadians be vaccinated as soon as possible as vaccination is a key
measure to protect themselves and their communities from the consequences of COVID-19 and to
increase opportunities to return to a more normal situation, including easing of measures put in place to
limit transmission, increasing social contacts, and resumption of economic activity21.
Vaccine efficacy and effectiveness

Evidence indicates that vaccines are very effective at preventing severe illness, hospitalization and death
from COVID-19, including against Alpha and Delta variants of concern. Recent reports in Canada indicate
that less than 1% of those who were fully vaccinated have become sick with COVID-19. In addition,
people who are fully vaccinated with a COVID-19 vaccine are less likely to have symptomatic COVID-19
disease or asymptomatic SARS-CoV-2 infection compared to unvaccinated individuals. MRNA vaccines
(Pfizer-BionTech and Moderna) appear to have higher vaccine effectiveness against symptomatic COVID-
19 and asymptomatic SARS-CoV-2 infection than viral vector vaccines (AstraZeneca).
COVID-19 vaccines have high efficacy (strong evidence)

 In clinical trials, the estimated efficacy against symptomatic illness after a complete vaccine series
was:
20 https://www.canada.ca/en/public-health/services/immunization/national-advisory-committee-on-immunization-
naci/recommendations-use-covid-19-vaccines.html
21 https://www.canada.ca/en/public-health/services/diseases/2019-novel-coronavirus-infection/awareness-
resources/vaccinated-against-covid-19-public-health-measures.html
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o 94% with Pfizer-BioNTech in individuals 16 years of age and older and 95% in individuals 65
years of age and older22,23;
o 94% with Moderna in individuals 18 years of age and older and 86% in individuals 65 years
of age and older24; and
o 62% with AstraZeneca in individuals 18-64 years of age25.
COVID-19 vaccines have high effectiveness (strong evidence unless indicated otherwise)
 In field studies, complete series of vaccines authorized in Canada have shown that they were 66% to
97% effective at preventing symptomatic infections, hospitalizations and deaths. The effectiveness
of mRNA vaccines, which have been mostly used in Canada, is generally in the higher levels of that
bracket (see Table 1 in Annex for details).
 Provincial data for health care workers in Québec showed that mRNA vaccines were 94.2% effective
against symptomatic disease after 2 doses and 97.9% effective against hospitalization after one
dose. The two dose hospitalization vaccine effectiveness is not able to be estimated as there were
no hospitalizations after the 2nd dose. The effectiveness was reduced by about 15% for variants of
concerns (90% Alpha at the time of the study)26.
 Some people with severe chronic conditions, particularly severe immunosuppression and end stage
kidney disease appear to have a reduced immune response to the currently available vaccines27 ,28. A
third dose may overcome the lack of response in some but not all of these individuals. Other
measures are also needed to protect them including in the workplace29 (medium to strong
evidence). Some guidance has also been issued for people with other chronic conditions (ex:
cardiovascular, pulmonary, diabetes) in the workplace that do not rely solely on vaccination status
as it is deemed insufficient for appropriate protection by some experts30. It is likely that people who
do not respond as well to COVID-19 vaccines, cannot be vaccinated because of a contraindication or
have high risk of complications from COVID-19 would benefit from reducing their exposure to
unvaccinated individuals in the workplace, or in other words, from working in a setting with a very
high vaccine coverage rate.
 COVID-19 variants are expected to continue to evolve and there is a possibility that an emerging
strain could evade immunity conferred by currently available vaccines. PHAC continues to actively
22
Polack FP, Thomas SJ, Kitchin N, Absalon J, Gurtman A, Lockhart S et al. Safety and efficacy of the BNT162b2 mRNA Covid-19
Vaccine. N Engl J Med. 2020 Dec 31;383(27):2603,2615. doi: 10.1056/NEJMoa2034577.
23 Frenck RW, Klein NP, Kitchin N, Gurtman A, Absalon J, Lockhart S et al. Safety, immunogenicity, and efficacy of the BNT162b2
Covid-19 Vaccine in adolescents. N Engl J Med. 2021 May 27. doi: 10.1056/NEJMoa2107456.
24 Moderna. Vaccines and Related Biological Products Advisory Committee Meeting December 17, 2020. FDA Briefing
Document. Moderna COVID-19 Vaccine [Internet].; 2020 Dec [cited 2020 Dec 23].
https://www.fda.gov/media/144434/download.
25 Voysey M, Clemens SAC, Madhi SA, Weckx LY, Folegatti PM, Aley PK et al. Safety and efficacy of the ChAdOx1 nCoV-19
vaccine (AZD1222) against SARS-CoV-2: an interim analysis of four randomised controlled trials in Brazil, South Africa, and the
UK. Lancet. 2021 Jan 9;397(10269):99,111. doi: 10.1016/S0140-6736(20)32661-1.
26 https://www.inspq.qc.ca/publications/3145-efficacite-vaccin-covid-19-travailleurs-sante
27 Chodick et al. Clinical Infectious Diseases, ciab438, https://doi.org/10.1093/cid/ciab438
28 Khan et al. Gastroenterology (2021). https://www.gastrojournal.org/article/S0016-5085(21)03066-3/pdf
29https://www.inspq.qc.ca/publications/2914-protection-travailleurs-immunosupprimes-covid19
30 https://www.inspq.qc.ca/publications/2967-protection-travailleurs-maladies-chroniques-covid-19
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monitor the evolution of variants, and evaluates key attributes such as ability for immune or vaccine
escape.
Vaccines are effective against the Delta variant (medium level of evidence):
 Two doses of both mRNA COVID-19 vaccines are highly effective in preventing Delta hospitalization
and death (over 90%), but vaccine effectiveness was lower against symptomatic
disease/asymptomatic infection than against severe outcomes. When vaccine effectiveness against
the Delta variant of two doses of Pfizer-BioNTech and Moderna was compared, it was generally
lower for Pfizer-BioNTech than Moderna for both symptomatic disease/asymptomatic infection and
severe disease, but more notably for symptomatic disease/asymptomatic infection. Two-dose
vaccine effectiveness against symptomatic disease/asymptomatic infection for AstraZeneca against
Delta is generally lower than for mRNA vaccines, but protection against severe disease was high.
One-dose Delta vaccine effectiveness for all vaccines was substantially lower than two-dose vaccine
effectiveness against symptomatic disease/asymptomatic infection, but one dose vaccine
effectiveness was higher against severe disease than against symptomatic disease/asymptomatic
infection . 31 32 33 34 35 36 37.
 A Canadian study showed that vaccine effectiveness against symptomatic infection caused by Delta
after the first dose was higher for Moderna (72%) than Pfizer (56%) and AstraZeneca (67%). Data
also showed that a second dose increased vaccine effectiveness for all three products: Moderna
(100%), Pfizer (87%%) and AstraZeneca (100%).38
Vaccines have significantly reduced outbreaks

Prior to vaccination rollout, there were high numbers of outbreaks in all settings (acute care, long-term
care, workplaces, etc.). The number of outbreaks in Canada decreased from January to February 2021;
however, it was followed by an increase from March to April 2021 probably associated with reopening
and transition to a dominance of the more contagious Alpha variant in many parts of Canada. The initial
phase of the vaccination campaign prioritized residents of long term care facilities followed by the
elderly in strata of decreasing age across the country. The impact of vaccination on the frequency of
outbreaks in dwellings for the elderly, and the reduction of death rates and hospitalizations has been
striking compared to the impact of other tools used prior to vaccination (mostly relying on closures and
31Tang P, Rubayet Hasan M, Hiam Chemaitelly H et al. Al BNT162b2 and mRNA-1273 COVID-19 vaccine effectiveness against the Delta
(B.1.617.2) variant in Qatar. medRxiv 2021.08.11.21261885; doi: https://doi.org/10.1101/2021.08.11.21261885
32 Stowe et al., 2021 pre-print
33 Lopez Bernal J, Andrews N, Gower C, et al. Effectiveness of Covid-19 Vaccines against the B.1.617.2 (Delta) Variant. N Engl J Med. July
2021:NEJMoa2108891. doi:10.1056/NEJMoa210889
34
Sheikh A, McMenamin J, Taylor B, Robertson C. SARS-CoV-2 Delta VOC in Scotland: demographics, risk of hospital admission, and vaccine
effectiveness. Lancet. June 2021. doi:10.1016/S0140-6736(21)01358-1
35 Public Health England (PHE) press release. Vaccines highly effective against hospitalisation from Delta variant. Available at:
https://www.gov.uk/government/news/vaccines-highly-effective-against-hospitalisation-from-delta-variant
36 Israel Ministry of Health press release. Data Compiled by the Vaccine Operation’s Supervising Committee Published 22 July 2021. Available at:
https://www.gov.il/en/departments/news/22072021-03.
37
Puranik A, Lenehan PJ, Eli Silvert E, Niesen MJM, Corchado-Garcia J, O’Horo JC, Virk A, Swift MD, Halamka J, Badley AD, Venkatakrishnan AJ,
Soundararajan V. Comparison of two highly-effective mRNA vaccines for COVID-19 during periods of Alpha and Delta variant prevalence.
medRxiv. 2021.08.06.21261707
Nasreen S, He S, Chung H et al. Effectiveness of COVID-19 vaccines against variants of concern, Canada. July 16, 2021.
38
medRxiv. Preprint available: https://www.medrxiv.org/content/10.1101/2021.06.28.21259420v2
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physical distancing)39. Similar outcomes have been reported in other countries with comparable vaccine
priority roll out, for example, the United Kingdom. Since May 2021, the number of outbreaks has
steadily decreased in Canada. Although vaccination status is not available for all cases linked to
outbreaks, the decreasing trend in number of outbreaks appears to align with increased vaccination
coverage in the population40 (medium level of evidence). Workplaces have been a frequent setting for
outbreaks, mostly in settings where physical distancing was difficult, working remotely not possible and
public health measures challenging to implement. Several workplace settings have succeeded in
minimizing transmission with proper infection control measures in place41.
Transmission of COVID-19 is reduced by vaccines (medium or weak level of evidence)

COVID-19 vaccines prevent transmission in two ways – by decreasing infection and then potentially by
decreasing transmission from vaccinated individuals who become infected. Vaccine effectiveness
described above indicate that extent to which infection is prevented. Three studies have demonstrated
that infected individuals who are vaccinated are less infectious to their household contacts than
unvaccinated individuals (30% lower risk of transmission by vaccinated health care workers to their
household contacts in Shah et al.42, approximately 40-50% lower risk of spread in Harris et al. where
most individuals received only one dose of Pfizer-BioNTech or AstraZeneca,43 and 58 to 88% lower risk
in de Gier et al. where a full course of Pfizer-BioNTech, Moderna, AstraZeneca or Janssen were used in
de Gier et al.44). These studies were however done prior to the circulation of the Delta variant. Emerging
evidence for the Delta variant points to the possibility of high viral loads in some breakthrough cases in
fully vaccinated people which can be as high as in unvaccinated people. Preliminary data from the U.S.
Centers for Disease Control and Prevention45 and from Public Health England46 indicate that levels of
virus in fully vaccinated people who become infected with Delta may be similar high compared to levels
found in unvaccinated people, and therefore infected vaccinated people may be as likely to transmit the
virus as infected unvaccinated people. However, further studies are needed to confirm levels of
infectiousness and also the extent of vaccine effectiveness against Delta, which at present appears to be
only slightly less than for other variants such as Alpha.
39
https://www.canada.ca/content/dam/phac-aspc/documents/services/diseases-maladies/coronavirus-disease-covid-
19/epidemiological-economic-research-data/update-covid-19-canada-epidemiology-modelling-20210326-en.pdf.
40 Canadian COVID-19 Outbreak Surveillance System (CCOSS) for BC, AB, MB, ON, QC, NS, PE and public information sources for
YT, NT, NU, SK, NL, NB)

41
https://www.inspq.qc.ca/covid-19/sante-au-travail/eclosions-travail
42
V Shah AS, Gribben C, Bishop J, Hanlon P, Caldwell D, Wood R, and others. Effect of vaccination on transmission of COVID-19:
an observational study in healthcare workers and their households. medRxiv. 2021:2021.03.11.21253275
43
Harris RJ, Hall JA, Zaidi A, Andrews NJ, Dunbar JK, Dabrera G. Impact of vaccination on household transmission of SARS-COV-2
in England Public Health England; 2021
44
de Gier B et al. Vaccine effectiveness against SARS-CoV-2 transmission and infections among household
and other close contacts of confirmed cases, the Netherlands, February to May 2021. Euro Surveill. 2021;26(31):pii=2100640.
https://doi.org/10.2807/1560-7917.ES.2021.26.31.2100640
45 https://www.cdc.gov/mmwr/volumes/70/wr/mm7031e2.htm
46 SARS-CoV-2 variants of concern and variants under investigation (publishing.service.gov.uk)
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Benefits of the COVID-19 Vaccines largely outweigh their risk (strong level of evidence)
 Canada’s independent drug authorization process is known around the world for its high standards
and rigorous review process. Decisions are based on scientific and medical evidence. Vaccines
authorized for use in Canada meet rigorous safety criteria and are of high quality.
 Once a vaccine is in use, Canada has a comprehensive safety monitoring system (i.e., post-market
surveillance), enabling quick identification of vaccination safety issues and change in
recommendations as needed. For example, NACI quickly adjusted the recommendations for the
AstraZeneca vaccine when rare thrombotic events were detected. As of August 6, 2021, a total of
50,254,577 vaccine doses had been administered in Canada, with adverse events (side effects)
reported by 12,006 people. That’s about 2 people out of every 10,000 people vaccinated who have
reported 1 or more adverse events. Most adverse events are mild and include soreness at the site of
injection or a slight fever. Of the 12,006 individual reports, 8,943 were considered non-serious
(0.018% of all doses administered) and 3,063 were considered serious (0.006% of all doses
administered). These adverse events aren’t necessarily related to the vaccine47. It is important to
note that he benefits of COVID-19 vaccination continue to substantially outweigh the risks.
 Contraindications to COVID-19 are infrequent (e.g. severe allergy to vaccine components) - (strong
level of evidence). NACI has also recommended that as precaution, patients who experienced
myocarditis and/or pericarditis following first dose of mRNA should defer second dose until more
information is available.
Strategies to improve vaccine coverage and vaccine mandates

Vaccine mandates can be effective to increase vaccine coverage (medium to strong level of
evidence)
 Vaccine requirements in day cares, schools and colleges/universities can increase vaccine coverage
by a mean of 18% according to a systematic review48 . However, the effectiveness of these
requirements is impacted by the ease of obtaining exemptions and the consistency of the
enforcement (strong level of evidence) and is less clear when the baseline immunization rate is
already high49. These policies generally have exemptions and don’t require exclusion of the
unvaccinated unless there is an outbreak. Ontario, New-Brunswick and British-Columbia have
legislation and policies about childhood (non COVID-19) vaccine requirements in daycare or school
settings. There is not a clear association between higher coverage rates in children across the
various PTs and these vaccine requirements in Canada50. Although experience with school or child
care vaccination requirements may be extrapolated to workplace settings in the context of COVID-
19, at this time there is limited evidence about the effectiveness of these policies to increase uptake
in the workplace.
47
https://health-infobase.canada.ca/covid-19/vaccine-safety/ (consulted August 11 2021)
48 Vaccination: School, College Requirements | The Community Guide (consulted August 11th)
49 https://www.annualreviews.org/doi/10.1146/annurev-publhealth-090419-102240#_i7 (consulted August 11th)
50 https://www.canada.ca/en/public-health/services/publications/healthy-living/2017-vaccine-uptake-canadian-children-
survey.html#_Children_aged_seven (consulted August 11th)
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 In Québec, a policy for health care workers implemented in some sectors of the health care system
requiring vaccination or regular testing has been associated with a rise in vaccine coverage from
50% to 90% for the first dose of COVID-19 vaccines (weak to medium evidence)51. British-Columbia
has also mandated COVID-19 vaccination for workers of long term care facilities very recently, the
impact of these measures will be known in the future.
 Several countries have recently implemented COVID-19 vaccination mandates, either for targeted
sectors (HCW, border agents, quarantine officers – New Zealand, Australia, Italy, France and
England), vaccine passports for cultural events and various services (France, Israel), or for
government employees (United States federal employees, New York and California). France and
Québec officials have publicly reported an increase in first dose appointment bookings following
announcements of their new policies. The effectiveness of these strategies will be better known as
jurisdictions implement and evaluate their policies.
 The scientifically supported approach towards medical exemptions used for travellers entering
Canada is to allow exemptions for medical contraindications as per the product monographs of the
vaccines authorized for use by Health Canada. The exemptions must be justified in a letter by a
licensed physician52. Various religious leaders are supportive of COVID-19 immunizations.
Exemptions based on religious beliefs do not have a scientific evidence basis. Alignment of the
federal workplace policy with the OIC requirements would be very beneficial in terms of consistent
messaging and operational considerations.
 Vaccine requirements which do not address underlying reasons for the vaccine hesitancy have the
potential to increase vaccine resistance53. For COVID-19 vaccines, strong resistors among the
general public make up 6-9% of the population. Research has shown that interventions that
decrease the freedom of choice can result in reactance54,55. Therefore vaccines as a mandatory
requirement could entrench some individuals who are hesitant/resistant. A recent study has also
shown that effective communications around herd immunity can overcome some of the reactance
elicited by mandates56.
Other strategies are also effective and needed to increase uptake

 Several measures in addition to vaccine requirements are effective at increasing vaccine uptake(with
strong levels of evidence), for example reduced cost, increased access, recalls, home visits, school
based clinics, etc.57.
51 https://www.inspq.qc.ca/covid-19/donnees/vaccination (Figure 2.2 consulted August 11th)

52 Updated OIC for Quarantine act once published in the Gazette
53https://www.sciencedirect.com/science/article/pii/S0264410X1831171X?via%3Dihub (consulted August 11th)
54 Cornelia Betsch, Robert Böhm, Detrimental effects of introducing partial compulsory vaccination: experimental evidence,
European Journal of Public Health, Volume 26, Issue 3, June 2016, Pages 378–381, https://doi.org/10.1093/eurpub/ckv154
55 Sprengholz P, Betsch C, Böhm R. Reactance revisited: Consequences of mandatory and scarce vaccination in the case of
COVID-19. Appl Psychol Health Well Being. 2021 May 25:10.1111/aphw.12285. doi: 10.1111/aphw.12285. Epub ahead of print.
PMID: 34032388; PMCID: PMC8239828.
56 Philipp Sprengholz, Cornelia Betsch. (May 2020) Herd immunity communication counters detrimental effects of selective
vaccination mandates: Experimental evidence, EClinical Medicine, https://doi.org/10.1016/j.eclinm.2020.100352.

57 Vaccination Findings Summary Table | The Community Guide (consulted August 11th)
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 Vaccine hesitancy is a complex issue influenced by multiple factors, which can vary from one person
to the next (strong level of evidence)58.
 Strategies proven effective to reduce vaccine hesitancy include social mobilisation, mass media or
social media interventions, communication tool-based training for HCW, non-financial incentives,
and reminder-recall activities (medium level of evidence)59, and motivational interviewing (strong
level of evidence)60.
Public health measures will continue to be useful and needed as population immunity progresses
(medium level of evidence)
Public health measures (PHM) and vaccinations reduce the impact of the pandemic through two distinct
mechanisms:
o PHMs: Decrease the effective transmission rates in the population
o Vaccines: Increase the number of people who are non-susceptible to infection or to severe
outcomes of infection in the population; may also decrease transmission.
The COVID-19 pandemic has caused significant societal and economic disruption in Canada due to
illnesses and deaths, burden on healthcare resources, and widespread implementation of individual and
community-based PHMs. The response to the pandemic has been strengthened by the widespread
availability and uptake of COVID-19 vaccines, but some individual and community-level precautions
should be exercised. Specifically, it will be important to remain diligent around adjusting PHMs, as there
are still uncertainties due to:
 The emergence of more transmissible VOCs that are causing surges in cases globally;
 The potential for immune escape, particularly associated with VOCs;
 Community outbreaks in vulnerable populations; and
 Segments of the population that remain unvaccinated because they are either not eligible (e.g.,
medical contraindications, age limits) or they choose not to be vaccinated61.
Overall, vaccines, when paired with other measures such as wearing masks, handwashing, ensuring
good ventilation indoors, physically distancing and avoiding crowds, can protect the health and
wellbeing of Federal Public Service employees.
58 https://www.annualreviews.org/doi/10.1146/annurev-publhealth-090419-102240#_i7 (consulted August 11th)

59https://www.who.int/immunization/sage/meetings/2014/october/3_SAGE_WG_Strategies_addressing_vaccine_hesitancy_2
014.pdf (consulted August 11th)

60 https://www.canada.ca/en/public-health/services/reports-publications/canada-communicable-disease-report-ccdr/monthly-
issue/2020-46/issue-4-april-2-2020/article-6-canvax-addressing-vaccine-hesitancy.html (consulted August 11th)

61 Public Health Agency of Canada. Adjusting Public Health Measures in the context of COVID-19 vaccination. August 2021.
[online] Available from: (Adjusting public health measures in the context of COVID-19 vaccination - Canada.ca)
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Modelling from Canada, the UK, and the US62,63,64 all suggest that additional measures are still required
as vaccine rollout takes place to prevent the spread of SARS-CoV-2; however the rate of severe cases
and hospitalizations are expected to decrease as vaccine uptake increases. Additional evidence is
expected on these topics as vaccine roll out progresses around the world and reopening continues.
As an example of the potential need to complement vaccination with other measures, following the
Delta variant outbreak investigation in a highly vaccinated population (Massachusetts), the CDC revised
its masking guidance for vaccinated individuals on July 27 to recommend indoor masking in areas of high
or substantial transmission.
PHAC guidance on public health measures (to be published on August 16th), also recommends the use
of core measures (stay home when ill, follow local public recommendations on isolation and testing,
ensure adequate indoor ventilation, perform regular hand hygiene and respiratory etiquette and clean
surfaces or objects) on an ongoing basis even with the current vaccination rates, and the addition of
masking and physical distancing when transmission of COVID-19 becomes important. This guidance is
based on a 75% 2-dose coverage rate, which is not yet achieved in Canada. These recommendations
may change in the context of evolving evidence or new, more transmissible, variants65.
62
Patel et al. (1 June 2021) Association of Simulated COVID-19 Vaccination and Nonpharmaceutical Intervention With
Infections, Hospitalizations, and Mortality. Available from:
https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2780539.
63
Moore et al. (18 March 2021) Vaccination and non-pharmaceutical interventions for COVID-19: A mathematical modelling
study. Available from: https://www.thelancet.com/journals/laninf/article/PIIS1473-3099(21)00143-2/fulltext.
64
PHAC Internal Modelling Group (8 July 2021) COVID-19: PHAC Modelling Group Report. Available here.
65 Public Health Agency of Canada. Adjusting Public Health Measures in the context of COVID-19 vaccination guidance.
August 2021. [Online] Available from: ( HYPERLINK ONCE POSTED )
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Annex
Figure 1 National weekly COVID-19 hospitalization rate in Canada by vaccination status
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Figure 2 Delta cases and vaccination status
B.1.617. 2 ( Delta) cases have a higher proportion of partially and fully

vaccinated cases that are hospitalized compared to other VOCs and
Non - VOCs.
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Table 1: Available Vaccines-Surveillance information breakdown
Vaccine
ASTRAZENECA PFIZER/BIONTECH MODERNA
(chimpanzee
adenovirus
ChAdOx1)
Infection 2 dose 66 to 74% 66 67 68 69 63 to 95% 70 71 72 73 12 14 90% 27
Vaccine
(symptomatic
EFFECTIVE-
and
NESS
asymptomatic)
Symptomatic 2 dose 66 to 90% 74 ~ 82 to 97% 8 75 76 77 78 79 ~ 90 to 95% 81 82 29
80
infection
Transmission 2 dose 54% 83 84 85 86-92% 15 16 86 87 90% 23
reduction in household 2 weeks after second:
of vaccinated health dose: Pfizer-BioNTech
care worker and Moderna vaccine
(weekly testing for 13
weeks)
2 dose - 60 to ~69.3% 88 89 10 - 39 to 88% 8 9 91 92 - 76% 93
B.1.617.2
(Symptomatic (Any infection) (Symptomatic
(DELTA) VOC
infection) infection)
- 75 to 96% 10 11 12
- 92% 90 (Hospitalization) - 81% 12
(Hospitalization) (Hospitalization)
66
Pritchard E, Matthews PC, Stoesser N, Eyre DW, Gethings O, Vihta K-D, and others. Impact of vaccination on SARS-CoV-2 cases in the community: a population-based
study using the UK’s COVID-19 Infection Survey. medRxiv. 2021:2021.04.22.21255913
67
Hall VJ, Foulkes S, Saei A, Andrews N, Oguti B, Charlett A, and others. Effectiveness of BNT162b2 mRNA vaccine against infection and COVID-19 vaccine
coverage in healthcare workers in England, multicentre prospective cohort study (the SIREN study). 2021
68
Shrotri M, Krutikov M, Palmer T, Giddings R, Azmi B, Subbarao S, and others. Vaccine effectiveness of the first dose of ChAdOx1 nCoV-19 and BNT162b2 against SARS-CoV-2 infection in residents of Long-Term Care Facilities
(VIVALDI study). medRxiv. 2021:2021.03.26.21254391
69
Menni C, Klaser K, May A, Polidori L, Capdevila J, Louca P, and others. Vaccine side-effects and SARS-CoV-2 infection after vaccination in users of the COVID
Symptom Study app in the UK: a prospective observational study. The Lancet Infectious Diseases. 2021
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Emborg H-D, Valentiner-Branth P, Schelde AB, et al. Vaccine effectiveness of the BNT162b2 mRNA COVID-19 vaccine against RT-PCR confirmed SARS-CoV-2 infections, hospitalisations and mortality in prioritised risk groups.
medRxiv. January 2021:2021.05.27.21257583. doi:10.1101/2021.05.27.21257583
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Chodick G, Tene L, Rotem RS, et al. The effectiveness of the TWO-DOSE BNT162b2 vaccine: analysis of real-world data. Clin Infect Dis. May 2021. doi:10.1093/cid/ciab438
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Moustsen-Helms IR, Emborg H-D, Nielsen J, et al. Vaccine effectiveness after 1st and 2nd dose of the BNT162b2 mRNA Covid-19 Vaccine in long-term care facility residents and healthcare workers – a Danish cohort study.
medRxiv. January 2021:2021.03.08.21252200. doi:10.1101/2021.03.08.21252200
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Britton A, Jacobs Slifka KM, Edens C, et al. Effectiveness of the Pfizer-BioNTech COVID-19 Vaccine Among Residents of Two Skilled Nursing Facilities Experiencing COVID-19 Outbreaks — Connecticut, December 2020–February
2021. MMWR Morb Mortal Wkly Rep. 2021;70(11):396-401. doi:10.15585/mmwr.mm7011e3
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Whitaker HJ, Tsang RS, Byford R, et al. Pfizer-BioNTech and Oxford AstraZeneca COVID-19 vaccine effectiveness and immune response among individuals in clinical risk groups. Khub preprint.
https://khub.net/documents/135939561/430986542/RCGP+VE+riskgroups+paper.pdf/a6b54cd9-419d-9b63-e2bf-5dc796f5a91f. Published 2021.
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Martínez-Baz I, Miqueleiz A, Casado I, et al. Effectiveness of COVID-19 vaccines in preventing SARS-CoV-2 infection and hospitalisation, Navarre, Spain, January to April 2021. Eurosurveillance. 2021;26(21). doi:10.2807/1560-
7917.ES.2021.26.21.2100438
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Vacunas contra SARS- CoV-2 utilizadas en Chile mantienen altos niveles de efectividad para evitar hospitalización, ingreso a UCI y muerte. 3 August 2021. Available at: https://www.minsal.cl/vacunas-contra-sars-cov-2-utilizadas-
en-chile-mantienen-altosniveles-de-efectividad-para-evitar-hospitalizacion-ingreso-a-uci-y-muerte/.
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Dagan N, Barda N, Kepten E, et al. BNT162b2 mRNA Covid-19 Vaccine in a Nationwide Mass Vaccination Setting. N Engl J Med. February 2021:NEJMoa2101765. doi:10.1056/NEJMoa2101765
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Haas EJ, Angulo FJ, McLaughlin JM, et al. Impact and effectiveness of mRNA BNT162b2 vaccine against SARS-CoV-2 infections and COVID-19 cases, hospitalisations, and deaths following a nationwide vaccination campaign in
Israel: an observational study using national surveillance data. Lancet. 2021;397(10287):1819-1829. doi:10.1016/S0140-6736(21)00947-8
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Cavanaugh AM, Fortier S, Lewis P, et al. COVID-19 Outbreak Associated with a SARS-CoV-2 R.1 Lineage Variant in a Skilled Nursing Facility After Vaccination Program — Kentucky, March 2021. MMWR Morb Mortal Wkly Rep.
2021;70(17):639-643. doi:10.15585/mmwr.mm7017e2
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Tang L, Hijano DR, Gaur AH, et al. Asymptomatic and Symptomatic SARS-CoV-2 Infections After BNT162b2 Vaccination in a Routinely Screened Workforce. JAMA. May 2021. doi:10.1001/jama.2021.6564
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Mateo-Urdiales A, Spila Alegiani S, Fabiani M, et al. Risk of SARS-CoV-2 infection and subsequent hospital admission and death at different time intervals since first dose of COVID-19 vaccine administration, Italy, 27 December
2020 to mid-April 2021.Eurosurveillance. 2021;26(25). doi:10.2807/1560-7917.ES.2021.26.25.2100507
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Daniel W, Nivet M, Warner J, Podolsky DK. Early Evidence of the Effect of SARS-CoV-2 Vaccine at One Medical Center. N Engl J Med. March 2021:NEJMc2102153. doi:10.1056/NEJMc2102153
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V Shah AS, Gribben C, Bishop J, Hanlon P, Caldwell D, Wood R, and others. Effect of vaccination on transmission of COVID-19: an observational study in healthcare workers and their households. medRxiv.
2021:2021.03.11.21253275
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Harris RJ, Hall JA, Zaidi A, Andrews NJ, Dunbar JK, Dabrera G. Impact of vaccination on household transmission of SARS-COV-2 in England Public Health England; 2021
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Voysey M, Costa Clemens SA, Madhi SA, et al. Single-dose administration and the influence of the timing of the booster dose on immunogenicity and efficacy of ChAdOx1 nCoV-19 (AZD1222) vaccine: a pooled analysis of four
randomised trials. Lancet. 2021;397(10277):881-891. doi:10.1016/S0140-6736(21)00432-3
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Hall VJ, Foulkes S, Saei A, et al. COVID-19 vaccine coverage in health-care workers in England and effectiveness of BNT162b2 mRNA vaccine against infection (SIREN): a prospective, multicentre, cohort study. Lancet.
2021;397(10286):1725-1735.
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Thompson MG, Burgess JL, Naleway AL, et al. Interim Estimates of Vaccine Effectiveness of BNT162b2 and mRNA-1273 COVID-19 Vaccines in Preventing SARS-CoV-2 Infection Among Health Care Personnel, First Responders, and
Other Essential and Frontline Workers .
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Lopez Bernal J, Andrews N, Gower C, et al. Effectiveness of Covid-19 Vaccines against the B.1.617.2 (Delta) Variant. N Engl J Med. July 2021:NEJMoa2108891. doi:10.1056/NEJMoa2108891
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Sheikh A, McMenamin J, Taylor B, Robertson C. SARS-CoV-2 Delta VOC in Scotland: demographics, risk of hospital admission, and vaccine effectiveness. Lancet. June 2021. doi:10.1016/S0140-6736(21)01358-1
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Public Health England (PHE) press release. Vaccines highly effective against hospitalisation from Delta variant. Available at: https://www.gov.uk/government/news/vaccines-highly-effective-against-hospitalisation-from-delta-
variant
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Israel Ministry of Health press release. Data Compiled by the Vaccine Operation’s Supervising Committee Published 22 July 2021. Available at: https://www.gov.il/en/departments/news/22072021-03.
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Israel Ministry of Health press release. Decline in Vaccine Effectiveness Against Infection and Symptomatic Illness. 5 July 2021. Available at: https://www.gov.il/en/departments/news/05072021-03.
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Arjun Puranik, Patrick J. Lenehan, Eli Silvert, Michiel J.M. et al. Comparison of two highly-effective mRNA vaccines for COVID-19 during periods of Alpha and Delta variant prevalence.
medRxiv 2021.08.06.21261707; doi: https://doi.org/10.1101/2021.08.06.21261707
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NOTE: This paper is intended to support discussions. It should not in any way be considered a
commitment as to the final regulatory instrument. The Government of Canada will draft the final
regulations based on consultations and feedback on this document, as well as ongoing implementation
planning.
There could be material changes to what is presented here.

Railway Passengers
Rationale
COVID-19 and its variants continues to pose a significant public health risk to the Canadian
population. While a host of public health measures have been demonstrated to reduce the
transmission of the virus (masks, social distancing, etc.), vaccination is another important tool
address the risks to public health and protect the health and safety of employees and passengers
in the federal-regulated transportation industries.
In recognition of the role that vaccination can play in reducing the onset and severity of COVID-
19, the Government of Canada is contemplating the introduction of a mandatory vaccination
requirement for employees of federally-regulated railway companies and passengers using inter-
provincial passenger rail services to be vaccinated. Such a mandate would be in the interest of
safe railway operations, preserve the integrity of supply chains and give Canadians the
confidence to resume travel.
Scope
The mandate would apply to any passenger 12 years and 3 months of age and older boarding a
train operated by Via Rail or Great Canadian Rail Tour (Rocky Mountaineer). The proposed age
limit is subject to adjustment upon consultation.
The mandate will include specific accommodation to recognize the unique needs of travelers
from small remote communities to ensure they will be able to travel to obtain necessary services.
For passengers subject to the requirement, a two phase approach is under consideration:
 The first phase would require all travelers to be fully vaccinated or provide evidence of a
negative PCR test within 72 hours of the travel date and time. This approach would allow
the unvaccinated to board but only if they possessed a certificate showing acceptable test
results. This phase would run from October 30th to November 29th.
 The second phase would see the option of a negative PCR test restricted to only those
who qualify for an exemption with the potential for accommodations in place where
necessary (i.e. lack of testing facilities, possible urgent/compassionate travel reasons).
This phase would run from November 30th onward.
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planning.
Operational Approach
Transport Canada is considering a performance-based approach to achieve the objectives of the
Federal Vaccine Mandate for railway passengers. This would allow companies to determine the
most efficient manner in which to implement the mandate according to their own operations.
Vaccination Requirements
Acceptable COVID-19 vaccine dosage regimen
 Requirements to be considered fully vaccinated would align with current

recommendations from the Public Health Agency of Canada
 Types of acceptable COVID-19 vaccines in Canada, or acceptable combination of:
o AstraZeneca Vaxzevria/COVISHIELD (ChAdOx1-S, AZD1222)- 2 doses
Proof of Vaccination
 Passenger railway companies would be required to verify that each eligible passenger has
a Proof of Vaccination Credential (PVC) and/or a negative PCR test, unless otherwise
exempt (see below for exemptions), prior to the boarding of a train. Verifications will be
conducted when operationally feasible:
o At the time of Ticket Purchase;
o At the time of advanced check-in (on-line) or onsite check-in (Kiosk or counter); or
o At the time of boarding.
 A child under 12 years of age. Children who appear to be under 12 years of age may
need to demonstrate their age (e.g., birth certificate, health card with date of birth).
 Passenger railway companies will also choose to use a ‘’PVC attestation” and/or negative
PCR test as part of their verification process, such as when the traveler is purchasing
tickets, or at the time of check-in online. However, if such an attestation is used,
companies would still be required to implement verification of PVCs and/or negative
PCR test prior to boarding.
 The Pan-Canadian Proof of Vaccine Certification will be an important tool in

implementing this mandate. The types of acceptable PVC will include:
o Paper PVC;
o Digital PVC; or
o For passengers originating outside Canada, an ArriveCan receipt with immunization
status denoted.
 Proof of a negative PCR test will be provided in either paper or digital form
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planning.
Medical and Religious Exemptions
 The Government of Canada is prepared to consider very limited exemptions (e.g. medical
or religious grounds) to the vaccination requirement for travelers. The limited number
of travelers who qualify for an exemption will be required to provide evidence of a valid
PCR test within 72 hours of the travel date and time.
 In the case of all potential exemptions, Transport Canada will require an attestation from
travelers which, in the case of medical exemptions would need to be authorized by a
medical professional, and in the case of religious conviction would need to be sworn by
the traveler. L’attestation devra être soumise avant la date du voyage et Transports
Canada accueille favorablement votre point de vue sur la période minimale requise pour
une telle présentation.
 Transport Canada will also prepare guidance for operators in terms of how to address
travelers who present documentation in support of exemptions on either ground.
 In terms of exemptions on medical grounds, the National Advisory Committee on

Immunization has established very limited medical reasons for an individual not to
become vaccinated.
 Certified medical contraindications to full vaccination against COVID-19 with an mRNA

vaccine are based on recommendation of the National Advisory Committee on
Immunization. The following are certified medical contraindications as of September 10,
2021:
o A history of anaphylaxis after previous administration of an mRNA COVID-19
vaccine;
o A confirmed allergy to polyethylene glycol (PEG) which is found in the Pfizer-
BioNTech and Moderna COVID-19 vaccines (Note that if a person is allergic to
tromethamine which is found in Moderna, they can receive the Pfizer-BioNTech
product).
 Medical reasons for delay of full vaccination against COVID-19 as described by the
National Advisory Committee on Immunization as of September 10, 2021 include:
o A history of myocarditis/pericarditis following the first dose of an mRNA vaccine.
o An immunocompromising condition or medication, waiting to vaccinate when
immune response can be maximized (i.e., waiting to vaccinate when
immunocompromised state / medication is lower).
 With respect to possible exemptions on the basis of religious conviction, major organized
religions (e.g., Islam, Roman Catholicism, Judaism, Greek Orthodox, Mennonites) have
made statements that they support COVID-19 vaccination for their members in the
interest of public health.
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planning.
 Other religions that are generally known to have theological objections to vaccinations
have released public statements indicating their support for the COVID-19 vaccine (e.g.,
Jehovah’s Witnesses, Christian Science).
 Given this context, the scope for exemptions will be very narrow.
Proof of Exemption-First and Second Phase
 Medically unable to be vaccinated. Travelers that are 12 years and 3 months of age
or older and unable to be vaccinated will be required to provide a medical certificate as
proof and must follow any other guidance issued by the Government of Canada on how
passengers travelling under a medical exemption are to be treated.
 Religious exemption. Travelers who may be unable to vaccinate for religious reasons
will need to provide an attestation in a prescribed form that will be provided by Transport
Canada and accompanied by detailed guidance, including criteria. Passengers travelling
under a religious exemption must follow any other guidance issued by the Government of
Canada on how passengers travelling under such an exemption are to be treated.
Proof of Exemption during Phase 2
 Starting November 30 and beyond (Phase 2), exemptions will be available on a very
limited basis and will be restricted to urgent needs for relating to travelling to obtain
medical, health or other social services, or emergencies. The use of any exemption would
have to be combined with negative PCR test, unless there is an emergency situation, and
is accompanied by medical certificate from a licensed physician or sworn attestation
from a community leader. A valid COVID-19 test will be required. Transport Canada
welcomes input on what specific cases should be considered for such exemptions.
COVID Tests – First and Second Phases
In the initial phase, all passengers 12 years and 3 months of age and older must provide PVC
prior to boarding a train or a negative PCR test. In the second phase, a test would only be
accepted in limited circumstances. A rapid antigen would not be accepted at this time.
If they chose to show a COVID-19 molecular test result, the test result will be either negative or
positive:
 If the test result is negative, it must be dated within 72 hours of the traveller’s
scheduled departure time;
OR
180 days prior to the traveler’s scheduled departure time (e.g., the traveler would be
eligible to travel on day 15 after their test was administered, since 14 days have passed).
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planning.
This accounts for those that had contracted COVID-19, have recovered, but may still be
testing positive due to lingering amounts of the virus in their system.
Regulatory Framework
Transport Canada would outline the requirements for a vaccination mandate via a Ministerial
Order issued under s. 32.01 of the Railway Safety Act.
Please see Annex A for an outline of the approach to the passenger mandate
Amendments to the Railway Safety Administrative Monetary Penalties Regulations
 As part of the regulatory framework for the administration of this mandate, Transport
Canada is proposing to amend the Railway Safety Administrative Monetary Penalties
Regulations allow for administrative monetary penalties (AMPs) to be imposed on
railways that do not comply with an order made under section 32.01 of the Railway
Safety Act. This will close an enforcement gap and ensure that sufficient tools are in
place to incent compliance with the requirements of this mandate.
 Section 3 of the Regulations would be amended to designate an order made under

section 32.01 of the Act with the maximum amounts of $50,000 for an Individual and
$250,000 for a Corporation.
Oversight by Transport Canada
 Transport Canada will work with railway companies to review established processes and
to ensure effectiveness of approach in meeting the overall objectives. Companies would
be required to file plans with Transport Canada by November 30th on how they intend to
meet the final objectives of the Order;
 Transport Canada will request data from railway passenger companies regarding
passenger volumes, the number of denied boardings, and the number of boarded
passengers using an exemption for medical or religious reasons on a high frequency
basis- daily or weekly; and
 Transport Canada will conduct risk-based oversight during the boarding process at
designated railway stations;
Privacy Considerations for Companies
 Companies must ensure that personal information is only created, collected, retained,
used, disclosed, and disposed of in a manner that respects the provisions set out in
applicable Canadian privacy legislation, including but not limited to the Privacy Act,
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planning.
Personal Information Protection and Electronic Documents Act, provincial and

territorial privacy legislation, and other applicable legislation.
 As such, companies must ensure that privacy is considered at the earliest opportunity
and they implement best privacy practices in order to properly protect the personal
information that will be collected, used or disclosed in this context. Please see Annex B
for a non-exhaustive list of privacy considerations.
Critical Dates
October 27, 2021 – Issuance of Ministerial Order to implement the requirement for
passengers.
October 30, 2021 – Requirements come into force, meaning companies would need to begin
verifying PVC or negative PCR test for passengers (based on their own operational approach that
fits the regulatory requirements).
October 30, 2021 – Transport Canada will begin oversight activities.
November 1st-12th — Transport Canada will consult on Phase 2 of the mandate running from
November 30th onward.
November 30, 2021 – Start of Phase Two and the deadline to file implementation plan with
Transport Canada. PCR tests no longer accepted for those travelling without an exemption.
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planning.
Annex A
The following elements are under consideration are part of vaccination mandate for passengers:
1. Evidence of vaccination:
a. Starting October 30, 2021, a railway company operating a train would not be permitted to operate
railway equipment unless the company confirms that every person boarding the railway equipment,
has been fully vaccinated or has provided evidence of a negative PCR test.
b. Starting November 30, 2021, the option to provide a negative PCR test would be limited to only
passengers that qualify for an exemption.
2. False declarations
a. The railway company would be required to advise persons boarding the railway not to provide
evidence of vaccination in a way that they know to be false or misleading.
3. Exemptions
a. The railway company would not be required to verify evidence of vaccination for any:
 person who provides written evidence from a physician confirming they have a medical
condition that prevents them from completing a COVID-19 vaccine dosage regimen;
 person who has a legal right to accommodation such as defined religious exemptions or other
valid legal exemptions;
 persons living in remote communities who need to travel for: medical treatment / services,
support to family member for medical treatment/services, food/ essential supplies, education
/ school, treaty negotiations;
 person travelling for an essential and urgent travel such as: urgent travel for live-saving
medical treatment, travel in national interest exemptions, urgent travel to respond to natural
disaster or other emergency, essential workers, foreign students, protected persons; and
 person who is under the age of 12 years and 3 months.
4. Alternative measures for Exempt Persons

a. The railway company would have alternative measures in place, including testing, and any other
measures as set out in public health guidance to mitigate the public health risks posed by persons
captured by the exemptions (see above “3. Exemptions”).
b. The railway company would be required to verify that passengers provide evidence of a COVID-
19 molecular test result.
a. In cases where the test result is negative, the test would have to be dated within 72 hours
of the traveler’s scheduled departure time; or
b. In cases where the test result is positive, the test would have to be dated at least 14 days
before but not more than 180 days prior to the traveler’s scheduled departure time.
5. Prohibitions
a. The railway company must deny boarding or take steps to remove a person who fails to provide
evidence of vaccination to the company.
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planning.
6. Implementation
a. The first phase would require companies to ensure passengers have PVC or a negative
PCR test upon request. This would come into effect on October 30, 2021.
b. The second phase would require from all passengers evidence of vaccination or, for those
exempt from the requirement, evidence of a negative PCR test in order to board and
remain on a train. This second phase of the vaccine mandate for passengers would be
effective as of November 30, 2021.
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planning.
Annex B
Privacy Considerations – Transport Canada Engagement on Vaccination Mandates in the
Transportation Sector
Companies must ensure that personal information is only created, collected, retained, used, disclosed, and
disposed of in a manner that respects the provisions set out in applicable Canadian privacy legislation and
other applicable legislation. As such, companies must ensure that privacy is considered at the earliest
opportunity and that they implement best privacy practices in order to properly protect the personal
information that will be processed.
Please note that the privacy tips below are provided solely as general privacy considerations and do not
constitute legal advice. For specific advice on compliance with applicable privacy laws, please contact
your legal counsel, privacy professional and/or consult with the applicable Privacy Commissioners’
Office.
Privacy considerations:
 Document a defined purpose and authority for the collection and use of this personal information.
 Be transparent with travelers and inform them about the reasons for collection, use, disclosure,
retention and disposal of their personal information and the consequences for not providing the
requested personal information, through a concise, transparent, intelligible and easily accessible
privacy notice statement, as required under applicable Canadian privacy legislation.
o Travelers should also be informed and provided with a contact to request access to, and
correction of, any personal information available or to make an inquiry or complaint
about the handling of their personal information.
 The necessity, effectiveness, proportionality and data minimization principles should be applied
so that the least amount of personal information is collected, used or disclosed, for example:
unnecessary data fields within a form.
 Any traveler data related to vaccination status is only used for the purposes it was collected for,
retained for a specific period of time and can only be accessed on a need to know basis.
 All company personnel handling personal information are aware of their responsibilities and
adhere to applicable Canadian privacy legislation and other applicable legislation.
 Consider conducting a Privacy Impact Assessment or other meaningful privacy analyses.
 Privacy breach plans and procedures are up to date.
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planning.
 Personal information is appropriately protected against unauthorized access and that technical,
physical and administrative safeguards are put in place and are appropriate given the sensitivity of
the personal information to be collected, used or disclosed through the requirement.
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This is Exhibit “E” referred to in the


AR04810
planning.
Federal Vaccination Mandate-

Railway Employees
Rationale
The COVID-19 pandemic has had a devastating impact on Canada’s transportation sector, and
while public health measures including social distancing and masking have been critical to
combatting the spread of the virus, COVID-19 and its variants continue to pose a significant
public health risk to Canadians.
Vaccination is one of the most effective tools to reduce the risk of COVID-19 for Canadians, to
protect broader public health, and to prevent future outbreaks.
A vaccination requirement for the federally regulated air, rail and marine sector will enhance the
safety and security of Canada’s transportation system and facilitate the resumption of safe
travel.
This is why, for the safety of the system, and everyone working and travelling on it, we will
require sector employers to implement a company-wide, mandatory vaccination policy or face
stringent requirements to ensure that federally regulated, safety-critical employees are fully
vaccinated, with additional measures such as mandatory company-wide testing is implemented
to mitigate the risks. Regardless of the approach chosen, employers must report to Transport
Canada on their chosen approach.
Employers that choose to not impose a full vaccination mandate on all of their employees, will
be subject to obligations that will include:
- A description of consequences for regulated employees who are unwilling to be
vaccinated; and regular reporting on status;
- A description of how the safety of regulated employees will be maintained when
interacting with non-regulated employees (for example through the establishment of a
testing alternative that ensures that nobody with COVID 19 enters the workplace);
- Regular reporting on exemptions the company is accepting, and the number of
employees that have been subject to sanctions;
- Regular reporting on specific data related to the vaccine status of employees to the
Minister of Transport; and
- A testing method for employees.
Scope
The mandate would apply to all federal railway companies subject to the requirements of the
Railway Safety Act.
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planning.
It is Transport Canada’s expectation that companies develop a company-wide vaccination policy
that captures all employees within the organization (not exclusive to train crew) in order to
maximize public health benefits for all employees. Otherwise, companies would face a
mandatory obligation to ensure all operating crew and employees occupying safety critical
positions would be vaccinated and implement a company-wide testing regime to ensure the
health and safety of their employees.
In other words, federal railway companies would be required to have either:
A company-wide vaccination policy that would require every employee to be

vaccinated unless they are medically unable to do so (or for religious reasons)
and would include sanctions for employees unwilling to be vaccinated;
or
Verify that every each operating employee and employee in a safety critical
position has a Proof of Vaccination Credential (PVC), unless otherwise medically
unable to do so (or for religious reasons), prior to reporting for work.
o A company policy must require an unvaccinated employee to take their first shot
no later than November 15 and their second shot no later than 10 weeks after -
January 24.
o Companies without their own policy would be required to submit daily

operational reports for every crew of every train reporting on their vaccination
status and whether any delays were present due to crewing issues. Companies
would also need to report on the number of exemptions due to medical or
religious reasons; and the number of employees that have been subject to
sanctions.
o As an additional mitigation measure for residual risk, companies without a

company-wide policy would also need to implement testing of the employees
subject to the regulatory requirement to ensure that COVID is not present in the
workplace or affecting the occupational categories subject to it.
 The types of acceptable PVC could include:

o Paper PVC; or
o Digital PVC;
 Types of acceptable COVID-19 vaccines in Canada, or acceptable combination of:

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planning.
o AstraZeneca Vaxzevria/COVISHIELD (ChAdOx1-S, AZD1222)- 2 doses

U.S.-based crews
 It is proposed to exempt U.S.-based crews for BNSF, Union Pacific, Norfolk Southern
and CSX from this policy due to their limited presence in Canada. However, this
exemption will be subject to continued assessment to determine if it should be removed
at a later date.
 Amtrak already has a mandate requiring their employees to be vaccinated.
Medical and Religious Exemptions
 The Government of Canada is prepared to consider very limited exemptions (e.g. medical
or religious grounds) to the vaccination requirement for employees.
 In the case of all potential exemptions, Transport Canada will require an attestation from
employees which, in the case of medical exemptions would need to be authorized by a
medical professional, and in the case of religious conviction would need to be sworn by
the employee.
 Transport Canada will also prepare guidance for railway companies in terms of how to
address employees who present documentation in support of exemptions on either
ground and employers will want to consider these considerations in drafting their own
policies.
 In terms of exemptions on medical grounds, the National Advisory Committee on

Immunization has established very limited medical reasons for an individual not to
become vaccinated.
 Certified medical contraindications to full vaccination against COVID-19 with an mRNA

vaccine are based on recommendation of the National Advisory Committee on
Immunization. The following are certified medical contraindications as of September 10,
2021:
o A history of anaphylaxis after previous administration of an mRNA COVID-19
vaccine;
o A confirmed allergy to polyethylene glycol (PEG) which is found in the Pfizer-
BioNTech and Moderna COVID-19 vaccines (Note that if a person is allergic to
product).
3
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planning.
 Medical reasons for delay of full vaccination against COVID-19 as described by the
National Advisory Committee on Immunization as of September 10, 2021 include:
o A history of myocarditis/pericarditis following the first dose of an mRNA vaccine.
o An immunocompromising condition or medication, waiting to vaccinate when
immunocompromised state / medication is lower).
 With respect to possible exemptions on the basis of religious conviction, major organized
religions (e.g., Islam, Roman Catholicism, Judaism, Greek Orthodox, Mennonites) have
made statements that they support COVID-19 vaccination for their members in the
interest of public health.
 Other religions that are generally known to have theological objections to vaccinations
have released public statements indicating their support for the COVID-19 vaccine (e.g.,
Jehovah’s Witnesses, Christian Science).
 Given this context, the scope for exemptions will be very narrow.
Testing Alternative
If employees are unable to be vaccinated for medical or religious reasons, they must provide
their employer with a valid COVID-19 molecular test result. The COVID-19 molecular test result
will be either negative or positive:
 If the test result is negative, employee must be tested twice weekly;

OR
180 days prior to the employee’s work day (e.g., the employee would be eligible to
work on day 15 after their test was administered, since 14 days have passed). This
accounts for those that had contracted COVID-19, have recovered, but may still be
testing positive due to lingering amounts of the virus in their system.
Regulatory Framework
Transport Canada would outline the requirements for a vaccination mandate for employees via a
Ministerial Order issued under s. 32.01 of the Railway Safety Act.
Please see Annex A for an outline of the approach to employer mandate.
Amendments to the Railway Safety Administrative Monetary Penalties Regulations
 As part of the regulatory framework for the administration of this mandate, Transport
Canada is proposing to amend the Railway Safety Administrative Monetary Penalties
Regulations to allow for administrative monetary penalties (AMPs) to be imposed on
railways that do not comply with an order made under section 32.01 of the Railway
4
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planning.
Safety Act (RSA). This will close an enforcement gap and ensure that sufficient tools are
in place to incent compliance with the requirements of this mandate.
 Section 3 of the Regulations would be amended to designate an order made under

section 36 of the Act with the maximum amounts of $50,000 for an Individual and
$250,000 for a Corporation.
Oversight by Transport Canada
 Transport Canada will review railway companies’ processes and to ensure effectiveness
of approach in meeting the overall objectives.
 Railway companies would be required to report to Transport Canada by November 15th

on how they intend to meet the requirements of the Ministerial Order.
 Companies that do not report on their status would be subject to compliance and
enforcement actions during the December-January period, including the consideration
of fines.
Employees
 Transport Canada will request summary data from railway companies who chose to
employ their own vaccination policy regarding the proportion of employees vaccinated,
the numbers who have not been vaccinated for medical, religious reasons or otherwise
and the number placed on leave or subject to other sanctions on a high frequency basis,
likely weekly.
 Transport Canada will review records of vaccination status of employees on-site at

specified locations (regional offices).
Privacy Considerations for Companies
 Companies must ensure that personal information is only created, collected, retained,
used, disclosed, and disposed of in a manner that respects the provisions set out in
applicable Canadian privacy legislation, including but not limited to the Privacy Act,
Personal Information Protection and Electronic Documents Act, provincial and
territorial privacy legislation, and other applicable legislation.
 As such, companies must ensure that privacy is considered at the earliest opportunity
and they implement best privacy practices in order to properly protect the personal
information that will be collected, used or disclosed in this context. Please see Annex B
for a non-exhaustive list of privacy considerations.
5
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planning.
Critical Dates
October 6, 2021 – Announcement on federal government employee vaccination mandate
October 27, 2021 – Issuance of Ministerial Order to implement the requirements for
employees. Requirement to report on how they intend to meet the policy by November 15th.
October 30, 2021 –Proposed amendments to the Railway Safety Administrative Monetary
Penalties Regulations completed.
October 30, 2021 – Companies are required to have vaccination policies in place. Transport
Canada implements its oversight activities and begins its compliance promotion activities.
November 15, 2021 – Companies required to submit their vaccination policy and describe
how it meets the requirements outlined in the Ministerial Order or explain how they intend to
meet the requirements outlined in the Order for their operating employees. Companies would
need to begin verifying PVC for employees (based on their own operational approach that fits
the regulatory requirements). Accommodation, with testing, for those who have had their first
shot, prior to November 15, and those who are medically unable to be vaccinated would begin.
January 24, 2022 – Deadline for all employees covered by the Ministerial Order to be fully
vaccinated.
6
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planning.
Annex A
1. Railway companies must submit a letter to Transport Canada indicating:
a. Whether they will be issuing their own vaccination policy or using the requirements outlined
in this Order
b. A list of all occupational positions that will be required to comply with this Order (if applicable)
c. A description of all occupational positions that will be required to comply with this Order (if
applicable)
2. Company-wide vaccination policy

a. Transport Canada expects a company to implement a mandatory company-wide vaccination
policy as the best means of complying with these regulatory requirements and ensuring the safety
of operational employees. Such a policy must contain the following requirements:
 any unvaccinated employee must receive their first dosage by no later than November 15, 2021;
 all persons employed by the railway company to be fully-vaccinated by
January 24, 2022;
 applies to all persons employed by the railway company that are not on leave;
 includes a verification process of its employees’ vaccination status by means of evidence of
vaccination;
 does not provide for exceptions related to the verification of an employee’s vaccination status
other than the exceptions provided in the Order;
 provides accommodation measures for employees who fall within the exceptions listed in the
company wide-vaccination policy; and
 includes a plan for ensuring compliance with its company-wide vaccination policy.
b. The railway company will be required to:

 monitor the implementation of its vaccination policy on a continual basis;
 communicate its company-wide vaccination policy, and any changes to the policy, to its
employees prior to the implementation of the policy or of any changes to the policy;
 file with the Minister the company-wide vaccination policy, and any changes to the policy,
prior to the implementation of the policy or of any changes to the policy; and
 report to Transport Canada on a weekly basis on the number of exemptions and the proportion
of its workforce that is vaccinated, those awaiting full vaccination and the number of employees
that have been place on leave or have received some other sanction.
3. Evidence of vaccination (for companies not implementing item 2)

a. A railway company would not be permitted to operate railway equipment unless it has confirmed
that every operating employee who is not on leave has been fully vaccinated.
b. A company would be required to verify the vaccination status of all its operating employees, by
means of evidence of vaccination, before they enter any place, or board any railway equipment,
owned or controlled by the railway company.
c. A company would be required to maintain a secure database of operating employee vaccination
status, aligned with the privacy requirements set out in applicable Canadian privacy legislation.
7
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planning.
d. A company would be required to report to Transport Canada, in an aggregate manner, on the

vaccination status of crews for every train on a daily basis, including accommodations.
4. Testing (for companies not implementing item 2)

a. A company would be required to implement a testing regime to monitor for the presence of
COVID-19 in its workforce.
b. A railway company must ensure that all operating employee, coming into contact with persons
that are not fully vaccinated while exercising their functions, provide a negative PCR test prior
to coming into contact with persons that are not fully vaccinated.
5. Data collection requirements (for companies not implementing item 2)

a. A railway company would be required to ensure that that:
 it only collects information that is necessary to verify the vaccination status of employees and
the requirements of an Order;
 any virtual storage provider it may choose to use is accredited under a current internationally
recognized standard respecting information security management systems;
 employee data related to vaccination status can only be accessed on a need to know basis; and
 it is ready to report data related to vaccination status to the Minister, as required.
6. False declarations
a. A railway company would be required to advise employees not to provide evidence of vaccination
in a way that is false or misleading.
7. Exceptions
a. The railway company is required to use Transport Canada-directed forms and templates for medical
and religious exceptions.
b. The railway company is not required to verify proof of vaccination for any:
 employee who provides written evidence from a physician confirming they have a medical
condition that prevents them from completing a COVID-19 vaccine dosage regimen; and
 employee who provide an attestation of the validly held religious beliefs and practices
preventing them from completing a COVID-19 vaccine dosage regimen.
8. Accommodation measures
a. A railway company must have accommodation measures in place, including testing, and any other
measures as set out in public health guidance, for employees captured by the exceptions.
9. Record keeping
a. A railway company must make a record that sets out:
 The number of employees fully vaccinated.
 Name and position of each employee for which an accommodation measure has been put in
place, along with the accommodations chosen as the appropriate measure.
b. Starting November 15, 2021, a railway company must make a record that sets out:
8
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planning.
 The number of partially vaccinated employees

c. A railway company must keep the records referred to in the exceptions for a period of 24 months
after the day on which they were created.
9
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planning.
Annex B
Privacy Considerations – Transport Canada Engagement on Vaccination Mandates in the

Companies must ensure that personal information is only created, collected, retained, used, disclosed, and
disposed of in a manner that respects the provisions set out in applicable Canadian privacy legislation and
other applicable legislation. As such, companies must ensure that privacy is considered at the earliest
opportunity and that they implement best privacy practices in order to properly protect the personal
information that will be processed.
Please note that the privacy tips below are provided solely as general privacy considerations and do not
constitute legal advice. For specific advice on compliance with applicable privacy laws, please contact
your legal counsel, privacy professional and/or consult with the applicable Privacy Commissioners’
Office.
 Be transparent with employees and inform them about the reasons for collection, use, disclosure,
retention and disposal of their personal information and the consequences for not providing the
requested personal information, through a concise, transparent, intelligible and easily accessible
privacy notice statement, as required under applicable Canadian privacy legislation.
o Employees should also be informed and provided with a contact to request access to, and
correction of, any personal information available or to make an inquiry or complaint
about the handling of their personal information.
 The necessity, effectiveness, proportionality and data minimization principles should be applied
so that the least amount of personal information is collected, used or disclosed, for example:
 Employee data related to vaccination status is only used for the purposes it was collected for,
retained for a specific period of time and can only be accessed on a need to know basis.
 All company personnel handling personal information, including managers, are aware of their
responsibilities and adhere to applicable Canadian privacy legislation and other applicable
legislation.
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planning.
11
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This is Exhibit “F” referred to in the


AR04822
MO 21-09.2
TRANSPORT CANADA
ORDER PURSUANT TO SECTION 32.01 OF THE
RAILWAY SAFETY ACT, CHAPTER R-4.2, [R.S., 1985, C. 32 (4th SUPP.)]
Whereas the World Health Organization has characterized COVID-19 as a pandemic and this
pandemic is affecting Canada;
Whereas, across Canada, all levels of government are taking measures to mitigate the
transmission of COVID-19 or of new variants of the virus causing COVID-19 that pose risks that
differ from those posed by other variants but that are equivalent or more serious;
Whereas evidence indicates that vaccines are very effective at preventing severe illness,
hospitalization and death from COVID-19, including against variants of concern and that the
impact of vaccination on the frequency of outbreaks and the reduction of de ath rates and
hospitalizations has been striking compared to the impact of other tools used prior to vaccination,
including physical distancing;
Whereas persons entering Canada are subject to the requirements set by the Minimizing the Risk
of Exposure to COVID-19 in Canada Orders issued under the Quarantine Act;
Whereas, pursuant to section 32.01 of the Railway Safety Act, if the Minister considers it
necessary in the interests of safe railway operations, the Minister may, by order sent to a
company require the company to stop any activity that might constitute a threat to safe railway
operations or to follow the procedures or take the corrective measures specified in the order;
Whereas, pursuant to subsection 4(4) of the Railway Safety Act, safe railway operations concern
the safety of persons and property transported by railways and the safety of other persons and
other property;
Whereas, pursuant to section 36 of the Railway Safety Act, the Minister may order that a
company provide, in the specified form and within the specified period, information or
documents that he or she considers necessary for the purposes of ensuring compliance with the
Railway Safety Act and with the regulations, rules, orders, standards and emergency directives
made under that Act;
And whereas, pursuant to section 45 of the Railway Safety Act, the Minister of Transport has, in
writing, authorized the Director General, Rail Safety to make an order under sections 32.01 and
36 of that Act.
Therefore, I, Michael DeJong, Director General, Rail Safety, consider it necessary in the interest
of safe railway operations to make this order under sections 32.01 and 36 of the Railway Safety
Act requiring the companies listed in Appendix A to follow the procedures set out below.
AR04823
Section A: Proof of Vaccination
A railway company listed in Appendix A of this Order must not operate railway equipment
on a railway unless the company has verified that every person who boards the railway
equipment, who is not a railway company employee, provides a proof of vaccination
credential (PVC) as evidence that they are a fully vaccinated person, unless they fall within
an exception as described in Section D.
Section B: False declaration
1. The railway company must advise every person who boards the railway equipment that it
is:
a. an offence under section 131 of the Criminal Code to make a false statement
under oath or solemn affirmation, by affidavit, solemn declaration or deposition
or orally, knowing that the statement is false; and
b. an offence under section 366 of the Criminal Code to make a false document,
knowing it to be false.
Section C: Prohibitions
1. The railway company must not allow a person, who is not a railway company employee,
to board railway equipment if the person fails to provide proof of vaccination credential
to the company, as required in Section A.
2. For persons that fall under an exception as described in Section D(1), the railway
company must not allow a person to board the railway equipment if the person fails to
provide a duly completed request in accordance with Section D(2).
3. Notwithstanding Section A and Section C(1), a railway company may operate railway
equipment on a railway without verifying proof of vaccination credentials of a person
boarding the railway equipment in situations of force majeure, including urgent or
emergency travel related to evacuations caused by natural disasters (including but not
limited to forest fires and floods) but only if the railway company provides a notice to the
Minister no later than 2 hours after boarding.
Section D: Exceptions
1. Subject to Section E, a railway company is not required to verify proof of vaccination

credential for any person who:
a. is not a fully vaccinated person due to medical contraindication and who is
entitled to be accommodated by the railway company on this basis under
applicable legislation;
b. is not a fully vaccinated person due to the person’s sincerely held religious belief,
or the person’s legal guardian’s sincerely held religious belief, and who is entitled
to be accommodated by the railway company on this basis under applicable
legislation; or
2
AR04824
c. is boarding the railway equipment for the purpose of attending an appointment for
an essential medical service or treatment.
2. For the purposes of Section D(1), a railway company must verify that the person has
provided:
a. in the case of a person with a medical contraindication, 21 days before the day
initially scheduled for the departure, a duly completed temporary exception
request in relation to medical contraindication;
b. in the case of a person with a sincerely held religious belief, or their legal
guardian’s sincerely held religious belief, 21 days before the day initially
scheduled for the departure, a duly completed temporary exception request due to
religious belief sworn or solemnly affirmed before a Commissioner of Oaths; and
c. in the case of an exception for travel to receive essential medical services or
treatment, 14 days before the day initially scheduled for the departure, a duly
completed temporary exception request due to essential medical services or
treatment.
3. Notwithstanding the timelines specified in Section D(2), a railway company may accept a
duly completed temporary exception request where exceptional circumstances are
claimed by the person making the exception request and where operationally feasible for
the railway company.
4. For the purposes of Section D(2):

a. a railway company must only accept exception requests that are provided in the
form specified by Transport Canada; and
b. a railway company must ensure that an exception request is submitted for every
round trip booking of a person, and must be valid for the period including both the
departure and return dates.
5. Subject to section E, and notwithstanding Section D(2)(c), a railway company is not

required to verify proof of vaccination credential for a person traveling for essential
medical services and treatment until 23:59 ET December 14, 2021 provided that:
a. the person provides a signed document from a medical doctor or nurse
practitioner who is licensed to practice in Canada that includes the date of the
appointment(s) for the essential medical service or treatment and the location of
the appointment(s); and
b. the date of the essential medical service or treatment is before December 13,
2021.
6. Subject to section E, and notwithstanding Section D(2)(a), a railway company is not

required to verify proof of vaccination credential for a person with a medical
contraindication boarding the railway equipment until 23:59 ET December 14, 2021,
provided that the person provides a medical note, from a medical doctor or nurse
practitioner who is licensed to practice in Canada, that demonstrates the contraindication.
3
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7. Subject to Section E, a railway company is not required to verify proof of vaccination for
a person who is at least 18 years old and who is boarding the railway equipment for the
purpose of accompanying a person referred to in Section D(1)(c) if the person needs to be
accompanied because they:
a. are under the age of 18 years;
b. have a disability; or
c. need assistance to communicate.

credential for any person who is a resident of a community which is:
a. only accessible using the VIA Rail Canada Inc. The Pas-Churchill route; or
b. any other remote community for whom VIA Rail Canada Inc. may be the only
means of transportation.
9. Subject to Section E(2), a railway company is not required to verify proof of vaccination
credential for any person that is under the age of 12 years and four (4) months.
credential for any person who is listed:
a. In the case of Via Rail Canada Inc, in Appendix B;

b. In the case of Great Canadian Railtour Company Ltd., in Appendix C;
c. In the case of National Railroad Passenger Corporation (AMTRAK), in
Appendix D; and
d. In the case of Pacific & Arctic Railway Navigation, British Columbia & Yukon
Railway, British Yukon Railway doing business as White Pass & Yukon Route
Railroad (WP&YR), in Appendix E.
credential for a person that is a foreign national, other than a person registered as an
Indian under the Indian Act, who is boarding the railway equipment if the initial
scheduled departure time is not more than 24 hours after the departure time of a flight
taken by the person to Canada from any other country, as confirmed by evidence of the
person’s travel itinerary or boarding pass and passport or other travel document issued by
12. Subject to section E, a railway company is not required to verify proof of vaccination
credential for a person that is boarding the railway equipment for a purpose other than
optional or discretionary purposes such as tourism, recreation or leisure, and who is:
a. a person who entered Canada at the invitation of the Minister of Health for the
purpose of assisting in the COVID-19 response;
b. a person who is permitted to work in Canada as a provider of emergency services
under paragraph 186(t) of the Immigration and Refugee Protection Regulations
and who entered Canada for the purpose of providing those services;
c. a person who entered Canada after August 31, 2021, who has been recognized as
a Convention refugee within the meaning of subsection 146(1) of those
4
AR04826
Regulations and who has been issued a permanent resident visa und er 139(1) of
those Regulations;
d. a person who has been issued a temporary resident permit within the meaning of
subsection 24(1) of the Immigration and Refugee Protection Act and who entered
Canada after August 31, 2021 as a protected temporary resident under subsection
151.1(2) of those Regulations;
e. an accredited person;
f. a person holding a D1, O1 or C1 visa who entered Canada to take up a post and
become an accredited person; or
g. a diplomatic or consular courier.
Section E: Accommodations
1. In the case of persons for whom the railway company is not required to verify proof of
vaccination credential by virtue of the exceptions in Section D(1), D(5), D(6), D(7), D(8),
D(10) or D(12), the company must verify that the person provides an acceptable proof of
a COVID-19 molecular test result or COVID-19 antigen test result. A person’s COVID-
19 test result is only acceptable if:
a. in the case of a negative result for a COVID-19 molecular test, a test that was
performed on a specimen collected no more than 72 hours before the
scheduled departure time;
b. in the case of a negative result for a COVID-19 antigen test, a test that was
performed on a specimen collected no more than one day before the initial
scheduled departure time; or
c. in the case of a positive result for a COVID-19 molecular test, a test that was
performed on a specimen collected at least 10 days and no more than 180 days
before the initial scheduled departure time.
2. A railway company must have in place any other accommodation measures as set out in
local public health guidance for persons described under Section D.
Section F: Privacy Requirements
1. The railway company must ensure that personal information is only created, collected,
retained, used, disclosed, and disposed of in a manner that respects the provisions set out
in applicable Canadian legislation, including but not limited to the Privacy Act, Personal
Information Protection and Electronic Documents Act, or provincial privacy legislation.
2. The railway company must ensure that it only collects the information that is necessary to
verify proof of vaccination credential, an exception under Section D, proof of a COVID-
19 molecular test result, or proof of a COVID-19 antigen test result of the person
boarding railway equipment and the requirements of this Ministerial Order.
3. If a railway company uses a virtual storage provider, including a cloud storage provider,
to store or back passenger or employee data related to vaccination status, the company
5
AR04827
must ensure that the provider is accredited under a current internationally recognized
standard respecting information security management systems.
4. The railway company must ensure that data related to personal information can only be
accessed for the purpose of the railway company meeting its obligations under this order.
Section G: Data Collection and Reporting Requirements
1. A railway company must keep a record, on weekly basis and in a manner consistent with
requirements outlined in Section F, of:
a. passenger volumes;
b. the number of exception request received for each category described in section
D(1);
c. the number of exception accepted for each category described in section D(1);
d. the number of persons denied boarding due to a person failing to provide
acceptable proof of vaccination credential;
e. the number of persons denied boarding due to requests not being accepted; and
f. In relation to COVID-19 molecular test results and COVID-19 antigen test results
obtained for persons falling under the exception described in D(5):
i. number of acceptable proof of a COVID-19 molecular test result or a
COVID-19 antigen test result in accordance with E(1); and
ii. number of test results that were not acceptable in accordance with E(1).
2. The company must retain the data referred to in Section G(1), and requests submitted
under Section D, for a minimum of 12 months.
3. A railway company must provide to the Minister, on a weekly basis, or at the request of
the Minister:
a. the data referred to in Section G(1); and
b. any suspicious patterns detected or documents that may have been false or
included false information.
For the purpose of this order,
“accredited person” means a foreign national who holds a passport that contains a valid
diplomatic, consular, official or special representative acceptance issued by the Chief of
Protocol for the Department of Foreign Affairs, Trade and Development.
“COVID-19” means the coronavirus disease 2019.
“COVID-19 antigen test” means a COVID-19 screening or diagnostic immunoassay

that:
a) detects the presence of a viral antigen indicating the presence of COVID-19; and
b) is authorized for sale or distribution in Canada or in jurisdiction in which it was
obtained.
6
AR04828
“COVID-19 molecular test” means a COVID-19 screening or diagnostic test, including

a test performed using the method of polymerase chain reaction (PCR) or reverse
transcription loop-mediated isothermal amplification (RT-LAMP) that is:
a) if the test is self-administered, observed and the result is verified
i. in person by any accredited laboratory or testing provider, or
ii. in real time by remote audio-visual means by the accredited laboratory or
testing provider who provided the test; or
b) if the test is not self-administered, performed by an accredited laboratory or
testing provider.
“foreign national” means a person who is not a Canadian citizen or a permanent resident
and includes a stateless person.
“fully vaccinated person” means a person who, at least 14 days prior to boarding a
railway equipment, has completed a COVID-19 vaccine dosage regimen if:
a) in the case of a vaccine dosage regimen that uses a COVID-19 vaccine that is
authorized for sale in Canada,
i. the vaccine has been administered to the person in accordance with its
labelling, or
ii. the Minister of Health determines, on the recommendation of the Chief
Public Health Officer, appointed under subsection 6(1) of the Public
Health Agency of Canada Act, that the regimen is suitable, having regard
to the scientific evidence related to the efficacy of that regimen in
preventing the introduction or spread of COVID-19 or any other factor
relevant to preventing the introduction or spread of COVID-19; or
b) in all other cases,
i. the vaccines of the regimen are authorized for sale in Canada or in another
jurisdiction, and
ii. the Minister of Health determines, on the recommendation of the Chief
Public Health Officer, appointed under subsection 6(1) of the Public
Health Agency of Canada Act, that the vaccines and the regimen are
suitable, having regard to the scientific evidence related to the efficacy of
that regimen and the vaccines in preventing the introduction or spread of
COVID-19 or any other factor relevant to preventing the introduction or
spread of COVID-19.
For greater certainty, a COVID-19 vaccine that is authorized for sale in Canada does not
include a similar vaccine sold by the same manufacturer that has been authorized for sale
in another jurisdiction.
“proof of a COVID-19 antigen test result” means proof that contains the following
information:
a. the name and date of birth of the person whose specimen was collected for the
test;
b. the name and civic address of the accredited laboratory or the testing provider that
performed or observed the test and verified the test result;
7
AR04829
c. the date the specimen was collected and the test method used; and
d. the test result.
An acceptable proof of a COVID-19 antigen test result includes a paper and digital copy.
“proof of a COVID-19 molecular test result” means proof that contains the following
information:
test;
b. the name and civic address of the accredited laboratory or the testing provider that
performed or observed the test and verified the test result;
d. the test result.
An acceptable proof of a COVID-19 molecular test result includes a paper and digital
copy.
“proof of vaccination credential” (PVC) means evidence issued by the government or

the non-governmental entity that is authorized to issue the evidence of COVID-19
vaccination in the jurisdiction in which the vaccine was administered, and must contain
the following information:
i. the name of the person who received the vaccine;

ii. the name of the government or the name of the non-governmental entity;
iii. the brand name or any other information that identifies the vaccine that was
administered; and
iv. the dates on which the vaccine was administered or, if the evidence is one
document issued for more than one dose and the document only specifies the date
on which the most recent dose was administered, that date.
An acceptable proof of vaccination credential includes: a paper PVC; a digital PVC; or

for passengers originating outside of Canada, an ArriveCAN receipt with immunization
status denoted, which demonstrates that the person is fully vaccinated. In all cases, the
PVC must be in English or French and any translation into English or French must be a
certified translation.
“testing provider” means

a. a person who may provide COVID-19 screening or diagnostic testing services
under the laws of the jurisdiction where the service is provided; or
b. an organization, such as a telehealth service provider or pharmacy, which may
provide COVID-19 screening or diagnostic testing services under the laws of the
jurisdiction where the service is provided and that employs or contracts with a
person referred to in paragraph (a).
8
AR04830
This Order is effective on February 28, 2022, and remains in effect until it is revoked by the
Minister of Transport.
Therefore, I find it necessary in the interest of safe railway operations to repeal the ministerial
Order 21-09.1, effective immediately.
Pursuant to subsection 32.1(1) of the Rail Safety Act (RSA), a person to whom an order is sent
under section 32.01 of the RSA may, on the date specified in the order, file a request for a review
with the Transportation Appeal Tribunal of Canada (Tribunal).
If you intend to request a review of this Order, you must file a request in writing with the
Tribunal, which must be postmarked no later than March 28, 2022. Requests for review must be
filed with:
The Registrar
Transportation Appeal Tribunal of Canada
333 Laurier Avenue West, Room 1201
Ottawa, ON
K1A 0N5
http://www.tatc.gc.ca
Pursuant to section 32.3 of the RSA, an order issued under section 32.01 of the RSA shall not be
stayed pending a review requested under section 32.1, an appeal under section 3 2.2 or a
reconsideration by the Minister of Transport under subsection 32.1(5) or 32.2.(3) of the RSA.
___________________________________
9
AR04831
APPENDIX A
Great Canadian Railtour Company Ltd.

National Railroad Passenger Corporation (AMTRAK)
Pacific & Arctic Railway Navigation, British Columbia & Yukon Railway, British Yukon
Railway doing business as White Pass & Yukon Route Railroad (WP&YR)
VIA Rail Canada Inc.
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APPENDIX B
Via Rail Canada Inc.
11
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APPENDIX C
12
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APPENDIX D
13
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APPENDIX E
14
AR04836
MO 21-09.2
TRANSPORTS CANADA
ARRÊTÉ EN VERTU DE L’ARTICLE 32.01 DE LA
LOI SUR LA SÉCURITÉ FERROVIAIRE, CHAPITRE R-4.2 [S.R.C. 1985, ch. 32

(4 e suppl.)]
Attendu que l’Organisation mondiale de la santé a qualifié la COVID-19 de pandémie et que

cette pandémie affecte le Canada;
Attendu que tous les ordres de gouvernement au Canada prennent des mesures afin de freiner la
propagation de la COVID-19, ou de nouveaux variants du virus à l’origine de la COVID-19 qui
présentent des risques différents de ceux posés par d’autres variants, mais qui sont équivalents ou
plus graves;
Attendu que des données probantes indiquent que les vaccins sont très efficaces pour prévenir les
maladies graves, les hospitalisations et les décès dus à la COVID-19, y compris les variants
préoccupants, et que l’incidence de la vaccination sur la fréquence des éclosions et la réduction
des taux de mortalité et d’hospitalisation a été frappante par rapport à l’incidence d’autres outils
utilisés avant la vaccination, y compris la distanciation physique;
Attendu que les personnes qui entrent au Canada sont assujetties aux exigences prévues dans les
décrets visant la réduction du risque d’exposition à la COVID-19 au Canada qui ont été pris au
titre de la Loi sur la mise en quarantaine;
Attendu que, selon l’article 32.01 de la Loi sur la sécurité ferroviaire, si le ministre l’estime
nécessaire pour la sécurité ferroviaire, il peut transmettre un arrêté à une compagnie lui
ordonnant de mettre fin à toute activité qui pourrait compromettre la sécurité ferroviaire ou de
suivre toute procédure ou d’apporter les mesures correctives nécessaires précisées dans l’arrêté;
Attendu que, selon le paragraphe 4(4) de la Loi sur la sécurité ferroviaire, la sécurité ferroviaire
concerne non seulement la sécurité des voyageurs et des marchandises transportées par chemin
de fer, mais aussi celle de toute autre personne et de tout autre bien;
Attendu que, selon l’article 36 de la Loi sur la sécurité ferroviaire, le ministre peut, par arrêté,
demander à une compagnie de lui fournir, en la forme et dans le délai qui y est prévu, tout
renseignement ou document s’il l’estime nécessaire pour vérifier le respect de la Loi sur la
sécurité ferroviaire et de ses textes d’application; et
Attendu que, selon l’article 45 de la Loi sur la sécurité ferroviaire, le ministre des Transports a
délégué, par écrit, au directeur général, Sécurité ferroviaire, le pouvoir de prendre un arrêté en
vertu des articles 32.01 et 36 de cette loi.
AR04837
À ces causes, je, Michael DeJong, directeur général, Sécurité ferroviaire, estime nécessaire pour
la sécurité ferroviaire de prendre le présent arrêté en vertu des articles 32.01 et 36 de la Loi sur la
sécurité ferroviaire. Cet arrêté enjoint les compagnies énumérées à l’annexe A à suivre les
procédures énoncées ci-après.
Section A : Preuve de vaccination
Il est interdit à une compagnie de chemin de fer dont le nom apparaît à l’annexe A du présent
arrêté d’exploiter du matériel ferroviaire sur un chemin de fer à moins d’avoir vérifié que
chaque personne qui embarque dans le matériel ferroviaire, qui n’est pas un employé de la
compagnie, présente un certificat de preuve de vaccination comme preuve qu'elle est une
personne entièrement vaccinée, sauf si elle est visée par l’une des exceptions prévues à la
section D.
Section B : Fausse déclaration
1. Une compagnie de chemin de fer doit aviser chaque personne qui embarque dans le
matériel ferroviaire :
a. qu’une fausse déclaration, après avoir prêté serment ou fait une affirmation
solennelle, dans un affidavit, une déclaration solennelle, un témoignage écrit ou
verbal, en sachant que la déclaration est fausse, constitue une infraction à
l’article 131 du Code criminel ; et
b. que toute personne qui crée un faux document, en le sachant faux, enfreint
l’article 366 du Code criminel.
Section C : Interdictions
1. Une compagnie de chemin de fer doit interdire l’embarquement à bord du matériel

ferroviaire à toute personne, qui n’est pas un employé de la compagnie, qui omet de lui
présenter un certificat de preuve de vaccination, tel qu’il est exigé à la section A.
2. En ce qui concerne les personnes visées par l’une des exceptions prévues à la
section D(1), une compagnie de chemin de fer doit interdire l’embarquement à bord du
matériel ferroviaire à toute personne qui omet de fournir un formulaire dûment rempli
dans les délais prévus à la section D(2).
3. Nonobstant la section A et la section C(1), une compagnie de chemin de fer peut

exploiter du matériel ferroviaire sur un chemin de fer sans vérifier les certificats de
preuve de vaccination des personnes embarquant à bord du matériel ferroviaire dans des
situations de force majeure, y compris les voyages urgents ou d'urgence liés aux
évacuations causés par des catastrophes naturelles (p. ex. incendie de forêt et
inondations), mais uniquement si la compagnie de chemin de fer fournit un avis au
ministre dans les 2 heures suivant l'embarquement.
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Section D : Exceptions
1. Sous réserve de la section E, une compagnie de chemin de fer n’est pas tenue de vérifier
le certificat de preuve de vaccination d’une personne qui :
a. n’a pas suivi un protocole vaccinal complet contre la COVID-19 en raison d’une
contre-indication médicale et qui a droit à une mesure d’adaptation pour ce motif,
aux termes de la législation applicable;
b. n’a pas suivi un protocole vaccinal complet contre la COVID-19 en raison d’une
croyance religieuse sincère, ou de la croyance religieuse sincère de son tuteur
légal, et qui a droit à une mesure d’adaptation pour ce motif, aux termes de la
législation applicable; ou
c. monte à bord de l’équipement ferroviaire afin de se rendre à un rendez-vous pour
obtenir des services ou traitements médicaux essentiels.
2. Aux fins de la section D(1), une compagnie de chemin de fer doit vérifier que la personne
lui a fourni :
a. dans le cas d’une exception en raison d’une contre-indication médicale, 21 jours
avant le jour initial prévu du départ, un formulaire de demande d’exception reliée
à une contre-indication médicale dûment rempli;
b. dans le cas d’une exception en raison de croyances religieuses sincères, ou les
croyances religieuses sincères de leur tuteur légal, 21 jours avant le jour initial
prévu du départ, un formulaire de demande d’exception dûment rempli
comprenant une déclaration sous serment ou une affirmation solennelle de la
personne devant une personne nommée à titre de commissaire aux serments au
Canada; et
c. dans le cas d’un voyage pour recevoir des services ou des traitements médicaux
essentiels, 14 jours avant le jour initial prévu du départ, un formulaire de demande
d’exception reliée à des services ou des traitements médicaux essentiels dûment
rempli.
3. Nonobstant les échéanciers établis à la section D(2), une compagnie de chemin de fer
peut accepter un formulaire de demande d’exception dûment rempli si des circonstances
exceptionnelles sont revendiquées par la personne présentant la demande d’exception et
qu’il est opérationnellement possible pour la compagnie de le faire.
4. Aux fins de la section D(2) :

a. une compagnie de chemin de fer doit uniquement accepter les demandes
d’exception soumises en utilisant le formulaire spécifié par Transports Canada; et
b. une compagnie de chemin de doit s’assurer qu'un nouveau formulaire est soumis
pour chaque réservation aller-retour d'une personne, et doit être valide pour la
période comprenant le voyage de retour.
5. Sous réserve de la section E, et nonobstant la section D(2)(c), et ce jusqu’au 14 décembre

2021 à 23 h 59 (heure de l’Est), une compagnie de chemin de fer n’est pas tenue de
vérifier le certificat de preuve de vaccination de toute personne voyageant pour recevoir
des services ou des traitements médicaux essentiels à condition que :
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a. la personne fournisse un document signé d’un médecin ou d’une infirmière

praticienne canadiens, lequel inclut la date ainsi que le lieu des services ou des
traitements médicaux essentiels; et
b. la date des services ou des traitements médicaux essentiels est avant le 13
décembre 2021.
6. Sous réserve de la section E, et nonobstant la section D(2)(a), et ce jusqu’au 14 décembre

2021 à 23 h 59 (heure de l’Est), une compagnie de chemin de fer n’est pas tenue de
vérifier le certificat de preuve de vaccination de toute personne avec une contre-
indication médicale embarquant à bord du matériel ferroviaire, à condition que la
personne fournisse un document signé par un médecin ou une infirmière praticienne
canadiens, lequel confirme la contre-indication médicale.
le certificat de preuve de vaccination de toute personne âgée d’au moins dix-huit ans qui
monte à bord du matériel ferroviaire afin d’accompagner une personne visée sous la
section D(1)(c) si cette personne a besoin d’être accompagnée pour l’une des raisons
suivantes :
a. elle est âgée de moins de dix-huit ans;
b. elle est handicapée;
c. elle a besoin d’aide pour communiquer.
le certificat de preuve de vaccination d’une personne résidante :
a. d’une collectivité dont le seul accès est l’itinéraire The Pas-Churchill de VIA Rail
Canada Inc.; ou
b. de toute autre collectivité éloignée pour laquelle VIA Rail Canada Inc. pourrait
être le seul moyen de transport.
9. Sous réserve de la section E(2), une compagnie de chemin de fer n’est pas tenue de
vérifier le certificat de preuve de vaccination d’une personne âgée de moins de 12 ans et
quatre (4) mois.
le certificat de preuve de vaccination de toute personne visée :
a. Dans le cas de VIA Rail Canada Inc., à l’annexe B;

b. Dans le cas de Great Canadian Railtour Company Ltd., à l’annexe C;
c. Dans le cas de National Railroad Passenger Corporation (AMTRAK), à
l’annexe D; et
d. Dans le cas de Pacific & Arctic Railway Navigation, British Columbia & Yukon
Railway, British Yukon Railway doing business as White Pass & Yukon Route
Railroad (WP&YR), à l’annexe E.
le certificat de preuve de vaccination d’un étranger, qui n’est pas inscrit à titre d’Indien
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sous le régime de la Loi sur les indiens et qui embarque à bord d’un matériel ferroviaire
au Canada si l’heure de départ prévue initialement est au plus tard vingt-quatre (24)
heures après l’heure de départ du vol qu’il a pris en partance de tout autre pays à
destination du Canada, tel que confirmé par leur itinéraire de voyage ou une carte
d’embarquement ou autre titre de voyage délivré par le pays de citoyenneté ou de
nationalité de la personne.
le certificat de preuve de vaccination d’une personne accréditée et qui embarque à bord
d’un matériel ferroviaire pour des fins autres que celles de nature optionnelle ou
discrétionnaire telles que le tourisme, les loisirs ou le divertissement et qui est, selon le
cas :
a. entrée au Canada à l’invitation du ministre de la Santé afin de participer aux
efforts de lutte contre la COVID-19;
b. autorisée à travailler au Canada afin d’offrir des services d’urgence en vertu de
l’alinéa 186t) du Règlement sur l’immigration et la protection des réfugiés et qui
est entrée au Canada afin d’offrir de tels services;
c. reconnue comme réfugié au sens de la Convention ou qui est dans une situation
semblable à celui- ci au sens du paragraphe 146(1) du Règlement sur
l’immigration et la protection des réfugiés, qui est titulaire d’un visa de résident
permanent délivré aux termes du paragraphe 139(1) de ce règlement si cette
personne est entrée au Canada après le 31 août 2021;
d. titulaire d’un permis de séjour temporaire au sens du paragraphe 24(1) de la Loi
sur l’immigration et la protection des réfugiés et qui est entrée au Canada après le
31 août 2021 à titre de résident temporaire protégé aux termes du paragraphe
151.1(2) du Règlement sur l’immigration et la protection des réfugiés;
e. est une personne accréditée;
f. est titulaire d’un visa D1, O1 ou C1 qui est entrée au Canada pour occuper un
poste et devenir une personne accréditée ;
g. est un courrier diplomatique ou consulaire.
Section E : Accommodement
1. Lorsqu’une compagnie de chemin de fer n’est pas tenue de vérifier le certificat de

preuve de vaccination d’une personne visée par l’une des exceptions prévues aux
sections D(1), D(5), D(6), D(7), D(8), D(10) ou D(12), elle doit s’assurer que la
personne lui fournit une preuve admissible d’un essai moléculaire relatif à la COVID-19
ou d’un essai antigénique relatif à la COVID-19. Le résultat d’un essai relatif à la
COVID-19 est seulement acceptable si :
a. dans le cas d’un résultat négatif d’un essai moléculaire relatif à la COVID-19, un
essai effectué sur un échantillon prélevé dans les 72 heures précédant l’heure
initialement prévue de départ prévue;
b. dans le cas d’un résultat négatif d’un essai antigénique relatif à la COVID-19, un
essai qui a été effectué sur un échantillon prélevé au plus tard un jour précédant
l’heure initialement prévue de départ; ou
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c. dans le cas d’un résultat positif d’un essai moléculaire relatif à la COVID-19, un
essai effectué sur un échantillon prélevé au moins 10 jours, mais pas plus de180
jours, précédant l’heure initialement prévue de départ.
2. Une compagnie de chemin de fer doit avoir d’autres mesures d’accommodement,

comme le prévoient les directives locales en matière de santé publique, pour les
personnes visées par la section D.
Section F : Exigences relatives à la protection de la vie privée
1. Une compagnie de chemin de fer doit veiller à ce que les renseignements personnels
soient uniquement créés, recueillis, conservés, utilisés, divulgués et éliminés d’une
manière qui respecte les dispositions énoncées dans les lois canadiennes pertinentes,
notamment la Loi sur la protection des renseignements personnels, la Loi sur la
protection des renseignements personnels et les documents électroniques, ou les lois
provinciales sur les renseignements personnels.
2. Une compagnie de chemin de fer doit veiller à ce qu’elle recueille uniquement les
renseignements qui sont nécessaires pour vérifier le certificat de preuve de vaccination,
une exception au titre de la section D, la preuve d’un essai moléculaire relatif à la
COVID-19, ou la preuve d’un essai antigénique relatif à la COVID-19 d’une personne
qui embarque dans le matériel ferroviaire ainsi que les exigences du présent arrêté
ministériel.
3. Si une compagnie de chemin de fer utilise un fournisseur de stockage virtuel, notamment

un fournisseur de stockage en nuage, pour sauvegarder ou emmagasiner des données par
rapport au statut vaccinal des voyageurs ou des employés, elle doit veiller à ce que le
fournisseur soit accrédité selon une norme en vigueur reconnue à l’échelle internationale
en matière de systèmes de gestion de la sécurité de l’information.
4. Une compagnie de chemin de fer doit veiller à ce que les renseignements personnels
soient uniquement accessibles selon le principe d’accès sélectif.
Section G : Exigences relatives à la collecte des données
1. Une compagnie de chemin de fer doit recueillir des données sur une base
hebdomadaire et d'une manière conforme aux exigences décrites à la section F, sur :
a. le volumes de passagers;
b. le nombre de demandes reçues pour chaque exceptions énumérées à la section
D(1);
c. le nombre de demandes d'exception acceptées pour chaque catégorie décrite à la
section D(1);
d. le nombre de personnes refusées d'embarquer à bord du matériel ferroviaire en
raison d'une personne omettant de fournir un certificat de preuve de vaccination
acceptable;
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e. le nombre de personnes refusées d'embarquer à bord du matériel ferroviaire en

raison de formulaires non dûment remplis; et
f. En ce qui concerne les résultats d’essais moléculaires relatifs à la COVID-19 et
les résultats d’essais antigéniques relatifs à la COVID-19 obtenus pour les
personnes relevant de l'exception décrite en D(5);
i. nombre de preuves acceptables d’essais moléculaires relatifs à la COVID-
19 ou d’essais antigéniques relatifs à la COVID-19 conformément à E(1);
et
ii. nombre de résultats d'essais qui n'étaient pas acceptables conformément à
E(1).
2. La compagnie de chemin de fer doit conserver les données visées à la section G(1) et
les formulaires soumis en vertu de la section D pour un minimum de 12 mois.
3. Une compagnie de chemin de fer doit déclarer au ministre, sur une base
hebdomadaire ou à la demande du ministre :
a. les données récapitulatives relatives aux données collectées en vertu de la section
G(1); et
b. toutes tendances suspectes détectées ou documents pouvant être faux ou contenant
de fausses informations.
Aux fins du présent arrêté :
« certificat de preuve de vaccination » (CPV) s’entend d’une preuve délivrée par le

gouvernement ou l’entité non gouvernementale qui a compétence dans la province ou le
territoire où le vaccin contre la COVID-19 a été administré, et elle doit contenir les
renseignements suivants :
i. le nom de la personne qui a reçu le vaccin;

ii. le nom du gouvernement ou le nom de l’entité non gouvernementale;
iii. la marque nominative ou tout autre renseignement permettant d’identifier le
vaccin qui a été administré;
iv. les dates auxquelles le vaccin a été administré ou, dans le cas où la preuve est un
document unique qui est délivré pour deux doses et qui ne spécifie que la date à
laquelle la dernière dose a été administrée, la date qui figure sur ce document.
Un certificat de preuve de vaccination acceptable comprend : une copie papier du CPV,

une copie numérique du CPV, ou pour les voyageurs en provenance de l’extérieur du
Canada, un reçu ArriveCAN qui indique le statut d’immunisation. Dans tous les cas, le
CPV doit être en français ou en anglais et, s’il s’agit d’une traduction en français ou en
anglais, celle-ci doit être certifiée conforme.
« COVID-19 » s’entend de la maladie à coronavirus 2019.
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« entièrement vaccinée » s’entend d’une personne qui a suivi un protocole vaccinal

complet contre la COVID-19 au moins 14 jours avant de monter à bord du matériel
ferroviaire, si :
a. dans le cas d’un protocole vaccinal précisant un vaccin contre la COVID-19 qui
est autorisé pour la vente au Canada :
i. soit le vaccin a été administré à la personne conformément à son
étiquetage,
ii. soit le ministre de la Santé, sur recommandation de l’administrateur en
chef de la santé publique nommé en vertu du paragraphe 6(1) de la Loi sur
l’Agence de la santé publique du Canada, conclut que le protocole vaccinal
est approprié compte tenu des preuves scientifiques relatives à son efficacité
pour prévenir l’introduction et la propagation de la COVID-19 ou de tout
autre facteur pertinent à cet égard;
b. dans tout autre cas :
i. d’une part, les vaccins du protocole vaccinal sont autorisés pour la vente
soit au Canada, soit dans un pays étranger,
ii. d’autre part, le ministre de la Santé, sur recommandation de
l’administrateur en chef de la santé publique nommé en vertu du
paragraphe 6(1) de la Loi sur l’Agence de la santé publique du Canada,
conclut que ces vaccins et le protocole vaccinal sont appropriés compte tenu
des preuves scientifiques relatives à leur efficacité pour prévenir
l’introduction et la propagation de la COVID-19 ou de tout autre facteur
pertinent à cet égard.
Il est entendu que ne constitue pas un vaccin contre la COVID-19 autorisé pour la vente
au Canada le vaccin similaire qui est vendu par le même fabricant et qui a été autorisé
pour la vente dans un pays étranger.
« essai antigénique relatif à la COVID-19 » s’entend d’un essai immunologique de

dépistage ou de diagnostic de la COVID-19 qui, à la fois :
a. détecte la présence d’un antigène viral indicatif de la COVID-19; et
b. est autorisé pour la vente ou la distribution au Canada ou dans un pays étrange r
dans lequel il a été obtenu.
« essai moléculaire relatif à la COVID-19 » s’entend d’un essai de dépistage ou de

diagnostic de la COVID-19, y compris l’essai effectué selon le procédé d’amplification
en chaîne par polymérase (ACP) ou d’amplification isotherme médiée par boucle par
transcription inverse (RT-LAMP) qui :
a. s’il est auto-administré, est observé et son résultat est vérifié :
i. en personne par un laboratoire accrédité ou un fournisseur de services
d’essais,
ii. à distance, en temps réel, par un moyen audio-visuel par le laboratoire
accrédité ou par le fournisseur de services d’essais qui a fourni l’essai;
b. s’il n’est pas auto-administré, il est effectué par un laboratoire accrédité ou par un
fournisseur de services d’essais.
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« étranger » s’entend d’une personne autre qu’un citoyen canadien ou un résident

permanent; la présente définition vise également les apatrides.
« fournisseur de services d’essais » s’entend :

a. d’une personne qui peut fournir des essais de dépistage ou de diagnostic de la
COVID-19 en vertu de la loi du pays dans lequel elle fournit ces essais;
b. de l’organisation, tel un fournisseur de télésanté ou une pharmacie, qui peut
fournir des essais de dépistage ou de diagnostic de la COVID-19 en vertu de la loi
du pays dans lequel elle fournit ces essais et qui emploie ou engage une personne
visée à l’alinéa a).
« personne accréditée » s’entend d’un étranger titulaire d’un passeport contenant une
acceptation valide l’autorisant à occuper un poste en tant qu’agent diplomatique ou
consulaire, ou en tant que représentant officiel ou spécial, délivrée par le chef du
protocole du ministère des Affaires étrangères, du Commerce et du Développement.
« preuve du résultat à un essai antigénique relatif à la COVID-19 » s’entend d’une

preuve qui contient les renseignements suivants :
a. les prénom, nom et date de naissance de la personne de laquelle l’échantillon a été
prélevé;
b. le nom et l’adresse municipale du laboratoire accrédité ou du fournisseur de
services d’essais qui a effectué ou observé l’essai et vérifié le résultat;
c. la date à laquelle l’échantillon a été prélevé et le procédé utilisé;
d. le résultat de l’essai.
Une preuve admissible d’un essai antigénique relatif à la COVID-19 comprend une copie
papier et une copie numérique.
« preuve du résultat à un essai moléculaire relatif à la COVID-19 » s’entend d’une

preuve qui contient les renseignements suivants :
a. les prénoms, nom et date de naissance de la personne de laquelle l’échantillon a
été prélevé;
c. la date à laquelle l’échantillon a été prélevé et le procédé utilisé; et
Une preuve admissible d’un essai moléculaire relatif à la COVID-19 comprent une copie
papier et une copie numérique.
Le présent arrêté entre en vigueur le 28 février 2022, et il demeurera en vigueur jusqu’à sa

révocation par le ministre des Transports.
À cette cause, j’estime nécessaire pour la sécurité ferroviaire d’abroger dès maintenant l’arrêté
ministériel 21-09.1.
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Conformément au paragraphe 32.1(1) de la Loi sur la sécurité ferroviaire, toute personne visée
par un arrêté transmis en vertu de l’article 32.01 de la Loi peut, à la date indiquée dans l’arrêté,
déposer une requête en révision auprès du Tribunal d’appel des transports du Canada (Tribunal).
Si vous avez l’intention de faire réviser le présent arrêté, vous devez déposer une requête par
écrit auprès du Tribunal au plus tard le 28 mars 2022, le cachet de la poste faisant foi. Les
requêtes doivent être envoyées comme suit :
Greffe
Tribunal d’appel des transports du Canada
333, avenue Laurier Ouest, bureau 1201
Ottawa (Ont.) K1A 0N5
http://www.tatc.gc.ca
Conformément à l’article 32.3 de la Loi sur la sécurité ferroviaire, ni la révision prévue à

l’article 32.1, ni l’appel prévu à l’article 32.2, ni le réexamen par le ministre des Transports
prévu aux paragraphes 32.1(5) ou 32.2(3) n’ont pour effet de suspendre l’arrêté pris en vertu de
l’article 32.01 de la Loi.
_______________________________
Directeur général, Sécurité ferroviaire
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ANNEXE A

VIA Rail Canada Inc.
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ANNEXE B
Via Rail Canada Inc.
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ANNEXE C
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ANNEXE D
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ANNEXE E
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This is Exhibit “G” referred to in the


AR04852
hi Transport
Canada
Transports
Canada
GUIDANCE MATERIAL FOR RAILWAY COMPANIES
Rail Safety’s Vaccination Mandate

for Passengers
Transport Canada’s Ministerial Order 21-09.2.
Important Caveat: Nothing in this guidance document supersedes any

requirement or obligation outlined in Transport Canada’s Ministerial Order. It
is meant to complement this legal document and provide recommendations
and guidance on how to understand and carry out the requirements.
1
/n
Canada
v.4 – February 28, 2022 li+i
AR04853
Table of Contents
Section 1 – General ......................................................................................................................... 4
Purpose........................................................................................................................................ 4
Federal Vaccination Mandate ..................................................................................................... 4
Section 2 - Operational Application ................................................................................................ 4
Verification of Proof of Vaccination Credentials......................................................................... 4
Considerations............................................................................................................................. 7
False declaration ......................................................................................................................... 7
Prohibitions ................................................................................................................................. 7
Force majeure ............................................................................................................................. 7
Section 3 – Medical and Religious Exceptions ................................................................................ 8
Issuing Exceptions: ...................................................................................................................... 8
Operational Guidance: ................................................................................................................ 9
Reviewing and Accepting a Temporary Exception Request...................................................... 10
Rejecting a Temporary Exception Request ............................................................................... 10
Temporary Exceptions due to Medical Inability ....................................................................... 10
Proof of a Medical Inability ................................................................................................... 11
Provincial/Territorial medical exemptions ........................................................................... 12
Foreign Nationals .................................................................................................................. 16
Reviewing a Temporary Exception Request due to Medical Inability .................................. 16
Temporary Exceptions to Travel for Essential Medical Services or Treatment ........................ 17
Reviewing a Temporary Exception Request to Travel for Essential Medical Services or
Treatment ............................................................................................................................. 18
Temporary Exceptions due to Sincere Religious Belief ............................................................. 18
Reviewing a Temporary Exception Request Due to a Sincere Religious Belief .................... 19
Section 4 – Other Exceptions ........................................................................................................ 21
 Remote communities ......................................................................................................... 21

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 Children .............................................................................................................................. 21
 Foreign Nationals* ............................................................................................................. 21
 Other .................................................................................................................................. 21
 Domestic National Interest Exemption Program ............................................................... 22

Section 5 – Accommodations ....................................................................................................... 24
A proof of a Covid-19 molecular test result.......................................................................... 25
A proof of a Covid-19 antigen test result.............................................................................. 25
Section 6 - Privacy Requirements ................................................................................................. 26
Privacy considerations: ............................................................................................................. 26
Section 7 - Data Collection and Reporting Requirements ............................................................ 27
Data Collection .......................................................................................................................... 27
Reporting ................................................................................................................................... 28
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Purpose
The purpose of this guidance document is to provide a summary of railway companies’
requirements, as well as advice and guidance for railway companies when implementing the
requirements under Ministerial Order 21-09.2.
This document complements the other guidance material that has been prepared to
accompany the COVID-19 response measures. A link to these documents can be found here:
COVID-19 measures, updates, and guidance for rail issued by Transport Canada.

The pandemic has had a devastating impact on Canada’s transportation sector. While public
health measures including social distancing and masking have been critical to combatting the
spread of the virus, COVID-19 and its variants continue to pose a significant public health risk to
Canadians. Therefore, additional measures are needed to ensure the safety and security of
Canada’s transportation system and facilitate the resumption of safe rail travel. A requirement
for travellers and crew to be vaccinated in federally regulated air, rail, and marine sectors
enhances the safety of the Canadian transportation system, and builds Canadians’ confidence
to resume travel, while still adhering to public health measures.
Section 2 - Operational Application

Verification of Proof of Vaccination Credentials
Beginning on November 30, 2021 at 03:01 Eastern Time the railway company must not operate
railway equipment on a railway unless it verifies proof of vaccination credential (PVC) of every
person, who is not railway company employee and does not fall under an exception, that may
board the train.
The timing of verifications can vary between companies based on operational feasibility*.
For example:
 At the time of Ticket Purchase;
 At the time of advanced check-in (on-line) or onsite check-in (Kiosk or counter); or
 At the time of boarding.
*It is best practice that the company advise travellers of these requirements prior to their ticket
purchase.
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Proof of Vaccination Credential Verified by the Railway Company

Proof of vaccination credential (PVC) is a proof of vaccination confirming that the person is
fully vaccinated by completing, at least 14 days prior, a COVID-19 vaccine dosage regimen. A
PVC may be presented in three formats: paper, digital or by an ArriveCAN receipt. Although all
are accepted, railway companies should promote and encourage the use of digital formats, as
they become available.
1. Digital format:
The Canadian SMART Health Card is a paper or digital copy of a person’s clinical
information, including their vaccination history. The Government of Canada has worked
with provincial health authorities to develop a pan-Canadian approach to verify proof of
vaccination.
The use of these digital formats at the time of ticket purchase is strongly encouraged, as
they:
 are a secure and verifiable health record that is digitally signed by a trusted
authority (for example, the issuing province or territory);
 use technology that allows officials to verify and authenticate the information
without giving access to other health or identity information;
 prevent forgeries and tampering by detecting any changes to the document after it
has been issued; and
 allow users to hold a digital copy on a portable device, such as a mobile phone or
tablet, or to print a copy directly or via a request to their provincial or territorial
government, where available.
For additional information on the SMART Health Card, please consult the following link:
https://www.canada.ca/en/immigration-refugees-citizenship/services/canadian-covid-19-
proof-vaccination.html
2. Paper format:
A paper copy must be one that is issued by the government or the non-governmental entity
that is authorized to issue the evidence of COVID-19 vaccination in the jurisdiction in which
the vaccine was administered, and must contain the following information:
1. the name of the person who received the vaccine;
2. the name of the government or the name of the non-governmental entity;
3. the brand name or any other information that identifies the vaccine that was
administered; and
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4. the dates on which the vaccine was administered or, if the evidence is one
document issued for more than one dose and the document only specifies the date
on which the most recent dose was administered, that date.
3. ArriveCAN receipt with immunization status denoted (for passengers originating
outside Canada):
Persons travelling to Canada are required to use ArriveCAN to provide mandatory travel
information before and after their entry into Canada. Once they have submitted their
information through ArriveCAN, a receipt is displayed and emailed to them.
For additional information on ArriveCAN, please consult the following link:
https://www.canada.ca/en/public-health/services/diseases/coronavirus-disease-covid-
19/arrivecan.html
Fully vaccinated person means a person who, at least 14 days prior to boarding a railway
equipment, has completed a COVID-19 vaccine dosage regimen, if;
1. in the case of a vaccine dosage regimen that uses a COVID-19 vaccine that is authorized
for sale in Canada,
a. the vaccine has been administered to the person in accordance with its labelling,
or
b. the Minister of Health determines, on the recommendation of the Chief Public

Health Officer, appointed under subsection 6(1) of the Public Health Agency of
Canada Act, that the regimen is suitable, having regard to the scientific evidence
related to the efficacy of that regimen in preventing the introduction or spread
of COVID-19 or any other factor relevant to preventing the introduction or
spread of COVID-19; or
2. in all other cases,
a. the vaccines of the regimen are authorized for sale in Canada or in another
jurisdiction, and
b. the Minister of Health determines, on the recommendation of the Chief Public

Health Officer, appointed under subsection 6(1) of the Public Health Agency of
Canada Act, that the vaccines and the regimen are suitable, having regard to the
scientific evidence related to the efficacy of that regimen and the vaccines in
preventing the introduction or spread of COVID-19 or any other factor relevant
to preventing the introduction or spread of COVID-19.
For additional information on vaccines for COVID-19, please consult the following link:
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19/vaccines.html
Considerations
 Verifying vaccination credentials after boarding: Vaccination credentials may only be
verified after boarding in very limited circumstances, such as in rural or remote locations
where verification of passengers’ tickets are only processed once boarded and the train is
underway. Should the passenger not be able to provide an acceptable PVC, they would be
required to get off the train at the next stop.
 PVC attestation: The railway companies can also choose to use a ‘’PVC attestation” for
preliminary screening of passengers. For example, a passenger could be required to attest
that they have an acceptable PVC at the time of ticket purchase or during online check-in.
However, companies would still be required to implement verification of PVCs prior to
boarding.
False declaration
The company must advise every person that it is an offence under section 131 of the Criminal
Code to make a false statement under oath or solemn affirmation, by affidavit, solemn
declaration or deposition or orally, knowing that the statement is false. It is further an offence
under section 366 of the Criminal Code to make a false document, knowing it to be false.
To assist companies, Transport Canada has developed posters that can be used to advise
passengers.
Prohibitions
The railway company must deny boarding to any person, who is not an employee and who
does not fall under an exception, who fails to provide an acceptable PVC.
The railway company must require removal at the next stop to any person, who is not an
employee and who does not fall under an exception, who fails to provide an acceptable PVC
when verification is done while the train is already in movement.
The railway company must deny boarding to any person fails to provide the required
documents in the required timelines in order to be considered for an exception.
Force majeure: In the event of a situation of force majeure, a railway company may operate
railway equipment on a railway without verifying proof of vaccination credentials of a person
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boarding the railway equipment, but only if the railway company provides a notice to the
Minister within 2 hours of boarding.
These specific situations could include urgent or emergency travel related to evacuations
caused by natural disaster (e.g., forest fire, floods, etc.), or other urgent or emergency
situations. In these cases, a COVID-19 test result will not be required.
Section 3 – Medical and Religious Exceptions

The Ministerial Order requires railway companies to provide exceptions from the requirement
to be fully vaccinated in very limited circumstances, namely if the person has either not
completed a COVID-19 vaccination regime due to a medical inability or the person’s sincerely
held religious beliefs or is required to travel to receive essential medical services or treatment.
The railway company should use forms specified by Transport Canada when an exception is
applied for a medical inability or on the ground of religion, or for travelling to receive essential
medical services and treatment.
A railway company must provide for accommodation measures for persons who are issued an
exception from providing a proof of vaccination credential. Further guidance on
accommodations can be found in "Section 5: Accommodations” of this document.
Issuing Exceptions:
Railway companies are responsible to ensure that the forms submitted by a person requesting
an exception have been duly completed and are accompanied by the appropriate supporting
documentations (if applicable). Companies will determine if the person’s request was properly
submitted for exceptions due to medical inability to be vaccinated, essential medical services or
treatment, or sincere religious belief, based on detailed guidance from TC (using this document
as a starting point).
A transition period covering the period between November 30, 2021, and December 14, 2021
at 23:59 ET will allow railway companies to provide exceptions from the requirement to be fully
vaccinated for a person that has not completed a COVID-19 vaccination regime due to a
medical inability or for travelling to receive essential medical services and treatment without
ensuring that the required form has been duly completed. In these cases, the railway company
will have to ensure that:
1. In the case of a person requesting an exception to travel to receive essential medical
services, and a person that accompanies them provided that they meet the criteria (as
applicable):
a. the person provides a signed document from a medical doctor or nurse
practitioner who is licensed to practice in Canada that includes the date of the
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AR04860
appointment(s) for the essential medical service or treatment and the location of
the appointment(s); and
b. the date of the essential medical service or treatment is before December 13,
2021.
2. In the case of a person requesting an exception due to a medical inability:
a. The person provides a medical note, from a medical doctor or nurse practitioner
who is licensed to practice in Canada, that demonstrates the contraindication.
Operational Guidance:
Railway companies are required to develop operational guidance and procedures on how they
will receive, evaluate, and accept requests for temporary exceptions, as well as how they will
confirm and communicate acceptance of the temporary exception to the person submitting the
request, and handle rejected requests. Railway companies’ operational guidelines and
procedures should be based on public guidance. Details on screening criteria can be found
below.
Railway companies should ensure that the required forms are submitted:
 21 days before the day initially scheduled for the departure for requests based on
medical contraindication or religious beliefs, and
 14 days before the day initially scheduled for the departure for requests based on
travelling to receive essential medical services or treatment.
In order to provide flexibility to the railway company to address specific cases, the railway
company may accept a duly completed temporary exception request at a later date in cases
where exceptional circumstances are claimed by the requestor, and as long as it is operationally
feasible.
It is also railway companies’ responsibility to communicate to passengers details on the
temporary exception request and acceptance process, including that they must submit their
requests for temporary exceptions before boarding and within the timelines outlined by the
company.
Persons whose requests have been accepted are required to carry the completed exception
forms and proof of the company’s acceptance with them during their travel journey. Railway
companies may verify proof of temporary exception and COVID-19 molecular test results or
COVID-19 antigen test results at any time during travel (check-in, boarding, during travel, etc.).
Temporary exceptions due to a medical inability, sincere religious belief, or to travel for
essential medical services and treatment is company specific. In other words, a temporary
exception by one railway company does not automatically allow the passenger to connect with
a different company, or to transfer modes (e.g., from train to plane). These exceptions are
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deemed to be ‘temporary’ as both the exception form and the company-administered

exception acceptance are time limited.
A high-level summary of information on exceptions for passengers will be located on this
webpage: COVID-19 Boarding flights, trains and cruise ships in Canada – Travel restrictions in
Canada – Travel.gc.ca (administered by Health Canada and Treasury Board Secretariat).
Passengers with temporary exceptions due to medical inability, essential medical services or
treatment or sincere religious belief will require a valid COVID-19 molecular test result or
COVID-19 antigen test result before boarding. Please refer to “Section 5 – Accommodations”
of this document for further guidance.
Reviewing and Accepting a Temporary Exception Request

Railway companies must notify the person that the exception request is accepted and issue
them a confirmation of acceptance that can be shown at check-in, boarding or while the train is
underway. The company must issue confirmation of acceptance to the passenger in advance of
boarding.
Temporary exceptions are only valid with the railway company that confirmed the exception
and for the period of the booked return trip.
The passenger will be required to present proof of exception to any authority requesting it
throughout the trip, including at the time of check-in or boarding, along with their valid COVID-
19 molecular test result or COVID-19 antigen test result. Please refer to “Section 5 –
Accommodations” of this document for further guidance on COVID-19 molecular tests and
COVID-19 antigen tests.
Rejecting a Temporary Exception Request

The railway company will notify the applicant accordingly if an exception request is rejected.
The company must issue rejections to the passenger in advance of check-in/boarding.
Passengers without a confirmed exception requests should not be permitted to board.
Passengers may re-apply for exception requests within the time period required by the railway
company in advance of the planned date of boarding only if they are providing additional
information.
Temporary Exceptions due to Medical Inability

Based on the October 22, 2021 recommendation of the National Advisory Committee on
Immunization, medical reasons that may qualify a passenger for a temporary exception are as
follows (also found in the form):
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1. Certified medical contraindications to full vaccination against COVID-19 with an mRNA

vaccine:
a. A history of anaphylaxis after previous administration of an mRNA COVID-19
vaccine (and noting that most people who experienced a severe immediate
allergic reaction after a first dose of an mRNA COVID-19 vaccine can safely
receive future doses of the same or another mRNA COVID-19 vaccine after
consulting with an allergist or another appropriate physician); and/or
b. A confirmed allergy to polyethylene glycol (PEG) which is found in the Pfizer-
BioNTech and Moderna COVID-19 vaccines (note that if a person is allergic to
product).
2. Medical reasons for delay of full vaccination against COVID-19:
a. A history of myocarditis/pericarditis following the first dose of an mRNA vaccine;
and/or
b. An immunocompromising condition or medication that requires waiting to
vaccinate when immune response can be maximized (i.e., waiting to vaccinate
when immunocompromised state or medication is lower).
3. A medical condition precluding full vaccination against COVID-19 (not covered above),
as briefly described by the medical physician or nurse practitioner.
Proof of a Medical Inability

To receive a temporary exception from the mandatory vaccination requirement, passengers
must submit to the company a duly completed temporary exception form due to medical
inability. This form is available from the company and must be completed prior to departure
and in accordance with the company’s exception application process. Temporary exception
requests due to medical inability must be submitted to the company 3 weeks* in advance, or in
accordance with the timelines established by the company.
*A railway company may accept a duly completed temporary exception request at a later date
in cases where exceptional circumstances are claimed by the requestor, and as long as it is
operationally feasible.
A railway company is not required to verify proof of vaccination credential for a person with a
medical contraindication boarding the railway equipment until 23:59 ET December 14, 2021,
provided that the person provides a medical note, from a medical doctor or nurse practitioner
who is licensed to practice in Canada, that demonstrates the contraindication.
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Who is considered a medical doctor or nurse practitioner for the purposes of the Mandatory
Vaccination Mandate
Considered a (provincial/territorial) licensed Not considered a licensed medical doctor or a

medical doctor or a nurse practitioner nurse practitioner
 Family doctor  Paramedical or alternative health

 Nurse practitioner providers (e.g., chiropractor, podiatrist,
optometrist, naturopath)
 Allergist
 Registered nurse (RN), registered practical
 Immunologist
nurse (RPN), licensed practical nurse (LPN)
 Cardiologist
 Physician’s assistant (PA)
 Rheumatologist
 Dentist or dental hygienist
 Oncologist
 Psychologist
Provincial/Territorial medical exemptions

A medical exemption issued by a Canadian province or territory may also be accepted. For
those provinces/territories where a medical letter or medical contraindication credential is
issued, the traveller must still request to the company an exception by completing and
submitting a Medical Inability exception form. The Provincial/Territorial issued letter or
credential, however, can be provided in lieu of the Medical Doctor or Nurse Practitioner’s
signature on the exception form.
To verify authenticity of the Provincial/Territorial exemption, railway companies should refer to
the list below. For the most up to date information on Provincial/Territorial exemptions, please
visit their webpage.
As of January 10, 2022:

Jurisdiction Provincial/Territorial Direction to traveler
Documentation
PEI, NWT Medical Letter issued by - Complete railway company’s exemption form
Province/Territory following a (with the exception of section F of the form)
review process. and attach the P/T issued medical letter in
lieu of completion of section F by a medical
doctor or nurse practitioner.
- COVID Test required for travel
12
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Jurisdiction Provincial/Territorial Direction to traveler

Documentation
MB, QC, NL Medical Contraindication - Complete railway company’s exemption form

Credential (with or without QR (with the exception of section F of the form)
ON, YK Code) issued following a review and attach the P/T issued medical credential
process. in lieu of completion of section F by a medical
Provincial Digital or Physical - COVID Test required for travel
Immunization Card
(exemption not indicated in
physical immunization card
or digital QR Code)
NB, AB, ON, Letter completed by Medical - Complete railway company’s exemption form
NS, NL Doctor or Nurse Practitioner (with the exception of section F of the form)
licensed to practice in the and attach the completed medical exemption
Province/Territory. letter in lieu of completion of section F by a
medical doctor or nurse practitioner.
- COVID Test required for travel
BC, NU, YK, SK N/A - Jurisdictions do not issue - Complete railway company’s exemption form
medical exemption letters or including section F by a medical doctor or
credentials, and do not provide nurse practitioner licensed to practice in the
templates for doctors. Medical Province/Territory.
exemptions are not recognized - COVID Test required for travel
in the Province.
Types of documents issued or accepted by each province/territory to persons medically

unable to be vaccinated against COVID-19:
P/T Exemption Document Provincial webpage

British There are no medical exemptions for the COVID-19 vaccines Proof of vaccination
Columbia recognized by the Province. and the BC Vaccine
Card - Province of
British Columbia
(gov.bc.ca)
Vaccine
Considerations
(bccdc.ca)
Alberta A valid medical exemption is the original signed letter from a COVID-19 public
physician or nurse practitioner that includes: health actions |
- Date which the letter was provided. Alberta.ca
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- Person's name that matches their identification.

- Physician’s or nurse practitioner’s complete information,
including:
o name, phone number, contact information,
professional registration number and signature
o statement that there is a medical reason for not
being fully vaccinated against COVID-19
o duration that the exemption is valid
Saskatchewan As immunization is not mandatory, exemption is not required.Government of
Saskatchewan / Proof
of COVID Vaccination
/ Affidavit
Submissions
Manitoba Provincial Digital or Physical Immunization Card (exemption Province of Manitoba
not indicated in digital or physical immunization card) = | Eligibility Criteria
(gov.mb.ca)
Ontario Enhanced vaccination certificate with official QR Code Medical Exemption
(exemption not indicated in digital certificate) Guidance (gov.on.ca)
• .
Quebec Provincial Digital Passport (exemption not indicated in COVID-19 protection
digital Passport) status |
Gouvernement du
Québec (quebec.ca)
New Brunswick A New Brunswick Medical Exemption template form signed by Proof of Covid-19
a physician or nurse practitioner licensed in New Brunswick is Vaccination (gnb.ca)
accepted as meeting the proof of vaccination policy. A note
written on a prescription pad is not accepted as an
exemption form.
Nova Scotia Valid Medical Contraindication for COVID-19 Vaccination Coronavirus (COVID-
template letter from doctor or nurse practitioner. 19): medical
exceptions -
Government of Nova
Scotia, Canada
PEI Individuals claiming a medical exemption from COVID-19 Residents - Important
vaccination will be required to have a Medical Exemption Letter PEI Vax Pass
issued by the Chief Public Health Office. Information |
Government of Prince
Edward Island
Newfoundland Acceptable proof of an approved medical exemption includes: Guidance for
and Labrador - An electronic QR code downloaded and shown on a mobile Residents - COVID-19
device (e.g., tablet or smartphone) (exemption not (gov.nl.ca)
indicated); or
- A physical copy of the QR code ) (exemption not
14
v.4 – February 28, 2022
AR04866
indicated); or,
- A Valid Medical Exemption for COVID-19 Vaccination letter.
Yukon Learn about
Temporary vaccine medical deferral issued by Government temporary medical
of Yukon by way of QR Code credential. Credential will deferrals for
show Vaccines Administered: 0. COVID-19 vaccines
| Government of
Yukon
Northwest Territorial (NTHSSA) Medical Letter of Exemption Public Notice -
Territories Medical Vaccine
Exemptions, Travel
and Workplace
Testing | Health and
Social Services
Authority (nthssa.ca)
Nunavut No medical exemption process defined Travel and Isolation |
Government of
Nunavut
NEW!! Note about QR Code Readers:

QR Code readers that indicate an ‘adequately protected’ status message in green (QC), or a
green check mark screen (ON), do not provide sufficient detail to verify that a traveller is fully
vaccinated. Digital vaccination credentials from certain provinces (ON, MB, NL, QC) will not
show medical exemptions. Travellers with medical exemptions must produce the results of a
valid COVID-19 test before travelling.
QR Code readers used for domestic and outbound travel must have the technical ability to
show sufficient information to validate an individual is fully vaccinated, including:
 Full name (family name and given name(s)) of the person who received the vaccine;
 The name of the government / non-government entity who issued the proof document;
 The manufacturer of the vaccine and number of doses (refer to: COVID-19 vaccinated
travellers entering Canada - Travel restrictions in Canada – Travel.gc.ca for information
on the accepted vaccines/regimens).
 The date the traveller received their second dose. This date must be at least 14 full days
prior to their date of travel. For example, if the last dose was administered on Thursday
July 1, then Friday July 16 would be the first day that the traveller would meet the 14-
day condition).
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Foreign Nationals
If a foreign national travelling in Canada requires an exception for medical inability to be
vaccinated, the process will be the same as for Canadian citizens and permanent residents. A
medical note or letter issued by a medical doctor/nurse practitioner in a country other than
Canada shall not be accepted by the railway company for domestic or outbound travel.
Reviewing a Temporary Exception Request due to Medical Inability

Before accepting an exception request due to medical inability, railway companies should
confirm it meets the following criteria:
1 A completed exception request form was submitted to the railway company prior to boarding,
and in accordance with the company’s requirements.
2 First and Last name of the person requesting an exception and civic address provided.
3 Where the form indicates a previous exception request has been rejected, the passenger may
be asked to provide further details to inform the railway company’s review. A company may
accept the exception request, regardless of a previous rejection, provided the exception request
meets the criteria.
4 Sufficient travel details provided as per the railway company’s requirements.
5 A duly completed form must be submitted along with one of the following:
1. Confirmation of the person’s medical inability and signature from a Canadian medical
doctor/nurse practitioner, licensed to practice in a Canadian province or territory, on the
form itself including one or more of the following boxes checked:
 Medical contraindication
 Medical reason for delay of full vaccination
 Medical condition precluding full vaccination (if checked, a brief description must be
included)
2. A medical letter or credential issued by a Canadian Province/Territory indicating a medical

inability to be vaccinated (medical exemption) accompanying the form.
6 The form must include contact details (civic address/phone number) for the medical doctor or
nurse practitioner, as well as their provincial/territorial medical license number.
The form must be signed and dated by the medical doctor or nurse practitioner licensed to
practice in a Canadian province or territory.
7 The form is valid for 1 year following the date of signature by the medical doctor or nurse
practitioner licensed to practice in a Canadian province or territory, or
For conditions which may be temporary in nature, the completed form may be valid until the
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end of the period of the temporary condition as established and identified by the medical
8 Attestation by the requestor signed and dated.
Temporary Exceptions to Travel for Essential Medical Services or Treatment

In order to receive a temporary exception from the mandatory vaccination requirement to
travel for essential medical services or treatment, a person must submit to the railway
company, a duly completed temporary exception form which has been completed and signed
by a medical doctor or nurse practitioner, licensed to practice in a Canadian province or
territory. This form is available through the company and must be completed prior to departure
and in accordance with the company’s exception application process. Temporary exception
requests to travel for essential medical services or treatment must be submitted to the
company 2 weeks* in advance, or in accordance with the timelines established by the company.
Medical doctors or nurse practitioners may indicate that an escort or travel companion is
required to accompany the passenger travelling for an essential medical service or treatment.
The Railway company is not required to verify proof of vaccination for a person that is at least
18 years old and who is boarding the railway equipment for the purpose of accompanying a
person that received a temporary exception to travel for essential medical services or
treatment if the person needs to be accompanied because they: are under the age of 18 years;
have a disability; or need assistance to communicate.
The acceptance provided by the railway company will be valid for the length of the return trip.
A new request is required for new trips.
A railway company is not required to verify proof of vaccination credential for a person
traveling for essential medical services and treatment until 23:59 ET December 14, 2021
provided that:
 the person provides a signed document from a medical doctor or nurse practitioner who
is licensed to practice in Canada that includes the date of the appointment(s) for the
essential medical service or treatment and the location of the appointment(s); and
 the date of the essential medical service or treatment is before December 13, 2021.
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Reviewing a Temporary Exception Request to Travel for Essential Medical Services or

Treatment
Before accepting an exception request to travel for essential medical services or treatment,
railway companies should confirm it meets the following criteria:
2 First and last name of person requesting an exception and civic address is provided.
3 Where the form indicates a previous exception request has been rejected, the person may be
asked to provide further detail to inform the railway company’s review. However, the company
may accept the exception request, regardless of a previous rejection, provided the exception
request meets the criteria.
4 Sufficient travel details provided as per the railway company’s requirements.
5 The person has submitted a duly completed form with confirmation from a Canadian medical
doctor or nurse practitioner, licensed to practice in a Canadian province or territory, that
contains the date and name and civic address of the facility where the essential medical services
or treatment appointment will be.
A brief description must also be included by the Medical Doctor/Nurse Practitioner.
In all cases, a completed exception form must be submitted along with the supporting
documentation.
6 The form must include contact details for the medical doctor or nurse practitioner, as well as
their provincial/territorial medical license number and civic address.
The form must be signed and dated by the medical doctor or nurse practitioner.
7 Completed temporary exception forms for persons due to essential medical care are valid for
the return trip only. New trips will require new forms to be submitted for approval.
Temporary Exceptions due to Sincere Religious Belief

Leaders and members of a number of religions and religious denominations (e.g., Islam, Roman
Catholicism, Judaism, Greek Orthodox, Mennonites, Jehovah’s Witnesses, Christian Science)
have released public statements indicating their support for the COVID-19 vaccine specifically in
the interest of public health. In addition, a number of provincial human right commissions,
including the Ontario Human Right Commission, have taken the position that objection to
vaccination for personal reasons is not a protected ground under their respective Code and
18
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does not need to be accommodated. Nevertheless, an individual may hold a strongly held
religious belief that prevents full vaccination.
For the purpose of domestic or outbound travel, railway companies must consider religious
exceptions to mandatory vaccination based on sincerely held religious belief, in recognition of
the obligations under the Canadian Human Rights Act.
Temporary exceptions due to sincere religious belief shall be considered only for domestic
and outbound travel. This includes domestic trains connecting to inbound international
trains.
To receive a temporary exception from the mandatory vaccination requirement, a person must
submit to the railway a form that includes a sworn, solemn oath of conviction co-signed by a
Commissioner of Oaths. This must be submitted to the company 3 weeks* in advance to
boarding, or in accordance with the timelines established by the company and in accordance
with the railway company’s exception application process. The completed temporary exception
form is valid for the person’s complete journey (i.e., booked return trip). The person required to
reconfirm their religious conviction by submitting a new form for any new trips.
Note: Provinces/Territories do not issue exemptions based on religious beliefs.
Reviewing a Temporary Exception Request Due to a Sincere Religious Belief

Requests to travel with a temporary exception due to a sincere religious belief must be
evaluated on a case-by-case basis.
Before accepting a request for a temporary exception due to a sincere religious belief, railway
companies should confirm it meets the following:
2 First and Last name of person requesting a temporary exception and civic address is provided.
3 If a previous request for a temporary exception has been rejected, the person may be asked to
provide further detail to inform the railway company’s review. However, the company may
approve the temporary exception request, regardless of a previous rejection, provided the
request meets the criteria.
4 Sufficient travel details required by the form and the railway company.
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5 The belief is religious in nature
Religion typically involves a particular and comprehensive system of faith and worship as well
as the belief in a divine, superhuman or controlling power (e.g., “I don’t believe in vaccination”
would not in itself be a reason).
It does not apply to beliefs, convictions or practices that are secular, socially based or only
conscientiously held; nor does it protect false empirical beliefs about the development, the
contents, effects, or purpose of the vaccines.
6 The belief prevents full vaccination
It is not sufficient for the person to state they have a certain religious belief, and they cannot
be vaccinated.
They must explain how vaccination would conflict with their religious belief in a way that is not
trivial or insubstantial (meaning, being vaccinated conflicts with the person’s genuine
connection with the divine).
7 The belief is sincerely held
The requirement is to focus on the sincerity of the individual belief rooted in religion, not
whether it is recognized by other members of the same religion.
The validity of the belief itself must not be challenged by the railway company.
8 The form is signed and dated by a Commissioner of Oaths. The form may be certified by the
Commissioner of Oath’s affixing a stamp/seal and date.
9 Completed temporary exception forms for persons due to religious conviction forms are valid
for the period of the return trip only.
* With respect to #5-#7, there are a number of false empirical beliefs about the development,
the contents, effects, or purpose of the vaccines to protect against COVID-19. However, these
are not grounds on which a temporary exception can be granted. If the sincere belief is not
based on a religious belief, but rather a personal preference or choice based on misinformation
or misunderstandings of scientific information, there is no need to accommodate.
For example, a conviction that the COVID-19 vaccine contains aborted human/animal fetal cells
or that DNA is altered by mRNA vaccines is empirically incorrect and should not be used as a
rationale for the granting of a religious exception, even where this belief is sincerely held
and/or rooted in religion. The following website includes additional information about COVID-
19 myths: COVID-19 mRNA vaccines.
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Section 4 – Other Exceptions

A railway company is not required to verify proof of vaccination credential (PVC) for a person
that qualifies for an exception listed in Section D of the Ministerial Order. The company must
provide for accommodation measures for persons who are issued an exception from providing
a PVC. Further guidance on accommodations can be found in “Section 5: Accommodations” of
this document.
 Remote communities: a railway company is not required to verify PVC for any
person who is a resident in a community which is accessed using the VIA The Pas-Churchill
route or any other remote community for whom VIA Rail Canada Inc. may be the only means of
transportation to or from the community. This also captures communities that are not directly
on The Pas-Churchill route, but that use other railway carriers, that are accessed using the same
line.
 Children: a railway company is not required to verify PVC for any person under the age
of 12 years and four (4) months.
 Foreign Nationals*: a railway company is not required to verify proof of vaccination

credential for a person that is a foreign national, other than a person registered as an Indian
under the Indian Act, who is boarding the railway equipment if the initial scheduled departure
time is not more than 24 hours after the departure time of a flight taken by the person to
Canada from any other country, as confirmed by evidence of the person’s travel itinerary or
boarding pass and passport or other travel document issued by their country of citizenship or
nationality.
*The Ministerial Order defines foreign national as a person who is not a Canadian citizen or a
permanent resident and includes a stateless person.
 Other: a railway company is not required to verify PVC for any for a person that is
boarding the railway equipment for a purpose other than optional or discretionary purposes
such as tourism, recreation or leisure, and who is:
o a person who entered Canada at the invitation of the Minister of Health for the
purpose of assisting in the COVID-19 response;
o a person who is permitted to work in Canada as a provider of emergency services
under paragraph 186(t) of the Immigration and Refugee Protection Regulations and
who entered Canada for the purpose of providing those services;
o a person who entered Canada after August 31, 2021, who has been recognized as a
Convention refugee within the meaning of subsection 146(1) of those Regulations
and who has been issued a permanent resident visa under 139(1) of those
Regulations;
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o a person who has been issued a temporary resident permit within the meaning of
subsection 24(1) of the Immigration and Refugee Protection Act and who entered
Canada after August 31, 2021 as a protected temporary resident under subsection
151.1(2) of those Regulations;
o an accredited person*;
o a person holding a D1, O1 or C1 visa who entered Canada to take up a post and
become an accredited person; or
o a diplomatic or consular courier.
*The ministerial Order defines an accredited person as a foreign national who holds a passport
that contains a valid diplomatic, consular, official or special representative acceptance issued by
the Chief of Protocol for the Department of Foreign Affairs, Trade and Development.
 Domestic National Interest Exemption Program (i.e., persons listed in

Appendix B, C, D or E of the Ministerial Order): Effective November 30th, Transport Canada will
launch a digital platform for its domestic National Interest Exemption Program (NIEP).
Transport Canada will maintain an application and review process for granting authorizations to
individuals in the national interest for domestic and outbound travel.
Under this Program, individuals would only be approved to travel unvaccinated if it is in

Canada’s national interest and/or to support critical infrastructure needs and/or when there is
a compelling situation that merits an exception from the vaccine mandate (https://vaccine-
exemption.tc.canada.ca / https://exemption-vaccination.tc.canada.ca).
Transport Canada will process national interest exception requests and issue authorization on a
case-by-case determination for the domestic portion of the travel journey.
National Interest Exemption applications are reviewed by Transport Canada on an individual,

case-by-case basis through a streamlined and standardize process that reviews cases to ensure
the travel is:
 In Canada’s national interest and/or to support critical infrastructure needs, and/or

 Exceptional urgent/time sensitive
These would only be authorized for the most compelling situations where there is no
vaccinated alternative.
The NIEP review and approval process for domestic and international outbound travel will be
complementary and will not duplicate the systems in place for entry into Canada.
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A high-level summary of information on exceptions for persons can be referenced at: COVID-19
Boarding flights, trains and cruise ships in Canada – Travel restrictions in Canada – Travel.gc.ca
(administered by Health Canada and Treasury Board Secretariat).
Obligations of the Traveller: An unvaccinated person (or group of accredited representatives)

may apply online to Transport Canada’s NIEP at https://vaccine-exemption.tc.canada.ca, or by
sending an application to Transport Canada. The person will submit the domestic NIE form to
Transport Canada, together with other required supporting documentation. All
communications with the person will be done through Canada Post Connect in order to protect
the exchange of sensitive information.
Individuals are encouraged to apply to Transport Canada a minimum of three weeks in advance
of their travel. Transport Canada recognizes that some exceptional cases may be time sensitive
and will address these applications on a case-by-case basis. Individuals are encouraged to
submit their applications earlier during peak holiday travel seasons.
The application will be reviewed by Transport Canada. The person will either be accepted,
denied, or more information will be requested to process the application. If the application is
not accepted, a letter will be issued to the applicant or accredited representatives explaining
the reasons for rejection. If accepted, the person will be issued a signed National Interest
Exemption letter that will provide exception to the individual, the operator(s), and/or CATSA
from certain legislated COVID-19 vaccine requirements in air, rail, and/or marine modes.
Persons approved under the NIEP will be responsible for submitting their TC issued National
Interest Exemption Letter to the railway company in advance of boarding. Persons are required
to carry a hard copy or digital copy of the National Interest Exemption Letter with them during
their travel journey, as they may be required to show a copy of their National Interest
Exemption Letter to the railway company, or any authority requesting it, throughout their
journey, including at the time of check-in or boarding, together with their valid COVID-19
molecular test result or COVID-19 antigen test result.
Further details on the national interest exemption program are provided at

https://travel.gc.ca/travel-covid.
Obligations of the Railway Company: It is the responsibility of the railway company to inform
persons that they must submit a copy of their National Interest Exemption letter to the
company before boarding, as well as show proof of the letter in digital or hard copy form at
check-in and/or boarding.
Railway companies will be responsible for validating the person’s National Interest Exemption
letter, along with their valid COVID-19 molecular test result or COVID-19 antigen test result (if
applicable), before the person is issued a boarding pass, a ticket, and/or permitted to board.
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The Transport Canada-issued National Interest Exemption letter to be verified by the railway
company, will have the following distinguishing features:
- Transport Canada letterhead / logo in the upper left corner of the letter
- Canada wordmark located at the bottom righthand side
- An exemption number that begins with NIE-YYYY-XXXX
- Name and date of birth of the passenger
- Travel information (railway company name, train number, departure/arrival station
codes)
- Period of validity for the letter
- Signed and dated by the Directors General at Transport Canada responsible Rail Safety
or COVID Recovery Team.
Transport Canada Support: Transport Canada’s National Interest Exemption Program will
operate from 7am to 7pm (Eastern Time), 7 days a week. After-hours support will also be
provided to railway companies.
Railway companies can validate if the person was granted a National Interest Exemption letter
by calling the Transport Canada Situation Centre, as required.
Transport Canada will support railway companies who encounter issues with a NIE Letters (e.g.
determining the validity of the authorization presented by a person) with 24/7 support through
TC’s existing TC Emergency Situation Centre.
Contact information:
NIE Program officials can be contacted by email at: NationalInterestExemption-
ExemptionInteretNational@tc.gc.ca
Section 5 – Accommodations
A railway company must ensure that a person who has been issued an exception from
providing a proof of vaccination credential (PVC), unless a person under the age of 12 years and
four (4) months or is a person captured under the exception for Foreign Nationals, provides to
the company a valid proof of a COVID -19 molecular test result or COVID-19 antigen test result.
A railway company must have in place any other accommodation measures as set out in local
public health guidance for persons who are issued an exception, including for any person under
the age of 12 years and four (4) months and any person captured under the exception for
Foreign Nationals.
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A proof of a Covid-19 molecular test result confirms that the person has received successful
results of a COVID-19 molecular test. An acceptable proof of a molecular test includes both a
paper and digital copy and must:
1. include:
test;
b. the name and civic address of the accredited laboratory or the testing provider
that performed or observed the test and verified the test result;
d. the test result.
2. in the case where the test result is negative, it must be for a COVID-19 molecular test
that was performed on a specimen collected no more than 72 hours before scheduled
departure time.
3. in the case where the test result is positive, it must be for a COVID-19 molecular test
that was performed on a specimen collected at least 10 days and no more than 180 days
before the scheduled departure time.
The Ministerial Order defines a COVID-19 molecular test as a COVID-19 screening or diagnostic
test, including a test performed using the method of polymerase chain reaction (PCR) or
reverse transcription loop-mediated isothermal amplification (RT-LAMP) that is:
a. if the test is self-administered, observed and the result is verified
i. in person by any accredited laboratory or testing provider, or
ii. in real time by remote audio-visual means by the accredited laboratory or testing
provider who provided the test; or
b. if the test is not self-administered, performed by an accredited laboratory or testing
provider.
For a list of tests that are considered molecular tests, please consult the “Accepted Types of
Tests” section that can be found on the following webpage: https://travel.gc.ca/travel-
covid/travel-restrictions/flying/covid-19-testing-travellers-coming-into-canada
A proof of a Covid-19 antigen test result confirms that the person has received successful
results of a COVID-19 antigen test. An acceptable proof of a antigen test includes both a paper
and digital copy and must:
1. include:
test;
b. the name and civic address of the accredited laboratory or the testing provider
that performed or observed the test and verified the test result;
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d. the test result.
2. be a negative test result for a test that was performed on a specimen collected no more
than one day before the initial scheduled departure time.
For a list of tests that are considered antigen tests, please consult the “Accepted Types of
Tests” section that can be found on the following webpage: https://travel.gc.ca/travel-
covid/travel-restrictions/flying/covid-19-testing-travellers-coming-into-canada
The Ministerial Order defines a COVID-19 antigen test as a COVID-19 screening or diagnostic
immunoassay that:
a. detects the presence of a viral antigen indicating the presence of COVID-19; and
b. is authorized for sale or distribution in Canada or in jurisdiction in which it was obtained.
A testing provider is either:

a. a person who may provide COVID-19 screening or diagnostic testing services under the
laws of the jurisdiction where the service is provided; or
b. an organization, such as a telehealth service provider or pharmacy, which may provide
COVID-19 screening or diagnostic testing services under the laws of the jurisdiction
where the service is provided and that employs or contracts with a person referred to in
paragraph (a).
Section 6 - Privacy Requirements

Railway companies must ensure that personal information is only created, collected, retained,
used, disclosed, and disposed of in a manner that respects the provisions set out in applicable
Canadian privacy legislation and other applicable legislation. As such, railway companies must
ensure that privacy is considered at the earliest opportunity and that they implement best
privacy practices in order to properly protect the personal information that will be processed.
Please note that the privacy tips below are provided solely as general privacy considerations
and do not constitute legal advice. For specific advice on compliance with applicable privacy
laws, please contact your legal counsel, privacy professional and/or consult with the applicable
Privacy Commissioners’ Office.
• Document a defined purpose and authority for the collection and use of this personal
information.
• Be transparent with passengers and inform them about the reasons for collection, use,
disclosure (including but not limited to the disclosure to Transport Canada), retention
and disposal of their personal information and the consequences for not providing the
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requested personal information, through a concise, transparent, intelligible and easily

accessible Privacy Notice Statement (“PNS”), as required under applicable Canadian
privacy legislation.
 Passengers should also be informed and provided with a contact to request
access to, and correction of, any personal information available or to make an
inquiry or complaint about the handling of their personal information, including
the contact for the Privacy Commissioner of the relevant jurisdiction and
accountable individual who can respond to questions and concerns regarding the
vaccine requirements.
 Provide a link to your vaccination policies for passengers, as applicable.
• The necessity, effectiveness, proportionality and data minimization principles should be
applied so that the least amount of personal information is collected, used or disclosed,
for example: unnecessary data fields within a form.
• Passenger data related to vaccination status is only used for the purposes it was
collected for, retained for a specific period of time and can only be accessed on a need-
to-know basis.
• All railway companies personnel handling personal information, including managers, are
aware of their responsibilities and adhere to applicable Canadian privacy legislation and
other applicable legislation.
• Consider conducting a Privacy Impact Assessment or other meaningful privacy analyses.
• Privacy breach plans and procedures are up to date.
• Personal information is appropriately protected against unauthorized access and that
technical, physical and administrative safeguards are put in place and are appropriate
given the sensitivity of the personal information to be collected, used or disclosed
through the requirement.
Relevant Links:
 Joint Statement issued by the Privacy Commissioner of Canada and his Provincial and
Territorial counterparts in May 2021 on Privacy and COVID-19 Vaccine Passports (The
Statement).
 Provincial and territorial privacy laws and oversight: List of the provincial and territorial
privacy laws as well as the privacy commissioner offices responsible for their
enforcement issued by the Privacy Commissioner of Canada.
Section 7 - Data Collection and Reporting Requirements

Data Collection
The company is required to collect data on a weekly basis and retain it for a minimum of 12
months, related to:
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 passenger volumes;
 the number of exception request received for each category of exception for which a
form is required;
 the number of exceptions accepted for each category of exception for which a form is
required;
 the number of persons denied boarding due to a person failing to provide acceptable
proof of vaccination credential;
 the number of persons denied boarding due to requests not being accepted; and
 In relation to COVID-19 molecular test results or COVID-19 antigen test results obtained
for persons falling under the exception described in section D(5) of the Ministerial
Order:
o number of acceptable proof of a COVID-19 molecular test result and of a COVID-
19 antigen test result; and
o number of test results that were not acceptable.
The railway company is further required to retain, for a minimum of 12 months, forms
submitted for the purpose of requesting an exception as outlined in section 3 of this document.
The information listed above must be collected in a manner that is consistent with privacy
requirements. This includes only collecting the information that is necessary to comply with the
requirements of the Ministerial Order. Further guidance on privacy can be found in “Section 6 –
Privacy Requirements” of this document.
Reporting
The company must report to the Minister, on a weekly basis or at the request of the Minister,
data captured under the Data Collection section above as well as any suspicious patterns
detected or documents that may have been false or included false information.
The company must report their data to the Minister in a .CSV file format to the Rail Safety
Directorate at railsafety@tc.gc.ca
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hi Transport
Canada
Transports
Canada
DOCUMENT D’ORIENTATION À L’INTENTION DES

COMPAGNIES DE CHEMIN DE FER
Sécurité ferroviaire – Vaccination obligatoire

des voyageurs
Le présent document d’orientation vise à fournir des recommandations et des directives concernant
l’application de l’arrêté ministériel 21-09.2 de Transports Canada.
Mise en garde importante : Aucune information contenue dans le présent

document d’orientation n’a préséance sur toute exigence ou obligation décrite
dans l’arrêté ministériel de Transports Canada. Il vise plutôt à compléter ce
dernier et à fournir des recommandations et des directives sur la façon
d’interpréter et de respecter les exigences.
/n
Canada
v.4 – 28 février 2022 li+i
AR04881
Table des matières

Section 1 – Généralités ................................................................................................................... 4
But ............................................................................................................................................... 4
Annonce du gouvernement fédéral concernant la vaccination obligatoire ............................... 4
Section 2 – Application opérationnelle........................................................................................... 4
Vérification du certificat de preuve de vaccination .................................................................... 4
Vérification du certificat de preuve de vaccination par la compagnie de chemin de fer ...... 5
Un certificat de preuve de vaccination (CPV) admissible ....................................................... 5
Considérations............................................................................................................................. 7
 Vérification de la preuve de vaccination après l’embarquement ................................... 7

Fausse déclaration....................................................................................................................... 7
Interdictions ................................................................................................................................ 7
Section 3 – Exceptions Médical et Religieuses ............................................................................... 8
Émission d'Exceptions : ............................................................................................................... 8
Procédure opérationnelle : ......................................................................................................... 9
Révision et acceptation d'une demande d'exception temporaire ........................................... 10
Rejeter une demande d'exception temporaire ........................................................................ 11
Exception temporaire pour les passagers en raison d’une contre-indication pour raison
médicale .................................................................................................................................... 11
Preuve de contre-indication pour raison médicale .............................................................. 12
Exemptions provinciales ou territoriales pour raison médicale ........................................... 13
Concernant les ressortissants étrangers............................................................................... 17
Examen d’une demande d’exception temporaire médicale ................................................ 17
Exception temporaire pour services médicaux ou traitements essentiels ............................... 18
Examen d’une demande d’exception temporaire pour services médicaux ou traitements
essentiels............................................................................................................................... 19
Exception temporaire pour les passagers en raison de croyances religieuses sincères........... 20
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AR04882
Examen d’une demande d’exception temporaire en raison d’une croyance religieuse

sincère ................................................................................................................................... 21
Section 4 – Autres exceptions....................................................................................................... 22
 Communautés éloignées ................................................................................................... 22
 Enfants ............................................................................................................................... 23
 Étrangers* .......................................................................................................................... 23
 Autres ................................................................................................................................. 23
 Programme d’exemption de l’intérêt national .................................................................. 24

Section 5 – Accommodations ....................................................................................................... 26
Section 6 - Considérations relatives à la protection des renseignements personnels................. 28
Section 7 - Exigences en matière de collecte de données et déclarations................................... 30
Collecte de données .................................................................................................................. 30
Déclarations............................................................................................................................... 31
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AR04883
Section 1 – Généralités
But
Le présent document d’orientation vise non seulement à résumer les exigences auxquelles les
compagnies de chemin de fer sont assujetties, mais également à fournir à ces dernières des
conseils et des directives quant au respect des exigences énoncées dans l’arrêté
ministériel 21-09.2.
Ce document vient compléter les autres documents d’orientation qui ont été rédigés pour aller
de pair avec les mesures en réponse à la COVID-19. Pour consulter ces documents en question,
veuillez suivre le lien ci-après : Mesures, mises à jour et lignes directrices pour le transport
ferroviaire liées à la COVID-19 émises par Transports Canada.
Annonce du gouvernement fédéral concernant la vaccination obligatoire

La pandémie a eu un effet dévastateur sur le secteur des transports au Canada. Bien que les
mesures de santé publique, notamment la distanciation physique et le port du masque, se
soient avérées essentielles pour prévenir la propagation du virus, la COVID-19 et ses variants
posent toujours un risque important pour la santé publique des Canadiens. Voilà pourquoi des
mesures supplémentaires doivent être prises pour veiller à la sécurité et la sûreté du réseau de
transport du Canada et faciliter la reprise des déplacements ferroviaires sécuritaires. La
vaccination obligatoire des voyageurs et des employés des secteurs du transport aérien,
ferroviaire et maritime de compétence fédérale permet d’accroître la sécurité du réseau de
transport du pays et de redonner confiance aux Canadiens afin qu’ils reprennent leurs voyages,
tout en respectant les mesures de santé publique.
Section 2 – Application opérationnelle

Vérification du certificat de preuve de vaccination
À compter du 30 novembre 2021 à 03:01, heure de l’Est (HE), il sera interdit à toute compagnie
de chemin de fer d’exploiter du matériel roulant sur un chemin de fer à moins qu’elle n’ait
vérifié le certificat de preuve de vaccination (CPV) de chaque personne, qui n’est pas un
employé de la compagnie ou qui n’est pas capturé dans la liste d’exceptions, qui monte à bord
du train.
La compagnie peut procéder à la vérification lorsque les opérations le permettent*.
Par exemple :
 à l’achat du billet;
 à l’enregistrement préalable (en ligne) ou à l’enregistrement sur les lieux (borne ou
comptoir); ou
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 à l’embarquement.
*Il est préférable que la compagnie informe les voyageurs de ces exigences avant qu’ils
achètent leur billet.
Vérification du certificat de preuve de vaccination par la compagnie de chemin

de fer
Un certificat de preuve de vaccination (CPV) admissible sert à confirmer que la personne est
entièrement vaccinée, depuis au moins 14 jours avant de monter à bord du train, en
complétant un protocole vaccinal complet contre la COVID-19. Le CPV est offert en trois
formats : la copie papier, la copie numérique ou le reçu d’ArriveCAN. Même si tous ces formats
sont acceptés, les compagnies de chemin de fer devraient encourager et favoriser l’utilisation
des formats numériques, à mesure qu’ils deviennent disponibles.
1. Format numérique :
La carte santé SMART du Canada est une version papier ou numérique des renseignements
cliniques, dont les antécédents de vaccination, d’une personne. Le gouvernement du
Canada a collaboré avec les autorités sanitaires provinciales à l’élaboration d’une approche
pancanadienne en matière de vérification des preuves de vaccination.
Il est fortement recommandé d’utiliser le format numérique au moment d’acheter le billet

puisqu’il :
 est un dossier de santé sûr et vérifiable signé par voie électronique par une autorité
digne de confiance (par exemple, la province ou le territoire de délivrance);
 a recours à une technologie qui permet aux autorités de vérifier et d’authentifier les
renseignements sans leur donner accès à d’autres renseignements personnels ou sur
la santé;
 prévient les contrefaçons et les altérations en détectant toute modification apportée
au document après sa délivrance; et
 permet au détenteur de conserver une copie numérique sur un dispositif portable,
comme un cellulaire ou une tablette, d’imprimer directement une copie ou de
présenter une demande à son gouvernement provincial ou territorial, le cas
échéant.
Pour obtenir de plus amples renseignements sur la carte santé SMART, veuillez consulter le
lien ci-après : https://www.canada.ca/fr/immigration-refugies-
citoyennete/services/preuve-canadienne-vaccination-covid-19.html.
2. Copie papier :
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AR04885
La copie papier est la preuve de vaccination contre la COVID-19 qui est délivrée par le
gouvernement ou l’entité non gouvernementale qui a compétence dans la province ou le
territoire où le vaccin a été administré. Elle doit préciser les renseignements suivants :
1. les prénom et nom de la personne qui a reçu le vaccin;
2. le nom du gouvernement ou le nom de l’entité non gouvernementale;
3. la marque nominative ou tout autre renseignement permettant d’identifier le vaccin
qui a été administré; et
4. les dates auxquelles le vaccin a été administré ou, dans le cas où la preuve est un
document unique qui est délivré pour deux doses et qui ne spécifie que la date à
laquelle la dernière dose a été administrée, la date qui figure sur ce document.
3. Reçu ArriveCAN et le statut vaccinal (exigence concernant les voyageurs en

provenance de l’extérieur du Canada)
Les personnes qui voyagent au Canada doivent utiliser ArriveCAN pour transmettre leurs
renseignements de voyage obligatoires avant et après leur entrée au Canada. Une fois
qu’elles ont transmis leurs renseignements au moyen d’ArriveCAN, le reçu qui est affiché à
l’écran leur est envoyé par courriel.
Pour obtenir de plus amples renseignements sur ArriveCAN, veuillez consulter le lien
ci-après : https://www.canada.ca/fr/sante-publique/services/maladies/maladie-
coronavirus-covid-19/arrivecan.html.
« entièrement vaccinée » s’entend d’une personne qui a suivi un protocole vaccinal complet
contre la COVID-19, si :
1. dans le cas d’un protocole vaccinal précisant un vaccin contre la COVID-19 qui est
autorisé pour la vente au Canada :
a. soit le vaccin a été administré à la personne conformément à son étiquetage, ou
b. soit le ministre de la Santé, sur recommandation de l’administrateur en chef de la
santé publique nommé en vertu du paragraphe 6(1) de la Loi sur l’Agence de la santé
publique du Canada, conclut que le protocole vaccinal est approprié compte tenu
des preuves scientifiques relatives à son efficacité pour prévenir l’introduction et la
propagation de la COVID-19 ou de tout autre facteur pertinent à cet égard;
2. dans tout autre cas :

a. d’une part, les vaccins du protocole vaccinal sont autorisés pour la vente soit au
Canada, soit dans un pays étranger; et
b. d’autre part, le ministre de la Santé, sur recommandation de l’administrateur en

chef de la santé publique nommé en vertu du paragraphe 6(1) de la Loi sur l’Agence
de la santé publique du Canada, conclut que ces vaccins et le protocole vaccinal sont
appropriés compte tenu des preuves scientifiques relatives à leur efficacité pour
v.4 – 28 février 2022

AR04886
prévenir l’introduction et la propagation de la COVID-19 ou de tout autre facteur

pertinent à cet égard.
Pour obtenir de plus amples renseignements sur les vaccins contre la COVID-19, veuillez
consulter le lien suivant : https://www.canada.ca/fr/sante-
publique/services/maladies/maladie-coronavirus-covid-19/vaccins.html
Considérations
 Vérification de la preuve de vaccination après l’embarquement : La preuve de vaccination

peut être vérifiée après l’embarquement dans des cas très limités, tel que dans un endroit
rural ou éloigné, où la vérification des billets des voyageurs est effectuée une fois
l’embarquement terminé et une fois que le train a pris sa route. Si un voyageur n’est pas en
mesure de fournir un CPV il devra descendre du train à l’arrêt suivant.
 Attestation que la personne possède un CPV : Les compagnies de chemin de fer peuvent
également décider d’employer une attestation qui indique qu’une personne possède un
CPV afin d’effectuer un contrôle préalable des voyageurs. Par exemple, un voyageur
pourrait devoir attester qu’il possède un CPV au moment d’acheter son billet ou lors de son
enregistrement en ligne. Toutefois, les compagnies seraient tout de même tenues de
vérifier les CPV avant l’embarquement.
Fausse déclaration
La compagnie doit aviser chaque personne qu’une fausse déclaration, après avoir prêté
serment ou fait une affirmation solennelle, dans un affidavit, une déclaration solennelle, un
témoignage écrit ou verbal, en sachant que la déclaration est fausse, constitue une infraction à
l’article 131 du Code criminel. De plus, la compagnie doit aviser que créer un faux document, en
le sachant faux, enfreint l’article 366 du Code criminel.
Pour aider les compagnies, Transports Canada a élaboré des affiches qui peuvent être utilisées
pour aviser les passagers.
Interdictions
Il est interdit à la compagnie de permettre l’embarquement d’une personne, qui n’est pas un
employé et qui ne relève pas d’une exception, qui omet de fournir un CPV.
La compagnie doit exiger le débarquement à l’arrêt suivant, à toute personne, qui n’est pas un
employé et qui ne relève pas d’une exception, qui omet de fournir un CPV acceptable lorsque la
vérification est effectuée alors que le train est déjà en mouvement.
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AR04887
Il est interdit à la compagnie de permettre l’embarquement à toute personne qui ne fournit pas
un formulaire dûment rempli conformément aux délais fixés par la compagnie ferroviaire pour
se prévaloir d’une exception.
Force majeure : une compagnie de chemin de fer peut exploiter du matériel ferroviaire sur un
chemin de fer sans vérifier les certificats de preuve de vaccination des personnes embarquant à
bord du matériel ferroviaire dans des situations de force majeure, y compris les voyages
urgents ou d'urgence liés aux évacuations causés par des catastrophes naturelles (p. ex.
incendie de forêt et inondations), mais uniquement si la compagnie de chemin de fer fournit un
avis au ministre dans les 2 heures suivant l'embarquement. Dans ces cas, un résultat d’un essai
relatif à la COVID-19 ne sera pas requis.
Section 3 – Exceptions Médical et Religieuses

L'arrêté ministériel oblige les compagnies de chemin de fer à prévoir des exceptions à l'exigence
d'être entièrement vaccinées dans des circonstances très limitées ; si la personne n'a pas
terminé un régime de vaccination COVID-19 en raison d'une incapacité médicale, en raison des
convictions religieuses sincères ou si la personne est requise de voyager pour recevoir des
services ou des traitements médicaux essentiels
La compagnie de chemin de fer doit utiliser les formulaires spécifiés par Transports Canada
lorsqu'une exception est appliquée pour une incapacité médicale ou pour motif religieux, ou
pour voyager afin de recevoir des services et traitements médicaux essentiels.
Une compagnie de chemin de fer doit prévoir des mesures d'accommodation pour les
personnes qui reçoivent une exception à la fourniture d'un certificat de preuve de vaccination.
Des conseils supplémentaires sur les accommodations peuvent être trouvés dans la « Section 5
: Accommodations » de ce document.
Émission d'Exceptions :
Les compagnies ferroviaires ont la responsabilité de s'assurer que les formulaires soumis par
une personne demandant une exception ont été dûment remplis et sont accompagnés des
pièces justificatives appropriées (si nécessaire). Les compagnies détermineront si la demande
de la personne a été correctement soumise pour des exceptions en raison d'une incapacité
médicale à se faire vacciner, de services ou de traitements médicaux essentiels, ou de croyance
religieuse sincère, sur la base des directives détaillées de TC (en utilisant ce document comme
point de départ).
Une période de transition couvrant la période entre le 30 novembre 2021 et le 14 décembre

2021 à 23 h 59 HE permettra aux compagnies de chemin de fer d’accorder une exception de
l’exigence d’être entièrement vaccinée pour une personne qui n’a pas complété un protocole
v.4 – 28 février 2022
AR04888
vaccinal complet contre la COVID-19 dû à une contre-indication ou voyageant pour recevoir des
services ou des traitements médicaux essentiels. Dans ces cas, la compagnie de chemin de fer
devra s’assurer que:
1. Dans le cas d’une personne demandant une exception afin de voyager pour recevoir des
services ou des traitements médicaux essentiels et pour une personne qui l’accompagne
si elle satisfait aux exigences (le cas échéant) :
a. la personne fournisse un document signé d’un médecin ou d’une infirmière
praticienne canadiens, lequel inclut la date ainsi que le lieu des services ou des
traitements médicaux essentiels; et
b. la date des services ou des traitements médicaux essentiels est avant le 13
décembre 2021.
2. Dans le cas d’une personne demandant une exception dû à une contre-indication
médicale :
a. la personne fournisse un document signé par un médecin ou une infirmière
praticienne canadiens, lequel confirme la contre-indication médicale.
Procédure opérationnelle :
Les compagnies de chemin de fer sont tenues d'élaborer des directives et des procédures
opérationnelles sur la manière dont elles recevront, évalueront et accepteront les demandes
d'exceptions temporaires, ainsi que sur la manière dont elles confirmeront et communiqueront
l'accordement de l'exception temporaire à la personne soumettant la demande, et traiteront
les demandes rejetées. Les directives et procédures opérationnelles des compagnies de chemin
de fer devraient être fondées sur des orientations publiques. Voire ci-dessous les détails sur les
critères de sélection.
Les compagnies de chemin de fer devraient s’assurer que les formulaires soient reçus :
 21 jours avant la date initialement prévue du départ pour des demandes basées sur une
contre-indication médicale ou pour des motifs religieux; et
 14 jours avant la date initialement prévue du départ pour des demandes pour des
voyages afin de recevoir des services ou des traitements médicaux essentiels.
Afin d’offrir à la compagnie de chemin de fer la souplesse nécessaire pour traiter des cas
spécifiques, la compagnie de chemin de fer peut accepter une demande d’exception
temporaire dûment remplie après cette échéance dans les cas où des circonstances
exceptionnelles sont réclamées par le demandeur, et tant que cela est réalisable sur le plan
opérationnel.
Il est également de la responsabilité des compagnies ferroviaires de communiquer aux
passagers les détails du processus de demande et d'acceptation d'exception temporaire, y
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AR04889
compris le fait qu'ils doivent soumettre leurs demandes d'exception temporaire avant
l'embarquement et dans les délais indiqués par la compagnie.
Les personnes dont les demandes ont été acceptées sont tenues de porter avec elles le
formulaire d'exception dûment rempli et la preuve de l'acceptation de la compagnie pendant
leur voyage. Les compagnies de chemin de fer peuvent vérifier la preuve d'une exception
temporaire et les résultats d’un essai moléculaire relatif à la COVID-19 ou d’un essai
antigénique relatif à la COVID-19 à tout moment pendant le voyage (par exemple ; lors de
l’enregistrement, embarquement, pendant le voyage, etc.).
Les exceptions temporaires en raison d'une incapacité médicale, d'une croyance religieuse
sincère ou pour voyager pour des services et traitements médicaux essentiels sont spécifiques à
la compagnie. En autres mots, une exception temporaire par une compagnie ferroviaire ne
permet pas automatiquement au passager de se connecter avec une autre compagnie ou de
changer de mode (par exemple, du train à l'avion). Ces exceptions sont considérées comme
« temporaires », car le formulaire d'exception et l'acceptation d'exception administrée par la
compagnie sont limités dans le temps.
Un résumé de l'information sur les exceptions pour les passagers se trouvera sur cette page
Web : COVID-19 Monter à bord d’avions et de trains au Canada – Restrictions de voyage au
Canada – Voyage.gc.ca (administré par Santé Canada et le Secrétariat du Conseil du Trésor).
Les passagers bénéficiant d'exceptions temporaires en raison d'une incapacité médicale, de

services ou de traitements médicaux essentiels ou d'une croyance religieuse sincère auront
besoin d'un résultat d’un essai moléculaire relatif à la COVID-19 ou d’un essai antigénique
relatif à la COVID-19 valide avant l'embarquement. Voire « Section 5 – Accommodations » de
ce document pour plus d'informations.
Révision et acceptation d'une demande d'exception temporaire

Les compagnies ferroviaires doivent aviser la personne que la demande d'exception est
acceptée et lui fournir une confirmation d'acceptation qui peut être présentée à
l'enregistrement, à l'embarquement ou pendant que le train est en route. La compagnie doit
fournir une confirmation d'acceptation au passager avant l’embarquement.
Les exceptions temporaires ne sont valides qu'avec la compagnie ferroviaire qui a confirmée
l’exception et pour la durée du voyage incluant le retour.
Le passager devra présenter une preuve d'exception à toute autorité qui en fera la demande
tout au long du voyage, y compris au moment de l'enregistrement ou de l'embarquement, ainsi
que le résultat valide de l’essai moléculaire relatif à la COVID-19 ou de l’essai antigénique relatif
à la COVID-19. Voire la « Section 5 – Accommodations » de ce document pour plus
v.4 – 28 février 2022

AR04890
d'informations sur les essais moléculaires relatifs à la COVID-19 et les essais antigéniques
relatifs à la COVID-19.
Rejeter une demande d'exception temporaire

La compagnie de chemin de fer informera le demandeur en conséquence si une demande
d'exception est rejetée. La compagnie doit émettre les rejets au passager avant
l'enregistrement/l'embarquement.
Les passagers sans demande d'exception confirmée ne doivent pas recevoir de carte
d'embarquement et ne doivent pas être autorisés à embarquer. Les passagers peuvent refaire
une demande d'exception dans le délai requis par la compagnie de chemin de fer avant la date
d'embarquement prévue uniquement s'ils fournissent des informations supplémentaires.
Exception temporaire pour les passagers en raison d’une contre-indication pour

raison médicale
Selon la recommandation du Comité consultatif national de l’immunisation du 22 octobre 2021,
les raisons médicaux pouvant exempter temporairement un passager sont les suivantes (elles
figurent également dans le formulaire) :
1. Contre-indications pour raison médicale autorisées pour l’exemption de vaccination
complète contre la COVID-19 au moyen d’un vaccin à ARN messager (ARNm) :
a. Anaphylaxie après l’administration d’un vaccin à ARNm contre la COVID-19 (sachant

que malgré leur grave réaction allergique immédiatement après une première dose
d’un tel vaccin, la plupart des personnes à risque peuvent recevoir en toute sécurité
d’autres doses du même vaccin ou d’un autre vaccin du même type sous réserve
d’une consultation avec un allergologue ou un médecin);
b. Allergie confirmée au polyéthylèneglycol (PEG) présent dans les vaccins contre la

COVID-19 de Pfizer-BioNTech et de Moderna (soulignons qu’une personne allergique
à la trométhamine présente dans le vaccin de Moderna peut recevoir celui de Pfizer-
BioNTech).
2. Raisons médicales justifiant le report de la vaccination complète contre la COVID-19 :
a. Myocardite ou péricardite après la première dose d’un vaccin à ARNm;
b. État immunodéprimé ou prise d’immunosuppresseurs justifiant le report de

la vaccination à un moment où la réponse immunitaire de la personne
touchée pourra être maximisée (c.-à-d. attendre que l’état immunodéprimé
v.4 – 28 février 2022

AR04891
s’améliore ou que la prise d’immunosuppresseur soit allégée avant

l’administration du vaccin).
3. Une condition médicale empêchant la vaccination complète contre la COVID-19 (non

couverte ci-dessus), décrite brièvement par le médecin ou l’infirmière praticienne.
Preuve de contre-indication pour raison médicale

Pour avoir droit à une exception temporaire de vaccination obligatoire, les passagers devront
présenter à la compagnie de chemin de fer le formulaire d’exception de vaccination pour raison
médicale dûment rempli et signé par un médecin ou une infirmière praticienne autorisé à
exercer dans une province ou un territoire canadien. Ce formulaire est accessible auprès de la
compagnie et doit être rempli avant le départ, conformément au processus d’acceptation de
l’exception de la compagnie de chemin de fer. Ce type de demandes d’exception doit être
soumis à la compagnie de chemin de fer trois semaines à l’avance*, ou selon l’échéancier
établi par la compagnie.
*Une compagnie de chemin de fer peut accepter une demande d’exception temporaire dûment
remplie après cette échéance dans les cas où des circonstances exceptionnelles sont réclamées
par le demandeur, et tant que cela est réalisable sur le plan opérationnel.
De plus, jusqu’au 14 décembre 2021 à 23h59 (heure de l’Est), une compagnie de chemin de fer
n’est pas tenue de vérifier le certificat de preuve de vaccination de toute personne avec une
contre-indication médicale embarquant à bord du matériel ferroviaire, à condition que la
personne fournisse un document signé par un médecin ou une infirmière praticienne
canadiens, lequel confirme la contre-indication médicale.
Qui est considéré comme un médecin ou une infirmière praticienne aux fins du mandat de
vaccination obligatoire?
Médecins (provinciaux ou territoriaux) ou Médecins ou infirmières praticiennes non

infirmières praticiennes autorisés : autorisés :
 Médecin de famille  Paramédicaux ou fournisseurs de soins

médicaux non traditionnels (p. ex.,
 Infirmière praticien ne
chiropraticiens, podiatres,
 Allergologue optométristes, naturopathes)
 Immunologiste  Infirmière autorisée, infirmière
v.4 – 28 février 2022

AR04892
 Cardiologue auxiliaire autorisée
 Rhumatologue  Adjoint au médecin
 Oncologue  Dentiste ou hygiéniste dentaire
 Psychologue
Exemptions provinciales ou territoriales pour raison médicale

Une exemption pour raison médicale délivrée par une province ou un territoire canadien peut
également être acceptée. Dans les provinces ou les territoires délivrant une lettre médicale ou
un avis justifiant une contre-indication à la vaccination, le passager doit tout de même
présenter une demande à la compagnie, accompagnée d’un formulaire d’exception pour raison
médicale. La lettre ou l’avis délivré par la province ou le territoire peut toutefois être fourni en
remplacement de la signature du médecin ou de l’infirmière praticienne sur le formulaire
d’exception.
Pour vérifier l’authenticité de l’exemption provinciale ou territoriale, les compagnies de chemin
de fer doivent consulter la liste ci-dessous. Pour obtenir les renseignements les plus à jour sur
les exemptions provinciales ou territoriales, veuillez consulter la page Web de la province ou du
territoire en question.
En date du 7 janvier 2022 :
Juridiction Documentation
Direction du voyageur
provinciale/territoriale
Î.-P.-É., T.N.-O. Lettre médicale émise par la province - Remplir le formulaire d'exception de
ou le territoire à la suite d'un la compagnie de chemin de fer (sauf
processus d'examen. la section F) et joindre la lettre
médicale délivrée par la province ou
le territoire au lieu de remplir la
section F par un médecin ou une
infirmière praticienne.
- Essai COVID requis pour les voyages
Man., Qc, . Carte d’immunisation numérique - Remplir le formulaire d'exception de
ou physique provinciale la compagnie de chemin de fer (sauf
T.-N.-L., Ont., Yn la section F) et joindre le certificat
(exemption non mentionnée sur
la carte d’immunisation médical délivré par la province ou le
physique ou le code QR territoire au lieu de faire remplir la
numérique) section F par un médecin ou une
infirmière praticienne.
v.4 – 28 février 2022

AR04893
Juridiction Documentation
Direction du voyageur
provinciale/territoriale
Alb., Ont., N.-É., Lettre remplie par un médecin ou un - Remplir le formulaire d'exception de
N.-B., T.-N.-L. infirmier praticien autorisé à exercer la compagnie de chemin de fer (sauf
dans la province ou le territoire. la section F) et joindre la lettre
d'exemption médicale remplie au
lieu de remplir la section F par un
médecin ou une infirmière
praticienne.
C.-B., Nu, Yk, Sk S.O. - Les administrations ne - Formulaire d’exception de la
délivrent pas de lettres d'exemption compagnie de chemin de fer
médicale ni de titres de dûment rempli, y compris la section
compétences, et ne fournissent pas F, par un médecin ou une infirmière
de modèles pour les médecins. Les praticienne.
exemptions médicales ne sont pas - Essai COVID requis pour voyager
reconnues dans la province.
Types de documents délivrés ou acceptés par chaque province ou territoire aux personnes
médicalement incapables d’être vaccinées contre la COVID-19 :
Province ou
Document d’exemption Page Web de la province
territoire
Colombie- Il n'y a pas d'exemption médicale pour les Preuve de vaccination et la carte
Britannique vaccins COVID-19 reconnue par la province. de vaccination de la C.-B. -
Province de la Colombie-
Britannique (gov.bc.ca)
Considérations relatives aux

vaccins (bccdc.ca) (en anglais
seulement)
Alberta Une exemption médicale valide est la lettre Actions de santé publique liées à
originale signée d'un médecin ou d'une la COVID-19 | Alberta.ca (en
infirmière praticienne qui comprend : anglais seulement)
- Date à laquelle la lettre a été délivrée.

- Le nom de la personne qui correspond à son
identification.
- Les informations complètes du médecin ou
de l'infirmière praticienne, y compris :
 nom, numéro de téléphone,
v.4 – 28 février 2022
AR04894
Province ou
territoire
coordonnées, numéro d'inscription au

registre professionnel et signature.
 une déclaration indiquant qu'il existe
une raison médicale de ne pas être
complètement vacciné contre le COVID-
19
 la durée de validité de l'exemption
Saskatchewan L'immunisation n'étant pas obligatoire, Gouvernement de la
l'exemption n'est pas requise. Saskatchewan / Preuve de
vaccination par le COVID /
Soumission d'affidavit
Manitoba Carte d'immunisation numérique ou physique Province du Manitoba | Critères

provinciale avec exemption (exemption non d’admissibilité actuels
mentionnée sur la carte d’immunisation (gov.mb.ca)
numérique ou physique)
Ontario Certificat de vaccination amélioré comportant Exemptions médicales à

un code QR officiel (exemption non mentionnée l’immunisation contre la COVID-
sur le certificat numérique) 19 (gov.on.ca)
Québec Passeport numérique provincial avec exemption Statut de protection contre la

(exemption non mentionnée dans le passeport COVID-19 | Gouvernement du
numérique) Québec (quebec.ca)
Nouveau- Un modèle de formulaire d'exemption médicale Preuve de vaccination COVID-19

Brunswick du Nouveau-Brunswick signé par un médecin ou (gnb.ca)
une infirmière praticienne titulaire d'un permis
au Nouveau-Brunswick est accepté comme
répondant à la politique de preuve de
vaccination. Une note écrite sur un carnet
d’ordonnances ne sera pas considérée comme
un formulaire d’exemption.
Nouvelle- Modèle de lettre valide de contre-indication Coronavirus (COVID-19) :

Écosse médicale à la vaccination par le COVID-19, exemption médicale -
rédigée par un médecin ou une infirmière Government of Nova Scotia,
praticienne. Canada
Î.-P.-É. Les personnes qui demandent une exemption Résidents : renseignements

médicale de la vaccination contre le COVID-19 importants sur le laissez-passer
devront avoir une lettre d'exemption médicale vaccinal de l’Î.-P.-É. |
du bureau principal de la santé publique. Gouvernement de l'Île-du-Prince-
Édouard (princeedwardisland.ca)
v.4 – 28 février 2022

AR04895
Province ou
territoire
Terre-Neuve- La preuve acceptable d'une exemption médicale Conseils à l’intention des

et-Labrador approuvée comprend : personnes résidentes - COVID-19
(gov.nl.ca)
- Un code QR électronique téléchargé et
affiché sur un appareil mobile (par exemple,
une tablette ou un smartphone) (exemption
non mentionnée); ou.
- Une copie physique du code QR (exemption
non mentionnée); ou,
- Une lettre d'exemption médicale valide
pour la vaccination par le COVID-19.
Yukon - Dispense médicale temporaire de Exemption temporaire de
vaccination délivrée par le gouvernement vaccination contre la COVID-
du Yukon au moyen d’un certificat 19 | Gouvernement du Yukon
comportant un code QR. Le certificat
indiquera le nombre de vaccins
administrés : 0.
Territoires du Lettre d’exemption médicale territoriale Avis Public - Exemptions À La
Nord-Ouest (ASTNO) Vaccination, Exigences Liées Aux
Voyages Et Dépistage De La
Covid-19 Avant Un Voyage |
Administration des services de
santé et des services sociaux
(nthssa.ca)
NOUVEAU!! Remarque au sujet des lecteurs de code QR

Les lecteurs de code QR qui affichent un message indiquant le statut vaccinal « adéquatement
immunisé » en vert (Québec), ou au moyen d’une coche verte sur l’écran (Ontario), ne
fournissent pas suffisamment d’informations pour confirmer qu’un voyageur est entièrement
vacciné. Les certificats de vaccination numériques de certaines provinces (Ont. Man., T.-N.-L.,
Qc) ne mentionneront pas les exemptions médicales. Les voyageurs bénéficiant d’exemptions
médicales doivent présenter les résultats d’un test de dépistage de la COVID-19 avant de
voyager.
Les lecteurs de code QR utilisés pour les voyages au Canada et à l’étranger doivent avoir la
capacité technique d’afficher suffisamment d’informations pour confirmer qu’une personne est
entièrement vaccinée, y compris :
 le nom complet (nom de famille et prénoms) de la personne qui a reçu le vaccin;

 le nom de l’entité gouvernementale ou non gouvernementale qui a délivré la preuve
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AR04896
 Le nom du fabricant du vaccin et le nombre de dose (se référer à Voyageurs vaccinés

contre la COVID-19 qui entrent au Canada pour de plus amples information sur les
vaccins/régimes acceptés).
 La date à laquelle le voyageur a reçu sa deuxième dose. Cette date doit correspondre à
une période d’au moins 14 jours complets avant la date du voyage. Par exemple, si la
dernière dose a été administrée le jeudi 1er juillet, le vendredi 16 juillet serait le premier
jour où le voyageur remplirait la condition des 14 jours.
Concernant les ressortissants étrangers

Si un ressortissant étranger qui voyage au Canada a besoin d’une exception pour des raisons
médicales à se faire vacciner, le processus sera le même que pour les citoyens canadiens et les
résidents permanents. La compagnie ne doit pas accepter de note médicale ni de lettre émise
par un médecin ou une infirmière praticienne dans un pays autre que le Canada pour un
voyage au pays ou à l’étranger.
Examen d’une demande d’exception temporaire médicale

Avant d’accepter une demande d’exception médicale, les compagnies de chemin de fer doivent
confirmer qu’elle répond aux critères suivants :
1. Le formulaire de demande d’exception rempli a été soumis à la compagnie de chemin de fer
avant le départ et conformément aux exigences de la compagnie.
2 Les prénoms et noms de famille de la personne qui demande l’exception et son adresse
municipale sont fournis.
3 Lorsque le formulaire indique qu’une demande d’exception antérieure a été refusée, on peut
demander au passager de fournir plus de détails pour éclairer l’examen par la compagnie de
chemin de fer. Une compagnie peut accepter la demande d’exception, sans égard à un rejet
antérieur, à la condition que la demande d’exception répond aux critères.
4 Suffisamment de détails sont fournis sur les déplacements conformément aux exigences de la
compagnie de chemin de fer.
5 Les passagers peuvent soumettre un formulaire rempli avec l’un des éléments suivants :
1. Confirmation de l'incapacité médicale de la personne et signature d'un médecin ou d'une

infirmière praticienne canadien, autorisé à exercer dans une province ou un territoire
canadien, sur le formulaire lui-même en incluant une ou plusieurs des cases suivantes
cochées :
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 Contre-indications médicales
 Raisons médicales pour le report de la vaccination complète
 Un état médical empêchant la vaccination complète (si coché, une brève description
doit être incluse)
2. Une lettre médicale ou un titre de compétence délivré par une province ou un territoire
canadien accompagnant le formulaire, et indiquant une raison médicale pour laquelle la
personne ne peut pas se faire vacciner (exemption médicale).
7 Le formulaire doit comprendre les coordonnées (adresse municipale/numéro de téléphone) du
médecin ou de l’infirmière praticienne, ainsi que le numéro de leur permis provincial ou
territorial d’exercer la médecine.
Le formulaire doit être signé et daté par le médecin ou l’infirmière praticienne.
8 Le formulaire est valide pendant un an à compter de la date de signature par le médecin ou

l’infirmière praticienne, ou
Pour les affections qui peuvent être de nature temporaire, le formulaire rempli peut être valide
jusqu’à la fin de la période de condition temporaire établie et déterminée par le médecin ou
l’infirmière praticienne.
9 Attestation signée et datée par le demandeur.
Exception temporaire pour services médicaux ou traitements essentiels

Les passagers doivent présenter aux compagnies de chemin de fer un formulaire d’exception
temporaire rempli et signé par un médecin ou une infirmière praticienne autorisé afin de
recevoir une exception temporaire de l’exigence de vaccination obligatoire. Ce formulaire est
accessible auprès de la compagnie de chemin de fer et doit être rempli avant le départ (deux
semaines à l’avance*), ou selon l’échéancier établi par la compagnie.
Les médecins ou les infirmières praticiennes peuvent indiquer qu'un accompagnateur est
nécessaire pour accompagner le passager qui voyage pour un service médical ou traitement
essentiel.
La compagnie ferroviaire n'est pas tenue de vérifier la preuve de vaccination d'une personne
âgée d'au moins 18 ans qui monte à bord du matériel ferroviaire dans le but d'accompagner
une personne qui a été accordée une exception temporaire pour se déplacer pour des services
médicaux ou traitements essentiels si le la personne doit être accompagnée car : elle a moins
de 18 ans ; a un handicap; ou a besoin d'aide pour communiquer.
L’acceptation fournie par la compagnie de chemin de fer sera valide pour la durée du
déplacement aller-retour. Un nouveau formulaire rempli est requis pour tout nouveau
déplacement.
v.4 – 28 février 2022
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* Une compagnie de chemin de fer peut accepter une demande d’exception temporaire un
formulaire de demande d’exception dûment remplie après cette échéance dans les cas où des
circonstances exceptionnelles sont réclamées par le demandeur, et tant que cela est réalisable
sur le plan opérationnel.
De plus, jusqu’au 14 décembre 2021 à 23 h 59 (heure de l’Est), une compagnie de chemin de fer
n’est pas tenue de vérifier le certificat de preuve de vaccination de toute personne voyageant
pour recevoir des services ou des traitements médicaux essentiels à condition que :
 la personne fournisse un document signé d’un médecin ou d’une infirmière praticienne
canadiens, lequel inclut la date ainsi que le lieu des services ou des traitements
médicaux essentiels ; et
 la date des services ou des traitements médicaux essentiels est avant le 13 décembre
2021.
Examen d’une demande d’exception temporaire pour services médicaux ou traitements

essentiels
Avant d’accepter une demande d’exception temporaire pour services médicaux ou traitements
essentiels, les compagnies de chemin de fer doivent confirmer qu’elle répond aux critères
suivants :
1 Un formulaire de demande d’exception rempli a été soumis à la compagnie de chemin de fer

avant le départ, conformément aux exigences de la compagnie.
2 Les prénoms et noms de famille de la personne qui demande l’exception et son adresse
municipale sont fournis.
3 Lorsque le formulaire indique qu’une demande d’exception antérieure a été rejetée, on peut
demander au passager de fournir plus de détails pour éclairer l’examen par la compagnie.
Toutefois, la compagnie peut approuver la demande d’exception, sans égard à un refus antérieur,
à condition que la demande d’exception répond aux critères.
4 Suffisamment de détails sur les déplacements sont fournis conformément aux exigences de la
compagnie.
5 Les passagers ont présenté un formulaire rempli avec la confirmation d’un médecin ou d’une
infirmière praticienne canadien qui contient la date, le nom et l’adresse municipale de
l’établissement où les services médicaux essentiels ou le rendez-vous de traitement seront
fournis.
Une brève description doit également être fournie par le médecin ou l’infirmière praticienne.
Dans tous les cas, un formulaire d’exception rempli doit être présenté avec les documents
justificatifs.
v.4 – 28 février 2022

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6 Le formulaire doit comprendre les coordonnées du médecin ou de l’infirmière praticienne, ainsi

que le numéro de leur permis provincial ou territorial d’exercice de la médecine et leur adresse
municipale.
Le formulaire doit être signé et daté par le médecin ou l’infirmière praticienne.
7 Les formulaires d’exception temporaire remplis pour les passagers en raison de soins médicaux
essentiels sont valides pour le déplacement aller-retour seulement. Il faudra présenter de
nouveaux formulaires pour tout nouveau déplacement.
Exception temporaire pour les passagers en raison de croyances religieuses

sincères
Les leaders religieux et adeptes d’un certain nombre de religions et de confessions religieuses
(p. ex. l’islam, le catholicisme, le judaïsme, la religion grecque – orthodoxe, la religion
mennonite, les Témoins de Jéhovah, la Science chrétienne) ont publié des déclarations
publiques indiquant leur soutien au vaccin contre la COVID-19, dans l’intérêt particulier de la
santé publique. En outre, un certain nombre de commissions provinciales des droits de la
personne, y compris la Commission ontarienne des droits de la personne, ont adopté la position
selon laquelle l’opposition à la vaccination pour des raisons personnelles n’est pas un motif
protégé en vertu de leur code respectif et qu’il n’est pas nécessaire d’y donner suite.
Néanmoins, une personne peut avoir une croyance religieuse bien ancrée qui empêche la
vaccination complète.
Aux fins des voyages domestiques ou à l’étranger, les compagnies de chemin de fer doivent
tenir compte des exceptions religieuses à la vaccination obligatoire fondées sur des croyances
religieuses sincères, en reconnaissance des obligations en vertu de la Loi canadienne sur les
droits de la personne.
Les exceptions temporaires en raison de croyances religieuses sincères ne doivent être

envisagées que pour les voyages intérieurs et les voyages de départ. Ceux-ci comprennent les
trains domestiques connectant aux trains internationaux.
Pour recevoir une exception temporaire de l’obligation de se faire vacciner, les passagers
doivent présenter un formulaire aux compagnies ferroviaires qui comprend un serment de
motif religieux solennel cosigné par un commissaire à l’assermentation. Cela doit être fait avant
le départ (trois semaines à l’avance*), ou selon l’échéancier établi par la compagnie. Le
formulaire d’exception temporaire rempli est valide pour le voyage complet du voyageur (c.-à-
d. déplacement aller-retour réservé). Le passager est tenu de reconfirmer sa conviction
religieuse en soumettant un nouveau formulaire pour tout nouveau voyage.
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AR04900
Remarque : Les provinces/territoires n'accordent pas d'exemptions fondées sur les croyances
religieuses.
* Une compagnie de chemin de fer peut accepter une demande d’exception temporaire un
formulaire de demande d’exception dûment remplie après cette échéance dans les cas où des
circonstances exceptionnelles sont réclamées par le demandeur, et tant que cela est réalisable
sur le plan opérationnel.
Examen d’une demande d’exception temporaire en raison d’une croyance religieuse sincère
Les demandes de voyage avec une exception temporaire en raison d'une conviction religieuse
sincère doivent être évaluées au cas par cas.
Avant d’accepter une demande d’exception temporaire pour motif religieux, les compagnies
ferroviaires doivent confirmer qu’elle répond aux critères suivants :
1 La demande d’exception temporaire a été soumise à la compagnie de chemin de fer avant le
départ et conformément aux exigences de la compagnie.
2 Les prénoms et noms de famille de la personne qui demande l’exception temporaire et son
adresse municipale sont fournis.
3 Si une demande antérieure d’exception temporaire a été rejetée, on peut demander au passager
de fournir plus de détails pour éclairer l’examen de l’exception. Toutefois, la compagnie peut
approuver la demande d’exception temporaire, sans égard à un rejet antérieur, à condition que
la demande réponde aux critères.
4 Suffisamment de détails sur les déplacements sont fournis conformément aux exigences
de la compagnie.
5 La croyance est de nature religieuse
La religion implique habituellement un système particulier et complet de foi et de culte, ainsi que
la croyance en un pouvoir divin, surhumain ou contrôlant (p. ex., « Je ne crois pas à la
vaccination » ne serait pas en soi une raison).
Elle ne s’applique pas aux croyances, aux convictions ou aux pratiques laïques, sociales ou
seulement consciencieuses; elle ne protège pas non plus les fausses croyances empiriques sur le
développement, le contenu, les effets, ni le but des vaccins.
6 La croyance empêche la vaccination complète
Il ne suffit pas que le passager déclare qu’il a certaines croyances religieuses et qu’il ne peut pas
être vacciné.
Il doit expliquer comment la vaccination entrerait en conflit avec ses croyances religieuses d’une
manière qui n’est ni triviale ni insignifiante (c’est-à-dire que la vaccination entre en conflit avec le
lien authentique de l’employé avec le divin).
7 La croyance est sincère
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AR04901
L’exigence est de se concentrer sur la sincérité de la croyance individuelle enracinée dans la

religion, et non sur le fait qu’elle soit reconnue par d’autres membres de la même religion.
La compagnie ferroviaire ne doit pas contester la validité de la croyance elle-même.

