ARCHIVED: Learning from SARS: Renewal of public health in Canada – Letter from Minister McLellan to Dr. Naylor

May 12^th, 2003

Dr. David Naylor
Dean of Medicine and Vice Provost
Relations with Health Care Institutions
University of Toronto
2109-1 King's College Circle
Toronto, Ontario
M5S 1A8

Dear Dr. Naylor:

Thank you very much for agreeing to serve as chair of the Advisory Group on SARS and Public Health. Please also pass along my thanks to your colleagues on the Committee. I understand that you had a productive inaugural meeting on May 7 and I look forward to receiving both your report on "lessons learned" in August and any interim advice that the Committee wishes to offer as your work progresses.

I also appreciate the Committee's preparedness to entertain requests for advice on strategic issues as the need arises. Our recent experience with SARS has highlighted the challenge we face in screening travellers coming to Canada from international destinations. A number of commentators over the past few weeks have highlighted that in a world with new and emerging diseases, where no place is more than a 24 hour journey away, it may be time to rethink the techniques we use to protect the health and safety of Canadians.

As you may know, we are implementing enhanced airport screening procedures for SARS for both inbound and outbound passengers. Thermal screening is being implemented for evaluative purposes, as it is a general screening tool of uncertain specificity and sensitivity. Other measures, however, are SARS specific. Therefore, we need to consider the possibility of more flexible tools for the future. As a result, consideration is being given to amending the standard customs declaration form (copy enclosed) to aid our Customs Officers in identifying incoming travellers at risk for various diseases of concern.

Two options are being considered:

1. Providing more space for travellers to list all the countries they have visited. Customs officers would be provided with a list of locales that are currently considered significant from a health perspective and, based on the information on the form, they could direct the traveller for further questioning.
2. Asking two or three health questions on the customs form itself. Based on the answers to those questions customs officers could then direct the passenger for further health screening.

Another avenue that could be explored would be to use the information that the CCRA will soon receive as part of "Passenger Name Record (PNR)" to identify the travellers that present a high risk. I understand that PNR will provide Customs officers, in advance, with the full itinerary of all travellers.

As your work will raise some privacy and other technical questions I invite you to consult with my department and the CCRA. Minister Elinor Caplan has assured me of the full cooperation of the CCRA in that regard.

I would be very interested in your Committee's advice on how best to manage the health risks to Canadians associated with global travel and more specifically, the merits of the options set out above or perhaps other options that you think would be more useful in protecting the health and safety of Canadians.

In conclusion, let me thank you again for all your efforts and also thank you in advance for any advice you can offer with respect to measures that might be directed at incoming international travellers so as to assist in the protection of Canadians from diseases such as SARS.

Yours truly,

A. Anne McLellan

Enclosure: (1)

• Dr Naylor's Response to Minister McLellan- June 15, 2003