Canada's bioterror plan: Martial law, forced quarantine

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Canada's bioterror plan: Martial law, forced quarantine

Mark Kennedy
The Ottawa Citizen


Saturday, March 01, 2003


A federal plan to respond to a bioterrorism smallpox attack includes provisions to suspend civil liberties under the Emergencies Act in order to contain the spread of the disease, the Citizen has learned.

The Canadian Smallpox Contingency Plan, developed by Health Canada in recent months in consultation with provinces, contains a wide array of measures the government could use if necessary.

They include "enforced isolation of noncompliant smallpox patients," enforced quarantine of other people who come into contact with them, restriction of travel and public activities, and "federalizing local facilities" to turn them into isolation and quarantine centres.

"The deliberate release of smallpox into the population is an act of such malfeasance that it would be considered an attack on Canada," says the 78-page plan.

"An outbreak of smallpox would have far-reaching implications for civil security, travel, the economy and human welfare. Because of population mobility, a case of smallpox in any Canadian province or territory would become a serious national concern. The requirements to effectively handle a smallpox outbreak could extend beyond the capacity of the provinces and territories."

Thus, the plan states that if there was a smallpox attack anywhere in the world, the government would activate the National Counter-Terrorism Plan. The document says this would "create a response framework" that includes the RCMP, the military's Joint Task Force 2, as well as a joint biological chemical response team of the RCMP and the National Defence Department "in both armed and technical response roles."

The plan also says the government could invoke the Emergencies Act, the federal statute that was enacted in the late 1980s and replaced the War Measures Act. The plan notes the act requires cabinet to declare a national emergency so it can exercise "appropriate exceptional powers ... subject to democratic safeguards and for limited periods."

Under the act, a national emergency is defined as an urgent and critical situation of a temporary nature that endangers the lives, health or safety of Canadians and is so severe that a province cannot deal with it by itself.

"Although debate would be required at the federal deputy and ministerial level, a smallpox outbreak would meet all the criteria for declaring a national emergency," says the contingency plan.

"It is through declaring a national emergency that extraordinary measures may be taken for the containment of smallpox."

The plan is an updated version of one which has been in place for many years. Government officials began modernizing it following the Sept. 11, 2001, terrorism attack on the United States. Although officials believe the risk of a bioterrorism attack is small, they are also intent on having a detailed response plan in place -- particularly with a likely war in Iraq on the horizon.

"Unlike the natural spread of smallpox in the past, a deliberate release of smallpox today could occur simultaneously in several strategic and densely populated locations throughout the world," says the plan.

"Combined with today's highly mobile and unvaccinated world population, the immediate control of a deliberate smallpox release would be very difficult."

Federal officials reviewed the latest version of the contingency plan at a closed-door meeting with provincial officials in February and then posted it on its Web site.

"It is conceivable that a smallpox outbreak would escalate into a 'crisis' (public panic, demands for mass vaccination)," says the plan.

It emphasizes that any such outbreak could escalate into a crisis if the public loses confidence in governments because of a perception that they lost control of the situation.

Thus, the plan outlines how municipalities should be prepared to quickly establish isolation centres for smallpox patients in places such as town halls, churches, youth offender facilities, army cadet camps, veterinary clinics and jails.

There are also strict measures outlined to prevent the "importation and spread" of the disease from another country. For instance, passengers on an airplane from a country where smallpox has broken out could be required to be vaccinated upon entering Canada or go into quarantine.

As well, if a suspected case of smallpox is detected in an airline passenger who has just arrived in Canada, the person would be immediately fitted with a mask, "covered with cloth or blankets, and removed to a local isolation facility, preferably out of the back door and via an ambulance."

The other people on the plane, even though showing no symptoms of the disease, would be required to go into quarantine, likely at a nearby hotel, and be vaccinated.

Indeed, in the event of a smallpox outbreak within Canada that requires people to be vaccinated, the plan contains specific terms on how to perform the task. It recommends vaccination clinics be located in elementary schools because of their easy access, parking and transportation, washroom facilities, and long hallways for traffic flow.

"Because of the potential for public panic, some individuals may arrive at a vaccination clinic with a sense of urgency, entitlement or anger. Patients who are denied vaccination due to (side effects) may react similarly. It is essential that local police forces be aware of all clinic locations, times and dates. It is also essential that security guards be deployed at the clinic to guard the vaccine, direct traffic flow and control any difficult situations that may arise."

Ron St. John, executive director of Health Canada's Centre for Emergency Preparedness and Response, said in an interview it's important the public is assured a plan is in place.

"We have a lot of confidence in the plan, that it's a national plan, it's an agreed-upon plan and it's ready to go."

Mr. St. John said the plan acts as a "safety valve." He stressed measures such as invoking the Emergencies Act would only be used if necessary, but need to be included in the "toolbox" of potential responses.

Under the plan, health officials would adopt the gradual "ring" approach to immunization -- vaccinating people who are infected and those who come into contact with them.

If the problem grows worse, the ring would be expanded to cover a larger geographical zone.

The government has ordered 10 million doses of the vaccine for delivery later this year, with an option to quickly get delivery of more doses to inoculate all 32 million Canadians if necessary.

� Copyright 2003 The Ottawa Citizen