8 Le formulaire est signé et daté par un commissaire à l’assermentation. Le formulaire peut être
certifié par le commissaire à l’assermentation qui appose un sceau et la date.
9 Les formulaires d’exception temporaire remplis pour les passagers pour des motifs religieux sont
valides pour la période du déplacement aller-retour seulement.
* En ce qui concerne les critères 5 à 7, il existe un certain nombre de fausses croyances

empiriques au sujet du développement, du contenu, des effets ou du but des vaccins. Ce ne
sont toutefois pas des motifs pour lesquels une exception temporaire peut être accordée. Si la
croyance sincère n’est pas fondée sur une croyance religieuse, mais plutôt sur une préférence
ou un choix personnel fondé sur de la désinformation ou des malentendus en matière
d’information scientifique, il n’est pas nécessaire de donner suite à la demande d’exception.
Par exemple, une croyance selon laquelle le vaccin contre la COVID-19 contient des cellules
fœtales humaines ou animales avortées, ou que l’ADN est altéré par les vaccins à ARNm est
empiriquement erronée et ne devrait pas être utilisée comme justification pour accorder une
exception religieuse, même lorsque cette croyance est sincèrement ancrée dans la religion. Le
site Web suivant contient des renseignements supplémentaires sur les mythes liés à la COVID-
19 : Site Web sur la modification de l’ADN : Vaccins à ARNm contre la COVID-19
Section 4 – Autres exceptions

Une compagnie de chemin de fer n'est pas tenue de vérifier le certificat de preuve de
vaccination (CPV) d'une personne qui se qualifie pour une exception énumérée à la section D de
l'arrêté ministériel. La compagnie doit prévoir des mesures d'adaptation pour les personnes
bénéficiant d'une exception à la fourniture d'un CPV. Des conseils supplémentaires sur les
accommodations peuvent être trouvés dans la « Section 5 : Accommodations » de ce
document.
 Communautés éloignées : une compagnie n’est pas tenue de vérifier le CPV ou la

preuve du résultat d’un essai moléculaire relatif à la COVID-19 de toute personne qui réside
dans une communauté qui est seulement accessible par la ligne The Pas-Churchill de VIA Rail
Canada Inc. ou dans toute autre communauté éloignée pour laquelle VIA Rail Canada Inc.
pourrait être le seul moyen de transport. Cela englobe également les communautés qui ne sont
pas directement sur la route The Pas-Churchill, mais qui utilisent d’autres transporteurs
ferroviaires, qui sont accessibles en utilisant la même ligne.
v.4 – 28 février 2022
AR04902
 Enfants : une compagnie de chemin de fer n’est pas tenue de vérifier le CPV d’une
personne âgée de moins de 12 ans et quatre (4) mois.
 Étrangers* : une compagnie de chemin de fer n’est pas tenue de vérifier le certificat
de preuve de vaccination d’un étranger, qui n’est pas inscrit à titre d’Indien sous le régime de la
Loi sur les indiens et qui embarque à bord d’un matériel ferroviaire au Canada si l’heure de
départ prévue initialement est au plus tard vingt-quatre (24) heures après l’heure de départ du
vol qu’il a pris en partance de tout autre pays à destination du Canada, tel que confirmé par
leur itinéraire de voyage ou une carte d’embarquement ou autre titre de voyage délivré par le
pays de citoyenneté ou de nationalité de la personne.
*L’arrêté ministériel défini étranger comme une personne autre qu’un citoyen canadien ou un
résident permanent; la présente définition vise également les apatrides.
 Autres : une compagnie de chemin de fer n’est pas tenue de vérifier le certificat de
preuve de vaccination d’une personne accréditée et qui embarque à bord d’un matériel
ferroviaire pour des fins autres que celles de nature optionnelle ou discrétionnaire telles que le
tourisme, les loisirs ou le divertissement et qui est, selon le cas :
o entrée au Canada à l’invitation du ministre de la Santé afin de participer aux efforts
de lutte contre la COVID-19;
o autorisée à travailler au Canada afin d’offrir des services d’urgence en vertu de
l’alinéa 186t) du Règlement sur l’immigration et la protection des réfugiés et qui est
entrée au Canada afin d’offrir de tels services;
o reconnue comme réfugié au sens de la Convention ou qui est dans une situation
semblable à celui- ci au sens du paragraphe 146(1) du Règlement sur l’immigration
et la protection des réfugiés, qui est titulaire d’un visa de résident permanent délivré
aux termes du paragraphe 139(1) de ce règlement si cette personne est entrée au
Canada après le 31 août 2021;
o titulaire d’un permis de séjour temporaire au sens du paragraphe 24(1) de la Loi sur
l’immigration et la protection des réfugiés et qui est entrée au Canada après le 31
août 2021 à titre de résident temporaire protégé aux termes du paragraphe 151.1(2)
du Règlement sur l’immigration et la protection des réfugiés;
o une personne accréditée;
o titulaire d’un visa D1, O1 ou C1 qui est entrée au Canada pour occuper un poste et
devenir une personne accréditée*; ou
o un courrier diplomatique ou consulaire.
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AR04903
* L’arrêté ministériel défini une personne accréditée comme étant un étranger titulaire d’un
passeport contenant une acceptation valide l’autorisant à occuper un poste en tant qu’agent
diplomatique ou consulaire, ou en tant que représentant officiel ou spécial, délivrée par le chef
du protocole du ministère des Affaires étrangères, du Commerce et du Développement.
 Programme d’exemption de l’intérêt national (personnes énumérées dans les

annexes B, C, D ou E de l’arrêté ministériel) : À compter du 30 novembre 2021, Transports
Canada mettra en place une plateforme numérique pour son Programme d’exemption de
l’intérêt national (PEIN). Transports Canada administrera un processus de réception et
d’examen des demandes d’exception à la vaccination obligatoire dans l’intérêt national, pour
les voyages intérieurs et au départ du Canada.
Dans le cadre de ce programme, les déplacements de personnes non vaccinées ne seront

autorisés que si cela est dans l’intérêt national du Canada et/ou pour répondre aux besoins
essentiels en matière d’infrastructure et/ou lorsque la situation justifie une exception.
(https://vaccine-exemption.tc.canada.ca/ https://exemption-vaccination.tc.canada.ca)
Transports Canada traitera les demandes d’exception d’intérêt national et accordera une
exception au cas par cas pour la partie nationale du déplacement.
Les demandes d’exception dans l’intérêt national sont examinées par Transports Canada au cas
par cas, selon un processus simplifié et normalisé qui permet de déterminer si le déplacement :
 est dans l’intérêt national du Canada et/ou pour répondre aux besoins d’infrastructures
essentielles, et/ou;
 est exceptionnel ou urgent.
Ces déplacements ne seront autorisés que dans les circonstances les plus exceptionnelles,
lorsqu’il n’existe aucune autre solution en matière de vaccination.
Le processus de révision et d’approbation des demandes présentées dans le cadre du PNIE

pour les voyages nationaux et internationaux sortants sera complémentaire aux systèmes en
place pour l’entrée au Canada. Ce processus ne reproduira pas les systèmes en place.
Un résumé de haut niveau des renseignements relatifs aux exemptions pour les passagers se
trouve à l’adresse suivante : COVID-19 Monter à bord d’avions et de trains au Canada –
Voyage.gc.ca (site administré par Santé Canada et par le Secrétariat du Conseil du Trésor).
Obligations du voyageur : Un passager non vacciné (ou un groupe de représentants accrédités)

peut faire une demande en ligne dans le cadre du PNIE de Transports Canada à l’adresse
https://vaccine-exemption.tc.canada.ca, ou en envoyant une demande à Transports Canada.
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AR04904
Toutes les communications avec le passager se feront par l’intermédiaire du service Connexion
de Postes Canada afin de protéger la transmission de renseignements de nature délicate.
Les personnes sont encouragées à présenter leur demande à Transports Canada un minimum
de trois semaines avant leur voyage. Transports Canada reconnaît que certains cas particuliers
peuvent être très urgents; il traitera ces demandes au cas par cas. Les personnes sont
encouragées à soumettre leur demande plus tôt pendant les périodes de pointe des voyages de
vacances.
La demande sera examinée par Transports Canada. Elle sera acceptée ou refusée, ou des
renseignements supplémentaires seront exigés. Si la demande n’est pas approuvée, une lettre
sera envoyée au demandeur ou aux représentants accrédités pour leur expliquer les raisons du
rejet. Si la demande est acceptée et approuvée, le passager recevra une lettre d’exception pour
des raisons d’intérêt national qui exemptera la personne, les exploitants et/ou l’ACSTA de
certaines exigences législatives relatives au vaccin contre le COVID-19 dans le transport aérien,
ferroviaire et/ou maritime.
Les passagers approuvés dans le cadre du PNIE devront présenter à l’exploitant leur lettre
d’exception dans l’intérêt national délivrée par TC avant leur voyage. Les passagers sont tenus
d’avoir sur eux une copie papier ou numérique de la lettre d’exemption dans l’intérêt national
pendant leur voyage, car ils peuvent être tenus de présenter cette pièce justificative à
l’exploitant ou à toute autorité qui la demande, pendant leur voyage, y compris au moment de
l’enregistrement ou de l’embarquement, ainsi que les résultats acceptables à un essai
moléculaire relatif à la COVID-19 ou à un essai antigénique relatif à la COVID-19.
De plus amples détails sur le programme d’exemption dans l’intérêt national sont fournis sur le
site https://voyage.gc.ca/voyage-covid.
Obligations de la compagnie de chemin de fer : Il est de la responsabilité des compagnies

d’informer les passagers qu’ils doivent soumettre une copie de leur lettre d’exception dans
l’intérêt national aux compagnies avant le départ, ainsi que de présenter une copie numérique
ou papier de la lettre au moment de l’enregistrement et/ou de l’embarquement.
Les compagnies ferroviaires seront responsables de vérifier la validité de la lettre d’exception

du passager, ainsi que la validité du résultat de l’essai moléculaire relatif à la COVID-19 ou de
l’essai antigénique relatif à la COVID-19 (le cas échéant), avant que le passager ne reçoive une
carte d’embarquement ou un billet, ou qu’il ne soit autorisé à monter à bord.
La lettre d’exception de l’intérêt national délivrée par Transports Canada, qui doit être validée
par la compagnie ferroviaire, présentera les caractéristiques suivantes:
- Papier à en-tête de Transports Canada/logo de Transports Canada dans le coin supérieur

gauche de la lettre;
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AR04905
- Le mot-symbole Canada situé dans le coin inférieur droit de la lettre;

- Un numéro d'exemption qui commence par NIE-YYYY-XXXX;
- Nom et date de naissance du passager;
- Renseignements sur le voyage (nom de la compagnie ferroviaire, numéro de train,
station de départ et d’arrivée);
- Période de validité de l’exception;
- Signature du directeur général, Transports Canada, Équipe de reprise COVID-19,
Sécurité ferroviaire, et date.
Soutien de Transports Canada : Transports Canada fournira un soutien dans le cadre du

programme d’exemption dans l’intérêt national de 7 h à 19 h (heure de l’Est), 7 jours sur 7. Les
compagnies ferroviaires bénéficieront également d’un soutien après les heures normales de
travail.
Les compagnies ferroviaires peuvent vérifier si le passager a reçu une lettre d’exception dans
l’intérêt national, en appelant le Centre d’intervention de Transports Canada, au besoin.
Transports Canada offrira aux compagnies qui rencontrent des problèmes avec une lettre
d’exception (par exemple, pour déterminer la validité de l’autorisation présentée par un
voyageur) un soutien 24 heures sur 24, 7 jours sur 7, par l’intermédiaire du Centre
d’intervention de Transports Canada.
Coordonnées
On peut communiquer avec les responsables du programme par courrier électronique à
l’adresse suivante : NationalInterestExemption-ExemptionInteretNational@tc.gc.ca
Section 5 – Accommodations
Une compagnie de chemin de fer doit s'assurer qu'une personne à qui on a accordée une
exception à la fourniture d'un certificat de preuve de vaccination (CPV), à moins une personne
âgée de moins de 12 ans et quatre (4) mois ou une personne qui relève de l’exception d’un
étranger, fournisse à la compagnie une preuve valide d'un résultat d’essai moléculaire relatif à
la COVID -19 ou d’un résultat d’essai antigénique relatif à la COVID-19.
Une compagnie de chemin de fer doit avoir mis en place toute autre mesure d’accommodations
énoncées dans les directives locales de santé publique pour les personnes qui font l'objet d'une
exception, y compris pour toute personne âgée de moins de 12 ans et quatre (4) mois et toute
personne qui relève de l’exception d’un étranger.
Une preuve d'un résultat à un essai moléculaire relatif à la COVID-19 confirme que la
personne a reçu des résultats d'un essai moléculaire relatif à la COVID-19. Une preuve
v.4 – 28 février 2022
AR04906
acceptable d'un un essai moléculaire relatif à la COVID-19 comprend à la fois une copie papier
et une copie numérique et doit :
1. inclure :
a. le nom et la date de naissance de la personne dont l'échantillon a été prélevé pour le
test;
b. le nom et l’adresse municipale du laboratoire accrédité ou du fournisseur de services
d’essais qui a effectué ou observé l’essai et vérifié le résultat;
2. dans le ca cas où le résultat de l’essai est négatif, il doit s'agir d'un essai moléculaire relatif à
la COVID-19 qui a été réalisé sur un échantillon prélevé au plus 72 heures avant l'heure de
départ prévue.
3. dans le cas où le résultat de l’essai est positif, il doit s'agir d'un essai moléculaire relatif à la
COVID-19 qui a été réalisé sur un échantillon prélevé au moins 10 jours et au plus 180 jours
avant l'heure de départ prévue.
L’arrêté ministériel défini un essai moléculaire relatif à la COVID-19 comme un essai de
dépistage ou de diagnostic de la COVID-19, y compris l’essai effectué selon le procédé
d’amplification en chaîne par polymérase (ACP) ou d’amplification isotherme médiée par
boucle par transcription inverse (RT-LAMP) qui :
a. s’il est auto-administré, est observé et son résultat est vérifié :
i. en personne par un laboratoire accrédité ou un fournisseur de services
d’essais,
ii. à distance, en temps réel, par un moyen audio-visuel par le laboratoire
accrédité ou par le fournisseur de services d’essais qui a fourni l’essai ;
b. s’il n’est pas auto-administré, il est effectué par un laboratoire accrédité ou par
un fournisseur de services d’essais.
Pour obtenir une liste des essais considérés comme des tests moléculaires, veuillez consulter la
section « Types de tests acceptés » qui se trouve sur la page Web suivante : Dépistage de la
COVID-19 pour les voyageurs – Restrictions de voyage au Canada – Voyage.gc.ca
Une preuve d'un résultat à un essai antigénique relatif à la COVID-19 confirme que la
personne a reçu des résultats d'un essai antigénique à la COVID-19. Une preuve acceptable d'un
un essai antigénique relatif à la COVID-19 comprend à la fois une copie papier et une copie
numérique et doit :
1. inclure :
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a. le nom et la date de naissance de la personne dont l'échantillon a été prélevé

pour le test;
2. dans le cas d’un résultat négatif d’un essai antigénique relatif à la COVID 19, un essai qui
a été effectué sur un échantillon prélevé au plus tard un jour précédant l’heure
initialement prévue de départ.
L’arrêté ministériel défini un essai antigénique relatif à la COVID-19 comme un essai

immunologique de dépistage ou de diagnostic de la COVID-19 qui, à la fois : détecte la présence
d’un antigène viral indicatif de la COVID-19; et est autorisé pour la vente ou la distribution au
Canada ou dans un pays étranger dans lequel il a été obtenu.
Pour obtenir une liste des essais considérés comme des tests antigénique, veuillez consulter la
section « Types de tests acceptés » qui se trouve sur la page Web suivante : Dépistage de la
COVID-19 pour les voyageurs – Restrictions de voyage au Canada – Voyage.gc.ca
Un fournisseur de services est soit :

a) une personne qui peut fournir des essais de dépistage ou de diagnostic de la COVID-19
en vertu de la loi du pays dans lequel elle fournit ces essais;
b) une organisation, tel un fournisseur de télésanté ou une pharmacie, qui peut fournir des
essais de dépistage ou de diagnostic de la COVID-19 en vertu de la loi du pays dans
lequel elle fournit ces essais et qui emploie ou engage une personne visée à l’alinéa a).
Section 6 - Considérations relatives à la protection des

renseignements personnels
Les compagnies de chemin de fer doivent s’assurer que les renseignements personnels ne sont
créés, recueillis, conservés, utilisés, divulgués et éliminés que dans le respect des dispositions
de la législation canadienne sur la protection des renseignements personnels et des autres lois
applicables. Pour cette raison, les compagnies de chemin de fer doivent veiller à ce que la
protection des renseignements personnels soit prise en compte dès que possible et à ce qu’ils
mettent en œuvre les meilleures pratiques en matière de protection des renseignements
personnels afin de protéger adéquatement les renseignements personnels qui seront traités.
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Veuillez noter que les conseils sur la protection des renseignements personnels ci-dessous ne
sont fournis qu’à titre de considérations générales sur la confidentialité et ne constituent pas
des conseils juridiques. Pour obtenir des conseils précis sur le respect des lois applicables en
matière de protection des renseignements personnels, veuillez communiquer avec votre
conseiller juridique, votre professionnel de la protection des renseignements personnels et/ou
consulter le bureau des commissaires à la protection de la vie privée applicable.
Considérations relatives à la protection des renseignements personnels :
• Documentez un but et une autorité définis pour la collecte et l’utilisation de ces
renseignements personnels.
• Soyez transparent avec les passagers et informez-les des raisons de la collecte, de
l’utilisation, de la divulgation (y compris, sans toutefois s’y limiter, la divulgation à
Transports Canada), de la conservation et de l’élimination de leurs renseignements
personnels et des conséquences de ne pas fournir les renseignements personnels
demandés, au moyen d’un énoncé de confidentialité concis, transparent, intelligible et
facilement accessible, tel que requis par la législation canadienne applicable en matière de
protection des renseignements personnels.
 Les passagers devraient également être informés et obtenir les coordonnées

d’une personne-ressource pour demander l’accès et la correction de toute
information personnelle disponible ou pour faire une demande ou une plainte
concernant le traitement de leurs renseignements personnels, y compris la
personne-ressource du Commissaire à la protection de la vie privée de la
juridiction concernée et la personne responsable qui peut répondre aux
questions et aux préoccupations concernant les exigences en matière de
vaccination.
 Fournissez un lien vers vos politiques de vaccination pour les passagers, selon le
cas.
 Les principes de nécessité, d’efficacité, de proportionnalité et de minimisation des données

devraient être appliqués de manière à ce que le plus petit nombre possible de
renseignements personnels soit recueilli, utilisé ou divulgué, par exemple : champs de
données inutiles dans un formulaire.
 Les données sur les passagers se rapportant au statut vaccinal ne sont utilisées qu’aux fins
pour lesquelles elles ont été recueillies, conservées pendant une période donnée et ne
peuvent être consultées que sur la base du besoin de savoir.
 Tous les employés de la compagnie de chemin e fer qui traitent des renseignements
personnels, y compris les gestionnaires, sont au courant de leurs responsabilités et se
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AR04909
conforment aux lois sur la protection des renseignements personnels et aux autres lois
canadiennes applicables.
 Envisagez de mener une évaluation des facteurs relatifs à la vie privée ou d’autres analyses
pertinentes relatives à la vie privée.
 Les plans et les procédures liés aux atteintes à la vie privée sont à jour.
 Les renseignements personnels sont protégés de façon appropriée contre tout accès non
autorisé et des mesures de protection techniques, physiques et administratives sont mises
en place et sont appropriées compte tenu de la sensibilité des renseignements personnels
qui doivent être recueillis, utilisés ou divulgués en vertu de l’exigence.
Liens pertinents :
 Déclaration conjointe publiée par le commissaire à la protection de la vie privée du Canada

et ses homologues provinciaux et territoriaux en mai 2021 sur la vie privée et les passeports
vaccinaux relatifs à la COVID-19 (la Déclaration).
 Lois et organismes de surveillance provinciaux et territoriaux en matière de protection de la

vie privée : Liste des lois provinciales et territoriales sur la protection de la vie privée ainsi
que des commissariats à la protection de la vie privée responsables de leur application
publiée par le commissaire à la protection de la vie privée du Canada.
Section 7 - Exigences en matière de collecte de données et

déclarations
Collecte de données
La compagnie ferroviaire est tenue de collecter des données sur une base hebdomadaire et de
les conserver pendant un minimum de 12 mois, relatives à :
 le volumes de passagers;
 le nombre de demandes reçues pour chaque exceptions pour laquelle un formulaire est
requis;
 le nombre de demandes d'exception acceptées pour chaque catégorie d’exception pour
laquelle un formulaire est requis;
 le nombre de personnes refusées d'embarquer à bord du matériel ferroviaire en raison
d'une personne omettant de fournir un certificat de preuve de vaccination acceptable ;
 le nombre de personnes refusées d'embarquer à bord du matériel ferroviaire en raison
de formulaires non dûment remplis;
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 En ce qui concerne les résultats d’essais moléculaire relatif à la COVID-19 ou d’essais

antigéniques relatifs à la COVID-19 obtenus pour les personnes relevant de l'exception
décrite sous la section D(5) de l’arrêté ministériel;
o nombre de preuves acceptables d’essais moléculaires relatifs à la COVID-19 et
d’essais antigéniques relatifs à la COVID-19 ; et
o nombre de résultats d'essais qui n'étaient pas acceptables.
La compagnie de chemin de fer est en outre tenue de conserver, pendant au moins 12 mois, les
formulaires soumis dans le but de demander une exception, comme indiqué à la section 3 du
présent document.
Les informations énumérées ci-dessus doivent être collectées d'une manière conforme aux
exigences de confidentialité. Cela comprend uniquement la collecte des informations
nécessaires pour se conformer aux exigences de l'arrêté ministériel. Des conseils
supplémentaires sur la confidentialité peuvent être trouvés dans la « Section 6 – Considérations
relatives à la protection des renseignements personnels» de ce document.
Déclarations
Une compagnie de chemin de fer doit déclarer au ministre, sur une base hebdomadaire ou à la
demande du ministre, les données saisies dans la section collecte de données ci-dessus ainsi
que toutes tendances suspectes détectées ou documents pouvant être faux ou contenant de
fausses informations.
La compagnie Ferroviaire doit déclarer ses données au ministre dans un format de fichier .CSV à
la Direction de la sécurité ferroviaire à railsafety@tc.gc.ca.
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This is Exhibit “H” referred to in the


3/21/22, 9:51 AM Railway Rules Governing Safety Critical Positions
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Railway Rules Governing Safety Critical
Positions
From: Transport Canada
On this Page:
1. Short Title
2. Scope
3. Definitions
4. Records To Be Kept by Company
1. Short Title
For ease of reference, this rule may be referred to as the "Safety Critical
Position Rules".
2. Scope
These rules have been developed pursuant to Section 20 of the Railway
Safety Act.
3. Definitions
A "Safety Critical Position" is herein defined as:
1. any railway position directly engaged in operation of trains in main track

or yard service; and
2. any railway position engaged in rail traffic control.
https://tc.canada.ca/en/rail-transportation/rules/railway-rules-governing-safety-critical-positions 1/2
3/21/22, 9:51 AM Railway Rules Governing Safety Critical Positions
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Any person performing any of the duties normally performed by a person
holding a Safety Critical Position, as set out in section 3 above, is deemed to
be holding a Safety Critical Position while performing those duties.
4. Records To Be Kept by Company

Each railway company shall:
a. maintain a list of all occupational names or titles which are governed by

this rule;
b. maintain a list of the names of all employees qualified to serve in Safety
Critical Positions; and
c. make all such records related to this rule available to Transport Canada
inspectors upon reasonable request.
I
 Transport Canada is closely monitoring the COVID-19 situation. In response, we have issued
some transportation-related measures and guidance. Please check if any of these
measures apply to you.
You may experience longer than usual wait times or partial service interruptions. If you
cannot get through, please contact us by email.
For information on COVID-19 updates, please visit Canada.ca/coronavirus.
Date modified:
2014-03-10
https://tc.canada.ca/en/rail-transportation/rules/railway-rules-governing-safety-critical-positions 2/2
3/21/22, 12:02 PM Règlement concernant les postes essentiels à la sécurité ferroviaire
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Règlement concernant les postes
essentiels à la sécurité ferroviaire
De : Transports Canada
Sur cette page :

1. Titre abrégé
2. Domaine d'application
3. Définitions
4. Dossiers à conserver par la compagnie
1. Titre abrégé
Pour simplifier, ce règlement peut s'intituler «Règlement sur les postes
essentiels à la sécurité».
2. Domaine d'application
Ce règlement a été rédigé conformément à l'article 20 de la Loi sur la
sécurité ferroviaire.
3. Définitions
Dans ce document, un «poste essentiel à la sécurité» est défini comme
étant:
a. un poste directement relié à la marche des trains sur une voie principale
ou dans le service de manoeuvre; et
b. un poste relié au contrôle de la circulation ferroviaire.
https://tc.canada.ca/fr/transport-ferroviaire/regles/reglement-concernant-postes-essentiels-securite-ferroviaire 1/3
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Toute personne qui exécute une tâche quelconque normalement exécutée
par une personne occupant un poste essentiel à la sécurité, tel qu'énoncé
au paragraphe 3 ci-dessus, est considérée comme occupant un poste
essentiel à la sécurité lorsqu'elle exécute ces tâches.
4. Dossiers à conserver par la compagnie

Chaque compagnie de chemin de fer s'engage à:
a. garder une liste de tous les métiers ou postes régis par ce règlement;
b. garder une liste des noms de tous les employés qualifiés pour travailler
à des postes essentiels à la sécurité; et
c. garder tous les dossiers en rapport avec ce règlement à la disposition
des inspecteurs de Transports Canada s'ils en font raisonnablement la
demande.
I
 Transports Canada surveille étroitement la situation liée à la COVID-19. Pour y réagir, nous
avons publié des mesures et des lignes directrices relatives aux transports. Veuillez en
prendre connaissance pour vérifier si l’une ou l’autre d’entre elles vous concernent.
Des temps d’attente plus longs qu’à l’habitude ou des interruptions partielles de service
sont possibles. Si vous ne parvenez pas à obtenir ce que vous voulez, veuillez communiquer
avec nous par courriel.
Pour obtenir des mises à jour sur la COVID-19, veuillez consulter le Canada.ca/la-
coronavirus.
Date de modification :
2014-03-10
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This is Exhibit “I” referred to in the


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GUIDANCE MATERIAL FOR RAILWAY COMPANIES
Rail Safety’s Vaccination Mandate

for Employees
Transport Canada’s Ministerial Order 21-07.
Important Caveat: Nothing in this guidance document supersedes any

requirement or obligation outlined in Transport Canada’s Ministerial Order. It
is meant to complement this legal document and provide recommendations
and guidance on how to understand and carry out the requirements.
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Table of Contents
Section 1 – General ..................................................................................................................................... 4

Purpose.................................................................................................................................................... 4
Federal Vaccination Mandate ................................................................................................................. 4
Operational Approach ............................................................................................................................. 4
Section 2 – Company-Wide Vaccination Policy .......................................................................................... 4
Application .............................................................................................................................................. 4
Timelines for vaccination and testing ..................................................................................................... 5
Verification Process ................................................................................................................................. 6
Exceptions ............................................................................................................................................... 7
Accommodation Measures ..................................................................................................................... 8
Communication and Filing Requirements ............................................................................................... 8
Record Keeping and Filing Requirements ............................................................................................... 8
Other Requirements................................................................................................................................ 9
Section 3 – Companies that Choose not to Implement a Company-Wide Policy ...................................... 9
Application .............................................................................................................................................. 9
Timeline for vaccination .......................................................................................................................... 9
Verification Process ............................................................................................................................... 10
Exceptions ............................................................................................................................................. 12
Accommodation Measures ................................................................................................................... 12
Testing Regime ...................................................................................................................................... 12
Data Collection, Record Keeping and Filing Requirements .................................................................. 13
Other Requirements.............................................................................................................................. 14
Section 4 – General Requirements ........................................................................................................... 14
Monitoring............................................................................................................................................. 14
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False declarations .................................................................................................................................. 15

Exceptions ............................................................................................................................................. 15
Medical and Religious Exceptions..................................................................................................... 15
Further considerations - Medical...................................................................................................... 15
Further Considerations – Religious Grounds: ................................................................................... 16
Accommodations .................................................................................................................................. 18
Privacy Considerations – Transport Canada Policies on Vaccination Mandates in the Transportation
Sector .................................................................................................................................................... 18
Annex A: Medical Exception Request Form .............................................................................................. 20
Annex B: Religious Exception Request Form ............................................................................................ 24
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Purpose
The purpose of this guidance document is to provide a summary of the railway companies’
requirements, as well as advice, guidance, and sample templates for railway companies when
implementing the requirements under Ministerial Order 21-07.
This document complements the other guidance material that has been prepared to accompany the
COVID-19 response measures. A link to these documents can be found here: COVID-19 measures,
updates, and guidance for rail issued by Transport Canada.

The pandemic has had a devastating impact on Canada’s transportation sector. While public health
measures including social distancing and masking have been critical to combatting the spread of the
virus, COVID-19 and its variants continue to pose a significant public health risk to Canadians.
The Government of Canada is requiring vaccination against COVID-19 for federally regulated
employees in the transportation sector. Vaccination is one of the most effective tools to reduce the
risk of COVID-19 for Canadians, to protect broader public health, and to prevent future outbreaks. A
vaccination requirement for the federally regulated air, rail and marine sector will enhance the safety
and security of Canada’s transportation system and facilitate the resumption of safe travel.
Railway companies are required to have either:
 A company-wide vaccination policy that would require every employee to be vaccinated unless
subject to an exception; or
 Verify that, unless subject to an exception, every operating employee has provided a Proof of
Vaccination Credential (PVC) prior to reporting for work.
Section 2 – Company-Wide Vaccination Policy

Application
A company-wide vaccination policy applies to all employees, including both operating employees and
all other employees employed by the railway company, who are not on leave.
A company that chooses to implement a company-wide policy as described in section B of the MO will
not be required to comply with the requirements set out in sections C, D and J of the Ministerial Order.
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However, they will still be subject to section E (COVID-19 molecular test results), section F (False
Declaration), section G (Exceptions), and section K (Filing).
Timelines for vaccination and testing

Date Requirement
No later than October 30, 201 Companies to have their vaccination policy developed and
implemented.
November 15, 2021 All persons employed by the railway company, who are not
subject to an exception, must have received their first dosage of
an approved COVID-19 vaccine.
November 15, 2021 Persons who are not fully vaccinated must be tested using a
COVID-19 test* on a regular basis until they are fully vaccinated.
January 24, 2022 All persons employed by the railway company, who are not
subject to an exception, must be fully vaccinated.
January 25, 2022 Companies to apply leave without pay for employees who remain
unvaccinated and are not subject to an exception from the
vaccination requirement.
*Different COVID-19 tests, such as rapid tests and COVID-19 molecular tests, are available. However, if
a positive test result is obtained by a method other than a molecular test, the railway company must
ensure that a result of a COVID-19 molecular test is obtained.
For additional information on COVID-19 testing and screening, please consult the following link:
https://www.canada.ca/en/public-health/services/diseases/coronavirus-disease-covid-19/testing-
screening-contact-tracing.html
The Ministerial Order defines a COVID-19 molecular test as a COVID-19 screening or diagnostic test
carried out by an accredited laboratory, including a test performed using the method of polymerase
chain reaction (PCR) or reverse transcription loop-mediated isothermal amplification (RT-LAMP). For a
list of tests that are considered molecular tests, please consult the “Accepted Types of Tests” section
that can be found on the following webpage: https://travel.gc.ca/travel-covid/travel-
restrictions/flying/covid-19-testing-travellers-coming-into-canada
A proof of a COVID-19 molecular test result includes both a paper and digital copy and must include:
a. the name and date of birth of the person whose specimen was collected for the test;
b. the name and civic address of the laboratory that administered the test;
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d. the test result.
The railway company must advise every employee that they would be subject to sanctions should they
provide a proof of a COVID-19 test result in a way that they know to be false or misleading. For
additional information on false declaration, please refer to “Section 4 – General Requirements” of this
document.
Verification Process
A company-wide vaccination policy must include a verification process that confirms the employee’s
vaccination status by means of a PVC. The railway company should develop an implementation plan for
their verification process.
provide a PVC in a way that they know to be false or misleading. For additional information on false
declarations, please refer to “Section 4 – General Requirements” of this document.
Proof of Vaccination Credential: an acceptable proof of vaccination credential confirms that the
person is fully vaccinated by completing, at least 14 days prior, a COVID-19 vaccine dosage regimen. A
PVC may be presented either in a digital or paper format and must be in English or French and any
translation into English or French must be a certified translation
Digital format:
The Canadian SMART Health Cards is a paper or digital copy of a person clinical information,
including their vaccination history. The Government of Canada has worked with provincial health
authorities to develop a pan-Canadian approach to verify proof of vaccination.
The use of these digital formats is strongly encouraged, as they:

 are a secure and verifiable health record that is digitally signed by a trusted authority (for
example, the issuing province or territory)
 use technology that allows officials to verify and authenticate the information without
giving access to other health or identity information
 prevent forgeries and tampering by detecting any changes to the document after it has
been issued
 allow users to hold a digital copy on a portable device, such as a mobile phone or tablet, or
to print a copy directly or via a request to their provincial or territorial government, where
available
https://www.canada.ca/en/immigration-refugees-citizenship/services/canadian-covid-19-proof-
vaccination.html.
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Paper format:
A paper copy must be one that is issued by the government or the non-governmental entity that is
authorized to issue the evidence of COVID-19 vaccination in the jurisdiction in which the vaccine
was administered, and must contain the following information:

3. the brand name or any other information that identifies the vaccine that was administered;
and; or
4. the dates on which the vaccine was administered or, if the evidence is one document issued
for more than one dose and the document only specifies the date on which the most recent
dose was administered, that date.
Fully vaccinated person means a person who completed, at least 14 days prior, a COVID-19 vaccine
dosage regimen, if;
1. in the case of a vaccine dosage regimen that uses a COVID-19 vaccine that is authorized for sale
in Canada,
a. the vaccine has been administered to the person in accordance with its labelling, or
b. the Minister of Health determines, on the recommendation of the Chief Public Health
Officer, appointed under subsection 6(1) of the Public Health Agency of Canada Act, that
the regimen is suitable, having regard to the scientific evidence related to the efficacy of
that regimen in preventing the introduction or spread of COVID-19 or any other factor
relevant to preventing the introduction or spread of COVID-19; or
a. the vaccines of the regimen are authorized for sale in Canada or in another jurisdiction,
and
the vaccines and the regimen are suitable, having regard to the scientific evidence
related to the efficacy of that regimen and the vaccines in preventing the introduction
or spread of COVID-19 or any other factor relevant to preventing the introduction or
spread of COVID-19.
19/vaccines.html
Exceptions
A company-wide vaccination policy must not provide for exceptions to the requirement that all
employees be vaccinated in accordance with the vaccination policy other than exceptions described in
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Section G of the Ministerial Order. Further guidance on these exceptions can be found in "Section 4:
General Requirements” of this document.
Accommodation Measures
A company-wide vaccination policy must provide for accommodation measures, including COVID-19
testing on a regular basis, for employees who fall within the exceptions listed in the company-wide
vaccination policy. Further guidance on accommodations can be found in "Section 4: General
Requirements” of this document.
Communication and Filing Requirements

Date Requirement
No later than November 15,  A railway company must file with the Minister its company-wide
2021 vaccination policy.
 A railway company must communicate its company-wide

vaccination policy to its employees.
After November 15, 2021  Any changes to the policy must be filed with the Minister prior
to the implementation of those changes.
 Any changes to the policy must be communicated to the railway

company’s employees prior to the implementation of those
changes.
When filing changes to the policy with the Minister, railway companies are asked to include the
following information in their submission:
 a description of the changes;

 the effective date of the changes; and
 an overview of the employees who will be affected by the changes (if not all employees).
Railway companies should submit their policy, and any subsequent changes to the Rail Safety
Directorate at railsafety@tc.gc.ca.
Record Keeping and Filing Requirements

A railway company must maintain records that note the name and position of an employee, their
location of employment, their vaccination status, whether they are subject to an exception and, if so,
the reason for the exception. These records should be maintained in accordance with the privacy
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requirements set by the Ministerial Order and are subject to all applicable legislation, which may
include the Personal Information Protection and Electronic Documents Act.
For additional information on the privacy requirements, please refer to “Section 4 – General
Requirements” of this document.
A railway company must file with the Minister, every 7 days, summary data on the number of
employees who:
 have been fully vaccinated;

 have not been fully vaccinated because they fall within an applicable exception category;
 have received their first dose of vaccine and are awaiting their second dose; and
 have been placed on leave without pay in relation to their vaccination status.
Railway companies must file their data to the Minister in a .CSV file format to the Rail Safety
Directorate at railsafety@tc.gc.ca.
Other Requirements
Please refer to “Section 4: General Requirements” of this documents for information on requirements
that apply to both company-wide policies and Ministerial Order requirements.
Section 3 – Companies that Choose not to Implement a Company-Wide

Policy
Application
The vaccination mandate outlined in the Ministerial Order applies to all operating employees of
companies that choose not to implement a company-wide policy as described in Section B of the
Order. For the purpose of the order, “Operating employee” means a person who is in a safety critical
position, as defined by the Rules Governing Safety Critical Positions.
A company that chooses not to implement a company-wide policy as described in section B of the MO
will be required to comply with the requirements set out an all other sections of the Ministerial Order.
Timeline for vaccination

Date Requirement
November 15, 2021 All operating employees, who are not subject to an exception, must
have their first dose of an approved COVID-19 vaccine.
November 15, 2021 All operating employees who are not fully vaccinated must be tested
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using a COVID-19 test every 72 hours until they are fully vaccinated.
The operating employee will also be subject to any other measures
put in place by the railway company as those set out by the public
health guidance.
December 29, 2021 All operating employees, who are not subject to an exception, must
be fully vaccinated.
December 30, 2021 Companies will begin to apply sanctions for operating employees
who remain unvaccinated and are not exempt from the vaccination
requirement.
Verification Process
The railway company must not operate railway equipment on a railway unless the company has
verified that every operating employee who is not on leave and does not fall within an exception has a
Proof of Vaccination Credential before they enter any place, or board any equipment, owned or
controlled by the railway company.
provide a PVC in a way that they know to be false or misleading. For additional information on false
declarations, please refer to “Section 4 – General Requirements” of this document.
For the purpose of verifying compliance with the Ministerial Order, a railway safety inspector could
request a PVC or a proof of exception (on a Transport Canada form) to any operating employee.
Therefore, the company must ensure that all operating employees carry their PVC or proof of
exception at all times.
Proof of Vaccination Credentials (PVC): an acceptable proof of vaccination credential confirms that the
person is fully vaccinated by completing, at least 14 days prior, a COVID-19 vaccine dosage regimen. A
PVC may be presented either in a digital or paper format and must be in English or French and any
translation into English or French must be a certified translation.
Digital format:
The Canadian SMART Health Cards is a paper or digital copy of a person clinical information,
including their vaccination history. The Government of Canada has worked with provincial health
authorities to develop a pan-Canadian approach to verify proof of vaccination. The use of these
digital formats is strongly encouraged, as they:
 are a secure and verifiable health record that is digitally signed by a trusted authority (for
example, the issuing province or territory)
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 use technology that allows officials to verify and authenticate the information without
giving access to other health or identity information
 prevent forgeries and tampering by detecting any changes to the document after it has
been issued
 allow users to hold a digital copy on a portable device, such as a mobile phone or tablet, or
to print a copy directly or via a request to their provincial or territorial government, where
available
https://www.canada.ca/en/immigration-refugees-citizenship/services/canadian-covid-19-proof-
vaccination.html.
Paper format:
A paper copy must be one that is issued by the government or the non-governmental entity that is
authorized to issue the evidence of COVID-19 vaccination in the jurisdiction in which the vaccine
was administered, and must contain the following information:

3. the brand name or any other information that identifies the vaccine that was administered;
and
4. the dates on which the vaccine was administered or, if the evidence is one document issued
for more than one dose and the document only specifies the date on which the most recent
dose was administered, that date.
Fully vaccinated person means a person who completed, at least 14 days prior, a COVID-19 vaccine
dosage regimen, if;
1. in the case of a vaccine dosage regimen that uses a COVID-19 vaccine that is authorized for sale
in Canada,
a. the vaccine has been administered to the person in accordance with its labelling, or
spread of COVID-19; or
a. the vaccines of the regimen are authorized for sale in Canada or in another jurisdiction,
and
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spread of COVID-19.
19/vaccines.html
Exceptions
A railway company is not required to verify proof of vaccination for an operating employee that
qualifies for an exception listed in Section G of the Ministerial Order. Further guidance on exceptions
can be found in "Section 4: General Requirements” of this document.
Accommodation Measures
A railway company must provide for accommodation measures, including COVID-19 testing every 72
hours, for operating employees who are exempted from providing a proof of vaccination credential.
Further guidance on accommodations can be found in "Section 4: General Requirements” of this
document.
Testing Regime
A railway company must implement a testing regimen to monitor for the presence of COVID-19, using
COVID-19 test methods*, for all employees as well as for all company contractors and agents who
enter onto the premises, at any company location frequented by operating employees. If an operating
employee who has come into contact with persons that are not operating employees begins
demonstrating symptoms of COVID-19, they should be refused access to railway equipment and
railway company locations and undergo a COVID-19 test.
provide a proof of a COVID-19 test result in a way that they know to be false or misleading. For
additional information on false declaration, please refer to “Section 4 – General Requirements” of this
document.
*Different COVID-19 tests, such as rapid tests and COVID-19 molecular tests, are available. However, if
a test result is obtained by a method other than a molecular test and is not considered an acceptable
result under section E of the MO, the employee can only return once they provide the railway
company an acceptable proof of a COVID-19 molecular test result and is authorized to return to work
by local public health authorities.
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For additional information on COVID-19 testing and screening, please consult the following link:
screening-contact-tracing.html
A proof of a COVID-19 molecular test result confirms that the person has received results of a COVID-
19 molecular test.
The Ministerial Order defines a COVID-19 molecular test as a COVID-19 screening or diagnostic test
carried out by an accredited laboratory, including a test performed using the method of polymerase
chain reaction (PCR) or reverse transcription loop-mediated isothermal amplification (RT-LAMP). For a
list of tests that are considered molecular tests, please consult the “Accepted Types of Tests” section
that can be found on the following webpage: https://travel.gc.ca/travel-covid/travel-
restrictions/flying/covid-19-testing-travellers-coming-into-canada
An acceptable proof of a COVID-19 molecular test includes both a paper and digital copy and must:
1. include:
a. the name and date of birth of the person whose specimen was collected for the test;
b. the name and civic address of the laboratory that administered the test;
d. the test result.
2. in the case where the test result is negative, it must be for a COVID-19 molecular test that was
performed on a specimen collected no more than 72 hours prior to receipt by the railway
company; and
3. in the case test result is positive, it must be for a COVID-19 molecular test that was performed
on a specimen collected at least 14 days and no more than 180 days prior to receipt by the
railway company.
If the operating employee does not provide acceptable results, they must not return to any location
controlled by the railway company until authorized to do so by local health authorities. For further
guidance on test analysis by local health authorities, please consult provincial resources. For example,
the Ontario Ministry of Health provides guidance here. Other provinces have also developed
guidelines.
Data Collection, Record Keeping and Filing Requirements

A railway company must maintain records that note the name, the position of the operating employee,
their location of employment, their vaccination status, whether they were subject to an exception and,
if so, the reason for the exception. These records should be maintained in accordance with the privacy
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requirements set by the Ministerial Order and are subject to all applicable legislation, which may
include the Personal Information Protection and Electronic Documents Act. For additional information
on the privacy requirements, please refer to “Section 4 – General Requirements” of this document.
A railway company must, on a daily basis, keep records and file with Transport Canada in a .CSV file
format to the Rail Safety Directorate at railsafety@tc.gc.ca, of:
 vaccination status of every operating employee of every train including:

o employees that are partially or fully vaccinated;
o exceptions due to medical or religious reasons; and
o employees that have been subject to sanctions
 whether any delays were incurred due to crewing issues
The information filed with Transport Canada must not contain personal information as defined in
section 3 of the Privacy Act, which includes employee names.
The company must keep all records referred to in this section and under the section on exceptions in
the Order for a period of 24 months after the day on which they were created.
Other Requirements
Please refer to “Section 4: General Requirements” of this documents for information on requirements
that apply to both company-wide and the requirements of the Ministerial Order.
Section 4 – General Requirements

The following requirements apply whether or not the company chooses to implement a company-wide
vaccination policy.
Monitoring
A railway company must, on a continual basis, monitor the implementation of either the vaccination
policy or the requirements of the Order. Below are some examples of techniques companies could use.
The list is not exhaustive.
 recording compliance to measures implemented by the company;

 using data capturing and record keeping measures;
 adjusting the application of the company-wide policy;
 asking employees to make declarations on the requirements of the policy;
 conducting an audit; or
 conducting surveys.
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False declarations
The railway company must advise every employee not to provide proof of vaccination credential, proof
of COVID-19 test or any written evidence or attestation related to an exception in a way that they
know to be false or misleading. False and/or misleading declarations may constitute fraud or perjury
under the Criminal Code.
Exceptions
Medical and Religious Exceptions

The Ministerial Order requires that employers provide for a procedure to grant exceptions from the
requirement to be fully vaccinated in very limited circumstances, namely if the person has not
completed a COVID-19 vaccination regime due to a medical contraindication or the person’s sincerely
held religious beliefs.
NOTE: Transport Canada appreciates the cooperation in delivering on this important initiative
in a limited amount of time. Given the complexity associated with the implementation of the
measures included in this Order and the obligations you or other entities may have under the
Canadian Human Rights Act or other applicable legislation in terms of prescribed
discrimination, Transport Canada will work closely with you with respect to oversight and
enforcement to ensure effective implementation and avoid unintended consequences.
As a basic guideline for establishing and administering company vaccination policies, employers are
encouraged to refer to the Treasury Board Framework for the Implementation of the Policy on COVID-
19 Vaccination for the Core Public Administration:
In terms of the limited available accommodations, the section on Accommodations, of this document,
provides more detailed information regarding a step-wise process to document and make informed
decisions around whether to accommodate an employee on the basis of medical or religious grounds.
Furthermore, the railway company should use the templates in Annex A and B, of this document,
where an exception is granted for a medical contraindication or on the ground of religion, and for
those who are not yet fully vaccinated.
Further considerations - Medical

It is important to stay abreast of NACI guidance on COVID-19 vaccines, which is based on current
evidence: https://www.canada.ca/en/public-health/services/immunization/national-advisory-
committee-on-immunization-naci/recommendations-use-covid-19-vaccines/summary-october-22-
2021.html
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At present, the Medical Exception form tracks three specific categories under which to make a certified
request for exception on medical grounds, namely if the individual:
1. Has a medical contraindication to full vaccination against COVID-19 with mRNA vaccine (Pfizer-
BioNTech or Moderna vaccines) based on recommendation of the National Advisory Committee
on Immunization (as follows based on NACI advice as of September 10, 2021), and whether the
condition is permanent or time limited and in effect until a certain date:
 Confirmed allergy to polyethylene glycol (PEG) which is found in the Pfizer-BioNTech

and Moderna* COVID-19 vaccines
(Note that if the patient is allergic to tromethamine which is found in Moderna, they can
receive the Pfizer-BioNTech product)
2. Has a medical reason for delay of full vaccination against COVID-19 as described by the National
Advisory Committee on Immunization (as follows based on NACI advice as of September 10,
2021), and how long that reason is in effect:
 Due to an immunocompromising condition or medication, waiting to vaccinate when

immunocompromised state / medication is lower)
3. Has a medical reason precluding full vaccination against COVID-19 not covered above, a
description of the reason, and whether that reason is permanent or time-limited and in effect
until a certain date.
Further Considerations – Religious Grounds:

Leaders and members of a number of religions (e.g., Islam, Roman Catholicism, Judaism, Greek
Orthodox, Mennonites, Jehovah’s Witnesses, Christian Science) have released public statements
indicating their support for the COVID-19 vaccine specifically in the interest of public health.
Nevertheless, an individual may hold a strongly held religious belief that prevents full vaccination.
As an additional reference, the Government of Canada has provided guidance with respect to how it
will evaluate requests for accommodation on the ground of religion, as follows:
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Each request is to be evaluated on a case-by-case basis. Managers should consider the information
provided by the employee to substantiate the request for accommodation based on religion. The
information must clearly demonstrate the following three elements:
1. That the belief is religious in nature:
 Religion typically involves a particular and comprehensive system of faith and worship
as well as the belief in a divine, superhuman or controlling power (e.g., “I don’t believe
in vaccination” would not in itself be a reason).
 It does not apply to beliefs, convictions or practices that are secular, socially based or
only conscientiously held; nor does it protect false empirical beliefs about the
development, the contents, effects, or purpose of the vaccines.
Note: it is not necessary for the employee to prove that the religious belief is objectively
recognized as valid by other members of the same religion or that it is required by official
religious dogma or is in conformity with the position of religious officials (e.g., confirmation
by a priest, rabbi, imam or other spiritual leader).
2. That the belief prevents full vaccination:
 The information provided by the employee must demonstrate how the religious belief
prevents vaccination.
 It is not sufficient for the employee to say they have a certain religious belief and they
cannot be vaccinated. They must explain how vaccination would conflict with their
religious belief in a way that is not trivial or insubstantial (i.e., being vaccinated conflicts
with the employee’s genuine connection with the divine).
3. That it is sincerely held:
 Where the employee provides a sworn affidavit, this can be a sign of the sincerity of the
belief since this becomes a record with legal standing. Swearing a false affidavit is a
serious offence and would constitute perjury under the Criminal Code. The seriousness
with which an affidavit is sworn before a Commissioner of Oaths is a safeguard of the
accuracy of the information contained within.
 Factors that indicate whether the belief is sincere could include: the overall credibility of
the employee’s statement as well as the consistency of the belief with the employee’s
other current religious practices (it is, however, inappropriate to rigorously focus on
past religious practices since these can evolve over time).
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Accommodations
If the employee is required to provide an acceptable proof of vaccination:
 The railway company must ensure that operating employees who are not yet fully vaccinated
provide an acceptable proof of a COVID-19 test result every 72 hours. If a result, other than an
acceptable result is obtained by a method other than a molecular test, the railway company
must ensure that an acceptable proof of a COVID-19 molecular test result is obtained.
If the employee is not required to provide an acceptable proof of vaccination because of an exception:
 The railway company must verify that the employee provides an acceptable proof of a COVID-
19 test result every 72 hours. If a result, other than an acceptable result is obtained by a
method other than a molecular test, the railway company must ensure that an acceptable
proof of a COVID-19 molecular test result is obtained.
A railway company must have in place any other accommodation measures as set out in local public
health guidance for the employees described in this section.
Privacy Considerations – Transport Canada Policies on Vaccination Mandates in the

Companies must ensure that personal information is only created, collected, retained, used, disclosed,
and disposed of in a manner that respects the provisions set out in applicable Canadian privacy
legislation and other applicable legislation. As such, companies must ensure that privacy is considered
at the earliest opportunity and that they implement best privacy practices in order to properly protect
the personal information that will be processed.
Please note that the privacy tips below are provided solely as general privacy considerations and do
not constitute legal advice. For specific advice on compliance with applicable privacy laws, please
contact your legal counsel, privacy professional and/or consult with the applicable Privacy
Commissioners’ Office.
 Be transparent with employees/passengers and inform them about the reasons for collection, use,
disclosure (including but not limited to the disclosure to Transport Canada), retention and disposal
of their personal information and the consequences for not providing the requested personal
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information, through a concise, transparent, intelligible and easily accessible Privacy Notice
Statement (“PNS”), as required under applicable Canadian privacy legislation.
 Employees/Passengers should also be informed and provided with a contact to request access to,
and correction of, any personal information available or to make an inquiry or complaint about the
handling of their personal information, including the contact for the Privacy Commissioner of the
relevant jurisdiction and accountable individual who can respond to questions and concerns
regarding the vaccine requirements.
 Provide a link to your vaccination policies for employees and/or passengers, as applicable.
 The necessity, effectiveness, proportionality and data minimization principles should be applied so
that the least amount of personal information is collected, used or disclosed, for example:
 Employee/Passenger data related to vaccination status is only used for the purposes it was
collected for, retained for a specific period of time and can only be accessed on a need to know
basis.
 All company/operator personnel handling personal information, including managers, are aware of
their responsibilities and adhere to applicable Canadian privacy legislation and other applicable
legislation.
Relevant Links:
Joint Statement issued by the Privacy Commissioner of Canada and his Provincial and Territorial
counterparts in May 2021 on Privacy and COVID-19 Vaccine Passports (The Statement).
Provincial and territorial privacy laws and oversight: List of the provincial and territorial privacy laws as
well as the privacy commissioner offices responsible for their enforcement issued by the Privacy
Commissioner of Canada.
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Annex A: Medical Exception Request Form

The person requesting a medical exception must submit a completed copy of this form in its entirety. All pages
must be reviewed and completed by the person to be exempted and/or requester, as well as the required medical
doctor or nurse practitioner. The employer evaluating this request must do so in accordance with its legal duty to
accommodate under the applicable legislation.
PART I OF MEDICAL EXCEPTION
Please provide the following concerning the person for which a medical exception is requested:
Home Address: ________________________________________
Requester’s Information
If the requester is different than the person to be exempted, please complete the following:
Mailing Address: ________________________________________
Provincial / Territorial Government
In some cases, a provincial or territorial government may issue a credential to the effect that an individual cannot be
vaccinated. The employer can accept this credential instead of a medical doctor or nurse practitioner attestation. If
this situation applies, the person requesting the exception must select the check box below and present their
provincial or territorial credential to their employer for verification.
 The person requesting a medical exception is in possession of a provincial or territorial government issued
credential (e.g. QR code) confirming that the person cannot be vaccinated. The employer must verify the
credential prior to granting a medical exception.
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Medical Doctor Or Nurse Practitioner
Medical Statement
I, _______________________________ am a licensed Physician/Nurse Practitioner in the province / territory of

___________________________. I hereby certify that ________________________________ (indicate one of the
following):
 1) Has a medical contraindication to full vaccination against COVID-19 with mRNA vaccine (Pfizer-
BioNTech or Moderna vaccines) based on recommendation of the National Advisory Committee on
Immunization (as follows based on NACI advice as of September 10, 2021):

 Confirmed allergy to polyethylene glycol (PEG) which is found in the Pfizer-BioNTech and Moderna
COVID-19 vaccines
(Note that if the patient is allergic to tromethamine which is found in Moderna, they can receive the
Pfizer-BioNTech product)

 Permanent
 2) Has a medical reason for delay of full vaccination against COVID-19 as described by the National
Advisory Committee on Immunization (as follows based on NACI advice as of September 10, 2021):
 Due to an immunocompromising condition or medication, waiting to vaccinate when immune
response can be maximized (i.e., waiting to vaccinate when immunocompromised state / medication
is lower)
This medical reason will be in effect until ___________________________
 3) Has a medical reason precluding full vaccination against COVID-19 (not covered above) as described
below (for privacy reasons, only include information related to why the medical reason precludes
vaccination):
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
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 Permanent
Signature: ______________________________________ Date: _______________________________
Name: ________________________________ Telephone number:______________________________
License number: __________________ Province/Territory: _____________________________
Requester’s Attestation
The following is to be completed by or on behalf of the person requesting a medical exception:
I hereby certify that I am/or the person for which a request is made is unable to be vaccinated due to a medical
condition:
Date: ________________________________ Location: ________________________________
As per the applicable Order Pursuant to section 32.01 of the Railway Safety Act MO 21-07, a person who provides
information to a carrier that is known to be false or misleading may also be subject to enforcement action, including
prosecution.
Your privacy is important. Personal information you provide in this form will be used for the purposes of determining
the qualification of the person identified on this form for medical exception from the requirements of the Order
Pursuant to section 32.01 of the Railway Safety Act MO 21-07. Please note that the railway company is subject to
applicable privacy legislation with respect to the handling of your personal information.
The personal information in this form may be provided to and used by Transport Canada for the purpose of audit and
enforcement. The Minister of Transport may collect this personal information pursuant to the applicable legislation,
under the Railway Safety Act
In the event that any personal information is provided to Transport Canada, it will only be used and disclosed by
Transport Canada in accordance with the Privacy Act and its’ regulations. The personal information collected, as well
as its use, disclosure and retention is described in the applicable personal information bank (“PIB”), which is currently
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being developed, and will be published on Transport Canada’s Info Source page (https://tc.canada.ca/en/info-
source). Under the provisions of the Privacy Act, individuals have the right of access to, correction of and protection
of their personal information. Instructions for obtaining personal information are provided in Info Source, a copy of
which is available in major public and academic libraries or online at http://www.infosource.gc.ca. Individuals who
wish to exercise their right to complaint under the Privacy Act about the handling of their personal information may do
so by filing a complaint with the Office of the Privacy Commissioner. For information on how the railway company
processes your personal information, please visit their applicable privacy policy or contact them directly.
PART 2 OF EXCEPTION
Important Notice: Only Part 2 of this exception is to be provided by the employee, upon request, to Transport
Canada. Should additional information be required by Transport Canada, a government official will contact the
Employer* directly.
Confirmation of Exception by
Employer*
This is to confirm that _______________________________ (full name of the exempted person), has an exception
from the mandatory vaccination requirements under the Order Pursuant to section 32.01 of the Railway Safety Act
MO 21-07.
Title: ________________________________ Organisation: _______________________________
Phone number (day): ________________________________
Date: ________________________________ Location: ________________________________
* Part 2 is to be completed by the employer or an organisation responsible to validate the exception request in
accordance with the applicable company-wide mandatory vaccination policy.
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Annex B: Religious Exception Request Form

The person requesting a religious exception must submit a completed copy of this form in its entirety. All pages
must be reviewed and completed by the person to be exempted and/or requester, as well as by the required
commissioner for taking oaths. The employer evaluating this request must do so in accordance with its legal duty
to accommodate under the applicable legislation.
PART I OF RELIGIOUS EXCEPTION
Please provide the following concerning the person for which a religious exception is requested:
Home Address: ________________________________________
Affidavit - Religious Belief
Please provide the requested information concerning your religious belief. Note, leaders and members of a number
of religions (e.g., Islam, Roman Catholicism, Judaism, Greek Orthodox, Mennonites, Jehovah’s Witnesses,
Christian Science) have released public statements indicating their support for the COVID-19 vaccine
specifically in the interest of public health.
Affidavit of ___________________________________ (name)
I, ________________________________ (full name), currently employed as ________________________ (position)
at __________________________________ (organization), MAKE OATH OR SOLEMNLY AFFIRM AND SAY AS
FOLLOWS:
1. The requirements of the Vaccination Policy for _______________________________ (organization) conflicts

with my sincerely held religious belief or practice that prohibits me from receiving the COVID-19 vaccine.
2. The nature of this sincerely held religious belief or practice is as follows (please describe the reasons why
your religious belief prohibits you from receiving the COVID-19 vaccine).
_________________________________________________________________________________
_________________________________________________________________________________
_________________________________________________________________________________
_________________________________________________________________________________
_________________________________________________________________________________
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_________________________________________________________________________________
_________________________________________________________________________________
_________________________________________________________________________________
_________________________________________________________________________________
Signature: ________________________________ Full Name: __________________________________
Date: ____________________________________ Location: ____________________________________
Signature of Commissioner Of Oaths
The following is to be completed by a commissioner of oaths:
SWORN OR SOLEMNLY AFFIRMED before me at: ________________________________ (Municipality)
in ________________________________ (Province, State, or Country) on __________________ (Date)
It is an offence under section 131 of the Criminal Code to make a false statement under oath or solemn
affirmation, by affidavit, solemn declaration or deposition or orally, knowing that the statement is false. It is further
an offence under section 366 of the Criminal Code to make a false document, knowing it to be false.
As per the applicable Order Pursuant to section 32.01 of the Railway Safety Act MO 21-07, a person who provides
information to a carrier that is known to be false or misleading may also be subject to enforcement action,
including prosecution.
Your privacy is important. Personal information you provide in this form will be used for the purposes of
determining the qualification of the person identified on this form for an exception on the grounds of religious belief
from the requirements of the Order Pursuant to section 32.01 of the Railway Safety Act MO 21-07. Please note
that the railway company is subject to applicable privacy legislation with respect to the handling of your personal
information.
The personal information in this form may be provided to and used by Transport Canada for the purpose of audit
and enforcement. The Minister of Transport may collect this personal information pursuant to the applicable
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legislation, under the Railway Safety Act
In the event that any personal information is provided to Transport Canada, it will only be used and disclosed by
Transport Canada in accordance with the Privacy Act and its’ regulations. The personal information collected, as
well as its use, disclosure and retention is described in the applicable personal information bank (“PIB”), which is
currently being developed, and will be are published on Transport Canada’s Info Source page
(https://tc.canada.ca/en/info-source). Under the provisions of the Privacy Act, individuals have the right of access
to, correction of and protection of their personal information. Instructions for obtaining personal information are
provided in Info Source, a copy of which is available in major public and academic libraries or online at
http://www.infosource.gc.ca. Individuals who wish to exercise their right to complaint under the Privacy Act about
the handling of their personal information may do so by filing a complaint with the Office of the Privacy
Commissioner. For information on how the railway company processes your personal information, please visit
their applicable privacy policy or contact them directly.
PART 2 OF EXCEPTION
>1
Important Notice: Only Part 2 of this exception is to be provided by the employee, upon request, to Transport Canada.
Should additional information be required by Transport Canada, a government official will contact the Employer* directly.
Confirmation of Exception by Employer*

This is to confirm that _______________________________ (full name of the exempted person), has an exception
from the mandatory vaccination requirements under the Transport Canada Order Pursuant to section 32.01 of the
Railway Safety Act MO 21-07.
Signature: _________________________ Full Name: _____________________________
Title: _______________________________ Organisation:_____________________________
Phone number (day): ________________________________
Date: _______________________ Location: ________________________________
* Part 2 is to be completed by the employer or an organization responsible to validate the exception request in
accordance with the applicable company-wide mandatory vaccination policy.
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DOCUMENT D’ORIENTATION À L’INTENTION DES

COMPAGNIES DE CHEMIN DE FER
Sécurité ferroviaire – Vaccination obligatoire

des employés
Le présent document d’orientation vise à fournir des recommandations et des directives concernant
l’application de l’arrêté ministériel 21-07 de Transports Canada.
Mise en garde importante : Aucune information contenue dans le présent

document d’orientation n’a préséance sur toute exigence ou obligation décrite
dans l’arrêté ministériel de Transports Canada. Il vise plutôt à compléter ce
dernier et à fournir des recommandations et des directives sur la façon
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Table de matière
Section 1 – Généralités ............................................................................................................................... 4

Objectif .................................................................................................................................................... 4
Mandat fédéral de vaccination ............................................................................................................... 4
Approche opérationnelle ........................................................................................................................ 4
Section 2 – Politique de vaccination à l’échelle de la compagnie .............................................................. 4
Application .............................................................................................................................................. 4
Délais de vaccination et dépistage .......................................................................................................... 5
Processus de vérification......................................................................................................................... 6
Exceptions ............................................................................................................................................... 8
Mesures d’adaptation ............................................................................................................................. 8
Communication et exigences de dépôt .................................................................................................. 8
Tenue de dossier ..................................................................................................................................... 9
Autres exigences ..................................................................................................................................... 9
Section 3 – Compagnies qui choisissent de ne pas mettre en place une politique à l’échelle de la
compagnie................................................................................................................................................... 9
Application .............................................................................................................................................. 9
Délais de vaccination ............................................................................................................................. 10
Processus de vérification....................................................................................................................... 10
Exceptions ............................................................................................................................................. 12
Mesures d’adaptation ........................................................................................................................... 12
Régime de dépistage ............................................................................................................................. 12
Collecte de données, tenue de dossiers et exigence de dépôt ............................................................ 14
Autres exigences ................................................................................................................................... 14
Section 4 – Exigences générales ............................................................................................................... 14
Surveillance ........................................................................................................................................... 14
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Fausses déclarations ............................................................................................................................. 15

Exceptions pour raisons médicales ou religieuses ................................................................................ 15
Considérations supplémentaires – Raison médicale ........................................................................ 16
Considérations Supplémentaires – Raisons religieuses.................................................................... 17
Accommodations .................................................................................................................................. 18
Considérations relatives à la protection des renseignements personnels – Politiques de Transports
Canada sur les mandats de vaccination dans le secteur des transports .............................................. 19
Annexe A : FORMULAIRE DE DEMANDE D’EXCEPTION MÉDICALE .......................................................... 21
Annexe B : FORMULAIRE DE DEMANDE D’EXCEPTION POUR MOTIF RELIGIEUX .................................... 26
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Section 1 – Généralités
Objectif
L’objectif de ce document est de fournir un résumé des exigences pour les compagnies de chemin de
fer ainsi que des conseils, des lignes directrices et des gabarits pour la mise en œuvre des exigences de
l’arrêté ministériel 21-07.
Ce document vient compléter les documents d'orientation précédents préparés pour appuyer les
mesures d'intervention contre la COVID-19. Un lien vers ces documents se trouve ici: Mesures, mises à
jour et lignes directrices pour le transport ferroviaire liées à la COVID-19 émises par Transports Canada.
Mandat fédéral de vaccination

La pandémie a eu un impact dévastateur sur le secteur des transports au Canada. Bien que les mesures
de santé publique, notamment la distanciation sociale et le port du masque, ont été essentielles pour
lutter contre la propagation du virus, la COVID-19 et ses variants continuent de poser un risque
important pour la santé publique des Canadiens et Canadiennes.
Le gouvernement du Canada requiert la vaccination contre la COVID-19 pour tous les employés de
juridiction fédérale du secteur des transports. La vaccination est l’un des outils les plus efficaces pour
réduire les risques liés à la COVID-19 pour les Canadiens, protéger la santé publique et prévenir les
éclosions futures. Une exigence de vaccination pour les secteurs aérien, ferroviaire et maritime sous
réglementation fédérale améliorera la sûreté et la sécurité du système de transport du Canada et
facilitera la reprise des déplacements en toute sécurité.
Approche opérationnelle
Les compagnies de chemin de fer sont tenues de, soit:
 Mettre en place une politique de vaccination à l’échelle de la compagnie qui exige la

vaccination de chaque employé, à moins d’une exception; ou
 Vérifier que chaque employé d’exploitation, sauf si une exception s’applique, a fourni un
certificat de preuve de vaccination (CPV) avant de se présenter au travail.
Section 2 – Politique de vaccination à l’échelle de la compagnie

Application
Une politique de vaccination à l’échelle de la compagnie s’applique à tous les employés, y compris les
employés d’exploitation et tout autre employé de la compagnie de chemin de fer qui n’est pas en
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congé.
Une compagnie qui choisit de mettre en œuvre une politique de vaccination telle que décrite dans la
section B de l’arrêté ministériel n’est pas tenue de répondre aux exigences des sections C, D, et J de
l’arrêté. Cependant, la compagnie sera toujours assujettie aux sections E (Résultats d’essai relatif à la
COVID-19), F (Fausse déclaration), G (Exceptions), et K (Exigences de dépôt).
Délais de vaccination et dépistage

Date Exigence
Au plus tard le 30 octobre, Les compagnies doivent développer et mettre en œuvre leur
2021 politique de vaccination.
15 novembre, 2021 Toute personne employée par la compagnie de chemin de fer, sauf
si une exception s’applique, doit avoir reçu sa première dose d’un
vaccin COVID-19 approuvé.
15 novembre, 2021 Les personnes qui ne sont pas entièrement vaccinées, sauf si une
exception s’applique, doivent subir un dépistage à l’aide d’un
essai COVID-19* jusqu’à ce qu’elles soient entièrement
vaccinées*.
24 janvier, 2022 Toute personne employée par la compagnie de chemin de fer doit
être entièrement vaccinée*, sauf si une exception s’applique.
25 janvier, 2022 Les compagnies doivent appliquer un congé sans solde aux
employés qui ne sont pas vaccinés et qui ne sont pas sujet à une
exception de l'obligation de vaccination.
*Différents essais COVID-19, tels que les essais rapides et les essais moléculaires COVID-19, sont
disponibles. Cependant, si un résultat positif d’un essai est obtenu par une méthode autre qu'un essai
moléculaire, la compagnie ferroviaire doit s'assurer qu'un résultat d'un essai moléculaire COVID-19 est
obtenu.
Pour plus d'informations sur les essais et le dépistage COVID-19, veuillez consulter le lien suivant :
https://www.canada.ca/fr/sante-publique/services/maladies/maladie-coronavirus-covid-19/test-
depistage-recherche-contacts.html
L’arrêté ministériel défini essai moléculaire COVID-19” comme un essai de dépistage ou de diagnostic
de la COVID-19 effectué par un laboratoire accrédité, y compris l’essai effectué selon le procédé
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d’amplification en chaîne par polymérase (ACP) ou d’amplification isotherme médiée par boucle par
transcription inverse (RT-LAMP). Pour obtenir une liste des tests considérés comme des tests
moléculaires, veuillez consulter la section « Types de tests acceptés » qui se trouve sur la page Web
suivante : https://voyage.gc.ca/voyage-covid/voyage-restrictions/liste-verification-avion-canada/tests-
depistage-covid-19-voyageurs-arrivent-canada
Une preuve d’essai moléculaire relatif à la COVID-19 comprend à la fois une copie papier et une copie
numérique et doit contenir les renseignements suivants :
a. les prénoms, nom et date de naissance de la personne de laquelle l’échantillon a été
prélevé;
b. le nom et l’adresse municipale du laboratoire qui a effectué l’essai;
c. la date de prélèvement de l’échantillon et la méthode d’essai utilisée; et
La compagnie de chemin de fer doit aviser chaque employé qu'il s'exposerait à des sanctions s'il fournit
une preuve d'un essai de COVID-19 d'une manière qu'il sait être fausse ou trompeuse. Pour plus
d'informations sur les fausses déclarations, veuillez-vous reporter à la « Section 4 – Exigences
générales » de ce document.
Processus de vérification
Une politique de vaccination à l’échelle de la compagnie doit comprendre un processus de vérification
du statut vaccinal de ses employés au moyen d’un certificat de preuve de vaccination. La compagnie
devrait développer un plan de mise en œuvre pour leur processus de vérification.
La compagnie de chemin de fer doit informer chaque employé qu'il s'exposerait à des sanctions s'il
fournit un CPC d'une manière qu'il sait être fausse ou trompeuse. Pour plus d'informations sur les
fausses déclarations, veuillez-vous reporter à la « Section 4 – Exigences générales » de ce document.
Certificat de preuve de vaccination (CPV) : un certificat de preuve de vaccination acceptable confirme
que la personne est entièrement vaccinée en complétant, au moins 14 jours avant, le régime
posologique du vaccin contre la COVID-19. Un CPV peut être présenté en format numérique ou papier
et doit être en français ou en anglais et toute traduction en français ou en anglais doit être une
traduction certifiée.
Format numérique:
La carte Santé SMART canadienne est une copie papier ou numérique de l’information clinique
d’une personne, y compris ses antécédents de vaccination. Le gouvernement du Canada a
collaboré avec les autorités de santé provinciales pour élaborer une approche pancanadienne de
vérification des preuves de vaccination.
Le format numérique est fortement encouragé parce qu’il :
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 est un dossier de santé sécurisé et vérifiable qui est signé numériquement par une autorité de
confiance (par exemple, la province ou le territoire de délivrance);
 utilise une technologie qui permet aux responsables de vérifier et d’authentifier les
renseignements sans donner accès à d’autres informations sur la santé ou l’identité;
 empêche la falsification et la contrefaçon en détectant toute modification du document après
sa délivrance;
 permet aux utilisateurs de détenir une copie numérique sur un appareil portatif, tel qu’un
téléphone mobile ou une tablette, ou de directement imprimer une copie ou d’en demander
une à leur gouvernement provincial ou territorial, le cas échéant.
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Format papier:
La copie papier doit être celle émise par le gouvernement ou l'entité non gouvernementale qui est
autorisée à émettre la preuve de vaccination contre la COVID-19 dans la juridiction où le vaccin a
été administré, et doit comprendre les informations suivantes :
1. le nom de personne qui a reçu le vaccin;

2. le nom du gouvernement ou de l’entité non gouvernementale;
3. le nom de la marque ou toute autre information qui permet d’identifier le vaccin qui a été
administré; et;
4. les dates auxquelles le vaccin a été administré ou, si la preuve est un document émis pour
plus d'une dose et que le document ne précise que la date à laquelle la dose la plus récente
a été administrée, cette date.
Entièrement vaccinée s’entend d’une personne qui, au moins 14 jours avant, a suivi un protocole
vaccinal complet contre la COVID-19, si :
1. dans le cas d’un protocole vaccinal précisant un vaccin contre la COVID-19 qui est autorisé
pour la vente au Canada :
a. soit le vaccin a été administré à la personne conformément à son étiquetage,
b. soit le ministre de la Santé, sur recommandation de l’administrateur en chef, nommé en
vertu du paragraphe 6(1) de la Loi sur l'Agence de la santé publique du Canada, conclut
que le protocole vaccinal est approprié compte tenu des preuves scientifiques relatives
à son efficacité pour prévenir l’introduction et la propagation de la COVID-19 ou de tout
autre facteur pertinent à cet égard;
a. d’une part, les vaccins du protocole vaccinal sont autorisés pour la vente soit au Canada,
soit dans un pays étranger,
b. d’autre part, le ministre de la Santé, sur recommandation de l’administrateur en chef,
nommé en vertu du paragraphe 6(1) de la Loi sur l'Agence de la santé publique du
Canada, conclut que ces vaccins et le protocole vaccinal sont appropriés compte tenu
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des preuves scientifiques relatives à leur efficacité pour prévenir l’introduction et la

propagation de la COVID-19 ou de tout autre facteur pertinent à cet égard.
Pour des informations supplémentaires concernant les vaccins contre la COVID-19, veuillez consulter le
lien suivant: https://www.canada.ca/fr/sante-publique/services/maladies/maladie-coronavirus-covid-
19/vaccins.html
Exceptions
Une politique de vaccination à l’échelle de la compagnie ne doit pas prévoir d'exceptions liées à la
vérification par la compagnie de chemin de fer du statut vaccinal d'un employé, autres que les
exceptions décrites dans la section G de l'arrêté ministériel. Plus de détails sur ces exceptions, voir la
“Section 4: Exigences générales” de ce document.
Mesures d’adaptation
Une politique de vaccination à l’échelle de la compagnie doit prévoir des mesures d’adaptation, y
compris des essais relatifs à la COVID-19 sur une base régulière, pour les employés qui relèvent des
exceptions énumérées dans la politique de vaccination. Plus de détails sur les mesures d’adaptation,
voir la “Section 4: Exigences générales” de ce document.
Communication et exigences de dépôt

Date Exigence
Au plus tard le 15 novembre,  La compagnie de chemin de fer doit déposer auprès du
2021 ministre, sa politique de vaccination à l’échelle de la compagnie.
 La compagnie de chemin de fer doit communiquer sa politique

de vaccination à ses employés.
Après le 15 novembre, 2021  Tout changement à la politique doit être déposé auprès du
ministre avant d’être mis en œuvre.
 Tout changement à la politique doit être communiqué aux

employés de la compagnie de chemin de fer avant d’être mis en
œuvre.
Les compagnies de chemin de fer sont demandées de fournir les informations suivantes, avec leur
soumission, lorsqu’elles déposent un changement à leur politique auprès du ministre :
 une description des changements;

 la date d’entrée en vigueur des changements; et
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 un aperçu des employés qui seront affectés par les changements (si ce n'est pas tous les
employés).
Les compagnies de chemin de fer doivent déposer leur politique et tout changement ultérieur à la
Direction de la sécurité ferroviaire securiteferroviaire@tc.gc.ca.
Tenue de dossier
Une compagnie de chemin de fer doit maintenir des dossiers qui indiquent le nom et le poste des
l’employés, l’endroit où ils travaillent, leur statut vaccinal, si une exception leur a été accordée, et, si
oui, la raison de l’exception. Ces dossiers doivent être conservés selon les exigences en matière de vie
privée fixées par l’arrêté ministériel et toutes lois applicables, ceci peut inclure la Loi sur la protection
des renseignements personnels et les documents électroniques.
Pour des informations supplémentaires sur les exigences en matière de vie privée, veuillez consulter la
« Section 4 – Exigences générales » de ce document.
Une compagnie de chemin de fer doit déposer auprès du ministre, à chaque période de 7 jours, des
données sommaires sur le nombre:
 ont été entièrement vaccinés;

 n’ont pas été entièrement vaccinés, car ils font partie d’une catégorie d’exception applicable;
 ont reçu leur première dose de vaccin et sont en attente de leur deuxième; and
 ont été placés en congé sans solde dû à leur statut de vaccination.
Autres exigences
Veuillez consulter la “Section 4: Exigences générales” de ce document pour les exigences qui
s’appliquent à la fois aux politiques de vaccination à l’échelle d’une compagnie et aux exigences de
l’arrêté ministériel.
Section 3 – Compagnies qui choisissent de ne pas mettre en place une

politique à l’échelle de la compagnie
Application
Le mandat de vaccination décrit dans l’arrêté ministériel s’applique à tous les employés d’exploitation
des compagnies qui choisissent de ne pas mettre en place une politique de vaccination à l’échelle de la
compagnie, telle que décrite à la Section B de l’arrêté. « Employé d’exploitation » veut dire une
personne qui tient un poste essentiel à la sécurité, tel que défini par le Règlement concernant les
postes essentiels à la sécurité ferroviaire.
Une compagnie qui choisit de ne pas mettre en œuvre une politique de vaccination à l’échelle de la
compagnie telle que décrite à la section B de l’arrêté devra se conformer aux exigences énoncées dans
toutes les autres sections de l'arrêté ministériel.
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Délais de vaccination
Date Exigence
15 novembre 2021 Tous les employés d’exploitation, qui ne sont pas exemptés, doivent
avoir reçu leur première dose d’un vaccin approuvé pour la COVID-
19.
15 novembre 2021 Tous les employés d’exploitation, non sujet à une exception, qui ne
sont pas entièrement vaccinées doivent subir un dépistage à l’aide
d’un essai relatif à la COVID-19 chaque 72 heures jusqu’à ce qu’ils
soient entièrement vaccinés.
L'employé d'exploitation sera également soumis à toutes les autres
mesures mises en place par la compagnie ferroviaire comme celles
prévues par les directives de santé publique.
29 décembre 2021 Tous les employés d’exploitation, qui ne sont pas sujets à une
exception, doivent être entièrement vaccinés.
30 décembre 2021 Les compagnies appliqueront des sanctions aux employés

d’exploitation qui ne sont pas vaccinés et qui ne sont pas sujets à une
exception de l'obligation de vaccination.
Processus de vérification
La compagnie de chemin de fer ne doit pas exploiter de matériel ferroviaire sur un chemin de fer à
moins qu'elle n'ait vérifier que tous les employés de l’exploitation qui ne sont pas en congé ont fourni
un certificat de preuve de vaccination (CPV) avant d’entrer dans tout lieu, ou embarquer dans le
matériel ferroviaire, possédé ou opéré par la compagnie de chemin de fer.
La compagnie de chemin de fer doit aviser chaque employé qu’il serait soumis à des sanctions s’il
fournit un CPV d'une manière qu'il sait fausse ou trompeuse. Pour plus d’information sur les sanctions,
veuillez consulter la « Section 4 – Exigences générales » de ce document
Aux fins de vérifier la conformité à l'arrêté ministériel, un inspecteur de la sécurité ferroviaire pourrait
demander un CPV ou une preuve d'exception (sur un formulaire de Transports Canada) à tout employé
de l’exploitation. Par conséquent, la compagnie doit s'assurer que tous les employés de l’exploitation
aillent sur eux leur CPV ou une preuve d'exception en tout temps.
Certificat de preuve de vaccination (CPV) : une preuve de vaccination acceptable confirmant que la
personne est entièrement vaccinée en complétant, au moins 14 jours avant, le régime posologique du
vaccin contre la COVID-19. Un CPV peut être présenté en format numérique ou papier et doit être en
français ou en anglais et toute traduction en français ou en anglais doit être une traduction certifiée.
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Format numérique:
La carte Santé SMART canadienne est une copie papier ou numérique de l’information clinique
d’une personne, y compris ses antécédents de vaccination. Le gouvernement du Canada a
collaboré avec les autorités de santé provinciales pour élaborer une approche pancanadienne de
vérification des preuves de vaccination. Le format numérique est fortement encouragé parce qu’il :
 est un dossier de santé sécurisé et vérifiable qui est signé numériquement par une autorité
de confiance (par exemple, la province ou le territoire de délivrance);
 utilise une technologie qui permet aux responsables de vérifier et d’authentifier les
renseignements sans donner accès à d’autres informations sur la santé ou l’identité;
 empêche la falsification et la contrefaçon en détectant toute modification du document
après sa délivrance;
 permet aux utilisateurs de détenir une copie numérique sur un appareil portatif, tel qu’un
téléphone mobile ou une tablette, ou de directement imprimer une copie ou d’en
demander une à leur gouvernement provincial ou territorial, le cas échéant.
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Format papier:
La copie papier doit être émise par le gouvernement ou l'entité non gouvernementale qui est
autorisée à émettre la preuve de vaccination contre la COVID-19 dans la juridiction où le vaccin a
été administré, et doit comprendre les informations suivantes :
1. le nom de la personne qui a reçu le vaccin;
2. le nom du gouvernement ou de l’entité non gouvernementale;
3. le nom de la marque ou toute autre information qui permet d’identifier le vaccin qui a été
administré; et;
4. les dates auxquelles le vaccin a été administré ou, si la preuve est un document émis pour
plus d'une dose et que le document ne précise que la date à laquelle la dose la plus récente
a été administrée, cette date.
Entièrement vaccinée s’entend d’une personne qui a suivi un protocole vaccinal complet contre la
COVID-19 au moins 14 jours au préalable, si :
1. dans le cas d’un protocole vaccinal précisant un vaccin contre la COVID-19 qui est autorisé
pour la vente au Canada :
c. soit le vaccin a été administré à la personne conformément à son étiquetage,
d. soit le ministre de la Santé, sur recommandation de l’administrateur en chef de la santé
publique nommé en vertu du paragraphe 6(1) de la Loi sur l’Agence de la santé publique
du Canada, conclut que le protocole vaccinal est approprié compte tenu des preuves
scientifiques relatives à son efficacité pour prévenir l’introduction et la propagation de
la COVID-19 ou de tout autre facteur pertinent à cet égard;
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c. d’une part, les vaccins du protocole vaccinal sont autorisés pour la vente soit au Canada,
soit dans un pays étranger,
d. d’autre part, le ministre de la Santé, sur recommandation de l’administrateur en chef de
la santé publique nommé en vertu du paragraphe 6(1) de la Loi sur l’Agence de la santé
publique du Canada, conclut que ces vaccins et le protocole vaccinal sont appropriés
compte tenu des preuves scientifiques relatives à leur efficacité pour prévenir
l’introduction et la propagation de la COVID-19 ou de tout autre facteur pertinent à cet
égard.
Pour des informations supplémentaires concernant les vaccins contre la COVID-19, veuillez consulter le
lien suivant: https://www.canada.ca/fr/sante-publique/services/maladies/maladie-coronavirus-covid-
19/vaccins.html
Exceptions
La compagnie de chemin de fer n'est pas tenue de vérifier la preuve de la vaccination d'un employé de
l’exploitation qui bénéficie d'une exception énumérée à la section G de l'arrêté ministériel. Plus de
détails sur les exceptions se trouvent à la “Section 4: exigences générales” de ce document.
Mesures d’adaptation
La compagnie de chemin de fer doit prévoir des mesures d’adaptation, y compris des essais
moléculaires relatif à la COVID-19 aux 72 heures, pour les employés qui sont exemptés de fournir un
certificat de preuve de vaccination. Plus de détails sur les mesures d’adaptation se retrouvent à la
“Section 4 : Exigences générales” de ce document.
Régime de dépistage
La compagnie de chemin de fer doit mettre en place un régime de dépistage pour surveiller la présence
de la COVID-19, par le biais d’essais relatif à la COVID-19, pour tout employé de l’exploitation et pour
tout contacteur et agent de la compagnie qui entre dans tous les lieux de travail de la compagnie
fréquentés par les employés de l’exploitation.
Si un employé d’exploitation qui est entré en contact avec une personne qui n’est pas un employé de
l’exploitation, démontre des symptômes de la COVID-19, il ne doit pas opérer de trains ni avoir accès
aux lieux de travail de la compagnie de chemin de fer, et doit subir un essai relatif à la COVID-19. Cet
employé ne peut retourner au travail jusqu’à ce qu’il démontre une preuve acceptable du résultat d’un
essai relatif à la COVID-19 et qu’il soit autorisé de retourner au travail par les autorités locales de santé
publique.
La compagnie de chemin de fer doit aviser chaque employé qu’il pourrait faire face à des sanctions s’il
fournit une preuve d’un résultat de test moléculaire pour la COVID-19 d'une manière fausse ou
trompeuse. Ceci peut constituer un faux sous le Code criminel. Pour des informations supplémentaires
sur les sanctions, veuillez consulter la « Section 4 – Exigences générales » de ce document.
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*Différents essais COVID-19, tels que les essais rapides et les essais moléculaires COVID-19, sont
disponibles. Cependant, si un résultat d’un essai est obtenu par une méthode autre qu'un essai
moléculaire et n’est pas considéré acceptable tel que décrit sous la section E de l’arrêté, la compagnie
ferroviaire doit s'assurer qu'un résultat d'un essai moléculaire COVID-19 est obtenu.
Pour plus d'informations sur les essais et le dépistage COVID-19, veuillez consulter le lien suivant :
https://www.canada.ca/fr/sante-publique/services/maladies/maladie-coronavirus-covid-19/test-
depistage-recherche-contacts.html
La preuve de résultat d’un essai moléculaire COVID-19 confirme que la personne a reçu les résultats
d’un essai moléculaire COVID-19.
L’arrêté ministériel défini un essai moléculaire COVID-19 comme un essai de dépistage ou de
diagnostic de la COVID-19 effectué par un laboratoire accrédité, y compris l’essai effectué selon le
procédé d’amplification en chaîne par polymérase (ACP) ou d’amplification isotherme médiée par
boucle par transcription inverse (RT-LAMP). Pour une liste d’essais qui sont considérés moléculaires,
veuillez consulter la section « Types de tests moléculaires de dépistage acceptés » à la page suivante :
Dépistage de la COVID-19 pour les voyageurs – Restrictions de voyage au Canada – Voyage.gc.ca
Une preuve d’essai moléculaire relatif à la COVID-19 comprend à la fois une copie papier et une copie
numérique et doit:
1. contenir les renseignements suivants:
a. les prénoms, nom et date de naissance de la personne de laquelle l’échantillon a été
prélevé;
b. le nom et l’adresse municipale du laboratoire qui a effectué l’essai;
c. la date de prélèvement de l’échantillon et la méthode d’essai utilisée; et
2. dans le cas d’un résultat négatif d’un essai moléculaire relatif à la COVID-19 qui a été effectué
sur un échantillon prélevé au plus tard 72 heures avant la réception par la compagnie de
chemin de fer; et
3. dans le cas d’un résultat positif, un résultat négatif d’un essai moléculaire relatif à la COVID-19
qui a été effectué sur un échantillon prélevé au moins 14 jours avant, mais pas plus de 180
jours avant la réception par la compagnie de chemin de fer.
Si un employé d’exploitation ne fournit pas un résultat acceptable, il ne doit pas retourner à un endroit
contrôlé par la compagnie de chemin de fer avant d'être autorisé à le faire par l’autorité de la santé
publique locale. Pour plus de renseignements sur l’analyse des résultats par les autorités de santé
publique locale, veuillez consulter les ressources provinciales. Par exemple, le Ministère de la santé de
l’Ontario offre des documents de soutien ici. D’autres provinces ont aussi développé des lignes
directrices semblables.
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Collecte de données, tenue de dossiers et exigence de dépôt

La compagnie de chemin de fer doit maintenir des dossiers qui indiquent le nom et le poste de
l’employé, leur lieu de travail, leur statut vaccinal, si une exception leur a été accordée, et, si oui, la
raison de l’exception. Ces dossiers doivent être tenus conformément aux exigences de confidentialité
fixées par l'arrêté ministériel et sont soumis à toutes les lois applicables, qui peuvent inclure la Loi sur
la protection des renseignements personnels et les documents électroniques. Plus de détails sur les
exigences en matière de vie privée, voir la “Section 4: exigences générales” de ce document.
La compagnie de chemin de fer doit maintenir des dossiers de rapports opérationnels quotidiens pour
chaque équipage de chaque train, indiquant leur statut vaccinal et si des retards sont survenus en
raison de problèmes d’équipage.
La compagnie de chemin de fer doit, quotidiennement, tenir des dossiers et déposer auprès de
Transports Canada dans un format de fichier .CSV à la Direction de la sécurité ferroviaire à
securiteferroviaire@tc.gc.ca, de :
 le statut vaccinal de chaque employé de l’exploitation de chaque train, y compris :
o les employés partiellement ou totalement vaccinés ;
o les exceptions pour raisons médicales ou religieuses ; et
o les employés ayant fait l'objet de sanctions.
 si des retards ont été encourus en raison de problèmes d'équipage.
Les renseignements déposés auprès de Transports Canada ne doivent pas contenir de renseignements
personnels tels que définis sous la section 3 de la Loi sur la protection des renseignements personnels,
qui comprend les noms des employés.
La compagnie de chemin de fer doit garder tous les dossiers visés par la section G, pendant une
période de 24 mois à compter du jour où ils ont été créés.
Autres exigences
Veuillez consulter la “Section 4: Exigences générales” de ce document pour les exigences qui
s’appliquent à la fois aux politiques à l’échelle d’une compagnie et aux exigences de l’arrêté ministériel.
Section 4 – Exigences générales

Les exigences suivantes s’appliquent, que la compagnie choisisse ou non de mettre en œuvre une
politique de vaccination à l’échelle de la compagnie.
Surveillance
Une compagnie de chemin de fer doit, de manière continue, surveiller la mise en œuvre de la politique
de vaccination ou des exigences de l'arrêté. Vous trouverez ci-dessous quelques exemples de
techniques que les compagnies de chemin de fer peuvent utiliser. Il ne s’agit pas d’une liste exhaustive.
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 conserver un registre du respect des mesures mises en place par l'entreprise;

 utiliser des mesures de saisies de données et de tenue de registres;
 adapter l’application de la politique de vaccination à l’échelle de la compagnie;
 demander aux employés de faire des déclarations sur les exigences de la politique;
 compléter une vérification; ou
 effectuer des sondages.
Fausses déclarations
La compagnie de chemin de fer doit aviser chaque employé de ne pas fournir un certificat de preuve de
vaccination, une preuve d’un résultat d’essai pour la COVID-19 ou toute preuve écrite ou attestation
liée à une exception d'une manière qu'elle sait être fausse ou trompeuse. Les déclarations fausses
et/ou trompeuses peuvent constituer une fraude en vertu du Code criminel.
Exceptions pour raisons médicales ou religieuses

L’arrêté ministériel exige que les employeurs prévoient une procédure pour accorder des exceptions à
l’obligation d’être complètement vacciné dans des circonstances très limitées, notamment si la
personne n’a pas suivi un régime de vaccination contre la COVID-19 en raison d’une contre-indication
médicale ou des croyances religieuses sincères de la personne.
NOTE : Transports Canada apprécie la collaboration dont tous doivent faire preuve pour mettre
en œuvre cette importante initiative dans un laps de temps limité. Compte tenu de la
complexité associée à la mise en œuvre des mesures incluses dans le présent arrêté et des
obligations que vous ou d’autres entités pourriez avoir en vertu de la Loi canadienne sur les
droits de la personne ou d’autres lois applicables en ce qui concerne la discrimination proscrite,
Transports Canada travaillera en étroite collaboration avec vous en ce qui concerne la
surveillance et l’application de la loi afin d’assurer une mise en œuvre efficace et d’éviter des
conséquences imprévues.
En tant que ligne directrice de base pour l’établissement et l’administration des politiques de
vaccination des entreprises, les employeurs sont encouragés à consulter le Cadre pour la mise en
œuvre de la Politique sur la vaccination contre la COVID-19 du Conseil du Trésor pour l’administration
publique centrale : https://www.canada.ca/fr/gouvernement/fonctionpublique/covid-19/vaccination-
fonction-publique/cadre-mise-oeuvre-politique-vaccination-contre-covid-19-applicable-apc-compris-
grc.html
En ce qui concerne les mesures d’adaptation limitées disponibles, la section sur les mesures
d’adaptation du présent document fournit des renseignements plus détaillés sur un processus par
étapes pour documenter et prendre des décisions éclairées quant à savoir s’il y a lieu de prendre des
mesures d’adaptation à l’égard d’un employé pour des motifs médicaux ou religieux.
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En outre, la compagnie de chemin de fer devrait utiliser les modèles des annexes A et B du présent
document, où une exception est accordée pour une contre-indication médicale ou pour des motifs
religieux, et pour ceux qui ne sont pas encore complètement vaccinés.
Considérations supplémentaires – Raison médicale

Il est important de se tenir au courant des lignes directrices du CCNI sur les vaccins contre la COVID-19,
qui sont fondées sur les données probantes actuelles : https://www.canada.ca/fr/sante-
publique/services/immunisation/comite-consultatif-national-immunisation-ccni/recommandations-
utilisation-vaccins-covid-19/resume-22-octobre-2021.html
À l’heure actuelle, le formulaire d’exception médicale suit trois catégories précises en vertu desquelles
présenter une demande d’exception certifiée pour des raisons médicales, à savoir si la personne :
1. A une contre-indication médicale à la vaccination complète contre la COVID-19 avec le vaccin à
ARNm (vaccins Pfizer-BioNTech ou Moderna) sur recommandation du Comité consultatif
national de l’immunisation (comme suit selon les conseils du CCNI en date du 10 septembre
2021), et si la condition est permanente ou limitée dans le temps et en vigueur jusqu’à une
certaine date :
 Antécédents d’anaphylaxie après l’administration antérieure d’un vaccin contre la

COVID-19 à ARNm.
 Allergie confirmée au polyéthylène glycol (PEG) qui se trouve dans les vaccins Pfizer-
BioNTech et Moderna* COVID-19.
(Notez que si le patient est allergique à la trométhamine qui se trouve dans Moderna, ils
peuvent recevoir le produit Pfizer-BioNTech.)
2. A une raison médicale de retarder la vaccination complète contre la COVID-19, telle que décrite
par le Comité consultatif national de l’immunisation (comme suit d’après les avis du CCNI en
date du 10 septembre 2021), et combien de temps cette raison est en vigueur :
 Antécédents de myocardite/péricardite à la suite de la première dose d’un vaccin à

ARNm.
 En raison d’une affection ou d’un médicament immunodéprimmant, attendre de

vacciner lorsque la réponse immunitaire peut être maximisée (c.-à-d. attendre de
vacciner lorsque l’état immunodéprimé ou le médicament est plus faible)
(Notez qu’une considération devrait être donnée aux risques et aux bénéfices lorsque la
vaccination est retardée.)
3. A une raison médicale excluant la vaccination complète contre la COVID-19 non couverte ci-
dessus, une description de la raison, et si cette raison est permanente ou limitée dans le temps
et en vigueur jusqu’à une certaine date.
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Considérations Supplémentaires – Raisons religieuses

Les dirigeants et les membres d’un certain nombre de religions (par exemple, l’islam, le catholicisme
romain, le judaïsme, les grecs orthodoxes, les mennonites, les Témoins de Jéhovah, la Science
chrétienne) ont publié des déclarations publiques indiquant leur soutien au vaccin contre la COVID-19
spécifiquement dans l’intérêt de la santé publique.
Néanmoins, une personne peut avoir une croyance religieuse fortement tenue qui empêche la
vaccination complète.
À titre de référence supplémentaire, le gouvernement du Canada a fourni des directives sur la façon
dont il évaluera les demandes d’accommodement fondées sur la religion, comme suit :
https://www.canada.ca/fr/gouvernement/fonctionpublique/covid-19/vaccination-fonction-
publique/cadre-mise-oeuvre-politique-vaccination-contre-covid-19-applicable-apc-compris-grc.html
Chaque demande doit être évaluée au cas par cas. Les gestionnaires devraient tenir compte des
renseignements fournis par l’employé pour justifier la demande de mesures d’adaptation fondées sur
la religion. L’information doit clairement démontrer les trois éléments suivants :
1. Que la croyance est de nature religieuse :
 La religion implique généralement un système particulier et complet de foi et de culte

ainsi que la croyance en un pouvoir divin, surhumain ou contrôlant (par exemple, « Je ne
crois pas à la vaccination » ne serait pas en soi une raison).
 Elle ne s’applique pas aux croyances, aux convictions ou aux pratiques qui sont laïques,
socialement fondées ou seulement consciencieusement tenues; il ne protège pas non
plus les fausses croyances empiriques sur le développement, le contenu, les effets ou le
but des vaccins.
Notez qu’il n’est pas nécessaire pour l’employé de prouver que sa croyance religieuse est
objectivement reconnue comme valide par d’autres membres de la même religion ou qu’il
est requis par le dogme religieux officiel ou est conforme à la position des officiels religieux
(par exemple, la confirmation par un prêtre, un rabbin, un imam ou un autre chef spirituel).
2. Que la croyance empêche la vaccination complète :
 Les renseignements fournis par l’employé doivent démontrer comment la croyance

religieuse empêche la vaccination.
 Il ne suffit pas que l’employé dise qu’il a une certaine croyance religieuse et qu’il ne
peut pas être vacciné. Ils doivent expliquer comment la vaccination entrerait en conflit
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avec leur croyance religieuse d’une manière qui n’est pas triviale ou insignifiante (c.-à-d.
être vacciné entre en conflit avec le lien authentique de l’employé avec le divin).
3. Qui est une croyance sincère :
 Lorsque l’employé fournit une déclaration sous serment, cela peut être un signe de la
sincérité de la croyance puisqu’il s’agit d’un document ayant qualité pour agir. Jurer un
faux affidavit est une infraction grave et constituerait une violation du Code de valeurs
et d’éthique du secteur public (qui est une condition d’emploi). Le sérieux avec lequel
un affidavit est assermenté devant un commissaire à l’assermentation constitue une
garantie de l’exactitude des renseignements qu’il contient.
 Les facteurs qui indiquent si la croyance est sincère pourraient inclure : la crédibilité
globale de la déclaration de l’employé ainsi que la cohérence de la croyance avec les
autres pratiques religieuses actuelles de l’employé (il est cependant inapproprié de se
concentrer rigoureusement sur les pratiques religieuses passées puisque celles-ci
peuvent évoluer au fil du temps).
Une fois que l’évaluation rigoureuse est terminée et que l’employé a fourni des attestations
acceptables, la compagnie peut remplir la partie 2 du formulaire de gestion des zones réglementées
pertinent afin que la compagnie ne soit pas tenue de vérifier la preuve de vaccination des personnes
exclues pour l’une des raisons suivantes : médicale ou religieuse
** Bien que le Code de valeurs et d’éthique ne s’applique qu’au secteur public, des conditions d’emploi
similaires peuvent également être en place pour vos employés.
Accommodations
Si la compagnie demande à l’employé de fournir un certificat de preuve de vaccination :
 La compagnie de chemin de fer doit s’assurer que l’employé d’exploitation qui n’est pas
entièrement vacciné fourni une preuve acceptable d’un essai moléculaire relatif à la COVID-19
chaque 72 heures. Si un résultat, autre qu’un résultat acceptable est obtenu par un moyen
autre que l’essai moléculaire, la compagnie doit s’assurer d’obtenir le résultat acceptable d’un
essai moléculaire.
Si la compagnie ne demande pas à l’employé de fournir un certificat de vaccination en raison d’une
exception :
 La compagnie de chemin de fer doit vérifier que l’employé fournit une preuve d’un essai relatif
à la COVID-19 chaque 72 heures. Si un résultat, autre qu’un résultat acceptable est obtenu par
un moyen autre que l’essai moléculaire, la compagnie doit s’assurer d’obtenir le résultat
acceptable d’un essai moléculaire.
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Une compagnie de chemin de fer doit mettre en place toute autres mesures d’adaptations définies
dans les directives de santé publique locale pour les employés décrit dans cette section.
Considérations relatives à la protection des renseignements personnels – Politiques de

Transports Canada sur les mandats de vaccination dans le secteur des transports
Les compagnies et les exploitants doivent s’assurer que les renseignements personnels ne sont créés,
recueillis, conservés, utilisés, divulgués et éliminés que dans le respect des dispositions de la législation
canadienne sur la protection des renseignements personnels et des autres lois applicables. Pour cette
raison, les compagnies et les exploitants doivent veiller à ce que la protection des renseignements
personnels soit prise en compte dès que possible et à ce qu’ils mettent en œuvre les meilleures
pratiques en matière de protection des renseignements personnels afin de protéger adéquatement les
renseignements personnels qui seront traités.
Veuillez noter que les conseils sur la protection des renseignements personnels ci-dessous ne sont
fournis qu’à titre de considérations générales sur la confidentialité et ne constituent pas des conseils
juridiques. Pour obtenir des conseils précis sur le respect des lois applicables en matière de protection
des renseignements personnels, veuillez communiquer avec votre conseiller juridique, votre
professionnel de la protection des renseignements personnels et/ou consulter le bureau des
commissaires à la protection de la vie privée applicable.
Considérations relatives à la protection des renseignements personnels :
 Documentez un but et une autorité définis pour la collecte et l’utilisation de ces renseignements
personnels.
 Soyez transparent avec les employés et/ou les passagers et informez-les des raisons de la collecte,
de l’utilisation, de la divulgation (y compris, sans toutefois s’y limiter, la divulgation à Transports
Canada), de la conservation et de l’élimination de leurs renseignements personnels et des
conséquences de ne pas fournir les renseignements personnels demandés, au moyen d’un énoncé
de confidentialité concis, transparent, intelligible et facilement accessible, tel que requis par la
législation canadienne applicable en matière de protection des renseignements personnels.
 Les employés et/ou les passagers devraient également être informés et obtenir les coordonnées
d’une personne-ressource pour demander l’accès et la correction de toute information personnelle
disponible ou pour faire une demande ou une plainte concernant le traitement de leurs
renseignements personnels, y compris la personne-ressource du Commissaire à la protection de la
vie privée de la juridiction concernée et la personne responsable qui peut répondre aux questions
et aux préoccupations concernant les exigences en matière de vaccination.
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 Fournissez un lien vers vos politiques de vaccination pour les employés et/ou les passagers, selon le
cas.
 Les principes de nécessité, d’efficacité, de proportionnalité et de minimisation des données

devraient être appliqués de manière à ce que le plus petit nombre possible de renseignements
personnels soit recueilli, utilisé ou divulgué, par exemple : champs de données inutiles dans un
formulaire.
 Les données sur les employés et les passagers se rapportant au statut vaccinal ne sont utilisées
qu’aux fins pour lesquelles elles ont été recueillies, conservées pendant une période donnée et ne
peuvent être consultées que sur la base du besoin de savoir.
 Tous les employés de la compagnie ou de l’exploitant qui traitent des renseignements personnels, y
compris les gestionnaires, sont au courant de leurs responsabilités et se conforment aux lois sur la
protection des renseignements personnels et aux autres lois canadiennes applicables.
 Envisagez de mener une évaluation des facteurs relatifs à la vie privée ou d’autres analyses
pertinentes relatives à la vie privée.
 Les plans et les procédures liés aux atteintes à la vie privée sont à jour.
 Les renseignements personnels sont protégés de façon appropriée contre tout accès non autorisé
et des mesures de protection techniques, physiques et administratives sont mises en place et sont
appropriées compte tenu de la sensibilité des renseignements personnels qui doivent être
recueillis, utilisés ou divulgués en vertu de l’exigence.
Liens pertinents :
Déclaration conjointe publiée par le commissaire à la protection de la vie privée du Canada et ses
homologues provinciaux et territoriaux en mai 2021 sur la vie privée et les passeports vaccinaux relatifs
à la COVID-19 (la Déclaration).
Lois et organismes de surveillance provinciaux et territoriaux en matière de protection de la vie privée :
Liste des lois provinciales et territoriales sur la protection de la vie privée ainsi que des commissariats à
la protection de la vie privée responsables de leur application publiée par le commissaire à la
protection de la vie privée du Canada.
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Annexe A : FORMULAIRE DE DEMANDE D’EXCEPTION MÉDICALE

La personne demandant une exception médicale doit soumettre une copie dûment remplie du présent
formulaire dans son intégralité. Toutes les pages doivent être revues et remplies par la personne à exempter
ou par le demandeur, ainsi que par le médecin ou l’infirmier praticien concerné. L'employeur qui évalue cette
demande doit le faire conformément à son obligation légale d'accommodement en vertu de la législation
applicable.
PARTIE I DE L’EXCEPTION MÉDICALE
Personne à exempter
Veuillez fournir les renseignements suivants concernant la personne au nom duquel une exception
médicale est demandée :
Prénom : __________________________ Nom de famille : __________________________
Adresse domiciliaire : ________________________________________
Renseignements sur le demandeur

Si le demandeur est différent de la personne à exempter, veuillez fournir les informations suivantes :
Adresse postale : ________________________________________
Gouvernements provinciaux et
territoriaux
Dans certains cas, le gouvernement d’une province ou d’un territoire peut délivrer une attestation
certifiant qu’une personne ne peut être vaccinée. L’employeur peut accepter cette attestation plutôt que
l’attestation d’un médecin ou d’une infirmière praticienne. Le cas échéant, la personne demandant
l’exception doit cocher la case ci-dessous et présenter un justificatif d’exception provincial ou territorial à
son employeur aux fins de vérification.
 La personne demandant une exception médicale est en possession d’une attestation (par exemple, un
code QR) délivrée par un gouvernement provincial ou territorial confirmant qu’elle ne peut être vaccinée.
Avant d’accorder toute exception médicale, l’employeur doit vérifier l’attestation.
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Médecin ou infirmière praticienne

Déclaration médicale
Je, _______________________________, suis un médecin autorisé ou infirmière(ère) praticien(ne) dans

la province/le territoire de/du/de l’ ___________________________. Je certifie par la présente que
________________________________ (indiquez au moins l’une des mentions suivantes) :
 1) a une contre-indication médicale à la vaccination complète contre la COVID-19 avec un vaccin à ARNm (Pfizer-
BioNTech ou Moderna) fondée sur la recommandation du Comité consultatif national de l’immunisation (CCNI)
(comme suit, d’après les conseils du CCNI en date du 10 septembre 2021) :
 antécédents d’anaphylaxie après l’administration précédente d’un vaccin à ARNm contre la COVID-19
 allergie confirmée au polyéthylèneglycol (PEG) qui se trouve dans les vaccins Pfizer-BioNTech et Moderna contre la
COVID-19
(Il convient de noter que si le patient est allergique à la trométhamine qui se trouve dans le vaccin Moderna, il peut
recevoir le produit Pfizer-BioNTech.)
Cette raison médicale est (veuillez en indiquer une seule)

 Permanente
 Temporaire et sera en vigueur jusqu’à/au _______________________
 2) a une raison médicale pour justifier le report de la vaccination complète contre la COVID-19, décrite par le Comité
consultatif national de l’immunisation (comme suit, d’après les conseils du CCNI en date du 10 septembre 2021) :
 des antécédents de myocardite ou de péricardite après la première dose d’un vaccin à ARNm
 en raison d’une immunodépression ou d’un médicament immunosuppresseur, en attendant de se faire
vacciner lorsque la réponse immunitaire sera maximale (c’est-à-dire attendre de se faire vacciner lorsque
l’état immunodéprimé ou le médicament immunosuppresseur est plus faible)
(Remarque: Il faudrait tenir compte des avantages et des risques lorsque la vaccination est retardée.)
Cette raison médicale sera en vigueur jusqu’à/au ___________________________
 3) a une raison médicale empêchant la vaccination complète contre la COVID-19 (non couverte ci-dessus), comme il
est décrit ci-dessous (pour des raisons de confidentialité, inclure uniquement la raison pour laquelle la condition
médicale exclut la vaccination)
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
Cette raison médicale est (veuillez en indiquer une seule)

 Permanente
 Temporaire et sera en vigueur jusqu’à/au _______________________
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Transports
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Signature: ______________________________________ Date: ______________________________

Nom: _______________________________ Numéro de téléphone:_____________________________
Numéro du permis de pratique: _________________ Province/Territoire: _________________
Attestation du demandeur
Le formulaire suivant doit être rempli par ou au nom de la personne demandant une exception médicale :
J’atteste par la présente être la personne ne pouvant être vaccinée ou au nom duquel la demande
d’exception est présentée, du fait de son état de santé :
Signature : ________________________________ Nom complet :
_______________________________
Date : ________________________________ Lieu : ________________________________
Renseignements faux ou trompeurs

En vertu de l’article 366 du Code criminel, toute falsification délibérée d’un document constitue une
infraction.
Conformément à l’Arrêté ministériel visant certaines exigences relatives à la sécurité ferroviaire en raison
de la COVID-19 toute personne fournissant, a une compagnie de fer, des renseignements qu’elle sait
être faux ou trompeurs s’expose également à une sanction administrative pécuniaire ou à d’autres
mesures d’exécution, y compris à des poursuites judiciaires.
Renseignements personnels
Votre vie privée est importante. Les renseignements personnels que vous fournissez dans ce formulaire
seront utilisés aux fins de déterminer la qualification de la personne identifiée sur ce formulaire pour
l'exception médicale aux exigences de l'arrêté en vertu de l'article 32.01 de la Loi sur la sécurité
ferroviaire MO 21-07. Veuillez noter que la compagnie de chemin de fer est soumise à la législation
applicable en matière de protection de la vie privée en ce qui concerne le traitement de vos
Les renseignements personnels contenus dans ce formulaire peuvent être fournis et utilisés par
Transports Canada à des fins de vérification et d'application. Le ministre des Transports peut recueillir
ces renseignements personnels conformément à la législation applicable, en vertu de la Loi sur la
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sécurité ferroviaire
Dans le cas où des renseignements personnels sont fournis à Transports Canada, ils ne seront utilisés et
divulgués par Transports Canada que conformément à la Loi sur la protection des renseignements
personnels et ses règlements. Les renseignements personnels recueillis, ainsi que leur utilisation, leur
divulgation et leur conservation sont décrits dans le fichier de renseignements personnels (« FRP »)
applicable, qui est en cours de développement et sera publié sur la page Info Source de Transports
Canada (https://tc.canada.ca/fr/ source d'informations). En vertu des dispositions de la Loi sur la
protection des renseignements personnels, les personnes ont le droit d'accéder à leurs renseignements
personnels, de les corriger et de les protéger. Les instructions pour obtenir des renseignements
personnels sont fournies dans Info Source, dont une copie est disponible dans les principales
bibliothèques publiques et universitaires ou en ligne à l'adresse http://www.infosource.gc.ca. Les
personnes qui souhaitent exercer leur droit de porter plainte en vertu de la Loi sur la protection des
renseignements personnels concernant le traitement de leurs renseignements personnels peuvent le
faire en déposant une plainte auprès du Commissariat à la protection de la vie privée. Pour plus
d'informations sur la façon dont la compagnie ferroviaire traite vos informations personnelles, veuillez
consulter leur politique de confidentialité applicable ou les contacter directement.
PARTIE 2 DE L’EXCEPTION
Avis important : L’employé n’est tenu de fournir que la partie 2 de la présente exception sur demande de la
compagnie de chemin de fer ou de Transports Canada. Dans le cas où Transports Canada exigerait des
renseignements supplémentaires, un fonctionnaire du gouvernement communiquera directement avec
l’employeur*.
Confirmation d’exception par

l’employeur*
Numéro de dossier de l’employeur* ____________
La présente est pour confirmer que _______________________________ (nom complet de la

personne exemptée), CIZR/PAR/Passe temporaire no : ___________________________, est
exempté(e) de toute exigence de vaccination obligatoire en vertu de l’Arrêté ministériel visant
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certaines exigences relatives à la sécurité ferroviaire en raison de la COVID-19 de Transports Canada.

_______________________________
Titre : ________________________________ Organisation :

_______________________________
Numéro de téléphone (jour) : ________________________________
Date : ________________________________ Lieu : ________________________________
* La partie 2 doit être remplie par l’employeur ou par une organisation chargée de valider la demande
d’exception, conformément à la politique de vaccination obligatoire en vigueur à l’échelle de la compagnie de
chemin de fer.
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Annexe B : FORMULAIRE DE DEMANDE D’EXCEPTION POUR MOTIF

RELIGIEUX
La personne demandant une exception pour motif religieux doit soumettre une copie dûment remplie du
présent formulaire dans son intégralité. Toutes les pages doivent être revues et remplies par la personne à
exempter et/ou le demandeur, ainsi que par le commissaire à l’assermentation concerné. L'employeur qui
évalue cette demande doit le faire conformément à son obligation légale d'accommodement en vertu de la
législation applicable.
PARTIE I DE l’EXCEPTION POUR MOTIF RELIGIEUX
Personne à exempter
Veuillez fournir les renseignements suivants concernant la personne au nom duquel une exception pour
motif religieux est demandée :
Adresse domiciliaire : ________________________________________
Déclaration sous serment - Croyance

religieuse
Veuillez fournir les renseignements demandés concernant vos convictions religieuses. II est à noter que les
leaders religieux et adeptes d’un certain nombre de religions (p. ex. l’islam, le catholicisme, le judaïsme,
la religion grecque — orthodoxe, la religion mennonite, les Témoins de Jéhovah, la Science chrétienne)
ont publié des déclarations publiques indiquant leur soutien au vaccin contre la COVID-19, dans l’intérêt
particulier de la santé publique.
DÉCLARATION SOUS SERMENT DE ___________________________________ (nom)
Je soussigné(e), ________________________________ (nom au complet), actuellement employé comme
________________________ (poste) au/à __________________________________ (organisation),
DÉCLARE SOUS SERMENT (OU AFFIRME SOLENNELLEMENT):
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1. Les exigences de la Politique sur la vaccination de ____________________________________

vont à l’encontre de mes croyances ou pratiques religieuses sincères qui m’interdisent de recevoir
le vaccin contre la COVID-19;
2. La nature de ces croyances ou pratiques religieuses sincères est la suivante (veuillez décrire les
raisons pour lesquelles vos croyances religieuses vous interdisent de recevoir le vaccin contre la
COVID-19):
_________________________________________________________________________________
_________________________________________________________________________________
_________________________________________________________________________________
_________________________________________________________________________________
_________________________________________________________________________________
_________________________________________________________________________________
_________________________________________________________________________________
_________________________________________________________________________________
_________________________________________________________________________________
Signature: ________________________________ Nom complet:

__________________________________
Date: ____________________________________ Lieu:
_________________________________________
Signature du commissaire à
l’assermentation
Les renseignements suivants doivent être fournis par un commissaire à l’assermentation :
DÉCLARÉ OU SOLENNELLEMENT AFFIRMÉ devant moi à :
________________________________ (municipalité)
à ________________________________ (province, État ou pays) le __________________

(date)
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Transports
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Signature : _______________________________ Nom complet :

________________________________
Information fausse ou trompeuse

En vertu de l’article 131 du Code criminel, faire une fausse déclaration sous serment ou faire une fausse
affirmation solennelle, par voie d’affidavit, de déclaration solennelle ou de déposition, ou oralement,
en sachant que la déclaration est fausse, constitue une infraction. Falsifier un document, en sachant
qu’il est faux constitue également une infraction à l’article 366 du Code criminel.
Conformément à l’Arrêté ministériel visant certaines exigences relatives à la sécurité ferroviaire en
raison de la COVID-19, toute personne fournissant, à un transporteur, des renseignements qu’elle sait
être faux ou trompeurs s’expose également à une sanction administrative pécuniaire ou à d’autres
mesures d’exécution, y compris des poursuites judiciaires.
Renseignements personnels
Votre vie privée est importante. Les renseignements personnels que vous fournissez dans ce formulaire
seront utilisés aux fins de déterminer la qualification de la personne identifiée sur ce formulaire pour
l'exception médicale aux exigences de l'arrêté en vertu de l'article 32.01 de la Loi sur la sécurité
ferroviaire MO 21-07. Veuillez noter que la compagnie de chemin de fer est soumise à la législation
applicable en matière de protection de la vie privée en ce qui concerne le traitement de vos
Les renseignements personnels contenus dans ce formulaire peuvent être fournis et utilisés par
Transports Canada à des fins de vérification et d'application. Le ministre des Transports peut recueillir
ces renseignements personnels conformément à la législation applicable, en vertu de la Loi sur la
sécurité ferroviaire
Dans le cas où des renseignements personnels sont fournis à Transports Canada, ils ne seront utilisés et
divulgués par Transports Canada que conformément à la Loi sur la protection des renseignements
personnels et ses règlements. Les renseignements personnels recueillis, ainsi que leur utilisation, leur
divulgation et leur conservation sont décrits dans le fichier de renseignements personnels (« FRP »)
applicable, qui est en cours de développement et sera publié sur la page Info Source de Transports
Canada (https://tc.canada.ca/fr/ source d'informations). En vertu des dispositions de la Loi sur la
protection des renseignements personnels, les personnes ont le droit d'accéder à leurs renseignements
personnels, de les corriger et de les protéger. Les instructions pour obtenir des renseignements
personnels sont fournies dans Info Source, dont une copie est disponible dans les principales
bibliothèques publiques et universitaires ou en ligne à l'adresse http://www.infosource.gc.ca. Les
personnes qui souhaitent exercer leur droit de porter plainte en vertu de la Loi sur la protection des
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renseignements personnels concernant le traitement de leurs renseignements personnels peuvent le

faire en déposant une plainte auprès du Commissariat à la protection de la vie privée. Pour plus
d'informations sur la façon dont la compagnie ferroviaire traite vos informations personnelles, veuillez
consulter leur politique de confidentialité applicable ou les contacter directement.
PARTIE 2 DE L’EXCEPTION
Avis important : L’employé n’est tenu de présenter que la partie 2 de la présente exception sur demande de la
compagnie de chemin de fer ou de Transports Canada. Dans le cas où Transports Canada exigerait des
renseignements supplémentaires, un fonctionnaire du gouvernement communiquera directement avec
l’employeur*.
Confirmation de l’exception par

l’employeur*
Numéro de dossier de l’employeur* : ____________
Je confirme par la présente que _______________________________ (nom complet de la

personne exemptée), CIZR/PAR/Passe temporaire no : ___________________________, est
exempté(e) des exigences en matière de vaccination obligatoire en vertu de l’Arrêté ministériel visant
certaines exigences relatives à la sécurité ferroviaire en raison de la COVID-19 de Transports Canada.

_______________________________
Titre : ____________________________________ Organisation :

_______________________________
Numéro de téléphone (jour) : ________________________________
Date : ________________________________ Lieu : ________________________________
* La partie 2 doit être remplie par l’employeur ou une organisation chargés de valider la demande
d’exception conformément à la politique de vaccination obligatoire en vigueur à l’échelle de la compagnie de
chemin de fer.
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This is Exhibit “J” referred to in the


AR04974
Vaccine Mandate – Reporting Snapshot for ADMs
As of April 19, 2022
Passenger Compliance Overview

Essential Care Rate Medical Exceptions Rate Religious Exceptions Rate
AVI AT I O N PA SSE N G E R VO LUMES
0% 8274% 100% 100% 0% /

g 3850% 100%
1,000,000
800,000
630,169 680,211 643,982
704,694
763,310
588,254 617,756
374 452 409 740 865 2247 600,000 692,942
Granted Requested Granted Requested Granted Requested
400,000
AVIATION Apr 8-14 Apr 1-7 Mar 25 - 31 Mar 18 – 24 Mar 11 – 17
200,000
Total Denials of Boarding1 763,310 1076 961 918 853
0
False/misleading 1 1 1 0 0
FEB 18 – FEB 25 – MAR 04 – MAR 11 – MAR 18 – MAR 25 – APR 01 – APR 08 –
Total being investigated 1 1 1 0 0 FEB 24 MAR 3 MAR 10 MAR 17 MAR 24 MAR 31 APR 07 APR 14
KEY POINTS VI A RA I L PA SSE N G E R VO LUMES

- Passenger volumes in the aviation sector increased by 8.3% since last week. Source: 60,000 53,585
CATSA data of 15 largest Canadian airports. 50,397
50,000 42,317
- Data on passenger exceptions represent cumulative reports from 72 air carriers (up 1 40,451
36,802
since last week): including Air Canada, Air Transat, Air France, Egyptair, Flair Airlines, 40,000
KLM Royal Dutch Airlines, Sunwing Airlines, Swoop, and Westjet. 30,000
- This week Air Canada received 0 religious exception requests (down 100% from last
20,000
week). The operator has not approved any religious exceptions to date.
- Westjet reported 50 religious exception requests and 90 granted. Westjet continues to 10,000
receive the highest number of requests week over week of all entities reporting. -
FEB 18-FEB FEB 25- MAR 04- MAR 11- MAR 18- MAR 25- APR 01-APR APR 08-APR
- Denials: Westjet continues to report 0 denials of boarding (excluding false or
24 MAR 03 MAR10 MAR 17 MAR 24 MAR 31 07 14
misleading information) week over week since the start of reporting. See Top 5
Companies - Denials (next page). Essential Care Rate Medical Exceptions Rate Religious Exceptions Rate
- Passenger volumes/data for rail is reported by VIA Rail into ECATS. Via Rail reports on
561,806
-
Mondays and have missed their last 3 reports. Data is only available up to March 24.
Denials: VIA Rail is averaging 20.4 denials/week since the start of reporting.
# Passengers
100% 0% g 3333% 100% 0%
[ 25 00% 100%
- Cruise ships have been invited to begin reporting on passenger/crew data in ECATS. 6 15 9 27 6 24
Data is available in the Cruise Ship Dashboard and in the Cruise Ship Executive Brief.
Granted Requested Granted Requested Granted Requested
1
Denials of Boarding are based on passenger data reported in ECATS from 72 air carriers (see Key Points). Denials are cumulative since the start of reporting, 12/30/2021.
1
AR04975
Passenger Exceptions Breakdown23
( Blank ) Essential Care Rate

Total Passengers
561.806
not available # Passengers 50%
# Passengers Aviation
Essential Care or
• Granted
• Requested
• Granted
• Requested 0% 81% 100%
Emergency
I Medical Exceptions Granted
237
40 %
Rail
Exceptions
704
237
83 % Rate
o 10 0 100 200 50%
Medical
• Granted
• Requested
• Granted
• Requested 100%
Religious Exceptions Granted
Contraindication
33 % 55 %
409
Rail Aviation Rate
Exceptions 27 740
0 10 20 0 500 50%
Religious
• Granted
• Requested
• Granted
• Requested 100%
Exceptions Granted Rate
Exceptions
38 %
* 25 %
0.9K
Rail Aviation
22 K
50%
0 10 20 OK 1K 2K
Total exception rate is 31.82 % based on a Total exception rate is 47.92 % based on a total Total exception rate is based on a total of
total of 21 out of the 66 requests received. . 0% 0% 100%
of 1648 out of the 3439 requests received out of the requests received.
Essential Care or Emergency 380 467 Medical Contraindication 418 767 Religious Exceptions 872 2272 Denials 1479
Exceptions Granted Requested Exceptions Granted Requested Granted Requested Denials
Exceptions by Mode Top 5 Companies Exceptions by Mode Top 5 Companies Exceptions by Mode Top 5 Companies Denials by Mode Top 5 Companies
• Granted
• Requests Company Name
.
# Granted
• Granted
• Requested Company Name # Granted
• Granted © Requested Company Name # Granted
1126
Company Name # Denied
1
CARSON AIR LTD 237 AIR CANADA 170
WESTJET 633 FLAIR AIRLINES LTD. 350
740 1000
500 AIR CANADA 50 WESTJET 108 2.2K
Swoop Inc. 50 VIA Rail Canada Inc. 347
2
.
AIR NORTH CHARTER &
TRAINING LTD.
41 :cc Sunwing Airlines Inc
AIR TRANSAT
32
25 - ;;1 KLM Royal Dutch Airlines
AIR TRANSAT
49
39
500 347
AIR CANADA
AIR TRANSAT
251
172
6 15 0 0 0 0 WESTJET 24 9 27 0 0 0 0 FLAIR AIRLINES LTD . 20 0.0K 0.0K 0.0K FLAIR AIRLINES LTD. 39 6 0 .
Sunwing Airlines Inc 148
FLAIR AIRLINES LTD. 15 0
Total 355 OK 0
Total 1268
Total 810
&°
& Total 367
& ,
00 #
&
JV
2
All totals shown are cumulative to date based on reported values up to 04/19/2022.
3
Reporting on passenger exceptions is submitted directly by industry into ECATS (rail and air). Marine companies will begin to submit data on passengers as cruise ships begin operations.
2
AR04976
Company Vaccination Policy – Compliance Overview45
Total
Tr&r KEY POINTS
601-690 federally-regulated companies have confirmed an
employee vaccine policy is in place (87.1%). Slight fluctuations in
Responses 601 512 70 19 the total number of companies are due to the fact that the
87.1 % of 690 89.4 % of 573 72.2 % of 97 95 % of 20 master lists continue to be refined week over week.
- Aviation: 512 out of 573 operators (89.4%) have reported: 84%
Mandatory Policy • Yes
have implemented a mandatory policy; 82% have company-wide
•
policies.
( 3lank)
- Marine: 70 out of 97 operators (72.2%) have reported: 70%

have implemented a mandatory policy; 60% have company-wide
Company Wide •Yes
10
policies.
•
Policies
(Blank) - Rail: 19 out of 20 operators (95%) have reported: 90% have
implemented a mandatory policy; 75% have company-wide
policies.
* Pictured above: (Blank) signifies where a company has submitted a report for one or more TC survey, other than the company
policy attestation. Meaning, companies in the ‘master list’ have reported to TC through another survey (e.g. employee
*no change from last week.
vaccinations or passenger exceptions) but have not yet reported on their employee policy.
Employee Vaccination Status – Compliance Overview

Company Mode Fully Vaccinated
180 84.336 78,682 401 138 1543 536
(Blank) Aviation Marine Rail Companies of
* Employees Fully Vaccinated Partial Exemptions On Leave Unable To Work
o.o% 93.3% 100% 690 93.30 % 0.48 % 0.16 % 1.83 % 0.64%

* Pictured above: The total number of companies reporting is anticipated to grow, as air carriers and airports continue to come online to ECATS: approximately 400 more operators.
4
More than 90% of marine companies that must attest, have attested; the remaining companies (approx. 32 Cdn companies) are not yet required to report as operations are seasonal. Cruise ship reporting will begin when
the cruise season restarts in early April.
5
100% of the 20 federally regulated railway companies have reported to TC. Work to include this data in the dashboard is nearing completion.
3
AR04977
KEY POINTS Vaccination Status Exemptions At Risk
180/690 companies have reported to TC on employee

• Employees
• Fully Vaccinated
• Partially Vaccinated
• Medical Exemption
• Religious Exemption
•
1000
Employees on Leave
• Unable to Work Due to COVID-19
vaccination status representing 84,336 employees in the 49,692 20

Aviation 46,744 Aviation
federally regulated transportation sector; +1 since last 151 64
week. Rail
I 21,118
19,905 Rail
13
500
191 24
 Of these reports, 93.3% of employees are reported I 13, 526 3
Marine 12,033 Marine
to be fully vaccinated (up from 93.2% last week) 59 14
 536 (0.64%) employees are unable to work due to 0

OK 20K 40K 0 20 40 60 Aviation
covid-19 (positive test or isolating). This number
has increased from 500 last week. Notes on Data Collection
 The percentage of exemptions continues to be low
(0.16%). The percentage of employees on leave - In Aviation, employer policy requirements apply to air carriers 703, 704, 705, specified aerodromes and NAV Canada. Passenger
also continues to be low (1.83%). requirements apply to air carriers 701, 703, 704, and 705. As such depending on which requirement is in question, the total
aviation numbers are subject to change. AvSec, CivAv and DSTO are working to reconcile the representation of the data in the
 Marine employers and rail employers with
Federal Vaccination Mandate Dashboard.
company-wide vaccination policies, must require all
- Transport Canada amended the request to report on employee vaccination status from one time voluntary to one time
employees (including on board a vessel) to be fully
mandatory for all employers in the aviation sector.
vaccinated by January 24, 2022, unless exempt, as
- Westjet reports in aggregate for Westjet and Westjet Encore. Air Canada reports in aggregate on behalf of Air Canada, Air
per the respective Orders.
Canada Rouge, and Jazz (passenger reporting only).
Employee Vaccination Status – Breakdown by Mode

Aviation:
- Since last week 1 additional company came online to ECATS. Currently 108 companies are reporting covering 49,692 employees in the aviation sector.
- As of March 07, 2022, air carriers 705, 703, 704, and specified airports (including class 1) have been notified to complete a one-time mandatory report.
o Note: TC does not require aviation companies to report on the number of employees unable to work due to COVID-19, so data is likely to be incomplete or unreliable.
- 664 of 904 employees on leave are associated with Air Canada’s January 10, 2022 report. However, due to the nature of one-time reporting, an updated number is not available.
108 49.692 46.744 151 84 905 308
100% 573 94.07 % 0.30 % 0.17% 1.82 % 0.62 %
4
AR04978
Rail:
- Number of partially vaccinated employees increased to 191 from 174 last week.
- CN (company wide vaccination policy in place) reported 166 partially vaccinated employees in their latest report on April 03, 2022. Rail employers with company-wide vaccination policies must
require all employees to be fully vaccinated by January 24, 2022, unless exempt, as per the Order.
- Of the outstanding 6 reports, 1 company has no employees and 2 are US companies with less than 15 employees present in Canada. One company is not operating.

14 21.118 19.905 191 37 310 185
(Blank) Aviation Marine Rail Companies of # Employees Fully Vaccinated Partial Exemptions On Leave Unable To Work
o.o% 94.3% 100% 20 94.26 % 0.90 % 0.18% 1.47% 0.88%
Marine:
- Since last week 0 companies came online to ECATS. Currently 58 companies are reporting covering 13,526 employees in the marine sector.
- Of the companies reporting, the number of employees partially vaccinated has decreased from 65 last week to 59 this week.

58 13.526 12.033 59 17 328 43
97 88.96 % 0.44 % 0.13 % 2.42 % 0.32 %
Vaccination Policy Compliance Overview – Air Passenger Process
KEY POINTS
• Air Carriers and Aerodromes were asked to report to TC on passenger Compliance Processes in place (verifying POV, keeping a record of denials,
COVID test results).
• The data continues to be refined as compliance is encouraged and data is validated.
5
AR04979
Remote Travellers – Aviation:
KEY POINTS
 As of March 28th, all remote traveller reporting is captured through the ECATS platform. In
April 2022, 35 self-tests have been reported as used of 46 total accommodations. Important
note: Xiamen Airlines, Thunder Airlines and Northwestern Airlines are the only operators to
report in the month of April. Additional follow up with industry is recommended.
 To date, 1117 (increase from 1095 last week) self-tests have been reported as used of the
16,712 tests delivered.
 984 (increase from 965 last week) negative test results and 35 (+2 from last week) positive
test results have been reported.
 No test available remained at 276 since last week. To date, Thunder Bay (77), Goose Bay (68)
and Yellowknife (57) have reported the highest number of no test available (number of
passengers who received a “Passenger Self-Test – No Test Available” form).
 As a result of provincial regulations, molecular test kits cannot be self-administered in the
province of Saskatchewan. As such the Lucira test kits currently made available to support
the remote accommodations are not used in the province of Saskatchewan. The instruction
on “maximum flexibility” allows operators to fly under a “no test” exemption.
6
AR04980
Self - Test Usage Trend No Test Available Trend
0 0
y /VvA A . -
A A« NV
_ _ AA
Self - Test Statistics by Region/Province / Airport (Departure ) Self - Test Statistics by Airport (Departure ) Self - Test Statistics by Carrier
• Negative
• Positive
• Unstated
• •
Invalid Age Restriction
• Negative
• Positive
• Unstated
• •Invalid Age Restriction
• Valid PCR
• Negative
•Positive
•
unstated
• invalid Age Restrction © No Test Aval able
CANADIAN NORTH
ON 428
James Armstron ... 204 B1244 WASAYA AIRWAYS
493
219
626
Iqaluit 191
PERIMETER AVIATION | 139
Thunder Bay 136 147
MB 266 AIRCREEBEC INC.
Macdonald-Cart ... 137
Xiamen Airlines Co., Ltd 81
159
NU 191 Yellowknife 126

KW
Timmins Victor ... CALM AIR
THUNDER AIRLINES LIMI ...
60
95
NT 126 Edmonton Inti 49
Provincial Airlines 99
Goose Bay MSB| 44 |23
Air Borealis
QC 56 Kingston ESI 37 (Blank|
) 19
...
Pierre-Elliott-Tru 34 NORTHWESTERN AIR LE .. | 11 .
NL 46 Thompson [721 22
Val-Dor 0 200 400 600
19
AB 49 Vancouver Inti |6
* Pictured left/above: self-test statistics by airport and air carrier, as well as self-test
h
Sept-lles |3
BC
Lester B. Pearso ... 1
usage trends and no test available trends. Canadian North, Wasaya Airways and
Perimeter Aviation continue to report the highest number of self-test results week over
0 100 200 300 400 0 100 200 week, compared to all air carriers that have reported.
Gateway Passengers PCR Pre- Ai rport Self-Tests Self -Test % Negative Self -Test Self-Test Self-Test No Test Age Restriction
Used Negative Results Positive Invalid Unstated Available / Invalid
Gateway 19433 93 1113 933 BB . 1% 35 73 25 274 52

0 Other 20 0 0 0 200.0 % 0 0 0 2 0
Total 19573 93 1117 984 BB. 1% 35 73 25 273 52
7
AR04981
National Interest Exemptions

Status Count UKR Related % UKR
Status Total: 739
Waiting for information from applicant 58 29 50% Waiting for information from applicant
3 2 67% Recommendation sent for decision Count of Ukraine Related
Recommendation sent for decision
New Count of Status
New 11 3 27%
In Progress
In Progress 7 1 14%
Closed - Withdrawn
Closed—Withdrawn 15 1 7%
Closed - Ukraine Right of Entry
Closed—Ukraine Right of Entry 49 49 100% Closed - Religious
Closed—Religious 39 - 0% Closed - Other
23 2 9% Closed - Medical
Closed—Other
Closed - Foreign National
Closed—Medical 25 1 4%
Closed - Duplicate
Closed—Foreign National 39 - 0%
Closed - Discretionary Travel
Closed—Duplicate 54 13 24% Closed - Did not Provide Required Information
Closed—Discretionary Travel 57 11 19% Closed - Compassionate
259 39 15% Closed - Business Travel
Closed—Did not provide required information
Approved - NIE Letter Issued
Closed—Compassionate 45 5 11%
28 - 0% 0 50 100 150 200 250 300
Closed—Business Travel
Approved—NIE Letter Issued 27 10 37% KEY POINTS
Grand Total 739 166 22%  NIEP receives an average of 36.95 requests per week. Requests in March 2022 were the highest since the
start of the Program.
Nb of Requests - Monthly  On March 28, 2022, one person submitted 4 requests.
250 222  NIEP received the first Ukrainian related case on February 24, 2022. Since, there were 140 requests
200 170 related to Ukraine. This week 43% (26/61) of requests were related to Ukraine.
141
150 112 Notes on Data Collection
94 83 82 Closed – Ukraine Right of Entry: Closed Business: *NEW* Closed Foreign National:
100 *NEW* •Job but not in national interest; • FN returning home; FN from a country that cannot
•Traveller with right of entry to Individual whose travel is business, enter Canada
50
1 Canada with CUET exemption from work or volunteer related; Business but Closed Compassionate:
0 IRCC (IRCC exemption allows not in the national interest • Funeral; Taking care of sick family
Dec-21 Jan-22 Feb-22 Mar-22 Apr-22 domestic travel within 24 hrs from Closed Others: Closed Compassionate:
departure for Canada to arrive at the •Part of an existing exempt category; • Funeral; Taking care of sick family
Dec-21 Jan-22 Feb-22 Mar-22 Apr-22 final destination); Canadian citizens Canadian citizen returning; Sufficient Closed discretionary travel:
# of All Requests 141 112 94 222 170 and PR requesting entry to Canada time for traveller to become fully • Business but not in the national interest; School,
# UKR related 1 83 82 fleeing the Ukrainian conflict. vaccinated; Insufficient evidence of holidays, family reunion; Job but not in national
clinical trial. interest; Buying a house; Other personal matters
8
AR04982
Nation Interest Exemptions – Ukraine Related

Ukraine Related Definitions
Combat related: % Ukraine Related Requests
 Individual who wishes to join a military force 70 60%
 Individual conscripted to fight in a war abroad (e.g., Ukrainian/Canadian 56% 57%
60 56
dual citizen) 50% 50%
46%
Family related: 50 43%
40%
 Individuals wanting to join family abroad
40 35
 Family reunification (abroad or domestically) 32 30 30%
 Individual wanting to travel to assist family or friends fleeing the 30 26 26
23%
Ukrainian conflict zone or countries bordering Ukraine 20%
20
 Family reunions 12
410% 10%
 To assist family abroad enter Canada 10
15%
Other: 0 0%
 Individuals who want to volunteer helping people fleeing Ukraine 2022-02-21 2022-02-28 2022-03-07 2022-03-14 2022-03-21 2022-03-28 2022-04-04 2022-04-11
 Individuals going to work assisting Ukrainian refugees (e.g., translators) - 2022-02- - 2022-03- - 2022-03- - 2022-03- - 2022-03- - 2022-04- - 2022-04- - 2022-04-
Unknown: 27 06 13 20 27 03 10 17
 Individual requesting to leave Canada for unspecified reasons Total Nb of Requests 19 42 53 64 63 53 61 56
 Traveller of unknown nationality Count of Ukraine related requests 1 4 12 32 35 30 26 26
FN – Foreign National % Ukrainian related requests 5% 10% 23% 50% 56% 57% 43% 46%
Canadian / RoE (Right of Entry):
 Individuals with right of entry to enter Canada Total Nb of Requests Count of Ukraine related requests % Ukrainian related requests
Nb of Ukraine related applications/approvals by type of travel Ukraine Related Applications by Type of Travel
120
Outbound travel
Unknown 9
100 3
Other 9
80 Family related 18
60 Combat related 11
102 1
40 Unknown 32
Inbound
travel
47 RoE 5
20 6
17 FN 65
0
Domestic travel Inbound travel Outbound travel Domestic Unknown 2
Nb Approved 6 3 1 travel RoE 1
Nb of Ukraine related applications 17 102 47 FN 14
Nb of Ukraine related applications Nb Approved 0 10 20 30 40 50 60 70
9
AR04983
Data Validation Work Underway
Activity Policy/Database OPI Status

Master list company name validation All All modes Ongoing
 Sub-activity: As companies come online to ECATS, they
must be validated by the modal reps before they are
captured in the vaccination mandate dashboard
Inputting data (company vaccine policy) reported to TC outside of Survey Monkey Rail 1 company left*
Survey Monkey into Survey Monkey
Encouraging industry to report to TC on employee vaccine status ECATS Rail Ongoing
via ECATS
Encouraging industry to seek out ECATs credentials/submit reports ECATS All modes Ongoing
into ECATS (employee + passenger surveys)
Transition Remote Passenger Survey from MS Forms to ECATS + MS Forms/ECATS Remote Complete
roll out to industry
 MS Forms closes March 28, 2022
Integrate TCOMMS data into Multimodal Vaccine Mandate TCOMMS DSTO In Progress
Dashboard
2nd and 3rd tranches of air operators to begin ECATS reporting ECATS Aviation Complete
Integrating NIE data into the vaccine mandate dashboard DSTO In progress
Development of Cruise Ship Survey ECATS Marine Complete - Launched
DSTO
Development of Cruise Dashboard and ADM Brief *new* Power BI DSTO Ongoing
10
AR04984
TAB 29
AR04985

FEDERAL COURT
BETWEEN:
NABIL BEN NAOUM
Demandeur
et
Défendeur

AND BETWEEN:
Demandeur
et
Défendeur

AND BETWEEN:
AND AEDAN MACDONALD
Applicants
and
Respondent
AR04986

AND BETWEEN:
Applicants
and
Respondent
AFFIDAVIT OF TYLER BROOKS

Fax: (204) 983-3636

Tel:
Email:

AR04987

FEDERAL COURT
BETWEEN:
NABIL BEN NAOUM
Demandeur
et
Défendeur

AND BETWEEN:
Demandeur
et
Défendeur

AND BETWEEN:
AND AEDAN MACDONALD
Applicants
and
Respondent
AR04988

AND BETWEEN:
Applicants
and
Respondent
AFFIDAVIT OF TYLER BROOKS
I, Tyler Brooks, of the City of Ottawa, in the Province of Ontario, SOLEMNLY AFFIRM
THAT:
1. I am currently the Director of the Civil Aviation Medicine (CAM) Branch at Transport
Canada. I have been in this position since March 2020. In this position I am responsible for setting
out and applying the standards for civil aviation flight crews in accordance with standards of the
International Civil Aviation Organization (ICAO) and for providing advice to the Minister of
Transport on matters related to the health of passengers who travel by air. Prior to that, I was a
senior consultant on policy and standards with CAM, in which I was responsible for providing
advice to the Director in respect of civil aviation medicine and policies. I otherwise have 26 years
experience in the Canadian Armed Forces including as a medical officer, a pilot, and other related
responsibilities. I obtained a Master’s degree in War Studies from the Royal Military College of
Canada in 1998 and a Medical Doctor from Queen’s University in 2010. I also have post-graduate
education and training in Aerospace Medicine. I attach as Exhibit “A” a copy of my curriculum
vitae.
2. As a result of my current position, I have personal knowledge of the facts and matters
following in this affidavit, except where I state the same to be based upon information and belief,
in which case I believe the same to be true.
3. Transport Canada’s mandate is to serve the public interest through the promotion of a safe,
secure, efficient, and environmentally responsible transportation system in Canada. Transport
Canada is responsible for transportation policies and programs, including air, rail, and marine
safety and security. In carrying out its responsibilities, Transport Canada works collaboratively
2
AR04989
with other government departments and agencies, as well as a diverse stakeholder and partnership
network, which includes transportation companies, labour organizations, provincial/territorial
governments, Indigenous groups, and international counterparts.
4. CAM is a branch within Transport Canada. Its mandate is to provide medical advice and
assistance in setting out physical standards for civil aviation personnel and to provide advice in
matters respecting the health of travellers by air. Its mission is to ensure aircrew and air traffic
controllers are medically fit, to close gaps in scientific knowledge of Canadian aviation medicine,
to promote health and safety in the field of aviation, and to prevent aircraft accidents due to
medically related human factors.
5. ICAO is a specialized agency of the United Nations charged with coordinating

international civilian aviation, generally being any non-military aviation. ICAO establishes the
principles and techniques of international air navigation and fosters the planning and development
of international air transport to ensure safe and orderly growth. Canada is a member state of ICAO,
being a signatory to the Convention on International Civil Aviation, commonly known as the
Chicago Convention, the standards and principles of which are incorporated in Canada through
domestic legislation.
6. ICAO periodically issues a series of guideline documents to member states. While not
binding, they are considered strong recommendations in order to achieve consensus and avoid
fragmentation in civil aviation standards among ICAO’s member states. Canada’s continued
compliance with these ICAO guidelines is important in ensuring the continued operation of air
corridors though Canadian and international airspace.
7. The Civil Aviation Recovery Task Force (CART) is a body within ICAO. It has produced
a series of reports to assist in the restart and recovery of the international air transport sector
following the impacts of the COVID-19 pandemic.
8. The Collaborative Arrangement for the Prevention and Management of Public Health
Events in Civil Aviation (CAPSCA) is a voluntary cross-sectorial collaboration programme
managed by ICAO with support from the World Health Organization. It brings together
international, regional, national and local organizations to improve coordination and combine
3
AR04990
efforts to improve preparedness planning and response to public health events, including
communicable diseases that affect the aviation sector. Its participants include aviation medicine
regulators including the United States Centers for Disease Control and Prevention (CDC),
European Centre for Disease Prevention and Control (ECDC), Aerospace Medical Association
(AsMA) and representatives from industry. Among its goals is the protection of public health
among air travellers, aviation personnel and the general public. CAPSCA has been the primary
body providing analysis and advice to ICAO for the provision of guidelines to safeguard civil
aviation during the COVID-19 pandemic. I am the Canadian representative on CAPSCA.
9. Within CAPSCA there is a COVID-19 Aviation Scientific Assessment Group (CASAG)

which reviews available scientific literature in respect of COVID-19 for CAPSCA to provide
advice to ICAO.
A. Risk Management
10. There is a low tolerance of risk for the importation or transmission of COVID-19 cases
through and within the civil aviation system. There is continuing concern regarding the role of
civil aviation in COVID-19 transmission within, and case importation through, air transportation
networks.
11. This limited risk tolerance assists in protecting: the health of communities served by
aviation or to which aviation passengers may travel, particularly remote communities which may
rely on aviation for various services; the health and safety of passengers and crew; and the viability
of the civil aviation industry. The level of risk tolerance and the measures to reduce risk are
dynamic matters under regular review as additional information becomes available and as the
pandemic situation evolves.
12. Further, this low level of risk tolerance assists in establishing a baseline level of biosecurity
in the event of further concerning developments with respect to COVID-19 which may affect civil
aviation.
13. As such, there are two broad components to a comprehensive strategy to reduce the risk of
transmission and importation of COVID-19 through civil aviation transportation networks: the
4
AR04991
application of a multilayered system of protective measures; and the application of those measures
through the entire aviation continuum to reduce risk throughout the traveller’s journey.
i. Multilayered measures
14. During the COVID-19 pandemic, Transport Canada has followed ICAO recommendations
to implement a multilayered approach to the limit the importation and transmission of COVID-19
though the civil aviation industry. I attach as Exhibit “B” a copy of a letter from the Secretary
General of ICAO dated 6 April 2022 in respect of “Maintaining flights during the COVID-19
pandemic transition period.” Within that letter, the Secretary General reiterated the importance of
implementing an effective multi-layered risk-management strategy as there was no single measure
to provide a definite solution to address the possibility of COVID-19 transmission. ICAO also
encourages all its member states to continue to mitigate the spread of COVID-19 using existing
recommendations in the CART reports, the fourth edition of Take-off: Guidance for Air Travel
through the COVID-19 Public Health Crisis (also a CART report) and the third edition of the
ICAO Manual on COVID-19 Cross-Border Risk Management in accordance with a risk and
evidence-based approach.
15. I attach as Exhibit “C” a copy of ICAO Manual on COVID-19 Cross-Border Risk
Management which was developed by CAPSCA in close collaborations with CART. It reiterates
that multi-layered risk mitigation is the most appropriate strategy in the context of pandemic risk
management in air transport. Given the complexity of the pandemic, no single measure can be
deemed as a definitive solution to the risk COVID-19 presents to civil aviation. As such, ICAO
has recommended that member states implement overlapping measures including masking,
distancing, enhanced cleaning, and public health measures, including vaccination as appropriate.
16. The picture below is taken from page 2-2 of that manual and is based on the James Reason
Swiss Cheese Model, used in aviation risk analysis. The concept of the model is that the possibility
of a threat for which there is no complete defence is mitigated by using multiple layers and types
of imperfect defences (depicted by layers of Swiss Cheese with holes). The picture illustrates how
a series of measures, none of which on its own provides a complete defence, can limit the risks
from COVID-19. The goal is to avoid the alignment of the “holes” in the Swiss Cheese by using
multiple layers.
5
AR04992
AVIATION MULTI - LAYERED

DISEASE DEFENSE STRATEGY
A multilayered approach increases success
17. The use of multi-layered measures also provides a reduction of risk when a risk is difficult
or impossible to quantify or when the effectiveness of any individual measure is unknown or
uncertain. The understanding of SARS-CoV-2 and its variants of concern and the effectiveness of
different measures of response continues to evolve. In the absence of full understanding, and as a
matter of precaution, the use of multi-layered measures offers the best protection for the health of
passengers and communities.
18. As set out in that picture, the multiple layers of defence include measures of both individual
and shared responsibility. They include self-assessment, testing, physical distancing, general
hygiene, proof of vaccination, education and training, disinfection, border controls, health
screening, and public health measures including vaccinations.
ii. Measures throughout the aviation continuum
19. It is important to recognize that the time that travellers spend aboard aircraft forms only
one part of the air travel continuum. That continuum includes travel to and from and within
airports. Passengers may face risks of infection at multiple stages of travel before and after
6
AR04993
boarding aircraft. As such, it is appropriate to use multi-layered measures throughout the

continuum to the extent possible to protect travellers throughout their journey.
20. I attach as Exhibit “D” a printed copy of Take-off: Guidance for Air Travel through the
COVID-19 Public Health Crisis (a CART report) provides recommendations for “end-to-end” risk
reduction in different aspects of civil aviation including airports, aircraft, flight crews, and air
cargo.
B. Dr. Sirek’s and Dr. Kettner’s Reports
21. I have reviewed the expert reports prepared by Dr. Adam Sirek and Dr. Joel Kettner filed
in Court File T-1991-21.
22. For the sake of completeness, I confirm that I otherwise know and am familiar with
Dr. Sirek from his appointment as a Civil Aviation Medical Examiner (CAME). I am responsible
for exercising the delegated authority of the Minister of Transport for the appointment of CAMEs.
CAMEs are physicians appointed to conduct aviation medical examinations of medical certificate
applicants (flight crews and air traffic controllers) in accordance with paragraph 404.16 (a) of the
Canadian Aviation Regulations based on international medical standards for aviation. To be
appointed as a CAME, a physician must be competent, qualified, and meet the necessary
conditions. The appointment must be in the public interest. CAME appointments are valid for four
years and may be renewed.
23. Regarding vaccination, I agree with Dr. Sirek’s opinion that “[w]ithin the framework of a
layered approach to aviation safety, vaccination can be seen as a further protective measure to
reduce risk.”
24. I am informed by counsel and do believe that Dr. Lisa Waddell of the Public Health Agency
of Canada is preparing a separate affidavit in respect of Dr. Sirek’s and Dr. Kettner’s reports.
Subject to Dr. Waddell’s comments, I do not take issue with Dr. Sirek’s conclusion that, based on
information currently available, the risk of in-flight transmission of COVID-19 particles in
commercial aircraft is low, compared to other common indoor settings.
7
AR04994
25. However, the relative risk of in-flight transmission is only one of the factors which must
be considered in limiting the risk of COVID-19 transmission in civil aviation. As above, the time
spent in an aircraft is only one part of the aviation continuum and is not the only portion of the
traveller’s journey in which there is a risk of transmission. For example, passengers congregate in
aggregate airport settings such as at security checkpoints, boarding gates, and in jet bridges while
waiting to board an aircraft. Those areas typically do not have the risk-reducing sophisticated
ventilation and filtration systems that are found aboard aircraft. Because the aviation continuum
consists of multiple environments, both on and off aircraft, with different protective systems and
levels of risk, it is necessary to maintain a robust multi-layered approach to risk mitigation
throughout the aviation continuum. Vaccination, among other measures, is currently considered
an element of this multi-layered defence.
C. Conclusion
AND I HAVE SIGNED by technological means

in the City of Ottawa, in the Province of Ontario,
TYLER BROOKS
Affirmed before me by technological

means in the City of Ottawa, in the
Province of Ontario, this 22nd day of April,
2022.
Diane Dubeau #213996

for outside Québec
8
AR04995

Affidavit of Tyler Brooks

AR04996
Dr. Tyler Brooks CD MD DAvMed DRCPSC CCFP
Professional Profile
▪ Current Director Civil Aviation Medicine, Transport Canada
▪ 26 years of Canadian Armed Forces service as a Pilot and Medical Officer
▪ Member of College of Physicians and Surgeons of Ontario (CPSO # 89362), Royal College of Physicians and
Surgeons of Canada (DRCPSC #2335285), Canadian College of Family Physicians (CCFP # 227349) qualified to
practice medicine independently since 2010
Education
▪ Diplomate Affiliate, Area of Focused Competence in Aerospace Medicine, Royal College of Physicians and
Surgeons of Canada (2018)
▪ Diploma in Aviation Medicine, Faculty of Occupational Medicine of the Royal College of Physicians of London,
London, UK (2014)
▪ Postgraduate Certificate in Aeromedical Science, King’s College London, London, UK (2014)
▪ Medical Doctor (Residency in Family Medicine), Queen’s University, Kingston, Ontario (2010)
▪ MA War Studies, Royal Military College of Canada, Kingston, Ontario (1998)
▪ BA Military and Strategic Studies, Royal Military College of Canada, Kingston, Ontario (1996)
Qualifications, Certifications, Appointments, Awards

▪ Transport Canada Award for Excellence in Response to COVID-19 Pandemic (2021)
▪ Canadian Forces Decoration with Rosette, Peacekeeping medal, NATO medal (Former Yugoslavia), Royal
Canadian Air Force Commander's Commendation
▪ Civil Aviation Medical Examiner (2015-2018)
▪ Aircraft Accident Investigator (2014-2018)
▪ Military Medical Officer, Dive Medical Officer, and Flight Surgeon (2010/2011/2012)
▪ Military Pilot and Commercial Pilot (1999/2004)
Work History
November 2020– present
▪ Director Civil Aviation Medicine, Transport Canada, Ottawa, Ontario, Canada
November 2018 – November 2020
▪ Senior Consultant Policy and Standards, Civil Aviation Medicine, Transport Canada, Ottawa, Ontario, Canada
▪ Reserve Force Medical Officer, 1 Canadian Field Hospital, Ottawa, Ontario, Canada
June 2018 - November 2018
▪ Senior Staff Officer Surgeon General, Office of the Surgeon General, Canadian Forces Health Services Group
Headquarters, Ottawa, Ontario, Canada
▪ Civil Aviation Medical Examiner, Ottawa, Ontario, Canada
July 2014 – June 2018
▪ Aircraft Accident Investigator, Directorate of Flight Safety, and Patient Safety Investigator, Professional Affairs and
Clinical Quality, National Defence Headquarters, Ottawa, Ontario, Canada
▪ Emergency Room Physician, Little Current, Ontario, Canada and Terrace Bay, Ontario, Canada
▪ Civil Aviation Medical Examiner, Ottawa, Ontario, Canada
July 2013 to July 2014
▪ Staff Officer Medical Education and Credentialing, Directorate of Health Services Personnel, Canadian Forces
Health Services Group Headquarters, Ottawa, Ontario, Canada
July 2010-July 2013
▪ Primary Care Physician, Team Leader and Flight Surgeon, 33 Canadian Forces Health Services Centre, Borden,
Ontario, Canada
▪ Emergency Room Physician, Alliston, Ontario, Canada
July 1999-Sep 2004
▪ Helicopter Pilot and Deputy Operations Officer, 427 Tactical Helicopter Squadron, Petawawa, Ontario, Canada
AR04997


International Organisation Organización Международная
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Civil Aviation de l’aviation civile de Aviación Civil организация
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JE
Organization internationale Internacional гражданской
авиации
Tel.: +1 514-954-8219 ext. 6088
Ref.: AN 5/28-22/42 6 April 2022
Subject: Maintaining flights during the COVID-19

pandemic transition period
Action required: a) adhere to ICAO health-related

Standards contained in Annexes 1, 6, 9, 17, 18 and 19;
b) maintain and expedite the approval process of repatriation
flights as requested in paragraph 9; and c) continue
collaboration in applying a risk and evidence-based
approach during the COVID-19 pandemic transition period
Sir/Madam,
1. I have the honour to bring to your attention updated COVID-19 information on Omicron
Variant Knowns, Unknowns and Recommendations published by the International Civil Aviation Organization
(ICAO) Collaborative Arrangement for the Prevention and Management of Public Health Events in Civil
Aviation (CAPSCA) Programme, following review of the recent scientific evidence in relation to the SARS-
CoV-2 Omicron variant (Attachment A refers).
2. The ongoing COVID-19 pandemic continues to be a fast-paced dynamic situation. The

epidemiological data informing mitigation measures might be inaccurate due to limitations in reporting.
Applicable measures are published on different platforms, complicating the ease of access to reliable and up-to-
date information. These factors can result in inconsistent mitigation measures being applied at short notice with
minimal global harmonisation.
3. It is important to recognize that States are in different stages of the pandemic, with some areas
managing their first outbreaks and others dealing with an acute wave of high caseloads due to the highly
contagious Omicron variant. In recognition that elimination of this variant is not achievable, some States are
reducing mitigation measures and have started transitioning from the acute pandemic management phase to a
new phase of “living with COVID”. In some of these areas, community level case numbers have increased after
the lifting of restrictions.
AR04998
4. Low levels of vaccination and/or natural immunity, as well as crowded situations, increase the
risk of infection and the evolution of new viral mutations. There is still a likelihood that future Variants of
Concern will evolve which could be associated with a greater immune escape rate and/or more serious illness,
before we reach a more stable situation where COVID-19 can be considered as a more predictable or manageable
disease.
999 Robert-Bourassa Boulevard Tel.: +1 514-954-8219 Email: icaohq@icao.int
Montréal, Quebec Fax: +1 514-954-6077 www.icao.int
Canada H3C 5H7
AR04999
-2-
5. Given the high complexity of the situation, there is no single measure that can provide a
definitive solution. Every mitigation measure affects the system in a different way. States should therefore
identify and compare levels of risk cognisant that risk cannot be eliminated at this stage.
6. In the aviation sector, some States have transitioned from government regulations to individual
responsibility, while others have modified or removed one or more layers of the multi-layer risk mitigation
measures, such as removing the requirement of wearing masks and phasing out of COVID-19 testing for some
categories of individuals or adjusting the requirements for quarantine or self-isolation.
7. All Member States are encouraged to continue to mitigate the spread of COVID-19 using the
existing recommendations in the ICAO guidance material contained in the Council Aviation Recovery Task
Force (CART) reports, the fourth edition of Take-off: Guidance for Air Travel through the COVID-19 Public
Health Crisis (TOGD)1 and the third edition of the ICAO Manual on COVID-19 Cross-Border Risk Management
(Doc 10152)2, in accordance with a risk and evidence-based approach, specifically with regard to the measures
highlighted in Attachment B.
8. States considering lifting or alleviating travel-related restrictions and public health risk
mitigation measures should ensure that it is risk-based and appropriate by continuing to apply the principles
recommended in Attachment C.
9. Recently it has been more difficult to maintain a reliable and consistent global supply chain in
order to support global health and safety, food security and economic recovery from the COVID-19 pandemic.
It is essential to maintain repatriation, medical evacuation and cargo flights to achieve this objective. As per
Amendment 29 of Annex 9, effective on 18 July 2022, repatriation flights are special flights organized,
facilitated, or supported by a State for the exclusive purpose of transporting that State’s nationals, and other
eligible persons, from foreign countries to that State, or a safe third country, through operations by State aircraft,
humanitarian flights or chartered/non-scheduled commercial flights.
10. In line with the relevant provisions of Annex 9 – Facilitation, States are urged to facilitate the
entry into, departure from and transit through their territories of aircraft engaged in repatriation flights and should
take all possible measures to ensure their safe operation. Such flights should be commenced as quickly as
possible after obtaining agreement with the States involved.
11. States are urged to adhere to the relevant ICAO Standards and Recommended Practices
(SARPs) in Annex 1 — Personnel Licensing, Annex 6 — Operation of Aircraft, Part I — International
Commercial Air Transport — Aeroplanes, Annex 9 — Facilitation, Annex 17 — Security — Safeguarding
International Civil Aviation against Acts of Unlawful Interference, Annex 18 — The Safe Transport of
Dangerous Goods by Air and Annex 19 – Safety Management when conducting these flights, as well as the
relevant State letters (SLs) and Electronic Bulletins (EBs) regarding these flights during the COVID-19
pandemic (Ref.: SL EC 2/76-21/64, SL AN 5/28-20/97, EB 2021/43 and EB 2020/36)3.
12. States are encouraged to continue to implement the Public Health Corridors (PHCs) concept
during the transition period. States should continue to explore bilateral or multilateral PHC Arrangements as a
preferable and more suitable alternative to border closure. Note that PHCs function as temporary solutions and
additional arrangements between two or more States outside of existing Air Services Agreements between
States. PHCs have proven to be useful for ‘closed loop’ cargo flights and for aircrew requiring medical
certification or flight training.
1 Documents and Forms (icao.int)

2 ICAO Manuals
3 Electronic Bulletins and State Letters (icao.int)
AR05000
-3-
13. In view of crew requirements, States should endeavour, as far as possible, to agree to implement
a coordinated approach in implementing risk mitigation measures. The crew-related guidance referring to
alleviations of testing and quarantine for vaccinated crew as well as layover requirements contained in the CART
reports, the crew module of TOGD and Doc 10152 should be considered. Harmonisation of crew requirements
is essential as unilateral or uncoordinated implementation of risk mitigation measures could have an adverse
effect on flight safety and the continuance of essential air service including:
a) fatigue due to layover conditions not being conducive to obtain uninterrupted rest prior to the next
flight or requiring additional time due to transportation or testing arrangements;
b) increased risk of COVID-19 infection due to transport challenges and not having access to crew-
specific testing, customs and immigration facilities resulting in unnecessary exposure at airports;
c) increased stress due to restrictive layover conditions – including access to exercise, food services,
etc., and excessive or repeated mitigation measures that could affect the health and mental
wellbeing of crew, sometimes resulting in crew being unavailable for flight; and
d) flight scheduling disruptions due to challenges with rigid testing schedules or repeated testing,
isolation and/or quarantine requirements.
14. States are encouraged to specifically review requirements for crew performing international
flights crossing several borders within a short timeframe and cargo crew performing round trips or closed loop
flights.
15. Cargo flights present lower risks to national public health situations as there are no commercial
passengers on-board and the crew is generally less numerous. In addition, cargo flights are essential for
maintaining vital humanitarian aid, supply chains and other air cargo operations, which in turn have significant
impacts on dependent industries and economies. For these reasons, particular considerations should be given to
cargo flights when defining multilayer risk management strategies.
16. States are urged to follow and implement this guidance in coordination with ICAO Regional
Offices according to their specific needs and circumstances, noting the importance of a global coordinated
approach to mitigate the transmission of the disease and facilitate the recovery of international travel, trade,
tourism and the global economy.
Accept, Sir/Madam, the assurances of my highest consideration.
Juan Carlos Salazar

Secretary General
Enclosures:
A — COVID-19 Aviation Scientific Assessment Group
(CASAG) – Omicron Variant Knowns, Unknowns and
Recommendations
B — Recommendations to mitigate the spread of COVID-19
C — Principles and example of factors to consider when
considering alleviating mitigation measures in aviation
during the COVID-19 transition period
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ATTACHMENT A to State letter AN 5/28-22/42
ICAO CAPSCA
COVID-19 AVIATION SCIENTIFIC ASSESSMENT GROUP (CASAG)
OMICRON VARIANT KNOWNS, UNKNOWNS AND RECOMMENDATIONS
12 February 2022
The CASAG met on four separate occasions during December, January and February to
consider if the emergence of the Omicron Variant of the COVID-19 Virus would necessitate any
modifications to the existing Cross Border Risk Management guidance developed by CAPSCA. In
particular, the group focussed on whether any changes might be needed to the multilayered risk
management process. This document summarizes what the CASAG group knows and does not know about
the Omicron Variant. In addition, based upon what the group knows about the Omicron Variant, several
recommendations are made to adjust testing strategies in the Conclusions and Recommendations section.
Given the dynamic nature of the COVID-19 Pandemic, the CASAG will continuously
monitor the situation and provide updates when evidence and peered reviewed literature becomes available.
Please note that there is a high likelihood that future Variants of Concern may arise before we reach a
situation where the disease has less impact and becomes more manageable.
What we know:
1. It is unlikely that undetected translocation of the Omicron Variant by travellers would significantly
increase the overall risk within a State that already has widespread circulation of the variant (2, 7,
16).
2. Transmission of the Omicron Variant is occurring much more rapidly than earlier variants even in
those individuals that are vaccinated (14, 21, 25). Based upon the limited evidence to date, it
appears that the incubation period for the Omicron Variant is shorter on average than for earlier
variants (4, 11, 23).
3. While the effectiveness of vaccines against infection and transmission of Omicron is reduced
compared to other variants, they provide strong protection against severe disease, hospitalization
and death. Protection is enhanced with a booster dose (10, 17, 18).
4. At the time of publication, most States are presumed to have widespread circulation of the Omicron
Variant (19, 24).
5. PCR tests continue to detect Omicron.
6. The public health and social measures such as proper use of face masks, enhanced respiratory and
general hygiene, and physical distancing reduce the risk of transmission of all SARS-CoV-2
variants, together with good ventilation of indoors settings (8, 9).
What we do not know:
1. The risk of transmission of the Omicron Variant compared to other variants during each stage
of the travel journey.
2. The optimum testing strategies for vaccinated and unvaccinated travellers, and what criteria
could be used to remove testing requirements.
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3. Whether the performance of any test is significantly different when testing for the Omicron
Variant. The sensitivity of the Ag-RDT in detecting Omicron is still under investigation.
4. The risk of infected vaccinated people passing the Omicron Virus to others. There is limited
information on this risk but there is some evidence that a vaccinated person will be less likely
pass the virus on to others.
5. The duration of protection from vaccines or prior infection.
Conclusions and Recommendations:
Considering the lessons learned from the COVID-19 Delta Variant and the emergence of
the Omicron Variant, CASAG reiterates the importance of implementing an effective multi-layered
risk management strategy as outlined in the ICAO Cross Border Risk Management Manual
(Doc 10152). Emphasis should be placed on vaccinations, masking, and testing.
Based upon the evidence available as of the publication of this document concerning the
emergence of the Omicron Variant, CASAG recommends that States consider the following in adjusting
their existing COVID-19 testing strategies:
 Pre-departure testing has limited capability to reduce the risk of translocation given that travel
may be during the incubation period.
 Depending on the epidemiological situation at the origin and destination, States may consider
post-arrival testing in conjunction with self-isolation or quarantine, pending the results of the
tests, as a strategy to mitigate the risk of translocation.
 Pre-departure testing may still be considered an effective layer of a risk mitigation strategy for
flight associated transmission of COVID-19. Tests should be done as close to departure time
as possible. Antigen testing may be more appropriate as it can identify currently infectious
travelers, provides results quickly and is less expensive.
References:
1. Adamson, B. J., Sikka, R., Wyllie, A. L., & Premsrirut, P. K. (2022). Discordant SARS-CoV-2 PCR and
Rapid Antigen Test Results When Infectious: A December 2021 Occupational Case Series. medRxiv.
2. Aleta, A., Hu, Q., Ye, J., Ji, P., & Moreno, Y. (2020). A data-driven assessment of early travel restrictions
related to the spreading of the novel COVID-19 within mainland China. Chaos, Solitons & Fractals, 139,
110068.
3. Bekliz, M., Adea, K., Essaidi-Laziosi, M., Sacks, J. A., Escadafal, C., Kaiser, L., & Eckerle, I. (2021). SARS-
CoV-2 antigen-detecting rapid tests for the delta variant. The Lancet Microbe.
4. Brandal, L. T., MacDonald, E., Veneti, L., Ravlo, T., Lange, H., Naseer, U., ... & Madslien, E. H. (2021).
Outbreak caused by the SARS-CoV-2 Omicron variant in Norway, November to December 2021.
Eurosurveillance, 26(50), 2101147.
5. Campbell Finlay, Archer Brett, Laurenson-Schafer Henry, Jinnai Yuka, Konings Franck, Batra Neale, Pavlin
Boris, Vandemaele Katelijn, Van Kerkhove Maria D, Jombart Thibaut, Morgan Oliver, le Polain de Waroux
Olivier. Increased transmissibility and global spread of SARS-CoV-2 variants of concern as at June 2021.
Euro Surveill. 2021;26(24):2100509. https://doi.org/10.2807/1560-7917.ES.2021.26.24.2100509
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6. CDC Interim Guidance for Antigen Testing for SARS-CoV-2. https://www.cdc.gov/coronavirus/2019-

ncov/lab/resources/antigen-tests-guidelines.html. (Updated Sept. 9, 2021; Accessed 19 November, 2021)
7. Chinazzi, M., Davis, J. T., Ajelli, M., Gioannini, C., Litvinova, M., Merler, S., ... & Vespignani, A. (2020).
The effect of travel restrictions on the spread of the 2019 novel coronavirus (COVID-19) outbreak.
Science, 368(6489), 395-400.
8. European Centre for Disease Prevention and Control. (2020). Guidelines for the implementation of non‐
pharmaceutical interventions against COVID‐19.
9. European Centre for Disease Prevention and Control. (2021). Assessment of the further emergence and
potential impact of the SARS-CoV-2 Omicron variant of concern in the context of ongoing transmission of
the Delta variant of concern in the EU/EEA, 18th update.
10. Fendler, A., Shepherd, S. T., Au, L., Wu, M., Harvey, R., Schmitt, A. M., ... & Turajlic, S. (2022). Omicron
neutralising antibodies after third COVID-19 vaccine dose in patients with cancer. The Lancet.
11. Hay, James, Stephen Kissler, Joseph R. Fauver, Christina Mack, Caroline G. Tai, et al. 2022. "Viral
dynamics and duration of PCR positivity of the SARS-CoV-2 Omicron variant." Pre-print. SPH Scholary
Articles. Available at https://dash.harvard.edu/handle/1/37370587
12. Helmsdal G, Hansen OK, Møller LF, Christiansen DH, Petersen MS, Kristiansen MF. Omicron Outbreak at
a Private Gathering in the Faroe Islands, Infecting 21 of 33 Triple-Vaccinated Healthcare Workers.
Infectious Diseases (except HIV/AIDS); 2021. doi:10.1101/2021.12.22.21268021
13. Jansen L. Investigation of a SARS-CoV-2 B.1.1.529 (Omicron) Variant Cluster — Nebraska, November–
December 2021. MMWR Morb Mortal Wkly Rep. 2021;70. doi:10.15585/mmwr.mm705152e3
14. Iuliano AD, Brunkard JM, Boehmer TK, et al. Trends in Disease Severity and Health Care Utilization
During the Early Omicron Variant Period Compared with Previous SARS-CoV-2 High Transmission
Periods — United States, December 2020–January 2022. MMWR Morb Mortal Wkly Rep 2022;71:146–
152. DOI: http://dx.doi.org/10.15585/mmwr.mm7104e4
15. Lee JJ, Choe YJ, Jeong H, et al. Importation and Transmission of SARS-CoV-2 B.1.1.529 (Omicron)
Variant of Concern in Korea, November 2021. J Korean Med Sci. 2021;36(50):e346.
doi:10.3346/jkms.2021.36.e346
16. Linka, K., Peirlinck, M., Sahli Costabal, F., & Kuhl, E. (2020). Outbreak dynamics of COVID-19 in
Europe and the effect of travel restrictions. Computer Methods in Biomechanics and Biomedical
Engineering, 23(11), 710-717.
17. Mazzoni, A., Vanni, A., Spinicci, M., Capone, M., Lamacchia, G., Salvati, L., ... & Annunziato, F. SARS-
CoV-2 Spike-specific CD4+ T cell response is conserved against variants of concern, including Omicron.
Frontiers in Immunology, 121.
18. Nemet, I., Kliker, L., Lustig, Y., Zuckerman, N., Erster, O., Cohen, C., ... & Mandelboim, M. (2021). Third
BNT162b2 vaccination neutralization of SARS-CoV-2 Omicron infection. New England Journal of
Medicine.
19. Our world in data. Share of SARS-CoV-2 sequences that are the omicron variant, Feb 2, 2022. Available at
https://ourworldindata.org/grapher/covid-cases-
omicron?country=GBR~FRA~BEL~DEU~ITA~ESP~USA~ZAF~BWA~AUS. Accessed 5 February, 2022.
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20. Perra, N. (2021). Non-pharmaceutical interventions during the COVID-19 pandemic: A review. Physics
Reports.
21. Saxena, S. K., Kumar, S., Ansari, S., Paweska, J. T., Maurya, V. K., Tripathi, A. K., & Abdel‐Moneim, A.
S. (2022). Transmission dynamics and mutational prevalence of the novel SARS‐CoV‐2 Omicron Variant
of Concern. Journal of Medical Virology.
22. Schrom, J., Marquez, C., Pilarowski, G., Wang, G., Mitchell, A., Puccinelli, R., ... & Havlir, D. (2022).
Direct Comparison of SARS Co-V-2 Nasal RT-PCR and Rapid Antigen Test (BinaxNOW (TM)) at a
Community Testing Site During an Omicron Surge. medRxiv.
23. Snell LB, Awan AR, Charalampous T, et al. SARS-CoV-2 variants with shortened incubation periods
necessitate new definitions for nosocomial acquisition [published online ahead of print, 2021 Aug 30]. J
Infect. 2021;S0163-4453(21)00445-X. doi:10.1016/j.jinf.2021.08.041
24. United Nations, United Nations News Global Perspectives. https://news.un.org/en/story/2021/07/1095252

(published 2 July 2021; Accessed 19 November, 2021)
25. Yang, W., & Shaman, J. (2021). SARS-CoV-2 transmission dynamics in South Africa and epidemiological
characteristics of the Omicron variant. medRxiv.
————————
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ATTACHMENT B to State letter AN 5/28-22/42
RECOMMENDATIONS TO MITIGATE THE SPREAD OF COVID-19
a) using the multilayer risk-based approach to mitigate the transmission of the disease;
b) continuing to apply general public health risk mitigation measures during air transport,
including hygiene and sanitation practices, recommending the wearing of masks, applying
physical distancing where feasible and ensuring adequate ventilation;
c) implementing evidence-based testing and quarantine practices;
d) recording and sharing data on testing, recovery and vaccination; and ensuring that the data
required for verification of this evidence is made available internationally in a global,
interoperable format;
e) considering exemptions from testing and/or quarantine based on vaccination or recovery

from infection;
f) recognizing aircrew, front-line aviation workers and aviation workers in critical safety and
security positions as essential workers to ensure the availability of air transportation during
the COVID-19 pandemic; and
g) encouraging COVID-19 vaccination and supporting States’ access to vaccines.
————————
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ATTACHMENT C to State letter AN 5/28-22/42
PRINCIPLES AND EXAMPLE OF FACTORS TO CONSIDER WHEN CONSIDERING

ALLEVIATING MITIGATION MEASURES IN AVIATION DURING THE COVID-19
TRANSITION PERIOD
1. Principles that States could consider when considering alleviations of mitigation measures
a) coordinate and communicate with the appropriate national authorities through national
facilitation committees and/or other existing national frameworks;
b) assess risk based on evidence regarding the local epidemiology, considering comparable
indicators such as case rate, hospitalization rate, death rate or levels of vaccination and
natural immunity in both departure and destination States;
c) assess health resources including public health capacity and treatment capability in both
departure and destination States;
d) consider States’ risk tolerance levels and other relevant national factors;
e) take into account priorities for international travel where traffic capacity is limited;
f) regularly review and update information on the relevant ICAO and World Health
Organization (WHO) platforms;
g) communicate risk mitigation measures and travel restrictions to all relevant stakeholders;
h) be prepared to regularly and rapidly adjust mitigation measures or strategies in response to

the epidemiological situation, health system capacity and other relevant factors; and
i) take care to balance the public health risk with the continuation of services by considering
the objectives, feasibility and effectiveness of each measure before alleviating restrictions
during the COVID-19 transition period, noting that objectives could be different for
individual States and that they could change over time.
2. An example of factors that States could consider in terms of objectives, feasibility and
effectiveness when considering alleviations of mitigation measures
1. Objectives
1.1 The choice of an objective for travel measures should depend on local and global prevalence
of SARS-CoV-2 variants; and
1.2 States should review objectives regularly as it might change over time due to progress on
national strategies e.g. increase in population immunity due to natural infection and/or
vaccination.
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2. Testing
2.1 Pre-departure testing primarily mitigates on-board transmission;
2.2 Post-arrival testing can play a role in contact tracing or monitoring for national surveillance
activities;
2.3 Post-arrival testing can provide more information on identification of a potential new VOC into
an arrival State;
2.4 Post-arrival testing can delay the introduction and reduce the risk of outbreaks resulting from
imported cases;
2.5 Post-arrival testing might not add value where there is already widespread community
transmission or where there is limited health capacity or resources;
2.6 Testing in general may be of greater value for symptomatic passengers, non-vaccinated
passengers or passengers with no history of COVID-19 infection due to their higher risk of
contracting or transmitting the disease;
2.7 Rapid antigen testing could be more appropriate or feasible in comparison to PCR testing in
aviation due to time, cost and practical considerations; and
2.8 Testing can be used to estimate SARS-CoV-2 prevalence in States to inform risk assessments,
if there is sufficient health capacity and resources.
3. Wearing of masks4
3.1 Their primary purpose is source control and to provide a degree of particulate filtration to
reduce the amount of inhaled particulate matter.
3.2 For any type of mask, appropriate use, storage, cleaning or disposal are essential to ensure that
they are as effective as possible and to avoid any increased risk of transmission. States should
follow WHO guidance on the correct use of masks.
3.3 In settings where there is community or cluster transmission of SARS-CoV-2, irrespective of

vaccination status or history of prior infection, wearing a well-fitting mask that covers the nose
and mouth is recommended for the general public when interacting with individuals who are
not members of their household:
 in indoor settings where ventilation is known to be poor or cannot be assessed, or the

ventilation system is not properly maintained, regardless of whether physical distancing of
at least 1 metre can be maintained; and
 in indoor settings that have adequate ventilation if physical distancing of at least 1 metre
cannot be maintained.
4 Source: Infection prevention and control in the context of coronavirus disease (COVID-19): a living guideline, 7 March 2022
(who.int)
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Note: The general population in public settings includes enclosed settings such as
transportation
3.4 The potential advantages of mask use by healthy people in the general public include:
 reduced spread of potentially infectious aerosols or droplets from exhaled breath, including
from infected people before they develop symptoms;
 encouraging concurrent transmission prevention behaviours such as washing hands and not
touching the eyes, nose and mouth; and
 preventing transmission of other respiratory illnesses such as tuberculosis and influenza

and reducing the burden of these diseases during the pandemic.
3.5 The potential disadvantages of mask use by healthy people in the general public include:
 difficulty with communicating clearly, especially for persons who are deaf or have poor
hearing or use lip reading;
 poor compliance with mask-wearing, in particular by young children;
 waste management issues; improper mask disposal leading to increased litter in public
places and environmental hazards; and
 further disadvantages for, or difficulty wearing masks by, certain members of the
population, especially: children; developmentally challenged people; those with mental
illness or cognitive impairment; those with asthma, chronic respiratory or breathing
problems; those who have had facial trauma or recent oral maxillofacial surgery; and those
living in hot and humid environments.
3.6 The utilization of masks in community settings is likely associated with a decreased risk of
SARS-CoV-2 infections compared with no mask-wearing; especially in variants with reported
increased transmissibility where the benefits of mask-wearing would outweigh potential harms,
with the exception of some individuals for such as young children or people unable to tolerate
masks due to medical conditions, etc.
3.7 In areas with known or suspected sporadic transmission, or no documented transmission, WHO
advise that decision-makers should apply a risk-based approach focusing on the following
criteria when considering the use of masks for the general public:
• purpose of mask use;

• risk of exposure to SARS-CoV-2;
• vulnerability of the mask wearer/population;
• setting in which the population lives;
• feasibility;
• type of mask;
• vaccination coverage; and
• circulating variants of concern.
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4. Physical distancing
4.1 States and aircraft operators could consider on-board factors such as airflow, HEPA-filters,
physical barriers and ventilation procedures when reviewing physical distancing requirements
as part of the multi-layer risk mitigation framework.
4.2 States and aircraft operators could, in conjunction with airport management, consider providing
separate facilities for air crew and scaling down the recommendations on the physical
distancing due to bottlenecks and the effects on flight time limitations for operations which
could have an adverse effect on flight safety
— END —
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Doc 10152
Manual on COVID-19 Cross-border
Risk Management
Third Edition, 2021
7 • i
SJ
r Approved by and published under the authority of the Secretary General
INTERNATIONAL CIVIL AVIATION ORGANIZATION

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ICAO
Doc 10152
Manual on COVID-19 Cross-border
Risk Management
Third Edition, 2021
Approved by and published under the authority of the Secretary General

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Published in separate English, Arabic, Chinese, French, Russian

and Spanish editions by the
999 Robert-Bourassa Boulevard, Montréal, Quebec, Canada H3C 5H7
For ordering information and for a complete listing of sales agents

and booksellers, please go to the ICAO website at www.icao.int
Third edition, 2021
Doc 10152, Manual on COVID-19 Cross-border Risk Management

Order Number: 10152
ISBN 978-92-9265-582-2
© ICAO 2021
All rights reserved. No part of this publication may be reproduced, stored in a

retrieval system or transmitted in any form or by any means, without prior
permission in writing from the International Civil Aviation Organization.
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AMENDMENTS
Amendments are announced in the supplements to the Products and

Services Catalogue; the Catalogue and its supplements are available
on the ICAO website at www.icao.int. The space below is provided to
keep a record of such amendments.
RECORD OF AMENDMENTS AND CORRIGENDA
AMENDMENTS CORRIGENDA
No. Date Entered by No. Date Entered by
(iii)
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FOREWORD
This manual has been prepared by aviation health experts led by the International Civil Aviation Organization (ICAO) with
support from the United States Centers for Disease Control and Prevention (CDC), European Centre for Disease
Prevention and Control (ECDC), Aerospace Medical Association (AsMA), and others, and it has been reviewed by the
World Health Organization (WHO). Contributions from other United Nations organizations, governments and industry
stakeholders ensured the practical applicability of this guidance in the aviation sector, no matter how big or small the State
and no matter what scale of COVID-19 challenge they face. Together, these experts and stakeholders form the ICAO
Collaborative Arrangement for the Prevention and Management of Public Health Events in Civil Aviation (CAPSCA)
programme. CAPSCA brings together international, regional, national and local organizations to work together to improve
preparedness planning and response to public health events that affect the aviation sector.
CAPSCA developed this guidance in close collaboration with the ICAO Council Aviation Recovery Task Force (CART),
which requested updated guidance on the inclusion of COVID-19 testing, vaccination and its interdependencies with other
risk mitigation tools for those States that choose to include testing and vaccination as elements of their overall COVID-19
risk management process.
The CART has published updated recommendations to States in the High-Level Cover Document (HLCD) including
Recommendations 13, 17, 18 and 19 on testing and vaccination, respectively quoted below:
Recommendation 13: “Member States using testing in their COVID-19 risk management strategy should apply
the approach outlined in the ICAO Manual on COVID-19 Cross-border Risk Management (Doc 10152),
recognizing that robust testing strategies allow for early detection of potentially infectious travellers. However,
testing may not be universally recommended by public health authorities as a routine health screening method
due to priority and resource considerations.”
Recommendation 17: “Member States should implement and recognize certificates of testing, recovery and
vaccination based on the protocol, minimum data set and implementation approaches outlined in the ICAO
Manual on COVID-19 Cross-border Risk Management (Doc 10152) to facilitate air travel. States are encouraged
to ensure such certificates are secure, trustworthy, verifiable, convenient to use, compliant with data protection
legislation and internationally/globally interoperable. Proof of vaccination could be based upon the World Health
Organization (WHO) International Certificate of Vaccination or Prophylaxis (ICVP) and should be issued in an
internationally/globally interoperable format aligned with the technical specifications and guidance outlined by the
WHO. Existing solutions should be considered and could incorporate a visible digital seal – non-constrained
(VDS-NC) or other interoperable formats from regional or global intergovernmental bodies, or internationally
recognized organizations.”
Recommendation 18: “Member States should facilitate access for air crew to vaccination as quickly as possible
as recommended by the WHO Strategic Advisory Group of Experts on Immunization (SAGE) Stage II for air crew
who work on aircraft that carry goods and no passengers and Stage III for other aviation workers.”
Recommendation 19: “Member States are encouraged to promote, to the greatest extent possible, a harmonized
and inclusive approach to facilitate international travel and entry of fully vaccinated and recovered passengers.
In this regard, Member States should consider alleviating or exempting testing and/or quarantine measures for
individuals who have been fully vaccinated or those with a history of previous SARS-CoV-2 infection who are no
longer infectious. The alleviations and exemptions should be made in accordance with a State’s accepted risk
threshold, national framework, the COVID-19 situation and the multilayer risk management framework described
(v)
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(vi) Manual on COVID-19 Cross-border Risk Management
in the Take-off: Guidance for Air Travel through the COVID-19 Public Health Crisis. In view of the global unequal
access to vaccines and the unsuitability or intolerance of use of vaccines by some individuals, vaccination should
not be a prerequisite for international travel.”
In addition, the CART revised Recommendation 14 in the HLCD concerning Public Health Corridors (PHCs) as follows:
“Member States considering the formation of a Public Health Corridor (PHC) should actively share information
with each other to implement PHCs in a harmonized manner. To facilitate the implementation, the ICAO
Implementation Package (iPack) on establishing a PHC is available to States, in addition to PHC-specific tools
published on the ICAO website and the application (App) providing a template PHC arrangement between States.”
CART guidance aligns with updated WHO guidance:
a) with regard to PHCs, the WHO supports exploring bilateral, multilateral and regional agreements across
countries, particularly with neighbouring countries and others of socioeconomic importance, with the aim of
facilitating the recovery of key activities for which international travel plays an important role, such as tourism
or the movement of a cross-border workforce1;
b) testing and vaccination can be considered as part of national multilayered risk mitigation strategies. The
WHO has stated that proof of vaccination should not be required as a condition of entry or exit to a country;
and
c) the WHO suggest that proof of vaccination could be based upon the ICVP or, if digital, should be issued in
an interoperable format aligned with the technical specifications and guidance outlined in the Digital
Documentation of COVID-19 Certificates: Vaccination Status technical specifications and implementation
guidance document. The format recommended by ICAO (“visible digital seal for non-constrained
environments” (VDS-NC)) is one possible option.
Furthermore, the WHO recommends, based on growing experiences from countries where national authorities continue
to review and adjust their travel-related measures to facilitate non-essential international travel, in addition to prioritizing
international travel for essential purposes as defined by national authorities, applying measures that take into account
individual travellers’ transmission risk, depending on their infection status, vaccination status and/or recovery status2.
As part of its CART endeavours, CART has updated the fourth edition of the Take-off: Guidance for Air Travel through the
COVID-19 Public Health Crisis (TOGD)3, originally issued in June 2020 and revised in September 2021. The fourth edition
of the TOGD reflects technological and medical advancements and provides the latest operational and public health
guidance related to air travel reflecting technological and medical advancements. The recommended multilayer risk
management strategy has been supplemented with considerations on testing protocols and proof-of-results certification
interoperability, considerations for testing and vaccination, as well as including evidence of vaccination for crew and
passengers. Guidance on the establishment of PHCs has been expanded and guidance on the transition to routine
operations in the future has been added.
The third edition of this manual was revised in close collaboration with CAPSCA. It provides updated detailed guidance
on risk management, PHCs, information on current scientific developments regarding Variants of Concern (VOC),
COVID-19 testing, vaccination, proof of recovery, health certificates, the interdependencies of public health risk mitigation
measures within a State’s multilayer risk management framework and considerations for transitioning to routine operations
1
https://www.who.int/publications/i/item/WHO-2019-nCoV-Policy-Brief-Risk-based-international-travel-2021.1
2
https://www.who.int/publications/i/item/WHO-2019-nCoV-Risk-based-international-travel-2021.1
3
https://www.icao.int/covid/cart/Pages/CART-Take-off.aspx
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Foreword (vii)
in the future. This guidance supplements the measures already outlined in the CART HLCD and TOGD4 and provides a
risk management process to facilitate States’ assessments of the applicability of a combination of measures available
today. Given the dynamic nature of the COVID-19 pandemic, this manual is intended to be a living document and will be
updated as new information becomes available.
COVID-19 testing, managing recovery from previous infection and vaccination, if applied according to the guidance
contained in this manual, could reduce reliance on measures that restrict air travel and the movement of persons arriving
in a country, such as quarantine, which evidence suggests is a disincentive to several important categories of travel, of
which the following list is non-exhaustive: pilot certification, pilot simulator training, essential business flights and tourism
for some States that are dependent on inbound tourism for economic sustainability. In addition, proof of recovery or
vaccination could reduce the need for additional COVID-19 testing, enabling quicker movement of air crew and passengers
through check-in and customs procedures, and reduce costs for travellers and States. Restoring confidence in aviation is
a key priority.
Note.― There are many available serologic assays (antibody tests) that measure the antibody response to
SARS-CoV-2 infection, but at the time of publication of this manual, the correlates of protection were not well understood.
The use of serologic assays is not recommended to prove recovery status given the limitations that are outlined in the
scientific brief “COVID-19 natural immunity”5.
Quarantine may still apply for persons infected with SARS-CoV-2, as well as known close contacts of persons diagnosed
with COVID-19, while self-isolation, self-quarantine or other measures could be applied for other individuals in accordance
with a State’s assessed risk tolerance.
In implementing testing and vaccination as components of States’ overall COVID-19 multilayered risk management
strategy, they are reminded that an effective application of a multilayered risk strategy, including testing and vaccination,
is one in which:
a) States perform a risk assessment6 using epidemiologic criteria including, but not limited to, disease
incidence and prevalence, new variants, disease trajectory, national testing strategy 7 , screening
capabilities, hospital capacity and robustness of contact tracing and status of national vaccination
strategy;
b) States share the results of the risk assessments, the local epidemiology (including genomic sequencing
of VOC, if possible) and transmission scenarios in the departure and destination countries or areas, as
well as the public health and health system capacity and performance to detect and care for returning
travellers and their contacts with other States to facilitate the opening of air routes or PHCs;
c) States consider their risk tolerance, and issues such as socio-economic and human rights, as a part of
their risk assessment;
d) States that choose to use testing for screening purposes in aviation after consideration of national testing
capacity8 and the local epidemiology in departure and destination countries, apply a cut-off value, based
on evidence generated from asymptomatic individuals, for sensitivity and specificity as high as possible
(with a minimum of 95 per cent sensitivity and specificity for molecular tests; and a minimum of
4 https://www.icao.int/covid/cart/Pages/Documents.aspx
5. https://www.who.int/publications/i/item/WHO-2019-nCoV-Sci_Brief-Natural_immunity-2021.1
6. WHO guidance on Considerations for implementing a risk-based approach to international travel in the context of COVID-19
7. Scientific brief on COVID-19 diagnostic testing in the context of international travel
https://apps.who.int/iris/handle/10665/337832?locale-attribute=fr&
8. https://www.who.int/publications/i/item/WHO-2019-nCoV-Risk-based-international-travel-2021.1
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(viii) Manual on COVID-19 Cross-border Risk Management
80 per cent sensitivity and 97 per cent specificity for rapid antigen tests) to reduce inaccurate test
results, although these values might change as science matures9;
e) States that use testing and vaccination as part of their multilayer risk management strategy take into
account any recent test results, proof of recovery from COVID-19 and vaccination status, when
considering the need for additional post-arrival testing or quarantine; including the duration of
quarantine, when addressing higher risk scenarios; and
f) States harmonize their procedures to the maximum extent possible.
This manual describes the risk management measures that can be applied; how epidemiology can be used to advise
States in developing a risk management strategy; possible testing protocols that might be put in place where there is
differential prevalence and therefore risk; vaccination as an effective mitigation factor including a series of examples to
help States in their decision-making processes; and information and tools to assist States with sharing of information
regarding the implementation of public health risk mitigation measures and the recognition thereof in order to open air
routes and global travel.
Note.— The content of this manual is largely based on information and studies conducted prior to the
emergence of the Delta variant. At the time of publication of this manual, the scientific information regarding the Delta and
other variants was limited but was included in this version. Further updates will be needed as more information becomes
available.
Scientific evidence that supports the guidance contained in this manual are available on the CAPSCA website10.
______________________
9. SARS-CoV-2 antigen-detecting rapid diagnostic tests: An implementation guide

https://www.who.int/publications/i/item/9789240017740.
10
https://www.icao.int/safety/CAPSCA/Pages/default.aspx.
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TABLE OF CONTENTS
Page
Glossary .......................................................................................................................................................... (xi)
Chapter 1. Introduction ................................................................................................................................ 1-1
Chapter 2. General risk management principles applied to air transport ............................................... 2-1
Chapter 3. Testing, vaccination and cross-border risk management measures .................................... 3-1
3.1 Overview ........................................................................................................................................ 3-1

3.2 Assessment of epidemiological indicators ...................................................................................... 3-3
3.3 Testing as a screening strategy applied to aviation ........................................................................ 3-5
3.4 Quarantine practices ...................................................................................................................... 3-16
3.5 Combined testing and quarantine strategies .................................................................................. 3-18
3.6 Vaccination and vaccinated persons .............................................................................................. 3-19
Chapter 4. Implementation — Model for multilayer assessment and mitigation .................................... 4-1
4.1 Overview ........................................................................................................................................ 4-1

4.2 Generic baseline model for multilayered risk assessment and determining
mitigation measures (four-step process) ........................................................................................ 4-2
4.3 Sample scenarios ........................................................................................................................... 4-4
Chapter 5. Public health corridor ................................................................................................................ 5-1
5.1 Principles ........................................................................................................................................ 5-1

5.2 Elements of a PHC ......................................................................................................................... 5-2
5.3 Implementation of a PHC arrangement between States................................................................. 5-5
5.4 Stakeholder and passenger communication................................................................................... 5-6
Chapter 6. Transitioning from crisis response to routine operations ........................................................ 6-1
Attachment A. Epidemiologic primer .................................................................................................. Att A-1
Attachment B. Estimated effectiveness of individual risk mitigation measures ............................. Att B-1
Attachment C. Decision aid .................................................................................................................. Att C-1
______________________
(ix)
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GLOSSARY
LIST OF ACRONYMS AND ABBREVIATIONS
Ab Antibody
Ab-RDT Antibody-detecting rapid diagnostic test
Ag Antigen
Ag-RDT Antigen-detecting rapid diagnostic test
API Advance Passenger Information
ATM Air traffic management
CAPSCA Collaborative Arrangement for the Prevention and Management of
Public Health Events in Civil Aviation
CART Council Aviation Recovery Task Force
CASAG COVID-19 Aviation Scientific Assessment Group
COVID-19 Coronavirus disease 19
CRRIC COVID-19 Response and Recovery Implementation Centre
ECDC European Centre for Disease Prevention and Control
EUL Emergency use listing
FTL Flight time limitation
HLCD High-Level Cover Document
IHR International Health Regulations
ICVP International Certificate of Vaccination or Prophylaxis
NAAT Nucleic acid amplification test
NPV Negative predictive value
MRTD Machine Readable Travel Documents
PCR Polymerase chain reaction
PHC Public health corridor
PNR Passenger Name Record
PPE Personal protective equipment
PPV Positive predictive value
RDT Rapid diagnostic tests
RT-PCR Reverse-transcription polymerase chain reaction
SAGE Strategic Advisory Group of Experts on Immunization
SARS-CoV-2 Severe acute respiratory syndrome coronavirus 2
SRA Stringent regulatory authorities
TOGD Take-off Guidance for Air Travel through the COVID-19 Public Health Crisis
VDS-NC Visible digital seal – non-constrained
VOC Variant of concern
VOI Variant of interest
WHO World Health Organization
(xi)
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DEFINITIONS
Asymptomatic. A person infected with COVID-19 who does not develop symptoms.
Breakthrough infection. A COVID case that occurs in someone who is fully vaccinated.
Contact. A person in any of the following situations from two days before and up to fourteen days after the onset of
symptoms in the confirmed or probable case of COVID-19:
— face-to-face contact with a probable or confirmed case of COVID-19 within one metre and for more than
fifteen minutes;
— direct physical contact with a probable or confirmed case of COVID-19;
— direct care for an individual with probable or confirmed COVID-19 without using proper personal
protective equipment; or
— other situations, as indicated by local risk assessments.
Refer to WHO for full definition https://www.who.int/publications/i/item/contact-tracing-in-the-context-of-covid-19.
Contact tracing. An investigative procedure aimed at acquiring contact information to approach contacts that were
potentially exposed to the virus, which is a key strategy for interrupting chains of transmission of SARS-CoV-2 and
reducing COVID-19-associated mortality.
Diagnostic. Relating to or using the methods for diagnosis.
Emergency use listing procedure. The WHO emergency use listing procedure (EUL) is a risk-based procedure for
assessing and listing unlicensed vaccines, therapeutics and in vitro diagnostics with the ultimate aim of expediting
the availability of these products to people affected by a public health emergency.
Epidemiology. The branch of medicine which deals with the incidence, distribution and possible control of diseases and
other factors related to health.
False negative test. A result that indicates that the disease is not present when the person actually does have the disease.
False positive test. A result that indicates that the disease is present when the person actually does not have the disease.
Fully vaccinated. For the purposes of this manual and CART guidance, an individual is defined as fully vaccinated
≥ 14 days after receiving all recommended primary doses of a COVID-19 vaccine that is listed for emergency use by
the World Health Organization or approved by other stringent regulatory authorities (SRAs).
Genomic sequencing. The process of determining the entirety, or nearly the entirety, of the DNA sequence of an
organism's genome, supporting the monitoring of the disease’s spread and evolution of the virus.
Immune escape. Immune escape occurs when the immune system of an individual is no longer able to respond
adequately to a pathogen such as a virus; in other words, the virus may escape the body’s immune response despite
vaccination or prior infection.
Incidence. The number of new cases in a specified population during a specified period of time.
Isolation. Separation of ill or contaminated persons in such a manner as to prevent the spread of infection or contamination.
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Foreword (xiii)
Molecular testing. A type of diagnostic tests, such as RT-PCR tests that detect the virus’s genetic material.
Monte Carlo approach. A broad class of computational algorithms that rely on repeated random sampling to obtain
numerical results.
Negative predictive value (NPV). How likely a negative test is a true negative.
Partial vaccination. Individuals who have partially completed the recommended primary dosage schedule of a COVID-19
vaccine that is listed for emergency use by the World Health Organization or approved by other stringent regulatory
authorities (SRA).
Point-of-care tests. Tests that provide results within minutes of the test being administered, allowing for rapid decisions.
Positive predictive value (PPV). How likely a positive test is a true positive.
Prevalence. Disease burden expressed as a percentage or rate with the total population as the denominator; in this
context, the number of existing cases in a defined population at a given point in time.
Proof of recovery. For the purposes of this manual and CART guidance, proof of recovery refers to individuals providing
proof of previous SARS-Co-V-2 infection as confirmed by real time RT-PCR (rRT-PCR), and not on the basis of
serological immune assay (antibody) test results.
Quarantine. The restriction of activities and/or separation from others of suspect persons who are not ill in such a manner
as to prevent the possible spread of infection or contamination.
Rapid diagnostic antigen tests. Tests that detect the presence of viral proteins (antigens) expressed by the COVID-19
virus in a sample from the respiratory tract of a person.
Risk management. Identification, evaluation, and prioritization of risks followed by coordinated application measures to
minimize, monitor, and control the probability or impact of the risk.
Risk threshold or tolerance. The amount of risk that governments, organizations and stakeholders are willing to accept.
Screening. Medical examination of a person or group to detect disease or abnormality, especially as part of a broad
survey rather than as a response to a request for treatment.
Sensitivity. The likelihood that a test will correctly identify a person with the disease; the “true positive” rate.
Serologic test. A blood test that measures the antibody response in an individual.
Specificity. The likelihood that a test will correctly identify a person without the disease; the “true negative” rate.
Stringent regulatory authority. A stringent regulatory authority (SRA) is a national drug regulation authority which is
considered by the World Health Organization (WHO) to apply stringent standards for quality, safety, and efficacy in
its process of regulatory review of drugs and vaccines for marketing authorization and listed on the WHO website
(https://www.who.int/initiatives/who-listed-authority-reg-authorities/SRAs).
Translocation. Travel-associated transfer (exportation, importation and onward transmission) of SARS-CoV-2 from one
region to another.
Vaccination. The administration of a vaccine to help the body’s immune system develop protection from a disease.
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Variant of concern1. A VOI (as defined below) is a variant of concern (VOC) if, through a comparative assessment, it has
been demonstrated to be associated with one or more of the following changes at a degree of global public health
significance:
— increase in virulence or change in clinical disease presentation; or
— decrease in effectiveness of public health and social measures or available diagnostics, vaccines or
therapeutics; or
— assessed to be a VOC by the WHO in consultation with the WHO SARS-CoV-2 Virus Evolution Working
Group.
Variant of interest (VOI). A SARS-CoV-2 isolate is a variant of interest (VOI) if it is phenotypically changed compared to
a reference isolate or has a genome with mutations that lead to amino acid changes associated with established or
suspected phenotypic implications;
AND has been identified to cause community transmission/multiple COVID-19 cases/clusters, or has been detected
in multiple countries;
OR is assessed to be a VOC by the WHO in consultation with the WHO SARS-CoV-2 Virus Evolution Working Group.
______________________
1
https://www.who.int/docs/default-source/coronaviruse/situation-reports/20210225_weekly_epi_update_voc-special-edition.pdf
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Chapter 1
INTRODUCTION
1.1 This guidance is intended for use by State regulators, service providers and other concerned entities, to
address cross-border risk management in commercial air transport operations. The objective of the guidance is to inform
States about public health risk management strategies, including those that could be applied to aviation personnel and
passengers to reduce the probability of translocation (transfer) of the disease from one region to another. This document
contains guidance for implementing a systematic process to identify risks related to the COVID-19 pandemic and mitigate
those risks to an acceptable level as determined by each individual State. The final objective is to create a harmonized
and cooperative effort to maintain global connectivity while ensuring public health security. Updates will be provided as
new scientific evidence becomes available, with States being informed of updates through the publication of electronic
bulletins. In the future, as more States begin to plan their route out of COVID restrictions, this updated manual offers clear
guidance on how best to use public health mitigation measures, including testing and vaccination, to reduce travel
restrictions and gradually return to restoring air connectivity in a safer way.
1.2 The guidance provides assessment tools that States can use to evaluate and implement measures as part
of their decision-making process. For this purpose, an example of the process is presented and applied to a strategy that
utilizes a range of risk mitigation measures. This guidance does not constitute a recommendation for application of any
specific measure but rather a guideline on how to assess different mitigation measures and on how they can contribute to
public health risk management. As an example of this approach, the document will provide the description of a strategy
based on the assessment of epidemiological indicators, testing, vaccination and quarantine practices. Additional detailed
guidance for States will be included as attachments by ICAO and references to the WHO publications.
1.3 This manual has been developed using the most recent information as of its publication date. The urgency,
continued rapid developments, and observed consequences of the pandemic required an expedited approach based on
expert consensus and current scientific evidence. Consequently, regular updates will be required as the evidence evolves
and as technology advances. Data-driven adjustments to the guidance will be made as the situation evolves.
1.4 Each State will need to conduct its own assessment and is encouraged to use the processes outlined in this
manual as the basis for its assessment. Risk tolerance varies between States and depends on many factors. This has an
influence on the amount of residual risk a State can accept. The determination of such level cannot be universal as it
depends on specific priorities and the sovereignty of each individual State.
______________________
1-1
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Chapter 2
GENERAL RISK MANAGEMENT PRINCIPLES

APPLIED TO AIR TRANSPORT
2.1 A multilayered risk management process is considered essential in the context of a public health risk
management framework and aligned with the intent of the WHO “Considerations for implementing a risk-based approach
to international travel in the context of COVID-19”1. The objective of this process is to identify the residual risk, considering
various risk mitigation measures in place for unknowingly transporting an infectious passenger or translocating the
SARS-CoV-2 virus. This approach is scalable in complexity and considered the baseline for more sophisticated processes,
e.g. end-to-end risk assessment models (see 2.6).
2.2 The proposed risk assessment process relies on a continuous process that considers risk holistically by
defining a risk scenario instead of focusing on a single hazard or threat. The determination of an inherent risk results from
evaluating the likelihood of the risk scenario, as well as defining the resulting impact. It is essential to consider risk
mitigation measures, which are already in place when conducting the initial assessment of the inherent risk. This step
does not consider future or potential management measures as it intends to provide the “as is” situational assessment.
The result provides States with information relevant to determining if the risk scenario lies within its public health
management capacity. As the inherent risk changes, States will need to modify their risk management measures.
(Attachment C of this manual illustrates an example of a basic decision-making process to determine such risk). In addition,
States should consult the Safety Management Manual (Doc 9859) and the ICAO Handbook for CAAs on the Management
of Aviation Safety Risks related to COVID-19 (Doc 10144).
2.3 The modelling of a risk scenario is the starting point in the process, based upon the existing situational
assessment but considering multi-agency collaboration within the context of the State. A generic baseline example for
such a scenario could be “the risk to be assessed is of an infectious person being on board an international flight” or “the
risk of translocation of the virus through air transport”. The risk scenario will need to address a State’s view on the most
critical aspect of public health management. The process then progresses through different available mitigation measures
that affect the overall risk. It is designed in a way that the efficacy of each mitigation measure can be assessed either
qualitatively or quantitatively.
Box 1. Risk management terminology
Risk avoidance. It is often the most powerful tool of risk management and aims at reducing
the likelihood of risk by avoiding it. It is, however, also the most limiting tool.
Risk mitigation. It aims at reducing the impact of the risk (by addressing the likelihood,
magnitude, or both when risk cannot be avoided).
2-1
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2-2 Manual on COVID-19 Cross-border Risk Management
Risk transfer. It aims to move the impact of the risk to a different environment. This is
complex and should only be used if the risk can be fully measured, addressed and mitigated
by the environment it is transferred to (an example could be to transfer risk to a State with
better health-care capacity).
Risk tolerance/acceptance. It is the process of accepting the consequence (impact) of a risk.

This technique is often advisable only when the risk is small but may need to be considered
in complex risk scenarios.
2.4 Risk mitigation is the most appropriate strategy in the context of pandemic risk management in air transport.
In the further conduct of the risk assessment process, it might be necessary to employ most of the available mitigation
measures such as requiring masks, completion of passenger locator forms, testing, physical distancing, quarantine, etc.,
at airports and during flights. Vaccination is likely the strongest risk mitigation tool that is effective, with increasing use
globally, but factors such as access to vaccines and vaccine hesitancy is a concern and it delays the overall response to
contain the pandemic. In multilayered defence models, the various mitigation measures are depicted as layers (e.g. based
on the James Reason Swiss Cheese Model — see Figure 2-1). Risk-free travel is not possible but the risk can be reduced
through the combined application of these mitigation measures. Currently, there may be limited scientific peer-reviewed
evidence-based efficacy for these mitigation measures, and the scope of their impact on transforming the inherent risk is
based on expert consensus and available evidence. However, the availability of peer-reviewed scientific evidence is
increasing. As a result, much of the risk assessment is qualitative and, as such, provides the flexibility to be adopted and
integrated into national public health and aviation plans. The risk assessment process will consider the chosen mitigation
measures, and regularly evaluate how they affect the likelihood and impact of the inherent risk. A State can then determine
if the residual risk is within public health management capacity.
Figure 2-1. Aviation multilayered strategy based on the James Reason Swiss Cheese Model
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Chapter 2. General risk management principles applied to air transport 2-3
2.5 Health risks (as related to air transport) can be approached in a similar way to aircraft safety and must be
addressed together. To this end, aeroplane manufacturers, for example, have created end-to-end risk assessment models
which calculate the risk of virus transmission and virus translocation by modelling steps and parameters in the door-to-door,
air travel journey. One example leverages an open data platform, considering a variety of airport, aircraft, personal health
and safety considerations, and different testing and quarantine scenarios. The model covers the complete air travel, from
entering the departure airport to leaving the arrival airport and relying on internal expertise and safety experience. The
model's objective is to support government agencies in making performance-based, data-substantiated decisions when
applying and evaluating risk management principles and strategies to secure air travel for the flying public.2
2.6 Another such model compares different screening approaches through one or more COVID-19 tests in order
to provide safe options that will allow the reopening of international travel. It uses a Monte Carlo approach to simulate a
group of COVID-19 infected travellers, each with an individual infection timeline, and a model test performance as a
function of that timeline, to compare the effectiveness of different screening strategies. The model provides an avenue to
compare the relative performance of different screening and quarantine strategies and to determine which approaches
may be appropriate for country-pair-specific travel journeys. It is built as a web-based tool that will provide users a flexible
interface to compare multiple screening options for travel between any two selected countries with available COVID-19
prevalence data. The inclusion of prevalence data allows for computation of a “post-screening prevalence” for screened
travellers (calculated using the negative predictive value) in order to compare the starting prevalence of the origin country,
the post-screening prevalence for a variety of screening options, and the prevalence of the destination country. This allows
for comparison of the prevalence among screened travellers to the existing prevalence in the destination country.3
2.7 One more model is a multi-disciplinary, adaptive, software-based risk management tool designed to support
risk-based decision-making that restores safety, confidence and convenience in commercial aviation. The model employs
a semi-quantitative, deterministic modular approach with group-structured mixing to demonstrate relative effectiveness of
layered disease control measures that protect against airborne and surface borne disease transmission throughout the
end-to-end travel journey in global transportation systems.4
2.8 The crucial result of an effective risk management process is that the residual risk is within the public health
management capacity of the State concerned. This determination needs to be done under the sovereignty and
responsibility of each State. Faced with a fast-evolving pandemic, the risk assessment process must be regularly reviewed
so that States’ mitigation measures are keeping the risks within the capacity of its public health system. WHO has
developed a suite of health service capacity assessments in the context of the COVID-19 pandemic to support rapid and
accurate assessment of current, surge and future capacities of health facilities throughout the different phases of the
COVID-19 pandemic5.
2.9 In the future, some of these risk mitigation measures might be gradually relaxed or removed following a
comprehensive risk assessment process, based on residual risk as informed by scientific evidence and aligned with WHO
guidance6. However, additional measures may also be needed based on the evolving situation and emergence of new
scientific evidence.
______________________
2. AIRBUS: " End-to-end risk assessment model”.

