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The Little Province That Could | How PEI Set the Bar for the Canadian COVID-19 Response

In Short: Although PEI will face the same challenges of other provinces in addressing the likely oncoming second wave of COVID-19, the Island’s response over the past six months has set a shining example for the rest of Canada.

Whenever someone from mainland Canada is asked what they know about Prince Edward Island, there is a tendency to revert to stereotypes like potatoes, Anne of Green Gables, dirt shirts, and Cows Ice Cream. That probably would have been my response If I were asked a few years ago.

  • But during the COVID-19 pandemic, PEI has acquired a brand-new identity as the province with one of the most effective Coronavirus responses.

At the outset of the pandemic, PEI stood to lose substantially from a COVID-19 outbreak.

  • PEI is Canada’s most densely populated province. This statistic caused some to speculate that the Island could be at a greater risk of community spread.
  • In April 2020, PEI had fewer than 250 ICU beds. Given that the province already has one of the oldest populations in Canada, public health officials expressed concerns that the Island would run out of beds by mid-May if no controls were imposed.
  • Additionally, PEI welcomes over a million tourists annually. Given that tourism more than quadruples PEI’s population, the risks of community spread and ICU bed shortages would be amplified.

Despite these very serious concerns, the Island was able minimize the overall impact of the first COVID-19 wave.

  • In total, PEI has announced 53 cases of COVID-19 to date. In addition to having the fewest overall cases, the Island had the second lowest per capita infection rate (after New Brunswick).
  • PEI has had no COVID deaths, community spread, or ICU capacity problems to date.
  • Throughout the summer, PEI has enjoyed extended periods with no active cases.

The factors that have led to PEI’s success are numerous, but three stand out:

  1. Quick action on controlling the movement of people,
  2. Strong collaboration with Atlantic provinces, and
  3. High confidence in public health officials.

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PEI has some of Canada’s strongest controls on inter-provincial travel.

  • To date, non-residents are only permitted onto the Island if they are immediate relatives of a resident, have property on PEI, or have been in Atlantic Canada for at least two weeks.
  • Health PEI has been effective in enforcing self-isolation and contract tracing to mitigate spread.
  • Additionally, the province required seasonal residents to apply to visit their properties. Priority access was given to seasonal residents from provinces with fewer COVID-19 cases.

The Atlantic premiers were effective in coordinating a reopening strategy.

  • In addition to exchanging information and lessons between provincial health authorities, the strong collaboration led to the successful implementation of the Atlantic Bubble.
  • PEI has also maintained comparatively strong rules for interprovincial travellers, requiring self-declaration forms for non-residents crossing the bridge even if they have been in Atlantic Canada for at least two weeks.
  • The communication between the premiers allowed for some collaboration with the Quebec Government so some Quebecois could access the ferry in Souris so that they could return to the Magdalen Islands.

The high confidence in PEI’s public institutions can be due to the celebrity status of Dr. Heather Morrison, PEI’s Chief Public Health Officer.

  • Dr. Morrison maintained high media visibility during the pandemic through her daily press briefings. The CBC PEI live streams for some of her briefings garnered nearly 40,000 views (nearly a quarter of PEI’s population).
  • Dr. Morrison’s advice received cross-party endorsement from provincial lawmakers, with Premier Dennis King publicly deferring to her judgement on a number of issues.
  • Additionally, the strong buy-in from PEI residents resulted in high individual compliance and community enforcement of social distancing and self-isolation periods.
Small businesses on PEI such as Nimrods’ have been selling Dr. Morrison-themed merchandise to raise money for local charities.

Although PEI has been successful in combatting COVID-19 to date, the response has not perfect.

  • In March, the PEI government initially made a poorly communicated decision to shut down liquor stores, deeming the stores not to be an essential service. Following public outcry that liquor store shutdowns would exacerbate alcohol-related public health concerns, the decision was reversed shortly after.
  • Testing and mask policies were not the focus of the government’s preliminary response. Although testing is now above the national average, PEI lacks clear guidelines on public mask use (leaving most mask policy decisions to business owners).
  • The government also faced criticism for prioritizing seasonal resident access over the immediate needs of PEI’s fulltime resident communities. This decision may have been in response to a legal challenge against Newfoundland and Labrador’s seasonal resident travel ban.
  • On Thursday, a demonstration was held outside the Charlottetown courthouse to protest the arrest of Jevan Nsangira who was charged with “assault, uttering threats, and failing to self isolate.” Mr. Nsangira is the only individual to have been charged under the Criminal Code of Canada, causing the protesters to raise concern that he has faced an unfair punishment based on ethnicity.

There remain concerns whether PEI’s success can be sustained for the rest of 2020.

  • Canada is bracing for more cases due to an expected second wave and the reopening of schools. The lack of COVID-19 cases offers the Island some leeway in welcoming the return of more students; however, this approach could also put their families at risk in the event of a second wave outbreak.
  • The PEI government must decide whether evictions should be enforced or delayed when the legislature resumes. Like many COVID-19 policy decisions, eviction enforcement may also be guided by Dr. Morrison’s advice.

The Bottom Line: Although PEI’s near-perfect record may become tarnished with the advent of colder weather, the province set a high bar for responding urgently and ensuring public confidence. Other provinces can take lessons from the Bright Red Mud on nipping COVID-19 in the bud.