What can provinces that haven't yet had a COVID-19 case do to prepare?

With Manitoba, Saskatchewan and New Brunswick all declaring their first cases of COVID-19 this week, the number of provinces and territories that have yet to see a confirmed case is dwindling. 

The pandemic has not yet reached Nova Scotia, Prince Edward Island, Newfoundland and Labrador, Northwest Territories, Yukon and Nunavut, but health officials say that can quickly change as more people are tested. 

So how well-prepared are we?

CBC News spoke with Elaine Gibson, a professor at Dalhousie University's Health Law Institute, to get her take. The interview has been edited for length and clarity.

Nova Scotia, P.E.I., Newfoundland and Labrador, and the North are the only places in Canada that don't have presumptive or confirmed cases. Is this an opportunity for these places to get ahead and take aggressive action to prevent the spread of COVID-19?

It's a good idea, although you can imagine that parts of the population are thinking that it's not going to come here because it's not here yet. That's a false assumption. It's definitely going to come. It's a question of when and how severely.

But the good thing about being behind the others is that we can learn from other communities and other nations that have been dealing with it.

What are some examples we can look at when it comes to how other places have handled COVID-19?

There are interesting contrasts to be had between South Korea and Italy. Both have a similar population base in terms of numbers, and both have been hit hard with COVID-19.

In South Korea, they went for massive testing and good social distancing measures, like limiting people's attendance at events, combined with aggressive cleaning. Whereas in Italy, they've not been big on testing, they've crippled the functioning of the economies and the borders are essentially closed.

In South Korea, there have been 67 deaths and about 8,000 people who got the disease. In Italy, there have been 1,016 — about 14 times the number of deaths in South Korea — and that's out of 15,000 people who tested positive.

So the difference in death rates is thought to be linked very strongly to massive testing being made available. And I don't know that Nova Scotia has taken this step yet to make massive testing available.

What is Nova Scotia doing well when it comes to containing the spread of the coronavirus?

I think that the basic idea of having all people call 811 first before getting a referral to the testing centres, which are being kept separate from regular emergency departments, is good.

Staffing has been an issue, and that's very unfortunate. The premier said they doubled the number of lines, and I hope they continue to increase staff because the system is a good one in theory, but it doesn't appear to be working smoothly yet.

One more thing I think the government is doing well is the decision that for people in long-term care facilities, if someone has been outside the country, they cannot visit them for two weeks. That was a wise move to take, as well as what the Nova Scotia Health Authority is doing in limiting visits to all the facilities throughout the provinces.

Where can Nova Scotia improve?

From what the chief medical officer of health was saying, we still don't have the means to have final [testing] validation in Nova Scotia. It needs to be sent off to the federal lab in Winnipeg to get confirmation. And that obviously causes delays.

On the other hand, if people take self-isolation very seriously, then at least they are taking those steps right away upon having been tested. So the delay is not quite as critical as otherwise.

I'm also interested that the education minister had said that the public schools will not be closed down after March Break. I think that that may be the wrong message to be sending to people. At a minimum, there should be a message that travel is discouraged.

Premier Stephen McNeil said any students that travelled internationally would have to self-quarantine for 14 days as well. Do you think that helps, or does it not go far enough?

I think it will help. Does it go far enough? We don't know yet. This is such a fast-developing situation, and we are all struggling a bit to come to terms with what is the best action to take.

What about the federal government's measures?

There is a principle in pandemic planning called reciprocity. What this means is that if the government is limiting people's liberty — like asking them to self-quarantine — they have, in turn, an obligation to provide resources for the person to not be seriously disadvantaged by it, or at least to reduce the disadvantage.

So I am very pleased to see the government announce changes to employment insurance to make people eligible right away if they are under quarantine or isolation, and also the amount they are giving to research.

But what happens also is that we know COVID-19 hits much harder for people who have other illnesses. If they start with a lower health status, there is an obligation to ensure measures that support those people who are more likely to get hit hard.

Indigenous communities were specifically mentioned, and I'm so pleased with that because they start with a lower health status and, presumably, are going to get enhanced support through that.

But I have not heard yet, other than the mention of Indigenous community support, about measures they are taking to best protect those who are less well-off in society.

What about the idea of closing our borders?

I'm of two minds about this because part of the International Health Regulations' idea was that you not have the economies crippled by borders shut down.

And if the disease is going to spread anyway, then I'm just not sure that locking down the borders for people from certain countries is the way to go as opposed to self-isolation.

What else can be done?

Health-care workers are our heroes in times of pandemic, and they need full support.

Something that I would like to see either the federal or provincial governments to take on is providing emergency daycare for the children of the health-care workers, and for providing transport if they need to get to and from the facilities. They are at the coalface of this disease, and they need as much support as we can provide them.

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