3. Boeing CTI passenger screening model.
4. Boeing Travel Risk of Infection Prevention (TRIP).
5. https://apps.who.int/iris/rest/bitstreams/1313691/retrieve
6. Considerations for implementing and adjusting public health and social measures in the context of COVID-19: interim guidance,
14 June 2021 https://apps.who.int/iris/handle/10665/341811
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Chapter 3
TESTING, VACCINATION AND CROSS-BORDER RISK

MANAGEMENT MEASURES
3.1 OVERVIEW
3.1.1 Air connectivity will be essential to enable economic recovery. As States restart international travel, they will
need effective strategies for mitigating the risk of active case importation and disease transmission within the air transport
system. States will rely on community accountability and ownership, traveller education, and other internationally agreed
cross-border measures in collaboration with other States
3.1.2 Given the high complexity of the crisis, there is no single measure that can be deemed as a definitive
solution. Every mitigation measure affects the system in different ways. States should identify and compare levels of risk
cognizant that public health risks cannot be eliminated. Therefore, the layered risk-mitigation defence discussed in
Chapter 2 is strongly recommended. The following guidelines are meant to assist States in understanding how current
mitigation measures can contribute to managing public health risks.
3.1.3 Emerging strategies should be considered and revised as new scientific evidence is published, innovative
approaches are tested, and potential outcomes are modelled. As the pandemic evolves, new approaches such as
probabilistic models, innovative testing technologies, air quality improvement, disinfection methods, vaccination and other
processes are under rapid development and should be added to the strategies as their efficacy and cost-effectiveness is
substantiated.
3.1.4 The layered defence measures against COVID-19 include steps being taken individually, at airports and on
board. Appropriate measures should be applicable to all passengers, as well as aviation personnel, including duties such
as training or certification activities, flight and cabin crew, maintenance engineers/technicians, air traffic management
(ATM) workforce, staff that have contact with the travelling public and ground service agents. Mitigation measures can be
categorized into personal and shared responsibilities and may include some or all the measures listed below:
a) promoting participation of aviation personnel in national vaccination programmes, recognizing that

vaccination offers protection from infection by reducing the likelihood of transmission and reducing the
severity of COVID symptoms in most cases;
b) administering and recognizing vaccination in alignment with the International Health Regulations, WHO
recommendations (including the recognition of emergency use listing (EUL)-approved vaccines1), and
national policies;
c) testing protocols consistent with the State's public health capacity and testing capacity, in particular, risk
threshold, transmission patterns, scientific evidence and multi-sector consultation;
1
https://www.who.int/news/item/15-07-2021-statement-on-the-eighth-meeting-of-the-international-health-regulations-(2005)-emergency-
committee-regarding-the-coronavirus-disease-(covid-19)-pandemic
3-1
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d) COVID-19 testing, isolation and quarantine, when applicable, with the exception of crew, in accordance
with the CART TOGD;
e) adhering to State, provincial, local policies and civil aviation procedures in both departure and arrival
States;
f) engineering factors, environmental control systems, such as the optimization of heating, ventilation and
air-conditioning (HVAC) systems;
g) enhanced cleaning and disinfection; contactless boarding/baggage processing; use of physical barriers
and disinfection in airports;
h) self-awareness orientation, including various channels of passenger communication to allow

passengers to identify symptoms and complete/submit health declarations or health attestations and
practice personal hygiene2;
i) physical distancing at airports and during boarding; use of face masks; separation between passengers
on board when feasible3;
j) general hygiene, hand hygiene, avoid touching face, covering cough;
k) communication, education and training;
l) facilitation of contact tracing if a passenger or crew member develops infection4;
m) adjustment of food and beverage service to reduce contact; control of access to aisles and bathrooms
to minimize contact; and
n) entry and exit screening (fever, loss of sense of smell or taste, chills, cough, shortness of breath,
headaches, muscle pains, etc.) and/or health declaration.
.
3.1.5 The following mitigation measures are specifically applicable to crew required on board for the air operator
to support the flight, including those that may be required to position before or after a duty, to facilitate the continued
operation of aircraft. The measures outlined below are consistent with the layered approach and are based on a risk
assessment for crew. States should, taking into consideration a State’s national framework and situation:
a) recognize crew members as essential personnel to contribute to the continuity of critical transport
services during the COVID-19 pandemic;
b) recognize crew members are required to cross international borders as a part of their duties and, as
such, conduct a separate risk assessment and implement minimal requirements to ensure global
connectivity;
c) not subject crew to screening or restrictions applicable to other travellers, but apply minimal
requirements aligned with the crew module in the TOGD;
2. https://www.who.int/news/item/15-07-2021-statement-on-the-eighth-meeting-of-the-international-health-regulations-(2005)-
emergency-committee-regarding-the-coronavirus-disease-(covid-19)-pandemic
3. WHO: Mask use in the context of COVID-19 (https://www.who.int/publications/i/item/advice-on-the-use-of-masks-in-the-community-
during-home-care-and-in-healthcare-settings-in-the-context-of-the-novel-coronavirus-(2019-ncov)-outbreak)
4. https://www.who.int/publications/i/item/contact-tracing-in-the-context-of-covid-19
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Chapter 3. Testing, vaccination and cross-border risk management measures 3-3
d) exempt crew from testing measures considering the frequency of travel and use of existing occupational
health programmes;
e) if crew cannot be exempted from testing, apply tests that are minimally invasive and reduce the need
for multiple tests on a journey (for example, by only requiring testing at the home base immediately prior
to and after duty);
f) facilitate access for air crew to vaccination as quickly as possible within the WHO Strategic Advisory
Group of Experts on Immunization (SAGE) Stage II and III recommendations5, the WHO Emergency
Committee Statement6 and applicable national policies;
g) follow vaccination guidelines for aviation workers described in 3.6.3;
h) not impose quarantine measures on crew who need to layover, or rest, for the purposes of complying
with flight time limitation (FTL) rest requirements; and in accordance with WHO guidelines on fully
vaccinated crew (refer to 3.3.1.4 h));
i) exempt fully vaccinated crew and crew with documented recovery from COVID-19, from testing;
j) expedite security and immigration clearance (e.g. dedicated crew line);
k) provide separate waiting areas from travellers;
l) provide access to dedicated ground transportation; and
m) implement layover protocols to prevent transmission of SARS-CoV-2 between crews, passengers and
the general public.
3.2 ASSESSMENT OF EPIDEMIOLOGICAL INDICATORS
3.2.1 General
3.2.1.1 States could consider implementing testing as part of their COVID-19 risk management strategy, taking into
consideration national testing capacity and resources and the principles of a “generic risk management process” contained
in Chapter 2 and the detailed Epidemiology Primer (Attachment A).
3.2.1.2 A critical step in assessing risk for States is understanding the real time epidemiologic indicators of incidence
and prevalence and the disease trajectory (escalated spread, diminishing cases or emergence of new variants) in addition
to the availability of testing, health-care system saturation, and robustness of contact tracing. Studying these factors will
allow countries to compare disease rates between points of origin and arrival by Member States or region, and in some
cases by cities depending on the detail of the disease reported by public health authorities and the ability of a State or
region to correctly identify and treat ill people. There are several sites reporting rolling averages of new cases per
100 000 people including the WHO (https://covid19.who.int/), the European Centre for Disease Prevention and Control
(ECDC) (https://qap.ecdc.europa.eu/public/extensions/COVID-19/COVID-19.html#global-overview-tab/) and Brown
5. WHO: WHO SAGE Roadmap for Prioritizing Uses of COVID-19 Vaccines in the Context of Limited Supply
https://www.who.int/publications/i/item/who-sage-roadmap-for-prioritizing-uses-of-covid-19-vaccines-in-the-context-of-limited-
supply
6. https://www.who.int/news/item/15-07-2021-statement-on-the-eighth-meeting-of-the-international-health-regulations-(2005)-
emergency-committee-regarding-the-coronavirus-disease-(covid-19)-pandemic
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Public Health (https://globalepidemics.org/key-metrics-for-covid-suppression/). The reliability of the case numbers is

affected by the availability of tests, testing intensity, national testing strategy in each phase of the pandemic and the
timeliness and accuracy of reporting of data.
3.2.1.3 Prevalence is the proportion of the population with a disease at a given time. In considering the goal of
lowering the risk of disease transmission during travel and disease translocation risk to the destination country, the
potential number of persons on board an aircraft who could be infectious during the journey is vital. That data must be
inferred as there is no current ability to determine it directly through routine surveillance testing. It can be estimated by
multiplying the cases per 100 000 by the infectivity period and then factoring in the asymptomatic rate. This number is
then converted to a percent infectious per 100 persons. In this case, prevalence is a better indicator of potentially infectious
individuals than incidence (new cases per day); however, an awareness of incidence will influence the shrinking or growth
of the disease cases in a given area.
3.2.1.4 Disease trajectory refers to whether the number of new cases of disease remains stable, increases or
decreases over time. An awareness of which way the infection rates are going may assist in monitoring risk. For instance,
if a State level of disease is in a moderate range, but there is a doubling of case rates per week, a State may want to
rethink requirements or risk mitigation strategy.
3.2.1.5 To gain a true picture of the prevalence and trajectory of disease, testing should be readily available and
utilized routinely when individuals are either displaying symptoms or are identified as close contacts. States may wish to
consider the proportion of testing compared to the population, the percentage of positive results, and the proportion of
positive tests in symptomatic or close contacts compared to asymptomatic persons. Testing strategy is further detailed in
WHO’s interim guidance on Recommendations for national SARS-CoV-2 testing strategies and diagnostic capacities
(https://www.who.int/publications/i/item/WHO-2019-nCoV-lab-testing-2021.1-eng).
3.2.1.6 States may use this information to classify or stratify cities, States, or regions by risk level (see Chapter 4).
By developing these benchmarks, States and regions can begin to discuss mitigation strategies necessary between States,
including potential bilateral, multilateral or regional arrangements to facilitate air transport (i.e. Public Health Corridors), or
temporarily expanding or liberalizing cargo traffic rights.
3.2.2 Variants of concern (VOC)
3.2.2.1 The pandemic continues to evolve with additional variants of concern (VOC) emerging, which are more
transmissible, may cause more severe disease and/or may lead to possible immune escape. It is further likely that possibly
more dangerous VOC may emerge in the future that may be even more challenging to control, especially in areas and
groups with high incidence and low vaccine coverage.
3.2.2.2 The scientific community continues to monitor emerging data regarding SARS-CoV-2 variants and immunity
following recovery, including the ability of emerging virus variants (variants of interest and variants of concern) to evade
immune responses.
3.2.2.3 Vaccine breakthrough cases are expected to occur regardless of virus strain because no vaccine is
100 per cent effective. Breakthrough cases should not necessarily be seen as a failure of the vaccine. However, vaccine
breakthrough cases may signal reduced vaccine effectiveness against emergent viruses or virus variants. It is thus
essential to assess how vaccines perform against new variants, to inform vaccination programmes7.
7. https://www.who.int/publications/i/item/WHO-2019-nCoV-vaccine_effectiveness-variants-2021.1
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3.2.2.4 In view of the continuing emergence of VOC and the risks they might represent, States are encouraged to
include the emergence and circulation of VOC in their risk assessments and refer to the relevant WHO epidemiology8
updates.
3.2.2.5 States are further encouraged to conduct surveillance using genomic sequencing and share epidemiological
information on a regular basis with WHO (in accordance with WHO requirements) and other States, specifically where
PHC agreements exist with other States.
3.3 TESTING AS A SCREENING STRATEGY APPLIED TO AVIATION
3.3.1 Testing concepts
3.3.1.1 States using testing in their COVID-19 risk management strategy should apply the approach outlined in this
manual, recognizing that robust testing strategies allow for early detection of potentially infectious travellers. However,
testing may not be universally recommended by public health authorities as a routine health screening method due to
priority and resource considerations.
3.3.1.2 In addition, in view of inaccessibility to vaccines or inability to use vaccines in some instances, as well as the
emergence of VOI and VOC, testing is considered to be an important mitigation measure in the detection of possible
SARS-Co-V-2 infection.
3.3.1.3 Antigen detection rapid diagnostic tests (Ag-RDTs) have a number of advantages for screening used within
the aviation environment due to their ability to detect active infection, their ability to detect current circulating variants, the
shorter waiting periods for results which enables testing closer to the time of departure, their high availability, and the lower
cost of their use. However, PCR testing is still considered to be the most reliable diagnostic test.
3.3.1.4 For those States that employ testing as a part of an overall risk mitigation strategy, the following concepts
could be considered:
a) Reducing risk to zero is impossible, but testing can be one measure supporting a multilayered risk
mitigation process.
b) There are four main reasons to consider testing:
1) reducing potential transmission during the actual travel;
2) reducing potential introduction of disease in a destination region/country;
3) potentially reducing or eliminating quarantine for the traveller at their destination; and
4) helping to identify imported cases of new variants through genomic sequencing.
c) States could also consider limiting the exportation of disease and developing methods to communicate
to travellers the need to remain at their residence when ill, when in isolation, when in quarantine, if they
have a pending test following the onset of symptoms compatible with COVID-19 and any other relevant
measures as recommended by the relevant Public Health Authority.
8. https://www.who.int/emergencies/diseases/novel-coronavirus-2019/situation-reports
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d) The current approved COVID-19 tests that are recommended by public health authorities are for testing
of symptomatic or exposed individuals for diagnostic purposes. Use in an asymptomatic population may
yield different test performance than that of symptomatic cases. In Attachment A, Epidemiologic Primer,
a margin of error is described and used to account for asymptomatic cases in the development of the
positive and negative predictive values. The use of antigen testing in low-prevalence settings including
asymptomatic individuals is described in detail in 3.3.2.
e) In areas with low test availability, States should balance the diagnostic needs in symptomatic individuals
and individuals in high-risk groups and high-risk settings (where the public health impact is greater)
against screening of healthy or asymptomatic potential travellers.
f) Testing requirements may reflect the difference in the epidemiological situation of the point of origin and
destination and where the epidemiological situation is equal, there should, in principle, be no testing
requirements, in accordance with States’ national policies.
g) For all tests, accurate results depend on good clinical sampling. Testing should thus be performed by
individuals in accordance with the appropriate authorities’ policies and procedures. At least one authority
has authorized the use of home-testing kits for travel purposes under specific criteria. Standards and
procedures for presenting test results for travelling purposes is described in 3.3.8 (Standardization and
validation of testing certificates) and included as PHC Form 5 in the CART TOGD to facilitate recognition
by different authorities. An initial positive test regardless of type should be considered positive, unless
it has been cleared by additional confirmatory testing (when appropriate), or the individual has been
assessed and cleared by a healthcare provider, or the individual has provided proof of a previous
SARS-CoV-2 infection.
h) Exempting travellers/air crew from measures, such as testing and/or quarantine requirements, to
individual travellers who:
1) were fully vaccinated, at least two weeks prior to travelling, with COVID-19 vaccines listed by the
WHO for emergency use or approved by a stringent regulatory authority9 or;
2) have had previous SARS-CoV-2 infection as confirmed by real time RT-PCR (rRT-PCR) within the
six months prior to travelling and are no longer infectious as per WHO’s criteria for releasing
COVID-19 patients from isolation10.
― For symptomatic patients: ten days after symptom onset, plus at least three additional days
without symptoms (including without fever and without respiratory symptoms).
— For asymptomatic cases: ten days after positive test for SARS-CoV-2.
i) Offer alternatives to travel for individuals who are unvaccinated or do not have proof of past infection,
such as through the use of negative RT-PCR tests, or antigen detection rapid diagnostic tests (Ag-RDTs)
that are listed by the WHO for emergency use or approved by other stringent regulatory authorities
should be considered11.
j) However, other basic mitigation strategies (wearing masks, physical distancing, etc.) should remain in
place while studies are under way to determine duration of immunity and until conclusive evidence is
available to support reduction of basic measures.
9. https://www.who.int/initiatives/who-listed-authority-reg-authorities/SRAs
10. https://www.who.int/publications/i/item/criteria-for-releasing-covid-19-patients-from-isolation
11. https://www.who.int/publications/i/item/WHO-2019-nCoV-Policy-Brief-Risk-based-international-travel-2021.1
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3.3.2 Testing methods and performance-based recommendation
Note.— Refer to Attachment A, Epidemiologic Primer for definitions, meaning of prevalence for testing and
sample equations.
3.3.2.1 Robust testing strategies are an essential aspect of preparedness and response to the COVID-19 pandemic,
allowing for early detection of potentially infectious individuals12. At the time of publication, molecular testing (e.g. real time
RT-PCR) is recommended by the WHO for routine diagnosis. However, the WHO allows for antigen detection rapid
diagnostic tests (Ag-RDTs) that are listed by the WHO for emergency use or approved by other stringent regulatory
authorities, to be used as alternatives13. Ag-RDTs with a minimum specificity of at least 97 per cent are recommended to
avoid false negative results, thus reducing the introduction of infected passengers into the travel continuum.
3.3.2.2 The performance of Ag-RDTs has significantly improved, allowing faster and cheaper, yet still effective, ways
to detect infections. Ag-RDTs have increasingly become an important part of the overall response to the pandemic where
reliable and cost-effective testing within short timeframes are needed; or where access is needed by individuals who are
unable to provide proof of vaccination. Rapid antigen tests will most often be positive when viral loads are highest and
patients are most infectious, typically one to three days prior to the onset of symptoms and during the first five to seven
days after the onset of symptoms – and will become negative as the patient clears the infection and recovers. Some States
have implemented high-performing Ag-RDTs successfully as a screening option for work, recreation or socio-economic
purposes. It has been used successfully in aviation for screening aviation employees prior to work; and for screening
passengers prior to pre-departure and following arrival.
3.3.2.3 Confirmatory testing by a Nucleic Acid Amplification Test (NAAT) is recommended to exclude false positive
Ag-RDTs results. Where NAAT tests are not readily available and in view of the advantages of Ag-RDTs, it is
recommended that Ag-RDTs with a minimum sensitivity of at least 95 per cent could be used for confirmatory testing.
3.3.2.4 Serological tests should not be utilized as the sole factor for COVID-19 diagnosis or recovery from infection. They
should be used in conjunction with clinical evaluation and judgment.
3.3.2.5 As more and different tests are approved for emergency use, including some that were previously considered
to be less effective, specifying a particular test or set of tests as the “best” regimen to use in a specific scenario becomes
challenging. Each of these tests has distinct advantages and disadvantages which need to be considered. The table below
describes the advantages and disadvantages of different testing methods. It should be noted that RT-PCR remains the
“gold standard” for diagnostic testing in health settings. More information can be found in the WHO guidance on
SARS-CoV-2 antigen detecting rapid diagnostic tests and in Table 3-1 below14.
12. COVID-19 diagnostic testing in the context of international travel https://www.who.int/publications/i/item/WHO-2019-nCoV-Sci_Brief-

international_travel_testing-2020.1
13. https://www.who.int/publications/i/item/WHO-2019-nCoV-Policy-Brief-Risk-based-international-travel-2021.1
14. https://www.who.int/publications/i/item/antigen-detection-in-the-diagnosis-of-sars-cov-2infection-using-rapid-immunoassays
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Table 3-1. Advantages and disadvantages of testing methods for SARS-Cov-2
Test type Advantages Disadvantages
Nucleic acid • Detects active SARS-CoV-2 infection • Turnaround time of hours to days
amplification testing • High sensitive and specificity • Labour intensive
(NAAT), e.g. • Requires laboratory infrastructure and
RT-PCR tests skilled personnel
• More expensive than RDTs
Rapid diagnostic • Detects active SARS-CoV-2 infection • Variable sensitivity and specificity,
tests: Antigen- • Can be used at the point of care generally lower than NAAT
detecting tests (outside laboratories) • Lower sensitivity means negative
• Easy to perform predictive value is lower than for NAAT,
• Quick results (typically under 30 especially in settings with high prevalence
minutes) enabling rapid implementation of SARS-CoV-2
of infection control measures, including • Confirmatory NAAT testing of RDT
contact tracing positives is advised in all low-prevalence
• Less expensive than NAAT settings and for RDT negatives in high-
prevalence settings
• Negative Ag-RDT results cannot be used
to remove a contact from quarantine
Rapid diagnostic • Ab-RDTs can be used to detect • Clinical significance of a positive Ab-RDT
tests: Antibody- previous infection with SARS-CoV-2 results is still under investigation
detecting tests • Can be used at the point of care • Positive Ab-RDT results do not guarantee
(outside laboratories) or in higher presence of neutralizing antibodies or
throughput formats in laboratories protective immunity
• Easy to perform • Ab-RDTs should not be used for
• Quick results (typically under 30 determining active infections in clinical
minutes for point-of-care testing) care or for contact tracing purposes
• Less expensive than NAAT • Interpretation of Ab-RDT results depends
on the timing of the disease, clinical
morbidity, the epidemiology and
prevalence within the setting, the type of
best used, the validation method, and the
reliability of the results
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3.3.2.8 One of the aims of this guidance is to establish a performance-based recommendation for testing regardless
of the methodology that the States could consider if they choose to use testing as a part of their risk mitigation measures.
This is aligned with the ICAO risk-based approach, supporting State sovereignty to make decisions based on a State’s
risk assessment and risk tolerance, guided by their own priorities and consideration of epidemiological indicators, practical
testing limitations and other relevant considerations.
3.3.2.9 States are advised to:
a) continuously consider and re-evaluate the performance of the tests available in the market and the
application for which it is being considered for use (e.g. study the population upon which performance
data is based, whether the performance data supports screening, diagnosis or monitoring, etc.);
b) implement a strategy to manage positive and false positive test results (e.g. confirmatory testing);
c) record and review testing data on a frequent basis;
d) monitor scientific developments and adjust their testing protocols accordingly; and
e) distinguish between passengers, crew members and other aviation occupations who are covered by
occupational health programmes, i.e. consider the role of existing occupational health programmes
when assessing crew risk.
3.3.3 Pre-departure testing
3.3.3.1 The goal of pre-departure testing is to limit the potential transmission of COVID-19 during travel and may
contribute to the reduction in the risk of translocation of the disease. A single pre-departure test alone is more effective in
mitigating on board transmission than in reducing the translocation of disease. Adding testing as a component to a
multilayered risk mitigation strategy reduces reliance on recognizing and reporting symptoms as a sole means to identify
infected travellers. No testing regime can reduce the risk to zero (completely eliminate the risk). Hence, travellers must
continue to employ routine recommended public health measures at all times. The current understanding of COVID-19
allows the assumptions below. The closer the testing is to the departure time, the more likely the person will remain unable
to infect others during the journey. Therefore, the use of rapid antigen testing could be beneficial in pre-departure testing,
providing cost-effective testing within a short time period just prior to travel. Testing too far in advance of departure results
reduces the advantage of the risk reduction allowed by pre-departure screening. Testing within 72 hours of departure is
still valid, considering the practical limitations with PCR testing. However, the optimum risk reduction results can be
achieved by PCR or rapid antigen testing as close as possible to the departure. This conclusion is based upon the following:
a) incubation time: 2 to12 days (95 per cent of cases) with a median of 5 to 6 days;
b) viral shedding can occur 48 hours prior to symptom onset;
c) the most sensitive tests turn positive 1 to 3 days (24 to 72 hours) prior to symptoms; and
d) leaving a 2- to 4-day period where a person could be infected but not contagious while travelling
(i.e. a negative test if the median incubation period is used). However, this could miss very short
incubation cases.
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3.3.3.2 Figure 3-115 provides an overview of the use of antibody and virus detection tests in relation to transmission
of the SARS-CoV-2 with reference to guidance from the Ministry of Health of Spain16.
Figure 3-1
3.3.4 Combined pre-departure and post-arrival testing
3.3.4.1 Post-arrival testing, in conjunction with pre-departure testing, can result in risk reductions. Consequently, as
part of a State’s risk assessment and determination of risk tolerance, a State may consider reducing quarantine time
frames.
3.3.4.2 Both PCR and rapid antigen testing could be used for post-arrival testing, but PCR testing could help identify
imported cases of new variants through genomic sequencing which could be communicated to States that share PHCs.
3.3.4.3 Modelling suggests that pre-departure testing, preferably close to departure, in combination with post-arrival
testing on day 4 to 5 and a shorter quarantine, may perform as well as a 14-day quarantine alone. These models are
currently undergoing further refinement, and updated findings will be included in future revisions.
15. EASA Guidelines for Aero-Medical Centres and Aeromedical Examiners regarding the examination and assessment of applicants
https://www.easa.europa.eu/document-library/general-publications/guidelines-aero-medical-centres-and-aeromedical-examiners
16. https://www.synlab-sd.com/en/blog/covid-19-tests-everything-you-need-to-know/
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3.3.4.4 The study results of 16 361 arriving passengers at Toronto Pearson Airport found that a single arrival PCR
test will pick up two-thirds of individuals who will become positive, with most of the remaining individuals detected on the
second test at day 7. These results and other scientific papers 17 support strategies from modelling that a reduced
quarantine combined with testing can be as effective as a 14-day18 quarantine. Alternative strategies include daily antigen
testing after arrival.
3.3.4.5 Models have also been developed taking into account vaccinated individuals, with some States using
pre-departure testing in combination with testing two days after arrival for vaccinated travellers. Additional modelling and
close follow-up of travellers will further refine when to conduct post-arrival testing in combination with pre-departure testing.
Refer to Chapter 4, 4.2 for more detailed information.
3.3.6 Selecting test devices based on statistical analysis
Note. — See Attachment A, Epidemiologic Primer for definitions and sample equations.
3.3.6.1 With the goal of allowing the greatest number of people to travel without increasing the risk of SARS-CoV-2
importation and onwards transmission, or exportation, the test device in the prevalence level in the traveller’s population
should have a high negative predictive value, meaning a negative test is in all likelihood truly negative. While there will be
a few false negatives who would enter the system, a significant number of false positives who are not infected and could
travel otherwise might be denied travel. A plan to evaluate false positives should be developed.
3.3.6.2 Even tests with relatively low specificity (the ability to correctly identify those who do not have the disease
as negative), result in high negative predictive values. Establishing a higher test sensitivity cut-off (i.e. the ability to correctly
identify those with the disease) will limit those with the disease but who might enter the travel corridor or be released from
quarantine.
3.3.6.3 For those States choosing to utilize testing, it is recommended that the cut-off values for sensitivity and
specificity be as high as possible, but with a minimum of 95 per cent19 for molecular tests (sensitivity cut-offs are based
on reported sensitivity for cases in the peak contagious period, not for very early or very late-stage infections) and a
minimum of 80 per cent sensitivity and 97 per cent specificity for rapid antigen tests based on data generated from
asymptomatic individuals. Given the reported test values were from the manufacturers as part of their Emergency Use
applications, where possible independently validated sensitivities and specificities should be used. No specific diagnostic
test(s) is recommended as the number of fielded test devices are growing too rapidly. Hence, a performance-based
approach to the selection of a test device(s) using sensitivity and specificity is preferred. States should use tests that have
been authorized for screening by relevant public health authorities or have been listed by WHO as part of their Emergency
Use Listing (EUL) procedure.
17. https://www.icao.int/safety/CAPSCA/Pages/Coronavirus.aspx
18. https://www.medrxiv.org/content/10.1101
19. The recommendation for a minimum sensitivity and specificity level of 95 per cent for molecular tests is based on the following:
– The minimum values of 95 per cent for sensitivity and specificity will allow for a wider range of test devices to be used that are
currently fielded as opposed to forcing States to procure newer models that are frequently hard to obtain.
– This range also allows for the use of rapid antigen tests as a screening device which are more accessible and practical for
application in the aviation environment; and are faster and less expensive to use. In addition, it would reserve the more
expensive real-time RT-PCR tests for confirmation of positives in conjunction with clinical correlation.
– Setting the specificity at 95 per cent reduces the false positives.
– Setting the sensitivity at 95 per cent will also reduce the risk of false negatives.
– In low prevalence settings (equating from 10 to 25 cases per 100 000 on a rolling average), the NPV equates to mislabelling
an infected person as negative between 1 in 5 000 and 10 000 negative tests. In a higher prevalence setting (equating to over
50 cases per 100 000 on rolling average) the mislabelling rises close to 1 in 300.
– In the same low prevalence and higher prevalence range, the PPV improves from correctly labelling of positive from
approximately 5 to 10 per cent, to slightly better than 1 out of 2 of positive tests.
– These are minimum recommended values. States should determine their own minimum levels for sensitivity and specificity that
they may require to improve test performance.
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3.3.6.4 Polymerase chain reaction (PCR) tests are in short supply in some States and typically expensive. Due to
short supply, PCR tests are often reserved only for symptomatic individuals. This might cause significant delays in
obtaining results. They are usually based on swab techniques which require suitable trained personnel, premises, and
equipment for the sampling process. This means they are difficult to apply in an airport setting. Many countries have called
for pre-travel PCR tests, but this creates problems of a window of possible infection after testing, as well as requirements
for test approval, identity verification and fraud-proofing of the test results. These have led to interest in using more rapid
point-of-care tests including antigen tests that could be used for screening purposes, with consideration of protocols to
manage positive test results. Refer to section 3.3.2 for more information regarding the use of rapid tests for screening and
confirmatory purposes.
3.3.7 Management of positive tests and proof of recovery
3.3.7.1 All positive tests should be referred for clinical diagnosis. Test results should be interpreted in the context of
the prevalence of infection or disease, the testing device’s performance characteristics and instructions for use, as well as
the patient’s clinical signs, symptoms and history.
3.3.7.2 States should ensure their testing regimes include clearly published processes for recovered cases to obtain
medical clearance for travel, which should be regularly updated in accordance with current scientific evidence. A positive
test in a traveller or crew member with a history of infection and clinical recovery could be considered safe for travel.
3.3.7.3 Positive antigen tests should be referred for clinical correlation and require confirmatory testing. For positive
rapid antigen tests in particular, a confirmative molecular test or different rapid antigen test of high specificity can be
considered when the pre-test probability is low, such as asymptomatic individuals with no known exposure. In symptomatic
cases, depending on the symptoms, negative antigen tests should be referred for clinical evaluation and might require
confirmatory testing.
3.3.7.4 PCR tests can remain positive for weeks to months following infection and depending on severity of disease
in some patients. Some authorities do not recommend additional PCR tests within a 90-day period of confirmation of
diagnosis.
3.3.7.5 Rapid diagnostic tests detecting viral proteins have the potential to expedite and simplify the detection of
active infection. Antigen tests that are listed by the WHO for emergency use or approved by other stringent regulatory
authorities may be considered to separate current infection from past/recovered infections.
3.3.7.6 Most patients, who have clinically recovered and who have mounted an antibody response to the virus, are
not considered to remain infectious20, although duration of this immunity is currently unknown. Current available evidence
indicates a period of immunity of at least six months. Individuals who have had previous SARS-CoV-2 infection, as
confirmed by real time RT-PCR (rRT-PCR) within the six months prior to travelling, should be assessed for infectiousness
as per the WHO’s criteria for releasing COVID-19 patients from isolation21:
— For symptomatic patients: ten days after symptom onset, plus at least three additional days without
symptoms (including without fever and without respiratory symptoms).
― For asymptomatic cases: ten days after positive test for SARS-CoV-2.
20. WHO: Interim position paper: considerations regarding proof of COVID-19 vaccination for international traveller (Interim position
paper: considerations regarding proof of COVID-19 vaccination for international travellers (who.int))
21. https://www.who.int/news-room/commentaries/detail/criteria-for-releasing-covid-19-patients-from-isolation
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3.3.7.7 Available scientific data suggests that, in most people, immune responses remain protective against
reinfection for at least six months after infection22. There are many available serologic assays (antibody tests) that measure
the antibody response to SARS-CoV-2 infection, but at the present time, the correlates of protection are not well
understood. The use of serologic assays is not recommended to prove recovery status given the limitations that are
outlined in the scientific brief “COVID-19 natural immunity23 ”.
3.3.7.8 The COVID-19 Aviation Scientific Assessment Group (CASAG) performed a literature search and systematic
review of scientific articles and technical reports regarding the duration of naturally acquired (post-infection) immunity.
Available evidence, at the time of publication, concluded that the duration of naturally acquired immunity following SARS-
CoV-2 infection is at least six months, and is likely longer. The main limitation is that all studies were limited by the available
duration of follow-up data, and that data from future studies could indicate an extension of the period. CASAG will continue
to monitor developments and update findings accordingly on the ICAO CAPSCA website24.
3.3.7.9 Other limitations are that not all studies have taken into account all of the circulating VOC and the
possibility of altered immune responses to variants, which may need to be considered in applying the conclusions.
More studies would be needed to determine the full spectrum of immune responses and special consideration should
be provided for individuals with reduced immune response, in particular, those having received renal transplant, and
those under treatment for blood-related cancers.
3.3.8 Standardization and validation of testing, recovery and vaccination certificates
3.3.8.1 Many States require pre-departure testing for COVID-19 as an entry requirement. Standardizing testing
certificates will facilitate mutual acceptance by States. Information should be reported in English (mandatory). Where the
certificate is issued in a language other than English, the certificate should include an English translation.
3.3.8.2 ICAO has established a minimum data set for testing certificates to facilitate States’ recognition and
harmonization of their use for air travel. The minimum information to be recorded on the certificate incudes:
a) personal information of test subject:
1) full name (surname, given name);

2) date of birth (YYYYMMDD);
3) ID document type25 (mandatory); and
4) ID document number (mandatory);
24. https://www.icao.int/safety/CAPSCA/Pages/default.aspx
25. Refers to any type of documentation, it does not need be a travel-specific document.
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b) service provider:
1) name of testing facility or service provider (mandatory);

2) country of test (mandatory); and
3) contact details (mandatory);
c) date and time of test and report:
1) date and time of specimen collection (mandatory); and

2) date and time of report issuance (mandatory);
d) test result:
1) type of test conducted: molecular (PCR); molecular (other); antigen; antibody (type) (mandatory);
2) result of test (normal/abnormal or positive/negative) (mandatory); and
3) sampling method (nasopharyngeal, oropharyngeal, saliva, blood, other (optional);
e) optional data field: issued at the discretion of the issuing authority.
3.3.8.3 ICAO has also established a minimum data set for proof of recovery certificates to facilitate States’
recognition and harmonization of their use for air travel. The minimum information to be recorded on the certificate includes:
a) personal information of test subject:
1) full name (surname, given name);

2) date of birth (YYYYMMDD);
3) ID document type26 (mandatory); and
4) ID document number (mandatory);
b) test result:
1) Member State of test; and

2) date of first positive test result (mandatory);
c) health-care provider/certificate issuer.
3.3.8.4 Where States do not issue a digital certificate of recovery, the minimum information described in 3.3.8.3
would need to be included in a paper-based format on a formal letterhead of the health-care provider. The document
should contain clear contact information and be manually signed by the health-care provider. The individual traveller could
be required to have evidence of the positive test result, and any additional certificates issued by the health-care provider,
to present to the relevant authority when requested to do so. Verification of paper-based certificates should be compliant
with data protection legislation.
3.3.8.5 ICAO has published a core data set for proof of vaccination, recommended by the WHO in August 2021.
The information to be recorded on the vaccination certificate includes:
a) unique certificate identifier (required);
b) certificate valid from (optional);
c) certificate valid to (optional);
26. Refers to any type of documentation, it does not need be a travel-specific document.
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d) personal identification:
1) name (required);
2) unique identifier (recommended);
3) additional identifier (optional);
4) sex (recommended); and
5) date of birth (conditional with unique identifier);
e) vaccination event:
1) vaccine or prophylaxis (required);

2) vaccine brand (required);
3) vaccine manufacturer (conditional with marketing authorization holder);
4) marketing authorization holder (conditional);
5) disease or agent targeted (recommended);
6) date of vaccination (required);
7) dose number (required);
8) country of vaccination (required);
9) administering centre (required);
10) vaccine batch number (required); and
11) due date of next dose (optional).
Notes:
1.— “REQUIRED” means that the definition is an absolute requirement of the specification.
2.—“RECOMMENDED” means that there may exist valid reasons in particular circumstances to ignore a particular item,
but the full implications must be understood and carefully weighed before choosing a different course.
3.― “OPTIONAL” means that an item is truly optional. One user may choose to include the item because a particular
application requires it or because the user feels that it enhances the application, while another user may omit the
same item.
4.—“CONDITIONAL” means the usage of an item is dependent on the usage of other items. It is therefore further qualified
under which conditions the item is REQUIRED or RECOMMENDED.
Example with regard to conditional: the field of vaccine marketing authorization holder is conditional; however, if the
marketing authorization holder is unknown, the vaccine manufacturer is REQUIRED.
3.3.8.6 The ICAO Machine Readable Travel Documents (MRTD) Technical Report on Visible Digital Seals for
non-constrained environments (VDS-NC) contains the aforementioned minimum and core data sets for testing and
vaccination certificates and can readily incorporate the newly developed minimum data set for recording a previous SARS-
CoV-2 infection (proof of recovery certificate). More detailed information is available in the manual on Machine Readable
Travel Documents (Doc 9303, Part 13) specifications.
Validation of testing, recovery and vaccination certificates
3.3.8.7 Member States should implement and recognize certificates of testing, recovery and vaccination based on
the protocol, minimum data set and implementation approaches outlined in this manual to facilitate air travel. States are
encouraged to ensure such certificates are secure, trustworthy, verifiable, convenient to use, compliant with data protection
legislation and internationally/globally interoperable. Proof of vaccination could be based upon the WHO International
Certificate of Vaccination or Prophylaxis (ICVP) and should be issued in an internationally/globally interoperable format
aligned with the technical specifications and guidance outlined by WHO. Existing solutions should be considered and could
incorporate a Visible Digital Seal (VDS-NC) or other interoperable formats from regional or global intergovernmental bodies,
or internationally recognized organizations.
3.3.8.8 Certificates may be issued in paper or digital format, depending on capabilities and preferences.
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3.3.8.9 There are a number of potential procedural challenges in verifying testing, proof of recovery or vaccination
certificates that could cause delays or other potential problems for passengers.
3.3.8.10 States are encouraged to implement the approaches provided in this manual and consider the following
processes and/or procedures to facilitate travel through the airport:
a) make available tools that allow travellers to submit travel-related health certificates;
b) inform passengers and stakeholders of the requirements with regard to testing, vaccination and
verification for international travel purposes;
c) provide the necessary guidance, resources and support to assist stakeholders; and
d) ensure these processes and/or procedures are in full compliance with applicable laws and regulations
on data protection and privacy.
3.3.9 Guidance on using both testing and vaccination
3.3.9.1 Vaccination provides very effective protection against severe disease, hospitalization and mortality. While
vaccination is a key mitigation measure to achieve widespread immunity, the scientific data is not yet mature enough to
make a definitive recommendation regarding the efficacy of all currently available vaccines to confer protective immunity,
the possible duration of such immunity and the efficacy of vaccination in reducing transmission of current or new emerging
VOC. This guidance will be amended as new evidence becomes available and is validated.
3.3.9.2 States are encouraged to share and publish evidence related to their vaccination campaigns as soon as that
becomes available, including interim reports to allow for early identification of trends.
3.3.9.3 The WHO recommends that Member States consider a risk-based approach to the facilitation of international
travel by lifting measures, such as testing to individual travellers who were fully vaccinated, at least two weeks prior to
travelling, with COVID-19 vaccines listed by the WHO for emergency use or approved by a stringent regulatory authority.
In addition, there should be consideration for non-vaccinated travellers (refer to 3.3.1.4 i)).
3.3.9.4 Vaccinated individuals may be exempted from testing and/or quarantine measures, in accordance with a
State’s accepted risk threshold, national framework and COVID-19 situation. However, vaccination should not be a
prerequisite for international travel. In view of the global inequity of access to vaccines and the limitations as described in
3.3.9.1, it is recommended that basic multilayer risk mitigation measures, including hygiene, masks and physical distancing
where possible, as included and periodically updated in the CART TOGD27 and this manual, are maintained during air
travel.
3.4 QUARANTINE PRACTICES
3.4.1 Many States have instituted a period of quarantine for incoming passengers as a measure to prevent
importation of new cases. States’ implementation of quarantine measures varies and may range from voluntary
self-quarantine, to mandatory quarantine in their residence and to enforced restrictions at specified locations. Contracting
States implementing quarantine for arriving passengers should comply with the IHR Article 43, which stipulates that such
additional health measures should be based upon scientific principles and supported by available scientific evidence of a
27. https://www.icao.int/covid/cart/Pages/Documents.aspx
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risk to human health, while recognizing that the IHR do not preclude States implementing health measures, in accordance
with their relevant national law and obligations under international law, in response to specific public health risks or public
health emergencies of international concern.
3.4.2 The quarantine period typically applied by States is 10 to 14 days. The WHO recommends the quarantine
of contacts of persons with confirmed and probable SARS-CoV-2 infection, for a duration of 14 days from the last contact
with the confirmed or probable case, to minimize risk of onward transmission28. However, many States are exploring
reducing the quarantine period based upon testing results and vaccination status. There can be considerable logistical
difficulties and cost in implementing a quarantine regime, and States electing to utilize quarantine need to plan and prepare
accordingly. Quarantine should only be implemented following a thorough risk assessment and with respect for travellers’
dignity, human rights and fundamental freedoms, while minimizing any discomfort or distress associated with the health
measures applied to them, as outlined in the IHR (2005)29. Depending on the implementation model, States may need to
ensure that all needs for transport, accommodation, food, exercise and communication are met and that there is no
cross-contamination between those in the quarantine facility including the staff. In some cases, given the frequency of
asymptomatic infection, the quarantine is now accompanied by COVID-19 testing.
3.4.3 The WHO identifies two scenarios in which quarantine could be implemented30:
1) the restriction of movement of travellers upon arrival from areas with community transmission; and
2) for contacts of individuals with confirmed or probable SARS-CoV-2 infection. For all contacts of
individuals with confirmed or probable SARS-CoV-2 infection, the WHO continues to recommend
quarantine in a designated facility or in a separate room in the household, for a duration of 14 days from
the last contact with the confirmed or probable case, to minimize risk of onward transmission.
3.4.4 International travellers should not be categorized as suspected COVID-19 cases and are not considered
contacts of COVID-19 in principle unless a traveller meets the definition of a contact. For travellers, the WHO recommends
self-monitoring for symptoms on arrival for 14 days, and reporting symptoms and travel history to local authorities, as per
instructions received by authorities in the host country, prior to departure and/or on arrival. Any traveller identified as a
contact of a COVID-19 case should be supported and quarantined – as part of national response strategies in accordance
with WHO guidance for quarantine – and tested if symptoms develop at any point during the quarantine period.
3.4.5 Quarantine may be most applicable to countries with a low incidence of COVID-19 and/or relatively high
volumes of unvaccinated arriving air travellers, as well as countries at the tipping point of exponential growth and/or with
limited public health and health system capacities to detect and care for new cases. The positive benefits of quarantine in
reducing SARS-CoV-2 transmission must be balanced against the related risks of infringement of human rights,
psychosocial and economic harm, disruption to travel and trade, reductions in the movement of essential goods and
workforce mobility31.
3.4.6 If States choose to implement quarantine measures for all passengers upon arrival, they should do so based
upon a risk assessment and consideration of above-mentioned considerations, including those for exemption of individuals
with vaccine-induced or natural immunity. While quarantine can be an effective means of ensuring any imported cases by
asymptomatic passengers do not spread the disease in the community, it can be a disincentive32 to travel, particularly if
required after both (outbound and return) legs of an international journey, as can government advisories recommending
against travel.
28. https://www.who.int/publications/i/item/WHO-2019-nCoV-IHR-Quarantine-2021.1
29. Considerations for implementing a risk-based approach to international travel, Interim Guidance, WHO – 16 December 2020.
30. https://www.who.int/publications/i/item/WHO-2019-nCoV-IHR-Quarantine-2021.1
31. https://apps.who.int/iris/handle/10665/342212
32…https://www.iata.org/en/iata-repository/publications/economic-reports/travel-impact-of-quarantine2
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3.4.7 Given the complexities and implications of quarantine, States choosing to implement a quarantine regime
should do so after conducting a risk assessment, taking into account the local epidemiology in departure and destination
countries; travel volumes between countries; the public health and health system capacity; public health and social
measures implemented; and contextual factors, such as assessing all the implications, including non-health related
implications, and considering them in accordance with their own national decision-making processes.
3.5 COMBINED TESTING AND QUARANTINE STRATEGIES
3.5.1 For States that choose to apply quarantine measures, such measures should be implemented in conjunction
with other public health risk mitigation measures and in accordance with a risk-based analysis conducted by the destination
State, considering the epidemiological situation of both origin and destination country or countries and other possible
mitigation measures (see Section 3.2 above). A metric may be chosen to assist in this assessment, such as the test
positivity rate.
3.5.2 In applying the risk assessment, States should consider their risk tolerance and the risks posed by the travel,
and how different mitigation measures may reduce that risk. If travel is from an area of low prevalence to one of high
prevalence, then the value of quarantine as a measure may be diminished. In situations where travel is between two
countries with similar levels of transmission in the community, any travellers who had been tested negative for COVID-19,
meeting the performance based criteria described in Section 3.3.2, upon departure, or had developed natural immunity
due to infection and had fully recovered, or had been fully vaccinated would be of lower statistical risk than the non-tested
members of the surrounding communities in either country. Travellers that have been tested negative for COVID-19 or
have developed natural immunity or have been fully vaccinated could be subjected to no more restrictions than the others
in the community at destination.
3.5.3 While quarantine can be effective in reducing SARS-CoV-2 importation when travelling from an area of high
community transmission to an area of low community transmission, the introduction of vaccination and testing into the
measures applied could potentially be used to reduce the risk of translocation and the duration of quarantine. There is
evidence to show that tests reduce the risk of an undetected positive case by some degree, and that a second test (in
combination with a period of quarantine) further reduces that risk33.
3.5.4 Public health authorities should make the final decisions about how long quarantine should last, based on
local conditions and needs. Options to consider reducing quarantine are as follows:
— After day 10 without testing or after day 7 after receiving a negative test result (test must occur on day 5
or later)
— After stopping quarantine, a person should:
• monitor for symptoms until 14 days after travel;
• if symptoms develop, immediately self-isolate and contact the local public health authority or
healthcare provider;
• wear a mask, stay at least 6 feet from others, wash hands, avoid crowds, and take other steps to
prevent the spread of COVID-19; and
33. Animal and Plant Health Agency (APHA), UK. Rachel A. Taylor, et al.; Tropical Medicine, UK, Samuel Clifford, et al and “Investigation
into the effectiveness of “double testing” travellers incoming to the UK for signs of COVID-19 infection”, Public Health England
Modelling Cell.
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• while a quarantine for 14 days is the general recommended period, a quarantine period shorter
than 14 days reduces the burden to travellers and the community. Public health authorities should
continue to evaluate new information and update recommendations as needed.34
3.5.5 On a careful analysis of the risks and evidence, as well as the government’s risk tolerance, if the prevalence
of infection at the point of origin of the passenger is less than or equal to, depending on risk tolerance, to the local
prevalence at destination, and the passenger is not ill and/or has a negative test for COVID-19, or is vaccinated, or has
recovered from COVID-19 infection, governments might consider relaxing or avoiding quarantine measures. Alternatively,
governments may determine that quarantine measures can be combined with other measures including testing to reduce
the duration of quarantine. A model has been developed taking into account serial antigen testing as a possible option to
reduce quarantine duration. This model is undergoing refinement and further updates might be provided in the future.
3.5.6 Several studies conclude that the combination of quarantine with other public health and social measures
improves its effectiveness; and that combining quarantine with SARS-CoV-2 testing, particularly repeated testing, may not
only improve effectiveness but also reduce the duration of quarantine35. Policies for testing and quarantine should be
regularly reviewed to ensure they are lifted when they are no longer necessary.
3.6 VACCINATION AND VACCINATED PERSONS
3.6.1 Vaccination concepts
3.6.1.1 Vaccination is a critical public health tool to bring the COVID-19 pandemic under control globally. At the time
of publication, some vaccines have been recommended by WHO, with additional vaccines being added progressively for
assessment for emergency listing/ pre-qualification.36 States have begun to roll out their vaccination programmes, with the
aim of protecting their populations and stop the spread of the virus.
3.6.1.2 Control of SARS-CoV-2 will depend on:
a) the prevalence of infection and of circulating variants;
b) the rate of growth or decline in incidence;
c) the types, use of and adherence to control measures in place;
d) the speed with which vaccination occurs;
e) the targeting and uptake of the vaccines among high-risk groups;
f) vaccine effectiveness;
g) natural immunity and vaccine coverage in the population; and
h) emergence of new VOC.
34. https://www.cdc.gov/coronavirus/2019-ncov/if-you-are-sick/quarantine.html
36. https://extranet.who.int/pqweb/sites/default/files/documents/Status_COVID_VAX_16Feb2021.pdf
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3.6.1.3 There are increasing levels of protection of the general population through natural infection and
vaccine-derived immunity. Vaccines have shown high levels of protective efficacy against COVID-19, however, some
vaccinated persons may still become infected and develop disease, which in most instances is mild. Vaccinated individuals
may also still transmit the virus, albeit at lower intensity. International travellers who are vaccinated are unlikely to develop
severe COVID-19 disease and consequently they do not impose increased strain on health systems at the countries of
destination.
3.6.1.4 WHO data also indicate that vaccination reduces transmission of SARS-CoV-2, although this data did not
include information on VOC. Current preliminary data indicate that the Delta variant can be transmitted by vaccinated
individuals, although further studies are needed to provide further information. Preliminary data on Delta variant
breakthrough infections indicates that high-risk individuals, e.g. older persons and those with chronic illnesses or being
treated with immune-system drugs are at a higher risk. Such individuals might benefit from booster doses of vaccines.
3.6.1.5 The CAPSCA COVID-19 Aviation Scientific Assessment Group (CASAG) performed a literature search and
review of scientific articles and technical reports, including observational studies in vaccinated populations to demonstrate:
a) an association between vaccination and protection of an individual from asymptomatic infection; and
b) an association between vaccine coverage and protection from transmission within the population.
3.6.1.5 The main conclusions of the CAPSCA report: “Vaccination and its Effect on SARS-CoV-2 Onward
Transmission: A Narrative Review”37 based on available evidence, include that:
a) vaccination against COVID-19 substantially reduces mild/asymptomatic infections, (as well as

preventing most severe/fatal infections); and
b) vaccination substantially reduces transmission of SARS-CoV-2, which indicates that on a travel setting,
fully vaccinated travellers might not be drivers of onward transmission of SARS-CoV-2.
3.6.1.6 However, limitations identified by the review, including vaccine types, variant emergence, non-standard
intervals of administering vaccine doses, combinations of different vaccines, certain medical conditions, and possible
decline in immunity over time, need to be monitored and updated as new evidence becomes available.
3.6.1.7 Available data across different population groups and VOC, confirm that the protection against asymptomatic
and symptomatic infection and severe disease conferred by full vaccination (specific vaccines were assessed) is
significantly higher than with partial vaccination. Evidence is limited with regard to long-term effectiveness of partial
vaccination38. The ECDC recommends that, in the context of increasing circulation of the Delta VOC, full vaccination
should be achieved as early as possible and the second vaccine dose be administered after the shortest possible interval,
with priority given to population groups at highest risk of severe outcomes following SARS-CoV-2 infection.
3.6.1.8 Evidence from studies on heterologous (‘mix and match’) vaccination suggests strong or enhanced antibody
response and that the combination of vaccines were generally well tolerated (specific combinations were assessed39).
While research is ongoing to provide more evidence on long-term safety, duration of immunity and effectiveness, the use
of heterologous schedules may offer flexibility in terms of vaccination options, particularly to mitigate the impact on the
vaccine roll-out should a vaccine product not be available, or if it is discontinued or paused. States are encouraged to
share such vaccination information with other States and accept these measures for bilateral recognition in order to restore
international travel.
37. https://www.icao.int/safety/CAPSCA/Pages/default.aspx
38. https://www.ecdc.europa.eu/en/publications-data/partial-covid-19-vaccination-summary
39. https://www.medrxiv.org/content/10.1101/2021.07.26.21261130v1
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8233006/
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3.6.1.9 Other areas where there is limited evidence available and where more research is needed regarding the
effects of vaccination on protection from the effects of COVID-19 and onward transmission include:
a) the need for booster vaccine shots;
b) vaccination of children and adolescents; and
c) the need for two doses of vaccine when considering the immunity conferred in relation to recovery from
COVID-19 infection.
Note 1.― The rationale for implementing booster doses should be guided by evidence on waning vaccine
effectiveness, in particular a decline in protection against severe disease in the general population or in high-risk
populations, or due to a circulating VOC40.
Note 2.— Preliminary laboratory evidence suggests that antibody responses following COVID-19 vaccination
provide better neutralization of some circulating variants than does natural infection. Preliminary study findings suggest
that full vaccination provides additional protection against reinfection 41 . Further studies are required to provide more
information.
3.6.1.10 ICAO will continue to monitor available evidence and update guidance material accordingly. At the time of
publication, vaccines against COVID-19 are not available across all States. There is also limited evidence regarding the
efficacy of vaccines against current and potentially new VOC.
3.6.1.11 In summary, until the majority of the global population has been vaccinated, control of disease will continue
to rely on the use of a multilayer risk management approach, e.g. wearing of masks and testing, modulated by different
levels of vaccination42.
3.6.2 A multilayered risk management strategy:

calibrating testing and quarantine strategies for vaccinated persons
3.6.2.1 In addition to its important role in bringing the pandemic under control, vaccination may also play an important
role in aviation recovery as the vaccinated proportion of the global population increases over time.
3.6.2.2 Early evidence points in the direction that unvaccinated individuals are more susceptible 43 to symptomatic
infection than vaccinated individuals. Furthermore, vaccination significantly reduces the severity of symptoms and
morbidity should a vaccinated individual become infected. Due to the limited availability of vaccines, it should be used for
priority populations considered at high risk of severe COVID-19 disease. In the context of limited supply, the WHO does
not recommend COVID-19 vaccination of travellers, unless they belong to a high-risk group (including older persons or
those with underlying medical conditions) or in epidemiological settings identified in the WHO SAGE Roadmap for
prioritizing uses of COVID-19 vaccines.44
40. https://www.who.int/news/item/10-08-2021-interim-statement-on-covid-19-vaccine-booster-doses
41. https://www.cdc.gov/mmwr/volumes/70/wr/mm7032e1.htm
42. https://www.who.int/publications/i/item/considerations-in-adjusting-public-health-and-social-measures-in-the-context-of-covid-19-
interim-guidance
43. https://www.cdc.gov/coronavirus/2019-ncov/science/science-briefs/fully-vaccinated-people.html
44. WHO: WHO SAGE Roadmap for Prioritizing Uses of COVID-19 Vaccines in the context of limited supply
https://www.who.int/publications/i/item/who-sage-roadmap-for-prioritizing-uses-of-covid-19-vaccines-in-the-context-of-limited-
supply.
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3.6.2.3 States should also facilitate access for air crew for vaccination as quickly as possible within the WHO SAGE
Stage recommendations as an important means to recovery of international civil aviation. The SAGE prioritization roadmap
supports countries in planning and suggests public health strategies and targeting priority groups for different levels of
vaccine availability and epidemiologic settings. At the time of publication, aviation workers, other than cargo aircraft crew,
would be included in the category of transport workers, falling within Stage III, i.e. to be vaccinated when there is moderate
vaccine availability and between 21 per cent and 50 per cent of the national population has been vaccinated. Air crew who
work on aircraft that carry goods and no passengers fall within Stage II, when there is limited vaccine availability and
between 11 per cent and 20 per cent of the national population has been vaccinated
3.6.2.4 The protective effect of vaccination of individuals is another layer of the multilayer risk strategy in the
mitigation of the effects of COVID-19 and reduction in disease transmission. The situation is evolving rapidly considering
the emergence of new variants and the efficacy of current vaccines on these variants. It is likely that not all vaccines will
offer the same level of protection against the different variants and that different vaccines could be used in different parts
of the world.
3.6.2.5 States should also take into consideration other relevant factors, such as local incidence rates of the travel
origin of the vaccinated person or the potential community transmission of new viral strains against which the existing
vaccines may offer a lower level of protection.
3.6.2.6 Recognizing the dynamic evolution of such a diverse scenario, States’ assessment of the risk of a vaccinated
person carrying the SARS-CoV-2 virus could factor in both the vaccine efficacy against transmission of the virus and the
incidence rate of the travel origin. This would help to determine the degree of relaxation of testing requirements or
quarantine requirements for vaccinated persons (dependent on efficacy of vaccines against transmission and access to
vaccination).
3.6.2.7 WHO has updated its previous position as of 5 February 2021 and now recommends that proof of vaccination
could exempt international travellers from some specific travel risk reduction measures (refer to section 3.3.9.4). States
are encouraged to accept all types of vaccines that have been recommended by WHO on the EUL for vaccines.
3.6.2.7 Updated guidance on these issues will be published periodically as evidence becomes available and as the
WHO updates its guidance.
3.6.3 Safety considerations for vaccinated aviation workers
3.6.3.1 States are encouraged to recognize aircrew, front-line aviation workers and aviation workers in critical safety
and security positions as essential workers to ensure the availability of air transportation during the COVID-19 pandemic.
They should be encouraged to be vaccinated as an added layer of individual protection and follow the recommended
vaccination considerations and protocols. States should facilitate the vaccination of these essential air transport workers
in accordance with the WHO SAGE Stage II and Stage III recommendations.
3.6.3.2 Vaccination considerations and protocols for crew:
a) Air crew vaccination should be administered using vaccines approved for use, including emergency use,
by the Health Authority or the Civil Aviation Authority of the State in which the air crew member’s licence
is issued or rendered valid.
b) Dosing intervals for the vaccine should take into account the impact on operations with vaccination being
given at different times to different individuals to ensure continuity of service.
c) After vaccination, flight crew may return to duty if they are fit to do so in accordance with national
guidelines.
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d) ICAO does not recommend a universal mandatory administrative post-vaccination grounding period.
However, States may wish to consider post-vaccination grounding periods or other mitigation measures
based on their own risk assessments. Considerations include:
1) vaccine side-effect profile;
2) type of vaccine authorization (e.g. licensed or authorized for emergency use);
3) individual reactions after first dose, which could indicate a grounding period after the second dose
(if applicable).
3.6.3.3 In States where crew have already been vaccinated or where States are considering vaccinating crew, it
should be noted that vaccines authorized in one country/region may not be under consideration or may be explicitly
unauthorized in others. To this end, States should use vaccines considered within the WHO EUL/PQ evaluation process45 .
3.6.4 Validation of vaccination certificates
3.6.4.1 In view of the current evidence regarding the extent and duration of immunity after infection or vaccination,
and in line with WHO recommendations, issuance of an “immunity passport” or “risk-free certificate” is currently not
recommended.46. While the WHO does not include international travellers in a priority category for vaccination, vaccinated
individuals should be given documentation in accordance with national policies.
3.6.4.2 The WHO encourages States to consider recording proof of COVID-19 vaccination in the International
Certificate of Vaccination or Prophylaxis (ICVP), as stated in the WHO interim position paper: considerations regarding
proof of COVID-19 vaccination for international travellers. The WHO’s Digital Documentation of COVID-19: Vaccination
Status Technical specifications and implementation guidance47 provides Member States with guidance on the necessary
requirements for a digital solution, as well as implementation considerations to take into account.
3.6.4.3 States are encouraged to request that evidence of vaccination status is captured in hard copy or digital
documentation or within an appropriate national registry, as determined by relevant national authorities. Member States
should implement and recognize vaccination certificates based on the core data set outlined in Section 3.3.8.5.
3.6.4.4 States are encouraged to ensure that vaccination certificates are secure, trustworthy, verifiable, convenient
to use, compliant with data protection legislation and internationally/globally interoperable. Proof of vaccination could be
based upon the WHO ICVP and should be issued in an internationally/globally interoperable format aligned with the
technical specifications and guidance outlined by the WHO. Existing solutions should be considered and could incorporate
a VDS-NC or other interoperable formats from regional or global intergovernmental bodies, or internationally recognized
organizations.
______________________
45. Status_COVID_VAX_16Feb2021.pdf (who.int)

46. https://www.who.int/news-room/commentaries/detail/immunity-passports-in-the-context-of-covid-19
47. https://reliefweb.int/report/world/digital-documentation-covid-19-certificates-vaccination-status-technical-specifications
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Chapter 4
IMPLEMENTATION — MODEL FOR MULTILAYER

ASSESSMENT AND MITIGATION
4.1 OVERVIEW
4.1.1 Many States have implemented risk mitigation strategies such as temperature measurements, traveller
symptom questionnaires, COVID-19 testing, vaccinations, and a variety of travel restrictions such as border closures, entry
bans from specific States, quarantines, etc. However, these measures are not harmonized across States. Furthermore,
there is very limited mutual recognition of mitigation measures even for States with equal COVID-19 prevalence. States
should assess their own level of COVID-19 disease burden, health system capacity, availability of testing and vaccines,
and level of risk tolerance. Once established, States can share risk assessments with other States and begin to discuss
developing bilateral or multilateral agreements to open public health corridors and stimulate the return of air travel.
Harmonization of procedures is crucial for facilitating air transport, and new practices should be coordinated with other
States and stakeholders. In developing bilateral arrangements, States will need to consider the implications of hub traffic
flows, and how they will accommodate third country-originating passengers.
4.1.2 To establish an internal State risk level, States should identify experts from State authorities, including but
not limited to aviation (national authorities and industry), public health, customs and immigration, diplomatic organizations
and legal departments, who can work collaboratively to assess the State’s current status with respect to disease patterns.
This collaborative assessment effort should be undertaken in a forum appropriate to a State’s system, but can be
undertaken by each State’s National Air Transport Facilitation Committee (or equivalent) as per CART report
Recommendation 6, which urges Member States that have not done so, to immediately establish a National Air Transport
Facilitation Committee, as required by Annex 9 — Facilitation, in order to increase national level cross-sectoral
coordination. The assessment should address the current capabilities to identify, diagnose, and treat COVID cases as well
as the status of the health-care system and the State’s overall willingness and readiness to accommodate increased
passenger flows. After reviewing this document and the CART Take-off Guidance available on the ICAO public site
(https://www.icao.int/covid/cart/Pages/CART-Take-off.aspx), States should identify the risk tolerance they can accept on
a bilateral basis and the mitigation measures that could be employed to meet that target using a safety management
system (SMS) approach.
4.1.3 Although data-driven decision making is encouraged, the current scenario may require a qualitative
approach, as validated data and information is incomplete. By implementing a combined strategy and assessing if an
acceptable residual risk is achieved, States should also evaluate alternatives to reduce or eliminate the burden to the
system posed by selected mitigation measures. Some consideration must be given to how those measures should vary
according to different stages of the pandemic in accordance with the stages in the CART Take-Off Guidance document
(https://www.icao.int/covid/cart/Pages/CART-Take-off.aspx).
4.1.4 Procedures related to each stage and measure should be aligned while considering availability, efficacy,
costs and implementation challenges for each State.
4.1.5 Consistency with the State’s national COVID-19 response policy and strategy is important, for example,
medical masks may be recommended in aviation, but their availability should be prioritized for health workers and the
public health response. In considering restrictions on aviation, the State should consider the role that aviation plays in the
4-1
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economy of the State and the public health response itself (such as the distribution of personal protective equipment (PPE),
test kits, medicines and vaccines). States should ensure alignment between the various public policies and measures
applied across government.
4.2 GENERIC BASELINE MODEL FOR MULITLAYERED RISK ASSESSMENT

AND DETERMINING MITIGATION MEASURES (FOUR-STEP PROCESS)
4.2.1 Introduction
This model has been developed to illustrate a baseline approach that States could use on a bilateral or multilateral basis
to assess risk at the points of origin and destination, and to assist in the selection of available risk mitigation measures.
States should align the process to integrate with other national decision-making processes and to meet available
conditions.
4.2.2 Step one — Determine that the following conditions have been met
This model is based upon the following assumptions (refer to CART take-off guidance
(https://www.icao.int/covid/cart/Pages/CART-Take-off.aspx)) and on WHO travel advice (guidance “Technical
considerations for implementing a risk-based approach to international travel in the context of COVID-19”).
a) travellers follow appropriate universal precautions at every stage of the travel continuum and:
1) do not travel when sick;
2) adhere to hand and respiratory hygiene practices;
3) use a face mask (with exceptions as appropriate);
4) practice physical distancing to the extent possible to lower the risk of disease spread; and
5) adhere to instructions provided by airport and airline personnel;
b) persons who test positive or are diagnosed with COVID-19 pre-travel do not travel and public health
authorities are notified;
c) persons who test positive at arrival isolate, and public health authorities are notified;
d) close contacts of persons who test positive or are diagnosed pre-travel should be identified, quarantined,
and not travel;
e) close contacts of persons who are positive post travel should be identified (including fellow passengers),
and quarantined. Where necessary, international contact tracing operations should be launched;
f) persons who have not been fully vaccinated or do not have proof of previous SARS-CoV-2 infection and
are at increased risk of developing severe disease and dying, including people 60 years of age or older
or those with comorbidities that present increased risk of severe COVID-19 (e.g. heart disease, cancer
and diabetes) should be advised to postpone travel to areas with community transmission;
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Chapter 4. Implementation — Combined strategies 4-3
g) all incoming travellers must follow recommendations and continue to adhere to personal protective
measures, such as the use of masks and physical distancing both while on board aircraft and at airports;
and
h) mechanisms are established to obtain and share complete, accurate and timely contact information to
allow public health authorities to execute necessary public health actions.
4.2.3 Step two — Identify the effectiveness of existing measures
There is a range of measures to reduce translocation of disease. The measures vary in their effectiveness; effectiveness
in this context is defined as the extent to which the measures are estimated to reduce the risk of introducing infectious
individuals into the community at the destination. Each measure represents a defence layered in a multilayered risk
management process and will also need to be assessed for its efficacy and interdependency, when implemented in concert
with other measures. Multiple models and tools allow States and other interested parties to estimate effectiveness of
multilayered approaches. While a multilayered risk mitigation process should be followed, the relative merit of individual
strategies is provided in Attachment B and will be updated in the future in accordance with scientific evidence.
4.2.4 Step three — Determine relative risks
The risk of translocating (transferring) COVID-19 from one State to another can be determined by looking at four conditions
within States: percentage of immune persons (vaccinated and naturally acquired), prevalence, test positivity rate and
testing rate. The cut-off values associated with each condition below is intended to provide guidance on a possible
framework for determining the risk levels in accordance with a colour code:
Potential cut-off values:
1. Percentage who are non-immune persons (vaccinated or naturally acquired) – below 30 per cent.
2. Prevalence — 7-day cases per 100 000 rate (rolling rate averages) with a cut-off of 25 cases
per 100 000.
Note.— Some States favour using a rolling rate determined over a 14-day period.
3. Test positivity rate — 5 per cent as the cut-off with the goal of being below 5 per cent where tests are
widely available for screening.
4. Testing rate — This condition would only be met if a State meets a testing capability of 250 tests per
100 000 people per week.
Possible colour coding based on conditions and cut-off values:
— Green: The origin State/area is below the cut-off values of 1, 2 and 3 above.
— Orange: The origin State/area is below the cut-off values of 2 of the three values above, but not all three.
— Red: The origin State/area exceeds the cut-off values for all three.
— Grey: there is insufficient data, or the State/area does not meet item 4.
Note.— This risk assessment framework might be updated in future taking into account different or additional
conditions, testing strategies, potential cut-off values or colours as the pandemic continues to evolve.
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4.2.5 Step four — Determine measures based upon identified risk levels
4.2.5.1 The model below is given as an example of how relative risk levels could be used in determining the
appropriate risk mitigation measures:
— From green to any colour: No restrictions or requirements.
— From orange to any colour: Could require passenger locator forms and/or tests, but no travel restrictions.
— From red or grey to any colour (particularly to green): Could restrict traveller’s movements depending
on symptoms and exposure and/or test.
4.2.5.2 States should consider the following exemptions subject to a risk assessment:
.—- crew members (including those positioning to and from duty);
— personnel critical for health-care delivery; or
— workers essential to maintaining the safety of the airspace.
Such personnel should not be made to quarantine unless they are ill or have been in close contact with symptomatic
individuals. Should States decide to require testing for such personnel, rapid and non-invasive testing should be given
preference.
4.2.5.3 As COVID-19 vaccination becomes more available and is progressively implemented across the world, it
would be appropriate for States to consider the vaccination status of travellers and crew members when determining the
measures to be applied, on the basis of reduced risk of translocating COVID-19 cross-border by the vaccinated persons
compared to non-vaccinated persons. Conceptually, a lower risk classification may be applied for vaccinated persons.
4.2.5.4 States that have vaccinated a large proportion of their vulnerable population may also consider their risk
levels given the reduced possibility of mortality within their State due to translocation.
Note.— Travellers originating outside of the departure State may need to be separately evaluated upon
arrival in comparison to people who were in the departure State for over 14 days. Where a suitable legal and administrative
framework is in place to allow for such use, Passenger Name Record (PNR) data, Advance Passenger Information (API),
border control records and other passenger information tools could be used to assist in identification of some passengers
who do not self-declare.
4.3 SAMPLE SCENARIOS
The case scenarios below are provided as practical illustrations of the risk assessment process outlined above. Additional
case scenarios, incorporating the effects of vaccination and VOC, will be provided as supplementary attachments as more
evidence becomes available in the future, and as the pandemic continues to evolve.
Scenario 1
State A has a 7-day rolling average of 7.0 cases per 100 000, a downward trajectory of cases, readily available testing,
less than 5 per cent positive tests, and over 25 per cent of hospital beds empty. State B has a 7-day rolling average of
7.8 cases per 100 000, a stable trajectory of cases, readily available testing, less than 2 per cent positive tests, and over
20 per cent availability of hospital beds. States A and B could reasonably enter into a discussion to allow free travel
between regions and implement minimal risk mitigation measures.
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Chapter 4. Implementation — Combined strategies 4-5
Options:
— As they are both in the “green” category, no intervention is a potential option.
— Providing passenger information on routine public health measures with public health authority contact
details, and requiring reporting should someone become ill.
— Electronic-based monitoring for a period of time if a more active approach is desired.
Scenario 2
State C has a 7-day rolling average of 43.4 cases per 100 000, an increasing disease trajectory, testing only for
symptomatic cases and close contacts, over 20 per cent positive tests, and less than 10 per cent available hospital beds.
State D has a 7-day rolling average of 12.6 per 100 000, readily available tests, and 20 per cent availability of hospital
beds. States C and D could negotiate a risk mitigation agreement where citizens of State D could freely travel to State C,
but citizens of State C would be subject to enhanced mitigation strategies.
Options:
— Travellers from State D could move freely about State C with a combination of one or all of the following:
traveller education on routine public health measures with public health authority contacts and reporting
procedures, electronic based monitoring, and/or traveller questionnaires with contact details.
— Travellers from State C to D could be quarantined with testing for early release, utilize serial testing, or
some other active monitoring (smartphone applications, routine call-ins from public health authorities,
limited restrictions such as business activities only). Travellers with a valid vaccination certificate or
certificate of recovery may be subjected to less stringent testing and quarantine requirements.
Passenger education could be a part of the overarching measures as stated above. PHC questionnaires
could be utilized for rapid contact tracing if necessary.
Scenario 3
Testing details and hospital data are unavailable. State E has a 7-day rolling average of 30.2 per 100 000 and readily
available tests. State F has a 7-day rolling average of 23.6 per 100 000 and tests only available for symptomatic cases
and close contacts. State F is dependent on tourism.
Options:
— These States could enter an agreement where persons from State F could travel to State E with minimal
mitigation strategies similar to travellers from State D to C as above.
— Those from State E to F could have slightly enhanced strategies depending on each State’s risk
tolerance. Options could include some or all of the following: serial testing with reduced or no quarantine,
short periods of isolation with a negative test for release, electronic contact tracing/monitoring with daily
reporting of symptoms and a post-arrival test at 5-7 days, and/or the use of “do not board” lists for
recalcitrant individuals. Travellers with a valid vaccination certificate or certificate of recovery may be
subjected to less stringent testing and quarantine requirements. Passenger education of public health
measures and reporting requirements would be critical.
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Chapter 5
PUBLIC HEALTH CORRIDOR
5.1 PRINCIPLES
5.1.1 A public health corridor (PHC) is formed when two or more States or regions agree to recognize the public
health mitigation measures each has implemented on one or more routes between their States. The PHC concept enables
essential cargo services, humanitarian flights, repatriations and medical evacuations to continue with minimal interruptions
or delays, while protecting the health of aircrew, and mitigating the spread of the disease. It also plays a significant role in
aviation safety, enabling aircrew and maintenance personnel to renew their licences and obtain recurrent training. PHCs
are built upon a risk-based approach to ensure as far as possible a “COVID-19 free” journey.
5.1.2. States are strongly encouraged to consider PHCs as an effective useful way to structure a collaborative
approach to managing cross-border health risks. For example, exchange of information through PHCs will enable States
to mutually recognize their respective public health risk management frameworks and to establish temporary and
exceptional bilateral or multilateral arrangements within which air travel can be resumed.
5.1.3 To support States in the establishment of PHCs, ICAO has developed:
a) targeted assistance in the ICAO Implementation Package (iPack);
b) a PHC template on the COVID-19 Response and Recovery Implementation Centre (CRRIC) 1 that
enables States to actively share information;
c) a new application (PHC App) featuring the PHC arrangement template and online builder to facilitate
discussions between two or more States and/or a region; and
d) general tools published on the ICAO PHC website2, providing detailed guidance, tools and checklists for
implementing public health risk mitigation measures using a multilayered risk-based approach.
5.1.4 States are encouraged to actively share information with other States by means of the PHC template on the
CRRIC. The PHC App takes into account data and information provided by States on the PHC template, as well as the
local epidemiology in departure and destination States that have been reported to WHO, which is incorporated into the
PHC App. The App uses the data to calculate the risk of transmission between States utilizing a traffic light system (refer
to section 4.2.4) and includes a template to establish a PHC arrangement, identification of routes for the arrangement,
data regarding disease translocation risk levels, and a list of public health measures to be considered in the arrangement.
5.1.5 A PHC arrangement is built on the principles of a stand-alone arrangement in bilateral (or multilateral) State
relations due to its exceptional and temporary nature. It would not be considered an amendment to existing air services
agreements or a reason for future re-negotiations of air services agreements, and States should use the instrument
appropriate to their legal systems, whether treaty- or less-than-treaty-status instruments, such as a Memorandum of
Understanding. As with any other Memoranda of Understanding, the inclusion of a provision on registration with ICAO (in
reference to Article 83 of the Convention on International Civil Aviation) is up to the Parties' discretion.
1. https://www.icao.int/covid/Pages/crric.aspx
2. https://www.icao.int/safety/CAPSCA/Pages/Public-Health-Corridor-(PHC)-Implementation-.aspx
5-1
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5.1.6 In forming a PHC, it is anticipated that participating States would apply a mutually supportive multilayered
risk-based approach to their implementation of public health mitigating risk measures, which includes a wide-ranging set
of considerations spanning across different sectors. A combination of risk mitigation measures will provide better protection
than the implementation of only one or two selected risk mitigation measures. By collaborating on the measures
implemented, States can establish a risk mitigation strategy that most effectively aligns to their risk tolerance and to their
health and safety management systems. Dependent upon the agreements between States, crew or passengers might be
exempted from COVID-19 testing, quarantine or other requirements. Alternatively, they could benefit from reduced
requirements.
5.1.7 A PHC arrangement should include criteria for regular review (including scheduled review and whenever
circumstances change), suspension (e.g. in case the number of infections raise dramatically in one State in comparison
to another State) and termination (e.g. when the pandemic has been brought under control).
5.1.8 ICAO developed the “Establishing a PHC” Implementation Package (iPack), which expands on existing
guidance, provides access to certificated training courses, as well as a practical hands-on workshop updated regularly
with the latest scientific evidence and lessons learned. It also includes dedicated subject matter experts to work remotely
with States and industry partners.
5.2 ELEMENTS OF A PHC
5.2.1 Crew journey through a PHC
a) Pre-departure testing is conducted based on a risk assessment and requirements of the departure and
destination States.
1) Test standards are established taking into consideration recognition of the test by the destination
State, avoiding the need for an additional test on arrival.
2) Considerations are made for vaccinated crew in accordance with scientific understanding, as
discussed in Chapter 3, 3.1.5 and 3.6.
3) Considerations should be made for crew who have recovered from a COVID-19 infection and may
return a positive test while not being in an infectious phase of the disease, as discussed in
Chapter 3, 3.1.5 and 3.3.7.
b) Crews are separated from the general public in the airport, including through the use of dedicated
security and immigration facilities as recommended in the CART Take-Off Guidance Airport module
(https://www.icao.int/covid/cart/Pages/CART-Take-off.aspx). Airports are encouraged to become
accredited through the Airport Health Accreditation programme run by Airports Council International
(ACI) and supported by ICAO. Airport Health Accreditation provides assurance to States and
passengers that the health and hygiene guidelines in the TOGD are being implemented. Airlines are
encouraged to make use of the International Air Transport Association (IATA) Health Safety Checklist
for Airline Operators also directed to ensuring alignment with ICAO guidance and industry best practices.
c) The aircraft is disinfected in accordance with the manufacturer’s instructions, as recommended in the
CART Take-Off Guidance Aircraft module.
d) In the aircraft, the crew take appropriate precautions against the transmission of COVID-19, as
described in the CART Take-Off Guidance Crew module. Operators should provide the necessary
procedures, training and equipment.
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Chapter 5. Public Health Corridor 5-3
e) At the destinations where crews disembark from the aircraft:
1) crew are separated from the general public for any necessary immigration, security or health
checks;
2) crew are provided with disinfected transport where COVID-safety protocols are able to be applied;
3) where crews are making use of a rest period, a clean hotel room is provided;
4) quarantine of crew members, if required, takes into account the prevalence of the disease and
segregation factors;
5) for crew members subjected to quarantine requirements:
i) adequate food is available at times that correspond to the needs of the crew member; and
ii) access to exercise or outdoor space is provided with COVID safety protocols implemented to
promote mental well-being.
e) On the return to base, crew members who have operated within the PHC with limited exposure to the
general population at the destination airport, should be considered to have a similar risk profile as any
other resident and should therefore not be subjected to additional testing or quarantine.
Note.— Guidance for crew management according to the measures identified in the airline’s own risk
assessment should be consulted in accordance with the CART TOGD Crew Module (page A-40 ‘Layover’)
(https://www.icao.int/covid/cart/Pages/CART-Take-off.aspx).
5.2.2 Passenger journey through a PHC
An example of information to be communicated to passengers prior to booking a flight, taking into account data
protection considerations, is described below.
5.2.2.1 Pre-departure
a) Confirm and follow the States’ requirements (departure, transfer, and arrival) at time of booking and
close to departure.
b) Consult airport/airline website and get acquainted with COVID-19 specific airport/airline
recommendations and instructions.
c) Obtain a COVID-19 health insurance (if necessary or recommended).
d) Ensure that vaccination is completed at least two weeks prior to travel, if choosing to be vaccinated.
e) Book an appointment in an approved testing facility in time to comply with States’ requirements.
f) Present an identification document during the test and collect testing results.
g) Obtain authorized test result, proof of recovery certificate or proof of vaccination (if applicable); and
upload it to a Smartphone App and/or provide relevant information via a government portal (if
applicable).
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h) Ensure all travelling and entry requirements are fulfilled prior to departure to the airport.
i) Make sure to have a copy of the printed test result, proof of recovery or proof of vaccination (if applicable)
or the digital certificates available to present at the airport.
j) Prepare your own travel kit (sufficient number of face masks for travel, hydro alcoholic gel less than
100 ml, etc.).
k) Do not travel if you are feeling unwell, have symptoms suggestive of COVID-19 or if you have been in
contact with someone with COVID-19, and inform the air carrier in advance.
l) Check for possible changes in requirements prior to travel and ensure that there have been no recent
changes.
5.2.2.2 At the airport
a) Arrive within the time frame as communicated by the airline.
b) Check in online or check in early to ensure compliance with travel requirements.
c) Comply with airport/airline instructions, including completion of any additional forms as requested.
d) Respect COVID-19-specific recommendations measures in place, including face masks, physical

distancing, etc.
e) Comply with designated airport pedestrian traffic movement and management indicators in place for
COVID-19, including one-way corridors, separation of staff and traveller areas, physical distancing
indicators, and hygienic recommendations for the use of touch screens, pens, etc.
5.2.2.3 On board
a) Listen and follow crew instructions:
• when to wear or remove face masks;
• how to dispose of face masks; and
• how to use lavatories, etc.
b) Avoid touching other passengers’ belongings.
c) Occupy only assigned seat.
d) Minimize movement in the cabin.
e) Complete passenger locator form, health questionnaire or other required documentation as completely
as possible.
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Chapter 5. Public Health Corridor 5-5
5.2.2.4 On arrival
a) Comply with airport COVID-19 specific recommendations and instructions.
b) If required, ensure health certificates (digital or printed) are readily available to show health or border
control authorities.
c) Respect measures in place, including face masks, physical distancing, etc.
d) Complete passenger locator form, health questionnaire, customs declaration and other documents as
requested.
5.3 IMPLEMENTATION OF A PHC ARRANGEMENT BETWEEN STATES
Bilateral and/or multilateral agreements should be based on the following principles:
a) national and international policies (health, welfare, transport, immigration, legislation, etc.);
b) available public health capacity;
c) State priorities and operational needs;
d) availability of resources (including equipment, system requirements, financial resources, human

resources);
e) implementation of public health measures based on the epidemiological situation;
f) agreement on criteria for implementation of testing and vaccination policies (including advantages and
disadvantages, resources, availability, costs, practicalities of administration, duration of immunity,
ensuring integrity of certificates, etc.);
g) implementation of quarantine policies;
h) management of multiple scenarios within a specified corridor and possible impact on other corridors
managed within each State;
i) establishment of a robust information exchange system agreed among all participants (including contact
points, chain of command, type of data to be shared, data quality, processes and procedures to share
results, analysis of the results, etc.):
j) channels for information-sharing, within and outside of the PHC arrangement;
k) obligation to inform participating States immediately and comprehensively if epidemiological situation,

risk assessment or public health requirements change; and
l) decision-making framework based on the mutual recognition of acceptable risk thresholds of

participating States.
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5.4 STAKEHOLDER AND PASSENGER COMMUNICATION
5.4.1 Establishing PHCs between States requires the sharing of information within national departments of a State,
and internationally between States, necessitating cooperative decision-making. Existing cooperation mechanisms may not
be sufficient to implement bilateral or multilateral arrangements between States during public health emergencies,
especially when there are several States and multiple sectors involved.
5.4.2 In order to mitigate the challenges of implementing a PHC, it is important to work in close coordination with
all relevant national stakeholders, including aircraft and airport operators in each stage of the PHC planning, thus
establishing a shared understanding of the outcomes each State wishes to achieve and ensuring clear communication
channels with all relevant stakeholders and the travelling public.
5.4.3 States are encouraged to share any relevant information about their PHC arrangements on the ICAO CRRIC,
with other States not party to a specific PHC arrangement and all relevant stakeholders, in order to promote, as far as
possible, a harmonized approach through recognition of mitigation measures globally.
5.4.4 States and relevant stakeholders are further encouraged to share relevant information with the public in
order to avoid confusion and disruptions that could negatively affect passenger confidence and return to travel.
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Chapter 6
TRANSITIONING FROM CRISIS RESPONSE

TO ROUTINE OPERATIONS
6.1. In the future, once the immediate crisis has been managed, performance indicators would need to be
developed to determine the transition from a crisis management mode to a “new normal” or routine operational mode,
which could be similar or different from pre-pandemic operations.
6.2 Performance indicators could serve as signposts as to when States could consider transitioning to a
normalized operational mode. This transition is typically based on the assessment of required vs. available resources to
manage the residual risk, taking into consideration criteria discussed in this manual. Additional criteria might also be
considered by a State based on other non-COVID-19 related considerations.
6.3 Such performance indicators could include, for instance, the percentage of the population that has been
vaccinated, findings relating to the use of vaccination passports, the capacity or capability of the health-care system to
manage new or severe COVID-19 infections, etc.
6.4 Transition can start from crisis response to routine operations, once States and organizations have
developed relevant key performance indicators and meet these adequately, and when the COVID-19 pandemic no longer
exceeds their risk and public health management capacity.
6.5 The post-emergency phase, normally considered to have started when the core emergency priorities have
been addressed with some level of stability, is an opportunity to address broader health- and aviation-related activities,
thus preparing better for the future.
6.6 Some measures, such as contactless processes and the digitalization of paper-based applications, have
already been implemented as part of the new routine operations. These should result in improved passenger flow and
enhanced customer experience in the future.
6.7 Lessons learned from the application of the multilayer risk mitigation measures; either how to implement
existing measures better or how to implement these measures differently, could provide further guidance for transitioning
to new operations.
6.8 Furthermore, the aftermath of a crisis provides an opportunity for innovation and for building resilience for
potentially similar situations in the future
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Attachment A
EPIDEMIOLOGIC PRIMER
GOAL: Provide the best testing advice to minimize the risk that a person infectious with SARS-CoV-2 could transmit the
virus during travel and propose a testing regimen to minimize quarantine.
TERMINOLOGY:
Disease status
Present Absent
Screening +
A B Total positive tests
test
result -
C D Total negative tests
Total infected Total not Total population (Tp)
(Ti) infected (Tni)
A: True Positives
B: False Positives
C: False Negatives
D: True Negatives
Prevalence. Disease burden, expressed as a percentage or rate with the total population as the denominator. Prevalence
in this context refers to the number of existing cases of disease in a specified population at a given point in time.
Incidence. Number of new cases of disease in a specified population during a specified period of time.
Sensitivity. The likelihood that a test will correctly identify a person with the disease. A/(A+C) is the mathematical formula.
Specificity. The likelihood that a test will correctly identify a person without the disease. D/(B+D) is the mathematical
formula.
Positive predictive value (PPV). How likely a positive test is a true positive. A/(A+B) is the mathematical formula.
Negative predictive value (NPV). How likely a negative test is true negative. D/(C+D) is the mathematical formula.
Att A-1
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Att A-2 Manual on COVID-19 Cross-border Risk Management
STEP ONE
Determine test performance requirements to maximize the number of people who could travel with reasonable certainty.
Prevalence assumptions/issues
1. It is important to know who might be infectious during travel as opposed to prevalence since the
beginning of the outbreak. This is calculated by multiplying the incidence with the time period of
infectiousness.
2. The Brown School of Public Health website, among others, tracks the incidence or current new cases
per 100 000 people: https://globalepidemics.org/key-metrics-for-covid-suppression/. However, it should
be noted that some statistics might not be accurate due to limitations of testing and reporting systems.
3. Among those who are sick, the vast majority of people are infectious from two days prior to symptom
onset to nine days following symptom onset; hence, 12 days are used to determine the time period
where people could most likely infect others.
4. The asymptomatic rate is assumed to be 40 per cent in accordance with a CDC reference published in
September 2020: https://www.cdc.gov/coronavirus/2019-ncov/hcp/planning-scenarios.html. This
implies that 60 per cent of people are symptomatic. Further assuming that mainly symptomatic people
get tested, the number of positive tests represents only 60 per cent of the total number of people who
are potentially infectious.
Calculating prevalence
To calculate the prevalence of potentially infectious people with positive tests, use the Brown daily average of new cases
per 100 000 people (a 7-day moving average; based on Assumption 2 above) and multiply it by 12 (the number of days a
person might be infectious; based on Assumption 3 above).
Prevalence = incidence x duration

= number of people per 100 000 with positive tests x 12
= potentially infectious people with positive tests per 100 000 people
Taking into account that the number of positive tests represents only 60 per cent of the total number of people who are
potentially infectious, the total number of potentially infectious people needs to be calculated. Setting the total number of
people who might be potentially infectious as “X”, the number of people with positive tests must equal 0.6 times “X” (based
on Assumption 3 above).
Potentially infectious people with positive tests = 0.6 x total number of potentially infectious people (“X”);
Total number of potentially infectious people (“X”) = potentially infectious people with positive tests / 0.6
To calculate the prevalence percentage, divide “X” by 100 000 to get the ratio, then multiply it by 100 to get the percentage.
Prevalence percentage = ratio x 100

= “X” / 100 000 x 100
= x per cent
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Attachment A Att A-3
Example:
For State A, using the data from 21 September 2020 with a daily average of 12.6 per 100 000 people, the equations are
as follows:
Prevalence = incidence x duration

= number of people per 100 000 with positive tests x 12
= 12.6 per 100 000 x 12
= 151.2 potentially infectious people with positive tests per 100 000 people
Potentially infectious people with positive tests = 0.6 x total number of potentially infectious people
Total number of potentially infectious people (X) = potentially infectious people with positive tests / 0.6
= 151.2 per 100 000 / 0.6
= 252 per 100 000 people
Ratio = X / 100 000
= 252 / 100 000
= 0.00252
Prevalence percentage = 0.00252 x 100

= 0.252 per cent
Quick calculation of prevalence:
Because the only variable in this calculation that changes is the daily average, while all others are fixed, the whole
calculation can be done by simply dividing the daily average per 100 000 people by 50. For example, State A with a daily
average of new cases per 100 000 people of 12.6 has a prevalence of 12.6 / 50 = 0.252 per cent. It should be noted that
this is only valid if the number of new cases is expressed per 100 000 people.
Performing the same functions for State B (7-day rolling average of 14.6/100 000) and State C (24.6/100 000 and the
highest average on the Brown site) yields 0.292 and 0.492 per cent.
Performing 2 x 2 tables
— The tables were developed initially with the sensitivity and specificity of a test with sensitivity of
97.1 per cent and specificity of 98.5 per cent.
— Then, the same prevalence values were run with the worst listed sensitivity (80 per cent) and specificity
(92 per cent) on the John Hopkins’ compendium of all COVID-19 tests currently approved.
— For additional comparison, the values for the poorest performing test were run using the highest
prevalence in the United States County X.
— Finally, the tables were populated using the proposed sensitivity and specificity of 95 per cent.
— PCR testing typically has higher sensitivities and specificities and would have even higher performance.
Calculations used for the 2 x 2 tables
A quick reminder of the 2 x 2 table terminology:
Tp = the total number of people in the population

P = the prevalence as calculated above (daily average of new cases per 100 000 people divided by 50)
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Ti = the total number of infected people in the population

Tni = the total number of people in the population who are not infected
A = the total number of people who are true positive
B = the total number of people who are false positive
C = the total number of people who are false negative
D = the total number of people who are true negative
The calculations are as follows:
P = daily average of new cases per 100 000 people / 50

Ti = A + C = Tp x P
Tni = B + D = Tp – Ti
Sensitivity = A / (A + C)
Specificity = D / (B + D)
PPV = A / (A + B)
NPV = D / (C + D)
(Prevalence of 10 per cent, sensitivity of 95 per cent, specificity of 95 per cent)
Step 1 — Using a population of 1 000, calculate the disease burden.
Disease status
Present Absent
Screening +
1 000 x 0.10 = 100 with the disease
test
result -
1 000 - 100 = 900 without the disease
100 900 1 000
Step 2 — Using sensitivity, calculate A (true +) and C (false -).
Disease status
Present Absent
Screening +
95 100 x 0.95 = 95 true positives
test
result -
5 100 - 95 = 5 false negatives
100 900 1 000
Step 3 — Using specificity, calculate B (false +) and D (true -). Then, add up test positives and negatives.
Disease status
Present Absent
Screening +
95 45 140 900 x 0.95 = 855 true negatives
test
result -
5 855 860 900 - 855 = 45 false positives
100 900 1 000
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Step 4 — Calculate the positive predictive value (PPV) and the negative predictive value (NPV).
PPV = true positives/test positives = (95/140) x 100 = 67.8 per cent
NPV = true negatives/all negatives = (855/860) x 100 = 99.4 per cent
Examples of calculations
(Varying prevalence, sensitivity and specificity)
Example 1
State A: Prevalence of 0.25 per cent using a test with a sensitivity of 97.1 per cent and a specificity of 98.5 per
cent.
Disease status
Present Absent
Screening +
2 428 14 962 17 390
test
result -
72 982 538 982 610
2 500 997 500 1 000 000
PPV = (2 428/17 390) x 100 = 14.0 per cent

NPV = (982 538/982 610) x 100 = 99.99 per cent
Example 2
State B: Prevalence of 0.292 per cent using a test with a sensitivity of 97.1 per cent and a specificity of
98.5 per cent.
Disease status
Present Absent
Screening +
2 835 14 956 17 791
test
result -
85 982 124 982 209
2 920 997 080 1 000 000
PPV = (2 835/17 791) x 100 = 15.9 per cent

NPV = (982 124/982 209) x 100 = 99.99 per cent
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Example 3
State C: Prevalence of 0.492 per cent using a test with a sensitivity of 97.1 per cent and a specificity of
98.5 per cent.
Disease status
Present Absent
Screening +
4 777 14 926 19 703
test
result -
143 980 154 980 297
4 920 995 080 1 000 000
PPV = (4 777/19 703) x 100 = 24.2 per cent

NPV = (980 154/980 297) x 100 = 99.98 per cent
Example 4
State A: Prevalence of 0.25 per cent, worst case test with a sensitivity of 80 per cent and a specificity of
92 per cent.
Disease status
Present Absent
Screening +
2 000 79 800 81 800
test
result -
500 917 700 918 200
2 500 997 500 1 000 000
PPV = (2 000/81 800) x 100 = 2.5 per cent

NPV = (917 700/918 200) x 100 = 99.94 per cent
Example 5
State B: Prevalence of 0.292 per cent, worst case test with a sensitivity of 80 per cent and a specificity of
92 per cent.
Disease status
Present Absent
Screening +
2 336 79 766 82 102
test
result -
584 917 314 917 898
2 920 997 080 1 000 000
PPV = (2 336/82 102) x 100 = 2.8 per cent

NPV = (917 314/917 898) x 100 = 99.93 per cent
AR05077
Example 6
State C: Prevalence of 0.492 per cent, worst case test with a sensitivity of 80 per cent and a specificity of
92 per cent.
Disease status
Present Absent
Screening +
3 936 79 606 83 542
test
result -
984 915 474 916 458
4 920 995 080 1 000 000
PPV = (3 936/83 542) x 100 = 4.7 per cent

NPV = (915 474/916 458) x 100 = 99.89 per cent
Example 7
County X: Prevalence of 5.994 per cent, worst case test with a sensitivity of 80 per cent and a specificity of
92 per cent.
Disease status
Present Absent
Screening +
47 952 75 205 123 157
test
result -
11 988 864 855 876 843
59 940 940 060 1 000 000
PPV = (47 952/123 157) x 100 = 38.9 per cent

NPV = (864 855/876 843) x 100 = 98.6 per cent
Example 8
State A: Prevalence of 0.25 per cent, worst case test with a sensitivity of 95 per cent and a specificity of
95 per cent.
Disease status
Present Absent
Screening +
2 375 49 875 52 250
test
result -
125 947 625 947 750
2 500 997 500 1 000 000
PPV = (2 375/52 250) x 100 = 4.75 per cent, or only 1 out of approximately 20 will be a true positive.
NPV = (947 625/947 750) x 100 = 99.99 per cent, or 1 in approximately 10 000 testing negative might be
positive.
AR05078
Example 9
State B: Prevalence of 0.292 per cent, worst case test with a sensitivity of 95 per cent and a specificity of
95 per cent.
Disease status
Present Absent
Screening +
2 774 49 854 52 628
test
result -
146 947 226 947 372
2 920 997 080 1 000 000
PPV = (2 774/52 628) x 100 = 5.27 per cent, or only 1 out of approximately 20 will be a true positive.
positive.
Example 10
State C: Prevalence of 0.492 per cent, worst case test with a sensitivity of 95 per cent and a specificity of
95 per cent.
Disease status
Present Absent
Screening +
4 674 49 754 54 428
test
result -
246 945 326 945 572
4 920 995 080 1 000 000
PPV = (4 674/54 428) x 100 = 8.59 per cent, or nearly 1 out of 10 will be a true positive.
positive.
Example 11
County X: Prevalence of 5.994 per cent, worst case test with a sensitivity of 95 per cent and a specificity of
95 per cent.
Disease status
Present Absent
Screening +
56 943 47 003 103 946
test
result -
2 997 893 057 896 054
59 940 940 060 1 000 000
PPV = (56 943/103 946) x 100 = 54.78 per cent, or slightly over 1 out of 2 will be a true positive.
NPV = (893 057/896 054) x 100 = 99.67 per cent, or 1 in approximately 300 with a negative test might be
positive.
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Notes:
1.— The prevalence does not affect the performance of the test with respect to the sensitivity and specificity. It affects
the number of infected and uninfected persons in a cohort of people.
2.— As prevalence goes up when performing a screening test, so does the positive predictive value.
3.— In a low prevalence situation, the negative predictive value is very little affected by even relatively poor performing
tests.
4.— Poor performing tests will significantly increase the number of false positives who would be denied boarding, at
least initially until confirmatory test can be completed.
Justifications for setting the minimum sensitivity and specificity levels at 95 per cent for molecular tests
1. It will allow a wider range of test devices to be used that are currently fielded as opposed to forcing
States to procure newer models that are frequently hard to obtain.
2. The wider range also allows for the use of rapid antigen tests as a screening device which are more
accessible and practical for application in the aviation environment; which are much faster and less
expensive to use. In addition, it would reserve the more expensive real-time RT-PCR tests for
confirmation of positives in conjunction with clinical correlation.
3. Setting the specificity at 95 per cent maintains a high NPV and reduces the false positives.
4. Setting the sensitivity at 95 per cent will reduce the risk of false negatives and improve the PPV.
5. In low prevalence settings (equating to 10-25 cases per 100 000 on a rolling average), the NPV equates
to mislabelling an infected person as negative between 1 in 5 000 and 10 000 negative tests. In higher
prevalence settings (equating to over 50 cases per 100 000 on a rolling average), the mislabelling rises
close to 1 in 300.
6. In the same low prevalence and higher prevalence range, the PPV improves from correctly labelling a
positive from approximately 1 in 10 to 20, to slightly better than 1 out of 2 of positive tests.
7. Few States set their sensitivity and specificity higher leading to further improvements in test
performance.
STEP TWO: Pre-departure testing interval
Assumptions
— Incubation time: 2-12 days (95 per cent) with a medial of 5-6 days.
— Shedding can occur 48 hours prior.
— The most sensitive tests turn positive 1-3 days prior to symptoms.
— Leaving a 2- to 4-day period where a person could be infected but not infectious with a negative test.
— The goal is to limit infectivity in flight.

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Considerations
1. If the testing is placed at 72 hours before their departure, at least 60 per cent of those infected with a
negative test will manifest their illness and hopefully remove themselves from travel even if they were
infected walking into the testing facility.
2. If the person with a negative test is a true negative and becomes infected walking out of the testing
facility, they should not begin shedding the virus in most cases until after arrival at the destination.
3. Moving testing to 48 hours prior to departure would potentially let a few more of the negative but infected
slip through who could begin shedding the virus in flight before developing symptoms, but would
increase the likelihood that a person subsequently infected would not become infectious in flight.
STEP THREE: Can quarantine be reduced with serial testing?
Considerations
Consideration was given to two studies from the United Kingdom examining the relative effectiveness of various health
measures on arrival to reduce the potential for onward transmission. It is summarized below:
• Quarantine of 14 days (Gold Standard): 78-99 per cent effective
• Single RT-PCR upon arrival: 39.6 per cent effective (2 in 5 cases detected)
• Single RT-PCR at 4 days after arrival: 64.3 per cent effective
• Single RT-PCR at 5 days after arrival: 88 per cent effective
• Upon arrival and 4 days after arrival (two tests): 68.9 per cent effective
• Single RT-PCR at 7 days after arrival: 94 per cent effective
Discussion
Assuming the effective percentages are the ability to find the people who could transmit the disease after release from
quarantine, it seems reasonable to say that a 5 or 7-day window prevents most of the subsequent transmigration of disease.
1. The question is whether testing 72 hours prior to arrival, with a second test on day 4 or 5, would
approach the 94 per cent effectiveness described for a single RT-PCR test 7 days after arrival.
2. Logically, it would appear a 7-day window of proven negativity would provide the same level of
effectiveness.
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Notes for consideration
1.— In the screening environment, the exact test is not as important as the technique in conjunction with the sensitivity
and specificity. The sensitivity and specificity should be of at least 95 per cent and performed by people adequately
trained using the techniques specified by the manufacturer. Laboratory certification is preferred.
2.— Evaluation of the positive cases must be considered.
3.— With the level of prevalence in various States, the PPV with the best tests available are going to be in the 10 to
25 per cent range, meaning 1 in 4 to 10 will be true positives.
4.— The other 75 to 90 per cent will be false positives and denied boarding.
5.— If less sensitive and specific tests are used for screening, the numbers go up significantly to as many 24 out of
25 positive tests being false positives.
6.— Furthermore, some of the true positives may be shedding viral remnants and no longer be infectious and could
therefore travel.
7.— Clinical correlation and more definitive testing will be required in case of positive screening test results.
8.— States should consider what form would be acceptable to declare someone with a positive test as not infectious
and ready to travel.
______________________
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Attachment B
ESTIMATED EFFECTIVENESS OF INDIVIDUAL

RISK MITIGATION MEASURES
Mitigation strategy Estimated effectiveness* Implementation cost**
Universal travel bans Very high (100%) Low
Selected travel bans Varies depending on the State Varies

selection and the timing of the
measure
Travel restrictions, do not board lists, for High Varies

persons ill with COVID-19 or high-risk
contacts who defy public health
recommendations
Pre-departure strategies:
Isolation of potential COVID-19 infected High Varies

cases and quarantine of contacts
Vaccination Very high Varies
Single pre-departure testing Low for preventing translocation* Medium to low
Health declaration forms Very Low Low

(symptom and contact checks)
Temperature screening Very Low Low
High ventilation Medium Low to medium
In-travel strategies:
Traveller health education Medium Low
Using appropriate general/basic public Medium Low

health countermeasures
Managing and positioning of sick Medium Low

passengers
Reduce plane capacity Low Medium to high
Airflow and HEPA filters Medium Low
Att B-1
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Att B-2 Manual on COVID-19 Cross-border Risk Management
By comparison, pre-departure tests have a higher effectiveness mitigating transmission during the journey. With regard to
preventing translocation, effectiveness increases the closer to the time of departure the test of carried out.
Post-arrival strategies
Quarantine for 14 days upon arrival High to very high (78-99% for State Varies (State supervised
supervised quarantine) quarantine can be high)
Data collection/sharing for proper Medium Low

contact tracing
Single PCR testing Medium (40%) Medium
Health declaration forms Low Low

(symptom and contact checks)
Temperature screening Low Low
Combined testing/quarantine strategies
7-day quarantine followed by testing Very high (94%) High
5-day quarantine followed by testing High (88%) Medium
Post-arrival testing and 4-day Medium (69%) Medium

quarantine followed by the second
testing
4-day quarantine followed by testing Medium (64%) Medium
Pre-departure testing with post-arrival Currently being explored. Medium

quarantine and testing Early models show similar rates
to quarantine
* The effectiveness estimates are based on:
a) strategies to reduce the risk of SARS-CoV-2 re-introduction from international travellers, Samuel Clifford et al., Centre
for Mathematical Modelling of Infectious Diseases, Department of Infectious Disease Epidemiology, London School
of Hygiene and Tropical Medicine, UK;
b) the risk of introducing SARS-CoV-2 to the UK via international travel in August 2020”, Rachel A. Taylor et al.,
Department of Epidemiological Sciences, Animal and Plant Health Agency (APHA), UK; and
c) public health authorities and expert consensus.
** Cost reflects the relative administrative expense of implementing a measure and is not meant to reflect societal or industry cost. States
should consider the value of implementing a strategy with respect to potential gains of increased traffic. Note that these costs do not
consider the impact of the measures on States’ economies.
______________________
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ATTACHMENT C
DECISION AID
Example of a basic decision process
Disclaimer: The chart below represents a basic decision process for a tabletop exercise. It is not complete, operational, or
universally applicable, but can support the development of operationally viable inter-agency risk management processes.
Att C-1
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Att C-2 Manual on COVID-19 Cross-border Risk Management
• Draft scenarios to be assessed, considering if the risk is related to passengers, crew members, staff at airports
and any other person inside the Public Health Corridor (PHC)
Draft Example: An infectious person, whose condition is unknown or revealed, is boarding an international flight.
appropriate risk
scenario
• Assess the likelihood of the risk scenario, considering existing management strategies
• Assess the impacts of the risk scenario and its context (health-care system, operational, social, political,
organizational), considering existing management strategies
Define the
inherent risks of • Collect data and information to support qualitative and quantitative assessments
the identified • Define the inherent risk as the combination of the likelihood and impacts of the risk scenario before any actions
risk scenarios by the State
Example: The likelihood of an infectious passenger, whose condition is unknown or revealed, to board an
international flight, is high. The application of the mitigation measures may result in a reduction of this
Select and likelihood.
evaluate A probabilistic estimation for the inflight transmission can be defined (x).
appropriate risk
management
measures States should consider one or more risk management strategies to modify the inherent risk: Avoidance, Transfer,
Mitigation, and Acceptance.
STEP 1 More information about risk management can be found in Chapter 2 of this manual.
Determine that A State may determine that the inherent risk is acceptable depending on its public health capabilities. As needed, the
the initial State may select additional mitigation, considering the individual effectiveness and result of combined strategies for
conditions have
risk management.
been met
The mitigation measures for public health risks are described in Chapter 3 of this manual.
In order to select other mitigation measures, useful questions may be posed by the State to help the evaluation of the
STEP 2
risk management strategy:
Identify the
• What is the individual efficacy and effectiveness of each risk mitigation?
effectiveness of
existing • If a risk management strategy is applied, would it reduce the likelihood of an infectious person to contaminate
measures others or reduce the impacts from this contamination in the public health system?
• What are the measures commonly practiced internationally?
• What are the methods available to apply each risk mitigation?
STEP 3 • What would be the recommended procedures to assure or enhance the effectiveness of each risk mitigation?
Determine • To what extent would procedures applied in aviation be applicable to domestic phases of the travel and
relative risks connection with other modes of transportation?
Are the risk management strategies coordinated with other national, regional and international stakeholders and the
aviation community?
STEP 4 More information about the selection of a combined strategy for risk mitigation is presented in Chapter 4 of this manual.
Determine Example: The States coordinate procedures to be conducted before people engage in air travel, during the
measures based flight, in the airport environment and after arrival.
upon identified A probabilistic estimation for the transmission at the arrival can be defined (y).
risk levels
Assess residual • After the application of the risk management strategy, assess if States are expected to effectively modify the
risk considering inherent risk
applied risk • The residual risk should be evaluated in order to be commensurate with the State’s public health capabilities and
management resilience
strategy Example: After the assessment of combined strategies, the State considers that the residual risk is acceptable.
A probabilistic estimation for the local transmission in the State can be defined (z).
Is the
residual risk
acceptable by
NO the State?
• The State should coordinate actions with other States in order to facilitate air travel
YES • After the strategies are implemented, their actual effectiveness, efficacy and the stabilization of the residual risk
Implement and should be continuously monitored
monitor the risk • As States are subjected to changing conditions, it is important to recognize the need to review the risk scenarios
management and applied mitigation strategies to ensure continuity of traffic connections between States
strategies Example: States should establish indicators and monitor the changing environment of their public health
systems and measures implemented by other States, in order to identify the need to reassess their initial risk
scenario.
— END —
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ISBN 978-92-9265-582-2
9 789292 655822
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International Civil Aviation Organization

Council Aviation Recovery Task Force (CART)
Take-off: Guidance for Air Travel

through the COVID-19 Public Health Crisis
Fourth Edition
Montréal, Canada, 5 October 2021

AR05091
Table of Contents
1. Background ............................................................................................................................................ 3
2. Overview ................................................................................................................................................ 3
3. Objectives ............................................................................................................................................... 3
4. Guiding considerations ........................................................................................................................... 4
5. Risk-based stages for mitigation measures............................................................................................. 5
APPENDIX
1. Public health risk mitigation measures .............................................................................................. A-1
1.1 General ............................................................................................................................................... A-1
1.2 Generally applicable risk mitigation measures ................................................................................... A-1
1.3 Risk mitigation measures applicable in specific modules .................................................................. A-4
1.4 Risk mitigation measures applicable to other aviation sectors ........................................................... A-5
1.5 Implementation through Public Health Corridors .............................................................................. A-5
2. Modules .............................................................................................................................................. A-7
Airports ............................................................................................................................................... A-7
Aircraft ............................................................................................................................................. A-22
Crew ................................................................................................................................................. A-33
Cargo ................................................................................................................................................ A-42
3. Forms and posters ............................................................................................................................. A-46

Crew COVID-19 status card (PHC Form 1) .................................................................................... A-47
Aircraft COVID-19 disinfection control sheet (PHC Form 2) ......................................................... A-48
XYZ Airport COVID-19 cleaning / disinfection control sheet (PHC Form 3) ................................ A-49
Public health COVID-19 passenger self-declaration Form .............................................................. A-50
Recommended dataset on reporting COVID-19 testing results ....................................................... A-51
Recommended dataset on reporting COVID-19 recovery ............................................................... A-52
Recommended dataset on reporting COVID-19 vaccination ........................................................... A-53
Posters in staff rest areas .................................................................................................................. A-54
Recommended Masks....................................................................................................................... A-55
How to select, wear, and clean your mask ....................................................................................... A-56
Aviation multi-layered strategy: based on the James Reason Swiss Cheese Model ........................ A-58
Take-off: Guidance for Air Travel through the COVID-19 Public Health Crisis
AR05092
-3-
1. Background
1.1 The impact of the coronavirus disease (COVID-19) pandemic on global air transport is
without precedent. For the year 2020, global passenger numbers fell by 60 per cent or 2.7 billion, compared
to 4.5 billion in 2019 (-74 per cent in international traffic and -50 per cent in domestic traffic). Airlines
have seen a 66 per cent decline in revenue passenger kilometres (RPKs) and airport passenger numbers
were down 57 per cent in 2020. The traffic decline was estimated to have resulted in revenue losses of USD
371 billion and USD 112 billion for airlines and airports, respectively. The World Tourism Organization
(UNWTO) also estimated a loss of USD 1.3 trillion in export revenues from tourism. With the COVID-19
pandemic accelerating across the globe, headwinds to air transport remain particularly pronounced in 2021.
The updated ICAO projections indicate that world scheduled passenger traffic for the first half of 2021 will
be reduced by 59 to 66 per cent (1.3 to 1.4 billion), compared to 2019 levels.
2. Overview
2.1 This document provides a framework for addressing the impact of the current COVID-19
pandemic on the global aviation transportation system. The appendix to this document includes mitigation
measures needed to reduce public health risk to passengers and aviation workers while strengthening
confidence among the travelling public, aviation workers, the global supply chain and governments. This
will assist in accelerating demand for essential and non-essential air travel impacted by COVID-19.
Complementing this material, this document also points to guidance material developed by international
industry organizations which aims to assist in mitigating the impact of COVID-19. All of this material is
kept under regular review and revised as necessary to keep it up to date.
2.2 With help and guidance from the civil aviation stakeholder community, ICAO recommends
a phased approach to enable the safe return to high-volume domestic and international air travel for
passengers and cargo. The approach introduces a core set of measures to form a baseline aviation health
safety protocol to protect passengers and aviation workers from COVID-19. These measures will enable
the growth of global aviation as it recovers from the current pandemic. It is, however, important to recognize
that each stage of that recovery will need a recalibration of these measures in support of the common
objectives, which are to safely enable air travel, incorporate new public health measures into the aviation
system, as well as support economic recovery and growth. Our work must recognize the need to reduce
public health risk while being sensitive to what is operationally feasible for airlines, airports and other
aviation interests. Our work also considers evolving protocols that are available to mitigate risk, including
testing and vaccination. This is essential to facilitate the recovery.
3. Objectives
3.1 In the aftermath of the COVID-19 outbreak, States, including government regulators,
airports, airlines and aircraft manufacturers among other stakeholders of the aviation ecosystem, developed,
in coordination with public health authorities, a set of measures aimed at reducing health risks to air
travellers, aviation workers and the general public. These measures, applicable to States, airport operators,
airlines and others in the air transport industry, are designed to enable a consistent and predictable travel
experience. They will also contribute to the efficient, safe, secure and sustainable transport by air of an
increasing number of passengers and cargo and will minimize the risk of COVID-19 transmission between
and among these groups and the general public. The implementation of these measures will facilitate and
strengthen the global recovery from the COVID-19 pandemic.
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-4-
4. Guiding considerations
4.1 In developing the measures contained in the appendix, the drafters were guided by the
following considerations:
a) Remain focused on fundamentals: safety, security, and efficiency;
b) Promote public health and confidence among passengers, aviation workers, and
the general public; and
c) Recognize aviation as a driver of economic recovery.
4.2 Based on these guiding considerations, the drafters further agreed that these measures
should be:
 implemented in a multi-layer approach commensurate to the risk level that does not
compromise aviation safety and security;
 able to capitalize on the sector’s longstanding experience and apply the same principles
used for safety and security risk management. This includes monitoring compliance,
reviewing the effectiveness of measures at regular intervals, and adapting measures to
changing needs as well as improved methods and technologies;
 able to minimize negative operational and efficiency impacts while strengthening and
promoting public confidence and aviation public health;
 consistent and harmonized to the greatest extent appropriate, yet flexible enough to
respond to regional or situational risk-assessment and risk-tolerance. The acceptance of
equivalent measures based on shared principles and internationally recognized criteria
will be a fundamental enabler to restore air services on a global level;
 supported by medical evidence and consistent with public health best practices;
 non-discriminatory, evidence-based and transparent;
 cost effective, proportionate and not undermining to the equal opportunity to compete;
 highly visible and communicated effectively and clearly to the aviation community as
well as the general public; and
 consistent with State obligations under the Convention on International Civil Aviation
(Chicago Convention) and other international treaties and agreements, as well as with
standards and recommended practices applicable to aviation and public health.
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5. Risk-based stages for mitigation measures
5.1 Resumption of higher volumes of passenger air travel will be dependent on a number of
factors, including foremost public health agency guidelines (driven by travel risk levels), governmental
travel restrictions and requirements, passenger confidence, and air carrier and airport operational capacity.
5.2 A risk-based approach to facilitate international travel is consistent with WHO

recommendations, and will enable recovery and the adjustment of mitigation measures based on risk, while
recognizing that reverting to previous stages of recovery may be necessary. The goal is to maximize
consistency and develop criteria for data reporting and the monitoring processes in support of evaluation
and progression to the next stage(s). It is currently not feasible to provide any specificity of timing between
these stages. At the time this document was published, most of commercial passenger aviation was in Stage
3 or 4.
 Stage 0: A situation with travel restrictions and only minimal movement of passengers between
major domestic and international airports.
 Stage 1: Initial increase of passenger travel. This initial stage will coincide with relatively low
passenger volumes, allowing airlines and airports to introduce aviation public health practices
appropriate to the volume. There will be significant challenges as each stakeholder community
adapts to both increased demand and the new operational challenges associated with risk
mitigation. Health measures for travel required at airports will need to, at a minimum, match those
from other local modes of transport and infrastructure.
 Stage 2: As health authorities review the applicability of measures based on recognized medical
criteria, passenger volumes will continue to increase. Several measures that were required in Stages
0 and 1 may be lifted. Health measures for travel required at airports will need to match those from
other local modes of transport and infrastructure.
 Stage 3: This stage may occur when the virus outbreak has been sufficiently contained in a critical
mass of major destinations worldwide as determined by health authorities. The reduction of
national health alert levels and associated loosening of travel restrictions will be key triggers. Risk
mitigation measures will continue to be reduced, modified, or will be stopped in this stage. There
may not be effective pharmaceutical interventions (e.g. therapies or vaccines) commonly available
during Stage 3, but contact tracing and testing should be readily available. Until specific and
effective pharmaceutical interventions are available, States may need to continue to loosen or
reinstate public health and social measures throughout the pandemic.
 Stage 4: This stage begins when specific and effective pharmaceutical interventions are readily
available in most countries. There may be a set of residual measures/mitigations that could be
retained, although these should also undergo a periodic review process.
Note.— There are no hard boundaries in these stages and the transition between them can be in
either direction.
————————
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A-1
Take-off: Guidance for Air Travel

through the COVID-19 Public Health Crisis
Appendix
1. PUBLIC HEALTH RISK MITIGATION MEASURES
1.1 General
1.1.1 These public health risk mitigation measures are divided into four sections. The first section
contains generally applicable risk mitigation measures that apply in all phases of passenger and cargo air transport.
The second section describes modules, attached to this appendix, that are specific to various aspects of commercial
air transport. The third section provides links to material, developed by industry organizations, to assist other
aviation sectors. The final section describes Public Health Corridors as one collaborative implementation strategy
for States to minimise the transmission of COVID-19 by aviation.
1.1.2 In the implementation of these measures, care should be taken to follow all applicable laws,
regulations, requirements, standards and guidance issued by relevant sub-national, national and international
authorities. Nothing in these guidelines is intended to supersede or contradict such requirements. States should
ensure their policies and measures are coordinated across all relevant sectors.
1.2 Generally applicable risk mitigation measures

1.2.1 None of the measures listed below should be considered as sole mitigation measures but
should be incorporated into a multilayered risk mitigation framework.
 Public education: States and stakeholders must work together to distribute accurate information quickly.
Information must be as clear, simple and consistent as possible across the entire passenger travel experience.
 General hygiene: Hand hygiene (washing hands with soap and water or, where this is not available, using
alcohol-based hand-sanitising solution), respiratory etiquette (covering the mouth and nose when sneezing
or coughing) and limiting direct contact with any surfaces at the airport and in the aircraft to only when
absolutely necessary should be observed at all times unless otherwise advised by airport staff or aircrew
members.
 Physical distancing: To the extent feasible, people should be able to maintain social distancing consistent
with World Health Organization (WHO) or applicable State health guidelines. Where this distancing is not
feasible (for example in aircraft cabins), adequate risk-based measures should be used including allowing
limited baggage in the cabin, orderly boarding processes, disembarkation announcements and procedures,
and limiting unnecessary movement of passengers and cabin crew on board.
AR05096
A-2
 Face masks. Non-medical and medical masks1 should be worn in line with WHO recommendations2 and
the applicable public health guidelines, including requirements of all States concerned (e.g., departure,
transit, arrival). Airlines should advise passengers in advance on type of masks required by the relevant
national public health authorities. Exempted groups (e.g. children up to 5 years3 or passengers that cannot
tolerate non-medical or medical masks such as individuals with physical disabilities, respiratory or other
conditions) should be clearly specified. Passengers and personnel should always follow best practice about
when and how to wear, remove, replace, and dispose of non-medical and medical masks in addition to
proper hand hygiene following removal. Non-medical masks should be three layers, fully cover the nose
and mouth and comply with WHO standards in terms of filtration and breathability. Masks should be worn
during all phases of flight except while eating or drinking for brief periods of time. It should be replaced
when it is no longer functional (e.g. becomes damp). Medical masks should be prioritized for use as
personal protective equipment by healthcare workers, passengers at high risk of developing complications
due to COVID-19, and persons suspected of being infected with COVID-19. Medical respirators (e.g. N95
or N99 or FFP2 or FFP3) should be reserved for healthcare workers. Masks with exhalation valves can
transmit the virus and should not be used4. Refer to the attached posters for more guidance.
 Routine sanitation: High touch surfaces should be cleaned and disinfected as prescribed by public health
authorities with frequency based on operational risk assessment.
 Health declarations: Where feasible and justified, health declaration forms or health attestations for
COVID-19 should be used for all passengers, in line with the recommendations of relevant health
authorities. Self-declarations in electronic format prior to airport arrival should also be encouraged to avoid
crowding at airports. Refer to Public health corridor (PHC) Form 4.
 Health screening: States should ensure that health screening, at exit or entry, is conducted in accordance
with the protocols of the relevant health authorities (e.g., departure, transit, arrival). Screening could consist
of pre-flight and post-flight health declarations, non-invasive temperature measurement and/or visual
observation conducted by employees trained to recognise signs suggestive of COVID-19 and in the use of
these measures. Such screenings could identify ill persons that may require additional examination prior to
working or flying. The availability of such information and insights can be leveraged in a risk-based
approach, which will further contribute to reassure the travelling public. This screening may be conducted
upon entry and/or exit. Temperature and other symptom-based screening could be a part of a multi-layered
approach but should not be relied on as a stand-alone mitigation measure as it has limited effectiveness5, in
detecting COVID-19 cases. The virus can be associated with mild symptoms or asymptomatic infections
and is transmitted from both pre-symptomatic or asymptomatic individuals.
If a person shows signs and symptoms suggestive of COVID-19, or their declaration form shows a history
of respiratory infection or/and exposure to high-risk contacts, appropriate follow up would be necessary,
including a focused health assessment performed by healthcare personnel either in a dedicated interview
space at an airport, or in an offsite pre-identified health care facility.
 Health monitoring and Contact Tracing: Methods for the collection of passenger and employee contact
information valid for the destination should be in place, including through web applications. Such
information is critical for health observation of incoming travellers, and would also be used to support
public health authorities in contact tracing should this be warranted following the identification of a
COVID-19 case. Updated contact information should be requested as part of the above mentioned
1 Medical masks (also known as surgical masks) refer to professional medical masks worn by healthcare workers. Medical respirators are
recommended for use by healthcare workers only.
2 Mask use in the context of COVID-19; https://www.who.int/publications/i/item/advice-on-the-use-of-masks-in-the-community-during-
home-care-and-in-healthcare-settings-in-the-context-of-the-novel-coronavirus-(2019-ncov)-outbreak
3 https://www.icao.int/safety/CAPSCA/Pages/ICAO-Manuals.aspx
4 www.who.int/emergencies/diseases/novel-coronavirus-2019/advice-for-public/when-and-how-to-use-masks
5 https://www.who.int/news-room/articles-detail/public-health-considerations-while-resuming-international-travel
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declaration. Public Health Passenger Locator Form (PLF) should be distributed during flight and collected
afterwards and handed over to relevant health authorities.6
1.2.2 The following considerations should be taken into account.
 Passengers with reduced mobility: The specific needs of passengers with reduced mobility should be
considered when implementing these measures in order not to unnecessarily limit their access to air travel.
 Risk management (including testing): A range of different and varied mitigation measures are available
to States to manage the risks posed to their populations and economies by COVID-19. States should assess
their risks and determine mitigation measures appropriate to their situation. At the same time, States are
encouraged to promote to the greatest extent possible, a harmonised and inclusive approach when
determining such measures to facilitate the recovery of aviation. As new COVID-19 tests are developed
and matured, and as testing capacity and availability improve, States may consider incorporating testing as
part of an overall risk management strategy. While testing is not universally recommended by public health
authorities and WHO advises against considering international travellers by default as suspected COVID-
19 cases or as priority group for testing, robust testing strategies allow for early detection of potentially
infectious travellers and have been implemented by some States as a routine health screening method for
international travellers. ICAO has published a Manual on COVID-19 Cross-Border Risk Management7 to
help States assess and develop their overall risk management strategy, including the possible use of testing.
The Manual will be regularly updated to reflect medical advances and increased understanding of the
disease.
 Promoting, maintaining and supporting mental well-being: COVID-19 and its associated restrictions
has had a significant impact on the mental health and well-being of both passengers and aviation workers,
which could impact operational safety. To provide for a psycho-socially safe and supportive aviation
environment, multi-sector multi-stakeholder collaboration is necessary to support mental well-being of
aviation workers, and to assist passengers in their preparations for travel. Principles and guidance material
to support mental well-being may be found on the Promoting, Maintaining and Supporting Mental Well-
Being in Aviation during the COVID-19 Pandemic Electronic Bulletin (EB 2020/55).
 Testing, recovery and vaccinations protocols: As more States apply testing, proof of recovery or
vaccination as part of their COVID-19 risk management strategy, they should consider the guidance
outlined in the ICAO Manual on COVID-19 Cross-Border Risk Management, to develop protocols and
standardize reporting of COVID-19 health information for the purposes of cross-border travel.
 Certification of testing, recovery and vaccination: States are encouraged to use documentary proofs of
COVID-19 certificates that are accessible, effective, secure, trustworthy, verifiable, convenient to use,
compliant with data protection legislation and interoperable. Proof of vaccination could be based upon the
WHO International Certificate of Vaccination or Prophylaxis (ICVP) and should be issued in an
internationally/ globally interoperable format aligned with the technical specifications and guidance
outlined by WHO8. Existing solutions should be considered and could incorporate a Visible Digital Seal9
(VDS-NC) or other interoperable formats from regional or global intergovernmental bodies, or
internationally recognized organizations.
 Verification of COVID-19 certificates: States are encouraged to consider the guidance outlined in the
ICAO Manual on COVID-19 Cross-Border Risk Management to facilitate travel if COVID-19 certificates
are required. This includes making available government tools to submit the certificates, inform passengers
and stakeholders of the requirements with regards to testing, vaccination and verification of these
certificates and providing the necessary guidance, resources and support to assist stakeholders. States
6 State Letter 20/97

7 https://www.icao.int/safety/CAPSCA/Pages/ICAO-Manuals.aspx
8 WHO technical specifications are contained in the Digital Documentation of COVID-19 Certificates: Vaccination Status technical specifications and implementation guidance document
9 ICAO guidance on Visible Digital Seal for non-constrained environments (VDS-NC) is contained in the ICAO Machine Readable Travel Documents (MRTD) Technical Report VDS-NC and the ICAO
Guidelines Visible Digital Seals (“VDS-NC”) for Travel-Related Public Health Proofs.
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should ensure these processes and/or procedures are in full compliance with applicable laws and regulation
on data protection and privacy.
 Vaccinated and recovered passengers. Vaccination plays an important role in aviation recovery as the
vaccinated proportion of the global population increases over time. While vaccination should not be a
mandatory requirement when traveling internationally10, States are encouraged to promote, to the greatest
extent possible, a harmonised and inclusive approach to facilitate the international travel and entry of fully
vaccinated or recovered passengers.
 Considerations for testing and quarantine alleviations and exemptions: States are encouraged to
streamline and harmonise international travel requirements, where possible, in keeping with World Health
Organisation technical considerations for implementing a risk-based approach to international travel,
particularly by working towards exempting international travellers from testing and/or quarantine who:
 are fully vaccinated, [meaning they have received all recommended primary doses of a vaccine
against COVID-19 listed by WHO for emergency use or approved by a Stringent Regulatory
Authority] at least two weeks prior to travelling; or
 have proof of previous SARS-CoV-2 infection confirmed by rRT-PCR received within the past 6
months and are no longer infectious as per WHO’s criteria for releasing COVID-19 patients from
isolation.
 Crew: Crew should be subject to minimal requirements in line with the crew module and guidance
in the Manual on COVID-19 Cross-Border Risk Management (Doc 10152).
 Vaccination considerations for aviation workers: The WHO Strategic Advisory Group of Experts on
Immunization (SAGE) Prioritization Roadmap supports countries in planning and suggests public health
strategies and targeting priority groups for different levels of vaccine availability and epidemiologic
settings. As transportation workers, aviation workers are essential workers falling within Stage III of the
WHO SAGE Prioritization Roadmap, whilst crew who work on aircraft that carry goods and no passengers,
fall into Stage II, to be vaccinated when there is moderate vaccine availability and between 21% and 50%
of the national population has been vaccinated.
1.3 Risk mitigation measures applicable in specific modules
A. Airport
The airport module contains specific guidance addressing elements for airport terminal building,
cleaning, disinfecting, hygiene, physical distancing, staff protection, access, check-in area, security
screening, airside areas, gate installations, passenger transfer, disembarking, baggage claim and
arrivals areas.
B. Aircraft
The aircraft module contains specific guidance addressing boarding processes, seat assignment
processes, baggage, interaction on board, environmental control systems, food and beverage service,
lavatory access, crew protection, management of sick passengers or crew members, and cleaning and
disinfection of the flight deck, cabin and cargo compartment.
C. Crew
In order to promote safe and sustainable international air travel, a closely coordinated international
approach to the treatment of air crews, consistent with recognized public health standards, will be
10 Interim position paper: considerations regarding proof of COVID-19 vaccination for international travellers (who.int)
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essential to alleviate burdens on critical transportation workers. These currently include screening,
quarantine requirements, and immigration restrictions that apply to other travellers. The crew module
contains specific guidance addressing the contact of a crew member with a suspected or positive
COVID-19 case, reporting for duty, dedicated end-to-end crew layover best practices, crew members
experiencing COVID-19 symptoms during layover and positioning of crew.
D. Cargo
Cargo flight crews should apply the same health and safety considerations as passenger flight crews
and are collectively included in the crew section of this document. Whilst air cargo consignments do
not come into contact with the travelling public, the cargo acceptance and handover process does
include interaction with non-airport employees. The cargo module addresses aviation public health
including physical distancing, personal sanitation, protective barriers for points of transfer to the ramp
and the loading and unloading, and other mitigation procedures.
1.4 Risk mitigation measures applicable to other aviation sectors
1.4.1 The Take-off Guidance Document was developed in collaboration with aviation industry
organizations. Several of these organizations have developed additional guidance pertinent to the operations of their
members. This material has been developed, and is being maintained, in line with the Key Principles set out in the
CART Report and with the Guiding Considerations included in this Take-off Guidance Document.
1.4.2 The guidance material developed by CANSO to support the operational safety and efficiency of air
traffic services provision may be found at [LINK11].
1.4.3 The guidance material developed by IBAC to support those business aviation operations that are
not covered under the guidance for commercial air transportation may be found at [LINK12].
1.4.4 The guidance material developed by IAOPA to support general aviation, including flying schools,
recreational and non-commercial flying, may be found at [LINK13].
1.5 Implementation through Public Health Corridors
1.5.1 In order to mitigate the spread of COVID-19 and safeguard the health and safety of aviation
personnel and passengers, States are strongly encouraged to collaborate with each other to establish Public Health
Corridors14.
1.5.2 A public health corridor is formed when two or more States agree to recognise the public health
mitigation measures each has implemented on one or more routes between their States. To enable such mutual
recognition, and promote, as far as possible, a harmonized approach States are strongly encouraged to actively share
information, including on PHC arrangements with other States by means of the PHC template on the CRRIC15.
1.5.3 In forming a public health corridor, it is anticipated that participating States would apply a mutually
supportive multi-layered risk-based approach to their implementation of public health mitigating risk measures. A
combination of risk controls will provide better protection than the implementation of only one or two selected risk
controls. By collaborating on the measures implemented, States can establish a risk mitigation strategy that most
effectively aligns to their risk tolerance and to their health and safety management systems.
11
https://canso.org/publication/covid-19-restart-and-recovery-guide/
12 https://ibac.org/guidance-documents
13 https://iaopa.aopa.org/-/media/Files/IAOPA/ICAO/ICAO-Take-off-GA-Module.pdf
14 the Manual on COVID-19 Cross-Border Risk Management (Doc 10152) has been updated (Chapter 5)
15 https://www.icao.int/covid/Pages/crric.aspx
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1.5.4 To facilitate implementation of PHCs, the Manual on COVID-19 Cross-Border Risk Management
(Doc 10152) has been updated (Chapter 5) and the ICAO i-PACK “Establishing a Public Health Corridor ” is
available to States. They include associated procedures and relevant tools that will be regularly updated in view of
latest scientific developments. One of these tools is the recently developed PHC Application (PHC App)16.
1.5.5 States are encouraged to establish key performance indicators to monitor the effectiveness of risk
mitigation measures especially with respect to aviation recovery included in each module. These indicators should
be developed from an aviation perspective and based on data released by public health authorities.
————————
16https://portal.icao.int/CRRIC/Pages/Public-Health-Corridors.aspx
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2. MODULES
Module
Airports
Target audience
Airport operators, authorities, governments, airport staff.
Element
Terminal building
Brief description (Objective)
Guidance for the operation of terminal buildings needs to consider all aspects of operations, including who
has access to the building, the upkeep of cleanliness and disinfection procedures in place within the terminal
building, as well as health measures, the provision of first-aid/medical attention guidance, and the protocols
for passengers and staff.
Considerations
Cleaning and disinfection

 A written plan for enhanced cleaning and disinfection should be agreed upon by the airport health
authority, airport operators and service providers, according to the standard operating procedures
outlined in the WHO Guide to Hygiene and Sanitation in Aviation. The plan needs to be updated in
terms of process, schedule and products, when new information becomes available. All relevant
personnel should be trained on increased disinfection requirements.
 Cleaning and disinfection of terminal infrastructure and all equipment should be done on a regular
basis, in accordance with the aforementioned plan, and its frequency should be increased as needed
based on traffic.
 Increase the availability of cleaning and disinfecting products approved by the applicable
authorities.
 All cleaning and disinfection staff should be made aware of the cleaning and disinfection plan. It is
necessary to ensure staff are utilizing products effectively, including the concentration, method and
contact time of disinfectants, and addressing areas that are frequently touched and most likely to be
contaminated, such as:
o Airport information desks, passengers with reduced mobility (PRM) desks, check-in areas,
immigration/customs areas, security screening areas, boarding areas, etc.
o Escalators, elevators and lifts, handrails.
o Washrooms, toilets and baby changing areas.
o Luggage trolleys and collection points: cleaned with dispensable wet wipes or disinfectants,
ensuring that disposal bins are made available.
o Seats prior to security screening and in boarding/check-in areas.
o Parking shuttle buses and airside buses.
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 Increase the use of air conditioning and effective filtration systems to keep air clean, reduce
re-circulation and increase the fresh-air ratio. Horizontal airflows should be limited.
Physical distancing
 Physical distancing is an effective measure to limit transmission of COVID-19 and should be part
of a comprehensive package of measures to limit the spread of COVID-19. Physical distancing
measures in airports should be:
o At least consistent with what is applied for other transport modes, particularly in urban
public transport used for access to and from airports.
o Applied to the greatest extent possible throughout the airport.
o Re-evaluated as epidemiological conditions permit.
 Physical distancing should target reaching at least one (1) metre between all individuals.
 Mutual recognition of equivalent physical distancing measures that mitigate the health risks at the
point of departure and of arrival is encouraged.
Staff protection:
 The level of adequate protection for staff members should be evaluated on a case-by-case basis.
Such protection may include personal protective equipment (PPE), health screening programmes
for staff, scheduling (keeping groups of staff in steady teams and shifts), easy alcohol-based hand
sanitizer access, specific staff process prior to and after completing a shift, and physical distancing
plans for workstations, including the consideration of barriers.
 Employees should be equipped with PPE based on the risk of exposure (e.g. type of activity) and
the transmission dynamics (e.g. droplet spread). PPE could include disposable gloves, masks,
goggles or face shields, and gowns or aprons.
 For staff and teams working shifts, handovers should be conducted in a contact-free manner, i.e. via
telephone, videoconference, electronic logs, or at least through physical distancing.
 Maintenance and repair work in public areas should be prioritized and their schedule adjusted or
postponed if it is non-essential.
 Staff training should maximize the use of online training and virtual classrooms.
 The use of physical separators between selected staff and passengers is recommended in areas of
repeated exchanges and transactions.
Airport terminal access
 According to each airport specificities and the national legislation in place, airport terminal access
may be restricted to workers, passengers and persons accompanying passengers with disabilities,
reduced mobility or unaccompanied minors in an initial phase, as long as it does not create crowds
and queues, which would enhance risks of transmission as well as create a potential security
vulnerability.
 Where health screening is required by applicable regulations, non-contact thermometers should be

used in a designated area, under conditions which minimize the impact on operations.
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Means for uniform implementation
 Collaborate with relevant authorities to ensure viewpoints are aligned.
 Collaborate with stakeholders in the community to ensure the timely and accurate dissemination of
information to the travelling public.
 Ensure alignment of measures with other local modes of transport and other infrastructures.
 Use the Airport COVID-19 Cleaning / Disinfection Control Sheet (PHC Form 3) or a similar one
where appropriate.
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Element
General check-in area
The general check-in area of an airport is usually an area that sees high passenger traffic. In order to limit
queues and crowds, passengers should complete as much of the check-in process as possible before arriving
at the airport (i.e. passengers should be ready to fly). Self-service options should be made available and
utilized as much as possible to limit contact at passenger touchpoints.
Considerations
 Implement measures that reduce congestion within these areas through advanced-planning and
monitoring of passenger flows.
 Airports should provide signage, floor markings and announcements via public address (PA)
systems to encourage physical distancing. In addition, support communication of key prevention
messages from health authorities through audio messages and signs at key touchpoints of the
passenger journey should be considered.
 Various self-service tools, such as boarding pass and baggage tag kiosks and baggage drops are of
specific concern due to the high levels of physical contact that increase the probability of
contamination. Usage of these devices should nonetheless be encouraged to reduce face-to-face
interactions, but with careful attention to the management of passenger flow and keeping such
devices adequately and constantly disinfected.
 Whenever possible, passengers should be encouraged to complete check-in processes prior to

arriving at the airport. Online check-in, mobile boarding pass, off-airport baggage tagging, and other
initiatives will contribute to the reduction in the amount of contact with airport staff and
infrastructure. It is therefore recommended that States remove any regulatory obstacles to enabling
such types of off-airport processes.
 At the traditional check-in counters, the use of retractable stanchions and floor signage in the
queuing area to encourage physical distancing and the installation of transparent barriers in front of
staff at counters should be considered.
 Self-sanitizing technology may also be considered for integration within kiosks with touch screens,
to allow for the disinfection of the screens between each use.
 Whenever possible, airport and other stakeholders should use contactless processes and technology,
including contactless biometrics such as facial or iris recognition. Such digital identification
processes can be applied to self-service bag drops, various queue accesses, boarding gates and retail
and duty-free outlets. This will eliminate or greatly reduce the need for contact with travel
documents between staff and passengers. It may also accelerate various processes, resulting in
enhanced health protection, reduced queuing and other process efficiencies.
 Collaborate with relevant authorities, airlines and other aviation stakeholders for cost-effective
solutions that protect the public.
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 Simplified formalities by enabling contactless processes.
 Greater use of standardized digital identity management solutions.
where appropriate.
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Element
Security Screening
In response to the continuing pandemic, we can expect the need for physical distancing measures to be
maintained at security screening checkpoints, including during the screening process. Measures to control
access to the security screening checkpoint may need to be considered, as well as possible modifications to
standard screening, in order to comply with new COVID-19 sanitary guidelines.
Security screening staff should be exempt from carrying out health and safety related screening to ensure
they remain focused on security screening and related processes.
Considerations
Checkpoint access procedures
 Appropriate procedures should be implemented in coordination with relevant government

departments in order to respond to any passengers showing signs of illness.
 Hand sanitizers and disinfection products should be provided prior to passengers and staff screening
access points where possible.
 Screeners and passengers should maintain physical distancing to the extent possible or wear the
appropriate PPE to mitigate the risk of exposure.
 Rearranging of security checkpoint accesses and layouts should be considered with the objective of
reducing crowds and queues, to the extent possible, and maintaining physical distance while
maintaining desirable throughput. This should include both divestment areas and those areas where
passengers retrieve their screened cabin baggage.
 Floor-markings, tensile barriers, or other suitable means should be established within the queueing
area to help secure the proper distancing recommended by the appropriate authorities.
 Procedures involving passengers presenting boarding passes and other travel documents to security
personnel should be done, to the extent possible, while avoiding physical contact and in a way that
minimizes face-to-face interaction. Should there be a need to identify a person wearing a non-
medical or medical mask against a government-issued photo identification, the non-medical or
medical mask could be removed temporarily if physical distancing measures are met. Appropriate
signage should be deployed that clearly informs about subsequent steps of the process.
Possible solutions include:
o Directing passengers to use automatic boarding pass scanners at access points while
maintaining appropriate physical distance.
o Using mobile boarding pass scanners operated by the security staff.
o Conducting a visual inspection of the boarding pass and relevant identification
documentation, as needed by standard operating procedures.
 Automated gates and mobile scanners’ reader surfaces should be disinfected with the same
frequency as for any other high-touch surface.
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 Passenger preparation officers should be deployed to ensure passengers are prepared for the
divestment needs. Screeners should reinforce processes with passengers accessing divesting areas,
such that they properly divest and are less likely to cause a false alarm (to minimize the use of
manual searches).
 Enhanced cleaning and disinfecting should be routinely conducted of frequently touched/exposed

surfaces and security screening equipment, including trays at the security checkpoint and baggage
areas.
Passenger Screening
 Alcohol-based hand sanitizer should be distributed to staff for the cleaning and disinfection of their
hands.
 Screeners should wear disposable gloves and masks when conducting manual searches on
passengers. Alcohol-based hand sanitizers should be applied to the disposable gloves between each
passenger screened. Disposable gloves should be changed when they are obviously soiled or torn.
 Employees should be advised to wash their hands after removing disposable gloves.
 Appropriate signage and information to passengers should be clearly displayed regarding newly
implemented health requirements, as well as modified screening processes. Signage should
highlight the need for passenger cooperation throughout the screening process.
 Whenever screening checkpoints are processing a high number of passengers, staff and crew
screening should be performed in dedicated checkpoints and separately from passengers (as an
additional preventive health measure), where possible.
 Appropriate alarm resolution arrangements should be put in place to mitigate the risk of queue build
up and to maintain passenger throughput. These might include alarm resolution in a dedicated area
separated from the flow of passengers which may need the positioning of additional security
personnel.
 For WTMD alarm resolution, prioritize the use of hand-held metal detectors to identify the cause of
alarm, followed by a targeted manual search where the alarm is.
 The use of explosive trace detection (ETD) equipment or explosives detection dogs (EDDs) should
not be limited to alarm resolution. Random use of such explosive detection should be encouraged
and leveraged where possible.
 Should there be a concern or an alarm that cannot be cleared solely by the primary screening
equipment used, it should undergo a secondary screening using, in order of availability and subject
to the nature of the screeners concern regarding the threat: EDD, ETD or manual search
 If the standard procedure allows for the reuse of ETD swabs, consideration should be given to
discontinuing this practice to limit the possibility of spreading COVID-19.
Note.- The standard procedure may continue if, for example, it could be determined that the high temperature
generated by the specific ETD in use will destroy the virus and if the process for handling and storage of swabs
eliminates the possibility of contamination.
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 If there is a need to conduct a manual search, screeners should adapt their methodology, if possible,
to avoid being face-to-face with passengers or other persons being screened.
 Staff needed to interact with passengers in close proximity should use a non-medical or medical
mask.
 Larger quantities of health-related liquids, aerosols and gels (LAGs) than prescribed by applicable
security regulations, such as alcohol-based hand disinfectants, could be accepted if permitted by the
appropriate authorities for aviation security and safety, taking into account the related regulations17.
 Work with the regulator to consider alternatives to manual searches when conducting random
searches. Such alternatives should only be implemented with the approval of the appropriate
authority and based on a risk assessment.
 Work with relevant health authorities to ensure cleanliness and disinfection protocols are developed
and implemented for items with a high likelihood of cross contamination (e.g., trays and divestment
area).
where appropriate.
17 https://www.icao.int/safety/COVID-19OPS/Pages/DangerousGoods.aspx
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Element
Terminal Airside Area
The post-security terminal airside area is an area of high passenger traffic with few physical barriers and
usually wide-open space. Consideration needs to be given to the temporary need for physical distancing,
while also providing passengers with access to the retail, duty-free concessions and food and beverage
offerings.
Gate areas, VIP lounges and other services in this area also see a high passenger volume. Various flow
monitoring tools, physical installations, floor markings and adapted wayfinding need to be evaluated and
deployed. Enhanced cleaning and hygiene measures may need to be scheduled and deployed to contribute
to the limiting of the virus spread.
Considerations
 Encourage the use of self-service options, established in compliance with local health authority
guidelines where passengers have limited contact with retail, food and beverage staff.
 An orderly boarding process will be necessary to reduce physical contact between passengers,
especially once load-factors start increasing. Close cooperation between the airline, airport and
government is vital. Airlines will need to revise their current boarding processes. Airports may need
to assist in redesigning gate areas and governments may need to adapt applicable rules and
regulations. The increased use of automation, such as self-scanning and biometrics should be
facilitated.
 Especially during the early stages of the restart phase, carry-on baggage that would need to use the
overhead bins should be limited to facilitate a smooth boarding process.
 Where possible, implementation of self-boarding technologies at the gate should be considered,

including units using automatic doors, integrated boarding pass readers, LCD displays for passenger
instructions and a device for printing seat assignment changes.
 Increase use of all other opportunities of self-scanning of documents when identification is needed.
 As a temporary measure, sitting areas (e.g., lounges, gates, restaurants) can open at limited capacity
to accommodate the short-term need for physical distancing. As the recovery phase progresses and
health requirements evolve, a return to regular capacity can be contemplated.
 Temporary closing or enhanced monitoring of certain service areas should be considered, based on
the stage of mitigation measures, such as:
o Self-service buffet food;
o Café seating or multi-purpose seating;
o Smoking areas; and
o Children’s play areas.
 Multiple alcohol-based hand sanitizer stations should be made available throughout the airport with
adequate signage for passengers.
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 Installation of touch-free equipment in toilet facilities such as the following should be considered:
o Automated door systems;
o Automatic toilet flushing system;
o Taps and soap/hand sanitizer dispensers; and
o Automated hand towel dispensers.
 Work with retail, food and beverage concessions to ensure the use of contactless technology
payment options and self-serve options.
 Involve airline stakeholders in measures needed in airport lounges.
 Collaborate with relevant authorities, airlines and other aviation stakeholders for cost-effective
solutions that protect the public.
where appropriate.
 To help shops, food and beverage outlets, and other in-airport suppliers to demonstrate that they
follow the ICAO / CART guidelines, ACI has developed guidance that can be found at LINK18.
18 https://aci.aero/about-aci/priorities/health/aci-airport-health-accreditation-programme/
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Element
Aircraft Terminal Gate Equipment
Many airports will have decommissioned certain assets in response to a lack of passenger traffic.
Appropriate safety checks need to be conducted prior to the recovery of the airline traffic. Airports and
airlines need to work together to ensure that accurate flight schedules are provided in order to meet this
demand.
Considerations
 Electromechanical equipment such as boarding bridges, escalators and elevators must be inspected
and periodically tested or started up. Inspections of such decommissioned equipment are essential
before returning them to service for passenger use, based on manufacturers’ recommendations and
national building codes.
 Maintenance protocols need to be defined and deployed.
 Where conditioned air is needed, power should be maintained in all outdoor-based equipment such
as jetways and pre-conditioned air units.
 Critical service providers and State authorities must be advised in advance on ramp-up schedules
and plans by the airport operator to return temporarily closed facilities into service.
 Passenger bus capacity should be adapted to facilitate physical distancing during boarding and
disembarking of passengers
Gate aircraft equipment and air filtering
 Where external pre-conditioned air (PCA) and fixed electrical ground power are available at the
stand, an aircraft can switch off its auxiliary power unit (APU) after arrival. A PCA system takes in
ambient air through an intake filter and provides conditioned air to the cabin.
 External air sources are not processed through the aircraft’s high-efficiency particulate air (HEPA)
filter. The aircraft APU should be permitted to be used at the gate to enable the aircraft’s air
conditioning system to be operated if equivalent air quality from PCA is not available.
 Ensure that airport capacity recommissioning is in step with airline schedules and phased in an
appropriate manner.
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Element
Disembarking and Arrivals
Border control and customs processes may need to be temporarily revised to increase physical distancing.
Where equipment already exists, the use of automated border control (ABC) equipment, digital passenger
identification (biometrics) as well as technology (thermal screening) could serve as an additional health
screening measure and could speed up the immigration process, with the objective of reducing queuing and
minimizing contact between border officials and passengers.
Furthermore, some governments are requiring passengers to complete health declarations or health
attestations before departure or on arrival as an initial assessment measure, which could be used to identify
passengers that might need a secondary assessment.
Considerations
 Coordination with various border regulatory authorities (e.g., immigration, health) should be
established for measures facilitating the clearance of entry/arrival, such as enabling contactless
processes (e.g., relating to the reading of passport chips, facial recognition).
 Where declarations are needed on arrival, governments should consider electronic options (e.g.,
mobile applications and QR codes) to minimize human-to-human contact. Information could be sent
in advance via government portals. For customs formalities, where possible, green/red lanes for self-
declarations are recommended.
 The identity verification process should be automated with the use of biometric technology. Use of
contactless technology, automated border control or eGates should be encouraged in order to
enhance transaction time and limit interaction between passengers, officers and staff.
 If needed by relevant regulations, smart thermal cameras can be installed to scan the temperature of
multiple passengers rapidly and unobtrusively.
 During initial stages of recovery and if needed, secondary health assessments could be set to
maintain the main general flow of passengers.
 For flights arriving from higher-risk areas where there are cluster or community transmission, a
particular section of the arrivals terminal could be utilized to increase physical distancing, and/or
smart thermal cameras could be placed at appropriate locations to screen arriving passengers, in
consultation with the public health authorities.
Health Declaration
 Some governments are implementing a health declaration solution that can be set-up on a web portal.
For those States that already have a platform to collect visa and electronic travel authorization
information they could be customized to accommodate the additional information needed.
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Transfer
 Develop health screening arrangements whereby passengers and property are not rescreened at
transfer locations based on mutual recognition of health screening measures between the States in
the travel itinerary.
 Where transfer security screening is needed, it should follow appropriate sanitary requirements as
previously described in the departure process.
 Collaborate with relevant authorities for cost-effective solutions that protect the public.
 Collaborate with relevant authorities and airlines to develop efficient and cost-effective solutions
that protect the travelling public.
 Work with governments and authorities if a health declaration is to be implemented.
 Greater use of standardized digital identity management solutions.
where appropriate.
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Element
Baggage Claim Area
The baggage claim area of an airport is susceptible to high passenger footfall and physical contact with
luggage carts, baggage, washrooms and other facilities. Disinfection measures and increased frequency of
cleaning should be implemented.
Considerations
 All efforts need to be made to provide a speedy baggage claim process and ensure that passengers are
not made to wait for excessive amounts of time in the baggage claim area.
 Maximize use of available arrival baggage carousels to limit the gathering of passengers, and, where
possible, use of dedicated baggage carousels for flights from high risk areas.
 Governments should ensure that the customs clearance process is as speedy as possible and that
appropriate measures are taken in case of physical baggage inspections.
 Cleaning schedules should be aligned based on flight schedules to ensure a more frequent, in-depth
disinfection of luggage carts, washrooms, elevator buttons, rails, etc.
 Self-service kiosks or online options for passengers needing to report lost or damaged luggage should
be made available.
 Floor-markings, tensile barriers, or other suitable means should be established to help secure the proper
distancing recommended by the appropriate authorities.
 Airline agents at lost luggage counters should be provided with physical barriers (transparent) when
possible.
 The use of baggage delivery services, where the passenger’s baggage can be delivered directly to their
hotel or home, should be encouraged.
 Baggage tracking information should be shared with passengers so that they are able to make a baggage
claim, in case of baggage mishandling, without waiting in the reclaim area.
 Protocols for cleaning and disinfection of the area should be established.
 Collaborate with relevant authorities and airlines for cost-effective solutions that protect the travelling
public.
 Use the Airport COVID-19 Cleaning / Disinfection Control Sheet (PHC Form 3) or a similar one where
appropriate.
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Element
Exit the Landside Area
Protocols and precautions need to be in place for arriving passengers who are exiting the landside area.
Consideration should be given to the greeter’s area as well as the terminal’s exit area. During initial restart
phases, measures could include establishing a perimeter around the greeter’s area or limiting access to the
terminal building.
Considerations
Airport terminal access
 According to each airport’s specificities and the national legislation in place, airport terminal access
may be restricted to workers, passengers and persons accompanying passengers with disabilities,
reduced mobility or unaccompanied minors in an initial phase, as long as it does not create crowds
and queues which would then increase risks of transmission as well as create a potential security
vulnerability.
 Multiple hand washing stations or hand sanitizers should be provided prior to the exit of the terminal
building.
 Cleaning should be increased based on flight schedules to ensure a more frequent, in-depth
disinfection of landside public areas, including seating areas, food and beverage and retail,
handrails, washrooms, automated moving systems and buses.
 Collaborate with stakeholders in the community to ensure the timely, accurate dissemination of
information to the travelling public.
where appropriate.
————————
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Module
Aircraft
Target audience
Operators covered under Annex 6 – Operation of Aircraft, Part 1 – International Commercial Air Transport
– Aeroplanes.
Element
Passenger and Crew – General
Provide a safe, sanitary operating environment for passengers and crew.
Considerations
 Adjust the boarding process. To the extent possible, and consistent with weight and balance
considerations, the boarding and disembarking of passengers should be conducted in ways that
reduce the likelihood of passengers passing in close proximity to each other.
 Seat assignment processes. When needed, seats should be assigned for adequate physical distancing
between passengers. Airlines should allow for separated seating arrangements when occupancy
allows it. Passengers should also be encouraged to stay in the assigned seat as much as possible.
 Limit interaction on board. Passengers should be encouraged to travel as lightly as possible with all
luggage checked-in except small hand luggage that fit under the seat. Newspapers and magazines
should be removed. The size and quantity of duty-free sales may also be temporarily limited.
 Limit or suspend food and beverage service. Food and beverage service should be limited or
suspended on short-haul flights or should be considered to be dispensed in sealed, pre-packaged
containers.
 The use of non-essential in-flight supplies, such as blankets and pillows, should be reduced to
minimize the risk of cross infection.
 Restrict lavatory access. When possible, one lavatory should be designated for crew use only,
provided sufficient lavatories remain available for passenger use without fostering congregation by
passengers waiting to use a lavatory. Passengers should be informed that closing the lavatory lid
before flushing is an effective method to mitigate the spreading of potentially infectious particles.
 Also, to the extent practicable depending on the aircraft, passengers should use a designated lavatory
based on seat assignment to limit passenger movement in flight, which reduces exposure to other
passengers.
 Crew protection measures. Sharing of safety equipment used for safety demonstrations should be
prohibited. Crew members should be instructed to provide service only to specific sections of the
cabin. Additional means of protection, for instance plastic curtains or Plexiglas panels during the
boarding process (to be removed once boarding is completed), should be explored.
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Note.- The following elements concerning disinfection contain the latest joint aircraft original equipment
manufacturer (OEM) recommendations currently available. Users of this guidance should note that:
 These recommendations are based on evolving circumstances and technology.
 While every attempt was made to provide common recommendations for disinfectants usage on
aeroplanes, there are differences between the products manufactured by each aircraft OEM. It is
strongly recommended that the operator is familiar with OEM guidance and consults the OEM for
any questions specific to that airframe.
 The intent of these guidelines is to provide operators with recommendations that are aligned with
the aircraft product. It is the responsibility of the operator to ensure that the disinfectants are used
per the manufacturer’s instructions, that proper protection is employed by those using the
disinfectant and that their use is in alignment with health organizations’ recommendations for
efficacy and in accordance with the label instructions of the disinfectant.
Element
Disinfection – Flight Deck
Provide a safe, sanitary operating environment for crew and ground staff.
Considerations
 Frequency of cleaning of the flight deck should account for the separation of the flight deck from the
passenger compartment as well as for the frequency of crew transitions.
 The flight deck should be cleaned and disinfected at an appropriate frequency to accommodate safe
operations for the crew.
 Disinfection methods should be adopted in consultation with the aircraft manufacturer and based on an
appropriate safety risk assessment. Any advice from WHO should also be taken into account. The risk
assessment should be informed by recommendations from airframe manufacturers and reference
instructions from appropriate health organizations on application to be effective against viruses.
 Aircraft manufacturers recommend:

o the use of a 70% aqueous solution of Isopropyl Alcohol (IPA) as a disinfectant for the flight deck
touch surfaces with specific care to be taken for application on leather and other porous surfaces;
o periodic equipment inspection to detect long-term effects or damage given the lack of data on the
long term effects of much more frequent application of disinfectants; and to contacting them for
guidance on alternate disinfectants should damage be observed;
o considering enhanced inspection intervals or maintenance when employing aggressive or new
disinfection techniques.
o following their instructions for ensuring proper application, ventilation and use of personal
protection equipment; and
o consulting them for more detailed recommendations or additional disinfecting chemicals noting
the discrepancy in approvals for disinfection products in different States and in their availability.
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 Surfaces should be cleaned of dirt and debris per instructions from the aircraft.
 Application to surfaces should be with pre-moistened wipes or single use wetted cloth and use limited
bottle sizes on board to minimize the risk of spilling the IPA solution. Do not spray IPA in the flight deck.
Do not allow the liquid to pool or drip into the equipment.
 IPA is flammable, so precautions should be taken around potential sources of ignition.
 The operator should consider whether increased cleaning and disinfection may affect compliance with any
applicable disinsection requirements established in accordance with ICAO Annex 9. Additional
information can be obtained from the appropriate authority and technical guidance is available on the
WHO publication on aircraft disinsection methods and procedures19.
 UV irradiation does not replace normal manual cleaning procedures but could be used to supplement
existing disinfection procedures. Where used, several important factors should be considered, including
that UV disinfection is only effective if the virus is exposed to the UV light. Materials that are exposed to
UV light may be damaged or discoloured. The Airframe OEM should be consulted to ensure that the
device intended for use is compatible with aircraft materials.
 Given the increased likelihood that switch positions may be inadvertently changed during the cleaning or
disinfection process, operators and flight crew should reinforce procedures to verify that all flight deck
switches and controls are in the correct position prior to operation of the airplane.
 Some equipment on the flight deck may have additional disinfectant needs based on usage (e.g., oxygen
masks) and procedures should be put in place accordingly.
.
 OEM communication through ICCAIA and OEM communication with operators.
 Use the Aircraft COVID-19 Disinfection Control Sheet (PHC Form 2) or a similar one when appropriate.
19 https://www.who.int/publications/i/item/cleaning-and-disinfection-of-environmental-surfaces-inthe-context-of-covid-19
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Element
Disinfection – Passenger Cabin
Provide a safe, sanitary operating environment for passengers, crew and ground staff.
Considerations
 The cabin should be cleaned and then disinfected at an appropriate frequency to accommodate safe
operations for the passengers and crew. The frequency should account for the operation of the
aircraft and the potential exposure of the cabin to an infected person.
 Disinfection methods should be adopted in consultation with the aircraft manufacturer and based on
an appropriate safety risk assessment. Any advice from WHO should also be taken into account.
The risk assessment should be informed by recommendations from airframe manufacturers and
reference instructions from appropriate health organizations on application to be effective against
viruses.

o the use of a 70% aqueous solution of Isopropyl Alcohol (IPA) as a disinfectant for cabin high-
touch surfaces with specific care to be taken for application on leather and other porous
surfaces;
o periodic equipment inspection to detect long-term effects or damage given the lack of data on
the long term effects of much more frequent application of disinfectants; and to contacting
them for guidance on alternate disinfectants should damage be observed;
protection equipment;
o consulting them for more detailed recommendations or additional disinfecting chemicals
noting the discrepancy in approvals for disinfection products in different States and in their
availability.
 Surfaces should be cleaned of dirt and debris before disinfecting to maximize effectiveness.
 Application to surfaces should be with pre-moistened wipes or singe use wetted cloth and use
limited bottle sizes on board to minimize the risk of spilling the IPA solution. Do not spray IPA in
the cabin. Do not allow the liquid to pool or drip into equipment (e.g., in-flight entertainment
electronic boxes).
 IPA is flammable, so precautions should be taken around potential sources of ignition.
 The operator should consider whether increased cleaning and disinfection may affect compliance
with any applicable disinsection requirements established in accordance with ICAO Annex 9.
Additional information can be obtained from the appropriate authority and technical guidance is
available on the WHO publication on aircraft disinsection methods and procedures20.
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 UV irradiation does not replace normal manual cleaning procedures, but could be used to
supplement existing disinfection procedures. Where used, several important factors should be
considered, including that UV disinfection is only effective if the virus is exposed to the UV light.
Materials that are exposed to UV light may be damaged or discoloured. The Airframe OEM should
be consulted to ensure that the device intended for use is compatible with aircraft materials.
 Airlines may wish to review their operating procedures to minimize the number of personnel who
need to contact high-touch surfaces such as access panels, door handles, switches, etc. For more
detailed recommendations or additional disinfecting chemicals, reach out to the specific airframe
manufacturer.
 OEM communication through ICCAIA and OEM communication with airlines.
 Use the Aircraft COVID-19 Disinfection Control Sheet (PHC Form 2) or a similar one when
appropriate.
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Element
Disinfection – Cargo compartment
Provide a safe, sanitary operating environment for crew and ground staff.
Considerations
 The cargo compartment touch surfaces should be cleaned and disinfected at an appropriate
frequency to accommodate safe operations for the ground staff.
 Disinfection methods should be adopted in consultation with the aircraft manufacturer and based on
an appropriate safety risk assessment. Any advice from WHO should also be taken into account.
The risk assessment should be informed by recommendations from airframe manufacturers and
reference instructions from appropriate health organizations on application to be effective against
viruses.

o the use of a 70% aqueous solution of Isopropyl Alcohol (IPA) as a disinfectant for the cargo
compartment high-touch surfaces with specific care to be taken for application on leather and
other porous surfaces;
o periodic equipment inspection to detect long-term effects or damage given the lack of data on
the long term effects of much more frequent application of disinfectants; and to contacting
them for guidance on alternate disinfectants should damage be observed;
protection equipment;
o consulting them for more detailed recommendations or additional disinfecting chemicals
noting the discrepancy in approvals for disinfection products in different States and in their
availability.
 Surfaces should be cleaned of dirt and debris before disinfecting to maximize effectiveness.
 Application to surfaces should be with pre-moistened wipes or single use wetted cloth and use
limited bottle sizes on board to minimize the risk of spilling the IPA solution. Do not spray IPA in
the Cargo Compartment. Do not allow the liquid to contact critical equipment (e.g., smoke detector,
electronic door operation equipment and fire extinguishing discharge nozzle).
 IPA is flammable, so precautions should be taken around potential sources of ignition. Pay particular
attention to hidden ignition sources as many aircraft have electronic boxes mounted in the cargo
compartment.
 The operator should consider whether increased cleaning and disinfection may affect compliance
with any applicable disinsection requirements established in accordance with ICAO Annex 9.
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Additional information can be obtained from the appropriate authority and technical guidance is
available on the WHO publication on aircraft disinsection methods and procedures21.
 UV irradiation does not replace normal manual cleaning procedures but could be used to supplement
existing disinfection procedures. Where used, several important factors should be considered,
including that UV disinfection is only effective if the virus is exposed to the UV light. Materials
that are exposed to UV light may be damaged or discoloured. The Airframe OEM should be
consulted to ensure that the device intended for use is compatible with aircraft materials.
need to contact high-touch surfaces such as access panels, door handles, switches, etc.
appropriate.
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Element
Disinfection – Maintenance
Provide a safe, sanitary operating environment for passengers, crew and ground staff.
Considerations
 Airlines should be mindful of regular maintenance to both air systems and water systems to ensure
they continue to protect the passenger and crew from viruses. Airlines should refer to the Airframe
OEM for specific maintenance actions and intervals.
 Airlines should include access panels and other maintenance areas in their disinfection procedures
to ensure a safe environment for the maintenance crews.
need to be in contact with high-touch surfaces such as access panels, door handles, switches, etc.
 Airlines should establish maintenance procedures to be applied after disinfection procedures in

order to check the Flight Deck, Passenger Cabin and Cargo Compartment for the correct positioning
of control handle, circuit breakers and control panels’ switches and knobs. Access panels and doors’
closure also should be checked.
appropriate.
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Element
Hazardous Waste
Hazardous Waste Management
Considerations
 Normal waste: Cabin wastes generated during flight operations where no passenger or crew member
exhibits COVID-19 symptoms should be handled as normal waste, as recommended by WHO, and
disposed of in line with the procedures for such waste applicable in the State of destination.
Note.- This includes non-medical and medical masks. Only non-medical and medical masks that
have been used by a person suspected by the cabin crew of having COVID-19 or visibly soaked
with blood or body fluids should be treated as biohazardous waste.
 Biohazardous waste: If a passenger or crew member exhibits COVID-19 symptoms, all waste
materials including partly-consumed meals, beverages and disposable items as well as used paper
towels, tissues and PPE (including non-medical and medical masks), generated whilst treating or
supporting the passenger or crew member should be treated as biohazardous waste.
 Biohazardous waste should be placed in the biohazard waste disposal bag in the aircraft’s UPK or
double bagged in standard plastic waste bag. In accordance with WHO and other relevant guidelines
the spraying or sprinkling of disinfectant into the contents of the biohazardous waste bags is not
necessary to reduce the spread of COVID-19. The action of spraying chemical disinfectant may
result in virus particles of becoming airborne, presenting an additional risk to passengers and crew.
The bags should be labelled and sealed. The airport authority and aircraft service providers must be
informed of the presence of biohazardous waste.
 States should consider relieving the ban on single use plastics to permit their use by airports and
civil aviation authorities for medical, hygiene and safety purposes during the pandemic.
 Airlines should prepare a written plan to share with stakeholders regarding their COVID-19 waste
management procedures and communicate the information accordingly. Crew should be trained in
the handling of biohazardous waste.
 Airports and/or the relevant waste handling stakeholders should identify potential options for the
treatment and disposal of biohazardous cabin waste resulting from the pandemic and communicate
the information accordingly. The relevant personnel should be trained in the handling of
biohazardous waste.

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Element
Air System Operations
The aircraft manufacturers recommend maximizing total cabin airflow and care should be taken to avoid
blocking air vents (particularly along the floor). These are general recommendations for cabin air
considerations and there may be exceptions for specific aircraft models. It is strongly recommended that
operators consult with the aircraft OEM for questions specific to an aircraft type.
Considerations
Ground Operations (before chocks-off and after chocks-on)
 Operations without the air conditioning packs or external pre-conditioned air (PCA) source should
be avoided. External air sources are not processed through a high-efficiency particulate air (HEPA)
filter. Use of the aircraft APU should be permitted at the gate to enable the aircraft’s air conditioning
system to be operated, if equivalent filtration from PCA is not available.
 If the aircraft has an air recirculation system, but does not have HEPA filters installed, reference
should be made to OEM published documents or the OEM should be contacted to determine the
recirculation system setting.
 It is recommended that fresh air and recirculation systems be operated to exchange the volume of
cabin air before boarding considering the following:
o For aircraft with air conditioning, run the air conditioning packs (with bleed air provided
by APU or engines) or supply air via external PCA source at least 10 minutes prior to the
boarding process, throughout boarding and during disembarkation.
o For aircraft with HEPA filters, run the recirculation system to maximize flow through the
filters.
o For aircraft without an air conditioning system, keep aircraft doors open during turnaround
time to facilitate cabin air exchange (passengers’ door, service door and cargo door).
Flight Operations
 Operate environmental control systems with all Packs in AUTO and recirculation fans on.
o Valid only if HEPA recirculation air filters are confirmed to be installed.
 If non-HEPA filters are installed, contact the aircraft OEM for recommendations on recirculation
settings.
 If the aircraft in-flight operating procedure calls for packs to be off for take-off, the packs should be
switched back on as soon as thrust performance allows.
Minimum Equipment List (MEL) Dispatch:
 Fully operational air conditioning packs and recirculation fans provide the best overall cabin
ventilation performance. It is recommended to minimize dispatch with packs inoperative. It is
recommended to minimize dispatch with recirculation fans inoperative for aircraft equipped with
HEPA filter.
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 Some aircraft have better airflow performance with all outflow valves operational. The OEM should
be contacted about ventilation performance of the aircraft with outflow valves inoperative and the
limitations associated with the dispatch in this situation.
High Flow (max Bleed) Switch:
 If the aircraft has an option for high flow operation, contact the OEM for setting recommendations.
For example:
Boeing recommends that airlines select High Flow Mode for 747-8, MD-80 and MD-90 aircraft, as
this will maximize total ventilation rate in the cabin.
Note 1.- This will increase fuel burn. However, for the 747-400 and 737, High Flow Mode should
NOT be selected as this does not result in an increase in total ventilation rate. For all models,
recirculation fans should remain on (when HEPA filters are installed).
Note 2.- Sick passenger positioning guidance is contained in Cabin Crew element of the Crew
module.
Filter Maintenance:
 Follow normal maintenance procedures as specified by the OEM. Take note of special protection
and handling of filters when changing them.
 Contact OEM or refer to OEM published document to check if an additional sanitization procedure
and/or personnel health protection is needed to avoid microbiological contamination in the filter
replacement area.
 OEM communication through International Coordinating Council of Aerospace Industries

Associations (ICCAIA) and OEM communication with airlines.
appropriate.
————————
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Module
Crew
Target audience
All operations covered under Annex 6 – Operation of Aircraft, Part 1 – International Commercial Air Transport
- Aeroplanes, Civil Aviation Authorities and public health agencies.
Element
Crew Members
Provide harmonised health protection and sanitation considerations applicable to crew members that can be
implemented globally.
Considerations
General
 Unless specified as flight crew or cabin crew, the term “crew” refers to all crew required on board for
the air operator to support the flight, including those that maybe required to position before or after a
duty. This element applies to all crew.
Facilitation
 Crew members operating passenger aircraft with cargo only, for example, should ensure that the correct
notification has been sent to all agencies, to ensure that there is no confusion, or that crew members
carried on board such as loadmasters, engineers, and cabin crew are correctly recognised and designated
on the crew manifest.
 Flight crew travel, including travel between States for training and medical certification purposes, is
essential in re-establishing operations as alleviations to medical certification, training and checking
requirements expire. Noting that many States do not have direct access to training facilities such as flight
simulation training devices, it is essential to consider flight crew as ‘essential workers’ to benefit from
PHC initiatives when accessing such facilities or being required to undergo medical examinations in
other States. Further details can be found in ICAO State letter AN 5/28 -20/97.
 States should require the airlines on their register to establish a coherent, effective and verifiable health
assurance programme for their staff that would enable the implementation of measures that facilitate the
continued operation of aircraft, such that:
o Quarantine measures are not imposed on crew who need to layover, or rest, for the purposes of
complying with flight time limitation (FTL) rest requirements.
o Crews are not subject to screening or restrictions applicable to other travellers.
o Health screening methods for crew members are as non-invasive as possible.
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Health monitoring
 Crew members should:
 participate in their national vaccination programmes recognising that vaccination offers personal
protection from infection and can assist in recovery of global connectivity;
 monitor themselves for fever or chills, cough, shortness of breath or difficulty breathing, loss of
taste, or other symptoms of COVID-19 according to WHO guidance. The WHO cut off point for
fever is 380C or higher;
 take their temperature at least twice per day during duty periods and at any time they feel unwell;
and
 stay at home or in their hotel room, notify their employers’ occupational health programme, and not
report for work if they develop a fever, shortness of breath, or other symptoms of COVID-19. They
should not return to work until cleared to do so by the employers’ occupational health programme
and public health officials.
Examples of crew exposure concerns, include the following:
 Are within a mandated period of quarantine related to previous travel and/or duty.
 A passenger testing positive for Covid-19 regardless of symptoms.
 Know that they have been exposed to a person showing symptoms of COVID-19.
 Are experiencing any symptoms of COVID-19.
 Have recovered from COVID-19 symptoms but have not been assessed by the employers’ occupational
health program and public health authority.
During Flight:
 If a crew member develops symptoms during flight, the crew member should stop working as soon as
practical, put on a medical mask, notify the pilot in charge, and maintain the recommended physical
distance from others, when possible to do so. Upon landing, individuals should follow up with airline
medical and public health officials.
 Guidelines for managing a passenger developing symptoms during flight are set out in the Cabin Crew
module.
Health protection
 To protect the health of crew and others, including co-workers, crew members should:
o Maintain recommended physical distance from others where possible, when working on the aircraft
e.g., while seated on the jump seat(s) during take-off or landing, during ground transportation and
while in public places.
o Wash their hands regularly. If hands are not visibly dirty, the preferred method is using an alcohol-
based hand rub for 20−30 seconds using the appropriate technique. When hands are visibly dirty,
they should be washed with soap and water for 40−60 seconds using the appropriate technique.
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o Be reminded to, along with frequent hand washing/sanitization, avoid touching their face including
while wearing disposable gloves.
o Wear a non-medical or medical mask while around other people, especially in situations where the
recommended physical distance from others cannot be maintained.
o Non-medical, medical masks and disposable gloves should not impact the ability to carry out
normal, abnormal and emergency safety procedures, such as the donning of oxygen masks, carrying
out firefighting procedures etc.
Note - A non-medical mask should not replace the use of medical masks or other PPE provided in
the universal precaution kit (UPK) when interacting with a sick traveller on board an aircraft.
o Inspect the integrity of the UPKs before each flight. Sealed kits need not be opened as it can be
assumed that the contents will be as labelled. Crew members should follow existing air carrier policy
and procedures regarding the use of PPE in the UPKs if needed to provide care to a sick passenger
on board.
o Follow the guidance and precautions of the State and relevant health authorities related to
COVID-19.
o Participate in their national vaccination programmes recognising that vaccination offers personal
protection from infection and can assist in recovery of global connectivity
Additionally, airlines should:
 Provide sufficient quantities of cleaning and disinfectant products (e.g. disinfectant wipes) that are
effective against COVID-19 for use during flight.
 Consider providing non-medical or medical masks to crew members for routine use when on duty, if
these do not interfere with PPE, while carrying out job tasks and when it is difficult to maintain the
recommended physical distance from co-workers or passengers.

Use of lavatories
 Ideally, one or more lavatories should be reserved for crew use, in order to limit the potential for
infection from passengers.
Crew rest compartments
 To minimize any possibility of cross infection, pillows, cushions, sheets, blankets or duvets, where
provided, should not be used by multiple persons unless coverings are disinfected.
 Some airlines issue each crew member with their own provisions and the cabin crew members are
responsible for ensuring that they are removed and bagged after use.
 Other airlines provide bulk loading for crew rest area bedding items. Where this is the case, crew
members should install their own bedding items before their rest period and remove them hygienically
afterwards.
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Training devices
 The same health protection and monitoring measures that apply to flight crew operating aircraft should
be applied to the use of flight simulators and other training devices.
 The frequency of routine cleaning of flight simulators and training devices and other training aids, or
equipment used during training (including oxygen masks) should be reviewed regularly against the risks
and adjusted accordingly’. Cleaning products used should be COVID-19 disinfectants that are compatible
with the materials being cleaned.
 Ensure that these considerations are fully supported by:

o The applicable non-governmental agencies
o Public health, immigration and customs agencies
o Civil aviation authorities.
 A high degree of collaboration between airport operators and their associated stakeholder community.
 Associated policy, procedures and training are developed to reinforce the importance of these
considerations.
 Use the Crew COVID-19 Status Card (PHC Form 1) or a similar one when appropriate.
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Element
Flight Crew
Provide harmonised health protection and sanitation considerations applicable to Flight Crew which can be
Considerations
 Access to the flight deck should be limited to the greatest extent possible.
 Flight crew members should only leave the flight deck for short physiological breaks and scheduled rest.
 In the case of flight crew at controls displaying symptoms, flight crew should don medical masks and
the operator should consider whether removal from the flight deck is an appropriate mitigation within
their risk assessment and refer to established procedures to identify whether a diversion is needed.
 Non-medical or medical masks, as defined by the airline, should be worn by flight crew and by others
who enter the cockpit. The airline or operating Flight Crew will complete an appropriate risk assessment
before determining if masks will be removed after the flight deck door has been closed. Masks should
be used whenever they leave the flight deck.
 Airlines should ensure that non-medical or medical masks worn by crew, can be removed rapidly so that
oxygen masks can be placed unhindered on the face, properly secured, sealed, and supplying oxygen on
demand and that crew are provided with the correct guidance on how to do so. When leaving the flight
deck, all items should be stowed, personal items removed, and flight deck made ready for cleaning and
disinfection.
 Prior to each cockpit crew change, the flight deck should have been fully cleaned and disinfected.
 In-person interactions with the cabin crew should be reduced to a minimum.
 If possible, only one person should be designated to be able to enter cockpit when necessary.
 Only one member of the flight crew or technical crew should be allowed to disembark the aircraft to
complete the external inspection, refuelling, etc. In such case direct contact with the ground crew should
be avoided.

o The applicable non-governmental agencies.
o Public health, immigration and customs agencies.
o Civil Aviation Authorities.
considerations.
AR05132
A-38
Element
Cabin Crew
Provide harmonised health protection and sanitation considerations applicable to Cabin Crew which can be
Considerations
 Cabin crew who are in contact with a passenger or a colleague suspected of being infected should not
visit the flight deck unless it is unavoidable.
 Crew members should continue to assist passengers who become ill in-flight.
 In the case of someone suspected of having COVID-19, a crew member is to be designated to care for
the passenger. That crew member must don the PPE provided in the UPK before engaging in close
contact with the ill passenger. The ill passenger should be fitted with a medical mask and provided
with appropriate assistance. Separate the ill person from the other passengers by a minimum of 1
metre. Where possible, this should be done by moving other passengers away. Depending on cabin
design, 1 metre is usually two seats left empty in all directions. If possible, assign one toilet for use
only by the ill passenger. The designated crew member(s) should comply with decontamination
procedures established by the operator before resuming other duties.
 A passenger who develops symptoms in-flight should be assessed by the local public health authorities
after landing and prior to disembarking the aircraft following national protocols.
 While limiting the number and frequency of physical flight crew checks, an alternative method of
checking on flight crew welfare such as regular interphone calls should be implemented.
 The use of PPE should not impact the ability to carry out normal, abnormal and emergency safety
procedures, such as the donning of oxygen masks, carrying out firefighting procedures etc.
 Safety demonstration equipment should not be shared to the extent feasible to reduce the likelihood of
virus transmission. If it must be shared, alternate means of demonstration without the equipment
should be considered or the equipment should be thoroughly sanitized between use.
 Safety demonstrations should highlight to passengers that non-medical and medical masks should be
removed before donning emergency oxygen masks, should they be needed. Note that this could be
achieved by an additional announcement after screening of the safety video.

o The applicable non-governmental agencies.
o Public health, immigration and customs agencies.
AR05133
A-39
considerations.
AR05134
A-40
Element
Layover
Ensure that all crew that need to layover or transit at an outstation are aware of the measures necessary to
reduce the risk of transmission of COVID-19.
Reference should be made to the ICAO Electronic Bulletin EB 2020/30 or as amended for the most up-to-date
guidance.
Considerations
Layover/ transits
Crew members who are involved in flights with a layover, should not be medically quarantined or detained for
observations while on layover or after returning, unless they were exposed to a known symptomatic passenger
or crew member on board or during the layover.
If crews need to layover or transit at an outstation, air operators should ensure compliance with relevant public
health regulations and policies together with measures identified by a risk assessment conducted by the
operator that takes account of specific local conditions.
In the absence of a risk assessment, air operators should implement the following:
 Commute arrangements (between airport and hotel, if needed): The air operator should arrange for the
commute between the aircraft and the crew’s individual hotel rooms ensuring hygiene measures are
applied and the recommended physical distancing, including within the vehicle, to the extent possible.
 At accommodation:
a) At all times, the crew must comply with relevant public health regulations and policies.
b) There should be one crew member per room, which is sanitized prior to occupancy.
c) The crew, taking account the above, and insofar as is practicable, should;
i. Avoid contact with the public and fellow crew members, and remain in the hotel room except
to seek medical attention, or for essential activities including exercise, while respecting
physical distancing;
ii. Not use the common facilities in the hotel;
iii. Dine in-room, get take-out or dine seated alone in a restaurant within the hotel, only if room
service is not available;
iv. Regularly monitor for symptoms including fever; and
v. Observe good hand hygiene, respiratory hygiene and physical distancing measures when
needed to leave the hotel room only for the reasons specified in (i), (iii) or in emergency
situations.
 Crew members experiencing symptoms suggestive of COVID-19 during layover or transit should:
a) Report it to the aircraft operator and seek assistance from a medical doctor for assessment of
possible COVID-19.
b) Cooperate with the assessment and possible further monitoring for COVID-19 in accordance with
the evaluation procedure implemented by the State (e.g. assessment in the hotel room, or an
isolation room within the hotel, or alternative location).
AR05135
A-41
 If a crew member has been evaluated and COVID-19 is not suspected in accordance with the above
procedures implemented by the State, the air operator may arrange for the crew member to repatriate
to base.
 If a crew member is suspected or confirmed as a COVID-19 case by the State and isolation is not
needed by the State, such crew member could be medically repatriated by appropriate modes of
transport; if there is agreement to repatriate the crew member to home base.

o The applicable non-governmental agencies
o Public health, immigration and customs agencies
considerations.
————————
AR05136
A-42
Module
Cargo
Target audience:
Airline, freight forwarder, trucker, ground handler (cargo terminal operator).
Element
Road Feeder to Freight Reception & freight pick up
Protect cargo handling staff and truckers during the handover points for physical freight (in warehouse) and
documentation (often office).
Considerations
 Onsite biosafety principles:

o Proximity for document handover should be minimized, floor markings should be indicated
and / or appropriate PPE should be worn.
o Wherever possible, hand washing stations or alcohol-based hand sanitizer should be placed
on entry.
o Surfaces (e.g. handles, kiosks) should be regularly cleaned and disinfected
o Alcohol-based hand sanitizer should be made available for users of kiosks, etc.
o Area(s) for donning and doffing of appropriate PPE as needed should be identified.
 Physical handover of goods (truck offload):
o Drivers should stay in vehicle cabin until instructed (as per relevant procedures).
o Physical distance should be kept between driver and facility staff where possible.
o Close contact of personnel should be limited, appropriate PPE should be worn where
appropriate.
 Documentation handover (office):
o Digital document systems and data exchange should be implemented wherever possible.
o Physical distancing of at least 1 metre should be kept between all parties where possible,
floor markings indicated or the appropriate PPE worn.
o Where physical documents need to be signed, each signatory should do so with their own
pen.
o Physical barriers (transparent) should be installed at counters and reception.
o Alcohol-based hand sanitizer should be made available when entering or exiting common
areas.
 Material handling equipment (MHE) usage (e.g., forklifts, hand carts):
o To avoid cross contamination, MHE should be cleaned and disinfected after use.
o Employees should be educated and should practice personal hygiene principles.
o Appropriate PPE should be worn where necessary.
 Wall posters, and handouts, downloadable from carrier and GHA web sites. See Posters in Staff
Rest Areas for samples.
AR05137
A-43
Element
Within Cargo facility (Origin / Destination / Transit)
Protect Cargo facility (warehouse) staff during business operations such as build-up, breakdown,
repositioning and documentation handling.
Considerations
 Onsite biosafety principles:

o Physical distance should be kept at all times when operational safety is not compromised.
o Close proximity for handover minimized (e.g. drop zones) or appropriate PPE should be
worn.
o Ground personnel rotations should take into account the need to avoid cross-infection.
o Alcohol-based hand sanitizer should be placed on entry into common areas.
o Regular cleaning and disinfection of surfaces (e.g. handles, mobile devices, kiosks) should
be established.
o Sanitizer should be made available for users of kiosks, shared mobile devices, and other
shared devices.
 Physical handling goods:

o Physical distance should be kept when operational safety is not compromised;
- When not possible (e.g. 2 person lift needed for heavy cargo) appropriate PPE should
be worn.
 Material handling equipment (MHE) / ground support equipment (GSE) usage:

o To avoid cross contamination MHE and GSE should be cleaned and disinfected between
uses.
o All employees should be educated and should practice personal hygiene principles.
 Posters displayed through cargo facility and staff rest areas.

AR05138
A-44
Element
Cargo facility to ramp (Origin / Transit / Destination)
Protect staff during the Cargo facility handover to/from ramp crews in preparation for aircraft loading and
unloading.
Considerations
 Onsite biosafety principles

o Physical distance should be kept at all times when operational safety is not compromised or
appropriate PPE should be worn.
o Regular cleaning and disinfection of surfaces (e.g. handles, kiosks) should be established.
o Alcohol-based hand sanitizer should be made available for users of kiosks, shared mobile
devices, etc.
o Close proximity for handover should be minimized (e.g. drop zones) or appropriate PPE
should be worn.
o Ground personnel rotations should take into account the need to avoid cross team infection.
 Physical handover of goods

o Physical distance should be maintained, and cargo drop zones used where possible.
o Close contact of personnel should be limited, and appropriate PPE should be worn where
necessary.
 Ground support equipment (GSE) usage

o To avoid cross contamination, GSE should be cleaned and disinfected between users.
 Posters displayed in staff rest areas.

AR05139
A-45
Element
Aircraft Loading / Unloading
Protect ramp handling staff during the loading and unloading of the aircraft, which is usually performed by
multiple crews of 3 to 4 persons depending on the operation.
Ensure enhanced public health safety when the number of close contact personnel rises during manual
loading of the passenger cabin.
Considerations
 Onsite biosafety principles

o Physical distance should be kept at all times when operational safety is not compromised or
appropriate PPE should be worn.
o Alcohol-based hand sanitizer should be placed on entry into common areas.
o Regular cleaning and disinfection of surfaces (e.g. handles, mobile devices, kiosks) should
be established.
o Alcohol-based hand sanitizer should be made available for users of kiosks, shared mobile
devices, etc.
o Close proximity of staff for loading should be minimized or appropriate PPE should be used
particularly for passenger cabin loading.
o Ground personnel rotations should take into account the need to avoid cross team infection.
 Physical Loading of goods

o Physical distance should be kept when operational safety is not compromised (encourage
single person operations).
o Close contact of personnel should be limited, and appropriate PPE should be worn where
necessary.
o For “human chain” loading, appropriate PPE should be used (non-medical or medical masks
and disposable gloves) and hygiene principles should be applied between operations.
 Material handling equipment (MHE) / ground support equipment (GSE) usage

o To avoid cross contamination, MHE/GSE should be cleaned and disinfected between users.
 Posters in staff rest areas.
where appropriate.
————————
AR05140
A-46
3. FORMS AND POSTERS

AR05141
A-47
CREW COVID-19 STATUS CARD

Purpose of this card:
Information to be recorded by crew prior to departure to confirm their COVID-19 health status and to
facilitate processing by State’s Public Health Authorities.
Notwithstanding completion of this card, a crew member might still be subjected to additional screening
by Public Health Authorities as part of a multilayer prevention approach e.g. when recorded temperature
is 38 C° (100.4 F°) or greater.
1. During the past 14 days, have you had close contact (face-to-face contact within 1 metre and
for more than 15 minutes or direct physical contact) with someone who was suspected of
having COVID-19 or had been diagnosed with COVID-19?”
Yes No
2. Have you had any of the following symptoms during the past 14 days:
Fever Yes No
Coughing Yes No
Breathing difficulties Yes No
Sudden loss of sense of taste or smell Yes No
3. Temperature at duty start:

Temperature not recorded due to individual not feeling/ appearing feverish
Temperature in degrees C° / F° : _______

Date: ______ Time: _______
Recording method : Forehead Ear Other ____________
4. Have you had a positive COVID-19 test during the past 3 days?
Yes No
Attach report if available
5. Have you received a COVID-19 vaccine? Yes No
Date of most recent vaccination:

Are you fully vaccinated22? Yes No
Crew member Identification:
Name:
Airline/ aircraft operator:
Nationality and Passport No:
Signature:
Date:
Public health corridor (PHC) Form 1
22
For the purposes of this document and CART guidance, an individual is defined as fully vaccinated 14 days or more after receiving all
recommended primary doses of a COVID-19 vaccine that is listed for emergency use by the World Health Organization or approved by other
stringent regulatory authorities (SRA).
AR05142
A-48
AIRCRAFT COVID-19 DISINFECTION CONTROL SHEET

Aircraft Registration: __________
Aircraft disinfection was made in accordance with the recommendation of the World Health Organization, at a frequency determined by the
National Public Health Authority and in accordance with approved products and application instructions of the aircraft manufacturer.
Date Time Airport Remarks Disinfector name

(dd/mm/yy) (24hr - (ICAO code)
Coordinated
Universal
Time
(UTC))
Aircraft areas treated Disinfectant Comments Disinfector signature

material
Flight deck □
Passenger cabin □
Cargo compartment(s) □
Other: _________________
_______________________

(dd/mm/yy) (24hr -UTC) (ICAO code)

material
Flight deck □
Passenger cabin □
Other: _________________
_______________________

(dd/mm/yy) (24hr -UTC) (ICAO code)

material
Flight deck □
Passenger cabin □
Other: _________________
_______________________
AR05143
A-49
XYZ- AIRPORT COVID-19 CLEANING / DISINFECTION CONTROL SHEET

Airport Area: __________
This airport area disinfection was made in accordance with the recommendation of the World Health Organization, at a frequency determined by the National Public Health
Authority and in accordance with approved products and application instructions.
Date Time Areas Cleaning/Disinfectant product Disinfector name

(dd/mm/yy) (24hr) and signature
Floor □
Seats □
Counter □
Screening equipment □
Conveyor belts □
Passenger mobility aids □
Hand railings □
Elevators □
Baggage Trolleys □
Washrooms □ Remarks
Information Desk □
Boarding Area □
(includes aerobridges and
airside buses)
Stanchions / queues □
Self-service kiosks □
Sanitization stations □
Other □
Date Time Areas Cleaning/Disinfectant product Disinfector name

(dd/mm/yy) (24hr) and signature
Floor □
Seats □
Counter □
Screening equipment □
Conveyor belts □
Passenger mobility aids □
Hand railings □
Elevators □
Baggage Trolleys □
Washrooms □ Remarks
Information Desk □
Boarding Area □
(includes aerobridges and
airside buses)
Stanchions / queues □
Self-service kiosks □
Sanitization stations □
Other □

AR05144
A-50
PUBLIC HEALTH COVID-19 PASSENGER SELF DECLARATION

FORM
Proper a! a health declaration to include on the never?? of the existing PLF.
PUBLIC HEALTH COVID- 19 PASSENGER SELF DECLARATION FORM
Purpose of this form:
This form is intended to support public health authorities by allowing arriving passengers to easily
provide relevant information pertaining to their health status, particularly with regard to COVID 19.
Information needs to be recorded by an adult member of the group or travel group.
-
Notwithstanding completion of this form, a passenger might still be subjected to additional health
-
screening by the Public Health Authority as part of a multi layer prevention approach.
Your information is intended to be held in accordance with applicable national laws and used only for
public health purposes.
1 ) Traveller Information :
First Nume( s):
Last Namefs): I I I I I I I I I I I I I I I
Dale of Birth (dd/mrtu' yyyy j: I
Travel document No. &
] I I I I I I I I I I I I I
issuing country :
Country of residence:
Port of Origin:
2) During the past 14 days, have you , ora member of your group travelling with you, had
close contact ( face - to-face contact for more than 15 minutes or direct physical contact )
with someone who had symptoms suggestive of COVID- 19? Yes KoP
3) Have you, or any member of your group travelling with yon, had any of the following
symptoms during the past 14 days:
Fever Yes NoD Shortness of breath Yes NoD
Coughing Yes No Sudden loss of sense of taste or smell Yes NoD
4) Have you, or any member of your group travelling with you, had a positive COVID- 19
test in the last 3 days ? Yes No
Please attach report if available
5) Please indicate all countries and cities that you and the group travelling with you have
visited or transited through in the last 14 days ( including airports and ports ), providing
the dates of the visit . List the most recent country first
For more information on penalties related to the provision of false information on this form,
please refer to the applicable national legislation and/or local health authorities.
Signature :
Date:

AR05145
A-51
Recommended dataset on reporting COVID-19 testing results (PHC Form 5)
The minimum information to be recorded on the certificate includes:
(1) Personal Information of Test Subject:

a) Full Name (Surname, Given Name)
b) Date of Birth (YYYYMMDD)
c) ID Document23 Type (mandatory)
d) ID Document22 Number (mandatory)
(2) Service Provider:

a) Name of testing facility or service provider (mandatory)
b) Country of test (mandatory)
c) Contact details (mandatory)
(3) Date and Time of Test and Report:

a) Date and time of specimen collection (mandatory)
b) Date and time of report issuance (mandatory)
(4) Test Result:

a) Type of test conducted: molecular (PCR); molecular (other); antigen; antibody (mandatory)
b) Result of Test (normal/abnormal or positive/negative) (mandatory)
c) Sampling method (nasopharyngeal, oropharyngeal, saliva, blood, other (optional))
(5) Optional Data Field: Issued at the discretion of the issuing authority
23 Refers to any type of documentation, it does not need be a travel-specific document.

AR05146
A-52
Recommended dataset on reporting COVID-19 recovery (PHC Form 6)
The minimum information to be recorded on the certificate includes:
(1) Personal information of test subject:

a) full name (surname, given name);
b) date of birth (YYYYMMDD);
c) ID document type (mandatory); and
d) ID document number (mandatory);
(2) Test result:

a) member State of test; and
b) date of first positive test result (mandatory);
(3) Healthcare Provider/ Certificate issuer

AR05147
A-53
Recommended dataset on reporting COVID-19 vaccination (PHC Form 7)
The information to be recorded on the vaccination certificate includes:

(1) Unique certificate identifier (required)
(2) Certificate valid from (optional)
(3) Certificate valid to (optional)
(4) Personal identification
(5) Name (required)
a) Unique identifier (recommended)
b) Additional identifier (optional)
c) Sex (recommended)
d) Date of birth (conditional with unique identifier)
(6) Vaccination Event
a) Vaccine or prophylaxis (required)
b) Vaccine Brand (required)
c) Vaccine manufacturer (conditional with Marketing Authorization holder)
d) Marketing authorization holder (conditional)
e) Disease or agent targeted (recommended)
f) Date of vaccination (required)
g) Dose number (required)
h) Country of vaccination (required)
i) Administering centre (required)
j) Vaccine batch number (required)
k) Due date of next dose (optional)
Note:
“REQUIRED” means that the definition is an absolute requirement of the specification.
“RECOMMENDED” means that there may exist valid reasons in particular circumstances to ignore a particular item, but the full implications must be
understood and carefully weighed before choosing a different course.
“OPTIONAL” means that an item is truly optional. One user may choose to include the item because a particular application requires it or because the
user feels that it enhances the application while another user may omit the same item.
“CONDITIONAL” means the usage of an item is dependent on the usage of other items. It is therefore further qualified under which conditions the item
is “REQUIRED” or “RECOMMENDED”.
Example with regards to conditional: the field of Vaccine Marketing Authorization Holder is conditional, however if the market
authorization holder is unknown, vaccine manufacturer is “REQUIRED”.
AR05148
A-54
Examples of POSTERS IN STAFF REST AREAS
Instruction for Staff during COVID-19
4
Regularly wash
your hands Disinfect.
‘Ahan handwashing Is
LI Fie I:IL d scan a "in
.
nc: ncrsir k disinfect
enter towash vtL "
hands for at lease 20
your (wish! ntm T .
SA cords wav hr
acahd ' biiEMc! hard rub
*
HVIL art or Ttic h J I.: re
Avoid shaking Respect physical

hands dlntandng
Vantain a sc fa alsmnso
-
.
Rananaar That the
1rom ornnrs fry k low q
vt~LS Fore DCs through
- -
ffcicr nvirl'q:' or st= p&
1 -
cooqhlnq ard sneoz ng
via alrbomo d'oriknk , re caters Q tvor ID s toy
as 'Mail nsdirough trU'o- vehcleurUI
rstructoc and telow
a
Clroct contact
local pmaftdLrtB .
Uuintain the din-tan co

Clean regularly
Autrid iirttslifl mdnwl
Dhlnhict :il Iragdartty
rooms rrtn ofr- cr people
touchac sunFries and al
grasnnt er woar
Ihc nqLbrnnnt bat-aeon
IIUS. appropdaui pnrsanal
arocncItM! nrqulpnrinnt.
Fallow any
Uae your own pen conpu ny, local or
Ere jne- youconftouch
nationat guidance
ethers' pens whan and rc- pul utianu,
signing especially bf you
eoeurverifcaitDri how potential
aymptOma,
OA Cl
BE RESPONSIBLE. «W
STAY SAFE. I ATA AIRPORTS COUNCIL
INTERNATIONAL
AR05149
A-55
RECOMMENDED MASKS
Efficiency at filtering Efficiency at filtering
COVERING/ MASK Use in Aviation
Large Droplets Aerosols
Not routinely
recommended, unless
Medical respirators
99.9% 95% required by national
e.g. N95, N 99, FFP2
health authorities. For use
or FFP3 masks in healthcare and other
occupational settings
Medical/ surgical 98.5% 89.5% Recommended

masks
Recommended 3 layers
Non- medical /fabric 99.5% 82% in accordance with
masks
WHO specifications
NOT RECOMMENDED MASKS
Tea Towel 98% 72.5% Not Recommended

or Dishcloth
100% Cotton T- shirt 97% 51% Not Recommended
Silk or Lace 56% 54% Not Recommended
f Scarf or Bandana 44% 49% Not Recommended
P
Masks with Built - in Not allowed due to risk of
90% 90%
Valve or Vent transmitting the virus
Based on Source: Democritus University of Thrace; Duke University; Journal of Hospital Infection;
Public Health England; University of Chicago; University of Illinois at Urbana-Champaign 0m? I ICAO
AR05150
A-56
HOW TO SELECT, WEAR, AND CLEAN YOUR MASK
DO choose masks that : DO NOT choose masks that :
Have three layers of

washable, breathable fabric
Are made of fabric that
makes it hard to breathe,
; for example, vinyl
Completely Have exhalation valves or
^
cover your nose vents, which allow virus
Fit snugly ag
the sides of yp»
nj and mouth particles to escape
face and dont

have gaps
^
Gaiters & Face Shields Special Situations: Children
|
| Not recommended for children _ _ ___
If you are able, find a mask that is made
Lfc
If you can't find a
mask made for
children, check to i
be sure the mask
fits snugly over the
Nor recommended, nose and mouth
unless worn with a mask and under the chin
Special Situations: Glasses

Do not put on children younger
If you wear glasses, find a than 5 years old or the age
mask that fits closely over specified by the national public
your nose or one that has health authority.
a nose wire to limit fogging 5
.
Based on Source: https:// mvm.cdc.gov/coronavirus/2019-ncov/ prevent-getting-sick/ about-face-coverings html
AR05151
A-57
DO wear a mask that:

• Covers your nose and mouth and
secure it under your chin
• Fits snugly against the sides of your face
For more information,

visit our How to Wear Masks web page.
How NOT to wear a mask:
^ Around your neck
ÎfcJ
On your forehead Under your nose
^ ^ ^
Only on your nose On your chin Dangling from one ear
3
How to take off a mask:
Om ©
••
Carefully, untie the Handle only by the Fold outside Be careful not to touch your
strings behind your ear loops or ties corners together eyes, nose, and mouth when
head or stretch the removing and wash hands
ear loops immediately after removing
.
Based on Source: https:/ /www cdcgov/coronavirus/2019-ncov/prevent-getting-sick/ about-face-coverings.html
'H’| ICAO
AR05152
A-58
Aviation multi-layered strategy: based on the James Reason Swiss Cheese Model
AVIATION MULTI- LAYERED

DISEASE DEFENSE STRATEGY
A multilayered approach increases success
!5 & ^«and Training

Proce
Educatof'
commanicatioa ^ engineering Fact '*
4
o
n0
'wsiônX: *n'n9
le
niCompi*'**
MonK* ®* ’”
' ^
Boeder vaccine ^
’ Do not travel when sick or had dose contact

* Hand hygiene, cough etiquette
1
MiAi-sector multi-state collaboration (PHQ
4
-
Touch less procedures, cabin airflow,
HEPA filter
1
By airports, artnet and relevant aviation personnel
un v Macuy woogyuovmunoKcom.
4
.
Contact traong quarantine, isolation .
M BMH C MM MM M I
. •
Causation, ty James T Reason 1990.
Appleo lo Avtaoon Mtvup prevention oy
’ The 'misedoanatian mouse* eats holes into the
defense slices, creating opportmtbes lor toe vwus
. .
Doupas A Wiegmann and Scott A snapped
– END –
AR05153
TAB 30
AR05154
FEDERAL COURT
BETWEEN:
NABIL BEN NAOUM

Demandeur
et

Défendeur

AND BETWEEN:

Demandeur
et

Défendeur

AND BETWEEN:
AND AEDAN MACDONALD
Applicants
and

Respondent
AR05155

AND BETWEEN:
Applicants
and

Respondent
AFFIDAVIT OF ELENI GALANIS

Fax: (204) 983-3636

Tel: (
Email:

AR05156
FEDERAL COURT
BETWEEN:
NABIL BEN NAOUM

Demandeur
et

Défendeur

AND BETWEEN:

Demandeur
et

Défendeur

AND BETWEEN:
AND AEDAN MACDONALD
Applicants
and

Respondent
AR05157

AND BETWEEN:
Applicants
and

Respondent
AFFIDAVIT OF ELENI GALANIS
I, Eleni Galanis, of the City of Vancouver, in the Province of British Columbia, SOLEMNLY
AFFIRM THAT:
1. I am currently the Director General of the Centre for Integrated Risk Assessment in the
Public Health Agency of Canada (PHAC) and have been in this position since December 2021. I
am responsible for coordinating public health risk assessments to provide advice to the Chief
Public Health Officer of Canada and senior executives on managing public health risks in Canada.
Prior to taking my current position, I spent over 20 years in public health practice, the majority of
which was spent at the British Columbia Centre for Disease Control. I have been a member of the
Canadian Pandemic Influenza Preparedness Task Force for two years. I obtained a Doctor of
Medicine from the Université de Sherbrooke in 1995 and a Masters of Public Health from the
Harvard School of Public Health in 1997. I attach as Exhibit “A” a copy of my curriculum vitae.
2. As a result of my current position, I have personal knowledge of the facts and matters
following in this affidavit, except as follows. In my role and as part of my responsibilities as the
Director General of the Centre for Integrated Risk Assessment, I necessarily receive information
from various groups within PHAC, or other federal government departments, agencies working
with PHAC, and internationally recognized public health authorities such as the World Health
Organization (WHO). Where in this affidavit I state that I received information gathered by others
in conducting my work functions, I confirm that I trust the accuracy of that information and believe
it to be true based on the professional conduct and ability of those providing that information.
Where I otherwise state my knowledge is based upon information and belief, I have stated the
source of my information and believe the same to be true.
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3. PHAC is a federal agency created by the Public Health Agency of Canada Act. It supports
the federal Minister of Health as part of the Health Portfolio. Its mandate includes the prevention
and control of infectious diseases, preparation for and response to public health emergencies, and
strengthening intergovernmental collaboration on public health and facilitating national
approaches to public health policy and planning.
4. The Centre for Integrated Risk Assessment is a new unit within PHAC. In part, its mandate
is to coordinate and implement standard best practices in conducting public health risk assessments
at PHAC. It also provides risk management advice to the Chief Public Health Officer of Canada.
A. Canadian Pandemic Influenza Preparedness: Planning Guidance for the Health Sector
5. I have reviewed the expert report prepared by Dr. Richard Schabas filed in Court File T-
1991-21. I note that generally around paragraphs 14 and 15 and again at paragraphs 19 and 20 of
his expert report, he refers to influenza pandemic planning as a model that should have been
followed in responding to the COVID-19 pandemic. In that portion he cites a paper from
Dr. Bonnie Henry in respect of the Canadian Pandemic Influenza Preparedness: Planning
Guidance for the Health Sector (CPIP).
6. I attach as Exhibit “B” a copy of the current version of the Canadian Pandemic Influenza
Preparedness: Planning Guidance for the Health Sector . The Canadian Pandemic Influenza Plan
for the Health Sector was first published in 2004 and its planning guidance was put to the test for
the first time in 2009 H1N1 influenza pandemic. Following H1N1 it was renamed The Canadian
Pandemic Influenza Preparedness: Planning guidance for the Health Sector to better reflect its
intended purpose to provide planning guidance for federal-provincial-territorial (FPT) health
ministries, which they can adapt into their own plans. The CPIP is a product of the Pan-Canadian
(FPT) Public Health Network Council. It was last updated in 2018. Since 2012, the CPIP Task
Force has overseen the CPIP renewal process. The Centre for Immunization and Respiratory
Infectious Diseases of PHAC is the custodian of the CPIP and provides secretariat support for the
expert CPIP Task Group.
7. The CPIP provides planning guidance to FPT authorities to prepare for and develop their
jurisdiction-specific plans for an influenza pandemic; however, it is not itself a pandemic response
plan. Its purpose is to achieve Canada’s influenza pandemic goals, which are firstly and most
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importantly, to minimize serious illness and deaths from influenza, and secondly, to minimize
societal disruption among Canadians as a result of an influenza pandemic. There are several
supporting objectives including reduction of the overall transmission and slowing the rate of
transmission of the novel or pandemic virus, thus lowering the total number of severely ill cases
and deaths, and delaying the accumulation of cases. I attach as Exhibit “C” a copy of the Public
Health Measures Annex to the CPIP, last updated in February 2019, which sets out this objective.
Another objective is the promotion of individual and community actions and protecting the
population through provision of pandemic vaccine and implementation of other public health
measures. These objectives are important to note as they provide supporting rationale for the
actions taken by public health authorities.
8. While it is expected that CPIP’s strategic direction and guidance will inform FPT planning
in order to support a consistent and coordinated response across jurisdictions in an influenza
pandemic, each level of government has the ultimate responsibility for planning and decision-
making within their respective jurisdictions. It is also important to note that the CPIP does not
address pandemic preparedness and response in the non-health sectors (e.g., community and social
services, public safety), although some of its content may be a useful reference.
B. Influenza is not equivalent to COVID-19
9. At paragraph 18 of his expert report, Dr. Schabas states
The principal difference between influenza and SARS Covid-19 is that the latter was
initially more virulent, i.e., the risk of death, for example, was at least two to three times
higher with SARS Covid-19 than is expected from influenza. This has changed with time
and the now dominant Omicron Variant has a virulence that is lower than the original
SARS Covid-19 disease and is closer to that of influenza, although still probably about two
times higher in unvaccinated people. Regardless, while the virulence of the infection may
advise the urgency of intervention it does not, by itself, affect the underlying dynamics of
viral transmission or the utility of public health interventions to reduce transmission.
10. COVID-19 and influenza are different. They are caused by different viruses with different
infectiousness, virulence and immune escape characteristics. Further, COVID-19 can result in
longer-term conditions not found in influenza cases. Most significantly, the mortality rate is higher
with COVID-19 than with influenza. I am informed by counsel and do believe that the Attorney
General of Canada will be filing expert reports which more fully explain the nature of the SARS-
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CoV-2 virus, the resulting disease, and the immune response from vaccination. I am further
informed by counsel and do believe that Owen Phillips of Statistics Canada is providing an
affidavit in which he sets out the numbers of deaths caused by influenza and COVID-19 in Canada.
C. CPIP as a Starting Point
11. While the CPIP was useful in planning and preparing for a pandemic, it needed to be
adapted to the specific circumstances of a particular pandemic, including the nature of the disease
agent, the nature of the disease, and the effectiveness of any particular health measure.
12. The use of established practices and systems to the extent possible is a key practice at the
beginning of a pandemic, as it is extremely difficult to implement new methods of operations
during an emergency situation. Further, pandemic planning and response activities are guided by
a precautionary/protective approach, which is particularly applicable in the early stages of a
pandemic when evidence-informed decision-making is not possible due to lack of data and the
uncertainty of an evolving event while there may be a need for immediate measures. As such,
response during the early stages of a pandemic is generally based on past experience and
understanding and existing plans. Nonetheless, it is fundamental that pandemic response activities
decisions should be based on the best available evidence to the extent possible, should be tailored
to the situation, and should be subject to change as new information becomes available.
13. The WHO declared a worldwide COVID-19 pandemic in March 2020, the nature of which
Canada had not seen in over 100 years. The pandemic has been unprecedented. Its severity, speed,
impact, and the lack of any previous immunity in the population or availability of an effective
vaccine meant that public health officials and others needed to react quickly in the interest of
protecting public health. The CPIP was based on the information available at the time of its 2018
update, largely the emerging evidence from the 2009 H1N1 pandemic and the then-known
evidence on the effectiveness of public health measures as set out in the Public Health Measures
Annex to the CPIP attached as Exhibit “C”. It was developed based on expectations of how an
influenza pandemic, not necessarily another pandemic, would unfold. The CPIP itself provides
for flexibility and adaptability and can be used as a supporting document in health emergencies
other than influenza pandemics. It provided a useful framework, including goals, principles,
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assumptions and ethical consideration that provided a foundation for the response to the COVID-
19 pandemic, especially during the initial stages.
14. Nonetheless, the CPIP lacked evidence for many of the measures that proved to be effective
during the COVID-19 pandemic. The CPIP was specific to influenza and was based on dated
evidence; public health authorities needed a COVID-specific plan based on evolving evidence. As
the pandemic progressed and the knowledge of SARS-CoV-2 grew, public health responses had
to evolve, with adjustments and re-adjustments, and layered approaches were needed.
15. The Federal-Provincial-Territorial Public Health Response Plan for Ongoing

Management of COVID-19, was built on experience in responding to the first wave of the COVID-
19 pandemic and draws upon concepts in the CPIP. It is an evergreen document that is intended
to provide a Pan-Canadian forward planning approach for ongoing management of COVID-19 in
Canada and facilitate awareness and coordination both within and beyond the public health sector.
The first edition (August 2020) covered immediate planning imperatives for the fall/winter 2020
period. The second edition (April 2021) focused largely on preparedness for variants of concern.
The third edition (March 2022) focused on the transition from the acute response to waves of
COVID-19 activity towards a more sustainable long-term response to the ongoing presence of
COVID-19 in the context of increased population immunity and other public health priorities.
16. The Plan is specific to managing the ongoing response to COVID-19. It builds on concepts
from the CPIP and introduces the concept of planning for ongoing response, recovery and
readiness given the anticipated long-term ongoing presence of COVID-19 and potential repeated
emergence of new variants of concern (VOC) of the SARS-Cov-2 virus. Similar to the CPIP, the
Plan promotes a risk management approach, which considers the likelihood and impacts of
potential threats like new VOC, while also mitigating the impact of realized risks. The Plan also
considers the pandemic fatigue resulting from the resurgences of VOC. I attach as Exhibit “D” a
copy of the latest edition of that plan.
17. As has occurred throughout the COVID-19 pandemic, recommended public health
measures have evolved as public health authorities have learned more about the nature of the virus
and the operational and logistical constraints of any measure. An example of how national and
international guidance has evolved based on new evidence is the use of masks in the community .
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Public health authorities did not initially recommend the use of masks use at the population level
based on the then-understanding of their effectiveness. In fact, the CPIP notes that little evidence
existed as to how the effective wearing of masks by healthy individuals would prevent them from
becoming infected.
18. However, the COVID-19 experience has advanced public health knowledge of the benefits
of mask use in the community setting by healthy individuals. The use of masks was later
recommended based on the evolution of the pandemic. Public health authorities now know that,
when layered with other public health measures, the wearing of a well-constructed, well-fitting ,
and properly worn mask can help prevent the spread of COVID-19 by acting as both a source
control and by providing protection to the wearer. The WHO recommends the use of well-fitted
masks, physical distancing, ventilation of indoor space, crowd avoidance, and hand hygiene
remain key to reducing transmission of SARS-CoV-2, even in the context of emerging variants. I
attach as Exhibit “E” a copy of January 2022 WHO technical brief which sets out this
recommendation.

in the City of Vancouver, in the Province of
British Columbia, this 25th day of April, 2022.
ELENI GALANIS

means in the City of Lorraine, in the
Province of Québec, this 25th day of April,
2022.
Maude L'Archêveque , #236299

for outside Québec
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Affidavit of ELENI GALANIS
in the City of Lorraine, in the Province of Québec,
this 25th day of April, 2022.
Maude L’Archevêque, #236299

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Eleni Galanis
PROFESSIONAL EXPERIENCE
2021-current Director General, Centre for Integrated Risk Assessment, Public Health Agency of
Canada (PHAC)
Provide leadership and management of Centre responsible for coordinating Agency-wide
public health risk assessments to advise Chief Public Health Officer of Canada and senior
executives on managing public health risks to Canada
2006-current Clinical Professor (2021-ongoing), Clinical Associate Professor (2014-21), Clinical

Assistant Professor (2006-14), School of Population and Public Health, Faculty of
Medicine, UBC Teach Surveillance in Public Health and supervise residents and students
2004-21 Physician Epidemiologist, BC Centre for Disease Control (BCCDC)

Conduct infectious diseases surveillance, control and prevention activities for BC
2014-2015 Interim Medical Director, Communicable Disease Prevention and Control, BCCDC
Provided leadership and management of 50 physicians, scientists and support personnel
2003-2004 Medical Epidemiologist, Danish Zoonosis Centre, Danish Institute for Food and
Veterinary Research, Ministry of Food, Agriculture and Fisheries, Denmark
Managed Danish arm of WHO Global Foodborne Disease Surveillance
2002-2003 Acting Associate Director, Canadian Field Epidemiology Program, Health Canada
Managed program including recruitment, guidelines, liaison with placement supervisors;
supervised field epidemiologists; taught training courses
LICENSES
Fellowship of the Royal College of Physicians of Canada in Community Medicine (FRCPC), 2000
Canadian College of Family Physicians (CCFP), 1997
License of the Medical Council of Canada (LMCC), 1996
EDUCATION
Community Medicine Residency Program University of Toronto 1995-2000

Masters of Public Health (MPH) Harvard School of Public Health, USA 1997-98
Family Medicine Residency Program University of Toronto 1995-97
Doctorate in Medicine (MD) Université de Sherbrooke 1991-95
LANGUAGES
April 2022 1
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Eleni Galanis
Fluent in spoken and written French and English, conversant in spoken Spanish and Greek
April 2022 2
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CANADIAN PANDEMIC
INFLUENZA PREPAREDNESS:
Planning Guidance for the
Health Sector
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Également disponible en français sous le titre :

PRÉPARATION DU CANADA EN CAS DE GRIPPE PANDÉMIQUE
Guide de planification pour le secteur de la santé
© Her Majesty the Queen in Right of Canada, as represented by the Minister of Health, 2018
HP40-144/2018E-PDF
ISBN: 978-0-660-26617-6
Pub.: 180093
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TABLE OF CONTENTS
PREFACE. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5
1.0 INTRODUCTION. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6
1.1 Background. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6
1.2 Purpose. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7
1.3 Audience and Scope . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7
1.4 Changes in This Version. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7
2.0 CONTEXT FOR PLANNING . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 9

2.1 Understanding Pandemic Influenza . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 10
2.1.1 Influenza and the Origin of Pandemics . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 10
2.1.2 Typical Pandemic Characteristics. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 10
2.1.3 Pandemic Impact. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 10
2.2 Uncertainties and Unpredictability . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 12
2.3 Lessons Learned from the 2009 Pandemic . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 13
2.4 Understanding Canada’s Diversity . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 14
2.5 Ethical Considerations . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 16
2.6 Legal Considerations. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 17
2.6.1 International Requirements. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 18
2.6.2 Federal Legislation. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 19
2.6.3 Provincial/Territorial Legislation. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 19
3.0 CANADA’S APPROACH TO PANDEMIC INFLUENZA. . . . . . . . . . . . . . . . . . . . . . . . . 20

3.1 Goals and Objectives. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 20
3.2 Guiding Principles and Approaches. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 21
3.3 Coordination of National Preparedness and Response . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 22
3.3.1 Emergency Management Frameworks and Plans . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 23
3.3.2 Pan-Canadian Coordination of the Pandemic Health Sector Response . . . . . . . . . . . . . . .23
3.3.3 North American Plan for Animal and Pandemic Influenza . . . . . . . . . . . . . . . . . . . . . . . . . 23
3.4 Pandemic Roles and Responsibilities . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 24
3.4.1 World Health Organization . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 24
3.4.2 Canada – FPT Governments . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 24
3.5 Risk Management Approach. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 28
3.5.1 Overview . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 28
3.5.2 Risk Management Considerations in Pandemic Planning and Response. . . . . . . . . . . . . . 30
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3.6 Planning Assumptions . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 31

3.6.1 Origin and Timing. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 31
3.6.2 Transmission . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 31
3.6.3 Pandemic Epidemiology. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 32
3.6.4 Clinical Features . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 32
3.6.5 Impact and Interventions. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 32
3.7 Pandemic Planning Scenarios. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 33
3.8 Pandemic Phases and Triggers for Action . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 36
3.8.1 WHO Pandemic Phases . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 36
3.8.2 Canada’s Approach to Pandemic Phases and Triggers for Action. . . . . . . . . . . . . . . . . . . . . 37
4.0 KEY COMPONENTS OF PANDEMIC INFLUENZA

PREPAREDNESS AND RESPONSE . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 41
4.1 Surveillance . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 42
4.2 Laboratory Services . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 42
4.3 Public Health Measures . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 44
4.4 Vaccine. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 45
4.5 Antiviral Medications . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 46
4.6 Infection Prevention and Control and Occupational Health . . . . . . . . . . . . . . . . . . . . . . . . . . . 48
4.7 Health Care Services . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 49
4.8 Clinical Care Guidelines . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 51
4.9 Communications . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 52
4.10 Research . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 53
5.0 ASSESSMENT AND EVALUATION OF PANDEMIC

PREPAREDNESS AND RESPONSE . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 55
5.1 Assessing Preparedness. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 55
5.2 Evaluating the Pandemic Response . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 56
APPENDIX A – FACTORS AFFECTING PANDEMIC IMPACT . . . . . . . . . . . . . . . . . . . . . . . 57
APPENDIX B – PANDEMIC RISK ASSESSMENTS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 60
4 CANADIAN PANDEMIC INFLUENZA PREPAREDNESS: Planning Guidance for the Health Sector
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PREFACE
Canadian Pandemic Influenza Preparedness: Planning Guidance for the Health Sector (CPIP) is a
federal, provincial, and territorial (FPT) guidance document that outlines how jurisdictions will work
together to ensure a coordinated and consistent health sector approach to pandemic preparedness and
response. CPIP consists of a main body, which outlines overarching principles, concepts, and shared
objectives, as well as a series of technical annexes that provide operational advice and technical
guidance, along with tools and checklists on specific elements of pandemic planning. The CPIP main
body and its annexes are intended to be used together.
CPIP was first published in 2004. In 2006, the Pan-Canadian Public Health Network (PHN) Council
approved an updated version of CPIP as an evergreen document to be updated as required. In 2009,
Canada’s pandemic preparedness planning efforts were tested for the first time, with the emergence of
the H1N1 influenza pandemic. In 2012, a CPIP renewal process was initiated by the PHN Council. This
latest version of CPIP was approved by FPT Deputy Ministers of Health in 2014, with further updates in
2018. It incorporates evidence from H1N1 lessons learned reviews conducted at the FPT and international
levels and by various stakeholder groups, and scientific advances. As an evergreen document, the CPIP
main body and each annex will be reviewed every 5 years, with updates made between review cycles,
if necessary.
Since 2012, the CPIP Task Group (CPIP TG) has overseen the CPIP renewal process. The CPIP TG
consists of members with expertise in the areas of pandemic and seasonal influenza, pandemic
preparedness planning and response, emergency management, epidemiology, public health, virology,
bioethics, immunization, surveillance, and laboratory diagnosis.
The updated CPIP allows for a more flexible and adaptable response to future pandemics, providing
scope for provinces and territories (PT) to adapt their own plans and responses to local and regional
circumstances. The title of the document also has changed, from Canadian Pandemic Influenza Plan for
the Health Sector to Canadian Pandemic Influenza Preparedness: Planning Guidance for the Health
Sector, to more accurately reflect its role and intended use as a guidance document.
CPIP now supports a risk management approach and includes new concepts such as pandemic impact
assessment, descriptions of pandemic scenarios of varying impact, and identification of triggers for a
Canadian response. It also better reflects Canada’s geographic, demographic, cultural, and socio-
economic diversity and the imperative for planners to take this diversity into account. CPIP has been
subject to extensive FPT government review and targeted stakeholder consultations. Stakeholders
included national level organizations representing health professionals, emergency preparedness and
first responders, community services, the private sector, and Indigenous peoples.
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1.0 INTRODUCTION
1.1 Background
Canadian Pandemic Influenza Preparedness: Planning Guidance for the Health Sector (CPIP) provides
planning guidance to prepare for and respond to an influenza pandemic. Influenza pandemics
(subsequently referred to as pandemics) are unpredictable but recurring events that occur when a novel
influenza virus strain emerges, spreads widely and causes a worldwide epidemic. Unfortunately, it is not
possible to predict the anticipated impact of the next pandemic or when it will occur.
Planning for a prolonged and widespread health emergency of unpredictable impact is challenging but
essential. It requires a “whole of society” response and the coordinated efforts of all levels of government
in collaboration with their stakeholders.
Pandemic planning activities within the health sector in Canada began in 1983. The first Canadian
pandemic plan was completed in 1988 and was followed by several updates. In 2004, the Canadian
Pandemic Influenza Plan for the Health Sector was published as the result of extensive collaboration
among FPT and other stakeholders. Before this version, the last major update to the CPIP and its
annexes occurred in 2006.
The 2009 influenza A (H1N1) pandemic (subsequently referred to as the 2009 pandemic) provided the
first real test of Canada’s pandemic preparedness planning efforts. Collaboration among all levels of
government and stakeholders was unprecedented compared with previous events like the Severe Acute
Respiratory Syndrome (SARS) outbreak in 2003. The public health and health care systems were stressed
but in most instances were able to cope. Antiviral stockpiles were deployed and pandemic vaccine
was administered to millions of Canadians. There were, however, many challenges identified in
this experience.
Canada’s pandemic planning continues to evolve on the basis of research, emerging evidence and the
lessons learned from the 2009 pandemic. The value of building on seasonal influenza surveillance
systems and control measures is well recognized. Making these systems and measures as robust as
possible in the interpandemic period will help prepare for a strong pandemic response.
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1.2 Purpose
CPIP’s overall purpose is to provide planning guidance for the health sector for pan-Canadian
preparedness and response, in order to achieve Canada’s pandemic goals:
First, to minimize serious illness and overall deaths, and second to minimize societal
disruption among Canadians as a result of an influenza pandemic.
The main body of CPIP provides strategic guidance and a framework for pandemic preparedness and
response, whereas the CPIP annexes provide operational advice and technical guidance, along with
tools and checklists. As an evergreen document, CPIP will be updated as required to reflect new
evidence and best practices.
It is important to note that CPIP is not an actual response plan. Rather, it is a guidance document for
pandemic influenza that can be used to support an FPT all-hazards health emergency response approach.
While CPIP is specific to pandemic influenza, much of its guidance is also applicable to other public
health emergencies.
1.3 Audience and Scope

CPIP is pan-Canadian pandemic planning guidance for the health sector developed under the guidance
of a group of Canadian experts. The primary audiences are the FPT ministries of health together with
other ministries that have health responsibilities. While it is anticipated that CPIP’s strategic direction
and guidance will inform FPT planning in order to support a consistent and coordinated response across
jurisdictions, PTs have ultimate responsibility for planning and decision-making within their respective
jurisdictions. CPIP also serves as a reference document for other government departments, non-
governmental organizations (NGOs) engaged in health issues, and other stakeholders.
While CPIP provides pandemic planning guidance, it does not address business continuity preparedness
or overall management of a health emergency. These activities are critical for an effective pandemic
response; however they are more appropriately addressed in the emergency plans of individual
jurisdictions and organizations. Neither does CPIP address pandemic preparedness and response
in the non-health sectors (e.g., community and social services, public safety), although some of its
content may be a useful reference.
1.4 Changes in This Version

There have been considerable changes to CPIP since the 2006 version in both format and content. The
strategic nature of the information in the main body of the planning guidance has been strengthened
and lessons learned from the 2009 pandemic have been incorporated. While the overall pandemic
goals remain the same, new objectives have been added along with a set of principles to support the
response. These are accompanied by a discussion of ethical considerations pertaining to pandemic
preparedness and response, and consideration of the implications of Canada’s diversity and the needs
of vulnerable persons. Roles and responsibilities for each level of government have been described
more explicitly.
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The new CPIP outlines a risk management approach to support a flexible and proportionate response.
Risk management involves setting the best course of action in an uncertain environment by identifying,
assessing, acting on and communicating risks. Information has been added about what is known and
what is uncertain about pandemic influenza. The planning assumptions have been updated, and four
hypothetical planning scenarios have been developed to illustrate the importance of developing plans
and response strategies that are flexible and can be adapted as circumstances require. CPIP also
provides triggers for action that are based on novel virus emergence and pandemic activity in Canada
rather than the global World Health Organization (WHO) phases. Finally, content has been updated
in each of the specific response areas.
The CPIP technical annexes are being renamed according to their subject (e.g., Surveillance, Vaccine)
instead of being named alphabetically. As part of the CPIP renewal process, it is intended that each
of the technical annexes will be revised.
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2.0 CONTEXT FOR PLANNING

2.1 Understanding Pandemic Influenza
2.1.1 INFLUENZA AND THE ORIGIN OF PANDEMICS
While there are four types of influenza virus (A, B, C and D), only influenza A and B viruses cause
seasonal outbreaks in humans, and only influenza A viruses have been known to cause pandemics.
Aquatic birds are the natural hosts for influenza A viruses, although a wide range of species can be
infected and significant disease outbreaks can occur in poultry, pigs and other species. Most of these
animal influenza virus strains do not cause disease in humans although occasional human (zoonotic)
infections occur, usually through close contact with infected poultry or animals.
Influenza pandemics or worldwide epidemics occur when an influenza A virus to which most humans
have little or no immunity acquires the ability to cause sustained human-to-human transmission leading
to community-wide outbreaks. Such a virus has the potential to spread rapidly worldwide, causing
a pandemic.1
These novel viruses may arise through genetic reassortment (a process in which animal and human
influenza genes mix together) or genetic mutation (when genes in an animal virus change, allowing the
virus to easily infect humans). Pigs can become infected with influenza viruses from different species and
act as a “mixing vessel” to facilitate the reassortment of genes from different viruses.
Not all novel influenza viruses evolve into pandemic viruses. Some novel subtypes, like the avian A
(H5N1) virus, have caused sporadic human cases on an ongoing basis since 1997 but have not gained
the ability to spread easily in humans. As the overall human case fatality rate for A (H5N1) infections has
been over 50%,2 there are concerns about the potential of a high impact human pandemic if this virus
gains the capacity to spread easily between people.
1
World Health Organization. Pandemic influenza risk management – WHO Pandemic Influenza Risk Management May 2017.
Available from: www.who.int/influenza/preparedness/pandemic/influenza_risk_management_update2017/en/
2
World Health Organization. Influenza at the human-animal interface. 4 July 2013. Available from:
www.who.int/influenza/human_animal_interface/Influenza_Summary_IRA_HA_interface_03July13.pdf.
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2.1.2 TYPICAL PANDEMIC CHARACTERISTICS

Historical evidence suggests that influenza pandemics occur three to four times per century. In the last
100 years there were four pandemics separated by intervals of 11 to 41 years. They varied greatly in
their impact, as measured by illness and deaths. The 1918–1919 pandemic had a high impact, killing an
estimated 30,000 to 50,000 people in Canada and 20 to 50 million people worldwide. The impact of the
1957 and 1968 pandemics was considered moderate, whereas the 2009 pandemic had a lower impact.
Pandemics of the Last 100 Years, subtypes and common names:

1918–1919: H1N1 “Spanish flu”
1957–1958: H2N2 “Asian flu”
1968–1969: H3N2 “Hong Kong flu”
2009: H1N1 Influenza A (H1N1) 2009
While every pandemic is different, some common characteristics can be recognized:

• The pattern of disease is different in pandemics than in seasonal influenza.
• Pandemics may arrive outside of the usual influenza season and typically have more than one wave
of illness.
• The total duration of a pandemic is likely to be 12 to 18 months.
• During a pandemic, the new pandemic virus replaces other circulating influenza strains. Afterwards,
the pandemic strain becomes part of (and may dominate) the mix of seasonal influenza A viruses.
• During seasonal influenza, most hospitalizations and deaths occur in the elderly and persons with
underlying health conditions, whereas, in a pandemic, disproportionately more severe disease and
death is seen in young people and in persons without underlying health conditions.3
• There is a gradual reversion back to the typical seasonal morbidity and mortality pattern over the
decade following the pandemic.
During the 1918–1919 pandemic, 99% of influenza-associated deaths in the United States (US) were in
persons under 65 years of age and nearly half of these among previously healthy adults 20–40 years of
age. In subsequent pandemics, the proportion of influenza-associated deaths in the US in persons
under 65 years of age was 36% (1957–58), and 48% (1968–69).4 In the 2009 pandemic 70% of reported
deaths in Canada were in persons under 65 years of age.5
3
Simonsen L, Clarke MJ, Schonberger LB, et al. Pandemic versus epidemic mortality: a pattern of changing age distribution.
J Infect Dis 1998;178:53–60.
4
Ibid.
5
Helferty M, Vachon J, Tarasuk J et al. Incidence of hospital admissions and severe outcomes during the first and second
waves of pandemic (H1N1) 2009. Can Med Assoc J 2010;182:1981−7.
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2.1.3 PANDEMIC IMPACT

The term “severity” is often used to describe both severity of disease in individuals (clinical severity) and
the overall “severity” of a pandemic in a population. In CPIP, the term severity is used to describe clinical
severity of disease in individuals and impact is used to describe the effects of a pandemic on the
population. For planning and response purposes, describing the impact of a pandemic on the population
is a more meaningful approach than talking about its “severity”. It is acknowledged that this usage may
vary from the approach of some other authorities. For example, the WHO uses the term “pandemic
severity” for what CPIP terms “impact” but the concepts are the same.6
Severity refers to clinical severity of disease in an individual (e.g., mild, moderate or severe disease)
Impact refers to the effects of a pandemic on a population (e.g., low, moderate, or high impact)
Pandemics vary in their impact, as do seasonal influenza outbreaks, although usually on a higher scale of
magnitude. A low impact pandemic might resemble moderate to severe seasonal influenza outbreaks,
although its epidemiological profile would be different in important ways as previously described. In
contrast, pandemics of moderate to high impact could result in high rates of illness and death across the
country and would severely challenge the health care sector. They could also disrupt the normal functioning
of society and put people with limited resources and support systems into a more vulnerable state.
Numerous factors can affect pandemic impact. These are outlined below and described in more detail
in Appendix A:
• Viral factors are perhaps the most important. These characteristics of the virus itself are usually
described as transmissibility (ability to spread) and virulence or clinical severity (the ability to cause
severe disease). Transmissibility can be defined in terms of both the extent and the speed of spread
and it can vary by season and setting.
• Factors affecting population vulnerability include pre-existing population immunity, the presence
of underlying health conditions, or unexpected new risk factors for severe disease. Impact may be
increased in vulnerable populations, including among Indigenous peoples or settings such as remote
communities, homeless shelters and overcrowded housing.
• Response factors include the effectiveness of interventions (e.g., public health measures, vaccine,
and antiviral medications), the health care system response (e.g., access, surge capacity), and
risk communications, along with the extent of public adoption of desired behaviours and
social mobilization.
The impacts of a pandemic in psychosocial terms may be acute in the short term but can also undermine
the long-term psychological well-being of the population. Psychosocial issues are not only experienced by
those who become ill; distress permeates through the family and the community (e.g. financial stress due
to economic downturns, caregiver burnout, occupational stresses, stigma/social exclusion).
The range of issues associated with psychosocial planning is broad involving all levels of government
and multiple planning partners, including humanitarian actors such as community-based organizations,
government authorities and NGOs and are closely aligned with the practice of risk communication.7
6
World Health Organization. Pandemic influenza risk management—WHO interim guidance. 2013. Available from:
www.who.int/influenza/preparedness/pandemic/influenza_risk_management/en/index.html
7
Inter-Agency Standing Committee (IASC) Guidelines on Mental Health and Psychosocial Support in Emergency Settings (2007).
Available from: www.who.int/mental_health/emergencies/guidelines_iasc_mental_health_psychosocial_june_2007.pdf
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2.2 Uncertainties and Unpredictability

Influenza is unpredictable – every influenza season and every pandemic is different. These uncertainties
make pandemic planning challenging and highlight the need for flexibility and adaptability. Some of the
major unknown areas about the next pandemic are the following:
• When the next pandemic will occur— although historically pandemics have occurred three to four
times per century, there is no predictable interval. It should not be assumed that the 2009 pandemic
has provided a respite during which preparedness efforts can be relaxed.
• Where it will emerge—while most seasonal influenza strains emerge in East/Southeast Asia,8 the
same is not true for pandemic influenza; the 2009 pandemic emerged in Mexico. An influenza
pandemic could emerge anywhere in the world, and there may be very little lead time before Canada
is extensively involved.
• What the nature of spread will be—pandemics often first arrive outside the usual influenza season (e.g.,
in late spring or summer) and typically have more than one wave of infection. However, this is not true
in all circumstances or in all areas. A small first wave is often followed by a larger second wave, but the
relative size of pandemic waves may vary. The speed of spread may also vary – pandemic waves can be
intense or more spread-out over time. An intense wave would put more stress on the health care system.
• What its characteristics will be—the basic characteristics of the next pandemic virus are unknown,
including its antigenic type (e.g., H2, H5, H7), its transmissibility and virulence, and the age groups
and clinical groups most affected.
• What its impact will be—the last four pandemics demonstrated that population impact can vary
from low to high and is not the same in all populations or settings. It is important to consider all
possibilities and make plans adaptable for different circumstances. This will help ensure that the
response is proportional to the evolution of the pandemic in any specific community.
• What effect interventions will have—typical seasonal influenza interventions are expected to be
effective during the pandemic. However, the novel virus could be resistant to antiviral medications
and/or pandemic vaccine production could be delayed or unsuccessful. The extent of vaccine uptake
and adoption of public health measures is also unknown. Furthermore, interventions could have
unintended consequences.
2.3 Lessons Learned from the 2009 Pandemic

There were many important epidemiological observations from the 2009 pandemic to take into account
in future planning and response. These include the speed with which cases and sporadic outbreaks
appeared in Canada after the novel virus was first detected and the early involvement of some remote
and isolated communities, with severe disease in some First Nations communities. There was considerable
variation in the timing and intensity of pandemic waves, especially the first wave, across the country.
Although the symptoms were similar, age groups affected and risk conditions varied from seasonal
influenza. Greater impact was seen in pregnant women and Indigenous peoples, and persons with
morbid obesity were newly recognized as being at high risk for complications. For the duration of the
pandemic, seasonal influenza strains were replaced by the pandemic strain and as with previous
pandemics, it was not certain whether this single A strain dominance would continue. In the 2010/2011
influenza season A (H3N2) and B strains began to re-circulate and the pandemic virus became the
seasonal A (H1N1) strain.
8
Russell CA, Jones TC, Barr IG et al. The global circulation of seasonal influenza A (H3N2) viruses. Science 2008;3210:340–6.
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A number of challenges were identified in the national response. Surveillance demands were very heavy
from the start, and were accentuated by the lack of linked information systems in some jurisdictions,
unclear protocols for sharing information, and limited capacity for epidemiological analysis. The process
for release of the National Antiviral Stockpile (NAS) was uncertain. There was high demand for critical
care and ventilators for affected children and adults. Preparation and timely approval of concise national
guidelines was difficult. The pandemic immunization program faced challenges with uncertain timelines
for vaccine delivery, prioritization of vaccine supply, logistics of local campaigns and communication of
changing recommendations.
On the positive side, previous planning processes and relationship-building led to unprecedented FPT
collaboration and many successful stakeholder engagement efforts. Existing surveillance systems, like
FluWatch, and ready-to-use hand hygiene and respiratory etiquette campaigns were valuable.
Mathematical modeling was successfully used to support decision-making in some areas (e.g.,
recommendations for vaccine prioritization) and it was recognized that a number of other areas would
benefit from modeling (e.g. predicting pandemic impact).
Following the pandemic, the Government of Canada (GC)9 and most PT governments conducted
lessons learned reviews. In addition, the Standing Senate Committee on Social Affairs, Science and
Technology held extensive hearings on the response.10 Some common themes emerging from these
reports and recommendations were identified to improve preparedness, such as:
• streamlined FPT governance structure and clarification of roles and responsibilities;
• improved scalability and adaptability of response, with triggers to activate and deactivate specific
responses while taking into account the variable impact and timing of the pandemic in different
geographic regions;
• development of integrated electronic information management systems;
• strengthened surveillance systems and epidemiological capacity;
• collaborative processes to develop and strengthen guidance documents for health care workers
(HCW) and other stakeholders to establish timely availability, accessibility, consistency and cultural
sensitivity of messages;
• strategies to communicate risk, uncertainty and changing information;
• active participation of all stakeholders in pandemic preparedness and response;
• strengthened linkages with primary care and other front-line service providers;
• development of mechanisms for rapid funding and research priority-setting, multi-jurisdictional
studies and centralized ethics approval for multi-centre studies;
• mechanisms to integrate new research findings into evidence-informed practice; and
• regular and rigorous testing of plans at all levels.
9
Public Health Agency of Canada. Lessons Learned Review: Public Health Agency of Canada and Health Canada Response to
the 2009 H1N1 Pandemic. November 2010. Available from:
www.phac-aspc.gc.ca/about_apropos/evaluation/reports-rapports/2010-2011/h1n1/index-eng.php
10
Standing Senate Committee on Social Affairs, Science and Technology. Canada’s Response to the 2009 H1N1 Pandemic.
December 2010. Available from:
www.parl.gc.ca/40/3/parlbus/commbus/senate/com-e/soci-e/rep-e/rep15dec10-e.pdf
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2.4 Understanding Canada’s Diversity

Canada’s geographic features and population diversity can create challenges in mounting an effective
response to a public health emergency. Canada is a huge country geographically with communities that
range in size from large cities to small rural and remote settlements. The proportion of people living in
rural areas in Canada (18.9%) is low in comparison to other developed countries and is steadily declining.
The proportion of the rural population, however, varies greatly (from 14% to 53%) from one province or
territory to another. It is lowest in British Columbia and Ontario and is highest in the Atlantic provinces
and the territories.11
Canada is diverse in terms of language, religious beliefs, ethnicity, culture and lifestyle. Indigenous
Peoples make up almost 4% of the population, the second highest percentage in the world after New
Zealand.12 While many Indigenous peoples live in remote and isolated communities in the North, about
half live in urban areas. The median age of Canada's Indigenous Peoples is considerably younger than
that of the non-Indigenous peoples (27 years compared with 40 years respectively). 13
The proportion of foreign-born people in Canada is one of the highest in the world at 20%,14 most of
whom settle in large cities. Toronto and Vancouver now have over 40% visible minority populations
and Montreal has 16%. In addition there are many temporary residents, such as foreign workers and
foreign students.15
The needs of remote and isolated communities may be greater than other communities because of
geographic isolation and health, social, environmental, economic and cultural considerations. These
may affect the baseline health status and thus increase the vulnerability of their residents. In addition,
some remote and isolated communities lack basic amenities, such as household access to running
water, that are assumed to be present when public guidance like hand hygiene is issued. It is important
to consider these factors, along with limited access to health care and transportation challenges, when
planning for all aspects of the pandemic response in remote and isolated communities. Similar concerns
may affect urban marginalized or vulnerable populations.
11
Statistics Canada. Canada’s rural population since 1851. 2012–02–09. Available from:www12.statcan.gc.ca/census-
recensement/2011/as-sa/98-310-x/98
12
Statistics Canada. 2006 Census: Aboriginal Persons in Canada in 2006: Inuit, Metis and First Nations, 2006 Census.
Available from: www12.statcan.ca/census-recensement/2006/as-sa/97-558/p2-eng.cfm
13
Statistics Canada. Canada Year Book 2011. Available from:
www.statcan.gc.ca/pub/11-402-x/2011000/pdf-eng.htm
14
OECD. Society at a Glance 2011: OECD Social Indicators. 4.5 Migration. Available from:
http://dx.doi.org/10.1787/soc_glance-2011-en
15
Statistics Canada. Canada Year Book 2011. Available from:
www.statcan.gc.ca/pub/11-402-x/2011000/pdf-eng.htm
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There are individuals within all jurisdictions whose needs are not fully addressed by traditional services
or who cannot comfortably or safely access and use standard resources. Examples of these vulnerable
persons include, but are not limited to, individuals who are:
• physically or mentally disabled (e.g., visually or hearing impaired, mobility limitations, cognitive
disorders);
• limited or non-English or French speaking;
• low literacy;
• geographically, culturally or socially isolated;
• low income;
• medically or chemically dependent;
• homeless or street-involved;
• housebound or frail seniors; and
• new immigrants and refugees.16
It may not be a single one of these conditions that determines the degree of vulnerability, but rather a
combination of them under certain circumstances.17
Studies indicate that there is a social gradient of risk during influenza pandemics, based on social
vulnerabilities that are likely to lead to increased exposure to infection, risk of basic human needs not
being met, insufficient support and/or inadequate treatment.18 Vulnerable populations might become
more marginalized if pandemic health services are streamlined into standard approaches to reach the
general population.
Within the nationally coordinated pandemic response it is important to allow sufficient local flexibility to
address the unique needs of vulnerable populations. Detailed influenza-specific planning guidance has
been developed for vulnerable populations in Canada.19,20 These referenced documents should be
useful for FPT and regional/local planners.
Responsibility for planning for vulnerable populations is often unclear and although public health is
typically involved, inclusion of all relevant stakeholders is important for comprehensive planning and
buy-in. It is important for planners to address the unique needs of their jurisdiction. This begins with
identifying populations and settings associated with increased risk of illness or severe outcomes from
pandemic influenza along with persons who might need tailored prevention and care services during a
pandemic. Specific planning considerations include information needs (e.g., language, cultural style
and methods of dissemination); access to assessment, treatment (including antiviral medications) and
convalescence support; access to vaccine; and need for support for activities of daily living.
16
International Centre for Infectious Diseases. Flu season and the most vulnerable people. Preparing your organization, staff,
volunteers and clients for seasonal and pandemic flu.
17
Pan American Health Organization. Protecting Mental Health During Epidemics. May 2009. Available from:
www.paho.org/hq/index.php?option=com_docman&task=doc_download&Itemid=270&gid=1433&lang=en
18
O’Sullivan T, Bourgoin M. Vulnerability in an influenza pandemic: looking beyond medical risk. Oct 2010.
19
International Centre for Infectious Diseases. Op cit.
20
International Centre for Infectious Diseases. Issues in pandemic influenza responses for marginalized urban populations;
key findings and recommendations from consultation meetings and key informant interviews. March 2010.
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2.5 Ethical Considerations

This section summarizes the more important ethical considerations in pandemic planning but is not
intended to be an actual ethical framework. Ethical considerations are also addressed more specifically
in various CPIP annexes with supporting tools and frameworks where available.
In Canada, ethical considerations are increasingly taken into account in the development of health
policy. Ethical analysis helps to identify the ethical issues and determine how to do the right thing in a
fair, just and transparent way. Many of the issues encountered in pandemic preparedness and response
involve balancing rights, interests and values. Examples include decisions over resource allocation;
prioritization guidelines for pandemic vaccine and antiviral medications; adoption of public health
measures that may restrict personal freedom; roles and obligations of HCWs and persons providing
medical first response, as well as their employers; the potential need for triage in the provision of critical
care; and responsibilities to the global community.21
The application of ethical reasoning to pandemic preparedness and response begins with identifying
and prioritizing the ethical questions in the issue under consideration. Analysis should include reflection
on the ethical considerations associated with the options, taking into account the societal versus
individual interests and values that are at stake. Ethical tensions are inevitable. When weighing the
options, it is important to be guided by the Canadian pandemic goals.
As pandemic planning initiatives fall within the domain of public health, they are guided by a code of
ethics that is distinct from traditional clinical ethics.22 Whereas clinical ethics focuses on the health and
interests of individuals, public health ethics focuses on the health and interests of a population. When a
health risk like a pandemic affects a population, public health ethics predominates, and a higher value
is placed on collective interests.
In practical terms, this means there should be an emphasis placed on trust and solidarity. Successful
public health activities require relationship-building and can contribute to creating and maintaining trust
between individuals, populations and health authorities. Solidarity is the notion that we are all part of a
greater whole, whether an organization, a community, nation or the globe. Another important
consideration is reciprocity, meaning that those who face disproportionate burdens in their duty to
protect the public (e.g., HCWs and other workers who are functioning in a health care capacity, for
example police or fire personnel who are providing medical first response) are supported by society,
and that to the extent possible those burdens are minimized.
The concept of stewardship is also closely related to trust. Stewardship refers to the responsible planning
and management of something entrusted to one’s care, along with making decisions responsibly and
acting with integrity and accountability. Trust, stewardship and the proper building of relationships also
mean that the power conferred to government and health authorities will not be abused. For example,
if restrictions are deemed essential for proper risk management, they must be effective and proportional
to the threat, meaning that they should be imposed only to the extent necessary to prevent foreseeable
harm. These restrictions should also be counterbalanced with supports to minimize the burden on those
individuals affected.
21
World Health Organization. Ethical considerations in developing a public health response to pandemic influenza. WHO/CDS/
EPR/GIP/2007.2. 2007. Available from: www.who.int/csr/resources/publications/WHO_CDS_EPR_GIP_2007_2c.pdf
22
Kenny NP, Sherwin SB, Baylis FE. Re-visioning public health ethics: a relational perspective. Can J Public Health. 2010;101:9-11.
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The concepts of equity and fairness are very important to Canadians. In a pandemic context, they lead
to a number of considerations. As much as possible, benefits and risks should be fairly distributed
through the population. This may be difficult, however, in some circumstances, such as a pandemic that
differentially affects certain populations or a very severe pandemic if resources are in short supply.
Decisions should take health inequities into account and try to minimize them, rather than make them
worse. Access to necessary health care may be restricted in a health crisis; however, available resources
(e.g., vaccine and antiviral medications) should be distributed in a fair and equitable way. What will
constitute fair and equitable distribution will be context dependent. Therefore the transparency and
reasonableness of decision-making processes are important.
Good decision-making processes are also essential for ethical decision-making. They involve
the following:23,24
• openness and transparency—the process is open for scrutiny, and information about the basis for
decisions and when and by whom they were made is publicly accessible;
• accountability—being answerable for decisions;
• inclusiveness—stakeholders are consulted, views are taken into account, and any disproportionate
impact on particular groups is considered; and
• reasonableness—decisions should not be arbitrary but rather be rational, proportional to the threat,
evidence-informed and practical.
2.6 Legal Considerations

The legal considerations that arise in the context of pandemic preparedness and response are varied
and complex. International laws as well as FPT legislation will be relied upon during both the preparedness
and responses phases of a pandemic.
2.6.1 INTERNATIONAL REQUIREMENTS
International Health Regulations (2005)

The current International Health Regulations (2005) [IHR (2005)] came into force in 2007. They provide
a framework for monitoring and enhancing global public health capacity and international communication
regarding potential public health emergencies of international concern (PHEIC). The aim of the IHR
(2005) is to prevent the international spread of disease while limiting interference with international
traffic and trade. The IHR (2005) also establish a more effective and transparent process for WHO and
its Member States (including Canada) who are States Parties to the Regulations, to follow when
determining and responding to a PHEIC. Most importantly, they broaden the scope of international
collaboration to include any existing, re-emerging or new disease that could represent an international
threat. The IHR (2005) are available at: www.who.int/ihr/en/.
23
University of Toronto Joint Centre for Bioethics Pandemic Influenza Working Group. Stand on Guard for Thee: Ethical
considerations in preparedness planning for pandemic influenza. 2005. Available from: www.jcb.utoronto.ca/people/
documents/upshur_stand_guard.pdf
24
UK Cabinet Office and Department of Health. Responding to pandemic influenza. The ethical framework for policy and
planning. 2007. Available from:
www.dh.gov.uk/en/Publicationsandstatistics/Publications/PublicationsPolicyAndGuidance/DH_080751
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The IHR (2005) include obligations for States Parties to:

• develop core capacity for surveillance and response;
• establish a national focal point (NFP) as the contact point for WHO on all IHR matters; and
• notify WHO of all potential PHEIC within specified time frames.
In order for Canada to meet the IHR (2005) requirements, all levels of government must collaborate. In
Canada, PTs use established protocols to report influenza infections of international concern to the
Public Health Agency of Canada (PHAC), which is Canada’s NFP. After an initial assessment if notification
is required, PHAC communicates with the WHO. Reportable influenza-related events include cases of
human influenza caused by a new subtype as well as cases having potential international public health
implications that meet the notification criteria established under Annex 2 of the IHR (2005). WHO then
re-assesses the event to determine whether the event constitutes an actual PHEIC. The first PHEIC
declared by the WHO under the IHR (2005) was the influenza A (H1N1) pandemic in 2009.
Pandemic Influenza Preparedness Framework

The Pandemic Influenza Preparedness Framework (PIP Framework) for the sharing of influenza viruses
and access to vaccines and other benefits was adopted by the World Health Assembly in 2011. The PIP
Framework aims to improve the sharing of influenza viruses with pandemic potential and to achieve
more predictable, efficient and equitable access for countries in need of life-saving vaccines and
medicines during future pandemics. The PIP Framework is available at:
www.who.int/influenza/pip/en/.
Under the Framework, Member States, including Canada, are responsible for:
• ensuring the timely sharing of influenza viruses with human pandemic potential with the Global
Influenza Surveillance and Response System (GISRS);
• contributing to the pandemic influenza benefit-sharing system; and
• continuing to support the GISRS.
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2.6.2 FEDERAL LEGISLATION

The Emergency Management Act (2007), section 6(1), makes each minister accountable to Parliament
for a government institution responsible to identify the risks that are within or related to his or her area
of responsibility and prepare emergency management and response plans with respect to those risks;
to maintain, test and implement those plans; and to conduct exercises and training in relation to them.
In accordance with responsibilities under the Act, the federal Minister of Health is primarily responsible
for developing, testing and maintaining mandate-specific emergency plans for the federal Health
Portfolio, which includes Health Canada (HC) and PHAC. These emergency plans outline the federal
response to national public health threats or events such as major disease outbreaks (including an
influenza pandemic), and to the health effects of natural disasters or major chemical, biological,
radiological, nuclear and explosive (CBRNE) events.
Furthermore, the Quarantine Act (2005) strives to prevent the introduction and spread of communicable
diseases into and out of Canada by providing the Minister of Health with the authority, including
enforcement mechanisms, to take public health measures as required. Pandemic Influenza Type A is
listed in the Act’s Schedule of Diseases.
2.6.3 PROVINCIAL/TERRITORIAL LEGISLATION

Health emergency management in the PTs in Canada is governed by legislation specific to each
jurisdiction. This legislation requires the PT governments to have comprehensive emergency plans
respecting preparation for, response to and recovery from emergencies and disasters, including those
with potential impact on critical infrastructure. Important health emergency management powers are
also found in public health legislation.
The 2009 pandemic provided an opportunity to identify problems or gaps in existing legislation
(including public health legislation) that should be addressed in order to respond more effectively to a
future pandemic. An effective response requires an authority to establish appropriate leadership for a
coordinated response, along with authority for PT and local public health officials to implement
appropriate control measures. Planners should ensure that they will have authority to mount an effective
response whether or not an emergency is officially declared.
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3.0 CANADA’S APPROACH TO PANDEMIC INFLUENZA

3.1 Goals and Objectives
Goals serve an important purpose in guiding preparedness and response, and in prioritizing the use of
resources if necessary. Canada’s goals for pandemic preparedness and response are:
First, to minimize serious illness and overall deaths, and second to minimize societal
disruption among Canadians as a result of an influenza pandemic.
These national goals were originally presented in the Canadian Pandemic Influenza Plan for the Health
Sector, which was endorsed by FPT Ministers of Health in 2004. The goals, and their sequence, had
undergone extensive deliberation by FPT pandemic planners and other stakeholders. A survey carried
out as part of the Canadian Program of Research on Ethics in a Pandemic (CanPREP) found that over
90% of participants agreed that the most important goal of pandemic influenza preparations was
saving lives.25 During the 2009 pandemic, the pandemic goals were invaluable in guiding aspects of
the response.
Ritvo P, Wilson K, Gibson JL, et al. Canadian survey on pandemic flu preparations. BMC Public Health 2010;10;125.
25
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The supporting objectives for the health sector are as follows:
A. MINIMIZE SERIOUS ILLNESS AND OVERALL DEATHS BY

• reducing the spread of infection through promotion of individual and community actions;
• protecting the population through provision of pandemic vaccine and implementation of
other public health measures; and
• providing treatment and support for large numbers of persons while maintaining other
essential health care.
B. MINIMIZE SOCIETAL DISRUPTION BY
• supporting the continuity of health care and other essential services;
• supporting the continuation of day-to-day activities as much as possible and promoting a
return to normal community functioning as soon as possible;
• maintaining trust and confidence through
–– support of evidence-informed decision-making by collection, analysis and sharing of
communication of appropriate and timely advice to decision-makers, health professionals
and the public; and supporting a coordinated response by working collaboratively with all
levels of government and stakeholders.
3.2 Guiding Principles and Approaches
The following principles underpin Canadian pandemic preparedness and response activities and
decision-making:
• Collaboration—all levels of government and health care stakeholders need to work in partnership to
produce an effective and coordinated response. This implies adopting consistent and collaborative
approaches to planning, response and recovery, and having an effective FPT decision-making
process. It also implies involvement of stakeholders in these steps.
• Evidence-informed decision-making—decisions should be based on the best available evidence to
the extent possible. It is recognized that other factors also enter into decision-making, such as legal
and institutional constraints, values, costs and availability of resources.26
• Proportionality—the response to a pandemic should be appropriate to the level of the threat.
• Flexibility—actions taken should be tailored to the situation and subject to change as new information
becomes available. The pan-Canadian approach should be consistent, although patterns of spread
may mean that regional and local jurisdictions will require flexibility in terms of the scale and timing
of their response.
Oxman AD, Lavis JN, Lewin S et al. SUPPORT Tools for evidence-informed health Policymaking (STP) 1: What is evidence-
26
informed policymaking? Health Res Policy Syst 2009;7(Suppl 1):S1
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In addition to these main guiding principles, Canadian pandemic planning and response activities are
also guided by:
• A precautionary/protective approach – this approach is particularly applicable in the early stages
of a pandemic when evidence-informed decision-making is not possible due to lack of data and
the uncertainty of an evolving event. This means taking timely and reasonable preventive action,
proportional to the threat and evidence-informed to the extent possible. This does not mean that
in the absence of evidence, all actions must be taken; rather, it means that as emerging evidence
reduces uncertainty, evidence-informed actions may supersede those precautionary measures taken
at the outset.
• Use of established practices and systems to the extent possible – it is extremely difficult to implement
new ways to do things during an emergency. Effective seasonal influenza responses support a strong
pandemic response, as well-practised strategies and processes can be rapidly ramped up to manage
the pandemic.
• Ethical decision-making – ethical principles and societal values should be explicit and embedded
in all decision-making, including the processes used to reach decisions. It is especially important
to ensure that all actions respect ethical guidelines tailored to the concerns of public health, while
respecting the rights of individuals as much as possible.
3.3 Coordination of National Preparedness and Response

The global nature of a pandemic requires a response that differs from many other types of emergency.
Traditionally, the responsibility to deal with an emergency is placed first on the individual/household to
manage the effects of the emergency as it affects them, and then on successive levels of government as
the resources and expertise of each are needed. Public Safety Canada is responsible for coordinating
the whole of government response when the federal government is involved in the response to an
emergency. Within the PTs a similar function is performed by the appropriate ministry or emergency
measures organization.
In a pandemic situation, a pan-Canadian whole-of-government response is required so that all potential
resources can be applied to minimizing the pandemic’s negative health, social and economic impacts.
Pandemic plans should be aligned across jurisdictions to facilitate successful FPT collaboration during
a pandemic.
The following sections provide a high-level overview of FPT health emergency planning and response
relevant to pandemics.
3.3.1 EMERGENCY MANAGEMENT FRAMEWORKS AND PLANS

The GC has in place a coordinated system of federal emergency management frameworks, systems and
emergency response plans, many of which can be accessed at Public Safety Canada’s website. These
plans are based on the four components of the emergency management continuum (prevention and
mitigation, preparedness, response and recovery) and they use an all-hazards approach. Emergency
response plans for the federal Health Portfolio are part of this GC system.
The FPT health sector also has a system of frameworks and emergency response plans parallel to those
of the federal health sector, that are comprehensive and flexible enough to address any type of national
health emergency. The development and maintenance of some of these documents, including CPIP, is
overseen by the PHN.
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The federal and FPT emergency management plans are supported by various operational annexes and
guidance documents. These are nested under the generic all-hazards emergency response plans and
deal with more specific threats.
3.3.2 PAN-CANADIAN COORDINATION OF THE PANDEMIC HEALTH SECTOR RESPONSE

Because a pandemic is a significant health event, the FPT ministries of health have the primary mandate
for the health sector response in their respective jurisdiction and act as advisor for other sectors on
health issues.
At the federal level, the Centre for Emergency Preparedness and Response (CEPR) at PHAC is the
Health Portfolio’s focal point for coordinating and providing a wide range of emergency management
services with other federal departments, PT governments, NGOs and the private sector. CEPR is
responsible for the Health Portfolio Operations Centre (HPOC) in Ottawa and its linkages to other
operational centres at the FPT level.
Coordination of the FPT health sector response to a pandemic will follow the governance structure
outlined in the FPT Public Health Response Plan for Biological Events (FPT-PHRPBE). The FPT-PHRPBE
is complementary in nature and used in conjunction with existing jurisdictional planning and response
systems.
The FPT-PHRPBE is intended to bridge the gap between PT public health response plans and federal
health response plans by providing a single, common overarching governance framework for the FPT
health sector that can be applied, in full or in part, during a significant public health event requiring a
coordinated FPT response, such as an influenza pandemic.
The FPT-PHRPBE defines a flexible FPT governance mechanism that identifies escalation considerations
and response levels for a scalable response, and to improve effective engagement amongst public
health, health care delivery and health emergency management authorities during a coordinated FPT
response. This will ensure that at the time of a response, notification processes and inter-jurisdictional
information-sharing will be enhanced; public and professional communication will be addressed; and
advance planning and decision-making between and amongst multiple jurisdictions will be facilitated.
Finally, as the effects of a pandemic are not exclusive to the health system, it is critical for FPT governments
and emergency management partners to use a common approach in responding to a pandemic.
Emergency social services (e.g. non-medical services considered essential for the immediate physical
and social well-being of people affected by disasters) should be coordinated within the broader PT
response and aligned with health system activities.
3.3.3 NORTH AMERICAN PLAN FOR ANIMAL AND PANDEMIC INFLUENZA

The North American Plan for Animal and Pandemic Influenza (NAPAPI) outlines how Canada, Mexico
and the US intend to work together to combat an outbreak of animal influenza or an influenza pandemic
in North America. The NAPAPI addresses both animal and public health issues, including early notification
and surveillance, joint outbreak investigation, epidemiology, laboratory practices, medical
countermeasures (e.g., vaccine and antiviral medications), personnel sharing and public health measures.
It also addresses border and transportation issues. While the NAPAPI is not legally binding, it reflects
strong commitments by the countries involved to work collaboratively.
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3.4 Pandemic Roles and Responsibilities

Collaboration in pandemic planning and response is strengthened by having clearly defined and well-
understood roles and responsibilities. While this section focuses on government responsibilities, it is
acknowledged that other partners also have important roles and responsibilities in a pandemic. These
partners include the non-health sector, private sector, NGOs, municipalities and local/regional health
authorities, and international organizations. Similarly, members of the general public bear responsibility
for keeping themselves informed and for cooperating with measures to reduce the spread of illness.
3.4.1 WORLD HEALTH ORGANIZATION

WHO’s pandemic roles and responsibilities are outlined in the WHO pandemic influenza risk management
guidance document and include:27
• coordination of the international response under the IHR (2005), including conducting global
risk assessments;
• communication of the global situation using the global pandemic phases;
• declaration of a PHEIC and pandemic as required under the IHR;
• provision of information and support to affected States Parties;
• selection of the pandemic vaccine strain and determination of when to move from seasonal to
pandemic vaccine production; and
• provision of oversight and support for implementation of the PIP Framework.
3.4.2 CANADA—FPT GOVERNMENTS

Responsibility for health services in Canada is shared across all levels of government. High-level roles
and responsibilities for FPT governments are outlined below; more detailed information about roles and
responsibilities for specific response components can be found in the CPIP annexes. It is recognized
that responsibilities for federal populations, which are summarized at the end of this section, are complex
and evolving.
A. INTERNATIONAL ASPECTS
International aspects of influenza management and liaison are a federal responsibility.
The federal government is responsible for:
• acting as the national focal point for the WHO on all IHR (2005) matters and managing all international
aspects of pandemic preparedness and response;
• providing travel health notices and other health related information relevant to international travel; and
• exercising powers under the Quarantine Act to protect public health by taking comprehensive
measures to help prevent the introduction and spread of communicable diseases in Canada. Such
measures may include, but are not limited to, the screening, examining and detaining of arriving
and departing international travellers, conveyances (e.g., airplanes and cruise ships) and their goods
and cargo.
27
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B. COLLABORATION, COMMUNICATION, INFORMATION SHARING

AND POLICY RECOMMENDATIONS
While PT governments are responsible for communications plans and messaging within their jurisdictions,
a coordinated pan-Canadian pandemic response requires collective infrastructures, response capacities
and coordinated activities.
• ensuring that risk assessments for novel and pandemic viruses are prepared and communicated as
required; and
• facilitating the coordination of the overall pan-Canadian response to a pandemic.
FPT governments will work collaboratively to:

• coordinate and support the process required for development and periodic updating of CPIP and its
annexes, for which PHAC acts as the custodian;
• assess capacity gaps for a pan-Canadian response and address gaps as necessary;
• align federal pandemic plans for federal populations, (see Section F for federal populations), with PT
plans, where relevant;
• assess surveillance capacity, standards and protocols and modify as necessary;
• assess laboratory capacity, standards and protocols and modify as necessary;
• establish and support pan-Canadian policies and recommendations on the use of antiviral medications
and vaccine during a pandemic;develop and implement public health guidance;
• ensure development and dissemination of clinical care guidance;
• develop a pan-Canadian communication strategy that reflects Canadian linguistic, literacy and cultural
characteristics and allows for the alignment of messaging by FPT jurisdictions where appropriate;
• establish protocols for the sharing of relevant information, including but not limited to FPT plans
and drafts; surveillance information; jurisdictional communications, strategies and messaging; and
pandemic response interventions and impacts; and
• identify and address rapid research response priorities and leverage their respective research
undertakings.
C. ANTIVIRAL MEDICATIONS AND INFLUENZA VACCINE

• providing regulatory authorization to market antiviral medications and influenza vaccines;
• acting as the focal point for vaccine manufacturers and international regulatory collaboration;
• providing regulatory authorization to conduct clinical trials;
• negotiating with manufacturers and establishing contracts for the FPT purchase of antiviral medications
and vaccine for pandemic purposes;
• national monitoring of adverse reactions to antiviral medications and vaccines; and
• providing antiviral medications and vaccine to those federal populations not covered by arrangements
for PT provision.
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PT governments are responsible for maintenance, monitoring, distribution and administration of antiviral
medications and vaccine in their respective jurisdictions. They will work collaboratively to:
• provide antiviral medications and, when available, vaccine to recommended populations;
• share information regarding the distribution and use of antiviral medications and vaccines in their
respective jurisdictions; and
• monitor and report adverse vaccine reactions.
The PT governments are also responsible for the distribution of vaccines and antiviral medications to
most federal populations, but this varies by federal population and jurisdiction (see section F on
federal populations).
FPT governments will work collaboratively to develop strategies to mitigate the effects of insufficient or
delayed antiviral drug and/or vaccine supply, should such a situation arise.
D. HEALTH SECTOR PREPAREDNESS AND RESPONSE

Health sector preparedness and response remains the responsibility of each jurisdiction. In some
jurisdictions responsibility for emergency social services also falls to the health sector.
PT governments are responsible for:
• ensuring that PT pandemic plans (or all-hazards plans depending on the jurisdiction) are developed,
tested and periodically updated;
• considering the content and intent of CPIP in the development of their PT jurisdictional plans;
• communicating and engaging with the general public, media and stakeholder groups about
their respective plans; and
• activating PT pandemic or all-hazards plans.
The federal government has similar responsibilities for federal departments within the health sector and
for federal populations in collaboration with the PTs (see section F on federal populations).
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E. HEALTH CARE PROVISION

The provision of health care is an essential component of pandemic response and is primarily a
PT responsibility.
PT governments are responsible for:
• developing plans to increase surge capacity in order to care for affected persons in their jurisdiction;
• providing health care services for persons within their jurisdiction, including for federal populations
while leveraging agreements that are in place. (federal populations and federal responsibility are
covered in the next section);
• developing and maintaining memoranda of understanding and protocols as needed, preferably
before the pandemic, to facilitate interprovincial/territorial movement of patients and licensed health
care professionals during a pandemic and other aspects of mutual aid;
• developing, as necessary, a strategy for collecting and monitoring data on health care service use;
• ensuring the provision of medications, supplies and equipment required for provision of pandemic
health care services; and
• working collaboratively to establish protocols and guidelines for prioritizing health care services
during times of high service demand and staff or supply shortages in the respective jurisdiction.

• ensuring the provision of health services, medications, supplies and equipment for specified federal
populations/employees who normally access federally operated health care services;
• facilitating access to surge capacity, including from federal programs, employees and resources, to
support PT responses if required;
• mobilizing medical supplies in the National Emergency Strategic Stockpile (NESS) as surge capacity
to support PT responses; and
• facilitating the acquisition of extra medical supplies through Public Services and Procurement Canada
and other federal agencies as appropriate.
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F. FEDERAL POPULATIONS
Federal populations are those populations for which the federal government either provides health care
and benefits, goods and/or services or reimburses the cost of providing health care and benefits. With
the exception of the Canadian Forces which has its own distinct health care system for active members,
the needs of federal populations must be integrated into PT pandemic planning activities in order to
establish a comprehensive and coordinated pandemic response.
Federal populations include the following:
• First Nations on-reserve, inclusive of First Nations who have assumed responsibility for health services
under a transfer agreement;
• active members of Canadian Forces;
• federal offenders or inmates of federal penitentiaries;
• refugee claimants, protected persons, detainees under the Immigration and Refugee Protection Act,
rejected refugee claimants, and other specified populations; and
• Canada-based staff at missions abroad.

• supporting the provision and distribution of medications, supplies and equipment to federal
populations, as noted in the list above, through existing FPT distribution and administration systems.
The federal government will work collaboratively with PT governments to:

• ensure that access to pandemic health services for all federal populations is available on the same
basis as is provided to other residents of Canada, while leveraging agreements that are in place. This
involves but is not limited to access to antiviral medications, influenza vaccines and supplies needed
for provision of pandemic health care services; and
• facilitate the coordination of federal planning for federal populations with PT pandemic plans.
3.5 Risk Management Approach

3.5.1 OVERVIEW
Risk management is a systematic approach to setting the best course of action in an uncertain
environment by identifying, assessing, acting on and communicating risks. A risk management approach
provides a useful framework for addressing the uncertainties inherent in pandemic planning and
response. Risk management supports the CPIP planning principles of evidence-informed decision-
making, proportionality, and flexibility; and a precautionary/protective approach when there is uncertainty
early in an event.
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Figure 1 provides a graphic overview of the risk management process as outlined in ISO 31000, the
international standard for risk management. The individual steps involved in risk management are then
briefly described.
FIGURE 1—ISO 31000 RISK MANAGEMENT PROCESS28
Establishing the context
Risk Assessment
Communication Risk Identification Monitoring

and and
Consultation Risk Analysis Review
Risk Evaluation
Risk Treatment
Risk assessment is a central component of risk management. Its purpose is to provide evidence-informed
information and analyses for making informed decisions on how to treat particular risks and select
between options. There are three parts to risk assessment:
• Risk identification involves identifying what might happen, or what situations might exist that could
affect achievement of the objectives of the organization or system.
• Risk analysis involves analysing the risks in terms of their probability and potential impact (who is
affected and to what extent). This analysis helps identify the planning considerations and options
for each component of the response. The analysis should also assess the public’s perception of risk
and how it could influence the risk management response, so that communications strategies and
messaging can be tailored appropriately.
• Risk evaluation involves determining the significance of the level and type of risk in order to make
decisions about future actions. Ethical, legal, financial and other considerations are also inputs to the
decisions. Decisions may include the need and priorities for treatment, whether an activity should be
undertaken or which of a number of paths should be followed.
Risk treatment follows risk assessment and involves identifying and recommending risk treatment
options, i.e. options for management or control. Risk treatment options should include steps that need
to be taken in advance, as well as potential actions at the time of the pandemic.
Communication and consultation are also integral parts of the risk management process. Effective
communication with stakeholders should facilitate adequate understanding of the risk management
decision-making process, ensure that the process is transparent and help people to make informed
decisions. A risk communications plan should be developed at an early stage.
Canadian Standards Association. CAN/CSA-ISO 31000-10. Risk management—Principles and guidelines (Adopted ISO
28
31000:2009, first edition 2009-11-15). 2010.
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Monitoring and review are important for assessing factors that could change over time and for
documenting effectiveness of interventions. Such reviews should lead to periodic updates of the
risk assessment.
3.5.2 RISK MANAGEMENT CONSIDERATIONS IN PANDEMIC PLANNING AND RESPONSE

Given the large number of variables that are involved in influenza pandemic planning, comprehensive
risk management is challenging. The four pandemic planning scenarios described in section 3.7 can
assist with risk identification by providing a starting point to think through the risks that would be
associated with pandemics of varying impact and their implications.
It is also worthwhile to anticipate key decisions that will need to be taken during the pandemic to help
guide the development and analysis of options. It is also worthwhile to clarify ahead of time and to the
extent possible what level(s) of government should be involved with which types of decision when the
time comes. Examples of these key decisions are as follows:
• what is the scale of the response;
• whether (and when) to escalate or de-escalate the response;
• when, what and how to communicate with the public;
• what amount of vaccine and the formulation(s) to order;
• how vaccine use should be prioritized;
• what public health interventions should be used, when and within which populations, and whether
they need to be adjusted over time;
• what influenza testing and treatment strategies to recommend and whether they need to be adjusted
over time; and
• what supplementary assessment and treatment services might be needed and, if necessary, when
they should be started and stopped.
Anticipating key decisions should be accompanied by identification of the types and sources of
information required for decision-making. Establishing robust surveillance for seasonal influenza
establishes baselines, develops capacity and provides a platform for escalation during the pandemic.
Anticipating key decisions should also lead to development of relevant options for risk treatment. From
a pandemic preparedness perspective, examples of risk treatment include continuity of operations
planning; establishment of stockpiles for antiviral medications and other key supplies; development of
advance contracts for pandemic vaccine; strengthening influenza surveillance systems, diagnostic and
analytical capacity; establishment of protocols for pandemic research; and establishment of
communications networks to plan effective and coordinated risk communications strategies.
When a pandemic occurs, planning scenarios are replaced by a real event and response activities will be
guided by the available evidence. During the initial stages, little may be known about the likely pandemic
impact or the populations most at risk. Many decisions will have to be made before solid information is
available and then adjusted, if necessary, as more becomes known, keeping in mind that it is often
difficult to scale back a response. As the evidence emerges over time, understanding of the situation will
continue to change as new information becomes available and will always be incomplete. A risk
management approach will be used throughout the response by all responders. Risk assessments will
provide key input into FPT decision-making by identifying what is known at that point in time, what
might occur and when, and the major areas of uncertainty.
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PHAC will facilitate development of timely and credible risk assessments to support FPT decision-
making. These formal risk assessments will be conducted at the start of the pandemic to inform the
initial response and then periodically as new information emerges (e.g., at the end of a pandemic wave).
Risk assessments will address key information needs, including viral characteristics, the anticipated or
experienced impact on the health care system and community, age and risk groups most affected,
occurrence of antiviral resistance and estimated effectiveness of control measures. As the pandemic
progresses, there will be questions about likely occurrence of more pandemic waves, whether new risk
factors are emerging and whether the response should be escalated or de-escalated. Appendix B
identifies relevant considerations for initial and ongoing pandemic risk assessments and identifies
potential sources for the supporting information.
3.6 Planning Assumptions

This section on planning assumptions and section 3.7 on pandemic planning scenarios describe two
important tools for pandemic planning. These tools provide distinct but complementary approaches.
Identifying planning assumptions is a way to deal with uncertainty. Assumptions provide a useful
framework for planning but should not be regarded as predictions. While planning assumptions are
rooted in evidence to the extent possible, 29,30 they are basically educated guesses. As the pandemic
unfolds, emerging evidence is used to guide the response. Informing the planning assumptions
identified below is the WHO’s Pandemic influenza risk management interim guidance (2013), the UK’s
Scientific summary of pandemic influenza & its mitigation (2011) and discussions from the Canadian
Pandemic Influenza Preparedness Planning Assumptions Workshop held in 2011.
3.6.1 ORIGIN AND TIMING

• The next pandemic could emerge anywhere in the world and at any time of year.
• There may be no lead time before the novel virus reaches Canada.
• The first peak of illness in a geographic area within Canada could occur within weeks of first detection
of the novel virus in that area. The first peak in mortality is expected to be several weeks after the
peak in illness.
29
30
Department of Health. Scientific summary of pandemic influenza & its mitigation. 2011. Available from:
www.dh.gov.uk/en/Publicationsandstatistics/DH_125318
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3.6.2 TRANSMISSION
• The pandemic virus will behave like seasonal influenza viruses in significant ways:
–– incubation period—is expected to last from one to three days;
–– period of communicability—adults are infectious from 24 hours before and up to five days from
the onset of symptoms, and children may be infectious for up to seven days. Longer periods have
been found, especially in persons with immune compromising conditions;
–– methods of transmission—mainly by large droplet and contact (direct and indirect) routes; the role
of airborne transmission is unclear.
• Transmission is expected to be relatively lower in spring and summer than in fall and winter (the
general pattern of transmission in temperate countries).
• Transmission is possible from asymptomatic persons but is greater when symptoms, such as coughing,
are present and viral shedding is high (i.e., early in the symptomatic period).
3.6.3 PANDEMIC EPIDEMIOLOGY

• Most communities will experience two or more pandemic waves of different magnitudes. In any
locality, the length of each wave will be from several weeks to a few months but may vary by community.
• There will be geographic variability with regard to the timing and intensity of waves, although multiple
jurisdictions will be affected simultaneously.
• The pandemic is expected to last 12 to 18 months.
• The novel virus is expected to displace other circulating seasonal strains during the pandemic. After
the pandemic, the pandemic virus will continue to circulate as a seasonal strain. It may completely
replace previously circulating seasonal influenza A subtypes or continue as one of several circulating
seasonal A subtypes.
• Relatively more severe disease and mortality is expected to occur in the young and in persons without
underlying health conditions compared to seasonal influenza.
3.6.4 CLINICAL FEATURES

• Population clinical attack rates (averaged across all age groups) are expected to be 25% to 45% over
the course of the pandemic.
• Clinical symptoms are expected to develop in about two-thirds of people who are infected with the
pandemic influenza virus.
• The general, uncomplicated clinical picture is expected to be the same as for seasonal influenza:
respiratory symptoms, fever and abrupt onset of muscle ache, fatigue and headache or backache.
• Persons at high risk for complications from seasonal influenza31 are expected to also be at increased
risk of severe disease and complications from pandemic influenza infection, although additional risk
groups may emerge.
National Advisory Committee on Immunization. Statement on seasonal influenza vaccine for 2013–2014. Can Commun Dis
31
Rep 2013; 39 (ACS-4):1–37. Available from: www.phac-aspc.gc.ca/publicat/ccdr-rmtc/13vol39/acs-dcc-4/index-eng.php
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3.6.5 IMPACT AND INTERVENTIONS

• Impact will vary across communities, and vulnerable populations are expected to be affected
more severely.
• Workplace absenteeism may be higher than the estimated clinical attack rate because of caregiving
or concern about personal safety in the workplace in addition to worker illness.
• Vaccine is expected to be available in time to have an impact on the overall pandemic but will not
be available for the first wave.
• Personal hygiene measures are expected to help to reduce transmission between individuals and
within households and other settings.
3.7 Pandemic Planning Scenarios

This section discusses another important tool for pandemic planning. The use of multiple planning
scenarios is specifically intended to support the planning principles of evidence-informed decision-
making, proportionality, and flexibility; and a precautionary/protective approach.
Planning scenarios provide a starting point to think through the implications and risks that would be
associated with pandemics of varying population impact. Scenarios can also be used for exercises and
training in support of pandemic plans. To help with risk identification, four pandemic planning scenarios
have been developed that describe potential pandemic impacts varying from low to high. Figure 2
displays the four scenarios in a two-by-two table and estimates where the past four pandemics might be
placed, according to an analysis conducted by the US Centers for Disease Control and Prevention (CDC).32
FIGURE 2—FRAMEWORK FOR THE PLANNING SCENARIOS, WITH PREVIOUS

PANDEMICS PLACED AS PER CDC ANALYSIS33
HIGH
1918
B 1968 1957
D
Transmission
2009
A C
LOW
LOW Clinical Severity HIGH
32
Reed C, Biggerstaff M, Finelli L et al. Novel framework for assessing epidemiological effects of influenza epidemics and
pandemics. Emerg Infect Dis. 2013;19:85-91.
33
Ibid
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Scenario A (low impact)—this scenario involves an influenza virus with low transmissibility (ability to
spread) and low virulence (clinical severity). Its impact is comparable to that of moderate to severe
seasonal influenza outbreaks or the 2009 pandemic. It might be expected to stress health care services.
Scenario B (moderate impact)—this scenario involves an influenza virus with high transmissibility and
low virulence. Its impact is worse than seasonal influenza in terms of numbers ill, which would be
expected to stress health care services through sheer volume. High absenteeism would put all sectors
and services under pressure.
Scenario C (moderate impact)—this scenario involves an influenza virus with low transmissibility and
high virulence. Its impact is worse than seasonal influenza outbreaks in terms of severe clinical illness,
which would be expected to stress critical care health services. The high virulence could cause significant
public concern and may lead to people staying home from school and work.
Scenario D (high impact)—this scenario involves an influenza virus with high transmissibility and high
virulence, and its anticipated impact is much worse than that of seasonal influenza outbreaks. It would
cause severe stress on health care services, and high absenteeism would put all sectors and services
under extreme pressure.
There are several important points to note about the scenarios:

• Whatever the pandemic impact, the epidemiological picture is expected to be significantly different
from that of seasonal influenza, in that relatively more severe disease and mortality will occur in the
young and in persons without underlying health conditions compared to seasonal influenza.34
• The four basic scenarios do not incorporate all of the potential factors (or “what-ifs”) that can affect
the impact of a pandemic and should be considered in risk assessment. Some of these factors are
population-wide and could affect all scenarios (such as seasonality, pre-existing immunity or antiviral
resistance), whereas others might be setting-specific (such as planning for a remote community). See
Appendix A for more details about these additional factors and their potential impact. Additional
risks may also be identified as planners consider all stages of the pandemic and components of the
proposed response.
Table 1 provides some added description to the scenarios for planning purposes, along with potential
impact considerations associated with each scenario.
TABLE 1 – DESCRIPTION AND POTENTIAL IMPACT OF THE FOUR PANDEMIC PLANNING SCENARIOS
PANDEMIC SCENARIO
NATURE
A B C D
OF IMPACT
(LOW IMPACT) (MODERATE (MODERATE (HIGH IMPACT)
IMPACT) IMPACT)
BASIC VIRUS Low High Low High

CHARACTERISTICS transmissibility/ transmissibility/ transmissibility/ transmissibility/
low virulence low virulence high virulence high virulence
Simonsen L, Clarke MJ, Schonberger LB, et al. Pandemic versus epidemic mortality: a pattern of changing age distribution.
34
J Infect Dis 1998;178:53-60.
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PANDEMIC SCENARIO
NATURE
A B C D
OF IMPACT
IMPACT) IMPACT)
NATURE AND • Similar numbers • Higher number of • Similar number of • Large numbers
SCALE OF ILLNESS as in moderate or cases than large cases as with large of people ill
severe seasonal seasonal outbreak seasonal outbreak • High proportion
influenza outbreaks but similar clinical but illness is more with severe
• Mild to moderate severity severe disease
clinical features • Overall increased • Overall increased
(in most cases) numbers needing numbers needing
medical care and medical care and
with severe with severe
disease disease
IMPACT ON • Ambulatory and • Ambulatory • Ambulatory and • Health care

HEALTH CARE acute-care and acute-care acute-care services may be
SERVICES services stressed services very services very overwhelmed
but able to cope stressed stressed • Ambulatory
• ICUs at capacity • Health care • Health care services fully
• Public health and services no longer services no longer stretched
laboratory services able to continue able to continue • Hospitals able
stressed all activities all activities to provide only
• Long-term care • ICUs under severe • ICUs under severe emergency
may or may not pressure pressure services
be affected • Long-term care • Long-term care • Triaging necessary
(depending on may or may not be may or may not be for critical care
pre-existing affected affected services
immunity) • Settings with • Settings with • Collapse of
limited surge limited surge services could
capacity (e.g., capacity e.g., lead to higher
nursing stations) nursing stations) mortality than
may be even more may be even more expected
stressed stressed • Settings with
limited surge
capacity (e.g.,
nursing stations)
may be highly
stressed
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PANDEMIC SCENARIO
NATURE
A B C D
OF IMPACT
IMPACT) IMPACT)
BROADER • Limited workplace • High workplace • Potential • High absenteeism

SOCIETAL IMPACT disruption absenteeism workplace • Services and
• Some school • Some services absenteeism and businesses under
disruption experience school disruption extreme pressure
pressures from fear of
• Elevated public • Potentially severe
exposure
concern • Schools likely supply chain
disrupted • Considerable problems
public concern
• Some supply chain • Could disrupt
over occurrence
problems provision of basic
of very severe
• Elevated public services
disease
concern • Extreme public
• Surges in need for concern and
health care psychosocial
services. distress
• Mass fatalities may
overwhelm death
care services (e.g.
funeral homes,
mortuaries)
ECONOMIC Minimal if any Productivity may Productivity may Very high

IMPACT be affected be affected
Initial period when impact is unknown—A formal scenario has not been proposed for the initial period
when the pandemic has not yet been characterized in terms of its potential impact. However, some of
the possible observations for this preliminary period are as follows:
• sporadic cases and limited outbreaks may be occurring;
• there will likely be elevated demand on telephone information lines, ambulatory care and laboratory
services;
• public health services may be stressed;
• elevated media and public concern can be anticipated;
• international travel and trade could be disrupted; and
• there could be increased demand and shortages of publicly available supplies, e.g., infection control
and basic emergency supplies, antivirals.
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3.8 Pandemic Phases and Triggers for Action

3.8.1 WHO PANDEMIC PHASES
Pandemic phases were introduced into pandemic plans to assist planning and serve as triggers for
action, thus supporting the principles of flexibility and proportionate response. Previous Canadian
pandemic plans incorporated the WHO pandemic phases, with additional designations proposed to
identify activity levels within Canada.
After the 2009 pandemic, the IHR Review Committee35 recognized that the WHO pandemic phases had
presented challenges in interpretation and were used in different ways – as a planning tool, as a method
to describe the global situation and/or as an operational tool to trigger action. The Committee
recommended simplifying the WHO phase structure and separating operational considerations at
country level from the WHO global preparedness plan and its phases.
WHO’s 2013 pandemic guidance36 describes the four phases that WHO will use to communicate a high-
level global view of the evolving picture. The phases reflect WHO’s risk assessment of the global situation
regarding each influenza virus with pandemic potential that is infecting humans. The four global phases are:
• Interpandemic phase—the period between influenza pandemics;
• Alert phase—when influenza caused by a new subtype has been identified in humans. This phase is
characterized by extra vigilance and careful risk assessment;
• Pandemic phase—the period of global spread of human influenza caused by a new subtype.
Movement between the interpandemic, alert and pandemic phases may occur quickly or gradually;
• Transition phase—reduction of the assessed risk resulting in de-escalation of global actions.
The global phases and their application in risk management are distinct from (1) the determination of a
PHEIC under the IHR (2005) and (2) the declaration of a pandemic. These are based upon specific
assessments and can be used for communication of the need for collective global action, or by regulatory
bodies and/or for legal or contractual agreements, should they be based on a determination of a PHEIC
or on a pandemic declaration.37
As pandemic viruses emerge, countries face different risks at different times and should therefore rely
on their own risk assessments, informed by the global phases, to guide their actions. The uncoupling of
national actions from global phases is necessary since the global risk assessment, by definition, will not
represent the situation in each country.
35
World Health Organization. Implementation of the International Health Regulations (2005). Report of the Review Committee
on the Functioning of the International Health Regulations (2005) in relation to Pandemic (H1N1) 2009. A64/10. 5 May 2011.
Available from: http://apps.who.int/gb/ebwha/pdf_files/WHA64/A64_10-en.pdf
36
World Health Organization. Pandemic influenza risk management – WHO interim guidance. 2013. Available from:
37
Ibid.
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3.8.2 CANADA’S APPROACH TO PANDEMIC PHASES AND TRIGGERS FOR ACTION

Canada’s response to the novel/pandemic virus will relate to its presence and activity levels in this
country, which may not coincide with the global picture. Therefore, the WHO global phases will not be
used to describe the situation in Canada or be used as triggers for action in Canadian jurisdictions.
While the triggers for action described below may parallel some of the global WHO phases, it is not
expected that they will line up exactly. For example, Canada might be well into the first pandemic wave
before WHO announces the global pandemic phase (as happened in the 2009 pandemic) or conversely
Canada might be still anticipating the first domestic outbreaks when the pandemic phase announcement
is made.In the 2009 pandemic, there was considerable variation in pandemic wave activity across
Canada and even within PTs, in terms of both timing and intensity. This was particularly apparent in the
first wave making blanket descriptions, triggers or responses inappropriate.
DESCRIBING PANDEMIC ACTIVITY

Descriptive terms such as the start, peak and end of a pandemic wave, will be used instead of phase
terminology to describe pandemic activity in the country or in a jurisdiction within Canada. Pandemic
wave activity can be further characterized for jurisdictions of any size using FluWatch definitions for no
activity, sporadic activity, localized activity and widespread activity.38
TRIGGERS FOR ACTION

Triggers for action provide guidance for initiation of FPT activities and for their modification and
cessation. Pandemic response should be appropriate to the local situation, so it is important that triggers
and related actions be applied at PT or regional/local level as appropriate to the situation. Potential
triggers for action in Canadian jurisdictions during the initial alert stages and the pandemic itself are
identified in Table 2. The typical actions listed are at a high level; more detailed triggers for individual
response components can be found in the annexes. Note that the triggers are not necessarily linear; for
example, not all jurisdictions may find their capacity exceeded and therefore some may not need to
invoke that particular trigger.
TABLE 2 – PANDEMIC TRIGGERS AND TYPICAL ACCOMPANYING ACTION
TRIGGER TYPICAL ACTIONS FOR CONSIDERATION COMMENTS
NOVEL VIRUS • Preparations to enhance surveillance • Tailored communications

CAUSING HUMAN within Canada to health sector and
CASES DETECTED • Intelligence gathering from affected areas general public continue
SOMEWHERE throughout the response
• Relevant public and health sector communications
IN THE WORLD
(NO OR LIMITED
TRANSMISSION)
Public Health Agency of Canada. FluWatch. Definitions & calendar for the current season. Available from:
38
www.phac-aspc.gc.ca/fluwatch/index-eng.php
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NOVEL VIRUS WITH • Enhanced surveillance by PTs within Canada • Pandemic may be imminent
SUSTAINED HUMAN • Intelligence gathering from affected areas; or have already started
TRANSMISSION preliminary risk assessment
DETECTED
• Development of specific laboratory diagnostics
SOMEWHERE
IN THE WORLD • Enhancement of illness prevention messages and
other public health measures (e.g., hand hygiene,
respiratory etiquette) as appropriate
• Confirmation of pandemic vaccine arrangements
with manufacturer
NOVEL/PANDEMIC • Continuation of above activities • Depending on

VIRUS (WITH • Activation of health emergency response protocols circumstances, activation
SUSTAINED HUMAN of health emergency
• Detailed investigations of early cases to determine
TRANSMISSION) protocols might already
epidemiological and clinical characteristics and
FIRST DETECTED have occurred
inform risk assessment
IN CANADA
• Arrangements for antiviral access/strategic
deployment of NAS
• Provision of clinical guidelines and public
health advice
NOVEL/PANDEMIC • Treatment of cases • Escalation of activities as

VIRUS DETECTED • Ramping up health sector capacity to deal with pandemic activity moves
IN PT OR LOCAL increasing number of cases from sporadic cases into
JURISDICTION full pandemic wave,
• Additional public health measures (e.g., school
followed by de-escalation
closures) as appropriate
as it wanes
• Preparation for vaccine distribution, administration
and monitoring
• Ongoing surveillance to monitor influenza activity
and epidemiological analysis to characterize
pandemic
• Relevant public and health sector communications
• Assess need for supportive emergency and social
services (e.g. reception centres, volunteers,
faith-based organizations
DEMANDS FOR • Further escalation of surge capacity • May not reach this level
SERVICE START TO • Prioritization or triage of services as needed in any or all jurisdictions
EXCEED AVAILABLE
• Implementation of broader public health measures
CAPACITY
(e.g., banning of large gatherings)
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THE PANDEMIC • Preparation for a resurgence of influenza

WAVE WANES • Replenishing of supplies as needed in anticipation
AND DEMAND FOR of another wave
SERVICE FALLS TO
• Evaluation of response and revision of plans
MORE NORMAL
as required
LEVELS
• Preparation for immunization program
• Ongoing surveillance to detect resurgence
• Assessment of the psychosocial impact on the
population (e.g. workforce resiliency, mental
health, social cohesion) of the first wave
PANDEMIC VACCINE • Administration of vaccine as quickly as possible

IS AVAILABLE FOR • Monitoring of vaccine uptake, safety
ADMINISTRATION and effectiveness
SECOND OR • Treatment of cases

SUBSEQUENT • Continuation of immunization if already started
PANDEMIC WAVE
• Ongoing surveillance to monitor influenza activity,
ARRIVES
antiviral resistance and strain changes
PANDEMIC IS OVER • Completion of pandemic studies and reports • Identification of lessons

AND NORMAL • Evaluation of response and revision of plans as learned and their
ACTIVITIES RESUME required incorporation into
pandemic planning are
• Return to more normal operations
critical activities in the
• Preparation for post-pandemic seasonal influenza recovery from a pandemic
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4.0 KEY COMPONENTS OF PANDEMIC INFLUENZA PREPAREDNESS

AND RESPONSE
This chapter provides a high-level overview of the major components of influenza preparedness and
response. Each section of the chapter describes the purpose and strategic approach of one of the
response components and demonstrates how it supports the overall pandemic goals. Detailed
operational guidance and tools for each component can be found in the respective CPIP annex.
All parts of the health sector, including public health, will be under stress during a pandemic. Advance
planning, training and exercises will greatly assist in handling this increased demand on health services,
staffing, resources and supplies and in providing the best possible clinical outcomes for persons ill with
influenza. Continuity of operations and surge capacity planning are key components of health sector
preparation, together with strong infection prevention and control and occupational health programs
within each organization that provides health services.
Public health authorities play a leadership role in their jurisdiction in pandemic preparedness, response
and recovery. They are responsible for communication to the public, the health sector and other
stakeholders. The public health response to a pandemic also includes surveillance (both epidemiological
and laboratory), the provision of pandemic vaccine and antiviral medications, and the application of
public health measures such as promotion of personal and social distancing measures to reduce spread
in households and the community.
In planning for the delivery of health services, it is important to encompass the entire continuum of care
from medical first response to critical care, and to include community health partners. Planning for the
provision of health care needs to be linked with public health and community-wide partners so that
interdependencies can be identified and addressed.
The health care system includes workers of many disciplines, who will be at varying levels of risk during
an influenza pandemic. HCWs are defined broadly as individuals who provide health care or support
services in the health care setting, such as nurses, physicians, dentists, nurse practitioners, paramedics,
medical laboratory workers, other health professionals, temporary workers from agencies, unregulated
health care providers, students, volunteers and workers who provide support services (e.g., food,
laundry, housekeeping). The concepts and advice that are provided for HCWs also apply to other
workers who are functioning in a health care capacity, for example police or fire personnel who are
providing medical first response.
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4.1 Surveillance
The purpose of pandemic surveillance is to provide decision-makers with the timely information they
need for an effective response. Pandemic surveillance uses data obtained through routine and enhanced
surveillance activities (e.g., data from sources such as laboratories, PT partners, hospital networks and
sentinel practitioners) together with information from special studies to obtain a comprehensive and
timely epidemiological picture of the pandemic.
These pandemic surveillance programs will monitor parameters such as:
• the geographic spread of the novel/pandemic virus across Canada;
• the trend of disease occurrence as it rises and falls within each PT and across the country;
• the intensity and impact of the pandemic (e.g., clinical cases, hospitalizations and deaths; severe
clinical syndromes and associated risk groups; and demands on the health system); and
• changes in the antigenicity and antiviral sensitivity of the virus.
STRATEGIC APPROACH
A risk management approach to an influenza pandemic requires access to timely information, analysed
and presented in a way that is useful to decision-makers. Epidemiological and laboratory surveillance
data are key components of the formal risk assessments that will be produced to inform the response.
One of the most critical needs is an early assessment of the potential impact of the pandemic so as to
prepare the health care system and to plan interventions that are proportional to the situation. Systems
or studies to produce the early impact assessment and other required information need to be in place
before the pandemic.
Pandemic surveillance should be built on existing surveillance systems for seasonal influenza, which
involve an extensive network of surveillance partners and are practised every year.
During a pandemic, collection of additional surveillance elements may be required to identify risk factors
for severe disease and populations at increased risk. Targeted surveillance activities may be required for
remote and isolated communities, including many Indigenous communities, to describe outbreaks
appropriately in these regions. Other special studies (e.g., seroprevalence surveys) will be needed to
inform decision-making.
Surveillance activities will need to be adapted in response to rapidly evolving situations; they may be
streamlined, expanded or scaled down depending on information needs at particular times within the
evolving pandemic. The scope of the pandemic and the urgency of information needs will require
expedited and secure electronic data transfer and enhanced capacity for data analysis and interpretation.
More details about pandemic surveillance strategies and activities can be found in the Surveillance Annex.
4.2 Laboratory Services

Laboratory-based surveillance is an integral part of monitoring influenza activity. Because the signs and
symptoms of influenza are similar to those caused by other respiratory pathogens, laboratory testing
must be conducted to diagnose influenza definitively. Rapid identification of a novel influenza virus and
timely tracking of virus activity throughout the duration of the pandemic are critical to the success of a
pandemic response. In the early stages of a pandemic, laboratory services also contribute to appropriate
clinical treatment.
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The purpose of laboratory services during a pandemic is to:

• identify the first cases of a novel influenza strain occurring in Canada;
• support public health surveillance by monitoring the geographic spread of disease and the impact
of interventions;
• facilitate clinical management by distinguishing patients infected with the pandemic influenza virus
from those with other respiratory diseases;
• monitor circulating influenza viruses for antiviral resistance and strain characteristics; and
• assess influenza vaccine match and support vaccine effectiveness studies.
STRATEGIC APPROACH
The pandemic laboratory response is built on the principles of collaboration, flexibility and use of
established practices and systems. As part of annual influenza surveillance, all public health laboratories
and other laboratories that routinely test for influenza submit aggregate data weekly during the influenza
season to the National Microbiology Laboratory (NML). These data are collated and disseminated by
PHAC through the Respiratory Virus Detection Surveillance System and FluWatch. In addition, public
health laboratories and other designated laboratories across the country submit isolates to the NML to
monitor for antigenic changes within the circulating viruses. This information is shared with international
partners through GISRS. Sustaining these relationships and strengthening capacity within the laboratory
system during the interpandemic period will support a timely and effective pandemic response.
During a pandemic, influenza testing laboratories will support epidemiological efforts to track the
spread and trends of the pandemic, monitor antiviral resistance and support clinical management. The
Canadian Public Health Laboratory Network (CPHLN) will support public health and diagnostic
laboratories by providing recommendations and best practices for specimen collection and testing for
the novel influenza virus. The NML will share protocols, reagents and proficiency panels to ensure that
test methods are capable of detecting the new virus. Molecular testing is the primary method used for
the diagnosis of influenza.
Antiviral resistance will be monitored and outcomes will inform clinical management of patients. Antiviral
resistance testing is conducted primarily at the NML, as well as some provincial laboratories.
The laboratory response will be adjusted as the pandemic progresses. Initially the NML will be heavily
engaged in characterization of the novel virus and development of diagnostic reagents. All laboratories
should anticipate high test volumes initially as the novel virus spreads across the country. During peak
periods, laboratories will need to prioritize specimen collection to prevent overload. At this point,
diagnosis of influenza in the community will be made primarily by clinical assessment; however, testing
to support the management of certain patients (e.g., those requiring admission to hospital) will be
expected to continue together with identification of outbreaks and surveillance. If ongoing monitoring
shows increasing levels of antiviral resistance, more testing may be necessary to support clinical
management of severely ill patients, especially those not responding to treatment.
Throughout the pandemic, public health, diagnostic and research laboratories, including those involved
in the Canadian Immunization Research Network (CIRN), will also play an important role in supporting
studies to better understand the novel pandemic virus and its impact.
More details about pandemic laboratory strategies and activities can be found in the Laboratory Annex.
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4.3 Public Health Measures

Public health measures are non-pharmaceutical interventions that can be taken by individuals and
communities to help prevent, control or mitigate pandemic influenza. Public health measures range
from actions taken by individuals (e.g., hand hygiene, self-isolation) to actions taken in community
settings and workplaces (e.g., increased cleaning of common surfaces) to those that require extensive
community preparation (e.g., pro-active school closures). The purpose of public health measures is to
• reduce transmission of the novel/pandemic virus, thereby helping to reduce the overall size of the
outbreak and the number of severely ill cases and deaths; and
• slow the rate of transmission in order to reduce the peak burden on the health care system and buy
time in anticipation of vaccine.
STRATEGIC APPROACH
Public health measures are typically implemented at the community level. The responsibility and
legislative authority for implementing public health measures belong to the relevant PT and local public
health authorities, with the exception of international border and travel related issues for which the
federal government is responsible. In addition, the Canadian Forces Health Services is responsible for
implementing public health measures on all Canadian Forces establishments/bases/wings/stations
across Canada and for Canadian Forces personnel deployed abroad.
There are important concepts to consider when planning and implementing public health measures.
The measures should be used in combination to provide “multi-layered protection”, as the effectiveness
of each measure on its own may be limited. Actions should be tailored to the anticipated pandemic
impact and the local situation, supporting the principles of flexibility and proportionality. Some measures,
like hand hygiene and respiratory etiquette, are applicable in all pandemics. Other measures (e.g.,
proactive school closures and travel restrictions) might be used only in moderate- to high-impact
situations, as they can be associated with significant societal and economic costs.
A risk management approach will help weigh the potential advantages of particular interventions against
their disadvantages and unintended consequences. Decisions about which measures to deploy also
raise fundamental ethical challenges. For example, when considering restrictive measures, it is important
to balance respect for autonomy against protection of overall population health. In such situations, the
principles of proportionality, reciprocity and flexibility are involved, with a view to safeguarding individual
freedom to the extent possible while promoting protection against the health and societal consequences
of influenza infection.
There are several types of public health measures for jurisdictions to consider during an influenza pandemic:
• Individual measures—Public health advice will be provided to protect well individuals against
influenza and prevent ill individuals from spreading infection, e.g., through hand hygiene, cough
etiquette, staying home while sick. These measures should already be familiar through annual public
health campaigns.
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• Community-based measures—Guidance will be produced and disseminated to minimize illness and

transmission of infection within settings such as workplaces, schools, post-secondary institutions,
childcare centres, communal living facilities, remote and isolated communities, camps and cruise
ships. Social distancing measures or strategies may be used to minimize close contact among persons
in public places, e.g., pro-active school closures; cancellation or modification of public gatherings;
and alternative workplace approaches, such as teleconferences and working from home. Because
of their potential societal impact, social distancing measures are most applicable in pandemics of
moderate to high impact.
• Border and travel measures—These interventions include provision of travel health advice, screening
of travellers and travel restrictions. Evidence for their effectiveness is limited and their implementation
would depend on the risk assessment and resultant risk/benefit analysis of the actions being
considered.
• Case and contact measures—Some circumstances involving novel/pandemic viruses may warrant
case and contact management by public health authorities. These might include an individual human
case or cluster involving a novel virus, suspected human infections associated with an animal influenza
outbreak, or initial cases of the pandemic virus in the country or area. The extent of the investigation
and recommended measures should be feasible and relevant to the situation.
While aggressive measures (e.g., widespread antiviral use and restriction of movement) to attempt to
contain or slow an emerging pandemic in its earliest stages were previously considered possible on the
basis of modeling, experience from the 2009 pandemic has resulted in general agreement that such
attempts are impractical, if not impossible.
Additional details about public health measures can be found in the Public Health Measures Annex.
4.4 Vaccine
Immunization of susceptible individuals is the most effective way to prevent disease and death from
influenza. The purpose of Canada’s pandemic vaccine strategy is to
• provide a safe and effective vaccine for all Canadians as quickly as possible;
• allocate, distribute and administer vaccine as efficiently as possible; and
• monitor the safety and effectiveness of pandemic vaccine.
The phrase “vaccine for all Canadians” is intended to be interpreted broadly. It refers to all persons in
Canada (whether or not they are citizens) as well as Canada-Based Staff (CBS), their dependents and
Locally Engaged Staff (LES) at Canadian missions abroad and Canadian active duty personnel (Canadian
Forces) abroad.
An effective pandemic vaccine strategy is built on strong seasonal influenza immunization programs.
The overall impact of the pandemic vaccine strategy will depend on vaccine efficacy and uptake, as well
as the timing of vaccine availability in relation to pandemic activity. Using current egg-based vaccine
production technology, pandemic vaccine production is expected to take from four to six months, so it
is not likely to be available by the time the first pandemic wave reaches Canada. Furthermore, it will
become available in stages, which may require prioritization of initial vaccine doses.
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STRATEGIC APPROACH
In 2011, Canada entered into a new ten-year contract for pandemic influenza vaccine supply to ensure
that there is rapid and priority access to a supply of adjuvanted pandemic influenza vaccine produced
in Canada. Canada’s pandemic vaccine strategy also includes contracting for a secondary supply of a
pandemic vaccine.
Health Canada has developed a regulatory strategy to review and authorize a safe and efficacious
pandemic vaccine for use in Canada within the shortest time frame possible. A pan-Canadian approach
to pandemic immunization, including prioritization of populations during initial roll-out of the vaccine,
will help optimize equitable access and desirable outcomes. Pan-Canadian guidance will include an
allocation plan for equitable vaccine distribution, recommendations for pandemic vaccine use and
recommendations for prioritization of initial supplies.
Other key elements of the national vaccine strategy include the monitoring of vaccine uptake, adverse
events and vaccine effectiveness, building on existing systems such as the Canadian Adverse Events
Following Immunization Surveillance System (CAEFISS). Rapid studies will be carried out to confirm or
refute vaccine safety concerns.
PTs, Canadian Forces Health Services, and federal departments with the responsibility for immunization
should have plans for efficient and timely vaccine administration, including the ability to target key
population groups and collect information on vaccine uptake and adverse events. Lessons learned from
the 2009 pandemic indicate that vaccine registries and electronic information systems to capture and
transmit data are essential tools to support the vaccine program.
More details about the pandemic vaccine program can be found in the Vaccine Annex, including a
prioritization framework to guide decision-making if vaccine is expected to be in short supply.
4.5 Antiviral Medications

Antiviral medications can be used to treat influenza cases or to prevent influenza in exposed persons
(prophylaxis). Antiviral medications are the only specific anti-influenza intervention available that can be
used from the start of the pandemic, when vaccine is not yet available.
Canada’s antiviral strategy supports FPT stockpiles of antiviral medications for use in the event of an
influenza pandemic, primarily for early treatment and for outbreak control in closed facilities. Early
treatment of influenza cases, as early as possible within 48 hours of symptom onset, is recommended in
order to reduce the severity and duration of illness, particularly the occurrence of influenza-related
complications, hospitalization and death. Early treatment may also help mitigate societal disruption by
reducing the duration and severity of illness experienced by workers in the health care and other critical
infrastructure sectors.
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STRATEGIC APPROACH
There are two national stockpiles in Canada:
• The NAS is a stockpile that is held and managed by the PTs. The NAS is composed of the antiviral
medications oseltamivir and zanamivir, with oseltamivir dosage formulations that are appropriate for
both adults and children.
• The NESS is a federally owned stockpile of emergency supplies. The NESS is held and managed by
PHAC and includes a stockpile of oseltamivir and zanamivir. NESS antivirals are intended to provide
surge capacity in support of the PT response during a pandemic.
Federal government departments, such as the Canadian Forces (for active duty personnel) and Global
Affairs Canada (for mission staff overseas), hold stockpiles of antiviral medications to meet the anticipated
needs of their staff.
Jurisdictions need strategies to facilitate timely access to antiviral medications, particularly for high-risk
persons including pregnant women, children (who need special formulations), vulnerable populations,
and residents of remote and isolated communities. Pre-positioning of antiviral medications should be
considered for some communities to facilitate rapid access (e.g., remote northern communities).
Clinical guidelines have been developed for antiviral use for seasonal influenza.39 Virus-specific clinical
guidance and treatment protocols will need to be developed at the onset of the pandemic, based on
pandemic epidemiology and available scientific evidence. Pandemic use will focus primarily on early
treatment of influenza cases, particularly persons with severe disease or with risk factors for complications
or severe disease. There are limited indications for the use of antiviral medications for prophylaxis
during a pandemic, primarily for control of laboratory-confirmed influenza outbreaks in closed health
care facilities or settings where persons at high-risk of complications reside.
Distribution and uptake of antiviral medications should be monitored in real time to optimize appropriate
use, identify the need for additional purchases during the pandemic, and support post-pandemic
utilization and effectiveness studies. Monitoring adverse reactions and antiviral resistance helps inform
decision-makers as to whether changes in the recommendations regarding antiviral use are required.
Adverse reaction reports are collected and assessed through the Canada Vigilance Program of the
Marketed Health Products Directorate (MHPD) of Health Canada. Ongoing monitoring of antiviral
resistance is conducted by the public health laboratory system and reported as part of FluWatch.
More details about antiviral medications and their use in a pandemic can be found in the Antiviral
Annex, including a prioritization framework to guide decision-making if antiviral medications are
expected to be in short supply.
Aoki FY, Allen UD, Stiver HG, Evans GA. The use of antiviral drugs for influenza: A foundation document for practitioners.
39
Can J Infect Dis Med Microbiol. 2013;24 Suppl C:1C-15C.
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4.6 Infection Prevention and Control and Occupational Health

A major influenza outbreak may have a substantial impact on the ability of health care organizations to
keep those providing or receiving health care services safe. Infection prevention and control (IPC) and
occupational health (OH) programs should work together to prevent exposure to and transmission of
pandemic influenza during the provision of health care. Working jointly with occupational health and
safety committees is essential in meeting these goals. The application of appropriate IPC and OH
processes by HCWs and organizations is important in all health care settings along the continuum of
care, including but not limited to medical first response, practitioners’ offices and other ambulatory care
settings, acute care, long-term care and home care settings.
STRATEGIC APPROACH
A timely pandemic response is only possible when an organization and its personnel are experienced in
IPC and OH protocols and practices, supported by strong programs. Well-functioning IPC programs
should prevent, limit or control the acquisition of health care associated infections for everyone in the
health care setting, including patients, HCWs, visitors and contractors. Well-functioning OH programs
should identify workplace hazards and support appropriate processes and training to ensure that
employees can perform their duties in an environment that minimizes exposure to environmental
hazards.
Important elements of IPC and OH programs for pandemic preparedness and response in the health
care setting include the following:
• adequate staffing of IPC and OH professionals in the health care organization to conduct education
and training for front line staff;
• organizational risk assessments, best carried out in the interpandemic period, to identify engineering,
administrative and personal protective equipment (PPE) controls that will best protect patients, HCWs
and visitors in the health care setting;
• comprehensive education and training for HCWs in the organization on influenza IPC and OH issues;
• point-of-care risk assessments that are carried out by individual HCWs before they enter a patient’s
environment or initiate patient care to determine the appropriate PPE, isolation and cohorting
strategies for a given patient, during a given intervention, in a specific room, area or facility;
• provision of influenza vaccine to persons working for or being cared for by the organization;
• ongoing surveillance for health care associated infections, including respiratory infections;
• respiratory protection programs to ensure that HCWs who may need to wear a respirator (including
N95 respirators) are trained, fit-tested and prepared;
• a wide range of “source control” policies, including a 2-metre spatial separation between infected
sources (e.g., patients) and uninfected hosts (e.g., other patients); admission screening; screening of
visitors; and expanded respiratory and hand hygiene programs for HCWs, patients and visitors; and
• systematic administrative practices to enable rapid identification and segregation of patients, HCWs
and visitors with symptoms of influenza-like illness (ILI).
For detailed guidance about IPC and OH activities during a pandemic, see the annex on Prevention and
Control of Influenza during a Pandemic for all Healthcare Settings.
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4.7 Health Care Services

The effective provision of health care provides patients with the right level of care in the right place, at
the right time. In a pandemic this means managing an influx of patients with influenza, while maintaining
care required for patients with urgent non-influenza conditions. It is necessary for any organization that
provides health care to plan for a range of scenarios, including those with very high patient load and
potential high staff absenteeism, as demand for health care services may exceed the capacity of the
existing system. At the start of a pandemic, early assessment of its anticipated impact will help the
health care sector to implement plans to manage the anticipated workload.
STRATEGIC APPROACH
Planning for the delivery of health care in a pandemic is a particular challenge as there is little excess
capacity in the Canadian health care system, particularly in remote and isolated communities.
Nonetheless surge capacity planning is an essential component of pandemic preparedness for all levels
of care, including telephone information lines, primary and ambulatory care practitioners, emergency
medical services, hospital and critical care, long-term and palliative care, home care and other community
care including death care services (funeral homes, medical examiners, coroners). Surge capacity planning
involves development of strategies for enhancing levels of staff and volunteers, equipment and supplies
and, potentially, space to accommodate more patients. It also includes consideration of novel approaches
to enhancing assessment and care. Surge capacity plans should include regional or even province-wide
components.
The 2009 pandemic highlighted the importance of improving integration and coordination so that the
health care response functions as a system during an emergency. This involves integration across the
continuum of care within a health region and across and among PTs. Integration is facilitated by involving
stakeholders from all levels of care in planning and exercises, including emergency medical services,
community service providers, volunteer organizations and public health. Electronic information
management systems are essential tools for monitoring service delivery and resource utilization across
the health care system and transferring information among organizations.
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The collection of health care delivery data is an important aspect of seasonal and pandemic influenza
surveillance. Monitoring hospital and ICU admissions and ventilator use were added surveillance
components in the 2009 pandemic, contributing valuable information on the epidemiology of severe
disease and its risk factors. Surveillance of emergency department utilization can indicate when
community health services are at or reaching capacity so that other measures can be considered.
Best practices and lessons learned advise that health care organizations and practitioners carry out
business continuity planning and maintain strategic reserves of critical equipment and supplies. Detailed
plans to store, distribute and track use of stockpiled items should be developed and exercised.
Pandemic-specific issues for health care provision include the following:
• Self-care instructions—self-care instructions can empower individuals and families, improve care and
optimize the use of the health system; they are useful for dealing with seasonal as well as pandemic
influenza. During the 2009 pandemic, many jurisdictions used the media, public announcements and
credible websites to promote tools to assist the public on conducting an influenza self-assessment,
self care and when to seek medical attention or go to the hospital.
• Telephone advice lines—these were extensively used in the 2009 pandemic to provide information
and advice, and to triage people with suspected influenza from those with other respiratory infections.
Trained operators directed people to appropriate clinical assessment and care if needed, and helped
avoid unnecessary visits to physicians and emergency departments by providing advice on self-
care at home. Heavy, and sometimes overwhelming, demand reinforced the necessity for business
continuity planning and for operation on a 24/7 basis during a pandemic.
• Primary care—the primary care sector will be responsible for the assessment and treatment of
ambulatory influenza patients. PTs often face challenges in engaging primary care practitioners, who
may not be well linked to the rest of the system. PTs should work with professional associations to
develop communications strategies, protocols and guidelines, e.g., for office business continuity
planning and IPC. At the time of the pandemic, PTs should anticipate providing primary care
practitioners with situation updates, guidance on laboratory testing and clinical management of
influenza patients, information on pandemic vaccine (with clear direction on their role in its provision)
and access to additional or pre-positioned PPE and supplies. Primary care surge capacity can be
enhanced by PT strategies such as new fee codes for telephone advice and prescribing, temporarily
allowing practice expansion to patients who are not registered with the practice (when this is not
normally permitted), and expanding the role of other health professionals and non-traditional
workers (e.g., allowing prescribing of antiviral medications by pharmacists). Influenza assessment
centres and alternate care sites may be needed in some communities, particularly in high-impact
situations. Responsibility for their establishment is best determined in advance so that appropriate
planning can take place.
• Hospital-based care—the impact on the acute care sector and the demand for critical care will be
influenced by the epidemiology of the pandemic, i.e., the overall numbers with severe disease,
the age and risk groups most at risk of severe disease and the dynamics of the pandemic wave
(compacted or prolonged), as well as the extent of early antiviral treatment in the community. Critical
care planning and preparation for high demand for ventilators or other specialized equipment (e.g,
extracorporeal membrane oxygenation) needs special attention. Critical care surge capacity plans
should include triage tools that contain both ethical guidance and processes to address bed flow
and ventilator utilization. Service needs for paediatric patients (including critical care) and pregnant
women should be specifically addressed.
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• Health care in remote and isolated communities—There may be limited capacity to provide acute
care and/or a lack of appropriate medical equipment and services (e.g., ventilators, oxygen therapy)
for treating critically ill patients in remote and isolated communities. Under normal circumstances,
these needs are met through medical evacuations to acute care facilities in larger centres. However,
an increase in medical evacuations could overwhelm the receiving jurisdictions, making it essential to
coordinate with receiving jurisdictions and to do everything possible to detect ILI as early as possible
and to treat and keep affected persons in the community.
• Other health care services—services such as mental health, home care, palliative and hospice
care, long-term care and other community health and social services may not be well linked to
regional and local pandemic planning processes. Though often overlooked in pandemic planning,
their functioning is critical to achieving the pandemic objectives by providing early and appropriate
treatment outside of hospitals to those who do not need acute hospital care. These organizations
must be involved in pandemic planning and encouraged to have business continuity plans in place
so that they can continue to provide their services to some of the most vulnerable patients in the
community with minimal interruption during a pandemic.
During a severe pandemic, death care services may be overwhelmed and local planners may need to
consider alternate systems and resources than those that normally manage deaths, such as setting up
temporary morgues and delaying funerals/burials. This may cause increased stress or complications in
the grieving process for families, particularly when certain religious and/or cultural practices have specific
directives about how bodies are managed after death. Planning guidance is available from the WHO,
Pan American Health Organization and the International Red Cross on the effective management of
mass fatalities during a disaster.40
4.8 Clinical Care Guidelines

Clinical care involves the assessment and treatment of persons with suspected or confirmed pandemic
influenza. The spectrum of illness seen with influenza is broad and ranges from asymptomatic infection
to severe illness causing death, which is frequently due to exacerbation of an underlying chronic
condition or secondary bacterial pneumonia. Certain aspects of pandemic influenza management may
be unfamiliar to some practitioners, and new risk factors and presentations may emerge. Critically ill
patients may require extraordinary support measures, some of which may not be universally available in
a high-impact pandemic.
STRATEGIC APPROACH
During a pandemic, health care practitioners will need clinical guidelines for assessment, laboratory
testing, treatment (including antiviral medications), and management of secondary infections and
critically ill patients. Service needs for specific populations (e.g., paediatrics, pregnant women) should
be specifically addressed. Guidelines specific to the clinical management of patients in remote and
isolated communities should also be available, as there are unique considerations in these settings.
Clinical care guidelines must be timely and user-friendly, and be produced by sources that practitioners
consider reliable. Establishing and testing agreed upon approaches for the development of clinical
guidelines during the interpandemic period will help to ensure that the necessary processes are in place
to support the pandemic response.
Pan American Health Association; World Health Association; International Committee of the Red Cross:
40
Management of Dead Bodies after Disasters: A field Manual for First Responders. 2016. Available from: http://iris.paho.org/
xmlui/handle/123456789/31295
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4.9 Communications
Communication of information and advice is often the first and most important public health intervention
during an emergency. This is especially true for an emerging pandemic, where behaviour change is a
central part of risk management. Providing clear and consistent information about the disease, who it
affects, how it spreads and ways to reduce risk is an effective way to help reduce the spread of infection
before other interventions like vaccine are available. Open and honest public communication also
reinforces trust in public health authorities and helps to minimize societal and economic disruption.
Communications planning for an influenza pandemic uses a risk communications approach.41 It
integrates a broad range of communication capacity and expertise, including social marketing,
stakeholder consultation and use of social media. It involves collaboration of all partners involved in the
pandemic response to deliver consistent, complementary, and effective communications that meet the
needs of the public and stakeholders.
STRATEGIC APPROACH
Pandemic risk communications incorporate the principles of collaboration, proportionality, flexibility
and use of established practices and systems. Research conducted during and after the 2009 pandemic
reinforced the importance of core risk communication principles such as transparency and stakeholder
collaboration in achieving pandemic response objectives.42
It is essential to be proactive about communication throughout the pandemic, with information and
updates for the media, the public, and other stakeholders. Information may be limited initially and will
change as the science evolves and more is learned. The post-2009 pandemic reviews identified
difficulties in communicating uncertainty and dealing with changing information, particularly for
pandemic vaccine. Therefore, strategies to communicate risk, uncertainty and changing information
are critical.
Communicating in ways that demonstrate transparency, cultural sensitivity and use of plain language is
essential in building and maintaining public trust. Consistent messaging and “speaking with one voice”
will also foster trust and understanding and help avoid confusion.
While communication and messaging within jurisdictions is ultimately a PT responsibility, pandemic
communications planning should involve all health partners. The FPT communication response will be
coordinated through the PHN Communications Network. Collaboration with nongovernmental, private
sector and international organizations is also important. The media should be seen as a key partner and
engaged in the interpandemic period as well as during the pandemic.
41
Health Canada. Strategic risk communication framework. 2005. Available from:
www.hc-sc.gc.ca/ahc-asc/pubs/_ris-comm/framework-cadre/index-eng.php
42
Risk Sciences International. Risk communication for H1N1 pandemic influenza. 2012. Report to the Public Health Agency of
Canada (unpublished)
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Communication with the public—Research has demonstrated that risk perception is the strongest
indicator of willingness to change behaviour during a public health event, and that it is largely shaped
by the public’s emotional response to the event.43 Monitoring of public perception, information needs
and concerns is an important role in the pandemic response and should be planned for. Effective
stakeholder identification and engagement will also play a large part in this work. Building relationships
with stakeholders in the interpandemic period will help facilitate productive interactions during the
pandemic. Federal and PT pandemic communications plans should pay particular attention to reaching
vulnerable populations and persons who may have limited access to mainstream media. These groups
may require a tailored communications approach, using a variety of formats and delivery mechanisms
(e.g., using ethnic media outlets as a conduit to ethno-cultural communities).44
Communication with the health care sector—Communications with HCWs and organizations deserves
special attention in the planning process. These stakeholders should be engaged in two-way dialogue
to help ensure that products and messages meet their needs for timely, clear, concise and relevant
communications. Resources should be developed in the interpandemic period so they can be quickly
adapted when a pandemic occurs.
For details on the pandemic risk communication approach, see the Communications and Stakeholder
Liaison Annex.
4.10 Research
Research plays a key role in addressing knowledge gaps about the influenza virus and effective influenza
prevention, treatment and control for both seasonal and pandemic influenza. Much of this research can
be carried out in the interpandemic period, but some can only be conducted during a pandemic. Given
the potentially long interval between pandemics, it is important not to miss these infrequent but
invaluable opportunities and to plan for a rapid research response.
STRATEGIC APPROACH
Key components of a successful pandemic influenza research strategy include identification of research
needs, development and ongoing support of partnerships and research networks, identification of
sustained funding sources, and advance establishment of protocols and rapid ethics review processes
for pandemic research. Knowledge translation strategies to bring significant findings to decision-makers
in a useful and timely way are other key components.
Ibid
43
Greenberg J. Emergency-risk communication for vulnerable populations in Canada. April 2012. Report to the Public Health
44
agency of Canada (unpublished)
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Identification of research needs—It is important that influenza research needs are periodically reviewed
and prioritized. This information is helpful to funding agencies like the Canadian Institutes of Health
Research (CIHR) and PHAC, and feeds into similar international initiatives by WHO and others. The
annexes to this document identify existing research needs in specific areas of the response, such as
vaccines and antiviral medications.
Research networks—Networks that are created to conduct research in the interpandemic period are
well placed to facilitate pandemic research. Provincial public health agencies and PHAC are increasingly
collaborating on epidemiological and other public health studies. The Canadian Immunization Research
Network (CIRN), a national network of key vaccine researchers, is active in ongoing influenza vaccine
research projects. The mathematical modeling community has developed several networks and is
collaborating more closely with public health. Canadian intensive care researchers have developed
international clinical networks, such as the International Forum for Acute Care Trialists (InFACT) that will
establish open access protocols, data-sharing processes and ethical frameworks to streamline the
response to a new emerging disease or pandemic. These existing networks need ongoing support. As
they may not be sufficient to address all of the pandemic research needs, ongoing focus on this aspect
is required to ensure readiness for the research response.
Rapid research response—Special research studies, such as seroprevalence studies and the role of
bacterial pathogens in serious outcomes, will be needed to inform pandemic decision-making. As these
studies must be mounted quickly, advance planning is critical for their success and timeliness. Leveraging
existing partnerships among PHAC, Health Canada, provincial public health agencies, clinical and
academic institutions and networks together with populations of research interest such as CIRN and
CIHR and engaging them in planning for a rapid research response is essential. Advance plans should
include preliminary agreements with potential researchers and development of research protocols and
strategies for rapid ethics approval and funding arrangements.
Knowledge translation —Many important decisions must be made quickly during a pandemic. Evidence-
informed decision-making requires strong knowledge translation strategies to ensure that existing and
new research findings are taken into account. Enabling strategies include compiling research findings
from the 2009 pandemic and maintaining up-to-date literature reviews in key areas, such as the
effectiveness of public health measures, relevant vaccine studies, and antiviral treatment and resistance.
Processes for critical appraisal and dissemination of new research findings should be established in the
interpandemic period. Strategies should also be developed to help decision-makers understand and
make optimal use of evidence and research.
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5.0 ASSESSMENT AND EVALUATION OF PANDEMIC PREPAREDNESS

AND RESPONSE
Preparing for and responding to a pandemic is a complex process that requires the coordinated efforts
of all orders of government in collaboration with their stakeholders. To ensure that pandemic plans (or
all-hazards plans according to the jurisdiction) are comprehensive and effective, jurisdictions should
assess their level of preparedness, test their plans regularly and evaluate their pandemic response.
5.1 Assessing Preparedness

Preparedness is a responsibility of individuals, organizations and jurisdictions at all levels. PTs are
responsible for preparedness activities that will take place at the PT level and they may also provide
advice and/or support to regional and local areas. Assessing the level of pandemic preparedness
enables jurisdictions to monitor the progress of their pandemic planning, identify gaps and prioritize
future planning efforts. Use of checklists, perhaps coupled with site visits, are potential tools for
monitoring progress and levels of preparedness.
It is also important to determine whether responses can be implemented effectively so as to achieve the
intended results. Training and exercises should be conducted on a regular basis to maintain preparedness
levels as part of a cycle of continuous improvement. Training should also be made a priority for new
workers. Exercises can take many forms, ranging from discussion-based activities such as seminars and
workshops to larger more complex activities such as activating plans and simulating response activities.
It is best for organizations to work their way up to larger exercises. This progression allows organizations
to understand their plans better and identify interdependencies, and to make changes and adjustments
before attempting a larger, more complicated activity. Following an exercise a formal After Action Report
should be prepared, along with an implementation plan to address the gaps identified. Problem areas or
weaknesses should be corrected through additional training and/or changes or additions to plans.
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In addition to specially designed exercises, seasonal influenza provides annual opportunities for all
jurisdictions to test specific components of a plan. For example, seasonal influenza immunization
campaigns allow PTs to test rapid distribution of vaccine and supplies while local jurisdictions can
practise mass clinic strategies and use of their health emergency management mechanisms to organize
the clinic rollout. Other emergencies also provide opportunities to practise and refine components of
an effective pandemic response, like command and control and communications.
5.2 Evaluating the Pandemic Response

For future reference, it is important to document completely the processes and activities used and
decisions made during the response to the pandemic, along with the outcomes achieved. The response
should be evaluated to see if it was carried out as intended and that it led to the desired outcomes. This
evaluation helps ensure that lessons learned from the real life event are captured and remain available
to inform pandemic plan revisions. The evaluation involves assessment through an After Incident or
Lessons Learned report following the pandemic, accompanied by an implementation plan to address
the identified gaps. A critical opportunity to evaluate and adjust the response also comes at the end of
the first pandemic wave.
In addition to gleaning lessons learned from the pandemic response, it is important to ascertain how
well the pandemic response met the goals and objectives of pandemic preparedness and response in
Canada. Lessons learned would focus on the assessment of the strategic approach for the key
components outlined in this document as a measurement of how well the response met the identified
purposes of each of the key components. This higher level and formal evaluation of the pandemic
response would involve FPT partners and consider various aspects of the pandemic response. A
comprehensive, harmonized approach to pandemic evaluation across jurisdictions should be developed
in the interpandemic period so that the main findings and best practices can be identified.
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APPENDIX A – FACTORS AFFECTING PANDEMIC IMPACT

The table lists a series of factors that could affect the impact of a pandemic and describes their potential
impact. Consideration of these factors and their potential mitigation will supplement use of the basic
planning scenarios and help planners prepare a more adaptable response.
TABLE—FACTORS THAT AFFECT PANDEMIC IMPACT AND THEIR POTENTIAL IMPACT
CATEGORY FACTOR POTENTIAL IMPACT
VIRUS CHARACTERISTICS
TRANSMIS- Degree of High infectivity means that a large number of people will
SIBILITY transmission become ill. This would affect absenteeism in schools and
workplaces, including health care settings. Health care services
would face increased demand. Disruptions in basic services
could occur if absenteeism affects critical infrastructure.
Speed of spread A concentrated wave with many people ill over a short period
would have higher impact on absenteeism and demand for
health care than the same number of cases spread over a longer
period.
Season of arrival Transmission is lower in spring and summer so pandemic waves

in that period might be smaller. Higher impact would also be
expected with late fall/winter waves due to juxtaposition of usual
winter pressures from other viruses and co-circulating bacteria.
VIRULENCE Clinical severity High virulence means a high proportion of severe cases among
the ill, placing strain on acute and critical care services. The
typical pandemic mortality age shift to younger age groups
could also increase public concern. Unexpected clinical features
could affect provision of acute and critical care.
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POPULATION VULNERABILITY
POPULATION Pre-existing population Pre-existing population immunity might be present in persons

VULNERABILITY immunity above a certain age due to previous circulation of related strains.
This could reduce their risk of infection (although their age might
increase their risk of severe disease if they did become ill).
Sparing of older persons would significantly reduce overall
impact on hospitals and long term care facilities. Higher impact
would be anticipated if all age groups are involved.
Unexpected risk factors New risk factors for severe disease could mean that more people
need health care services. They could also affect vaccine
prioritization.
Special groups and Impact may be increased in high-risk populations or settings

settings (e.g. remote communities, homeless shelters and overcrowded
housing). Risk could be elevated because of age, underlying
health conditions, poor access to health care, poor
socioeconomic conditions, etc.
RESPONSE FACTORS
PUBLIC HEALTH Vaccine availability, Timing of vaccine availability in relation to pandemic activity
INTERVENTIONS timing, effectiveness could influence vaccine prioritization and affect uptake. Vaccine
impact would be reduced if most people experience illness
before vaccine is available.
Antiviral availability Antiviral supply might be insufficient in a very large pandemic.

and resistance Antiviral drug resistance would reduce supply of effective
antiviral medications, thus resulting in need to prioritize use.
Supply issues could lead to increased numbers of
hospitalizations, severe illness and death.
Public health measures In some circumstances (e.g. virus with lower transmissibility),
wide adoption of public health measures could lead to
significant reduction in transmission.
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HEALTH CARE Access to care Good access to primary care and early antiviral treatment would
SYSTEM reduce rates of complications and hospitalizations. Lack of
RESPONSE access to critical care could increase mortality in seriously ill
patients.
Surge capacity Lack of surge capacity could affect outcomes if demand for
services outstrips supply. Triaging of critical care services would
be needed as surge capacity is exceeded. As services become
overwhelmed, mortality might increase in both influenza and
non-influenza emergency patients.
Availability of Drug supply problems or antibiotic resistance could affect

antibiotics and other clinical outcomes. Shortages of infection control supplies could
drugs, supplies affect viral transmission and increase staff concern.
RISK Behavioural response Levels of public awareness and understanding and risk
COMMUNICA- perception, along with level of trust in health authorities, could
TIONS affect degree of adoption (and therefore potential effectiveness)
of preventive behaviours such as infection prevention
behaviours, social distancing, and uptake of vaccine and antiviral
medications.
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APPENDIX B—PANDEMIC RISK ASSESSMENTS

The table identifies relevant considerations for initial and ongoing pandemic risk assessments and
identifies potential sources of data to generate the information needed. In a pandemic, the Public
Health Agency of Canada will prepare or arrange for the risk assessments to be prepared
and disseminated.
TABLE - PANDEMIC RISK ASSESSMENTS
WHAT INFORMATION IS NEEDED?

HOW WILL THIS BE
CATEGORY
INITIAL RISK ONGOING RISK LEARNED?
ASSESSMENT ASSESSMENTS
OVERALL RESPONSE
NATURE OF RESPONSE What will be the overall Is the impact changing? Estimates/predictions
impact? How are we coping? of impact (see sections
below)
CHARACTERISTICS OF THE VIRUS
TRANSMISSIBILITY How fast will it spread? Will there be more than Molecular and genetic
one pandemic wave? studies
Is transmissibility Incubation period and
changing? generation time
Reproductive number
(R0)
Real-time modeling
How many will be Will follow-up waves be As above

affected? larger or smaller? Serological attack rate
See also population When will the next wave Clinical attack rates in
vulnerability begin, peak, end? various settings
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HOW WILL THIS BE
CATEGORY
VIRULENCE (CLINICAL How severe is the Is disease severity Molecular and genetic
SEVERITY) disease? changing? studies
What proportion of ill Rates of hospitalization,
people will have intensive care unit (ICU)
complications, need admission, ventilator
hospitalization, die? use
Are there unusual Case fatality rate/ratio
clinical presentations? Clinical case series of
persons with severe
disease
Outbreak reports
POPULATION VULNERABILITY
POPULATION Will all age groups be How is population Levels of pre-existing

VULNERABILITY affected and to what immunity changing as population immunity
extent? the outbreak Periodic seroprevalence
progresses? surveys
What are the risk factors Are new risk factors/ Epidemiological studies
for severe disease? groups emerging? Clinical case series
Outbreak reports
Are there settings and Are there additional Epidemiological studies

populations at settings and PT/NGO feedback
increased risk? populations at
Socioeconomic data
increased risk?
Are we effectively
targeting our
interventions?
Any unintended
consequences from
our interventions?
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HOW WILL THIS BE
CATEGORY
PUBLIC HEALTH INTERVENTIONS
ANTIVIRAL Is there antiviral Are antiviral resistance Antiviral susceptibility

MEDICATIONS resistance? patterns changing? and resistance testing
Will antivirals be safe? Are the antivirals safe? Antiviral distribution
Will antivirals be Are the antivirals and uptake
effective? effective? Adverse reaction
Are we able to Are the right patients reports
effectively mobilize the receiving them in a Effectiveness studies
NAS? timely way? Distribution reports
and special studies
VACCINE Will vaccine be safe? When will vaccine Early epidemiological

Will vaccine be be available? studies (re: high-risk
effective? Are there changes groups)
When will it be to the usual high-risk PT monitoring and
available? groups? feedback
Is there adequate Vaccine uptake and
capacity for rapid effectiveness
immunization? AEFI reports
How can vulnerable
groups be reached?
Is pandemic vaccine
safe?
Is it effective?
PUBLIC HEALTH What is the anticipated Are the interventions Measures of

MEASURES impact, including on acceptable? transmissibility and
transmission? Are they effective? virulence
Mathematical modeling
Public opinion research
Community surveys
INFECTION PREVENTION Will the usual IPC Are the usual IPC Information on
AND CONTROL (IPC) measures be effective? measures effective? incubation period,
If not or unsure, what If not or unsure, what infectivity, routes of
additional precautions additional precautions transmission, etc.
should be taken? should be taken?
Are there unintended
consequences?
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HOW WILL THIS BE
CATEGORY
SYSTEM RESPONSE
PUBLIC HEALTH What will be the What is the impact on Measures of

potential impact? public health services transmissibility and
and health human virulence
resources (HHR)? Surveillance and clinical
Are they able to cope? studies
PT feedback
COMMUNITY What will be the What is the impact on Measures of

HEALTH CARE potential impact? community health care transmissibility and
services and HHR? virulence
Are they able to cope? Surveillance and clinical
studies
Information on antiviral
resistance
PT feedback
Media monitoring
ACUTE CARE SERVICES What will be the What is the impact on Measures of
potential impact? acute care services and transmissibility and
HHR? virulence
Are they able to cope? Surveillance and clinical
What bacterial studies
complications are Information on antiviral
occurring? and antibiotic resistance
Are the treatment Clinical studies
strategies effective? PT monitoring and
feedback
Media monitoring
LONG-TERM CARE AND Will long-term care or What is the impact on Information on pre-
OTHER COMMUNITY other residential these facilities, their existing immunity
RESIDENTIAL CARE facilities for the elderly services and HHR? Surveillance and
or disadvantaged be at outbreak investigations
significant risk of
PT feedback
outbreaks?
Media monitoring
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HOW WILL THIS BE
CATEGORY
SOCIETAL IMPACT Will there be significant What is the impact on Measures of

workplace or school schools, businesses, transmissibility and
absenteeism? critical infrastructure virulence
Will community services and other community School and workplace
be affected? services? absenteeism
What is the impact on surveillance
vulnerable populations? PT feedback
What is the psychosocial Media monitoring and
impact on the public surveys
population?"
Clinician surveys
What is the economic
Qualitative studies
impact?
RISK What will be the level What are the levels of Traditional and social
COMMUNICATIONS of public concern? public concern? media monitoring
What issues will be What issues are of most Tracking of public
of most concern? concern and are we inquiries
addressing them Public opinion research
effectively?
Stakeholder feedback
What is the level of (PTs and NGOs)
public awareness and
understanding of the
situation?
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CANADIAN PANDEMIC
INFLUENZA PREPAREDNESS:
Planning Guidance for the
Health Sector
Public Health Measures Annex
Canadian Pandemic Influenza Preparedness Task Group

February 14, 2019
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Health Canada is the federal department responsible for helping the people of Canada maintain and improve
their health. Health Canada is committed to improving the lives of all of Canada's people and to making this
country's population among the healthiest in the world as measured by longevity, lifestyle and effective use of the
public health care system.
Également disponible en français sous le titre :

PRÉPARATION DU CANADA EN CAS DE GRIPPE PANDÉMIQUE : Guide de planification pour le secteur de la santé
To obtain additional information, please contact:
Health Canada
Address Locator 0900C2
Ottawa, ON K1A 0K9
Tel.: 613-957-2991
Toll free: 1-866-225-0709
Fax: 613-941-5366
TTY: 1-800-465-7735
E-mail: hc.publications-publications.sc@canada.ca
© Her Majesty the Queen in Right of Canada, as represented by the Minister of Health, 2019
Publication date: July 2019
This publication may be reproduced for personal or internal use only without permission provided the source is fully
acknowledged.
Cat.: HP40-144/2-2019E-PDF
ISBN: 978-0-660-31870-7
Pub.: 190211
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TABLE OF CONTENTS
LIST OF ABBREVIATIONS AND ACRONYMS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5
PREAMBLE . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6
1.0 INTRODUCTION. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6
1.1 Background. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6
1.2 Purpose. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7
1.3 Changes in this Version. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7
2.0 CONTEXT FOR PLANNING . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 8

2.1 Role of Public Health Measures in the Prevention of Pandemic Influenza. . . . . . . . . . . . . . . . 8
2.1.1 Factors Influencing Public Health Measures in a Pandemic. . . . . . . . . . . . . . . . . . . . . . . . . 9
2.2 Uncertainties and Unpredictability . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 11
2.3 Lessons Learned from the 2009 H1N1 Pandemic . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 12
2.3.1 Programmatic Lessons Learned. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 12
2.3.2 Scientific Findings. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 13
2.4 Program Delivery in the Canadian Context. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 14
2.4.1 Understanding Canada’s Diversity. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 15
2.5 Ethical Considerations. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 16
2.6 Legal Considerations. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 16
3.0 CANADA’S PANDEMIC PUBLIC HEALTH MEASURES STRATEGY . . . . . . . . . . . . . . . 17

3.1 Objectives. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 17
3.2 Guiding Principles and Approaches. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 18
3.3 Public Health Measures—Specific Assumptions. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 19
3.4 Pandemic Roles and Responsibilities. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 20
3.5 Key Elements of the Response . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 22
3.5.1 Individual Measures . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 22
3.5.2 Community-Based Measures. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 29
3.5.3 Border and Travel Measures. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 33
3.5.4 Case and Contact Management Measures . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 35
3.5.5 Public Education. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 36
3.6 Risk Management Approach. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 39
3.6.1 Overview. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 39
3.6.2 Risk Management Considerations for the Public Health Measures Strategy. . . . . . . . . . 39
3.7 Triggers for Action and Key Decisions and Activities . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 43
CANADIAN PANDEMIC INFLUENZA PREPAREDNESS: Planning Guidance for the Health Sector – Public Health Measures Annex 3
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4.0 INTEGRATION WITH OTHER RESPONSE COMPONENTS. . . . . . . . . . . . . . . . . . . . . 46

4.1 Surveillance. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 46
4.2 Communications and Stakeholder Liaison. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 46
5.0 RESEARCH NEEDS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 48

5.1 Individual Measures. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 48
5.2 Community-Based Measures. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 49
5.3 Special Considerations . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 49
6.0 ASSESSMENT AND EVALUATION OF PUBLIC HEALTH

MEASURES PREPAREDNESS AND RESPONSE . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 50
APPENDIX A: RECOMMENDED PUBLIC HEALTH MEASURES,

BY SETTINGS AND SEVERITY . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 51
APPENDIX B: GUIDANCE FOR REMOTE AND ISOLATED (RI) COMMUNITIES . . . . . . . . 53
4 CANADIAN PANDEMIC INFLUENZA PREPAREDNESS: Planning Guidance for the Health Sector – Public Health Measures Annex
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LIST OF ABBREVIATIONS AND ACRONYMS

CDC (US) Centers for Disease Control and Prevention
CNPHI Canadian Network for Public Health Intelligence
CPIP Canadian Pandemic Influenza Preparedness: Planning Guidance for the Health Sector
CPIP-TG Canadian Pandemic Influenza Preparedness Task Group
ECDC European Centre for Disease Prevention and Control
FNIHB First Nations and Inuit Health Branch
FPT federal/provincial/territorial
FP family physician
GC Government of Canada
GPHIN Global Public Health Intelligence Network
HC Health Canada
HCW health care workers
ILI influenza-like illness
NGO non-governmental organization
NPI non-pharmaceutical interventions
OBTH Office of Border and Travel Health
PEP post-exposure prophylaxis
PHAC Public Health Agency of Canada
PHEIC public health emergency of international concern
PHM public health measures
PT provincial and territorial
SARS severe acute respiratory syndrome
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PREAMBLE
The Public Health Measures Annex of the Canadian Pandemic Influenza Preparedness: Planning
Guidance for the Health Sector (CPIP) is a federal, provincial and territorial (FPT) guidance document
that outlines how jurisdictions will work together to ensure a coordinated and consistent health sector
approach to Canada’s public health measures strategy. The CPIP main body and annexes are intended
to be used together.
While it is anticipated that CPIP’s strategic direction and guidance will inform FPT planning to support a
consistent and coordinated response across jurisdictions, the provinces and territories (PTs) have ultimate
responsibility for planning and decision-making within their respective jurisdictions.
It is important to note that CPIP is not an actual response plan. Rather, it is a guidance document for
pandemic influenza that can be used to support jurisdictional pandemic plans. While CPIP is specific to
pandemic influenza, much of its guidance is also applicable to other public health emergencies, such as
outbreaks of other communicable diseases.
1.0 INTRODUCTION
1.1 Background
Public health is defined as an “organized activity of society to promote, protect, improve, and, when
necessary, restore the health of individuals, specific groups or the entire population.”1 Perhaps nowhere is
this definition more evident than in the implementation of public health measures in an influenza pandemic.
Public health measures are also known as non-pharmaceutical interventions (NPI)—which are used to slow
the spread of a communicable disease, such as seasonal and pandemic influenza, in communities.
1 Last JM. A Dictionary of Public Health. Oxford University Press, 2007.
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Canada’s public health measures strategy includes actions:

• taken by individuals, such as hand hygiene and self-isolation;
• taken in community settings and workplaces, such as increased cleaning of common surfaces and
public education;
• that require extensive community planning and have considerable impact, such as closure of schools,
cancellation of mass gatherings, and travel and border restrictions.
This Annex describes the many factors to consider when planning public health measures aimed at
preventing, controlling and mitigating pandemic influenza. It is meant to facilitate a common approach
to community-based disease control strategies across jurisdictions during an influenza pandemic.
1.2 Purpose
The purpose of this Annex is to outline Canada’s approach to public health measures in an influenza
pandemic and offer specific operational and technical guidance for the health sector in provinces,
territories and locations where the federal government provides health care services. It is one of a series
of annexes that support CPIP.
The primary audiences for this Annex are the FPT ministries of health, along with other government
departments that have responsibilities for the health care of specific populations, such as Indigenous
Services Canada, Department of National Defence and Correctional Services Canada. The Annex also
serves as a reference document for other government departments, non-governmental organizations
(NGOs), and for other stakeholders interested in Canada’s strategy for public health measures in an
influenza pandemic.
1.3 Changes in this Version

This version of the CPIP Public Health Measures Annex is considerably changed from the 2006 edition
in both format and content. Content has been updated based on post-H1N1 pandemic reviews
conducted at the FPT and international levels and by key Canadian stakeholder groups.
The underlying principles and approaches outlined in the CPIP are highlighted throughout this annex,
and the CPIP’s pandemic risk management approach has been incorporated. The CPIP’s planning
scenarios are used to identify specific risk management considerations related to public health measures
in pandemics of varying impact, along with potential mitigation approaches. The key elements of the
public health measures strategy are described, and triggers for key activities are identified.
Guidance documents that were produced for the 2009 influenza pandemic continue to serve as useful
tools for a future pandemic, and concepts from these guidance documents have been incorporated into
this Annex.
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2.0 CONTEXT FOR PLANNING

2.1 Role of Public Health Measures in the Prevention of Pandemic Influenza
Public health measures are the most basic actions that can be taken to reduce community transmission
of a pandemic influenza virus. In the context of pandemic influenza, public health measures seek to
reduce both the occurrence and duration of human infections so as to delay the peak of pandemic
influenza activity. They are commonly used across Canada for seasonal influenza and other communicable
disease outbreaks and will play an important role throughout a pandemic. During the period before an
effective pandemic vaccine becomes available, antiviral drugs, primarily for treatment of cases, and
non-pharmaceutical public health measures will be the only tools available early on to mitigate the
effects of the pandemic. According to the CPIP Vaccine Annex, using the current egg-based pandemic
vaccine production technology, it will take four to six months for vaccine to become available. Thus, a
pandemic vaccine may not be available during the first pandemic wave in Canada.
The defining features of public health measures are that they can be implemented early and involve
multidisciplinary collaboration, between and across health and non-health sector settings, including
homes, workplaces, public and educational settings, ports of entry, various community-based service
organizations and correctional facilities.
Public health measures include:
• Personal protective measures (also referred to as individual measures), such as respiratory etiquette,
hand hygiene and environmental cleaning of surfaces to protect uninfected individuals against
influenza, and staying home when ill (self-isolation) to prevent the spreading of infection.
• Community-based measures to reduce transmission of infection within community settings such
as workplaces, schools, and communal living facilities. Social distancing measures (e.g., minimizing
close contact with others) include proactive school closures, public gathering cancellations and
alternative workplace approaches (e.g., teleworking). Since these actions may require extensive
community preparation and may have significant secondary consequences, they are most applicable
in pandemics of moderate to high impact.
• Case management of individuals with pandemic influenza in the early stage of a pandemic.
Associated measures may include educating and advising individuals to self-isolate; reporting cases
to appropriate public health authorities; and managing contacts of suspected or confirmed cases,
which may include educating exposed individuals and advising voluntary home quarantine (i.e., in an
individual’s home or other setting where they reside).
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• Travel and border-related actions, such as providing disease information to travellers and measures
taken with suspected cases and their contacts (under the Quarantine Act) to prevent the spread of
a communicable disease across Canada’s international borders. These actions depend on various
factors, such as the extent of pandemic influenza virus activity in Canada at the time of detection, the
pandemic’s epidemiology, and feasibility considerations.
• Public education to promote and to support the implementation and adoption of measures at the
individual and community levels, based in a risk communications approach. It will also be important
to provide educational materials to health professionals that reinforce existing recommendations for
public health measures for individuals presenting with influenza-like illness (ILI).
The guidance contained in this Annex is designed to be adaptable to different situations, as well as
regional and jurisdictional contexts. Many of the recommended measures are contingent upon local
triggers; therefore, the timing of their implementation depends on local circumstances that may not
occur simultaneously across Canadian jurisdictions. However, a consistent approach to the application
of public health measures and the messaging that accompanies them will improve public perception,
trust and compliance with guidance.
2.1.1 FACTORS INFLUENCING PUBLIC HEALTH MEASURES IN A PANDEMIC

When planning public health measures, decision-makers must weigh not just the costs of implementation
but also any secondary impacts. Social and economic impacts on individuals, families, communities and
businesses due to, for example, closing schools or cancellation of public events, should be considered
with any intervention and weighed against its potential benefit. Individual behavioural measures, such
as practicing hand hygiene, respiratory etiquette and self-isolation when ill, are promoted during
seasonal influenza and should be encouraged in any pandemic scenario. Other measures, such as school
closures and border restrictions, are complex, costly to sustain and likely to have unintended societal
and economic consequences.
The success of any public health measure depends on a variety of factors, such as:
• Epidemiology: This factor includes the use of epidemiological tools and methods to collect,
analyze and interpret data (e.g., clinical cases, hospitalizations, deaths, severe clinical outcomes
and associated risk factors). Such data will help detect a pandemic, identify populations at risk,
and estimate the population health burden of the pandemic, all of which will ultimately inform the
planning of public health measures.
• Timing of public health measures: Implementing interventions early on is generally seen to be more
effective than waiting until a pandemic is well under way.2,3 For example, early communication to the
public of a potential influenza outbreak and the personal protective measures that can be taken will
give health authorities more time to control viral spread and impact. However, some measures may
be difficult to sustain because of their secondary impacts.
2 Institute of Medicine (US). Modeling community containment for pandemic influenza: a letter report. Washington, DC:
The National Academies Press, 2006.
3 Duerr HP, Brockmann SO, Piechotowski I, Schwehm M, Eichner M. Influenza pandemic intervention planning using InfluSim:
pharmaceutical and non-pharmaceutical interventions. BMC Infectious Diseases. 2007, 7:76.
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–– Given the geographic breadth of the country and the specifics of the pandemic epidemiology, it
is likely that public health authorities will implement measures at different times across Canada.
Overall pandemic severity and local conditions will inform the choice and timing of measures;4
however, the triggers for such actions, the rationale(s) for their implementation, and clear
communication to the public should remain consistent.
–– For case and contact management to be most effective, follow-up of suspected or confirmed
cases is recommended when the first few hundred cases occur in Canada. When data are collected
from investigation and follow-up of these initial cases, the focus should shift away from individual
management towards public education in order to reinforce individual and community measures.
–– Decisions around when and if to initiate or discontinue a specific public health measure should
consider such factors as the need to prevent case resurgence, the economic costs or social
disruption, and intervention fatigue among the public.
• Public compliance with the measures: Previous pandemic influenza experience indicates that
individuals generally comply with personal protective measures (e.g., handwashing and self-isolation)
and to a lesser degree with social distancing, particularly at the early stage of a pandemic. However,
as more individuals become ill, compliance wanes.5,6,7,8 Therefore, maintaining public engagement in
and compliance with public health measures as the pandemic evolves is an important consideration.
See Section 3.5 regarding specific public health measures.
• Layering of public health measures: No single public health measure is adequate to prevent virus
transmission. It is more effective to use combinations of measures in a layered approach to reduce virus
transmission. Data analysis of the 1918 influenza pandemic shows that early and sustained public health
measures over several weeks may have helped to limit mortality, although no single measure could be
identified as responsible.9,10,11 In addition to layering of measures, evidence from more recent pandemic
events and modelling exercises suggests that combining public health measures with vaccination and
targeted antiviral use delays and flattens the pandemic peak stage (see Figure 1 on page 18).12,13
4 Barrios LC, Koonin LM, Kohl KS, Cetron M. Selecting non-pharmaceutical strategies to minimize influenza spread: the 2009
influenza A (H1N1) pandemic and beyond. Public Health Rep 2012, 127:565–71.
5 SteelFisher GK, Blendon RJ, Bekheit MM, Lubell K. The public’s response to the 2009 H1N1 influenza pandemic.
N Engl J Med. 2010, 362:e65.
6 SteelFisher GK, Blendon RJ, Ward JRM, Rapoport R, Kahn E, Kohl K. Public response to the 2009 influenza A H1N1 pandemic:
a polling study in five countries. Lancet Infect Dis. 2012, 12:845-50.
7 Meilicke G, Riedmann K, Biederbick W, Müller U, Wierer T, Bartels C. Hygiene perception changes during the influenza A
H1N1 pandemic in Germany: incorporating the results of two cross-sectional telephone surveys 2008–2009. BMC Public
Health. 2013 Oct 16, 13:959.
8 Aburto NJ, Pevzner E, Lopez-Ridaura R, et al. Knowledge and adoption of community mitigation efforts in Mexico during the
2009 H1N1 pandemic. Am J Prev Med. 2010, 39:395–402.
9 Bootsma MC, Ferguson NM. The effect of public health measures on the 1918 influenza pandemic in U.S. cities. Proceedings
of the National Academy of Sciences of the United States of America. 2007, 104(18), 7588–7593.
10 Markel H, Lipman H., Navarro JA, Sloan A, Michalsen JR, Stern AM, et al. Non-pharmaceutical interventions implemented
by US cities during the 1918–1919 influenza pandemic. JAMA. 2007, 298(6), 644–654.
11 Hatchett RJ, Mecher CE, Lipsitch M. Public health interventions and epidemic intensity during the 1918 influenza
pandemic. Proceedings of the National Academy of Sciences of the United States of America. 2007, 104(18), 7582–7587.
12 Morse SS, Garwin RL, Olsiewski PJ. Public health. Next flu pandemic: what to do until the vaccine arrives? Science. 2006,
314:929.
13 Institute of Medicine (US). Modeling community containment for pandemic influenza: a letter report. Washington, DC:
The National Academies Press, 2006.
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• Scalability, flexibility and proportionality: Lessons learned from the 2009 influenza pandemic
included the importance of scaling the public health measures response to the associated risk of
disease. In addition, public health measures need to be flexible to accommodate different settings,
potentially over many months. Finally, the choice of measures should be proportionate to the
pandemic’s severity and the transmissibility of the novel virus. To help guide decisions about the
scale of the local public health measures response, public health jurisdictions would ideally have
access to epidemiological data so that they can calculate attack rates, hospital and intensive care unit
admission, and mortality associated with the novel virus. However, it is important to note that, during
the 2009 pandemic, it was difficult to obtain such data at the initial and early stages; and this may
not be an atypical experience for jurisdictions trying to contain the virus at the source in any future
pandemic.14 The Surveillance Annex describes an approach to collecting additional information that
may be required during the pandemic, built on existing surveillance systems for seasonal influenza.
2.2 Uncertainties and Unpredictability

Public health measures will play a significant role during a pandemic, especially before a vaccine
becomes available. Aligned with the CPIP’s risk management approach is the need for planners to be
aware of the uncertainties associated with the use of public health measures during a pandemic.
In addition to the areas of uncertainty outlined in the CPIP main body (i.e., when and where a pandemic
will occur, nature of spread, the virus’s characteristics), specific uncertainties are associated with the
selection and timing of the implementation of public health measures. They include:
• Effectiveness of measures—In general, public health measures for communicable disease control are
now studied and reported in the scientific literature more regularly. However, many of the studies
are not of high quality, making it difficult to draw conclusions; therefore, expert opinion continues to
inform recommendations about public health measures where there is a lack of scientific efficacy and
effectiveness data.
• Selection of appropriate measures—Public health authorities will have to judge what measures are
most appropriate when working under the condition of scientific uncertainty and public pressure to
“do something.”
• Public acceptance and adoption of measures—Key to the success of public health measures is public
adherence to them. To comply with a measure, the public needs to understand not only how to
perform the measure properly, but also the rationale behind the measure’s implementation. Therefore,
comprehensive public messaging about how and why specific measures are being implemented is
critical to their adoption during an evolving pandemic. The Communication and Stakeholder Liaison
Annex provides a strategic approach to risk communications during a pandemic.
• Assessment of potential societal and economic consequences of selected measures—Public health
measures do not take place in a vacuum. When choosing and implementing measures, public
health authorities will have to account for a variety of societal and economic realities within their
communities, realities that may be adversely affected by any given measure. For example, closing
schools may delay the transmission of a novel influenza virus but will have significant consequences
for certain groups, such as single parents and caregivers, children who participate in school-based
nutrition programs, families who cannot afford increased child care costs, and parents without flexible
work arrangements or paid leave benefits.
14 World Health Organization. Pandemic influenza risk management: A WHO guide to inform and harmonize national and
international pandemic preparedness and response. Geneva, 2017, www.who.int/influenza/preparedness/pandemic/PIRM_
withCoverPage_201710_FINAL.pdf. Accessed 14 December 2018
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2.3 Lessons Learned from the 2009 H1N1 Pandemic

Following the 2009 pandemic, FPT governments and other expert stakeholder groups reviewed Canada’s
H1N1 response efforts, including guidance documents that were produced by the health portfolio on a
variety of public health measures, such as hand hygiene and respiratory etiquette for various settings (e.g.,
home, schools, summer camps, daycares). Those reviews produced valuable lessons learned about the
type, use and impacts of public health measures and will be used to inform future pandemic planning.
2.3.1 PROGRAMMATIC LESSONS LEARNED

Many of the lessons learned that were related to planning and implementation of public health measures
have been incorporated into this Annex, such as:
• Public health measures should be chosen according to the pandemic’s anticipated impact and should
be implemented early in a targeted and layered manner to be most effective.
• The public health benefits of any given measure must be weighed against the economic and social
costs of its implementation.
• General public health measures and principles applicable to any pandemic influenza event (e.g., hand
hygiene, self-monitoring, staying home when ill, environmental cleaning) are key, and the rationales
for implementing them must be clear and consistently communicated to the public and updated as
the situation evolves.
• Local public health authorities must provide specific, in-depth guidance to non-health sectors on
when and if they need to take specific actions to reduce the spread of the virus (e.g., closing schools,
delaying mass gatherings) and when to stop or scale back these actions.
• Preparedness and response activities must be tailored for remote and isolated communities to
address issues such as: their limited access to health care workers and supplies; the distance required
to travel to hospital for acute care; the overall difficulty in gaining timely access to a full complement
of health care services; high rates of pregnancy; overcrowding; and, in some communities, limited
access to running water for hand hygiene.15
• Widespread restrictions of movement to contain or slow an emerging pandemic are impractical, if not
impossible, to implement.
• To achieve a flexible response that will serve a variety of settings and populations, public health
measures must be implemented at the right time and tailored to the specific setting and population.
Specific settings that may require unique considerations or guidance include:
–– workplaces;
–– residential facilities (retirement homes, group homes);
–– correctional facilities;
–– schools, daycares, post-secondary institutions and camps (e.g., children’s summer camps,
work camps);
–– shelters, drop-in centres and other settings with transient populations;
–– mass gatherings (concerts, sporting events, large meetings and conferences);
–– conveyances (aircraft, passenger trains, ferries, buses, cruise ships) and transit terminals; and
–– remote and isolated communities.
15 Public Health Agency of Canada. Lessons Learned Review: Public Health Agency of Canada and Health Canada response to
the 2009 H1N1 pandemic. Government of Canada, 29 Dec. 2010, www.phac-aspc.gc.ca/about_apropos/evaluation/reports-
rapports/2010-2011/h1n1/index-eng.php. Accessed 14 December 2018.
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Populations that may require unique considerations, guidance or tailored approaches include:
–– populations with vulnerabilities such as isolation, poverty, etc. (see CPIP, Section 2.4);
–– essential service workers (e.g., police, firefighters, paramedics); and
–– employees involved in pandemic response activities.
Following the H1N1 pandemic, detailed influenza-specific pandemic planning guidance was developed
to address vulnerabilities of populations in Canada. Some of the challenges related to implementation
of public health measures included implementing social distancing due to lack of space, and difficulty
in accessing sufficient supplies of masks and gloves.16,17,18
2.3.2 SCIENTIFIC FINDINGS

Public health measures studies conducted during and after the 2009 influenza pandemic produced
many key findings that have informed Canada’s public health measures strategy and are further discussed
in Section 3.5. The key findings include:
• Masks worn by ill individuals may protect uninfected individuals from virus transmission, but little
evidence exists that mask use by well individuals avoids infection.19,20
• The combination of good hand hygiene and early initiation of mask use by ill individuals reduced
influenza transmission within households21,22 and among university students in residence.23,24
• A growing body of evidence indicates that pre-emptive school closures can help prevent or reduce
the spread of influenza,25,26,27,28,29 but the extent of the social and economic impacts of school closures
in a pandemic of mild to moderate severity is not yet known.30,31
16 International Centre for Infectious Diseases. Flu season and the most vulnerable people. Preparing your organization, staff,
volunteers and clients for seasonal and pandemic flu. The Homeless Hub, 2010, http://homelesshub.ca/resource/flu-season-
and-most-vulnerable-people-preparing-your-organization-staff-volunteers-and. Accessed 14 December 2018.
17 International Centre for Infectious Diseases. Issues in pandemic influenza responses for marginalized urban populations; key
findings and recommendations from consultation meetings and key informant interviews. The Homeless Hub, March 2010,
www.homelesshub.ca/sites/default/files/attachments/Issues%20in%20Pandemic%20Preparedness%20-%20Final%20report.
pdf. Accessed 14 December 2018.
18 Buccieri K, Schiff R., eds. Pandemic preparedness and homelessness: Lessons from H1N1 in Canada. Toronto: Canadian
Observatory on Homelessness Press, 2016.
19 Cowling BJ, Zhou Y, Ip DK, Leung GM, Aiello AE. Face masks to prevent influenza transmission: a systematic review.
Epidemiol Infect. 2010, 138:449–56.
20 Bin-Reza F, Lopez VC, Nicoll A, Chamberland ME. The use of masks and respirators to prevent transmission of influenza:
a systematic review of the scientific evidence. Influenza Other Respi Viruses. 2012, 6:257–67.
21 Suess T, Remschmidt C, Schink SB, et al. The role of facemasks and hand hygiene in the prevention of influenza transmission
in households: results from a cluster randomized trial; Berlin, Germany, 2009–2011. BMC Infect Dis. 2012, 12:26.
22 Cowling BJ, Chan KH, Fang VJ, et al. Facemasks and hand hygiene to prevent influenza transmission in households:
a cluster randomized trial. Ann Intern Med. 2009, 151:437–46.
23 Aiello AE, Murray GF, Perez V, et al. Mask use, hand hygiene, and seasonal influenza-like illness among young adults: a
randomized intervention trial. J Infect Dis. 2010, 201:491–8.
24 Aiello AE, Perez V, Coulborn RM, Davis BM, Uddin M, Monto AS. Facemasks, hand hygiene, and influenza among young
adults: a randomized intervention trial. PLoS One. 2012, 7(1):e29744.
25 Earn DJ, He D, Loeb MB, Fonseca K, Lee BE, Dushoff J. Effects of school closure on incidence of pandemic influenza in
Alberta, Canada. Ann Intern Med. 2012, 156:173–181.
26 Jackson C, Vynnycky E, Hawker J, Olowokure B, Mangtani P. School closures and influenza: systematic review of
epidemiological studies. BMJ Open. 26 Feb 2013, 3(2).
27 Chao DL, Halloran ME, Longini IM Jr. School opening dates predict pandemic influenza (A) H1N1epidemics in the USA.
J Infect Dis. 2010, 202:877–80.
28 Copeland DL, Basurto-Davila R, Chung W, et al. Effectiveness of a school district closure for pandemic influenza A (H1N1) on
acute respiratory illnesses in the community: a natural experiment. Clin Infect Dis. 2013, 56:509–16.
29 Chowell G, Echevarría-Zuno S, Viboud C, et al. Characterizing the epidemiology of the 2009 influenza A/H1N1 pandemic in
Mexico. PLoS Med. May 2011, 8(5):e1000436.
30 Community Preventive Services Task Force. Emergency preparedness: school dismissals to reduce transmission of pandemic
influenza [Internet]. The Community Guide, 2012, www.thecommunityguide.org/findings/emergency-preparedness-and-
response-school-dismissals-reduce-transmission-pandemic-influenza. Accessed 14 December 2018.
31 Roth DZ, Henry B. Social distancing as a pandemic influenza prevention measure. National Collaborating Centre for Infectious
Diseases, July 2011.
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• International border entry screening is ineffective, largely because of limited sensitivity in detecting all
cases. At best, it can delay local epidemics by only a few weeks.32,33,34,35,36 Border departure screening
has a higher reported effectiveness, which seems to be related to the reduced numbers of infected
passengers on board the conveyance and the consequent decreased transmission.37,38
More details on Canada’s lessons learned from the 2009 influenza pandemic can be found in the reports
from the Government of Canada and the Standing Senate Committee on Social Affairs, Science and
Technology.39,40
2.4 Program Delivery in the Canadian Context

The responsibility and legislative authority for implementing the majority of public health measures
belong to the relevant PTs and local public health authorities, with the exception of international border
and travel-related issues, for which the federal government is responsible.
32 Mateus ALP, Otete HE, Beck CR, Dolan GP, Nguyen-Van-Tam JS. Effectiveness of travel restrictions in the rapid containment
of human influenza: a systematic review. Bulletin of the World Health Organization. 2014, 92(12):868–80D.
33 Yu H, Cauchemez S, Donnelly CA, Zhou L, Feng L, Xiang N et al. Transmission dynamics, border entry screening, and school
holidays during the 2009 influenza A (H1N1) pandemic, China. Emerging Infectious Diseases. 2012, 18(5):758–66.
34 Cooper BS, Pitman RJ, Edmunds WJ, Gay NJ. Delaying the international spread of pandemic influenza. PLoS Medicine. 2006,
3(6):845–855.
35 Cowling BJ, Lau LLH, Wu P, Wong HWC, Fang VJ, Riley S, et al. Entry screening to delay local transmission of 2009 pandemic
influenza A (H1N1). BMC Infectious Diseases. 2010, 10(1):82.
36 Malone JD, Brigantic R, Muller GA, Gadgil A, Delp W, McMahon BH, et al. U.S. airport entry screening in response to
pandemic influenza: modeling and analysis. Travel Medicine and Infectious Disease. 2009, 7(4):181–191.
37 Baker MG, Thornley CN, Mills C, Roberts S, Perera S, Peters J, et al. Transmission of pandemic A/H1N1 2009 influenza on
passenger aircraft: retrospective cohort study. BMJ 2010, 340:c2424.
38 Bell DM, World Health Organization Writing Group. Non-pharmaceutical interventions for pandemic influenza, international
measures. Emerging Infectious Diseases 2006, 12(1):81–87.
39 Public Health Agency of Canada. Lessons Learned Review: Public Health Agency of Canada and Health Canada Response to
the 2009 H1N1 Pandemic. Government of Canada, November 2010, www.phac-aspc.gc.ca/about_apropos/evaluation/
reports-rapports/2010-2011/h1n1/index-eng.php. Accessed 14 December 2018.
40 Senate of Canada. Standing Senate Committee on Social Affairs, Science and Technology. Canada’s Response to the 2009 H1N1
Pandemic. Parliament of Canada. Dec. 2010, https://sencanada.ca/content/sen/committee/403/soci/rep/rep15dec10-e.pdf.
Accessed 14 December 2018.
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The Canadian Armed Forces Health Services is responsible for implementing public health measures on
all Canadian Forces establishments, bases, wings and stations across Canada and for Canadian Armed
Forces personnel deployed abroad. Indigenous Services Canada provides health services to Indigenous
communities and develops context-specific guidance for them while also encouraging the inclusion of
Indigenous considerations in on-reserve First Nations communities to align and to be integrated with
the provincial public health authority planning. In addition, there is ongoing federal responsibility for the
provision of health services and advice on any public health measures aligned to other specific federal
populations (e.g., Global Affairs Canada to missions abroad, Correctional Services Canada to federal
inmates). The planning guidance for the health sector provided in the CPIP main body (Section 3.4.2)
and throughout this Annex also applies to these federal departments or agencies.
2.4.1 UNDERSTANDING CANADA’S DIVERSITY

Canada is diverse in terms of language, religious beliefs, ethnicity, culture and lifestyle. Many public
health measures used during a pandemic will be modifications of existing practices for seasonal influenza
and will therefore be familiar to public health jurisdictions and the public. Nevertheless, there may be
individuals in any community whose needs are not being fully addressed by standard services, or these
individuals may not be able to access and use resources, making them more vulnerable to infection or
complications of influenza during a pandemic (e.g., those who are physically or mentally disabled,
homeless or street involved, housebound or frail seniors, socially isolated, new immigrants, refugees,
and persons who do not speak English or French). These groups will need special consideration to
support their adoption of recommended public health measures.
It will also be important to consider the circumstances of individuals living in remote and isolated
communities in Canada because such circumstances may make them more susceptible to infection and
complications of influenza in an influenza pandemic. These include social, environmental and economic
factors, including the state of their housing, water, food security, personal health, education and income,
in addition to limited access to health care services due to lack of health care professionals and
geographical considerations. It will be important for planners to take these circumstances into account
when planning for the implementation of public health measures in a pandemic.41 Appendix B provides
more pandemic planning considerations for remote and isolated communities.
It was anecdotally reported that, during the 1918–19 Spanish influenza pandemic, small villages in
Alaska that stringently restricted movement in and out of the village remained free of influenza. During
the 2009 pandemic, some remote and isolated communities experienced early and intense outbreaks.
In response, a task group was formed to provide technical advice on the public health pandemic
response and delivery of health services in remote and isolated communities. Local planners should
consider ways to leverage the potential for pandemic delay in isolated communities, for example by
engaging the residents in the planning process to explore their potential support for early measures.
These measures must be evaluated carefully in the context of the pandemic impact, potential benefit
and social acceptability.
The main body of the CPIP (Section 2.4) further discusses the planning considerations related to the
Canadian context.
41 Public Health Agency of Canada. Guidance for remote and isolated communities in the context of the pandemic (H1N1) 2009
outbreak. Nov. 2009, https://web.archive.org/web/20100129052023/http://www.phac-aspc.gc.ca/alert-alerte/h1n1/guidance_
lignesdirectrices/ric-cei/index-eng.php. Accessed 14 December 2018.
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2.5 Ethical Considerations

The ethical principles set out in the main body of the CPIP (Section 2.5)—trust and solidarity, reciprocity,
stewardship, equity and fairness—inform decision-making for implementing the public health measures
strategy. Ethical decision-making also involves openness and transparency, accountability, inclusiveness
and reasonableness.
These principles should guide all decision-making around the selection and implementation of public
health measures in an influenza pandemic, including those situations in which information is limited. As
noted in the CPIP Communications and Stakeholder Liaison Annex, jurisdictions need to communicate
proactively with the public, even when gaps in scientific evidence exist or information is limited, to help
ensure the public’s trust in those managing the pandemic response.
Several aspects of the public health measures strategy have specific ethical considerations, including
the need to:
• Balance respect for individual freedoms with the duty to protect the population’s health, especially
when deploying more restrictive measures (i.e., adhere to the guiding principles of proportionality
and flexibility as well as the ethical concept of reciprocity).
• Aim for an equitable distribution of public health resources, benefits and burdens for all groups,
including remote and isolated communities and other individuals identified in Section 2.4, whose
circumstances require special consideration to support the adoption of recommended public health
measures. If these circumstances result in a distribution of resources that is not equitable, a clear and
transparent rationale should be provided to explain the decision-making process.
• Inform the public about the rationale for implementing individual and community-based restrictions
to mitigate influenza transmission.
2.6 Legal Considerations

The authority to implement public health measures in a pandemic may lie at the federal, provincial/
territorial or local public health level, depending on the particular setting and measure. For example,
the federal government has authority under the Quarantine Act (2005) to take public health measures
to prevent the introduction and spread of communicable disease at Canada’s international borders. PT
and local governments also have authority for certain public health measures and health emergency
management activities under their respective legislation.
In addition, the International Health Regulations (IHR), which aim to prevent the international spread of
disease while limiting interference with international traffic and trade, establish processes to be followed
by Member States, including Canada, when responding to a public health emergency of international
concern. Therefore, a collaborative and co-ordinated approach that includes all levels of government and
awareness of obligations under the IHR is essential, both when identifying gaps in the ability to undertake
certain public health measures and when measures are actually implemented during a pandemic.
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3.0 CANADA’S PANDEMIC PUBLIC HEALTH MEASURES STRATEGY

3.1 Objectives
The public health measures strategy supports Canada’s goals for pandemic preparedness and response:
First, to minimize serious illness and overall deaths, and second, to minimize societal disruption
among Canadians as a result of an influenza pandemic
The specific objectives of the public health measures strategy are:
• To reduce the overall transmission and slow the rate of transmission of the novel or pandemic virus,
thus lowering the total number of severely ill cases and deaths and delaying the accumulation of
cases.
• To reduce peak demands on health care institutions, thereby protecting to the greatest extent
possible against societal disruption and the overwhelming of community services, and buying time
before an effective vaccine is produced.
The epidemiologic curve below illustrates the goal of flattening and delaying the peak of the epidemic
by implementing public health measures to reduce and slow transmission of a novel influenza virus.
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FIGURE 1: GOAL OF PUBLIC HEALTH MEASURES FOR PANDEMIC INFLUENZA
Slow acceleration of number of cases
Pandemic outbreak:
no intervention
Daily number of cases
Reduce peak number of cases

and related demands on
hospitals and infrastructure
Reduce number of overall

cases and health effects
Pandemic outbreak:
with intervention
Number of days since first case
Source: Adapted from CDC. Interim pre-pandemic planning guidance: community strategy for pandemic influenza mitigation in
the United States—early, targeted, layered use of nonpharmaceutical interventions. Atlanta, GA; US Department of Health
and Human Services, CDC; 2007. https://stacks.cdc.gov/view/cdc/11425.
3.2 Guiding Principles and Approaches

All principles underpinning Canadian pandemic preparedness and response activities and decision-
making (see CPIP main body, Section 3.2) apply to the public health measures strategy, especially:
• Collaboration—All levels of government as well as health care stakeholders need to work together to
help ensure that individuals and communities understand and adopt public health measures.
• Evidence-informed decision-making—Decisions related to public health measures should be based
on the best available evidence.
• A precautionary or protective approach—Public health measures are implemented in a timely
manner and include reasonable preventive actions that are proportional to the threat. This principle
is particularly important in the pandemic’s early stage, when evidence-informed decision-making is
challenged by a lack of data.
• Proportionality—Public health measures should be appropriate to the level of the threat and tailored
to the anticipated pandemic impact and local situation.
• Flexibility—Public health measures are local by nature and subject to change as new information
arises. Thus, flexibility will likely be needed when scaling and timing interventions to reflect local
conditions.
• Use of established practices and systems to the extent possible—Effective seasonal influenza activities
support a strong pandemic response, as these well-practiced public health measures can be rapidly
ramped up to manage the pandemic.
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Ethical decision-making—When implementing, communicating and managing public health measures,

decision-makers must always balance collective versus individual rights, interests and values. This aspect
of decision-making is discussed in more detail in Section 2.5.
3.3 Public Health Measures—Specific Assumptions

Identifying assumptions is a way to deal with uncertainty and provide a useful framework for planning.
However, while rooted in evidence as much as possible, assumptions should not be regarded as
predictions. As the pandemic unfolds, new and emerging evidence will be incorporated to guide the
response.
Informing the planning assumptions identified below are the WHO's Pandemic Influenza Risk
Management guidance,42 the UK's Scientific Summary of Pandemic Influenza and Its Mitigation43 and
discussions from the Canadian Pandemic Influenza Preparedness Planning Assumptions Workshop held
in 2011. The CPIP main body contains a number of assumptions related to a pandemic that are particularly
relevant to the public health measures context:
• The pandemic virus will behave like seasonal influenza viruses in significant ways:
–– incubation period—expected to last from 1–3 days;
–– period of communicability—adults are infectious from 24 hours before and up to 5 days from the
onset of symptoms, and children may be infectious for up to 7 days. Longer periods have been
found, especially in persons with immune compromising conditions;
–– methods of transmission—mainly by large droplet and contact (direct and indirect) routes; the
role of airborne transmission is unclear and unproven.
• Most communities will experience two or more pandemic waves of different magnitudes. In any
locality, the length of each wave will be from several weeks to a few months but may vary by community.
• There will be geographic variability with regard to the timing and intensity of waves, although some
jurisdictions will be affected simultaneously.
• The pandemic impact will vary across communities, and some members of the public may be affected
more severely than others.
• In addition to workers’ illness, workplace absenteeism may be higher than the estimated clinical
attack rate because of caregiving or concern about personal safety in the workplace.
• Vaccine is expected to be available in time to have an impact on the overall pandemic but is unlikely
to be available for the first wave. Given current technology, it will take four to six months for vaccine
to become available. The earlier the vaccine is available, the greater its impact on the pandemic.
• Individual personal protective measures are expected to help reduce transmission between individuals
and within households and other settings.
• Impact will vary across communities, and vulnerable populations are expected to be affected more
severely.
42 World Health Organization. Pandemic influenza risk management: A WHO guide to inform and harmonize national and
international pandemic preparedness and response. Geneva, May 2017, www.who.int/influenza/preparedness/pandemic/
PIRM_withCoverPage_201710_FINAL.pdf. Accessed 14 December 2018.
43 Government of United Kingdom. Department of Health. Scientific summary of pandemic influenza and its mitigation. UK,
2011, https://assets.publishing.service.gov.uk/government/uploads/system/uploads/attachment_data/file/215666/dh_125333.
pdf. Accessed 14 December 2018.
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There are additional assumptions specific to the public health measures response:
• Public health measures will be the primary means for slowing down transmission in the early stages
of a pandemic. Should resistance to antivirals occur, public health measures will become even more
important.
• The pandemic will evolve over time, requiring flexibility and scalability in terms of public health
measure responses (see section 3.6).
• Decision-makers will need to establish triggers to indicate when to scale up and scale down public
health measures within their response strategy, and these may vary across the country.
• Canadians will seek information or public health advice, requiring effective communications strategies.
• Public acceptance of restrictive control measures will correlate with the process used to arrive at
these decisions, the transparency and inclusiveness of the process, the articulation of explicit and
transparent rationales for measures, and the public’s perception of risk.
3.4 Pandemic Roles and Responsibilities

The public health measures strategy requires a collaborative approach with clearly defined roles and
responsibilities. This section focuses on FPT government responsibilities, although it is recognized that
local public health authorities may have a role in the activities listed under PT responsibilities.
The roles and responsibilities for the pandemic public health measures strategy (Table 1 on page 21) are
adapted from those set out in the CPIP main body, Section 3.4.2. Note that some roles and responsibilities,
such as FPT decision-making processes, are beyond the scope of this annex.
It is also acknowledged that other partners play important roles in a pandemic with respect to public
health measures, such as sharing credible information, supporting new and flexible policies and in the
area of communications. These partners include the private sector (e.g., workplaces), NGOs,
municipalities and international organizations.
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TABLE 1: FPT GOVERNMENTS’ ROLES AND RESPONSIBILITIES FOR PUBLIC HEALTH MEASURES
LEVEL OF GOVERNMENT ROLES AND RESPONSIBILITIES
FEDERAL GOVERNMENT • Developing recommendations for populations who are beneficiaries

of federal health programs and services (e.g., some First Nations
communities, Canadian Armed Forces, federal correctional facilities).
• Providing travel health notices and other health-related information
relevant to international travel.
• Exercising powers under the Quarantine Act to protect public health by
taking comprehensive measures to help prevent the introduction and
spread of communicable diseases in Canada. Such measures may
include, but are not limited to, the screening, examining and detaining
of arriving and departing international travellers, conveyances (e.g.,
airplanes and cruise ships) and their goods and cargo.
• Engaging with stakeholders (e.g., national health-sector NGOs,
professional associations) to facilitate information exchange aimed at
supporting public education efforts around public health measures.
PT GOVERNMENTS • Developing a pandemic public health measures strategy for their

respective jurisdiction that addresses a wide range of settings and
groups.
• Adapting, implementing, maintaining, monitoring, discontinuing,
evaluating and communicating on specific public health measures that
are within their authority and associated guidance during a pandemic.
• Engaging and communicating the jurisdictional public health measures
strategy to local public health agencies, regional health authorities,
municipalities, other health system partners, other PT ministries, relevant
stakeholders, PHAC and the public.
FPT GOVERNMENTS IN • Co-ordinating and facilitating consistent messaging around public health
COLLABORATION measures for Canadians.
• Establishing and supporting pan-Canadian recommendations on the use
of public health measures during a pandemic.
• Developing, implementing and disseminating public health guidance.
• Coordinating and aligning plans and activities for federal populations
(including Indigenous Peoples), where relevant.
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3.5 Key Elements of the Response

Public health measures for influenza pandemics are a modification and intensification of existing public
health practices. Since public health measures are implemented by many people in a variety of settings,
context is important when planning and implementing a layered approach to public health measures.
3.5.1 INDIVIDUAL MEASURES

Individuals play an important role in an influenza pandemic and must feel equipped to adopt personal
protective measures to protect themselves, their families and their communities. These measures are at
the core of good public health practice for influenza and other respiratory illnesses and are routinely
recommended during seasonal influenza campaigns. During an influenza pandemic, they become even
more crucial.
3.5.1.1 Hand Hygiene and Respiratory Etiquette

The effectiveness of rigorous hand hygiene and respiratory etiquette in limiting the spread of a novel
virus should be emphasized. The public should be strongly encouraged to undertake proper hand
hygiene and respiratory etiquette when at home and in all community settings.
New studies have found that hand hygiene and respiratory etiquette are generally well accepted by the
public.44 However, some individuals may view these more common personal measures as trivial and
therefore neglect them. Consistent messaging about these measures and their benefits may reinforce
them in the public’s mind so that ignoring them becomes socially unacceptable.
These measures are applicable in all pandemic scenarios.
3.5.1.1.1 Hand Hygiene

Hand hygiene is a comprehensive term that refers to hand washing or hand antisepsis and to actions
taken to maintain healthy hands and fingernails.45 Hands can become contaminated with the influenza
virus through direct contact (e.g. hand-to-hand) with an infectious individual or through indirect means
(e.g. contact with contaminated fomites).46 Influenza survives on hands for roughly three to five minutes47
and, in some cases, infectious influenza virus remains detectable after 30 minutes.48 Studies have
identified that frequent handwashing, across a variety of settings, reduced viral transmission by up to
44%.49,50,51,52 A systematic review on hand hygiene in office settings demonstrated that hand hygiene
44 Teasdale E, Santer M, Geraghty AWA, Little P, Yardley L. Public perceptions of non-pharmaceutical interventions for reducing
transmission of respiratory infection: systematic review and synthesis of qualitative studies. BMC Public Health. 2014, 14:589.
45 Public Health Agency of Canada. Routine practices and additional precautions for preventing the transmission of infection in
healthcare settings. Government of Canada, 2016, www.canada.ca/content/dam/phac-aspc/documents/services/publications/
diseases-conditions/routine-practices-precautions-healthcare-associated-infections/routine-practices-precautions-healthcare-
associated-infections-2016-FINAL-eng.pdf. Accessed 14 December 2018.
46 Brankston G, Gitterman L, Hirji Z, Lemieux C, Gardam M. Transmission of influenza A in human beings. Lancet Infect Dis.
2007, 7:257–65.
47 Bean B, Moore BM, Sterner B, Peterson LR, Gerding DN, Balfour HH. Survival of influenza viruses on environmental surfaces.
J Infect Dis. 1982, 146:47–51.
48 Thomas Y, Boquete-Suter P, Koch D, Pittet D, Kaiser L. Survival of influenza virus on human fingers. Clin Microbiol Infect 2014;
20:058.
49 Rabie T, Curtis V. Handwashing and risk of respiratory infections: a quantitative systematic review. Trop Med Int Health. 2006;
11:258–67.
50 Fung IC-H, Cairncross S. Effectiveness of handwashing in preventing SARS: a review. Tropical medicine and international
health. 2006, 11(11):1749–58.
51 Jefferson T, Del Mar C, Dooley L, Ferroni E, Al-Ansary LA, Bawazeer GA, et al. Physical interventions to interrupt or reduce the
spread of respiratory viruses: systematic review. BMJ (Clinical research ed.) 2009, 339:b3675.
52 Luby SP, Agboatwalla M, Feikin DR, Painter J, Billhimer W, Altaf A, et al. Effect of handwashing on child health: a randomised
controlled trial. Lancet (London, England) 2005, 366(9481):225–33.
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was effective in reducing respiratory and GI illness in office employees.53 The use of antibacterial soap
for hand washing is generally not recommended due to a lack of evidence of its superiority to plain soap
and water and potential adverse health effects, and concern that their frequent use may contribute to
antimicrobial resistance.54,55
HAND HYGIENE
Regularly and thoroughly wash hands (i.e., washing all surfaces of the hands including between fingers,
under and around fingernails using friction) with soap and water. If soap and water are not available, use
alcohol-based hand sanitizers containing at least 60% ethanol or isopropanol.
Avoid touching the mouth, nose or eyes with unwashed hands to prevent self-inoculation.
Another systematic review conducted in 2018 identified 16 studies that assessed the impact of hand
hygiene practice in the community setting on influenza infection or transmission. This review restricted
its scope to hand hygiene interventions independent of other public health measures; it is not reflective
of the recommended multi-layering approach to public health measures for reducing the spread of
influenza. Findings were mixed as to whether hand hygiene practices helped to prevent laboratory-
confirmed or possible influenza infection. Further, the evidence identified by this review must be
considered within the context of (1) the methodological challenges of studying the effectiveness of
hand hygiene in the community setting, (2) the already documented potential benefits of hand hygiene
for general infectious disease prevention and control, and (3) the fact that hand hygiene is one of several
non-pharmaceutical protective measures that can be taken to prevent influenza infection, and is difficult
to assess in isolation from other measures. The review concluded that good hand hygiene practice
should continue to be recommended as a public health measure to reduce the risk of influenza infection
and transmission in the community setting, given its non-invasiveness and broad applicability as an
infection prevention and control intervention.56
Unlike most urban communities in Canada, some remote and isolated communities have limited
access to clean running water for hand hygiene. Therefore, public health planners and health
service providers should increase awareness among individuals and families in these communities
about alternative means for effective hand hygiene.57 Guidance developed during the 2009
pandemic for communities without clean running water recommended treating available water
(i.e., boiling for one minute, adding chemicals such as chlorine bleach), using two separate
containers to hold the water (e.g., pail, bowl), and moving the hands around to mimic running
water.58
53 Zivich PN, Gancz AS, Aiello AE. Effect of hand hygiene on infectious diseases in the office workplace: a systematic review.
Am J Infect Control. 2017, 46, 4, 448–455. https://doi.org/10.1016/j.ajic.2017.10.006.
54 Kim S.A., Moon H., Lee K., Rhee M.S. Bacteriocidal effects of triclosan in soap both in vitro and in vivo. Journal of
Antimicrobial Chemotherapy. 2015, 70(12):3345–52.
55 Public Health Ontario. Best practices for hand hygiene in all health care settings, 4th edition. Government of Ontario, 2014,
www.publichealthontario.ca/en/BrowseByTopic/InfectiousDiseases/PIDAC/Pages/Best_Practices_Hand_Hygiene.aspx.
56 Moncion K, Young K, Tunis M, Rempel S, Stirling R, Zhao L. Effectiveness of hand hygiene practices in preventing influenza
virus infection in the community setting: A systematic review. Can Commun Dis Rep 2019;45(1):12–23. https://doi.
org/10.14745/ccdr.v45i01a02.
57 Public Health Agency of Canada. Guidance for remote and isolated (RI) communities in the context of the pandemic (H1N1)
2009 outbreak. Nov. 2009. https://web.archive.org/web/20100129052023/http://www.phac-aspc.gc.ca/alert-alerte/h1n1/
guidance_lignesdirectrices/ric-cei/index-eng.php.
58 Public Health Agency of Canada. Hand hygiene recommendations for remote and isolated community settings. Oct. 2009,
https://web.archive.org/web/20100129051514/http://www.phac-aspc.gc.ca/alert-alerte/h1n1/public/handhygiene-eng.php.
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3.5.1.1.2 Respiratory Etiquette

Respiratory etiquette is the term used to describe a combination of measures intended to minimize the
dispersion of influenza virus via droplets through coughing, sneezing and talking.
While there is no direct evidence that respiratory etiquette prevents respiratory virus transmission, this
assumption is indirectly supported by scientific studies showing that droplets generated by coughing or
sneezing among those not practicing respiratory etiquette can travel up to two metres and potentially
can infect others within that distance.59,60,61 It is a practice commonly recommended by experts and was
adapted by many Canadians during the 2009 pandemic. This practice continues to be promoted today
during seasonal influenza campaigns.
RESPIRATORY ETIQUETTE
Cover coughs and sneezes with a tissue. Dispose of tissues in a container and perform hand hygiene
immediately after a cough or sneeze.
OR
Cough and sneeze into the bend of your arm, not your hand.
Wear a mask if you have ILI and must leave the house
3.5.1.2 Environmental Cleaning (home/personal environment)

Influenza viruses have been detected on surfaces in homes and daycare centres during regular influenza
seasons,62 with higher rates of contamination found in some homes with young children.63 Viruses can
survive on hard non-porous surfaces for 24 to 48 hours,64 during which time they can spread to human
hands. Recent literature on influenza survival on dry surfaces determined that the virus may survive for
longer periods, in some cases, up to months, on a variety of materials.65 Although influenza viruses
survive on hands for three to five minutes,66 touching contaminated surfaces followed by touching the
eyes, nose or mouth can result in self-inoculation.
59 Barrios LC, Koonin LM, Kohl KS, Cetron M. Selecting non-pharmaceutical strategies to minimize influenza spread: the 2009
influenza A (H1N1) pandemic and beyond. Public Health Rep. 2012, 127:565–71.
60 Monto AS, Webster RG. [Chapter 2]. In: Webster RG, Monto AS, Braciale TJ, Lamb RA, eds. Textbook of influenza. 2nd.
West Sussex, UK: John Wiley and Sons, Ltd. 2013, 20–33.
61 Monto AS, Webster RG. [Chapter 2]. In: Webster RG, Monto AS, Braciale TJ, Lamb RA, eds. Textbook of influenza. 2nd.
West Sussex, UK: John Wiley and Sons, Ltd. 2013, 20–33.
62 Boone SA, Gerba CP. The occurrence of influenza A virus on household and day care center fomites. J Infect. 2005, 51:103–9.
63 Simmerman JM, Suntarattiwong P, Levy J, et al. Influenza virus contamination of common household surfaces during the 2009
influenza A (H1N1) pandemic in Bangkok, Thailand: implications for contact transmission. Clin Infect Dis. 2010, 51:1053–61.
64 Bean B, Moore BM, Sterner B, Peterson LR, Gerding DN, Balfour HEH Jr. Survival of influenza viruses on environmental
surfaces. J Infect Dis. 1982, 146:47–51.
65 Otter JA, Donskey C, Yezli S, Douthwaite S, Goldenberg SD, Weber DJ. Transmission of SARS and MERS coronaviruses and
influenza virus in healthcare settings: the possible role of dry surface contamination. J Hosp Infect. 2016, 92:235–50.
66 Moncion K, Young K, Rempel S, Stirling R, Zhao L. Effectiveness of hand hygiene practices in preventing influenza virus
infection and transmission in the community setting: a systematic review. Can Commun Dis Rep 2018; 45(01) (pending
publication).
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To reduce their risk of exposure to infectious droplets, individuals may consider more frequent cleaning
of their home environments, especially in cases of home isolation of an ill individual. Influenza viruses
can be removed from surfaces by routine cleaning practices that use detergent-based cleaners (e.g.,
dish soap) or disinfectants (e.g., bleach).67 As a result, frequent cleaning of potentially contaminated
surfaces, such as commonly touched surfaces, will potentially protect others sharing the same space.
ENVIRONMENTAL CLEANING (HOME/PERSONAL ENVIRONMENT)
Frequently clean and disinfect potentially contaminated and commonly used surfaces, such as:
• telephone handsets, mobile phones; • table and desk tops;
• tablets • door knobs/handles;
• TV remotes; • light switches;
• keyboards; • toys;
• faucets; • kitchen appliances.
Many readily available household or commercial disinfectant cleaning products are effective against influenza
viruses.
Dishes, clothing and sheets used by an individual with influenza-like illness (ILI) can be washed using ordinary
detergent and water.
Waste should be handled according to usual practices.
It is recommended that businesses and community organizations increase the frequency of cleaning high-
touch surfaces (at least twice daily) and ensure that adequate hand hygiene supplies are available at all times.
Adapted from: Public Health Agency of Canada. Individual and community-based measures to help prevent transmission of
influenza-like-illness (ILI,), including the pandemic influenza (H1N1) 2009 virus, in the community. Guidance Document
(archived).
3.5.1.3 Voluntary Self-isolation

To help reduce transmission between ill persons and those who are healthy during an influenza pandemic,
prompt recognition of symptoms and early self-isolation of symptomatic individuals are key. Individuals
with ILI should self-isolate while symptomatic and for at least 24 hours after the resolution of acute ILI
symptoms, unless there is a need to visit a health care provider or to seek other forms of support.68
For self-isolation to be effective, prompt recognition of illness onset will be important; therefore, public
health messaging about self-isolation should instruct the public about the signs and symptoms of
pandemic influenza.69,70 Also, individuals will need to know that illness onset and deterioration in health
may be sudden and be aware of how and when to obtain further medical care or access to support
systems (e.g., neighbours, family), while minimizing the risk of exposing others.
67 Bloomfield, S., Exner, M., Fara, G. M., and Scott, E. A. Prevention of the spread of infection—the need for a family-centred
approach to hygiene promotion. Euro Surveill. 2008, 13(22).
68 Qualls N, Levitt A, Kanade N, et al. Community mitigation guidelines to prevent pandemic influenza—United States, 2017.
MMWR Recomm Rep 2017, 66(No. RR-1):1–34.
69 Zhang, Q., and Wang, D. Assessing the role of voluntary self-isolation in the control of pandemic influenza using a household
epidemic model. International Journal of Environmental Research and Public Health. 2015, 12(8), 9750–9767.
70 Wu, J. T., Riley S., Fraser C., and Leung G. M. Reducing the Impact of the next influenza pandemic using household-based
public health interventions. PLoS Medicine. 2006, 3(9), e361.
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Voluntary self-isolation can potentially delay the spread of the virus in the community and therefore will
likely have high public acceptance, especially if the pandemic has higher clinical severity. During the
2003 severe acute respiratory syndrome (SARS) outbreak, compliance with this measure was generally
high in many affected centres.71 Moreover, some studies indicate that the public complies better with
voluntary and common-sense measures than with those that are mandatory and enforced.72,73
However, it is important to recognize that this measure may be disruptive to businesses and other social
settings, as well as for self-isolating individuals. Staying home while ill can be financially and practically
challenging (e.g., tolerance of employers for absences, availability of paid leave while in isolation, loss of
income from self-employment, households with ill children also requiring care). It is also recognized that,
in Canada, up to 30,000 people experience homelessness on any given night.74 Shelters, drop-in centres
and other day programs play a key role in supporting and co-ordinating support for infected individuals in
their programs. Self-isolation will be challenging in these and other circumstances, such as crowded
households or institutions, and for travellers. Individuals in these circumstances may need additional
supports and alternate strategies to protect others (e.g., wearing a mask, being provided with an area that
allows for a two-metre distance from others, limiting the number of people providing care).
VOLUNTARY SELF-ISOLATION WHEN ILL
Stay home (from work, school, daycares) and away from large crowds (e.g., malls, mass transit, public events)
when ill and for at least 24 hours after symptom resolution.
Family and other household members in homes with ill persons can continue their normal daily activities but
should self-isolate if they develop symptoms of ILI.
See Section 3.5.1.5 (page 27) for advice on the use of masks when self-isolating
Adapted from: Individual and community based measures to help prevent transmission of influenza-like-illness (ILI), including
the pandemic influenza (H1N1) 2009 virus, in the community. Guidance Document (archived).
Employers should be encouraged to consider implementing flexible work arrangements and sick leave
policies that support individuals who adhere to self-isolation advice, such as teleworking and suspending
the need for a medical leave note. Studies conducted during the 2009 pandemic indicated that the
availability of paid sick leave reduced H1N1 infection in the workplace by 20%75 and found that higher
ILI incidence was linked to the lack of paid sick leave.76
71 Health Canada. Learning from SARS. Renewal of public health in Canada. A report of the National Advisory Committee on
SARS and Public Health, October 2003. [Archived] https://www.canada.ca/en/public-health/services/reports-publications/
learning-sars-renewal-public-health-canada.html. Accessed on 14 December 2018.
72 Blendon RJ, DesRoches CM, Cetron MS, Benson JM, Meinhardt T, and Pollard W. Attitudes toward the use of quarantine in a
public health emergency in four countries. Health Affairs. 2006, 25(2), w15–25.
73 Lau JT, Kim JH, Tsui HY, and Griffiths S. Anticipated and current preventive behaviors in response to an anticipated human-to-
human H5N1 epidemic in the Hong Kong Chinese general population. BMC Infectious Diseases. 2007, 7, 18.
74 Buccieri K, Schiff R., eds. Pandemic preparedness and homelessness: lessons from H1N1 in Canada. Toronto: Canadian
Observatory on Homelessness Press, 2016.
75 Miyaki K, Sakurazawa H, Mikurube H, et al. An effective quarantine measure reduced the total incidence of influenza A
H1N1 in the workplace: another way to control the H1N1 flu pandemic. J Occup Health. 2011, 53:287–92.
76 Kumar S, Quinn SC, Kim KH, Daniel LH, Freimuth VS. The impact of workplace policies and other social factors on
self-reported influenza-like illness incidence during the 2009 H1N1 pandemic. Am J Public Health. 2012, 102:134–40.
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3.5.1.4 Voluntary Home Quarantine

Voluntary home quarantine of healthy contacts of infected individuals may help reduce community
transmission from households to schools, workplaces, neighbouring households and other settings.
Household contacts of an individual with pandemic influenza are at increased risk for infection or may
already be infected but asymptomatic. For quarantine measures to be effective, exposed household
members should stay home, starting from the time of their initial contact with the symptomatic ill
individual(s), for up to three days following the last contact with the ill individual, in order to assess for
early signs and symptoms of pandemic influenza virus infection.77,78 If other household members become
ill during this period, the quarantine may need to be extended for another three days. If they then
become ill, they should voluntarily self-isolate.
The evidence indicates that voluntary home quarantine, like voluntary self-isolation, can help prevent
the spread of pandemic influenza when used in combination with other measures, such as hand hygiene,
respiratory etiquette and antiviral prophylaxis.79,80
VOLUNTARY HOME QUARANTINE (BY HEALTHY CONTACTS OF

PROBABLE OR CONFIRMED CASES OF INFLUENZA)
Household members exposed to someone with influenza should remain at home from the time of initial
contact and for up to three days after the last contact with the symptomatic ill individual.
Monitor for signs and symptoms of infection and practice voluntary self-isolation if ILI develops.
Given the secondary consequences for healthy individuals who undertake home quarantine (e.g.,
absence from work), this measure may be recommended during pandemics of moderate to high impact,
in combination with respiratory etiquette and hand hygiene, to help reduce transmission beyond
households. Planning for supporting members of households in quarantine should also be considered
(e.g., access to essential medications, food).
3.5.1.5 Use of Masks

Face masks (i.e., disposable surgical, medical or dental procedure masks) provide a physical barrier that
may help prevent the transmission of influenza viruses from an ill person to a well person by blocking
large-particle respiratory droplets propelled by coughing or sneezing.81 It will be important for planners
to consider the number and availability of masks that may be required for this measure, taking into
account the range of pandemic scenarios (see Section 3.6).82
77 Cori A, Valleron AJ, Carrat F, Scalia Tomba G, Thomas G, Boëlle PY. Estimating influenza latency and infectious period
durations using viral excretion data. Epidemics 2012, 4:132–8.
78 Qualls N, Levitt A, Kanade N, et al. Community mitigation guidelines to prevent pandemic influenza — United States, 2017.
MMWR Recomm Rep 2017, 66(No. RR-1):1–34.
79 Tognotti E. Lessons from the history of quarantine, from plague to influenza A. Emerg Infect Dis. 2013; 19:254–9.
80 Wu JT, Riley S, Fraser C, Leung GM. Reducing the impact of the next influenza pandemic using household-based public
health interventions. PLoS Med. 2006 Sep; 3(9):e261.
81 Cowling BJ, Zhou Y, Ip DK, Leung GM, Aiello AE. Face masks to prevent influenza transmission: a systematic review.
Epidemiol Infect. 2010; 138:449-56.
82 Cristina C, Rainisch G, Shankar M, Adhikari BB, Swerdlow DL, Bower WA, Pillai SK, Meltzer MI, Koonin LM. Potential
demand for respirators and surgical masks during a hypothetical influenza pandemic in the United States. Clin Infect Dis.
1 May 2015, 60 Suppl 1:S42–51.
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During the 2009 pandemic, some studies showed that the combination of good hand hygiene and early
initiation of mask use by ill individuals reduced influenza transmission within households83,84 and among
university students in residence.85,86 The use of masks may be recommended for individuals with ILI,
especially in pandemics of moderate to high impact since this measure may prevent viral spread to
household members or to others in the community if the ill individuals must leave the place of residence.
Little evidence exists as to how effectively the wearing of a mask by well individuals will prevent them
from becoming infected.87,88 However, mask use by well individuals, in combination with other protective
measures, might be beneficial in certain situations (e.g., when high-risk individuals must be in crowded
settings or for well parents caring for ill children at home).
For masks to be effective, individuals must wear them consistently and correctly; these actions can be
challenging. Masks must be worn only once, never shared and always changed when soiled or wet. If
not used properly, masks may lead to a greater risk of pandemic influenza transmission because of
contamination, or they may make the user overconfident and hence neglectful of other personal
protective measures, such as hand hygiene, respiratory etiquette and self-isolation when ill89—measures
that have been deemed important complementary actions to the use of masks for the reduction of
disease transmission.90 Finally, given that masks cannot be used when eating and drinking and may
make communication difficult, wearing them for prolonged periods may be impractical and ineffective.
It is important to present the limitations of mask use to the public.91 Advice on proper disposal of used
masks should accompany any recommendations for their use in the community setting.
Providing masks to well people is unlikely to be feasible or sustainable on a population basis in a
pandemic and may not be an appropriate use of public resources since little evidence exists regarding
their effectiveness in reducing the spread of disease in the general population.
83 Suess T, Remschmidt C, Schink SB, et al. The role of facemasks and hand hygiene in the prevention of influenza transmission
in households: results from a cluster randomized trial; Berlin, Germany, 2009–2011. BMC Infect Dis. 2012, 12:26.
84 Cowling BJ, Chan KH, Fang VJ, et al. Facemasks and hand hygiene to prevent influenza transmission in households:
a cluster randomized trial. Ann Intern Med. 2009, 151:437–46.
85 Aiello AE, Murray GF, Perez V, et al. Mask use, hand hygiene, and seasonal influenza-like illness among young adults:
a randomized intervention trial. J Infect Dis. 2010, 201:491–8.
86 Aiello AE, Perez V, Coulborn RM, Davis BM, Uddin M, Monto AS. Facemasks, hand hygiene, and influenza among young
adults: a randomized intervention trial. PLoS One. 2012, 7(1):e29744.
87 Cowling BJ, Zhou Y, Ip DKM, Leung GM, Aiello AE. Face masks to prevent influenza transmission: a systematic review.
Epidemiol Infect. 2010,138:449–56.
88 Bin-Reza F, Lopez VC, Nicoll A, Chamberland ME. The use of masks and respirators to prevent transmission of influenza:
a systematic review of the scientific evidence. Influenza Other Respi Viruses. 2012,6:257–67.
MMWR Recomm Rep 2017, 66 (No. RR-1):1–34.
90 United States Department of Health and Human Services. Interim public health guidance for the use of facemasks and
respirators in non-occupational community settings during an influenza pandemic. Washington, DC: US Department of Health
and Human Services, 2007.
MMWR Recomm Rep 2017, 66 (No. RR-1):1–34.
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3.5.2 COMMUNITY-BASED MEASURES

Community-based measures, such as school closures or cancellation of mass gatherings, are disease-
control strategies aimed at reducing and slowing the transmission of influenza in communities. Decisions
about implementing these measures will likely be made at the level of the local public health authority
(i.e., Medical Officers of Health) with co-ordination by the PTs or regional levels to ensure the consistency
of a broad-based approach. The experience of past pandemics indicates that early decisions about
whether to implement these measures are often made before complete information about the impact
of the pandemic is known. The choice and timing of implementation of these measures will depend on
the pandemic’s impact, as well as the local community context.
Community-based measures are likely to have secondary consequences for individuals, families and
communities, such as loss of income, an elevated need for support services, and potentially reduced
availability of certain services. During a pandemic of lesser severity, the infection control benefits of
implementing some community measures (e.g., proactive school closures) may not be offset by the cost
and societal disruption caused by these measures. Hence, such measures are likely to be implemented
only during a high impact pandemic or in certain situations in some communities.92
3.5.2.1 Environmental Cleaning (Public Spaces)

Environmental cleaning (see Section 3.5.1.2) of public spaces is a community-based measure to consider
in keeping with usual pre-pandemic practices (e.g., cleaning products used, surfaces cleaned). More
frequent cleaning is likely not practical or sustainable in high-traffic public settings (e.g., airports, malls).
Therefore, more frequent cleaning may be desirable, but this is not an evidence-based recommendation
in the context of community-based measures in public settings.
Instead, it would be more effective for public health communications to continue to promote individual
practices (i.e., hand hygiene, respiratory etiquette, self-isolation at home when ill) in all settings. Also,
private companies, institutions and organizations can be encouraged to increase the frequency of
cleaning their own sites, particularly where hand and surface contacts are greatest (e.g., shared work
stations or items, such as phones, elevators, washrooms) and recommend increased hand hygiene
before eating, touching one’s face, etc.
3.5.2.2 Social Distancing Measures

Social distancing measures (e.g., cancelling or limiting communal events or activities) aim to reduce viral
transmission by limiting the frequency and duration of close contact among individuals of all ages in
settings where people congregate, such as workplaces, schools, shelters, spiritual or cultural settings
(e.g., churches, mosques, synagogues, sweat lodges) and mass gathering venues (e.g., concerts,
sporting events).
These measures are most applicable in pandemics of moderate to high impact since they can be
associated with significant societal and economic costs. The measures should align with the anticipated
pandemic impact and the local situation, while supporting the principles of flexibility and proportionality.
92 European Centre for Disease Prevention and Control. Guide to public health measures to reduce the impact of influenza
pandemics in Europe: ‘The ECDC menu’, 2009.
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During the 1918 influenza pandemic, which exhibited high virulence and high transmissibility, there was
a strong correlation between the early, sustained and layered application of public health measures
aimed at social distancing, and reduced mortality. School closures and public gathering bans were
associated with reductions in the weekly death rate. Early bans on public gatherings (e.g., early closures
of churches and theatres) were associated with a lower mortality peak.93 Overall, there was a statistically
significant association between increased duration of public health measures and reduced total mortality
burden in the municipalities studied; conversely, with the deactivation of those interventions, death
rates rose.94 However, the implementation and effectiveness of these measures in the 2009 H1N1
pandemic were not documented.
3.5.2.2.1 School and Daycare Closures

Children shed more virus for a longer period of time, making them more infectious.95,96 They are also less
likely to practice effective hand hygiene and respiratory etiquette. In addition, research indicates that
the presence of school-aged children in a household is a risk factor for influenza virus infection in
families.97 Many studies have shown that higher attack rates among children increased influenza virus
transmission in schools over other community settings.98,99,100,101,102 These studies suggest that the closing
of schools and daycare centres to allow students and staff to remain at home may help reduce influenza
transmission during a pandemic.
During the 2009 pandemic, proactive school closures were not recommended as a widespread measure
in Canada due to the less severe nature of the clinical illness. While a growing body of evidence indicates
that pre-emptive school closures can help prevent or reduce the spread of influenza,103,104,105,106,107 it is
still unclear whether those health benefits outweigh the social and economic impacts of school closures
93 Hatchett RJ, Mecher CE, and Lipsitch M. Public health interventions and epidemic intensity during the 1918 influenza
pandemic. Proceedings of the National Academy of Sciences of the United States of America. 2007, 104(18), 7582–7587.
94 Markel H, Lipman HB, Navarro JA, Sloan A, Michalsen JR, Stern AM, et al. Non-pharmaceutical interventions implemented by
US cities during the 1918–1919 influenza pandemic. JAMA. 2007, 298(6), 644–654.
95 Sato M, Hosoya M, Kato K, Suzuki H. Viral shedding in children with influenza virus infections treated with neuraminidase
inhibitors. Pediatr Infect Dis J. 2005, 24:931–2.
96 Hall CB, Douglas RG , Geiman JM, Meagher MP. Viral shedding patterns of children with influenza B infection. J Infect Dis.
1979, 140:610–3.
MMWR Recomm Rep. 2017, 66(No. RR-1):1–34.
98 Chen SC, Liao CM. Modelling control measures to reduce the impact of pandemic influenza among schoolchildren.
Epidemiology and Infection. 2008, 136(8):1035–45.
99 Zhao H, Joseph C, Phin N. Outbreaks of influenza and influenza-like illness in schools in England and Wales, 2005/06.
Euro Surveill. 2007, 12(5):E3–4.
100 Jongcherdchootrakul K, Henderson AK, lamsirithaworn S, Modchang C, Siriarayapon P. First pandemic A (H1N1) outbreak in a
private school, Bangkok, Thailand, June 2009. Journal of the Medical Association of Thailand, Chotmaihet Thangphaet. 2014,
97 Suppl 2:S145–52.
101 Cauchemez S, Bhattarai A, Marchbanks TL, Fagan RP, Ostro S, Ferguson NM, et al. Role of social networks in shaping disease
transmission during a community outbreak of 2009 H1N1 pandemic influenza. Proceedings of the National Academy of
Sciences of the United States of America. 2011, 108(7):2825–30.
102 Guclu H, Read J, Vukotich CJ Jr, Galloway DD, Gao H, Rainey JJ, et al. Social contact networks and mixing among students
in K-12 schools in Pittsburgh, PA. PLoS One. 2016, 11(3):e0151139.
103 Earn DJ, He D, Loeb MB, Fonseca K, Lee BE, Dushoff J. Effects of school closure on incidence of pandemic influenza in
Alberta, Canada. Ann Intern Med. 2012, 156:173–181.
104 Jackson C, Vynnycky E, Hawker J, Olowokure B, Mangtani P. School closures and influenza: systematic review of
epidemiological studies. BMJ Open. 26 February 2013, 3(2).
105 Chao DL, Halloran ME, Longini IM Jr. School opening dates predict pandemic influenza (A) H1N1epidemics in the USA.
J Infect Dis. 2010, 202:877–80.
106 Copeland DL, Basurto-Davila R, Chung W, et al. Effectiveness of a school district closure for pandemic influenza A (H1N1)
on acute respiratory illnesses in the community: a natural experiment. Clin Infect Dis. 2013, 56:509–16.
107 Chowell G, Echevarría-Zuno S, Viboud C, et al. Characterizing the epidemiology of the 2009 influenza A/H1N1 pandemic in
Mexico. PLoS Med. 2011 May, 8(5):e1000436.
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in a pandemic with lower impact.108,109 One post-H1N1 pandemic study indicated that decision-making
around measures carrying potential societal conflict will be affected by a “conflict avoidance” mindset
of decision-makers, wanting to avoid the potentially large societal costs of closing schools.110
Planners should weigh potential health benefits against the secondary consequences of school and
daycare closures; principally, this involves the potential shift of transmission from schools and daycares
to other community settings where children congregate, such as malls or community centres.111 Equally
important with respect to health equity is the fact that particular groups may be disproportionately
affected in other ways, such as children no longer being able to receive school-based meals or
counselling, single parents having to make arrangements for childcare, low-income families and parents
lacking flexible work arrangements or paid leave allowing them to stay home to care for their children.
Advance planning will be needed to reduce the secondary effects of this measure (e.g., replacing
school-based meals).
It is important to note that, while PTs and federal public health authorities can make recommendations
about school closures, the authority to close schools lies with local Medical Officers of Health or individual
school boards. With potential public fear about sending children to school when a pandemic influenza
case has been identified and the need for school boards to consider any increased risk to their employees
in school settings, school boards—and daycare administrators—may choose to close facilities regardless
of FPT recommendations or the pandemic’s epidemiology.110 Therefore, school boards should be
encouraged to plan for teaching disruptions and find means to continue education (e.g., online
submission of assignments for older students) in the event of a school closure. Schools may also elect
to close due to high staff or student attack rates and absenteeism.
This measure is most effective in pandemic situations where there are high attack rates in pre-school or
school-aged children. In addition, school closures would need to be proactive, that is, started before
there are significant levels of viral transmission in the community. Once the virus is established in children
and there is an observable level of school absenteeism caused by ILI, “reactive” closing of schools is
unlikely to slow further viral transmission.112 In this scenario, it is also recommended that all symptomatic
individuals from schools (e.g., teachers, support staff, students) be encouraged to practice voluntary
self-isolation at home.
In remote and isolated communities, school closures may have an even greater impact. Given limited
qualified substitute staff in the community, the school may not be able to implement a business continuity
cycle in a pandemic with higher transmissibility, potentially causing the school closure to be longer than
in urban communities. Public health planners should actively involve schools in monitoring and
surveillance to identify cases before an outbreak occurs and develop a business continuity plan.113
108 Community Preventive Services Task Force. Emergency preparedness and response: school dismissals to reduce transmission
of pandemic influenza. The Community Guide, 2012, www.thecommunityguide.org/findings/emergency-preparedness-and-
Diseases. July 2011.
110 Rosella LC, Wilson K, Crowcroft NS, Chu A, Upshur R, Willison D, Deeks SL, Schwartz B, Tustin J, Sider D, Goel V. Pandemic
H1N1 in Canada and the use of evidence in developing public health policies—a policy analysis. Soc Sci Med. April 2013,
83:1–9.
111 Antommaria AHM, Thorell EA. Non-pharmaceutical interventions to limit the transmission of a pandemic virus: the need for
complementary programs to address children's diverse needs. Journal of Clinical Ethics. 2011, 22(1):25–32.
112 Community Preventive Services Task Force. Emergency preparedness and response: School dismissals to reduce transmission
of pandemic influenza. The Community Guide, 2012, www.thecommunityguide.org/findings/emergency-preparedness-and-
2009 outbreak. Nov. 2009. https://web.archive.org/web/20100129052023/http://www.phac-aspc.gc.ca/alert-alerte/h1n1/
guidance_lignesdirectrices/ric-cei/index-eng.php. Accessed 14 December 2018.
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3.5.2.2.2 Alternative Social Distancing Approaches

Alternative social distancing measures can help reduce the spread of influenza in settings where people
have frequent close contact and share equipment (e.g., computers, desks, lunch tables), such as
workplaces, shelters, churches, fitness centres and other public spaces where people congregate.
Although the evidence is not conclusive, increasing the distance between work stations and school
desks to at least one metre between individuals may reduce viral transmission. In a severe pandemic,
the minimal distance between people might be increased.114 Symptomatic individuals should be
separated from well individuals and then sent home.
In workplaces, adjustments to policies and procedures may be made to help workers enact measures
aimed at reducing social contacts, such as teleworking arrangements and flexible hours allowing start
times to be staggered. A modelling study on combined social distancing measures found that staggered
workforce shifts in combination with school closures would decrease attack rates and disease incidence,
thus delaying a pandemic’s peak.115 Recent evidence indicates that teleworking and workplace closures
are somewhat effective in reducing viral transmission and are readily complied with; however, the
resulting business disruption may have significant secondary effects.116
3.5.2.2.3 Cancellation of Mass Gatherings

Mass gatherings occur in a range of public places (e.g., spiritual and cultural settings, theatres, sports
arenas, festivals) and result in a large number of people being in close contact for extended periods
of time.
Cancelling large events may be feasible, but compliance and sustainability may be difficult and may
cause significant social disruption. This is particularly true for the discontinuation of gatherings and
activities that are considered essential. Therefore, this measure is generally not recommended on a
widespread basis.
Instead, it is recommended that public education be intensified to support acceptance of the need to
make the decision personally to avoid or not avoid mass gatherings by, for example, not attending non-
essential gatherings, arranging to work from home or refraining from running errands during peak
hours.117 Reinforcement of individual measures (i.e., hand hygiene, respiratory etiquette and voluntary
self-isolation at home of symptomatic individuals) should be included in the messaging, which should
emphasize in particular that people who are ill should not attend mass gatherings.
With respect to remote and isolated communities, the potential for spread of infection during public
gatherings may put undue strain on already limited resources in these communities. Therefore, public
health planners should take into account the presence of ILI activity as well as the availability of health
care providers, basic medical supplies, medications, isolation beds, etc. when considering the
cancellation or postponement of public gatherings.118
MMWR Recomm Rep. 2017, 66 (No. RR-1):1–34.
115 Zhang T, Fu X, Ma S, et al. Evaluating temporal factors in combined interventions of workforce shift and school closure for
mitigating the spread of influenza. PLoS One. 2012, 7(3):e32203.
116 Rashid H, Ridda I, King C, et al. Evidence compendium and advice on social distancing and other related measures for
response to an influenza pandemic. Paediatr Respir Rev. 2015 16(2):119–26.
outbreak. Nov. 2009. https://web.archive.org/web/20100129052023/http://www.phac-aspc.gc.ca/alert-alerte/h1n1/guidance_
lignesdirectrices/ric-cei/index-eng.php.
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Guidance developed during the 2009 H1N1 pandemic stressed how important it is for planners of mass
gatherings to consult with public health officials and conduct a risk assessment in order to determine the
extent of local influenza activity and the capacity of the health care system to respond.119
3.5.3 BORDER AND TRAVEL MEASURES

The response to an emerging influenza pandemic will include the use of public health measures targeted
to international travellers arriving in or departing from Canada. Such measures will be based on federal
programs and procedures that are already in place; these include:
• Providing education and issuing travel health advisories or notices to inform Canadians about specific
situations in other countries that may pose a health risk to Canadian travellers. The information is
communicated via the Government of Canada’s Travel Health and Safety web site and social media
platforms (e.g., Twitter); it may also be provided directly to persons travelling to or from areas of
the world affected by a specific communicable disease. This information advises travellers about
the health risks of concern and provides recommendations on actions travellers can take to protect
themselves before, during and after travel. Additionally, health care providers are provided with
information about health events that may impact Canadian travellers.
• Administering the Quarantine Act at all international points of entry. The Quarantine Act aims to
prevent the introduction and spread of the novel/pandemic influenza virus into or out of Canada.
It imposes obligations on arriving and departing travellers, including the obligation to present to a
screening officer, who may be a border services officer, to provide information to that officer, and to
disclose if they have or might have a communicable disease.
• Designating quarantine officers, as defined in the Quarantine Act, who are authorized to implement
various control activities and measures with arriving or departing international travellers or conveyances
in order to prevent the introduction and spread of certain communicable diseases that pose a risk of
significant harm to public health. These activities include performing health assessments on travellers
who are suspected of having, or of having been exposed to, a communicable disease, and referring
ill travellers and their contacts for a medical examination or to local public health authorities for
monitoring and follow-up.
At the time of an emerging influenza pandemic, it is expected that the volume, intensity and/or frequency
of border and travel health activities and measures will be increased, particularly in the early stages
before there are cases and sustained viral transmission in Canada. Travel health advice may evolve and
be updated more frequently, and there may be more targeted messaging for persons travelling to
affected areas. While research is lacking on the effectiveness of traveller education in reducing
transmission of pandemic influenza, a broader body of evidence presented in the CPIP supports the
value of communication and public education campaigns in promoting the adoption of behaviours that
will help reduce the risk of exposure to, or transmission of, the virus. These strategies need to be
considered early on and adapted as necessary. There may also be an increase in the number of travellers
referred to local public health authorities near ports of entry. FPT and local health planners will want to
consider the impact that this increase in referrals will have on their programs.
119 Public Health Agency of Canada. Public health guidance for the prevention and management of influenza-like-illness (ILI),
including the pandemic (H1N1) 2009 influenza virus, related to mass gatherings. Sept 2009, https://web.archive.org/
web/20100129051541/http://www.phac-aspc.gc.ca/alert-alerte/h1n1/phg-ldp-eng.php. Accessed on 14 December 2018.
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Decisions to implement specific border measures in respect of a traveller, to make emergency orders
under sections 58, 59 or 60 of the Quarantine Act (e.g., to prohibit entry into Canada), and to implement
any other measures at borders, will be informed by many factors, including the characteristics of the
virus (e.g., transmissibility, virulence, risk factors), evidence of the effectiveness of the measures, and the
risk posed to the traveller and the public.
Where appropriate, public health measures implemented at Canada’s borders in an influenza pandemic
will be coordinated with, and be complementary to, PT and local public health actions for communicable
disease control, containment and mitigation.
In accordance with the Quarantine Act, all ill travellers are subject to entry and departure screening at
Canada’s borders. Currently, identifying cases of novel or pandemic influenza at points of entry is difficult
owing to the similarity of influenza symptoms to various other respiratory viruses. In addition, using
entry and departure screening measures for detecting influenza cases may be challenging, given the
current inadequate sensitivity of detection methods. These measures may identify more people without
influenza than with it (low specificity) and may fail to identify asymptomatic cases and those in the
incubation phase (low sensitivity). Departure screening is deemed to be more effective than entry
screening in decreasing influenza transmission because it reduces the number of ill travellers boarding
conveyances.120,121
Travel restrictions—The effectiveness of international travel restrictions on the containment of influenza
pandemics may be limited. International travel restrictions may delay influenza transmission but appear
unlikely to prevent it, except in unique settings (e.g., on a small island).122,123 Such restrictions may delay
the peak of the pandemic curve, but even with scrupulous limits on air travel, by only two to three
weeks.124,125,126 Moreover, such restrictive measures may result in significant social and economic
burdens.
At the time of a pandemic, consideration of the use of travel restrictions will need to take into account
evidence for their effectiveness and Canada’s existing international obligations, such as the North
American Plan for Animal and Pandemic Influenza (NAPAPI) and the IHR.
The NAPAPI outlines how Canada, Mexico and the US intend to prepare for and manage animal and
pandemic influenza, and implement appropriate public health measures at shared borders in order to
mitigate the impact of a novel strain of human influenza in North America. The Plan notes that highly
restrictive measures aimed at controlling the movement of people, live animals and goods might initially
delay but would not stop the eventual spread of a novel strain of human influenza within North America,
and could have significant negative social, economic and foreign policy consequences.127
120 Baker MG, Thornley CN, Mills C, Roberts S, Perera S, Peters J, et al. Transmission of pandemic A/H1N1 2009 influenza on
passenger aircraft: retrospective cohort study. BMJ. 2010, 340: c2424.
121 Bell DM, World Health Organization Writing Group. Non-pharmaceutical interventions for pandemic influenza, international
measures. Emerging Infectious Diseases. 2006, 12(1):81–87.
122 Mateus ALP, Otete HE, Beck CR, Dolan GP, Nguyen-Van-Tam JS (2014). Effectiveness of travel restrictions in the rapid
containment of human influenza: a systematic review. Bulletin of the World Health Organization 92(12):868–80D.
124 Ferguson NM, Cummings DAT, Fraser C, Cajka JC, Cooley PC, Burke DS. Strategies for mitigating an influenza pandemic.
Nature. 27 July 2006, 442, 448–452.
125 Mateus ALP, Otete HE, Beck CR, Dolan GP, Nguyen-Van-Tam JS. Effectiveness of travel restrictions in the rapid containment of
human influenza: a systematic review. Bulletin of the World Health Organization. 2014, 92(12):868–80D.
126 Cooper BS, Pitman RJ, Edmunds WJ, Gay NJ. Delaying the international spread of pandemic influenza. PLoS Med. 2006,
3(6):e212.
127 Public Safety Canada. North American Plan for Animal and Pandemic Influenza. 2012, www.publicsafety.gc.ca/cnt/rsrcs/
pblctns/nml-pndmc-nflnz/index-en.aspx. Accessed 14 December 2018.
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The IHR provide a framework for monitoring and enhancing global public health capacity and
international communication regarding potential public health emergencies of international concern
(PHEIC). The aim of the IHR is to prevent the international spread of disease while limiting interference
with international traffic and trade. If the WHO Emergency Committee determines that a PHEIC is
occurring, the Director General of the WHO will issue temporary recommendations under the IHR
involving measures relating to persons, baggage, cargo, containers, conveyances, goods and postal
parcels, in order to prevent or reduce the international spread of the specific disease.
Countries that are State Parties to the IHR, including Canada, may implement additional measures in
response to a specific health risk or PHEIC. In determining whether to implement such measures, the
State Party is required to base the determination on scientific principles, evidence of risk to public
health and any available guidance from the WHO. If the additional measures significantly interfere with
international traffic, the State Party is required to provide the WHO with the public health rationale and
relevant scientific information for the measures.
3.5.4 CASE AND CONTACT MANAGEMENT MEASURES

The event of a novel or pandemic influenza virus first being detected in Canada or elsewhere in the
world will trigger public health activities aimed at preventing or limiting the spread of the virus in
Canada. It will include various surveillance activities to detect, monitor, describe and report on the novel
influenza virus. Some circumstances may also warrant public health management of cases and their
close contacts. These circumstances might include:
• an individual case or cluster involving a novel virus;
• suspected human infections associated with an animal influenza outbreak; or
• initial cases of the pandemic virus.
The findings from public health case and contact management will provide essential epidemiological
information on the virus that will inform risk assessments. The CPIP Surveillance Annex indicates that
FPT surveillance plans call for comprehensive case and contact investigation on the first few hundred
cases and provides details of FPT reporting protocols. National case definitions will be developed early
in the pandemic; these will provide the definitions for confirmed and probable cases, and persons under
investigation, as well as the definition of close contacts.
It will be important for planners to consider the implications of the management of cases (confirmed,
probable or persons under investigation) of novel or pandemic viruses and their contacts by public health
authorities. This measure would likely be implemented most aggressively in the early stages of a pandemic,
before there is sustained transmission in Canada, in an effort to contain or delay the spread of the virus.
Once there is sustained pandemic virus transmission in Canada, public health activities will shift from
individual management to public education in order to reinforce individual and community measures.
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When it is determined that case and contact management is required, national-level public health
guidance on the management of cases and contacts will be developed collaboratively by FPT public
health authorities, informed by the available epidemiological data and anticipated pandemic impact.
The guidance should provide public health authorities with recommendations on:
• Case management:
–– Data collection and reporting protocols (or identifying where the protocol is found);
–– Monitoring: type (active vs. passive), frequency of monitoring (e.g., daily), method (e.g., in person,
by phone); duration (i.e., until illness resolves or until novel influenza virus infection is ruled out);
–– Education to be provided on care of ill persons: when, where, how to access medical care and
treatment, prevention of transmission to others (e.g., voluntary self-isolation, hand hygiene,
respiratory etiquette, use of masks and environmental cleaning);
–– Clinical management: public health will need to facilitate appropriate clinical management by
providing relevant information and instructions to front-line clinicians; it is expected that virus-
specific clinical guidance on the use of antiviral drugs will be developed at the onset of the
pandemic (see Antiviral Annex);
–– Laboratory testing (per virus-specific laboratory protocols); and
–– Infection control measures for cases and others in their living environment.
• Contact management:
–– Confirm definition of a close contact (proximity to patient, e.g., within two metres of a case;
duration of an exposure, e.g. may be variable); these factors will need to be considered as part
of the risk assessment;
–– Data collection and reporting protocols;
–– Monitoring: type (e.g., active, passive), frequency (e.g., daily), method (e.g., in person or by
phone); and length of monitoring period (i.e., number of days from date of last exposure);
–– Education to be provided to the contact: period of monitoring, voluntary home quarantine; use of
personal protective measures (e.g., hand hygiene, social distaqcing and environmental cleaning
of household surfaces), self-monitoring for symptoms of ILI, what to do if symptoms develop; and
–– Circumstances for which antiviral prophylaxis should be considered: it is expected that virus-
specific clinical guidance on the use of antiviral drugs will be developed at the onset of the
pandemic (see Antiviral Annex).
3.5.5 PUBLIC EDUCATION

During an influenza pandemic, public demand for information is expected to be extremely high and
sustained as the illness spreads in Canada and into local communities. Before a pandemic vaccine is
available, public health measures will be the primary means to slow transmission in the early stages of a
pandemic. Preventive actions taken by the public will be informed by timely public education messages.
Most public health authorities already see public education as one of their key responsibilities. In several
Canadian jurisdictions, public surveys conducted after the 2009 pandemic found that education on
hand hygiene, respiratory etiquette and staying home when ill were delivered effectively and resulted in
positive behaviour change.128 Indeed, many public health measures direct the public to restrict specific
128 Public Health Agency of Canada. H1N1 synthesis report: Synthesis of findings from the FPT and other reviews of Canada’s
pandemic planning and response to the 2009 H1N1 influenza pandemic. April 2011. (Internal report.)
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personal activities for some period of time. Therefore, it should be considered an ethical duty to explain
the rationale for such measures and how they may change over time.129
Public education campaigns should be grounded in a risk communications approach (see CPIP
Communications and Stakeholder Liaison Annex) to support compliance with public health measures.
Clear communication of public health messages is crucial, and information must be consistent, accurate,
reassuring and trustworthy.130
The strategies, interventions and products developed for seasonal influenza campaigns can be the
building blocks for pandemic-related education campaigns. The contacts established by public health
programs that already target schools, large businesses, governments and municipalities could facilitate
pandemic-related public education implementation.
The entire population will need general information, while specific groups (see Section 2.4.1) will require
more targeted information that may need to be delivered in less conventional ways.
Public health planners should consider:
• Preparing educational materials for the public during the interpandemic period and modifying them
as needed, including:
–– Providing instruction on proper techniques for hand hygiene, respiratory etiquette, environmental
cleaning, as well as symptoms of influenza, prompt self-diagnosis, self-care, and how to obtain
further medical care while minimizing exposure.
–– Giving advice on preparing for public health measures, such as isolation protocol, restriction
and cancellation of mass gatherings, closure of schools and child care facilities, closure of public
facilities and other places of assembly.
–– Emphasizing that those at high risk for serious illness or complications from influenza should:
Consult with their health care provider to plan what they can do to protect themselves;
Know what to do if they become ill;
Avoid large gatherings when ILI is circulating in their community; and
Plan ahead for the possibility of getting sick and ensuring an in-house supply of groceries and
other necessities (e.g., medication) should they be self-isolated at home for several days.131
• Tailoring public health awareness campaigns for remote and isolated communities during the
interpandemic period:
Engage key community members (e.g., cultural interpreters, translators, elders, healers,
Indigenous physicians) in developing and delivering public health measures to the community,
tailored to their language, health literacy level and culture.
Identify communities where circumstances, such as lack of clean running water and supplies
or limited access to telecommunications (e.g., telephone, internet) require tailored messages.
129 Government of British Columbia. British Columbia’s H1N1 Pandemic Influenza Response Plan. Public health measures
summary document. Oct. 2009, https://www2.gov.bc.ca/assets/gov/health/about-bc-s-health-care-system/office-of-the-
provincial-health-officer/public_health_measures_-_summary.pdf. Accessed on 17 December 2018.
130 Leung GM, Nicoll A. Reflections on Pandemic (H1N1) 2009 and the international response. PLoS Med. 2010, 7(10):e1000346.
outbreak. Nov. 2009. https://web.archive.org/web/20100129052023/http://www.phac-aspc.gc.ca/alert-alerte/h1n1/guidance_
lignesdirectrices/ric-cei/index-eng.php. Accessed 14 December 2018.
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Develop communication strategies (e.g., mail outs, community radio, working with neighbouring
communities to obtain necessary information, posters, door-to-door messaging, community
meetings) to address local circumstances.
• Anticipating additional resource needs:
Encourage organizations to undertake business continuity planning (e.g., potential staff
absences due to self-isolation).
Advise school boards to strategize about ways of maintaining education should schools close
(e.g., internet or other ways for students to receive and submit assignments).
Encourage the use of a “flu buddy” system whereby neighbours check on one another,
particularly those at high risk of complications of influenza, elderly or single people, and single
parent families, to help ensure that assistance is available, if required. It is important that
precautions be taken to avoid exposing the flu buddy to infection.
• Reviewing and updating educational materials for health professionals that reinforce existing
recommendations for management of individuals presenting with ILI (e.g., provide surgical masks for
people with coughs).
KEY MESSAGES ON PUBLIC HEALTH MEASURES
• Use appropriate hand hygiene and respiratory etiquette at all times;

• Avoid touching your eyes, nose and mouth;
• Avoid sharing drinks, eating utensils, cigarettes;
• Avoid contact with people who are sick with ILI and, if unable to do so, maintain a two-metre
separation from them as much as possible;
• Be aware of signs and symptoms of ILI;
• Stay home if ILI develops;
• When ill, stay away from others as much as possible to help avoid infecting them;
• If ILI develops, plan ahead on how to return home as soon as possible by a means that will minimize
exposure to others (e.g., avoid mass transit);
• Make a plan with a friend or neighbour to help ensure that assistance is available (e.g., to pick up
medication, run errands) in case ILI develops;
• Wear a mask to prevent viral spread to household members or others in the community if you must
leave the house; and,
• Avoid contact with animals while you have ILI (to prevent possible transmission).
Adapted from: Individual and community based measures to help prevent transmission of influenza-like-illness (ILI,), including
the pandemic influenza (H1N1) 2009 virus, in the community. Sept. 2009, https://web.archive.org/web/20100129051725/
http://www.phac-aspc.gc.ca/alert-alerte/h1n1/hp-ps-info_health-sante-eng.php. Accessed on 14 December 2018.
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3.6 Risk Management Approach

3.6.1 OVERVIEW
Risk management is a systematic approach to setting the best course of action in an uncertain
environment by identifying, assessing, acting on and communicating risks. This framework for pandemic
planning and response supports the CPIP planning principles and approaches of evidence-informed
decision-making, proportionality, flexibility and a precautionary and protective approach.
Planning assumptions for using the public health measures strategy as a risk management planning tool
are identified in Section 3.3; planning scenarios are described in the next section.
3.6.2 RISK MANAGEMENT CONSIDERATIONS FOR THE PUBLIC HEALTH MEASURES STRATEGY
The public health measures strategy is subject to numerous risks, including the possibility of unintended
secondary consequences of measures and uncertainty of adequate public uptake of such measures. It is
expected that communication on public health measures will need to be adjusted based on the
implications of each scenario.
Table 2 describes potential implications for the public health measures strategy for pandemics of varying
impact, using the four planning scenarios described in greater detail in the CPIP main body (Section 3.7).
TABLE 2: IMPLICATIONS AND POTENTIAL ADJUSTMENTS TO THE PUBLIC HEALTH MEASURES STRATEGY
FOR PANDEMICS OF VARYING IMPACT
TRANSMISSION CLINICAL SEVERITY
LOW HIGH
HIGH Scenario B Scenario D

• Due to high case volume, public • Expect high public perception of risk
perception of risk may increase and and high media attention due to
drive demand for school and event differing applications of public health
closures. measures within and outside of
• Expect media attention. Canada.
• Consider release of travel health • Consider school and daycare closures
advice (especially re: high risk and cancellation of mass events.
groups). • Consider self-isolation, use of masks
• Intensify voluntary individual for all cases; likely need to activate
measures, with rationale. plans for additional supply of PPE
and human resources.
• Communicate and reinforce voluntary
community-based measures, with • Consider ongoing home quarantine
rationale (social distancing and caring of exposed household contacts.
for the ill). • Update travel health notices and
recommendations (especially re: high
risk groups).
• Intensify measures and communicate
rationale (voluntary and mandatory,
individual and community-based
social distancing and caring for the ill).
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TRANSMISSION CLINICAL SEVERITY
LOW HIGH
LOW Scenario A Scenario C

• Public complacency (low perception • Public perception of risk may
of risk). increase and cause absenteeism from
• Public perception of risk may shift school and work.
quickly, as ongoing surveillance may • Target communications to high-risk
identify settings and vulnerable groups.
populations at higher risk, or if • Consider ongoing self-isolation and
individual deaths receive media use of masks for all cases.
coverage.
• Consider ongoing quarantine of
• Communicate and reinforce voluntary exposed household contacts.
individual measures.
• Communicate and reinforce voluntary
• Before widespread transmission of community-based measures, with
virus is observed, conduct rationale (social distancing and caring
comprehensive case and contact for the ill).
investigation on first few hundred
• Expect media attention.
cases.
It is important to note that pandemic impact will not be uniform across Canada and may be higher in
some settings (e.g., remote and isolated communities) and in vulnerable populations. For additional
detail on applying measures based on severity to specific settings, see Appendix A: Recommended
Public Health Measures, by Settings and Severity.
Table 3 provides a more detailed outline of the risks and events that could affect the public health
measures strategy, their implications and potential mitigation/response, should the risk or event occur.
Timely and transparent risk communications to the public and health care providers should be an integral
part of the response to each event.
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TABLE 3: RISKS AFFECTING THE PANDEMIC PUBLIC HEALTH MEASURES STRATEGY, THEIR IMPLICATIONS
AND POTENTIAL MITIGATION OR RESPONSE
FACTOR /
EVENT IMPLICATIONS POTENTIAL MITIGATION / RESPONSE
PUBLIC OPINION AND RISK PERCEPTION
Media report • Sudden increase in demand for • Communicate and reinforce public
severe illness or information about public education: i.e., individual public health
a large number health measure efficacy. measures and their rationales (e.g., hand
of cases. • Need for implementation of hygiene, respiratory etiquette, voluntary
more public health measures self-isolation when ill, environmental
(or perhaps more targeted cleaning, caring for the ill, seeking medical
measures). assessment). Use tailored approaches to
communicate with vulnerable populations.
• Explain to the public how each additional
measure used will increase personal and
group protection and prevention.
• Advise the public that measures may
change as new information becomes
available.
Public fear • Increased demand on health • Proactively communicate messages about

associated with care services (such as illness prevention, self-care, when and how
perception emergency departments), to seek medical advice.
of severe associated with individuals • Increase accessibility to websites and
pandemic. who perceive great risk but telephone advice lines.
could be managed more
appropriately in the
community.
Differences in • Selection and implementation • Acknowledge differences in, and provide

implementation of public health measures will rationale for, differing local or regional
of public health differ depending on local or approaches.
measures regional situations. • Ensure that public health measures benefit
between • Public perception that another all groups within a community or region
jurisdictions and jurisdiction’s approach is better. and that burdens are equitably
internationally. distributed.
• Public concern if there is
perception of inequitable
distribution of public health
resources.
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FACTOR /
EVENT IMPLICATIONS POTENTIAL MITIGATION / RESPONSE
POPULATION RISK FACTORS
Some settings • Communities with limited • Consider resources required to implement

or parts of the capacity (e.g., remote and the measures (e.g., at early stage, contact
country are isolated communities) may be tracing is labour-intensive and likely will
affected more challenged with not be effective once the virus is
severely than implementation of some widespread in the community).
others. public health measures.
New risk factors • Public perception that public • Communicate the rationale for
identified health measures are ineffective implementing, not implementing or
for severe or or no longer important. de-escalating any given measure.
complicated • Evaluate public health measures
disease. throughout the pandemic.
• Remind the public that influenza is a
community-based infection, and therefore
focussing on a single setting (e.g., school,
workplace, airport) is ineffective.
Rates of severe • Groups at risk of severe illness • Communicate change in risk factors and
outcomes are are changing. rationale for new focus or type of public
greater than • Groups at risk of severe illness health measure(s).
for seasonal may involve those with access • Identify strategies for implementing public
influenza. and functional issues. health measures with groups assessed to
• Need for communication to be at risk of severe illness or complications
health care providers and the based on epidemiology.
public. • Identify strategies for implementing public
health measures with persons who are
culturally or geographically isolated, have
physical disabilities, have low income or
those in remote communities.
• Continue to monitor over time to assess
further changes in the virus as it adapts.
INTERNATIONAL CONSIDERATIONS
Other countries • Perception that another • Acknowledge differences and provide

use different country's approach is better. rationale for Canadian approach.
public health • International results may not • Share public health measures information
measures or at be comparable. internationally.
different times.
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3.7 Triggers for Action and Key Decisions and Activities

Key decisions needed to implement the public health measures strategy and their associated triggers
are shown in Table 4. Note that communications to the public and health care providers about the
public health measures strategy and implementation should occur at all stages. PTs may experience
different trigger timelines; hence, key decisions and activities may vary among PTs at any given time.
TABLE 4: TRIGGERS AND KEY DECISIONS FOR THE PUBLIC HEALTH MEASURES STRATEGY
TRIGGERS /
TIMELINES KEY DECISIONS / ACTIVITY CONSIDERATIONS
Novel virus • Gather intelligence from affected areas (e.g., • Likely will have limited
causing human via WHO, Global Public Health Intelligence information.
cases detected Network (GPHIN). • Promote seasonal
somewhere • Disseminate relevant communications to influenza prevention and
in the world, public and health sector. control measures.
outside of Canada • Consider border and travel advisories and • Tailored communications
(no or limited applicable measures. to health sector and
transmission). • Ensure that an evaluation framework is in general public.
place for the public health measures that will
be taken.
• Release public education on individual, family
and community-based public health measures
to prevent influenza.
Novel virus with • Gather intelligence from affected areas (e.g., • If clinical severity is high,
sustained human via WHO, GPHIN). there may be public fear,
transmission • Tailor considerations of public health measures anxiety, demand or
detected based on epidemiology. anger.
somewhere in the • Consider public messaging about Canada’s
world, outside of pandemic strategy.
Canada. • Keep public informed about what is currently
known/unknown.
• Consider border and travel measures (e.g.,
traveller education, assessment of ill travellers
and appropriate referral to local public health
authorities).
• Monitor for novel influenza virus occurring in
Canada.
• Identify and investigate clusters of ILI cases.
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TRIGGERS /
Novel virus with • Keep public informed about what is currently • It is unknown whether
sustained human known/unknown. cases will be distributed
transmission first • Recommend use of public health measures across the country or be
detected in Canada implemented during seasonal influenza (e.g., more localized within a
(early stage). hand hygiene, voluntary self-isolation). jurisdiction(s).
• Develop and tailor public health measure • Epidemiology will be
recommendations as knowledge about evolving.
transmissibility and clinical severity become • Public messaging about
available; update as information evolves. Canada’s pandemic
• Conduct comprehensive case and contact strategy will evolve as
investigations of first few hundred cases new knowledge is
occurring in Canada. gained.
• It is important to signal
that changes should be
expected based on new
knowledge and to
explain the rationale for
changing
recommendations.
• Sharing new knowledge
and rationale for
decisions with
international partners is
important.
Novel/pandemic • Keep public informed about what is currently • Actions may be

virus detected known/unknown. dependent on reported
in PT or local • Recommend use of public health measures clinical severity and
jurisdiction. based on evolving epidemiology and on extent of transmission.
those implemented during seasonal influenza
(e.g., hand hygiene, voluntary self-isolation).
• Depending on clinical severity and
transmissibility, local or regional closures or
social distancing measures may be
considered.
Localized or • Keep public informed about what is currently • Actions may be

widespread activity known/unknown. dependent on reported
in Canadian • Recommend use of personal public health clinical severity and
population: first measures based on epidemiology of extent of transmission.
pandemic wave circulating virus (e.g., voluntary self-isolation,
under way quarantine, hand hygiene, respiratory
(peak stage). etiquette).
• Consider instituting community-based
measures.
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TRIGGERS /
Pandemic wave • Keep public informed about what is currently • Public fatigue after the
wanes. known and unknown. first wave may factor into
• Recommend continuation of public health maintaining vigilance in
measures used during seasonal influenza the interim period.
(e.g., hand hygiene, respiratory etiquette,
voluntary self-isolation).
• Based on the epidemiology of the first wave,
plan for public health measure
recommendations for second wave.
• Begin evaluation of public health measures
response based on evaluation framework
designed in interpandemic period.
• Monitor stock of hand sanitizer and personal
protective equipment recommended for use
by the public.
Second (and • Keep public informed about what is currently • Public fatigue from
subsequent) known/unknown. restrictions during first
pandemic wave • Adapt recommendations of public health wave may impact
(late stage). measures used during previous wave (e.g., compliance with some
hand hygiene, respiratory etiquette, voluntary measures including
self-isolation and quarantine) based on facility closures.
updated epidemiology.
• Consider school closures and cancellation of
mass gatherings based on clinical severity,
transmissibility and effectiveness of these
measures if already used during the first
wave.
Pandemic ceases. • Complete evaluation of public health • Depending on pandemic

measures response. severity, significant staff
• Undertake after-action review to assess what turnover and fatigue may
worked and what did not work. impact completion of
this activity.
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4.0 INTEGRATION WITH OTHER RESPONSE COMPONENTS

This section demonstrates the way in which certain response elements (Surveillance and Communications)
are essential to the effective implementation of public health measures in a pandemic. Other response
components, such as Vaccines and Antivirals, play a complementary role, as indicated where relevant in
this Annex.
4.1 Surveillance
Timely surveillance information is needed for public health measures decision-making. PHAC collates
and analyzes surveillance information from across Canada and other countries to produce risk
assessments and provide decision-makers with timely and relevant surveillance data.
Surveillance information required for public health measures decision-making includes the following:
–– indicators of transmissibility and severity of clinical disease;
–– rates of illness, severe disease and death by age and risk groups and risk of severe disease in
those affected;
–– risk factors for severe illness, hospitalization and death (including settings with increased risk); and
–– proportion of severe disease in persons with and without underlying health conditions.
For further details on surveillance during a pandemic, see the CPIP Surveillance Annex.
4.2 Communications and Stakeholder Liaison

The imperative for effective communications and the strategic engagement of key stakeholders is an
integral element of all CPIP annexes and the planning guidance they provide. Communications must
build and maintain the trust and confidence of the public and other stakeholders by providing clear,
concise, consistent, realistic and timely information.
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Key goals of public health measure communication include:

• Informing the public of the disease (symptoms and signs, how it is transmitted);
• Providing guidance on appropriate responses, including:
–– hand hygiene and respiratory etiquette;
–– what to do should people become ill (e.g., when to present to health care providers); and
–– when to defer travel if unwell.
• Addressing public concerns (giving an accurate assessment of risk while acknowledging uncertainty
and reassuring the public).
The planners of public health measures response strategies should consult the CPIP Communications
and Stakeholder Liaison Annex in conjunction with this Annex, especially for the public education
aspects of public health measures. It provides planning guidance on how to address the information
needs of the public; describes factors that support public acceptability and compliance; and contains
information about educating key stakeholders and intermediaries whose perceptions of the pandemic
response may influence public opinion. Of special note is the guidance provided on communicating to
the public about risks, the evolving nature of the pandemic and the subsequent need for public health
measures to change over the course of the event.
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5.0 RESEARCH NEEDS

Research plays a key role in pandemic preparedness and response. Although additional research has
been undertaken since the 2009 pandemic to build an evidence base for a public health measures
response to pandemic influenza, more research is needed on the effectiveness of public health measures,
the choice and timing of implementation and the potential for unintended secondary consequences.
While some research questions can be carried out during the interpandemic period, others will need to
be conducted during a pandemic; therefore, it is important to plan in advance for a rapid research
response. Putting in place and sustaining an infrastructure during the interpandemic period is the best
way to ensure that timely research can be conducted during a pandemic.
As research resources are limited across jurisdictions, it is critical that research topics related to pandemic
public health measures be periodically reviewed and prioritized. In addition, periodic review has the
potential to reduce duplication of research efforts and to find means to collaborate on a given initiative.
If possible, consideration should be given to sharing pre-publication research results of importance with
other jurisdictions (i.e., results that may impact the efficacy of public health measures). The research
needs outlined below have been identified as interpandemic (I) or pandemic (P), depending on when
the research is required. They include:
5.1 Individual Measures

• How do increased frequency and quality of hand hygiene affect influenza virus transmission in the
community setting? (I) (P)
–– Are hand sanitizers as effective as hand washing with soap and water?
–– What is the effect of the combined use of respiratory etiquette and hand hygiene?
• What educational activities are most effective for changing behaviours and improving compliance for
hand hygiene and respiratory etiquette across population groups? (I) (P)
• What social media tools are most effective for disseminating public education messages about
individual and community-based measures to prevent influenza transmission? (I)
• What situations call for increased surface cleaning in various settings (e.g., households or schools
with confirmed influenza cases)? (I)
• What is the effectiveness of individual measures (e.g., hand hygiene, respiratory etiquette, use of
masks) in preventing transmission of the pandemic influenza virus? (P)
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5.2 Community-Based Measures

• How do school policies for hand hygiene and availability of soap and water influence hand-washing
behaviours in school-aged children? (I)
• How do various types of face masks, weather conditions (e.g., humidity and temperature) and social or
behavioural factors influence the effectiveness of face masks in preventing influenza transmission? (I)
• What are the optimal triggers (e.g., number of cases, transmissibility of the virus, severity of influenza)
for recommending mask use among ill individuals and well individuals in community settings? (I) (P)
• What are the effectiveness, timing and optimal implementation of school closures, other social
distancing measures and environmental control methods in specific settings? (P)
• What are the secondary consequences (e.g., missed work) of community-level measures (e.g., school
closures, cancellation of mass gathering events) that have direct economic effects for families and
communities? What is the magnitude of the impact, and does it make these measures unfeasible?
What is the impact of these secondary consequences on community living settings (e.g., group
homes and retirement homes)? (P)
• How can the transmission be slowed in circumstances that need to be continued during waves, such
as public transportation and other essential services? (I) (P)
• What factors influence the public acceptability of, and adherence to, community-based measures? (P)
• What is the level of compliance with public health measures in a pandemic and the impact of
intervention fatigue? (P) What is the effectiveness of public health measures in mitigating pandemic
impact (e.g., effect on virus transmission, hospitalizations, deaths)? (P)
5.3 Special Considerations

• How is viral transmission affected by social structures and behaviours (e.g., population density, living
conditions, social interactions)? (P)
• What are the transmission dynamics among populations whose circumstances (e.g., low income,
homelessness, remote and isolated communities) may increase their susceptibility to infection and/
or complications of pandemic influenza? (P)
• Are there additional factors besides universal susceptibility that allow the rapid spread of the virus in
the first wave? (P)
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6.0 ASSESSMENT AND EVALUATION OF PUBLIC HEALTH MEASURES

PREPAREDNESS AND RESPONSE
An evolving pandemic can be volatile as, for example, disease characteristics shift or resulting social
disruptions complicate efforts to implement and manage public health measures. Planners need to
design an evaluation program that is flexible enough to work under conditions of considerably greater
uncertainty than other contexts that require evaluation.
This task poses considerable challenges. Public health measures planners must develop an agile strategy
for evaluating such measures, both during and after a pandemic response. There is a duty to collect data
that can be used to conduct an evaluation for purposes of identifying optimal public health measure
implementation, maintenance and discontinuation. Therefore, PTs and local public health authorities
need to work together to identify upfront what data to collect during a pandemic.
Forward planning for evaluation will establish the protocols and priorities that can facilitate any needed
changes in direction during the pandemic, as well as facilitate an overall after-action evaluation of the
response in order to identify lessons learned and best practices. In addition, evaluation activities should
be identified for different pandemic scenarios.
Evaluation activities may be more successful if they are co-ordinated to ensure that selected sites
examine specific issues, thus potentially reducing duplication of effort and the need for all sites to
participate. This approach may improve the acceptability of evaluation activities among health authorities
in jurisdictions that are still recovering from the pandemic.
Areas to evaluate include:
• Type and degree of public health measures implementation;
• Differences in approaches to implementation of public health measures within and between PTs;
• Resource availability (e.g., personnel, masks);
• Impact of pandemic on provision of other public health services;
• Secondary or unintended consequences of public health measures and the effectiveness of strategies
to mitigate them, including impact on community living settings, such as group homes and retirement
homes;
• Accuracy and timeliness of guidance provided; and
• Information gaps.
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APPENDIX A: RECOMMENDED PUBLIC HEALTH MEASURES,

BY SETTINGS AND SEVERITY
SCENARIOS A AND B: SCENARIO C: HIGH SCENARIO D: HIGH

LOW CLINICAL SEVERITY CLINICAL SEVERITY AND CLINICAL SEVERITY AND
AND LOW-TO-MODERATE LOW TRANSMISSIBILITY HIGH TRANSMISSIBILITY
TRANSMISSIBILITY
All settings Recommend hand hygiene Recommend hand hygiene Recommend hand hygiene
(including and respiratory etiquette, and respiratory etiquette, and respiratory etiquette,
community self-monitoring, voluntary self-monitoring, voluntary self-monitoring, voluntary
living settings, self-isolation when ill, self-isolation when ill, routine self-isolation when ill, routine
such as group routine environmental environmental cleaning of environmental cleaning of
homes, cleaning of surfaces. surfaces, use of masks by ill surfaces, use of masks by ill
retirement Use of masks by well individuals when interacting. individuals when interacting.
homes, individuals is not Use of masks by well Use of masks by well
shelters, recommended. individuals is not individuals is not
correctional recommended unless they recommended unless they
facilities) are caring for an ill are caring for an ill
individual. individual.
Workplaces Social distancing measures Social distancing measures Social distancing measures
are generally not are generally recommended are recommended (e.g.,
recommended. (e.g., teleworking, teleworking, staggered start
staggered start hours, hours, flexible sick leave
flexible sick leave policies to policies to support workers
support workers to stay to stay home if ill).
home if ill).
Child care Proactive school and Proactive school and Proactive school and
facilities, daycare closures are not daycare closures should be daycare closures should be
schools recommended. considered if increased considered.
virulence in children and If schools remain open,
school-aged populations. recommend social
Social distancing measures distancing measures (e.g.,
(e.g., students spaced students spaced further
further apart) should be apart).
considered.
Residences Voluntary home quarantine Voluntary home quarantine Voluntary home quarantine
of exposed household of exposed household of exposed household
members is not generally members is recommended. members is recommended.
recommended. Use of masks by ill persons Use of masks by ill persons
Use of masks by ill persons is especially recommended is especially recommended
is recommended when when contact with when contact with
contact with household household members or household members or
members or crowded crowded community crowded community
community settings cannot settings cannot be avoided. settings cannot be avoided.
be avoided.
Mass
Cancellations are not Cancellations are not Cancellations may be
gatherings
recommended. recommended. considered.
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Camps (e.g., Cancellations are not Cancellations may be Cancellations are

day, residential, recommended. considered for special needs recommended for all camps.
special needs, Establish a dedicated area camps. If camps remain open,
work) to isolate residential If there is increased virulence recommend social
campers with ILI. in children and school-aged distancing measures (e.g.,
Send day campers with ILI populations, consider maximize distance between
home. cancellations for day and campers’ beds as well as
residential camps. during activities or meal
Send campers with ILI home. times).
If camps remain open, Quarantine campers

recommend social distancing exposed to cases of ILI.
measures (e.g., campers Send campers with ILI
spaced further apart). home.132
Remote and Deliver education regarding Conduct early outbreak Conduct early outbreak
isolated public health measures that investigation and case and investigation and case and
communities is appropriate to the contact management. contact management.
language, culture and Consider the impact of Consider the impact of
circumstances of the overcrowded housing and overcrowded housing and
community. Consider lack of alternative caregivers lack of alternative caregivers
alternate means to deliver or spaces in decisions about or spaces in decisions about
messages (e.g., radio, school closures. school closures.133
flyers, door-to-door visits,
elders).
Consider stockpiling
alternative means for
effective hand hygiene
(e.g., hand sanitizer) in
homes and community
settings where there is a
lack of access to clean
running water.
Consider stockpiling face
masks because of
overcrowded housing and
delivery delays.
Consider early outbreak
investigation and case and
contact management.
Adapted from: Qualls N, Levitt A, Kanade N, et al. Community mitigation guidelines to prevent pandemic influenza—United
States, 2017. MMWR Recomm Rep 2017;66(No. RR-1):1–34. TABLE 10. Recommended non-pharmaceutical interventions for
influenza pandemics, by setting and pandemic severity.
132
133
132 Public Health Agency of Canada. Prevention and management of cases of influenza-like-illness (ILI) suspected to be due to the
pandemic (H1N1) 2009 influenza virus in summer camps. Aug. 2009, https://web.archive.org/web/20100129051436/http://
www.phac-aspc.gc.ca/alert-alerte/h1n1/guidance-orientation-06-30-eng.php. Accessed 14 December 2018.
2009 outbreak. Nov. 2009, https://web.archive.org/web/20100129052023/http://www.phac-aspc.gc.ca/alert-alerte/h1n1/
guidance_lignesdirectrices/ric-cei/index-eng.php. Accessed 14 December 2018.
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APPENDIX B: GUIDANCE FOR REMOTE AND ISOLATED (RI)

COMMUNITIES134
Considerations for people living in RI communities
The overall health of Canadians living in remote and isolated communities can be affected by social,
environmental and economic factors, including housing, water, food security, personal health, education
and income. These factors, in addition to limited access to health care, are important to take into
account when planning for, and responding to, pandemic influenza in remote and isolated communities.
The social circumstances and needs of people living in RI communities may differ when compared to the
general Canadian population in the following ways:
• Housing: There are typically higher rates of overcrowding, and housing standards are often below
adequacy and suitability standards. This is of concern because overcrowded and inadequate housing
conditions contribute to increased likelihood of transmission of communicable diseases (e.g.,
influenza, TB).
• Water: There is frequently a lack of adequate quantity and quality of water. This is of concern because
of the importance of effective hand washing for infection prevention and control.
• Food Security: Access to affordable, nutritious food is often a challenge, especially because of the
increased costs associated with the logistics of transporting fresh produce. This is of concern because
food insecurity compromises the overall health and resiliency of affected people.
• Personal Health: The proportion of people with pre-existing chronic health conditions, such as
asthma and diabetes, is significantly higher. This is of concern because of the evidence of increased
severity of influenza in groups with chronic medical conditions.
• Education: The proportion of people with high school or post-secondary education tends to be
significantly lower. This is of concern in designing public communications/education campaigns (e.g.,
literacy, use of pictorial or visual messaging) that people will understand.
• Income: The overall unemployment rate is significantly higher, and the annual income is significantly
lower. This is of concern because health, morbidity and mortality follow a social and economic
gradient, and availability of income is a practical consideration with respect to stockpiling food and
supplies, access to transportation options, etc.
• Access to health care: Communities may have challenges in accessing health care due to a lack of
health care workers and extreme weather conditions. This is of concern because prompt access to
health care will be essential in a pandemic.
• Culture: Cultural practices include a community and family-centred approach to health (e.g., multiple
family members attending medical appointments or providing care for sick household members, high
respect for elders). These practices will need to be considered when planning health care services
for communities.
134 Public Health Agency of Canada. Hand hygiene recommendations for remote and isolated community settings. Oct. 2009,
https://web.archive.org/web/20100129051514/http://www.phac-aspc.gc.ca/alert-alerte/h1n1/public/handhygiene-eng.php.
Accessed on 14 December 2018.
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Public Health Measures in RI Communities

RI communities are at risk of influenza outbreaks due to multiple predisposing factors for transmission.
In these settings, it is important to minimize the impact of possible rapid spread. It is recommended that
early outbreak investigation and management be considered in consultation with the local public health
unit.
Challenges and potential strategies for implementing community-based public health measures are
listed below:
RI Challenge: Lack of availability of non-medical supplies

Delivery and transportation of non-medical supplies (e.g., soap, food, household items) in RI communities
can be challenging due to limited transportation, possible illness in the household and other factors,
such as inclement weather.
Strategies for public health planners to consider:
• Encourage and increase the awareness of individuals, families and communities of the need to have a
surge of essential supplies (e.g., soap, household cleaning products, non-perishable food and fluids,
tissues) in order to meet their needs.
RI Challenge: Limited access to running water

Some RI communities have limited access to running water or clean running water for hand hygiene.
• Increase the awareness of individuals and families in RI communities vis-à-vis alternative means for
effective hand hygiene if they lack clean running water. Consider treating available water (e.g., boiling
for one minute with chemicals, such as chlorine bleach), using two separate containers for their water
(e.g., pail, bowl) and moving hands around to mimic running water Alternatively, alcohol-based hand
sanitizer may be used for hand hygiene. However, if hands are visibly soiled, hand wipes should be
used to remove any such soil or organic material; this should then be followed by the use of hand
sanitizer.
RI Challenge: Public gatherings

The potential for spread of infection during public gatherings may put undue strain on already limited
resources in RI communities.
• Consider the presence of ILI activity as well as the availability of health care providers, basic medical
supplies, medications, isolation beds or rooms, etc. when considering the postponement of public
gatherings.
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RI Challenge: Impact of school closures

School closures in RI areas may have a significant impact on a community. Given limited qualified
substitute staff in the community, the school may not be able to implement a business continuity cycle
if there is a high attack rate. Hence, the school closure may be longer than in urban communities.
• Communities considering school closures should consult with local public health authorities and
follow various school guidelines.
• Actively involve schools in surveillance to identify cases before an outbreak occurs.
• Communities develop a business continuity plan for each school which would include a list of human
resources.
RI Challenge: Potential lack of tailored public health awareness campaigns

RI communities may be less exposed to public health awareness campaigns than urban communities. In
addition, the messaging that RI communities receive is often not suited or tailored to the circumstances
(e.g., limited water, limited accessibility to supplies) in these communities, or consideration may not be
given to health literacy, language barriers and limited access to telecommunications, including basic
phone and internet).
• Identify communities where tailored communication strategies are required given the local
circumstances. Tailored strategies could include: mail-outs, community radio, posters, door-to-door
messaging and community meetings. Tailoring may also include messaging from people who are
familiar or trusted (e.g., Indigenous elders or physicians).
• Develop and communicate campaigns that are specifically tailored to the circumstances of RI
communities.
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FEDERAL/PROVINCIAL/
TERRITORIAL PUBLIC
HEALTH RESPONSE
PLAN
FOR ONGOING
MANAGEMENT OF
COVID-19
3rd Edition
March 25, 2022
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F/P/T PUBLIC HEALTH RESPONSE PLAN FOR ONGOING MANAGEMENT OF COVID-19
Table of Contents
List of Acronyms and Abbreviations ............................................................................................................. 3
Executive Summary....................................................................................................................................... 4
1. Introduction .......................................................................................................................................... 6
2. Context .................................................................................................................................................. 7
2.1 Omicron........................................................................................................................................... 7
2.2 Disproportionate impacts and societal consequences ................................................................... 8
2.3 Societal disruption .......................................................................................................................... 8
2.4 Risk framework ............................................................................................................................... 9
2.5 Response governance and concept of operations ........................................................................ 10
2.6 Previous waves.............................................................................................................................. 10
3. COVID-19 Response Goal and Objectives ........................................................................................... 11
3.1 Goal ............................................................................................................................................... 11
3.2 Objectives...................................................................................................................................... 12
4. Forward Planning ................................................................................................................................ 15
4.1 Planning Assumptions and Areas of Uncertainty.......................................................................... 15
4.2 Planning for ongoing COVID-19 risks, response and readiness needs.......................................... 18
4.3 Planning for recovery .................................................................................................................... 25
4.4 Planning with Indigenous Communities ....................................................................................... 27
5. Addressing the consequences of pandemic response ........................................................................ 30
6. COVID-19 F/P/T Response Components ............................................................................................. 33
7. Assessment and Evaluation ................................................................................................................ 34
Appendix 1: Modelling Support for Forward Planning ............................................................................... 35
Appendix 2: Epidemiological Drivers .......................................................................................................... 37
Appendix 3: Planning for the reasonable worst case scenario ................................................................... 39
Appendix 4: COVID-19 Response Planning with Indigenous Communities ................................................ 44
Appendix 5: Surveillance ............................................................................................................................. 49
Appendix 6: Laboratory Response Activities .............................................................................................. 52
Appendix 7: Public Health Measures .......................................................................................................... 55
Appendix 8: Infection Prevention and Control ........................................................................................... 57
Appendix 9: Vaccination ............................................................................................................................. 58
Appendix 10: International Border and Travel Health Measures ............................................................... 64
Appendix 11: Health Care Systems Infrastructure ...................................................................................... 66
Appendix 12: Communications and Outreach ............................................................................................ 69
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Appendix 13: Research ............................................................................................................................... 72

References .................................................................................................................................................. 76
List of Acronyms and Abbreviations
AEFI Adverse events following immunization

CIC Canadian Immunization Committee
CPIP Canadian Pandemic Influenza Preparedness: Planning
Guidance for the Health Sector
F/P/T Federal/Provincial/Territorial
F/P/T PHRPBE Federal/Provincial/Territorial Public Health Response Plan for
Biological Events
IPC Infection prevention and control
ISC Indigenous Services Canada
LAC Logistics Advisory Committee
NACI National Advisory Committee on Immunization
PHA(s) Public health authority/authorities
PHAC Public Health Agency of Canada
PHM(s) Public health measure(s)
P/T Provincial/Territorial
PT Province, Territory
SAC Special Advisory Committee
TAC Technical Advisory Committee
VOC(s) Variant(s) of concern
2SLGBTQI+ Two-Spirit, lesbian, gay, bisexual, transgender, queer (or
questioning), intersexed plus
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Executive Summary
This document is the third edition of the Federal/Provincial/Territorial (F/P/T) plan which was developed
in collaboration with federal, provincial and territorial public health officials via the F/P/T Special
Advisory Committee (SAC) on COVID-19, First Nations, Inuit and Métis partners, and health system
partners, for these and other stakeholders. It is an evergreen document that is intended to provide a
Pan-Canadian forward planning approach for ongoing management of COVID-19 in Canada and facilitate
awareness and coordination both within and beyond the public health sector.
This edition focuses on the transition from the acute response to waves of COVID-19 activity occurring in
a largely susceptible Canadian population, towards a more sustainable long-term response to the
ongoing presence of COVID-19 in the context of increased population immunity and other public health
priorities. This is referred to as the Transition phase, and while acute response needs may be reduced
during this time, there is a need to maintain readiness to respond to any new COVID-19 risks while
addressing ongoing response and recovery needs. Much like other technical guidance, this document
may require updating as our scientific knowledge of the SARS-CoV-2 pathogen and duration of immunity
due to the COVID-19 vaccines and previous infections increases, and the epidemiological picture evolves
in Canada and globally.
The plan acknowledges jurisdictional roles and responsibilities, and therefore provincial/territorial (P/T)
flexibility and customization are expected. The autonomy of provinces and territories with respect to
management of their respective health systems is acknowledged; this document is not intended to
convey any requirements or obligations. First Nations, Inuit and Métis communities may choose to
adapt approaches to the specific needs and contexts of their communities, as highlighted in the sections
focusing on planning with Indigenous Communities.
Key elements of this edition of the plan include:
 public health objectives for the Transition phase;

 forward planning assumptions;
 planning for ongoing response, recovery and readiness;
 a section on addressing the consequences of pandemic response; and
 Appendices with updated summaries of each main component of the public health response (i.e.,
Surveillance, Laboratory Response Activities, Public Health Measures, Infection Prevention and
Control and Clinical Care Guidance, Vaccination, International Border and Travel Health Measures,
Health Care Systems Infrastructure, Risk Communications and Outreach, and Research).
The pandemic response goal, to minimize serious illness and overall deaths while minimizing societal
disruption as a result of the COVID-19 pandemic, highlights the need to balance the impact of COVID-19
in terms of both severe outcomes and societal disruption. The ability to achieve this balance has been
challenging during the response and is likely to be one of the key lessons learned for future pandemic
responses.
Vaccination and public health measures (PHMs) have been successful in reducing the number of cases of
COVID-19 and associated serious illness and deaths in Canada, however, the Omicron-driven wave
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necessitated the re-implementation of restrictive measures in many jurisdictions in order to ensure

health care systems did not become overwhelmed. The COVID-19 response has been unprecedented
with the swift implementation and public adoption of response measures. However, use of these
measures now needs to be de-escalated or adapted in the context of: decreasing incidence of infection,
circulation of a less virulent variant, high vaccination coverage, infection-acquired immunity, public
fatigue with the pandemic response1 2 3 4 5, and the unintended physical and mental health
consequences of the pandemic response6 7 8. At the same time there is a need to plan ahead for the
potential for repeated emergence of new variants of concern (VOCs) that may be more transmissible,
severe, and/or immune-evasive. This will involve evaluating the menu of options for public health
measure (i.e., pharmaceutical and non-pharmaceutical) with consideration of the triggers and timing of
each. It is expected that jurisdictions may not enact broad, restrictive measures unless absolutely
necessary (e.g., if there is high observed severity).
The World Health Organization (WHO) promotes use of a risk-based approach across the continuum of
pandemic phases, including the Alert phase, Pandemic phase, Transition phase and Interpandemic
phase.9 This edition of the plan promotes a risk management approach, which involves considering the
likelihood and impacts of potential threats like new VOCs, while also mitigating the impact of realized
risks.
As jurisdictions move out of the acute response phase and start to focus on recovery and preparedness
for the routine management of COVID-19 in the Canadian population, there is a need to monitor, assess
and revisit COVID-19 risks in the context of other public health priorities. This is reflected in the updated
ongoing management objectives for the Transition phase. In particular, recovery activities need to
address health consequences and risks, backlogs within health care systems and the impact of
interrupted public health program delivery, that have occurred over the course of the pandemic
response.
The disproportionate impact of both health outcomes and response measures, on some groups within
Canada10 11 has been another key observation over the course of the pandemic to date. The restrictive
nature of many of the response measures have had some negative health, well-being and societal
consequences for groups such as: older adults, essential workers, children and youth, racialized
populations, Indigenous Peoples, people living with disabilities, women, Two-Spirit, lesbian, gay,
bisexual, transgender, queer (or questioning), intersexed plus, (2SLGBTQI+) communities, people who
use drugs, people living on low incomes, newcomers to Canada, and people who are experiencing
homelessness and/or under-housed.12 13 14
An overall lack of public health and health care capacity, in particular surge capacity, in Canada, both in
terms of human resources and infrastructure, has been clearly illustrated clearly during this pandemic
but particularly with the Omicron-driven wave.
The deleterious impact the COVID-19 pandemic response has had on the mental and physical health of
responders, given its duration and intensity, and how this might affect recovery efforts and future
response capacity, also requires consideration. This is the time to document “lessons learned” and to
think broadly about system-wide improvements. How lessons learned will be addressed by current
responders and effectively “passed on” to decision-makers, the next cohort of responders (e.g., students
in health disciplines) and society at large, needs to be a part of this multi-faceted process.
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1. Introduction
The purpose of the Federal/Provincial/Territorial Public Health Response Plan for Ongoing Management
of COVID-19, is to provide federal, provincial and territorial public health officials, First Nations, Inuit and
Métis partners, health system partners and other stakeholders with a Pan-Canadian forward planning
approach for ongoing management of COVID-19 in Canada. This plan promotes a long-term risk
management approach.
The first edition covered immediate planning imperatives for the fall/winter 2020 period and the second
edition focused largely on preparedness for variants of concern (VOCs). This third edition focuses on the
transition from the acute response to waves of COVID-19 activity occurring in a largely susceptible
Canadian population, towards a more sustainable long-term response to the ongoing presence of
COVID-19 in the context of increased population immunity and other public health priorities.
As an evergreen document this third edition reflects that scientific knowledge of the SARS-CoV-2
pathogen has increased, the epidemiological picture has further evolved in Canada and globally, the
understanding of the disproportionate impact the pandemic has had on marginalized population groups
has grown15 16, risk mitigation strategies have shifted, and new medical countermeasures have become
available (i.e., vaccines, therapeutics and diagnostics). It recognizes the need to balance the strategies
and measures necessary to minimize COVID-19 risks against the need to address the public health and
societal impacts of the sustained pandemic and the unintended consequences of the measures that
have been required to mitigate risks to date.
Referencing the World Health Organization’s (WHO) “Continuum of Pandemic Phases”, previously
developed for pandemic influenza preparedness, response and recovery; this document focuses on
federal/provincial/territorial (F/P/T) public health activities that are needed for the “Transition phase”.
This is the phase between the acute pandemic response and the phase where COVID-19 is able to be
managed like other common infectious diseases in Canada. While acute response needs may be reduced
during this time, there is a need to maintain readiness to respond to any new COVID-19 risks while
addressing ongoing response and recovery needs. The Transition phase may occur over years, not
months, and the emergence of new VOCs and/or impact of waning immunity that may be associated
with increased disease activity and possibly increased severity, could necessitate a return to more acute
response type activities during this time frame.
The timing of the transition may be varied across Canada due to differences in epidemiology, availability
of health care resources, and risk tolerance. This edition of the Plan is informed by the current context,
and experience and evidence gained over the course of the pandemic response. As with previous
editions, this third edition also draws on existing intergovernmental pandemic preparedness, public
health emergency planning and data, information and resource sharing agreements, arrangements and
protocols in addition to the Canadian Pandemic Influenza Preparedness: Planning Guidance for the
Health Sector (CPIP). It is assumed that an ongoing (but appropriately scaled) F/P/T coordinated
response structure and activities as outlined in the F/P/T Public Health Response Plan for Biological
Events (F/P/T PHRPBE), will be needed to support the ongoing response, recovery and readiness
requirements during the Transition phase.
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As with other F/P/T plans, this document outlines overarching objectives, acknowledges jurisdictional
roles and responsibilities, identifies when cohesive F/P/T approaches are anticipated and when
provincial/territorial (P/T) flexibility and customization are expected. The autonomy of provinces and
territories with respect to management of their respective health systems is acknowledged; this
document is not intended to convey any requirements or obligations. This document has been
developed to facilitate planning for the management of COVID-19 that is not only flexible and adaptive
but driven by the assessment of COVID-19 risks in the Canadian population going forward.
2. Context
COVID-19 continues to represent an unprecedented challenge to the health, social and economic well-
being of Canadians, and the global community. More than two years into the pandemic, the Canadian
response has been strengthened by the availability of vaccines, testing, and therapeutics but further
challenged by the emergence of highly transmissible and immune evasive VOCs.
The availability of vaccines and rollout of population-based vaccine programs that prioritized reducing
the health impact in people at higher risk for poor health outcomes first, had a significant impact on
COVID-19 associated serious illness and overall deaths experienced in Canada. A high level of adherence
to the recommended public health measures (PHMs) remained essential, especially when the Omicron
variant of concern (VOC), which was associated with increased transmission and decreased vaccine
effectiveness (primarily effectiveness against transmission) and some therapeutics, emerged.
Mitigating the impact of COVID-19 in Canada continues to require a comprehensive, integrated and
cross-sectoral “whole-of-society”, “whole-of-government” strategy that focuses on what is within our
span of control while trying to reduce the risk and impact of what is not. The context of our planning,
therefore, is primarily Canadian-centric but recognizes that the global situation has a significant effect
on our response activities, the risk of resurgence, and the duration of the Transition phase in Canada.
2.1 Omicron
The Omicron-driven wave highlighted the need for ongoing adjustments and tailoring of the response as
the risk profile changes. The Omicron variant, although causing less severe disease among infected
individuals, still threatened to exceed health care delivery capacity limits due to the sheer number of
people infected with this highly transmissible, immune evasive VOC. Omicron arrived prior to the winter
holiday season while considerable Delta VOC activity was ongoing and when a pandemic fatigued
Canadian population was spending more time indoors, and gathering in large numbers. This increased
the risk of transmission at a time when vaccine-induced protection had started to wane and booster
dose programs had not yet been broadly implemented. To mitigate the risks associated with Omicron,
booster dose programs were quickly expanded across the country and restrictive PHMs were re-
instated, but were unsustained in many jurisdictions. Rapid antigen test use was expanded as
overloaded public health systems largely shifted surveillance and testing strategies away from individual
case and contact identification and management. Focusing on outbreak response in high-risk settings,
and measures to reduce overload of health care systems due to community circulation of Omicron,
became the priority in many jurisdictions.
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2.2 Disproportionate impacts and societal consequences
From the start of the pandemic, Canada implemented extraordinary broad and restrictive community-
based PHMs (e.g., school closure, restrictions on gatherings, workplace/ business restrictions).
Restrictive community-based PHMs were maintained or re-implemented in many jurisdictions in
response to Omicron. Many of these measures have had unintended negative health, well-being and
societal consequences,17 18 19 despite implementation of a significant level of societal support measures
(e.g., income support, housing support, and expansion of social services such as mental health and food
assistance).
The unintended, yet largely foreseeable, societal consequences of the pandemic response, have
affected virtually the entire population. However, diverse groups within Canada have been
disproportionately impacted by the pandemic, in part due to pre-existing inequities that were
exacerbated by the pandemic.20 21 These groups include but are not limited to: older adults , essential
workers, children and youth, racialized populations, Indigenous populations, people living with
disabilities, women, 2SLGBTQI+ communities, people who use drugs, people living on low incomes ,
newcomers to Canada and people who are experiencing homelessness and/or under-housed. 22 23 24 As a
result, their recovery as well as preparedness for future pandemics may require a more intensive and
expansive approach that focuses on reducing inequities and building resilience.
2.3 Societal disruption
Societal disruption was associated not only with high levels of disease activity, but also the restrictive
measures implemented to reduce transmission during these periods. The closure or reduced access to
workplaces, businesses, schools and daycares, and recreational facilities, disrupted normal routines, and
often created confusion as recommendations and requirements changed over time and differed
between jurisdictions. Paradoxically, many of those experiencing these disruptions were those least at
risk of severe disease (e.g., school aged children, healthy young adults). 25
Health care worker absenteeism from the workplace, due to the need to isolate or quarantine, further
compromised already reduced health care capacity even in well resourced jurisdictions. Similarly,
absenteeism amongst other essential service providers led to business continuity challenges.
The initial acceptance of necessary but disruptive response measures was impressive and beneficial as
Canadians were learning about the impact of SARS-CoV-2 in our population and how best to reduce it.
However, it is uncertain if the same level of personal sacrifice and societal disruption will be widely
acceptable in the future. It is important that forward plans revisit the triggers and timing of measures
implemented to reduce serious illness that also carry broader societal consequences. Even with the
availability of economic and other supports, there is a limit to the public tolerance of these measures
that are known to disrupt societal routines and functioning.
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2.4 Risk framework
The WHO’s Pandemic Influenza Risk Management Guidance, encourages a risk-based approach to
planning across a continuum of pandemic phases. The WHO phases (Figure 1) are intended to represent
how the global incidence of cases (with all waves of pandemic activity collapsed into one pandemic
phase) progresses over time and consequently provides a framework for the WHO's risk assessment of
the global situation. This terminology, developed as part of influenza pandemic planning, has been less
prominent during the COVID-19 pandemic, but still provides a useful context for transition planning.
Specifically, this terminology and risk framework can be utilized at F/P/T tables to foster a Pan-Canadian
approach to describing the current situation and planning by phase based on the level of pandemic,
epidemic and ongoing level of disease activity in Canada.
Figure 1: The continuum of pandemic phases26
The Transition phase is the phase between the acute pandemic response and the phase where COVID-
19 is able to be managed like other common infectious diseases in Canada; the latter being the
Interpandemic phase. The Interpandemic phase is not intended to represent the period between waves
of pandemic activity; rather, it is the time between new pandemics which has ranged from 10-40 years
for influenza but has not been established for SARS-CoV-2 since this is the first documented pandemic
caused by a coronavirus. The WHO characterizes the Transition phase as the time at which “as the
assessed global risk reduces, de-escalation of global actions may occur, and reduction in response
activities or movement towards recovery actions by countries may be appropriate, according to their
own risk assessments”.
Within Canada, federal and P/T risk assessments can now be informed by a substantial evidence base
that when combined with local/regional epidemiological data, response experience and impact analysis,
will help determine a risk-based approach for recovery and ongoing preparedness activities through the
transition and interpandemic phases. However, uncertainty will continue to factor into risk assessments
going forward since the emergence of VOCs with varied epidemiological characteristics need to be
considered and the incidence and impact of COVID-19 during the Transition and Interpandemic phases
will not be known until it is observed over a number of months to years. Given these caveats and
recognizing that risk tolerance will likely vary between jurisdictions and over time, this document
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proposes planning based on achieving F/P/T objectives, using risk-based approaches for the use of
measures and the communication of public health recommendations.
2.5 Response governance and concept of operations
Throughout the response the F/P/T Public Health Response Plan for Biological Events, has provided the
framework for our F/P/T governance and concept of operations. This governance structure, which
includes the Special Advisory Committee, Technical Advisory Committee (TAC), Logistics Advisory
Committee (LAC) and Public Health Network Communications Group and associated secretariats has
facilitated the coordination of the public health response. The frequent meeting of these groups have
enabled real-time discussion of evidence, risk and strategic planning which has led to a robust response.
These forums for developing broad recommendations, approving response related products (e.g.,
guidance, risk communications, operational protocols), assessing risk and information sharing, have
been functioning at a “Level – 4 Emergency” F/P/T response level throughout the pandemic. As
expected, provinces and territories (PTs) have adapted the F/P/T products and PHAC guidance products
approved in these forums for use as needed in their jurisdictions. This has resulted in variations in the
level of application and differences in timing of use of these products but nevertheless the structure has
ensured thorough consideration and discussion of all aspects of the public health response.
As many PTs have now shifted into the Transition phase based on assessed risks and observed
transmission levels, it will be important to consider whether (and when) the level of F/P/T response can
be scaled back from a Level 4 - Emergency response to a Level 3 - Escalated response as part of forward
planning. The concept of operations, supports ongoing review of the required F/P/T response level in
the form of a feedback loop that includes ongoing monitoring of risks and necessary risk mitigation
activities.
2.6 Previous waves
Before looking forward, it is important to think about the epidemiological characteristics and key drivers
of previous waves, as these essentially are different scenarios that we have already faced and can
potentially learn from the response to each. Specifically, there is a need to examine the triggers and
timing of response measures implemented in each previous wave and subsequently, the impact these
had on reducing serious illness, but also the societal consequences of the measures.
Figure 2 depicts the number of cases and prevalence of hospitalization due to COVID-19 in the Canada
over time. Although influenced by testing capacity and policies, the data is sufficient to summarize the
national trends in incidence and severity, recognizing that the impact of the waves varied between PTs.
Each significant wave was driven by a change in variant and/or contact rates (i.e., degree of interaction
between people outside of households). The impact of vaccination, which has included a relative
reduction in severe disease (i.e., requiring hospitalization), is not clearly evident in the figure due to the
underestimate of Omicron incidence. Also, testing in hospitals may have identified those with Omicron
who were admitted for another reason which could affect the death data.
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Figure 2: Pandemic waves and key drivers of COVID-19 impact
3. COVID-19 Response Goal and Objectives

3.1 Goal
Canada’s goal for responding to the COVID-19 pandemic is based on that established for pandemic
influenza in the Canadian Pandemic Influenza Preparedness: Planning Guidance for the Health Sector
document (last updated August 2018). The goal is:
 To minimize serious illness and overall deaths while minimizing societal disruption as a result of
the COVID-19 pandemic.
This goal has guided F/P/T public health response actions during the pandemic phase in Canada, with an
emphasis on minimization of serious illness and death. Measures and strategies implemented with this
goal in mind have helped reduce the incidence of COVID-19 in Canada and associated serious illness and
deaths.
Reducing the health impact of COVID-19 while minimizing societal disruption has been extremely
challenging especially as “pandemic fatigue” 27 28 has increased and led to related challenges with
respect to public adherence to recommended measures. Recognizing that some groups of Canadians
face disproportionate barriers in their ability to adhere to these measures, has influenced the way local
response measures have been implemented (e.g., off hour vaccination clinics for shift workers, mobile
or pop-up clinics). Strategies to address these barriers will be an important lesson to carry forward for
future responses and planning documents.
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The goal statement, which highlights the need to balance the impact of COVID-19 in terms of both
health outcomes and societal disruption, will lead to shifts in emphasis during the Transition phase.
During periods of lower disease activity, the amount of serious illness should be manageable within our
existing health care systems and with the use of therapeutics. Therefore, the use of measures that are
known to have disruptive impacts in our society (i.e., restrictive measures) should be limited. However,
given the ongoing risk of a virulent VOC with immune escape properties, there may be a need to re-shift
the emphasis back to a focus on minimizing serious illness and death.
3.2 Objectives
As jurisdictions move out of the acute response phase and start to focus on recovery and preparedness
for managing COVID-19 as a routine infectious disease in Canada, there is a need to revisit ongoing
management objectives in the context of other public health priorities – many of which have not
received adequate resources during the pandemic response phase.
3.2.1 Transition Phase

The Transition phase is a challenging time. The risk of resurgence will remain uncertain, but must be
planned for as the level of protection provided by vaccination and/or previous infection decreases over
time in the Canadian population and while pandemic activity continues globally. There will be a need for
multiple concurrent public health activities, all dependent on a largely exhausted public health work
force, all in the context of ongoing uncertainties regarding new variants.
Reducing COVID-19 associated serious illness to a locally manageable level (i.e., that can be managed
without disruption of other public health and health care services and programs), while maintaining
surveillance and readiness for any resurgence, and strengthening risk assessment capacity, are key
objectives during the Transition phase. However, during this phase there is also the need to
concurrently address recovery activities, documenting “lessons learned” for future reflection, and
starting to resume public health programs that were inadequately resourced due to the need to re-
direct resources towards COVID-19 pandemic response and may have large unmet needs. This also
includes starting to address ongoing health system capacity and data collection challenges. Any reliance
on State of Emergency status to achieve the necessary support for the pandemic response should be
considered and accounted for prior to discontinuing this declared State in order to ensure Transition
phase objectives will be met.
The following public health objectives aim to mitigate risks during the Transition phase.
Approach:
 To take risk and evidence based public health action to reduce the morbidity and mortality of
COVID-19 to a locally low, manageable and tolerable level, while minimizing or mitigating the
negative physical and mental health consequences of these actions especially amongst
populations in situations of vulnerability; and,
 To work collaboratively with the international community to support response and recovery in
other countries.
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Tools/Measures/Resources:
 To identify and address, with dedicated health resources, the unintended mental and physical
health consequences and risks that have occurred over the course of the pandemic response, as
part of current response and recovery activities.
 To continue delivering COVID-19 vaccination programs as recommended, in an efficient,
equitable manner;
 To support the administration of therapeutics in an efficient, equitable manner;
 To use testing strategies and genomic surveillance to optimize the management of ongoing risks
(e.g., to facilitate early treatment of those at high-risk of severe disease; to prevent introduction
into congregate living settings; to detect potential VOCs; to assess wastewater as an indicator of
community disease activity; to support targeted test, trace and isolate interventions, should a
future variant have characteristics that justify doing so);
 To replenish and support access to vaccines, personal protective equipment, testing, and COVID-
19 therapeutics as needed;
 To examine COVID-19 related risks in the context of other public health risks and re-balance
resources as needed to identify and address priorities;
 To bolster positive individual health behaviours and facilitate incorporation of individual,
business and institutional changes into everyday practices; and,
 To use mathematical modeling to help inform preparations for different epidemiological
patterns that may occur during the Interpandemic phase in Canada.
Readiness:
 To ensure ongoing surveillance to facilitate early detection of resurgence signals and to inform
risk assessments; and,
 To ensure readiness and capacity to respond appropriately to new risks (e.g., emergence of new
VOCs) and manage ongoing residual risks.
Recovery and Evaluation:
 To support recovery and physical and mental health of pandemic responders;

 To foster public understanding of ongoing risks while managing expectations for the recovery
period (e.g., duration and potential need to re-implement pandemic response measures) and
changes to improve resilience as COVID-19 transitions to an ongoing, more predictable,
infectious disease in Canada; and,
 To document lessons learned and start forward planning aimed at improving future response
capacity, efficiency and addressing response elements identified as gaps or weaknesses in after
action evaluative reports/activities.
Within health care systems there will be a need to focus on clearing “backlogs” of services and care that
was interrupted or delayed due to the need to re-allocate resources for treatment of COVID-19 cases
and increasing future surge capacity. Canada’s research, surveillance, national collaborating centres,
public health agencies, health care and laboratory systems will continue to provide necessary supports
during the Transition phase.
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3.2.2 Interpandemic Phase

The onset of the Interpandemic phase will likely be identifiable only with retrospective data analysis.
While coronaviruses routinely circulate and cause illness in the Canadian population, COVID-19 has
newly emerged and therefore what the ongoing/stabilized epidemiology will be in the future is not yet
known. For planning purposes it is important to consider different epidemiological patterns that may
occur during the Interpandemic phase in Canada. Mathematical modeling and scenario based planning
can help inform these preparations, however it is clear that monitoring the epidemiology of COVID-19 in
the context of other diseases and ensuring a readiness to respond to signals of concern will be necessary
on an ongoing basis.
Pandemic recovery activities may still be occurring during this phase, however, the focus should shift
towards achieving preparedness-oriented objectives. During this phase it will be important to examine
and implement broad improvements in public health and health care systems; particularly those that
increase surge capacity and resilience. System-wide improvements that aim to reduce the
disproportionate impact experienced by several diverse populations during the COVID-19 pandemic
phase should also be prioritized as these improvements have the potential for immediate (non-COVID
specific) benefits to health status. Furthermore, public health objectives in this phase should include
addressing post-pandemic recommendations (“lessons learned”) and measures that not only improve
capacity but also efficiency and timeliness of response components. Robust situational awareness and
linkages across the health sector will also improve preparedness during this phase.
Upon reaching the Interpandemic phase, our public health objectives will shift to mitigate risks and
improve preparedness for a broad range of risks. Anticipated objectives for the Interpandemic phase
include:
 To ensure an ongoing state of readiness to identify risk signals;
 To prepare to mitigate risks to the extent possible through a cycle of timely, informed risk
assessment, capacity assessment and preparedness activities;
 To build capacity and improve efficiency within the public health and health care systems to
ensure ongoing health priorities are sufficiently resourced and surge capacity is available to
address response needs for future epidemics and pandemics;
 To examine ongoing acquisition and stockpiling needs;
 To improve linkages (e.g., data, professional networks, research community) and connectivity
across health sector to foster real-time data analysis and rapid scale-up during response periods;
 To modernize and improve efficiency of data management and risk assessment processes;
 To update pandemic guidance products aimed at preparedness, response and recovery with a
focus on addressing elements identified as gaps or weaknesses in after action evaluative
reports/activities (i.e., integrate lessons learned for the COVID-19 response); and,
 To work with other sectors to strengthen the social and economic services and policies that
promote and protect health, prevent disease and build resilience (e.g., adequate housing,
employment and income supports).
While not within the scope of public health planning, it should be noted that health care settings should
also consider actions during the Interpandemic phase that will increase preparedness for infectious
disease management in their settings. This could include revising and/or increasing training in infection
prevention and control practices to be better protect health care workers and patients/residents from
disease transmission and addressing infrastructure needs (including space and ventilation components).
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4. Forward Planning
Transition phase activities must simultaneously address: ongoing response, recovery and readiness
needs in order to achieve the numerous objectives for this phase. Therefore, forward planning must be
comprehensive with recognition that flexibility and nimbleness are critical since some needs may
become higher priority than others at different points during the phase. Prioritization may also be
necessary during this potentially long transition period, due to reliance on an exhausted and/or reduced
public health workforce.
4.1 Planning Assumptions and Areas of Uncertainty
This third edition of the plan aims to support consistent but flexible public health planning at all levels of
government in order to support long-term COVID-19 response, recovery and readiness activities. Plans
should reflect a combination of cohesive F/P/T approaches and objectives with regionally and locally
adaptable actions; taking into account the needs of diverse groups within Canada on the basis of health
status, age, gender, race/ethnicity, culture, ability status, and other socio-economic and demographic
factors.
Table 1 identifies forward planning assumptions that aim to provide a basis for planning in the Canadian
context following the Omicron-driven wave. The areas of uncertainty, listed in Table 2, help identify
current unknowns and areas where the evidence base is rapidly expanding but is not at the point where
it can support a planning assumption. Given these areas of evolving evidence and knowledge,
operational plans need to include flexible elements or placeholders that can be updated over time and
as knowledge and experience increase. Both planning assumptions and areas of uncertainty require
validation and/or updating and may be triggers for re-visiting and modifying plans.
Table 1: Summary of planning assumptions
Forward planning assumptions

Epidemiology and Risk:
 Transmission of COVID-19 will be ongoing, however the baseline level of transmission, as well
as the impact, frequency or timing of resurgences are as yet unknown.
 COVID-19 adds a continuous net burden on health care.
 Epidemiology of the Transition phase could include surges in disease activity (due to outbreaks
and/or new variants).
 Viral evolution is to be expected.
 Timing of phases (progression through and duration of) may vary between PTs and may not be
a linear progression from response to transition to interpandemic.
 The proportion of infected individuals experiencing asymptomatic, symptomatic or severe
disease could vary significantly based on the infecting variant. Transmission by asymptomatic
and pre-symptomatic cases will continue to occur.
 The risk factors for severe disease will not change significantly over time (i.e., including with
the emergence of new variants).
 There will be ongoing risk of internationally-imported COVID-19 cases that will vary with the
global epidemic risk (e.g. the risk in neighboring countries, the level of global immunity etc.).
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Impact and Interventions:
 Public health management during the Transition phase will shift from a focus on requirements
to recommendations and support for individual evidence and risk-based decision-making.
 A strong surveillance system is needed during the Transition phase.
 The vaccination strategy will continue to evolve based on new evidence, availability of new
vaccines and related supply, and the epidemiological situation in Canada.
 Vaccination can reduce the incidence and impact of long-COVID.
 Recovery activities include addressing unintended consequences and risks, backlogs with
health care systems and the impact of interrupted public health program delivery that have
occurred over the course of the pandemic response.
 There is ongoing potential for emergence of new variants that may require a shift of focus
from recovery actions back to response actions. This shift will be risk-based with consideration
of other public health priorities.
 There will continue to be a Pan-Canadian approach to prioritization/targeting of any limited
resource which will be based on an ethics framework. Policy development around prioritizing
limited resources will also be informed by other logistical, epidemiological and societal
considerations, for example the Declaration of the Rights of Indigenous Peoples.
 Response and recovery measures implemented in one jurisdiction could have an impact on
neighbouring jurisdictions, even if they themselves do not implement that measure.
 Initiatives to address human resource and infrastructure needs will be required to build health
care and public health system capacity.
 Ongoing/long term management of COVID-19 will require public health programs to mitigate
surges in the demand for hospital resources.
 Determining an acceptable level of risk together with ongoing assessment of the global
epidemic risk will inform ongoing management activities at international borders.
Immunity:
 A significant level of population immunity, together with PHMs and other measures will be
required to reduce COVID-19 transmission to levels that are manageable without disruption to
health systems and broader societal function.
 A variant that has significant genotypic and/or phenotypic changes (i.e., through mutation,
recombination, or evolution from an earlier ancestor) compared to previously circulating SARS-
CoV-2 variants, increases the risk of immune escape.
 Circulation of a variant with immune escape properties means that the proportion of the
population that is susceptible to infection with this new variant will be increased.
 The level of immunity in the population (achieved through prior vaccination or infection) will
wane over time.
 Circulating neutralizing antibodies and cellular immunity are key to providing protection
against infection and severe disease, respectively, with other immune mechanisms
contributing to each as well. Both are generally effectively induced by intramuscular
vaccination, but vaccine-induced protection against variants may vary and protection,
particularly against infection and also somewhat against severe disease, is expected to
decrease over time.
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 The level of protection received from vaccination will correlate in the short term with the
number of appropriately spaced doses received and time from receipt of their last dose. This
level may be affected by the immune competence of the individual, the intervals between the
doses they received, the products received and the time since last dose.
 Infection stimulates the immune response (i.e., production of antibodies and cellular immune
response), and is likely to induce mucosal as well as systemic immunity in immunocompetent
individuals.
 Infection-induced immunity varies by a host of factors (age, severity of the illness, underlying
medical conditions, vaccination status). .
 Infection-induced immunity may offer good level of protection but compared to vaccination it
is less consistent and predictable.
 Infection in addition to being vaccinated confers better protection than infection alone.
 Population immunity is function of the combination of individuals with varied levels of
protection achieved through vaccination (with various products and/or combinations of
products with varying effectiveness) and differing histories of prior infection.
Table 2: Summary of areas of uncertainty
Areas of uncertainty
• The epidemiology of COVID-19 endemicity in Canada- meaning the baseline level of transmission, as well
as the impact, frequency or timing of resurgences (e.g., whether and when COVID-19 will eventually
have a seasonal pattern similar to other respiratory infections).
• How ongoing circulation of SARS-CoV-2 will interact with other respiratory viruses (e.g., influenza, RSV),
and the impact this will have on health care service demand during seasonal peaks and on population
immunity.
• The epidemiology of other respiratory viruses after 2 years of limited circulation.
• The prevalence of Post-COVID Condition/Long-COVID in our population and the impact this sustained
manifestation of COVID sequelae will have on morbidity, mortality, future health system resources, the
workforce/economy and society in general.
• The level of COVID-19 morbidity and mortality considered acceptable/tolerable by the Canadian
population.
• The level of PHMs that Canadians will tolerate and use of PHMs in the absence of mandates.
• The degree to which new variants will require adjustments to the response, recovery and ongoing
preparedness activities in order to achieve objectives.
• The effectiveness of mucosal vaccines and whether they elicit better protection against infection and
elicit immune protection against illness.
• There may be a limit to the protection received from repeated vaccination.
• Immune correlates of protection against infection or severe disease.
• How effective different current and new vaccines and therapeutics will be in response to new VOCs.
• The deleterious impact the COVID-19 pandemic response has had on the mental and physical health of
Canadians, including those disproportionately impacted.
• How the deleterious impact the COVID-19 pandemic has had on responders might impact recovery
efforts and future response capacity.
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• Whether the lessons “observed” (i.e., not yet “learned”) can be addressed by current responders and
effectively “passed on” to decision makers, the next cohort of responders, (e.g., students in health
disciplines) and society at large.
• The extent of provincial and territorial formal review and inquiry processes.
• The extent to which the pandemic will catalyze change in various sectors to address social determinants
of health and conditions for marginalized, racialized, Indigenous or harder to reach communities.
• The degree to which public trust in public health leaders, approaches and science in general has been
negatively and positively impacted, and the duration of these impacts.
4.2 Planning for ongoing COVID-19 risks, response and readiness needs
Ongoing COVID-19 response activities and readiness for detection and response to resurgences of
COVID-19, must continue to be addressed during the Transition phase. Throughout this period of
transition towards more predictable COVID-19 disease activity in Canada it is important to consider that:
 the timing/specific characteristics of potential new variants is unpredictable, therefore
transition to a relatively stable pattern of disease will likely take years, not months;
 immune escape variants can be expected to emerge over time – this may be a key driver of any
increased spread, although increased intrinsic transmissibility is also possible;
 variants with higher severity remain possible and whether the intrinsic virulence of the variant
causes an increase in observed severity in our population, will be determined by a number of
factors (i.e., who is getting infected, residual protection from vaccination and past infections,
and the effectiveness of tools and measures implemented);
 genetically-divergent variants could suddenly emerge (e.g., from zoonotic sources, evolution in
immune compromised hosts); and,
 determining the epidemiology of a new variants will require time and will therefore challenge
our ability to make timely risk-based decisions without a high level of uncertainty.
4.2.1 Population immunity

Population immunity will be considered significant when it is sufficient to decrease and sustain COVID-
19 activity in Canada at a level where it can be managed concomitantly with other public health issues
and without straining public health and health care resources. However, population immunity is a
product of the combined immunity of all individuals in a population and to some degree the protective
herd immunity effect when a high proportion of individuals are well protected at the same time (and
mixing with unprotected individuals). Individuals will have varied levels of protection achieved through:
 vaccination - with products/combinations of products, with varying effectiveness, and in people
with varied immune competence, and
 prior infection(s).
The protection achieved through vaccination or infection will wane over time and may be insufficient to
prevent infection with a new VOC, as was seen with Omicron. For these reasons, there are multiple
scenarios for the future of COVID-19 in Canada, and at this point it is not possible to predict with any
certainty which scenario or combination of scenarios we will experience. This is not unique to Canada
and similar conclusions have been reached by other countries.29
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4.2.2 Ongoing transmission

Given the shifts in the level of population immunity that can be expected to occur over time, ongoing
transmission, due to imported cases, outbreaks and changes in contact rates amongst susceptible
populations, is anticipated. It is also expected that waves of infection may continue to occur
predominantly due to the introduction and spread of new variants. The frequency and amplitude of
these waves of infection will depend on:
 the characteristics of the variant; in particular the degree of immune evasion will impact the size
of the susceptible population and together with intrinsic transmissibility, the subsequent degree
of spread, and
 the timing of, triggers for, and effectiveness of tools/measures implemented to reduce
transmission and prevent serious illness and deaths.
Mathematical modelling supports planning our response to epidemics and outbreaks, and the COVID-19
pandemic has demonstrated the important role and need for the full range of modelling tools required
to support decision-making during a complex public heath crisis. This role and the types of models
currently in use are described in Appendix 1: Modelling Support for Forward Planning.
For forward planning purposes, it is helpful to think about a range of possible scenarios and the key
drivers/characteristics of each; keeping in mind how the characteristics of the circulating variant (or
variants) may manifest in Canada based on our level of population immunity at the time. Figure 3,
depicts possible patterns of incidence, hospitalizations and the level of population immunity. The
possibility of an “off season” wave is depicted in Figure 3 with a dotted orange line for case incidence
and a corresponding dotted blue line for hospitalization prevalence.
Figure 3: Possible patterns of incidence, hospitalizations and population immunity
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In Appendix 2: Epidemiological Drivers, the epidemiological drivers that influence: 1) the number and
timing of new cases and, 2) health related impacts of cases, is presented for reference. (Note: this
content has been retained from the 2nd edition of this Plan)
4.2.3 Observed severity

The number of hospitalized cases is one of the key variables used to represent observed severity in the
population over time. This will be driven by the level of ongoing transmission in the population and the
intrinsic transmissibility of the circulating variant(s). The observed severity of a new variant in the
Canadian population will be a function of:
 the intrinsic virulence of the variant;
 who is getting infected (i.e., individuals with high-risk medical conditions, the elderly or low-risk,
younger individuals) and who is not (i.e., due to residual protection from prior vaccination
and/or infection; and
 the effectiveness of measures aimed at reducing severity and infection particularly amongst
high-risk groups (e.g., evasion of therapeutics).
There is a role for the effective use of therapeutics, especially those that can be accessed and taken in
the community early in an individual’s course of infection, which subsequently will impact the amplitude
of the wave of COVID-19 related hospitalizations (see Figure 3). Pre-exposure prophylaxis with
monoclonal antibodies for very high risk group who may not make good responses to vaccinations will
also be available in the near future. Figure 4 identifies the 3 main drivers of observed severity in a
population and highlights where public health action has the most influence.
Figure 4: Drivers of observed severity in a population
Serious outcomes of SARS-CoV-2 infection beyond the acute hospitalization period, specifically the Post-
COVID Condition, also known as “Long-COVID”, also requires attention in forward plans. Public health
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authorities (PHAs) could play a leadership role in highlighting the need for, and facilitating funding of,
research aimed at increasing the understanding of the epidemiology, including risk factors, for this
syndrome. As more people experience this post-virus syndrome, necessary physical/rehabilitative and
mental supports must be identified, quantified and used to plan for resources required for new
programs and long-term management strategies. Collaboration across the health sector would facilitate
a coordinated approach.
4.2.4 Risk management

Planning for the Transition phase, requires a risk management approach. As the epidemiology of COVID-
19 in Canada becomes more stable and predictable, COVID-19 specific actions need to be transitioned
into sustainable public health activities. Critical to this transition is ensuring that public health has the
capacity to: provide informed, timely risk assessments on an ongoing basis that include but are not
limited to COVID-19, and to response rapidly to signals of increased risk (e.g., severe VOCs). This risk
management approach will help determine where to allocate and prioritize public health resources. It
will also inform the need for system wide enhancements that will increase readiness and resilience for
future pandemics.
While supporting and recognizing the interrelatedness of public health and health care delivery within
our health care systems, the optimal public health response will be contingent on the ability to:
 rapidly assess new risks (e.g., new variants) - which includes monitoring the level of
susceptibility and vulnerability in the population,
 mitigate the risk – by prioritizing and appropriately timing the use of highly effective, lower
consequence measures, and implementing measures that are commensurate to the risk,
 minimize residual risk and response-associated consequences – which includes considering
additional tools and measures that can lower residual risk as well as minimizing foreseeable,
unintended, societal consequences of our responses
 evaluate impact of measures – to inform what worked well and what could be improved upon,
 scale up and down the response - based on the epidemiology of COVID-19 and related risks,
with consideration of timing, triggers, effectiveness and risk tolerance
 increase the resilience in population and our health care systems – through addressing
inequities in the social determinants of health, encouraging investment to improve surge
capacity in both human resources and infrastructure, bolstering positive individual health
behaviours and facilitating incorporation of individual, business and institutional changes into
everyday practices.
Ongoing management of COVID-19 during the Transition phase includes ensuring the capacity to detect
signals of resurgence, and the readiness to ramp up a response that is proportionate to the risk. Risk
assessment is an important first step but the data needed to confidently inform the risk level is usually
inadequate at the time the new signal is detected, especially if the signal is the emergence of a new
variant. If the signal arises in another country, even if data is available on observed severity, the
generalizability to the Canadian population and challenges with inferring intrinsic virulence from early
population-level impact will remain30. Genetic analysis of the variant may be helpful if there are
mutations that are common to previously circulated variants but the ability to extrapolate population
impact from these data will also be highly uncertain.
To facilitate readiness to respond in a manner proportionate to the risk, consideration of the viral
characteristics and observed severity together with risk factors, can help inform which tools or measures
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to employ in the response. Content regarding planning for a reasonable worst case scenario has been
retained from the second edition of this plan in Appendix 3: Planning for the reasonable worst case
scenario, as it is still relevant and potentially applicable during the Transition phase.
Table 3 links these considerations with potential measures. Most non-restrictive measures will likely
become recommended as opposed to mandated during the Transition phase. Therefore the role of
public health will focus on empowering individuals to increase their resiliency by adopting individual
health behaviours and make well-informed, risk-based decisions regarding what measures and
protections to use and when, based on up-to-date evidence. This will involve doing: 1) a risk analysis as
soon as possible after detection of a signal of concern, and 2) ongoing assessment of the risk factors
identified in Table 3 in order to track the level of vulnerability in the Canadian population (e.g., due to
waning immunity) over time, and 3) then providing credible advice to the public through risk
communication activities. The list of tools/measures to mitigate the risks in Table 3 is intended to be
illustrative not exhaustive.
Essential roles of public health and other government officials beyond encouraging individuals to
conduct risk assessments and improve their protective behaviours is to strengthen societal structures
through legislation and regulation so that there can be adequate testing, data collection, analysis and
reporting, as well as enforcement of comprehensive border and travel health measures and
opportunities for children, students, workers and other populations to have access to proper protective
equipment and avoid exposure to coronaviruses.
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Table 3: Considerations for use of public health tools and measures
Viral Risk factors Tools/Measures to mitigate

Characteristic (level/degree of each affects risk
and Impact level)
Transmissibility –  inherent transmissibility of the virus  Surveillance sufficient for early detection
how much it will  viral growth potential/growth rate  Test, trace and isolate / quarantine (increased access to rapid
spread in Canada  population immunity tests)
 vaccine effectiveness against infection  Restrictive measures (capacity limits, school closures, vaccine
 contact rates mandates)
 indoor vs outdoor exposure  PHMs (community and personal measures e.g. masks)
 Correct use of, and adherence to,  Measures to prevent reverse zoonotic transmission and
recommended PHMs secondary zoonosis,31 i.e., decreasing high-risk human-animal
interactions
Immune escape –  size of susceptible population  Vaccine boosters
who will be effectiveness and availability of  Rapid assessment of vaccine effectiveness in different
vulnerable to vaccines and therapeutics (e.g., populations
infection effectiveness of monoclonal antibodies)  Enhanced lab genetic sequencing capacity
 Monitoring for resistance to therapeutics
 Monitoring of treatment effectiveness in immunocompromised
populations (to mitigate risk of mutated variants developing)
 Measures to prevent reverse zoonotic transmission and
secondary zoonosis – i.e., indirectly reducing risk of viral
evolution in animals32
Virulence  viral attachment and replication site  Availability of effective therapeutics and treatment
– potential for  Speed of viral replication and resulting  Pre-positioning of therapeutics in community
severe disease viral load  Research (e.g., identification of animal models for early severity
due to viral  immune evasion estimates/projections)
properties and host  ability to cause lung injury
response  ability to cause hyperinflammation and
immune dysregulation33
Observed  Size and clustering of high-risk  Early implementation of targeted protective measures for
severity group(s) i.e., those that are: individuals at high risk of severe disease especially for those in
–how much severe o elderly congregate settings (e.g., active screening, visitor restrictions,
disease is o immunocompromised use of masks)
experienced or o experiencing chronic medical  Prioritized access to vaccines and therapeutics
could be expected conditions  Increase health care capacity/surge capacity (infrastructure and
(Note: this is o pregnant human resources)
influenced by the o obese
viral characteristics  vaccination status and time since last
previously listed in dose
this table)  history of prior infection
 how effective PH measures are at
protecting high risk groups
 vaccine effectiveness and vaccine
coverage in high risk groups
 Treatment access & capacity
 Effectiveness of therapeutics
The risks of a variant with high intrinsic virulence, health care systems becoming overwhelmed, and the
need to implement restrictive measures (which have known negative societal consequences and
increase the risk of public backlash and lack of adherence to public health recommendations), are all
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connected. Forward planning needs to focus on the timing of, triggers for, and effectiveness of
tools/measures implemented to reduce transmission of variants expected to have high observed
severity in the Canadian population.
4.2.5 Timing
The timing of when to implement a measure, is usually based on an imminent risk or observed impact
and the level of risk tolerance amongst decision makers and the public. In response to Omicron,
measures were initiated before the impact of Omicron in our population was well understood. During
the Transition phase we are now seeing pandemic fatigue, public risk perception and risk tolerance
playing a greater role in the expeditious lifting of response measures.
Since most public health measures are preventive in nature, the effectiveness is usually affected by the
timing of implementation. In short, the earlier after detection of a risk, the better. However, given the
duration of the pandemic and the now known societal consequences of restrictive measures, there may
be more reluctance to implement these types of measures early and broadly without strong evidence of
observed severity in the Canadian, or a comparable, population. Individuals, equipped with public health
recommendations, will likely take precautions when the risk is real to them or their friends and family.
This will be too late for optimal population-based effectiveness.
Assuming there is no significant change in the population sub-groups at highest risk for severe outcome,
it is likely that early implementation of restrictive measures will only be widely acceptable if they are
targeted at, and known to be effective in, those at highest risk of severe disease and death. For example,
targeting measures at settings where risk is likely to be greatest (e.g., long term care homes and other
congregate living for older adults, as well as other high risk congregate living settings).
4.2.6 Triggers
The triggers for risk mitigation tools and measures will require consideration of how likely it is that the
risk will be realized, what the potential severity of impact will be and the expected effectiveness of risk
mitigation measures. Moving forward into the Transition phase it can be expected that decisions
regarding the timing and triggers for action will include an element of risk tolerance, especially if
expected severity is uncertain.
Triggers for public health action during the Transition phase will be based on the current epidemiology
and subsequently, the demand on response resources and objectives of the response. Any significant
change in response needs and requirements, which may or may not be able to be met with the existing
capacity, may require adjustments in the public health response. Changes on demands for laboratory
diagnosis, hospital treatment, or vaccines, could trigger an increase or decrease in response activity. For
example, availability of vaccine for children triggered an increase in the number of clinics occurring in
the community settings; whereas a decrease in laboratory capacity triggered a need for an increase in
rapid test use and recommendations for self-care.
Similarly a change in emphasis of the response, for example to focus less on reducing transmission in the
general population and more on protecting those at risk of severe disease, will also trigger a change in
public health approach.
From an advanced planning perspective, the triggers for use of tools and measures should be based on a
risk analysis that includes a focus on the risk of observed short-term and long-term severity, the risk of
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health care systems becoming overwhelmed, and the risk of societal disruption due to both disease and
response measures implemented to reduce transmission.
4.2.7 Effectiveness
The effectiveness of any measure is highly variable and depends on the intrinsic properties (e.g.,
filtration capacity in a mask), whether it is consistently used properly (e.g., fit of mask) and at the
population level, the uptake/adherence amongst the at risk proportion of the population (e.g.,
consistent mask use whenever in a public indoor setting). The relative effectiveness will vary between
populations and over time, which is why timing and triggers are linked to effectiveness.
Recognizing that there are consequences of every measure both at an individual and population level,
our experience to date has highlighted the need to balance the expected effectiveness of the measure
against the possible negative consequences. Ideally, we all want highly effective measures with low
negative consequences. Vaccination is one of the few measures that might be considered in this
category. Therefore, forward planning for the public health response need to include:
 vaccine research and domestic production of vaccines,
 ongoing monitoring of the evidence base for the effectiveness of tools and measures,
 conducting research in the Canadian context to contribute to the evidence base,
 survey of knowledge, attitudes and behavior regarding measures to inform potential
acceptance/uptake/adherence of recommended and mandated measures,
 evaluation the effectiveness of measures used during the pandemic, and
 examination of how to best to support adoption of effective behaviours at a population level.
4.3 Planning for recovery
In addition to ongoing response activities, the implementation of recovery-oriented activities is essential

during the Transition phase. Planning for recovery in society includes addressing the broad
consequences, backlogs within health care systems and the impact of interrupted public health program
delivery, that have occurred over the course of the pandemic response. From a risk perspective, this
involves examining COVID-19 related risks in the context of other public health risks, and re-balancing
resources as needed to identify and address priorities. Recovery activities should include dedicating
public health resources to address the broad, unintended mental and physical health consequences and
risks that have occurred over the course of the pandemic response (See section 8).
4.3.1 Societal recovery

Given the uncertainties imbedded in the Transition phase, this will be an important time to foster public
understanding of the ongoing risk environment while managing expectations for the recovery period
(e.g., duration and potential need to re-implement pandemic response measures) and changes to
improve resilience and mental wellbeing as COVID-19 becomes a persistent infectious disease in
Canada. A part of this involves recognizing varying levels of risk tolerance in our population and the
impact the information public health officials have provided to the public has had on how individuals
accept and manage risk.
Many people have become more risk averse over the course of the pandemic and recovery for them
may involve “normalizing” risk by providing reminders of what was tolerated previously and putting
COVID-19 in the context of other daily risks. For those at higher-risk of severe disease (e.g.,
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immunocompromised) the addition of SARS-CoV-2 as another pathogen that they need to beware of can
be fear-provoking and overwhelming and therefore is likely best managed on an individual basis. At the
other end of the spectrum, we now have people who feel confident in their understanding of COVID-19
risks to undertake, and make behavioral decisions, based on their own personal risk assessments. This
type of empowerment is positive and public health facilitation of well-informed individual decision-
making will be needed throughout the Transition phase.
Part of this transition back to more individual health decision-making and self-care, involves recognizing
and respecting that people may make decisions that deviate from public health recommendations and
that are not foremost in the interest of public health. Therefore, fostering recovery will include
contextualizing risk and risk reduction measures for the population, while respecting individual
differences.
Effective risk communication, in addition to ongoing knowledge translation and transparency, will be
important to managing public expectations, facilitating evidence-based individual decision-making and
maintaining public trust. Replenishing and supporting equitable access to effective vaccines, personal
protective equipment and COVID-19 therapeutics as needed during this phase, will also mitigate the risk
of future shortfalls and loss of public trust in our health care systems.
Societal recovery will require broad consideration and implementation of recovery activities adapted for
population sub-groups and settings, for example: public health systems, health care systems, racialized
communities, critical infrastructure, workplaces, schools, and congregate living settings.
4.3.2 Responder recovery

Planning activities are also needed to address the fact that the COVID-19 pandemic response has had a
deleterious impact on the mental health of many responders (which include but is not limited to: public
health workers, health care workers and social service providers). How this might impact recovery
efforts and future response capacity is a major concern. Decreases in the available workforce have
occurred due to burnout, early retirement, extended health/stress leaves and use of short-term
solutions to supplement the workforce. There is also a need for the remaining responders to take time
off work to recover, decompress and regain the energy required to continue to work in a stressful, often
challenging, environment. Recovery efforts need to start with measures to improve the physical and
mental health of pandemic responders, recognizing that this may be a prolonged need. This is necessary
as some mental health conditions, such as post-traumatic stress disorder, may take months or even
years to develop. Consideration should be given to increasing access to employee assistance programs
(e.g., to all, not just full-time employees), and expanding the coverage available for counselling and
other mental health services.
The period following an acute response often includes a series of inquiries, external evaluations and
even legal challenges that require the same exhausted responders, expecting a reprieve, to continue
work under potentially stressful conditions. It is important to recognize and prepare responders for this
disheartening and challenging reality as this is difficult to avoid. Strategic planning for how to lessen the
load on any one individual or team and be more efficient in terms of meeting these ongoing demands is
needed.
This is also a time where changes to the workplace would be beneficial to ensure access to proper
ventilation and protective equipment in the event of continued transmission of variants. Many workers,
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who were working virtually/remotely, may be anxious about returning to their designated office in
person while those who routinely work virtually from a remote location may feel more disconnected
and less well supported than they did when the majority were working virtually.
4.4 Planning with Indigenous Communities
In response to the COVID-19 pandemic, Indigenous Services Canada (ISC) has provided or supported
primary health care and public health services in First Nations and Inuit communities (see Appendix 4).
For example, ISC provided access to personal protective equipment (PPE), supported communities in
acquiring temporary assessment, screening, and isolation structures, assessed and supported re-
opening of schools and other public facilities, provided surge capacity to address additional mental
wellness needs, testing and contact tracing, and worked alongside provinces and territories, and
Indigenous organizations, to prioritize access to vaccines for Indigenous people across Canada.
While First Nations living on reserve and Inuit living in land claim regions originally experienced lower
rates of COVID-19 than the general Canadian population, First Nations, Inuit, and Métis had higher
infection rates during the latest wave dominated by the Omicron variant. Urban First Nations, Inuit, and
Métis have also been overrepresented in COVID-19 case counts throughout the pandemic.
Currently the most recent wave dominated by the Omicron variant is subsiding across the Indigenous
population. Decisions made by Indigenous communities, regarding the lifting of health restrictions at
the same time as many of their provincial and territorial counterparts, vary according to the local
context and case rates. The vaccine rollout across Canada continues to prioritize access and allocation
for Indigenous Peoples, and the uptake of vaccines has been largely successful, especially in light of
vaccine hesitancy as a result of mistrust in the government due to colonial practices. As of February 15,
2022, 87.6% of First Nations living on reserve aged 12 years and older have received at least two doses
of the vaccine.
While a full evaluation of the pandemic and response is a vital task to be undertaken during or following
the Transition phase of the pandemic, some lessons learned have already become apparent. These
include:
 the need to continue to work with Indigenous partners to prioritize Indigenous knowledge,
lived experiences, priorities, and concerns around health and healthcare;
 the need to continue to work to gain trust from Indigenous Peoples and communities in
order to effectively provide both primary and public health care services;
 significant discrepancies in social determinants of health is an increased risk for Indigenous
Peoples with respect to both incidence and severity of communicable disease, particularly
for respiratory illnesses; and,
 preparedness for health emergencies and pandemics and the ability to move quickly and
flexibly allows a response to meet the distinct needs of First Nations, Inuit and Métis. This
preparedness includes funding flexibility, access to PPE and medical supplies, timely
knowledge translation, timely Indigenous (and non-Indigenous) language translation
services, and health care personnel surge capacity.
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4.4.1 Focus for Transition Phase

As Canada moves into the Transition phase of the COVID-19 pandemic, First Nations, Inuit, and Métis
will have specific needs and considerations to be addressed in addition to those of the general Canadian
population. Health equity gaps for First Nations, Inuit, and Métis populations are the result of colonial,
historical, political, societal, and economic factors that have long influenced Indigenous health and
Indigenous social determinants of health. Vaccination in the context of COVID-19 has shown, in several
communities, the positive spin-offs of P/T collaboration with health and social services institutions as
well as the added value of the cultural safety approach adopted by these institutions as part of their
public health responsibilities towards communities and Indigenous Peoples. However, inequalities
persist in part due to systemic racism experienced in the healthcare system and increased access to
culturally safe services, as defined by Indigenous Peoples themselves, are required to support these
populations. Important risk factors, such as higher rates of overcrowding and major repairs in homes,
and inadequate resources to improve built environments, have the potential to contribute to
transmission. Additionally, the waves of increased cases across Canada have not necessarily occurred in
the Indigenous population at the same time as the general population; this has increased the
comparative difference in risk between Indigenous Peoples and the general Canadian population. The
impacts of the pandemic were exacerbated by overcrowded housing and other deficiencies in their built
environment. As a result, it is important to recognize that First Nations, Inuit, and Métis, may have
distinct needs and objectives that could differ from the general Canadian population, and from each
other. Nonetheless, key priorities are expected to include:
 continuing to prioritize access to vaccines and therapeutics (particularly those designed to

mitigate severe disease and hospitalization) in order to reduce the greater burden of risk
experienced by Indigenous Peoples;
 taking public health action to reduce the incidence, morbidity, and mortality of COVID-19
among First Nations, Inuit, and Métis populations to low levels, as determined by each
community, in a way that minimizes the negative physical health and well-being impacts and
impediments to each community’s ways of life;
 assessing and addressing the impacts of the redirection of resources (financial, personnel,
and expertise) toward COVID-19 to the possible detriment of other public health services
and primary health care delivery;
 addressing and catching up with the back-log of public health activities, particularly TB
screening and testing, childhood immunizations, and STBBI screening that have been
delayed during the pandemic;
 dedicating public health resources and providing community support to address the
unintended physical health and well-being impacts of the pandemic and consequences of
pandemic response that have in particular impacted First Nations, Inuit, and Métis given
their historical and colonial experiences;
 remaining in a state of readiness in order to swiftly address the potential threat that
possible new variants may pose to Indigenous communities;
 Providing access to trauma-informed and cultural competency training to public health
surge staff and responders to ensure culturally safe and appropriate care is provided to First
Nations, Inuit, and Métis;
 Supporting the assessment, investigation and identification of risks and hazards in the built
environment (e.g. restaurants, schools, and long-term care facilities) so as to reduce
transmission and supporting communities in mitigating and preventing those risks;
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 ensuring ongoing surveillance to facilitate early detection of resurgence signals and to

inform risk assessments;
 provide access to First Nations, Inuit, and Métis to COVID-10 surveillance data that is
distinctions-based for decision-making by Indigenous leadership;
 supporting the recovery and well-being of Indigenous pandemic responders and pandemic
responders supporting Indigenous people and communities;
 in partnership with Indigenous communities and organizations, developing future strategy
and approaches for managing and responding to COVID-19 in the long-term, as it becomes a
more predictable ongoing infectious disease in Canada;
 support the education of clinicians to be able to respond adeptly to future variants of
COVID-19, and other novel pathogens as they arise;
 assessing and articulating the additional burden of risk placed on First Nations, Inuit, and
Métis by ongoing COVID-19 as a result of colonial, historic, political, societal, and economic
factors that impact social determinants of health;
 reflecting, analyzing, learning, and documenting lessons learned and developing a plan
aimed at improving future response capacity and efficiency; it will also address response
elements identified as gaps or weaknesses in evaluation reports/activities in partnership
with Indigenous communities and organizations;
 fostering understanding of the ongoing risk environment while managing expectations for
the recovery period (e.g., duration and potential need to re-implement pandemic response
measures) and changes to improve resilience as COVID-19 becomes an ongoing, predictable
infectious disease, in a sustainable way; and,
 evaluating community based testing capacity that has been established over the pandemic
and plan for transition to testing for other pathogens and maintain readiness for future
emerging diseases concern.
4.4.2 Planning Variables and Signals

There are several unknown variables as well as currently held assumptions that will change the course of
actions that will be taken during the Transition phase. The assumptions are:
 COVID-19 will become an ongoing, predictable infectious disease in Canada; and,
 the ongoing evolution of the virus is assumed, and therefore additional variants of concern are
considered likely, including those which may prove to be more transmissible or virulent.
Unknown Variables include:

 The degree to which the relaxation of restrictive public health measures will increase the
risk for resurgent secondary wave of Omicron cases or other variants of concern, and the
degree to which that risk may be disproportionally borne by Indigenous communities.
 It is unknown if COVID-19 will eventually become seasonal in nature, as with other
respiratory viral illnesses.
 The scale of the “backlog” of primary care and public health services that were not available
to First Nations, Inuit and Métis individuals and communities during the height of the
pandemic, and the resources required to address it is unknown, but can be assumed to be
quite significant based on information from regions, communities, and care providers.
 The scale of the additional physical and well-being impacts caused by the pandemic and the
pandemic response for First Nations, Inuit, and Métis and the resources required to address
it is unknown but should be assumed to be quite high.
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 The waning protection of vaccines over time, and their efficacy when novel variants of
concern may arise.
 The Indigenous community self-determined acceptable level of COVID-19 incidence,
morbidity, and mortality among First Nations, Inuit, and Métis, and the degree to which that
tolerance may differ from the general Canadian population.
 The future response capacity available to support future needs during resurgences of
COVID-19, and other illnesses to the trauma, moral injury, fatigue, and burnout faced by
healthcare providers and other responders.
 The future response capacity of Indigenous communities given the collective trauma caused
by COVID-19, “COVID-19 fatigue”, and the impact on physical health and well-being.
 The degree of trust First Nations, Inuit, and Métis may have in the federal government,
provincial and territorial governments, and local public health providers, as well as public
health, in general, has been improved or damaged during the ongoing response to COVID-
19.
4.4.3 Transition Planning and Recovery

While it is understandable that the during the transition phase significant resources are directed
towards planning, learning, and reassessing best practises for managing COVID-19 on an ongoing basis,
as well as planning for potential other novel pathogens, it is critical to ensure that these important
exercises do not draw resources away from the recovery period required within First Nations, Inuit, and
Métis communities. Indigenous communities will face considerable challenges in addressing the backlog
of primary care and public health services and will require additional resources in order to do so. There
is a risk that inadequate support for Indigenous communities in addressing this backlog will further
widen the gap of health inequities between First Nations, Inuit, and Métis and non-Indigenous
Canadians. There is, however, an opportunity that appropriate support in addressing this backlog will
both serve to decrease those inequities, and act to make steps toward decolonizing health services, as
Indigenous leaders and organizations are invited to partner in this work.
5. Addressing the consequences of pandemic response

The response to COVID-19 over the last 2 years has yielded multiple diverse impacts aside from the
successful reduction in serious illness and deaths experienced in Canada due to COVID-19. On the
positive side, the need for strong public health capacity as part of the health care continuum is now
more fully recognized and decision-makers, the media, and the public are now highly aware of the role
and responsibilities of public health in pandemic response. Connectivity across the health system has
also improved, but still requires more work in particular to support timely, evidence-based decision
making for the Canadian context. There has also been an increase in public understanding of scientific
concepts, particularly regarding immunology and epidemiology, and the use and trust in science as a
basis for decision making. Similarly, public health literacy and understanding, as evidenced by
widespread uptake of recommended public health measures, has increased in the population.
Furthermore, changes in workforce surge capacity (e.g., employment of foreign-trained health

professionals), domestic manufacturing and infrastructure, and increased capacity and flexibility to work
virtually from home, may prove to be positive long-term consequences of the pandemic response.
Strengthened stakeholder collaboration and relationships were also noted across multiple levels. The
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accelerated development of online technology, tools and platforms such as schedulers for public to self
schedule lab testing, vaccine scheduling, public access to lab results and apps which can be used for
other health care needs in the future were also positive outcomes.
Some of the positive consequences, however, were also temporary or diminished over time. For
example, initially there was an increased public trust in governmental decision-making and sense of
unity as evidenced by large turnouts to mass testing, support for health care workers, and high
adherence to recommended measures. However, as the pandemic progressed this seemed to decline as
public trust began to erode and community divisiveness increased especially in certain populations
whose employment and economic prospects were diminished. 34
Unfortunately, there are also many negative consequences, many of which affected specific segments of
the Canadian population. These groups include but are not limited to: older adults, essential workers,
children and youth, racialized populations, Indigenous populations, people living with disabilities,
women, 2SLGBTQI+ communities, people who use drugs, people living on low incomes, newcomers to
Canada and people who are experiencing homelessness and/or under-housed. These consequences of
the response include impacts on childhood development, access to health services, mental health,
family and gender-based violence, and social isolation and exclusion. 35 36
Many of the negative unintended consequences of the pandemic response were the result of existing
baseline inequities in Canadian society. Table 4 provides examples of some of the negative
consequences, contributing factors and potential sources of data or evidence that could help inform the
magnitude of the impact.
Table 4: Negative consequences of the COVID-19 public health pandemic response
Negative consequence Contributing factors Data/evidence sources (examples)
Delayed diagnosis of  Office/clinic closures  Hospital booking data

treatable medical conditions  Restricted access to health care facilities  Laboratory requisition volumes
 Prioritization of health service delivery  Comparison of annual trends in incidence
 Isolation and quarantine requirements requiring of chronic diseases (e.g., cancer) between
appointment postponement pre-pandemic and pandemic years,
 Reallocation of health care workers to COVID-19 controlling for changes to screening
focused areas practices etc.
 Laboratory capacity for other diagnostics limited due
to COVID-19 laboratory demands
Delayed surgical and  Office/clinic closures  Hospital admission and length of stay data
medical treatment  Restricted access to health care facilities  Comparison of annual trends in hospital
 Prioritization of health service delivery services usage (e.g., number of surgeries)
 Isolation and quarantine requirements resulting in between pre-pandemic and pandemic
postponement of treatment/surgery years
 Reallocation of health care workers to COVID-19  Surveys
focused areas
 Reallocation of hospital beds for COVID-19
treatment
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Domestic abuse, child  Isolation and quarantine requirements, stay at home  Police reports
safety orders, and work from home recommendations  Hotline / Support service usage
(increasing stress level and time in close contact in  Emergency room data
the home)  Referrals to community services (e.g.,
 Lack of access to supports Children’s Aid)
Delayed child  School, daycare, camp and recreational service  School based data (e.g., progress reports,
development/education closures or restrictions standardized testing results)
 Isolation and quarantine requirements  Hotline / Support service usage
 Recommendations for physical distancing, gathering  Surveys of parents, child care providers
limits and other public health measures  Speech and language service referrals
Increased substance use  Isolation and quarantine requirements, stay at home  Alcohol and cannabis sales data
and related harms, such as orders, and work from home recommendations  Paramedic call data
overdoses (increasing stress level and time in close contact in  Public health and community service
the home) provider data re. overdose calls, harm
 Reallocation of public health and health care reduction materials use, safe injection site
workers and services (e.g., safe injection sites, usage
paramedics) to COVID-19 focused areas – so  Coroner’s data
decreased access to harm reduction and support
services
 Changes in toxicity of drug supply
 Lack of access to supports
Increased levels of anxiety  Isolation and quarantine requirements, stay at home  Hotline / Support service usage
and depression orders, and work from home recommendations  Trends in prescriptions for anti-anxiety
(increasing stress level and time without in person and anti-depressant medication
social contact)  Referrals for counselling, psychological
 Isolation and quarantine requirements limiting services
workforce participation and income (leading to  Emergency room data (e.g., for incidents
feelings of lack of purpose, lack of control, etc.) of self-harm, psychiatric holds)
 Uncertain nature of pandemic progression (and  Mental health facility admissions
occurrence of resurgences after period of low  Social/Behavioural science publications
transmission), disease severity, need to take  Population surveys
precautions
 Limitations on social gatherings and recreational
service closures or restrictions (i.e., normal outlets
for stress/anxiety/depression relief)
 Lack of access to supports
Increased personal and  Isolation and quarantine requirements limiting  Internal tracking at food banks and other
societal economic burden workforce participation and income community service organizations (e.g.,
 PH restrictions limiting number of customers shelters)
 PH messaging urging caution with certain activities  Uptake of relief benefits
(e.g., business travel)  Data from Affordable Housing
 Price increases with/without supply chain Associations
interruption  Unemployment insurance claims
 Bankruptcy claims/number of business
closures
 Inflation rates
Interruption of routine  Isolation/quarantine requirements and public health  Analysis of: disease rates and preventable
preventative health and measures limiting ability to hold and participate in health outcomes, usually mitigated by
public health services public health administered programs (e.g., prenatal public health programs
classes)  Immunization registry data / routine
vaccine coverage data
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 Reallocation of public health workers and services  Data on use of preventative services (e.g.,
(e.g., surveillance and outbreak response for other mammograms, PAP smears, colon cancer
diseases) to COVID-19 focused areas screening)
 Virtual appointments with health care providers  Data on health workforce changes (e.g.,
reduced opportunities for in person health services Human resource data base, Professional
(e.g., administration of routine childhood College membership renewals)
vaccinations at well baby visits)
 Health care and public health worker absenteeism
(e.g., due to burnout)
Health authorities and health care institutions need to identify priorities for immediate action – like the
resumption of elective surgeries, non-COVID public health programs and full capacity operation of
diagnostic services and community services and clinics, and allocate resources accordingly.
Public health planning going forward needs to ensure capacity to detect, assess and mitigate negative
impacts that arose during the Pandemic phase; in particular, the consequences of the response that
may be ongoing but not currently substantiated by robust data. The prerequisites for this capacity need
to be identified (e.g., increase access and timeliness of data/evidence, cross-sector collaboration) and
tangible deliverables need to be incorporated into work plans that extend well beyond the Transition
phase. PTs have identified this as a priority; for immediate public health attention, for after action
reviews, and for incorporation in future pandemic plans. Specific public reports on the various pandemic
response consequences are now being produced in some jurisdictions.37
The pandemic response goal to “minimize serious illness and overall deaths…as a result of the
pandemic”, was intentionally phrased to recognize that a certain degree of non-COVID-19 serious illness
and deaths, due in part to the consequences of the response itself, was unavoidable. The onus is now on
PHAs to incorporate measures to address these consequences as a response component in pandemic
preparedness guidance and response plans. PHAs also have a role in communicating to decision-makers,
stakeholders and the public, the impact the social determinants of health have on population health and
resilience. With the pandemic in the forefront of the public consciousness, now is the time to connect
these dots using the measurable disproportionate impacts of the COVID-19 pandemic on the Canadian
population to prevent increasing health inequities for higher risk populations.
The diversity and magnitude of the consequences observed over the course of the acute pandemic
response phase requires a “call to action,” since addressing these challenges will require a cross-sector,
all of society approach. Furthermore, it is important that the multi-sectoral, multi-departmental
response to COVID-19 continues during the Transition phase in order to address these broad societal
consequences effectively.
6. COVID-19 F/P/T Response Components

Forward plans and current actions will also be informed by ongoing reflection regarding what has
worked well, what we have learned and what can be adjusted based on evidence and experience. The
response components identified in the CPIP have been used in the COVID-19 response structure. In this
edition of the plan each of the following components are addressed in dedicated appendices, to
facilitate rapid access to the specific content.
 Surveillance (Appendix 5)
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 Laboratory Response Activities (Appendix 6)

 Public Health Measures (Appendix 7)
 Infection Prevention and Control and Clinical Care Guidance (Appendix 8)
 Vaccination (Appendix 9)
 International Border and Travel Health Measures (Appendix 10)
 Health Care Systems Infrastructure (Appendix 11)
 Risk Communications and Outreach (Appendix 12)
 Research (Appendix 13)
With a focus on those actions requiring F/P/T public health leadership and consultation, these
appendices provide details on the current status of F/P/T activities that are planned or already
underway that will assist and expedite complementary planning in each federal government
department, province and territory.
7. Assessment and Evaluation

One of the objectives of the Transition phase is to document lessons learned and start forward planning
aimed at improving future response capacity, efficiency and addressing response elements identified as
gaps or weaknesses in after action evaluative reports/activities. How lessons learned will be addressed
by current responders and effectively “passed on” to decision-makers, the next cohort of responders
(e.g., students in health disciplines) and society at large, needs to be a part of this multi-faceted process.
Assessing and evaluating pandemic response efforts during the Transition phase, while recent and
outstanding challenges are still front of mind, will help identify areas of improvement and prioritize
future planning efforts. It is also vital, on an ongoing basis, to determine whether response activities
have been effective and implemented efficiently and balanced appropriately to minimize societal
disruption and negative consequences in addition to minimizing serious illness and overall deaths.
The F/P/T COVID-19 response governance structure, which includes the SAC, TAC and LAC, provides
multiple fora for these discussions and opportunities for sharing of experience, lessons learned and
identified best practices. More structured processes for assessment and evaluation, including in-action
and after-action reviews should be considered at all levels of government and diverse sectors to inform
forward planning and future pandemic preparations. Findings from formal audits undertaken by F/P/T
governments will also be taken into consideration in future planning processes.
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Appendix 1: Modelling Support for Forward Planning

Modelling facilitates planning and informs ongoing readiness needs by exploring how possible ranges of
parameters relevant to these issues affect the extent and impact of the pandemic in Canada. Modelling
inputs require epidemiological data from surveillance and other sources, while outputs largely depend
on the underlying assumptions. Forecasting models are best suited to inform what may occur in the
coming 2-3 months, while modelling of scenarios provides additional information to decision makers for
long-term planning regarding the potential impact of control measures.
Modelling recreates the essential components of pathogen transmission cycles from our understanding
of the biology of the pathogens and their interactions with their hosts. Models help to predict where
and when infectious diseases may emerge or re-emerge, and they can be used to explore the best
methods or combinations of methods to control disease outbreaks or epidemics and protect the health
of Canadians. Models can take into account new events during the course of the pandemic such as
vaccination or emergence of new variants of concern.
For response to COVID-19, there are three broad types of model being used:
1. Deterministic compartment models. These are Susceptible-Exposed-Infectious-Recovered

(SEIR) type dynamic models in which the population is divided into “susceptible”, “exposed”,
“infectious” and “recovered” classes. After encountering infection, individuals in a population
move from one state to the next. This basic structure includes elements to model SARS-CoV-2
and impacts of public health measures, with more realism. These elements include
compartments for isolated cases and quarantined “exposed” contacts from which onward
transmission to susceptible people is limited or absent, compartments for asymptomatic cases
that may or may not be detected by surveillance, as well as flows to “isolation” and
“quarantine” compartments that allow variation according to different levels of public health
effort. These models are used to inform broad policies at F/P/T tables, including i) estimating
numbers of cases, hospitalisations and deaths; ii) estimating the effects of non-pharmaceutical
interventions (NPIs), (physical distancing, case detection and isolation, and contact tracing and
quarantine), iii) design of vaccination programs; iv) the design of programs to enhance “herd
immunity” via use of antivirals/therapies in combination of vaccination; and v) estimating the
effect of the emergence of new variants of concern on the disease transmission.
2. Agent-based models. These are also SEIR models, and they can also be used to inform
development of Pan-Canadian strategies. However, because they can simulate disease
transmission with some detail in and amongst homes, work places leisure spaces etc., they are
particularly useful for decision-making at an individual community level regarding effects of
vaccination, needs for NPIs, and strategies for relaxing restrictive closures.
3. Branching models. These simply assess what factors cause single chains of transmission to
expand or become extinct. They are often used to assess the needs for controlling transmission
in work places or importation of cases.
The PHAC has developed models that can be shared, and are constantly undertaking modelling to
support decisions. The PHAC External COVID-19 Modelling Expert Group was formed in February 2020,
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and currently comprises 37 members from 21 universities across Canada, as well as 74 members from
other Federal departments/organisations provincial/territorial public health organisations. The group
comprises the majority of infectious disease modelling group leads in Canadian universities, and is
capable of supporting modelling needs for decision-making.
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Appendix 2: Epidemiological Drivers

This content has been retained from the 2nd edition of this plan as it may serve as a good reference,
particularly for new responders.
An epidemic curve pattern is one part of a planning scenario as it reflects the potential changes in the
number of new cases occurring over a period of time (see Figure A2-1). To ensure optimal planning, it is
important to consider not only the number of cases but variables that may shift the health and societal
impacts of those new cases and subsequently possible surges that exceed current health care and
public health capacity thresholds.
Figure A2-1: Epidemiological Drivers: Incidence
Figure A2-2 describes epidemiological drivers of health impact in terms of variables that may increase or
decrease the occurrence of severe illness and deaths due to COVID-19. These variables include but are
not limited to: changes in severity of illness experienced by the majority of cases due to increased
virulence, changes in high-risk groups (i.e., both the demographic characteristics of who is getting
severely ill and identification of new risk factors for severe illness), the impact of variants of concern,
availability of effective therapeutics and hospital care, and vaccine coverage. The manifestation of these
variables will also influence public risk perception and therefore, in a somewhat circular manner,
epidemiological drivers like adherence to recommended PHMs.
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Figure A2-2: Epidemiologic Drivers: COVID-19 Related Health Impact
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Appendix 3: Planning for the reasonable worst case scenario

This content has been retained from the 2nd edition of this plan. Minor edits (e.g., removal of dates)
have been made to make this a more generic reasonable worst-case scenario.
Reasonable worst-case scenario characteristics
• A large wave with a peak of prolonged duration followed by ongoing peaks of decreasing amplitude but
several exceeding health care delivery, laboratory and public health capacity thresholds.
• Peak is similar or higher than the incidence experienced at the peak of the Omicron wave.
• Relatively high seasonal peak in winter occurs concurrently with severe influenza/other respiratory
pathogens season.
• Similar timing of peaks across the country (each jurisdiction experiences peaks at same time).
• New VOC with high transmissibility, increased severity and immune escape properties becomes the
dominant strain.
• VOC with immune escape properties reduce vaccine effectiveness.
• There is reluctance to take the licensed vaccines (or specific vaccines) or vaccine supply is insufficient or
delayed, reducing vaccine coverage.
• Available vaccines do not significantly reduce transmission and do not confer long-term immunity.
• Available treatment/therapeutics are less effective against dominant variant.
• Weak/non-sustained post-infection immunity (recovered cases become susceptible again).
• Demand for health care resources (hospitalizations, ICU beds, ventilators, personal protective equipment
(PPE), Long-term care spaces, etc.) exceeds system capacity (during wave peaks).
• Shortage of health care providers (e.g., due to illness, burnout, work refusal, international competition).
• Demands on both laboratory and public health resources exceed capacity (during all wave peaks).
• Low level of compliance with public health measures.
• Permeation of mis /disinformation in Canadian society and/or loss of public trust/confidence.
The generic reasonable worst-case scenario can be used to identify any new or outstanding
preparedness and response needs or issues that would require, or benefit from, a coordinated F/P/T
effort should Canada be faced with this scenario. It is provided as a “stress-test” not a prediction and is
intended to stimulate thinking concerning our current response efforts, capacity thresholds and
resiliency.
More specifically, the scenario presents a set of potential risks, each requiring mitigation strategies
based on an assessment of capacity requirements and our capability to manage the risks. Figure A3-1
identifies high-level capabilities that need to be in place for this scenario and Table A3-1 identifies
associated requirements that should be considered at all levels of government.
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Figure A3-1: Capabilities for management of the reasonable worst-case scenario
Table A3-1: Reasonable worst-case scenario risk management requirements
Capability Risk Management Requirements

DETECT –signals  timely surveillance data (local, P/T, national and international)
indicating a  analysis of international data for the same or similar strain
significant surge  laboratory resources to rapidly distinguish between COVID-19 strains (including VOCs)
in cases may and other respiratory viruses and to identify mutations associated with immune
escape and/or increased transmissibility
occur
 rapid analysis/investigation to assess risk of large peak based on international,
national, P/T and precise/granular local level data (to assess risk of change in
dominant strain, risk of importation into and within Canada, and risk of exceeding
local health care and public health response capacity)
 screening activities including targeted use of point of care screening tests
 health system-wide early warning for increased demand on resources and response
activities
 communication/education/sensitization regarding what constitutes a signal and how
to ensure appropriate timely notification of potential signal
 ongoing vigilance/commitment to COVID-19 response
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PREVENT –large  continued use of restrictive community-based measures until key locally-adapted
prolonged peak indicators for relaxation of measures have been achieved
and surges,  public health resources to ensure ongoing response measures are adequate to control
especially those spread of highly transmissible and virulent variants and prevent new cases of severe
disease (e.g., use of highly conservative assumptions for defining exposure, household
that exceed
quarantine approach)
capacity to
 capacity for rapid detection (through screening and testing) and isolation of cases,
respond and rapid identification and quarantine of high exposure risk contacts
 public cooperation with surveillance and case and contact management activities and
tools (i.e., to facilitate timely identification and isolation/quarantine, optimize use of
alerting apps)
 use of suitable isolation and quarantine sites and high adherence to recommended
measures in place in these locations
 gradual, controlled "re-opening" of settings and gradual resumption of activities (with
modifications) that are known to be associated with increased risk
 high adherence to ongoing modifications/controls put in place especially as restrictive
PHMs are lifted
 modified restrictions for essential workers
 screening strategies that aim to prevent and/or rapidly detect introduction of the
virus into a susceptible high-risk population or setting
 consistent, clear localized indicators for implementation or re-implementation of
restrictive PHMs
 rapid deployment of targeted outbreak control/containment resources (including
implementation of local “lockdowns”, deployment of outbreak response teams)
 high compliance with personal protective measures
 proactive international border control measures (i.e., including quarantine, testing
requirements, travel restrictions)
 increased messaging and public education regarding personal protective measures,
effectiveness of vaccines and requirement for PHMs following vaccination
 evidence-based results from vaccine hesitancy efforts and work with diverse
populations to support vaccine trust, interest in getting informed, and in being
vaccinated
 increased health care system capacity (especially in high-risk settings such as long-
term care) and consideration of how to deliver needed health care (e.g., at alternate
sites, using retired workers or students or alternate care providers)
REDUCE –surges  rapid implementation and maximizing efficiency of vaccine administration programs
in incidence and  use of vaccine strategies that prioritize immunization of high-risk individuals, groups
hospitalizations and settings
 adequate public health resources to ensure ongoing response measures to control
current spread and prevent new cases, hospitalizations and deaths
 focus on rapid detection and isolation of cases, and rapid identification and
quarantine of contacts
 rapid detection of outbreaks in high-risk settings and deployment of outbreak
control/containment resources
 consideration of how to re-implement restrictive community PHMs and which PHMs
to re-implement based on clear local-level triggers
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 increased use of/compliance with, personal protective measures

 ongoing international border control measures with possible re-introduction of
restrictions
INCREASE—  laboratory surge capacity to: ensure rapid diagnosis and case notification, identify
health care and new VOCs, and lab-epi linkage to characterize and learn from current variants
public health  sufficient resources to facilitate optimal delivery of the vaccine program (including
capacity clinic staff; immunizers; security; schedulers; local, accessible and appropriate
facilities; clear communication on who, when and how; tracking programs/registries
etc.)
 availability of public health resources for surges in case and contact management
requirements in the community (including isolation of cases and quarantine of
contacts at home/alternative designated sites), development of new guidance
products and provision of expert advice based on evolving scientific literature
 resources (i.e., human and equipment/supplies), planning and training for outbreak
control activities in high-risk settings, including clear emergency back-up contact
points
 surge capacity to ensure availability/access to health care resources including
equipment (e.g., ventilators, PPE) during peaks
 availability of sufficient health care providers to meet surge in demand
 ability to access and distribute effective therapeutics
 ongoing monitoring of scientific literature, networks and expert advice to inform best
practices for treatment and identification of effective therapeutics that reduce
hospitalization requirements and/or duration of hospitalization
 recovery policies and measures (e.g., discharge for recovery at home or alternate site)
to avert potential backlogs in the hospital system
MONITOR—  surveillance for early indicators that other illnesses that may cause a surge in demand
demand for for health care resources (e.g., seasonal influenza, other respiratory pathogens)
health care  strategic clearing of “backlog” – i.e., re-scheduling of delayed treatments, procedures
resources and surgeries, in a way that demand is met without exceeding capacity thresholds
 linkages between health care delivery and public health to ensure timely
establishment of alternative/over-flow care sites
 enhanced monitoring of global supply chains that could trigger drug shortages and
identified alternatives and strategies to prioritize and conserve supply (e.g., critical
supply reserve etc.)
FOSTER –ongoing  ongoing public trust in PHAs

public vigilance  clear, effective, culturally safe and appropriately tailored communication and
and adherence to education products to support continued public adherence to personal protective
measures and measures, community-based public health measures and to support vaccine
confidence and uptake
recommendations
 transparency and clarity regarding rationales for recommendations
 ability to provide feedback on impact, progress and success of measures
 public knowledge, attitudes and behavior research to inform sustainable effective
behavioral changes and to combat pandemic fatigue and vaccine hesitancy
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 monitoring of risk tolerance and public opinion in order to maximize adherence while
adjusting measures to locally tolerable/sustainable levels
 support for enabling policy changes (e.g., paid sick leave) that facilitate adherence to
public health measures and compensate affected sectors
 addressing of equity issues – especially those that affect access to needed resources
(e.g., availability of suitable isolation and quarantine settings), ensuring public
messaging is providing in multiple languages and formats etc., and ensuring these
resources are shared with various partners such as Indigenous partners
 consideration of incentives for adherence or adoption of new practices
 empowerment focused initiatives
 involvement of community to ensure community needs and potential barriers to
adherence are considered in public health measures
 transparent, clear, and equitable application of reasonable enforcement activities (if
necessary)
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Appendix 4: COVID-19 Response Planning with Indigenous Communities

Indigenous Services Canada (ISC), the Public Health Agency of Canada (PHAC) and the F/P/T response
partners have been involved in various activities to support the COVID-19 response in First Nations, Inuit
and Métis communities and partners, including the work of the SAC. These supportive activities are
summarized below.
 Preparedness: Resources to support pandemic planning updates/activation; access to vaccines,

medical supplies and PPE; training; and, guidelines. In the context of transitioning from the
Pandemic phase of COVID-19 (to managing it as another infectious disease in Canada), all partners
will continue to work to provide Indigenous communities the tools and resources needed in order to
respond to ongoing clusters of outbreaks within communities.
 Health Human Resources: Resources to support community hired nurses and other health workers
as well as to support surge capacity for health human resources, including nursing, medical and
paramedical supports; as well as, charter services to get health human resources into communities.
Indigenous Services Canada is currently working with its regional offices, F/P/T response partners
and Indigenous partners and communities on a project to develop a surge response team of
logisticians, epidemiologists, public health nurses and social workers. The surge team members’
primary focus would be deployments out to regions and communities that identify needs and
capacity for public health response, surveillance, and mental health crisis support and response.
Additional resources are also needed to provide for the logistical needs of these teams or
community-hired personnel including infrastructure and housing.
 Infrastructure: Resources to procure temporary shelter solutions and to support communities in
efforts to re-tool existing spaces to offer safe assessment and overflow space; and, additional surge
supports for food, water and other supply chain components; coordination of chartered flights to
ensure availability of critical infrastructure supplies and professionals.
 Infection prevention and control (IPC): Ongoing sharing of information (i.e., guidance on public
health measures and promoting personal health measures for individuals and health providers),
training and increasing capacity to support community response, including public service
announcements in Indigenous languages. Provision of training of community workers and health
providers on IPC. Ongoing funding for communities and service providers to increase their capacity
for infection prevention and control, including First Nations-run schools, boarding homes, family
violence shelters and friendship centres.
 Testing: Resources to develop capability and capacity to conduct COVID-19 testing including the
provision of testing swabs, and rapid molecular and antigen point-of-care tests. In March 2020, the
NML initiated the Northern, Remote and Isolated (NRI) initiative in collaboration with Indigenous
Services Canada to build community-based testing (CBT) capacity in Indigenous and remote
communities across Canada. This includes First Nation, Inuit, and Metis communities, organizations
and service centres that are located in community or nearby communities that provide health
services. This initiative was aimed at addressing the unacceptable turnaround time for diagnostic
results experienced by people living in NRI communities, during the early phase of the pandemic.
The NRI initiative is community-led, and enabled by the NML with the goal of ensuring that
Indigenous communities have access to testing equivalent or better services found in major urban
centres, with turnaround times to results available in under 1 hour. As of March 7, 2022, this
initiative has seen diagnostic testing implemented in or near more than 300 Indigenous
communities across Canada, with more than 2 million tests and devices for COVID19 distributed
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through the NRI initiative. The NRI will serve as a foundation for CBT for other infectious diseases
(Tuberculosis, Hepatitis C, and others) beyond the current pandemic. This resource serves as a
critical infrastructure for pandemic preparedness and outbreak response for Indigenous Peoples and
hard to reach populations living in NRI sites.
 Public health advice and guidance: Have developed and are continuing to keep up to date advice
and guidance to health professionals and communities that take into consideration the unique
context of communities.
 Public facility control and prevention: Supporting high risk public facilities such as schools, day care
centres, restaurants and long-term care facilities, in implementing of COVID-19 prevention
measures. This included targeted inspections and assessments, and the provision of guidance,
advice and training to community leadership, facility operators, and staff. Participation in technical
networks to develop and apply building related interventions, such as ventilation, and to guide
policy, program and funding opportunities. Indigenous Services Canada is continuing to seek
resources to address the pre-pandemic service delivery gap and resulting backlog created from
diverting resources.
 Governance: Continue to work with First Nations, Inuit, and Métis partners, the Public Health
Agency of Canada (PHAC), Health Canada, Public Safety’s Government Operations Centre, and other
departments, as well as their provincial and territorial counterparts for a coordinated and consistent
Canadian approach to COVID-19 to protect the health and safety of all First Nations, Inuit and Métis,
regardless of where they live in Canada.
 Communications: Continue to develop and broadly disseminate communication messaging through
Indigenous Service Canada’s COVID-19 Single Window to networks with public service
announcements in multiple Indigenous languages. Using digital media to further reach stakeholders
with communications such as public health measures and maintaining an online, publicly available
repository of COVID-19 resources relevant for Indigenous Peoples in multiple languages and
formats. Multilateral calls with partners at the national and regional levels continue.
 Surveillance: Adaptation of the Department’s flu surveillance tool to track COVID-19 across First
Nations communities; and development of a tracking tool to inform dashboards on key indicators of
COVID-19. COVID-19 epidemiological and vaccination data is updated regularly on the ISC COVID-19
webpage. ISC continues to fund and facilitate partnerships with Indigenous-led, distinctions-based
data initiatives. PHAC is working with provinces and territories to support collection of COVID-19
case and vaccination information, including race/ethnicity and Indigeneity to support understanding
of the impacts of COVID-19 and inform response planning and actions.
 Vaccine response planning: Collaborating with federal departments, provinces and territories, and
First Nations, Inuit and Métis partners to ensure that health facilities in Indigenous communities
have the necessary immunization supplies, PPE, testing kits, and health human resources to deliver
vaccines as needed. Facilitating a COVID-19 Vaccine Planning working group with representation
from federal, provincial and territorial, and First Nations, Inuit and Métis partners to co-develop
approaches to support the ongoing access to COVID-19 vaccines for Indigenous Peoples, including
those living in urban settings. The work on vaccine access and response planning for Indigenous
Peoples will continue from the Pandemic phase and into the Transition and Interpandemic phases,
as needs arise for further doses in underserved populations due to variants of concern, and waning
immunity, etc.
Based on knowledge and feedback learned to date, ongoing collaboration and funding is needed to
support First Nations, Inuit, and Métis partners and their communities to respond to any future
surges/resurgences. This includes continued access to timely testing supplies, P/T labs for processing,
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and results, including point of care testing for northern, remote and isolated communities and capacity
to detect VOCs.
Access to care to treat more severe symptoms of COVID-19 in remote and isolated communities also
requires that ongoing arrangements, or new ones, are in place to ensure an adequate number of beds in
hospitals south of 60, to support the treatment of Indigenous Peoples living in northern, remote and/or
isolated communities without this type of service. In communities where there are long-term care
facilities, or Elders residences, it is important to have access to adequate resources to support their
planning in keeping Elders safe and healthy, including funding for basic infection prevention control
measures (i.e., PPE, high dose flu vaccine, cleaning supplies, etc.), as well as, developed public health
measures.
Learning from H1N1 and now COVID-19, we know that long standing public health gaps and health
inequities between First Nations Inuit and Métis, and non-Indigenous Canadians increase the likelihood
and potential severity of a COVID-19 outbreak in Indigenous communities, and we have seen this
throughout the pandemic, as well as in many cases, urban Indigenous populations. These inequities are
exacerbated in remote or fly-in communities, where access to necessary supplies and health care
services is limited as compared to non-Indigenous communities. We also know that during H1N1, data
for First Nations, Inuit, and Métis were not captured in a consistent way, or a way that supported
communities in their preparedness and response efforts. A distinctions-based approach has been
adopted by the federal government to ensure that the unique rights, interests and circumstances of the
First Nations, Inuit, and Métis are acknowledged, affirmed, and implemented. In this context, it takes
into account the cultural and socio-economic realities of First Nations, Inuit, and Métis communities
involved. Distinctions-based, Indigenous-led analysis of COVID-19 data is necessary to advancing
culturally appropriate and evidence-based approaches, for First Nations, Inuit and Métis communities.
The strategy/approach, actions and deliverables for these preparations for the short, medium and long-
term are presented below.
Short term: In the short term, ongoing work to continue to ensure First Nations, Inuit, and Métis
communities and organizations have access to necessary supplies (e.g., PPE, vaccines and related
administration supplies), human resources, and funding to support the COVID-19 response and planning
for future waves. Vaccine planning is a priority in the short term and is being conducted through
collaborative efforts in working groups to facilitate culturally safe and equitable access to the COVID-19
vaccine for all Indigenous Peoples, regardless of where they live in Canada. Communications regarding
the vaccine are being developed and distributed in multiple Indigenous languages, in partnership with
Indigenous leaders and organizations, to build vaccine confidence. ISC and PHAC continue to work with
partners to advocate for the prioritization of Indigenous Peoples for access to the COVID-19 vaccine.
There is a need for continued work on COVID-19 surveillance and tracking of the COVID-19 vaccine
administration, which is underway in collaboration with federal departments, provinces and territories,
and Indigenous partners. Resources to support Indigenous-led data
collection/governance/infrastructure to support data optimization for the longer term in Canada are
essential. Resources to bolster community-led public health supports, culturally appropriate
communication and information, and work are required, as well as training and capacity building to
support these functions.
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Medium term: As COVID-19 vaccine programs continue and the supply of the vaccine increases, the
tracking and reporting of vaccine uptake and effectiveness will be critical. ISC will also continue to work
with Indigenous partners to increase vaccine confidence, building on lessons learned from the vaccine
rollout. Continued work is required to support access to patient care, as well as the work of community
based workers and nurses in northern, remote and/or isolated communities, and increased funding for
telemedicine and virtual health care providers is necessary. This work aims to reduce the anticipated
backlog of medical or specialist appointments after the acute COVID-19 response phase, and support
access to timely care supporting better health outcomes. Ongoing monitoring of forest fires and flood
for possible evacuations and planning in light of COVID-19 will be maintained over the summer and fall
months.
Longer term: During the Transition phase, ISC will work with partners to facilitate after action reviews
that will inform emergency management funding and planning for future pandemics. ISC will be
supporting health emergency management capacity in First Nations and Inuit communities through
sustained funding for community-driven and designed health emergency management preparedness
and mitigation activities. The department will also prioritize culturally-informed health emergency
management capacity development and training opportunities with First Nations and Inuit partners.
ISC will also address the ongoing management of COVID-19 as an ongoing infectious disease with a
possible seasonal pattern of increased incidence. Part of this management plan will include monitoring
the high level signals that would necessitate a change in timelines or strategies and approaches and
subsequent actions and deliverables. These include:
 community spread of new VOCs;

 ongoing and prolonged community outbreak scenario;
 signals and risks of community spread, where communities may be at a higher risk due
to geographic location;
 access to health care to treat more severe symptoms;
 strain on system for medevacs;
 shifts in hospitalization rate, ICU admission rate, case fatality rate;
 Post-COVID Condition/Long COVID;
 reproductive rate;
 outbreaks in long-term care facilities or Elder lodges; and,
 shift in age/sex distribution of cases.
This new continuum approach could cover the full spectrum of services from supports for people living
with disabilities, to aging in place approaches, improvements to facility-based care, and services like
those required by young adults that were previously served under the Jordan’s Principle. This continuum
must address anti-Indigenous racism within health service systems and seek, as a matter of core
principle, to eliminate health inequities for all Indigenous Peoples.
Finally, ISC will undertake a review, in collaboration with Indigenous communities, partners and
organizations. The review will cover actions taken during the pandemic to learn about the challenges, ,
successes, weaknesses, strengths and opportunities in the approach taken, as well as to learn about the
distinct ways in which pandemics may impact Indigenous communities differently than non-Indigenous
communities. It will be important to work with Indigenous communities, partners, and organizations
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from the conception of this undertaking all the way through to the course of the review; this is critical in
creating an opportunity to continue the effort to decolonize health care, and promote Indigenous self-
determination within the field of public health.
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Appendix 5: Surveillance
The purpose of surveillance is to provide decision makers with the timely epidemiological and risk
information they need to inform action. Similar to national influenza surveillance (FluWatch), COVID-19
surveillance is a pan-Canadian initiative that integrates numerous data streams including existing
surveillance systems with novel, non-traditional data sources. Ongoing COVID-related surveillance, is
expected throughout the Transition phase with connectivity across health sectors to foster real-time
data analysis to facilitate early detection of resurgence signals and examine COVID-19 related risks in
the context of other public health risks.
Current Status/Focus
Currently, the following data sources enable monitoring of COVID-19 epidemiology:
 Case-level data reported by PTs: A national dataset including demographic, race/ethnicity,
occupation, symptoms, clinical course and outcomes, exposures, vaccine history and variant
lineage information for all confirmed and probable COVID-19 cases in Canada. This information
used to monitor and describe the distribution of COVID-19 across priority epidemiologic factors.
 Aggregate laboratory result data reported by Provincial public health laboratories: numbers of
positive tests and the number of tests performed to detect SARS-CoV-2. This information is used
to measure the level of SARS-CoV-2 transmission in the community and to monitor the need for
changes in community testing practices.
 Whole genome sequencing data reported by PTs: national genomic sequencing data detects
SARS-CoV-2 variants, including VOCs.
 Aggregate sampling: Wastewater surveillance is underway and showing some promise as a
surveillance and alert component at the regional level.
 Data on travellers and border testing: Used to identify new genomic variants and monitor trends
at the border; thus facilitating early detection, situational awareness, and together with
isolation and quarantine measures, the reduction of travel associated transmission in Canada.
 Special surveys: Impact of COVID- 19 on specific populations (e.g., health care worker).
 Sentinel Surveillance Networks:
o Hospital networks - Several hospital-based data streams measure the impact of COVID-
19 in Canadian hospitals and collect detailed case information on most severe cases.
o Canadian Pediatric Surveillance Program - occurrence of Multi Inflammatory System in
Children (MIS-C).
o Community-based systems/ networks - Assess the level of transmission in the
community and the epidemiologic characteristics of outpatient cases.
 Publicly available data: supplementary data source to add situational awareness on COVID-19
transmission in jurisdictions and internationally.
 The federal, provincial and territorial public health partners are leveraging existing mechanisms
and operating procedures to collaborate on multijurisdictional and complex COVID-19 outbreak
investigations. This allows sharing of capacity and resources toward the goal of better
understanding COVID-19 in our communities.
 Outbreak surveillance: systematically collates COVID-19 outbreak events in Canada through
partnership with federal, provincial and territorial health authorities.
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Preparations/Forward Planning
Forward planning will ensure that Canada’s surveillance strategy aligns with the public health
management goals as they evolve through the next phases of the pandemic. Key changes to the public
health management strategy with impacts on surveillance include: the withdrawal of population-level
PCR testing and the reduction or elimination of public health follow-up of cases, which impacts data
availability; and the relaxation of restrictive public health measures, which may have impacts on the
epidemiology of COVID-19. As a result of these changes, alternative surveillance approaches are
required to accurately inform timely public health policy and intervention decisions.
The surveillance strategy will focus on a multi-component/multi-pathogen surveillance model where

applicable, with improved linkages and efficiency of data management. The focus will be on: i)
monitoring, detecting and assessing signals of COVID-19, including the detection of variants of interest
/VOCs; ii) monitoring and describing the clinical and epidemiologic features of severe COVID-19 infection
(hospitalizations and deaths); iii) gaining a greater understanding of impacts of COVID and long COVID
and populations at high risk for poor health outcomes; and iv) understanding waning of vaccine
immunity. Multiple data streams are required to address these areas of focus: some existing; some
requiring modification; and some new initiatives requiring implementation.
The preparations and ongoing activities based on the anticipated short, mid or long-term timeframe are
identified below.
Short term:
 Establish Pan-Canadian surveillance goals and objectives, updated surveillance system
framework (i.e., identification of data streams to retain, modify and develop), and revised
surveillance guidance for the transition period
 Explore options for implementation or enhancement of sentinel or other community-based
surveillance data stream(s) (e.g., cohorts) to compensate for reductions in public health follow-
up of non-severe cases
 Monitor vaccine performance, including coverage, safety and effectiveness, waning immunity
and vaccine escape.
 Transition from Genome Canada/CanCOGeN support to sequencing laboratories, to PHAC
delivered support to integrated genomic surveillance and analysis
 Support operationalization of genomic capacity and screening strategies and continue to
support mechanisms to facilitate linkages between epidemiological and laboratory data to
monitor on-going viral evolution including VOCs.
 Further validation and integration, and use of wastewater testing as an early detection
mechanism.
 Initiate planning for surveillance to identify broader impacts of COVID-19 and associated control
measures on health of Canadians.
 Conduct scenario-based planning to identify signals that may arise, the surveillance information
required to detect and characterize the signals, and the associated public health actions
required to respond.
 Support rapid epidemiologic investigations to characterise the transmission and impacts of new
variants and impact of vaccination in the context of outbreaks.
 Provide federal surge capacity support.
 Share timely information effectively with partners and publicly with Canadians.
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Medium to Long term:

 Support rapid epidemiologic investigations if there is a concern that a new variant is driving
transmission (immune escape) and/or impacting severity outcomes.
 Monitor vaccine performance, including coverage, safety and effectiveness, including issues
such as waning immunity and vaccine escape.
 Conduct targeted surveillance on broader consequences of the response to inform public health
action.
 Enhance data integration to evaluate evolving epidemiology in the context of increased
vaccination and immunity to support recovery.
 Continue to build and maintain data and analytics capacity and knowledge transfer networks to
support on-going development and sharing of intelligence.
 Consideration of surveillance strategies for Post-COVID Condition/Long COVID.
 Integrate and operationalize wastewater genomic surveillance as a routine element of pathogen
detection and tracking.
 Establish national reference center to enable monitoring for drug resistance for approved COVID
anti-virals.
 Support the expansion of the current VirusSeq Data Portal for genomic data to support
controlled access for collaborative FPT and Academic investigation to lab data and associated
case data (pilot under Pan-Canadian Health Data Strategy).
 Consideration of strategies that could detect zoonotic and reverse zoonotic (zooanthroponosis)
transmission. This could involve leveraging some of what has been established for human
testing/response and human genomic surveillance and new mechanisms beyond referrals from
wildlife agencies to the Canadian Food Inspection Agency’s National Centre for Foreign Animal
Disease (CFIA-NCFAD).
Planning Variables or Signals

It is possible that a new syndrome or rare event would require the development of a new, or
adjustments to, the surveillance strategy as has occurred for Multisystem Inflammatory Syndrome in
Children (MIS-C).
New settings or populations affected by outbreaks could emerge in outbreak surveillance (or via
outbreak intelligence gathering) which could precipitate new data needs, additional surveillance
activities or new variables to be collected to inform actions. For example, outbreaks among temporary
foreign workers have highlighted the need to be prepared to rapidly implement specific surveillance and
coordination mechanisms, as well as drawn attention to how social determinants of health (e.g.,
crowded housing, precarious work, access to medical services) can impact transmission and control of
COVID-19.
Surveillance strategy, capabilities and capacity, will focus on a multi-component/multi-pathogen

surveillance model as Canada transitions to the next phase of the COVID-19 pandemic. With the
expected withdrawal of population-level testing via PCR tests, alternative surveillance approaches are
needed to accurately inform timely public health policy and intervention decisions.
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Appendix 6: Laboratory Response Activities

Laboratory-based surveillance is an integral part of monitoring respiratory virus activity. Since the start
of the COVID-19 outbreak, Canada’s National Microbiology Laboratory (NML) has been providing
leadership in regard to testing for COVID-19 and surge capacity for provincial and territorial public
health laboratories. The NML has also contributed to domestic and international efforts to better
understand COVID-19 virus characteristics that can inform the development of medical
countermeasures.
The NML, Indigenous Services Canada and CPHLN have worked closely and successfully with northern,
remote, and Indigenous communities to enable those communities to have greater access to laboratory
diagnostic tools (e.g., point-of-care, diagnostic platforms, reagents, training). Through collaboration with
the NML, the territories have been able to set up COVID-19 testing within each territory.
Canada’s genomic surveillance capacity has increased exponentially in response to the COVID-19
outbreak. Provincial and territorial involvement in the sequencing efforts across Canada through the
Canadian COVID-19 Genomics Network (CanCOGeN) has greatly enhanced genomic sequencing
throughput. Ongoing communications with partners within industry, academia, and various government
levels have fostered a collaborative approach to sequencing and monitoring novel virus variants. The
National Microbiology Lab (NML) plays a lead role in supporting and guiding these efforts at all levels,
including through laboratory and bioinformatic analyses.
Wastewater-based surveillance of SARS-CoV-2 has emerged as an innovative tool to complement clinical

epidemiology and testing data and is a rapid and cost-effective approach for early detection of
outbreaks and surges as it monitors the circulation of variants of concern. The Public Health Agency of
Canada (PHAC), through the National Microbiology Laboratory (NML), developed a Pan-Canadian
Wastewater Surveillance Network with key partners and programs across different government levels
(federal/provincial/territorial/municipal) and academia to sample and test wastewater for COVID-19
from a large number of municipalities across Canada.
The Omicron-driven wave of the pandemic caused cases to surge, with testing demand exceeding
available laboratory capacity in most jurisdictions. In response, most P/T jurisdictions limited the use of
PCR testing to diagnose COVID-19 to specific target groups, including the unvaccinated,
immunocompromised, or those working or living in high-risk settings, with public health testing
guidance varying between jurisdictions.
Rapid antigen detection tests (RADT) are increasingly being used to support self-testing and case
detection. RADTs are comparatively less sensitive than RT-PCR-based testing, but may be appropriate
for screening purposes in higher prevalence settings where timely access to RT-PCR testing is limited.
The positive predictive value of RADTs will decrease as the true prevalence of infection in the target
population decreases.
The evolution of novel virus variants with altered characteristics has been observed, including increased
transmissibility and partial immune escape, posing new challenges to Canadians. Canada’s public health
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laboratories, working through the CPHLN, are meeting this new challenge while continuing to address
other key COVID-19 and non-COVID-19 pressures through the following activities:
 development and validation of diagnostic VOC screening assays;

 updating of F/P/T screening and sequencing guidance for SARS-CoV-2 variants;
 continued support for acceleration of whole genome sequencing and improvement of timeliness
of analysis and communication of variant information;
 transition of support to PT sequencing laboratories from initial capacity building through
CanCOGeN to sustainable operation through NML support undertaking genomic surveillance
efforts to monitor the emergence and prevalence of VOCs within Canada, including through
border surveillance initiatives;
 acquiring VOC samples to support Canadian diagnostic initiatives and research, including the
assessment of vaccine efficacy in the face of evolving variants;
 continued work to evaluate serological testing kits as well as developing in-house serological
tools such as ELISA, neutralization assays and point of care tests (serological work is in support
of the broader Canadian Immunology Task Force), incorporating the ability to distinguish natural
infection from vaccine-derived antibodies;
 collaboration with other partners, such as CIHR and academic, to undertake studies that help us
understand pathogen characteristics, including the differences brought on by virus variants;
 continued readiness to tackle multiple respiratory virus outbreaks as needed, recognizing that
the PHMs in place have largely suppressed influenza and RSV activity but a resurgence might be
observed with the relaxation of PHMs;
 continued growth of the Pan-Canadian Wastewater Surveillance network through various
federal, provincial, territorial and academic collaborations (currently almost 60% Canadian
population on sewage treatment systems is covered).
During the Omicron wave, access to molecular testing in most provinces and territories was constrained
due to very high case numbers. Many provinces and territories are continuing a shift to rapid testing
and individual responsibility for limiting the spread of COVID-19. This means reduced availability of
population-level surveillance testing with PCR tests that can then be used for genomic surveillance.
Efforts will be needed to transition to targeted surveillance (e.g., hospitals, primary care, and borders)
while also ensuring a minimum level of testing of a random selection of samples from communities.
The NML together with the CPHLN, is undertaking the following activities in order to continue to prepare
for potential surges/resurgences based on the reasonable worst-case scenario but also as part of the
laboratory preparedness long-term vision.
The Pan-Canadian Wastewater Surveillance network needs to be expanded further to cover more
Canadian population especially those in Northern, remote and isolated areas.
Short term:
 Continuing strong communication among Canada’s public health partners through CPHLN to
ensure laboratory response strategies are aligned and appropriate.
 Continuing a strong collaborative approach toward developing and validating diagnostic testing.
 Provide support for point of care testing.
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 Work together to develop a robust collaborative research agenda into SARS-CoV-2 variants of
concern, their detection and public health impacts as vaccines are administered.
Mid term:
 Continue optimizing various testing platforms and their uses to determine whether individuals
have been previously infected, especially for healthcare and other service providers such as
police, fire fighters, employees in long-term care facilities, etc.
 Continue streamlining molecular and serological testing as well as variant screens and whole
genome sequencing, including stewardship of reagents so they are conserved as testing
demands increase.
 Continue developing, validating, and enabling greater access to faster diagnostic tools such as
Point of Care tests and self tests (prioritizing northern, remote, isolated and Indigenous
communities).
 Continue working with PTs and other stakeholders to inform the use of testing in specialized
settings (such as borders).
 Create a sustainable wastewater-based epidemiology program.
 Ongoing assessment of RADT performance characteristics and sample approaches; address gaps
in PH reporting of positive cases identified via RADTs; provide updated guidance regarding the
use of RADTs for the identification of SARS-CoV-2 infection.

Epidemiological data from January 2022 are beginning to demonstrate declines in case counts in most
Canadian jurisdictions, but with the combination of relaxation of public health measures, the very high
transmissibility of Omicron, and the expectation that additional high-transmissibility and immune
escape variants, effective genomic surveillance will be required. Early identification, detection and
tracking of additional variants will continue to be a priority as we move into the inter-pandemic phase.
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Appendix 7: Public Health Measures

PHMs are the range of non-pharmaceutical interventions implemented by individuals and PHAs at the
F/P/T and local level to reduce the risk of infectious disease transmission. PHM range from those applied
at the individual-level to community-based measures implemented in non-health care community
settings (e.g., schools, workplaces/businesses, gatherings and events).
Individual-level PHMs include actions that individuals can take to protect themselves and others,
including wearing masks, physical distancing, improving indoor ventilation, practising hand hygiene and
respiratory etiquette, self-monitoring for symptoms and staying home when sick.
Community-based measures range from public education campaigns, case and contact management
activities, and mask mandates; to restrictive measures to reduce interactions and prevent transmission
in population groups, settings and the community at large. “Restrictive” community-based measures
aim to reduce contacts by limiting movement, activities, or access to resources and public spaces.
Examples of such measures include: school closures, restrictions on gatherings, workplaces/businesses
restrictions or closures, inter- or intra-provincial or territorial travel restrictions, and curfews).
PHMs have been shown to be effective in controlling transmission of COVID-19 even where VOCs with
increased transmission are dominant.9,10 However, many of these measures have important
consequences that must be considered in public health decision-making. These consequences require
careful consideration and prioritization in relation to other determinants of health, such as impacts on
childhood development, access to health services, mental health, family and gender-based violence,
social isolation and exclusion, and at-risk communities. PHM effectiveness depends on the level of
adherence by the public, which is influenced by pandemic fatigue and factors such as living, working,
community conditions, and financial and social circumstances.
Since the start of the COVID-19 pandemic the F/P/T public health response has involved working closely
with multilateral partners, other government departments, and First Nations, Inuit and Métis partners
to develop, update and disseminate appropriate public health guidance for a range of target audiences
on how to detect, report, prevent and manage COVID-19 infection. One example of this is the formation
of the Public Health Working Group on Remote and Isolated Communities that adapts public health
measures guidance to the unique needs, context and considerations of these communities in the
response.
Currently, PHAs continue to adjust (re-instate, maintain, ease) PHMs in response to local circumstances
as the pandemic evolves, including the emergence of new COVID-19 variants that have the potential to
be more transmissible, cause more severe disease, or have known or potential for vaccine immune
escape. During the Transition phase it will be important to maintain readiness for new VOCs, seasonal
resurgence, decreased protection against infection over time, and community outbreaks among
populations at high risk of poor health outcomes. As part of readiness activities, effective public risk
communication regarding these possibilities will be needed in order to prepare the public for any
corresponding adjustments in the use of PHMs.
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Focus for Transition Phase

The focus during the Transition phase includes:
 ongoing updates to existing or development of new F/P/T and/or PHAC guidance as evidence
evolves;
 continuing to provide advice to the public on how to assess and mitigate COVID-19 risks, and
fostering public understanding of the on-going risk environment;
 collaborating with F/P/T stakeholders on pandemic recovery and adjusting PHMs as required;
o highlighting current guidance for adjusting PHMs
 normalizing individual-level PHMs so that they may become a part of everyday practices to help
reduce the risk of transmission of COVID-19 and other respiratory viruses (e.g., staying at home
when sick, improving indoor ventilation, hand hygiene, respiratory etiquette, cleaning and
disinfecting);
 continuing to promote the use of additional layers of protection (e.g., wearing well-constructed
and well-fitted masks or respirators, physical distancing, avoiding or limiting time spent in closed
spaces and crowded places) across jurisdictions and normalize their use, particularly among
higher risk populations/settings. Individual use of these measures should be based on a personal
risk assessment which considers local COVID-19 activity and individual risk factors;
 continuing to monitor the situation to identify triggers for reinstatement of certain PHMs (e.g.,
based on VOCs that are more transmissible, cause more severe disease, or have immune escape
properties);
 identifying current gaps in knowledge and facilitating research activities to inform current and
future advice surrounding PHMs;
 in alignment with scoping exercises and stakeholder consultations, as well as lessons learned
activities from the COVID-19 pandemic, evaluating the PHMs component of the COVID-19
pandemic response to incorporate outputs into PHMs planning for future pandemics; and
 developing proactive, seasonal infectious illnesses prevention strategies/messaging for COVID-
19, similar to other respiratory illnesses (e.g., influenza, RSV).

Going forward, it will be important to consider uncertainties and challenges around:
 the emergence of VOCs domestically and globally, particularly those associated with increased
transmissibility, more severe disease or immune escape;
 decreased protection from vaccines over time;
 community outbreaks in populations at high risk of poor health outcomes;
 pandemic fatigue, as well as challenges related to public adherence and trust; and
 managing risk for segments of the population that remain unvaccinated because they are either
not eligible (e.g., medical contraindications) or they choose not to be vaccinated.
Indicators such as COVID-19 epidemiology, health care and public health capacity, as well as risk
reduction measures in place for high-risk populations and settings should be considered when
determining if/when additional PHMs need to be implemented. If PHMs need to be re-instated, they
should be proportionate with the risk in the local community, balanced against the risk of unintended
consequences of the intervention, and responsive to the local circumstance (e.g., taking into
consideration key indicators and factors such as transmissibility and severity of a VOC.
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Appendix 8: Infection Prevention and Control

While impacting the F/P/T public health response, the provision of infection prevention and control (IPC)
and expert advice has predominantly been aimed at informing healthcare setting and infection
prevention and control professionals. Guidance for infection prevention and control will focus on
ongoing measures based on emerging IPC science for managing COVID-19 as an ongoing, predictable
infectious disease in Canada.
The current focus of response activities pertaining to IPC include:
 ensuring that previously published COVID-19 Infection Prevention and Control documents
continue to provide up-to-date relevant and evidence-informed guidance; and,
 preparing guidance for an ongoing COVID-19 activity in Canada particularly related to
routine practices, additional precautions, and other IPC guidance.
All COVID-19 Infection Prevention and Control guidance documents should be reviewed on an ongoing
basis to ensure they reflect the most up to date emerging science in IPC. This includes key infection
prevention and control findings in the literature, responding to new and/or changing science.

If additional infection prevention and control information emerges, (e.g., a change in mode of
transmission, dominance of VOCs with immune escape characteristics, or additional risk groups), there
may be a need to revise or develop additional IPC guidance documents.
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Appendix 9: Vaccination
In December 2020, Canada received its first shipments of COVID-19 vaccines and proceeded to
administer more than one million doses in the first two months of the national vaccination campaign.
Since then, the Government of Canada has been able to offer all people residing in Canada 5 years of
age and older a primary vaccine series, as well as booster doses to all those who are eligible.
To support the ongoing COVID-19 vaccination campaign, Canada has secured sufficient vaccine supply to
meet current and future needs including possible new vaccine formulations that may be variant specific.
The Government of Canada signed advance purchase agreements to secure access to several COVID-19
vaccine candidates, including Moderna, Pfizer-BioNTech, AstraZeneca, Janssen (Johnson & Johnson),
Novavax, Medicago, and Sanofi/GlaxoSmithKline. P/T governments, together with federal and
Indigenous partners, developed plans for the efficient, equitable and effective distribution and
administration of COVID-19 vaccines across Canada, including prioritizing key populations for early
vaccination based on risk of severe outcomes and risk of COVID-19 exposure, particularly in the context
of limited vaccine supply.
Much of this work was done in collaboration with the SAC and the Canadian Immunization Committee
(CIC), which have both played integral roles in Canada’s COVID-19 pandemic response by fostering FPT
collaboration and vaccine rollout coordination. Most P/T immunization plans are informed by guidance
from Canada’s National Advisory Committee on Immunization (NACI), an advisory body of experts
external to government who provide independent advice to the Public Health Agency of Canada and PTs
on the use of authorized vaccines in Canada. NACI continues to develop guidance on the optimal use of
COVID-19 vaccines, as new COVID-19 vaccines continue to be authorized and as new real world data and
evidence on COVID-19 and COVID-19 vaccines continue to emerge.
In addition to collaborative work with jurisdictions and Indigenous partners to purchase, allocate,
distribute and administer vaccines as efficiently, equitably and effectively as possible, work has also
been undertaken across Canada to monitor the safety, coverage and effectiveness of COVID-19 vaccines.
Vaccination will continue to be an important tool to prevent severe outcomes from COVID-19 and to
prevent healthcare system capacity from being overwhelmed, supporting continued access to health
care for both COVID-19 and non-COVID needs.
As of February 24, 2022 a total of six COVID-19 vaccines are authorized by Health Canada for use in
Canada including:
 two mRNA vaccines (e.g. Pfizer-BioNTech Comirnaty, Moderna Spikevax),
 two viral vector vaccines (e.g. AstraZeneca Vaxzevria and Janssen),
 a protein subunit vaccine (e.g. Novavax Nuvaxovid), and
 a virus like-particle-based vaccine (Medicago Covifenz).
Canada continues to be a world leader in COVID-19 vaccination coverage. With its robust vaccine supply
Canada is now focusing on providing booster and pediatric doses to all eligible people in Canada, guided
by scientific data and advice.
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F/P/T governments, First Nations, Inuit and Métis leadership and public health authorities continue to
collaborate38 to ensure that vaccination programs and vaccine delivery models are designed and
implemented in a manner that is equitable, accessible and sensitive to individual and community needs,
including robust, culturally appropriate communication and delivery plans. PHAC’s Vaccine Rollout Task
Force has hosted over 50 bilateral and multilateral engagements with PTs, 1 Rehearsal of Concept, and 5
Federal, Provincial, Territorial and Indigenous summits (4 of which had international presenters) to
discuss various aspects of vaccine rollout and facilitate the sharing of best practices and lessons learned.
Implementation as documented in the Comprehensive Distribution Plan, and guided by the Vaccine
Annex of the CPIP is continuing. Canada’s COVID-19 immunization plan includes enhanced tracking
systems for monitoring adverse events following immunization (AEFI), the Vaccine Injury Support
Program, vaccine effectiveness, as well as assessment of vaccine uptake/coverage; allocation, storage
and handling; and vaccine delivery strategies. Instrumental to the FPT vaccine rollout is VaccineConnect,
a digital vaccine management platform, which has been designed to augment existing provincial and
territorial public health information technology systems to facilitate end-to-end vaccine and
therapeutics management. These enhanced tracking and monitoring systems have been critical for
alerting and signaling safety concerns, identifying supply challenges and for informing overall
immunization programming.
The National Operations Centre for COVID-19, is the federal logistical coordination entity and focal point
for managing vaccine delivery and collaboration with provinces and territories for distribution. The NOC
supports partners involved in Canada’s COVID-19 immunization roll out and continues to lead the
tracking of vaccine delivery and distribution across Canada.
PHAC has contracted logistics service providers who are supporting importation, storage and
distribution for several vaccine candidates. The logistic service providers complement provincial and
territorial supply chains, and align with the activities that provinces and territories and Indigenous,
remote and isolated communities have undertaken to strengthen supply chains within their jurisdiction.
Building upon the collaborative work to date to strengthen cold chains, continued F/P/T engagement
will facilitate advancement of this initiative throughout the supply chain.
A key component to the COVID-19 immunization roll out has been to ensure that health care providers
have the training, tools and resources they need to support public health practice for primary series,
booster and pediatric vaccination. The federal government continues to collaborate with PTs,
Indigenous partners, and other health system stakeholders and partners to facilitate the timely sharing
of scientific advice, provide educational webinars, immunization clinic guidance and evidence-based
information on vaccination decision supports to healthcare providers
Efforts to support COVID-19 immunization roll out also include emphasis on promoting vaccine
confidence and uptake. Through engagement with key partners, stakeholders and experts the
Government of Canada has taken a collaborative approach to better understand public opinion and
behaviour. This enhanced understanding informs the development of partnerships, educational tools,
vaccination projects, and communication strategies to further educate and build trust in COVID-19
vaccines, while addressing mis- and dis-information about vaccine safety and effectiveness. The
Immunization Partnership Fund (IPF) is a key funding tool in the federal toolbox to support public health
and non-traditional partners at community, regional and national levels to combat vaccine mis- and dis-
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information, address access barriers, and support culturally appropriate strategies to increase vaccine
confidence and uptake, and to reduce the incidence of vaccine preventable diseases including COVID-19.
Further, the Government of Canada has worked closely with P/ T governments and Indigenous partners
to develop a standardized Canadian COVID-19 proof of vaccination credential. This collaboration has
ensured Canadian citizens and residents had access to a trusted and secure way to demonstrate their
vaccination status internationally and domestically. The Government of Canada also engaged with
Indigenous communities and organizations to understand and respond to concerns associated with
proof of vaccination credentials, including gaps in reporting Indigenous vaccination data into P/T
systems.
The Government of Canada’s COVID-19 Vaccine Task Force, as well as the COVID-19 Joint
Biomanufacturing Subcommittee, helped identify areas for strategic investments in vaccine research,
development, and domestic bio-manufacturing. This has helped guide ongoing work by the Health
Portfolio, in partnership with Innovation, Science and Economic Development Canada, to facilitate
longer-term domestic production capacity and support future pandemic preparedness; In addition, a
COVID-19 Vaccine Clinical Trial Discussion Forum is convening academic, government, and industry
partners to discuss vaccine clinical trial challenges and optimal designs.
The Government of Canada continues to implement the Biomanufacturing and Life Sciences Strategy,
which was released in July 2021 and presents a long-term vision for strengthening Canada’s
biomanufacturing sector and protecting individuals in Canada against pandemics and other health
emergencies in the future. Through strategic investments and partnerships, the Government of Canada
is working to grow Canada’s capacity to rapidly develop and produce vaccines, therapeutics and other
life saving medicines. This includes an agreement with leading COVID-19 vaccine developer Moderna to
build a state-of-the art mRNA vaccine production facility in Canada.
Through a variety of bilateral and multilateral mechanisms the Government of Canada will continue to
collaborate with provinces, territories, municipalities, Indigenous partners and other partners to
facilitate the rollout of COVID-19 vaccines. Guidance and tracking systems will continue to be updated as
vaccine supply changes. The National Emergency Strategic Stockpile procured sufficient supplies to
support F/P/T vaccine administration.
Timelines for activities that support Canada’s COVID-19 Immunization Plan are:
Short term
Immunization Readiness and Vaccine Rollout:
 Ensure vaccines are deployed to all populations, as the result of detailed demand planning with
provinces and territories, to support subsequent doses as recommended, and for all eligible age
cohorts.
 Developing a Vaccine Confidence Plan as Canada transitions to managing COVID-19 as an
ongoing infectious disease including: continue to integrate vaccine confidence messaging and
tactics into communications strategies for campaigns (e.g., COVID-19 boosters and pediatric
immunization).
 Continue providing appropriate ancillary supplies to PTs for vaccine administration and explore
alternative technologies to optimize use.
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 Work with provincial and territorial governments and Indigenous partners to ensure that COVID-
19 proof of vaccination credentials continue to be issued in a consistent and trusted manner,
and remain available to individuals in Canada for use internationally and domestically as
needed.
 Work with partners to (1) harmonize eligibility, accessibility, security, and service support for
proof of vaccination credentials across the country; and (2) update the credential in response to
evolving needs both internationally and domestically.
Vaccine Surveillance:
 Continue to collaborate with PTs to monitor vaccine safety and coverage and make information
available to Canadians to support vaccine confidence.
 Monitor vaccine effectiveness to inform policy decisions, including the need for additional
booster doses.
 Identification of vaccine strategies and vaccine-related research priorities to address changing
epidemiological context and emerging evidence (e.g., evidence on the duration of vaccine
protection).
 Build additional functionality of VaccineConnect, the digital vaccine management system to
support jurisdiction vaccine program management and pan-Canadian reporting.
Vaccine Acquisition:
 Manage existing and future supply arrangements, guided by scientific data and advice, to
support PT’s COVID-19 vaccination campaigns; considerations include ensuring appropriate mix
of mRNA and non-mRNA options as well as balancing current versus future supply needs in light
of new product vaccine technologies and formulations.
 Continue to collaborate with manufacturers to obtain sufficient supportive guidance and
training to build the capacity and capability of provinces, territories, First Nations, Inuit and
Métis partners and federal department to manage anticipated supply and distribution of
vaccines.
 Continue to work with FPT and international partners on the management of doses that are
surplus to domestic requirements to support Canada’s commitment to global vaccine equity.
Engagement:
 Continue F/P/T and Indigenous collaboration to promote vaccines, confidence and uptake,
including booster and pediatric doses by reducing barriers to vaccination, including access to
convenient community vaccination sites and pop-up/mobile options.
 Continue to foster F/P/T collaboration on Canada’s COVID-19 pandemic response via the F/P/T
Special Advisory Committee, Canadian Immunization Committee, and bilateral and multilateral
engagements.
 In conjunction with Indigenous Services Canada and First Nations Inuit Health Branch, continue
to engage with Indigenous partners to support collaboration on vaccination programs and
vaccine delivery models that are equitable, accessible, and sensitive to needs and conditions of
communities
 Ongoing F/P/T/I dialogues for sharing challenges and lessons learned, including strategies to
bolster vaccine roll-out capacity, target uptake in hard-to-reach populations and communities,
and to prepare for rapid roll-out of campaigns for new vaccine formulations for eligible age
cohorts and additional booster doses as needed.
 Provide continuing support through the Immunization Partnership Fund regarding efforts by
partners at the community, regional and national levels to reach at-risk and underserved
populations, reduce access barriers and increase vaccine confidence and uptake through
evidence-based and culturally appropriate approaches.
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 Continue bilateral and multilateral engagement with international partners to ensure Canada’s
proof of vaccination credential is accepted internationally, and to seek mutual
verification/interoperability of credentials with other countries where possible and appropriate.
Mid term:
 Work on vaccine confidence including public education and communication campaigns,
partnership project investments and tailored efforts targeted to the population as a whole and
priority subgroup in Canada as vaccine options, eligibility and COVID-19 epidemiology evolves
and to catch-up on uptake of routine immunization programs.
 Prepare to address new challenges and the future vaccination needs of individuals in Canada by
building on best practices and lessons learned during COVID-19 through the renewal of the
National Immunization Strategy
 Conduct/support data analysis to inform the need for new vaccine formulations to ensure
protection against emerging VOCs, booster doses, and/or seasonal vaccination programs.
 Undertake causality assessments and support research to better understand specific safety
signals.
 Explore new data collection methodologies, and partnerships to understand barriers to
vaccination
 Manage vaccine supply arrangements, considering the possible recommendation for seasonal
booster campaigns, and the need to secure doses past 2023.
 Continue to work with suppliers on availability of new product presentations, including single-
dose formats, in order to meet the evolving vaccine administration needs in Canada.
Engagement:
 Build and maintain relationships, support community engagement and equip trusted community
leaders (e.g., faith-based leaders, newcomer support organizations, family/youth organizations)
with evidence-based information, resources and tools to support informed vaccination choices
and address mis- and dis-information.
Longer term:
 Explore innovations/strategies to enhance the speed and scale of distribution and uptake of
vaccines and other medical counter measures to support planning for efficient and effective
response to pandemics and other infectious disease outbreaks.
 Ongoing vaccine confidence, promotion and uptake support programming for COVID-19
vaccines, and to protect against other vaccine preventable diseases.
 Adaptation of the contents of the CPIP Vaccine Annex for the COVID-19 context as necessary.
 Explore options for leveraging VaccineConnect to support pan-Canadian medical counter
measure initiatives beyond COVID-19.
 Ongoing monitoring of vaccine safety, coverage, and effectiveness in collaboration with
partners.
 Evaluate current vaccine surveillance efforts to inform signal detection and the surveillance of
population risk or protection from vaccine preventable diseases.
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 Capitalise on ongoing vaccine coverage surveillance to ensure necessary evidence is available to

assess the level of protection among different population.
 Strategic planning for ongoing COVID-19 vaccine supply, including domestic bio-manufacturing
capacity, allocation and distribution models and logistics as needed.
Engagement
 Maintain and enhance robust collaborative infrastructures with provincial, territorial and
Indigenous partners to support the evolution of COVID-19 vaccination campaigns and inform the
integration of lessons learned into routine immunization programming.
 Work with key partners and stakeholders to explore how greater vaccine acceptance can be
fostered across Canada, taking into consideration lessons learned and best practice from COVID-
19, to allow for effective response to possible future pandemics and other infectious disease
outbreaks.
 Application of lessons learned on COVID-19 vaccine confidence, promotion and uptake to
support and maintain partnerships and community outreach efforts for engagement and
equipping trusted community leaders with evidence-based information, resources and tools to
address mis-information and build long term vaccine confidence and support informed
vaccination choices to protect against vaccine preventable diseases.
In addition to COVID-19 vaccine planning, reducing hospitalizations due to seasonal influenza and
invasive pneumococcal disease through increased vaccine coverage can preserve both public health
resources (e.g., diagnostic/testing, outbreak response) and health care capacity (i.e., outpatient visits
and inpatient stays).
Routine immunization programs and Influenza vaccines

COVID-19 has required significant public health resources and has inadvertently led to temporary pauses
or disruption of routine immunization programs to prioritize pandemic response efforts. As provinces
and territories lift public health measures and as travel increases, the risk of vaccine preventable
diseases (VPDs) may also increase. Monitoring routine vaccination coverage and identifying and
addressing gaps in routine vaccinations will be important in preventing further spread of VPDs and
outbreaks, and in ensuring that the pandemic does not leave a long-lasting immunization gap in any
Canadian communities.
NACI will gradually resume activities to provide guidance on other VPDs as new vaccine products
emerge, and also to consider strategic use of existing products to prevent VPD resurgence and promote
health equity. Guidance from PHAC on managing VPD outbreaks (e.g., measles) will need to be updated
in order to prepare for a possible resurgence of VPDs in light of immunization gaps that have resulted
from the pandemic. CIC will also resume activity related to routine immunization to ensure that any
gaps in routine vaccinations as a result of the pandemic are addressed as well as any other issues
regarding immunization programs.

The evolving evidence on vaccine effectiveness and levels of vaccine confidence will be monitored to
support continued planning for education, outreach, and uptake supports for routine vaccination
programs and campaigns, including response to AEFI reports or signals. This requires continued AEFI
surveillance, health promotion and education, vaccine confidence monitoring, health care provider
supports, project partnerships, behavioural science and risk communication expertise.
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Appendix 10: International Border and Travel Health Measures

Since the onset of the pandemic, the Public Health Agency of Canada (PHAC) has significantly shifted and
expanded its border and travel health programs to focus primarily on mitigating the risk of COVID-19
importation. These measures, together with other F/P/T responses, help to protect the capacity of
provinces and territories to provide health services to Canadians. Prior to COVID-19, it was not
envisioned that Canada would implement extensive border closures as a pandemic response measure.
Successful implementation of border and travel health measures has required intensive and ongoing
multilateral engagement and cooperation with government and non-government stakeholders (e.g., the
air travel industry).
Focus for Transition Phase

Throughout the past two years, several border and travel health measures critical to the COVID-19
response have been developed and implemented. The following measures remain important during the
Transition phase, as F/P/T partners work to reduce COVID-19 incidence and associated serious illness to
a locally manageable level and kick starting recovery activities, while maintaining surveillance, risk
assessment capacity and readiness for any resurgence:
 leveraging the provisions of the Quarantine Act and introducing 74 Emergency Orders as of January
31, 2022;
 originally prohibiting entry of foreign nationals (unless exempt), followed by a limitation on entry
based on vaccination status;
 restricting direct flights from countries of concern via a Notice to Airmen (NOTAM);
 requiring that travellers obtain a negative pre-departure test from a third country when there are
issues with the quality of testing in a country of concern;
 testing and quarantine/isolation requirements for incoming travellers to Canada, including a shift
from increased testing and quarantine in light of Omicron back to a surveillance testing model;
 increasing the public health presence at the border (i.e., public health officers being assigned to 36
high volume points of entry) as well as enhanced PHAC capacity to conduct virtual health
assessments for COVID-19 via access to a 24/7 Central Notification System;
 updated messaging and communication tools for the travelling public, including through travel
advisories, web presence, and travellers handouts;
 linkages between federal and P/T guidance and oversight for the management of international and
domestic travellers;
 ongoing cooperation and work with provincial and/or local law enforcement-related partners to
support compliance verification and enforcement activities, including ticketing travellers not
complying with federal quarantine and/or testing requirements; and,
 enhanced partnerships with provincial and territorial health authorities and other key players to
support data-sharing, and compliance and enforcement of quarantine.

The emergence of the Omicron variant underscored the need for ongoing surveillance and operational
readiness for resurgence. Moving forward, PHAC will continue to maintain a high level of readiness to
respond to COVID-19 through a combination of border and travel measures that are intended to:
 monitor the COVID-19 situation, most notably with the aim of quickly detecting VOCs at points
of entry (POEs) and limiting their importation;
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 consider domestic epidemiological factors, including regionally-specific factors and provincial

and territorial public health measures;
 track the progress of COVID-19 vaccine coverage both domestically and internationally and
ongoing scientific evidence on vaccine effectiveness;
 monitor the availability and quality of COVID-19 testing both in Canada and abroad;
 update modelling and risk analysis of other countries and international experiences to capture
lessons learned;
 maintain operational capacity pre-, at- and post-border to handle anticipated incoming and
outbound travel volumes along with additional measures;
 identify scalable border measure options in case of resurgence;
 evaluate border measures including enhancing or easing measures in coordination and
alignment with F/P/T requirements (while factoring in whole of health system capacity);
 consider the public health/health system capacity to manage potential increase in imported
cases (testing, provincial and territorial health care capacities, etc.); and,
 monitor volumes into Canada by cohort (e.g., immigration status, purpose of travel, etc.) and
arrival mode.
As international and domestic contexts shift, border and travel measures need to be adapted
accordingly. PHAC is working towards a sustainable and adaptive border framework that mitigates
serious illness and severe outcomes while enabling economic recovery, enhances the surveillance
approach that is ready to respond if new threats are detected, and applies lessons learned from
Omicron in Canada and abroad. There is a variety of possible approaches that could be explored and
implemented in any combination, as the current Omicron-driven wave subsides.
 Global restrictions: Reduce restrictions for travellers from all destinations, provide relevant
travel advice to Canadians, and continue surveillance at the borders.
 Country-specific restrictions: Remove prohibition of entry for all foreign nationals, but
maintain/impose restrictions for high-risk countries by exception, based on risk of importation
as determined by surveillance testing data from Canada’s Border Testing Program.
 Cohort restrictions: Modify exemptions to entry prohibitions and/or border measures based on
a sectoral analysis.
 Testing and/or vaccination certification: Continue to ease or impose measures according to
travellers’ test results and/or Proof of Vaccination, in a way that is justified by available scientific
evidence and is sensitive to legal and ethical issues, including around equity and accessibility.
The objective of this border framework will be to move towards an empowerment and surveillance
approach that is ready to respond if new threats are detected. Surveillance will continue to be the
primary goal and a readiness “playbook” will be prepared, as the Government of Canada and F/P/T
partners will need to maintain the ability to ramp up measures in case of a resurgence of COVID-19 or
the emergence of new VOCs.
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Appendix 11: Health Care Systems Infrastructure

A significant resurgence of COVID-19 in any jurisdiction can have a substantial impact on health care
service capacity and the ability of health care organizations to provide optimum care to all patients.
Canadian businesses have stepped up to offer their solutions and expertise, or pivoted their
manufacturing facilities. Canada is now successfully producing: therapeutics (e.g., Molnupiravir) Made-
in-Canada PPE, medical equipment and supplies to address the urgent needs of frontline workers, and
the safety of Canadians at large. In addition, Innovation, Science and Economic Development Canada,
Health Canada, PHAC and PSPC Canada continue to work closely together to assess and monitor
Canada’s domestic manufacturing of medical equipment and supplies.
With respect to therapeutics, the Interim Order Respecting the Prevention and Alleviation of Shortages
of Drugs in Relation to COVID-19, made by the federal Minister of Health on October 16, 2020
introduced tools for the Minister to address drug shortages, or the risk of drug shortages, that may be
caused or exacerbated, directly or indirectly, by COVID-19.
The F/P/T public health response in terms of health care system infrastructure has involved linking with
those partners responsible for monitoring, anticipating and planning for surges in capacity within health
care systems in order to increase mutual knowledge and situational awareness, and support response
activities regarding the delivery of health care to COVID-19 cases in Canada. To support this work:
 PTs have taken steps to support hospital surge capacity and ensure timely access to critical
equipment and supplies;
 the Government of Canada continues to work with provinces and territories: to help ensure
health care systems are ready for future waves of the virus, to support populations in situations
of vulnerability and high-risk Canadians, including those in long-term care, home care, acute
care and palliative care, and to support people experiencing challenges related to mental
health, substance use, or housing;
 PTs are working to develop, expand and launch virtual care and mental health tools, including
through the use of federal funding to support P/T services;
o The federal government is also committed to sustaining the Wellness Together Canada
portal, which is a free 24/7 bilingual online resource that all Canadians can access. The
portal serves to supplement any online mental health tools provided by PTs.
 through the federal Safe Long-Term Care Fund, governments will work together to protect
people living and working in long-term care, including carrying out infection prevention and
control readiness assessments, making improvements to ventilation and hiring and training
additional staff or topping up wages to support workforce stability;
 the federal government is supporting infection prevention and control measures in long-term
care, including funding for Healthcare Excellence Canada (formerly the Canadian Foundation for
Healthcare Improvement) to expand its LTC+ initiative and funding to engage with third parties
to help identify resources to conduct readiness assessments in long-term care facilities and
support training on infection prevention and control;
 the federal government is also supporting PT testing programs in workplace and high risk
congregate settings through the procurement and distribution of free rapid tests;
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 the Canadian Red Cross and other non-governmental organizations are being supported by the
federal government to build and maintain a humanitarian workforce to provide surge capacity
in response to COVID-19 outbreaks and other large-scale emergencies;
 modelling has been used to project anticipated demands;
 sharing of hospital-based data (on rates of admission, current capacity and
equipment/supplies/resources usage) has been included in surveillance products; and
 the Logistics Advisory Committee (LAC) was convened in February 2020 to provide an F/P/T
forum for collaboration including identification of F/P/T PPE, equipment and supply needs,
informing procurement and facilitating allocation.
In terms of forward planning, the Government of Canada will continue to:
 collaborate and work with PTs to better understand the rapid tests and PPE needs across the Pan
Canadian landscape;
 explore opportunities to consider sustainable domestic production capacity for medical equipment
and supplies such as vaccines, therapeutics, rapid tests and PPE;
 monitor for potential COVID-related drug shortages and work with PTs and stakeholders to
proactively develop and implement strategies to manage these risks;
 through the Indigenous Services Canada (ISC) Stockpile and PHAC’s National Emergency Strategic
Stockpile (NESS), provide medical equipment and supplies to First Nations, Inuit and Métis
communities to support the delivery of health care services;
 consult regularly with PTs to identify need for federal COVID-19 surge capacity supports to
jurisdictions, including health human resources and mobile hospital units, as well as identify
initiatives over the medium-term to help address gaps in Canada’s health human resources, and
encourage PTs to bolster their existing health human resources through the use of other sources
such as international medical graduates and foreign-credentialed health professionals;
 facilitate sharing of best practices on alternate care facilities, triage and management of delivery of
non-COVID-19 health care services review the latest available scientific evidence to inform guidance
for health settings and develop tailored approaches for communities with specific health care needs,
such as remote, northern and isolated communities as well as Indigenous Peoples in urban settings;
 work with PTs to support safe resumption of in-person primary care and mental health services
(where this were suspended/delayed or shifted to virtual care platforms);
 work through the Health Standards Organization and the Canadian Standards Association (CSA)
group to set new national standards for long-term care so that older adults get the best support
possible, and work with PTs to use the standards to drive lasting change;
 take more action to help people live longer at home;
 work with PTs as well as other partners and stakeholders to develop national mental health and
substance use standards. (These standards will help ensure that Canadians receive high-quality
mental health and substance use services, no matter where they live or seek to access services); and
 work with PTs to make sure that the entire Canadian population has access to high-quality care,
including ensuring access to a family doctor or primary care team, expanding capacity to deliver
virtual care, and increasing access to mental health services.
Provincial and territorial governments, along with health care facilities, many of which are already
working close to full capacity, continue to do further planning for how they have in some regions (and
could in the future) accommodate potentially large influxes of patients, including establishing triage
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protocols for the allocation of scarce resources such as ICU beds and specialized health human
resources. In remote, northern and isolated communities it is also critical to plan for further potential
supply-chain and medical evacuation interruptions due to weather.
The level and type of health care system resources needed to manage the Post-COVID Condition/Long-
COVID also requires coordinated planning, especially since its full impact remains to be determined.
Forward planning must also consider the broad health care system impacts and changes that have
occurred as a result of the COVID-19 pandemic in Canada; for example, the unanticipated reduction in
emergency room visits for serious conditions, the shift of primary care to virtual care, the unintended
but severe health and safety impacts of removing family caregivers from long-term care facilities,
increased incidence of opioid overdose, delayed/decreases in routine immunization, and the backlog of
elective procedures.
The implications of these impacts and changes include the need to plan for: more and different
supportive care for older adults, “catch-up” of delayed medical tests, treatments and procedures and
the need to plan for future waves in a way that doesn’t impede health care systems more than is
necessary. In addition, understanding gaps that appeared, and lessons to be learned from how they
were addressed, in the intersection between PHMs, health care services and other social determinants
of health will be important to consider in a holistic way for future planning. For example, how to make
sure individuals experiencing homelessness receive adequate supports to be able to follow PHMs (e.g.,
isolation and quarantine protocols).

In the event health care institutions start to see an increase in the number or change in the
characteristics (e.g., demographics, underlying medical conditions) of patients being treated for COVID-
19, the Government of Canada will continue to work with PTs to monitor capacity and facilitate timely
access to medical equipment and supplies such as PPE, vaccine ancillary supplies, biomedical equipment
and intensive care unit (ICU) beds. The federal government continues to be ready to respond to PT
requests for assistance and surge support, (e.g., limited health human resource support, facilitation of
mobile health services capacity, safe voluntary isolation sites).
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Appendix 12: Communications and Outreach

Communication of information and advice in a public health emergency is a critical public health
intervention that helps to protect public health, save lives, and minimize the overall social and economic
impacts. To ensure this, information must be available in plain language and multiple formats and
languages so that it is accessible to all people in Canada, including those with low literacy. Using a risk
communications approach, the Public Health Agency of Canada, together with other government
departments and P/T counterparts and Indigenous partners, have worked hard to provide health care
providers, Canadians and key stakeholders with the timely, trusted, accessible, evidence-informed and
complete information they require to protect themselves, their families, their communities and
businesses. As Canada transitions to a more sustainable, long-term management of COVID-19, ongoing
proactive and targeted communications from trusted sources will continue to be important.
Focus for Transition phase

The focus remains on communicating clear, concise and timely information, within a constantly evolving
public environment, that will cut through mounting COVID-19 fatigue and mis- and dis-information. The
goal is to ensure people in Canada have the information they need to make informed decisions to help
protect themselves, their families and their communities from COVID-19.
As Canadians emerge from the latest wave, it is an opportune time to recognize all that we have
collectively accomplished, take a broad perspective and map out the path forward. While transitioning
out of the acute response phase, it is important to remain nimble and ready to respond to new risks in
an appropriate and proportionate manner. All levels of government need to communicate to Canadians
that progress may not be linear and continue to promote the various tools, including vaccines,
therapeutics, robust surveillance and individual public health measures, to avoid resurgences.
Communications, public education and advertising activities will:

 encourage continued use of individual public health measures, including staying home when sick,
washing hands, wearing a mask, ventilation and rapid testing;
 promote COVID-19 booster doses and pediatric vaccination, and possible seasonal immunization
programs, such as seasonal flu;
 raise awareness of evolving border measures;
 use credible/trusted sources to counter misinformation and address vaccine hesitancy;
 communicate transitions to management of COVID-19 as an ongoing infectious disease in Canada
when prudent; and
 communicate with empathy and honesty to recognize the efforts and sacrifices of Canadians have
saved lives; that we are now in a stronger position than ever before; and encourage everyone to
continue to use the various tools available.
These activities will be supported by F/P/T strategies, content and implementation plans that include:
 sufficient public opinion research (POR) and behavioural insights (re. behaviours, vaccine, public
health measures, back to school) to identify Canadians’ priorities, values and concerns, and capture
regional variations;
 public education campaigns (COVID-19 vaccines, PHMs and mental health);
 campaigns to ensure Canadians are aware of COVID-related travel requirements; and,
 testing and contact tracing related communication activities.
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Effective communications will be achieved through a coordinated, strategic and scalable approach to
outreach and engagement. This includes communications by the Chief Public Health Officer (CPHO),
Deputy Chief Public Health Officer (DCPHO), Chief Medical Officers of Health (CCMOHs) across the
country and other P/T and local spokespersons, as appropriate; public education campaigns; traditional
and digital media outreach, social media, and website updates.
Significant outreach and engagement with a range of health and non-health stakeholders has been an
essential part of the national response to COVID-19. This outreach and engagement has evolved
throughout the pandemic from a focus on proactively sharing the latest public health developments and
resources to identifying stakeholder information needs and perspectives, to collaborating on guidance
development and joint communication initiatives, to transitioning towards a more sustainable approach
to long term management of COVID-19. A range of stakeholders have been engaged through regular
COVID-19 briefings, teleconferences and webinars including the following: CPHO Health Professionals
Forum (national health professional organizations), national allied health organizations, local public
health medical officers of health, critical infrastructure stakeholders, agriculture and agri-food
stakeholders, business groups, travel associations, airlines, and childcare and education stakeholders. A
range of community-level leaders have also been engaged including faith-based organizations,
organizations representing racialized communities, and engagement with national and community level
First Nations, Inuit and Métis organizations.
It has been and continues to be especially important to engage community leaders from Indigenous
communities, rural communities, racialized communities, groups representing newcomers to Canada,
and faith-based organizations to help deliver critical information39.
Challenges and Considerations:

Messages in the earliest phase of the pandemic were clear – stay home; physical distance; wash your
hands; wear a mask. Now the environment is much more complex.
 As populations and health care capacities differ across jurisdictions, there will be variability in
how each province, territory and community assesses risk and responds to the needs of their
respective jurisdictions. Messages and their delivery must be clear so as to avoid confusion and
assure Canadians that public health officials are aligned in their approach.
 Canadians have gone through multiple waves across the country and there is a real balance that
needs to continue to be communicated as we transition away from the crisis phase: keeping
COVID-19 vaccinations up to date, being aware of personal and family risks, and maintaining
individual public health measures. This messaging can support individuals to make the right
choices for themselves and their family and can help mitigate the impact of pandemic fatigue.
 COVID-19 is here for the foreseeable future and there will continue to be new and important
roles for public health to play. Messages must be designed to help manage expectations and
emphasize a risk-based approach.
 The risk perception (and compliance) of Canadians will vary based on their individual
experiences and their unique reality. Canadians need to assess their activity, their risk tolerance,
their risk to others and the importance of their own behaviour in reducing risk. Our
communications efforts must arm them with the information to do so easily and accurately.
 There is still much uncertainty that impacts how precise and definitive we can be in our
messaging, especially with the new VOCs. As science evolves and we learn more, advice to
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Canadians may change. It will be important to continue to communicate what is known and
what is not known.
 There will continue to be an overwhelming amount of information on COVID-19 and some
Canadians may find it hard to distinguish misinformation or disinformation from information
from Governments and other credible health sources. Communications efforts must address
misinformation and provide everyone in Canada with evidence-based information to help them
make the decision to keep their COVID-19 vaccinations up to date.
 Canadians expect timely and responsive communication using newer social media platforms
(e.g., TikTok, Instagram) and from leaders and influencers that are meaningful and trustworthy
within their communities and social media circles.
 The pandemic has revealed and amplified deeply entrenched health, social, and economic
inequities that exist in Canada. The interaction of the social determinants of health in shaping
negative health outcomes and driving health inequities is more evident than ever before.
Communications efforts will need to acknowledge and address the broader health impacts of
this pandemic and consequences of the pandemic response.
 Public opinion research has shown that public trust in messages from the medical and scientific
community is declining. Collaborative or complementary communications approaches, and
consistent messaging across jurisdictions can help to regain public trust.
 Throughout the pandemic response, there has been an increase in the public’s understanding of
public health measures, which can be leveraged in the ongoing fight against COVID-19 as well as
with other future public health events.

Surges in cases requiring adjustments to or re-instatement of community-based measures or
restrictions, along with any changes in science (e.g., new information about COVID-19 that requires a
shift in Canada’s public health response or guidance to specific populations), changes to border
measures, emergence of VOCs, availability of boosters or pediatric vaccines, will all necessitate updating
of the current F/P/T communication strategy and products.
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Appendix 13: Research

The Government of Canada quickly mobilized Canada’s research and scientific communities in response
to the spread of the novel coronavirus (COVID-19). Early in the pandemic, research areas focused on
medical countermeasures (vaccines, therapeutics, and diagnostics), clinical management research,
predictive modelling, as well as social and policy research. Since then, the research focus has expanded
to areas such as mental health and substance use during the pandemic, safety in long-term care homes,
Indigenous communities’ experiences with COVID-19, and variants of concern. Community engagement
is important to ensure culturally appropriate research approaches.
 The Government of Canada established mechanisms for mobilizing rapid research responses for this
type of emergency, which have been activated to accelerate development of medical
countermeasures, to support priority research on the transmission and severity of COVID-19, and to
understand the potential benefits and potential limitations of medical, social and policy
countermeasures (e.g., the COVID Immunity Task Force).
 Within the Canadian Institutes of Health Research (CIHR), the recently created Centre for Research
on Pandemic Preparedness and Health Emergencies, will build on Canada’s research strengths and
continues to grow its capacity to be a leader in preventing, preparing for, responding to, and
recovering from existing and future pandemics and public health emergencies.
 The funding for the Centre for Research on Pandemic Preparedness and Health Emergencies
includes funds for studies on Post-COVID Condition/Long-COVID in Canada.
 Health Canada established and continues to apply a number of temporary innovative and flexible
measures to help prioritize and expedite the regulatory review of COVID-19 health products without
compromising Canada's high standards for safety, efficacy and quality (these measures have been
put in place to facilitate safe and timely access to products Canadians and health care workers
need).
 A wide array of Clinical Trials activities for therapeutics and vaccines are underway under the
Canadian Treatments for COVID-19 (CATCO) trial.
 PHAC has established a pan-Canadian network for wastewater surveillance for SARS-CoV-2 in
collaboration with other federal departments, provincial, territorial and municipal governments and
academia across Canada that lays the foundation for timely detection and surveillance of COVID-19
across the country.
 Several federal programs available aimed at mobilizing industry, innovation and research continue
to respond to COVID-19.
 Networks such as CanCOVID, COVID-END and National Collaborating Centres, have been launched to
facilitate research effort and leverage transdisciplinary knowledge synthesis, translation and
expertise among Canada's scientific, policy, and health communities.
 Capacity at federal research facilities is being leveraged, and federal granting agencies are
strategically aligned to support Canadian research capacity.
 Knowledge on indoor air quality is being mobilized with federal, provincial, territorial and private
sector partners.
 The Canadian private sector (R&D, manufacturing) is engaged in contributing to research and
development solutions.
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 The Government of Canada is also supporting various strategies to bring significant findings arising
from these research efforts to decision-makers in a useful and timely way.
In an earlier version of this Plan, a number of needs had been identified in order to prepare against
surges/resurgences based on the reasonable worst-case scenario. In addition to the activities described
above, work has begun in earnest in several crucial areas.
i. Strengthening our capacity to deliver on relevant COVID-19 modelling work.

 The COVID-19 pandemic has demonstrated the important role and need for greater and
ongoing capacity to implement the full range of modelling tools required to support
decision-making during a complex public heath crisis. Models help to predict where and
when COVID-19 infections may emerge or re-emerge, emergence of new variants of
concern, and they can be used to explore the best combinations of approaches to control
disease progression and protect the health of Canadians, including vaccination. Expert
groups continue their ongoing work on modelling the reproductive number (Rt) over the
course of the pandemic, and are working on modelling several scenarios for de-escalation
strategies, including border reopening and lifting travel restrictions.
ii. Examining and addressing the need to pursue research and surveillance studies aiming at better
understanding mechanisms of infections, transmission and immunity against the SARS-CoV-2 virus.
 F/P/T governments are currently focusing on the investigation and tracking of the genetic
diversity of SARS-CoV-2, across Canada to better respond to its spread, particularly new
variants of concern. However, research is needed to examine the full potential of these
variants in their transmissibility, virulence and vaccine efficacy, and to monitor their
emergence and presence over time. The Government of Canada launched the COVID-19
Immunity Task Force, which engages universities, hospitals and public health officials to use
blood test (serologic) methods to track and study the immune status of various Canadian
populations, and will be used to support vaccine surveillance, safety and efficacy. The need
for research and research coordination with partners to understand transmission dynamics
and impact of non-medical measures (e.g., ventilation, portable air cleaners, etc.) is
beginning to take shape through early aerosol transmission studies in high-risk settings, such
as hospitals, prisons, and long-term care homes. Discussions and work continues with
domestic and international partners to develop COVID-19 animal models and medical
countermeasures.
iii. Strengthening our capacity to coordinate, perform, mobilize and utilize rigorous and rapid evidence
review.
 More experts within and outside of government are being leveraged to generate and
disseminate evidence reviews and answer specific questions to provide the most up-to-date
scientific evidence for optimal decision-making.
iv. Exploring the epidemiological value of new, innovative methods to track community spread, such as
testing SARS-CoV-2 from sewage water.
 Testing wastewater is providing early warning ability at the community level (municipality,
special settings such as Long-Term Care Facilities, prisons, hospitals and remote
communities). With its F/P/T partners, the federal wastewater surveillance program is
further strengthening the network throughout Canada for surveillance of public health
outcomes such as COVID-19.
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 NML is conducting wastewater based metagenomics sequencing of COVID-19 virus for early
identification of VOCs/variants of interest.
v. Examining and addressing the need to pursue research and surveillance studies on COVID-19 at the
human-animal interface, and in particular to enhance our understanding of the possible impact of
new variants, the range of species that can get infected, and how different species may be affected,
carry and transmit the virus.
 While there is limited information on the susceptibility of wildlife to SARS-CoV-2, the virus
has infected multiple animal species globally, including farmed mink, companion animals
(e.g., cats, dogs, ferrets, hamsters), and zoo animals (e.g., tigers, lions, gorillas, cougars,
otters, other).
 Transmission from animals-to-humans has been reported from mink, and recently from
hamsters. Other instances of animal-to-human transmission have been suspected (e.g., big
cat-to-human in a zoo in the US); however, it has been difficult to clearly demonstrate
directionality, given the virus is transmitting so widely in people.
 A collaborative team of scientists, and wildlife and public health experts from across Canada
has recently reported a unique lineage of SARS-CoV-2 in white-tailed deer that also includes
a viral genome from a human case from southwestern Ontario. According to the paper, the
human case had contact with deer prior to contracting COVID-19. This is the first report of
this new SARS-CoV-2 lineage and possible deer-to-human transmission of the virus.
 There is currently no scientific evidence that animals play a large role in the current spread
of COVID-19. However, as the virus continues to evolve and change, the role of animals as a
source of new variants may also change.
 Deer and other cervid species (such as elk and moose) are abundant across the provinces
and territories in Canada. More research is required to understand how widespread the new
lineage is in deer populations, how and if the virus is transmitted between species, and how
this virus differs from existing SARS-CoV-2 lineages in terms of transmission and potential to
cause disease.
vi. Strengthening laboratory capacity in the area of genomic innovation and bioinformatics.
 The Government of Canada has begun to secure investments in this area.
 NML is participating in Genome Canada funded consortium – CanCOGen - for genomic
studies, both host and virus.
vii. Mobilizing knowledge from the social sciences.
 There continues to be a need to invest in and mobilize knowledge relating to social sciences
such as sociology, anthropology and psychology. Specifically behavioural science and ethnic
research can guide future policy and regulatory actions.
Short to Mid term:

In the short to mid term, the approach to these preparations continues to be to:
 work collaboratively with National partners, F/P/T, stakeholders groups, Indigenous partners
(including National Indigenous Organizations; Indigenous researchers and scholars; the National
Collaborating Centres for Public Health), and the Federal Science Community to support the
work of key task groups mandated to support Canada’s COVID-19 response (Immunity Task
Force, the Vaccine Task Force, the Therapeutic Task Group) and Indigenous-led culturally
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grounded research (with appropriate community engagement and cultural safety in

approaches);
 work collaboratively with federal science based departments and agencies with specific targeted
engagement with the CIHR and the Chief Science Advisor of Canada; and
 continue engagement with the COVID-19 Governance Structure (via the Technical Advisory
Committee (TAC), LAC and SAC). Activities include sharing research, data and local experience
that will inform further planning in alignment with our stated public health pandemic goal and
objectives (e.g., quantifying the negative and positive consequences of the PHM that were uses
in the initial response to be better able to address the inequities that have arisen, evidence
generation in the effective and appropriate use of home rapid testing).

Similar to the other COVID-19 response components above, there are several factors that could
potentially impact preparations for the ongoing COVID-19 response, including: a significant shift in
genomic pattern of SARS-CoV2 (leading to examination of possible shift in virulence or infectivity),
significant increases in the mortality ratio, data from vaccine and therapeutic clinical trials, data on
immunological protection of Canadians, new/rigorous knowledge on the impact of COVID-19 specific
high-risk groups, and new/rigorous knowledge of the importance of a non-respiratory mode of
transmission.
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youth-families.pdf?la=en.
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(Oxford, England), 43(3), e462–e481. https://doi.org/10.1093/pubmed/fdab102
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Fiorillo, A., Sampogna, G., Giallonardo, V., Del Vecchio, V., Luciano, M., Albert, U., Carmassi, C., Carrà, G., Cirulli,
F., Dell'Osso, B., Nanni, M. G., Pompili, M., Sani, G., Tortorella, A., & Volpe, U. (2020). Effects of the lockdown on
the mental health of the general population during the COVID-19 pandemic in Italy: Results from the COMET
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“The presence of genetic polymorphisms and pathogenic auto-autoantibodies in severe COVID-19 also suggests
a significant contribution of immune dysregulation to poor outcomes.”
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https://pubmed.ncbi.nlm.nih.gov/34264880/
34
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This is Exhibit “E” referred to in the


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Enhancing response to Omicron SARS-CoV-2 variant:

Technical brief and priority actions for Member States
World Health Organization: Headquarters, Geneva, Switzerland
Update #6: 21 January 2022 (updated from previous version, dated 7 January 2022)
____________________________________________________________________________________________
A. Context
On 26 November 2021, WHO designated the variant B.1.1.529 a variant of concern (VOC) (1), following advice from
the WHO’s Technical Advisory Group on Virus Evolution. The variant was given the name Omicron. Omicron is a
highly divergent variant with a high number of mutations, including 26-32 mutations in the spike protein, some of
which are associated with humoral immune escape potential and higher transmissibility. The Omicron variant
comprises four lineages including B.1.1.529, BA.1, BA.2 and BA.3.
_____________________________________________________________________________________________
B. Key current technical information: executive summary

B.1. Global risk assessment
The overall threat posed by Omicron largely depends on four key questions: (i) how transmissible the variant is;
(ii) how well vaccines and prior infection protect against infection, transmission, clinical disease and death; (iii)
how virulent the variant is compared to other variants; and (iv) how populations understand these dynamics,
perceive risk and follow control measures, including public health and social measures (PHSM).
Based on the currently available evidence, the overall risk related to Omicron remains very high. Omicron has a
significant growth advantage over Delta, leading to rapid spread in the community with higher levels of incidence
than previously seen in this pandemic. Despite a lower risk of severe disease and death following infection than
previous SARS-CoV-2 variants, the very high levels of transmission nevertheless have resulted in significant
increases in hospitalization, continue to pose overwhelming demands on health care systems in most countries,
and may lead to significant morbidity, particularly in vulnerable populations.
B.2. Current evidence summary

This section contains an executive summary of the current best available evidence (as of 20 January 2022)
regarding the potential impact of the Omicron variant. More detailed information is included in Section C.
Impact on epidemiology
• As of 20 January 2022, the Omicron variant had been identified in 171 countries across all six WHO Regions.
• Omicron has a substantial growth advantage over Delta, and it is rapidly replacing Delta globally. There is now
significant evidence that immune evasion contributes to the rapid spread of Omicron, but further research is
needed to better understand the relative contribution of intrinsic increased transmissibility and immune evasion
in explaining transmission dynamics. While the BA.1 lineage has previously been the most dominant, recent
trends from India, South Africa, the United Kingdom, and Denmark suggest that BA.2 is increasing in proportion.
Drivers of transmission and other properties of BA.2 are under investigation but remain unclear to date.
21 January 2022 World Health Organization 1

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• Data on clinical severity of patients infected with Omicron are increasingly available. Epidemiological trends
continue to show a decoupling between incident cases, hospital admissions and deaths, compared to epidemic
waves due to previous variants. This is likely due to a combination of the lower intrinsic severity of Omicron, as
suggested by a number of studies from different settings, and that vaccine effectiveness is more preserved
against severe disease than against infection. However, high levels of hospital and ICU admission are
nevertheless being reported in most countries, given that levels of transmission are higher than ever seen before
during the pandemic. Moreover, more data are needed to better understand how clinical markers of severity –
such as the use of oxygen, mechanical ventilation, and number of deaths are associated with Omicron. This is
particularly important given that current evidence about severity and hospitalization has largely been shared
from countries with high levels of population immunity, and there remains uncertainty about the severity of
Omicron in populations with both lower vaccination coverage and lower prior exposure to other variants.
Impact on diagnostics and testing

• The diagnostic accuracy of routinely used PCR and the WHO emergency use listing (EUL) approved antigen-
detection rapid diagnostic tests (Ag-RDT) assays does not appear to be significantly impacted by Omicron;
studies of the comparative sensitivity of Ag-RDTs are ongoing.
• Most Omicron variant sequences reported include a deletion in the S gene, which can cause an S gene target
failure (SGTF) in some PCR assays. As a growing minority of publicly shared sequences (including all BA.2 sub-
lineage sequences) lack this deletion, using SGTF as proxy marker to screen for Omicron will miss Omicron
lineages lacking this deletion.
Impact on immunity (following infection or vaccination)

• Current evidence consistently shows a reduction in neutralizing titres against Omicron in individuals who have
received a primary vaccination series or in those who have had prior SARS-CoV-2 infection. In addition, increased
risk of reinfection has been reported by South Africa, the United Kingdom, Denmark, and Israel.
• There is a growing body of evidence on vaccine effectiveness (VE) for Omicron, with data available from 15
observational studies from five countries (the United Kingdom, Denmark, Canada, South Africa, and the United
States of America), evaluating four vaccines (mRNA vaccines, Ad26.COV2.S, and AstraZeneca-Vaxzevria).
Available preliminary data should be interpreted with caution because the designs may be subject to selection
bias and the results are based on relatively small numbers. Early data suggest that the effectiveness of studied
vaccines is significantly lower against Omicron infection and symptomatic disease compared to Delta, with
homologous and heterologous booster doses increasing vaccine effectiveness. Despite this, follow-up time after
booster doses for most studies is short, and there is evidence of waning of VE in months following booster doses.
VE estimates against severe outcomes, usually defined as hospitalization, are lower for Omicron than Delta, but
mostly remain greater than 50% after the primary series and improve with a booster dose to above 80%. More
data are needed to assess these preliminary findings across studies, vaccine platforms and dosing regimens.
There are no effectiveness data for several vaccines, particularly the inactivated vaccines.
Impact on host tropism, virus fitness and pathogenicity

• Preliminary evidence suggests a potential shift in tropism of the Omicron variant towards the upper respiratory
tract, as compared to Delta and the wild type (WT) virus that have a tropism for the lower respiratory tract. There
is also evidence of less severe pathogenicity in the Syrian hamster (M. auratus) model, but this needs to be
confirmed by peer-reviewed evidence and larger studies.
Impact on therapeutics and treatments

• Therapeutic interventions for the management of patients with severe or critical Omicron-associated COVID-19
that target host responses (such as corticosteroids, and interleukin-6 receptor blockers) are expected to remain
effective. However, preliminary data from non-peer reviewed publications suggest that some of the monoclonal
antibodies developed against SARS-CoV-2 may have impaired neutralization against Omicron. Monoclonal
antibodies will need to be tested individually for their antigen binding and virus neutralization, and these studies
should be prioritized. Preliminary in vitro data suggests that antivirals retain activity against Omicron.

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B.3. Priority actions for Member States

This section contains an executive summary of the current priority action for Member States. Further details are
included in Section D. These recommended priority actions are based on the current global risk assessment (see
Sections B.1. and C.5.) and the best available evidence (as of 20 January 2022) regarding Omicron.
Surveillance and testing

• PCR-based screening assays (e.g. Single Nucleotide Polymorphism (SNP) genotyping) may be useful proxy
markers of Omicron and should be validated for a given setting.
• SGTF from commercial PCR kits is indicative for most Omicron isolates and may also be considered as a proxy
marker for this variant. However, it should be noted that a minority of Omicron sequences (including all BA.2
lineage) lack the 69-70 deletion, and will therefore be missed by this screening method. An increasing trend in
the proportion of BA.2 is currently being observed in a number of countries, including in Denmark, India and the
United Kingdom, and therefore use of SGTF-based screening should be interpreted with caution. Drivers of
transmission of BA.2 are under investigation but remain unclear to date. PCR-based screening assays (e.g. Single
Nucleotide Polymorphism genotyping) may be useful proxy markers depending on the setting.
• Member States’ initial cases/clusters associated with the Omicron variant infection should be reported to WHO
through the International Health Regulations (IHR) mechanism.
• Member States are further encouraged to report (publicly or through IHR) the weekly relative prevalence of
Omicron as the number of sequences of Omicron (numerator) divided by the total number of sequences generated
through routine surveillance (denominator) and/or, where applicable, the number of PCR-based screening method
positive (genotyping or SGTF) out of the number tested in the same unit of time, according to sampling date.
Vaccination
• Efforts to rapidly accelerate COVID-19 vaccination coverage in at-risk populations in all countries should be
intensified. Particular focus among populations designated as high priority (2) who remain unvaccinated or
whose vaccination remains incomplete should be a priority for vaccination campaigns in all countries. In
accordance with the position of the Strategic Advisory Group of Experts on Immunization (SAGE), the priority
for booster doses is to maintain and optimize vaccine effectiveness against severe disease outcomes, especially
for those at high risk for serious disease.
Infection Prevention and Control

• Health care facilities should have an infection prevention and control (IPC) programme or at least a dedicated
and trained IPC focal point; engineering and environmental controls; administrative controls; standard and
transmission based -precautions; screening and triage for early identification of cases and source control; and
COVID-19 surveillance and vaccination of health workers. In contexts with community transmission, universal
masking by all persons in health facilities, using a well-fitted medical mask, is recommended.
Public health and social measures

• With the emergence of the Omicron variant, physical distancing, the use of well-fitting
masks (in conjugate indoor settings and outdoors when distancing can’t be maintained), ventilation of indoor
spaces, hand hygiene and avoidance of crowds where appropriate PHSM measures are not in place
remain critical to reducing transmission of SARS-CoV-2. Enhanced surveillance with rapid testing, cluster
investigations, contact tracing, isolation of cases and supported quarantine of contacts are strongly advised to
interrupt chains of transmission. WHO continues to advise implementing the comprehensive, multi-layered and
targeted use of public health and social measures to reduce the spread of all variants of SARS-CoV-2.
Contact tracing and Quarantine

• WHO recommends a risk-based, pragmatic approach for Member States to consider when introducing any
changes to existing CT and quarantine measures, taking into account the continuity of the critical functions in
society and the public health risks and benefits in relation to the pandemic. Any curtailing of CT or quarantine
will increase the risk of onward transmission and must be weighed against pragmatic needs.

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• Prioritization for identification and follow-up of contacts should be given to those at highest risk of getting
infected and highest risk of spreading the virus to vulnerable people; and those at highest risk for development
of severe disease. Shortening of quarantine of contacts may be considered, in particular for essential workers,
including health workers, when combined with rigorous application of infection prevention and control and public
health and social measures; and with SARS-CoV-2 testing, when possible.
Travel-related measures
• A risk-based approach to adjust international travel measures in a timely manner is recommended. See WHO
advice for international traffic in relation to the SARS-CoV-2 Omicron variant (3) for additional information.
• Blanket travel bans will not prevent international spread of any variant of SARS-CoV-2, including Omicron, and
can place a heavy burden on lives and livelihoods. In addition, they can adversely impact global health efforts
during a pandemic by disincentivizing countries to report and share epidemiological and sequencing data.
Health system readiness and responsiveness

• WHO asks all Member States to regularly reassess and revise national plans based on their current situation and
national capacities.
• In anticipation of increased COVID-19 caseloads and associated pressure on the health system (many of which
are significantly overburdened after two years of the COVID-19 pandemic), ensure mitigation plans are in place
to maintain essential health services and that necessary health care resources are in place to respond to
potential surges. This would include surge capacity plans for health workers as well as plans for providing
additional practical support to health workers, with particular attention to the needs of mothers and single-
parent families.
• Clinical care of patients with COVID-19, infected with any SARS-CoV-2 variant, should be administered within
health systems according to evidence-based guidelines, such as the WHO living guidelines for clinical
management (4) and therapeutics (5), adapted appropriately for local context and resource settings.
Risk communication and community engagement

• Ensure early warning systems are in place to inform efficient and rational adjustment of public health and social
measures, with effective approaches for engaging affected communities and communicating these adjustments
while anticipating populations’ concerns.
• Authorities should regularly communicate evidence-based information on Omicron and other circulating
variants and potential implications for the public in a timely and transparent manner, including what is known,
what remains unknown and what is being done by responsible authorities. Communication should emphasise
the likelihood that we will learn more and the guidance may change.
• Individuals and communities should be provided with timely, accessible and accurate information about how to
protect themselves and others from Omicron and other variants, with an emphasis on getting fully vaccinated
and continuing to practice protective behaviours to reduce transmission and infection.
B.4. Priority research needed

• Studies are needed to better understand the properties of BA.2, including comparative assessments of BA.2 and
BA.1 for key characteristics such as transmissibility, immune escape and virulence.
• Surveillance should continue to be enhanced, including increasing testing and sequencing efforts to better
understand circulating SARS-CoV-2 variants, including Omicron and its sub-lineages. Where capacity exists,
countries should perform field investigations such as household transmission studies (6), “first few” cases
studies (7), contact follow up, and laboratory assessments, to improve understanding of the epidemiological
characteristics of Omicron in various settings. The epidemiological studies and sequencing of specimens can be
targeted to those with particular individual-level characteristics (e.g. suspected reinfections, clinical
characteristics, immunocompromised patients and selective sequencing of vaccine breakthrough) as well as
regular clusters and super-spreading events.

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• More data, across different countries, are needed to understand how clinical markers of disease severity (such
as oxygen use, mechanical ventilation, deaths) are associated with Omicron, including among unvaccinated
individuals and individuals without prior infection. WHO encourages countries to contribute to the collection
and sharing of hospitalized patient data through the WHO COVID-19 Clinical Data Platform (8).
• The WHO Joint Advisory Group on COVID-19 Therapeutics research agenda (9) has identified urgent
prioritization for more data regarding 1) antigen binding and virus neutralization by antiviral monoclonal
antibodies and 2) characterization of the COVID-19 phenotype caused by infection with the Omicron variant in
a diverse patient population.
• Further research is needed to better understand Omicron’s immune escape potential against vaccine- and
infection-induced immunity, and Omicron-specific responses to vaccines, especially for inactivated vaccines
where no evidence is currently available. The Technical Advisory Group on Vaccine Composition (TAG-Co-VAC)
regularly assesses the need for changes to vaccine composition and has recently issued an interim statement on
COVID-19 vaccines in the context of the circulation of Omicron.
• Where capacity exists and in coordination with the international community, countries and partners are
encouraged to perform studies to improve understanding of transmission parameters; vaccine effectiveness and
impact; mechanisms of protection; disease severity; effectiveness of PHSM against Omicron; diagnostic
methods; immune responses; antibody neutralization; population risk perception, knowledge, attitude and
behaviour towards PHSM, vaccines and tests; or other relevant characteristics. Generic study protocols (10) are
available.
• Further studies that compare the relative sensitivity of diagnostic tests (i.e. antigen-detecting and PCR) to detect
Omicron using clinically-relevant specimens are needed. Studies elucidating the impact of infection history and
vaccine status on the performance of diagnostic tests should also be prioritized.
__________________________________________________________________________________________
C. Current evidence regarding Omicron

This section contains a summary of the current best available evidence (as of 20 January 2022) regarding the
potential impact of the Omicron variant.
C.1. Epidemiology
Incidence
• As of 20 January 2022, the Omicron variant has been identified in 171 countries. The variant has rapidly outpaced
Delta in most countries, driving an upsurge of cases in all regions.
• The case incidence of COVID-19 continues to increase globally with a 20% weekly increase in week 2 (10-16
January 2022) compared to the previous week. However, the global rate of increase does appear slower given
that there was a 55% increase that was reported for week 1 (3-9 January) compared to week 52 (27 December
2021–2 January 2022).
• During week 2, the South-East Asia Region and the Eastern Mediterranean Region reported the highest increases
in case incidence of 145% and 68%, respectively. However, a decrease of 27% was reported in the African Region
following a peak in week 52, 2021.
• The large increase in the South-East Asia Region is mainly driven by the increase in the number of cases in India
which reported 1 594 160 million new cases compared to 638 872 cases the previous week (a 150% increase).
In the Eastern Mediterranean Region, the highest numbers of new cases were reported from Morocco (46 104
vs 31 701 new cases, a 45% increase); Lebanon (45 231 vs 38 112 new cases, a 19% increase) and Tunisia (39 487
vs 13 416 new cases, a 194% increase).
• In the WHO European Region, the increase in weekly case incidence has slowed, with a 10% increase in week 2
compared to 31% in week 1 (2 – 9 January 2022). However, differences within the Region are reported; while a
decline or plateauing is starting to be observed in a few countries in Western Europe, many Eastern European
and Central Asian countries are seeing high growth rates, with the highest increases seen in week 2 in Kazakhstan

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(54 927 vs 6672 new cases in week 1, a 723% increase), Uzbekistan (4744 vs 1223 new cases, a 288% increase)
and Kosovo 1 (2990 vs 842 new cases, a 255% increase).
• The increase in weekly case incidence has also slowed in the WHO Region of the Americas, with a 17% increase
as of 16 January compared to 78% as of 9 January, mainly driven by the decrease in the number of new cases in
the United States of America. However, large increases in case incidence continued to be seen in Central and
South America and the Caribbean and Atlantic Ocean Islands, with the largest increases in cases in week 2
reported in Martinique (13 540 vs 1835 new cases, a 638% increase), El Salvador (1343 vs 289 new cases, a 365%
increase) and Ecuador (42 992 vs 10 532 new cases, a 308% increase).
• In the WHO Western Pacific Region, the rate of increase in case incidence has begun to slow, mainly driven by
the trend in Australia. During week 2 of 2022, an increase of 38% was reported while in week 1, a 122% increase
compared to their previous week was reported.
• In South Africa, where Omicron was first reported and is now the dominant variant, there has been a sustained
decrease in reported cases since the peak was reported in mid-December 2021. Moreover, the decline in the
incidence of cases seen in much of the southern Africa is now starting to be seen in other countries, particularly
those which reported an early introduction of Omicron and rapid replacement of Delta.
Transmission
• Omicron has been found to have a significant growth advantage, higher secondary attack rates and a higher
observed reproduction number compared to Delta.
• An analysis of GISAID data following a previously published methodological approach (11) shows a growth rate
advantage of Omicron over Delta in all countries with sufficient sequence data, translating to a pooled mean
transmission advantage (i.e. relative difference in effective reproduction numbers) of 189% (95% Confidence
Interval: 162% – 217%) across epidemiological contexts under the assumption of an unchanged generation time.
However, early evidence for a reduced generation time of Omicron (12) suggests the transmission advantage
may be lower; for a 20% shorter generation time, the estimated pooled mean transmission advantage of
Omicron over Delta is 163% (139% – 186%) (13–15).
• Household transmission studies further corroborate the transmission advantage of Omicron. For example,
household secondary attack rates for Omicron consistently show higher values compared to Delta: 13.6% (95%
CI: 13.1%-14.1%) vs 10.1% (95% CI: 10.0%-10.2%) in the UK (16), and 31% vs. 21% in Denmark (17).
• The transmission advantage of Omicron appears to be largely driven by immune evasion, but also potential
increased intrinsic transmission fitness (18). While there is significant evidence of immune evasion against
transmission from infection and vaccine-derived immunity (see later sections), more data are needed to better
understand the relative contribution of intrinsic increased transmission fitness and immune evasion in explaining
transmission dynamics.
• There is evidence that the Omicron variant infects human bronchus tissue faster and more efficiently than
Delta (19) and outcompetes Delta in competition experiments using cells derived from the human nose, but not
in lung-derived cells (20). This points at a predominance of viral replication in the upper respiratory tract that
may confer, at least to some extent, a transmission advantage independent of immune evasion.
• Preliminary results from South Africa have suggested that if there is intrinsic higher transmission fitness, it is likely
modest, with some analyses suggesting that immune evasion levels of 25% to 50% could explain the observed growth
advantage, even without an increase in intrinsic transmissibility (21). Another study from South Africa (non-peer
reviewed) estimates that Omicron is 36.5% (95% CI 20.9-60.1) more transmissible than Delta and that Omicron erodes
63.7% (95%CI 52.9-73.9) of the population immunity accumulated from prior infection and vaccination (22).
• Further studies are required to better understand the drivers of transmission, and of declining incidence in
various settings. These factors include the intrinsic transmission fitness properties of the virus, degree of
immune evasion, the level of vaccine-derived and post-infection immunity, levels of social mixing and degree of
application of public health and social measures.
1
All references to Kosovo should be understood to be in the context of the United Nations Security Council resolution 1244 (1999).

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Disease severity
• Globally, there has been a 4% increase in the number of new deaths from in week 2 (10 – 16 January 2022)
compared to the previous week, with highest increases in the South-East Asia Region (12%) and the Region of
the Americas (a 7% increase).
• Data on case severity (including hospitalization, need for oxygen, mechanical ventilation, or deaths) are
increasingly becoming available, improving our understanding of the impact of Omicron on severe cases,
hospitalisation and deaths.
• Surveillance trends from most countries show a decoupling between incident cases and hospitalisations in many
countries, with proportionally lower incidence of hospitalisation, given the level of community transmission,
than what was observed with other variants. This decoupling appears to be driven partially by a lower intrinsic
severity of Omicron compared to Delta (see below), as well as by more preserved vaccine effectiveness against
severe disease than against infection.
• Several studies have looked at the risk of hospitalization and severe disease with Omicron compared to Delta. The
most recent analysis from the United Kingdom Health Security Agency with the Medical Research Council (MRC)
Biostatistics Unit, University of Cambridge showed a 47% reduction in the risk of presentation to emergency care
or hospital admission with Omicron compared to Delta (Hazard Ratio (HR) 0.53, 95%CI 0.50-0.57) and 66%
reduction in the risk of admission from emergency departments (HR 0.33, 95%CI 0.3-0.37) (23). A report by Imperial
College London on 22 December 2021 (24) calculated a 41% (95% CI: 37%-45%) reduced risk of a hospitalization
resulting in a stay of one or more nights. Similarly, using a record linkage approach (25), a study in South Africa
found that laboratory-confirmed SARS-CoV-2 infected individuals with SGTF, as a proxy for Omicron, had lower
odds of severe disease (adjusted odds ratio 0.3, 95% CI 0.2-0.6). In the USA, a recent report from Case Western
Reserve University (26) compared electronic health records from a period of assumed Delta dominance (1
September 2021 to 15 November 2021) to a period of assumed Omicron dominance (15 December 2021 to 24
December 2021). This report found a reduced risk ratio (RR) of emergency department visit (RR 0.30 95% CI 0.28-
0.33), hospital admission (RR 0.44, 95% CI 0.38-0.52), ICU admission (RR 0.33, 95% CI: 0.23-0.48), and ICU admission
(RR: 0.16, 95% CI 0.08-0.32) in the Omicron period when compared to the Delta period. Another study conducted
in the USA (27) reported better clinical outcomes for Omicron compared to Delta, with a 52% (HR 0.48, 95%CI;
0.36-0.64), 53% (HR 0.47 95%CI; 0.35-0.62), 74% (HR 0.26, 95%CI; 0.10-0.73), and 99.1% (HR 0.01, 95%CI; 0.01-
0.75) reductions in risk of any subsequent hospitalization, symptomatic hospitalization associated with COVID-19,
ICU admission, and mortality respectively, for cases infected with the Omicron relative to the Delta variant. In
Canada, preliminary data from cohorts of patients with onset date between 22 November and 25 December 2021
also show a reduced risk of hospitalization and death for Omicron compared to Delta (HR 0.35, 95%CI: 0.26, 0.46)
after adjusting for vaccination status, further suggesting a reduction in intrinsic severity (28).
• Furthermore, using samples from the lower respiratory tract, researchers at Hong Kong University found (29)
that the Omicron variant replicates up to 70 times faster in the human bronchi compared to the Delta variant
and the wild-type SARS-CoV-2 virus. In contrast, the Omicron variant showed relatively much slower replication
in the lung. A similar finding was reported in the United Kingdom where Omicron showed a reduction in
replication kinetics compared to Delta and the original SARS-CoV-2 strain (30). These observations could further
support a reduction in intrinsic severe clinical presentation of patients infected with the Omicron variant.
In terms of symptoms, preliminary data from the United Kingdom show that Omicron infections appear to be
associated with more frequent sore throat than for Delta, and reduction in frequency in loss of smell and taste
(31), although these findings need to be interpreted with caution given increase circulation of other respiratory
viruses, and potential co-infection.
• Nevertheless, despite lower severity, significant increases in hospitalization, severe disease and death are
occurring and likely to continue in the coming weeks, with significant pressure on health services, given the high
incidence levels of community transmission. Moreover, current evidence about severity and hospitalization
comes largely from countries with high levels of population immunity (post-infection and vaccine-derived), and
there remains uncertainty about the severity of Omicron in populations with lower vaccination coverage and
prior exposure to other SARS-CoV-2 variants.

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• Further data are needed from more countries to better understand the full clinical picture of Omicron. WHO
encourages countries to contribute to the collection and sharing of hospitalized patient data through the WHO
COVID-19 Clinical Data Platform (8).
C.2 Host tropism, virus fitness and pathogenicity
• Two studies reported that cleavage efficiency of Omicron is lower than for WT and Delta (19,20), leading to
impaired fusogenicity (particularly in lung tissue) and reduced syncytia formation, which may reduce
pathogenicity (32,33).
• Efficient cleavage of the spike protein is especially important for the virus TMRPRSS-2 dependent entry into
human cells; cells that express TMPRSS-2 are more abundant in the lower respiratory tract, as compared to the
upper respiratory tract (33). The Omicron variant seems to therefore preferentially enter cells via the endosomal
(TMRPSS-2 independent) pathway. This is confirmed by the observation that Omicron replicates less efficiently
(10x) compared to Delta in freshly harvested human lung tissue (19).
• To date, two animal models have been used to assess severity; human ACE2 expressing mice have significantly
less weight loss, recover faster and have less lung pathology when infected with Omicron compared to Delta or
WT (34). A Syrian hamster (M. auratus) model similarly demonstrated weight gain rather than loss in Omicron-
infected animals, as well as substantially reduced pathogenicity indicators compared to Delta or WT, associated
with the poorer capability of Omicron to infect or spread in lung tissue (32).
• Additional studies on Syrian hamsters have yielded similar results, confirming that Omicron-infected animals
show fewer clinical signs and have milder disease (35,36). Viral load in lung tissues is also lower in Omicron-
infected animals compared to Delta or WT in both animal models.
C.3. Impact on diagnostics and testing

Assays
• SARS-CoV-2 infection can be diagnosed using either molecular tests (NAAT, PCR) or antigen-detection assays.
Interim guidance on diagnostic testing for SARS-CoV-2 (37) and on the use of antigen-detection tests can be
found here (38). Negative results should be interpreted within the clinical/epidemiological context.
• PCR tests that include multiple gene targets, as recommended by WHO, are unlikely to be significantly affected
and should continue to be used to detect SARS-CoV-2 infection, including the Omicron variant. This has been
confirmed by statements issued by manufacturers as well as the United States Food and Drug Administration
(US FDA) (39) based on sequence analysis and preliminary laboratory evidence. An overview of the predicted
impact of Omicron on several commercially-available PCR kits can be found here (40) and demonstrates limited
impact.
• The Omicron variant includes four Pango lineages: the parental B.1.1.529 and the descendent lineages BA.1,
BA.2 and BA.3. The BA.1 lineage, which accounts for 97.4% of sequences submitted to GISAID as of 19 January,
and BA.3 (only few dozen sequences), have the 69-70 deletion in the spike protein, while BA.2 does not.
Knowledge of B.1.1.529 is still developing, but this lineage is more diverse, with the 69-70 deletion present in
nearly 80% of all currently available sequences. Presence of the 69-70 deletion in the spike protein causes a
negative signal for the S-gene target in certain PCR assays. This S-gene target failure (SGTF) can be considered
as a marker suggestive of Omicron, but depending on which Omicron lineages are circulating locally, will miss
cases of BA.2 or other isolates lacking the 69-70 deletion. As well, confirmation should be obtained by
sequencing for at least a subset of SGTF samples, because this deletion is also found in other VOCs (e.g. Alpha
and subsets of Gamma and Delta), which are circulating at low levels worldwide.
• Depending on the context, other PCR-based assays are being developed to specifically detect Omicron (41–44)
and may be useful to screen for Omicron.

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• All four WHO emergency use listing (EUL) approved (45) antigen-detection rapid diagnostic tests (Ag-RDTs),
target the nucleocapsid protein of SARS-CoV-2. Omicron has G204R and R203K mutations in the nucleocapsid
protein, which are also present in many other variants currently in circulation. So far, these mutations have not
been reported to affect the accuracy of Ag-RDTs to detect SARS-CoV-2. In addition, Omicron sequences contain
a 3-amino acid deletion at positions 31-33 and the P13L mutation in the nucleocapsid protein. The specific
impact of these mutations on the performance of Ag-RDTs is under investigation.
• Statements from manufacturers indicate that most currently used Ag-RDTs, including three WHO EUL listed
tests, have retained their ability to detect SARS-CoV-2 variants, including Omicron.
• Preliminary data are emerging investigating the sensitivity of Ag-RDTs to detect Omicron: several groups have
demonstrated that dilutions of viral culture of Omicron or of clinical samples are detected by several Ag-RDTs
with similar sensitivity as the wild-type virus or other VOCs (46–51). On the other hand, a recent study suggests
that the analytical sensitivity of seven Ag-RDTs trended slightly lower for detection of Omicron compared to the
wild-type virus or other VOCs and that four Ag-RDTs showed significantly lower sensitivity to detect Omicron
compared to Delta (52). In addition, a recent case report from the United States noted that two Ag-RDTs (using
nasal swabs) failed to detect Omicron cases early (days 0-3) in their disease course despite high viral loads
detected in the saliva (53). More data are needed to better understand if there are any differences in antigen-
based detection of Omicron.
• WHO is assessing the risk posed by Omicron on diagnostics that are EUL approved by reviewing summarized risk
assessments conducted by manufacturers, conducting independent in-silico analysis for NAAT assays and
considering the results of independent laboratory testing using clinical specimens, clinically-derived isolates or
synthetic constructs/recombinant antigen. Any urgent safety information would be communicated by the
manufacturers using field safety notices and/or by WHO via posting a WHO Information Notice for Users here
(54).
• Laboratory personnel are encouraged to report any unusual findings to the manufacturer using this form (55).
This may include increased discrepancies in cycle threshold (Ct) values between different gene targets and
failure to detect specific gene targets, including those containing gene sequences that coincide with
documented mutations or misdiagnosis (for example, false negative results).
• To date, there have been no reported misdiagnoses (false negative results) for any WHO EUL approved
diagnostic product related to Omicron.
C.4. Impact on immunity (following prior infection or vaccination)

• Immune evasion after past infection or vaccination plays a significant role in the rapid growth in Omicron cases
as described in the WHO technical brief published on 23 December 2021 (56).
Re-infection risk (immune evasion following prior infection)
• A meta-analysis from A. Netzl, et al., (57) aggregated all antibody neutralization studies against Omicron datasets
until 22 December 2021. Here, with convalescent sera, the fold drop in neutralisation associated with Omicron
was substantial (20x). This is complicated by the fact that the majority of titres associated with Omicron were
below their individual assays’ limit of detection. Conversely, individuals who were previously infected followed by
two or three doses of vaccine demonstrated a 7-fold reduction. Importantly, almost all samples from third dose
vaccinees were obtained within one month of the last dose administration. Reduction in antibody titers to
Omicron may contribute towards the increased risk for reinfection, as covered previously.
• Multiple datasets on cellular immunity have concluded that 70-80% of CD4+ and CD8+ responses were maintained
for Omicron infection, in those that had been previously infected, and/or had been previously vaccinated (58–62).
Well-preserved cellular immunity to Omicron may assist in protecting against severe disease and death, and likely
underlies the observed reduced risk of hospitalisation for those with reinfection due to the Omicron variant (24).
• The risk of reinfection in England with the Omicron variant was estimated to be 5.4fold 95% CI: 4.87-6.00) higher
in comparison the Delta variant (63). The relative risks were 6.36 (95% CI: 5.23-7.74) and 5.02 (95% CI: 4.47-5.67)
for unvaccinated and vaccinated cases, respectively. This implies that the protection against reinfection by

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Omicron after a past infection may be as low as 19%. A report by UKSHA (46) found that 5.9% of the confirmed
cases between 1 November to 13 December 2021 resulted from reinfection, estimating the relative risk for
reinfection with Omicron at 3.3 (95%CI: 2.8 to 3.8) compared to other variants. A report from the UK Office of
National Statistics found that the risk of reinfection was 16 times higher in the Omicron dominant period (20 Dec
2021 to 8 Jan 2022) than the Delta dominant period (17 May 2021 to 19 Dec 2021) (64). Increased risk of
reinfection was also associated with unvaccinated individuals. In addition, those who were asymptomatic during
their primary infection, or had high Ct values in their primary infection were at a higher risk of reinfection. An
increased trend in reinfection case count was observed in Denmark (65). Similarly, an increase in reinfection cases
classified by vaccination status was also reported by the Israeli ministry of health (66). These estimates are aligned
with previous reports from South Africa that Omicron can evade immunity after infection. Similar trends (67) were
also reported in South Africa in earlier technical briefs. Further definition on reinfection can be found in the
technical brief published on 10 December(56). As of now, there are no data on the risk of reinfection with Omicron
following a prior Omicron infection.
• A pre-print by researchers in Qatar have shown that protection afforded by prior infection in preventing
symptomatic reinfection with Omicron was 56%, a drop from around 90% protection against reinfection with
Alpha, Beta, or Delta (68).
Vaccine effectiveness (immune evasion following vaccination)

• Laboratory data on the immune response to Omicron is rapidly emerging, but most studies are not peer-
reviewed. Most studies report a substantial fall in neutralizing titers against Omicron (8-to-128 fold reductions
compared to the ancestral strain) in sera collected within six months of vaccination (69). Booster doses following
primary series with multiple vaccines increase the geometric mean titers of neutralizing antibodies, but still show
a 2-to-16 fold reduction compared to the ancestral strain. In contrast to findings about the humoral immune
response, CD8+ and CD4+ T cell responses seem to be >80% preserved in the majority of studies (60,70,71).
• As of January 20, there are 14 studies evaluating the vaccine effectiveness from five countries (United Kingdom,
Denmark, Canada, South Africa, USA), evaluating four vaccines (both mRNA vaccines, Ad26.COV2.S, and
AstraZeneca-Vaxzevria). Only one appears in a peer-reviewed publication (72); the others are preprints. Overall,
there is accumulating evidence of lower vaccine effectiveness against infection and symptomatic disease soon
after vaccination compared to Delta. There is also evidence of accelerated waning of VE over time of the primary
series against infection and symptomatic disease for the studied vaccines, with some studies showing no
effectiveness against these outcomes several months after vaccination. Homologous and heterologous booster
doses increase vaccine effectiveness against Omicron, although follow-up time after booster for most studies is
short, precluding a long-term evaluation of waning. VE estimates against severe outcomes, usually defined as
hospitalization, are lower for Omicron than Delta, but mostly remain greater than 50% after the primary series
and improve with a booster dose to over 80%.
• A brief summary of the evidence of vaccine performance against Omicron to date is given below.
Infection/symptomatic disease
United Kingdom
• In England, using a test-negative design, VE for symptomatic infection dropped to under 20% by 20 weeks
after vaccination (completion of the primary series) for Pfizer BioNTech-Comirnaty, Moderna mRNA-1273,
and AstraZeneca-Vaxzevria. An mRNA booster dose for all three vaccines following a primary two dose
series restored VE to >60%, with some evidence of waning of VE by 10 weeks post-booster (73).
• Using a different design than the previously mentioned study, estimates of VE against symptomatic infection
from Omicron were between 0% and 19% following two doses of Pfizer BioNTech-Comirnaty or AstraZeneca-
Vaxzevria, and between 54% and 77% after a booster dose (63).
• In Scotland (74), a third/booster mRNA vaccine dose was associated with a 57% (95% CI 55, 60) reduction in
symptomatic infection relative to ≥25 weeks post second dose (Pfizer BioNTech-Comirnaty, Moderna mRNA-
1273, and AstraZeneca-Vaxzevria), as compared to a relative VE of 88% (95% CI 86,89) for presumed Delta
infection.

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• Another Scottish study found the VE for symptomatic infection a median of five months post-vaccination to
be 5% for AstraZeneca-Vaxzevria and approximately 25% for both mRNA vaccines, with an increase to 59-
64% after an mRNA booster dose (75).
• The SIREN cohort study among health care workers found the VE against any infection for the two mRNA
vaccines and AstraZeneca-Vaxzevria combined was 32% after two doses among those without previous
infection and 60% among those with previous infection, increasing to 62% and 71%, respectively after a
booster dose (31).
Denmark
• A nationwide cohort estimated a VE against infection of 55% (95% CI 24-74%) and 37% (95% CI -70-76%) for
Pfizer BioNTech-Comirnaty and Moderna- mRNA 1273, respectively, in the month after vaccination, with
evidence of waning VE to negligible VE by two to three months. A booster dose among those who received
a primary series of Pfizer BioNTech-Comirnaty was found to restore the VE to 55% in the first month post-
booster.
Canada
• In Ontario, there was negligible VE against infection among recipients of a primary series that included at least
one mRNA vaccine. The VE increased to >40% after an mRNA booster (76). Subsequent analysis with more
cases suggests that confounding bias among early Omicron cases likely lowered early VE estimates.
U.S.A.
• In a study among members of a large health maintenance organization in California, the VE for two doses of the
Moderna mRNA-1273 vaccine was 30% (5%-49%) within three months of full vaccination and dropped to 0% by
6 months (77). The VE increased to 64% (58-90%) within six weeks after a third dose among immunocompetent
persons; the VE was 49% (13%-70%) among persons boosted >6 weeks before. Immunocompromised persons
had negligible VE after a booster dose (VE= 11.5% [0-66.5]).
Severe disease/hospitalization
South Africa
• An insurance company study reported a VE of the Pfizer BioNTech-Comirnaty vaccine of 50-70% against (72)
hospitalization.
• The Sisonke trial of health care workers showed that a second dose of the Janssen-Ad26.COV2.S vaccine had
85% (54-95) VE against hospitalization through two months post-vaccination (78).
• In a cohort study from Western Cape Province that was a case-only analyses (i.e., VE was not calculable), persons
vaccinated with the primary series either Pfizer BioNTech-Comirnaty or Janssen-Ad26.COV2.S vaccine, had a
55% reduced probability to progress from SARS-CoV-2 infection to hospital admission or death, and a 76%
reduced probability to progress to death, than did persons who were unvaccinated (79).
United Kingdom
• Combined data from England/Wales for three vaccines (Pfizer BioNTech-Comirnaty, Moderna mRNA-1273, and
AstraZeneca-Vaxzevria) showed that the VE against hospital admission fell to 44% (95% CI 30-54) by 25 weeks
post-full vaccination, and increased to >80% through 10 weeks after booster vaccination (80). There was
approximately a 70% reduction in progression from symptomatic infection to hospital admission after the
booster dose.
Caution should be used in interpreting vaccine effectiveness studies. Observational studies are inherently subject
to biases, and these biases might be exaggerated when evaluating the early cases of Omicron in a geographic area,
as early cases likely have differences in exposure risk and vaccination status compared to the general population.
While no single study result should be seen as definitive, results across studies, consistency of findings, and trends

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in results are more relevant for drawing conclusions. More such data are needed beyond these early studies to
establish a more complete picture of vaccine performance against Omicron variant.
WHO is closely assessing the impact of the Omicron variant on vaccines through our research and development
network by setting up and coordinating a live repository (81) of reagents to facilitate research focusing on the
understanding of vaccine performance through animal model studies, antibody neutralization activity and cellular
protection. Omicron neutralization and vaccine effectiveness data from studies in preprint or published are
available at View Hub.
C.5. Impact on therapeutics and treatments

1. WHO continues to work with researchers to understand the effectiveness of therapeutics against the Omicron
variant. Interleukin-6 receptor blockers and corticosteroids are expected to remain effective in the management
of patients with severe and critical disease, since they mitigate the host inflammatory response to the virus.
Preliminary in vitro data published in preprints suggests that some of the monoclonal antibodies developed
against SARS-CoV-2 may have decreased neutralization against Omicron (82–85). On 16 December 2021, Roche
issued a statement on diminished potency of casirivimab and imdevimab against Omicron in vitro studies
(2021216_Roche statement on Ronapreve Omicron.pdf) (86). Sotrovimab retained activity against Omicron but
with a 3-fold lower potency in neutralization as measured by EC50 (84).
2. Preliminary in vitro data suggests that antivirals retain activity against Omicron (87–90).
• WHO is working with its experts to prioritize the therapeutics research agenda (9) and collect further data
regarding the efficacy of monoclonal antibodies and antivirals. Urgent prioritization is for 1) antigen binding and
virus neutralization by antiviral monoclonal antibodies and 2) characterization of the COVID-19 phenotype
caused by infection with the Omicron variant in a diverse patient population.
• For the most up-to-date guidelines, see the WHO website on COVID-19 Therapeutics (5).
C.6. Global risk assessment

This Global Risk Assessment is based on the evidence provided (in Sections C.1. - C.4. above), as of 20 January 2022.
The methods for assessing and including evidence in this technical brief are detailed in Annex E.2.
Based on the currently available evidence, the overall risk related to Omicron remains very high. Omicron has a
significant growth advantage over Delta, leading to rapid spread in the community with higher levels of incidence
than previously seen in this pandemic. Despite a lower risk of severe disease and death following infection than
previous SARS-CoV-2 variants, the very high levels of transmission nevertheless result in a significant increases in
hospitalization, continue to pose overwhelming demands on health care systems in most countries, and may lead
to significant morbidity, particularly in vulnerable populations.
__________________________________________________________________________________________
D. Priority actions for Member States

All countries should regularly reassess and revise national plans based on the current situation, public risk
perceptions and national capacities. WHO currently recommends the following priority actions:
D.1. Surveillance
Indicators
• Ensure early warning systems are in place, composed of multiple indicators such as growth (e.g. growth rate,
effective reproduction number), case incidence and test positivity proportion. It is also crucial to monitor
indicators related to disease severity and pressure on health care systems (e.g. bed occupancy of general ward
and intensive care units and health care worker exposure and burnout).
• Where capacity exists and in coordination with the international community, perform studies to improve
understanding of transmission parameters; vaccine effectiveness; severity; effectiveness of public health and

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social measures (PHSM) against Omicron; diagnostic methods; immune responses; antibody neutralization;
population risk perception, knowledge, attitude and behaviour towards PHSM, vaccines and tests; or other
relevant characteristics. Generic study protocols (10) are available. Specimens collected during such
investigations may warrant prioritization for sequencing. The epidemiological studies and sequencing of
specimens can be targeted to those with particular individual-level characteristics (e.g. suspected reinfections,
clinical characteristics, immunocompromised patients and selective sequencing of vaccine breakthrough) as well
as regular clusters and super-spreader events.
• When recording case data, particular attention should be paid to cases’ vaccination status, including dates and
vaccine products; history of previous SARS-CoV-2 infection; symptoms/clinical presentation; and clinical
severity/outcome.
Sampling strategies
3. Countries should continue to undertake targeted sampling of specific populations, as outlined in the guidance
for surveillance of SAR-CoV-2 variants (91) for sequencing.
4. To enhance prospective detection of Omicron, the following should be considered:
o Countries that have not yet detected Omicron should (i) monitor Omicron introduction through targeted
sequencing of suspected Omicron cases (see case definitions in the Annex E.1.), and (ii) detect Omicron
community transmission through enhanced random sampling among SARS-CoV-2 confirmed cases (see
case definitions in the Annex E.1.) in the community.
o In countries with confirmed community transmission of Omicron, emphasis should be put on enhanced
random sampling for sequencing among confirmed cases of SARS-CoV-2 infection in the community (see
case definitions in the Annex E.1.).
• Once evidence from representative sequencing demonstrates that Omicron is the dominant strain circulating,
it can be assumed that SARS-CoV-2 infections detected are most probably due to Omicron. Routine surveillance
should continue to ensure early detection of newly emerging variants.
• Importantly, countries should ensure genomic sequences are reported in a timely manner, including sharing via
databases in the public domain (e.g. GISAID) to facilitate analysis.
• All countries should report the numerator and denominator of Omicron samples detected through sequencing
or PCR screening (e.g. SNP-based assays or SGTF) to allow calculation of the prevalence of circulating Omicron
variant. This can be done through the IHR mechanism, public reporting or direct report sharing with WHO.
• Sampling strategies for detection of Omicron (random or targeted) should be reported adjoining the relative
prevalence reports of Omicron, to permit an understanding of the representativeness of estimates.
• Countries in which sequencing shows that Omicron is the dominant variant, should continue representative and
targeted sequencing to understand which Omicron lineages are circulating and to enable detection of other
potentially emerging variants.
• For further details on surveillance in the context of emerging variants, including sampling strategy, please refer
to WHO guidance for surveillance of SARS-CoV-2 variants Interim guidance 9 August 2021 (91). Additional
guidance is available in ECDC Guidance for representative and targeted genomic SARS-CoV-2 monitoring (92).
D.2. Laboratory testing

Sequencing and PCR-based screening for variants
1. Suspected and probable cases of Omicron infection should be confirmed by sequencing. Both targeted
sequencing of the spike gene (using Sanger sequencing or Next Generation Sequencing) or whole genome
sequencing are appropriate to confirm the presence of Omicron.
2. Reflecting the fact there are many mutations that may be suggestive of Omicron, and that the relative presence
of Omicron sub-lineages or other VOCs including the del69-70 will vary by geography, different PCR-based
methods (e.g. diagnostic tests that include SGTF or other gene target failure, or SNP-detection assays) may be
considered by countries to screen for variants, including Omicron. Of note, the increase in BA.2 in recent weeks,

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which lacks del69-70, must be taken into account when developing such proxy screening strategies.
3. PCR-based screening methods should be validated to reflect the national context and should not be the only
method used for variant surveillance. Results of these assays may be used as a proxy marker of Omicron infection;
samples with gene-target failure or SNP profiles compatible with Omicron should be considered suspected
Omicron infection and prioritized for sequence confirmation.
Testing programs
4. The use of either molecular tests (NAAT, PCR) or antigen-detection assays are both appropriate to diagnose SARS-
CoV-2 infection as per existing Interim guidance on diagnostic testing for SARS-CoV-2 (37) and on the use of
antigen-detection tests here (38). No test is perfect, and negative results should be interpreted within the
clinical/epidemiological context.
5. As part of routine quality assurance, testing programs should document and report any unexpected results,
including using this form (55). This may include increased discrepancies in cycle threshold (Ct) values between
different gene targets; failure to detect specific gene targets, including those containing gene sequences that
coincide with documented mutations; or misdiagnosis (for example, false negative results).
6. WHO recommends that national testing strategies be adaptable to the evolving epidemiological situation,
resource availability and national context including adjusting testing and genomic sequencing capacities in
anticipation of possible surges in testing demand from the community or international travelers (93).
7. It is critical that SARS-CoV-2 testing is linked to public health actions to ensure appropriate clinical and supportive
care, and Public Health and Social Measures.
D.3. Vaccination
Vaccination programs
• Efforts should be intensified by public health authorities to accelerate uptake of COVID-19 vaccination in all
eligible populations but prioritizing individuals at risk (41) for serious disease who remain unvaccinated or whose
vaccination remains incomplete. These include older adults, health care workers and those with underlying
conditions putting them at risk of severe disease and death.
• In accordance with the SAGE review, the priority for booster doses is to maintain and optimize vaccine
effectiveness against severe disease outcomes, especially for those at high risk for serious disease.
• Further research is needed to better understand Omicron’s escape potential against vaccine- and infection-
induced immunity. Research efforts are ongoing, and it is anticipated that additional data will be available in the
coming weeks.
D.4. Public health and social measures (PHSM)

• Crowd avoidance, physical distancing, the use of well fitted masks, ventilation of indoor space, and hand hygiene
remain key to reducing transmission of SARS-CoV-2, especially in the context of emerging variants. Acceptable
mask types for use by the general public include reusable, non-medical masks that comply with standards
(the ASTM F3502 standard or CEN Working Agreement 17553), or disposable medical masks. With reduced
vaccine effectiveness against Omicron, increasing adherence to protective behaviours is essential to reduce
transmission. Risk reduction Policies should be strengthened, and implemented to encourage appropriate
adherence to a comprehensive package of prevention and control measures.
• PHSM may need to be enhanced to further limit interpersonal contact to control transmission with a more
transmissible variant. RCCE activities should be expanded to emphasize the importance of the six protective
behaviours.
• The use of established PHSM in response to individual cases or clusters of cases, including contact tracing,
quarantine of contacts and isolation of cases must continue to be adapted, with community involvement and
input, to the existing epidemiological and social context. This can be most effective when working through
community leaders, civil society and community-based organizations to understand the impacts of PHSM on
different population groups. In this way, practical, relevant and acceptable advice can be provided, and the

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secondary impacts of restrictive measures can be better anticipated and mitigated.

• Guided by risk assessment, and considering the epidemiological situation, response capacities, vaccination
coverage and public behaviours, knowledge and perceptions (as well as uncertainties related to the rapidly
evolving situation of Omicron), countries should be ready to escalate PHSM in a timely manner to avoid
overwhelming demands on health care services.
• For further guidance on risk-based calibration of PHSM, please see WHO’s interim guidance (94).
D.5. Infection prevention and control (IPC)

• Health facilities should have an IPC programme or at least a dedicated and trained IPC focal point, engineering
and environmental control, administrative controls, standard and transmission based -precautions, screening
and triage for early identification of cases and source control, and COVID-19 surveillance and vaccination of
health workers (95).
• Health facilities should continue to adhere to and strengthen key WHO-recommended IPC measures, in
particular, adhering to respiratory etiquette and hand hygiene best practices, contact, droplet and airborne
precautions, adequate environmental cleaning and disinfection; ensuring adequate ventilation; isolation
facilities of COVID-19 patients; in addition, where possible, maintaining a physical distance among all individuals
in health facilities of at least 1 meter (increasing it whenever feasible), especially in indoor settings.
• In areas of known or suspected community or cluster SARS-CoV-2 transmission, masking by all health workers,
including community health workers and caregivers, other staff, visitors, outpatients and service providers using
a well-fitted medical mask, is strongly recommended at all times. This is important in all contexts, including
where caring for non-COVID-19 patients, and in any common area (e.g., cafeteria, staff rooms). In areas with
known or suspected sporadic transmission, targeted continuous medical mask use is recommended in health
facilities.
• Either a respirator or a medical mask should be used by health workers when caring for a suspected or confirmed
COVID-19 patient (96). Additionally, all health workers should wear a respirator in the following circumstances:
• When ventilation is known to be poor or cannot be assessed or the ventilation system is not properly
maintained
• Based on health workers’ values and preferences and on their perception of what offers the highest
protection possible to prevent SARS-CoV-2 infection.
• A respirator should always be worn along with other PPE (gloves, gowns, eye protection) by health workers
performing aerosol-generating procedures (AGPs) and by health workers on duty in settings where AGPs are
regularly performed on patients with suspected or confirmed COVID-19, such as intensive care units, semi-
intensive care units or emergency departments
• Appropriate mask fitting should always be ensured (for respirators through initial fit testing and seal check and
for medical masks through methods to reduce air leakage around the mask) as should compliance with
appropriate use of PPE and other precautions (96).
D.6. Contact tracing and quarantine in a high caseload environment in the context of Omicron
• The available scientific evidence around contact tracing (CT) and quarantine measures for Omicron is currently
limited . WHO therefore continues to recommend a risk-based, pragmatic approach for Member States to
consider when introducing any changes to existing CT and quarantine measures, taking into account the
continuity of the critical functions in society and the public health risks and benefits in relation to the pandemic.
• Any curtailing of CT or shortening of the duration of quarantine will increase the risk of onward transmission and
must be weighed against healthcare capacity, population immunity, and socio-economic priorities.

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Prioritizing contact tracing in a high caseload environment
• WHO recognizes that in scenarios in which case numbers are high, it may not be possible to identify, monitor
and quarantine all contacts. Prioritization for identification and follow-up of contacts should therefore be
given to:
• contacts at highest risk of getting infected and highest risk of spreading the virus to vulnerable
people, health and care staff, particularly those working in nursing homes long-term care facilities
and hospitals; and other frontline essential workers
• contacts at highest risk for developing severe disease: people with co-morbidities, the
immunocompromised, the elderly, and unvaccinated adults with no known prior SARS-CoV-2
infection
• When a contact develops COVID-19 symptoms, they should be considered as a suspected case of COVID-19
and, as such, a referral pathway to testing should be available and recommended as per existing guidance
(93). In resource-constrained settings and/or when testing capacity is limited and thus, testing of all
symptomatic contacts is not possible, highest-risk contacts should be prioritized, as above (93)
Quarantine in a high caseload environment
• When the number of cases and the number of identified contacts requiring quarantine are high and
impacting essential societal functions, changes to the duration of the quarantine period (the current WHO
recommendation is 14 days) may be considered. However, they need to recognize that changes will have
risks and benefits. These changes should always be combined with rigorous application of infection
prevention and control and public health and social measures, and with an adequate testing strategy based
on RT-PCR or Rapid Antigen Test, when possible.
• When rapid and accurate testing is available and as a measure to exit quarantine earlier, modelling and
observational studies based on data for previous variants (97–100) have shown that quarantine maybe
shortened, if the contact has no symptoms and presents a negative PCR or antigen test, performed in an
accredited laboratory or by a qualified professional, at the end of the shortened quarantine period. WHO
does not recommend self-administered antigen tests to shorten quarantine.
• Where testing to shorten quarantine is not possible, the absence of symptom development after a certain
number of days can be used as a proxy. For example, the post-quarantine transmission risk for 10 days
quarantine (based on pre-Omicron data) is estimated to be around 1%, with an upper limit of about 10%
(100).
• If the quarantine period is shortened WHO recommends individuals to continue to wear a well-fitted mask
at all times, during all indoor and outdoor activities where interaction with other people may occur, along
with other infection prevention and control measures including physical distancing, appropriate ventilation
of indoor spaces, and hand hygiene for the remainder of the total 14 days. These individuals should also
continue to carefully self-monitor for symptoms, and seek testing if symptoms arise.
D.5. International travel-related measures

• National authorities should lift or ease international traffic bans, as they do not provide added value and continue
to contribute to the economic and social stress in countries. The failure of travel bans introduced after the
detection and reporting of the Omicron variant to limit the international spread of Omicron demonstrates the
ineffectiveness of such measures over time. Blanket travel bans will not prevent international spread and can
place a heavy burden on lives and livelihoods. In addition, they can adversely impact global health efforts during
a pandemic by disincentivizing countries to report and share epidemiological and sequencing data (3).

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• National authorities should continue to apply an evidence-informed and risk-based approach when implementing
international travel measures in accordance with the statement from the 10th meeting of the IHR Emergency
Committee and WHO’s interim guidance published in July 2021 (101).
• National authorities may apply a multi-layered risk mitigation approach to potentially delay the exportation or
importation of the new variant, including via the use of entry/exit screening, testing or quarantine of travellers.
These measures should be informed by a risk assessment process and be commensurate with the risk, time-
limited, and applied with respect to travellers’ dignity, human rights and fundamental freedoms.
• All travellers should remain vigilant for signs and symptoms of COVID-19, get vaccinated when it is their turn and
adhere to public health and social measures at all times.
D.6. Health system readiness and responsiveness

• As part of preparedness activities while studies are ongoing to better understand the phenotypic characteristics
of Omicron, and in the anticipation of possible increase in COVID-19 case-load and associated pressure on the
health system, countries are advised to ensure mitigation plans are in place to maintain essential health services
(102) and that necessary resources are in place to respond to potential surges.
• Tools such as the COVID-19 Essential Supplies Forecasting Tool (103) are available for use to estimate needs in
personal protective equipment (PPE), diagnostics, oxygen and therapeutics. Training and re-training of
workforce with standardized materials (https://openwho.org/) (104) should be continued on the COVID-19 care
pathways (Living guidance for clinical management of COVID-19 (who.int)) (5).
• Clinical care of patients with COVID-19, caused by any variant version, should be administered within health
systems according to evidence-based guidelines, such as the WHO living guidelines for clinical management (4)
and therapeutics (5), adapted appropriately for local context and resource settings.
• Protecting health workers remains a priority, including by training (or refreshers) for health workers on infection,
prevention, and control (https://openwho.org/courses/ipc-health-workers), as well as appropriate respiratory
protection equipment, in light of Omicron (95,96).
D.7. Risk communication and community engagement (RCCE)

• National all-hazard or COVID-19 specific RCCE plans and activities should be updated to incorporate changing
needs in light of Omicron, in the context of the broader pandemic response.
• RCCE activities in response to Omicron should be well coordinated between partners.
• Authorities should communicate information related to Omicron and potential implications for individuals and
communities in a timely, transparent, empathetic and accessible manner to maintain and strengthen trust and
increase acceptance of response measures and authorities. Targeted communication and engagement should be
designed for high-risk individuals and communities who may not perceive the nuanced risks of Omicron or who
may be more at risk (e.g., people who are older, who have existing health conditions or who have not been
vaccinated, minority groups, those in fragile, conflict and violent states etc.).
• One of the most important and effective interventions in the public health response to any event is to maintain
trust and credibility by proactively communicating with the population what is known, what is unknown and what
is being done by responsible authorities to reduce risk. All RCCE efforts related to Omicron should emphasise that
the scientific evidence is growing and recommendations may change.
• Listening to community perceptions through online or offline methods and socio-behavioural surveys and
analysing this data are key to responding with effective communication and engagement interventions. This
should be done in an ongoing manner, with RCCE and other public health interventions being iteratively adapted
based on findings. Social and behavioural data should be a key component of multi-source surveillance systems.
• RCCE plans, strategies and activities should be targeted to specific populations based on social, cultural,
behavioural, demographic and environmental data to encourage vaccine uptake and adherence to protective
measures by all individuals and communities, including among individuals who are fully vaccinated who may
perceive the risk to be lower.

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• COVID-19 information overload and misinformation should be managed at all stages of the response by providing
the right information at the right time to the right people through trusted channels (e.g., community and faith
leaders, health workers and other influential members of society who are well respected by the target audience).
There should be an information monitoring system in place to capture emerging trends, rumours and
misinformation to enable delivery of a targeted communication package.
• Two way communication systems should be established or existing platforms utilized to facilitate community
dialogue and incorporate community voices in the design and implementation of the response.
• When PHSM are adjusted, communities should be fully and regularly informed, engaged and enabled before
changes are made. Clear, concise and transparent risk communication, including an evidence-based rationale for
adjusting measures, should be developed with communities targeted for PHSM and explained consistently
through several information sources that communities regularly use (e.g. local radio, hotlines, community
networks). Communicating the benefits of these measures and framing the protective behaviours as a series of
choices versus directive messages will enhance uptake.
• RCCE activities should emphasise the continued importance of getting fully vaccinated and of continuing to
practice the protective behaviours (avoiding crowds, keeping a safe distance, wearing a well-fitting mask, keeping
indoor spaces well ventilated, cleaning hands regularly and covering coughs and sneezes).
___________________________________________________________________________________________
Acknowledgement
The first version of the document was based on the SEARO technical brief and priority action on Omicron V2.1
developed with contribution of various staff members of WHO Regional Office for the South-East Asia Region and
WHO India Country Office.
WHO thanks the countless public health professionals, officers, health and care workers, academics and
researcher, experts and others who are working to support the ongoing efforts to better understand Omicron.
___________________________________________________________________________________________

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E. Annexes
E.1. Working definitions
(Interim) Omicron-specific case definitions

Suspected case of SARS-CoV-2 Omicron variant infection
• Confirmed COVID-19 case, irrespective of symptoms (as per current WHO case definition) (105), who is a contact
(as per WHO contact definition) (106) of a probable or confirmed Omicron case.
• Confirmed COVID-19 case (as per current WHO case definition) , residing in or travelling from an area with
detection of Omicron anytime within the 14 days prior to symptom onset., residing in or travelling from an area
with detection of Omicron anytime within the 14 days prior to symptom onset.
Probable case of SARS-CoV-2 Omicron variant infection

• Confirmed COVID-19 case positive for S-gene Target Failure (SGTF) or a PCR-based SNP-detection assay
suggestive of Omicron.
Note: the target deletions/mutations may not be unique to Omicron and may be missing from certain minority Omicron sequences. Samples tested through
these methods should therefore be confirmed through sequencing.
Confirmed case of SARS-CoV-2 Omicron variant infection

• A person with a confirmed sequencing result for SARS-CoV-2 Omicron (can be through targeted spike or whole
genome sequencing).
Note: Clinical and public health judgment should determine the need for further investigation in patients who do not strictly meet clinical or epidemiological
criteria. Surveillance case definitions should not be used as the sole basis for guiding clinical management.
SARS-CoV-2 reinfection case definitions

Suspected reinfection case
• Confirmed or probable COVID-19 case (as per current WHO case definition)(105), with a history of a primary
confirmed or probable COVID-19 infection, with at least 90 days between the episodes.
Probable reinfection case

• Positive RT-qPCR testing results for both episodes or equivalent positive antigen tests fitting the WHO case
definition with episodes occurring at least 90 days apart, based on the sampling date. Alternatively, genomic
evidence for the second episode is available and includes lineage that was not submitted to SARS-Cov-2 genomic
databases at the time of first infection.
Reinfection confirmed by sequencing

• Samples available for both primary and secondary episodes allowing for full genomic sequencing, whereby
samples must be shown to be phylogenetically distinct from one another. Evidence should be generated at
clade/lineage, as defined by genomic classification of SARS-CoV-2 between the first and second infection. If
evidence of different clades is demonstrated in episodes less than 90 days apart, this also constitutes evidence
of confirmed reinfection. If there are more than two nucleotide differences for every month separating the
samples between the sequences for first and second infections, i.e. exceeding the expected single nucleotide
variation, these would be considered as different lineages/clades. The 90-day cut-off should ideally be
determined between onset dates (for probable cases), or sampling dates (for confirmed cases) of primary and
secondary episodes.

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Vaccine breakthrough definitions

Vaccines should be authorized by a stringent regulatory authority or listed under WHO Emergency Use Listing.
Cases and infections are expected in vaccinated persons, albeit in a small and predictable proportion, in relation to
vaccine efficacy values. The following definitions should be used to characterize infections and cases in vaccinated
persons:
• Asymptomatic breakthrough infection: detection of SARS-CoV-2 RNA or antigen in a respiratory specimen
collected from a person without COVID-19-like symptoms ≥ 14 days after they have completed all recommended
doses of the vaccine series.
• Symptomatic breakthrough case: detection of SARS-CoV-2 RNA or antigen in a respiratory specimen collected
from a person with COVID-19-like symptoms ≥ 14 days after they have completed all recommended doses of
the vaccine series.
Note: The mention of specific companies or of certain manufacturers' products does not imply that they are endorsed or recommended by WHO in preference
to others of a similar nature that are not mentioned. Apart from limited exceptions, the names of proprietary products are distinguished by initial capital
letters.
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AR05396
TAB 31
AR05397

FEDERAL COURT
BETWEEN:
NABIL BEN NAOUM
Demandeur
et
Défendeur

AND BETWEEN:
Demandeur
et
Défendeur

AND BETWEEN:
AND AEDAN MACDONALD
Applicants
and
Respondent
AR05398

AND BETWEEN:
Applicants
and
Respondent
AFFIDAVIT OF DONNA CAIRNS

Fax: (204) 983-3636

Tel:
Email:

AR05399

FEDERAL COURT
BETWEEN:
NABIL BEN NAOUM
Demandeur
et
Défendeur

AND BETWEEN:
Demandeur
et
Défendeur

AND BETWEEN:
AND AEDAN MACDONALD
Applicants
and
Respondent
AR05400

AND BETWEEN:
Applicants
and
Respondent
AFFIDAVIT OF DONNA CAIRNS
I, Donna Cairns, of the City of Winnipeg, in the Province of Manitoba, SOLEMNLY

AFFIRM THAT:
1. I am an acting junior paralegal in the employ of the Department of Justice Canada and in
this capacity I am assisting Sharlene Telles-Langdon, Counsel for the Attorney General of Canada,
in these matters. As such, I have personal knowledge of the matters hereinafter deposed to by me,
except where they are stated to be based upon information and belief, in which case I believe them
to be true.
2. On Tuesday, May 10, 2022, Sharlene Telles-Langdon provided me with the link
https://www.americaoutloud.com/who-we-are/ and requested that I turn this description into a
document for use for the cross-examination of Dr. Peter McCullough. This examination was
scheduled for Wednesday, May 11, 2022.
3. Following this request, I clicked on the link provided to access the web page. My default
web browser for opening such links is Microsoft Edge. I then chose the Print function from the
browser options and used Foxit Phantom PDF Printer to create a PDF copy of the web page. The
PDF created from this option, however, was not legible as there was overlapping of text. I did not
save a copy of this document on May 10, 2022. Attached and marked as Exhibit “A” to this
affidavit, is a PDF document I created on May 15, 2022, following this process that reflects the
same issue with the overlapping text.
4. My next step was to go back to the web page opened in Microsoft Edge and attempt to
create a PDF by clicking on the browser option “Web Capture” and then choosing “Capture Full
2
AR05401
Page”. I then used the “Save” option available and this opened a Download option to open the
file. I clicked on this and the file opened as a .jpeg file in Microsoft Paint. From here, I created a
PDF document by choosing Print to FoxIt PhantomPDF Printer. This version of the document,
however, was not readable as it created a very small version of the web page that was not readable
even when trying to zoom within the PDF. I did not save a copy of this document on May 10,
2022. Attached and marked as Exhibit “B” to this affidavit, is a PDF document I created on May
15, 2022 following this process and that reflects the same issue with unreadable small image.
5. My next step was to return to the web page opened in Microsoft Edge. I used the browser
“Web Capture” option and then used the “Capture Area” option. After trying a few different area
captures, I decided to capture the web page content in two sections as I believed this would allow
for the best image transfer for legibility. The first capture included the image of “The America
Out Loud Story” with the content below this from the paragraph starting at “So what is America
Out Loud?” to and including the content until the end of “America Out Loud – Liberty and Justice
for All!” I then scrolled down the web page to capture the content under “Malcolm Out Loud”.
This capture included the banner information “Home, Our Team, Shows, Schedule, Who We Are,
Contact, Newsletter, Search” as well as the content from the heading “Malcolm Out Loud” to and
including the paragraph ending in “His voice is a clarion call for reason and truth.” After each of
the two Capture Area selections, I pasted these into a Word document. I then added the link to the
web page Who We Are - America Out Loud to the footer section in the Word document in order
to have this citation in the document. I then used the Save As function in Microsoft Word to save
this as a PDF document. I did not save a copy of the Word document. Attached and marked as
Exhibit “C” to this affidavit, is the PDF document I created on May 10, 2022.
6. On May 10, 2022, I advised Sharlene Telles-Langdon that the document she requested,
being Exhibit “C” to this affidavit, was available for her use in our document database.
7. On May 12, 2022, I received an email from Keith Wilson, counsel for the Applicants in
matter T-168-22. In the email, Keith Wilson advised that Dr. Peter McCullough’s response is
“No” to the undertaking question “Is the content of pdf document the same as what appears on
‘America Out Loud, Who We Are’ webpage?”
3
AR05402
8. Following receipt of this answer from Keith Wilson, I compared the document I created as
Exhibit “C” to this affidavit to the web page link provided to me by Sharlene Telles-Langdon on
May 10, 2022. I then advised Sharlene Telles-Langdon that I completed the comparison and that
the text of the document I captured and used to create the document attached as Exhibit “C” to this
affidavit are identical with those as set out on the web page https://www.americaoutloud.com/who-
we-are/ at this time.
9. I acknowledge that by using the Capture Area function of the web browser to create the
document attached to this affidavit as Exhibit “C” that this does not include all of the information
as it would be viewed on the web page but only those items that I selected. For example, the date,
ads, links to other documents, websites and articles that are viewable on the web page were not
captured in the document I prepared.

in the City of Winnipeg, in the Province of
Manitoba, this 16th day of May, 2022.
DONNA CAIRNS

means in the City of Montreal, in the
Province of Québec, this 16th day of May,
2022.

for outside Québec
4
AR05403

Affidavit of Donna Cairns
in the City of Montreal, in the Province of Québec,
this 16th day of May, 2022.

AR05404
LIBERTY AND JUSTICE FOR ALL
May 15, 2022
America Out Loud began in April of 2i(l~~fltf brilliant idea of Malcolm, the network's
Founder, President, CEO, a~¥Jiffle8fl(!8ffitt,r'ffflil8~ America Out Loud has evolved
inCJ>lJ'~trtdn~~k-4Jol~af~ctomd~<tQl§>1~!i~~,db\d•Mlllt~~~d
facts, opinions, analyses, and truer-than-life stories voiced through the magic of talk
. d . d. 1 pm ET
ra d 10 an prmt me 1a. Th e p nsm. of A menca. ,s Ed uca t·10n
Who are the 1l\nPH8\R~J?8~J~~ffi~ri?£~8ll'i¥6~ir~t?Ml?~ are a diverse

army of citizen patriots from all walkiqfrH~ith thousands of years of rich and
detailed life experiences. We-ato ~Qflo@BbiAOpffl;tScientists, authors, speakers, radio
hosts, writerspWUia~~Ji~$(:IW~littu~~mih driven by an
unquenchable curiosity about all things American. Critically, we're Americans willing to
research the issues and events of the day and to say what must be said to keep us all
informed of the evil politics and mach11Rmiifs of the Marxist Left.
Viewpoint This Sunday
t
AR05405
May 15, 2022

platform to bring new energy and authenticity to talk radio and
website journalism.
Malcolm is a speaker, author, and the creator of "Brink Thinking:' His previous career in
marketing and as creative director of television and radio advertising spanned over two
Find out more about D,~ fending t!ie ~~pyblic, as hlearp.onhViewppjntfThis Su.n(fay with Sidney
decades. He was l\nown as t, ,e 'big idea cata yst m t e world o advert1smg and
Powel.
marketing, working his magic in corporate boardrooms throughout America. Then, in
June 2010, he made the leap to the radio mic.
Malcolm launched America Out Loud in April 2016 as a new voice in the talk radio
Biden Uc;\WJ;a§:iQ~ntlvS¥~Y,'1f~WbWJ.\Q driving force behind America Out
by Peter~AiD1\)10:h~t Bf-iggimost insightful programming and online journalism
Please t~~~9 tR@~msJ~·this existential threat to everything free people hold dear. Do
everything in your power to pass this report on to others and to find ways to communicate with and
to influence people to stop empowering WHO to take over our...
t
AR05406
May 15, 2022
Christians should be sou1

Dr. Steve LaTulippe
Unity Without Compromise
Listen live ►
Listen on iHeart Radio

or our Media Player
Sunday Talk
Noon ET
Unity Without Compromise
Christians should be sounding the alarm as never before w/ Dr. Steven LaTulippe
t
AR05407
May 15, 2022
t
AR05408
May 15, 2022
t
AR05409
May 15, 2022
The Data Didn't Lie ... People Did.

The Case of the Diaper Rash Goes all the way to the Supreme Court
We The People Deserve and Demand Answers on the biggest scam in history, COVID-19.
by Paul Engel
What would you do to defend your home? Would you stand your ground when law enforcement,
t
AR05410
May 15, 2022
Notables
The Ministry of Truth is a Bucket of Lies
by Dr. Joel S. Holmes
ffh~Nftfiffi.t~~~Pi9Mr'affif¥IfMr· ~~fiffittmLPRhfme~ new Ministry of

Truth actually works, I'm speaking of. When the Biden administration talked about a new
~ lsMfcY~lion Governance Board" and that Ms. TikTok herself, Nina Jankowicz, would ...
President Joe Biden boasted to a staged throng of dozens assembled for his Earth Day speech th;
t
AR05411
May 15, 2022
The Biptdntllefili11ptnj{Mml.U.PcrH<lninw~ronM1cointt
by 0rl.61s,uulnie Coxon
\Mttnltlwm:tlaC!f~Clhs i:nldeflmliwous aD'flbsfrWdilidtfeimpm~ i,gl'mrrlabeetimr1!'em2iflt, t
AR05412
May 15, 2022
Dnp:rwuhink~thwltaw~dWndmiDtlslltt-midf Here!
by Watt,98elliarneau
~emddnia.toEBBitlsa\haiistimEili>SBmla~tlbherigmdldtettEifil&~rlobtedtfi:be ismmiaimltlfihiv~brthr t
AR05413
May 15, 2022
The Right to Refuse Any Medical Procedure, Treatment, or Vaccine

by Dr. Stephanie Coxon
If the last two years have shown us anything, it's the importance of keeping our liberties even if
t
AR05414
May 15, 2022
Stop Waiting for the New World Order to Arrive. It's Already Here!
by Wallace Garneau
I often hear - and have at times said - that the hard left is crazy, but while some in the hard left m2
t
AR05415
May 15, 2022
Vaccine Injury, Long COVID, Nasal Rinse and Q & A 19 on America Out
Loud PULSE
t
AR05416
May 15, 2022
t
AR05417
May 15, 2022
Vaccine Injury, Long COVID, Nasal Rinse and Q & A 19 on America Out
Loud PULSE
t
AR05418
May 15, 2022
t
AR05419
May 15, 2022
Dilute Povidone-Iodine Nasal/Oral Washes for the Prevention and

t
AR05420
May 15, 2022
t
AR05421
May 15, 2022
Dilute Povidone-Iodine Nasal/Oral Washes for the Prevention and

t
AR05422
May 15, 2022
Risks of Vaccines for Those Recovered from COVID-19 - Krammer, Raw &
Mathioudakis
t
AR05423
May 15, 2022
t
AR05424
May 15, 2022
World Economic Forum must be commended, in a nefarious kind of way, for its great efforts to seize
the opportunity of the pandemic to introduce the Great Reset. But...
W.s!~.,.9(~~c;~nes..for Thos.e.Recovered frmn.COVIIl-J..<> - Krammer, Raw &

M5mru-dlfiilUY. - Kignts to Treatment anel Misplaced uata
t
AR05425
May 15, 2022
While POTUS Biden deflects the blame for the highest inflation rate in 40 years, Americans are
genuinely suffering regardless of their political persuasion. The costs for everything are up, from gas
to utilities, food, and new and used cars to travel. Americans who ...
t
AR05426
May 15, 2022
What YOU Should Do Now About the WHO Takeover

by Peter Breggin MD and Ginger Ross Breggin
The independence and authority of every nation, including the United States, and the sovereignty of
every state in the U.S., is being handed to the globalists. Specifically, the healthcare infrastructure
and actions of every country, every state, and every county will...
Take a Look at the Positive Side of Anarchy

by Dr. Steve LaTulippe
Only the dimmest of minds cannot see how the world is rapidly sliding into a lawless free-for-all. The
World Economic Forum must be commended, in a nefarious kind of way, for its great efforts to seize
the opportunity of the pandemic to introduce the Great Reset. But. ..
Mental Health - Rights to Treatment and Misplaced Data

t
AR05427
May 15, 2022
It's a LONG-HAUL with COVID-19

by Dr. Peter McCullough
Now that the epidemic curves have subsided substantially, and rates of hospitalization and death are
considerably reduced, the large bulge of Omicron outbreak cases are now experiencing COVI D-19
long-hauler syndrome or long-COVID or post-COVID syndromes {synonyms) ....
Inflation is Destroying the American Way of Life

by Dr. Ron and Linda Martinelli
While POTUS Biden deflects the blame for the highest inflation rate in 40 years, Americans are
genuinely suffering regardless of their political persuasion. The costs for everything are up, from gas
to utilities, food, and new and used cars to travel. Americans who ...
t
AR05428
May 15, 2022
t
AR05429


AR05430
-
■
AR05431


AR05432
So what ls America Out Loud? America Out Loud is exactly what It sounds like It is - It's American pat lots that
are Out Loud in their love of our constitution and ou way of life. It's Americans that are Out Loud on every
imaginable topic of concern to We The People. These are Americans who understand the threats facing
America and refuse to remain silent.
America Out Loud began in April of 2016 as a brilliant idea of Malcolm, the network's Founder, President,
CEO, and daily clarion voice. Today, America Out loud has evolved into an Americ n values media colossus,
bringing you unbridled and unadulterated facts, opinions, analyses, and truer-than-life stories voiced through
the magic of talk radio and print media.
Who are the Americans who comprise America Out Loud? In short, we are a diverse army of citizen patriots
from all walks of life with thousands of years of rich and detailed life experiences. We are doctors, engineers,
scientists, authors, speakers, radio hosts, writers, we are morns and dads. We are vib ant men and women
driven by an unquenchable curiosity about all things American. Critically, we're Americans willing to research
the issues and events of the day and to say what must be said to keep us all informed of the evil politics and
machinations of the M rxist Left.
Think of us as the voice of a nation, as minutemen and women soldiers, always watching, reporting and
analyzing every Constitutional and cultural threat against America First. We stand for our flag. We are
unabashedly proud to be Americans. And with our First and Second Amendment rights. we will defend
American exceptional ism against all enemies or detractors. We are the Paul Revere of Patriotic Media.
Never before has our American cultural, economic, spiritual, and politkal fabric been more threadbare. The
America most of us have grown up with and love is under a relentless and pernicious siege from those carrying
the banners of corrosive Socialism, Communism, and Marxism. America Out Loud is the antidote to these
poison "isms! " We believe to be forewarned is to b forearmed. And we do more than Inform you; we detail
why it's vital to your future and that of your family.
I challenge you to find a broader array of voices, a deeper bench of experience, o a more dedicated collection
of passionate patriots than here on America Out Loud.
American Out Loud - Liberty and Justice for All!
Who We Are - America Out Loud

AR05433
Home OUrTeam Shows Schedule Who We Are Contact Newsletter Search p
Malcolm is the passion and driving force behind America Out Loud. He created America
Out Loud Talk Radio and the America Out Loud platform to bring new nergy nd
authenticity to talk r dio and website journalism.
Malcolm Is a speaker, author, and the create of "Brink Thinking: His previous ea eer In
marketing and as creative directo of television and adio advertising spanned over two decades. He was
known as the 'big idea catalyst' in the world of advertising and marke ing working his magic in corporate
boardrooms throughout America. Then, in June 2010, h made the leap to the radio mic.
Malcolm launched America Out loud in April 2016 as a new voice In the talk radio world. For the past five
yea s, Malcolm has been the driving force behind America Out Loud's growth, bringing some of th most
insightful programming and online journalism available on the web today.
As a daily voice on the America Out Loud Talk Radio airwaves, Malcolm has brought some of the world's
leading newsmakers to the platform, presenting stimulating. informed, and uncensored discussions on the
critical issues confronting our nation nd the world today.
Malcolm also crea ed the Brink of Greatn ss platform that showcases th greatness harbored in so many of
us. He nur ures and promotes the people who deserve to be celebrated and cherished, focusing a spotlight on
the b st of humanity. And in some cases, th worst.
Malcolm's vision for America Out Loud provides progr mming for a vast and growing audience looking for
news and analyses without the liberal spin nd heavily filte ed commentary too often found in the mainstream
media.
Malcolm combines the energy of his own passion with a critic.al awareness of the world in which we live that
tr nscends the barriers dividing Americans today. His programming opens the path to civil discussion about
the issues that really matter. His voice is a clarion call for reason and truth.
Who We Are - America Out Loud

AR05434
TAB 32
AR05435
Court File No.: T-1991-21-ID
FEDERAL COURT OF CANADA
BETWEEN:

Applicants
-and-
HER MAJESTY THE QUEEN, as represented by ATTORNEY GENERAL OF

CANADA and TRANSPORT CANADA
Respondents
APPLICATION UNDER s. 57.1 of the Federal Courts Act, RSC 1985, c F-7 and ss. 61(2), 69,
and 300 of the Federal Courts Rules, SOR/98-106
CERTIFICATE CONCERNING CODE OF CONDUCT

FOR EXPERT WITNESSES
I, Adam Sirek, having been named as an expert witness by the Applicants, certify that I have read
the Code of Conduct for Expert Witnesses as set out in the schedule to the Federal Courts Rules
(and attached hereto) and agree to be bound by it.
March 11th, 2022 _____________________________________

Adam Sirek
AR05436
CODE OF CONDUCT FOR EXPERT WITNESSES
GENERAL DUTY TO THE COURT
1. An expert witness named to provide a report for use as evidence, or to testify in a

proceeding, has an overriding duty to assist the Court impartially on matters relevant to
his or her area of expertise.
2. This duty overrides any duty to a party to the proceeding, including the person
retaining the expert witness. An expert is to be independent and objective. An expert is
not an advocate for a party.
EXPERTS' REPORTS
3. An expert's report submitted as an affidavit or statement referred to in rule 52.2
of the Federal Courts Rules shall include:
a) a statement of the issues addressed in the report;
b) a description of the qualifications of the expert on the issues addressed in

the report;
c) the expert's current curriculum vitae attached to the report as a schedule;
d) the facts and assumptions on which the opinions in the report are based; in that
regard, a letter of instructions, if any, may be attached to the report as a schedule;
e) a summary of the opinions expressed;
f) in the case of a report that is provided in response to another expert's report, an

indication of the points of agreement and of disagreement with the other expert's
opinions;
g) the reasons for each opinion expressed;
h) any literature or other materials specifically relied on in support of the opinions;
i) a summary of the methodology used, including any examinations, tests or other

investigations on which the expert has relied, including details of the
qualifications of the person who carried them out, and whether a representative of
any other party was present;
j) any caveats or qualifications necessary to render the report complete and accurate,
including those relating to any insufficiency of data or research and an indication of
any matters that fall outside the expert's field of expertise; and
k) particulars of any aspect of the expert's relationship with a party to the proceeding
AR05437
or the subject matter of his or her proposed evidence that might affect his or her duty
to the Court.
4. An expert witness must report without delay to persons in receipt of the report any
material changes affecting the expert's qualifications or the opinions expressed or the data
contained in the report.
EXPERT CONFERENCES
5. An expert witness who is ordered by the Court to confer with another expert
witness
a) must exercise independent, impartial and objective judgment on the issues

addressed; and
b) must endeavour to clarify with the other expert witness the points on which they
agree and the points on which their view differ.
AR05438
Court File No.: T-1991-21
BETWEEN:

Applicants
- and -

Respondents
AFFIDAVIT OF DR. ADAM SIREK
1. I, Dr. Adam Sirek, of the City of Windsor, in the Province Ontario, MAKE OATH AND
SAY AS FOLLOWS:
2. I am a Physician and Adjunct Research Professor at Schulich School of Medicine and
Dentistry at Western University and as such have personal knowledge of the facts and
matters hereinafter deposed to save and except where the same are stated to be based upon
information and belief and where so stated I verify believe the same to be true.
3. Attached to this Affidavit and marked as Exhibit “A” is a true copy of my current
curriculum vitae outlining my education, relevant experiences, and publications.
4. Attached to this Affidavit as Exhibit “B” is a true copy of my expert report with respect to
this matter.
AR05439
5. Attached to this Affidavit and marked as Exhibit “C” is a true copy of the list of documents
relied upon my report.
Sworn before me )
by videoconference )
at the City of Toronto, )
in the Province of Ontario, )
this 11th day of March, 2022 )
___________________________ ________________________
A Commissioner for taking Affidavits DR. ADAM SIREK
within the Province of Ontario
Sam Presvelos
Presvelos Law LLP

141 Adelaide Street West, Suite 1006
Toronto, ON M5H 3L5
AR05440
This is Exhibit “A” referred to in the Affidavit of Dr. Adam Sirek sworn March 11, 2022
Commissioner for Taking Affidavits

Sam A. Presvelos
DRAFT
AR05441
This is a draft version only. Do not submit to any funding organization. Only the
final version from the History page can be submitted.
Protected when completed
Dr. Adam Sirek

Correspondence language: English
Sex: Male
Date of Birth: 9/13
Canadian Residency Status: Canadian Citizen
Country of Citizenship: Canada
Contact Information
The primary information is denoted by (*)
Address
Primary Affiliation (*)
Schulich School of Medicine & Dentistry
Western University
860 Tecumseh Rd. E
Suite 101
Windsor N8X 2S5
Telephone
Fax
Mobile
Work (*)
Email
Personal
Work (*)
Website
Corporate https://www.facebook.com/drsirek/
Corporate https://leapbiosystems.ca/adamsirek
Corporate https://www.asc-csa.gc.ca/eng/astronauts/recruitment/profiles.asp?sirek-
adam
Personal
Social Media https://ca.linkedin.com/in/adamsirek
i
DRAFT
AR05442 Dr. Adam Sirek
This is a draft version only. Do not submit to any funding organization. Only the
final version from the History page can be submitted.
Dr. Adam Sirek
Language Skills
Language Read Write Speak Understand Peer Review
English Yes Yes Yes Yes Yes
French Yes Yes No Yes No
Degrees
2013/7 - 2016/6 Post-doctorate, Residency in Family Medicine, Family Medicine, St. John Hospital and
Medical Center
Degree Status: Completed
2009/8 - 2013/5 Doctorate, Doctor of Medicine, Medicine, St. George's University
2009/8 - 2010/6 Diploma, Diploma in Higher Education in Medical Sciences, Medicine, University of
Northumbria at Newcastle
2007/9 - 2009/5 Master's Thesis, Master of Science, Physiology, University of Toronto
Thesis Title: Novel regulatory mechanismsunderlying the expression of the carbohydrate
response element binding protein(ChREBP): the roles of insulin and the POU protein
Oct-1
Areas of Research: Physiology
Research Disciplines: Endocrinology, Molecular Biology, Physiology
Supervisors: Tianru Jin; Dominic Ng
2003/9 - 2007/5 Bachelor's Honours, Honours Bachelor of Science, Physiology, University of Toronto
Credentials
2019/10 Fellow, American Academy of Family Physicians
2019/5 Fellow, Aerospace Medical Association
2017/11 Independant Practice, Texas Medical Board
2016/10 Civil Aviation Medical Examiner, Transport Canada
2016/9 Independant Practice, College of Physicians & Surgeons of Ontario
2016/9 Certification in the College of Family Physicians of Canada, College of Family Physicians
of Canada (The)
2016/6 Diplomate of the American Board of Family Medicine, American Board of Family Medicine
1
DRAFT
2016/6 Independant Practice, Michigican Department of Licensing and Medical Affairs

2016/5 Licentiate, Medical Council of Canada
2003/6 Grade 10 Piano, Royal Conservatory of Music
Recognitions
2021/3 Canadian Forces Decoration (Canadian dollar)
Department of National Defence
Honor
2020/6 Distinguished Catholic Alumni Award (Canadian dollar)
Durham Catholic District School Board
Prize / Award
The Distinguished Catholic Alumni Award recognizes former students of the Durham
Catholic District School Board who have achieved significant success in their chosen
pathway. Through their pursuit of personal excellence, they have made a positive
contribution to their communities and represent the image of the Catholic learner as
outlined in the Ontario Catholic School Graduate Expectations.
2018/5 Outstanding Mentorship Award (Canadian dollar)
Aerospace Medicine Students and Resident Organization
Prize / Award
The AMSRO Outstanding Mentorship Award serves to formally recognize those in the
aerospace medicine community who have played an active role in educating and training
future aerospace medicine healthcare providers.
Research Disciplines: Physiology
2017/6 Award of Excellence (Canadian dollar)
Ontario Provincial Committee Board of Governors
Prize / Award
The OPC annually recognizes up to six outstanding CIC Officers holding the rank of
Major or Captain and up to six exceptional ‘junior’ CIC Officers (i.e., those holding the
rank of Lieutenant, 2nd ant, or Officer Cadet). The awards are to recognize
exemplary service and/or exceptional ment in Regional, Area, CTC or Squadron
venue. Most often, the CIC Officers Award also takes length of service and command
responsibility into account, while those for Junior Officers, of sity, focus on
performance in staff or operational roles. Any member of the OPC community may initiate
a nomination; however, it must be endorsed by the appropriate Area Training Officer
or RCSU(C) Headquarters, who will forward nominations to the Honours & Awards
Committee.
2016/5 2nd Place Poster Award - 500 (United States dollar)
Southeast Michigan Center for Medical Education
Prize / Award
The Southeast Michigan Center for Medical Education, in collaboration with the Wayne
State University School of Medicine and Oakland University, presents awards based on
resident research and excellence annually.
2016/3 1st Place Poster Award - Resident Research Day - 500 (United States dollar)
St. John Hospital and Medical Center
Prize / Award
2016/2 2nd Place Poster Award - Family Medicine Research Day - 200 (United States dollar)
Prize / Award
2
DRAFT
2014/5 Jeffrey R. Davis Aerospace Medicine Endowed Scholarship - 500 (United States dollar)
Aerospace Medical Association
Prize / Award
2014/5 Space Medicine Association (Canadian dollar)
Prize / Award
The Space Medicine Association Award for Journal Publication is presented to an
individual who is the first or primary author of an outstanding article on space medicine
published in the official journal of the Aerospace Medical Association, Aviation Space and
Environmental Medicine, during the previous calendar year.
2013/5 Fellow's Award - 2,000 (United States dollar)
Prize / Award
One of the stated purposes of the AsMA Foundation is "To provide scholarships for the
purpose of underwriting, in whole or in part, the cost of registration fees, transportation,
a meal per diem, or any other valid fees or expenses incurred by eligible students or
residents in relation to their attendance at one or more scholarly meetings on topics
related to aerospace medicine". The AsMA Foundation delegated to the AsMA Fellows
Group the task to develop and administer a scholarship program to accomplish the
previously stated purpose. Therefore, the AsMA Fellows Scholarship Committee (AsMA-
FSC) was formed to establish the "AsMA Fellows Scholarship". The amount of this
scholarship is currently set at $2,000 U.S. for the 1st Place and $1,000 for the 2nd Place
and it is given annually to an AsMA member who is a student in an aerospace medicine
residency program, graduate program in aerospace medicine (Masters or Ph.D.), medical
certificate or aerospace diploma course, or in a full time ed
2013/5 Young Investigator of the Year - 500 (United States dollar)
Prize / Award
The Space Medicine Association Jeffrey Myers Young Investigator Award is presented
to a young investigator who is the first or primary author of an outstanding presentation
(slide or poster), in the area of Aerospace Medicine with an emphasis on Space Medicine,
presented at the current Annual Scientific Meeting of the Aerospace Medical Association.
2013/5 Scientific Paper Award - 200 (United States dollar)
Aerospace Medicine Student and Resident Organization
Prize / Award
The AMSRO Scientific Paper Award is the oldest honor awarded to a student or resident
first-listed author submission to the AsMA annual scientific meeting. It is also the only
award in AsMA for students and residents selected by other students and residents.
2012/10 Aerospace Medicine Grant - 5,000 (Canadian dollar)
Canadian Space Agency
Prize / Award
2012/1 Operation Aquilis Flying Scholarship - 5,000 (Canadian dollar)
Prize / Award
2011/1 Operation Aquilis Flying Scholarship - 5,000 (Canadian dollar)
Prize / Award
2009/9 International Peace Scholarship - 20,000 (United States dollar)
St. George's University
Prize / Award
3
DRAFT
2009/5 1st Place Research Award - 150 (Canadian dollar)

University of Toronto
Prize / Award
2008/9 Banting and Best Diabetes Centre, Novo-Nordisk Scholarship - 21,000 (Canadian dollar)
Prize / Award
2008/5 Fellowship Award - 1,600 (Canadian dollar)
Prize / Award
2007/9 Academic Grant - 2,000 (Canadian dollar)
Prize / Award
2007/9 Physiology Fellowship Award - 1,800 (Canadian dollar)
Prize / Award
2007/5 Charles Hollenberg Summer Studentship - 4,800 (Canadian dollar)
Prize / Award
2006/6 Cadet Long Service Medal (Canadian dollar)
Cadet League of Canada
Honor
2004/6 Royal Canadian Legion Medal of Excellence (Canadian dollar)
Royal Canadian Legion
Honor
User Profile
Researcher Status: Researcher
Research Career Start Date: 2016/10/01
Engaged in Clinical Research?: Yes
Research Interests: Aerospace Medicine, Microgravity, Physiological Effects of Spaceflight, Human Systems
Interaction
Research Experience Summary: My research experiences began with an in-depth course of study in human
physiology, in particular the adaptation of body systems to stressors. Further studies into the physiological
responses led to work in cell and molecular biology in relation to diabetes. Subsequent to pursuing a medical
degree, my research has expanded to include an understanding of the human system in the extreme enivornment
of space. My interest focusses on understanding the stressors and adaptations required to survive in this setting
for long duration spaceflight. Currently, I am leading projects related to the adaptation of the human system in
spaceflight through collaboration with researchers on the Axiom-1 mission to the International Space Station. As
a prime science payload integrator, trainer and subsequent primary investigator reviewing the data obtained by a
private astronaut we seek to expand the opportunities for future commercial space-related research opportunities.
Fields of Application: Biomedical Aspects of Human Health, Health System Management, Public Health
Disciplines Trained In: Cell Biology, Epidemiology and Biostatistics, Family Medicine, Molecular Biology,
Physiology
Technological Applications: Medical equipment, Medication administration devices, Monitoring and diagnostic
equipment, Nutritional supplements, Software
Countries: Canada, United States
Areas of Research: Armed Forces, Physiology, Preventive medicine, Telemedicine
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DRAFT
Research Specialization Keywords: Aerospace Medicine, Aviation, Extreme Physiology, Family Medicine,
Hypobarics, Operational Medicine, Rural and Remote Medicine, Space Medicine, Translational Medicine
Research Disciplines: Emergency Medicine, Family Medicine, Physiology
Geographical Regions: North America
Employment
2022/1 Physician
Calian/Canadian Armed Forces
Full-time
2021/10 Hospitalist, Department of Medicine
London Health Sciences Centre
Part-time
2019/9 Adjunct Research Professor
University of Western Ontario
Adjunct, Assistant Professor
2019/6 Faculty Member
Part-time, Adjunct
Institute for Earth and Space Exploration
2018/1 Director
Leap Biosystems
Part-time
2016/10 Family Physician
Full-time
Private practice focussing on Family Medicine, Aerospace Medicine and Occupational
Medicine
2005/6 Canadian Forces Reserves
Royal Canadian Air Force, Canadian Armed Forces
Part-time
Comissioned Officer and Pilot
2020/3 - 2021/11 Locum Tenens and Temporary Active Staff
Full-time
Windsor Regional Hospital
2020/3 - 2021/11 Clinical Lead - COVID-19 Assessment Centers
Part-time
2019/3 - 2021/11 Associate Staff
Part-time
Erie Shores Healthcare
2017/1 - 2020/3 Courtesy Staff
Part-time
2016/10 - 2020/2 Physician
Tecumseh Medical Center
Part-time
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2016/10 - 2019/9 Adjunct Clinical Professor

Adjunct, Assistant Professor
2018/1 - 2019/6 Faculty Member
Part-time, Adjunct
Center for Planetary Sciences and Exploration
2016/10 - 2017/6 Hospitalist
Family Medicine, Erie Shores Healthcare
Full-time
2013/6 - 2016/7 Resident Physician
Full-time
2015/7 - 2016/6 Chief Resident
Full-time
Affiliations
The primary affiliation is denoted by (*)
(*) 2021/3 Research Advisory Council, Institute for Earth and Space Exploration, University of
Western Ontario
The key responsibilities of a committee member are to provide advice andinput to
the Executive Committee on matters such as the roadmap,budget, and the Institute’s
research, training and outreach programs.The Research Advisory Committee is
responsible for approving andreviewing membership status within the Institute and will
assistthe Executive Committee in implementing the Institute’s roadmap.
2018/6 Undergraduate Medical Education - Academic Lead, Schulich School of Medicine &
Dentistry, University of Western Ontario
Academic Lead, responsible for curriculum development, planning, and implementation
of a longitudinal program for the integration of inter-disciplinary learning for medical
education.
2018/1 Faculty, Institute for Earth and Space Exploration, University of Western Ontario
2016/10 Post Graduate Supervisor, Schulich School of Medicine & Dentistry, University of Western
Ontario
Supervisor for residents in the department of Family Medicine and Psychiatry
(*) 2016/10 Adjunct Research Professor, Schulich School of Medicine & Dentistry, University of
Western Ontario
2016/10 Undergraduate Medical Education - Supervisor, Schulich School of Medicine & Dentistry,
Supervisor of undergraduate medical learners. Primarily responsible for the development
of clinical skills, clinical reasoning and communication skills.
Research Funding History
Completed [n=3]
2018/1 - 2019/12 Contract 9F063-180463 Technology Concept Studies in the Fields of Medical Diagnostic
Co-investigator Tools, Radiation Protection and Medical Training and Simulation for Deep Space
Missions, Contract
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DRAFT
Clinical Research Project?: No
Project Description: Public Works and Government Services Canada (PWGSC) on behalf
of Canadian Space Agency(CSA) located in St-Hubert, (Quebec), is seeking bids to
conduct Technology Concept Studies inthe fields of Medical Diagnostic Tools, Radiation
Protection, and Medical Training and Simulationfor Deep Space Missions. These activities
form part of the CSA's effort to define potentialopportunities for Canadian participation in
future international Human Spaceflight (HSF) missionsinto deep space.
Research Settings: Canada (Both)
Research Disciplines: Biomedical Engineering and Biochemical Engineering, Emergency
Medicine, Family Medicine
Research Uptake Stakeholders: Academic Personnel, Government Personnel, Healthcare
Personnel, Industrial Consortium
Fields of Application: Biomedical Aspects of Human Health, Pathogenesis and Treatment
of Diseases
Funding by Year:
2018/1 - 2018/12 Total Funding - 500,000 (Canadian dollar) (Canadian dollar)
Funding Sources:
2018/1 - 2018/6 Canadian Space Agency (CSA)
Total Funding - 500,000 (Canadian dollar) (Canadian dollar)
Funding Renewable?: No
Funding Competitive?: Yes
Funding Reference Number: PW-$MTB-575-15066
2018/1 - 2018/12 Socio-Economic Benefits Study of Deep Space Healthcare Solutions Used in Operational
Co-investigator Settings, Contract
Project Description: Canada is examining potential contributions to future collaborative
international spaceexploration missions, notably beyond low Earth orbit (BLEO). The
development of these technologies and their terrestrial applications could generate
multiple benefits to Canadian citizensgiven the synergies between space and terrestrial
health care needs. The study assesses and compares the crossover challenge areas
associated with health care delivery and health monitoring for astronauts in deep space
with those of military personnel or industrial workers in remote or harsh operational
settings. The study also offers an impact assessment and detailed case studies on the
potential benefits that space health care solutions could provide to help overcome the
similarchallenges present in these operational settings.
Research Settings: Canada (Both) , Canada (Rural) , Canada (Rural)
Medicine, Family Medicine, Internal Medicine, Preventive and Community Medicine
Areas of Research: Biomedical Technologies, Bioprocesses and Biomedical systems,
Community Health / Public Health, Health and Security
Research Uptake Stakeholders: Academic Personnel, Government Personnel, Industrial
Association/Producer Group
Fields of Application: Biomedical Aspects of Human Health, Communication and
Information Technologies, Economic Growth, Economic Policies
Funding by Year:
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DRAFT
Funding Sources:
Funding Reference Number: 9F001-20180385
2018/1 - 2018/12 Socio-Economic Benefits Study of Deep Space Health Care Solutions Used in Northern
Co-investigator and Remote Communities, Contract
Project Description: In addition to traditional areas ofparticipation such as robotics and
rover technologies, health care solutionsare a key area of consideration. The development
of these technologies and their terrestrialapplications could generate multiple benefits to
Canadian citizens given thesynergies between space and terrestrial health care needs.
Thestudy assesses the crossover challenge areas associated with health caredelivery
and health monitoring in deep space and in Canada’s remote andnorthern communities. It
offers analysis of how the health care solutionsdeveloped specifically for deep space can
also be used to help overcomechallenges in these terrestrial settings. The study provides
an impactassessment and detailed case studies on the potential benefits that theutilization
of health care deep space solutions could bring to northern andremote locations.
Research Settings: Canada (Both) , Canada (Both) , Canada (Rural) , Canada (Urban)
Medicine, Family Medicine, Health Administration, Internal Medicine, Preventive and
Community Medicine
Areas of Research: Biomedical Technologies, Bioprocesses and Biomedical systems,
Community Health / Public Health, Employment and Technology, Socio-Economic
Conditions
Research Uptake Stakeholders: Academic Personnel, Government Personnel, Industrial
Association/Producer Group
Fields of Application: Biomedical Aspects of Human Health, Health System Management,
Public Health
Funding by Year:
Funding Sources:
Funding Reference Number: 9F008-20180394
Courses Taught
2019/07/01 - Instructor, University of Western Ontario
2020/05/30 Course Title: PCCM2
Course Topic: Clinical Skills
Course Level: Undergraduate
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DRAFT

2019/05/03 Course Title: Longitudinal Professional Development/Mentorship Program
Course Topic: Professional Development
2017/07/01 - Instructor, Family Medicine, University of Western Ontario
Program Development
Instructor, University of Western Ontario
Program Title: Living and Working in Space
Course Level: Post Graduate
Program Description: Developed by Dr. Dave Williams, Canadian Astronaut, and
further co-developed, this course is part of a professional master's program hosted by
the Institute for Earth and Space Exploration which explores the extreme physiology,
adaptation and countermeasures to long duration spaceflight.
2019/1 Instructor, University of Western Ontario
Program Title: Longitudinal Aerospace Medicine Elective
Course Level: College
Program Description: Introductory elective in aerospace medicine including clinical
experiences with pilots and certification
2018/1 Instructor, University of Western Ontario
Program Title: Inderdisciplinary Education for Undergraduate Medical Education
Course Level: College
Program Description: Program development and implementation for interdisciplinary
education models for undergraduate medical education at the Schulich School of Medicine
& Dentistry
Unique / innovative characteristics: Inter-disciplinary Education, Flipped Classroom,
Problem Based Learning
Student/Postdoctoral Supervision
Doctorate Equivalent [n=40]

2022/1 - 2022/2 Shozab Ahmed (In Progress) , Schulich School of Medicine & Dentistry
Principal Supervisor Student Canadian Residency Status: Canadian Citizen
Thesis/Project Title: Family Medicine and Aerospace Rotation
2021/7 - 2021/7 Hasan Hawilo (In Progress) , Schulich School of Medicine & Dentistry
Thesis/Project Title: Family Medicine Clerk
2021/5 - 2021/5 Dalia Kashash (In Progress) , Schulich School of Medicine & Dentistry
Thesis/Project Title: Family Medicine Clerkship
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DRAFT
2021/5 - 2021/8 Mark Mackie (In Progress) , Institute for Earth and Space Exploration
Thesis/Project Title: Summer Space Internship
2021/5 - 2021/8 Nicholas James (In Progress) , Institute for Earth and Space Exploration
Thesis/Project Title: Summer Space Internship
2021/4 - 2021/4 Melissa Cowell (In Progress) , Schulich School of Medicine & Dentistry
Thesis/Project Title: Family Medicine Elective
2021/3 - 2021/8 Shozab Ahmed (In Progress) , Institute for Earth and Space Exploration
Co-Supervisor Student Canadian Residency Status: Canadian Citizen
Thesis/Project Title: ESA Internship: Passive Spaceflight Countermeasures
2021/2 - 2021/3 Markus Masad (In Progress) , Schulich School of Medicine & Dentistry
2020/10 - 2020/10 Charles Burke (In Progress) , Schulich School of Medicine & Dentistry
2020/9 - 2020/10 Melissa Cowell (In Progress) , Schulich School of Medicine & Dentistry
2020/5 - 2020/8 Shozab Ahmed (In Progress) , Institute for Earth and Space Exploration
Thesis/Project Title: Autonomous Use of Ultrasonography during LDSMs: Lessons from
Remote andRural Medicine
2020/5 - 2020/8 Mohsyn Malik (In Progress) , Institute for Earth and Space Exploration
Thesis/Project Title: ImmersiveExtened Reality use in Medical Education with Implications
for Remote andSpace Medicine Training
2020/4 - 2020/5 Jacob Bender (In Progress) , Schulich School of Medicine & Dentistry
2019/12 - 2020/1 Abbey Nicoletti (Completed) , Schulich School of Medicine & Dentistry
2019/9 - 2019/9 Carlee Stoyanovich (Completed) , University of Toronto
Thesis/Project Title: Visiting Student Elective
2019/8 - 2019/8 Robin McKay (Completed) , St. George's University
2019/8 - 2019/8 Katie Collins (Completed) , Trinity College Dublin School of Medicine
2019/4 - 2019/4 Antoni Hanna (Completed) , University of Lodz
10
DRAFT
2019/4 - 2019/5 Joseph Brockman (In Progress) , Schulich School of Medicine & Dentistry
Thesis/Project Title: 1st Year Clinical Experiences
2019/3 - 2019/3 Sumeet Bhardwaj (Completed) , Schulich School of Medicine & Dentistry
2019/2 - 2019/2 Jacob Im (Completed) , Schulich School of Medicine & Dentistry
2019/1 - 2019/1 Shayne Snider (Completed) , Schulich School of Medicine & Dentistry
2019/1 - 2019/2 Harjiwan Singh (Completed) , Schulich School of Medicine & Dentistry
2018/8 - 2018/8 Savannah Grodecki (Completed) , Royal College of Surgeons in Ireland School of
Principal Supervisor Medicine
Student Canadian Residency Status: Canadian Citizen
2018/7 - 2018/7 Danielle Wuebbolt (Completed) , Royal College of Surgeons in Ireland School of Medicine
2018/7 - 2018/7 Sarah Abdulfattah Abdullah (Completed) , Dubai Medical College for Girls
2018/7 - 2018/7 Anthony Piazza (Completed) , Schulich School of Medicine & Dentistry
Thesis/Project Title: 2nd Year Longitudinal Program
2018/6 - 2018/6 Ryan Towes (Completed) , St. George's University
2018/5 - 2018/5 Victor Tat (In Progress) , Schulich School of Medicine & Dentistry
2018/5 - 2018/5 Jovana Momic (In Progress) , Schulich School of Medicine & Dentistry
2018/2 - 2018/2 Eric Hempel (Completed) , Schulich School of Medicine & Dentistry
2017/11 - 2017/11 Dimitar Saveski (Completed) , Schulich School of Medicine & Dentistry
2017/9 - 2017/10 Josh Kosta (Completed) , Schulich School of Medicine & Dentistry
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DRAFT
2017/7 - 2017/8 Nicole Grbevski (Completed) , Wroclaw Medical University

Thesis/Project Title: Visiting Student Clerkship
2017/5 - 2017/5 Ahmad Al-Askar (Completed) , Schulich School of Medicine & Dentistry
2017/2 - 2017/2 Marko Brasic (Completed) , Schulich School of Medicine & Dentistry
2017/1 - 2017/1 Dimitar Saveski (Completed) , Schulich School of Medicine & Dentistry
2015/1 - 2016/6 Multiple Students, Central Michigan University
Co-Supervisor Thesis/Project Title: 3rd Year Medical Student Supervision
2013/6 - 2016/6 Multiple Students, Wayne State University
Co-Supervisor Thesis/Project Title: 3rd and 4th Year Medical Student Supervision
2013/6 - 2016/6 Multiple Students, St. George's University
Co-Supervisor Student Canadian Residency Status: Not Applicable
Thesis/Project Title: 3rd and 4th Year Medical Student Supervision
Post-doctorate [n=9]
2021/7 - 2021/7 Komal Bajwa (In Progress) , Schulich School of Medicine & Dentistry
Thesis/Project Title: PGY2 Hospitalist Rotation Supervisor
2021/7 - 2021/7 Jagpreet Kaler (In Progress) , Schulich School of Medicine & Dentistry
Thesis/Project Title: PGY1 Hospitalist Rotation Supervisor
2021/7 - 2021/8 Corey Parent (In Progress) , Schulich School of Medicine & Dentistry
Principal Supervisor Student Degree Start Date: 2021/7
Thesis/Project Title: Primary Preceptor/Core Supervisor - Resident
2021/6 - 2021/6 Milan Radulj (In Progress) , Schulich School of Medicine & Dentistry
Thesis/Project Title: Psychiatry Resident - Family Medicine Rotation
2021/5 - 2021/5 Julia Roberts (Completed) , Schulich School of Medicine & Dentistry
Thesis/Project Title: Family Medicine Hospitalist Rotation
2020/10 - 2021/2 Ross Lepera (In Progress) , Schulich School of Medicine & Dentistry
Student Degree Expected Date: 2022/6
Thesis/Project Title: Resident Primary Preceptor
2018/9 - 2018/9 Amin Abu-Khatir (Completed) , St. John Hospital and Medical Center
Thesis/Project Title: Family Medicine Residency Supervision
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DRAFT
2018/2 - 2018/3 Sara Axford (Completed) , Schulich School of Medicine & Dentistry
Thesis/Project Title: Family Medicine Resident Elective
2017/5 - 2017/6 Ryan Parker (Completed) , Schulich School of Medicine & Dentistry
Thesis/Project Title: Family Medicine Psychiatry Rotation
Staff Supervision
Event Administration
2020/1 Organizer, Canadian Society of Aerospace Medicine Rounds Series, Association
The Canadian Society of Aerospace Medicine is the authoritative organization for matters
relating to aerospace medicine in Canada. Our goal is to promote the subspecialty of
aerospace medicine and bring together those in the field through education, outreach, and
collaboration. Quarterly rounds are presented on topics relevant to aerospace practice.
2021/4 - 2021/4 Panel Chair, Western Space Day: Space Health Panel, Conference
Western Space Day highlights the Institutes' research and progress in the previous year.
This year's Space Health panel will highlight the five hazards to human spaceflight.
2019/3 - 2019/3 IPE Lead/Organizer, Interprofessional Education Day, Seminar
Interprofessional Education (IPE) Day has become an important staple in the curriculum
for Schulich medicine and dentistry students. It’s an annual opportunity for students to
spend time working with and learning from their future colleagues across the health care
spectrum. And much like they will in the future, students worked in teams focusing on
unique and dynamic health care cases during the Day. In addition to the teamwork, small
group exercises and case studies, students also had the opportunity this year to listen to
panel discussions related to effective collaborative patient care.
2018/3 - 2018/3 IPE Lead/Organizer, Interprofessional Education Day, Seminar
2017/3 - 2017/3 Facilitator, Interprofessional Education Day, Seminar, IPE Lead
13
DRAFT
2016/3 - 2016/3 Facilitator, Interprofessional Education Day, Seminar, IPE Lead

Editorial Activities
2017/6 Primary Editor, Bellagio II Report: Terrestrial Applications of Space Medicine Research,
Journal
For over 50 years, investigators have studied the physiological adaptations of thehuman
system during short- and long-duration spaceflight exposures. Much of the knowledge
gained in developing health countermeasures for astronauts onboard the International
Space Station demonstrate terrestrial applications. To date, a systematic process for
translating these space applications to terrestrial human health has yet to be defined.
The Bellagio ll Summit identified a snapshot of space medicine research and mature
science with the highest probability of translation and developed a “Roadmap” ofterrestrial
application from space medicine-derived countermeasures. These evidence-based
findings can provide guidance regarding the terrestrial applications of best practices,
countermeasures, and clinical protocols currently used in spaceflight.
Mentoring Activities
2020/6 Primary Preceptor, University of Western Ontario
Number of Mentorees: 1
Resident Primary Longitudinal Mentor and Primary Preceptor
2019/5 Advisor, University of Western Ontario
Mentorees: Sayra M. Cristancho S., PhD Associate Professor, Dept. of Surgery and
Faculty of Education Scientist, Centre for Education Research & Innovation (CERI)
Advisor for team adaptation and resilience research, CIHR grant applications.
2021/3 - 2021/8 Advisor/Co-Investigator, European Space Agency
Mentorees: Shozab Ahmed
Advisor to human countermeasures program research intern.
2019/6 - 2020/6 Mentor, University of Western Ontario
Portfolio Program - Undergraduate Medical Education, Schulich School of Medicine &
Dentistry
Journal Review Activities

2016/1 Reviewer,Journal of Aerospace Medicine & Human Performance
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DRAFT
Conference Review Activities
2017/11 Reviewer, Annual Scientific Sessions of the Aerospace Medical Association, Blind
Event Participation
2021/4 - 2021/4 Speaker, Identifying Burnout and Building Resilience, University of Windsor, Faculty of
Nursing, Seminar
2021/3 - 2021/3 Speaker, So You Want to be an Astronaut?, 2 Whitby, RC(Air)CS, Association
2020/5 - 2020/6 Participant, Palliative Care for Health Professionals, Pallium Canada, Seminar
2019/1 - 2019/12 Participant, University of Alberta Foundations Course in Occupational Medicine – Part A,
Course
2019/10 - 2019/10 Speaker, Bombardier Safety Standdown 2019, Workshop
2019/9 - 2019/9 Speaker, Royal Astronomical Society of Canada, Windsor, Club
2019/5 - 2019/5 Participant, NASA Chief Medical Officer’s Primer on Human Spaceflight, Seminar
2019/4 - 2019/4 Speaker, Fatigue Management, University of Windsor, Faculty of Nursing, Seminar
2019/3 - 2019/3 IPE Lead, Interprofessional Education Day, Seminar
2018/12 - 2018/12 Speaker, Exploring by the Seat of Your Pants, presented by NSERC, Seminar
2018/11 - 2018/11 Participant, Air Canada: Onboard Medical Emergencies, Workshop
2018/10 - 2018/10 Speaker, Train Like an Astronaut. Science Literacy Week 2018, Science North, Seminar
2018/10 - 2018/10 Participant, Aircare International: Land and Water Evacuation Drills, Workshop
2018/10 - 2018/10 Presenter, 69th International Astronautical Congress, Conference
2018/10 - 2018/10 Speaker, Bombardier Safety Standdown 2018, Workshop
2018/10 - 2018/10 Participant, Aircare International: Inflight Medical Training, Workshop
2018/9 - 2018/9 Participant, Canadian Forces Directorate of Flight Safety Aircraft Crash Investigator
Training Program, Workshop
2018/5 - 2018/5 Presenter, Aerospace Medical Association 89th Annual Scientific Sessions, Conference
2018/5 - 2018/5 Participant, Henry Ford Ultrasound University – Point of Care Ultrasound Course, Course
2018/5 - 2018/5 Participant, Canadian Center for Child Protection – Child Sexual Abuse Prevention
Training, Course
2018/3 - 2018/3 IPE Lead, Interprofessional Education Day, Seminar
2018/3 - 2018/3 Speaker, How to Pick an Astronaut! West Gate Public School (Grade 6-7 Students),
Seminar
2017/10 - 2017/10 Participant, Aero-Formatech: Aircrew Firefighting Program, Workshop
2017/10 - 2017/10 Particpant, Aero-Formatech: Aircrew Water Evacuation Program, Workshop
2017/3 - 2017/3 Facilitator, Interprofessional Education Day, Seminar
2016/5 - 2016/5 Presenter, Michigan Family Medicine Research Day, Conference
2016/5 - 2016/5 Presenter, South East Michigan Center for Medical Education (SEMCME) Annual
Research Forum, Conference
2016/4 - 2016/4 Presenter, Aerospace Medical Association 87th Annual Scientific Sessions, Conference
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DRAFT
2016/3 - 2016/3 Facilitator, Interprofessional Education Day, Seminar

2016/3 - 2016/3 Presenter, St. John Hospital and Medical Center Resident Research Day, Conference
2016/3 - 2016/3 Presenter, St. John Hospital and Medical Center Family Medicine Research Day,
Conference
2015/10 - 2015/10 Presenter, Family Medicine Experience, Conference
Conference
2014/6 - 2014/7 Participant, University of Texas Medical Branch: Principles of Aviation and Space
Medicine Short Course, Course
2014/2 - 2014/2 Presenter, St. John Hospital and Medical Center Family Medicine Researcch Day,
Conference
2013/5 - 2013/5 Presenter, AsMA Meeting, Conference
Conference
2012/10 - 2012/10 Participant, NASA Johnson Space Center Aerospace Medicine Clerkship, Course
2010/6 - 2010/6 Participant, Elective – Traditional & Eastern Medicine, Course
2009/10 - 2009/10 Presenter, St. George’s University Global Scholars Research Symposium, Seminar
2009/6 - 2009/6 Presenter, American Diabetes Association Annual Scientific Sessions, Conference
2009/2 - 2009/2 Presenter, University Health Network & Samuel Lunenfeld Research Institute Diabetes
Seminar Series, Seminar
2008/10 - 2008/10 Presenter, Canadian Diabetes Association Professional Conference & Annual Meetings,,
Conference
2008/5 - 2008/5 Presenter, Endocrinology & Diabetes Research Group Annual Research Day, Conference
Community and Volunteer Activities

2005/5 Youth Leader / Officer, Royal Canadian Air Cadets
The Royal Canadian Air Cadets is a Canadian national youth program for young
individuals aged 12 to 19. Under the authority of the National Defence Act, the program
is administered by the Canadian Forces and funded through the Department of National
Defence.
International Collaboration Activities

2021/4 Co-Supervisor, Germany
Co-Supervisor for student internship with the European Space Agency
2017/6 Scientific Lead / Editor, Italy
Collaborative research group identifying terrestrially-ready innovations and findings from
research and operational medical experience onboard the international Space Station. A
translational science model from space to ground.
Committee Memberships
2021/3 Committee Member, Research Advisory Council, University of Western Ontario
Institute for Earth and Space Exploration
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DRAFT
2020/1 Committee Member, Centre for Education Research & Innovation (CERI) Project Advisor,
Project Advisor
2019/6 Committee Member, Clerkship & Electives Committee, Schulich School of Medicine and
Dentistry, University of Western Ontario
2019/1 Committee Member, Space Generation Advisory Council – Space Medicine and Life
Sciences Project Group, Space Generation Advisory Council
2017/6 Committee Member, Bellagio II Committee, NASA, Johnson Space Center
Collaborative research group identifying terrestrially-ready innovations and findings from
research and operational medical experience onboard the International Space Station. A
translational science model from space to ground.
2018/6 - 2020/6 Committee Member, PARO Award Committee, University of Western Ontario
Other Memberships
2017/1 Members, Wilderness Medical Association
2016/1 Member, Ontario Medical Association
2015/1 Member, Canadian Historical Aircraft Association
2014/1 Life Member, Space Medicine Association
2013/1 Life Member, Windsor Flying Club
2012/10 Fellow, Aerospace Medical Association
2011/1 Fellow, American Academy of Family Physicians
2010/1 Member, Canadian Medical Association
Presentations
1. James, Nicholas, Mackie, Mark. (2022). Augmented and Mixed Reality to Support Clinical Decision Making.
Aerospace Medical Association’s 92nd Annual Scientific Meeting, Reno, United States
Main Audience: Knowledge User
Invited?: No, Keynote?: No, Competitive?: Yes
2. Sirek, AS., Hindle, A., Sleno, N., Bishop, S., Williams, D. (2021). Advanced Technology to Improve
Autonomous Healthcare Delivery for Exploration Class Missions. Canadian Space Agency 2021 Lunar
Workshop, Montreal, Canada
Main Audience: Researcher
3. Malik, M., Ahmed, S., Dahrouj, T., Sirek, AS. (2021). Translating clinical thinking into space-bound
technology: a multidisciplinary undergraduate internship experience. 72nd International Astronautical
Congress, Dubai, United Arab Emirates
4. Sirek, AS., Hindle, A., Sleno, N., Bishop, S., Williams, D. (2021). Advanced Technology for Enhancing
Autonomy in Space Medicine. 72nd International Astronautical Congress, Dubai, United Arab Emirates
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DRAFT
5. Samoil, K., Sirek, AS. (2020). Defining the Crew Medical Officer: Stage One. 71st International
Astronautical Congress, Dubai, UAE (Virtual), Dubai, United Arab Emirates
6. Sirek, AS., Hindle, A., Sleno, N., Bishop, S., Williams, D. (2020). Enhancing Autonomy in Exploration Class
Mission Crew Medical Officers. 71st International Astronautical Congress, Dubai, UAE (Virtual), Dubai,
United Arab Emirates
7. Samoil, K., Sirek, AS. (2019). Developing a Competency Map for Space Medicine Education. 70th
International Astronautical Congress, Washington, DC, United States
8. Sirek, AS., Samoil, K., Harrison, MF. (2018). Space Medicine Opportunities for Undergraduate Medical
Education in Canada: Past, Present, and Future. 69th International Astronautical Congress, Bremen,
Germany
Main Audience: Decision Maker
9. Antonsen, E., dos Santos, M., Epstein, A., Flynn-Evans, E., Lockley, S., Macovei, A., Martindale, V., Saary,
J., Shimada, K., Sirek, AS. (2018). The Spaceflight Habitable Environment – Terrestrial Implications.
Aerospace Medical Association 89th Annual Scientific Sessions, Dallas, TX, United States
10. Sirek, AS. (2018). Is There a Doctor Onboard? Managing In-Flight Medical Emergencies. Schulich School
of Medicine & Dentistry, Windsor, ON, Canada
Invited?: No, Keynote?: Yes, Competitive?: No
11. Reyes, D., Locke, J., Sargsyan, A., Garcia, K., Johnson, S., Sirek, AS., Shelhamer, M., Antonsen, E.
(2018). Application of NASA research, surveillance, and countermeasures for nephrolithiasis to the general
population.Aerospace Medical Association 89th Annual Scientific Sessions, Dallas, TX, United States
12. Sirek, AS. (2017). What is Aerospace Medicine?. St. George's University, St. George's, Grenada
Invited?: Yes, Keynote?: Yes, Competitive?: No
13. Vinson, T., Morrow, R., Sirek, AS., Panthangi, V. (2016). Cardiomyopathy with Preterm Premature Rupture
of Membranes. St. John Hospital and Medical Center Family Medicine Research Day, Detroit, MI, United
States
14. Sirek, AS. (2016). Lessons from Extreme Environments: EVA and Decompression Sickness. Department of
Family Medicine, St. John Hospital and Medical Center, Detroit, MI, United States
15. Sirek, AS., Rusinow, W., Paschall, M. (2016). Comparing Novice to Experienced Autonomous Orbital
Sonography. St. John Hospital and Medical Center Family Medicine Research Day,, Detroit, MI, United
States
Invited?: No, Keynote?: No, Competitive?: No
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DRAFT
16. Sirek, AS., Panthangi, V. (2016). Community Acquired Clostridium difficile in a 2-Year-Old. Michigan Family
Medicine Research Day, Howell, MI, United States
17. Sirek, AS. (2016). Comparison of Orbital Ultrasonography Between Novice and Experienced Observers:
An Analog of Long Duration Spaceflight and Astronaut Medical Autonomy. Aerospace Medical Association
87th Annual Scientific Sessions, Atlantic City, NJ, United States
18. Sirek, AS., Francis, K. (2015). I GET SMASHED – A Case of Acute Pancreatitis without the Usual
Suspects. Family Medicine Experience, Denver, CO, United States
19. Sirek, AS., Simcina, M., Sawaf, H. (2014). Transient Aplastic Crisis in an Infant with an Underlying
Hemoglobinopathy.St. John Hospital and Medical Center Family Medicine Research Day, Detroit, MI,
United States
20. Sirek, AS. (2014). A Primer in Space Medicine.Department of Pediatrics Conference, St. John Hospital and
Medical Center, Detroit, MI, United States
21. Sirek, AS. (2013). So, You Want to be a Flight Surgeon? My Experiences from the Johnson Space Center.
Department of Medicine Grand Rounds, St. John Hospital and Medical Center, Detroit, MI, United States
22. Sirek, AS., Scofield, B. (2013). Adenoic Cystic Carcinoma – A Rare Finding of Prostatic Basal Cell
Carcinoma.St. John Hospital and Medical Center Family Medicine Research Day, Detroit, MI, United States
23. Sirek, AS., Garcia, K., Ebert, D., Sargsyan, A., Wu, JH. (2013). Physiological Effects of Microgravity: Is
There a Role for Central Retinal Artery Doppler?. Aerospace Medical Association 84th Annual Scientific
Meeting, Chicago, IL, United States
24. Sirek, AS., Ng, DS., & Jin, T. (2009). Novel Regulatory Mechanisms Affecting the Carbohydrate Response
Element Binding Protein (ChREBP). University Health Network & Samuel Lunenfeld Research Institute
Diabetes Seminar Series, Toronto, ON, Canada
25. Sirek, AS., Ng, DS., Jin, T. (2009). Regulation of a “Master Regulator of Lipogenesis” – the Transcriptional
Control of ChREBP by Oct-1 & Insulin. St. George’s University Global Scholars Research Symposium,
Newcastle-Upon-Tyne, United Kingdom
19
DRAFT
26. Sirek, AS., Liu, L., Ng, DS., Jin, T. (2009). A novel mechanism in controlling the expression of ChREBP: the
involvement of insulin & the POU homeodomain protein Oct-1.American Diabetes Association 69th Annual
Scientific Sessions, New Orleans, LA, United States
27. Sirek, AS., Ng, DS., & Jin, T. (2008). Transcriptional Control of the Carbohydrate Response Element
Binding Protein (ChREBP).Endocrinology & Diabetes Research Group 1st Annual Research Day, Toronto,
ON, Canada
28. Sirek, AS., Ng, DS., & Jin, T. (2008). The POU homeodomain protein Oct-1 as a potential transcriptional
repressor of ChREBP, a key regulator of lipogenesis. University of Toronto DDRG Monthly Seminar Series,
Toronto, ON, Canada
29. Sirek, AS., Ng, DS., & Jin, T. (2008). Transcriptional Regulation of ChREBP: Controlling a key player in
lipogenesis. Canadian Diabetes Association Professional Conference & Annual Meetings, Montreal, QC,
Canada
30. Bates, HE, Sirek, AS., Kiraly, MA., Yue, JTY., Goche Montes, D., Matthews, SG., & Vranic, M. (2007).
Intermittent Restraint Increases Sympathetic Activity, Lowers Pituitary Adrenal Activity, & Delays
Hyperglycemia in ZDF rats Independent of Food Intake. American Diabetes Association 67th Scientific
Sessions, Chicago, IL, United States
31. Bates, HE., Sirek, AS., Kiraly, MA., Yue, JTY., Goche Montes, D., Matthews, SG., & Vranic, M. (2007).
Intermittent Restraint Increases Sympathetic Activity, Lowers Pituitary Adrenal Activity, & Delays
Hyperglycemia in ZDF rats Independent of Food Intake.Frontiers in Physiology, Toronto, ON, Canada
32. Sirek, AS., Yue, JTY., & Vranic, M. (2007). Normalization of Glucagon & Corticosterone Responses to
Hypoglycemia in STZDiabetic rats using a Somatostatin Receptor Type 2 Antagonist (SSTR2a). Banting &
Best Diabetes Centre Charles Hollenberg Summer Studentship Program, Toronto, ON, Canada
Broadcast Interviews
2017/02/08 - CSA Astronaut Recruitment Campaign, iHeart Radio, iHeart Radio
2018/02/20 https://www.iheartradio.ca/am800/news/local-doctor-makes-short-list-to-be-an-
astronaut-1.2388215
2017/07/04 - Tecumseh Doctor Says Never Give Up on Your Dreams, iHeart Radio, AM800, Rob Hindi
2017/07/04 https://www.iheartradio.ca/am800/news/tecumseh-doctor-says-never-give-up-on-your-
dreams-1.2781432
2017/04/24 - Canadian astronaut finalists include two from Windsor region, CBC Windsor, CBC
2017/04/24 https://www.cbc.ca/news/canada/windsor/canadian-astronaut-finalists-include-two-from-
windsor-region-
20
DRAFT
2017/04/03 - Windsor-Essex residents at higher risk of suffering heart attack or stroke: study, CTV
2017/04/10 Windsor News, CTV Windsor, Chris Campbell
https://windsor.ctvnews.ca/windsor-essex-residents-at-higher-risk-of-suffering-heart-
attack-or-strok
2017/02/06 - CSA Astronaut Recruitment Campaign, CTV Windsor News, CTV, Chris Campbell
2017/02/06 https://windsor.ctvnews.ca/two-southwestern-ontario-men-shortlisted-to-become-
canadian-astronauts-1.
Text Interviews
2021/12/29 Humans and Space Travel, Elizabeth Howell, Space.com
https://www.space.com/spacex-record-breaking-2021-year
2017/05/21 Former Pickering resident in running to become an astronaut, Kristen Calis, Pickering
News Advertiser
https://www.durhamregion.com/news-story/7318617-former-pickering-resident-in-running-
to-become-an-as
2017/04/28 'Huntsville has always been home,' says shortlisted astronaut candidate, Rolland Cilliers,
Huntsville Forrester
https://www.toronto.com/community-story/7267217--huntsville-has-always-been-home-
says-shortlisted-as
2017/04/27 Adam Sirek, astronaut candidate, has a Huntsville connection, Dawn Huddlestone,
Hunstville Doppler
https://doppleronline.ca/huntsville/adam-sirek-astronaut-candidate-has-huntsville-
connection/
2017/04/24 Finalists hope to become a Canadian astronaut, Stan Behal, Toronto Sun
https://torontosun.com/2017/04/24/finalists-hope-to-become-a-canadian-astronaut
2017/03/01 Counting down to two, Jennifer Parraga, Western Communications
https://www.schulich.uwo.ca/communications/windsor_newsletter/2017/march/
counting_down_to_two.html
Publications
Journal Articles
1. Smith L Johnston*, Marian B Sides*, Peter H Lee, Adam Sirek, Rebecca S Blue, Eric L Antonsen Marlise
Araujo dos Santos Pamela Baskin, Mathias Basner, Shehzad Batliwala, Lisa Brown, Philip Buys, Ilaria
Cinelli, Rebekah Davis Reed, Pam Day, David Deyle, Grace L Douglas, Ari Epstein, Aubrey Florom-Smith,
Erin E Flynn-Evans, Jennifer Fogarty, Michael B Gallagher, Alex Garbino, Judith Hayes, Laurel Kaye,
Karen Klingenberger Stuart MC Lee, Steven W Lockley, Adrian Macovei, Valerie E. Martindale, Brent
Monseur, Nicolas G Nelson, Peter Norsk, Karen M Ong, Thais Russomano, Joan Saary, Kathleen EA
Samoil, Ashot Sargsyan, Mark Shelhamer, Kazuhito Shimada, Scott M. Smith, Michael B Stenger, Eran
Schenker, Alexandra Whitmire, Sara R. Zwart, Jan Stepanek, The Bellagio ll Team. (2021). Bellagio II
Report: Terrestrial Applications of Space Medicine Research. Aerospace Medicine & Human Performance.
92(8): 650-669.
http://dx.doi.org/doi: 10.3357/AMHP.5843.2021
Co-Editor
Accepted,
Refereed?: Yes, Open Access?: Yes, Synthesis?: Yes
Editors: Smith L Johnston, Marian B Sides, Adam Sirek
21
DRAFT
2. Sirek AS, Samoil K, Harrison MF. (2019). Space Medicine Training in Canada.Aerospace Medicine and
Human Performance. 90(8): 1-5.
http://dx.doi.org/10.3357/AMHP.5341.2019
First Listed Author
Published,
Refereed?: Yes, Open Access?: No, Synthesis?: Yes
Number of Contributors: 3
3. Zeng, K., Tian, L., Sirek, AS., Shao, W., Liu, L., Chiang, Y., Chernoff, J., Ng, DS., Weng, J., Jin, T. (2017).
Pak1 mediates the stimulatory effect of insulin and curcumin on hepatic ChREBP expression. Journal of
Molecular Cell Biology. 9(5): 384-394.
http://dx.doi.org/10.1093/jmcb/mjx031
Co-Author
Published,
Refereed?: Yes, Open Access?: No, Synthesis?: No
4. Sirek, AS., Garcia, K., Foy, M., Ebert, D., Sargysan, A., Wu, J., Dulchavsky, D. (2014). Doppler Ultrasound
of the Central Retinal Artery in Microgravity.Aviation, Space, and Environmental Medicine. 85(1): 3-8.
http://dx.doi.org/10.3357/asem.3750.2014
First Listed Author
Published,
5. Sirek, AS., Liu, L., Ng, Naples, M., Adeli, K., DS., Jin, T. (2009). Insulin stimulates the expression
of Carbohydrate Response Element Binding Protein by attenuating the repressive effect of POU
homeodomain protein Oct-1.Endocrinology. 150(8): 3843-3492.
http://dx.doi.org/10.1210/en.2008-1702
First Listed Author
Published,
6. Bates, HE., Sirek, AS., Kiraly, MA., Yue, JTY., Riddell, MC., Matthews, SG., & Vranic, M. (2008).
Adaptation to Intermittent Stress Promotes Maintenance of cell Compensation: Comparison with Food
Restriction. American Journal of Physiology – Endocrinology & Metabolism. 295(4): E947-958.
http://dx.doi.org/10.1210/en.2007-1473
Co-Author
Published,
7. Bates, HE., Sirek, AS., Kiraly, MA., Yue, JTY., Goche Montes, D., Matthews, SG., & D., Vranic, M.
(2008). Adaptation to Intermittent Restraint Stress Delays Development of Hyperglycemia in the ZDF Rat
Independent of Food Intake: Role of Habituation of the HPA Axis. Endocrinology. 149(6): 2990-3001.
http://dx.doi.org/10.1210/en.2007-1473
Co-Author
Published,
22
DRAFT
Thesis/Dissertation
1. Novel regulatory mechanisms underlying the expression of the carbohydrate response element binding
protein (ChREBP): the roles of insulin and the POU protein Oct-1. (2009). University of Toronto. Master's
Thesis.
Number of Pages: 118 Supervisor: Tianru Jin
Intellectual Property
Trademarks
1. MedChecker
Registered
Date Issued: 2020/1
Filing Date: 2020/01/08
(1) Medication management system with label recognition and dose guidance (2) Computer programming
in the medical field
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the preparation and dispensing of medications; providing information to patients in the field of administering
medications
23
AR05465
This is Exhibit “B” referred to in the Affidavit of Dr. Adam Sirek sworn March 11, 2022

Sam A. Presvelos
AR05466
The Aircraft Environment and COVID-19

Report
Prepared With Respect to:

Shaun Rickards et al. v. The Attorney General (Canada) et al.
Prepared:
March 2022
Prepared By:
Adam Sirek MD, MSc, DABFM, CCFP, FAsMA, FAAFP

Faculty, Department of Family Medicine, Schulich School of Medicine & Dentistry, Western University
Faculty, Institute for Earth and Space Exploration, Western University
Hospitalist, Department of Medicine, University Hospital, London Health Sciences Cent re
860 Tecumseh Road East
Windsor, Ontario
N8X 2S5
Schulich School of Medicine & Dentistry, Western University

101-860 Tecumseh Rd. E. Windsor, ON, Canada N8X 2S5
t. 519.255.7118 f. 519.255.9845 www.schulich.uwo.ca
AR05467
1. AREA OF EXPERTISE
I am a commissioned officer of the Royal Canadian Air Force and serve as a reserve force officer in
support of the Royal Canadian Air Cadets flying program. The details and expert opinion contained
herein are directly a result of my civilian activities where I serve as a physician and Adjunct
Professor at Western University and do not in any way represent my service to the government, the
views of the Canadian Armed Forces or the Government of Canada
To highlight my specific qualifications in the field of aerospace medicine, I am a Fellow of the
Aerospace Medical Association which is the foremost organization dedicated to the determination
and maintenance of the health, safety, and performance of persons involved in air and space travel.
My appointment as a Fellow in this organization was based on my service and quality of research
presentations and publications in the field of aerospace. Aerospace medicine is a unique branch of
medicine that combines operational and occupational knowledge in the aerospace domain, with the
practice of medicine. It requires individuals to have appropriate and often extensive field
experience to be able to competently perform their duties and understand the unique environment
within which the aviator or astronaut lives and works.
I have been a Civil Aviation Medical Examiner as appointed by Transport Canada since 2016 and
routinely examine pilots based on their medical status for medical certification and fitness to fly on
behalf of the Transport Canada. I have been a regularly invited aviation safety expert and guest
speaker representing the Canadian Armed Forces/1 Canadian Air Division and the Directorate of
Flight Safety to the annual Bombardier Safety Standdown. I have served an expert consultant for
several projects initiated by the Canadian Space Agency related to the application of space medicine
to Canadian priority populations including remote and operational communities. Through Leap
Biosystems Inc., a Canadian company I co-founded with other finalists of the Canadian Astronaut
Recruitment campaign in 2017, I am currently working with NASA and Axiom Space in support of
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the Axiom-1 mission. This mission will be the first commercial spaceflight to the International
Space Station launching from the United States. Directly related to this, I am training and
integrating the Canadian scientific payload for the Canadian commercial astronaut, Mr. Mark Pathy.
Along with other senior members of the aerospace medicine community in Canada, I am a founder
and director of the Canadian Society of Aerospace Medicine. This organization serves to bring
together clinicians, researchers, learners and interested parties to a central organization for
education and coordination of aerospace medicine activities in Canada. As a faculty member with
the Schulich School of Medicine and Dentistry at Western University, I provide aerospace medicine
training to medical students and residents. I also serve as a faculty member and a member of the
research advisory council to the Institute for Earth and Space Exploration at Western University.
A copy of my Curriculum Vitae is attached to this report Schedule A.
2. INSTRUCTIONS PROVIDED
I have been asked to provide an expert report addressing the following two questions related to
aerospace medicine:
1) Are there any features or conditions concerning aircraft and air travel, generally, that
increase the risk of COVID-19 transmission?
2) Did the COVID-19 safety measures in place for air travel in Canada, prior to the mandatory
vaccine requirement, keep travellers safe from COVID-19?
To that end, I respectfully submit the following evidence based on the available published data.

AR05469
3. BODY OF EVIDENCE
3.1 COVID-19 TRANSMISSION ON AIRCRAFT IS LOW
3.1.1 EPIDEMIOLOGY OF COVID ONBOARD AIRCRAFT
Since the beginning of the COVID-19 pandemic, multiple researchers have assessed the
transmission of COVID-19 particles onboard aircraft (Freedman & Wilder-Smith, 2020; Hu et al.,
2021; Mun et al., 2021; Pang et al., 2021; Rosca et al., 2021; Saretzki et al., 2021; Toyokawa et al.,
2022; Zhang et al., 2021). Bielecki et al developed a narrative review of the early published reports
on COVID transmission associated with air travel prior to October 2020. This article describes the
early transmission, in particular mass-transmission events, and discusses some of the early
strategies put in place to protect the travelling public (Bielecki et al., 2021). Also highlighted were
the variable implementations of safety protocols, despite early guidance from the International Air
Transport Safety Authority (IATA) during that period. The authors conclude that air travel, while
safe, required a unified front with all stakeholders participating in reducing transmission through
multiple layers of defence against COVID-19.
Pang et al reviewed the published literature from May until September 2020 with the goal of
identifying COVID-19 cases related to air travel. While acknowledging underreporting and
asymptomatic transmission, they identified 2866 infectious passengers from within a 1.4 billion
1 in 1.7 million with the safety precautions in place at the time of the study (Pang et al., 2021).
A summary of the Transport Canada safety measures in place for the Canadian air travel system in
and around that timeframe is as follows:
• 2020 March 13 Notice to avoid all non-essential travel (Transport Canada, 2020a);

AR05470
• 2020 March 18 Consolidation of incoming international travel to 4 major hubs (Transport
Canada, 2020a);
• 2020 March 18 Banning of entry to foreign nationals who have been outside Canada or the
United States in the last 14 days (Transport Canada, 2020a);
• 2020 March 19 Health checks (simple health questions and screen for visible illness) for
international and transborder travel. Positive screen results in denial of travel for 14-days
without a medical certificate (Transport Canada, 2020a);
• 2020 March 20 Restrictions on discretional and non-essential transborder travel
(Transport Canada, 2020a);
• 2020 March 26 Mandatory 14-day self-isolation on return to Canada (Transport Canada,
2020a);
• 2020 March 30 Health checks for domestic travel (Transport Canada, 2020a);
• 2020 April 17 All passengers to wear a non-medical mask or face covering (Transport
Canada, 2020b); and
• 2021 January 17 Mandatory pre-departure COVID-19 testing for entry to Canada
(Transport Canada, 2020c).
3.1.2 RISK OF COVID EXPOSURE ON AIRCRAFT COMPARED TO COMMUNITY
A 2021 epidemiological study of COVID transmission reviewed cases and contact details of
domestic flights in China. This study reviewed 5797 passengers and undertook the task of
reviewing potential transmission in flight. Flight times ranged from 2-3.3 hours in the study.
Unfortunately, the authors were unable to comment on the use of personal protective equipment or
the specific public health measures in place during that early phase of the pandemic. The index
cases were found to infect up to 0.19 cases with the highest risk being the immediately adjacent

AR05471
(economy class) seat with an attack rate1 of 9.2% (Hu et al., 2021). The authors concluded that the
risk of COVID transmission on domestic flights remained low irrespective of the type of aircraft.
They also concluded that increasing distance from an individual reduced risk of COVID exposure.
Figure 1: COVID testing and positivity rate in Ontario from March 29, 2020 until February 12,
2022
Published data from Public Health Ontario demonstrating the COVID testing rates and percent
positivity of tests from March 2020 until February 2022.
Image from: https://www.publichealthontario.ca/-/media/documents/ncov/epi/covid-19-daily-

epi-summary-report.pdf?la=en
The overall reporting of COVID transmission related to aircraft remains low compared to the
transmission rates reported by Canadian provinces. Data for Ontario is presented in Figure 1 and
shows a percent positive rate (of those tested) of ~1-5% for the first half (Jan-Jul) of 2021 (Public
Health Ontario, 2022). Transport Canada has amplified the safety of air travel in their statements
1Attack rates are calculated as the number of people who became ill as a result of the exposure divided by the
number of people at risk for the illness.
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and published that even if 90% of cases were unreported, they estimate only 1 case in every 2.7
million travellers would occur (Transport Canada, 2021).
3.1.3 BORDER TESTING DATA
The Public Health Agency of Canada has provided data on pre-arrival testing since it was required
and the data is presented in table I for the first half of 2021 (Government of Canada, 2022). From
March 21, 2020, until January 30, 2022, Canada had 9,248,721 air travellers while in 2019 the
volume of air travel was 36,590,236. The low percent positive rates in air travel likely occurs from
an increased public health awareness and a self-selection bias whereby symptomatic individuals
opt to change or cancel their flights.
Table I: Border testing results for air travel from February 21 to July 4, 2021 (from:
19/testing-screening-contact-tracing/summary-data-travellers.html)
Date Tests Completed Percent Positive
21-28 Feb 2021 10,177 1.4%
1-31 Mar 2021 125,953 1.6%
1-30 Apr 2021 175,171 2.1%
1-31 May 2021 161,787 0.4%
1-30 Jun 2021 192,662 0.3%
1-4 Jul 2021 22,517 0.4%
Totals 688,207 0.9%

AR05473
3.2 AIRCRAFT DESIGN AND ENGINEERING REDUCE THE RISK OF COVID-19
TRANSMISSION
The aviation industry has long worked to become the safest form of long-distance travel (IATA,
2022a). Aerospace medicine strives to add to the safety culture of aviation by generally accepting
risk threshold of incapacitation of aircrew by any condition to 1% or less. Data from IATA, which
represents 290 member airlines in 120 countries and accounts for 83% of
(IATA, 2002), demonstrated that in 2018 the fatal accident rate was 0.28 per 1 million flights. This
emphasis on safety is based on strict rules and adherence to regulations which begin with the
International Civil Aviation Organization (ICAO) as United Nations organization and are amplified
and upheld by national organizations such as Transport Canada (TC). These stringent policies and
guidelines have resulted in aviation being one of the safest forms of travel worldwide.
Specifically related to the COVID-19 pandemic, numerous organizations have reviewed the quality
of aircraft cabin air and demonstrated that it is of high quality and better than most indoor
environments. A summary of the relevant documentation is provided below.
IATA report that the risk of transmission of disease onboard an aircraft is very low for the following
reasons:
a. All passengers face the same direction;
b. Seatbacks act as barriers;
c. Air flow is from the top to bottom (Figure 2); and
d. The air is clean. (IATA, 2022b)

AR05474
3.2.1 CABIN AIR QUALITY
Figure 2: Aircraft cabin air circulation

An illustration of air circulation within the aircraft cabin
demonstrating the flow from overhead vents to return at
floor level inlets.
Image from:
https://www.iata.org/en/youandiata/travelers/health/low-
risk-transmission/
Aircraft cabin air enters from the jet engines. A segment of the compressed air is bled from the
engine to an air conditioning unit where it is cooled. Subsequently, the air is mixed with recycled air
from the aircraft cabin that has been filtered through a high efficiency particulate absorbing (HEPA)
filter at the mixing manifold. This air then is used and cycled in the cabin before 50% is exhausted
and the remaining cabin air repeats the cycle. A diagram of the cabin air cycle is presented in Figure
3.

AR05475
Figure 3: Diagrammatic representation of air intake and mixing in aircraft

Air is brought onboard through the aircraft engine where it is compressed. A portion of the
compressed air is bled into the air conditioning unit where it is cooled and then subsequently
mixed with recycled and filtered cabin air in the mixing manifold. This air is then circulated in the
cabin and 50% is exhausted.
Image from: https://www.howitworksdaily.com/how-do-cabin-air-systems-work/
IATA goes further to qualify some statistics about the quality of the cabin air itself. They identify
that the cabin air is refreshed 20 to 30 times per hour (IATA, 2022b) which exceeds the standard of
most hospital operating rooms. The air exchange rate of 20 to 30 times per hour results in a
turnover on average of every 2 to 3 minutes and is significantly higher than in residential buildings
(0.35 times per hour (US EPA, 2022a)) and hospital airborne infection isolation rooms for
managing conditions such as Tuberculosis (6 to 12 times per hour (Sehulster et al., 2003)). A
diagram of typical airline cabin airflow is presented in Figure 1.
for operating rooms in January 2022 specifically related to the COVID-19 pandemic. This
AR05476
publication was based upon and aligned with recommendations from the Canadian Standards
ber of
air exchanges per hour required for 99.9% efficiency of airborne contaminant removal.
Table II: Air Exchanges Per Hour Required For Airborne Contaminant Removal at 99% and
99.9% efficiency (Jensen et al., 2005)
Air exchanges/hour Time required for Time required for
99% removal (mins) 99.9% removal (mins)
2 138 207
4 69 104
6 46 69
8 35 52
10 28 41
12 23 35
15 18 28
20 14 21
50 6 8
The American Institute of Architects (AIA) guidelines recommend that operating rooms have
ventilation that meets at least 12 air exchanges per hour (AIA, 2016). Since the start of the
pandemic, most hospitals have determined and implemented a rule that operating rooms require a
15-minute air exchange following an aerosol generating medical procedure (e.g., intubation) to
reduce the risk of COVID transmission. This has been based primarily on recommendations
referencing Table I and the need for an air exchange of 12-20 times per hour (LHSC, 2020;
Manitoba Health, 2021). It should be noted that the chart and data provided in Table I is based on
studies from the National Institute for Occupational Safety and Health (NIOSH). The dataset used to
generate the table was originally performed in 1973 and relied primarily on laminar air flow.
Equipment, chairs, operating room tables and people can disrupt the airflow and reduce the
efficiency of ventilation.

AR05477
Current aircraft design includes a mixture of fresh (50%) and recycled (50%) air as illustrated in
Figure 4. This design allows aircraft cabins to exceed the values recommended for hospital-grade
operating rooms in two ways:
a. A higher air refresh rate of 20-30 times per hour; and
b. Re-using only 50% of the cabin air (and filtering that portion)
Figure 4: Sources of cabin air

An illustration of air sources in the aircraft cabin. Cabin
air available to passengers in the cabin consists of a
mixture of air that is: 50% fresh air from the
environment and 50% HEPA-filtered air recycled from
the cabin.
Image from Kinahan et al. (Kinahan et al., 2021)
3.2.2 HEPA FILTERS
Government and health standards also recommend that hospital operating rooms utilize high
efficiency in filtering small particles) (US EPA, 2022c). In general, operating rooms are expected to
have a MERV of 14 or greater (Barrick JR, 2014). HEPA filters, such as those typically used on
aircraft, are sometimes expressed to have a MERV of 17 and are manufactured and tested to
remove at least 99.7% of particles to a size of 0.3 microns (US EPA, 2022b). The SARS-CoV-2
particle has been estimated at 0.1 micron in size, however transmissibility depends on spread via
aerosolization or droplet which increases the size of the particle from 3 30 microns in diameter.
AR05478
Researchers from the University of British Columbia have released information which describes
that level II surgical masks, N95 respirators and HEPA filters are sufficient to filter particles 0.1 2
microns in diameter (UBC Aerosol Lab, 2022). IATA highlights that the HEPA filters used in the
aviation environment filter 50% of the cabin air, and that the other 50% is exhausted and replaced
with fresh air from outside the cabin (IATA, 2022b).
It should also be noted that while newer, larger aircraft are likely to have HEPA filters, older and
smaller aircraft may not be fitted with them, potentially lowering the quality of cabin air (Goh,
2020). In reviewing major Canadian air carriers:
a. Air Canada reports that as part of their CleanCare+ program, all of their fleet of
Airbus A220, A319, A320, A321, A330 and Boeing 777 and 787 aircraft operate with
HEPA filters (Air Canada, 2020);
i. Details were not provided for the Air Canada Express fleet operated by
Jazz/Chorus Aviation;
b. WestJet reports that all of their aircraft are equipped with HEPA filters (WestJet,
2022);
c. Air Transat reports that their fleet all use HEPA filters (Air Transat, 2022); and
d. Sunwing reports that their fleet all use HEPA filters (Sunwing, 2022).
American air carriers have published similar details regarding use of HEPA filters on their websites
including American Airlines (American Airlines, 2020), Delta Airlines with their CareStandard SM
(Delta Airlines, 2022) (United Airlines, 2022) programs.
3.3 MEASURING COVID-19 TRANSMISSION IN AIR TRAVEL
As discussed above, Bielecki et al published a narrative review of COVID transmission on aircraft
based on the available known and reported events (Bielecki et al., 2021). Their data reviewed the

AR05479
preventive measures used by various airlines and compared to the published aircraft-mediated
transmission at the time. Bielecki et al concurred with the IATA data that transmission could
remain low (Bielecki et al., 2021), in particular with a layered approach such as that recommended
(Harvard T.H. Chan
School of Public Health, 2020), incorporating elements such as:
1) Airline Actions:
a. High quality ventilation systems;
b. Disinfection protocols;
c. Screening;
d. Physical distancing during boarding and deplaning; and
e. Education and awareness.
2) Traveller Actions:
a. Routine public health measures; and
b. Wearing of face masks.
Rosca et al assessed the transmission of COVID-19 based on a literature review from February 2020
until January 2021. They found 273 index cases amongst the dataset which included 18 studies.
Attack rates were generally reported as 0 to 8.2%. Their data again supported the safety features of
the aircraft environment and the effectiveness of the layered approach to safety enacted by
agencies worldwide.
On October 15th, 2020, the United States Transport Command collaborated with Boeing, United
Institute to assess the transmission of aerosol particles in a typical wide-body aircraft cabin. Using
Boeing 767 and 777 aircraft, mannequins were placed with and without face masks in various
positions around the aircraft and fluorescent tracer particles were released at intervals timed to be

AR05480
representative of a breathing pattern. Sensors were placed to collect real time particulate travel
data. The maximum exposure was in a nearby seat (immediately adjacent) within the economy
section of the 777 aircraft measured at a 0.4614% penetrance of a particle which the authors
equated to a 99.54% reduction of risk from an aerosolized source such as COVID-19 (Kinahan et al.,
2021). Release and measurement sites as performed in the study are presented in Figure 5. The
conclusion of the authors is that the risk of transmission is low and that it decreases rapidly with
distance. On average, their data demonstrated removal of particulate matter within 6 minutes
which is significantly faster than the standards used in hospital operating rooms. 6 minutes (vice 2
3 minutes as presented by IATA) likely accounts for the non-linear airflow in the environment
created by seats, individuals and the reality of the aircraft interior environment and may be a more
realistic description of the air turnover time for a cabin.
Figure 5: Diagram of particle

release sites
Results of the particle release
tests on Boeing 767 and 777
aircraft performed. The
authors concluded that
distance reduced risk of
transmission and overall risk
remained low.
Image from Kinahan et al.

(Kinahan et al., 2021)

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This seminal study assessed the movement of aerosolized particles, however, lacks key elements
that occur during routine flight which likely result in an under-estimation of the risk of COVID
transmission. Primarily, the study design considered a single point source which may not be the
case on an aircraft if multiple individuals are infectious. The authors themselves highlight that
especially in early mass transmission flights, multiple sources could be identified as reviewed by
Freeman et al (Freedman & Wilder-Smith, 2020). Furthermore, variable shedding rates or
infectivity of particular variants or particles are also missing from the analysis and play a key role
in COVID transmission as we have witnessed over the past two years. Lastly, there was no data
concerning the routine movement of individuals throughout the cabin, changes in airflow due to
meal service, or any analysis of COVID/COVID-like particle changes due to humidity or transmission
from other surfaces. Interestingly, some mannequins were also masked and although the efficacy of
masking was not a primary goal of the study, further details about these results are discussed
below.
Modelling studies have reviewed the differences in cabin airflow and environmental variables
based on class of service (economy vs. business or first) and location within the aircraft (aisle vs.
window vs. middle). Findings from the study by Desai et al ranked the seats and position in the
cabin based on CO2 mass (i.e., stuffiness), temperature and airflow velocities (Desai et al., 2021).
Figure 5 highlights the results table from their study demonstrating the variable effects of class of
service presented. Comparative differences in the manufacturer of the aircraft leads to variable seat
conditions. The authors concluded that in economy class, the best seat on an Airbus A380 was next
to the window while the best Boeing 747 seat was in the middle of the bank next to the window
(Desai et al., 2021). Increasing class of service increased available airflow and distance from other
passengers. This dataset correlates with the recent guidelines from IATA with respect to Omicron
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that highlight the value of Business Class travel to reduce transmission risk, primarily from
increased distancing and reduced exposures compared to a more crowded economy class cabin.
Schwartz et al. published a case report in the Canadian Medical Association Journal of a single,
symptomatic COVID positive individual onboard a flight from Guangzhou, China to Toronto, Ontario
in January 2020 (Schwartz et al., 2020). There were 35 passengers on the 15-hour flight and 25
individuals were identified as close contacts (within 2m) of the index case. One close contact
individual became symptomatic but tested negative for COVID-19. Five non-close contact
individuals became symptomatic later and tested negative for COVID-
supported the safety of the aircraft cabin with relation to COVID despite the long-haul flight and a
known exposure. While the authors indicate some degree of masking during the flight, this occurred
before any mandatory masking, pre-flight testing, or general public health measures outside of
temperature checks and health checks performed prior to flight in China.
3.3.1 AIRBUS DATA
Airbus performed a study using computational fluid dynamics to recreate a model of air movement
in the cabin of an A320 cabin. The goal of this study was to see how droplets from a cough would
move within the cabin. Interestingly, Airbus performed the same model in a simulated non-aircraft
environment and compared the results. The 50 million datapoints demonstrated a lower risk of
exposure when sitting next to a source (e.g. COVID positive individual) than when in a non-aircraft
environment such as a grocery store or office building (Airbus, 2020).
3.3.2 BOEING DATA
Boeing also performed a computational fluid dynamics study in addition to modelled situations and
studies on real aircraft (737, 776, 777) (Boeing, 2020; Pang et al., 2021). The Boeing results are

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reviewed in detail above in the US Transport Command discussion and are similar to Airbus in that
they conclude the risk of transmission is low.
3.3.3 EMBRAER DATA
Embraer performed computational fluid dynamics and modelling studies in cabin mock-ups. They
demonstrated an extremely low risk of particle transmission which they reported as 0.13% fraction
of a cough mass without a mask and 0.02% fraction of a cough mass with a mask (Embraer, 2020).
3.4 ADDITIONAL ELEMENTS OF THE LAYERED APPROACH TO AVIATION SAFETY
3.4.1 MASKING
Masking is mandatory onboard aircraft and a key recommendation of the International Civil
Aviation Authority (ICAO) and the World Health Organization (WHO) (IATA, 2022c). While not a
goal of the study, the United States Transport Command study discussed above did include some
mannequins with 3-ply masks. There was a statistically significant change in the results from the
masked to unmasked results further decreasing the particle count measured at the sensor by an
additional 15.6% (Kinahan et al., 2021). The study by Rosca et al also assessed the change in attack
rates when individuals were masked and found a reduction in maximal attack rate2 from 8.2% to
0.32% when masks were worn.
3.4.2 PRE-FLIGHT TESTING
Tande et al published a study of a program initiated by Delta Airlines, the Mayo Clinic, and the
Georgia Department of Health assessing the effectiveness of pre-flight screening of passengers. This
2Attack rates are calculated as the number of people who became ill as a result of the exposure divided by the
number of people at risk for the illness.
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study was designed to review the effectiveness of testing strategies to reduce the risk of COVID
exposure onboard commercial aircraft. Through pre-flight identification of positives and denial of
boarding, the hypothesis was that COVID exposure and transmission could be further reduced. The
authors tracked 9853 passengers who had taken a PCR test performed 72 hours before their flight
departure leading to a frequency of active infection of less than 1 in 1000 passengers (Tande et al.,
2021). Despite this being performed during a period of high infectivity in the United States, the use
of a PCR test to screen individuals effectively decreased the risk of onboard infection. This result
demonstrated the efficacy of screening and denying boarding to COVID positive individuals and
reduced the rates of air travel COVID transmission and exposure to levels significantly below the
community rate.
3.4.3 DISTANCING
Most studies of COVID-19 transmission in aircraft highlight the importance of distancing. Attack
rates and odd ratios of COVID transmission and infection increase with proximity to the infectious
source. Despite the high quality of the aircraft cabin air, screening measures and safety protocols
put in place, transmission may still occur in that context (Freedman & Wilder-Smith, 2020; Hu et al.,
2021; Mun et al., 2021; Pang et al., 2021; Rosca et al., 2021). As with community settings, distancing
is a key protective measure although it is difficult in the aircraft cabin environment.
The CDC performed a study to assess the change in COVID transmission onboard aircraft through
increased distancing. Using a model, they assessed exposure (not transmission). By eliminating
passengers in a middle seat the authors modelled a reduction of 33% in COVID (Dietrich et al.,
2021). This net result, however, must be viewed in the context of the reduction in total passenger
volume which provides the overall benefit. Computational modelling of seat blocking and variable
positioning in the cabin to increase distance has demonstrated similar results (Salari et al., 2020).

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Data in these studies mirror studies mentioned previously in this report which also concurred with
decreased risk of transmission with increased distance from a source (Dietrich et al., 2021; Kinahan
et al., 2021).
3.4.6 VACCINATION
At the time of this report, data is lacking regarding the effect of vaccination on transmission of, or
exposure to COVID-19 with respect to the air travel system. Currently, analysis on the effect of
vaccination on air travel safety can only be drawn from generalizations based upon the
effectiveness of the vaccines from non-aviation-based studies. I am aware that general vaccine
efficacy and public health data will be presented by other experts. Within the framework of a
layered approach to aviation safety, vaccination can be seen as a further protective measure to
reduce risk. However, there is currently insufficient data to ascertain the specific percentage of
safety improved by any specific element used within the layered approach. Further studies related
to the effectiveness of the vaccine to the various novel variants specific to the aircraft environment
are needed.
4. SUMMARY AND CONCLUSIONS

The engineering design of the aircraft cabin has created one of the safest environmental air spaces
as demonstrated by the studies on air quality and filtration. Aircraft cabins exceed the air quality
standards set for operating rooms within Canadian medical facilities. While transmission of COVID-
19 can occur in air travel, the data available indicates that it is at an exceptionally low rate and
studies linking positive cases onboard and subsequent positive cases of COVID-19 cannot
completely rule out exposure or transmission prior to flight.

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Aerospace medicine generally uses a 1% risk as the rule as the barrier between acceptable and
unacceptable. While this is typically applied to risk of crew incapacitation3 and began as a risk
acceptance level for cardiovascular factors, it has been applied in other circumstances to increase
aviation safety.
Large studies performed during COVID such as the US Transportation demonstrated a 99.54%
reduction in particle transmission (Kinahan et al., 2021) due to the aircraft cabin design, resulting
in a 0.46% particle risk for an immediately adjacent passenger falling within the 1% risk rule. The
average breathing zone particle reduction across 767 and 777 aircraft were found to be 99.97%
and 99.98% respectively. Based on the available data, the risk from COVID-19 onboard aircraft
remains much lower than many other community settings (i.e. sporting venues, movie theatres, and
restaurants). likelihood of passenger-to-
passenger transmission aboard aircraft appears to be low (Transport Canada, 2021). Overall, the
layered approach to air travel safety both prior to and during the COVID-vaccination phases of the
pandemic have maintained COVID transmission at an acceptably low rate. Furthermore, this
layered approach has made it difficulty in many instances to ascertain whether COVID-19 cases
were related to air travel or to pre-flight/post-flight exposures.
Taken together, the above data and rationale demonstrate that air travel remains one of the safest
methods of travel, despite the pandemic.
Sincerely,
A. Sirek, MD, MSc, CCFP, DABFM, FAsMA, FAAFP
3An incapacitation is traditionally defined by aerospace medicine as the inability of a pilot or crewmember to
carry out their normal duties due to the effects of physiological factors (i.e. illness, effect of medical condition,
death, etc.)
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This is Exhibit “C” referred to in the Affidavit of Dr. Adam Sirek sworn March 11, 2022

Sam A. Presvelos
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5. REFERENCES
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American Airlines. (2020). American Minute: Learn How HEPA Filters Clean Cabin Air. Retrieved February
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%20the%20coronavirus.
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https://doi.org/10.1016/j.tmaid.2020.101915

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Boeing. (2020). Cabin Air Quality Research and Analysis.
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quality-research-analysis.pdf
Delta Airlines. (2022). Delta CareStandard. Retrieved February 14 from
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Desai, P. S., Sawant, N., & Keene, A. (2021). On COVID-19-safety ranking of seats in intercontinental
commercial aircrafts: A preliminary multiphysics computational perspective. Build Simul, 1-12.
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Dietrich, W. L., Bennett, J. S., Jones, B. W., & Hosni, M. H. (2021). Laboratory Modeling of SARS-CoV-2
Exposure Reduction Through Physically Distanced Seating in Aircraft Cabins Using Bacteriophage
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Embraer. (2020). Healthy Journey.
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Freedman, D. O., & Wilder-Smith, A. (2020). In-flight transmission of SARS-CoV-2: a review of the attack
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Goh, S. (2020). Don't Abdicate Personal Safety to Airplane Measures. JAMA Network.
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Government of Canada. (2022). COVID-19: Summary data about travellers, testing and compliance.
Retrieved February 14 from https://www.canada.ca/en/public-

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health/services/diseases/coronavirus-disease-covid-19/testing-screening-contact-
tracing/summary-data-travellers.html
Harvard T.H. Chan School of Public Health. (2020). Assessment of risks of SARS-CoV-2 transmission
during air travel and non-pharmaceutical interventions to reduce risk phase one report: gate-to-
gate travel onboard aircraft. https://cdn1.sph.harvard.edu/wp-
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IATA. (2002). Members. Retrieved February 2 from https://www.iata.org/en/about/members/
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IATA. (2022b). Low Risk Transmission. Retrieved February 2 from
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IATA. (2022c). Why are Masks Mandatory when Traveling by Air. Retrieved February 3 from
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Jensen, P. A., Lambert, L. A., Iademarco, M. F., Ridzon, R., & Cdc. (2005). Guidelines for preventing the
transmission of Mycobacterium tuberculosis in health-care settings, 2005. MMWR Recomm Rep,
54(RR-17), 1-141. https://www.ncbi.nlm.nih.gov/pubmed/16382216
Kinahan, S. M., Silcott, D. B., Silcott, B. E., Silcott, R. M., Silcott, P. J., Silcott, B. J., Distelhorst, S. L.,
Herrera, V. L., Rivera, D. N., Crown, K. K., Lucero, G. A., & Santarpia, J. L. (2021). Aerosol tracer

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testing in Boeing 767 and 777 aircraft to simulate exposure potential of infectious aerosol such
as SARS-CoV-2. PLoS One, 16(12), e0246916. https://doi.org/10.1371/journal.pone.0246916
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Failed ARI Screen or Unable to Assess or Confirmed COVID-19. In. London, Ontario: LHSC.
Manitoba Health. (2021). COVID-19 Provincial Guidance for Aerosol Generating Medical Procedures
(AGMPs). In: Manitoba Health.
Mun, E., Kim, Y. M., Han, B., Jeong, J., Kim, W., & Lee, C. (2021). A case series of flight attendants at risk
of COVID-19 in South Korea in 2020. Ann Occup Environ Med, 33, e1.
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Conly, J. M., & Jefferson, T. (2021). Transmission of SARS-CoV-2 associated with aircraft travel: a
systematic review. J Travel Med, 28(7). https://doi.org/10.1093/jtm/taab133
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E., Stubing, F., & Kupper, T. (2021). Are small airplanes safe with regards to COVID-19
transmission? J Travel Med, 28(7). https://doi.org/10.1093/jtm/taab105

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Schwartz, K. L., Murti, M., Finkelstein, M., Leis, J. A., Fitzgerald-Husek, A., Bourns, L., Meghani, H.,
Saunders, A., Allen, V., & Yaffe, B. (2020). Lack of COVID-19 transmission on an international
flight. CMAJ, 192(15), E410. https://doi.org/10.1503/cmaj.75015
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Sunwing. (2022). SAFE WITH SUNWING. Retrieved February 14 from https://www.sunwing.ca/en/safe-
with-sunwing
Tande, A. J., Binnicker, M. J., Ting, H. H., Del Rio, C., Jalil, L., Brawner, M., Carter, P. W., Toomey, K., Shah,
N. D., & Berbari, E. F. (2021). SARS-CoV-2 Testing Before International Airline Travel, December
2020 to May 2021. Mayo Clin Proc, 96(11), 2856-2860.
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S., Kudaka, J., Kakita, T., Kuroda, M., & Nakasone, T. (2022). Transmission of SARS-CoV-2 during
a 2-h domestic flight to Okinawa, Japan, March 2020. Influenza Other Respir Viruses, 16(1), 63-
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Transport Canada. (2020b). New measures introduced for non-medical masks or face coverings in the
Canadian transportation system. Retrieved February 14 from

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https://www.canada.ca/en/transport-canada/news/2020/04/new-measures-introduced-for-
non-medical-masks-or-face-coverings-in-the-canadian-transportation-system.html
Transport Canada. (2020c). Pre-departure COVID-19 testing and negative results to be required for all air
travellers coming to Canada
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canada.html
Transport Canada. (2021). RISK OF COVID-19 TRANSMISSION ABOARD AIRCRAFT. Retrieved February 14
from https://tc.canada.ca/en/binder/risk-covid-19-transmission-aboard-aircraft#_edn2
UBC Aerosol Lab. (2022). What size particle is important to transmission of COVID-19?
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Zhang, J., Qin, F., Qin, X., Li, J., Tian, S., Lou, J., Kang, X., Lian, H., Niu, S., Zhang, W., & Chen, Y. (2021).
Transmission of SARS-CoV-2 during air travel: a descriptive and modelling study. Ann Med, 53(1),
1569-1575. https://doi.org/10.1080/07853890.2021.1973084

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SHAUN RICKARD AND - and - HER MAJESTY THE QUEEN, as represented by the ATTORNEY
KARL HARRISON GENERAL OF CANADA and TRANSPORT CANADA
Applicants Respondents
FEDERAL
COURT OF CANADA
Proceeding Commenced at Toronto, Ontario
AFFIDAVIT OF DR. ADAM SIREK
PRESVELOS LAW LLP

Toronto, Ontario
M5H 3L5
Sam A. Presvelos (LSO #:

Tel: (
Email:
Evan A. Presvelos (LSO #: )

Tel:
Email:
Lawyers for the Applicants

AR05496
TAB 33
AR05497
BETWEEN:

Applicants
-and-

Respondents

I, Dr. Jennifer Grant, having been named as an expert witness by the Applicants, certify that I have
read the Code of Conduct for Expert Witnesses as set out in the schedule to the Federal Courts
Rules (and attached hereto) and agree to be bound by it.
March 11th, 2022 _____________________________________

Dr. Jennifer Grant
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EXPERTS' REPORTS

the report;

opinions;

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to the Court.
EXPERT CONFERENCES
witness

addressed; and
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BETWEEN:

Applicants
- and -

Respondents
AFFIDAVIT OF DR. JENNIFER GRANT
1. I, Dr. Jennifer Grant, of the City of Vancouver, in the Province of British Columbia, MAKE
OATH AND SAY AS FOLLOWS:
2. I am a Medical Microbiologist and Infectious Disease Physician and as such have personal
knowledge of the facts and matters hereinafter deposed to save and except where the same
are stated to be based upon information and belief and where so stated I verify believe the
same to be true.
3. Attached to this Affidavit and marked hereto as Exhibit “A” is a true copy of my current
4. Attached to this Affidavit and marked hereto as Exhibit “B” is a true copy of my expert
report with respect to this matter.

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5. Attached to this Affidavit and marked hereto as Exhibit “C” is a true copy of the list of
documents relied upon my report.
Sworn before me )
___________________________ ________________________
A Commissioner for taking Affidavits DR. JENNIFER GRANT
Sam Presvelos
LSO#
Presvelos Law LLP

Toronto, ON M5H 3L5
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This is Exhibit “A” referred to in the Affidavit of Dr. Jennifer Grant sworn March 11, 2022

Sam A. Presvelos
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Page 1/8
Jennifer M. Grant
Infectious Diseases Specialist and Medical Microbiologist
CONTACT INFORMATION
ADDRESSES
Home:
Work: JPPN 1112 – 855 W 12th Ave., Vancouver BC, V5Z 1M9
PHONE NUMBERS
Phone - Cell : +
Phone - Work: +1
FAX - Work:
EMAIL ADDRESSES
Work:
Home:
EMPLOYMENT RECORD
Jul, 2013 - present Medical Director ASPIRES, antimicrobial stewardship; Vancouver Coastal Health
Jul, 2010 - present Specialist Physician; Infectious Diseases, Vancouver General Hospital
Jun, 2007 - present Microbiologist; Pathology and Laboratory Medicine; Vancouver Coastal Health
Jun, 2007 - present Infection Control Officer; Long Term Care and Rehabilitation, Richmond Hospital; VCH
Dec, 2007 - Nov 2014 Specialist Physician; Infectious Diseases; St. Paul's Hospital
Jan, 2008 - Feb, 2011 Travel medicine consultant; Travel Medicine and Vaccine Centre
Jul, 2005 - Dec, 2005 Hospital Physician; Ivory Coast mission; Medecins Sans Frontieres
Jul, 2003 - Dec, 2006 Fellow; Infectious diseases and microbiology; McGill University Health Centre
Jul, 2000 - Jun, 2003 Resident; Internal Medicine; McGill University Health Centre
LEAVES OF ABSENCE
Nov 2014 - Jun, 2015 Maternity
Jan 2011 - Sep, 2011 Maternity
Nov 2008 - May, 2009 Maternity
LANGUAGES
English (Read, Write, Speak, Understand )
French (Read, Write, Speak, Understand ) – Office de la Langue Français certified for practice in Québec
Spanish (Read, Speak, Understand )
EDUCATION
DEGREES
Jun, 2007 Collège Des Médecins du Québec Certification; Medical Microbiology

May, 2007 Royal College Certification; Microbiology; Royal College of Physicians and Surgeons of Canada
Sep, 2006 Royal College Certification; Infectious Diseases; Royal College of Physicians and Surgeons of Canada
Aug, 2004 Royal College Certification; Internal Medicine; Royal College of Physicians and Surgeons of Canada
Jun, 2000 MDCM; Medicine; McGill University
Jun, 1996 B.S.; Molecular biophysics and biochemistry; Yale University, Graduus Cum Laude
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Jennifer Grant – specialist physician Page 2 of 8
AWARDS AND DISTINCTIONS
SCHOLARSHIP
Oct 2021 CIHR SNAP, Staphylococcus aureus network adaptive platform, co-investigator $1.5 million
Jun, 2018 Transplant BC Pilot Project Grant, Assessment of Risk Factors for Infections in Solid Organ Transplants – $15 000
Feb, 2015 Award of Merit for Collaborative Solutions, BC Health Care Awards
Nov, 2017 ACCOLADE Award (Award for exCeptional COntribution to Learning AnD Education (ICU teaching award)
Feb, 2012 NCCID/AMMI; Antimicrobial Use Monitoring and Antimicrobial Resistance Surveillance Project. PI – $153 000
Aug, 2008 Renal Agency of BC; Interferon Gamma Release Assay in Dialysis population study; $49 900
Jun, 2008 Best Poster CHICA Canada conference 2008; CHICA Canada; $250
Apr, 2006 Johnathan Freeman Scholarship; Johnathan Freeman Foundation; $1500
Jun, 1997 Medical Research Council of Canada research scholarship; $4000
Aug, 1999 Hubert student fellowship in international health; Centres for Disease Control; $2500
PROFESSIONAL ACTIVITES
MEDICAL LEADERSHIP
Apr 2020 – present Medical lead for Infection Prevention; Physician Occupational Safety and Health (POSH)
Mar 2020 – present Infection Control Officer, Richmond Hospital
Jun 2012 – present Regional Medical Director ASPIRES
COMMITTEE LEADERSHIP
Nov 2021 – present Clinical Therapeutics Committee for COVID therapies: Role Co-Chair
Jun, 2019 – present Canadian Nosocomial Infection Surveillance Program antibiogram working group; Role: Chair
Jan, 2016 - present AMMI Canada, Board of Directors, Role: Infections Diesease Section Head
Jan, 2017 - Dec 2018 Provincial Antimicrobial Clinical Expert Group, role: Chair
Jan, 2010 - Jan, 2013 CHICA (IPAC) Canada Standards and Guidelines Committee; Role: Director
Jan, 2010 - present Drugs and Therapeutics Committee; Vancouver Coastal Health; Role: Chair
Feb, 2010 - Feb, 2011 British Columbia Health Authorities Infectious Disease Subcommittee; Role: Chair
Apr, 2008 - Feb, 2011 Long Term Care Working Group; PICNet BC; Role: Chair
COMMITTEE MEMBERSHIPS
Sep 2020 – Oct 2021 Clinical Therapeutics Committee for COVID therapies; Role: Member
Jun, 2016 - Jan 2020 SHEA Guidelines Committee: AMMI Canada representative; Role: Member
Apr, 2015- Apr 2018 AMMI Canada Guidelines Committee: AMMI Canada; Role: Member
Jan, 2015 - present Resident Training Committee Medical Microbiology; role: Member
Jan, 2014 - present Provincial Antimicrobial Stewardship Clinical Expert Group; BC Ministry of Health; Role: Member
Sep, 2011- Sep, 2016 Multi-Drug Resistance Guidelines Review Committee; PICNet BC; Role: Member
Oct, 2010 - present Canadian Nosocomial Infection Surveillance Program; VCH; Role: Delegate
Oct, 2010 - present Antimicrobial Utilization Working Group; CNISP; Role: Member
May, 2010 - present AMMI Canada antimicrobial stewardship and resistance committee; Role: Member
Jan, 2010 - Jan 2013 Executive Committee; CHICA Canada; Role: Member
Jan, 2010 - present Regional pharmacy and therapeutics committee; Vancouver Coastal Health; Role: Member
Sep, 2010 - Feb 2012 CSA Strategic Steering Committee on Health Care Systems and Technology; role: CHICA representative
Jan, 2009 - present British Columbia Tropical Medicine Group; Role: Member
Mar, 2008 - present Antimicrobial Utilization Subgroup; Vancouver General Hospital; Role: Member
Jun, 2008 - Dec, 2009 Diagnostics and Therapeutics Committee; Vancouver General Hospital; Role: Member
ADVISORY ACTIVITIES
Apr 2017 - present Associate Editor JAMMI; editor for stewardship related articles
Apr 2015 - present ID Section Representative Royal College of Physicians Infectious Diseases Residency Training Committee
Jan, 2012 - present Advisory Committee for Do Bugs Need Drugs; community antimicrobial stewardship programme
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Jan, 2012 - present Reviewer for Bugs and Drugs; guidelines for antimicrobial use in community settings
Jan, 2008 - Dec, 2010 Advisor to Canadian Refugee Guideline Committee; Canadian Collaboration for Immigrant and Refugee
Health; University of Ottawa
REVIEW ACTIVITIES
Refereeing Activities Articles reviewed for publication

Canadian Journal of Infectious Diseases and Medical Microbiology: 15 works reviewed
International Journal of Antimicrobial Agents: 1 work reviewed
Canadian Journal of Emergency Medicine: 1 work reviewed
American Journal of Infection Control: 1 work reviewed
UBC Medical Journal: 1 work reviewed
Vaccine: 1 work reviewed
CheckSample: 1 work reviewed
Grant Application Assessment Activities

Jan, 2018 New Investigator Grant; PSI Foundation
Jan, 2010 CIHR Catalyst Grant; CIHR
SCHOLARLY ACTIVITIES
RESEARCH PROJECTS
Jul, 2021 SNAP; PI VGH: Staphlylococcus aureus Adaptive Network trial; University of Melbourne, Victoria, Australia
Jun, 2020 CATCO; PI Richmond Hospital; Canadian treatments for COVID-19; Sunnybrooke Hospital, ON
Jul 2018 BALANCE; PI VGH, Bacteremia antibiotic length actually needed to treat trial; Sunnybrooke Hospital, ON
Oct, 2018 OPAT antimicrobial Utilization; University of British Columbia, Vancouver, BC
Sep, 2018 Cefazolin with Penicillin Allergy; University of British Columbia &ASPIRES, Vancouver, BC
Mar, 2018 Risk Factors for Sterile Site Infection in Solid Organ Transplant Patients; Transplant BC, Vancouver, BC
Jun, 2017 AcceleratePheno clinical impact on management of sepsis; University of British Columbia, Vancouver, BC
Jun, 2016 Role of FMT in Solid Organ Transplant Patients; University of British Columbia, Vancovuer, BC
Feb, 2014 Bioaerosols of respiratory viruses; University of British Columbia & Worksafe BC, Vancouver, BC
Jan, 2014 BMT Stewardship Evaluation; Universities of British Columbia and Toronto, Vancouver and Toronto
Nov, 2013 Urinary Tract Infection in the ED; University of British Columbia, Vancouver, BC
Nov, 2013 C. Diffence, vaccine against C. difficile infection; University of British Columbia, Vancouver, BC
Sep, 2013 Uganda Pediatric Sepsis Study; University of British Columbia, Ugandan Ministry of Health, Uganda
Jun, 2012 Theraclone detection of antibacterial antibodies; Vancouver General Hospital, Vancouver BC
PRESENTATIONS
Feb, 2020 Outcomes of Administering Cefazolin vs other antibiotics in Penciilin allergy, Quality Forum, Feb 2020, Vancouver, BC
Oct, 2018 ESBL, To Report or Not To Report; VITEK Users Group: Vancouver, BC
May, 2018 Plenary Debate: β-lactams plus inhibitors for ESBL and AmpC; AMMI Canada Conference: Vancouver, BC
May, 2018 Role of AcceleratePheno System’s Potential Influence on Timeliness of Management Decisions; AMMI: Vancouver, BC
Nov, 2016 Myths of Urinary Tract Infection, IPAC BC conference: Vancouver, BC
Sep, 2016 Antimicrobial Stewardship in Urology: BC Urologic society: Vancouver, BC
Apr, 2016 The Future of Stewardship: AMMI Canada Annual Conference: Vancouver, BC
Mar, 2016 AROs in the Community, How do we Harness the Force?: PICNet conference, Richmond, BC
Feb, 2016 Antimicrobial Stewardship in the Community: Post-Graduate Review in Family Medicine. Vancouver, BC
Sep, 2014 Clinical Pearls in Infectious Diseases: Canadian Society of Hospital Medicine. Vancouver, BC
Apr, 2014 Travel Acquired Infections: IPAC BC conference, Vancouver BC
Jun, 2010 Diagnosing TB in dialysis: the role of interferon gamma release assays; BC Provincial Renal Agency; Vancouver, BC
May, 2010 So you think you have an outbreak; CHICA Canada annual conference; Vancouver
Jan, 2010 How to Prevent TB; CHICA BC education day; Royal Columbian Hospital
Sep, 2009 Introduction to Microbiology; SPPH 524 / PATH 457; University of British Columbia, British Columbia
Sep, 2008 The Superfluous Third Specimen; British Columbia Association of Medical Microbiologists; with Amanda Wilmer
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Sep, 2008 Introduction to Microbiology; SPPH 524 / PATH 457; University of British Columbia, British Columbia, Canada
Apr, 2008 Understanding TB risk; Internal Medicine Academic half day
Mar, 2008 Understanding TB Risk ; Vancouver Coastal Health; World Tuberculosis Day Vancouver, British Columbia
CONJOINT PRESENTATIONS
Jan, 2009 Incidence of Invasive Fungal Infections in the Leukemia/Bone Marrow Transplant ; Pharmacy Research Day, VGH, May
2009; with: D. Roscoe, J. Yeung, M. Power, D. Warkinton, W. Ma
May, 2010 The Superfluous Third Specimen; Presented To: AMMI; AMMI/CACMID annual meeting; Edmonton, Alberta, Canada; with:
Amanda Wilmer
TEACHING ACTIVITIES
LECTURES AND SEMINARS
2017- present Host Defense and Immunity: Introduction to antimicrobial stewardship. 1 lecutre/yr with 400 students
2016 - present Respiratory Block, Undergraduate Medicine: Introduction to respiratory pathogens. 1 lecutre/yr with 400 students
2014 - present ASPIRES teaching rounds; Noon lectures for IM residents antimicrobial prescribing 20 lectures/yr with 20-30 students
2011 - present Tropical Medicine Rounds; morning lecture series for ID & MM residents 4 lectures /yr with 10-15 students
2008 - present Academic Half Day; lecture series for ID & MM residents 4 lectures /yr with 10-15 students
2007 - present Host Defense and Immunity laboratory; 224-400 students
2007 - present PATH 722; Microbiology lab & lecture series for Pathology, Microbiology and Infectious Diseases residents
2007 - 2017 PHAR 501; Advanced Pharmacotherapeutics; Microbiology for pharmacists
Nov, 2007 e-test workshop; Pathology and Laboratory Medicine; 2 hours; 40 students
STUDENT/EMPLOYEE SUPERVISION
M.D. & Student projects (2007-present)

Aleksandra Stefanovic; Kennard Tan; Jocelyn Chase; Jijon Humberto; Jennifer Rajala; Erica Peterson; Evan Wood; Saad Al Khowaiter;
Amanda Wilmer; Victor Leung; Ghada Al Rawahi; Katherine Plewes; Melanie Murray; Clement Kwok; Peyman Tavassoli; Inna Sekirov;
Shazia Masud; Raidan Alyazidi; Claire Campion-Wright; Gannon Yu; Caitlyn Marek; Matt Michaleski; Yiannis Hiamaras; Connor
McSweeney; Wendy Song.
Employee supervision
June 2020 – present Glen Pineda, Aybaniz Ibrahimova, ICP Richmond Hospital
Sept 2019 – June 2020 Gail Busto, Mary Cameron Lane, ICP Richmond Hospital
May, 2018 – present Amneet Aulakh; PharmD ASPIRES; co-supervisor
Jan, 2017 – present May Tang; ICP GF Strong Rehabilitation Centre; Primary Supervisor
Jun, 2011 – present Daljit Ghag; PharmD ASPIRES; co-supervisor
Jun, 2013 – present Salomeh Shajari; Data analysist; ASPIRES; co-supervisor
Feb, 2012 – present Rita Declerc; ICP George Pearson Centre; Primary Supervisor
Dec, 2011 - Jan 2017 Lisa Harris; ICP GF Strong Rehabilitation Centre; Primary Supervisor
Aug, 2008 - Feb 2012 Jackie Ratzlaff; ICP George Pearson Centre, GF Strong Rehabilitation Centre; Primary Supervisor
Aug, 2008 - Dec 2011 Gail Busto; ICP UBC Purdy Pavilion; Supervisor Role: Primary Supervisor
PUBLICATIONS
JOURNAL ARTICLES
CATCO collaborators. Remdesivir for the treatment of patients in hospital with COVID-19 in Canada: a randomized controlled trial. CMAJ 2022.
Jan 2022. cmaj.211698
German G, Frenette C, CAissy JA, Grant JM et al., The 2018 Global Point Prevalence Survey of antimicrobial consumption and resistance in 47
Canadian hospitals: a cross-sectional survey, CMAJ open. 9(4):1242-51. Dec 2021
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Yassi A, Grant JM, Lockheart K, Barker S, Sprague S, Okpani A, Wong T, Daly P, Henderson W, Lubin S, Kim Sing C, Infection control,
occupational and public health measures including mRNA-based vaccination against SARS-CoV-2 infections to protect healthcare workers
from variants of concern: A 14-month observational study using surveillance data. PLOS One, 6(7): e0254920. Jul 2021
Grant, JM, Song W, Shajari S, Mak R, Meikle A, Partovi N, Masri BA, Lau TTY, Safety of administering cefazolin versus other antibiotics in
penicillin-allergic patients for surgical prophylaxis at a major Canadian teaching hospital, Surgery, 170(3):783-89. Apr 2021
Buffone B, Lin YC, Grant JM, β-lactam exposure outcome among patients with a documented allergy to penicillins post-implementation of a new
electronic medical record system and alerting rules. JAMMI. 6(2):104-13. Jun 2021
Grant JM, Schwartz IS, Lauplant KB, Stockholm syndrome: How to come to peace with our captor, JAMMI, 5(4):209-13. Dec 2020
Frenette C, Sperlea D, German G, Afra K, Boswell J, Chang S, Goossens H, Grant JM, Lefebvre MA, McGeer A, Mertz D, Science M, Versporten
A, Thirion D, The 2017 Global Point Prevalence Survey of Antimicrobial Consumption and Resistance in Canadian Hospitals, Antimicrobial
Resistance and Infection Control, 9: 104. Jul, 2020.
Kumar DS, O’Neill SB, Johnston JC, Grant JM, Sweet DS, Sars-CoV-2 infection in a 76 year old man with negative results for nasopharyngeal
swabs and possible nosocomial transmission. CMAJ. Apr 24 2020.
Rudnick W, Science M, Thirion et al., Antimicrobial Use among Adult Inpatients at Hospital Sites within the Canadian Nosocomial Infection
Surveillance Program: 2009 to 2016. Antimicrobial Resistance and Infection Control. (2020) 9:32. 2020.
Locher K, Roscoe DR, Jassem A, Wong T, Hoang L, Charles M, Bryce E, Grant JM, Stefanovic A, FilmArray Respiratory Panel Assay: An
Effective Method for Detecting Viral and Atypical Bacterial Pathogens in Bronchoscopy Specimens. Diagnostic Microbiology & Infectious
Disease. 95(4):114880. 2019.
Grant JM, Porter C, Charles M, Bryce EA, Wong T, Stefanovic A, Shajari S, Roscoe DR. Potential influence of rapid diagnostics on timeliness of
management decisions for patients with positive blood cultures. Journal of the Association of Medical Microbiology and Infectious Disease.
Epublished Dec 20 2019.
Grant JM, Afra K, Point-Counterpoint the MERINO trial and what it should imply for future treatment of ESBL bacteremia. Journal of the
Association of Medical Microbiology and Infectious Disease. Accepted July 29 2019.
Morris AM, Rennert-May E, Dalton B, Daneman N, Dresser L, Fanella S, Grant J, Kenyan Y, Le Saux N, McDonald J, Shevchuck Y, Thirion D,
Conly JM, Rationale and development of a business case for antimicrobial stewardship programs in acute care hospital settings. Antimicrobial
Resistance and Infection Control, (2018) 7:104 https://doi.org/10.1186/s13756-018-0396-z
So, M, Mamdani M, Morris A . . . Grant JM et al., Effects of an antimicrobial stewardship programme on antimicrobial utilization and costs in
patients with leukaemia: a retrospective controlled study. Clinical Microbiology and Infection. 24(2018):882-8. 2018
Le Saux N, Dalton B, Abbas K et al., Funding for Antimicrobial Stewardship Programs: A Customizable Business Case Template. Canadian Journal
of Hospital Pharmacy. Letter. 71(1):50-1. 2018
Stefanovic A, Roscoe D, Wong T et al., Performance Assessment of Urine Flow Cytometry (UFC) to Screen Urines to Reflex to Culture in
Immunocompetent and Immune suppressed Hosts. Journal of Medical Microbiology. 66(9):1308-15. 2017
Grant J, Jastrzabeski J, Johnston J, et al. 'Interferon Gamma Release Assays Are a Better TB Screening Test for Hemodialysis Patients, a Study and
Review of the Literature'. Canadian Journal of Infectious Diseases and Medical Microbiology. 23(3): 114-116, 1-8. 2012
Tavassoli P, Paterson R and Grant JM, Case Reports in Urology:. 'Actinobaculum Schaalii: An Emerging Uropathogen?'. 2012 (article ID: 468516).
Gamage B, Schall V, Grant JM et al., 'Identifying the Gaps in Infection Prevention and Control Resources for Long Term Care Facilities in British
Columbia. American Journal of Infection Control. 40(2012):150-4.2012
Mulvey, M, Grant JM, Plewes K, et al.. 'New Delhi Metallo-β-Lactamase in Klebsiella pneumoniae and Escherichia coli,Canada'. Emerging
Infectious Diseases, 17.1 (Jan 2011): 103 - 106. 2011
Pottie, K, Bilkis V, Grant JM, et al. 'Human Immunodeficiency Virus, Evidence Review for Newly Arriving Immigrants and Refugees,’ CMAJ.
183.12 (July 26, 2011 ): e35 - e37. 2011
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Wilmer A, Bryce E and Grant JM. 'The role of the third AFB smear in TB screening for infection control purposes: A controversial topic revisited'.
Canadian Journal of Infectious Diseases and Medical Microbiology. 22.1 (Spring 2011): e1 - e3.
Stephanovic A, Nadon C, Reid J and Grant JM, 'Epidemic Listeria monocytogenes Acquired Nosocomially Presenting as Multiple Brain Abscesses
Resembling Nocardiosis'. Canadian Journal of Infectious Diseases and Medical Microbiology. 21 (1) (2010, Spring): 57 - 60. 2010
Tan K and Grant JM. 'Trichosporon species: Classification, Identification, and Clinical Relevance'. Checksample. 53.6 (August 2010): 61 - 71. 2010
Murray M, Grant J, Bryce E, et al., 'PPE, Personnel and Pandemics: Impact of H1N1 on personnel and facial protective equipment use.' Infection
Control and Hospital Epidemiology. 31.10 (October 2010): 1011 - 1016. 2010
Perry, T. L., P. Pandey, J. M. Grant and K. C. Kain. 'Severe Atovaquone-Resistant Plasmodium Falciparum Malaria in a Canadian Traveller
Returned from the Indian Subcontinent.’ Open Medicine. 3.1 (2009): 10 - 16. 2009
Grant, J.M.. 'Malaria Diagnosis: Microscope to Molecular'. Checksample. 52.3 (April 2009): 33 - 47. 2009
Leung, V. , G. Alrawahi, J. Grant and B. Bowie. 'A case of strongyloides treated with parenteral ivermectin'. American Journal of Tropical
Medicine and Hygiene. 79.6 (2008): 853 - 55. 2008
Lavoie E, Levesque B, Proulx J, et al. 'Evaluation of the toxoplasmosis screening program among pregnant Nunavik (Canada) women between 1994-
2003'. Canadian Journal of Public Health. 99.5 (September-October 2008): 397 - 400. 2008
Grant, J. M. , L. Ramman-Haddad , N. Dandukuri and M. Libman. 'The Role of Gowns in Preventing Transmission of Methicillin Resistant
Staphylococcus aureus, Infection Control and Hospital Epidemiology 27(2):191-194'. Infection Control and Hospital Epidemiology. 27.2
(2006): 191 - 194. 2006
Grant, J. M. , G. St.-Germain and J. McDonald. 'Successful Treatment of Invasive Rhizopus Infection in a Child with Thalasemia'. Medical
Mycology. 44 (December 2006): 771 - 775. 2006
Grant, J. M. , S. Mahanty, A. Khadir, J. D. MacLean, E. Kokoskin, B. Yeager, L. Joseph, E. Gotuzzo, N. Mainville and B. J. Ward. 'Wheat Germ
Supplement Reduces Cyst and Trophozoite Passage in People with Giardiasis'. American Journal of Tropical Medicine and Hygiene. 65.6
(2001): 705 - 710. 2001
Grant, J.M., 'Tropical Medicine, the Hydra that Technology will not Slay'. McGill Journal of Medicine. 5.2 (2000): 127 - 132. 2000
PREPRINTS AND SUBMITTED MANUSCRIPTS
Okpani A, Barker S, Lockhart K, Grant JM et al., A mixed-methods study of risk factors and experiences of healthcare workers tested for the novel
coronavirus in Canada., MedRxiv, Dec 2021 https://www.medrxiv.org/content/10.1101/2021.12.04.21267231v1
Yassi A, Barker S, Lackhart . . . Grant JM et al., COVID-19 infection and vaccination rates in healthcare workers in British Columbia, Canada: A
longitudinal urban versus rural analysis of the impact of the vaccine mandate. https://www.medrxiv.org/content/10.1101/2022.01.13.22269078v1.
Jan 2022
Lau V, Fowler R . . . Grant JM et al., CMAJ-22-0076 - Cost-effectiveness of remdesivir plus usual care versus usual care alone for hospitalized
patients with COVID-19 as part of the Canadian treatments for COVID-19 (CATCO) randomized clinical trial. Submitted CMAJ. Manuscript
#CMAJ-22-0076
LETTERS TO THE EDITOR
Grant JM, Batt J, Fulford M, Srigley J, Vozoris N, Re: A no more waves strategy. CMAJ. Jan 6, 2021, response to Morris et al. A No More Waves
Strategy for COVID-19 in Canada. CMAJ 193 (4) E132-4. Jan 25 2021. https://doi.org/10.1503/cmaj.202685
Srigley J, Fulford M, Golden A, Grant JM, Re: SARS-CoV-2 vaccination should be required to practise medicine in Canada. CMAJ November 09,
2021 cmaj.211839; DOI: https://doi.org/10.1503/cmaj.211839
Meikle A, Grant JM, Beta-Lactam Allergy in the Operating Theatre Comment. Letter. Anesthesiology. 130(5):853. 2019
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C ONF E R E NC E P O S T E R S A N D I N V I T E D P R E S E N T A T I O N S
Song W, Lau TTY, Shajari S, Aulakh A, Forrester L, Partovi N, Grant JM, Outcomes of Administering Cefazolin vs. Other Antibiotics in Penicillin
Allergic Patients with Anaphylactic Reactions for Surgical Prophylaxis at a Major Canadian Teaching Hospital. AMMI Canada Conference.
Oral Presentation. Ottawa 2019.
Rudnick W, Pelude L, Abdesselam et al., Antimicrobial Use among Adult Inpatients at Canadian Nosocomial Infection Surveillance Program
(CNISP) Hospital Sites across Canada, 2009 to 2016. Oral presentation. AMMI Canada conference. Ottawa 2019.
German G, Grant J, Lefebvre M et al., The 2018 Global point prevalence Survey of antimicrobial usage (AMU) and resistance in 42 Canadian
Hospitals. Oral presentation. AMMI Canada conference. Ottawa 2019.
German G, Lee B, Frenette C et al., Antimicrobial Resistance Non-Susceptibility Rates for Escherichia coli Isolates from Canadian Hospitals (2016
vs. 2017) using a Standardized Antibiogram Collection Protocol. Poster presentation. AMMI Canada conference. Ottawa 2019.
Tong S, Masoudi S, Grant JM et al., Impact of New Electronic Medical Record System on Duration of Active Antimicrobials. Poster presentation.
AMMI Canada conference. Ottawa 2019.
Masoudi S, Tong B, Grant JM et al., Identifying Antimicrobial Stewardship Opportunities through Point Prevalence Comparison. Poster
presentation. AMMI Canada conference. Ottawa 2019.
Yuen V, Shajari S, Aulakh A, Lau TTY, Grant JM, Audit and Feedback Interventions Associated with Lower Mortality in a Retrospective Analysis
of Clinical Outcomes from an Antimicrobial Stewardship Program. Poster presentation. AMMI Canada conference. Ottawa 2019.
Parkes L, Grant JM, et al., Modern Problem, Medieval Cure; Resistant Aeromonas in Medicine Leeches. ID Week. San Francisco, CA. 2018
Grant JM, Porter C, Charles M et al., Accelerate Pheno™ System’s Potential Influence on Timeliness of Management Decisions for Patients with
positive blood cultures. AMMI Canada Conference. Oral Presentation. Vancouver BC, 2018
Grant JM, Porter C, Charles M et al., Assessment of Accelerate Pheno™ (AXDX) for Investigation of Positive Blood Cultures in Remote Health
Care Centres with a Centralized Off-site Microbiology Laboratory. AMMI Canada Conference. Vancouver BC, 2018
Grant JM, Porter C, Charles M et al., Practical Assessment of Accelerate Pheno™ Performance on Growth from Routine Positive Blood Cultures.
AMMI Canada Conference. Vancouver BC, 2018
Abdesselam K, Prelude L, Laverty M et al., Quantitative Antimicrobial Usage Surveillance from 2009–2015 among Hospitals Participating in the
Canadian Nosocomial Infection Surveillance Program (CNISP). AMMI Canada Conference. Vancouver BC, 2018
LI L, Roscoe D , Zhang W et al., Impact of the BioFire FilmArray® Respiratory Panel on Time in Isolation, Antibiotic Prescribing and Use of
Ancillary Chest Imaging at a Tertiary Care Hospital. AMMI Canada Conference. Vancouver BC, 2018
Grant JM, Evans G, Plenary Debate: Be it resolved that beta-lactams/beta-lactamase inhibitors can be used for infections caused by gram-negative
bacilli carrying ESBL and AmpC. AMMI Canada Conference. Vancouver BC, 2018
Frenette C, Lefebvre M, McGeer A et al., The global point prevalence survey of antimicrobial consumption and resistance in Canadian hospitals
(2017). ECCMID.Madrid, Spain. 2018
Grant JM, Porter C, Charles M et al., Accelerate Pheno™ System’s Potential Influence on Timeliness of Management Decisions for Patients with
Positive Blood Cultures. AMMI Canada conference, oral presentation. Vancouver BC. 2018
Wong T, Stefanovic A, Locher K et al., Biofire FilmArray Decreases Infection Control Isolation Times by 4 days in ICU, BMT and Respiratory
Wards. ID Week. San Diego Ca. 2017
Grant JM, Evaluation of Penicillin Allergy. This Changed My Practice. Faculty of Medicine UBC. accesible at https://tcmp.med.ubc.ca/penicillin-
allergy/. 2017
Grant JM, Lau TTY, Laing F, et al. Prospective Audit and Feedback of Antimicrobial Prescriptions in the Clinical Teaching Unit at Vancouver
General Hospital. Canadian Society of Hospital Pharmacists (BC Branch) Annual General Meeting. 2016
Harris, L, L Forrester and J Grant. 'Preventing Catheter-Associated Urinary Tract Infections (CAUTI) in a Rehabilitation Facility, Meeting the
Standards'. CHICA. Saskatoon, Saskatchewan, Canada. 2012
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Gamage B, Schall V and Grant J. 'Identifying the Gaps in Infection Prevention and Control Resources for Long Term Care Facilities in British
Columbia '. CHICA Canada. Vancouver, BC. 2010
Murray M, Grant J, Bryce E, et al. 'PPE, Personnel and Pandemics: Impact of H1N1 on personnel and facial protective equipment use' CHICA
Canada. Vancouver, BC. 2010
Boyd D, Grant J, Roscoe D, et al. 'First Occurrence of NDM-1 Metallo-Beta-Lactamase in Canada and Evidence for In Vivo Horizontal
Transmission Between Klebsiella and E. coli'. Infectious Diseases Society of America, Vancouver. 2010
Chapman M, Tan K, Petric M, et al. 'Pandemic Influenza A (H1N1) Testing by PCR versus Seroconversion '. Infectious Diseases Society of
America, Vancouver, 2010
Grant JM, Johnson J, Stefanovic A, et al. 'The Role of Interferon Gamma Release Assays in Screening Dialysis Patients for Mycobacterium
Tuberculosis Infection'. Infectious Diseases Society of America, Vancouver. 2010
Grant JM, Bryce E and Forrester L. 'Infectious Causes for Admission to Acute from Long-Term Care Institutions'. Infectious Diseases Society of
America, Vancouver. 2010
Wilmer A, Bryce E and Grant JM. 'Is the Third AFB Smear Necessary to Remove Patients from Respiratory Isolation?’ International Union Against
Tuberculosis and Lung Disease. Vancouver, British Columbia, Canada. 2009
Grant, JM, Ratzlaff J, Busto B and Roscoe D. 'Antibiotic use and susceptibility patterns in one rehabilitation and two long-term care (LTRC)
institutions, Community and Hospital Infection Control Association Canada. Montreal, 2008
TEXTBOOKS
'Médicaments Anti-Parasitaires'. Précis de pharmacologie. Ed. Pierre Beaulieu. Montréal: Presses de l'Université de Montréal, 2008.
LAY-PRESS ARTICLES
Grant JM, Kestler M, Fulford M, Hohl C, Opinion: As physicians, mothers and daughters, we have concerns with COVID-19 rules, Post Media, Oct
8, 2020 https://torontosun.com/opinion/columnists/opinion-as-physicians-mothers-and-daughters-we-have-concerns-with-covid-19-rules
Grant JM, Stop blaming people for the behaviour of a virus, Toronto Sun April 8, 2021 https://torontosun.com/opinion/columnists/grant-stop-
blaming-people-for-the-behaviour-of-a-virus
Golden A, Grant JM, Srigley J, Whatley S, Opinion: It's time to learn to live with COVID, National Post, Aug 18 2021
https://nationalpost.com/opinion/opinion-its-time-to-learn-to-live-with-covid
Grant JM, I'm a doctor who supports vaccines but opposes lashing out at the unvaccinated, Toronto Sun, Sept 23 2021
https://torontosun.com/opinion/columnists/grant-im-a-doctor-who-supports-vaccines-but-opposes-lashing-out-at-the-unvaccinated
Grant JM, Fulford M, Srigley J and Rau N, Five reasons why COVID shouldn't spook us this Halloween, Oct 19, 2021
https://nationalpost.com/opinion/opinion-five-reasons-why-covid-shouldnt-spook-us-this-halloween
Grant JM, Closing Schools at this point is inexcusable, Post Media, Jan 3 2022 https://lfpress.com/opinion/columnists/column-closing-schools-at-
this-point-is-inexcusable,
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This is Exhibit “B” referred to in the Affidavit of Dr. Jennifer Grant sworn March 11, 2022

Sam A. Presvelos
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Dr. Jennifer Grant Inc.

Infectious diseases specialist and medical microbiologist, MDCM FRCPC
Presvelos Law LLP

Toronto, Ontario
M5H 3L5
Attention: Sam A. Presvelos
Dear Mr. Presvelos,
Re: Litigation Expert - Shaun Rickards et al. v. The Attorney General (Canada) et al.
I have been asked to provide expert opinion regarding the medical benefits and/or necessity of requiring
vaccination for travelers and to comment on the efficacy of the federal government’s mandates of proof of
vaccination status which is required for all forms of travel in federally regulated transportation sectors.
I. Statement of Qualifications
1. I am an attending physician currently practicing Medical Microbiology and Infectious Diseases at

Vancouver Coastal Health. My practice includes diagnostic microbiology, infection prevention and
control as well as in-patient infectious diseases consultation at Vancouver General Hospital,
University of British Columbia Hospital and the Vancouver branch of the British Columbia Cancer
Agency. I have, an undergraduate degree cum laude from Yale in Molecular Biophysics and
Biochemistry, attended medical school at McGill University, internal medicine residency at the
Montreal General Hospital and completed sub-speciality training in both infectious diseases and
medical microbiology at McGill University. I have a double certification from the Royal College of
Physicians and Surgeons in Medical Microbiology and as a subspecialist of Internal Medicine in
Infectious Diseases and am certified by the Collège des Médécins in Quebec as an infectiolgue-
microbiologiste.
2. I am currently the physician co-chair of the British Columbia clinical therapeutics committee (CTC)
for COVID-19. This committee, appointed by the ministry of health, provides expert opinion on
treatment recommendations for patients infected with COVID-19 for the province of British
Columbia. I am actively involved in investigating novel therapies for COVID -19 as the principal
investigator for Richmond Hospital for the CATCO clinical trial, the Canadian arm of SOLIDARITY,
an international trial examining the efficacy of treatments for COVID-19.
3. A substantial part of my practice is infection prevention and control. I contributed to the emergency
response to Ebola and the H1N1 pandemic for the Vancouver Coastal Health authority in 2009 and
the 2018 pandemic plan. I was named as infection control officer for Richmond Hospital by the
regional director of infection prevention and control for Vancouver Coastal Health at the time of the
COVD-19 pandemic declaration to support Richmond Hospital’s response. Prior to this appointment I
served as infection control officer for GF Strong rehabilitation centre and several long-term care
centres for 14 years.
4. I have held national leadership positions in both infection prevention and control and Infectious
diseases. I served a full 4-year term as a board member and chaired the standards and guidelines
committee for CHICA (now Infection Prevention and Control -- IPAC) Canada, the national
Dr. Jennifer Grant Inc, 958 W 22nd Ave., Vancouver, BC, V5Z 2A1
Ph: 604-603-0683 F: 604-875-4359 e-mail: jengrant.frcpc@yahoo.com
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professional body for infection preventionists. Subsequently, I was nominated by the general
assembly to serve as the Infectious Diseases representative on the board of the Association of Medical
Microbiology and Infectious diseases (AMMI) Canada for the maximum of 2 consecutive terms (6
years). I have been an active member of the editorial board and reviewer for the national journal of
AMMI (JAMMI – Journal of the Association of Medical Microbiology and Infectious-disease) for the
past 4 years, served two years on the guidelines committee and two full terms on the Antimicrobial
Stewardship and Resistance Committee (A committee that makes national recommendations on
appropriate use of antibiotic drugs). I have also acted as a member of the Royal College of Physicians
and Surgeons training committee for Infectious Diseases, the group that determines training
requirements and standards for those certified by the Royal College in infectious diseases. I currently
chair the section on antimicrobial resistance monitoring for the Public Health Agency of Canada
committee on nosocomial infections (CNISP). I am also a member, and past chair, of the Provincial
Antimicrobial Clinical Expert (PACE) committee – also a Ministry of Health expert committee
advising and creating practice guidelines for appropriate use of antibiotics in British Columbia.
5. I am an author of 30 peer reviewed papers, and numerous academic conference presentations.
Pertinent to this opinion, I have published on the efficacy of personal protective equipment,
diagnostics and management of pandemic H1N1,1 the use of diagnostics2 and isolation3 in the
reduction of nosocomial tuberculosis transmission and gaps in infection prevention and control in
long term care settings.4 I have also published or am preparing publications on occupational health
and safety of health-care workers in the COVID-19 pandemic,5 6 vaccine uptake amongst health care
workers,7 diagnostic efficacy of COVID-19 tests, efficacy8 and cost-efficacy of antiviral therapies
against COVID-19.9
1
Murray M, Grant JM, Bryce E et al., Facial protective equipment, personnel, and pandemics: impact of the
pandemic (H1N1) 2009 virus on personnel and use of facial protective equipment. Infect Control Hosp Epidemiol,
31(10):1011-6. Oct 2010.
2
Grant JM, Jastrzebski J, Johnson J et al., Interferon-gamma release assays are better tuberculosis screening test for
hemodialysis patients: A study and review of the literature, Can J Infec Dis Med Microbiol. 23(3):114-6. 2012
3
Wilmer A, Bryce E and Grant JM. 'The role of the third AFB smear in TB screening for infection control purposes:
A controversial topic revisited'. Canadian Journal of Infectious Diseases and Medical Microbiology. 22.1 (Spring
2011): e1 - e3.
4
Gamage B, Schall V, Grant JM et al., 'Identifying the Gaps in Infection Prevention and Control Resources for
Long Term Care Facilities in British Columbia. American Journal of Infection Control. 40(2012):150-4.2012
5
Yassi A, Grant JM, Lockhart K et al., Infection control, occupational and public health measures including mRNA-
based vaccination against SARS-CoV-2 infections to pretect healthcare workers from variants of concern: a 14-
month observational study using surveillance data. PLOS ONE 16(7):e0254920. 2021.
6
Okpani A, Barker S, Lockhart K, Grant JM et al., A mixed-methods study of risk factors and experiences of
healthcare workers tested for the novel coronavirus in Canada., MedRxiv, Dec 2021,
https://www.medrxiv.org/content/10.1101/2021.12.04.21267231v1.
7
Yassi A, Barker S, Lackhart . . . Grant JM et al., COVID-19 infection and vaccination rates in healthcare workers
in British Columbia, Canada: A longitudinal urban versus rural analysis of the impact of the vaccine mandate.
https://www.medrxiv.org/content/10.1101/2022.01.13.22269078v1. Jan 2022.
8
Ali K, Azher T, Baqi M . . . Grant JM et al., Remdesivir for the treatment of patients in hospital with COVID-19
in Canada: a randomized controlled trial. CMAJ. 194(3): doi:10.1503/cmaj.211698. Jan 2022
9
Lau V, Fowler R . . . Grant JM et al., CMAJ-22-0076 - Cost-effectiveness of remdesivir plus usual care versus
usual care alone for hospitalized patients with COVID-19 as part of the Canadian treatments for COVID-19
(CATCO) randomized clinical trial. Submitted CMAJ. Manuscript #CMAJ-22-0076.
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6. The views expressed in this opinion are based on my expertise and experience in the field but do not
necessarily represent the opinions of my employers or the organizations for which I have worked.
II. Purpose of Report
7. The purpose of this report is to offer an objective opinion, for the assistance of the court on whether
mandatory vaccination policy on federally regulated transportation is necessary to protect the health
and safety of travelers.
8. In order to form this opinion, I have reviewed and considered medical literature (both peer-reviewed
and pre-print) and publicly available reports and data made available through government and non-
governmental organizations. All sources have been included as exhibits to my affidavit.
III. Basis of Opinion; Facts and Assumptions:
9. According to the Ministry of Transportation website the vaccine mandate for travel is intended to
“control the spread of COVID-19 by reducing the number of exposures to the virus” 10 This report
will examine what role, if any, transportation has on the transmission and clinical outcomes of SARS-
CoV-2 in vaccinated or unvaccinated travellers. My assessment of the medical literature, government
reports and publicly available data shows the following:
a. Vaccination is ineffective at preventing infection with SARS-CoV-2, especially newer
variants of concern i.e. Omicron.
b. Requiring vaccination does not prevent people from being infectious with SARS-CoV-2.
c. Vaccination is ineffective at preventing transmission of SARS-CoV-2.
d. Vaccination passports fail to recognize important forms of immunity.
e. Transportation is not a major source of transmission in travellers regardless of
vaccination status.
f. Participating in transportation has no impact on the health outcomes of vaccinated or
unvaccinated passengers.
g. The Canadian health care system overload is unrelated to the vaccine status of travelers.
IV. Assessment
A. Vaccination is ineffective at preventing infection with SARS-CoV-2, especially newer variants of

concern i.e. Omicron
10
Government of Canada, COVID-19: Readiness criteria and indicators for easing restrictive public health
measures, https://www.canada.ca/en/public-health/services/diseases/2019-novel-coronavirus-infection/guidance-
documents/readiness-criteria-indicators-easing-restrictive-public-health-measures.html, accessed Jan 7 2022
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10. The nitial reports of vaccine efficacy used for regulatory approval in late 2020 and early 2021 showed
very high protection from infection with SARS-CoV-2,11 12 13 however these studies had limited
follow-up, in most cases around 2 months. This means that data were restricted to the vaccine’s
efficacy within a median of 8 weeks following the second dose and that the long-term efficacy of the
vaccines was unknown at that time. What has become evident with more time is that vaccine
protection wanes. This is typical of corona viruses, where repeated infection is common.14 In a study
in a large US health-care system published in the Lancet 15 looking at over 3 million individuals, the
effectiveness of the vaccine against infection waned from an initial 88% to 47% within 5 months.
Data from Denmark16 and the UK17 similarly showed that by 90 days following vaccination, vaccine
efficacy was around 50%. Even booster doses have limited duration to reduce risk of infection and
drop to around 50% efficacy10 within several months. It is not clear to what extent this drop would
continue, since shortly after these data were gathered the delta variant was replaced by the omicron
variant.
11. Emerging data on the Omicron variant suggest vaccines are minimally effective (between 18-34%),18
and wane quickly. Danish data13 examined vaccine efficacy for the Danish population showed
between 36% and 52% efficacy (depending on type of vaccine) against infection with Omicron
amongst those who had been recently vaccinated or boosted, which dropped to essentially no
protection against Omicron in 90 days following vaccination. Data from the UK,14 likewise show that
vaccine efficacy against Omicron is maximally 70% immediately after vaccination, but that efficacy
drops to 10% by 20 weeks after vaccination. Boosting restored efficacy, but for a period of only 10
weeks, at which point efficacy dropped to 50% or below.
12. Figure 1: data from the UK19 showing waning efficacy of vaccines and booster doses for Omicron
variant.
11
Baden LR, El Sahly HM, Esink B et al., Efficacy and safety of the mRNA-1237 SRAS-CoV-2 vaccine, N Engl J
Med, 384:403-16. Dec 2020.
12
Polak FP, Thomas SJ, Kitchin N et al., Safety and efficacy of the BNT162b2 mRNA covid-19 vaccine, N Engl J
Med, 383:2603-15, Dec 2020.
13
Voysey M, Clemes SAC, Madhi SA et al., Safety and efficacy of the ChAdOx1 nCoV-19 vaccine (AZD1222)
against SARS-CoV-2: an interim analysis of four randomised controlled trials in Brazil, South Africa, and the UK,
The Lancet, 397(10269):99-111 Jan 2021.
14
Kiyuka PK, Agoti CN, Munywoki PK et al., Human Coronavirus NL63 Molecular epidemiology and
evolutionary patterns in rural coastal Kenya. J Infect Dis., 217(11):1728-39. Mar 2018.
15
Tartof SY, Slezak JM, Fischer H et al., Effectiveness of mRNA BNT162b2 COVID-19 vaccine up to 6 months in
a large integrated health system in the USA: a retrospective cohort study. Lancet. 398(10309): 1407-16. Oct 2021
16
Hansen CH, Schelde AB, Moustsen-Helm IR et al., Vaccine effectiveness against SARS-CoV infection with the
omicron or delta variants following a two-dose or booster BNT162b2 or mRNA-1273 vaccination series: A Danish
cohort study. https://www.medrxiv.org/content/10.1101/2021.12.20.21267966v3.full.pdf. Accessed Jan 29, 2022
17
UK Government, SARS-CoV-2 variants of concern and variants under investigation in England: Technical
briefing 34,
https://assets.publishing.service.gov.uk/government/uploads/system/uploads/attachment_data/file/1050236/technical
-briefing-34-14-january-2022.pdf, accessed Feb 2 2022.
18
Andrews N, Stowe J, Kirsebom F et al., Effectiveness of COVID-19 vaccines against the Omicron (B.1.1.529)
variant of concern. https://www.medrxiv.org/content/10.1101/2021.12.14.21267615v1. Accessed Dec 22 2021.
19
Government of the UK, COVID-19 vaccine surveillance report week 4,
https://assets.publishing.service.gov.uk/government/uploads/system/uploads/attachment_data/file/1050721/Vaccine-
surveillance-report-week-4.pdf, accessed Feb 2 2022.
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13. Table 2:
14. In Canada, there are similar rates of infection in those who are vaccinated and those who aren’t. For
example, data from the Ontario government on January 8, 2022 show higher rates of infection with
Omicron in vaccinated individuals as compared to unvaccinated individuals (92 cases per 100 000 in
vaccinated and 69 cases per 100 000 in unvaccinated people)20 data are shown visually in Figure 1.
Data from British Columbia show similar findings with rates of infection for Omicron being the same
or higher in vaccinated people. International data, where accessible, show the same pattern. For
example, Iceland shows identical rates of infection in vaccinated and unvaccinated adults.
20
Government of Ontario, COVID-19 Vaccinations data , https://covid-19.ontario.ca/data accessed Jan 8 2021.
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Importantly, the fact that vaccines are not stopping transmission has been acknowledged by public
health officials 21 22 23 and politicians.24 25
15. Figure 2: Rates of COVID-19 per 100 000 population by vaccination status. a) data from
Ontario28from December 2021 to January 2022 b) data from British Columbia 26 from July 2021 to
January 2022 c) Iceland27 from July 2021 to January 2022
a) Ontario
b) British Columbia
21
CBC News, Dr. Bonnie Henry says 'new game' with Omicron variant could signal end of COVID-19 pandemic
, https://www.cbc.ca/news/canada/british-columbia/dr-bonnie-henry-year-ender-1.6301202, accessed Feb 2 2022
22
CNN, The. Highly contagious omicron variant will ‘findj ust about everybody’ Fauci says, but vaccinated people
will still fare better, https://www.cnn.com/2022/01/11/health/us-coronavirus-tuesday/index.html, accessed Feb 2
2022.
23
CNBC, Omicron is spreading faster than any other Covid variant, WHO warns
, https://www.cnbc.com/2021/12/14/who-says-omicron-is-spreading-at-a-rate-not-seen-with-any-other-covid-
variant.html, accessed Feb 2 2022.
24
CBC News, Experts criticize Sask. premier's statement that vaccines don't reduce COVID-19 transmission
, https://www.cbc.ca/news/canada/saskatchewan/scott-moe-vaccination-covid-19-not-reducing-transmission-
1.6332710, accessed Feb 2 2022.
25
Sky News, https://news.sky.com/story/covid-19-boris-johnson-urges-those-eligible-to-get-coronavirus-booster-
jabs-this-winter-12442495, accessed Feb 2 2022.
26
BCCDC, regional surveillance dashboard, http://www.bccdc.ca/health-professionals/data-reports/covid-19-
surveillance-dashboard, accessed Jan 10 2022.
27
Iceland, COVID-19 in Iceland – statistics, https://www.covid.is/data accessed Jan 29 2022.
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c) Iceland
B. Requiring vaccination does not prevent people from being infectious with SARS-CoV-2
16. In the context of a highly vaccinated population, it is more likely that an infectious person boarding a
flight is, in fact, vaccinated. In other words, vaccine mandates will exclude a minority of infections. 28
This is because of the numeric superiority of vaccinated people as a proportion of the population. In
the Canadian context, 83% of the population is at least partially vaccinated.29 Consider the following
illustrative example: 100 people of whom 83 are vaccinated and 17 are not, with vaccine efficacy of
28
Kampf, The epidemiological relevance of the COVID-19 vaccinated population is increasing, Lancet Regional
Health 11(100272). Dec 2021.
29
Public Health Agency of Canada,Covid-19 vaccination in Canada , https://health-infobase.canada.ca/covid-
19/vaccination-coverage/, accessed Jan 8 2022.
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50%. If all have an equal risk of being exposed so SARS-CoV-2 (using an 15% risk of being
infected30); of the 17 who are unvaccinated, between 2 - 3 will get infected (15% of 17). Similarly,
around 6 will be infected in the vaccinated group (7.5% of 85) group.
17. Current data, from the four most populous provinces, show that the majority of infections are in
people who have previously been vaccinated.16 In Ontario, there are 10-fold more infections in
vaccinated (10 865) compared to unvaccinated people (1714).27 Data from British Columbia show a
similar pattern with 81% of cases occurring in fully vaccinated people,29 Alberta, data show that 79%
of cases are in vaccinated people,31 while Quebec data32 show that 6-fold more cases have occurred in
vaccinated than unvaccinated people. Excluding unvaccinated members of the public from
transportation, does not prevent the majority of infections from boarding flights or other forms of
transportation.
18. Figure 3: Vaccinated individuals account for the majority of COVID cases. Data from a) Ontario33
and b) the BCCDC34 on numbers of cases of COVID-19 by vaccination status from December 2021
to January 2022 c) data from Alberta29 from January 2022 showing percent of positive results of
active cases attributable to vaccinated and unvaccinated Albertans d) from Santé Québec29 from 4
weeks prior to January 11 2022.
a) Ontario data
30
The choice of 15% is based on UK data (reference # 14) showing 15% attack-rate in households with Omicron
variant.
31
Government of Alberta, COVID-19 Alberta statistics, https://www.alberta.ca/stats/covid-19-alberta-
statistics.htm#vaccine-outcomes, accessed Dec 10 2022
32
Santé Québec, Data on COVID in Quebec, https://cdn-contenu.quebec.ca/cdn-
contenu/sante/documents/Problemes_de_sante/covid-19/20-210-382W_infographie_sommaire-
executif.jpg?1642003223, accessed Dec 12 2021
33
Government of Ontario, COVID-19 vaccinations data, https://covid-19.ontario.ca/data, accessed Jan 8, 2022
34
British Columbia Centres for Disease Control, COVID-19 Regional Surveillance Dashboard,
http://www.bccdc.ca/health-professionals/data-reports/covid-19-surveillance-dashboard, accessed Jan 12 2022
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b) British Columbia data
c) Alberta Data
d) Quebec data
C. Vaccination is ineffective at preventing transmission of SARS-CoV-2

19. Vaccinated people with infection not substantially less likely to spread SARS-CoV-2 as unvaccinated
people, especially as time passes since the most recent vaccine dose. Put differently, unvaccinated
individuals do not pose a more significant transmission risk when infected. The number of copies of
virus in a sample is commonly referred to as the “viral load”. The viral load is often used to measure
infectivity. Several studies have shown that viral loads are similar between vaccinated and
AR05521

unvaccinated people, particularly several months after vaccination.35 36 For example, in a study
published by the New England Journal of Medicine, 37 researchers looked at around 20 000 PCR
samples taken from the nasopharynx of 173 NBA players and staff who were infected with SARS-
CoV-2. By following these players from before symptoms started (routine screening) to after
clearance of infection, researchers were able to show that there was no meaningful difference in the
amount of virus in vaccinated and unvaccinated participants.
20. Likewise, a study published by the well-respected Nature Medicine Journal 38 showed that, of 16 000
individuals in Israel, with 3100 infections in unvaccinated people and 12 934 infections in vaccinated
people, the viral loads were similar between the groups, especially as time passed after vaccination. It
is likely because of the ability of vaccinated people to have a mild breakthrough infection that
transmission has been clearly documented from vaccinated individuals, 39 including several outbreaks
documented in a highly vaccinated populations,40 41 including at least one instance where it was
possible to identify the person who introduced the infection (the ‘index case’) as a vaccinated
person.42
21. Looking at the role of vaccination in high-risk situations shows that vaccine plays little role in
preventing transmission. One study in the UK 43 followed 231 contacts of 162 COVID cases with
regular testing of the nasopharynx for 20 days after exposure to see how many were infected. The
proportion of household contacts who became infected was similar if the original case was vaccinated
or unvaccinated (23% v. 25%). While there was a slight difference in the percent of people infected
after they were exposed who were unvaccinated (38%) compared to vaccinated (25%), the difference
was not statistically significant (meaning the difference could be due to chance). This difference
became less noticeable the further the time since vaccination. These results have been corroborated by
a population-based study of 146 243 contacts of positive cases in the UK. Follow up of these contacts
35
Acharya CB, Schrom J, Mitchell AM et al. No significant difference in viral load between vaccinated and
unvaccinated, asymptomatic and symptomatic groups infected with SARS-CoV-2 delta variant.
https://www.medrxiv.org/content/10.1101/2021.09.28.21264262v1. Accessed Dec 21 2021
36
Salvatore PP, Lee CC, Sleweon S et al., Transmission potential of vaccinated and unvaccinated persons infected
with the SARS-CoV-2 Delta variant in a federal prison July – Aug 2021.
https://www.medrxiv.org/content/10.1101/2021.11.12.21265796v1.full.pdf . Accessed Dec 21 2021.
37
Kissler SM, Fauver JR, Mack C et al., Viral dynamics of SARS-CoV-2 variants in vaccinated and unvaccinated
persons. N Engl J Med, Correspondance. Dec 1 2021
38
Levine-Tiefenbrun M, Yelin I, Alapi H et al., Viral loads of delta-variant SARS-CoV-2 breakthrough infections
after vaccination and booster with BNT162b2. Nature Med., 27:2108-10. Nov 2021
39
Brown CM, Vostok J, Johnson H et al. Outbreak of SARS-CoV-2 infections, including COVID-19 vaccine
breakthrough infections, associated with large public gatherings – Barnstable County, Mass July 2021. MMWR
Morb Mortal Wkly Rep 70:1059-62. Aug 2021
40
Brown CM, Vostok J, Johnson H et al., Outbreak of SARS-CoV-2 infections, including COVID-19 vaccine
breakthrough infections, associated with large public gatherings – Barnstable county Massachusetts, July 2021.
MMWR, 70(31):1059-62. Aug 2021
41
Keehner J, Horton LE, Binkin NJ et al., Resurgence of SARS-CoV-2 infection in a highly vaccinated health
system workforce. N Engl J Med., 385:1330-2. Sep 2021
42
Shitrit P, Zuckerman NS, MOr O et al., Nosocomial outbreak caused by the SARS-CoV-2 Delta variant in a
highly vaccinated population, Israel, July 2021. Eurosurveillance. 23(39):pii=2100822. Sep 2021
43
Singanayagam A, Hakki S, Dunning J et al., Community transmission and viral load kinetics of the SARS-CoV
Delta Variant in vaccinated and unvaccinated individuals in the UK: a prospective, longitudinal, cohort study.
Lancet Infec Dis., Published online: https://www.thelancet.com/journals/laninf/article/PIIS1473-3099(21)00648-
4/fulltext. Accessed Dec 21 2021.
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showed almost identical rates of transmission from vaccinated and unvaccinated individuals with the
Delta variant by 3 months following vaccination.44
22. Figure 4: transmission from vaccinated and unvaccinated people to close contacts in the UK.
23. Data show that while there is an initial reduction in transmission, depending on the vaccine and the
timing of receiving a vaccine, that protection decreases reaching very low levels (0-25%) by 14
weeks following vaccination with the Delta variant. These differences are more marked with Omicron
for which vaccination is even less effective at reducing risk of infection. Provincial surveillance data
from Ontario45 showed with Omicron, there was no vaccine efficacy against infection by 6 months
following vaccination, and this is corroborated by the UK data already presented in the previous
section.
24. The fact that vaccines do not prevent transmission are evident in the ongoing transmission in highly
vaccinated populations, including Canada. Using the Our World in Data46 platform to compare
vaccination rates in OECD countries with the omicron spikes we see that vaccination rate is not
closely associated with population transmission. At this time, highly vaccinated countries like
Portugal (90%) and Denmark (80%) are seeing much higher rates of infection per million people than
poorly vaccinated countries, such as Slovakia (45%) and Poland (56%). Comparing these two data
sets show that vaccination rates are not poorly correlated with disease transmission with Omicron,
suggesting pushing vaccination rates slightly higher are unlikely to alter trajectory of the pandemic.
25. Figure 4a: Rates of full vaccination in OECD countries ranked highest to lowest.
44
Eyre DW, Taylor D, Purver M et al., The impact of SARS-CoV-2 vaccination on Alpha and Delta variant
transmission. https://www.medrxiv.org/content/10.1101/2021.09.28.21264260v2. Accessed Dec 21 2021.
45
Buchan SA, Chung H, Brown KA et al., effectiveness of COVID-19 vaccines against Omicron or Delta infection,
https://www.medrxiv.org/content/10.1101/2021.12.30.21268565v2, accessed Jan 30 2022.
46
Our world in data, data explorer, https://ourworldindata.org/explorers/coronavirus-data-
explorer?zoomToSelection=true&time=latest&facet=none&pickerSort=desc&pickerMetric=total_vaccinations_per_
hundred&Metric=People+fully+vaccinated&Interval=Cumulative&Relative+to+Population=true&Color+by+test+p
ositivity=false&country=AUS~AUT~BEL~CAN~CHE~CHL~COL~CZE~DEU~DNK~ESP~EST~FIN~FRA~GB
R~GRC~HUN~IRL~ISL~ISR~ITA~JPN~KOR~LTU~LUX~LVA~MEX~NLD~NOR~NZL~POL~PRT~SVK~SV
N~SWE~TUR~USA~CRI accessed Jan 8, 2022.
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26. Figure 4b: epidemic curves47 of high and low vaccinated countries compared to Canada.
D. Vaccination passports fail to recognize important forms of immunity
47
Our world in Data, https://ourworldindata.org/covid-cases, accessed Jan 30 2022
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27. In contrast to other viral diseases for which vaccine mandates exist,48 49 previous COVID-19
infection is not accepted as a form of immunity in Canada, despite the existing body of medical
literature supporting the premise that infection induced immunity is robust. 50 The current vaccine
passport system does not recognize previous infection, although it represents a common reason for
people to choose not to be vaccinated.51 Many jurisdictions including the European Union,52 Israel53
and the WHO54 accept immunity through infection as a valid form of protection against reinfection.
Likewise, the American CDC notes that both vaccination and natural infection protect the individual
against reinfection for at least 6 months.55 Protection against symptomatic disease and severe
outcomes are robust to at least 9 months,56 57 58 59 60 61 62 and likely longer in younger people.63 One
study has shown up to 20 months of protection.64 In fact, recent data from New York State and
California (representing 18% of the US population) published by the American CDC shows that
previous infection predicts lower risk of infection than vaccination alone, and that the protection was
48
Public Health Agency of Canada, Measles vaccine, Canadian immunization guide,
https://www.canada.ca/en/public-health/services/publications/healthy-living/canadian-immunization-guide-part-4-
active-vaccines/page-12-measles-vaccine.html#p4c11t1, accessed Feb 2 2022
49
Public Health Agency of Canada, Varicella vaccine, Canadian immunization guide,
https://www.canada.ca/en/public-health/services/publications/healthy-living/canadian-immunization-guide-part-4-
active-vaccines/page-24-varicella-chickenpox-vaccine.html#p4c23a5c,accessed Feb 2 2022.
50
Kojima N, Klausner J, Protective immunity after recovery from SARS-CoV-2 infection, The Lancet Infectious
Diseaes, 22(1):12-14. Jan 2022.
51
Court E, They suffered through COVID, and still don’t want the vaccine. Bloomberg News.
https://www.bloomberg.com/news/articles/2021-09-05/they-suffered-through-covid-and-still-don-t-want-the-
vaccine.
52
European Commission, The EU digital COVID certificate, vaccinations and travel restrictions,
https://ec.europa.eu/info/policies/justice-and-fundamental-rights/eu-citizenship/movement-and-residence/eu-digital-
covid-certificate-vaccinations-and-travel-restrictions_en, accessed Dec 30 2021.
53
COVID passport, Israel: the Ramzor Green Pass and booster shots, https://www.covidpasscertificate.com/israelis-
can-obtain-covid-green-pass/, accessed dec 30 2021.
54
World Health Organization, COVD-19 Natural immunity, https://www.who.int/publications/i/item/WHO-2019-
nCoV-Sci_Brief-Natural_immunity-2021.1, accessed Dec 30 2021.
55
CDC, https://www.cdc.gov/coronavirus/2019-ncov/science/science-briefs/vaccine-induced-immunity.html
56
Chemaitelly H, Bertollini R, Abu-Raddad LJ, Efficacy of natural immunity against SARS-CoV-2 reinfection with
the Beta Variant. N Engl J Med, letter, Dec 2021.
57
Lumley SF, O’Donnell D, Soesster NE et al., Antibody Status and Incidence of SARS-CoV-2 infection in health
care workers, N Engl J Med, 384:533-40. Jan 2021
58
Kojima N, Klausner JD Protective immunity after recovery from SARS-CoV-2 infection, The Lancet Infect Dis,
22(1):12-14. Jan 2022.
59
Pilz et al., SARS CoV-2 re-infection risk in Austria, Eur J. Clin Invest, 51(4):e13520. Feb 2021.
60
Gazit et al., Comparing SARS-CoV-2 natural immunity to vaccine-induced immunity: reinfections versus
breakthrough infections, https://www.medrxiv.org/content/10.1101/2021.08.24.21262415v1.full.pdf, accessesd Feb
1, 2022.
61
Maccabi KS et al., Comparing SARS-CoV-2 natural immunity to vaccine-induced immunity: reinfections versus
breakthrough infections,https://www.medrxiv.org/content/10.1101/2021.08.24.21262415v1.full.pdf, accessed Feb 1
2022.
62
Vitale J, Mumoli N, Clerici P et al., Assessment of SARS-CoV-2 Reinfection 1 Year After Primary Infection in a
Population in Lombardy, Italy, JAMA Int. Med 181(10):1407-8. May 2021.
63
Dowell AC, Butler MS, Jinks E et al., Children develop robust and sustained cross-reactive spike-specific immune
responses to SARS-CoV-2 infection. Nature immunology. S41590-021-01089-8. Dec 2021
64
Nordstrom P, Ballin M, Nordstrom A, Risk of SARS-CoV-2 Reinfection and COVID-19 Hospitalisation in
Individuals With Natural- and Hybrid Immunity: A Retrospective, Total Population Cohort Study in Sweden,
https://papers.ssrn.com/sol3/papers.cfm?abstract_id=4000584, accessed Feb 3 2022.
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especially better with the Delta variant.65 Data from the UK, published in the prestigious journal The
Lancet,66 followed over 30 000 health care workers in England from June to December 2020, prior to
vaccine availability and showed previous infection provided 77% protection from reinfection. Other
preliminary studies 67 68 suggest a single dose of vaccine might be more than adequate after infection.
These data point to the fact that it is unnecessary to be vaccinated with two or more doses of vaccine
to have equivalent protection. However, current vaccine passports in Canada only recognize a two-
dose regime, ignoring past immunity or a single vaccination following infection.
28. Figure 5: data from New York and California showing better protection from infection by previous
infection compared to vaccination alone.
29. There is also a potential downside to vaccinating people who have been previously infected. A recent
publication69 from the Veterans Administration following over 3 million veterans, showed that in
those who had previously been infected the rate of hospitalization increased from 57/100 000 to
158/100 000 hospitalizations in the day after vaccination. Of these, around 57% were deemed likely
to be a result of the vaccination itself. This compares to 28/100 000 hospitalizations per day following
vaccination, which remained unchanged in those without previous infection. User reported data from
65
Leon TM, Dorabawila V, Nelson L et al., COVID-19 cases and hospitalizations by COVID-19 vaccination status
and previous COVID-19 diagnosis – California and New York, May – November 2021. MMWR 41(4):125-31. Jan
2022.
66
Hall VJ, Foulkes S, Charlett A et al., SARS-CoV-2 infection rates of antibody-positive compared with antibody-
negative health-care workers in England: a large, multicentre, prospective cohort study (SIREN), The Lancet,
397(10283):1459-69. April 2021.
67
Krammer F, Srivastava K. PARIS team, Simon V. Robust spike antibody responses and increased reactogenicity
in seropositive individuals after a single dose of SARS-CoV-2 mRNA vaccine. MedRxiv [Preprint].
2021. https://www.medrxiv.org/content/10.1101/2021.01.29.21250653v1
68
Saadat S, Rikhtegaran-Tehrani Z, Logue J, et al. Single dose vaccination in healthcare workers previously infected
with SARS-CoV-2. MedRxiv [Preprint]. 2021. https://www.medrxiv.org/content/10.1101/2021.01.30.21250843v2
69
Li LL, Zheng C, La J et al., Impact of prior SARS-CoV-2 infection on incidence of hospitalization and adverse
events following mRNA SARS-CoV-2 vaccination: A nationwide, retrospective cohort study, Vaccine, epub ahead
of print, https://www.sciencedirect.com/science/article/pii/S0264410X22000512. Jan 2022.
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the ZOE application in the UK,70 shows higher side effects of vaccine in those with previous history
of COVID-19 infection than those without. In a pre-print researcher from Mount Sinai School of
Medicine in New York found that those with previous infections mounted a more robust immune
response and had more side effects following vaccination.71 A preprint from Oxford University 72
estimates an extra 30 cases of myocarditis per million vaccinations in the 28 days following
vaccination in people who previously had infection. While these data are preliminary and need
confirmation, it is reasonable to consider infection to provide protection, at least for a period of time
after infection, especially for those at low risk of being sick enough to need hospitalization.
30. Similarly, many people have been vaccinated with one of the 31 vaccines approved in other countries
but that are not one of the 5 vaccines approved in Canada. This is true even for the additional 5 that
are recognized by the WHO , but not Health Canada approved or recognized (Covaxin, Sinopharm,
Sinovac, Novavax and Covovax).73 Therefore, people are excluded from travel despite being
recognized as fully vaccinated in other countries.74 This is particularly pertinent for new immigrants,
temporary foreign workers and tourists who are therefore not eligible for a vaccine passport in
Canada, despite having followed appropriate protocols in their home country.
31. As a clinician, I have been in the very uncomfortable position of counseling patients who, due to
previous vaccination (not Canadian approved), infection or both, are not eligible for the vaccine
passport but for whom I do not think vaccines offer significant benefit. I personally find it unethical
to counsel vaccination when I do not think the patient benefits simply in order to meet bureaucratic
requirements. This is not consistent with science or medical ethics.
E. Transportation is not a major source of SARS-CoV-2 transmission in travellers regardless of

vaccination status
32. Prior to widespread vaccination, or vaccination mandates, engineering and infection control protocols
made air-travel safe.75 This has been confirmed by Dr. Tam in a recent media release,76 and is
emphasized on the Transport Canada’s website.77 Multiple measures can be employed to reduce the
risk of an infection occurring during travel. One example is face coverings which have been used
since April of 2020 to protect travellers. 78 The US Department of Defence has used modeling to
70
Zoe app, Vaccine after effects more common in those who already had COVID,
https://covid.joinzoe.com/post/vaccine-after-effects-more-common-in-those-who-already-had-covid, accessed Feb 2
2022.
71
Krammer F, Srivastava Paris team et al., Robust spike antibody responses and increased reactogenicity in
seropositive individuals after a single dose of SARS-CoV-2 mRNA vaccine,
https://www.medrxiv.org/content/10.1101/2021.01.29.21250653v1, accessed Feb 2 2022.
72
Patone M, Mei X, Handunnetthi L et al., Risk of myocarditis following sequential COVID-19 vaccinations by age
and sex, https://www.medrxiv.org/content/10.1101/2021.12.23.21268276v1, accessed Feb 2 2022.
73
COVID-19 vaccine tracker, https://covid19.trackvaccines.org/, accessed dec 30 2021
74
Transport Canada, https://tc.canada.ca/en/initiatives/covid-19-measures-updates-guidance-issued-transport-
canada, Accessed Jan 30 2022.
75
canada/aviation-measures-response-covid-19, accessed Jan 30, 2022.
76
CBC, COVID-19 transmission on flights ‘extremely rare’ Dr Tam Says, https://www.cbc.ca/news/politics/covid-
transmission-flights-extremely-rare-1.5797065. Accessed Dec 23 2021.
77
Transport Canada, Risk of COVID-19 Transmission Aboard Aircraft. https://tc.canada.ca/en/binder/risk-covid-19-
transmission-aboard-aircraft. Accessed Dec 23 2021.
78
Transport Canada, https://www.canada.ca/en/transport-canada/news/2020/04/new-measures-introduced-for-non-
medical-masks-or-face-coverings-in-the-canadian-transportation-system.html, accessed Jan 30 2022.
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show that one would have to sit next to an infectious person for 54 hours before transmission
becomes likely, based on an aerosol particle model in common commercial jets with substantial risk
reduction associated with mask-wearing.79 Symptom screening is also used to reducing the likelihood
a traveler will board with infection and can defer travel in the event of a symptomatic infection, 80 and
cleaning protocols have been engaged to reduce the likelihood of viral transfer from surfaces.81
However, the most effective means of ensuring that people are not infectious on flights, vaccinated or
not, is to use testing to rule out the possibility of an undetected infection. Polymerase Chain Reaction
(PCR) testing assays are commercially available for travellers and have a sensitivity of >99% is close
to 100% in detecting infection,82 and can be performed within 48 hours of travel to ensure that a
person is not infected on the flight. Rapid antigen tests are also widely available and predict and
infection that is likely transmissible with 93% sensitivity83 and could be deployed at the time of travel
to ensure infectious travelers are not boarding planes or other forms of transportation. Other
jurisdictions allow people to present a negative test if they are unvaccinated. For example, Germany
considers proof of vaccination, recovery from infection or a negative test as equivalent for travel, 84 as
does Sweden,85 France,86 the UK,87 and The Netherlands. 88
33. Based on data from the Canadian military,89 a group of researchers calculated the number of
unvaccinated people it would be necessary to exclude to avoid a transmission event during
transportation.90 In Canada, that number was estimated to be 2026, during the delta surge. In other
words, only one unvaccinated person in over two thousand would be likely to transmit during
transportation. The differential between vaccinated and unvaccinated are based on the assumption that
79
Kinahan S, Silcott DB, Silcott BE et al., Aerosol tracer testing in Boeing 767 and 777 aircraft to simulate
exposure potential of infectious aerosol such as SARS-CoV-2. PloS One. 16(12). Dec 2021.
80
canada/aviation-measures-response-covid-19#toc6, accessed Jan 30 2021.
81
canada/aviation-measures-response-covid-19#toc8, accessed Jan 30 2022.
82
Public Health Ontario, https://www.publichealthontario.ca/-/media/documents/lab/covid-19-lab-testing-
faq.pdf?la=en. Accessed Dec 23 2021.
83
Pilarowski G, Lebel P Sunshine S et al., Performance characteristics of rpid severe acute respiratory syndrome
coronavirus 2 antigen detection assays at a public plaza testing site in San Francisco. J Infect Dis., 223(7):1139-44.
Apr 2021.
84
Government of Germany, Coronavirus, https://www.germany.info/us-en/service/covid-19/2321562, accessed Jan
20 2022
85
Public Health Agency of Sweden, Proof of COVID-19 status required for foreign nationals entering Sweden,
https://www.folkhalsomyndigheten.se/the-public-health-agency-of-sweden/communicable-disease-control/covid-
19/if-you-are-planning-to-travel/proof-of-covid-19-status-required-from-foreign-nationals-entering-sweden/,
accessed Jan 30 2022.
86
Ambassade De France Au Canada, COVID-19: update on the covid health pass in France
https://ca.ambafrance.org/COVID-19-Update-on-the-Covid-Health-Pass-in-France, Accessed Jan 30 2022
87
UK Government, Coronavirus (COVID-19), https://www.gov.uk/coronavirus accessed Feb 2 2022
88
Government of the Netherlands, Mandatory negative COVID-19 test result,
https://www.government.nl/topics/coronavirus-covid-19/visiting-the-netherlands-from-abroad/mandatory-negative-
test-results-and-declaration, accessed Jan 30 2022.
89
Defence Reearch and Development Canada, COVID-19 Toolset, https://covid-app.cloud.forces.gc.ca, accessed
Feb 3 2022.
90
Prosser A, Helfer B, Streiner DL, Evaluating the number of unvaccinated people needed to exclude to prevent
SARS-CoV-2 transmissions, https://www.medrxiv.org/content/10.1101/2021.12.08.21267162v1.full.pdf. Accessed
Jan 30 2022.
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vaccination would be perfectly effective, which, as described above, is not the case. With current
vaccine efficacy, the difference in likelihood of transmission between vaccinated and unvaccinated
number would be expected to be massively higher. In the case of Omicron, the number would be
infinite (meaning that even if all travellers were excluded, it would have no impact on likelihood of a
transmission event) given the failure of the vaccines to prevent infection and transmission.
34. The safety of travel has been confirmed by public health follow-up of exposures which shows that
there is very little transmission while in transit. British Columbia 91 and Canada92 have identified
thousands of exposures on federally regulated transportation, however, travellers have been identified
as the source of infection for only 0.7% of cases of COVID-19 in Canada. Likewise, only 0.9% of
infections were acquired outside the country and imported into Canada. 28 Provincial pages that
identify the source of COVID-19 outbreaks do not identify travel as being a common cause of
outbreak. 93 94 95 Unvaccinated travelers are not at higher risk of infection as a result of travel
compared to other permitted activities, therefore mandating vaccinations for travellers is unlikely to
alter the trajectory of the pandemic or the burden on the healthcare system.
F. Travelling has no meaningful impact on the health outcomes of vaccinated or unvaccinated

passengers
35. While vaccination does not prevent infection and transmission, there is substantial evidence that
vaccination is effective in preventing hospitalization and death. 11 96 97 98 99 Data from the UK show
that vaccinated people have rates of hospitalization and death at least 3-fold lower than for the
unvaccinated with increased impact in older age groups who are at the highest risk for hospitalization
and death.100 Likewise, data from the Veterans Administration in the USA show real-world efficacy
91
BCCDC, COVID-19 pubic exposures, http://www.bccdc.ca/health-info/diseases-conditions/covid-19/public-
exposures#flights accessed Dec 23 2021.
92
Public Health Agency of Canada, COVID-19 Passenger Transport where you may have been exposed,
https://www.canada.ca/en/public-health/services/diseases/2019-novel-coronavirus-infection/latest-travel-health-
advice/exposure-flights-cruise-ships-mass-gatherings.html ,accessed Dec 23 2021
93
Public Health Ontario, Likely Source of Infection, https://covid-19.ontario.ca/data/likely-source-infection.
Accessed Dec 23 2021.
94
INSPQ, Donées sur les éclosions de COVID-19 au Québec, https://www.inspq.qc.ca/covid-19/donnees/eclosions.
Accessed Dec 23 2021
95
Government of Alberta, Cases in Alberta, https://www.alberta.ca/covid-19-alberta-data.aspx#p25721s5. Accessed
Dec 23 2021.
96
Baden LR, El Shahly HM, Essink B et al., Efficacy and safety of the mRNA-1273 SARS-CoV-2 Vaccine, E Engl
J Med. 384:403-16. Feb 2021.
97
Skowronski DM, Setayeshgar S, Febriani Y et al., Two-dose SARS-CoV-2 vaccine effectiveness with mixed
schedules and extended dosing intervals: test-negative design studies from British Columbia and Quebec, Canada.
https://www.medrxiv.org/content/10.1101/2021.10.26.21265397v1. Accessed Dec 21, 2021.
98
Nordstrom P, Ballin M, Nordstrom A, Effectiveness of COVID-19 vaccination against risk of symptomatic
infection, hospitalization, and death up to 9 months: A Swedish total-popoulation cohort study.
https://papers.ssrn.com/sol3/papers.cfm?abstract_id=3949410. Accessed Dec 21 2021.
99
Ioannou GN, Locke ER, O’Hare AM et al., COVID-19 vaccination effectiveness against infection or death in a
national US Health care system. Ann Int Med., https://www.acpjournals.org/doi/pdf/10.7326/M21-3256 accessed
Dec 22 2021.
100
Public Health England, COVID-19 vaccine surveillance report – week 38.
https://assets.publishing.service.gov.uk/government/uploads/system/uploads/attachment_data/file/1019992/Vaccine
_surveillance_report_-_week_38.pdf. Accessed Dec 18, 2021.
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of 86% against hospitalization.101 Although data on the newly emerged Omicron variant remains to be
elucidated, initial evidence supports substantial protection against severe disease. One study in South
Africa found the efficacy of vaccination against Omicron was 70% for reducing severe disease
(hospitalization and death).102 The rates of full vaccination in Canada are 81% of the overall
population, including rates above 95% for those 80 and older, dropping to below 90% only for those
under the age of 50.103 Therefore the vast majority of travelers are protected by vaccination with rates
of vaccination highest in those age categories that are most at risk for severe outcomes.82 The risk of
hospitalization or death for those under the age of 50 are substantially lower than older age groups.
People above the age of 50 represent 76% of hospitalizations and 97% of deaths, almost all in these
age cohorts have multiple co-morbid conditions.74 Specifically, 90% occurred in people with pre-
existing comorbidities, and 80% resided in long-term-care (a group of people who are very unlikely
to travel).104 This is particularly relevant looking at the now dominant Omicron variant which
appears less virulent. Data from Denmark105 suggest that cases of Omicron are around 30% those of
previous strains and that many hospitalizations identified as incidental to SARS-CoV-2 infection.
Data from other jurisdictions suggest hospitalization and mortality are lower with Omicron, than with
other variants 106 107 7 108 Most recently, the UK government has summarized the emerging data on
Omicron,109 showing that hospitalization was roughly 1/3 with Omicron as compared to Delta variant
and that vaccination further reduced the risk of hospitalization for those infected with Omicron by
between 81% and 88%. Data from British Columbia show a 6-fold reduction in severity with
101
Tartof SY, Slezak JM, Fischer H et al., Effectiveness of mRNA BNT162b2 COVID-19 vaccine up to 6 months in
a large integrated health system in the USA: a retrospective cohort study. Lancet. 398(10309): 1407-16. Oct 2021
102
Discovery Health, Discovery Health, South Africa’s largest private health insurance administrator, releases at-
scale, real-world analysis of Omicron outbreak based on 211 000 COVID-19 test results in South Africa, including
collaboration with the South Africa. https://www.discovery.co.za/corporate/news-room, accessed Dec 22 2021
103
Public Health Agency of Canada, COVID-19 vaccination in Canada, https://health-infobase.canada.ca/covid-
19/vaccination-coverage/, accessed Jan 8 2022.
104
Public health agency of Canada, COVID-19 and deaths in oder Canadians: excess mortality and the impacts of
age and comorbidity, https://www.canada.ca/en/public-health/services/diseases/coronavirus-disease-covid-
19/epidemiological-economic-research-data/excess-mortality-impacts-age-comorbidity.html, accessed Dec 30 2021.
105
Statens Serum Institut, COVID-19 Rapport Om Omikrovarianten, Artillerivej 5,
https://files.ssi.dk/covid19/omikron/statusrapport/rapport-omikronvarianten-20122021-9j51. Accessed Dec 23 2021
106
Imperial College London, Report 49 - Growth, population distribution and immune escape of Omicron in
England.
https://www.imperial.ac.uk/mrc-global-infectious-disease-analysis/covid-19/report-49-Omicron/, accessed Dec 22
2021.
107
Espenhain L, Funk T, Overvad M et al., Epidemiological characterisation of the first 785 SARS-CoV-2 Omicron
variant cases in Denmark, December 2021. Eurosurveillance. 26(50):pii+2101146. Dec 2021
108
Sheikh A, Kerr S, Woolhouse M et al., Severity of Omicron variant of concern and vaccine effectiveness against
symptomatic disase: national cohort with nested test negative design study in Scotland.
https://www.research.ed.ac.uk/en/publications/severity-of-omicron-variant-of-concern-and-vaccine-effectiveness-,
accessed Dec 22 2021.
109
UK Government, Technical briefing: Update on hospitalisation and vaccine effectiveness for Omicron VOC-
21NOV-01 (B.1.1.529),
https://assets.publishing.service.gov.uk/government/uploads/system/uploads/attachment_data/file/1044481/Technica
l-Briefing-31-Dec-2021-Omicron_severity_update.pdf, accessed Jan 8 2022
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Omicron compared to Delta, and up to 9-fold reduction in need for hospitalization for the
vaccinated.110 Data provided by the BCCDC during the omicron outbreak shows this data visually:
36. Figure 6: BCCDC data on risk of hospitalization with predominantly Omicron variant.111
37. Allowing unvaccinated individuals to travel does not pose a meaningful risk to their health and safety.
The risk of becoming severely ill is not higher in travel than in any other activity, as evidenced by the
low rate of transmission during travel as an identified source of infection.
38. In fact, as COVID-19 becomes an endemic virus (meaning it circulates widely and will not be
eliminated for the foreseeable future) 112 113 - as confirmed by many public health officials 114 115 116-
it is inevitable that all people, vaccinated or not, will end up infected. Traveling will not change this
eventuality, so excluding the unvaccinated from travel will not substantially impact the outcome for
them.
G. The Canadian health care system overload is unrelated to the vaccine status of travelers
39. One of the arguments for requesting proof of vaccination is to protect the health care system from
overload. However, health care system functionality is not sensitive to the use of vaccine passports by
110
Government of British Columbia, COVID-19: Hospitalization Risk,
https://news.gov.bc.ca/files/1.21.22_covid_hospitalizations.pdf, accessed Jan 30 2022
111
Government of British Columbia, https://news.gov.bc.ca/files/1.21.22_COVID_Hospitalizations.pdf, accessed
Feb 2 2022.
112
Veldhoen M, Simas JP, Endemic SARS-CoV-2 will maintain post-pandemic immunity. Nature reviews
Immunology. 21:131-2. Jan 2021.
113
Torjesen I, CVOID-19 will become endemic but with decreased potency over time, scientists believe. Brit Med J,
372 (494). Feb 2021.
114
CTV News, Ontario's top doctor says it's time to learn to live with COVID-19
https://toronto.ctvnews.ca/ontario-s-top-doctor-says-it-s-time-to-learn-to-live-with-covid-19-1.5757373, accessed
Feb 2 2022.
115
The Toronto Star, https://www.thestar.com/politics/federal/2022/01/18/canadas-top-doctor-says-covid-19-will-
likely-become-endemic.html, https://www.thestar.com/politics/federal/2022/01/18/canadas-top-doctor-says-covid-
19-will-likely-become-endemic.html, accessed Feb 2 2022.
116
Vancouver Sun, COVID-19: When the pandemic becomes endemic, it may or may not be a less dangerous
disease, https://vancouversun.com/news/local-news/endemic-vs-pandemic-heres-what-you-need-to-know, accessed
Feb 2022.
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travelers. Healthcare has been over-burdened for years,117 118 119 120 121 leaving it vulnerable during
times of increased need. For example, during the 2009 H1N1 influenza pandemic PHAC reported
that H1N1 infections took up to 51% of hospital beds, 49% of ICU admissions and 53% of in-hospital
deaths.122 This crisis was investigated by the Canadian Senate which notes in their 2010 report123 :
a. “Nevertheless, despite the mild severity associated with the H1N1 pandemic, many
witnesses testified that Canada’s resources were pushed to their limit”; and,
b. “The committee heard that innovative approaches need to be considered in order to

increase surge capacity.”
40. Keep in mind that the H1N1 pandemic was remarkably mild3 and experts expected a substantially
more severe pandemic to be inevitable.124 Since the time of that report hospital beds per capita have
decreased, not increased from 2.78 beds/1000 population in 2010 to 2.52 beds/1000 people in 2019.125
41. The generally accepted bed occupancy rate for hospital systems to retain flexibility and surge
capacity is 85%.126 Some even argue that lower rates are better.127 In contrast, right before the
pandemic in 2019, Canada ranked second last in the OECD with a bed occupancy rate of 91.6% up
from 91.2% in 2000.128 129 Remember that is the average, during the winter peak Canadian hospitals
regularly function at rates exceeding 100%. For example, the yearly Health Quality Ontario report for
2018 notes that, “many Ontario hospitals are regularly operating at over 100% capacity, which can
lead to compromised care for patients”.130
117
https://www.cbc.ca/news/canada/toronto/ontario-hospital-hallway-medicine-healthcare-beyond-capacity-
1.5420434 accessed Feb 23 2022.
118
https://www.vicnews.com/news/infographic-b-c-s-most-crowded-hospitals-are-in-fraser-valley-northern-b-c/
accessed feb 23 2022.
119
https://www.theglobeandmail.com/news/national/hospital-overcrowding-has-become-the-norm-in-ontario-
figures-show/article35076965/ accessed feb 23 2022
120
https://www.theglobeandmail.com/news/british-columbia/hospital-turns-tim-hortons-into-temporary-er-to-
handle-overflow-of-patients/article569059/ accessed feb 23 2022
121
https://www.cbc.ca/news/canada/montreal/quebec-hospitals-overflowing-flu-1.4961414 accessed Feb 23 2022
122
Helfert M, Vachon J, Tarasuk J et al., Incidece of hospital admissions and severe outcomes during the first and
second waves of pandemic (H1N1) 2009.
123
Eggleton A, Senate of Canada, Canada’s Response to the 2009 H1N1 Influenza Pandemic, Dec 2010,
https://sencanada.ca/content/sen/Committee/403/soci/rep/rep15dec10-e.pdf, accessed Feb 19 2022
124
Branswall, Stat news, The last pandemic was a ‘quiet killer.’ Ten years after swing flue, no one can predict the
next one, June 2019, https://www.statnews.com/2019/06/11/h1n1-swine-flu-10-years-later/, , accessed Feb 19, 2022
125
Statista, Density of hospital beds in Canada from 1976-2019, https://www.statista.com/statistics/831668/density-
of-hospital-beds-canada/, accessed Feb 19 2002.
126
Performance magazine: The KPI institute certification programs 2022,
https://www.performancemagazine.org/smartkpi-hospital-bed-occupancy-rate/ accessed Feb 19 2022.
127
What is the ideal hospital occupancy rate, Medical Economics, https://hospitalmedicaldirector.com/what-is-the-
ideal-hospital-occupancy-rate/, accessed Feb 19 2022.
128
Statista, Occupancy rates of curative (acute) care beds in hospitals in select countries worldwide in 200 and 2019,
https://www.statista.com/statistics/1116612/oecd-hospital-acute-care-occupancy-rates-select-countries-worldwide/
accessed Feb 19 2022.
129
Organization for Economic Cooperation and Development, Hospital Beds and Occupancy, https://www.oecd-
ilibrary.org/sites/e5a80353-en/index.html?itemId=/content/component/e5a80353-en , accessed Feb 19 2022.
130
Health Quality Ontario, Measuring up 2018, http://www.hqontario.ca/Portals/0/Documents/pr/measuring-up-
2018-en.pdf, accessed feb 19 2022.
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42. CIHI data show that Canada had around 56 000 hospital beds (adult acute care and ICU) staffed and
operating in 2019.131 If Canada had been operating at 85% capacity, there would have been 4034
more beds available to address patients affected by the pandemic. Similarly, CIHI data show that
between 7.5% and 27% of hospital beds are occupied by patients awaiting placement in nursing
homes or other care settings (also known as alternate level of care or ALOC patients).132 This means
approximately 4 000 to 15 000 beds could have been available in hospitals for those acutely ill with
COVID-19, if we managed patients awaiting placement better. The total number of potentially
available beds based on these two numbers is between 8 000 and 19 000. Compare this to data from
the Public Health Agency of Canada which shows that bed-occupancy due to COVID peaked at 5000
until Omicron.133 While the Omicron wave peaked at around 10 000, between 30-50% of patients
were incidentally infected with COVID, it was not the cause of their hospitalization,134 135 136 meaning
the additional bed occupancy was at worse 7000 during the omicron peak (less than the 8000
estimated above). Therefore, there would have been more than adequate bed space had we better
managed our health care system and heeded the warning of the relatively mild H1N1 pandemic back
in 2009.
43. Based on the data above, it is reasonable to conclude that better management of the healthcare system
would provide better protection against health-care overload than a policy of asking for proof of
vaccination for travel.
V. Opinion:
44. While there is strong evidence that vaccination provides significant protection against developing
severe disease and death for those population groups at risk, there is little evidence that excluding
individuals from transportation, based on their vaccination status, will make a significant difference to
the safety of travel or the vaccinated or unvaccinated public who travel, especially with the
emergence of the Omicron variant.
VI. Conclusion:
45. Generally, vaccination is a beneficial health intervention and should be encouraged in all people at
risk of developing severe outcomes. The data suggest that those who are over 60, have significant
medical conditions or a weakened immune system are particularly at risk and benefit substantially
from being vaccinated. However, requiring vaccination for access to transportation provides
essentially no protection against infection, transmission, hospitalization or death before, during or
131
Canadian Institute for Health Information. Hospital Beds Staffed and In Operation, 2019–2020. Ottawa, ON:
CIHI; 2021. https://www.cihi.ca/en/cihi-updates-annual-indicators-and-data Accessed Feb 22 2022
132
https://www.cihi.ca/sites/default/files/document/dad-hmdb-childbirth-quick-stats-2017-2018-snapshot-en-
web.pdf, accessed Feb 22 2022.
133
https://health-infobase.canada.ca/covid-19/epidemiological-summary-covid-19-cases.html#a4 accessed Feb 22
2022.
134
Government of British Columbia, COVID-19 Hoispitalizations in BC,
https://news.gov.bc.ca/files/Feb_1_2022_Slidedeck.pdf, accessed Feb 24 2022.
135
https://www.governor.ny.gov/news/governor-hochul-updates-new-yorkers-states-progress-combating-covid-19-
131 acessed feb 23 2022.
136
https://biv.com/article/2022/02/incidental-covid-19-hospitalizations-bc-are-about-44-total accessed Feb 23 2022.
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after transportation. Any theoretical risk is easily mitigated through simple measures such as well
engineered environments, infection control protocols and could be further reduced by using readily
available and effective testing strategies.
46. This information is based on documents reviewed as of December 18 2021. If my opinion changes
after further consideration of these facts or through a review of additional information, I will notify
you in writing as soon as possible.
47. Thank you very much for asking me my opinion on this matter. I have done my best, in preparing my
opinion to accurate and complete. This information is based on documents reviewed as of December
18 2021. If my opinion changes after further consideration of these facts or through a review of
additional information, I will notify you in writing as soon as possible.
Sincerely,
J. Grant MDCM, FRCPC
AR05534
This is Exhibit “C” referred to in the Affidavit of Dr. Jennifer Grant sworn March 11, 2022

Sam A. Presvelos
AR05535
LIST OF DOCUMENTS IN EXPERT REPORT OF DR. JENNIFER GRANT
Acharya CB, Schrom J, Mitchell AM et al. No significant difference in viral load between
vaccinated and unvaccinated, asymptomatic and symptomatic groups infected with SARS-CoV-2
delta variant. https://www.medrxiv.org/content/10.1101/2021.09.28.21264262v1. Accessed Dec
21 2021
Ali K, Azher T, Baqi M . . . Grant JM et al., Remdesivir for the treatment of patients in hospital
with COVID-19 in Canada: a randomized controlled trial. CMAJ. 194(3):
doi:10.1503/cmaj.211698. Jan 2022.
Ambassade De France Au Canada, COVID-19: update on the covid health pass in France
https://ca.ambafrance.org/COVID-19-Update-on-the-Covid-Health-Pass-in-France, Accessed Jan
30 2022.
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FEDERAL
COURT OF CANADA
AFFIDAVIT OF DR. JENNIFER GRANT
PRESVELOS LAW LLP

Toronto, Ontario
M5H 3L5
Email:
Evan A. Presvelos (LSO #:

Tel:
Email:

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TAB 34
AR05548
BETWEEN:

Applicants
-and-

Respondents

I, Dr. Joel Kettner, having been named as an expert witness by the Applicants, certify that I have
read the Code of Conduct for Expert Witnesses as set out in the schedule to the Federal Courts
March 11th, 2022 _____________________________________

Dr. Joel Kettner
AR05549

EXPERTS' REPORTS

the report;

opinions;

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to the Court.
EXPERT CONFERENCES
witness

addressed; and
AR05551
BETWEEN:

Applicants
- and -

Respondents
AFFIDAVIT OF DR. JOEL KETTNER
1. I, Dr. Joel Kettner, of the City of Winnipeg in the Province of Manitoba, MAKE OATH
AND SAY AS FOLLOWS:
2. I am a Public Health Physician and as such have personal knowledge of the facts and matters
hereinafter deposed to save and except where the same are stated to be based upon
information and belief and where so stated I verify believe the same to be true.
3. Attached to this Affidavit and marked hereto as Exhibit “A” is a true copy of my current
4. Attached to this Affidavit and marked hereto as Exhibit “B” is a true copy of my expert
report with respect to this matter.

AR05552
5. Attached to this Affidavit and marked hereto as Exhibit “C” is a true copy of the list of
documents relied upon my report.
Sworn before me )
___________________________ ________________________
A Commissioner for taking Affidavits DR. JOEL KETTNER
Sam Presvelos
LSO#
Presvelos Law LLP

Toronto, ON M5H 3L5
AR05553
This is Exhibit “A” referred to in the Affidavit of Dr. Joel Kettner sworn March 11, 2022

Sam A. Presvelos
AR05554
CURRICULUM VITAE
Joel David Kettner

MSc MD FRCSC FRCPC
December 1, 2021
AR05555
TABLE OF CONTENTS
Personal and Professional Information 3
Present Employment 5
Education 6
University Degrees and Certification 8
Fellowships, Academic Prizes, Distinctions and Awards 9
Medical Work Experience 10
Selected Continuing Professional Development 12
Current Memberships, Organizations and Licenses 14
University Activities 15
Selected Services, Committees and other Relevant Activities 19
Published Books, Reports, and Papers 22
Published Abstracts and Letters 23
Presentations, Webinars and Other Scholarly and Educational Activities 24
Contracted Reports and Recent Media 30
Page 2 of 31
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PERSONAL AND PROFESSIONAL INFORMATION, CONTACT INFORMATION
Home Address:
Home Telephone Numbers:
Work Phone Number: ( )
Mobile Phone
Work Emails:
UM Address: University of Manitoba

Dept. of Community Health
Sciences
College of Medicine, Faculty of Health Sciences
University of Manitoba
S108C-750 Bannatyne Avenue
Winnipeg MB
R3E 0W3
(204) 789-3277
Personal History
Date of Birth: June , 1951
Place of Birth: Minneapolis, Minnesota, U.S.A.

(Canadian citizen born abroad)
Citizenship: Canadian
Marital Status: Married, six children, seven grandchildren
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Places of Residence
1951 – 1955 Minneapolis, Minnesota, U.S.A.
1955 – 1967 Winnipeg, Manitoba, Canada
1967 – 1968 London, England, United Kingdom
1968 – 1985 Winnipeg, Manitoba, Canada
1985 – 1988 London, England, United Kingdom
1988 – present Winnipeg, Manitoba, Canada
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PRESENT EMPLOYMENT
University of Manitoba Associate Professor, Departments of Community Health

Sciences and Surgery (since 1990);
Associate Director, Public Health clerkship rotation,
undergraduate medical education program;
Postgraduate Medical Education CanMEDS intrinsic roles lead;
Co-chair, Postgraduate Medical Education Truth and
Reconciliation Action Plan Committee
University of Winnipeg Adjunct professor, Dept of Indigenous Studies
Self-Employment Independent consultant
Consultant to several organizations with respect to COVID-19

(see court affidavits and expert reports, page 31.
Lead and administrator, WhatsApp chat group for COVID-19

Open Minded Critical Thinkers (physicians from across Canada)
Consultant, Advisory Circle, Health Transformation Project,

Southern Chief’s Organization, Manitoba.
Vaccinator, First Nations Communities COVID-19 vaccine

project.
Chair, College of Physicians and Surgeons of Manitoba Inquiry

Panel
Page 5 of 31
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EDUCATION and TRAINING
Pre-University
1968 – 1969 St. John’s High School, Winnipeg, Canada
1967 – 1968 Woodhouse Grammar School, London, England
1964 – 1967 St. John’s High School, Winnipeg, Canada
University – Undergraduate
1972 – 1976 Faculty of Medicine, University of Manitoba,
Dean A. Naimark
Winnipeg, Canada
1969 – 1971 “Pre-med” Arts & Science”

University of Manitoba, Winnipeg, Canada
University – Graduate and Post – Graduate
2000 Medical Assistance in Dying

Addictions medicine, opiate agonist therapy
1989 – 1990 Family Medicine Weekly clinics,

(6 months) Family Medicine Centre,
Winnipeg, Canada
1988 – 1990 Community Medicine (now Public Health and Preventive Medicine)
Residency,
Dept. of Community Health
Sciences, Faculty of Medicine
Winnipeg, Canada
1987 – 1988 Clinical Research Fellow, Imperial

Cancer Research Fund
Colorectoral Cancer Unit, St.
Mark’s Hospital, London, England
1986 – 1987 Clinical Research Fellow, Hepato-

biliary Surgical Unit, Dept. of Surgery,
University of London
Royal Postgraduate Medical School
and Hammersmith Hospital,
London, England
Page 6 of 31
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1985 – 1986 Master of Science, Epidemiology,

Faculty of Medicine, University of
London, England, London School
of Hygiene and Tropical Medicine
1985 Post – fellowship, Gastrointestinal

Endoscopy, Gastrointestinal Surgery and
Gastroenterology (Health Sciences Centre and
St. Boniface General Hospital, Winnipeg
Canada
1979 – 1984 General Surgery Residency, Dept.

Faculty of Medicine, University of
Manitoba (Health Sciences Centre
and St. Boniface General Hospital),
Winnipeg, Canada
1977 Extended Internship, Intensive

Care (voluntary), Health Sciences
Centre and St. Boniface General
Hospital, Winnipeg, Canada
1976 – 1977 Rotating Internship, University of

Manitoba, Faculty of Medicine
(Manitoba Affiliated Teaching
Hospitals – Health Sciences Centre
and St. Boniface General Hospital,
Winnipeg, Canada)
Page 7 of 31
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UNIVERSITY DEGREES AND CERTIFICATES
1991 Specialist Certification, Community Medicine (now Public Health and

Preventive Medicine), Royal College of Physicians of Canada (FRCPC)
1985 Master of Science in Epidemiology, London School of

Hygiene and Tropical Medicine, Faculty of Medicine,
University of London, England, (MSc) (MSc Thesis –
Epidemiology for Surgeons)
1984 Specialist Certification, General Surgery, Royal College

Surgeons of Canada (FRCSC)
1976 Doctor of Medicine (MD), University of Manitoba,

Winnipeg, Canada
1976 Licentiate, Medical Council of Canada (LMCC)
Page 8 of 31
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FELLOWSHIPS, ACADEMIC PRIZES, DISTINCTIONS AND AWARDS
1991-2020 Nominated for best teacher of the year by undergraduate medical

students in most years; most recently for small group teaching,
inspiration, innovation, and mentorship by first and second year medical
students.
2016 Long Service Award in Recognition and Appreciation of Twenty-five

Years of Loyal Service, University of Manitoba.
2012-2014 McArthur Foundation Fellowship (two years), Masters Development

Practice program, University of Winnipeg
2012 Nominated for Manitoba Civil Service Excellence Team Award –

CPPHO Report on the Health of Manitobans report-team (leader).
2010 Winner of Manitoba Civil Service Excellence Team Award - Manitoba

Health Pandemic H1N1 Influenza Incident Command Team (Medical
lead)
1987 – 1988 University of Manitoba Faculty Fund Fellowship for

studies in the clinical epidemiology of colorectal cancer.
1987 – 1988 Visiting Clinical Research Fellowship, Imperial Cancer

Research Fund, UK, to study clinical epidemiology and
Screening of colorectal cancer at the ICRF Colorectal
Cancer Unit, St. Mark’s Hospital, London, England
1985 – 1987 J.H.F. Knight Fellowship (University of London, England)

to study epidemiology and screening for colorectal cancer
1985 – 1987 R.S. McLaughlin Foundation Fellowship (University

of Manitoba) to study epidemiology and surgery at the
University of London, England
1983 Davis and Geck Award for Best Surgical Resident

of the Year
1982 Second Prize for paper presented at the American

College of Surgeons (Manitoba Chapter), Manitoba
1969 – 1971 Dean’s Honour List, both years of Pre-Medicine,

Faculty of Science, University of Manitoba
Page 9 of 31
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MEDICAL WORK EXPERIENCE
Current See “Present Employment”
2017 Consultant to Manitoba Keewatinowi Okimakanak, Inc. re northern

health clinical transformation
2012-2017 Medical director, International Centre for Infectious Diseases
2012-2015 Director, Master of Public Health program, University of Manitoba
2012-2015 Scientific director, National Collaborating Centre for Infectious

Diseases, International Centre for Infectious Diseases.
2012-2014 University of Winnipeg

Visiting Professor and Senior Fellow
Masters in Development Practice Program, Indigenous
Faculty of Graduate Studies
2008-2012 Chief Provincial Public Health Officer of Manitoba
1999 – 2008 Chief Medical Officer of Health

Province of Manitoba
1999 Medical Officer of Health

Winnipeg Community Health Authority
1995 – 1999 Medical Officer of Health

Winnipeg Region, Manitoba
1995 - 1999 Part-time general medical practice and travel clinics, Winnipeg City
Clinic, 385 River Avenue, Winnipeg
1995 – 2010 Casual employment as emergency room physician, urgent care

physician, and surgical assistant, Seven Oaks General Hospital
Concordia General Hospital, Misericordia General Hospital, Grace
Hospital, Victoria Hospital
1991 – 1995 Medical Officer of Health

Thompson, Norman and Interlake
Regions, Manitoba Health
1990 Attending surgeon, Surgical

Intensive Care Unit, Health
Sciences Centre
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1986 – 1988 Locum tenens as senior registrar

in Surgery, Hammersmith and
St. Mark’s Hospitals,
London, England
1984 – 1985 Surgical Assistant, Cardiac,

Surgery Unit, Health Sciences
entre, Winnipeg, Canada
1977 – 1979 Full-time emergency room physician,

St. Boniface General Hospital,
Winnipeg, Canada
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SELECTED CONTINUING PROFESSIONAL DEVELOPMENT
2020 Weekly Dept of Community Health Sciences Colloquia, on-line

sessions, webinars, and conferences on topics including medical
education and COVID-19.
2019 Many family medicine sessions and teaching development sessions at

the University Office of Continuing Professional Development and the
Office of Educational and Faculty Development.
Annual Scientific Assembly, Manitoba College of Family Physicians,
Canadian Conference of Medical Education, Niagara Falls.
Canadian Public Health Association annual conference, Ottawa
Public Health Physicians of Canada annual Continuing Professional
Development Symposium, Ottawa.
2018 Canadian Conference Medical Education, Halifax.

Canadian Public Health Association annual meeting, Montreal.
Public Health Physicians of Canada annual meeting, Montreal.
Weekly Colloquia, Department of Community Health Sciences.
CPD sessions, Office of Educational and Faculty Development.
Preparation for CAPE (clinical assessment and professional
enhancement for re-entry to clinical practice.
2017 Canadian Conference Medical Education, Winnipeg.

Canadian Public Health Association annual meeting.
Public Health Physicians of Canada annual meeting.
Weekly Colloquia, Department of Community Health Sciences.
2015-2016 Canadian Conference Medical Education, Montreal.

Canadian Public Health Association Annual Meeting, Toronto.
Choosing Wisely symposium, Public Health Physicians of Canada,
Toronto.
Association of Medical Microbiology and Infectious Diseases Annual
Meeting, Vancouver.
Annual BIO Conference, San Francisco.
Weekly Colloquia, Department of Community Health Sciences and
Weekly Medical Microbiology Case Presentations.
Peer Mentoring session for instructors of Indigenous health course.
2014 Faculty Development Workshop - Community Health Sciences June 12,

2014
2012 Medical Education Workshops, University of Manitoba

Learning Styles in the Classroom Feb 16/12
Teaching Clinical Reasoning April 10/12
Teaching Critical Thinking May 22/12
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2007 Queen’s University Executive Leadership Course
1994-1995 Observation and supervised experience in Emergency Medicine, Seven

Oaks Hospital, Winnipeg Canada (organized by Dr. Kopelow,
Department of Continuing Medical Education)
1993 Clinician’s Assessment and Enhancement Program, Department of

Continuing Medical Education, Faculty of Medicine, University of
Manitoba, Winnipeg, Canada
Page 13 of 31
AR05567
PROFESSIONAL MEMBERSHIPS, ORGANIZATIONS AND LICENSES
2020 Lead, WhatsApp Chat Group, Open-Minded Critical Thinkers, COVID-

19
2013 – 2016 President, Public Health Physicians of Canada.
2012 – present Member, Board of Directors, Canadian Association of Medical

Education Foundation, currently liaison member to the Canadian
Medical Education Journal.
2012 – 2015 Executive member, Clinical Teachers Association of Manitoba
2012 – 2014 Member, Board of Directors, Canadian Public Health Association of

Canada
1999 – present Member, Public Health Physicians of Canada, previously National

Specialty Society of Community Medicine
1993 - present Member, College of Family Physicians of Canada
2000 – present Member, Canadian Association of Medical Education
1991 – present Fellow of the Royal College of Physicians of Canada

(Community Medicine – now Public Health and Preventive Medicine)
1990 – 2012 Assistant Professor, Depts. of Community Medicines, Surgery and

Family Medicine, Faculty of Medicine, University of Manitoba
2012 - present Associate Professor, Depts. of Community Medicines, Surgery and

Family Medicine, College of Medicine, Faculty of Health Sciences,
1990 – present Member of the Canadian Association of Teachers of

Community Health
1988 – present Member of the Canadian Public Health Association and the
Manitoba Public Health Association
1984 – present Fellow of the Royal College of Surgeons of Canada

(General Surgery)
1976 – present Licentiate of the College of Physicians and Surgeons of

Manitoba, Current license, General Practice, with
Specialty privileges in General Surgery and Community
Medicine
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1976 – present Licentiate of the Medical Council of Canada
1976 – present Member of the Canadian Medical Association

(Manitoba Division)
1976 – present Member of the Canadian Medical Protective Association
UNIVERSITY AND OTHER ACADEMIC ACTIVITIES
2020 Faculty appointee, Undergraduate Medical Education Financial Award

Committee
2018 - 2020 Member, Postgraduate Medical Education Assessments Committee,

Professional Curriculum Committee, Education Advisory Committee,
Accreditation Working Group, and Competency-based Medical
Education Committee.
2019 – present Co-chair, Post-graduate Medical Education Truth and Reconciliation

Action Plan Working Group
2017 - present Post-graduate medical education CanMEDs intrinsic roles subject

advisor
2015 - present Associate director, Public Health part of Family Medicine/Public Health
Clerkship.
2013- 2017 Member, Healthy Campus Advisory Committee, University of

Winnipeg.
1991- present Member (and previous chair), Dept of Community Health Sciences
Undergraduate Committee
2012-2015 Director, Master of Public Health program, University of Manitoba
2012-2014 Visiting professor and senior fellow, University of Winnipeg, Masters

in Development Practice program, Faculty of Graduate Studies
2012 Promoted to associate professor, University of Manitoba
2012-2015 Elected to University of Manitoba Senate by the Faculty Council of

Medicine
2011-2012 Co-chair Curriculum Renewal Task Group on Health systems, Public

Health, and Environmental and Occupational Health and member of the
Curriculum Renewal Steering Committee, Faculty of Medicine,
Page 15 of 31
AR05569
2007-2012 Founding member of the first national Public Health Educators

Network, and participant author of its first national on-line learning
resource for medical students (The Primer);
1995, 2006, 2010 Member, Search Committees for Head of the Department
Community Health Sciences, Department of Community
Health Sciences, Faculty of Medicine, University of
Manitoba
1992-1994 MSc thesis advisor for Anita Kozyrskyj: Validation of an Electronic

Prescription Database in Manitoba: An Opportunity to Evaluate
Pharmacist Participation in Drug Utilization Review.
1994 – 1996 Member, Med I and II Curriculum Reform Committee –Core Concepts
Block, Faculty of Medicine, University of Manitoba
1994 - 1995 Member, Search Committee for new tenure-track position, Department
of Community Health Sciences, Faculty of Medicine, University of
Manitoba
1991 – 2011 Member, Executive Committee, Department Community

Health Sciences, Faculty of Medicine, University of
Manitoba
1991 – 2015 Member, Committee of Evaluation, Faculty of Medicine, University of

Manitoba
1991 – 2015 Member, Clerkship Curriculum Committee, Faculty of Medicine,

1991 – 2011 Director, Undergraduate Program, Department of Community Health

Sciences, Faculty of Medicine, University of Manitoba (special teaching
responsibilities include Course Director, Line and major clerkship-
Family Medicine Community Medicine, graduate course teaching,
thesis supervision and teaching and supervision of community medicine
residents).
Page 16 of 31
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Undergraduate courses taught at University of Manitoba
2015 - present Small group teaching in the population and public health pre-clerkship
and clerkship programs and the Indigenous health longitudinal course,
totaling now more than 100 hours per year.
1991- 2014 Average of more than 50 hours per year in undergraduate teaching,
including 2-5 lectures and 2-3 tutorials in Population Health and
Medicine, including Introduction to Health and Medicine (first lecture
to first year medical students), Natural History of Disease and Levels of
Prevention, Measurements of Health and Disease, Determinants of
Health, Social Responsibility of Physicians;
Public Health part of the Family Medicine/Public Health clerkship

rotation (8 rotations per year), including orientation, community health
status assessment, a “hot” current topic, followed after the rotation by a
debrief;
Annual summary presentation of Population and public health (invited

consistently by 4th year students) as part of the LMCC QE Part I exam
review.
Graduate and Postgraduate courses taught at University of Manitoba
2004 – present Graduate teaching (MPH, MSc and PhD level): Problem Solving in
Public Health (formerly Current Topics in Community Medicine
93.7510)
2016 - present Invited speaker on Population Health and Health Care Organization to
surgical residents as part of their Principles of Surgery training
program.
2019 Invited speaker, Clinical Investigators Program: Health advocacy and

health advocacy research.
1991- 2015 Annual guest teaching of “Principles of Prevention” in Epidemiology I

and “Risk Communication” in Epidemiology II
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1995-2008 Designer, supervisor, and lecturer in a recurring series of learning

sessions in Epidemiology, Statistics, and Critical Appraisal in the
PGME Core curriculum for all residents at the Faculty of Medicine;
Graduate Student Supervision
2015-2016 Supervised practicum of MPH student at International Centre for

Infectious Diseases and National Collaborating Centre for Infectious
Diseases
1994 - 2015 Supervisor for PGME students in Public Health and Preventive
Medicine (average one - two per year for one to four month rotations)
2012-2015 Advisor to 13 MPH students, including field placement supervision.
1992-1994 MSc thesis advisor for Anita Kozyrskyj: Validation of an Electronic

Prescription Database in Manitoba: An Opportunity to Evaluate
Pharmacist Participation in Drug Utilization Review.
Current Research Activities
2013 – present Health mentor, Grand Challenges Phase 1 Grant (total $100,000)
"Improving Maternal and Child Health at the Root through Village
Level Biotechnologies" with International Institute of Sustainable
Development (co-PI) and CTx Green (P.I.)
Page 18 of 31
AR05572
SELECTED SERVICES, PROVINCIAL COMMITTEES AND OTHER RELEVANT

ACTIVITIES
2012 – present Member, Manitoba Provincial Vaccine Advisory Committee
2015-2016 Member, planning committee, Conference to develop a federal

framework on Lyme disease, Ottawa, May 15-17, 2016
1994 – 2018 Examiner, Medical Council of Canada Part II Qualifying Exam
2014 - 2016 Member, Winnipeg Harvest Health and Hunger Committee
2015 - 2016 Member, Advisory committee to the Public Interest Law Committee
research study on guaranteed annual income.
2003 – 2015 Statistics Canada Canadian Health Measures Survey Expert Advisory
Committee
2013-2015 Member, Public Health Infrastructure Task Group to develop a

blueprint for a federated surveillance system in Canada
2006 – 2012 Member of the Advisory Committee, National Collaborating Centre for
Infectious Disease
2003 – 2007 Healthy Living Issue Group of the Population Health Promotion Expert
Group, Canadian Public Health Network responsible for leading the
writing of the Pan-Canadian Healthy Living Strategy,
2006 – 2011 Federal Provincial Territorial Roles & Responsibilities in Pandemic

Preparedness and Response Task Group, Public Health Network
Council
2006 Member of the selection committee for scientific director, National

Collaborating Centre for Infectious Disease
2006 – 2008 Medical Advisory Committee, Health Science Centre, Winnipeg,

Manitoba, representing Department of Community Health Sciences
2002 – 2009 Emergency Preparedness Expert Group, Canadian Public Health

Network
2002 – 2006 Manitoba member, Federal Provincial Territorial Deputy Ministers of

Health Advisory Committee Population Health
and Health Security
2004 Member of the Canadian delegation to the World Health

Organization special meeting in Geneva November 1-12, 2004 to
Page 19 of 31
AR05573
develop the fourth edition (2005) of the International Health

Regulation introducing the concept, definition, and expectations of
countries during a Public Health Emergency of International
Concern (PHEIC).
2002 – 2003 Co-chair, Health Disparities Task Group, Federal Provincial Territorial
Deputy Ministers of Health Advisory Committee Population Health and
Health Security
2000-2001 Chair, Province of Manitoba Drinking Water Advisory Committee and

sole accountable author of Report on Bacterial Safety of Drinking
Water In Manitoba
1999 – 2002 Chair, Federal Provincial Territorial Deputy Ministers of Health

Advisory Committee on Population Health
1999 – 2012 Council of Chief Medical Officers of Health of Canada (CCMOH)
1995 – 1999 Co-chair, Project Team, Community Health Status Assessments,

Epidemiology Unit, Manitoba Health
1995 Participant, Federal-Provincial Working Group/Workshop for present

the Prevention of Neural Tube Defects, Manitoba Health and Health
Canada, Ottawa
1995 Member, Provincial Committee on Hepatitis A, B and C amongst

Winnipeg street-evolved youth
1995 – 1999 Member, core committee to review the Public Health Act of Manitoba
1995 Member, Advisory Committee to the Baby Alert Program
1994 – 1995 Member, Steering Committee for Psychiatric Day Hospital and
Community Services in Mental Health for Winnipeg, Manitoba Health
1994 – 1999 Member of the Manitoba Health Communicable Disease Control

Surveillance Review Committee and Chairman, Subcommittee on
Analysis and Dissemination of Results.
1994 – 1999 Member of the Winnipeg Air Quality Index Committee
1993 – 1995 Member, Provincial Cancer Control Committee and Chair of

Subcommittee on Secondary Prevention of Cancer, Manitoba Health
1993-1994 Member, Working Group for Psychogeriatric Services in Winnipeg,

Manitoba Health
Page 20 of 31
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1993-1994 Member, Committee to Define Core Services for Rural Health

Associations, Manitoba Health
1993-1994 Member, Provincial Surgery Committee, Manitoba Health
1993 Participant, national workshop and consensus conference on the training

of community medicine specialists, Toronto
1991 – 1995 Member, National Population Health Survey Provincial Advisory

Committee, Manitoba Health
1989 Member, Provincial Task Force on Breast Cancer Screening in

Manitoba, Manitoba Health
1986-1988 Member, Public Health Alliance of Britain
1985-1988 Member, International Physicians for the Prevention of Nuclear War
1977-1985 President, Progressive Medical Association, Winnipeg
1974-1976 Founding member of “The Community Medicine Group” medical

students concerned about social and public health issues
1974-1976 Founding co-editor (with Dr. Brian Postl) of “The Meditoban”, medical
school student newspaper
1974-1976 Founding board member, NorWest Health Co-op, Winnipeg
Page 21 of 31
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PUBLISHED BOOKS
Northover, John M.A., Kettner, Joel D. and Mr. Barry Paraskeva PhD, FRCS. Your Guide to Bowel
Cancer (Royal Society of Medicine). A Hodder Arnold Publication, 2007
Northover, John M.A. and Kettner, Joel D. Bowel Cancer: The Facts. New York, Oxford University
Press, 1992
SIGNIFICANT REPORTS
Chief Provincial Public Health Officers’ “Report on the Health Status of Manitobans 2010: Priorities
for Prevention – Everyone, Every Place, Every Day” (published November, 2011)
PUBLISHED PAPERS
• SM Moghadas, M Haworth-Brockman, H Isfeld-Kiely, J Kettner. Improving public health

policy through infection transmission modelling: Guidelines for creating a Community of
Practice. Can J Infect Dis Med Microbiol 2015;26(X):1-5.
• Mahmud S, Hammond G, Elliott L, Hilderman T, Kurbis C, Caetano P, Van Caeseele P,

Kettner J, Dawood M. Effectiveness of the pandemic H1N1 influenza vaccines against
laboratory-confirmed H1N1 infections: population-based case-control study. Vaccine. 2011
Oct 19;29(45):7975-81. Epub 2011 Aug 30.
• Writing Committee of the WHO Consultation on Clinical Aspects of Pandemic (H1N1) 2009
Influenza, Bautista E, Chotpitayasunondh T, Gao Z, Harper SA, Shaw M, Uyeki TM, Zaki SR,
Hayden FG, Hui DS, Kettner JD, Kumar A, Lim M, Shindo N, Penn C, Nicholson KG.
Clinical aspects of pandemic 2009 influenza A (H1N1) virus infection. Review. N Engl J
Med. 2010 May 6;362(18):1708-19.
• Zarychanski R, Stuart TL, Kumar A, Doucette S, Elliott L, Kettner J, Plummer F. Correlates

of severe disease in patients with 2009 pandemic influenza (H1N1) virus infection. CMAJ.
2010 Feb 23; 182(3): 257-64. Epub 2010 Jan 21, 2010
• Verne J, Kettner J, Mant D et al. Self-administered faecal occult blood tests do not increase
compliance with screening for colorectal cancer: results of a randomized controlled trial. Eur
J Cancer Prev 1993; Jul: 301-305
• Yassi A, Kettner J, Hammond, G et al. Effectiveness and costs-benefit of an Influenza

Vaccine Program for Healthcare Workers. Can J In Dis 1991: 101-108;
• Kettner, JD, Whatrup C, Verne JE et al. Is there a preference for different ways of performing
faecal occult blood tests? Int J. Colorectal Dis 1990; May:82-86;
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PUBLISHED ABSTRACTS
Kettner JD, Whatrup C, Miller K. A comparative study of three patient approach methods for faecal
occult b1000 testing in a North London general practice. Coloproctology. 1988;10:129
Kettner JD, Whatrup C, Young K. A within-person comparison of efficacy and individual preference
for two methods of faecal occult blood detection. Coloproctology 1988;10:123
Kettner JD, Whatrup C, Miller K et al. Evaluation of new faecal occult blood test-a comparison of
individual preference and efficacy using Early Detector and Haemoccult. Theoretical Surgery
1987;2:82
Kettner JD, Whatrup C, Miller K et al. A randomized trail of invitation methods for occult blood
screening. Theoretical Surgery 1987;2:81-82
Kettner J, Paetkau D, Slykerman L et al. Effect of treatment on cardiac performance when right
ventricular afterload is gradually increased in dogs. Critical Care Medicine 1983; II;3:217
Paetkau D, Kettner J, Girling L, Slykerman L, Prewitt RM. What is the appropriate therapy to
maintain cardiac output as pulmonary vascular resistance increases? Anacsthesiology, 57;3:A-56,
September, 1982
PUBLISHED LETTERS
Kettner, J. Quebec’s Public Health Cuts Canadian Journal of Public Health 2015:106:3 March/April.
Scholefield JH, Kettner, JD, Northover JMA. Papillomavirus infection and progress to abnormal
cervical smears. Lancet, 1988:i:1405;
Scholefield JH, Kettner, JD, Northover JMA. Problems with anal cancer demographics. Diseases of
the Colon and Rectum; 1988:31:10:831;
Kettner JD, Mant D, Northover JMA. Ethics of preventive medicine. Lancet; 1988;ii:44-45;
Kettner Joel and Northover, JM. Screening for colorectal cancer, Lancet 1986;i:562-563;
Kettner Joel and Northover, JM. Occult-blood screening, Lancet 1986;ii:110;
Page 23 of 31
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PRESENTATIONS, WEBINARS AND OTHER SCHOLARLY AND EDUCATIONAL

ACTIVITIES
2016 Planning consultant and facilitator, NCCID-York University Workshop on

Mathematical Modelling in Public Health Infectious Diseases, York University,
Toronto, October 3-4, 2016
2016 Guest (as Infectious Diseases Public Health specialist) on This Hour Has 22
Minutes, CBC Television.
2016 Member of scientific planning committee, Lyme Disease symposium, May 15-17,
2016, Ottawa.
Public Health 2016 (annual conference of the Canadian Public Health Association)
- Member, Conference Scientific Planning Committee

- Welcoming remarks on behalf of the Public Health Physicians of Canada at the opening
ceremony
- Organized and participated in a panel discussion on “Public Health Inspectors, Public Health
Nurses, and Public Health Physicians As Leaders: A Candid Conversation about Collaboration
and Change ”
Moderator, and member of the scientific planning committee, International Centre for Infectious
Diseases National Grand Rounds:
- February 18, 2016: Zika virus - What to Know, What to Do, University of Manitoba, in
collaboration with the Dept of Community Health Sciences Bold Ideas Colloquium Series.
Diseases International Webinars:
- December 1, 2016: Difficult-to-treat Gram Negative Pathogens

- November 8, 2016: The Burden and Preventability of Non-respiratory Complications of
Influenza in Older Adults
- October 27, 2016: Antibacterial Resistance in Gram-Negatives: Prevalence, risk factors, and
impact of inappropriate therapy
- October 13, 2016: Pneumococcal Immunization for Older Adults.
- August 17, 2016: Pneumococcal conjugate vaccines for infants: What have we learned since
their introduction?
- June 22, 2016: HPV Immunization Programs: What is the advantage of including males?
- February 25, 2016: Vaccine Hesitancy: What is it, Why is it, What to do about it?
- January 13, 2016: Mind your T's and Q's - What do we know about today’s influenza vaccine
options? (moderator) and speaker: Today’s Menu of Vaccine Choices – the Basics and the
New Ingredients
2017 Radio interview re: legal age of marijuana purchase and use in Manitoba.
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2015-2016 Radio, Television, and Media interviews on subjects including Ebola, ZikaVirus,
Malathion, Influenza.
2015-2016 Designer, moderator, and speaker of ICID National Grand Rounds (Influenza
vaccine for under 2 year olds, Influenza vaccine choices for seniors, Zika virus)
and webinars (e.g. HPV vaccine, new vaccine options including quadrivalent,
pneumococcal disease)
2015-2016 Co-chair (International Centre for Infectious Diseases/National Foundation for

Infectious Diseases) of scientific planning committee and chair of international
advisory committee for an accredited on-line learning module produced by
MDBriefcase on Seasonal Influenza in Older Adults: Immunization Challenges
and Options for Vaccination Strategies
2015:
Diseases National Grand Rounds:
- December 17, 2015: Influenza Vaccines for Adults Over 65: Evaluating the Evidence,
University of Manitoba Medical College
- October 27, 2015: Flu Vaccines for Little Kids – What’s New, What’s True, University of
Toronto
Diseases International Webinars:
- May 6, 2015: Males and HPV: Burden of Disease and Prevention through Immunization
November 25, 2015: Invited speaker, Public Health Physicians of Canada Residents’ national
educational webinar series: Life After Residency.
Lyme Disease Best Brains Exchange in Ottawa, June, 2015.
Chaired panel discussion at annual meeting of CHVI RD Alliance Coordinating Office at Canadian
Association of HIV Research annual meeting, Toronto, 2015.
DCHS Colloquium presentation on the NCCID program: with Ms. Margaret Haworth Brockman:
Ebola Virus Disease and other Challenges and Opportunities for the NCCID
Activities at Public Health 2015 (annual conference of the Canadian Public Health Association)
- Welcoming remarks on behalf of the Public Health Physicians of Canada at the opening
ceremony
- Organized and chaired a panel discussion on “The ebola outbreak: What have we learned that
we didn’t know before?”
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- Facilitated a workshop on Burden of Illness in Infectious Diseases
Association of Medical Microbiology and Infectious Diseases annual conference, Charlottetown,

May, 2015.
- Poster presentation: AMR, Public Health, and Knowledge Translation: A Forward Approach
2014 Reviewer of research proposals for CIHR SPOR projects, Institutes of Population
and Public Health and Health Services Delivery.
2013-2014 Member, scientific planning committee, Consensus Conference on Antimicrobial

Resistant Organisms, University of and Institute of Health Economics, June 18-20,
2014
2014 Invited speaker, Consensus Conference on Antimicrobial Resistant Organisms,

University of Alberta Institute of Health Economics, June 18-20, 2014: “What is
surveillance? What is screening? How are they related?”
2014 Series of four public lectures at the University of Winnipeg on Public Health in the
21st Century:
- Public Health Unpacked: What is it? Who needs it?
- Priorities for Prevention in Manitoba: our Provincial Profile
- Public Health ahead: What are the Possibilities? How can we prevent the threats
that we do not see or know?
- Power, Process, and Public Policy: The Peculiar Ethics and Politics of Public
Health and its relationship to Sustainable Development.
2013-2014 National webinars for Public Health and Preventive Medicine residents and public
health physicians hosted by the National Collaborating Centres for Public Health.
Topic:
- “Treatment as Prevention” with Drs. A. Ronald and J. Montaner
- “ Knowledge Translation for Emerging Diseases”
2013 Options (VIII) for the Control of Influenza, September 5-9, Capetown, South
Africa
- Paper: Rapid Knowledge Translation during the 2009 influenza pandemic
- Poster: A project to translate and exchange knowledge towards more effective,
efficient and equitable public health and primary care strategies for influenza and
influenza-like illness (ILI) in Canada. JD Kettner , E Cheuk
2013 Innovation in Medicine and Health Care, University of Piraeus, Piraeus, Greece
- Paper: Knowledge Translation for Emerging Infectious Diseases: Challenges and
Opportunities
Page 26 of 31
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2013 University of Winnipeg Summer Institute Course: Hosted a morning session and
presented a lecture on "Principles of prevention of infectious and chronic diseases"
2014 Series of four public lectures on public health, University of Winnipeg.
2012 Surgery Grand Rounds: “A Surgeon’s Career in Public Health – the Long and
the Short of It”
2003-2011 Annual lecture (most years) at “Bug Day” including SARS, “Little Bugs in the
Big Picture”, H1N1, and tuberculosis.
2010 National Collaborating Centre for Public Health, Making Connections, Opening
Ceremony and plenary, keynote speaker, and co-presenter with Dr. Pat Martens
on partnerships between government and university in public health policy
setting, Summer Institute of the National Collaborating Centres of Canada
2010 The Manitoba College of Family Physicians, 52 Annual Scientific Assembly,

key note speaker: H1N1 De-Brief
2010 Doctors Manitoba, Western Conference of Provincial/Territorial Medical

Association, “How to Survive a Pandemic –What have we learned?”
2010 International College of Dentists Annual meeting, Winnipeg. Public Health and
the H1N1 Pandemic Influenza
2009 Continuing Medical Education, Mini Medical School, University of Manitoba

2009;
2009 Presented on H1N1 for disadvantaged populations and led a practice guidelines
consensus session at the Pan-American Health Organization of the World Health
Organization consultation conference in October 14-16, 2009 in Washington,
D.C.,
2008 Mini-university lecture on what on public health and evidence for the news
2007-2013 Annual lecture on Issues and Trends in Public Health at Red River Community
College Issues and Trends in Health course taught by Jim Hayes as part of the
Health management course for employees in regional health authorities
2007 Plenary speaker and panel discussant: Ethical issues in the practice of public
health. The First Canadian Roundtable on Public Health: Exploring the
Foundations, Montreal, Quebec.
Page 27 of 31
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2000-2018 Department of Community Health Sciences Colloquia:
• 2020: COVID-19 – Is the Prevention Worse than the Disease?

• February 5, 2020: Organizer and moderator of Coronavirus – an Open
Forum, livestreamed, University of Manitoba Faculty of Health Sciences.
• 2018: Seeking Bold Ideas to Strengthen Inter-College Collaboration in
Primary Care and Public Health
• 2017: Trumpism: Another Global Public Health Threat Originating in
the USA?
• 2015: Colloquium presentation on the status and future of the National
Collaborating Centre for Infectious Diseases
• 2014: Hosted colloquium and joint learning session with students and
staff of the University of Winnipeg MDP program and University of the
North Midwifery program: Dr. Janet Smylie and Sara Wolfe:
“Indigenous Knowledge Work as a tool for Community Driven Health
Services Development”
• 2013: Co-presented with Dr. Julie Pelletier (University of Winnipeg) on
“Two Masters Programs – Two Universities – One Vision?”
• CPPHO Report on the Health Status of Manitobans ... Priorities for
Prevention: Everyone, Every Place, Every Day – 2011
• The New Public Health Act “Does it meet the Public’s Needs of Today
and Tomorrow?” – 2009
• Reorganization of Public Health in Manitoba: Challenges and
Opportunities –2008
• Healthy Living Strategy: New-Old or Old-New? –2003
• Walkerton Water – Could it happen here? - 2000
1993 The role of the urban medical officer of health. Cadham Provincial Laboratory
Seminar
1990 “Screeening” for an awful disease. Community Health Sciences, Colloquium,
Faculty of Medicine, University of Manitoba
1990 Epidemiology in Orthopedic Surgery, Orthopedic Grand Rounds, Health
Sciences Centre
1989 Surgical Epidemiology, Western Association of Clinical Surgeons
1989 Screening for colorectal cancer, Concordia General Hospital Medical Rounds
1989 Screening for colorectal cancer, Surgery Grand Rounds, Health Sciences Centre
1987 Epidemiology of hepatic metastases, Annual course in advance hepatobiliary and
pancreatic surgery, Royal Postgraduate Medical School, Hammersmith Hospital,
London, England
1987 Obstructive jaundice, Surgery for GPs annual course. Royal Postgraduate
Medical School. Hammersmith Hospital, London England
1987 Epidemiological aspects of hepatobiliary malignancies. Workshop in Research
Methods in Surgery, Royal Postgraduate in Medical School, Hammersmith
Hospital, London, England
Page 28 of 31
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1987 The surgical epidemiology of cholangiocarcinomas. UK Chapter of the World

Congress of Hepato-biliary Surgeons, Cardiff, Wales
1987 Community Screening – Early Diagnosis and Prevention of Colorectal Cancer –
a meeting for general practitioners, St. Mark’s Hospital, London, England
1987 Mass Screening for colorectal cancer. Common Gastrointestinal Problems –
Course for general practitioners, St. Bartholomew’s Hospital Medical College,
London, England.
1986 Mass Population Screening for Colorectal Cancer. Symposium on Screening,
Carmarthen General District Hospital Carmarthen, Wales
Prior to career as medical officer of health 1990-2012:
1990 “Community Health Status Assessment – A model for Aboriginal Communities”.

Poster presentation, circumpolar health Conference, Whitehorse, Yukon;
1987-1988 The following two papers were presented by me at the Surgical Efficiency and
Economy World Conference, Lund, Sweden, August, 1987 and at the 2nd Beonnial
Congress of the European Council of Coloproctology Advances in Coloproctology,
Geneva, Switzerland, 1988:
“ A randomized trail of invitation methods for occult blood screening”
“Evaluation of new faecal occult blood test- a comparison of individual preference

and efficacy using Early Detector™ and Haemoccult™”
1982-1983 “Effect of treatment on cardiac performance when right ventricular afterload is

gradually increased in dogs” (Authors: Kettner Joel, Paetkau Don, Slykerman M,
Girling L and Prewitt R. Departments of Surgery, Anaesthesia and medicine,
University of Manitoba.
This paper was presented by me at the following meetings:

American College of Surgeons, Manitoba Chapter, Winnipeg, 1982
(awarded 2nd prize);
Critical Care Society Meeting, New Orleans, USA, 1983;
American Society of Anaesthesiologists, Las Vegas, USA 1982;
Canada Anaesthetists Society Meeting, Vancouver, 1983
Page 29 of 31
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CONTRACTED AND OTHER REPORTS
Manitoba Health Provincial Health Indicators, member of Working Group. 1999.

https://www.gov.mb.ca/health/documents/ind-all.pdf
Kettner, Joel D. Community Health Status Assessment, Waterhen First nation; 1993 (for Waterhen
First Nation, Manitoba)
Kettner, Joel D. and Postl, B Community Health Status Assessment: a tool to understand and
improve the health of Aboriginal communities: 1991 (Northern Health Research Unit for Medical
Services Branch, Health Canada)
Kettner, Joel D. Community Health Status Assessment, Cross Lake, Manitoba; 1989 (for Medical
Services Branch, Health Canada)
INVITED REVIEWS
2017- 2021: Canadian Journal of Public Health
2018-2021: Canadian Journal of Medical Education
2021: Association of Medical Microbiologists and Infectious Disease Specialists of Canada
2021: University of Manitoba Medical Students Journal
SELECTED MEDIA, COVID 19
Winnipeg Free Press panel, Dec 10, 2020

https://www.youtube.com/watch?v=9l52CWsUGTE
Toronto Caribbean interview, November 26, 2020

https://www.youtube.com/watch?v=cpjk53umB_0&feature=emb_title
CBC West of Centre panel discussion

Circuit Breakers and Personal Freedom, November 12, 2020.
https://www.cbc.ca/listen/cbc-podcasts/407-west-of-centre/episode/15808413-circuit-breakers-and-
personal-freedom
Open letter to first ministers, July 29, 2020

https://healthydebate.ca/opinions/an-open-letter-to-pm-covid19
Opinion piece CBC Manitoba, July 25, 2020

A new normal, or new abnormal? Change in direction needed on COVID-19 response
https://www.cbc.ca/news/canada/manitoba/joel-kettner-opinion-covid-19-response-1.5654062
Page 30 of 31
AR05584
Letter to the editor, Winnipeg Free Press, June, 27, 2020

https://www.winnipegfreepress.com/search/?keywords=clergy+kettner&searchSubmitted=y&sortBy=
-startDate
Cross-country Check-up, March 15, 2020.

https://www.cbc.ca/listen/live-radio/1-13-cross-country-checkup/clip/15765826-march-15-2020-is-
enough-done-slow-covid-19
Invited interviews and expert advice between March 15, 2020 till August 15, 2021:
- CTV local news
- Global TV local news
- CBC TV local news
- CJOB local radio
- Winnipeg Free Press
- Shaw local television, Victoria, BC
COURT AFFIDAVITS AND EXPERT REPORTS (available from courts or by request to

joel.kettner@umanitoba.ca)
Supreme Court of Yukon 20-AP002

Mercer vs Government of Yukon
Affidavit filed January 28, 2021
Supreme Court of British Columbia S 210209

Beaudoin vs Government of British Columbia and the Provincial Health Officer
Affidavit filed February 12, 2021
Supreme Court of Manitoba CI 20-01-29284

Gateway Bible Baptist Church et al vs Government of Manitoba
Affidavit filed April 1, 2021
Ontario Superior Court of Justice CV-20-00652216-000

Adamson Barbeque et al vs Ontario (Attorney General)
Affidavit filed April 14, 2021
Reply affidavit filed May 17, 2021
Ontario Superior Court of Justice CV-21-00013361-0000

Wellandport United Reformed Church vs Ontario (Attorney General)
Affidavit filed May 4, 2021.
Page 31 of 31
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This is Exhibit “B” referred to in the Affidavit of Dr. Joel Kettner sworn March 11, 2022

Sam A. Presvelos
AR05586
Joel Kettner MD MSc FRCSC FRCPC S108C-750 Bannatyne Avenue1
Associate professor Winnipeg, Manitoba
Dept of Community Health Sciences R3E 0W3
College of Medicine 204-789-3277
University of Manitoba joel.kettner@umanitoba.ca
Presvelos Law LLP

Toronto, Ontario
M5H 3L5
Attention: Mr. Sam Presvelos
Dear Mr. Presvelos:
Re: Shaun Rickard et al v. The Attorney General of Canada et al.
Thank you for engaging me as an expert in the above referenced court matter. Below are
the questions I have been asked to consider together with my analysis and conclusions.
For ease of reference, my report has been divided into two parts. In art I, I define and
explain terminology, concepts, and scientific bases pertinent to my answers to the
questions that I have been asked to consider. The answers to the following questions can
be found in Part II of this report.
The questions
1. What factors are associated with the risk of transmission of COVID-19 during an
airplane flight?
2. What factors are most important to consider in estimating the risk/probability of

transmission of COVID-19 during an airplane flight?
3. What has been observed and reported with respect to the numbers and frequency of
COVID-19 transmissions that have occurred during an airplane flight?
4. If an airplane traveler becomes infected by transmission during an airplane flight,

what is the probability that they will need hospitalization, intensive care, or die?
5. If an airplane traveler becomes infected during an airplane flight, what is the

probability that they will infect another person that will subsequently need
hospitalization, intensive care, or die?
6. In your opinion, what should be demonstrated from a public health perspective to

justify a policy for mandatory vaccination of airplane passengers?
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Part I
Terminology, Concepts, and Scientific Foundations
for the Answers to the Questions in Part II
Caveat:
Wherever possible, data and estimates in this report have been obtained from
government and official public health organization sources. In the absence of relevant
data and estimates, I have used information which I could find from reputable sources,
which I have identified in this report. Where necessary, I have calculated estimates
based on simple modelling techniques and assumptions, using my knowledge and my
expertise-based opinion.
Where helpful for clarification and interpretation, some numbers have been rounded.
Infected vs Infectious
The presence of virus material in the back of one’s nose is not synonymous with having
an infection. Infection is a clinical and pathological state as explained in the next
paragraph. Tests, such as the polymerase chain reaction (PCR) detect virus genetic
material but cannot determine whether the sample is from a person that has an active
infection and potentially infectious to others. Without further details about the PCR test
result cycle threshold - an indicator of viral volume (load) in the sample - and without
information about the duration of time since the onset of symptoms or the time period
since the putative exposure, one cannot be confident that a person with a positive test
result had an active infection or was infectious at the time the sample was taken. It is
unlikely for a person to be infectious more than one week after their onset of symptoms
or to have viruses capable of replicating1, but a person can have a positive test result
from a sample taken as long as three months after their symptoms or infection2.
For a virus to cause infection, cells must be invaded. The replication of the virus causes
cell and tissue damage, inflammation, and an antibody response by the host (person).
This pathological state usually results in clinical conditions such as fever, sore throat,
cough, and pneumonia. Severe infection may result in the need for hospitalization or
death. Mild infection is characterized by mild inflammation and mild symptoms – or no
symptoms at all. As with other respiratory viruses, COVID-19 infection, for most people
infected, is a self-limiting illness without the need for medical care.
1 https://academic.oup.com/cid/article/71/10/2663/5842165
2 https://www.cdc.gov/coronavirus/2019-ncov/hcp/testing-overview.html A positive NAAT diagnostic
test should not be repeated within 90 days, because people may continue to have detectable RNA after risk of
transmission has passed
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During the period of the infection, the person is also infectious. This refers to the
potential to transmit their infection to others. Typically, the more severe the illness, the
greater the infectiousness. This is because the viral load may be greater or because
symptoms are more frequent (e.g. coughing, sneezing). These symptoms project
viruses more forcefully and further towards other persons, thus exposing them to a
higher dose. Persons without symptoms (pre-symptomatic or asymptomatic) are
considered less likely to infect others, especially if they do not ever develop symptoms
(asymptomatic) during their infection3.
These concepts and definitions are important when we consider the probability that a
person taking their seat on an airplane may be infected and to what degree may be
infectious to other passengers. In other words, if only passengers who feel and look well
– i.e. without symptoms from any cause - were permitted to board an aircraft, the
likelihood of transmission would be lower.
Because PCR border testing does not identify the presence of infection or
infectiousness in travelers, and because it does not identify where or when infection
occurred, its results cannot be used to determine or estimate the risk of transmission
during air travel. Border sampling results4, comparing vaccinated and unvaccinated
travelers, are discussed later in this report.
Opinion
Given the importance of the level of infectiousness associated with these different
clinical states, to justify a public health policy requiring vaccination for all airline
passengers, the following should be described as part of a risk-assessment:
1) evidence-based estimates of the frequency distribution of each of these clinical states

(asymptomatic, pre-symptomatic, mild symptoms, severe symptoms) and their absolute
and relative attribution for COVID-19 transmission in the airplane cabin setting; and,
2) evidence-based estimates of the impact of vaccination mandates and other mitigating
measures on transmission from each of these clinical states.
I have been unable to find such estimates and analyses on a Canadian government
website.
3https://www.who.int/news-room/commentaries/detail/transmission-of-sars-cov-2-implications-for-infection-
prevention-precautions
4 https://www.canada.ca/en/public-health/services/diseases/coronavirus-disease-covid-19/testing-
screening-contact-tracing/summary-data-travellers.html
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Factors affecting the likelihood of transmission between airline passengers
Factors affecting the likelihood of transmission are not necessarily the same factors that
affect the severity of an illness resulting from a transmitted infection. There is a
relationship between the likelihood of transmission and the likelihood of severe illness,
but it is important to consider them separately. This is because are mild and of little
consequence; the main concern is about the minority of cases which are severe.
Whether or not transmission of infection will occur from an exposure is determined by

several factors. The most important of these are: (i) the “contagiousness of” the virus (ii)
the “viral dose” of the exposure and (iii) the susceptibility of the exposed person
(contact).
Contagiousness refers to the transmission characteristics of the virus and each of its
variants. Some respiratory viruses have higher rates of transmission than others. The
Omicron variant is more contagious – i.e., higher rates of transmission – than other
variants of SARS-CoV-2. Contagiousness is not synonymous with severity of illness,
which is often referred to as virulence. For example, the Omicron variant appears to be
more contagious, but less virulent.
Viral load refers to the volume of virus in the respiratory tract of the infected person
(case).
Viral dose refers to the volume of virus that reaches the respiratory tract of the exposed
person (contact). The higher the viral load of the infectious person (source), the more
likely that a higher exposure dose will reach the contact and that transmission will occur.
The viral dose for the exposed person (contact) is a result of:
1) the viral load of the infectious person (case) and
2) the characteristics of the exposure. These characteristics include the propulsion of
virus (e.g. coughing vs talking), the direction of propulsion (e.g. face-to-face vs sitting
behind), the duration of exposure (e.g. greater or less than 15 minutes), and the barriers
in place (e.g. masks, shields).
Susceptibility is the propensity to becoming infected from exposure. The term

susceptibility is also used to describe the propensity to becoming severely ill from an
infection. It is important to distinguish susceptibility to getting infected (transmission)
from the susceptibility to getting severely ill from an infection. This is important because
the risk factors are not necessarily the same.
Opinion
To estimate the risk of transmission during air travel, it is necessary to consider the
proportion of passengers which are likely to be infectious, their degree of
AR05590
infectiousness, the probability of high-risk exposures, and the susceptibility of the

passengers. These can be measured or estimated. To estimate the impact of a vaccine
requirement policy, it is necessary to estimate how much the prohibition of non-
vaccinated persons from travel will reduce that risk.
To justify a public health policy requiring vaccination for all airline passengers, the
following should be established in a transparent and clear manner:
1) evidence-based risk analysis and estimate of the incidence, prevalence, and degree
of contagiousness of the current circulating viruses, the probability of infectiousness in
passengers boarding an airplane, the probability of high-risk exposures on the airplane,
and the levels of susceptibility of the passengers in an airplane cabin setting; and
2) evidence-based estimates of the quantified impact of vaccination on infectiousness of

boarding passengers, susceptibility of the exposed, and transmission, specific to the
current circulating variants.
I have been unable to find such analyses or estimates on a Canadian government

website, including the Prime Minister’s October 6, 2021 announcement of the
mandatory vaccination plans and the links posted on the site5.
Susceptibility, vaccination, natural immunity, innate immunity
Susceptibility refers to (i) the probably of becoming infected and, (ii) if infected, the
probability of becoming severely ill.
Susceptibility to infection transmission from a given exposure is affected by the

presence of one or more of the following states of immunity:
• Innate immunity, the ability to defend against previously unseen viruses;
• Natural immunity from previous infection;
• Vaccine-induced immunity.
In addition to these types of immunity, susceptibility to becoming severely ill from

infection is increased by the presence of one or more of the following states of health
conditions.
• Medications and pre-existing health conditions which affect the immune system
• Pre-existing health conditions that effect the cardio-respiratory system;
• Pre-existing health conditions that effect the cough reflex and/or respiratory
muscle function;
5 https://pm.gc.ca/en/news/news-releases/2021/10/06/prime-minister-announces-mandatory-vaccination-
federal-workforce-and
AR05591
• Age;
• Other conditions, which in addition to biological factors, include access to timely
and appropriate care to interrupt progression of the illness to a more severe
state.
Opinion
Because of the association of these states and conditions with the probability of
transmission and the probability of severe illness, the age, states of immunity, and
conditions of health of passengers must be known or estimated to analyze the risks of
air travel transmission, for vaccinated and unvaccinated potential passengers. Although
intuitively and anecdotally6, it would be expected that air passengers are generally
younger and healthier than the population in general – especially with respect to people
over 80 and those living in long term care facilities – I was unable to find Canadian data
on the demographics or health status of airline passengers before or during the
pandemic period.
To assess the risk of transmission and the risk of severe illness resulting from
transmission during an airplane flight requires estimates of the absolute number and the
proportions of passengers which have one or more of these of states of immunity of
conditions of health. These are estimable by survey, screening, testing, and other
methods and should be reviewed on a regular basis – in combination with cases and
contact tracing analyses - to assess the occurrences, rates, and levels of risk
associated with airplane travel – stratified by risk factors of the passengers. To justify a
vaccine requirements policy, the impact of vaccination, vaccination mandates, and other
mitigations should be analyzed and estimated in the context of the distribution of risk
conditions amongst the passengers.
I have been unable to find such analyses on a Canadian government website.
Vaccine effectiveness
The following data from the UK Health Security Agency Technical Briefing, 14 January,
20227 show the results of recent research on the effectiveness of vaccines used in
Canada against the Delta and Omicron variants. I am using these data because they
were the best current analysis by an official government agency that I was able to find,
including my effort to find similar analyses on a Canadian government website.
6https://www-statista-com.uml.idm.oclc.org/statistics/1191651/air-passengers-airline-flight-pandemic-reached-
country-age/
7
https://assets.publishing.service.gov.uk/government/uploads/system/uploads/attachment_data/file/1050236/tec
hnical-briefing-34-14-january-2022.pdf p.23
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Based on these graphs, the effectiveness of the two mRNA vaccines to prevent infection
(i.e. transmission) of the Omicron variant fell from 70% at 2-4 weeks after immunization
to 10% at 25+ weeks.
Vaccine effectiveness against the Delta variant was higher, 90% at 2-4 weeks, falling to
between 60-80% by 25+ weeks.
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AR05594
* BNT162b2 = Pfizer mRNA vaccine, used in Canada

* mRNA-1273 = Moderna mRNA vaccine, used in Canada
These data are relevant to policy decisions regarding current vaccine requirements. The
main purpose of mandating or encouraging vaccination prior to travel is to reduce
transmission during travel or, secondarily, at the destination of travel. The size of the
benefit for vaccine requirements is directly proportional to the effectiveness of a vaccine
to prevent transmission. To mandate two-dose vaccination when the effectiveness
against the dominant variant (Omicron) is 10% after 6 months requires explanation and
justification.
Opinion
To justify a public health policy requiring vaccination for all airline passengers, there
should be a transparent and clear (i) evidence-based estimate of the proportion of
airline passengers that have natural or vaccine-induced immunity and their likelihood of
getting infected in the airplane cabin setting, specific to their degree of protection from
the circulating variants at any specific time; (ii) evidence-based estimate of the
proportion of airline passengers that are at higher risk for severe illness resulting from
transmission of infection, and (iii) evidence-based estimate of the quantified impact
(effect size) of vaccination requirements on the likelihood of transmission and on the
likelihood of severe illness resulting from transmission of infection.
I have been unable to find such data or analyses on a Canadian government website.
Natural history of disease and risk of developing severe illness
Transmission of infection on an airplane can directly or indirectly result in severe illness

that requires hospital care or results in death.
• Direct: A person that becomes infected during an airplane flight develops over
the next few days a severe illness;
• Indirect: A person that becomes infected during a flight transmits (after

disembarking) their infection to another person who becomes severely ill.
(Theoretically, this chain of transmissions can continue, but the probabilities
become increasingly negligible.)
Severe illness resulting from transmission can occur in any setting. The probability of
severe illness is dependent on several factors, as described in the previous section on
susceptibility. To assess the risk of developing severe illness resulting from
transmission during flight requires estimates of the proportion of passengers that would
be infectious, the probability of transmission during the flight, the proportion of
AR05595
Joel Kettner MD MSc FRCSC FRCPC S108C-750 Bannatyne Avenue
10
passengers with a higher susceptibility to getting infected, and the proportion of

passengers with a higher susceptibility to getting severely ill.
Opinion
should be an ongoing collection and analysis of passenger data to support transparent
and clear (i) evidence-based estimates of the probability of in-flight transmission (direct)
multiplied by the probability of subsequent severe illness, specific to the current
circulating variants; (ii) the probability of after-flight (indirect, secondary) transmission
multiplied by the probability of severe illness, specific to the current circulating variants;
and (iii) evidence-based estimates of the quantified impact of vaccination on direct and
indirect transmission and on subsequent severe illness, specific to the current
circulating variants.
I have been unable to find such data or analyses on a Canadian government website.
Mitigating factors – reducing the probability of infection and the degree of

infectiousness of passengers.
An estimate of the probability of transmission amongst passengers during one flight

should consider the following:
1) The prevalence of infectious passengers

2) The degree of infectiousness of the infectious passengers
Prevalence is an epidemiological measurement of the proportion of a group of people that

have a specific characteristic, in this case being infectious with the SARS-CoV-2 virus.
For a single point in time (i.e. at entry to the airplane cabin) the proportion of passengers
that are infectious would be described as the point prevalence. This is estimable by
sampling, surveys and other methods previously described.
The degree of infectiousness, as described earlier, is dependent on viral load and

symptoms (e.g. coughing, sneezing) that increase the expulsion of virus towards
others8.
For symptomatic infections, it is estimated that the infectious period, on average, begins
two days before the onset of symptoms and continues for five days after the onset of
symptoms.9
8 https://www.canada.ca/en/public-health/services/diseases/2019-novel-coronavirus-infection/health-
professionals/main-modes-transmission.html
9 https://www.uptodate.com/contents/covid-19-epidemiology-virology-and-
prevention?search=covid%20infectious%20period&source=search_result&selectedTitle=1~150&usage_type=defau
lt&display_rank=1
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11
There are two ways to reduce the prevalence of infectious persons boarding an
airplane.
1) Actions or states that can reduce the likelihood of being infectious prior to embarking
are:
a) reduction of close contact exposures by use of non-pharmaceutical interventions
(barriers, distancing, handwashing) between the third and seventh days before
departure. Between three and seven days10 is considered the time of the incubation
period – the time from exposure to the virus until the onset of symptoms.
b) States of conditions of health which reduce the likelihood of being infectious at the
time of embarking such as natural or vaccine-mediated immunity.
2) Actions that can be taken to reduce the probability that an infectious persons will
enter an airplane cabin are:
a) Screening of passengers, which can be done by observing passengers for
symptoms and by asking questions about symptoms.
b) Tests prior to boarding as discussed above, including polymerase chain reaction
(PCR) tests, rapid antigen testing, and serological antibody (immune) testing.
Opinion
There are a variety of ways to reduce the probability that an infectious person will board
an aircraft. Each of these can be compared with respect to their effectiveness and
feasibility in different circumstances. For example, previous infection is considered
comparable to vaccination with respect to effectiveness and duration of protection, as
demonstrated in several published papers including this systematic review and pooled
clinical studies of September 21, 2021.11 Policies that do not accept proof of previous
infection (positive serological antibody tests or positive PCR tests > 10 days and < 180
days before travel) as an alternative to proof of vaccination should be explained and
justified by transparent, clear evidence and scientific rationale.
10 https://www.canada.ca/en/public-health/services/diseases/2019-novel-coronavirus-infection/symptoms.html#s
11 https://www.medrxiv.org/content/10.1101/2021.09.12.21263461v1
AR05597
12
Mitigating factors – reducing transmission.
Although the evidence is not strong or precise with respect to the effect size or
magnitude of impact of the non-pharmaceutical interventions, it is reasonable to expect
that masks, distancing, handwashing, sanitation, and ventilation all contribute to the
reduction of transmission on an airplane12.
Air travel policies of governments and airlines can support and enforce these mitigating
measures in the controlled environment of an airplane. Although I am not aware of
evidence to confirm this, it is likely that the ability to achieve compliance with these
measures in an airplane cabin with continuous vigilance of the crew are greater than in
other settings (private, social, entertainment, retail, restaurants, bars, etc.). where
passengers would otherwise be if not on an airplane.
Opinion
should be a transparent and clear 1) evidence-based description of the policies,
implementation, and effectiveness of all other mitigating measures and 2) evidence-
based estimate of the quantified additional and incremental impact of vaccination
requirements on transmission, specific to the current circulating variants.
Mitigating factors – reducing secondary transmission of new variants of concern
If an objective of vaccination requirements is to reduce the frequency of transportation

of viruses from one location to other - especially new variants of concern that have a
greater transmission rate and/or a greater severity rate – then, to achieve this, the
following must be true, to a significant quantified degree.
1. There must be a differential of prevalence of new variant viral infections between

two or more travel locations.
2. The transmission during travel must be greater than the transmission in the
destination location. In other words, if the prevalence and transmission of a new
variant is the same at the two points of travel, the probability of transmission from
one location to the other is equal and inconsequential with respect to incidence
or prevalence of infections.
12https://www.aircanada.com/content/dam/aircanada/portal/documents/PDF/en/Onboard_Transmission_FactSh
eet_en.pdf
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13
3. Vaccination requirements must significantly reduce the transmission of new

variant infections, measured absolutely and relative to other mitigating options
that have been or are currently in place.
Opinion
should be a transparent and clear (i) evidence-based estimate of the absolute and
relative attribution of airline travel to the transportation of new variants of concern from
one location to another, specific to the circulating variants at any specific time; and (ii)
evidence-based estimates of the quantified impact of vaccination requirements on the
transportation of viruses and variants of concern.
Mitigating factors – reducing hospitalizations for severe cases.
The overall goal of the federal/provincial/territorial response to COVID-19 is “to minimize

serious illness and overall deaths while minimizing societal disruption as a result of the
COVID-19 pandemic.” 13 Towards these goals, COVID-19 public health interventions
include the prevention of severe illness and “ensuring access to health services”
including hospitals and ICU’s. Whether on airplanes, other modes of travel, or in any
setting, the prevention of infection transmission is one of several ways to prevent the
number of severe cases.
Any strategy to prevent infections and infection severity – whether by non-

pharmaceutical interventions or by vaccination – must be evaluated for its absolute
impact as well as its impact relative to other interventions. As required by Canada’s
national overall goal, it must also be evaluated for its impact on societal disruption. To
justify a vaccine requirement with respect to prevention of severe illness and the need
for hospitalization, it is necessary to evaluate its absolute benefit and its incremental
benefit – in comparison to harmful disruptions - over other mitigating interventions.
The effectiveness of the following measures for infected persons to decrease their
probability of severe illness should be estimated and considered as part of a
comprehensive strategy for the general population and for persons with specific risk
factors and in specific settings, such as air travel.
Measures to reduce the number of severe cases include the following:

1. Optimization of modifiable risk factors for severe illness:
a. Chronic disease management (e.g. regular health care visits, timely
adjustment of medications);
b. Health-related behaviours (e.g. reduction of smoking);
13https://www.canada.ca/en/public-health/services/diseases/2019-novel-coronavirus-infection/guidance-
documents/federal-provincial-territorial-public-health-response-plan-ongoing-management-covid-19.html#a2
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2. Prompt and appropriate care for symptoms, especially for higher-risk persons;
3. When indicated, specific drugs for SARS-CoV-2 infection (e.g. antivirals,
monoclonal antibodies).
These considerations are important because, like most infectious diseases, strategy
options to reduce morbidity and mortality include a range of interventions and a
combination of options from primary prevention to clinical treatment. Each intervention
has its advantages and disadvantages, its benefits, and harms. Vaccine requirements
for air travel to reduce transmission and severe illness should be estimated
quantitatively and reviewed regularly during the changing trajectory of a pandemic or
other infectious disease outbreaks.
Similarly, quantitative estimates should be described for combinations of interventions,

from which the most effective and efficient strategy combinations can be described and
justified. For example, during the first year of the COVID-19 pandemic, vaccines were
not available. An expectation was created that vaccines would achieve herd immunity,
that the use of non-pharmaceutical interventions and other public health restrictions
would suppress transmission until vaccines became available. Despite 80% being
double-vaccinated, it has become apparent that herd immunity has not been achieved,
especially for the more highly contagious variant such as Omicron.14
For a complex biological and social event like a pandemic, it is important to constantly
review and adjust interventions to ensure that the most effective, least intrusive, and
least harmful interventions are prioritized. Interventions which become less effective,
more intrusive, and more harmful should be de-prioritized or eliminated.
Opinion
should be a transparent and clear (i) evidence-based estimate of the absolute and
relative risk associated with unvaccinated passengers in comparison to vaccinated
passengers ; and (ii) evidence-based estimate of the quantified impact of vaccination
requirements on the rate of transmission of infection and severe illness, in absolute
terms and relative to other interventions of prevention and treatment, including
mitigating factors discussed in this section, specific to the current dominant variants.
14https://assets.publishing.service.gov.uk/government/uploads/system/uploads/attachment_data/file/1050236/te
chnical-briefing-34-14-january-2022.pdf p.23
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PART II
The Questions
1. What factors are associated with the risk of transmission of COVID-19 during
an airplane flight?
Conditions for transmission

For transmission of infection to occur during a flight on an airplane, the following
conditions must all be true:
• At least one person that is infectious has boarded the flight.
• A non-infected person must be exposed to the virus of an infectious person –
directly or indirectly.
• The exposure must result in infection in the exposed person. Transmission is
defined as an infection which results from the exposure to the virus from an
infectious person.
Transmission dynamics
There are four main ways for transmission of a respiratory virus to occur, listed here
from the most to least frequent15.
• Direct transfer of virus (mostly on droplets) from the infectious person to the
exposed person (e.g. coughing, kissing). The virus is transferred directly from the
respiratory tract of the infectious person to the respiratory tract of the exposed
person.
• Indirect exposure through the air – i.e. indirect transfer of virus from the infectious
person to the exposed person in which virus is transferred indirectly from the
infectious person to the respiratory tract of the exposed person by aerosolized
(airborne) transmission; e.g. more than two meters distance.
• Indirect exposure by other body part contact – person to person i.e. virus does
not go directly from the respiratory tract of the infectious person to the respiratory
tract of the exposed person; instead, for e.g., it is transferred from the nose to the
hand of the infectious person, to the hand and nose of the exposed person.
• Indirect exposure via inanimate objects – e.g. it is transferred from the nose of
the infectious person to the doorknob, then to the hand and nose of the exposed
person.
15https://www.who.int/news-room/commentaries/detail/transmission-of-sars-cov-2-implications-for-infection-
prevention-precautions. Implications for infection prevention precautions. Scientific Brief, World Health
Organization. 9 July 2020.
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These factors apply to any setting. In the next question I will consider them in the setting
of air travel.
2. What factors are most important to consider in estimating the risk/probability

of transmission of COVID-19 during an airplane flight?
The Ontario Ministry of Health, consistent with Canada16, British Columbia17, and
Quebec18, uses the following three factors to determine whether a close contact or high-
risk exposure to an infectious person has occurred:
a. duration of exposure,
b. distance from the infectious person,
c. use of a mask or other barrier.
The current case and contact management guidelines of Ontario Ministry of Health that
have been used to determine whether a person is a “close contact”19 and should,
therefore, be followed up for further action (i.e. self-isolate or self-monitor)20 are:
a. 15 minutes or more of cumulative exposure, and

b. a distance of less than two meters from the infectious source person,
and
c. the absence of wearing a mask or other barrier.
In other words, a person that is wearing a mask while sitting within two meters of an
infectious person during a flight of any duration would not be defined as a close
contract, and according to the Ontario guidelines, therefore, would not be advised to
self-isolate or self-monitor. This guideline indicates that the Ontario Ministry of Health
has assessed the probability of transmission to be too low to warrant such action.
In Quebec, the scenario above would be classified as a “low-risk contact”, defined as

“people who have been within less than 2 meters of the case for at least 15 minutes
while wearing a mask (both the case and the person in contact).” If a person’s exposure
professionals/interim-guidance-cases-contacts.html#a3 December 24, 2021.
17 http://www.bccdc.ca/health-info/diseases-conditions/covid-19/self-isolation/close-contacts January 26, 2022.
18 https://www.quebec.ca/en/health/health-issues/a-z/2019-coronavirus/instructions-for-people-who-have-been-
in-contact-with-a-confirmed-case-of-covid-19 February 15, 2022.

19https://www.health.gov.on.ca/en/pro/programs/publichealth/coronavirus/docs/contact_mngmt/management_
cases_contacts_omicron.pdf COVID-19 Integrated Testing & Case, Contact and Outbreak Management Interim
Guidance: Omicron Surge Version 2.0 January 13, 2022. Page 15.
20https://www.health.gov.on.ca/en/pro/programs/publichealth/coronavirus/docs/contact_mngmt/management_
cases_contacts_omicron.pdf COVID-19 Integrated Testing & Case, Contact and Outbreak Management Interim
Guidance: Omicron Surge Version 2.0 January 13, 2022. Page 16.
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to an infectious person was classified as a “low-risk contact”, self-monitoring would be

advised, but self-isolation would not be required.
Similarly, in British Columbia, the scenario above would not have been classified as a
“close contact”, defined as “someone who has been near a person with COVID-19 for at
least 15 minutes when health and safety measures were not in place or were
insufficient”. In other words, self-isolation or other special measures would not be taken
for a passenger sitting beside an infectious person during a flight if masks were worn by
each person.
The above definitions and guidance for self-isolation and contact tracing apply to
persons that are vaccinated or unvaccinated. In other words, based on these criteria, if
a case was identified and considered infectious during the flight, neither the persons
sitting closest to them nor any of the crew would be considered high-risk exposures or
close contacts as long as any one of the three protective conditions were met. This
would be true whether the potential contacts were vaccinated or not.
3. What has been observed and reported with respect to the numbers and
frequency of COVID-19 transmissions that have occurred during an airplane
flight?
I have been unable to find an adequate description or summary data, information, or

analyses by the Government of Canada to estimate answers to this question.
Data on border testing results21 of passengers provide information on the proportion of

passengers entering Canada that have had a positive test result, but do not provide
information on the transmission rate during flight. As explained in part I, PCR test results
are not reliable indicators of active infection and infectiousness. Comparisons of positivity
rates between vaccinated and unvaccinated passengers need to be validated by further
clinical, laboratory and epidemiological information. Having said that, the comparison of
6.4% and 4.4% positivity rates for unvaccinated and vaccinated passengers, respectively,
is consistent with the relative estimates used below to answer this question.
In the absence of modeling or other data analyses to estimate the frequency of

transmission during air travel, I have provided my own best estimates, using explicit
assumptions, available data from stated sources, extrapolations, and simple modeling
methods. I invite others that have other perspectives, assumptions, data, or methods to
show them also and explain them transparently as I have tried to do here.
In a report22 to the Standing committee on Transport, Infrastructure and Communities

(TRAN) entitled Risk of COVID-19 Transmission Aboard Aircraft, The International Air
21 https://www.canada.ca/en/public-health/services/diseases/coronavirus-disease-covid-19/testing-screening-
contact-tracing/summary-data-travellers.html
22 https://tc.canada.ca/en/binder/risk-covid-19-transmission-aboard-aircraft 4 November 2020.
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Transport Association (IATA) is quoted: “The risk of a passenger contracting COVID-19

while onboard appears very low. With only 44 identified potential cases of flight-related
transmission among 1.2 billion travelers, that’s one case for every 27 million travelers.
We recognize that this may be an underestimate but even if 90% of the cases were un-
reported, it would be one case for every 2.7 million travelers.”
The IATA report goes on to state that the true rate of COVID-19 transmission during
flight is difficult to ascertain “due to the low percentage of passengers tested, limited
contact tracing, and difficulty proving transmission occurred during a flight”. These are
valid cautions, but they do not necessarily negate the accuracy of their estimates based
on available data. The lack of necessary data to estimate these risks – information
which should have been collected, analysed, and transparently shared to justify vaccine
requirements - leave independent epidemiologists, including those providing information
to IATA, no alternatives other than to make their best estimates on limited data. Where
are the estimates of transmission from relevant departments of the Government of
Canada?
Other data to consider in estimating the probability of transmission is to use the

incidence rate of cases in the location of the departing flight. For example, the average
daily new cases in Canada over the past two years can be estimated as 3.35 M 23/365*2
= 4500 per day. The rate per person per day = 4500/38M24 = 0.00011 = 0.01% = 1 in
8500. Considering each case to be infectious for one week25, the probability that a
passenger representative of the general population is infectious at arrival to the airport
can be estimated at (1/8500)*7 = one per 1200. This could be an underestimation if the
case rate underestimates the actual (untested, unreported) infection rate, but it may be
an overestimation considering that the more infectious26 symptomatic persons are less
likely to travel and/or more likely to be screened out for travel prior to boarding.
When the vaccine requirements were announced in October 6, 2021, the daily
incidence of new cases was about one-half of this 2-year average and was on the
downslope of the (4th ) wave. In other words, at that time, the estimated probability of a
passenger being infectious on arrival at the airport of departure was one per 2400.
How does this compare with border testing results of passengers arriving in Canada?
Test results for the period September 10 – November 27, 2021 indicated that 0.4% of
23https://www.google.com/search?q=cases+covid+canada&rlz=1C5CHFA_enCA765CA765&oq=cases+covid+canad
a&aqs=chrome..69i57j69i60l2.4980j0j15&sourceid=chrome&ie=UTF-8 March 9, 2022.

24https://www.google.com/search?q=population+canada&rlz=1C5CHFA_enCA765CA765&oq=&aqs=chrome.0.69i5
9i450l8.288310j0j7&sourceid=chrome&ie=UTF-8
lt&display_rank=1
lt&display_rank=1
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passengers tested positive for SARS-CoV-2.27, i.e. 1 in 250 persons. Which estimate is
more accurate? Screening asymptomatic passengers with a test that can identify virus
remnants 90 days after infection is likely to have a significant number of false positives,
i.e. false with respect to infectiousness. On the other hand it is known that many
infections are not tested or reported as cases, so case counts are likely to
underestimate the actual number of infections.
Another approach is to use estimates of the number and rate of cases associated with
air travel.
The following estimates are based on available data from official and reputable sources.
Statistics Canada collects data on transmission sources28. Of the 1,471,626 cases in

which the transmission exposure was stated, the number associated with travel outside
Canada was 12,585, accounting for 0.9% of all cases.29
The proportion of these cases that are associated with air travel is not stated. The
proportion of reported cases attributed to air travel can be estimated by using Statistics
Canada data of the proportion of international travel that has occurred on airplanes.
Information posted on Transport Canada’s website, as of 2022-02-03, showed that

during 2020 and 2021, air travel accounted for 49% of all Canadian residents returning
from other countries.30 In the absence of other data, it is reasonable to assume the
same rate of transmission for all types of international travel. Accordingly, the proportion
of all reported cases in Canada that would be attributed to international air travel could
be estimated as 0.009*.49 = 0.0044 = 0.4% = 1 in 250 cases.
Without further analyses by Health Canada or Transport Canada of the cases in which
international travel was reported as the cause, it is difficult to estimate the accuracy of
these attributions. The temporal association of a positive test and a trip outside the
country does not establish the time or location of the exposure that caused the
transmission. This is because 1) a positive PCR, NAAT (polymerase chain reaction,
nucleic acid amplification test) can reflect transmission that occurred several weeks or
months prior to the test sampling31 and 2) because other exposures prior to or after
27 https://www.canada.ca/en/public-health/services/diseases/coronavirus-disease-covid-19/testing-screening-
contact-tracing/summary-data-travellers.html
28 Statistics Canada. Table 13-10-0775-01 Detailed preliminary information on cases of COVID-19, 2020-2022: 4-
Dimensions (Aggregated data), Public Health Agency of Canada

DOI: https://doi.org/10.25318/1310077501-eng
February 15, 2022.
29 https://www150.statcan.gc.ca/n1/pub/66-001-p/2021012/tbl/tbl-1-eng.htm
31 https://www.cdc.gov/coronavirus/2019-ncov/hcp/testing-overview.html USA CDC: A positive NAAT diagnostic
test should not be repeated within 90 days, because people may continue to have detectable RNA after risk of
transmission has passed
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travel may have been the source of transmission. Conversely, the number of
transmissions associated with travel may not have been tested or reported.
The estimated rate of COVID-19 transmission associated with international air travel
can be calculated by dividing the estimated number of COVID-19 cases associated with
international air travel by the number of international air passengers.
The following estimates are based on the number of air passengers. I was unable to
find relevant data on the number of flights or the duration of flights. Accordingly, the
units of exposure (to air travel, not the virus) for these analyses are passenger-flights or
flights per passenger. To estimate the baseline risk of transmission on airplanes for
unvaccinated persons, it is necessary to use data on case rates and airplane travel
before vaccination programs began.
By January 1, 2021, there were 580,000 reported cases of COVID-19 in Canada.32 The
number of returning international air passengers (all destinations, including the USA)
between March 1, 202033 and December 31, 2020 was 2,574,31334. Based on the
estimate that 0.4% of all reported cases were associated with international air travel, it
is reasonable to estimate that the rate of transmission per passenger per flight from
March 1, 2020 until December 31, 2020 was 580,000*0.004/2,574,313 = 0.09% = one
per 1100 flights per passenger. By January 1st, 100,000 Canadians (0.3% of the
population) had received their first vaccine dose35. In other words, it is reasonable to
assume that 99.7% of passengers had not received any vaccine during this period.
Opinion
There are several variables to consider in interpreting these data, including the
accuracy of case counts attributed to air travel, fluctuating rates of cases in Canada and
other countries of travel, new variants, and the use of screening and non-
pharmaceutical interventions. These rates may be overestimates or underestimates,
but, in my opinion, are reasonable best estimates. In the absence of other data or
analyses posted on a Canadian government website, these are my best estimates
based on the data and methods demonstrated here.
It is reasonable to use Health Canada data on cases attributable to travel and Transport
Canada’s data on international flights for the year 2020 to estimate that the overall rate
of transmission before vaccines were available is one per 1100 flights per passenger.
32 https://health-infobase.canada.ca/covid-19/epidemiological-summary-covid-19-
cases.html?stat=num&measure=total&map=pt#a2
35https://www.google.com/search?q=vaccination+rates+canada&rlz=1C5CHFA_enCA765CA765&oq=vaccination+r
ates+canada&aqs=chrome..69i57.4590j0j15&sourceid=chrome&ie=UTF-8
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However, these estimates do not compare the risk of transmission during air travel with
the risk of transmission in other settings (i.e. in the community) that passengers would
be in if they were not traveling in an airplane. If the risks are similar, then estimates of
any additional transmission and cases associated with air travel would be debatable. In
the absence of data or estimates, this question cannot be easily answered.
The estimates and analyses that follow have not been adjusted for the proportion of
unvaccinated passengers that have natural immunity from previous COVID-19 infection.
After two years since March 2020, more than 3 million Canadians have now tested
positive for SARS-CoV-2 - approximately 8% of the population. I was unable to find on a
Canadian government website an estimate of the proportion of vaccinated passengers
or the proportion of prohibited unvaccinated air passengers that have natural immunity
from previous infection, but it is reasonable to assume that it is at least as high as 8%
amongst unvaccinated persons. Factoring this into the analyses below would reduce the
absolute risk of transmission by an equivalent amount to vaccination, given ongoing
evidence that protection from natural immunity is comparable, if not more durable, than
vaccination.36
Assuming a transmission reduction effectiveness of 85% (the average rate between

zero and 6 months after immunization) for the Delta virus and a 35% transmission
reduction (the average rate between zero and 6 months after immunization) for
Omicron, the transmission rate of the Delta variant for vaccinated passengers can be
estimated at 1/1100*0.15 = 0.01% = one per 7,400 flights per passenger and, for
Omicron, 1/1100*0.65 = 0.06% = one per 1700 flights per passenger.
Applying these rates to flights since Omicron became the dominant variant on January
24, 202237, we can estimate the comparison of rates of transmission of COVID-19 with
respect to vaccination status of passengers below.
Before showing the calculations, an explanation might be helpful. In epidemiological

terms, we are estimating the population attributable fraction for COVID-19 transmission
from each of two groups – vaccinated passengers and unvaccinated passengers. In this
scenario, it is assumed that 80% of the passengers are vaccinated and 20% of
passengers are unvaccinated, reflecting approximately current rates in the population.
Based on the estimates of vaccine effectiveness and baseline (pre-vaccinations) rate of
transmissions, the calculations show what proportion of transmissions can be attributed
to each group and what the difference would be if 100% of passengers were vaccinated
instead of 80%.
36 https://www.who.int/publications/i/item/WHO-2019-nCoV-Sci_Brief-Natural_immunity-2021.1 World Health

Organization, May 2021, most recent brief on this question.
37 https://nccid.ca/covid-19-variants/ Public Health Agency of Canada National Collaborating Centre for Infectious
Diseases
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This formula multiplies the transmission rate for vaccinated passengers by the proportion
of passengers that are vaccinated and adds that to the product of the transmission rate
for unvaccinated passengers and the proportion of passengers that are unvaccinated.
This enables an estimation of the contribution – absolute and relative – of both groups of
passengers to the overall rate of transmission.
For a flight with 100 passengers, in which 80% of the passengers are vaccinated, the
blended probability of one transmission occurring amongst all passengers (vaccinated
and unvaccinated combined) can be estimated as (1/1,700)*100*0.8 + (1/1,100)*100*0.2
= 0.05 + 0.02 = 0.07 = 1/15. In other words, one transmission would occur in every 15
flights of 100 passengers or one in 1500 flights per passenger. Of importance, as evident
from the calculation, the proportion of cases attributable to the unvaccinated passengers
is 0.02/0.07 = 30% of all transmissions. If everyone was vaccinated, everything else being
equal, transmission would be expected to occur in one in 17 flights with 100 passengers
– or one in 1,700 flights per passenger. Another way to think about this is that the
additional absolute rate of transmissions (comparing a flight of 100% vaccinated
passengers with a flight of 80% vaccinated passengers) is = 1/1500 – 1/1700 = 1/13,000
flights per passenger. In other words, the estimated number of additional transmissions
associated with allowing unvaccinated passengers to travel can be expressed that one
additional case would occur for every 130 flights of 100 passengers.
4. If an airplane passenger becomes infected by transmission during an airplane

flight, what is the probability that they will subsequently need hospitalization,
intensive care, or die?
Several factors have been associated with severe illness or death in persons diagnosed
with COVID-19. These are important to consider in assessing the risk of individuals that
are participating in specific activities of specific settings. For example, the risk
characteristics of most people that are well enough to travel by plane are different than
those who are less likely to travel. I was unable to find data on the age distribution of
Canadian airline passengers. As shown in Table 1 below, 1/4 of hospitalizations and 2/3
of deaths attributed to COVID-19 have occurred in persons over the age of 80. To assess
the probability of severe illness resulting from COVID-19 transmission on airplanes, it
would be important to know what proportion of air passengers are in high-risk groups.
The following framework and examples could provide a useful guide for government and
public health officials to analyze the risk factors specifically for airplane travelers and to
estimate their actual risk for developing severe illness if transmission were to occur during
a flight.
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Characteristics of the virus:

• Virulence of the specific variants in circulation at the time of infection.
Biological pre-existing health conditions of the person

• Advanced age
• Chronic diseases
Social determinants
• Socio-economic, racialized, otherwise disadvantaged
Health care
• Ongoing management of chronic conditions
• Timely and appropriate care for COVID-19 symptoms.
Self-care
• Diet, activity, mental well-being, social support.
• Medication vigilance, vaccination.
Using Canada’s February 11, 2022, cumulative data38 on cases, hospitalizations, ICU
admissions, and deaths and Statistics Canada’s 2021 age-specific population data39,
Table 1 below shows calculations of the rates of severe outcomes per reported case.
These data are cumulative from the time that cases were first reported to Health Canada,
a period of two years. This cumulative incidence rate can be used to calculate average
incidence rates for any specific time period. The cumulative incidence rate for two years
can be calculated as 3,082,000/38,246,108 = 8% of Canadians = one-in-12. To calculate
the average annual incidence rates, the numerator of this two-year rate is divided by 2,
resulting in an average annual incidence rate of 4% of Canadians = one-in-25. It is
important to note that any calculations of average incidence rates over shorter periods
may vary significantly from the actual incidence rate of any specific period. This is
because of waves and other variations during specific time periods.
38 https://health-infobase.canada.ca/covid-19/epidemiological-summary-covid-19-cases.html#a7 as of February
11, 2022.
39 https://www150.statcan.gc.ca/t1/tbl1/en/cv.action?pid=1710000501
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Table 1
Age Pop- Cases Hos- ICU Death Hosp/ 1/x ICU/ 1/x Deaths/ 1/x
ulation pital case case case
<10 240 18 0.7% 0.1% 0.01%
3,926,808 345,726 2,448 141 1,441 19,207
10-19 155 11 0.5% 0.1% 0.00%
4,148,725 280,039 1,427 196 1,807 25,458
20-29 679 101 1.0% 0.1% 0.02%
5,092,811 596,736 6,036 99 879 5,908
30-39 1395 250 1.8% 0.3% 0.05%
5,364,435 540,716 9,543 57 388 2,163
40-49 2310 558 2.4% 0.5% 0.12%
4,894,137 463,972 11,054 42 201 831
50-59 4318 1544 4.5% 1.1% 0.41%
5,130,515 378,065 16,953 22 88 245
60-69 5762 3678 9.6% 2.5% 1.62%
4,840,878 226,570 21,826 10 39 62
70-79 4958 7332 21.0% 4.2% 6.28%
3,134,079 116,683 24,542 5 24 16
80+ 2251 21120 24.3% 1.7% 15.82%
1,713,720 133,493 32,414 4 59 6
Total 4.1% 0.7% 1.12%
38,246,108 3,082,000 126,243 22,068 34,612 24 140 89
Applying these rates to relatively healthier airplane travelers would be expected to

overestimate their actual risks. In other words, the actual probabilities of severe outcomes
would be expected to be less than those in the table.
The average hospitalizations per transmission (case) for all ages is 4.1% (one in 25). For
ICU admissions, it is 0.7% (one in 140). For deaths, it is 1.1% (one in 90).
Applying these Canadian population age-specific rates, a more accurate estimate can be
made of the probability of a severe outcome for a group less than a given age. More
specific rates can be obtained from the table for any specific age decile.
If we consider passengers less than 80 years old, it can be estimated that the proportion
of cases resulting in hospitalization is 3.2% (one in 30), in ICU is 0.7% (one in 150), and
in death is 0.5% (one in 200).
If we consider passengers less than 70 years old, it can be estimated that the proportion
of cases resulting in hospitalization is 2.4% (one in 42), in ICU is 0.5% (one in 200), and
in death is 0.2% (one in 500).
If we consider all passengers less than 60 years old, it can be estimated that the
proportion of cases resulting in hospitalization is 1.8% (one in 55), in ICU is 0.35% (one
in 285), and in death is 0.1% (one in 1000).
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Combining probabilities of transmission and severe outcomes, using transmission rates

for unvaccinated persons during the past months when the Omicron variant has been
dominant, and using cumulative data from Table 1 above for persons under 80,
respectively, the probability of hospitalization per passenger per flight = 1/1100 * 0.032
= 1 in 35,000; the probability of an ICU admission is 1/1100 * 0.007 = 1 in 160,000 flights
per passenger; and the probability for a death is 1/1100* 0.005 = 1 in 220,000 flights per
passenger.
As estimated in the answer to question 3, the number of additional cases that would be
expected to result from allowing unvaccinated passengers to travel by air, if 20% of seats
would be occupied by unvaccinated passengers on any given flight, is one additional case
of COVID-19 every 30 flights of 100 passengers – or one additional case per 3,000 flights
per passenger. Using this factor, the rate difference of additional hospitalizations, ICU
admissions, and deaths associated with air travel in which 20% of passengers are
unvaccinated = (1/3,000)*0.032 = 1 per 100,000 flights per passenger, (1/3,000)*0.007 =
1 per 400,000 flights per passenger, and (1/3,000)*0.005 = 1 per 600,000 flights per
passenger, respectively.
These data – or any other data available that is more accurate - should be used for
assessing risk, setting public health policy, and monitoring the results of interventions.
For example, what is the rationale for vaccine requirements for all passengers, given that
80% are already vaccinated, and that the increase in transmission, hospitalization, ICU,
and death rates are as low as these estimated using data available from Health Canada
and Transport Canada.
There are several caveats to be considered for this method of estimating the probabilities
of transmission and subsequent severe illness. In addition to the caveats described in the
answer to question three, two more points should be made.
The hospitalization rates in this table are based on reports from each provinces. A recent
(February 10, 2022) Rapid Review Report from the University of Saskatchewan and
Saskatchewan Health Authority concluded that “there are no clear universal case
definitions for a COVID-19 hospitalization” and that “new data from Australia, New
Zealand, the US, and Canada indicate that 30 to 50% of COVID-19 hospitalizations are
“incidental COVID-19 hospitalizations” including 46% of COVID-19 hospitalizations in
Ontario (as of January 11th, 2022) and 40% in Saskatchewan (as of January 26th, 2022).40
Incidental COVID-19 hospitalizations are those that are attributed to COVID-19 when in
fact there were other primary causes of their admission to a hospital. If these data are
valid, the disease severity of COVID-19 has been overestimated by two-fold.
40 https://covid19evidencereviews.saskhealthauthority.ca/en/permalink/coviddoc443 February 10, 2022.

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26
There is a similar concern about overcounting COVID-19 as a cause of death, in part

because of changes in the rules for death certification and vital statistics reporting.41
As described in my answer to question 4, the age-stratified rates of deaths attributed to

COVID-19 show that 2/3 of deaths have occurred in persons over 80. It is likely that
airplane passengers are, generally, younger and healthier than the Canadian average,
and would include few long term care residents or people over the age of 80 considered
higher risk for severe illness from COVID-19 (and other health-related events such as
other respiratory infections, blood clots in the legs, or injuries).
As described in the documents Conceptual Framework for Public Health42; British

Columbia Centre for Disease Control (BCCDC) Ethics Framework and Decision-
Making Guide43; Ontario’s Hazard Identification and Risk Assessment Guidelines
(2019)44; Public Health Framework: A guide for use in response to the COVID-19
pandemic in Canada45; and Auditor-General’s 2021 Report on Pandemic
Preparedness, Surveillance, and Border Control Measures46 and a letter to first
ministers from senior health administrators and former federal and provincial chief
medical officers of health physicians,47 public health strategies should be balanced
and should be based on risk analyses.
There are alternative strategies that could have been considered such as prohibiting
higher-risk passengers from air travel or limiting vaccine requirements to such
persons. I am not necessarily advocating for any specific strategies. To transparently
justify such broad and general restrictions, it is incumbent on governments to explain
how they are proportionate to the risk and why less restrictive alternatives were not
implemented.
41 https://www.who.int/classifications/icd/Guidelines_Cause_of_Death_COVID-19.pdf
42 https://www.cpha.ca/sites/default/files/uploads/policy/ph-framework/phcf_e.pdf
43 http://www.bccdc.ca/resource-
gallery/Documents/Guidelines%20and%20Forms/Guidelines%20and%20Manuals/BCCDC_Ethics_Framework_Deci
sion_Making_Guide.pdf
44https://www.emergencymanagementontario.ca/english/emcommunity/ProvincialPrograms/HIRA/Guidelines/
main.html#StepFour
45 https://www.canada.ca/en/public-health/services/diseases/2019-novel-coronavirus-infection/canadas-
reponse/ethics-framework-guide-use-response-COVID-19-pandemic.html
46 https://www.oag-bvg.gc.ca/internet/English/parl_oag_202103_03_e_43785.html#hd3c
47 https://www.thesuburban.com/opinion/op_ed/a-balanced-response-an-open-letter-to-the-prime-minister-and-
the-premiers-on-covid/article_981e7fe6-8c65-51ad-b694-bd38ee9d5437.html
AR05612
27
5. If an airplane traveler becomes infected by transmission during an airplane

flight, what is the probability that they will secondarily infect another person
that will need hospitalization or die?
To accurately answer this question, one would need to have information about the
settings, activities, and contacts of the disembarked passenger that had been infected on
an airplane or prior to embarking on the plane. The risk of transmission is increased by
the presence of symptoms and decreased by the number of days since the onset of
symptoms. Regarding contacts of the infectious passenger, the probability of a severe
outcome resulting from transmission would be higher for a passenger returning to a
household with a family member that is over 70 years of age and has a pre-existing
condition such as chronic bronchitis or emphysema. It would be lower for a passenger
whose potential close contacts are younger and without a pre-existing condition. It would
be higher during the one day before and during the two days after the onset of symptoms.
The simplest way to estimate probabilities for severe outcomes is to use average age-
based rates, as described in Table 1 above.
The first estimate is the probability that a disembarked infected passenger would infect
another person. Using an estimated Re of 148, the average number of new infections
generated from one infected person, the probability that the one transmission would result
in hospitalization, ICU, or death is 1 in 24, 1 in 140, and 1 in 89, respectively. These
numbers are the average for all age groups. Excluding high-risk close contact events with
people over the age of 70, especially those in personal care homes or with higher-risk
pre-existing conditions, these probabilities, as described above, can be estimated as 1 in
42, 1 in 200, and 1 in 500, respectively.
The probability that a passenger would become infected during a flight and transmit their
infection to another person is the same as the probability of a transmission occurring
during the flight. This is because the Re value is one. Therefore, the probability of a severe
outcome from a transmission after arrival is the same as the probability of a severe
outcome occurring from transmission during the flight. Mathematically this is the product
of the probability of transmission and the probability of a severe outcome, as described
in the answer to question 3.
48https://www.publichealthontario.ca/-/media/Documents/nCoV/epi/covid-19-epi-evolution-case-growth-
ontario.pdf?sc_lang=en
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28
6. What, in your opinion, should be demonstrated by governments to require a

general policy for mandatory vaccination of all airplane passengers?
Public health interventions that limit personal autonomy and rights or cause other
harms must be necessary and proportionate to the threat. To be consistent with
good public health practice and ethics, such interventions must be justified in a
transparent manner49. Such justification must include an assessment of the severity
of the threat, an explanation for the necessity of the interventions, and reasonable
estimates of the expected benefits and harms from these interventions. It must
include considerations of alternative options.
In my opinion and professional experience, the following ten criteria should be met
to justify public health interventions. These criteria are consistent with several
published standards and guidelines of public health practice, including Conceptual
Framework for Public Health50; British Columbia Centre for Disease Control
(BCCDC) Ethics Framework and Decision-Making Guide51; Public Health
Framework: A guide for use in response to the COVID-19 pandemic in Canada52;
and Auditor-General’s 2021 Report on Pandemic Preparedness, Surveillance, and
Border Control Measures53.
(a) The severity of the public health threat has been estimated in absolute and
relative terms.
Absolute measurements of the threat of an infectious disease outbreak include the

estimated or measured rates of cases, hospitalizations, and deaths. It is also
important to put these in perspective relative to other diseases. For example, the
absolute cumulated number of deaths attributed to COVID-19 in Canada is 36,00054.
The absolute two-year death rate is 36,000/39,000,00055 = one per 1,000 persons
per 2 years = 1 per 2000 persons per year.
50 https://www.cpha.ca/sites/default/files/uploads/policy/ph-framework/phcf_e.pdf
51 http://www.bccdc.ca/resource-
gallery/Documents/Guidelines%20and%20Forms/Guidelines%20and%20Manuals/BCCDC_Ethics_Framework_Deci
sion_Making_Guide.pdf
53 https://www.oag-bvg.gc.ca/internet/English/parl_oag_202103_03_e_43785.html#hd3c
54https://www.google.com/search?q=canada+covid+deaths&rlz=1C5CHFA_enCA765CA765&oq=canada+covid+dea
ths&aqs=chrome..69i57.7430j0j15&sourceid=chrome&ie=UTF-8
55 https://www150.statcan.gc.ca/n1/pub/71-607-x/71-607-x2018005-eng.htm February 23, 2022
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29
A relative measurement would compare the rate or number of deaths from COVID-
19 with other causes of death as well. For example, using the annual number of
deaths from all causes extrapolated over two years, the proportion of all deaths that
were attributed to COVID-19 = 36,000/600,00056 = 6%. In other words, 94% of all
deaths were not caused by COVID-19.
6% is probably an overestimate because of changes in the WHO rules for death

certification to “to identify all deaths that were COVID-19”57. These new rules were
adopted or adapted by the Public Health Agency of Canada as part of the national
case definitions for COVID-1958. It is self-evident how overestimations could result
from these definitions and rules for attributing a death to COVID-19.
Deceased case:
A probable or confirmed COVID-19 case whose death resulted from a clinically

compatible illness, unless there is a clear alternative cause of death identified
(e.g., trauma, poisoning, drug overdose).
A Medical Officer of Health, relevant public health authority, or coroner may use
their discretion when determining if a death was due to COVID-19, and their
judgement will supersede the above-mentioned criteria.
A death due to COVID-19 may be attributed when COVID-19 is the cause of

death or is a contributing factor.
I have not seen a study or analysis of the validity of death certifications or death
statistics with respect to identification of the main causes of death. Neither have I seen
an official estimate of the number, ages, and types of deaths that have been prevented
by public health measures.
More specifically, I was unable to find a public health threat analysis or risk estimate
of the absolute probability of transmission of infection and/or severe consequences
associated with the presence of unvaccinated passengers.
(b) A reasonable strategy has been described with a clear rationale and
justification, including general goals and specific objectives that are
measurable, achievable, relevant, and time-defined.
I was unable to find a clear description of goals and objectives of the vaccine
mandate strategy for domestic and international travel.
56 https://www150.statcan.gc.ca/t1/tbl1/en/tv.action?pid=1310039401
57 https://www.who.int/classifications/icd/Guidelines_Cause_of_Death_COVID-19.pdf
professionals/national-case-definition.html
AR05615
30
The broad goals of the national and provincial COVID-19 strategies are similar.
These include (i) reduction of severe illness and death from COVID-19, and (ii)
reduction of need by COVID-19 patients for hospital and ICU beds. Some goals also
include minimization of societal disruption and other unintended harms59.
Most vaccine mandate policies have three (implicitly or explicitly stated) goals:
1) encourage people to get vaccinated,
2) reduce transmission from or to unvaccinated persons, and
3) reduce severe illness, need for hospitalization, or death.
These broad and general goals are not specific enough to define priorities or choose
strategies. These should be based on risk analysis and evidence for effectiveness
of interventions. Otherwise, there can be no reasonable basis for the priorities for
vaccination policies and mandates, focused protection strategies for those at higher
risk, and the policies for travel restrictions.
In the absence of a clear and quantitative description of such objectives, it is not

possible to explain clearly to the media or to the public what the purpose, necessity,
or expected impacts are of the interventions. Furthermore, there is no basis to
monitor the progress of the intervention towards meeting its objectives, and there is
no defined target to justify modifications or discontinuation of an intervention.
(c) The interventions are expected to significantly contribute to achieving one or

more of the objectives of the strategy.
I was unable to find an explanation of how a vaccine requirement for air passengers
would persuade unvaccinated persons to get vaccinated, reduce severe illness and
deaths, and reduce the need for hospitalization and intensive care.
(d) To describe the anticipated impact of an intervention, the quantifiable effect

size should be estimated and monitored throughout the implementation of the
intervention.
I was unable to find an estimate of how much the vaccine mandate for air
passengers would increase uptake of vaccination, reduce transmission during air
travel, reduce severe illness, or reduce the need for hospitalization and intensive
care.
(e) The anticipated and potential harms of the intervention are estimated and
monitored.
59https://www.canada.ca/en/public-health/services/diseases/2019-novel-coronavirus-infection/canadas-
AR05616
31
For public health interventions that impact economic, social, and other determinants
of health, it is just as important to measure and monitor unintended harms as it is to
monitor intended benefits. In the same way that it is expected to monitor and report
on adverse effects of vaccination, surveys and other methods should be used to
monitor the impacts on people (and, for example, their loved ones and associates)
prohibited from air travel because of their vaccination status.
I was unable to find estimates or surveys of anticipated harmful outcomes from the
prohibition of travel for unvaccinated persons – and others affected - such as mental
distress, physical health, interrupted social support networks, social isolation, and
economic loss.
(f) The balance of benefits and harms are estimated and monitored.
This balance should be assessed in the broadest context of all health problems,
health equity, and the determinants of health of the whole population.
I have been unable to find estimates or explanations of how this intervention will
impact on broader health issues and social determinants of health such as overall
quality of life, social inclusion, economic sustainability, de-stigmatization (of
unvaccinated persons), and non-discrimination.
(g) Comparisons of alternative strategies and interventions should be made

transparently to identify options that could optimize the balance between
the benefits to be achieved through mandatory vaccination requirement
for travel and harms associated with imposing such a mandate.
I was unable to find any estimates, discussion, or explanation of alternatives to

vaccination mandates such as age and health status risk-based travel
restrictions, SARS-CoV-2 testing, screening, and use of non-pharmaceutical
interventions.
(h) The data, information, analyses, evidence, estimates, and rationale

specifically used to justify vaccination interventions should be made
available to the public in an accessible manner.
The Government of Canada’s “COVID-19 Boarding flights and trains in

Canada”60 website describes the vaccination requirements to board a flight or
train in Canada. It contains no data or information regarding estimated risks of
COVID-19 transmission during airplane or train travel – whether vaccinated or
not -; nor does it include a description of goals or specific objectives of the
60 https://travel.gc.ca/travel-covid/travel-restrictions/domestic-travel Date modified 2022-02-17.

AR05617
32
requirements policy; nor does it include any estimates of the anticipated effects
– beneficial and harmful - of the vaccine requirements.
Good and ethical public health practice is based on clear and transparent
communication and explanations of the rationale behind its interventions.
Informed consent for vaccination includes a description and explanation of the
purpose, expected benefits, and anticipated harms, estimated and quantified.
The same expectations should apply to all public health interventions, especially
those that significantly restrict mobility of the public.
I was unable to find transparent descriptions of the information and rationale

used to justify this policy.
(i) Regular reviews of data and reassessment of strategies and interventions

should foster reconsideration of the proposed interventions.
This is expected to occur for all public health strategies and interventions, but it
becomes especially important in a public health emergency characterized by
uncertainties, evolving biological variation (e.g. new variants of a virus), new
information and knowledge, and the progression of public needs and
understanding.
For these reasons, public health advisors and government decision-makers are
expected to regularly review all aspects of the changing biological and social
circumstance and to regularly review and evaluate the net effectiveness –
including benefits and harms - of the interventions that have been in place and
of potential interventions that could be put in place.
I have been unable to find transparent descriptions of such reviews.
(j) Engagement with others to provide input to public health interventions,

ensuring that decision-makers are informed of relevant considerations of
the effectiveness and equity of the interventions.
In the same way that good and ethical medical practice requires that a clinical
physician provides relevant information and answers to their patient’s questions
to meet the standard for informed consent from their patient, good and ethical
public health practice requires that the public have the opportunity to ask
questions, express their concerns, and give their opinions. There are many
mechanisms that public health officials can and use to obtain such input and to
explain their rationale for the decisions taken. For example, during the pandemic
H1N1 influenza in Manitoba, focus groups were held with Indigenous and other
lay persons to provide feedback and to express their concerns about the policies
and communications about specific issues such as prioritization for vaccines.
During COVID-19, virtual “town halls” were held for Manitobans, including
AR05618
33
surveys whose results were published.
With respect to the vaccine requirements for airplane travel, I have not seen on
a Canadian government website any Q’s and A’s, survey results, or other
formats that acknowledge or describe the questions, concerns, and feedback of
affected citizens, including unvaccinated persons prohibited from airplane travel,
stakeholders and experts from the travel and aviation industry, and others that
have been affected by decreased air travel.
I have not seen transparent and reasonable explanations of the scientific or

social basis for this specific policy of vaccine requirements.
AR05619
34
Concluding Summary
For 5 months, Canadians with less than two vaccinations have been
prohibited from travel on airplanes and other federally regulated modes of
transformation.
For a general and restrictive public health intervention of this reach and
for this length of time, it is reasonable to expect more data, more
analyses, more information, and more rationale to justify its necessity and
to quantify its benefits and harms.
I was unable to find any comprehensive analyses of a quantified

estimated threat posed by the presence of unvaccinated passengers.
I was unable to find any comprehensive analyses of the benefits and

harms associated with the travel restrictions placed on unvaccinated
persons.
In the absence of sufficient information and rationale, I have used

available data to estimate the risks of transmission and the impact of
removing the restrictions, as shown here.
1 in 250 of all cases of COVID-19 were associated with international

air travel.
The rate of infection transmission amongst unvaccinated passengers
is one per 1100 flights per passenger.
Using vaccination effectiveness against the Omicron variant, the rate
of infection transmission amongst vaccinated passengers is one per
1700 flights per passenger.
Comparing the estimated rates of transmission between a flight with
20% unvaccinated passengers and a flight with 0% unvaccinated
persons, the additional rate of transmission is one per 13,000 flights
per person.
Comparing the estimated rates of severe outcomes between a flight
with 20% unvaccinated passengers and a flight with 0% unvaccinated
persons, the additional rates of hospitalizations, ICU, and death are
one per 100,000 flights per passenger, one per 400,000 flights per
passenger, and one per 600,000 flights per passenger, respectively.
The probability that an unvaccinated passenger would become
infected during air travel and transmit their infection after disembarking
to another person who became severely ill is the same as the
calculated probabilities in 5(e).
AR05620
35
Sincerely,
Dr. Joel Kettner, M.D., MSc., FRCSC, FRCPC

AR05621
This is Exhibit “C” referred to in the Affidavit of Dr. Joel Kettner sworn March 11, 2022

Sam A. Presvelos
AR05622
LIST OF DOCUMENTS IN EXPORT REPORT OF DR. JOEL KETTNER
http://www.bccdc.ca/resource-
gallery/Documents/Guidelines%20and%20Forms/Guidelines%20and%20Manuals/BCCDC_Ethi
cs_Framework_Deci sion_Making_Guide.pdf
https://academic.oup.com/cid/article/71/10/2663/5842165
https://www.cdc.gov/coronavirus/2019-ncov/hcp/testing-overview.html USA CDC: “A positive
NAAT diagnostic test should not be repeated within 90 days, because people may continue to
have detectable RNA after risk of transmission has passed.”
/1050236/tec hnical-briefing-34-14-january-2022.pdf p.23
https://covid19evidencereviews.saskhealthauthority.ca/en/permalink/coviddoc443 February 10,
2022.
https://health-infobase.canada.ca/covid-19/epidemiological-summary-covid-19-
cases.html?stat=num&measure=total&map=pt#a2
https://health-infobase.canada.ca/covid-19/epidemiological-summary-covid-19-cases.html#a7 as
of February 11, 2022
https://nccid.ca/covid-19-variants/ Public Health Agency of Canada National Collaborating
Centre for Infectious Diseases

AR05623
https://pm.gc.ca/en/news/news-releases/2021/10/06/prime-minister-announces-mandatory-
vaccination-federal-workforce-and
https://tc.canada.ca/en/binder/risk-covid-19-transmission-aboard-aircraft 4 November 2020.
https://travel.gc.ca/travel-covid/travel-restrictions/domestic-travel Date modified 2022-02-17.
https://www-statista-com.uml.idm.oclc.org/statistics/1191651/air-passengers-airline-flight-
pandemic-reached-country-age/
https://www.aircanada.com/content/dam/aircanada/portal/documents/PDF/en/Onboard_Transmis
sion_FactSheet_en.pdf
https://www.canada.ca/en/public-health/services/diseases/2019-novel-coronavirus-
infection/health-%20professionals/main-modes-transmission.html
infection/symptoms.html#s
infection/guidance- documents/federal-provincial-territorial-public-health-response-plan-
ongoing-management-covid-19.html#a2
infection/health- professionals/interim-guidance-cases-contacts.html#a3 December 24, 2021.
17 http://www.bccdc.ca/health-info/diseases-conditions/covid-19/self-isolation/close-contacts
January 26, 2022. 18 https://www.quebec.ca/en/health/health-issues/a-z/2019-

AR05624
coronavirus/instructions-for-people-who-have-been- in-contact-with-a-confirmed-case-of-covid-
19 February 15, 2022.
infection/canadas- reponse/ethics-framework-guide-use-response-COVID-19-pandemic.html
infection/canadas- reponse/ethics-framework-guide-use-response-COVID-19-pandemic.html
infection/health-%20professionals/national-case-definition.html
infection/canadas-%20reponse/ethics-framework-guide-use-response-COVID-19-pandemic.html
screening-contact-tracing/summary-data-travellers.html
screening- contact-tracing/summary-data-travellers.html
screening- contact-tracing/summary-data-travellers.html
https://www.cdc.gov/coronavirus/2019-ncov/hcp/testing-overview.html USA CDC: “A positive
NAAT diagnostic test should not be repeated within 90 days, because people may continue to
have detectable RNA after risk of transmission has passed.”

AR05625
https://www.cpha.ca/sites/default/files/uploads/policy/ph-framework/phcf_e.pdf
https://www.emergencymanagementontario.ca/english/emcommunity/ProvincialPrograms/HIRA
/Guidelines/
https://www.google.com/search?q=canada+covid+deaths&rlz=1C5CHFA_enCA765CA765&oq
=canada+covid+dea ths&aqs=chrome..69i57.7430j0j15&sourceid=chrome&ie=UTF-8
https://www.google.com/search?q=population+canada&rlz=1C5CHFA_enCA765CA765&oq=&
aqs=chrome.0.69i5 9i450l8.288310j0j7&sourceid=chrome&ie=UTF
https://www.google.com/search?q=vaccination+rates+canada&rlz=1C5CHFA_enCA765CA765
&oq=vaccination+r ates+canada&aqs=chrome..69i57.4590j0j15&sourceid=chrome&ie=UTF-8
https://www.health.gov.on.ca/en/pro/programs/publichealth/coronavirus/docs/contact_mngmt/ma
nagement_ cases_contacts_omicron.pdf COVID-19 Integrated Testing & Case, Contact and
Outbreak Management Interim Guidance: Omicron Surge Version 2.0 – January 13, 2022. Page
https://www.health.gov.on.ca/en/pro/programs/publichealth/coronavirus/docs/contact_mngmt/ma
nagement_ cases_contacts_omicron.pdf COVID-19 Integrated Testing & Case, Contact and
Outbreak Management Interim Guidance: Omicron Surge Version 2.0 – January 13, 2022. Page
16.
https://www.medrxiv.org/content/10.1101/2021.09.12.21263461v1
https://www.oag-bvg.gc.ca/internet/English/parl_oag_202103_03_e_43785.html#hd3c
https://www.oag-bvg.gc.ca/internet/English/parl_oag_202103_03_e_43785.html#hd3c
AR05626
https://www.publichealthontario.ca/-/media/Documents/nCoV/epi/covid-19-epi-evolution-case-
growth- ontario.pdf?sc_lang=en
https://www.thesuburban.com/opinion/op_ed/a-balanced-response-an-open-letter-to-the-prime-
minister-and- the-premiers-on-covid/article_981e7fe6-8c65-51ad-b694-bd38ee9d5437.html
https://www.uptodate.com/contents/covid-19-epidemiology-virology-and-
prevention?search=covid%20infectious%20period&source=search_result&selectedTitle=1~150
&usage_type=defau lt&display_rank=1
https://www.who.int/classifications/icd/Guidelines_Cause_of_Death_COVID-19.pdf
https://www.who.int/news-room/commentaries/detail/transmission-of-sars-cov-2-implications-
for-infection- prevention-precautions
https://www.who.int/news-room/commentaries/detail/transmission-of-sars-cov-2-implications-
for-infection- prevention-precautions. Implications for infection prevention precautions.
Scientific Brief, World Health Organization. 9 July 2020.
https://www.who.int/publications/i/item/WHO-2019-nCoV-Sci_Brief-Natural_immunity-2021.1
World Health Organization, May 2021, most recent brief on this question.
https://www150.statcan.gc.ca/n1/pub/66-001-p/2020003/tbl/tbl-1-eng.htm
https://www150.statcan.gc.ca/n1/pub/71-607-x/71-607-x2018005-eng.htm February 23, 2022
https://www150.statcan.gc.ca/t1/tbl1/en/cv.action?pid=1710000501
AR05627
https://www150.statcan.gc.ca/t1/tbl1/en/tv.action?pid=1310039401
Statistics Canada. Table 13-10-0775-01 Detailed preliminary information on cases of COVID-
19, 2020-2022: 4- Dimensions (Aggregated data), Public Health Agency of Canada DOI:
https://doi.org/10.25318/1310077501-eng, February 15, 2022.

AR05628
FEDERAL
COURT OF CANADA
AFFIDAVIT OF DR. JOEL KETTNER
PRESVELOS LAW LLP

Toronto, Ontario
M5H 3L5

Tel: (
Email:

Tel:
Email:

AR05629
TAB 35
AR05630
Court File No.: T-1991-21 -ID
BETWEEN:

Applicants
-and-

Respondents

I, Dr. Neil Rau, having been named as an expert witness by the Applicants, certify that I have read
the Code of Conduct for Expert Witnesses as set out in the schedule to the Federal Courts Rules
(and attached hereto) and agree to be bound by it.
March 11 th, 2022

I Dr. Neil Rau
AR05631

EXPERTS' REPORTS

the report;

opinions;

AR05632
to the Court.
EXPERT CONFERENCES
witness

addressed; and
AR05633
BETWEEN:

Applicants
- and -

Respondents
AFFIDAVIT OF DR. NEIL RAU
1. I, Neil Rau, a resident of Oakville, Ontario, MAKE OATH AND SAY AS FOLLOWS:
2. I am an Infectious Diseases/Internal Medicine and Medical Microbiologist and as such
have personal knowledge of the facts and matters hereinafter deposed to save and except
where the same are stated to be based upon information and belief and where so stated I
verify believe the same to be true.
curriculum vitae outlining my education, relevant experiences and publications.
4. Attached to this Affidavit and marked as Exhibit “B” is a true copy of my expert report
with respect to this matter.

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This is Exhibit “A” referred to in the Affidavit of Dr. Neil Rau sworn March 11, 2022

Sam A. Presvelos
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Neil V. Rau M.D. F.R.C.P (C)
Medical Microbiologist and Infectious Diseases Consultant,
Assistant Professor, University of Toronto
Halton Healthcare,
Office Address:
, FAX (905) 849-6551 email:
Education and Post-Graduate Training

University of Toronto, Toronto, Ontario (October 2007 June 2008)
Medical Microbiology
o Completed additional training in various fields of medical microbiology (bacteriology, virology,
mycology and molecular microbiology). Royal College of Physicians and Surgeons of Canada
certification in Medical Microbiology obtained in 2008.
McGill University, Montreal, Quebec (1991 1996)

Infectious Diseases / Medical Microbiology
o Infectious Diseases training completed 1996, with a Royal College Certificate of Special
Competence designation obtained in 1996. Partial training in medical microbiology prior to
completion of training in 2018 (see above)
Internal Medicine
o Montreal General Hospital Programme completed 1994; Royal College Certification in Internal
Medicine obtained in 1995.
University of Toronto, Toronto, Ontario (1987 1991)

o M.D. June 1991
University of Waterloo, Waterloo, Ontario (1984 1987)

o Bachelor of Mathematics August 1987.
o Recipient of Sir Isaac Newton Scholarship in Physics, 1984 1986.
o
Professional Practice Experience (1996 to present)

Humber River Hospital, Department of Laboratory Medicine, Toronto, Ontario (2020
present), Associate Staff
o Medical microbiologist
Halton Healthcare, Department of Laboratory Medicine and Department of Medicine,

Oakville, Ontario (1997 present), Active Staff
Current Roles:
o Medical Microbiologist
o Testing protocol and algorithm review
o Antibiotic susceptibility reporting protocols
o New equipment / technology selection and implementation
o Quality systems essentials in the laboratory, incident management, proficiency testing
review.
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o Real-time feedback to microbiology technologists and physicians regarding the types of
o New equipment purchase and implementation decisions (most recent: MALDI, BD-MAX)
o Medical Director (Infection Control Officer) of Infection Prevention and Control since 1997.
o Chair, Infection Prevention and Control Committee
o Communicable diseases surveillance, risk management, critical incident review, infection
control policy development / review, physician education
o Emerging infection / emergency preparedness planning
o Outbreak management and communications
o Consultant to Occupational Health Department for Infectious Diseases / Infection
Control matters.
o Consultant in Infectious Diseases (Inpatient and Outpatient services) to a 450 bed
community tri-hospital network
o Consultant in Infectious Diseases (Inpatient and Outpatient services) to a 500+ bed community tri-
hospital network
o Participation in antibiotic stewardship initiatives with three other ID physicians.
Prior Roles:
o Chair of the Patient Safety Steering Committee 2006 2014
o Infectious Diseases consultant to the Region of Halton Public Health Department to assist with
the new immigrant tuberculosis medical surveillance process, and other regional outbreak issues
2004 2012
o Clinical infectious diseases and infection control consultant to the Maplehurst Correctional
Complex 2006 2012
The Credit Valley Hospital, Mississauga, Ontario (1996 2006)
o Active Staff in Department of Medicine (Internal Medicine / Infectious Diseases) 1996 2003;
Courtesy privileges as the Infectious Diseases consultant 2003 2006.
o Physician Director, Antibiotic Stewardship Programme 1996 2003
o Member of the Pharmacy and Therapeutics Committee and Infection Control Committees
Ontario Ministry of Health and Long Term Care Ontario Public Drug Programme Branch
o Appointed by Order-in-Council as a member of the Committee to Evaluate Drugs (CED) May

2012 July 2019. Reappointed by Order-in-Council in May 2015 and March 2018.
o Consultant to the CED since 1999; reviewer of New Drug Product Manufacturer Submissions of
Anti-Infectives to the Ontario Drug Benefit formulary 1999 2019..
o Ongoing reviewer for individual case adjudication for the Exceptional Access Programme that
addresses access to agents not listed on the Ontario Drug Programme Formulary.
o Member of the Exceptional Access Programme Digital Management Subcommittee to facilitate
electronic applications to EAP reimbursement.
Neil V. Rau, MD FRCP(C) 2

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Ontario Agency of Health Protection and Promotion (now Public Health Ontario)
o Medical Coordinator of Mississauga-Halton Regional Infection Control Network from April 2008
April 2012
Academic Activities
Current Academic Appointment: Assistant Professor, University of Toronto, Department of

Medicine, Division of Infectious Diseases.
Clinical Instruction to visiting students and fellows in training at Halton Healthcare
r Fourth Year Medical Students 2012 2014

Occasional (four to eight weeks yearly) supervisor of ID Fellows from McMaster University
Publications:
1. COVID-19: An interim report for Canada as of August 2020. Richardson S and Rau N.
Canadian Journal of Pathology; 12(4): 16 24.
2. Frozen vs Fresh Fecal Microbiota Transplantation and Clinical Resolution of Diarrhea in

Patients with Recurrent Clostridium difficile Infection: A Randomized Clinical Trial.
Lee CH, Steiner T, Petrof EO, Smieja M, Roscoe D, Nematallah A, Weese JS, Collins S,
Moayyedi P, Crowther M, Ropeleski MJ, Jayaratne P, Higgins D, Li Y, Rau NV, Kim PT.
JAMA. 2016 Jan 12;315(2):142-9. doi: 10.1001/jama.2015.18098.
3. Invasive Pneumococcal Disease Among Immunocompromised Persons: Implications for

Vaccination Programs. Shigayeva A, Rudnick W, Green K, Chen DK, Demczuk W, Gold WL,
Johnstone J, Kitai I, Krajden S, Lovinsky R, Muller M, Powis J, Rau N, Walmsley S, Tyrrell G,
Bitnun A, McGeer A; Toronto Invasive Bacterial Diseases Network. Clin Infect Dis. 2016 Jan
15;62(2):139-47.
4. Warren T, Lau R, Ralevski F, Rau N, Boggild AK. Fever in a Visitor to Canada: A Case of
Mistaken Identity. J Clin Microbiol. 2015 Mar 11
5. Sandre M., Ralevski F., Rau N. An Elderly Long Term Care Resident with Crusted Scabies.
Can J Infect Dis Med Microbiol. 2015 Jan-Feb;26(1):39-40.
6. Kuster SP, Rudnick W, Shigayeva A, Green K, Baqi M, Gold WL, Lovinsky R, Muller MP,
Powis JE, Rau N, Simor AE, Walmsley SL, Low DE, McGeer A; Toronto Invasive Bacterial
Diseases Network. Previous Antibiotic Exposure and Antimicrobial Resistance in Invasive
Pneumococcal Disease: Results from Prospective Surveillance. Clinical Infectious Diseases
2014 October; 59(7): 944 52
7. Schachter ME, Wilcox L, Rau N, Yamamura D, Brown S, Lee CH. Rat-bite fever, Canada
[letter]. Emerg Infect Dis [serial on the Internet]. 2006 Aug;12(8): 1301 - 2

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8. Singh S.M., Rau N.V., Cohen L.B. and Harris H. Cutaneous nocardiosis complicating
management of Crohn's disease with infliximab and prednisone. CMAJ. 2004 Oct;
26;171(9):1063-4.
9. Pepperell C., Rau N., Krajden S., et al. West Nile virus infection in 2002: morbidity and
mortality in among patients admitted patients to a hospital in southcentral Ontario. Canadian
Medical Association Journal 2003 May 27;168(11): 1399 - 1405.
10. Borgia S.M., Low D.E., Andrighetti S., and Rau N.V. Group A Streptococcal Sepsis Secondary
to Peritonitis and Acute Pelvic Inflammatory Disease. European Journal of Clinical
Microbiology and Infectious Diseases, 2001, Vol 20: 437 439.
11. Rau, N.V. and Libman, M.D. Laboratory Implementation of the Polymerase Chain Reaction
for the Confirmation of Pulmonary Tuberculosis. European Journal of Clinical Microbiology
and Infectious Diseases, 1999; Vol 18: 35 41.
12. Rau, N.V. Antibiotic Stewardship Program at The Credit Valley Hospital, Canadian Journal of
Infectious Diseases, Vol. 9, Supplement C, September 1998, 43C 44C.

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Abstracts (Posters):
1. Stacey-Works T., Blue J., Rau N. Clostridium difficile Rates Associated with Engineering Controls
in a New Hospital Facility: What is the Impact of Point of Care Waste Disposal Systems?
Accepted for oral presentation at the Infection Prevention and Control Canada National
Education Conference, Charlottetown PEI. June 18 21, 2017
2. Rau N.V., Mazzulli T., McGeer A., Akhavan P., and Poutanen S. Yield of Sending Multiple
Specimens for C. difficile Testing Using the C. difficile Tox A/B II Enzyme Immunoassay
(CDT A/B). Presented at the 28th ICAAC, October 2008. Washington D.C.
3. Rau N.V., Gindi G., Du T., Spreitzer D., Mulvey M.R. A Pyoderma Cluster Caused by a New
Strain of Community-Acquired MRSA (CA-MRSA) in a Family of Egyptian Origin. Presented
at the 45th ICAAC, December 2005. Washington D.C.
4. Rau N., Lanza S., Matthews F., and Gilland J. A Nosocomial S. aureus Cellulitis / Scalded Skin
Syndrome(SSSS) Outbreak in Neonates at a Community Hospital: Use of PFGE to Identify a
Staff Reservoir. Presented at the 44th Annual ICAAC Meeting, November 2004. Washington
D.C.
5. Fearon M., Artsob H., Drebot M., Andonova M., Chiang W., Simmons P., ChenSee G.,
Papageorgiou I., Cheung E., George P., Guglielmi I., Rau N., Shapiro H., Nosal B., Finkelstein
M., Heimann, Middleton D. A Report on the First Human Cases of Endemic West Nile
Infection in Canada. Presented at the 103rd General Meeting of the American Society of
Microbiology, May 2003, Washington, D.C.
6. Hui C., Clark K., Tirilis V., Pennie R.A., Rau N.V., and Smaill F.M. Lack of infant-to-infant
transmission of TB in the NICU: A Case Report and critical appraisal of the literature.
Presented at the 13th Annual Meeting of the Society for Healthcare Epidemiology of America,
Arlington ,Virginia, 2003.
7. Fearon M., Artsob H., Drebot M., Andonova M., Chiang W., Simmons P., ChenSee G.,
Papageorgiou L., Cheung E., George P., Guglielmi I., Rau N. et al. A Report on the First
Human Cases of Endemic West Nile Virus Infection in Canada. Presented at the CACMID
2002 Meeting, Halifax N.S.
8. Rau, N.V. and Libman, M.D. Laboratory Implementation of the Polymerase Chain Reaction
for the Confirmation of Pulmonary Tuberculosis. Presented at the 37 th ICAAC Meeting,
October 1997. Toronto ON
9. Rau, N.V. and Lumsden, C.J. Biophysical Journal 1988;55(2):605a. Coupled Multiple
Convective Streams: A Model of Renal Tubular Reabsorption of Molecular Weight Indicators.
Presented at the Biophysical Society Meeting, Cinnicinati, Ohio, 1988.

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Provincial / National Committee Memberships:
o Institute for Quality Management in Healthcare (IQMH) Virology Subcommittee January 2021
present
o Councillor, MedicoLegal Society of Toronto (MLST) 2017
o International Collaboration between the Kuwait Institute of Medical Specialization and the
Royal College of Physicians and Surgeons of Canada. Clinical Microbiology Examination Board
member 2017 present
o RCPSC Infectious Diseases Subspecialty Exam Committee Member and Examiner 2003
2007, and 2010 2012
o Association of Medical Microbiology and Infectious Diseases (AMMI) Canada. Section Head
(Infectious Diseases) from 2009 to 2012
o Committee to Evaluate Drugs (CED) 2012 2019 as described above.
o Ontario Drug Policy Research Network committee member since 2014
o West Nile virus Human Subcommittee, Public Health Agency of Canada. Management of
Patients with West Nile virus: Guidelines for Health Care Providers CCDR31S3, December
2005
o Occasional external reviewer of publications submitted to the Canadian Journal of Infectious
Diseases
o Ontario Anti-infective Review Panel Member
o
o Physician Leader for the Ontario Medical Association: Section Chair of the Infectious Diseases
Subspecialty Section from 2007 to 2017
Invited Presentations to Learned Societies / Peers:
1. COVID-19 WEBINAR What Does the Future Hold Part One (June 24 th, 2020) and Part Two
(November 12th, 2020) for the MedicoLegal Society of Toronto
2. Will Faster Results Translate into Antibiotic Microbial Stewardship (AMS) Dividends?
BD-CACMID Dinner Presentation, Ottawa ON, April 5th, 2019
3.
November 11th, 2017.
4. Invited Witness Presentation:
Committee on Health. Ottawa ON. November 7th, 2017.
5. Department of Paediatric and
Laboratory Medicine, Hospital for Sick Children, Toronto ON, February 2nd, 2017.
6.
Toronto, ON. November 28, 2016.

7. C. difficile Colonization from Infection: Antigen PCR or PCR Vancouver
Island Health Authority (VIHA) BD Workshop, March 2016.
8.
Ontario Association of Pathologists Annual Meeting. Niagara Falls ON, September
2015.
9. -CACMID Annual
Conference, Victoria BC, April 2014.

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10. ented to
the Ontario Association of Pathologists Meeting, Collingwood, Ontario, November 2013
11.
, Hamilton ON, October 2010
12. Clini
Public Health Agencies, Toronto ON, November 2002
13.
14. Continuing Education
Rounds, Edmonton, Alberta May 2003
15.
Grand Rounds, May 2003
16. of
Medicine Grand Rounds, Winnipeg MB March 2003
17. Toronto
ON, November 2003
18.
Toronto ON, November 2004
19. First Canadian Experiences 2002 2003 Ontario Hospital Association
Conference Hamilton ON, May 2003
20.
Medicine Conference, Toronto ON October 2003

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Conferences Attended:
o Canadian Association for HIV Research (CAHR) Meeting, Montreal PQ (2000)

o HIV Resistance Meeting Rome Italy, March 2004
o Synergie et Resistances (HIV) Nice France, October 2004
o IX, XII International Conference on AIDS (1993, 2002)
o European AIDS Clinical Society Conference, Warsaw, Poland, November 2003
o Interscience Conference on Antimicrobial Agents and Chemotherapy (1994 2010 inclusive)
o Infectious Diseases Society of America Meetings (2011, 2012, 2015, 2016)
o Society for Healthcare Epidemiology of America Conference , Toronto ON (2001)
o AMMI Conference 2008 to 2012 inclusive; 2014 and 2019
o 64th American Association for the Study of Liver Diseases, Washington DC, November 2013
o HIV Drug Therapy, Glasgow UK 2014
o ECCMID Conferences:
o Berlin, Germany 2013
o Barcelona, Spain 2014
o Copenhagen, Denmark 2015
o Madrid, Spain 2018
o Amsterdam, Netherlands 2019
o European AIDS Clinical Society Conference, Basel Switzerland, November 2019
Creative Professional Activity
o Canadian Television Inc. (CTV) News Infectious Diseases Expert (includes Canada AM , CTV
National News and CTV News Channel, CP24) from 2005 2020. Key roles included:
o assisting journalists with the interpretation of the significance of breaking infectious
diseases news
o attendance at scienitific conferences (World AIDS Conference 2016, Toronto ON)
o facilitating accurate reporting of this information to the general public
o on-air appearances, including live-to-tape interviews
o directing journalists to other Canadian infectious diseases experts to comment on
breaking infectious diseases news stories, where time is less critical
o live web interactive sessions regarding emerging infections (e.g. Ebola, EV- D68, Zika,
COVID-19)
o web Q&A regarding outbreaks (e.g. Germany E. coli HUS outbreak, COVID-19)
o regular blog contributor to ctvnews.ca regarding emerging infectious diseases issues
o assistance to field journalists / producers with travel health advice immediately prior to
urgent travel to disaster areas (e.g. Haiti post earthquake).
o Multiple other media interviews 2002 2005 for CBC and CBC Newsworld (Health Matters),
CTV National News and Global TV News, CBC Radio (The Current, The World at Six, As It
Happens), Radio-Canada (CBC French) to discuss emerging / late-breaking issues in Infectious
Diseases
Opinion Editorials in Mainstream Canadian Print Media
o Neil Rau et al. Get the children back to class. National Post January 6, 2021.

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o Neil Rau, Nicole LeSaux and Joan Robinson. As vaccines roll out, politicians must establish a clear path
to easing lockdowns. National Post December 22, 2020
o Neil Rau and Susan Richardson. Why draconian measures may not work: Two experts say we should
prioritize those at risk from COVID-19 than to try to contain the uncontainable. National Post March 15,
2020
o Neil Rau, Susan Richardson, Martha Fulford and Dominik Mertz. We are infectious disease experts:
-19 lockdowns. National Post May 21, 2020
o Neil Rau and Richard Schabas. Stop the Hysteria over Measles Outbreaks. Globe and Mail October
2nd, 2018.
o Richard Schabas and Neil Rau. he Rio Olympics. Globe and Mail May
th
18 , 2016.
o Richard Schabas and Neil Rau. Are We Taking the Flu (Shot) Too Seriously? Globe and Mail
January 24th, 2015.
o Richard Schabas and Neil Rau. Ebola: Can We Learn from SARS? Globe and Mail August 24th,
2014.
Awards
Certifications and Memberships
o Fellow of the Royal College of Physicians and Surgeons of Canada (Medicine Division) since June
1995
o Certificate of Special Competence in Infectious Diseases, 1996
o Additional fellowship certification in Medical Microbiology since June 2008
o Independent practice medical licence for the province of Ontario since 1992
o Member of the Association of Medical Microbiology and Infectious Diseases (formerly the
Canadian Infectious Diseases Society) since 1995
o Member of the Canadian Hospital Infection Control Association since 2007
o Member of the Infectious Diseases Society of America since 2012
o Member of the European Society of Clinical Microbiology and Infectious Diseases since 2013

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Extracurricular / Volunteer Interests
Piano
o Completed the requirements for the practical component of the Royal Conservatory of Music
Grade X Examination in 1984.
o Continue to play (classical) piano regularly; competing annually in Open Section classes (ARCT
level and above) of Kiwanis Festival of Greater Toronto since 2007.
o Kiwanis Festival of Greater Toronto Silver Award for Mozart Piano Sonatas (2010), Chopin
Major Work (2011), Romantic Composer Sonata (2012), Concert Group (2013), Romantic
Composer Major Work (2014). Winner Romantic Sonatas 2012.
o Kiwanis Festival of Greater Toronto Gold Award and Second Place Finish (Romantic Era
Work) 2015
o Kiwanis Festival of Greater Toronto Gold Award First (Chopin Etudes) and Second Place
Finish (Impressionist Era Work) 2016
o Lessons continue to be taken with Mr. Daniel Nachmann (Private Lessons)
Tennis
o Active member of the Lambton Golf and Tennis Club
Volunteer Activities
o Honorary Co-Chair, Lisgar Collegiate Institute 175th Alumni Reunion Campaign, 2018
o
Performing Arts in November 2017 and November 2018
o Member of the New Oakville Hospital Campaign Cabinet Member 2009 2015
o Occasional c
activities 2006 2008
o Member of the Board of Governors for the CCOC June 2007 June 2008
o Member of the High Park Chorus Artistic Committee 2008 2009
o Ad hoc afternoon piano performances in the hospital lobby for patients and families at Halton
Healthcare since 2015
o Regional Infection Control Network (Mississauga Halton) Planning Committee member
2006
o Member of Halton AIDS Action Committee
o (in my
neighbourhood)
Foreign Languages
French; functional in Spanish

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This is Exhibit “B” referred to in the Affidavit of Dr. Neil Rau sworn March 11, 2022

Sam A. Presvelos
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Neil V. Rau M.D., F.R.C.P. (C)

Infectious Diseases / Medical Microbiology
3075 Hospital Gate, Suite 416., Oakville, ON L6M 1M1
Medical Director, Infection Prevention and Control

Infectious Diseases Specialist and Medical Microbiologist
Active Staff, Departments of Medicine and Laboratory Medicine, Halton Healthcare
3001 Hospital Gate, Oakville, Ontario L6M 0L9
Active Staff, Department of Laboratory Medicine, Humber River Hospital
1235 Wilson Avenue, Toronto, Ontario, M3M 0B2
Assistant Professor, University of Toronto, Department of Medicine, Division of Infectious Diseases

Phone 905-844-5346 email: nrau@haltonhealthcare.com
Fax 905-849-6551
March 10, 2022
Mr. Sam Presvelos

Presvelos Law LLP
141 Adelaide Street W, Suite #1006
Toronto, ON
M5J 1A7
Re: Shaun Rickards et al. v. The Attorney General (Canada) et al.
Dear Mr. Presvelos:
Thank you for asking me to provide an opinion on various aspects of the transmission
and the diagnostic detection of COVID-19 in the context of vaccinated and unvaccinated
individuals.
Credentials
I am a duly certified specialist in two separate Royal College disciplines (Internal Medicine
and Medical Microbiology). In addition, I have a Royal College Certificate of Special
Competence in Infectious Diseases. I have been in private practice as an Infectious
Diseases specialist since 1996, and as a medical microbiologist since 2008. In my clinical
practice as a medical microbiologist, I oversee the medical microbiology laboratories at
two large community hospitals in the Greater Toronto Area. In these laboratories, I have
overseen the implementation of COVID-19 testing from clinical specimens using various
testing platforms since March 2020.
At Halton Healthcare, as the Medical Director of Infection Prevention and Control, I have
been responsible for the institutional response to COVID-19 since the outbreak began,
prior to the WHO declaration of the pandemic in March 2020. I also work as an infectious
diseases consultant at Halton Healthcare, where I have provided consultations on
severely ill patients with COVID-19 while on the clinical infectious diseases service.
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I am a member in good standing with the College of Physicians and Surgeons of Ontario.
I have previously testified in trials before the Ontario Superior Court of Justice where I
have been qualified as an expert in both Infectious Diseases and Medical Microbiology.
My recent CV is attached for your reference.
In accordance with Federal Court Rules for the Code of Conduct for Expert Witnesses, I
have completed the Form 52.2 which is attached to this report.
Background on COVID-19:
COVID-19 Before the Vaccine: Rise and Fall in 2019 - 2020
1. COVID-19 was first reported in December 2019 in China. However, cases were
retrospectively identified in France as early as November 20191 and continued to
spread in Western Europe until the COVID-19 pandemic was declared in March
2020.
2. Initially, many countries introduced strict risk mitigation measures for international
travel in March 2020. However, many Northern Hemisphere countries with
temperate climates (middle latitudes) were unable to prevent large COVID-19
outbreaks by the spring of 2020 despite these mitigation measures.
3. Contrary to popular belief, a recently published analysis demonstrated that case
growth in Canada during the early 2020 period did not correlate with the stringency
(“strictness”) of numerous nonpharmacologic interventions (NPIs) implemented
during the first wave. These NPIs included a combination of school and workplace
closures, public event cancellations, gathering size restrictions, public
transportation closures, internal movement restrictions, and travel controls.
Notably, case growth rates declined identically between provinces during the first
wave, independent of a province’s initial mitigation strategy.2 More importantly,
this analysis applies to the period well before the vaccine was available.
4. Independent of either the mask mandates that were implemented in Canada
beginning August 2020 or the availability of vaccines starting in late December
2020, most Northern Hemisphere locales with temperate climates (middle
latitudes) saw a fall in COVID-19 rates during the summer months of 2020,
followed by a seasonal resurgence during the fall months of the same year3. During
this time, many nations continued to implement strict border mitigation measures
such as testing of incoming travelers, quarantine, symptom screening and in some
cases border closure.
1
Deslandes A, Berti V, Tandjaoui-Lambotte Y, Alloui C, Carbonnelle E, Zahar JR, Brichler S, Cohen Y.
SARS-CoV-2 was already spreading in France in late December 2019. Int J Antimicrob Agents. 2020
Jun;55(6):106006. doi: 10.1016/j.ijantimicag.2020.106006. Epub 2020 May 3. PMID: 32371096; PMCID:
PMC7196402.
2
Vickers DM, Baral S, Mishra S, Kwong JC, Sundaram M, Katz A, Calzavara A, Maheu-Giroux M,
Buckeridge DL, Williamson T. Stringency of Containment and Closures on the Growth of SARS-CoV-2 in
Canada prior to Accelerated Vaccine Roll-Out. Int J Infect Dis. 2022 Feb 21:S1201-9712(22)00108-4. doi:
10.1016/j.ijid.2022.02.030. Epub ahead of print. PMID: 35202783; PMCID: PMC8863413.
3
https://health-infobase.canada.ca/src/data/covidLive/Epidemiological-summary-of-COVID-19-cases-in-
Canada-Canada.ca.pdf
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Strict Border Measures Do Not Stop the Variants
5. Island nations such as Australia, New Zealand, Japan and Singapore which
implemented strict border mitigation measures in early 2020 were able to maintain
low rates of infection only until 2021. After this time, they failed to control the
importation of COVID-19 and all subsequent variants of concern, and also failed
to control the propagation of outbreaks caused by all subsequent variants. Almost
all, save China, have now abandoned their “COVID Zero” strategies. New Zealand
formally abandoned its strategy in October 2021, despite its use of stringency
measures that now exceed those in use elsewhere.4
6. The COVID-19 Omicron variant was first reported in December 2021 in South
Africa. Researchers at Dalhousie University in Halifax NS identified Omicron using
wastewater samples collected in mid-November 20215. (Wastewater sampling has
been used to retrospectively and prospectively track COVID-19 community
circulation.6) Therefore, by the time a new variant is reported in a given locale, it is
already widely disseminated globally. By the time that South Africa reported
Omicron, over fifty countries had confirmed cases of Omicron7. Implementing
additional border controls in response to the identification of a new variant is futile.
7. While higher vaccination rates may be desirable to prevent health care strain,
lower vaccination rates do not predict that a catastrophic situation will follow form
the introduction of a new variant. For example, in South Africa, where only 40% of
the population had been vaccinated by the time that the Omicron wave was
emerging8, daily infection rates ultimately fell precipitously well before there was
time to vaccinate more of the population. This observation demonstrates that
vaccination alone does not lead to a fall in infection rates. It also demonstrates the
importance of natural immunity in the rise and fall of daily infections rates. This is
a similar observation to the rise and fall of seasonal influenza cases following the
introduction of new strains each season.
8. Thus far, as future variants have emerged, there is no evidence to suggest that
pre-existing high vaccination rates have blunted the trajectory of daily new
infections of a COVID-19 variant. In fact, no new variant outbreaks have been
averted or significantly attenuated in countries with high vaccination rates. This in
contrast with the example of measles, where high vaccination rates avert
community spread and outbreaks following importation. Unlike measles, neither
COVID-19 nor influenza are vaccine preventable diseases nothwithstanding the
4
https://www.thestar.com/news/canada/2021/10/05/new-zealand-has-ditched-its-covid-zero-strategy-will-
proponents-in-canada-do-the-same.html
5
https://nationalpost.com/news/canada/omicron-was-in-nova-scotia-wastewater-before-it-was-identified-
in-south-africa
6
Chavarria-Miró G, Anfruns-Estrada E, Martínez-Velázquez A, Vázquez-Portero M, Guix S, Paraira M,
Galofré B, Sánchez G, Pintó RM, Bosch A. Time Evolution of Severe Acute Respiratory Syndrome
Coronavirus 2 (SARS-CoV-2) in Wastewater during the First Pandemic Wave of COVID-19 in the
Metropolitan Area of Barcelona, Spain. Appl Environ Microbiol. 2021 Mar 11;87(7):e02750-20. doi:
10.1128/AEM.02750-20. PMID: 33483313; PMCID: PMC8091622.
1. 7 https://www.dw.com/en/coronavirus-digest-omicron-reported-in-57-countries-who-reports/a-
60052649
8
https://www.bbc.com/news/59462647
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personal protective benefits of each vaccine. Japan – one of the most immunized
countries in the world – is an excellent example to illustrate the minimal impact of
enviable prior COVID-19 vaccination rates. Japan, with 80% of the population
having received two doses of vaccine prior to the arrival of Omicron, nonetheless
saw daily case counts surge in January 2022 to record numbers9 until peaking
recently.10 Travel restrictions were implemented in January 2022, well after the
introduction of Omicron to Japan based on recently published data.11 Cases counts
continued to surge long after these measures were imposed. Therefore, border
restrictions implemented after the local identification of Omicron in Japan had
minimal impact on the course of the outbreak which was already well established
locally.
9. Strict border control measures implemented prior to COIVD-19 introduction has
been unsuccessful in preventing the introduction of new variants and subsequent
outbreaks. New Zealand, which has had some of the world’s strictest measures
including the need for hotel quarantine hotels for all international arrivals,
prolonged isolation for cases and contact tracing still could not avert the
introduction of new variants such as Delta or Omicron12. Record daily case counts
are now reported in New Zealand, despite over 95% of those over age 12 having
been fully vaccinated, with an additional 57% having received the booster shot
prior to the arrival of Omicron recently.13
Variants and Herd Immunity
10. “COVID Zero” is an approach that relied on numerous measures – mass testing,
stringent border controls, strict isolation of cases and extensive contact tracing, in
addition to snap lockdowns – all to extinguish nascent outbreaks. This concept
developed early in the pandemic, and was adopted by numerous countries,
including Canada to some degree. Of note is that this approach was developed
prior to the identification of new variants and the subsequent realization that
vaccine immunity was transient (with waning immunity over time following
vaccination) and unable to stop transmission (not sterilizing immunity).
11. As the pandemic has unfolded, there has been a shift away from the “COVID Zero”
approach a number of reasons14:
a. Contact tracing capabilities become overwhelmed15 as a means to limit or
stop chains of transmission when case numbers grow exponentially and
9
https://www.reuters.com/world/asia-pacific/japan-poised-widen-covid-19-controls-omicron-drives-record-
infections-2022-01-19/
10
https://www.channelnewsasia.com/asia/japan-omicron-surge-more-deadly-covid-19-booster-delay-
2501831
11
https://www.japantimes.co.jp/news/2022/02/15/national/japan-omicron-four-types/
12
https://www.nzherald.co.nz/nz/covid-19-omicron-outbreak-covid-cases-confirmed-in-invercargill-
gore/HAMRYLCQHKJJAVM52QOLICEUIA/
13
https://www.nytimes.com/2022/03/03/world/australia/new-zealand-covid-omicron.html
14
https://www.bloomberg.com/news/articles/2022-02-10/hong-kong-is-risking-everything-with-zealous-
covid-zero-pursuit
15
https://www.abc.net.au/news/2022-01-26/omicron-spread-what-is-the-future-of-contact-
tracing/100770948
AR05651
become too large to manage.16 This has been seen recently in Japan, which
was once a role model for COVID-19 containment17. The WHO interim
guidance document from July 2, 2021 indicates that “international contact
tracing is particularly important for countries with no cases,
imported/sporadic cases or a small number of cluster cases. In countries
where community transmission is ongoing and surveillance capacities are
overwhelmed, international contact tracing may be challenging.” Canada
falls into the latter category where surveillance capacities have now been
overwhelmed, and contact tracing has been abandoned. Not surprisingly,
most provinces have now curtailed contact tracing of cases.18
b. Suppression of virus transmission using NPIs in the community does not
succeed indefinitely. COVID Zero community infection suppression
strategies were intended to be imposed briefly to allow for time to both
develop a vaccine and to then vaccinate the population en masse to a level
that achieved herd immunity before relaxing restrictions. Unfortunately,
given the time that it takes to vaccinate an entire population despite best
unprecedented efforts, and given the issues with waning immunity and
variants, the suppression strategy becomes unsustainable, with Hong Kong
being the latest example. As mentioned earlier, independent of the intensity
of restrictions imposed to suppress community virus transmission, case
growth ensues and reaches a plateau in response to emerging (transient)
immunity to a given variant.
c. Vaccination does not stop reinfection, nor does it stop transmission in the
event of a breakthrough infection. A recent study in the New England
Journal of Medicine found that the reduction in transmission of the delta
variant declined over time, notwithstanding vaccination, and reached
transmission levels that approached those of unvaccinated persons by 12
weeks following vaccination.19
d. Before the emergence of COVID-19 variants, it was initially believed that
widespread vaccination would stop almost all infections and therefore stop
transmission to create “herd immunity”, similar to the experience seen with
measles vaccine20. Instead, COVID-19 has proven to be akin to influenza,
which changes periodically (drifts). COVID-19 vaccination, similar to the
influenza vaccine, protects against severe outcomes, but does not stop
most infections, let alone virus circulation. Booster campaigns offer only a
transient (approximately ten weeks) benefit in the reduction of infection risk,
16
17
https://foreignpolicy.com/2022/02/02/japan-omicron-covid-19-hospitals/
18
https://www.cbc.ca/news/canada/saskatoon/saskatchewan-health-authority-covid-19-contact-tracing-
reduced-staff-1.6169970
19
Eyre DW, Taylor D, Purver M, Chapman D, Fowler T, Pouwels KB, Walker AS, Peto TEA. Effect of
Covid-19 Vaccination on Transmission of Alpha and Delta Variants. N Engl J Med. 2022 Feb
24;386(8):744-756. doi: 10.1056/NEJMoa2116597. Epub 2022 Jan 5. PMID: 34986294; PMCID:
PMC8757571.
20
https://globalnews.ca/news/7501905/canada-coronavirus-herd-immunity-unknown-tam/
AR05652
before this benefit begins to fall over time due to waning immunity
(described further until f. below).21
e. The virus has not remained “stable” with respect to the original strain. The
virus evolves in response to evolutionary pressure, as one strain fills the
void of a previous one (described under 13. below). Of note is that four
different variants of concern have already emerged since late 2020. In fact,
even now a subvariant of Omicron appears to be developing as Omicron
wanes. The emergence of variants leads to either reinfections or
breakthrough infections in those with prior vaccination, especially as time
elapses from either infection or vaccination (waning immunity).
f. Moreover, waning immunity over time from vaccination (more so than
natural infection22) has been demonstrated, as was seen in Italy with mass
vaccination being administered during the alpha variant era of December
2020 to June 2021, followed by introduction of the Delta variant in July
202123. Vaccine efficacy against infection fell from 82% to 33%, while
efficacy against severe disease fell from 96% to 80%.
12. Given the impossibility of attaining “herd immunity” for reasons cited above, the
objectives of existing travel restrictions need to be revisited, as recently stated in
an editorial in the Journal of American Medical Association.24 This means that
imposing travel restrictions until a said vaccination threshold is reached is no
longer logical.
Travel Restrictions and Variants

13. To date, all variants of concern associated with significant worldwide spread have
originated from countries with significant prior outbreaks featuring a predecessor
variant. Significant outbreaks ultimately lead to (transient) natural immunity in
those countries leading to a decline in daily case countries for a period of time. The
virus then faces an evolutionary pressure to evolve (“mutate”) to overcome
population immunity to the previous strain so that I can continue to spread. The
evolution into a new variant leads to a combination of reinfections, infections in
those who are previously vaccinated, as well as new infections. Therefore, it is
more likely than not that new variants of concern will emerge in the future despite
21
https://assets.publishing.service.gov.uk/government/uploads/system/uploads/attachment_data/file/1050
236/technical-briefing-34-14-january-2022.pdf
22
León TM, Dorabawila V, Nelson L, Lutterloh E, Bauer UE, Backenson B, Bassett MT, Henry H,
Bregman B, Midgley CM, Myers JF, Plumb ID, Reese HE, Zhao R, Briggs-Hagen M, Hoefer D, Watt JP,
Silk BJ, Jain S, Rosenberg ES. COVID-19 Cases and Hospitalizations by COVID-19 Vaccination Status
and Previous COVID-19 Diagnosis - California and New York, May-November 2021. MMWR Morb Mortal
Wkly Rep. 2022 Jan 28;71(4):125-131. doi: 10.15585/mmwr.mm7104e1. PMID: 35085222.
23
Fabiani M, Puopolo M, Morciano C, Spuri M, Spila Alegiani S , Filia A et al. Effectiveness of mRNA
vaccines and waning of protection against SARS-CoV-2 infection and severe covid-19 during
predominant circulation of the delta variant in Italy: retrospective cohort
study BMJ 2022; 376 :e069052 doi:10.1136/bmj-2021-069052
24
Emanuel EJ, Osterholm M, Gounder CR. A National Strategy for the “New Normal” of Life With
COVID. JAMA. 2022;327(3):211–212. doi:10.1001/jama.2021.24282
AR05653
natural immunity25, from prior waves or prior vaccination. On a more positive note,
the impact of each variant generally on our health care system should lessen as
population immunity acquired from either infection or vaccination emerges.
14. All variants to date have followed the same pattern of being highly transmissible
and then becoming less so with the emergence of population immunity to the given
variant. Travel restrictions, unless capable of keeping out every single imported
case, will not prevent the exponential growth pattern / trajectory once a variant of
concern enters a particular country. Without the complete interdiction of the
movement of people across borders by any means, the import or export of variants
cannot be stopped. This explains why island jurisdictions were initially the most
successful in sustaining the suppression of the SARS-CoV-2 virus, and their
subsequent failure months later (Australia and New Zealand, for example). Given
the experience with variants to date, it is anticipated that a similar pattern will occur
with the emergence of future variants.
15. Therefore, variants which may be introduced across borders as a result of the
movement of people or goods do not warrant special restrictive measures based
on assumptions of increased virulence or propensity to cause health care strain as
compared with prior or existing circulating strains. Initial estimates of virulence are
frequently revised downwards as better data from larger data sets emerge. This is
due to a phenomenon of ascertainment bias, where assumptions regarding case-
fatality rates (the “deadliness” of a disease) are based on the more serious cases
initially identified and related to newly identified variant. Subsequently, the case-
fatality rate is downgraded as milder cases are identified in a community or a
population. Further, as mild and even asymptomatic cases are encountered, the
case fatality, and ultimately a lower value called the infection fatality rate, is further
revised downwards, in some cases to the same level seen with previous variants.
16. Thus far in Canada, the majority of new variant cases have been initially detected
as travel-related cases. This is followed by community cases which soon overtake
travel-related cases with exponential growth and a subsequent plateau.26
Therefore, traveler screening becomes perfunctory as the community outbreak
contributes to the majority of the new variant cases and therefore poses a greater
risk of healthcare strain than travel cases.27
17. At this time in Ontario, international travel has been responsible for only 1.7% of
all diagnosed cases since the arrival of COVID-19 in 2020.28
18. Pre-departure testing at a country of origin followed by immediate quarantine of all
arriving travelers for 14 days is a very aggressive strategy to dramatically prevent
importation of cases. This measure is being employed in New Zealand, whose
25
https://www.paho.org/en/news/14-5-2021-virus-variants-are-expected-surveillance-should-continue-
monitor-possible-changes
26
https://health-infobase.canada.ca/src/data/covidLive/Epidemiological-summary-of-COVID-19-cases-in-
Canada-Canada.ca.pdf
27
Russell TW, Wu JT, Clifford S, Edmunds WJ, Kucharski AJ, Jit M; Centre for the Mathematical
Modelling of Infectious Diseases COVID-19 working group. Effect of internationally imported cases on
internal spread of COVID-19: a mathematical modelling study. Lancet Public Health. 2021 Jan;6(1):e12-
e20. doi: 10.1016/S2468-2667(20)30263-2. Epub 2020 Dec 7. PMID: 33301722; PMCID: PMC7801817.
28
https://files.ontario.ca/moh-covid-19-weekly-epi-report-en-2020-10-08.pdf
AR05654
border remains closed to international travelers, and Australia, but was

unsuccessful in eliminating all COVID-19 variant introductions as described above.
19. The percent positive tests amongst travelers arriving to Canada is currently less
than in the general population. One can find this by comparing the data sets in the
COVID 19: Summary data about travelers, testing and compliance29 with the
COVID-19 daily epidemiology update.30 Therefore, it is conceivable that domestic
travel could pose a higher risk of importation to a given area of Canada than
travelers arriving from abroad.
Vaccines and Variants
20. The first vaccines for COVID-19 were not available in Canada until December
2020.The current vaccines in use have not been specifically modified since
December 2020 to address successive variant strains – such as Delta and
Omicron. This claim applies to the booster vaccines being administered since late
2021.
21. Vaccine efficacy (protection against infection) against variants has dropped
successive with the emergence of each variant.31 The vaccine efficacy directed at
the first COVID-19 strain before the emergence of variants was higher than with
subsequent variants. No new vaccine has been developed yet. As noted above,
the time since vaccination is an important determinant of vaccine efficacy against
infection and to a lesser extent severe outcomes.
22. Despite the fall in vaccine efficacy against infection with variants, vaccines appear
to maintain efficacy against hospital admission and death, even when variants are
implicated.32
23. The alpha variant emerged prior to the widespread availability of vaccines globally.
Alpha case rates began to fall in the UK and Canada in early 2021, well before a
significant proportion of the general population in either country had been
vaccinated. Therefore, having a variant-specific vaccine is not necessary to control
future outbreaks with new variants.
24. In South Africa, Omicron emerged and peaked despite low vaccination uptake
rates (40%). Similarly, despite high vaccination rates (90% over age 12*), Omicron
infections followed a similar pattern in Canada. The same pattern was seen in
Japan despite high vaccination rates prior to the introduction of Omicron. In
summary, vaccination rates, alone, do not determine whether a new variant will be
introduced to a population or the impact of that variant. Pre-existing natural
immunity is an important additional consideration.
25. The health system impact of a new variant is driven by prior population immunity.
This is a combination of natural immunity from previous waves and vaccine
29
https://www.canada.ca/en/public-health/services/diseases/coronavirus-disease-covid-19/testing-screening-contact-
tracing/summary-data-travellers.html.
30
https://health-infobase.canada.ca/covid-19/epidemiological-summary-covid-19-cases.html#a4.
31
32
Fabiani M, Puopolo M, Morciano C, Spuri M, Spila Alegiani S , Filia A et al. Effectiveness of mRNA
vaccines and waning of protection against SARS-CoV-2 infection and severe covid-19 during
predominant circulation of the delta variant in Italy: retrospective cohort
AR05655
immunity (partly measured by vaccination rates). As mentioned above regarding

the example of Japan, enviable vaccination uptake rates alone do not determine
the trajectory of the epidemic curve of each variant, including Omicron. Therefore,
vaccination uptake rates should not influence travel restriction policies.
26. Based on recent literature, the time since immunization (i.e. when the vaccine was
administered) has now emerged as an important determinant of vaccine efficacy.
This concept is known as “waning immunity”.33 Those vaccinated more recently
have greater protection against infection than those who were vaccinated many
months previously. Therefore, not all “fully vaccinated” have the same degree of
protection against infection, and hence risk of transmission, as time since
completion of vaccination is an important consideration.
27. Based on a recent US Centre for Diseases Control analysis, those with a prior
history of (documented) infection who are unvaccinated are less likely to acquire
infection from a new variant than those with a history of vaccination alone (i.e.
individuals who are vaccinated but were not previously infected with COVID-19).
The current restrictive policies directed at unvaccinated individuals do not make
this distinction in terms of risk of acquiring infection, and hence transmitting it to
others.34 Those with a prior history of infection should be given an “immunity
passport”, as occurs in the EU, and should be considered equivalent to the
vaccinated.
28. During the latest Omicron wave in Ontario, testing capacity was overwhelmed.
Therefore, many who were infected were not tested. Any of these individuals
without a history of vaccination would not be identified with a test result, and yet
would be restricted from travel based on current policies in Canada.
29. Based on a recent analysis from Qatar published in the New England Journal of
Medicine, those with prior infection from any of the three preceding variants were
protected against infection to varying degrees based on the variant in question,
with the lowest protection of 56% against Omicron. Prior infection reduced the risk
of severe disease due to Omicron by 87.8%. Time since vaccination did not affect
the results of protection against severe disease, in contrast with decreasing
protection against infection. This is similar to the findings of the CDC.
30. In addition, based on a recent household transmission study performed during the
delta variant era in the UK, those who are vaccinated an are infected transmit as
easily as unvaccinated with infection.35
33
Goldberg Y, Mandel M, Bar-On YM, Bodenheimer O, Freedman L, Haas EJ, Milo R, Alroy-Preis S, Ash
N, Huppert A. Waning Immunity after the BNT162b2 Vaccine in Israel. N Engl J Med. 2021 Dec
9;385(24):e85. doi: 10.1056/NEJMoa2114228. Epub 2021 Oct 27. PMID: 34706170; PMCID:
PMC8609604.
34
Bregman B, Midgley CM, Myers JF, Plumb ID, Reese HE, Zhao R, Briggs-Hagen M, Hoefer D, Watt JP,
Silk BJ, Jain S, Rosenberg ES. COVID-19 Cases and Hospitalizations by COVID-19 Vaccination Status
and Previous COVID-19 Diagnosis - California and New York, May-November 2021. MMWR Morb Mortal
Wkly Rep. 2022 Jan 28;71(4):125-131. doi: 10.15585/mmwr.mm7104e1. PMID: 35085222.
35
Singanayagam A, Hakki S, Dunning J, Madon KJ, Crone MA, Koycheva A, Derqui-Fernandez N,
Barnett JL, Whitfield MG, Varro R, Charlett A, Kundu R, Fenn J, Cutajar J, Quinn V, Conibear E, Barclay
W, Freemont PS, Taylor GP, Ahmad S, Zambon M, Ferguson NM, Lalvani A; ATACCC Study
Investigators. Community transmission and viral load kinetics of the SARS-CoV-2 delta (B.1.617.2)
variant in vaccinated and unvaccinated individuals in the UK: a prospective, longitudinal, cohort study.
AR05656
Testing Approach
31. PCR testing should not be used for either pre-departure (e.g. at point of origin) or
following arrival testing (regardless of a traveler’s vaccination status) for the
following reasons:
i. Historic infections may be detected by PCR for up to four months
after an infection. A positive result may result in non-infectious fully
recovered individuals needlessly being prevented from travel, or
being subjected to isolation after arrival. Antigen tests do not have
this pitfall as the duration of positive results following infection is
much less.
ii. There has been inequitable access to testing during the latest
Omicron wave due to a change in testing criteria. This has resulted
in preferential treatment for someone who had access to testing and
was positive in the last six months vs. someone who had COVID and
followed provincial guidance (Ontario) and did not get tested to
confirm the diagnosis.
iii. Some individuals who are not tested prior to departure from Canada
may test positive by PCR prior to their anticipated return, only to face
isolation abroad and an inability to travel home. For example, the US
requires an antigen test prior to air travel into the country, while
Canada until recently required a PCR test.
32. In my opinion, traveler testing strategy should not depend on vaccination status
for the following reasons:
i. Vaccination does not prevent transmission of COVID-19 if one get
infected with COVID-19.
ii. Vaccination, unless administered within the preceding twelve weeks,
does not significantly reduce the risk of infection with COVID-19.
iii. An unvaccinated who was previously infected with COVID-19 is at
lower risk of new infection than someone who is vaccinated without
having had an infection.
33. A traveler testing strategy should also not look to third doses (“boosters”) which
provide only transient benefit. A booster shot has the same limitations of wining
immunity as is seen following the first two doses of a COVID-19 vaccine.
34. If testing of incoming travelers is to continue, it should be targeted to the risk of
infection in the country of origin, rather than a “one size fits all” approach.
Specifically, where a traveler is arriving from a country with dramatically higher
incidence of disease than Canada, testing might be selectively considered and
later abandoned based on the course of events in the country. For consistency
reasons, and to prevent travelers from being “trapped” by different testing
methods, testing strategies should be similar to those in use in another country
(e.g. Canada’s approach should copy to the US approach).
Lancet Infect Dis. 2021 Oct 29:S1473-3099(21)00648-4. doi: 10.1016/S1473-3099(21)00648-4. Epub

ahead of print. Erratum in: Lancet Infect Dis. 2021 Dec;21(12):e363. PMID: 34756186; PMCID:
PMC8554486.
AR05657
35. If a traveler is coming from a country with a similar incidence of disease, there is
simply no added value to testing, by any methodology.
36. If testing is used for travel screening purposes, antigen tests should for the
following reasons:
i. Historical infections are not captured
ii. Immediate results are available
iii. There is better access to antigen testing locally and globally, with results
being available in time prior to travel.
iv. Antigen tests are more affordable than PCR tests and can be performed in
front of the traveler, rather than having to be sent away to a remote
laboratory.
37. COVID-19 vaccination, though generally safe, has been associated with rare and
sometimes debilitating adverse effects, some of which became apparent only after
large scale administration. For example, the rare blood clotting adverse effect of
the Oxford Astra Zeneca vaccine was not apparent until April 2021, and primarily
affected otherwise healthy women under age 60 within two weeks of their first
dose36. This vaccine was eventually removed from use in Canada.
38. Myocarditis also became evident as a risk of vaccine only well after the initial use
of the mRNA vaccines. While the incidence rates of myocarditis and/or pericarditis
following a COVID vaccination remain low. However, as noted in a communique
from the Chief Medical Officer of Alberta37, the occurrence is not predictable:
a. Cases happen more frequently following the second dose of an mRNA
vaccine (Pfizer-BioNTech or Moderna COVID-19 vaccine).
b. Cases were reported more often in adolescents and younger adults under
30 years of age than older individuals, and more often in males than
females.
c. Usually, symptoms started within one week after vaccination (4-7 days).
d. Most cases had mild illness, responded well to usual medical treatment and
rest, and their symptoms improved quickly.
e. No long-term data is available yet.
39. Where a vaccine is being administered to a population already at low-risk of

developing adverse outcomes (i.e. hospitalization and death) to COVID-19, the
small risks of severe disease need to be weighed against the small risks of severe
adverse reactions. Mandating vaccination in this population (e.g. adolescents or
young adults) removes patient autonomy in the consideration of these competing
risks.
36
https://www.ema.europa.eu/en/news/astrazenecas-covid-19-vaccine-ema-finds-possible-link-very-rare-
cases-unusual-blood-clots-low-blood
37
https://www.alberta.ca/assets/documents/health-myocarditis-and-pericarditis-following-covid.pdf
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AR05659
This is Exhibit “C” referred to in the Affidavit of Dr. Neil Rau sworn March 11, 2022

Sam A. Presvelos
AR05660
LIST OF DOCUMENTS IN EXPERT REPORT OF DR. NEIL RAU
Chavarria-Miró G, Anfruns-Estrada E, Martínez-Velázquez A, Vázquez-Portero M, Guix S,
Paraira M, Galofré B, Sánchez G, Pintó RM, Bosch A. Time Evolution of Severe Acute
Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) in Wastewater during the First Pandemic
Wave of COVID-19 in the Metropolitan Area of Barcelona, Spain. Appl Environ Microbiol.
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PMC8091622.
Deslandes A, Berti V, Tandjaoui-Lambotte Y, Alloui C, Carbonnelle E, Zahar JR, Brichler S,
Cohen Y. SARS-CoV-2 was already spreading in France in late December 2019. Int J
Antimicrob Agents. 2020 Jun;55(6):106006. doi: 10.1016/j.ijantimicag.2020.106006. Epub 2020
May 3. PMID: 32371096; PMCID: PMC7196402.
Emanuel EJ, Osterholm M, Gounder CR. A National Strategy for the “New Normal” of Life
With COVID. JAMA. 2022;327(3):211–212. doi:10.1001/jama.2021.24282
Eyre DW, Taylor D, Purver M, Chapman D, Fowler T, Pouwels KB, Walker AS, Peto TEA.
Effect of Covid-19 Vaccination on Transmission of Alpha and Delta Variants. N Engl J Med.
2022 Feb 24;386(8):744-756. doi: 10.1056/NEJMoa2116597. Epub 2022 Jan 5. PMID:
34986294; PMCID: PMC8757571.
Fabiani M, Puopolo M, Morciano C, Spuri M, Spila Alegiani S , Filia A et al. Effectiveness of
mRNA vaccines and waning of protection against SARS-CoV-2 infection and severe covid-19
during predominant circulation of the delta variant in Italy: retrospective cohort

AR05661
Goldberg Y, Mandel M, Bar-On YM, Bodenheimer O, Freedman L, Haas EJ, Milo R, Alroy-
Preis S, Ash N, Huppert A. Waning Immunity after the BNT162b2 Vaccine in Israel. N Engl J
Med. 2021 Dec 9;385(24):e85. doi: 10.1056/NEJMoa2114228. Epub 2021 Oct 27. PMID:
34706170; PMCID: PMC8609604.
/1050236/technical-briefing-34-14-january-2022.pdf
https://files.ontario.ca/moh-covid-19-weekly-epi-report-en-2020-10-08.pdf
https://foreignpolicy.com/2022/02/02/japan-omicron-covid-19-hospitals/
https://globalnews.ca/news/7501905/canada-coronavirus-herd-immunity-unknown-tam/
https://health-infobase.canada.ca/covid-19/epidemiological-summary-covid-19-cases.html#a4.
https://health-infobase.canada.ca/src/data/covidLive/Epidemiological-summary-of-COVID-19-
cases-in-Canada-Canada.ca.pdf
https://nationalpost.com/news/canada/omicron-was-in-nova-scotia-wastewater-before-it-was-
identified-in-south-africa
https://www.abc.net.au/news/2022-01-26/omicron-spread-what-is-the-future-of-contact-
tracing/100770948
https://www.bbc.com/news/59462647
AR05662
https://www.bloomberg.com/news/articles/2022-02-10/hong-kong-is-risking-everything-with-
zealous-covid-zero-pursuit
screening-contact-tracing/summary-data-travellers.html.
https://www.cbc.ca/news/canada/saskatoon/saskatchewan-health-authority-covid-19-contact-
tracing-reduced-staff-1.6169970
https://www.channelnewsasia.com/asia/japan-omicron-surge-more-deadly-covid-19-booster-
delay-2501831
https://www.dw.com/en/coronavirus-digest-omicron-reported-in-57-countries-who-reports/a-
60052649
https://www.japantimes.co.jp/news/2022/02/15/national/japan-omicron-four-types/
https://www.nzherald.co.nz/nz/covid-19-omicron-outbreak-covid-cases-confirmed-in-
invercargill-gore/HAMRYLCQHKJJAVM52QOLICEUIA/
https://www.paho.org/en/news/14-5-2021-virus-variants-are-expected-surveillance-should-
continue-monitor-possible-changes
https://www.reuters.com/world/asia-pacific/japan-poised-widen-covid-19-controls-omicron-
drives-record-infections-2022-01-19/
AR05663
https://www.thestar.com/news/canada/2021/10/05/new-zealand-has-ditched-its-covid-zero-
strategy-will-proponents-in-canada-do-the-same.html
https://www.who.int/publications/i/item/WHO-2019-nCoV-Risk-based-international-travel-
2021.1
Bregman B, Midgley CM, Myers JF, Plumb ID, Reese HE, Zhao R, Briggs-Hagen M, Hoefer D,
Watt JP, Silk BJ, Jain S, Rosenberg ES. COVID-19 Cases and Hospitalizations by COVID-19
Vaccination Status and Previous COVID-19 Diagnosis - California and New York, May-
November 2021. MMWR Morb Mortal Wkly Rep. 2022 Jan 28;71(4):125-131. doi:
10.15585/mmwr.mm7104e1. PMID: 35085222.
Bregman B, Midgley CM, Myers JF, Plumb ID, Reese HE, Zhao R, Briggs-Hagen M, Hoefer D,
Watt JP, Silk BJ, Jain S, Rosenberg ES. COVID-19 Cases and Hospitalizations by COVID-19
Vaccination Status and Previous COVID-19 Diagnosis - California and New York, May-
November 2021. MMWR Morb Mortal Wkly Rep. 2022 Jan 28;71(4):125-131. doi:
10.15585/mmwr.mm7104e1. PMID: 35085222.
Russell TW, Wu JT, Clifford S, Edmunds WJ, Kucharski AJ, Jit M; Centre for the Mathematical
Modelling of Infectious Diseases COVID-19 working group. Effect of internationally imported
cases on internal spread of COVID-19: a mathematical modelling study. Lancet Public Health.
2021 Jan;6(1):e12-e20. doi: 10.1016/S2468-2667(20)30263-2. Epub 2020 Dec 7. PMID:
33301722; PMCID: PMC7801817.

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Singanayagam A, Hakki S, Dunning J, Madon KJ, Crone MA, Koycheva A, Derqui-Fernandez
N, Barnett JL, Whitfield MG, Varro R, Charlett A, Kundu R, Fenn J, Cutajar J, Quinn V,
Conibear E, Barclay W, Freemont PS, Taylor GP, Ahmad S, Zambon M, Ferguson NM, Lalvani
A; ATACCC Study Investigators. Community transmission and viral load kinetics of the SARS-
CoV-2 delta (B.1.617.2) variant in vaccinated and unvaccinated individuals in the UK: a
prospective, longitudinal, cohort study. Lancet Infect Dis. 2021 Oct 29:S1473-3099(21)00648-4.
doi: 10.1016/S1473-3099(21)00648-4. Epub ahead of print. Erratum in: Lancet Infect Dis. 2021
Dec;21(12):e363. PMID: 34756186; PMCID: PMC8554486.
Vickers DM, Baral S, Mishra S, Kwong JC, Sundaram M, Katz A, Calzavara A, Maheu-Giroux
M, Buckeridge DL, Williamson T. Stringency of Containment and Closures on the Growth of
SARS-CoV-2 in Canada prior to Accelerated Vaccine Roll-Out. Int J Infect Dis. 2022 Feb
21:S1201-9712(22)00108-4. doi: 10.1016/j.ijid.2022.02.030. Epub ahead of print. PMID:
35202783; PMCID: PMC8863413.

AR05665
FEDERAL
COURT OF CANADA
AFFIDAVIT OF DR. NEIL RAU
PRESVELOS LAW LLP

Toronto, Ontario
M5H 3L5
Sam A. Presvelos (LSO #: )

Tel:
Email:
Evan A. Presvelos (LSO

Tel:
Email:

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TAB 36
AR05667
Court File No.: T-1991-21-1D
BETWEEN:

Applicants
-and-

Respondents
APPLICATION UNDER s. 57.1 of the Federal Courts Act, RSC 1985, c F-7 and ss. 61 (2), 69,

I, Dr. Richard Schabas, having been named as an expert witness by the Applicants, certify that I
have read the Code of Conduct for Expert Witnesses as set out in the schedule to the Federal Courts
March 11 th , 2022
Dr. Richard Schabas

AR05668

EXPERTS' REPORTS

the report;

opinions;

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to the Court.
EXPERT CONFERENCES
witness

addressed; and
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BETWEEN:

Applicants
- and -

Respondents
AFFIDAVIT OF DR. RICHARD SCHABAS
1. I, Dr. Richard Schabas, a resident of Toronto, Ontario, MAKE OATH AND SAY AS
FOLLOWS:
2. I am a retired physician and the former Chief Medical Officer of Ontario and as such have
personal knowledge of the facts and matters hereinafter deposed to save and except where
the same are stated to be based upon information and belief and where so stated I verify
believe the same to be true.
curriculum vitae outlining my education, relevant experiences and publications.
4. Attached to this Affidavit and marked as Exhibit “B” is a true copy of my expert report
with respect to this matter.

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AR05672
This is Exhibit “A” referred to in the Affidavit of Dr. Richard Schabas sworn March 11, 2022

Sam A. Presvelos
AR05673
May 7, 2021
CURRICULUM VITAE:
RICHARD SCHABAS MD, MHSc, FRCPC
Professional Experience:
2008-2016 Antibiotic Steward

Campbellford Memorial Hospital
Campbellford, Ontario
2005-2016 Medical Officer of Health

Hastings and Prince Edward Counties Health Unit
Belleville, Ontario
2005-2016 Consultant in Internal Medicine

Campbellford Memorial Hospital
2003-5 Chief of Staff

York Central Hospital
Richmond Hill, ON
1997-2007 President
Schabas Associates Inc.
Health Consultants
2001-2 Vice President, Medical Affairs

GlycoDesign Inc.
2000-01 Vice President, Corporate Development

GlycoDesign Inc.
1998-2001 Head, Division of Preventive Oncology

Cancer Care Ontario
1997 Director of Screening Programs

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Cancer Care Ontario
198798 Chief Medical Officer of Health and

Director, Public Health Branch,
Ontario Ministry of Health
198387 Medical Officer of Health,

Borough of East York Health Unit,
Toronto, Ontario
198199 Consultant in Internal Medicine

Orthopaedic and Arthritic Hospital,
Toronto, Ontario
198397 Consultant in Internal Medicine

Eastwood Medical Clinic
Toronto, Ontario
197778 General Practitioner,

Parry Sound, Ontario
Degrees:
1983 Fellowship in the Royal College of Physicians and

Surgeons of Canada in Community Medicine (now called
Public Health and Preventive Medicine)
1982 Masters in Health Sciences,

1982 Fellowship in the Royal College of Physicians and

Surgeons of Canada in Internal Medicine
1976 Medical Doctor (with Honours)

1970 General Certificate of Education (Advanced) in

History, English Literature and Geography,
University of London Board,
London, England
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Academic Appointments:
2007-2016 Associate Professor

Faculty of Medicine
Queen’s University
1996-2009 Associate Professor,

Department of Public Health Sciences,
Faculty of Medicine,
1994-2000 Adjunct Associate Professor,

Department of Health Studies and Gerontology,
University of Waterloo
1987-96 Assistant Professor,

Department of Biostatistics and Preventive Medicine,
19838-7 Lecturer,
Department of Biostatistics and Preventive Medicine,
Previous Appointments (Selected List):
2003-5 Infection Control Committee

(Chair)
2001-2 Health Policy Sub-committee

BIOTECanada
1998-9 Ontario Expert Panel on Colorectal Cancer Screening

(vice Chair)
1998-9 Expert Panel on Cancer Epidemiology in Cape Breton

(Chair)
Cancer Care Nova Scotia
3
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1998-9 Ontario Tobacco Strategy Expert Panel
1998 Expert Panel on Hepatitis C Epidemiology (Chair)

Health Canada
1998 Multidisciplinary Assessment Committee for New

Opportunities
Canadian Foundation for Innovation
1997=98 Steering Committee (Chair)

Canadian Consensus Conference on a National
Immunization Records System
Health Canada
1987-98 Advisory Committee on Communicable Diseases (Chair)

Ontario Ministry of Health
1987-98 Residency Committee,

Community Medicine Program,
1987-98 Federal/Provincial Advisory Committee on

Occupational and Environmental Health
1993-98 Editorial Board,

"Health News",
1996-7 Federal/Provincial/Territorial Implementation Team

National Blood Agency
1996-7 Board of Directors

Canadian Blood Agency
1994-97 Children At Risk Advisory Committee,

Laidlaw Foundation
1996 Federal/Provincial/Territorial Working Group on Blood

Governance (Cochair)
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1994-6 Provincial (Ontario) Cancer Network
1994-7 Advisory Committee,

Centre for Health Economics and Policy Analysis,
McMaster University
1994 Task Force on the Primary Prevention of Cancer

(Miller Report)
1992=4 Expert Advisory Committee

National Population Health Survey
1988-92 Federal/Provincial Advisory Committee on Community

Health (Chair, 1992)
1990-92 National Health Information Council
1990 Canadian Delegation,

World Health Assembly,
Geneva, Switzerland
1986-92 Public Health Committee

Ontario Medical Association
1987-91 Provincial (Ontario) Advisory Committee on AIDS
1987-88 Expert Advisory Committee on Immunization,

College of Physicians and Surgeons of Ontario
1983-87 Health Protection and Promotion Committee,

Metropolitan Toronto District Health Council
1985-87 Emergency Services Committee,

Metropolitan Toronto District Health Council
1986-87 Working Group on AIDS Services, (Chair)

Metropolitan Toronto District Health Council,
1985-87 Executive Committee,

Association of Local Official Health Agencies
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Consultation Contracts for Schabas Associates Inc.(Selected List)
Biochem Pharma: Adviser on influenza vaccine issues
Cameco Corporation: Adviser on epidemiology
Canadian Blood Agency: Observer, GAT Task Force, June 25, 1998,
Washington D.C.
Canadian Cancer Society: Cancer Control in Canada: Strategic

Priorities for the Next Decade
Capital Health Authority (Edmonton, Alberta): Strengthening

Population Health
Health Canada:
Biotechnology Surveillance, Centre for Surveillance

Coordination
Health Protection Branch Surveillance Project
Setting Priorities in Public Health
Canadian Consensus Conference on a National Immunization

Records System
Expert Panel on Hepatitis C Epidemiology
Expert Opinion of Canadian Red Cross Society Frozen Blood

Samples
Laboratory Centre for Disease Control Business Plan

Development (with HDP Consultants)
Evaluation of the Canadian Health Network
Surveillance Transition: Principles of Data Collection
Ontario Ministry of Health:
Ministerial adviser on blood issues
6
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Primary Care Reform
Aventis Pasteur Ltd: Advisor on vaccine issues
Hospital Appointments:
2005- Campbellford Memorial Hospital

2002-5 York Central Hospital
Richmond Hill, Ontario
1981-99 Orthopaedic and Arthritic Hospital,

Toronto, Ontario
1983-87 Toronto East General and Orthopaedic Hospital,

Toronto, Ontario
1977-78 Parry Sound District General Hospital,

1977-78 St. Joseph's Hospital,

Professional Training:
1981-83 Senior Resident in Community Medicine,

1980-81 Senior Resident in Internal Medicine,

Wellesley Hospital,
Toronto, Ontario
1979-80 Junior Resident in Internal Medicine,

Toronto General Hospital,
Toronto, Ontario
1978-79 Junior Resident in Internal Medicine,

Women's College Hospital,
Toronto, Ontario
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1976-77 Rotating Intern,

St. Joseph's Hospital,
Toronto, Ontario
Scientific Publications:
I. Peer Reviewed Journals:
Schabas, Fisman and Schabas, Control of Clostridium difficile-associated diarrhea.by antibiotic

stewardship in a small community hospital. Canadian Journal of Infectious Diseases and Medical
Microbiology. 2012;23(2):82-83.
Schabas, Is the Quarantine Act relevant? CMAJ 2007; 176: 1840 - 1842
Schabas, Severe acute respiratory syndrome: Did quarantine help? Canadian Journal of
Infectious Diseases and Medical Microbiology July/August 2004, Volume 15, Number 4
Schabas, Pre-Hospital Intubation and SARS. CMAJ (Published On-line August 25, 2003).
Dwosh, Hong, Austgarten, Herman and Schabas, Identification and containment of an outbreak
of SARS in a community hospital. CMAJ 2003; 168: 1415-1420.
Schabas, SARS: prudence, not panic. CMAJ 2003 168: 1432-1434
Schabas, Colorectal Screening - Time to Act. CMAJ 2003 168:

178-179
Schabas, Is public health ethical? Can J Public Health. 2002 Mar-

Apr;93(2):98-100.
Schabas, Population Screening for Colorectal Cancer; perspectives

from the Canadian health care system. J Psychosocial Onc 2001
19(3/4):21-28
Shapero, Alexander, Hoover, Burgis, Schabas, Colorectal cancer

screening: video-reviewed flexible sigmoidoscopy by nurse
endoscopists--a Canadian community-based perspective. Can J
Gastroenterol. 2001 Jul;15(7):441-5.
Schabas, “Mass influenza vaccination in Ontario: a sensible

move.” CMAJ. 2001 Jan 9;164(1):367.
8
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Schabas, "Adolescent and adult pertussis. A problem and a

solution." Can Fam Physician. 2000 Nov;46:216970, 21767.
Schabas, “Pertussis in Adolescents and Adults.” Can J Public
Health. 2000 Jan-Feb;91(1):73
Elliot, Taylor, Cameron, Schabas, “Assessing Public Health

Capacity to Support Community-based Heart Health Promotion: the
Canadian Heart Health Initiative, Ontario Project (CHHIOP).”
Health Educ Res. 1998 Dec;13(4):607-22
Glasgow, Schabas, Williams, Wallace, Nalezyty, "A Populationbased
Hepatitis B Seroprevalence and Risk Factor Study in a Northern
Ontario Town." Canadian Journal of Public Health 88(2):87 March/
April 1997
Schabas "Promoting Heart Health Promotion." Canadian Journal of

Public Health 87(Supplement 2) November/December 1996
Whiting , Schabas, and Ashley "Hib Vaccine Coverage in Children

Attending Day Care/Nursery School in East York." Canadian Journal
of Public Health 81(2):152 March/April 1990
Leake, Locker, Price, Schabas, and Chia "Results of Sociodental

Survey of People Age 50 and Older Living in East York, Ontario."
Canadian Journal of Public Health 81(2):152 March/April 1990
Frank, Schabas, Arshinoff, Brant, "DiphtheriaTetanus

Overimmunization in Children with No Records." Canadian Medical
Association Journal, 1989
Leake, Price and Schabas, "Oral Health Status and Need for Dental
Care Among Elderly in East York, Ontario Collective Residences
1985." Canadian Journal of Public Health 78(5):323 September/
October 1987
Schabas, "Spreadsheet Epidemiology: an easy route into the

computer age." Canadian Journal of Public Health, 1985
Keystone and Schabas, "An Unusual Reaction to Azothioprine."

Journal of Arthritis and Rheumatism, 1981
9
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Other Journals:
Schabas “The Real Lessons of SARS.” Ottawa Citizen, 2007
Schabas, “Don’t Chase Phantom Flu.” Globe and Mail, 2006
Schabas, “Much Ado About Clucking.” Globe and Mail, 2005
Schabas, “Don’t cry wolf on every flu.” Globe and Mail, February 2, 2004
Schabas, "SARS, it's a nasty bug but it's not the next plague." Globe and Mail. April 24, 2003.
Schabas, “Petussis: New Challenges, New Opportunities”. Canadian

Journal of Clinical Medicine. December 1999 p. 112-3
Schabas, “Pertussis Immunization: Time for Action.” Canadian

Journal of Allergy and Clinical Immunology. 5(5):209-10 June 2000
Schabas, "Colorectal Cancer Screening; what's ahead for Ontario?"

Ontario Medical Review, April 1999
Schabas, "Reengineering the Ontario Breast Screening Program."

Ontario Medical Review, April 1998
Schabas, "Public Health Home Visiting", IMPrint 17(Winter

19967):23
Schabas, "Public Health and the Health of Populations", Centre

for Health Research News, Winter 1997, No. 16
Schabas, "Measles Elimination: Time to CatchUp", Measles Update

3(3): 1
Schabas, "High Risk: Is It Real?" Ontario Medicine, 1991
Schabas, "Burkitt: More Foods for Thought." Ontario Medicine,

1991
Schabas, "Public Health: New Challenges." Ontario Medicine, 1990
Heinmann, Mikel, Naus, Goel, Tischler, Carlson, Schabas, Pasut,
10
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Borczyk, Krishnan, "Meningococcal Disease in Ontario During the

Winter of 19881989." Canadian Diseases Weekly Report, 1989
Goel, Carlson, and Schabas, "Lyme Disease, an update." Ontario

Medical Review, May, 1989
Gilmour, Matsamura, Kelly and Schabas, "Bacterial Contamination

of Bowling Alley Water Wells." Ontario Diseases Surveillance
Report, 1984
Barretto, ChungJames, and Schabas, "An outbreak of Rubella in a

Toronto High School." Ontario Diseases Surveillance Report, 1983
Public Reports as Chief Medical Officer of Health:
1996: Tobacco sounding the alarm
increasing smoking rates in Ontario teenagers, attributable to

tax cuts and cigarette promotion are a public health crisis this
report recommends wideranging action to curtail this problem
1995: Immunization the next steps
a review of the successes in immunization and a strategic plan

for expansion of Ontario's immunization program, with a second
dose measles catchup, a hepatitis B high school catchup and
introduction of a pneumococcal program
1994: Opportunities for Health progress against cancer
a description of the epidemiology and etiologies of cancer a

discussion of strategies for cancer control a strong emphasis
for promotion of nonsmoking and healthy eating as our best means
of controlling cancer over 100,000 copies distributed
1993: Opportunities for Health promoting heart health
a description of the underlying determinants of ischemic heart

disease smoking, blood cholesterol, blood pressure, body weight
and physical activity their distribution in Ontario and
strategies for promoting heart health over 100,000 copies
11
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distributed
1992: Opportunities for Health a report on youth
an analysis of the main health challenges facing year old in

Ontario with wideranging policy recommendations in areas of
tobacco control, alcohol abuse, fitness, nutrition, pregnancy
planning, control of sexually transmitted diseases, motor vehicle
crashes and mental health promotion
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1991: Tobacco and Your Health
a descriptive review of the patterns of tobacco use in Ontario

and their health impacts over 200,000 copies distributed
Research:
1996 CoInvestigator (Rena Mendelson, Principal Investigator)

Ontario Nutrition Survey
Health Canada Grant (Project #E311212)
1994 Principal Investigator (with Prof. R. Cameron, Prof. Susan

Elliot, and Prof.M. Taylor)
Canadian Heart Health Initiative Ontario Project
National Health Research and Development Program Grant
199193 Principal Investigator

Ontario Heart Health Survey
National Health Research and Development Program Grant
198587 Principal Investigator (with Dr. John Frank)

A study to test of efficacy of the Schick test and
tetanus ELISA antibody in determining primary immunization
Awards:
2006 Smoke Free Champion Award

Association of Local Official Health Agencies/Ontario Public
Health Association
1997 Amethyst Award for outstanding achievement in the Ontario

public service
1997 Salute to the City Award

Presented to honour the 20th Anniversary of the Toronto
Eaton Centre
1990 Distinguished Service Award

Association of Local Official Health Agencies
13
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1981 Milton H. Brown Award

Department of Biostatistics and Epidemiology,
14
AR05687
Public Presentations (Selected List):
2010 SARS, H5N1 and H1N1 – three panic-demics

Curso Internacional de Medicina Interna de America del Norte
Mexico City, Mexico
2009 H1N1 – What lies Ahead

Ontario Agency for Health Protection and Promotion
Toronto
SARS – The Real Story

Internal Medicine Interest Group
Faculty of Medicine
Kingston Ontario
SARS – Did Quarantine Work?

American Association for the Advancement of Science
Washington DC
2007 Confessions of a Public Health Doctor

Public Health Interest Group
Faculty of Medicine
Kingston Ontario
Does Vitamin D Prevent Cancer?

Department of Public Health Sciences
SARS, the Precautionary Principle and Public Health

Centre de recherche en droit public
Université de Montréal
2006 Pandemic Planning in Perspective

Continuing Professional Development
Kingston, Ontario
Flu Fraud
Pandemics and the Media
15
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Prudent Pandemic Planning

Plenary Panel on Pandemic Planning
National Healthcare Leadership Conference
Victoria, British Columbia
2004 Toronto SARS Outbreak

National University of Ireland
Galway, Ireland
My Biotech Career – a cautionary tale

Dublin Molecular Medicine Centre
Dublin Ireland
Lessons from SARS

16
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2003 Lessons from SARS

Ontario SARS Commission
Toronto
Lessons from SARS

SARS Symposium
SARS Lessons from the Toronto Outbreak

International Science Symposium on SARS
Beijing, China
Why Public Health in Canada Fails

University of Toronto Alumni Lecture
Canadian Public Health Association Annual Meeting
Calgary, Alberta
The Future of Public Health in Canada

Canadian Institutes for Health Research Symposium
Calgary Alberta
Colorectal Cancer Screening

Medical Rounds
Opportunities for Cancer Prevention

Department of Health Studies and Gerentology
Waterloo, Ontario
2002 Controversies in Cancer Screening

Annual Clinic Day
Toronto East General Hospital
Politics of Colorectal Cancer Screening

McGill Conference on GI Cancers
Montreal, Quebec

Cape Breton Cancer Symposium
Sydney Nova Scotia
17
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Feasibility of Eradication of H.pylori to Prevent Stomach

Cancer
Cancer Care Ontario Workshop
Toronto
Progress Towards a National Immunization Registry

National Immunization Conference
Victoria, British Columbia
2001 Cancer Prevention

Helping Hands Conference
North Bay, Ontario

Canadian Digestive Diseases Week
Banff, Alberta
2000 Updates in Oncology - Screening

Royal Victoria Hospital
Barrie, Ontario
1999 "Colorectal Cancer Screening What's ahead for Ontario?"

Focus on the Future Conference
Thunder Bay, Ontario

Fabian Curry Memorial Clinic Day
Minet, Ontario
"Politics, the Environment and Cancer in Cape Breton."

Joint Preventive Oncology Seminar
Toronto
"Colorectal Cancer Screening What's ahead for Ontario?"

Annual Preventive Oncology Seminar
Cancer Care Ontario
Toronto
"Preventive Oncology at Cancer Care Ontario."

Ontario Hospital Association
Toronto
18
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1998 "Colorectal Cancer Screening What's ahead for Ontario?"

Annual General Meeting
Ontario Association of Gastroenterology
Toronto
"Colorectal Cancer Screening What's ahead for Ontario?"

Colorectal Cancer Symposium
Ottawa Regional Cancer Centre and University of Ottawa
Ottawa, Ontario
Labelle Lecture (Responder)

McMaster University
Hamilton, Ontario
"The Evolving Role of the Community Medicine

Specialist" (panel chair)
Annual Meeting
Royal College of Physicians and Surgeons of Canada
Toronto
"Adolescent and Adult Pertussis" (afternoon chair)

Canadian Public Health Association
Toronto
1997 "The State of Public Health in Ontario" (keynote speaker)

Ontario Public Health Association Annual Conference
Kingston, Ontario
"Public Health and the Health of Population"

"Public Health and Who Does What"

Annual Meeting
Association of Local Public Health Agencies
Hamilton, Ontario
"What Ahead for Public Health"

Spring Exchange
Ontario Society of Nutrition Professionals in Public Health
Kempenfelt Bay, Ontario
"Genetic Screening and Public Policy"

Association of Genetic Colleagues of Ontario
19
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Mississauga, Ontario
"Promoting Heart Health" (keynote speech)
Peel Heart Health Network

Mississauga, Ontario
"Public Health and Environmental Health"

Seminar, Diploma Program in Environmental Health
McMaster University
"Public Health in the Age of Krever"

2nd National Conference on Communicable Disease Control
Toronto
"Ministry of Health and the Blood System"

Update on Transfusion Medicine
Michener Institute and the Canadian Red Cross Society
Toronto
"Immunization Update"
Saturday at the University Series
Keynote Address
Tobacco Control Enforcement Conference
Toronto
"Community Health Research and Public Health Policy"

Panel presentation
Community Health Research Day
1996 "Barriers to Implementation and Achievement of National

Goals"
(plenary presentation) and
"An Anti/Anti Immunization Panel" (breakout session)
Canadian National Immunization Conference
Health Canada
Toronto, Ontario
20
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"Program Evaluation in Public Health (panel presentation)

Association of Public Health Epidemiologists in Ontario
Workshop
Toronto, Ontario
"Tobacco sounding the Alarm" (keynote presentation) and

"Public Health Reform" (concurrent session) and
"Community Action and Public Health in Ontario" (panel
presentation)
Toronto, Ontario
"Priorities for Tobacco Control in Ontario" (panel

presentation)
Preventive Oncology Seminar
Ontario Cancer Treatment and Research Foundation
Toronto, Ontario
"Restructuring Public Health"

Association of Local Official Health Agencies Annual
Conference
Gananoque, Ontario
"Cancer Control and Public Health"

Future Directions in Cancer Control
"Public Health and Confidentiality"

Health Information and Privacy
Canadian Institute of Law and Medicine
Toronto, Ontario
1995 "Immunization the next steps" (keynote presentation) and

"Future Directions in Public Health" (panel presentation),
London, Ontario
"Promoting Heart Health Promotion"

Canadian Conference on Dissemination Research
21
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University of British Columbia
2nd International Heart Health Conference

Barcelona, Spain
presented three papers and one poster about the
Canadian Heart Health Initiative Ontario Project
1994 "Implementing New Vaccine Programs"

National Conference on Immunization in the 90's
Health Canada
1992 "What is Safer Sex"

Annual Conference
"Understanding Population Health"
Annual Conference
Ontario Public Health Association
1989 "New Directions for Public Health in Ontario"
Annual Conference
1987 "High Risk versus Population Strategies a debate"

Annual Conference
1986 "Planning for Change in Public Health"

Annual Conference
Educational Activities (University of Toronto):
Supervision of Community Medicine Residents: Joel DeKoven, Robert

Gin, Medhat Gindi, Paul Gully, Robert Kyle, Verna Mai, Paul
Martiquet, Cordell Neudorf, Lynn Noseworthy, Howard Njoo, Sandor
Demeter, Elizabeth Richardson, Eric Young, Shelley Deeks, Troy
Herrick, Donna Reynolds, David Buckeridge, Matthew Hodge,
Christine Kennedy
22
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Supervision of MHSc Students: Jane Colonna, Walter Ewing, Bromwyn

Mears, Anthony Shardt, Catherine Whiting, Luba Wolchuk, Barbara
Stolz, Jennifer Bridge, Paul Alexander
Course Lectures: Canada's Health Care System, Health

Administration, Health Politics
Course Seminars: Cancer Epidemiology
Educational Activities (other)
1996 "Public Health and Environmental Health" (seminar)

Diploma Program in Environmental Health
McMaster University
Memberships:
Canadian Medical Association

Canadian Medical Protective Association
College of Physicians and Surgeons of Ontario
Ontario Medical Association
Medical Staff Association, York Central Hospital
Royal College of Physicians and Surgeons of Canada
23
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This is Exhibit “B” referred to in the Affidavit of Dr. Richard Schabas sworn March 11, 2022

Sam A. Presvelos
AR05697
RICHARD SCHABAS MD, MHSc, FRCPC
Presvelos Law LLP

Toronto, Ontario
M5H 3L5
Attention: Sam A. Presvelos
Dear Mr. Presvelos:
Re: Expert Report – Rickards et al. v. The Attorney General (Canada) et al.
Qualifications: Education and Experience
1. I am Richard Schabas. I was a practicing physician for 40 years. I have specialist
qualifications in both Internal Medicine and in Public Health. I also have a Master’s Degree
in epidemiology from the University of Toronto. Prior to my retirement, I practiced clinical
medicine as a general practitioner and then as a general internist, including hospital
appointments at Parry Sound District General Hospital, the Orthopedic and Arthritic Hospital
in Toronto, York Central Hospital and Campbellford Memorial Hospital. I practiced public
health for twenty-five years at a local (Easy York and Hastings Prince Edward County) and
provincial level, including serving as Ontario’s Chief Medical Officer of Health for ten years
from 1987-97. This was longer than anyone has held the position before or since.
2. I have worked in hospital management as Chief of Staff at York Central Hospital and was
directly involved in the 2003 SARS outbreak. I have held academic appointments at three
Ontario universities - University of Toronto, Waterloo University and Queen’s University. I
gave testimony at three Royal Commissions on public health issues - the Krever Commission
AR05698
on blood safety, the O’Connor Commission on Walkerton and the Campbell Commission on
SARS. A summary of my curriculum vitae is appended.
3. I have also contributed to 29 peer reviewed published papers – 14 as first or sole author. These
include publications that are directly relevant to SARS Covid-19 control including the
management of SARS in 2003123 and the role of quarantine in modern public health.4
4. In 2003 I was Chief of Staff at York Central Hospital, one of a handful of Toronto area
hospitals dealing with the SARS outbreak. This role gave me direct experience in managing
hospital capacity on the face of a novel respiratory virus, including the rapid mobilization of
an ICU surge capacity. Specifically, we created on short-notice a special care that eventually
provided care to more than 20 people with SARS, many of whom were severely ill. We had
no deaths on our SARS unit and there was no secondary transmission of infection there. This
experience also provided me with insights that contributed to the publications cited above.
Issues Considered
5. I have been asked to discuss the necessity and efficacy of public health measures that restrict
domestic and international travel, based on a traveler’s vaccination status, in order to control
the spread of Covid-19.
6. I will analyze these questions based on the evidence of effectiveness, the balance between the
plausible benefits and the harms of the intervention and reasonable alternatives.
Analysis and Discussion
1
Schabas R. SARS: prudence, not panic. CMAJ 2003 May 27;168(11):1432-4
2
Schabas R. Severe acute respiratory syndrome: Did quarantine help? Can J Infect Dis Med Microbiol. 2004
Jul;15(4):204.
3
Dwosh HA, Hong HH, Austgarden D, Herman S, Schabas R. Identification and containment of an outbreak of
SARS in a community hospital. CMAJ 2003 May 27;168(11):1415-20.
4
Schabas R. Is the Quarantine Act Relevant? CMAJ. 2007 Jun 19;176(13):1840-42.
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7. SARS Covid-19 emerged in 2020 as a novel respiratory virus that has caused a global outbreak.
The issues around SARS Covid-19 are complex and much of the science remains uncertain.
Canada has responded to SARS Covid-19 with a variety of restrictive measures and has
persisted with these restrictions notwithstanding a lack of compelling evidence to support their
continued use.
8. From a public health perspective, coercive public health measures can only be justified, even
to manage an extraordinary crisis, such as SARS Covid-19, if they are effective, demonstrably
do more good than harm for the population, and are as unobtrusive as possible to achieve their
intended effect.
9. Health is a state of complete physical, mental and social well-being and not merely the absence
of disease or infirmity.”5 A wholistic view of health has long been a cornerstone of public
health practice. Furthermore, public health practice should be rooted in the social determents
of health and consistent with social justice.6
10. For the past two years, public health in Canada has focused on controlling just one disease to
the detriment of many other diseases and other aspects and determinants of overall health.
People travel for many reasons - business, recreation and to see friends and family. For at least
some people in some circumstances, the freedom to travel is an important component of their
health and well-being.
11. Restrictions on travel cause harm and violate the principal of “first do no harm.”7 When a
public health intervention causes harm there is an onus to show persuasive evidence that the
intervention is both necessary and is effective. Furthermore, public health officials have a
5
World Health Organization. www.who.int FAQ.
6
Canadian Public Health Association. Public Health: a conceptual framework. March 2017
7
Hippocratic Oath. en.m.wikipedia.org.
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responsibility to take all reasonable measures to mitigate the harms from the intervention,
including using these measures for the shortest time possible.8
12. Restrictions on travel have been a component of the response to SARS Covid-19 from the
beginning of the pandemic. These restrictions have included, at various times, limiting border
access, quarantine, restrictions on inter and intra provincial travel as well as vaccine passports.
The intended purpose was to prevent the introduction of new cases into Canada, slow the
spread of new variants and protect travelers by reducing their exposure to infection.
13. These travel restrictions are based on little or no evidence, as I explain below, and are contrary
to the guidance of the World Health Organization on international travel during the pandemic.
They were and are an intuitive reaction. In particular, the current mandatory vaccine
requirement for travel is not an evidence-based approach to public health.
14. While SARS Covid-19 was a novel disease when it emerged in early 2020, global public health
had substantial experience dealing with analogous illnesses and had developed rational
evidence-based plans to deal with them. The scientific understanding gained from such
previous experiences ought to have been used to address the current pandemic.
15. Public health has dealt with influenza and influenza control for more than a century. There is
substantial scientific evidence about influenza, it’s transmission and the means of controlling
its transmission. When faced with a novel respiratory virus – SARS Covid-19 – with many
unknowns, public health should have made better use its knowledge and experience about
influenza.
16. While influenza is not the same as SARS Covid-19, these diseases share many similarities,
particularly related to the dynamics of transmission and, by analogy, the presumed
8
https://www.canada.ca/content/dam/phac-aspc/documents/services/reports-publications/canada-communicable-
disease-report-ccdr/monthly-issue/2018-44/ccdr-volume-44-1-january-4-2018/ccdr-rmtc-44-1-ar02-eng.pdf
AR05701
effectiveness of control measures. 910 Both these disease are respiratory viruses that spread
person-to-person by respiratory droplets (relatively large particles spread by coughing and
sneezing that can spread the infection by prolonged close contact with a symptomatic person)
and, in some circumstances, by aerosols) much smaller particles that can become airborne and
spread over a larger area).
17. Initially, SARS Covid-19 had an infectivity (put simply, a propensity to spread) similar to
pandemic influenza. However, SARS Covid-19 has evolved to become substantially more
infectious with emergence of the Delta Variant and now the Omicron Variant. Both infections
have relatively short incubation periods – which refers to the time between infection and the
development of symptoms. The Omicron Variant has an average incubation period of three
days, that is close to the two-day average incubation period for influenza. Both infections
cause predominantly mild illness with similar symptoms. Both have substantial proportion
infections that have no discernible symptoms (i.e. individuals who are asymptomatic or
paucisymptomatic). Both can cause severe illness, but this risk is predominantly concentrated
in the elderly or people with significant medical comorbidities.
18. The principal difference between influenza and SARS Covid-19 is that the latter was initially
more virulent, i.e., the risk of death, for example, was at least two to three times higher with
SARS Covid-19 than is expected from influenza. This has changed with time and the now
dominant Omicron Variant has a virulence that is lower than the original SARS Covid-19
disease and is closer to that of influenza, although still probably about two times higher in
unvaccinated people. Regardless, while the virulence of the infection may advise the urgency
9
https://en.wikipedia.org/wiki/Influenza
10
https://en.wikipedia.org/wiki/COVID-19#Transmission
AR05702
of intervention it does not, by itself, affect the underlying dynamics of viral transmission or
the utility of public healthinterventions to reduce transmission.
18. Put simply, until changed by strong new evidence specific to SARS Covid-19, such as
cluster-randomized trials, we should expect that non-pharmaceutical interventions that work
to reduce transmission for pandemic influenza will work for SARS Covid-19 and non-
pharmaceutical interventions that don’t work for pandemic influenza won’t work for SARS
Covid-19.
19. Canada’s plan for pandemic influenza10 took an appropriately wholistic approach to health by
embracing two overarching principles. First, to minimize the impact of death and illness, not
just death and illness from the pandemic infection. Second, to minimize the disruption of
normal life. Canada’s response to SARS Covid-19 did not embrace this wholistic perspective.
20. Canada also embraced “the use of established practices” as a guiding principle in its pandemic
response.11
21. There are important differences between the vaccines for influenza and for SARS Covid-19.
The vaccines for influenza are modestly effective at preventing serious illness and death
attributable to influenza but also reduce the risk of infection. In contrast, vaccines for SARS
Covid-19 are highly effective at preventing serious illness after infection but have little, and
after some time, no lasting impact lasting on infection rates and, by analogy, disease
transmission particularly with the Omicron Variant.
22. Prior to 2020, public health authorities in Canada and globally invested substantial resources
in establishing plans for an influenza pandemic. These were based on the substantial body of
evidence about the transmission of influenza that had been developed over more than fifty
11
https://www.canada.ca/content/dam/phac-aspc/documents/services/reports-publications/canada-communicable-
disease-report-ccdr/monthly-issue/2018-44/ccdr-volume-44-1-january-4-2018/ccdr-rmtc-44-1-ar02-eng.pdf
AR05703
years. Since it was clear from very early days that the dynamics of transmission of SARS
Covid-19 were fundamentally like those expected of pandemic influenza, public health should
have relied on these plans as a basis for its response to SARS Covid-19. Unfortunately, this
didn’t happen. Instead, in the panic of the early days of the SARS Covid-19 pandemic, public
health essentially ignored the extensive planning for pandemic influenza and adopted a range
of measures rejected by pandemic influenza plans, including those related to travel.
23. Over the ensuing two years, public health authorities have not made any serious effort to
generate new evidence to evaluate the effectiveness of the measures that were contrary to the
existing evidence - for example, quarantine and border closure, and modify them appropriately.
24. The World Health Organization in 2019 produced an excellent and timely review of the
evidence for non-pharmaceutical interventions 12 including travel restrictions, to control
epidemic (i.e., seasonal) and pandemic influenza. The relevant conclusions of this report as
they relate to the travel measures subsequently adopted by Canadian governments were as
follows.
25. “Travel advice”, intended to help “the public make informed decisions while travelling” was
recommended but only during “the early phase of pandemics”. According to the WHO, the
quality of the evidence for this measure was characterized as “none”. The report cautioned
that “travel advise that recommends public avoidance of travel or trade may have financial
consequences to the local and global economy.” The report said that “studies measuring the
effect of travel advice on influenza transmission would be welcome.” I am not aware of any
subsequent substantive evidence specific to SARS Covid-19 to change this assessment.
12
Global Influenza Program. Non-pharmaceutical public health measures for mitigating the risk and impact of
epidemic and pandemic influenza. World Health Organization 2019 ISBN 978-92-4-151683-9.
AR05704
26. “Entry and exit screening” of travelers was “not recommended”. The quality of the evidence
for this measure was characterized as “very low”. The WHO report observed “there were no
high-quality studies on the effectiveness of entry and exit screening. Studies on the best
approaches to screening travelers at different times, with different measures and for different
pathogens are required to understand the potential advantages of screening travelers.” I am not
aware of any subsequent substantive evidence specific to SARS Covid-19 to change these
conclusions.
27. “Internal travel restrictions” were “conditionally recommended” but only “during an early
stage of a localized and extraordinarily severe pandemic for a limited period of time”. It went
on to caution “it is important to consider cost-effectiveness, acceptability and feasibility, as
well as ethical and legal considerations in relation to this measure.” The quality of the evidence
for this measure was characterized as “very low”. The report observed that “studies to assess
the effectiveness of internal travel restrictions and the cost-effectiveness of this measure would
be valuable to inform decisions on its use and to identify potential barriers to its
implementation.” I am not aware of any subsequent substantive evidence specific to SARS
Covid-19 to change these conclusions or any studies taken by the Canadian government to
assess the effectiveness of internal travel restrictions.
28. “Border closure” was “not recommended”. The quality of the evidence for this measure was
characterized as “very low”. The low-quality evidence suggested “generally, only strict
borders closures are expected to be effective within small island nations.” I am not aware of
any subsequent substantive evidence specific to SARS Covid-19 to change these conclusions.
29. It is important to distinguish between quarantine and case isolation as public health measures.
These terms are often confused or used interchangeably. They are, in fact, quite different.
AR05705
Quarantine is the isolation of a person thought to have been exposed to and potentially
incubating an infection. Case isolation is the isolation of a person thought to be actively
infected, based on symptoms, laboratory tests or both. Some form of case isolation is standard
in the management of many infectious disease spread person-to-person. Quarantine has almost
no role whatsoever in the evidence-based practice of public health.4 Mass quarantine was used
in the management of the 2003 SARS outbreak at great cost and with essentially no benefit.1314
30. Quarantine of travelers was not even considered by the WHO report, presumably because it
was not regarded as a plausible policy for a rational government. The report did consider
“quarantine of exposed individuals” and concluded that this measure was “not recommended”.
The report characterized the quality of the evidence for this measure as “very low”. The report
cautioned that “there is no obvious rationale for this measure”. The report identified critical
weakness in the evidence, including the lack of randomized trials, the reliance on “simulation
studies” which did not rely fully on laboratory-confirmed influenza as the outcome of interest”.
These studies “require more robust evidence; for example, the symptomatic fraction among all
infection, the possibility of “super spreaders” and the nature of compliance behaviours.” I am
not aware of any subsequent substantive evidence specific to SARS Covid-19 to change these
conclusions.
31. Vaccines against SARS Covid-19 have been in widespread use for more than a year. These
vaccines have, as a group, been highly effective at preventing serious illness and death
resulting from infection with SARS Covid-19 however they have been considerably less
effective at preventing actual infection with SARS Covid-19. This has worsened over time
13 Schabas R. Severe acute respiratory syndrome: Did quarantine help? Can J Infect Dis Med Microbiol. 2004
Jul;15(4):204.
14
Dwosh HA, Hong HH, Austgarden D, Herman S, Schabas R. Identification and containment of an outbreak of
SARS in a community hospital. CMAJ 2003 May 27;168(11):1415-20.
AR05706
because of the increased infectivity of first Delta Variant and then Omicron Variant and
because the effectiveness of the vaccines wane with time. Current evidence suggests that a
two-dose vaccine regimen provides essentially no protection against infection with the now
dominant Omicron Variant.15
32. Canada enacted a policy of vaccine requirements for federally regulated transportation
employees and travelers in October 2021. Presumably the purpose of this policy was to reduce
the risk of transmission of infection on airplanes and trains, but this was not clearly stated other
than a general intent to keep people “safe and secure.”16 This policy has used a two-dose
standard as its vaccine requirement. There is now no basis to conclude that a person
immunized to this standard is less likely to be infected with SARS Covid-19 and less likely to
transmit the infection than a person who is not immunized.
33. In summary, Canada embraced and has persisted with a range of travel restrictions to control
SARS Covid-19 that are not evidence-based. Because it was a novel infection public health
authorities need to make decisions quickly in the absence of evidence specific to SARS Covid-
19. In this circumstance good public health and medical practice dictated that they should rely
on the best available evidence, which, in this case, is evidence about influenza control. This
did not happen.
34. The harms from restricting travel o those individuals who are unvaccinated, are obvious. The
benefits, if any, are uncertain. There is, therefore, no basis to conclude that these measures do
more good than harm or that unvaccinated travelers pose a greater risk of transmitting and
thereby infecting others with Covid-19, than travelers who are vaccinated.
15
https://www.medrxiv.org/content/10.1101/2021.12.30.21268565v1.full
16
https://www.canada.ca/en/transport-canada/news/2021/10/mandatory-covid-19-vaccination-requirements-for-
federally-regulated-transportation-employees-and-travellers.html
AR05707
35. The risk of contracting SARS Covid-19 during air travel is probably very low - “lower than
from an office building, classroom, supermarket, or commuter train.” 17 For example, by
November 2020 at a time almost a year into the SARS Covid-19 epidemic and before any
impact from immunization there had only been reports of about 42 episodes in total globally
of transmission between airplane passengers anywhere in the world.18 Considering that there
were about 10 million scheduled passenger flights during this period,19 the observed risk of
SARS Covid-19 transmission from air travel was trivially small.
36. There are many factors that may have contributed to this low risk associated with air travel.
These include the ventilation and filtration systems on airplanes; the screening of passengers
for symptoms and fever; and hygienic measures including surface cleaning and mandatory
masking. These measures are far less intrusive than travel measures that have been adopted in
Canada - quarantine, entry and exit screening, border closures, internal travel restrictions and,
most recently, the vaccine mandate.
37. Most transmission of SARS Covid-19 is by people with symptomatic infection - probably more
than 95%. A person with asymptomatic infection with SARS Covid-19 is far less likely - about
seven times less likely in one large meta-analysis of household transmission20 - to transmit
infection than a person with symptomatic illness. Presymptomatic transmission, i.e., during
the period of time immediately before the development of symptoms does occur but probably
accounts for about 15% of cases.21 In sum, this means that the vast majority - more than 80%
- of all transmissions of SARS Covid-19 is by people with active symptoms of infection.
17
https://jamanetwork.com/
18
19
https://www.canada.ca/en/transport-canada/news/2021/10/mandatory-covid-19-vaccination-requirements-for-
federally-regulated-transportation-employees-and-travellers.html
20
https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2783544
21
AR05708
38. Simple measures to exclude a person with symptomatic illness from SARS Covid-19 - by
symptom screening and fever checks - will do far more to reduce the risk of transmission on
an airplane or a train and are far less intrusive than the mandatory vaccine mandate.
39. A possible rationale for vaccine passports, although not explicitly stated by the government, is
that they serve the public good by increasing immunization generally. In other words, a person
who would not otherwise choose to be vaccinated will be vaccinated so that he or she can
travel. This would serve the public good not by reducing transmission during travel but
indirectly by reducing the risk that that person, if infected at any time, will require
hospitalization.
40. There are many possible unintended harms from, in effect, coercing people to be immunized.
These include recalcitrance and entrenchment, cognitive dissonance, stigma and scapegoating,
conspiracy theories and distrust, erosion of civil liberties, polarization and the anti-vax
movement, disunity in global health governance, disparity and inequality, reduced health
system capacity, exclusion from work and social life, erosion of informed consent, erosion of
trust in public health policy and erosion of trust in regulatory oversight.22
41. A critical question will these policies of using coercion to promote immunization - ultimately
increase vaccine uptake in Canada, is unanswered by any good evidence. I am concerned that
they will not. Canada has enjoyed high levels of public acceptance of vaccines by voluntary
means – persuasion not coercion. In my many years of practicing public health and clinical
medicine I have only rarely encountered entrenched vaccine resistance. Instead, give people
good information and give them a choice and the vast majority will accept immunization.
22
https://papers.ssrn.com/sol3/papers.cfm?abstract_id=4022798
AR05709
42. For example, I have been involved in enforcing Ontario’s Immunization of School Pupils Act,23
a law that has book in place for 40 years. Although it is popularly perceived as a mandatory
immunization law its effective implementation is dependent on persuasion and gentle pressure,
not coercion. The Act does not require that a child be immunized. To comply, a parent can
either produce a record of adequate immunization or a valid exemption – either medical or
philosophical. When asked to produce the required record, the vast majority of parents in
Ontario choose to immunize their children. Completion of a philosophical exemption is easy
and while the child can still be excluded from school during an outbreak of the disease that
they are not vaccinated against these events are very rare. In practical terms, most children
with philosophical exemption face no penalty under the Act. Regardless of this, rates of
exemptions – combining medical and philosophical – have hovered at around 2%24 for 40
years. In other words, notwithstanding an easy alternative to avoid vaccination, the vast
majority of parents opt for immunization. On this evidence, it is reasonable to conclude that
anti-vax sentiment is not strong in Canada
43. In contrast, Canada’s immunization uptake for SARS Covid-19 vaccines has been much less
– currently running at less that 85% - and seems to be stalled at this level. Undoubtedly, there
are many contributory factors, but I fear that for at least some people we have changed the
issue from immunization to the perception of “government overreach”. If so, we may well
find that the coercive approach to immunization - so anathema to Canada’s medical and public
health traditions - may undermine our effort to immunize the entire Canadian population.
23
24
https://www.publichealthontario.ca/-/media/Documents/I/2020/immunization-coverage-2018-19.pdf?sc_lang=en
12:37 PM Thu Mar 10 •••
AR05710
X Dr. Schabas Affidavit.pdf c!J
44. In summary, the Government of Canada responded to the SARS Covid-19 pandemic with
measures to restrict domestic and international travel that were not based on evidence and were
contrary to the basic principles of public health and to the Government's own plans for an
influenza pandemic - the most relevant precedent. These restrictions have a significant
negative impact on the well-being of Canadians. Subsequently, the Government has not
produced any substantive evidence of the effectiveness of these restrictions in controlling
SARS Covid-19. Restrictions based on a two-dose immunization regimen are particularly
egregious because they run counter to the evidence that shows this provides no protection
against infection. The Government's coercive approach to immunization has polarized
Canadians and locked-in opposition for a substantial minority.
Sincerely,
Richard Schabas MD, MHSc, FRCPC

AR05711
This is Exhibit “C” referred to in the Affidavit of Dr. Richard Schabas sworn March 11, 2022

Sam A. Presvelos
AR05712
LIST OF DOCUMENTS IN EXPERT REPORT OF DR. RICHARD SCHABAS
Schabas R. SARS: prudence, not panic. CMAJ 2003 May 27;168(11):1432-4
Schabas R. Severe acute respiratory syndrome: Did quarantine help? Can J Infect Dis Med
Microbiol. 2004 Jul;15(4):204
Dwosh HA, Hong HH, Austgarden D, Herman S, Schabas R. Identification and containment of
an outbreak of SARS in a community hospital. CMAJ 2003 May 27;168(11):1415-20
Schabas R. Is the Quarantine Act Relevant? CMAJ. 2007 Jun 19;176(13):1840-42
World Health Organization. www.who.int FAQ
Canadian Public Health Association. Public Health: a conceptual framework. March 2017
Hippocratic Oath. en.m.wikipedia.org
https://en.wikipedia.org/wiki/Influenza
https://en.wikipedia.org/wiki/COVID-19#Transmission
Canadian Pandemic Influenza Preparedness Planning Guidance for the Health Sector
https://www.canada.ca/content/dam/phac-aspc/documents/services/reports-publications/canada-
communicable-disease-report-ccdr/monthly-issue/2018-44/ccdr-volume-44-1-january-4-
2018/ccdr-rmtc-44-1-ar02-eng.pdf
Global Influenza Program. Non-pharmaceutical public health measures for mitigating the risk
and impact of epidemic and pandemic influenza. World Health Organization 2019 ISBN 978-
92-4-151683-9
https://www.canada.ca/en/transport-canada/news/2021/10/mandatory-covid-19-vaccination-
requirements-for-federally-regulated-transportation-employees-and-travellers.html
https://jamanetwork.com/ on 02/05/2022
https://www.faa.gov/air_traffic/by_the_numbers/
https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2783544
AR05713
https://www.ontario.ca/laws/statute/90i01
https://www.publichealthontario.ca/-/media/Documents/I/2020/immunization-coverage-2018-
19.pdf?sc_lang=en
AR05714
FEDERAL
COURT OF CANADA
AFFIDAVIT OF
DR. RICHARD SCHABAS
PRESVELOS LAW LLP

Toronto, Ontario
M5H 3L5

Tel:
Email:

Tel:
Email: e

AR05715
TAB 37
e-document T-168-22-ID 24
AR05716 F
I 1COURT
FEDERAL
D
É
L COUR FÉDÉRALE P
E O
D S
March 11, 2022 É
11 mars 2022
COURT FILE NO: T-168-22-ID-1

Kevin Lemieux
CAL 12
BETWEEN:

AND AEDAN MACDONALD
Applicants
-and-
THE MINISTER OF TRANSPORT and

THE ATTORNEY GENERAL OF CANADA
Respondents
APPLICATION UNDER ss. 18 and 18.1 of the Federal Courts Act, RSC 1985, c F-7 and
Rules 300(a) and 317 of the Federal Courts Rules, SOR/98-106
AFFIDAVIT OF DR. BYRAM W. BRIDLE
WILSON LAW OFFICE JUSTICE CENTRE FOR

Suite 195, 3-11 Bellerose Drive CONSTITUTIONAL FREEDOMS
St. Albert, AB T8N 5C9 #253, 7620 Elbow Drive SW
Calgary, AB T2V 1K2
Keith Wilson, Q.C. Allison Kindle Pejovic/Eva Chipiuk

Tel
Counsel for the Applicants

AR05717 2
AFFIDAVIT OF DR. BYRAM W. BRIDLE
I, Dr. Byram W. Bridle, of the City of Guelph, in the Province of Ontario, SWEAR
AND SAY THAT:
1. I have personal knowledge of the facts and matters hereinafter deposed to by me,
except where same are stated to be based upon information and belief, and those
I do verily believe to be true.
2. I am an Associate Professor of Viral Immunology in the Department of

Pathobiology at the University of Guelph. I have an MSc and Ph.D. in immunology
and completed a post-doctoral fellowship in viral immunology. I teach in several
courses at the undergraduate and graduate level on the topics of immunology,
virology, and cancer biology.
3. I am also a vaccinologist. Vaccinology is a sub-discipline of immunology in which

I have extensive expertise. My research program focuses on the development of
vaccines to prevent infectious diseases and treat cancers, as well as studying the
body’s immune responses to viruses. The overall aim of my research efforts is to
develop safe and effective new therapies for people.
4. With respect to COVID-19, I received funding from the Ontario government

(COVID-19 Rapid Research Fund, Ministry of Colleges and Universities) and
federal government (Pandemic Response Challenge Program, National Research
Council of Canada) to develop vaccines against COVID-19. The scope of this
COVID-19 ‘vaccine’ research is limited to the pre-clinical realm and is, realistically,
likely years away from being ready for testing in a clinical trial.
5. As a vaccinologist I teach the value of high-quality, well-validated vaccines that

have been robustly safety-tested for at least several years and promote their use.
I consider vaccines that have been developed on a foundation of sound science
to be an efficient type of medicine; they have cost-effectively saved many people
from sickness and/or death by preventing the transmission of potentially
AR05718 -3
dangerous pathogens. I have received all previously mandated vaccines

throughout my lifetime, plus non-mandated vaccines; so have my wife and my
children. However, I am concerned that the risk-benefit profile of SARS-CoV-2
'vaccines' currently being used in Canada does not yield a net benefit. As such,
mandating them is not appropriate. My scientific reasoning substantiated by the
peer-reviewed literature is contained within this report.
6. My qualifications are set out in the attached Curriculum Vitae (“CV”) and marked as
Exhibit “A” to this my Affidavit.
7. The Applicants’ counsel contacted me about providing expert opinion on:
1) The seriousness of SARS Co-v-2;

2) Whether COVID-19 is a pandemic of the unvaccinated;
3) The results of the COVID-19 vaccines’ clinical trials;
4) Whether vaccines that have been approved and distributed quickly have
caused injuries in the past;
5) Whether COVID-19 spreads in asymptomatic people;
6) Whether COVID-19 recovered people can spread COVID-19;
7) The seriousness of the COVID-19 variants;
8) Whether there are safety issues with the COVID-19 vaccines in general,
and for young people specifically;
9) Whether there are safety issues with the COVID-19 vaccines for pregnant
women or women of childbearing age;
10) Whether the vaccines are made with or derived from aborted foetal cells at
any stage of production;
11) Whether there is a way to prevent COVID-19; and,
12) Whether there are early treatment options for Covid-19 instead of relying on
the Covid-19 vaccines.
8. Here is a summary of some of my conclusions from my expert report:
1) The currently dominant Omicron variant, although highly infectious, does

not appear to be particularly dangerous for most people;
2) There are a disproportionate number of cases of infection with the Omicron
variant among ‘vaccinated’ individuals compared to those being defined as
‘unvaccinated;”
AR05719 -4
3) Pfizer’s published data from its 6 month follow up in the ongoing phase 2/3
clinical trial provided a risk-benefit analysis that suggested the COVID-19
vaccine should never have received regulatory authorization in Canada;
4) Asymptomatic transmission of SARS-CoV-2 is negligible;
5) Naturally acquired immunity against SARS-CoV-2 has been shown to be
both long-lasting and protective;
6) The current COVID-19 inoculations were designed to target the original
Wuhan strain of SARS-CoV-2. As such, they have little to no efficacy
against the substantially different Omicron variant;
7) Alberta Public Health’s own recent data derived directly from their website
shows that the COVID-19 inoculations proved to be ten times more
dangerous than the annual flu vaccine;
8) Pfizer has a massive list of “adverse events of special interest” which is
unusually long;
9) Serious adverse events from the COVID-19 vaccines were not identified
earlier because the time taken to assess safety was too short, and the
number of people that were evaluated in clinical trials was too small;
10) The spike protein from SARS-CoV-2 is a dangerous toxin when it gets into
the blood and is distributed throughout the body. The mRNA vaccines do
not stay in the shoulder muscle, they have the potential to spread far and
wide throughout the body via the blood. There is even greater potential for
damage to organs and tissues arising from circulating vaccine material;
11) The mRNA vaccines promote robust inflammation. Promotion of
inflammation in critical tissues, such as the ovaries, after being seeded with
the vaccine could have dire consequences that could affect fertility;
12) COVID-19 Vaccines may have the potential to cause long term
neurological disease;
13) AstraZeneca’s and Janssen’s vaccines were produced in the HEK 293 and
PER.C6 cell fetal cell lines, respectively. The HEK 293 and PER.C6 cell
lines were derived from aborted fetuses both Pfizer-BioNTech and
Moderna used the aborted fetus-derived HEK 293 cell line in the research
and development phase of their program;
AR05720 -5
14) Vaccines approved under rushed timelines have caused injuries in the
past, which is why 10-15 years represents a typical timeline to develop a
vaccine which has a favourable safety profile;
15) Vitamin D sufficiency is strongly associated with lower risk of developing
COVID-19, less severity of COVID-19, reduced hospital admissions, faster
recovery if admitted to a hospital, and, importantly, a reduced risk of
COVID19-induced death; and,
16) Early treatment options exist that represent reasonable alternatives to
COVID-19 vaccines.
9. Attached hereto and marked as Exhibit “B” to this my Affidavit is a copy of my

report which I adopt and sets out the information and assumptions on which my
opinion is based and a summary of my opinion.
10. Attached hereto and marked as Exhibit “C” to this my Affidavit is a list of
documents relied upon in preparing my expert report.
11. A copy of my Certificate Concerning the Code of Conduct for Expert Witnesses in
the Federal Court of Canada is attached to this my Affidavit as Exhibit “D”. Where
I have relied on a document or data in forming my opinion, I have set out the
citation to that document or data in the endnotes.
12. I confirm that I was not physically present before Henna Parmar, a lawyer and
Notary Public at the time of swearing this Affidavit. I was, however, linked to Ms.
Parmar utilizing videoconferencing software.
AR05721 6
13. I make this Affidavit bona fide and for no improper purpose.
SWORN REMOTELY by Byram W.

Bridle, of the City of Guelph, in the )
Province of Ontario, before me at the )
City of Brampton, in the Province of )
Ontario, this 11th day of March 2022 in )
~
r
t
accordance with O.Reg. 431/20 )
Administering Oath or Declaration )
Remotely ) DR. BYRAM W. BRIDLE
)
r
r
Barrister & Solicitor
AR05722 7
This is Exhibit “A” referred to in the Affidavit

of Dr. Byram W. Bridle sworn before me
virtually this 11 day of March, 2022.
r
f
________________________________
Barrister and Solicitor in the
Province on Ontario
AR05723 8
Canadian ~ commun
Common _.. canadien
Date Submitted: 2022-02-17 14:38:44

Confirmation Number: 1428493
Template: Full CV
Dr. Byram W. Bridle

Correspondence language: English
Sex: Male
Date of Birth: 12/02
Canadian Residency Status: Canadian Citizen
Country of Citizenship: Canada
Contact Information
The primary information is denoted by (*)
Address
Primary Affiliation (*)
Room #4834, Building #89
Department of Pathobiology
University of Guelph
50 Stone Road East
Guelph Ontario N1G 2W1
Canada
Telephone
Laboratory
Work (*)
Email
Work (*)
Website
Corporate https://ovc.uoguelph.ca/pathobiology/people/faculty/Byram-W-Bridle
i
Dr. Byram Bridle
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Canadian ~ commun
Common _.. canadien
Dr. Byram Bridle
Language Skills
Language Read Write Speak Understand Peer Review
English Yes Yes Yes Yes Yes
Degrees
2005/9 - 2011/12 Post-doctorate, Post-doctoral fellowship, Viral Immunology, McMaster University
Supervisors: Dr. Yonghong Wan, 2005/9 - 2011/12
Research Disciplines: Immunology, Virology
Areas of Research: Vaccine and Cancer, Immunotherapy, Vaccination, Virus, Auto-
Immune Diseases, Cerebral Tumors
Fields of Application: Biomedical Aspects of Human Health
2000/1 - 2005/10 Doctorate, Doctor of Philosophy, Immunology, University of Guelph
Thesis Title: Suppression and modulation of rat immune responses against porcine cells.
Supervisors: Dr. Bonnie A. Mallard, 2000/1 - 2005/10
Research Disciplines: Immunology
Areas of Research: Transplantation and Graft Rejection
1994/9 - 1997/4 Master's Thesis, Masters of Science, Immunology, University of Guelph
Thesis Title: The influence of age and strain on the peripheral blood lymphocytes of
commercially raised chickens.
Supervisors: Dr. Azad Kaushik, 1994/9 - 1997/4
Areas of Research: Immune System
Fields of Application: Pathogenesis and Treatment of Diseases
1990/9 - 1994/4 Bachelor's Honours, Bachelors of Science, Biomedical Sciences, University of Guelph
Credentials
2018/8 Awarded Tenure, University of Guelph
2018/1 Associate Professor, University of Guelph
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2012/1 - 2017/12 Assistant Professor, University of Guelph
Named to the Regular Graduate Faculty in the Department of Pathobiology by the Board
of Graduate Studies, University of Guelph.
Areas of Research: Vaccine and Cancer, Immunotherapy, Vaccination, Virus, Cerebral
Tumors, Leukemia, Lymphoma, Auto-Immune Diseases
Recognitions
2021/5 Recognized as an outstanding reviewer for the Canadian Institutes of Health Research
Canadian Institutes of Health Research
Distinction
CIHR’s Review Quality Assurance (RQA) Process recognizes outstanding contributions
to peer review. Through feedback and observations from Committee Chairs, Scientific
Officers and CIHR staff, the RQA process captures contributions that exemplify the very
best of peer reviewers. It is my pleasure to inform you that you are among a select group
of reviewers who have been identified through this process as an Outstanding reviewer in
recognition of your exemplary contribution to peer review for the Fall 2020 Project Grant
competition. Among the 1107 reviewers that participated in the competition, only 12.6%
obtained this recognition. On behalf of CIHR and the College of Reviewers, thank you for
your selfless generosity volunteering your time and expertise and for your commitment to
excellence in peer review. Your institution will be informed of your achievement as part of
the College of Reviewers’ Institution Activity Report planned to be sent to your institution’s
Vice-President.
2020/11 Invited to be a member of the Canadian Institutes of Health Research College of
Reviewers (Canadian dollar)
Honor
"On behalf of the Canadian Institutes of Health Research (CIHR), we are very pleased
to invite you to become a member of the College of Reviewers (College). This invitation
is made in recognition of your accomplished career, demonstrated track record of
excellence, and dedication to peer review."
2020/11 Identified as an outstanding reviewer for the Canadian Institutes of Health Research
Distinction
CIHR’s Review Quality Assurance (RQA) Process recognizes outstanding contributions
to peer review. Through feedback and observations from Committee Chairs, Scientific
Officers and CIHR staff, the RQA process captures contributions that exemplify the very
best of peer reviewers, such as providing reviews that exceeded expectations, completing
additional tasks on short notice, and participating constructively in discussions about
applications that were not assigned to them. It is my pleasure to inform you that you are
among a select group of reviewers who have been identified through this process as an
outstanding reviewer in recognition of your exemplary contribution to peer review during
the fall 2019 Project Grant competition. On behalf of CIHR, thank you for your selfless
generosity volunteering your time and expertise and for your commitment to excellence
in peer review. Feel free to inform the Vice-President of Research or equivalent at your
institution on this achievement.
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2020/4 Honourary class president of the Ontario Veterinary College's Doctor of Veterinary
Medicine class of 2023
Honor
Voted by class as professor of the year (for teaching immunology)
2020/3 Zoetis Award for Research Excellence - 1,000
Zoetis
Prize / Award
This award recognizes outstanding research effort and productivity.
2019/6 Donation made on behalf of my research program. - 25,000 (Canadian dollar)
Canadian Cancer Society Research Institute
Honor
Hawkesbury Regional Catholic High School, via the Relay for Life Youth program, donated
$25,000 to the Canadian Cancer Society in support of my research program.
2019/6 Donation made on behalf of my research program. - 75,000 (Canadian dollar)
Honor
The Arts and Science Undergraduate Society at Queen's University donated $75,000 to
the Canadian Cancer Society to support my research program.
2019/4 Monetary donation made in Dr. Bridle’s honour by the DVM class of 2020 to the Down
Syndrome Research Foundation.
Honor
Done in recognition of teaching excellence.
2018/7 Promotion to the position of Associate Professor
Distinction
Based on meritorious performance as an Assistant Professor, I was promoted to the
position of Associate Professor, effective July 1, 2018.
2017/12 Tenure
Distinction
Based on meritorious performance as an Assistant Professor, I was awarded tenure in
December 2017.
2015/6 Carl J. Norden Distinguished Teaching Award The highest teaching award given by each
North American Veterinary College; the recipient is chosen based on a vote of the second,
third and fourth year veterinary classes. - 1,000
Prize / Award
The highest teaching award given by each North American Veterinary College
2015/4 - 2018/3 Terry Fox Research Institute New Investigator Award - 449,587 (Canadian dollar)
Terry Fox Research Institute
Prize / Award
To provide outstanding young researchers with support as they develop their career
as independent research scientists or clinician scientists and to undertake high-quality
research into cancer in close collaboration with established research teams.
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2015/4 Was one of three nominees for honourary class president for the Doctor of Veterinary
Medicine class of 2018.
Honor
The honourary class president is voted by the students as the professor of the year.
2014/6 Junior Investigator Grant Panel Travel Award
Prize / Award
An travel award provided to successful applicants by the Canadian Cancer Society to
attend and observe a grant review panel meeting.
2014/4 Monetary donation made in Dr. Bridle’s honour by the DVM class of 2017 to the Guelph
Giants Special Hockey organization.
Honor
Done in recognition of teaching excellence.
2014/3 Honourary class president of the Ontario Veterinary College's Doctor of Veterinary
Medicine class of 2017
Honor
Voted by class as professor of the year (for teaching immunology).
2010/12 Next generation of cancer researchers
Ontario Institute for Cancer Research
Distinction
Featured in the Ontario Institute for Cancer Research 2010 annual report as one of the
“next generation of cancer researchers” that is a “rising star” that should be retained in
Ontario (see page 20 of report).
Areas of Research: Vaccine and Cancer
2010/10 Best oral presentation
McMaster University
Prize / Award
1st Annual McMaster University Faculty of Health Sciences Post-Doctoral Research Day
2009/3 Poster award
Prize / Award
Award for poster presented at the OICR annual scientific meeting.
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2009/2 Post-doctoral travel award - 1,500 (Canadian dollar)
5th International Meeting on Replicating Oncolytic Virus Therapeutics
Prize / Award
Travel award to attend the 5th International Meeting on Replicating Oncolytic Virus
Therapeutics.
Research Disciplines: Virology
2008/3 Poster award - 100 (Canadian dollar)
Prize / Award
Award for poster presented at the OICR annual scientific meeting.
Canadian Society for Immunology
Prize / Award
Canadian Society for Immunology Poster Award for scientific presentation at annual
scientific meeting.
2005/3 D.G. Ingram Travel Award - 400 (Canadian dollar)
Prize / Award
Travel award to attend the Canadian Society for Immunology annual scientific meeting.
Canadian Society for Immunology
Prize / Award
Canadian Society for Immunology poster award for presentation at annual scientific
meeting.
2005/3 Dr. J. Sherman Travel Award - 150 (Canadian dollar)
Prize / Award
Travel award to attend the Canadian Society for Immunology annual scientific meeting.
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2004/7 American Association of Veterinary Immunologists Travel Award - 1,000 (United States
dollar)
American Association of Veterinary Immunologists
Prize / Award
American Association of Veterinary Immunologists travel award to attend the International
Congress on Immunology.
2004/1 Graduate Student Recognition Award
Distinction
Elected by peers to receive the Ontario Veterinary College Graduate Student Recognition
Award for outstanding leadership and contributions.
2004/1 Ontario Veterinary College Travel Award - 500 (Canadian dollar)
Prize / Award
Ontario Veterinary College travel award to attend the International Congress of
Immunology.
2003/1 Graduate Student Recognition Award
Prize / Award
Elected by peers to receive the Ontario Veterinary College Graduate Student Recognition
Award for leadership and contributions.
2003/1 Dr. F. Schofield Korean-Canadian Scholarship - 2,000 (Canadian dollar)
Korean-Canadian Scholarship Association
Prize / Award
Established by the Dr. Schofield Memorial Association of Korean-Canadian, in partnership
with the Korean-Canadian Scholarship Association. The scholarship honours Dr. Frank
Schofield's active role in the Korean independence movement, as well as his academic
and medical contributions in the early 20th century. It is awarded annually to a student
who demonstrates scholarship and contributions to academic life.
2002/9 - 2002/12 University Graduate Scholarship - 500 (Canadian dollar)
Prize / Award
To recognize academic excellence.
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Prize / Award
2001/1 Ontario Veterinary College Travel Award - 500 (Canadian dollar)
Prize / Award
Travel award to attend the annual scientific meeting of the Canadian Society for
Immunology.
Prize / Award
Prize / Award
1990/9 University of Guelph Entrance Scholarship - 1,000 (Canadian dollar)
Prize / Award
Scholarship awarded for students entering their undergraduate program with an academic
average of >90% in secondary school.
1990/9 - 1994/4 Canada Scholarship - 8,000 (Canadian dollar)
Government of Canada
Prize / Award
Scholarship to support undergraduate-level university education. Only 1,250 of these
scholarships were awarded to men across Canada in 1990. Awarded based on academic
merit with semesterly renewal dependent on maintaining high academic standards.
1990/9 Wellington County Scholarship - 500 (Canadian dollar)
County of Wellington
Prize / Award
Awarded in recognition of academic excellence.
1990/9 Ontario Scholar
Ontario Government
Prize / Award
Awarded to students who maintained an academic average >80% throughout secondary
school.
User Profile
Researcher Status: Researcher
Research Career Start Date: 1994/09/06
Engaged in Clinical Research?: No
Key Theory / Methodology: My research crosses the disciplines of immunology and virology. There are two areas
of emphasis within my research program: one focuses on human health, the other on basic science. My health-
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related research is both pre-clinical and translational and aims to develop novel biotherapies for the treatment
of cancers. My basic program studies fundamental mechanisms of initiation and regulation of innate anti-viral
immunity, with an emphasis on identifying causes of aberrant cytokine storms.
Research Interests: In an effort to destroy malignant cells with minimal bystander damage to normal tissues,
I combine two approaches: 1. cancer immunotherapy, which directs the power of the immune system against
tumours and, 2. oncolytic virotherapy that utilizes viruses that replicate in and kill only cancerous cells. The
exquisite specificity and systemic targeting capability of these two approaches holds promise that some day
cancer patients might be effectively treated without the toxicities associated with many conventional therapies.
My extensive work with oncolytic viruses has also led to the discovery of a novel mechanism for the negative
regulation of complex cytokine networks. This has led to a keen interest in basic aspects of innate antiviral
immunity. In summary, my specific interests include: vaccines, oncolytic viruses, immunological tolerance,
autoimmunity (to kill cancerous but not normal self), tumour biology, host anti-viral response and antigen
presentation.
Research Experience Summary: I am an early-career faculty member, appointed Jan. 3, 2012, in the department
of Pathobiology, University of Guelph. Key milestones achieved to date include: 1. Establishing a new viral
immunology research program to develop effective new cancer biotherapies and to understand the regulation
of cytokine networks in response to viral infections. 2. Using my expertise to fuel local, provincial, national
and international collaborations. Research highlights as a post-doctoral fellow at McMaster University
inlcuded: 1. Discovering that histone deacetlyase inhibition can enhance an oncolytic booster vaccine while
abrogating autoimmune pathology. 2. Developing a novel method to synergize oncolytic virotherapy with cancer
immunotherapy. 3. Advancing the field of cancer vaccinology. As a PhD student I developed a strategy to use
oral tolerance to modulate host immunity to facilitate xenotransplantation. I also have significant management
experience from industry appointments.
Research Specialization Keywords: immunology, virology, treating cancers in the brain, type I interferon signaling,
type I interferon, vaccines, cancer, cytokines, regulation of cytokines, immunotherapy, viruses, flow cytometry
Disciplines Trained In: Immunology, Virology
Areas of Research: Immunotherapy, Vaccine and Cancer, Cerebral Tumors, Immune System, Vaccination, Virus
Fields of Application: Pathogenesis and Treatment of Diseases, Biomedical Aspects of Human Health
Employment
2018/1 Associate Professor
Pathobiology, Ontario Veterinary College, University of Guelph
Full-time, Associate Professor
Tenure Status: Tenure
I received tenure in December 2017 and was promoted to the position of Associate
Professor, effective July 1, 2018. I specialize in viral immunology and am responsible
for training highly qualified personnel, managing a research program, teaching
undergraduate, Doctor of Veterinary Medicine and graduate students, and providing
community service.
2017/10 Goalie Coach
Guelph Giants Special Needs Hockey Club (affil. with Special Hockey International and
Hockey Canada)
I am a volunteer coach. I teach children with special needs on the Guelph Giants junior
team how to play the goaltending position for ice hockey.
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2012/1 - 2017/12 Assistant Professor
Full-time, Assistant Professor
Tenure Status: Tenure Track
A tenure-track early career faculty position, specializing in viral immunology. Responsible
for training highly qualified personnel, managing a research program, teaching
undergraduate, Doctor of Veterinary Medicine and graduate students, and providing
community service.
Areas of Research: Vaccine and Cancer, Immunotherapy, Vaccination, Virus, Immune
Mediators: Cytokines and Chemokines, Auto-Immune Diseases, Cerebral Tumors,
Leukemia
2005/9 - 2011/12 Post-doctoral fellow
Pathology and Molecular Medicine, Medicine, McMaster University
Full-time
Tenure Status: Non Tenure Track
McMaster Immunology Research Centre, McMaster University Advisor: Dr. Yonghong
Wan Research: Developed expertise in the areas of cancer immunotherapy and oncolytic
viruses for the purpose of rationally designing novel vaccine strategies for treating
cancers and infectious diseases. Emphases: brain cancer, neuroimmunology, T and
B cell biology and a diverse array of research techniques and analytical methods.
Strategic collaborations: virologists, immunologists, nuclear imaging scientists who were
interested in using brain cancer models as imaging tools, mathematics department
(to model biological findings), McMaster Industry Liason Office (intellectual property
interests), University of Ottawa, Ontario Institute for Cancer Research. I also gained some
experience co-supervising graduate and undergraduate students.
Areas of Research: Vaccine and Cancer, Immunotherapy, Virus, Cerebral Tumors
2000/1 - 2005/10 Research Assistant
Full-time
PhD research project. Advisor: Dr. Bonnie Mallard Collaboration between the University
of Guelph and University of Western Ontario. Developed strategies to suppress and
modulate rat immune responses against porcine cells in support of xenotransplantation
research.
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1999/7 - 2000/12 Research Project Manager
Full-time
Managed a xenotransplantation research project that represented collaboration between
the Universities of Guelph, Western Ontario and Toronto and Imutran (former subsidiary of
Novartis) for the purpose of breeding transgenic pigs to be used as organ/tissue donors.
1999/1 - 1999/6 Quality Control Laboratory Technician
Microbiology Quality Control Laboratory, Schneider’s Meats, Ltd., Kitchener
Full-time
Quality control testing in a microbiology laboratory to monitor safety of meat products.
Research Disciplines: Microbiology
1997/5 - 1998/12 Research Project Manager
International Bio-Institute, Fergus, Ontario
Full-time
Obtained GLP (good laboratory practices) certification for research division. Managed
veterinary drug efficacy and safety pre-clinical trials for submissions to the Canadian
Bureau of Veterinary Drugs and the U.S.A. Food and Drug Administration. Also
established a small ELISA (enzyme-linked immunosorbent assay)-based diagnostic
laboratory.
Research Disciplines: Veterinary Sciences
Areas of Research: Infectious Diseases
1994/9 - 1997/4 Research Assistant
Full-time
MSc research project. Advisor: Dr. Azad Kaushik Characterized the influence of age and
strain on the peripheral blood lymphocytes of commercially raised chickens.
Areas of Research: Animal
1994/5 - 1994/8 Undergraduate Research Assistant
Full-time
Cloned and sequenced antibody variable region genes from lupus-prone mice in support
of an autoimmunity research project. Sequences were subsequently published. Advisor:
Dr. Azad Kaushik
Areas of Research: Antibodies, Auto-Immune Diseases
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1993/5 - 1993/8 Undergraduate Research Assistant
Food Science, Ontario Veterinary College, University of Guelph
Full-time
Studying the viscoelastic properties of acid milk gels using a nametre. Supervisor: Dr.
Arthur Hill
Research Disciplines: Biology and Related Sciences
Areas of Research: Nutriceuticals and Functional Foods
Fields of Application: Industrial Manufacturing and Production
Affiliations
The primary affiliation is denoted by (*)
(*) 2018/1 Associate Professor, Pathobiology, University of Guelph
2012/1 - 2017/12 Assistant Professor, Pathobiology, University of Guelph
A tenure-track early career faculty specializing in viral immunology. Responsible for
educating students, managing a research program that results in publishing independent
academic work in scholarly peer-reviewed journals and providing community service.
Leaves of Absence and Impact on Research

2021/1 - 2021/12 Sabbatical, University of Guelph
I was granted a research leave. This allowed me to focus on research-related activities,
including service to the research community during the declared COVID-19 pandemic. To
accomplish this, I was relieved of all teaching and local service activities for a period of
one year.
Research Funding History
Awarded [n=41]
2019/3 - 2024/2 Combined Anti-Angiogenic, Metronomic Chemotherapy, and Immunotherapy in the
Co-applicant Treatment of Advanced Stage Ovarian Cancer, Grant
Funding Sources:
2019/4 - 2024/3 Canadian Institutes of Health Research (CIHR)
Project Grant
Total Funding - 725,000 (Canadian dollar)
Portion of Funding Received - 100,000
Co-applicant : Jack Lawler; Sarah K. Wootton;
Principal Applicant : James J. Petrik
2021/9 - 2023/8 Oxidative Stress as a Mechanism Causing Off-Target Infections of T Cells with Oncolytic
Principal Investigator Viruses (student stipend support), Scholarship
Funding Sources:
2021/9 - 2023/8 Ontario Veterinary College (OVC)
Master's Scholarship
Principal Applicant : Sierra Vanderkamp
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2021/9 - 2023/8 Heat- and Cold-Adaptation of Oncolytic Rhabdoviruses to Improve Their Clinical Utility,
Principal Applicant Grant, Operating
2020/7 - 2023/6 Characterization of Innate Lymphoid Cells in Canine Blood, Grant
Co-applicant
Funding Sources:
OVC Pet Trust
Operating Grant
Total Funding - 16,100
Portion of Funding Received - 0
Co-applicant : Dr. Samuel Hocker;
Principal Investigator : Dr. Khalil Karimi
2020/7 - 2023/6 The use of SPECTRA OPTIA, Apheresis System from TERUMO, in Veterinary Medicine,
Co-applicant Grant
Funding Sources:
OVC Pet Trust
Equipment Grant
Principal Investigator : Dr. Alice Defarges
2020/9 - 2022/8 OVC MSc Scholarship, Scholarship
Principal Investigator
Funding Sources:
MSc Graduate Scholarship
Principal Applicant : Lily Chan
2020/9 - 2022/8 Advancing a Promising Infected Cancer Cell Vaccine Platform into the Translational
Principal Applicant Research Pipeline, Grant
Funding Sources:
Cancer Research Society (The)
Operating Grant
Co-applicant : Dr. Sarah K. Wootton
2017/7 - 2022/6 Vascular Normalization as a Mechanism to Increase Oncolytic Virus Spread and Efficacy
Co-applicant (a sub-project within a Program Project Grant that was awarded by the Terry Fox
Research Institute to the Canadian Oncolytic Virus Consortium [$7,396,160]), Grant
Funding Sources:
2017/7 - 2022/3 Terry Fox Research Institute (TFRI)
Program Project Grant
2020/3 - 2022/3 Developing Prophylactic Virus-Vectored Vaccines for COVID-19, Grant

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Principal Applicant Funding Sources:
Ontario Ministry of Colleges and Universities
COVID-19 Rapid Research Fund
Co-investigator : Dr. Leonardo Susta; Dr. Sarah K. Wootton
2019/3 - 2022/2 AAV Gene Therapy for the Treatment of Surfactant Protein B Deficiency, Grant
Co-applicant
Funding Sources:
Project Grant
Co-applicant : Bernard Thébaud; Martin Kang;
Collaborator : Jeffrey Whitsett; Laura van Lieshout; Lawrence Nogee;
Principal Applicant : Sarah K. Wootton
2020/12 - 2021/12 Translational Development of an Avian Orthoavulavirus-1-Vectored Vaccine for
Principal Investigator COVID-19, Grant
Funding Sources:
National Research Council Canada (NRC) (Ottawa, ON)
Pandemic Response Challenge Program
Co-investigator : Leonardo Susta; Sarah K. Wootton
2019/9 - 2021/8 Nora Cebotarev Memorial Graduate Scholarship (student stipend funding), Scholarship
Funding Sources:
2019/9 - 2021/8 University of Guelph
Nora Cebotarev Memorial Graduate Scholarship
Principal Applicant : Jessica Minott
2020/9 - 2021/8 Ontario Graduate Scholarship (student stipend funding), Scholarship
Funding Sources:
2020/9 - 2021/8 Ontario Ministry of Colleges and Universities
2021/5 - 2021/8 Andrea Leger Dunbar Summer Studentship (student salary funding), Scholarship
Funding Sources:
Andrea Leger Dunbar Summer Studentship
Principal Applicant : Christina Napoleoni
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2018/7 - 2021/6 Developing Biotherapies for the Treatment of Canine Cancers, Grant
Funding Sources:
2018/1 - 2022/12 Private Donation
private donation
Funding Competitive?: No
2018/6 - 2021/5 PD-1 Expression on Blood Leukocytes in Dogs with Bladder Cancer, Grant
Co-applicant
Funding Sources:
2018/4 - 2021/3 Pet Trust Fund (The)
Operating Grant
Co-applicant : Anthony Mutsaers;
Principal Applicant : Samuel Hocker
2018/1 - 2021/1 Oncolytic Viral Vaccine Therapy of Feline Mammary Carcinoma, Grant
Co-investigator
Funding Sources:
Operating Grant
Co-applicant : Michelle Oblak; Robert Foster;
Co-investigator : Geoffrey Wood;
Principal Applicant : J. Paul Woods
2020/3 - 2021/1 Developing Prophylactic Virus-Vectored Vaccines for COVID-19, Grant
Co-investigator
Funding Sources:
University of Guelph, Ontario Veterinary College and Department of
Pathobiology
Seed funding for COVID-19 research
Co-investigator : Dr. Sarah K. Wootton;
Principal Applicant : Dr. Leonardo Susta
2020/5 - 2020/8 NSERC Undergraduate Student Research Assistantship (student salary funding),
Principal Investigator Scholarship
Funding Sources:
2020/5 - 2020/8 Natural Sciences and Engineering Research Council of Canada
(NSERC)
Undergraduate Research Assistantship
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2018/9 - 2020/8 Treatment of Osteosarcoma Lung Metastases with an Infected Cancer Cell Vaccine, Grant
Principal Applicant
Funding Sources:
2018/9 - 2021/8 Cancer Research Society (The)
Operating Grant
CRS Operating Grant (jointly funded)
Co-applicant : Sarah K. Wootton
2018/9 - 2020/8 Combining Oncolytic Virotherapy and Epigenetic Modifiers to Treat Acute Leukemias,
Principal Applicant Grant
Funding Sources:
CCS-RI Innovation Grant (jointly funded)
2018/8 - 2021/7 Canadian Cancer Society Research Institute (CCSRI)
Innovation Grant
2017/9 - 2020/8 Enhancing Immunogenic Cancer Cell Death Through the Novel Combination of Oncolytic
Principal Investigator Viruses and Photodynamic Therapy (student stipend support), Scholarship
Funding Sources:
Vanier Scholarship
Principal Applicant : Ashley Ross;
Principal Investigator : Sarah Wootton
2020/5 - 2020/8 Andrea Leger Dunbar Summer Studentship (student salary funding), Scholarship
Funding Sources:
Andrea Leger Dunbar Summer Studentship
Principal Applicant : Kiersten Hanada
2019/9 - 2020/8 Ellen Nilsen Memorial Graduate Scholarship (student stipend funding), Scholarship
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Funding Sources:
Ellen Nilsen Memorial Graduate Scholarship
2018/9 - 2020/8 Combining Oncolytic Viruses with Epigenetic Modifiers to Treat Acute Myeloid Leukemias
Principal Investigator (student stipend support), Scholarship
Funding Sources:
Graduate Scholarship
Principal Applicant : Elaine Klafuric
2020/5 - 2020/8 BioCanRx Summer Studentship (student salary funding), Scholarship
Funding Sources:
2020/5 - 2020/8 National Centre of Excellence in Biotherapeutics for Cancer
Treatment
Summer Studentship
Funding Sources:
private donation
2017/7 - 2020/6 Synthesis of a Novel Oncolytic Newcastle Disease Virus to Support the Treatment of
Co-applicant Companion Animal Cancer Patients, Grant
Funding Sources:
Operating Grant
Co-applicant : Sarah Wootton;
Principal Applicant : Leonardo Susta
2018/1 - 2019/12 The Role of Interleukin-17-Producing Cells in the Pathophysiology of Canine Immune
Co-investigator Mediated Hemolytic Anemia, Grant
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Funding Sources:
Operating Grant
Co-investigator : Anthony Abrams-Ogg; Darren Wood; Dorothee Bienzle; Geoffrey Wood;
Principal Applicant : Shauna Blois
2019/5 - 2019/8 Undergraduate Research Assistantship (student salary funding), Scholarship
Funding Sources:
2017/9 - 2019/8 Vascular Normalization as a Mechanism to Increase Uptake and Efficacy of Oncolytic
Co-applicant Viruses and Vaccine-Induced Effector Cells for the Treatment of Advanced Stage Ovarian
Cancer, Grant
Funding Sources:
Operating Grant
Co-applicant : Sarah Wootton;
Principal Applicant : James Petrik
2018/9 - 2019/4 The Development of Recombinant Parapoxvirus ovis (OrfV) for Use in Oncolytic
Principal Investigator Virotherapy (student stipend support), Scholarship
Funding Sources:
2018/9 - 2019/4 Ontario Graduate Scholarship
Principal Applicant : Jacob van Vloten;
Principal Investigator : Sarah K. Wootton
2014/4 - 2019/3 Developing Novel Cancer Biotherapies: Infrastructure to Support Translational Research
Principal Applicant in Companion Animals, Grant
Funding Sources:
2014/4 - 2019/3 Ministry of Research and Innovation (MRI) (Ontario)
Ontario Research Fund - Research Infrastructure Program
2013/4 - 2019/3 Type I Interferon Receptor Signalling as a Master Switch for the Negative Regulation of
Principal Applicant Cytokine Networks, Grant
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Funding by Year:
2013/7 - 2018/6 Total Funding - 175,000
Time Commitment: 16
2015/4 - 2019/3 Development of Cutting-Edge Biotherapies for the Treatment of Cancers, Grant
Principal Applicant
Funding Sources:
2015/4 - 2018/3 Terry Fox Research Institute (TFRI)
New Investigator Award
Funding Sources:
private donation
Total Funding - 400 (Canadian dollar)
2016/1 - 2019/1 Construction and Validation of Viral-Vectored Vaccines to Induce Robust Tumour-Specific
Principal Applicant T Cell Responses in Dogs with Oral Melanomas, Grant
Funding Sources:
2016/1 - 2019/1 Pet Trust Foundation
Operating Grant
2016/7 - 2018/12 Accelerated Clinical Development of Synthetic Antibody Immuno-Modulators Through

Co-applicant Companion Animal Trials (the "total funding" represents the amount awarded to B. Bridle;
the award for both applicants was $708,893), Grant
Funding Sources:
Treatment (BioCanRx)
Enabling Grant
Principal Applicant : Jason Moffat
Funding Sources:
Principal Applicant : Jacob van Vloten;
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2015/9 - 2018/8 Art Rouse Cancer Biology Graduate Stipend (student stipend support), Scholarship
Funding Sources:
Art Rouse Cancer Biology Graduate Stipend
Principal Applicant : Robert Mould (PhD student)
2016/9 - 2018/8 Sex Disparity in Innate Immune Responses to Viral Infection: the Role of Type I Interferon
Funding Sources:
Graduate Tuition Scholarship
Principal Applicant : Katrina Allison (MSc student)
Completed [n=39]
2018/5 - 2018/8 Assessing the Impact of Sex Hormones on the Efficacy of Oncolytic Viruses ($8,000 for
Principal Investigator student salary support; $1,000 for operating funds), Scholarship
Funding Sources:
Ontario Veterinary College (OVC)
Andrea Leger Dunbar Summer Research Studentship
Co-investigator : Jessica Minott
2018/5 - 2018/8 Type I Interferon-Mediated Regulation of IL-17 Production by Mast Cells (student salary
Principal Investigator support), Scholarship
Funding Sources:
Natural Sciences and Engineering Research Council of Canada
(NSERC)
Undergraduate Student Research Assistantship
Principal Applicant : Elaine Klafuric
2018/5 - 2018/8 Combining Oncolytic Virotherapy with Epigenetic Modifiers to Treat Lymphomas (student
Principal Investigator salary support), Scholarship
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Funding Sources:
National Centre of Excellence in Biotherapeutics for Cancer
Summer Studentship
Principal Applicant : Samantha Holtz
2015/6 - 2018/4 Development of a Vaccine to Protect Against Toxoplasma gondii Infection in Sheep, Grant
Co-applicant
Funding Sources:
2015/6 - 2018/4 Ontario Ministry of Agriculture, Food and Rural Affairs (OMAFRA)
Tier I Operating Grant (Production Animal Systems)
Co-applicant : John Barta; Paula Menzies;
2017/5 - 2017/8 Assessing the Impact of an Acidic Tumour Microenvironment on the Efficacy of Oncolytic
Principal Investigator Viruses (student salary support), Scholarship
Funding Sources:
Natural Sciences and Engineering Research Council of Canada
(NSERC)
Principal Applicant : Julia Saturno
Funding Sources:
Highly Qualified Personnel PhD Scholarship
Principal Applicant : Jacob van Vloten (PhD student; co-advised);
2017/5 - 2017/8 Enhancing Dendritic Cell-Based Anti-Cancer Vaccines Through Adaptation to a Hypoxic
Principal Investigator Microenvironment (student salary support), Scholarship
Funding Sources:
National Centre of Excellence in Biotherapeutics for Cancer
Summer Studentship
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Principal Applicant : Mankerat Singh;
Principal Investigator : Khalil Karimi
2014/9 - 2017/8 Using Oncolytic Viruses to Potentiate Histone Deacetylase Inhibitor-Mediated Killing of
Principal Investigator Acute Lymphoblastic Leukemia B Bells (student stipend support), Scholarship
Funding Sources:
2014/9 - 2017/8 Ontario Veterinary College
PhD Scholarship
Principal Applicant : Megan Whaley (PhD student)
2016/9 - 2017/8 Augmentation of a Canine Melanoma Vaccine with Immunomodulatory Antibodies
Funding Sources:
Canada Graduate Scholarship - Master's
Principal Applicant : Wing Ka "Amanda" AuYeung (MSc student)
2016/9 - 2017/8 Support for Development of Novel Cancer Biotherapies, Grant
Co-applicant
Funding Sources:
2016/9 - 2016/12 Private donation
Private donation
Co-applicant : James Petrik;
Principal Applicant : Sarah Wootton
2014/6 - 2017/6 Assessment of Canine Melanoma Samples from the Ontario Veterinary College-
Principal Applicant Companion Animal Tumour Bank for Expression of Antigens that can be Targeted with an
Oncolytic Cancer Vaccine, Grant
Funding Sources:
Operating Grant
2016/1 - 2016/12 Support for Development of Novel Cancer Biotherapies, Grant

Co-applicant
Funding Sources:
Private donation
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Co-applicant : James Petrik;
Principal Applicant : Sarah Wootton
Funding Sources:
OVC Pet Trust Scholar Program
Principal Applicant : Wing Ka "Amanda" Au Yeung (MSc student)
2016/5 - 2016/8 Evaluating the Impact of Oxygen Level, Temperature and pH on the Oncolytic Potential of
Principal Applicant Viruses and Epigenetic Modifiers in Canine Osteosarcoma Cells (student salary support),
Scholarship
Funding Sources:
2016/5 - 2016/8 Zoetis Canada
Summer Student Research Fund
Co-applicant : Manali Desai (summer research assistant)
2016/5 - 2016/8 Type I Interferon Signalling as a Master Switch for the Negative Regulation of a Broad
Principal Investigator Array of Cytokines (student salary support), Scholarship
Funding Sources:
(NSERC)
Undergraduate Student Research Award
Principal Applicant : Katrina Allison (summer research assistant)
2016/5 - 2016/8 Temperature as a Confounding Variable in Oncolytic Virotherapy for Canine Melanomas
Principal Applicant (student salary support), Scholarship
Funding Sources:
2016/5 - 2016/8 Merial
Summer Research Assistantship
Co-applicant : Julia Saturno (summer research assistant)
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Funding Sources:
(NSERC)
2014/9 - 2016/8 Evaluation of Adjunct Oncolytic Immunotherapy in a Canine Lymphoma Clinical Trial,
Funding Sources:
Operating Grant
Co-applicant : J. Paul Woods
2014/8 - 2016/6 Oncolytic Viral Vaccine Therapy of Breast Carcinoma, Grant
Co-applicant
Funding Sources:
2014/6 - 2016/5 Canadian Breast Cancer Foundation (CBCF)
Research Project Grant Program
Co-applicant : J. Paul Woods;
Principal Applicant : Brian D. Lichty
2015/7 - 2016/6 Accelerated Clinical Development of Synthetic Antibody Immuno-Modulators Through
Co-applicant Companion Animal Trials, Grant
Funding Sources:
Enabling Grant
Principal Applicant : Jason Moffat
Funding Sources:
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2013/9 - 2015/8 The Role of Type I Interferon Receptor-Mediated Signaling in the Regulation of Cytokines
Principal Investigator Produced by Dendritic Cells (student stipend support), Scholarship
Funding Sources:
Ontario Veterinary College MSc Fellowship
Funding by Year:
2013/9 - 2015/8 Total Funding - 30,000
Time Commitment: 0
Principal Applicant : Alexandra Rasiuk (MSc student)
2015/5 - 2015/8 Transient Lymphopenia as a Mechanism to Allow an Oncolytic Virus to Replicate Inside
Principal Applicant a Tumour Despite Vaccination Against a Virus-Encoded Antigen (student salary support),
Scholarship
Funding Sources:
(NSERC)
Co-applicant : Wing Ka "Amanda" Au Yeung (summer student)
2014/9 - 2015/8 Using Virus-Infected Dendritic Cells as Cancer Vaccines (student stipend support),
Funding Sources:
Graduate Research Assistant Tuition Supplement
Principal Applicant : Robert Mould (MSc student)
2015/5 - 2015/8 Assessment of the Potential to Treat Canine Cancers with an Oncolytic Vaccine (student
Principal Applicant salary support), Scholarship
Funding Sources:
2015/5 - 2015/8 Zoetis Canada
Zoetis Summer Student Research Fund
Co-applicant : Julia Kim (summer student)
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2014/8 - 2015/7 Replacement of a Core Facility's Heavily-Used, 22-Year-Old Analytical Flow Cytometer for
Principal Applicant Which Parts and Service are no Longer Guaranteed, Grant
Funding Sources:
(NSERC)
Research Tools and Infrastructure
Co-applicant : Brandon Plattner; Dorothee Bienzle
2013/7 - 2015/6 In Vitro Efficacy Testing of Oncolytic Viruses, Grant
Principal Applicant
Funding Sources:
Private donation
2012/6 - 2015/5 Assessment of the Potential to Treat Canine Lymphoma with an Oncolytic Vaccine, Grant,
Principal Investigator Operating
Project Description: We have published a strategy to synergize immunotherapy and
oncolytic virotherapy, leading to durable cures in mouse models of cancer. To translate
our success into a future canine lymphoma clinical trial, we must conduct preliminary
studies to demonstrate safety and efficacy. This proposal has four aims: 1. prove that
oncolytic immunotherapy is safe in dogs, 2. show that robust tumour-specific immune
responses can be induced, 3. confirm expression of the targeted tumour antigen on canine
lymphomas, and 4. show that effector mechanisms mediated by the treatment can kill
lymphoma cells. This will provide the scientific rationale for a future clinical dog lymphoma
trial. It will also allow us to get a permit for field testing from the Canadian Food Inspection
Agency (CFIA), which is required before clinical testing of oncolytic viruses in pets.
Research Uptake: The goal of this research is to translate the findings into a clinical
veterinary trial in which dogs with lymphoma will be treated. This will serve two purposes.
It will provide a direct, practical benefit to pet owners and will serve as an intermediate
animal model in support of a broad collaborative effort to test oncolytic vaccines in human
clinical trials. Findings from these studies will also be disseminated via submission for
publication in peer-reviewed journals.
Research Uptake Stakeholders: Academic Personnel
Research Settings: Canada (Urban)
Funding Sources:
Operating Grant
Portion of Funding Received - 100 (Canadian dollar)
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Dr. Byram Bridle
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Funding by Year:
2012/9 - 2013/8 Total Funding - 45,016 (Canadian dollar)
Portion of Funding Received - 100 (Canadian dollar)
Time Commitment: 6
Areas of Research: Vaccine and Cancer, Immunotherapy
Co-investigator : Dr. J. Paul Woods
2014/9 - 2015/4 Testing the Efficacy of Cancer Therapeutics in Ovarian and Mammary Carcinoma Cells
Principal Applicant (student salary support), Scholarship
Funding Sources:
Work-Study
Co-applicant : Wing Ka "Amanda" Au Yeung (undergraduate student)
2012/9 - 2014/8 Characterizing a Novel Immunoevasion Strategy for Brain Cancer and How to Circumvent
Principal Investigator It (student stipend support), Scholarship
Funding Sources:
Ontario Veterinary College MSc Scholarship
Funding by Year:
2012/9 - 2014/8 Total Funding - 30,000
Time Commitment: 0
Principal Applicant : Zafir Syed (MSc student)
2014/5 - 2014/8 Evaluation of an Oncolytic Vaccine in Dogs (student salary support), Scholarship
Principal Applicant
Funding Sources:
(NSERC)
Co-applicant : Larissa Hattin (summer student)
2012/9 - 2014/8 Combining Histone Deacetylase Inhibition and Transient, Virus-Induced Lymphopenia to
Principal Applicant Treat Leukemia (student stipend support), Scholarship
26
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Funding Sources:
Ontario Veterinary College MSc Scholarship
Funding by Year:
2012/9 - 2014/8 Total Funding - 30,000
Time Commitment: 0
Principal Applicant : Christian Ternamian (MSc student)
2013/6 - 2014/5 Upgrade to State-of-the-Art Flow Cytometric Equipment, Grant
Co-applicant
Funding Sources:
(NSERC)
Research Tools and Instruments Grant
Funding by Year:
2013/6 - 2015/5 Total Funding - 148,230
Time Commitment: 7
Co-applicant : Dr. Dorothee Bienzle;
Principal Applicant : Dr. Brandon Plattner
2013/5 - 2014/4 Development of an Immune Response Monitoring Facility to Support Clinical Testing of
Principal Applicant Novel Cancer Biotherapies in Companion Animals, Grant
Funding Sources:
2013/5 - 2014/4 The Smiling Blue Skies Cancer Fund
Donation
Funding by Year:
2013/5 - 2014/4 Total Funding - 14,554
Time Commitment: 3
2013/9 - 2014/4 Evaluating the Role of Akt Isoforms in the Sensitivity of Lung Cancer Cells to Oncolytic
Principal Applicant Viruses (student salary support), Scholarship
Funding Sources:
Work-Study
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Co-applicant : Wing Ka "Amanda" Au Yeung (undergraduate student)
2012/5 - 2013/8 Using an Innate Anti-Viral Immune Response in the Presence of a Histone Deactylase
Principal Applicant Inhibitor to Treat Leukemias (student salary support), Scholarship
Funding Sources:
2012/5 - 2012/8 Canadian Society for Immunology
Summer Internship in Immunology
Funding by Year:
2012/5 - 2012/8 Total Funding - 2,400
Time Commitment: 0
Co-applicant : Evan Lusty (summer student)
2013/5 - 2013/8 Development of Flow Cytometry-Based Immunological Assays to Support Pre-Clinical and
Principal Applicant Clinical Companion Animal Cancer Trials (student salary support), Scholarship
Funding Sources:
Undergraduate Research Assistant
Funding by Year:
2013/5 - 2013/8 Total Funding - 6,600
Time Commitment: 0
Co-applicant : Wing Ka "Amanda" Au Yeung (summer student)
2012/9 - 2013/4 Testing the Efficacy of Cancer Therapeutics in Prostate Cancer Cell Lines (student salary
Principal Applicant support), Scholarship
Funding Sources:
Work-Study
Co-applicant : Jason Morgenstern (undergraduate student)
2012/5 - 2012/8 Establishment of Leukemia/Lymphoma Cell Lines from Clinical Specimens and Evaluation
Principal Applicant of Their Susceptibility to Oncolytic Viruses (student salary support), Scholarship
Funding Sources:
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Funding by Year:
2012/5 - 2012/8 Total Funding - 6,000
Time Commitment: 0
Co-applicant : Jason Morgenstern (summer student)
Declined [n=6]
Principal Investigator Viruses and Photodynamic Therapy (student stipend support), Scholarship
Funding Sources:
2017/9 - 2020/8 Ontario Government
Ontario Graduate Scholarship
Co-applicant Viruses and Photodynamic Therapy (student stipend support), Scholarship
Funding Sources:
Doctoral Scholarship
Co-applicant Virotherapy (student stipend support; declined due to receipt of external scholarships),
Scholarship
Funding Sources:
Ontario Veterinary College (OVC)
Co-applicant : Sarah K. Wootton;
Principal Applicant : Jacob van Vloten
Co-applicant (student stipend support), Scholarship
29
Dr. Byram Bridle
AR05753 38
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Funding Sources:
OVC Pet Trust Scholar Program
Principal Applicant : Wing Ka "Amanda" AuYeung (MSc student)
Funding Sources:
2015/9 - 2016/8 Using Virus-Infected Dendritic Cells as Cancer Vaccines (student stipend support),
Funding Sources:
Graduate Research Assistant Tuition Supplement
Principal Applicant : Robert Mould (MSc student; transferred to PhD)
Under Review [n=5]

2021/6 - 2026/5 Calming the Storm: Interventions to Abrogate Toxic Cytokine Responses to Viruses, Grant
Principal Applicant
Funding Sources:
Co-applicant : Khalil Karimi; Leonardo Susta; Sarah K. Wootton
2021/6 - 2026/5 AAV-vectored immunoprophylaxis for the prevention and treatment of infectious diseases,
Co-applicant Grant
Funding Sources:
Co-applicant : Darwyn Kobasa; Kevin Stinson; Leonardo Susta; Rob Kozak;
2021/9 - 2023/8 Mechanism of Oncolytic ORFV-Activated Innate and Adaptive Anti-Tumor Immunity in a
Co-investigator Preclinical Model of Late-Stage Ovarian Cancer, Grant
30
Dr. Byram Bridle
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Funding Sources:
Operating Grant
2021/9 - 2023/8 Heat- and Cold-Adaptation of Oncolytic Rhabdoviruses to Improve Their Clinical Utility,
Funding Sources:
Operating Grant
2020/11 - 2021/10 Translational Development of an Avian Orthoavulavirus-1-Vectored Vaccine for

Principal Applicant COVID-19, Grant
Funding Sources:
National Research Council Canada (NRC) (Ottawa, ON)
Collaborative R&D Initiative Pandemic Response Challenge
Program Grant Application
Co-investigator : Dr. Leonardo Susta; Dr. Sarah K. Wootton;
Collaborator : Dr. Andrew Winterborn; Dr. Anh Tran
Student/Postdoctoral Supervision
Bachelor’s [n=1]
2020/9 - 2021/4 Julia Kakish, University of Guelph
Principal Supervisor Thesis/Project Title: Cold-Adaptation of Viruses for Use as Vaccine Vectors
(undergraduate research project student)
Present Position: Currently a member of my research team
Bachelor’s Equivalent [n=10]

2020/5 - 2020/8 Lily Chan, University of Guelph
Principal Supervisor Thesis/Project Title: Calming the Storm: Dissecting the Roles of Innate Lymphoid Cells
in Cytokine-Mediated Pulmonary Inflammation Induced by Oncolytic Vesicular Stomatitis
Virus (undergraduate summer research assistant)
Present Position: Currently a MSc student in my laboratory, University of Guelph
2020/5 - 2020/8 Kiersten Hanada (In Progress) , University of Guelph
Principal Supervisor Thesis/Project Title: Calming the Cytokine Storm: Developing a Model to Study Toxic
Cytokine Responses to Viruses (undergraduate summer research assistant)
Present Position: Completing the DVM program, University of Guelph
31
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2018/5 - 2018/8 Samantha Holtz (Completed) , University of Guelph
Student Degree Received Date: 2018/8
Thesis/Project Title: Combining Oncolytic Virotherapy with Epigenetic Modifiers to Treat
Lymphomas (undergraduate summer research assistant)
Present Position: Completed a post-graduate diploma program., Queen's University
2017/5 - 2017/8 Julia Saturno (Completed) , University of Guelph
Thesis/Project Title: Pyrexia Can Impair Oncolytic Virotherapy (summer research
assistantship)
Project Description: This student conducted research in my laboratory for the summer of
2017, while enrolled in the doctor of veterinary medicine program, University of Guelph.
Project title: Temperature as a confounding variable in oncolytic virotherapy for canine
melanomas.
Present Position: veterinary practice
2016/5 - 2016/8 Manali Desai (Completed) , University of Guelph
Thesis/Project Title: Evaluating the Impact of Temperature on the Oncolytic Potential of
Viruses in Canine and Murine Osteosarcoma Cells (summer research assistantship)
Project Description: Studied the efficacy of oncolytic viruses in a panel of canine and
murine osteosarcoma cell lines.
2016/5 - 2016/8 Julia De Carvalho Nakamura (Completed) , University of Sao Paulo, Brazil
Thesis/Project Title: The Impact of Temperature on the Oncolytic Activity of Viruses
(summer research assistantship)
Project Description: Participated in Students Without Borders Program, May-September
2016; conducted research in my laboratory stydying the effect of high and low
temperatures on oncolytic viruses.
Present Position: Veterinary practice, Sao Paulo, Brazil
2016/5 - 2016/8 Julia Saturno (Completed) , University of Guelph
Thesis/Project Title: Temperature as a Confounding Variable in Oncolytic Virotherapy for
Canine Melanomas (summer research assistantship)
Project Description: Studied the efficacy of oncolytic viruses in a panel of canine
melanoma cell lines.
2015/5 - 2015/8 Haley Spangler-Forgione (Completed) , University of Guelph
Thesis/Project Title: Par6 Influences the Susceptibility of Mammary Carcinoma Cells to
Oncolytic Viruses (summer research assistantship)
Project Description: Title of project: Par6 influences the susceptibility of mammary
carcinoma cells to oncolytic viruses
Present Position: Veterinary practice
32
Dr. Byram Bridle
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2015/5 - 2015/8 Julia Kim (Completed) , University of Guelph
Thesis/Project Title: Assessment of the Potential to Treat Canine Cancers with an
Oncolytic Vaccine (summer research assistantship)
Project Description: Undergraduate summer research assistant, May - August 2014.
Project: Used western blotting to assess canine osteosarcoma, melanoma and lymphoma
specimens for the expression of various tumour-associated antigens. The results will
guide the development of novel viral vectors to be used in a future canine cancer trial.
Present Position: Graduate student, Department of Population Medicine, University of
Guelph
2014/5 - 2014/8 Julia Kim (Completed) , University of Guelph
Thesis/Project Title: Assessment of Canine Melanoma Samples from the Ontario
Veterinary College-Companion Animal Tumour Bank for Expression of Antigens that can
be Targeted with an Oncolytic Cancer Vaccine (summer research assistantship)
Project Description: Undergraduate summer research assistant, May - August 2015.
Project: Assessment of the potential to treat canine cancers with an oncolytic vaccine.
Present Position: Graduate student, Department of Population Medicine, University of
Guelph
Bachelor’s Honours [n=22]

2020/9 - 2021/4 Sierra Vanderkamp, University of Guelph
Principal Supervisor Thesis/Project Title: Evaluating the Role of Oxidative Stress in Off-Target Infections of T
Cells by Oncolytic Rhabdoviruses (undergraduate research project student)
2018/9 - 2019/4 Jessica Minott (Completed) , University of Guelph
Principal Supervisor Thesis/Project Title: Assessing the Impact of Sex Hormones on the Efficacy of Oncolytic
Viruses (4th year undergraduate research project student)
2018/5 - 2018/8 Jessica Minott (Completed) , University of Guelph
Principal Supervisor Thesis/Project Title: Assessing the Impact of Sex Hormones on the Efficacy of Oncolytic
Viruses (undergraduate summer research assistant)
2018/5 - 2018/8 Elaine Klafuric (Completed) , University of Guelph
Principal Supervisor Thesis/Project Title: Type I Interferon-Mediated Regulation of IL-17 Production by Mast
Cells (undergraduate summer research assistant)
Present Position: Currently a MSc student in my laboratory
2017/5 - 2017/8 Mankerat Singh (Completed) , University of Guelph
Thesis/Project Title: Optimizing the Antigen Presentation Potential of Cultured Dendritic
Cells Through the Use of Interleukin-4 (summer research assistantship)
Project Description: Mankerat complete his Honour's BSc program in April 2017 and then
conducted a research project under my supervision for the summer 2017. Project title:
Enhancing dendritic cell-based anti-cancer vaccines through adaptation to a hypoxic
microenvironment.
Present Position: unknown
33
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2016/9 - 2017/4 Mankerat Singh (Completed) , University of Guelph
Thesis/Project Title: Optimizing a Dendritic Cell-Based Vaccine for Induction of
Immunological Memory (4th year undergraduate research project)
Project Description: Mankerat conducted research in my laboratory for two semesters
as an undergraduate student enrolled in the course HK*4371/2 (Research in Human
Biology and Nutritional Sciences). His project was entitled: Differentiating dendritic cells
in the presence of interleukin-4 to enhance their potential as vaccines. He subsequently
presented this work at the Summit for Cancer Immunotherapy, Gatineau, QC, in June
2017, where he received the only undergraduate award for best poster.
2016/5 - 2016/9 Katrina Allison (Completed) , University of Guelph
Thesis/Project Title: Sex Disparity in Innate Immune Responses to Viral Infection: the Role
of Type I Interferon
Project Description: Undergraduate summer research assistant in my laboratory; May-
August 2016. Studied gender bias in the role of type I interferon signalling on the cytokine
response to viral infection.
Present Position: Naturopathic Medicine College Training Program (Toronto, Ontario)
2015/5 - 2015/8 Wing Ka "Amanda" AuYeung (Completed) , University of Guelph
Thesis/Project Title: Transient Lymphopeniaas a Mechanism to Allow an Oncolytic Virus to
Replicate Inside a Tumour Despite Vaccination Against a Virus-Encoded Antigen (NSERC
Undergraduate Student Research Assistantship)
Project Description: Undergraduate summer research assistant, May-August 2015.
Project: Transient lymphopenia as a mechanism to allow an oncolytic virus to replicate
inside a tumour despite vaccination against a virus-encoded antigen
Present Position: Flow Cytometry Technician, The Hospital for Sick Children, Toronto,
Ontario, Canada
2014/5 - 2014/9 Larissa Hattin (Completed) , University of Guelph
Thesis/Project Title: Evaluation of an Oncolytic Vaccine in Dogs (NSERC Undergraduate
Student Research Assistantship)
Project Description: Assessed the oncolytic potential of a recombinant Newcastle disease
virus in human prostate cancer cell lines.
Present Position: Emergency medicine residency program, University of British Columbia
2014/5 - 2014/8 Robert Mould (Completed) , University of Guelph
Thesis/Project Title: Combining Antigen-Presenting Cell-Based Vaccination with Oncolytic
Viruses for the Treatment of Prostate Cancers (summer research assistantship)
Project: The potential to use Orf virus and Newcastle disease virus-infected dendritic cells
and/or macrophages as cancer vaccines.
Present Position: Postdoctoral fellow in my laboratory, University of Guelph
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2013/9 - 2014/4 Larissa Hattin (Completed) , University of Guelph
Thesis/Project Title: Testing the Oncolytic Potential of Two Recombinant Newcastle
Disease Viruses in Human Prostate Cancer Cell Lines (summer research assistantship)
Project Description: Sept. 2013-April 2014: Larissa conducted her 4th-year undergraduate
research project (Course codes: BIOM*4521 [Fall semester] and BIOM*4522 [Spring
semester]) in my laboratory. Project title: Testing the oncolytic potential of a novel
recombinant Newcastle Disease Virus in human prostate cancer cell lines. She continued
this project as a summer undergraduate research assistant, May-August 2014
Present Position: Emergency medicine residency program, University of British Columbia
Thesis/Project Title: Evaluating the Role ofAkt Isoforms in the Sensitivity of Lung Cancer
Cells to Oncolytic Viruses (Work-Study Program; part-time research while pursuing full-
time undergraduate studies)
Project: Development of flow cytometry-based immunological assays to support pre-
clinical and clinical companion animal cancer trials.
Ontario, Canada
2013/9 - 2014/4 Sofia Oke (Completed) , University of Guelph
Thesis/Project Title: Determining Whether TLR3 and/or TLR7 Ligation Causes
Dysregulation of Cytokine Signaling in Macrophages Lacking the Type I Interferon
Receptor (summer research assistantship)
Project Description: Sofia conducted her 4th-year undergraduate research project (Course
codes: BIOM*4521 [Fall semester] and BIOM*4522 [Spring semester]) in my laboratory,
September 2013-April 2014. Project: Determining whether TLR3 and/or TLR7 ligation
causes dysregulation of cytokine signaling in dendritic cells lacking the type I interferon
receptor.
Present Position: Research technician (Dr. Sachdev Sidhu's lab, University of Toronto)
2013/9 - 2015/8 Alexandra Rasiuk (Completed) , University of Guelph
Thesis/Project Title: The Role of Type I Interferon Signalling in the Regulation of Cytokines
Produced by Antigen-Presenting Cells (4th year undergraduate research project)
Project Description: Undergraduate research project course (BIOM*4521 and
BIOM*4522), Sept. 2012 - August 2013. Project: Studying the role of type I interferon
receptor-mediated signaling in the regulation of cytokines produced by dendritic cells.
Present Position: Research associate in industry
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Thesis/Project Title: Development of Flow Cytometry-Based Immunological Assays
to Support Pre-Clinical and Clinical Companion Animal Cancer Trials (NSERC
Undergraduate Student Research Assistantship)
Project Description: Part-time undergraduate research assistant (work-study program,
September 2013 - April 2014. Project: The role of Akt isoforms in the rate of proliferation of
cancer cell lines and their susceptibility to oncolytic viruses.
Ontario, Canada
2013/5 - 2013/7 Jason Morgenstern (Completed) , University of Guelph
Thesis/Project Title: Testing the Efficacy of Oncolytic Viruses, Histone Deacetylase
Inhibitors and Toll-Like Receptor Ligands in Cancer Cell Lines (summer research
assistantship)
Project Description: Undergraduate summer research assistant, May -August 2012.
Project: Establishment of leukemia/lymphoma cell lines from clinical specimens and
evaluation of their susceptibility to oncolytic viruses.
Present Position: Medical residency program in public health + Master's of Public Health
program, McMaster University
2012/9 - 2013/4 Evan Lusty (Completed) , University of Guelph
Thesis/Project Title: Characterizing Oncolytic Viruses and Toll Like Receptor Ligands
in the In Vitro Treatment of Human Prostate Cancer (4th year undergraduate research
project)
Project Description: Evan conducted his 4th-year undergraduate research project (Course
codes: BIOM*4521 [Fall semester] and BIOM*4522 [Spring semester]) in my laboratory.
Project: Testing oncolytic viruses in human prostate cancer cell lines.
Present Position: MD program, Queen's University (Kingston, Ontario)
Thesis/Project Title: Investigating the Potential to use Recombinant Newcastle Disease
Viruses as Oncolytic Virotherapies for Prostate and Cervical Cancers (Work-Study
Program; part-time research while pursuing full-time undergraduate studies)
Project Description: Undergraduate summer research assistant, May - July 2013. Project:
Characterizing the oncolytic potential of a novel fowl reovirus in established cancer cell
lines.
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Dr. Byram Bridle
AR05760 45
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Thesis/Project Title: Optimization of a Protocol for Harvesting and Differentiating
Murine Bone Marrow-Derived Dendritic Cells for use as a Cancer Vaccine (4th year
undergraduate research project)
Project Description: Alexandra conducted her 4th-year undergraduate research project
(Course codes: BIOM*4521 [Fall semester] and BIOM*4522 [Spring semester]) in my
laboratory. Research project: Optimization of a protocol for harvesting and differentiating
murine bone marrow-derived dendritic cells for use as a cancer vaccine.
Present Position: Post-graduate diploma program in clinical research at Seneca College,
Toronto
Thesis/Project Title: Evaluation of the Susceptibility of Cancer Cell Lines to Oncolytic
Viruses (summer research assistantship)
Project Description: Part-time undergraduate research assistant (work-study program),
September 2012-April 2013. Project: Testing oncolytic viruses in human prostate and
cervical cancer cell lines.
Thesis/Project Title: Testing Various Oncolytic Viruses, Histone Deacetylase Inhibitors
and Toll-Like Receptor Ligands as Monotherapies in Human Prostate and Cervical Cancer
Cells (summer research assistantship)
Project Description: Undergraduate summer research assistant, May - August 2012. Was
awarded a Canadian Society for Immunology - Summer Internship in Immunology for this
work. Project: Using an innate anti-viral immune response in the presence of a histone
deactylase inhibitor to treat leukemias.
Thesis/Project Title: Using an Innate Anti-Viral Immune Response in the Presence of a
Histone Deacetylase Inhibitor to Treat Leukemias (summer research assistantship)
Project Description: Undergraduate summer research assistant May - June 2013. Project:
Testing oncolytic viruses in human prostate cancer cell lines.
Master’s Equivalent [n=1]

2020/2 Yeganeh Mehrani (In Progress) , Ferdowsi University of Mashhad, Iran
Thesis/Project Title: Development of Flow Cytometric Methods to Evaluate Canine Innate
Lymphocyte Subsets
Present Position: Visiting scientist in my laboratory
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Dr. Byram Bridle
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Master’s Thesis [n=12]
2021/9 Sierra Vanderkamp (In Progress) , University of Guelph
Academic Advisor Student Degree Start Date: 2021/9
Thesis/Project Title: Mechanisms Governing Off-Target Infection and Killing of T Cells by
Oncolytic Viruses
2021/9 Julia Kakish (In Progress) , University of Guelph
Thesis/Project Title: Sensitization of Decitabine-Treated Leukemias to Oncolytic
Virotherapy
2021/4 - 2022/8 Fatemeh Darya Fazel (In Progress) , University of Guelph
Thesis/Project Title: mRNA-Based Vaccines for Preventing the Infection of Poultry with
Influenza Viruses
2020/9 Lily Chan (In Progress) , University of Guelph
Thesis/Project Title: The Roles of Innate Leukocytes in Dendritic Cell-Based Vaccinations
2018/9 Elaine Klafuric (In Progress) , University of Guelph
Thesis/Project Title: Combining Oncolytic Viruses with Epigenetic Modifiers to Treat Acute
Myeloid Leukemias
Present Position: Currently a member of my research team, University of Guelph
2017/9 - 2019/12 Adriana Bianco (Completed) , University of Guelph
Thesis/Project Title: Anti-Cancer Effects of Beta Glucans
2016/9 - 2016/12 Katrina Allison (Withdrawn) , University of Guelph
Thesis/Project Title: Sex Disparity in Innate Immune Responses to Viral Infection: the Role
of Type I Interferon
Project Description: Studying gender bias in the role of type I interferon signalling on the
cytokine response to viral infection.
Present Position: Naturopathic Medicine College Training Program (Toronto, Ontario)
Thesis/Project Title: Developing Novel Biotherapies for the Treatment of Melanomas
Project Description: Amanda is studying the mechanisms underlying biotherapies for
melanomas.
Present Position: Research Associate, Notch Therapeutics, Toronto, Ontario, Canada,
The Hospital for Sick Children, Toronto, Ontario, Canada
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2015/1 - 2016/8 Nahla El Skhawy (Completed) , University of Guelph
Thesis/Project Title: The Role of the Immune System in Johne's Disease in Cattle
Project Description: Immunological aspects of Johne's disease in cattle.
Thesis/Project Title: Role of Type I Interferon Signalling in Regulating Survival,
Proliferation, and Cytokine Production in Antigen-Presenting Cells
Project Description: Thesis title: Role of Type I Interferon Signalling in Regulating Survival,
Proliferation, and Cytokine Production in Antigen-Presenting Cells
2012/9 - 2014/8 Christian Ternamian (Completed) , University of Guelph
Thesis/Project Title: Targeting Acute Lymphoblastic Leukemia with Oncolytic Virotherapy
and Immunotherapy
Project Description: Combining histone deacetylase inhibition and transient, virus-induced
lymphopenia to treat leukemia.
Present Position: Completed Medical Doctorate program at Queen's University
2012/9 - 2014/8 Zafir Syed (Completed) , University of Guelph
Thesis/Project Title: Oncolytic Immunotherapy for the Treatment of High-Grade Gliomas
Project Description: Synergizing immuno- and oncolytic viro-therapies for the treatment of
primary brain cancer.
Present Position: Radiology residency program, University of Western Ontario
Doctorate [n=19]
2021/3 Ben Muselius (In Progress) , University of Guelph
Academic Advisor Degree Name: PhD
Student Degree Start Date: 2021/1
Thesis/Project Title: Proteomics Analysis of Infections with the Fungal Pathogen
Cryptococcus neoformans
Present Position: graduate student
2020/11 Brenna Stevens (In Progress) , University of Guelph
Thesis/Project Title: Gene Therapy for Cystic Fibrosis
Project Description: Transferred from MSc program.
Present Position: graduate student
2019/9 Sylvia Thomas (In Progress) , University of Guelph
Thesis/Project Title: Adeno-Associated Virus-Vectored Gene Editing Platform for the
Correction of Monogenic Lung Diseases
Project Description: Transferred from the MSc program.
Present Position: Graduate student in Wootton lab
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2019/9 - 2023/8 Jason Knapp (In Progress) , University of Guelph
Thesis/Project Title: Heat-Adaptation of Oncolytic Rhabdoviruses to Improve Their Clinical
Utility
Present Position: Graduate student in my laboratory
2019/9 - 2024/8 Jessica Minott (In Progress) , University of Guelph
Thesis/Project Title: Development of an Oncolytic Orf Virus-Infected Cell Vaccine for
the Treatment of Spontaneous Mammary Carcinoma Metastases (transferred from MSc
program)
Present Position: Graduate student in my laboratory
2018/9 - 2022/8 Amira Rghei (In Progress) , University of Guelph
Thesis/Project Title: Adeno-Associated Virus-Vectored Immunoprophylaxis for Filovirus
Infections
Present Position: Graduate student in Wootton lab
2017/9 - 2021/8 Ashley Stegelmeier (Completed) , University of Guelph
Thesis/Project Title: Vectorizing Immunomodulatory Antibodies for the Treatment of
Canine Melanomas
Project Description: The objective of this research is to enable tumour-bearing dogs
to synthesize anti-canine PDL-1 in vivo using AAV with an inducibleTet-on promoter,
which will allow fine control of expression of the antibody.This novel administration of an
immunomodulatory canine antibody with aninducible promoter has the potential to improve
efficacy of immunotherapies inmelanoma-bearing dogs while minimizing risk of off-target
autoimmunity.
Present Position: Research Manager, Kitchener, Ontario, Canada
2017/1 - 2020/1 Maedeh "Mahi Azizi" Darzianiazizi (Completed) , University of Guelph
Thesis/Project Title: Elucidating the Roles of Sex, Neutrophils and Mast Cells in Type I
Interferon-Regulated Cytokine Responses to Viruses
Present Position: Working in industry
2017/1 - 2020/12 Nadiyah Alqazlan (Completed) , University of Guelph
Thesis/Project Title: Low Pathogenic Avian Influenza Virus H9N2 in Chickens:
Transmission Routes, Effects of Environmental Factors on Transmission and Means to
Disrupt Transmission
Project Description: LowPathogenic Avian Influenza Virus H9N2 in Chickens:
Transmission Routes, Effectsof Environmental Factors on Transmission and Means to
Disrupt Transmission
Present Position: PhD student (Sharif Lab, University of Guelph)
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2016/9 - 2020/8 Thomas McAusland (Completed) , University of Guelph
Thesis/Project Title: Development of Newcastle Disease Virus-Based Oncolytic
Virotherapies
Project Description: Development of oncolytic Newcastle disease virus vectors for cancer
therapy.
Present Position: Enrolled in police college
2015/9 - 2021/12 Kathy Matuszewska (In Progress) , University of Guelph
Thesis/Project Title: Combined Vessel Normalization and Oncolytic Virus Therapy in the
Treatment of Advanced Stage Ovarian Cancer
Project Description: Using a derivative of thrombospondin-1 to normalize tumour
vasculature for enhanced delivery of oncolytic viruses.
Present Position: PhD student (Petrik lab), University of Guelph
2015/9 - 2018/12 Laura van Lieshout (Completed) , University of Guelph
Thesis/Project Title: Using Adeno-Associated Viruses for Antibody-Mediated Vectored
Immunophrophylaxis
Present Position: Postdoctoral fellow in the Wootton lab, University of Guelph
2015/6 - 2022/4 Peyman Asadian (In Progress) , University of Guelph
Thesis/Project Title: The Role of SAMHD1 in Feline Immunodeficiency Virus Infections
Project Description: Thesis title: Expression profile and role of restriction of Sterile
alpha motif domain- and HD domain-containing protein 1 in restriction of Feline
Immunodeficiency Virus
Present Position: Leave of absence (PhD student in Bienzle lab, University of Guelph)
2014/9 - 2019/12 Joelle Ingrao (Withdrawn) , University of Guelph
Thesis/Project Title: Development of a Vaccine to Protect Against Toxoplasmagondii
Infection in Sheep
Project Description: Development of a recombinant parapoxvirus vaccine to protect
against Toxoplasma gondii infection in sheep
Present Position: Director, Catalent, Baltimore, Maryland, USA
Thesis/Project Title: Development of Novel Cancer Biotherapies
Project Description: Was in the MSc program Sept. 2014-Aug. 2015; transferred into the
PhD program, effective Sept. 2015. Project: Development of novel biotherapies for the
treatment of osteosarcomas.
Present Position: Scientist at Ensoma, USA
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2014/9 - 2020/4 Jacob van Vloten (Completed) , University of Guelph
Co-Supervisor Student Degree Start Date: 2014/9
Thesis/Project Title: The Development of Recombinant Parapoxvirus ovis (OrfV) for Use in
Oncolytic Virotherapy
Project Description: Direct entry from the BSc program into the PhD program. Project:
Development of a novel Orf virus natural isolate into a cancer biotherapy.
Present Position: Postdoctoral fellow in the lab of Dr. Richard Vile, Mayo Clinic,
Rochester, Minnesota
2014/9 - 2017/8 Megan Strachan-Whaley (Completed) , University of Guelph
Thesis/Project Title: Combination of Epigenetic Modifier Drugs with Oncolytic Viral
Therapy as a Novel Treatment for Leukemias
Project Description: Using oncolytic viruses to potentiate histone deacetylase inhibitor-
mediated killing of acute lymphoblastic leukemia B cells.
Present Position: Postdoctoral fellow in industry
2014/2 - 2016/8 Marianne Wilcox (Completed) , University of Guelph
Thesis/Project Title: Mathematical Modeling of Cytokine Storms in Rhabdovirus-Infected
Mice Lacking Type I Interferon Signaling in Hematopoietic Cells
Project Description: Mathematical modeling of cytokine storms in rhabdovirus-infected
mice lacking type I interferon signaling in hematopoietic cells.
2013/8 - 2018/9 Lisa Santry (Completed) , University of Guelph
Thesis/Project Title: Functional Role of AKT Isoforms in Jaagsiekte Sheep Retrovirus
Envelope Protein-Induced Lung Tumourigenesis and the Susceptibility of the Resulting
Tumours to Viral Oncolysis
Project Description: Project #1: Functional role of AKT isoforms in Jaagsiekte Sheep
Retrovirus envelope protein-induced lung tumorigenesis and the susceptibility of the
resulting tumours to viral oncolysis. Project #2: Using a derivative of thrombospondin-1
to normalize tumour vasculature for enhanced delivery of oncolytic viruses. Project #3:
Development of a Newcastle disease virus vector expressing an immunomodulatory
antibody.
Doctorate Equivalent [n=1]

2018/1 - 2022/4 Karen Carlton (In Progress) , University of Guelph
Thesis/Project Title: Crimean-Congo Hemorrhagic Fever DNA Vaccine trial: Pilot Safety
and Toxicity Study in Cattle and Goats
Present Position: DVSc student in the Arroyo and Lillie labs, University of Guelph
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Post-doctorate [n=6]
Thesis/Project Title: Development of Vaccines for COVID-19
Present Position: Still part of my research team
2020/3 - 2020/7 Jacob van Vloten (Completed) , University of Guelph
Thesis/Project Title: Development of Vaccines for COVID-19
Present Position: Postdoctoral fellow in the lab of Dr. Richard Vile, Rochester, MN, USA,
Mayo Clinic, Rochester, Minnesota
2018/9 - 2019/8 Megan Strachan-Whaley (Completed) , University of Guelph
Thesis/Project Title: Combining Oncolytic Viruses and Epigenetic Modifiers to Treat Acute
Leukemias
Present Position: Enrolled in medical school (Dalhousie University)
2015/5 - 2017/12 Dr. Li Deng (Completed) , University of Guelph
Thesis/Project Title: Engineering Virus-Vectored Cancer Vaccines for Clinical Canine
Cancer Trials
Project Description: Development of novel virus vectors for use in oncolytic and
immunotherapies.
Present Position: Postdoctoral fellow (Wan lab, McMaster University)
2013/9 - 2014/4 Dr. Scott Walsh (Completed) , University of Guelph
Thesis/Project Title: Type I Interferon Receptor Signalling as a Master Switch for the
Negative Regulation of Cytokine Networks
Project Description: Type I interferon receptor signalling as a master switch for the
negative regulation of cytokine networks.
Present Position: Postdoctoral fellow in the laboratory of Dr. Yonghong Wan, McMaster
University, Hamilton, ON, Canada
2013/2 - 2013/8 Dr. Jondavid de Jong (Completed) , University of Guelph
Thesis/Project Title: Construction of Human Adenovirus Serotype 48 and Maraba Virus
Vectors
Project Description: Construction of recombinant Maraba virus and human adenovirus
serotype 48 vectors for use in cancer immune- and oncolytic viro-therapy.
Present Position: Research Associate, Mirexus (Guelph, Ontario; biotechnology company)
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Diploma [n=4]
2015/10 - 2016/3 Katrina Geronimo (Completed) , St. Joan of Arc Catholic Secondary School, Mississauga,
Principal Supervisor Ontario
Thesis/Project Title: Hypoxia Variably Affects Oncolytic Virus Efficacy While Potentiating
the Growth of Human Cervical Cancer Cells
Project Description: September 2015 - May 2016: Participated in the Sanofi BioGENEius
Challenge Canada. This is a national research competition for secondary school students
(http://biogenius.ca/). Over a 6-month period she averaged 2-3 bus trips to the University
of Guelph per week to work approximately half-days in my laboratory. Her project title was
"Hypoxia variably affects oncolytic virus efficacy while potentiating the growth of human
cervical cancer cells".
Present Position: BSc program, University of Guelph, University of Guelph
2015/10 - 2016/3 Arthane Kodeeswaran (Completed) , St. Joan of Arc Catholic Secondary School,
Principal Supervisor Mississauga, Ontario
Thesis/Project Title: The Effect of Temperature on the Efficacy of Oncolytic Viruses in
Human Cervical Cancer Cells
Project Description: September 2015 - May 2016: Participated in the Sanofi BioGENEius
Challenge Canada. This is a national research competition for secondary school students
(http://biogenius.ca/). Over a 6-month period she averaged 2-3 bus trips to the University
of Guelph per week to work approximately half-days in my laboratory. Her project title
was "The effect of temperature on the efficacy of oncolytic viruses in human cervical
cancer cells". Notably, Arthane was one of the award winners for the Greater Toronto
Area regional competition.
Present Position: BSc program, University of Guelph, University of Guelph
2013/12 - 2014/4 Micaella Talan (Completed) , St. Joan of Arc Catholic Secondary School, Mississauga,
Thesis/Project Title: High School Research Project: The Effects of Quercetin and
Kaempferol on the Cytotoxicity of Carboplatin and Entinostat on Cancer Cell Lines
Project Description: I am serving as a mentor for this secondary school student as she
competes in the Sanofi BioGENEius challenge (see: http://sanofibiogeneiuschallenge.ca/).
Project title: Using plant flavonoids quercetin and kaempferol in combination with the
chemotherapeutic agent, carboplatin, to treat cancer cell lines.
Present Position: BSc program, McMaster University
2013/12 - 2014/4 Brittney Tin (Completed) , St. Joan of Arc Catholic Secondary School, Mississauga,
Thesis/Project Title: High School Research Project: The Effects of Quercetin and
Kaempferol on the Cytotoxicity of Carboplatin and Entinostat on Cancer Cell Lines
Project Description: I am serving as a mentor for this secondary school student as she
competes in the Sanofi BioGENEius challenge (see: http://sanofibiogeneiuschallenge.ca/).
Project title: Using plant flavonoids quercetin and kaempferol in combination with the
chemotherapeutic agent, carboplatin, to treat cancer cell lines.
Present Position: BSc program, McMaster University
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Research Associate [n=2]
2021/10 - 2022/4 David Speicher (In Progress) , University of Guelph
Thesis/Project Title: Virus Vectors for the Prevention of Infectious Diseases and Treatment
of Cancers
2016/5 - 2023/4 Dr. Khalil Karimi (In Progress) , University of Guelph
Thesis/Project Title: Role of Type I Interferon Signalling on the Responses of Innate
Lymphoid Cell Subsets to Viral Infection
Project Description: Assists with co-management of my research program, with an
emphasis on studying the role of innate lymphoid cell subsets in response to viral
infection.
Present Position: Research Associate/Associated Faculty Member in my laboratory,
Technician [n=1]
2019/12 - 2024/12 David Marom (In Progress) , University of Guelph
Thesis/Project Title: General research support.
Present Position: A part-time member of my research team
Staff Supervision
Event Administration
2019/9 - 2020/1 Local Organizing Committee Member, Canadian Society for Virology 2020 Annual
Scientific Meeting (Note: this meeting was cancelled due to COVID-19), Conference,
2020/6 - 2020/6
Editorial Activities
2020/7 - 2025/12 Reviewer, Viral Immunology, Journal
2019/11 - 2025/12 Reviewer, Clinical Cancer Research, Journal
2018/6 - 2025/12 Reviewer, Canadian Journal of Veterinary Medicine, Journal
2018/5 - 2025/12 Reviewer, Reviews in Medical Virology, Journal
2017/9 - 2025/12 Reviewer, Science Translational Medicine, Journal
2017/5 - 2025/12 Reviewer, Veterinary Immunology and Immunopathology, Journal
2015/5 - 2025/12 Reviewer, Canadian Journal of Veterinary Research, Journal
2015/5 - 2025/12 Reviewer, Viruses, Journal
2014/5 - 2025/12 Reviewer, Journal of Visualized Experimentation, Journal
2013/12 - 2025/12 Reviewer, PLOS ONE, Journal
2020/9 - 2025/8 Guest Editor, Viruses, Journal
2018/5 - 2018/5 Reviewer, Reviews in Medical Virology (reviewed the second of a linked pair of
manuscripts), Journal
2017/12 - 2018/1 Reviewer, PLOS ONE (reviewed a manuscript), Journal
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2016/11 - 2016/12 Reviewer, Canadian Journal of Veterinary Research (reviewed a manuscript), Journal
2015/10 - 2015/10 Reviewer, Viruses (reviewed a manuscript), Journal
2015/5 - 2015/5 Reviewer, Viruses (reviewed a manuscript), Journal
2013/10 - 2013/10 Reviewer, Canadian Journal of Veterinary Research (reviewed a manuscript), Journal
2013/7 - 2013/8 Reviewer, Molecular Therapy (reviewed a manuscript), Journal
2013/1 - 2013/3 Reviewer, Journal of Vaccines and Immunization (reviewed a manuscript), Journal
2012/8 - 2012/8 Reviewer, Canadian Veterinary Journal (reviewed a manuscript), Journal
2011/10 - 2011/11 Reviewer, Clinical Medicine Insights Oncology (reviewed a manuscript), Journal
Mentoring Activities
2021/4 PhD qualifying examination committee member, University of Guelph
Mentorees: Jason Knapp
April 30, 2021; Jason Knapp's PhD qualifying examination
2021/4 Chair of MSc final examination committee, University of Guelph
Mentorees: Christine Yanta
April 27, 2021; Christine Yanta's MSc thesis defence.
2020/12 Chair of PhD final examination committee, University of Guelph
December 21, 2020; Ryan Snyder's PhD thesis defence
2020/7 Chair of PhD Qualifying Examination Committee, University of Guelph
July 28, 2020; Melanie Iverson's PhD qualifying examination
June 12, 2020; Ran Xu's PhD qualifying examination
2020/5 PhD final examination committee member, University of Guelph
May 27, 2020; Robert Mould's PhD thesis defence
2020/5 MSc final examination committee member, University of Guelph
May 15, 2020; Elana Raaphorst's MSc thesis defence
April 16, 2020; Heng Kang's PhD qualifying examination
April 20, 2020; Sugandha Raj's PhD qualifying examination
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January 3, 2020; Maedeh Darzianiazizi's PhD thesis defence
2019/12 Chair of PhD Qualifying Examination Committee, University of Guelph
December 6, 2019; Ayumi Matsuyama's PhD qualifying examination
May 3, 2019; Seyed Hossein's PhD qualifying examination
2019/4 Chair of MSc final examination committee, University of Guelph
April 15, 2019; Megan Neely's MSc thesis defence
April 26, 2019; Kristen Lamers's MSc thesis defence
April 18, 2019; Gary Lee's PhD qualifying examination
2019/2 DMin final examination committee member, Tyndale University
February 3, 2019; Jeffrey Roy's DMin thesis defence
January 29, 2019; Karen Carlton's PhD qualifying examination
2018/12 PhD final examination committee member, University of Western Ontario
December 6, 2018; Corby Fink's PhD thesis defence
December 17, 2018; Thomas McAusland's PhD qualifying examination
November 26, 2018; Ashley Stegelmeier's PhD qualifying examination
September 4, 2018; Maedeh Darzianiazizi's PhD qualifying examination
June 22, 2018; Laura van Lieshout's PhD qualifying examination
April 27, 2018; Jegarubee Bavananthasivam's PhD thesis defence
January 15, 2018; Lisa Santry's PhD thesis defence
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January 19, 2018; Nadiyah Alqazlan's PhD qualifying examination
January 9, 2018; Megan Strachan-Whaley's PhD thesis defence
December 1, 2017; Benoit Cuq's PhD Qualifying Examination
September 25, 2017: Carina Cooper's PhD qualifying examination
August 21, 2017; Amanda AuYeung's MSc thesis defence
March 27, 2017: Jacob van Vloten's PhD qualifying examination
January 25, 2017; Neda Barjesteh's PhD thesis defence
2017/1 MSc final examination committee member, University of Toronto
January 16, 2017; Tiffany Ho's MSc thesis defence
December 19, 2016: Peyman Asadian's PhD qualifying examination
August 24, 2016: Kathy Matuszewska's PhD qualifying examination
June 14, 2016: Megan Strachan-whaley's PhD qualifying examination
June 6, 2016: Seyedmehdi Emam's PhD qualifying examination
May 3, 2016: Served on the examination committee for Shirene Singh's PhD defence
April 27, 2016: Alexander Bekele-Yitbarek's PhD qualifying examination
2015/9 MSc examination committee member, University of Guelph
September 2, 2015: Alexandra Rasiuk's MSc thesis defense
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2015/8 Chair of MSc examination committee, University of Guelph
August 18, 2015: Chaired James Ackford's MSc thesis defense
April 27, 2015: Jegarubee Bavananthasivam's PhD qualifying examination
February 18, 2015: Marianne Wilcox's PhD qualifying examination
August 13, 2014: Served on the examination committee for Zafir Syed's MSc thesis
defence
August 12, 2014: Served on the examination committee for Christian Ternamian's MSc
thesis defence
June 10, 2014: Chaired Kelly Fleming's MSc thesis defence
January 3, 2014: Scott Walsh's PhD defense
December 16, 2013: Lisa Santry's PhD qualifying examination
December 11, 2013: Shirene Singh's PhD qualifying examination
November 19, 2013: Chaired Shaun Kernaghan's MSc thesis defense
June 14, 2013: Ian Villanueva's MSc thesis defense
September 5, 2012: Sonja Zours' MSc thesis defense
July 20, 2012: Chaired Inas Elawadli's MSc thesis defense
2012/5 PhD qualification examination committee member, University of Guelph
May 7, 2012: Li Deng's PhD qualification examination
April 19, 2012: Chaired Iman Mehdizadeh Gohari's MSc thesis defense
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Organizational Review Activities

2020/8 Reviewer, Canadian Institutes of Health Research
Served on the Cancer Biology and Therapeutics grant review panel
2020/5 Reviewer, Cancer Research Society
Served on grant review panel C2 - Tumour suppressor genes, oncogenes and DNA repair
2019/10 Reviewer, Canadian Foundation for Innovation
Served on an expert committee to review an application to the John R. Evans Leaders
Fund
2018/10 Reviewer, Canadian Institutes of Health Research
Started a three-year term serving on the Virology and Viral Pathogenesis grant review
panel
2014/6 Reviewer, Canadian Cancer Society Research Institute
Served on grant review panel I3 - Immunology Signalling and Stem Cells
2020/6 - 2020/7 Reviewer, Swiss National Science Foundation
Spark Grant
2019/12 - 2020/1 Reviewer, Natural Sciences and Engineering Research Council of Canada (NSERC)
Discovery Grant
2019/12 - 2019/12 Reviewer, New Foundations in Research Fund
Reviewed an Exploration Grant
2019/9 - 2019/10 Reviewer, Prostate Cancer UK
Reviewed a grant application.
2018/8 - 2018/9 Reviewer, Mitacs Accelerate
Reviewed one grant application.
2017/12 - 2018/1 Reviewer, Student Scinapse Competition
Reviewed 7 applications.
2017/9 - 2017/10 Reviewer, Breast Cancer Now_UK
2017/3 - 2017/4 Reviewer, Graduate Women in Science Fellowship
Reviewed one application.
2016/12 - 2017/1 Reviewer, Student Scinapse Competition
Reviewed 10 applications.
2016/11 - 2016/12 Reviewer, Mitacs Accelerate
Reviewed one grant application.
Collaborative Health Research Program
Served as an external reviewer for a NSERC Discovery Grant application
2014/4 - 2014/5 Reviewer, Croatian Science Foundation
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Community and Volunteer Activities
2015/1 Member of the Animal Isolation Unit Advisory Committee, University of Guelph
To provide advice from the perspective of a researcher to Campus Animal Facilities in an
effort to balance the needs of technicians, the administration and those conducting animal
research at biosafety level 2.
2014/12 Volunteer Fundraiser, University of Guelph
Assisting fundraising efforts for the Global Vets program by auctioning an immunology
review session (2014) and a faculty-student hockey game (2015).
2014/5 Volunteer Interviewer, University of Guelph
Conducting annual entrance interviews for the Doctor of Veterinary Medicine program.
2014/2 Member of the Dept. of Pathobiology Research Committee, University of Guelph
Deliberate on departmental research-related issues and provide recommendations to
the department. Keep track of departmental equipment. Coordinate equipment grant
applications.
2013/2 Member of the Dept. of Pathobiology Seminar Committee, University of Guelph
Organize and run the Dept. of Pathobiology's annual seminar series, which runs from
September to April. Host visiting speakers. Also organize and run an annual 3-minute
thesis competition for trainees. I chaired this committee Sept. 2015-Aug. 2016
2013/2 Member of the Dept. of Pathobiology Awards Committee, University of Guelph
Review and rank all award applications submitted in the Department of Pathobiology.
2013/1 Scientific Reviewer of Animal Utilization Protocols, University of Guelph
Review the scientific content of applications for animal utilization protocols for the Animal
Care Committee.
2012/11 Volunteer Judge, University of Guelph
Annual poster judging for the Graduate Student Research Symposium (showcases
graduate student research projects).
2012/8 volunteer judge, University of Guelph
Annual poster judging for the Career Opportunites and Research Experience Program
(formerly called "Summer Leadership and Research Program"; showcases summer
student research projects).
2012/2 Co-Manager of the University of Guelph Core Flow Cytometry Facility, University of
Guelph
Manage the core flow cytometry facility at the University of Guelph in conjunction with one
other faculty member.
2011/10 Scientific Reviewer, Various scientific journals
Review manuscripts submitted to the following journals: Molecular Therapy PLOS ONE
Journal of Vaccines and Immunization Canadian Veterinary Journal Clinical Medicine
Insights Oncology Canadian Journal of Veterinary Research Journal of Visualized
Experimentation Reviews in Medical Virology Viruses
1997/1 Member, Canadian Society for Immunology
A registered member of the Canadian Society for Immunology
2016/3 - 2016/3 volunteer judge, University of Guelph
Judged student-run exhibits that are open to the public at the Ontario Veterinary College.
2014/4 - 2016/1 Grant Review Panel Member, Prostate Cancer Canada
I served on Panel C "Experimental Therapeutics"
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2015/2 - 2015/3 Scientific Reviewer, Oxford University Press
Reviewed Chapter 12: Tumor Immunology and Immunotherapy from the textbook
"Molecular Biology of Cancer, fourth edition" by Pecorino.
2015/1 - 2015/2 Scientific Reviewer, Natural Sciences and Engineering Research Council of Canada
(NSERC)
Discovery Grant review
2014/5 - 2014/6 Scientific Reviewer, Croatian Science Foundation
Grant review
2010/9 - 2014/5 Assistant Coach, Stanley Stick Hockey Association, Guelph, Ontario
Serve as a volunteer for this not-for-profit hockey association. Assist with coaching a boys
hockey team. Learn to skate program: 2010-11 Novice division: 2011-2014
2003/9 - 2012/4 Organizer, Men's recreational hockey group, Guelph, Ontario
Managed a men's recreational hockey group.
Knowledge and Technology Translation

2014/1 Co-Investigator, Technology Transfer and Commercialization
Group/Organization/Business Serviced: University of Guelph
Target Stakeholder: General Public
Outcome / Deliverable: Submitted an invention disclosure form:Avianorthoreovirus (ARV)
strain PB1: a potential oncolytic, vaccine and adjuvant
Activity Description: Invention disclosure to the University of Guelph Catalyst Centre:
"Avian orthoreovirus (ARV) strain PB1: a potential oncolytic, vaccine and adjuvant"
2011/3 Co-investigator, Technology Transfer and Commercialization
Group/Organization/Business Serviced: McMaster University, Hamilton, Ontario
Outcome / Deliverable: Patent
Evidence of Uptake/Impact: Used as part of the intellectual property to establish a new
biotechnology company called "Turnstone Biologics"
References / Citations / Web Sites: http://www.turnstonebio.com/ http://www.google.com/
patents/WO2012122629A1?cl=en
Activity Description: Bridle BW, Bell JC, Diallo JS, Lemay C, Lichty BD, Wan Y
“Vaccination and HDAC inhibition” Provisional Patent 61/451,794 filed March 11, 2011,
PCT Patent Application No. PCT/CA2012/000212 national phase filings in Europe, North
America, China, and Japan underway
References / Citations / Web Sites: http://www.turnstonebio.com/
Activity Description: Bridle BQ, Lichty BD, Wan Y “Vaccination method utilizing follicular B
cells” Provisional patent 61/446,248 (filed February 24, 2011)
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References / Citations / Web Sites: http://www.turnstonebio.com/ http://www.google.com/
patents/WO2010105347A1?cl=en
Activity Description: Bridle BW, Bramson J, Lichty BD, Wan Y “Vaccination Methods” PCT
Patent application No. PCT/CA2010/000379 (PCT filed March 16, 2010) national phase
filings in Europe, North America, and China underway
2019/9 - 2030/7 Co-Founder, Involvement in/Creation of Start-up
Group/Organization/Business Serviced: IHN Pharma, Inc.
Target Stakeholder: Patients
Outcome / Deliverable: Novel biotherapies for the treatment of cancers.
Evidence of Uptake/Impact: This company is in the start-up phase.
Activity Description: Along with six collaborators, we are establishing a start-up
biotechnology company called "INH Pharma, Inc." to leverage intellectual properties
related to proprietary oncolytic viruses.
Committee Memberships
2019/8 Committee Member, Chair search committee, University of Guelph
To recruit and hire a new Chair for the Department of Pathobiology
2019/6 Committee Member, Faculty Search Committee, University of Guelph
To hire a new virologist for a tenure-track faculty position in the Department of
Pathobiology
2018/9 Committee Member, Virology and Viral Pathogenesis Grant Review Panel, Canadian
Institutes of Health Research
Review and rank grant proposals.
2017/12 Chair, Department of Pathobiology Awards Committee, University of Guelph
Review and rank applications for academic awards.
2017/12 Committee Member, Ontario Veterinary College Graduate Awards Committee, University
of Guelph
Review and rank award applications from graduate students at the college level.
2017/12 Committee Member, Scientific Review Committee for the Pet Trust Foundation, University
of Guelph
Review and rank applications to the Pet Trust Foundation's bi-annual operating grant
competitions.
2017/12 Committee Member, Ontario Veterinary College Undergraduate Awards Committee,
Review and rank award applications from students in the Doctor of Veterinary Medicine
and other undergraduate programs within the Ontario Veterinary College.
2016/7 Committee Member, Department of Pathobiology Seminar Series Committee, University of
Guelph
Help schedule a weekly seminar series that spans the Fall and Winter semesters. Host
external speakers.
53
Dr. Byram Bridle
AR05777 62
--
2014/12 Co-chair, Ad hoc committee to manage the University of Guelph's flow cytometry facility.,
Co-management of institutional core flow cytometry facility (two high-throughput analytical
flow cytometers, plus one flow sorter). Other co-managers: Dorothee Bienzle and Brandon
Plattner.
2014/9 Ex-Officio, Scientific Reviewer for Animal Care Committee, University of Guelph
Provide expert scientific reviews of animal utilization protocols that have been submitted to
the institutional animal care committee.
2014/1 Committee Member, Department of Pathobiology Research Committee, University of
Guelph
Identify, review and make recommendations related to departmental research issues.
2020/7 - 2020/8 Committee Member, Cancer Biology and Therapeutics Grant Review Panel, Canadian
Institutes of Health Research
Review and rank grant applications.
2020/6 - 2020/7 Chair, PhD Qualifying Examination Committee, University of Guelph
Examinee: Melanie Iverson
2020/5 - 2020/6 Committee Member, PhD Qualifying Examination Committee, University of Guelph
Examinee: Ran Xu
2020/4 - 2020/5 Committee Member, PhD Thesis Examination Committee, University of Guelph
Examinee: Robert Mould
2020/4 - 2020/5 Committee Member, MSc Thesis Examination Committee, University of Guelph
Examinee: Elana Raaphorst
Examinee: Sugandha Raj
2019/12 - 2020/1 Committee Member, PhD Thesis Examination Committee, University of Guelph
Examinee: Maedeh Darzianiazizi
Examinee: Ayumi Matsuyama
2019/7 - 2019/8 Committee Member, Expert Review Committee, Canadian Foundation for Innovation
To review a grant application for funding from the John R. Evans Leaders Fund
2019/6 - 2019/7 Committee Member, Technician search committee., University of Guelph
To recruit and hire a new technician for the Department of Pathobiology
Examinee: Seyed Hossein Karimi
2019/3 - 2019/4 Committee Member, Thesis Examination Committee, University of Guelph
Examinee: Kristen Lamers (MSc)
2019/3 - 2019/4 Chair, Thesis Examination Committee, University of Guelph
Examinee: Megan Neely (MSc)
2019/3 - 2019/4 Committee Member, MSc Thesis Examination Committee, University of Guelph
Examinee: Kristen Lamers
Examinee: Gary Lee
2019/1 - 2019/2 Committee Member, Thesis Examination, Tyndale College and Theological Seminary
Examinee: Jeffrey Roy (DMin)
54
Dr. Byram Bridle
AR05778 63
--
Examinee: Karen Carlton
2018/11 - 2018/12 Committee Member, Thesis Examination Committee, University of Western Ontario
Examinee: Corby Fink (PhD)
Examinee: Thomas McAusland
Examinee: Ashley Ross
Examinee: Maedeh Darzianiazizi
Examinee: Laura van Lieshout
Examinee: Jegarubee Bavananthasivam (PhD)
Examinee: Megan Strachan-Whaley (PhD)
Examinee: Lisa Santry (PhD)
Examinee: Nadiyah Alqazlan
Examinee: Benoit Cuq
2012/5 - 2017/11 Committee Member, Department of Pathobiology Awards Committee, University of Guelph
Review and rank applications for academic awards.
Examinee: Carina Cooper
Examinee: Amanda AuYeung (MSc)
Examinee: Megan Stachan-Whaley (written and oral portions of exam were separated due
to a maternity leave).
Examinee: Jacob van Vloten
Examinee: Neda Barjesteh (PhD)
2016/12 - 2017/1 Committee Member, Thesis Examination Committee, University of Toronto
Examinee: Tiffany Ho (MSc)
Examinee: Peyman Asadian
2014/1 - 2016/12 Committee Member, Prostate Cancer Canada - Panel C - Experimental Therapeutics
Grant Review Panel, Prostate Cancer Canada
Review grants submitted to the "Experimental Therapeutics" panel and make
recommendations for funding.
Examinee: Kathy Matuszewska
55
Dr. Byram Bridle
AR05779 64
--
Examinee: Seyedmehdi Emam
2015/8 - 2016/6 Chair, Department of Pathobiology Seminar Series Committee, University of Guelph
external speakers.
Examinee: Shirene Singh (PhD)
Examinee: Alexander Bekele-Yitbarek
Examinee: Alexandra Rasiuk (MSc)
Examinee: James Ackford (MSc)
2013/6 - 2015/8 Committee Member, Department of Pathobiology Seminar Series Committee, University of
Guelph
external speakers.
2015/5 - 2015/5 Committee Member, Doctor of Veterinary Medicine Admissions Interview Committee,
Interviewed and ranked applicants to the Doctor of Veterinary Medicine program.
Examinee: Jegarubee Bavananthasivam
Examinee: Marianne Wilcox
Examinee: Christian Ternamian (MSc)
Examinee: Zafir Syed (MSc)
Examinee: Kelly Fleming (MSc)
Examinee: Scott Walsh (PhD)
Examinee: Shirene Singh
Examinee: Lisa Santry
Examinee: Shaun Kernaghan (MSc)
Examinee: Ian Villanueva (MSc)
Examinee: Sonja Zours (MSc)
Examinee: Inas Elawadli (MSc)
56
Dr. Byram Bridle
AR05780 65
--
Examinee: Li Deng
Examinee: Iman Mehdizadeh Gohari (MSc)
Other Memberships
2020/6 Member, One Health Institute University of Guelph
Within One Health, University of Guelph researchers work across disciplines and sectors
to interrogate the biological and social factors that impinge on the health of organisms,
from the level of molecules to that of ecosystems, with unique strengths in comparative
medicine. This research also explores how these factors are shaped by environmental
parameters, such as climate change, ultimately informing public health and environmental
health practice and policy.
2017/6 Member Scientist, Dog Osteosarcoma Group: Biomarkers Of Neoplasia (DOG BONe)
This groups consists of eight faculty members from the Ontario Veterinary College,
University of Guelph, who share a vision for collaborative research to advance our
understanding of canine osteosarcomas, how to predict clinical outcomes and to develop
novel therapies. The group includes two veterinary oncologists, two veterinary surgical
oncologists, a statitician, a veterinary pathologist, an immunologist and a cancer biologist.
2016/9 Member, European Academy for Tumor Immunology
I was invited to be a member of this international organization that is based in Europe.
The purpose is to promote international collaborations and unify research in the area of
immunotherapies for cancers.
2015/4 Member Scientist, Canadian Oncolytic Virus Consortium (COVCo)
COVCo is a pan-Canadian network of fifteen clinical and basic scientists dedicated to
developing and advancing the oncolytic virus platform as a targeted and revolutionary
approach to cancer therapeutics. Our common vision is that an iterative cycle of discovery
and clinical testing is the fastest and most effective way to develop new biological
therapeutics. We are funded by the Terry Fox Research Institute (Program Project Grant).
2014/12 Member scientist, National Centre of Excellence in Biotherapeutics for Cancer Treatment
(BioCanRx)
Total funding: $60 million ($25 million from the federal government + $35 million
from partners) over 5 years. Total # of researchers across Canada: 42 (representing
17academic institutions). Also supported by: 8 private sector and 19 community partners.
Scientific Director: Dr. John Bell, Ottawa Hospital Research Institute. I am one of the 42
founding members.
2012/1 Member, Institute for Comparative Cancer Investigation, University of Guelph
The Institute for Comparative Cancer Investigation at the University of Guelph facilitates
translational oncology research in companion animals at the OVC Mona Campbell Centre
for Animal Cancer by managing clinical trials and the Companion Animal Tumour Sample
Bank. Our goals: to advance the understanding of cancer and improve treatment options
to benefit both companion animal and human cancer patients.
2001/3 Member, Canadian Society for Immunology
The mandate of the Canadian Society for Immunology is to foster and support
Immunology research and education throughout Canada
57

COVID-19 Molecular Test - Flights To Canada Essai Moléculaire Relatif À La COVID-19 - Vols À Destination Du Canada

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COVID-19 Molecular Test - Flights To Canada Essai Moléculaire Relatif À La COVID-19 - Vols À Destination Du Canada

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AR04331

FOR PUBLIC CONSULTATION POUR CONSULTATION PUBLIQUE

paragraphe 8(1) qu’elle présente ne sont pas liés à la CO-

COVID-19 Molecular Test — Essai moléculaire relatif à la

Evidence — result of test Preuve — résultat de l’essai

Evidence — location of test Preuve — lieu de l’essai

Evidence — elements Preuve — éléments

False or misleading evidence Preuve fausse ou trompeuse

Notice to Minister Avis au ministre

Vaccination — Flights Departing Vaccination – vols en partance

(d) a screening authority at an aerodrome listed in d) l’administration de contrôle à un aérodrome visé à

Prohibition — person Interdiction — personne

Exception Exception — étranger

(vi) est un courrier diplomatique ou consulaire.

Request — contents Éléments de la demande

Timing of request Soumission de la demande

Content of document Contenu du document

b) la date et le numéro du vol à l’égard duquel le do-

Record keeping Tenue de registre

Ministerial request Demande du ministre

Copies of requests Copies des demandes

Ministerial request Demande du ministre

Request for evidence — air carrier Demande de présenter la preuve — transporteur

Request for evidence — screening authority Demande de présenter la preuve — administration de

Provision of evidence Présentation de la preuve

Evidence of vaccination — elements Preuve de vaccination — éléments

Evidence of vaccination — translation Preuve de vaccination — traduction

Person referred to in paragraph 17.3(2)(a) Personne visée à l’alinéa 17.3(2)a)

Person referred to in paragraph 17.3(2)(b) Personne visée à l’alinéa 17.3(2)b)

Person referred to in subparagraph 17.3(2)(d)(i) Personne visée au sous-alinéa 17.3(2)d)(i)

Person referred to in subparagraph 17.3(2)(d)(ii) Personne visée au sous-alinéa 17.3(2)d)(ii)

Person referred to in subparagraph 17.3(2)(d)(iii) Personne visée au sous-alinéa 17.3(2)d)(iii)

False or misleading information Information fausse ou trompeuse

False or misleading evidence Preuve fausse ou trompeuse

Notice to Minister — information Avis au ministre

Notice to Minister — evidence

Prohibition — air carrier Interdiction — transporteur aérien

Prohibition — screening authority Interdiction – administration de contrôle

Notification to air carrier Avis au transporteur aérien

Air carrier requirements Exigences du transporteur aérien

Record keeping — air carrier Tenue de registre — transporteur aérien

Ministerial request Demande du ministre

Record keeping — screening authority Tenue de registre — administration de contrôle

(a) the person’s name; a) les prénom et nom de la personne;

Ministerial request Demande du ministre

[17.19 reserved] [17.19 réservé]

Policy Respecting Mandatory Politique à l’égard de la

(c) NAV CANADA. c) à NAV CANADA.

Definition of relevant person Définition de personne concernée

d) l’accès à une zone réglementée d’un aérodrome visé

Comprehensive policy — operators of aerodromes Politique globale — exploitant d’un aérodrome

Policy — content Politique — contenu

j) prévoir une procédure permettant de veiller à ce

Medical contraindication Contre-indication médicale

Religious belief Croyance religieuse

Applicable legislation Législation applicable

Policy — content Politique — contenu

m) exiger que le transporteur aérien ou NAV

Medical contraindication Contre-indication médicale

Religious belief Croyance religieuse

Applicable legislation Législation applicable

Ministerial request — policy Demande du ministre — politique

Ministerial request — implementation Demande du ministre — mise en œuvre