Over a year into the COVID-19 pandemic, policy restrictions across Canadian provinces and territories are highly divergent, yet largely unified in how they are described: strong, tough, stringent, and serious. Faced with a variant-fueled third wave, Ontario is in lockdown and has introduced long overdue restrictions on travel between neighbouring Manitoba and Quebec. At the same time, Manitoba is at its highest response level (Critical), which restricts travel north of the 53rd parallel, yet permits weddings of up to 25 people indoors. Alberta introduced what it called “stronger public health measures” yet still permits unmasked indoor school sports and outdoor dining on patios. Both Nova Scotia and Newfoundland and Labrador are focused on controlling transmission, and each permits groups of up to 100 people to gather indoors. The majority of Quebecers are subject to a nightly 8:00 or 9:30 p.m. curfew, and indoor gathering limits are between zero and one additional household. British Columbia is in the midst of a province-wide “circuit breaker” that bans indoor worship, but permits dining on patios.
The pandemic has taken an outsized human and social toll and has been enormously challenging for all levels of government. But with such a varied approach to introducing public health restrictions, and deeply subjective, loophole ridden, definitions of what a “strong” restriction looks like, it’s reasonable that Canadians are questioning why some provincial policy actions were taken over others. Beginning March 14, 2020, provinces began to declare public health emergencies and enter periods of lockdown, with residents mandated to stay home. The relative severity of the 2020 spring lockdowns differed minimally across the country, but the post-lockdown period has been marked by a grab bag of dissimilar approaches.
To begin to understand this variance, in my role as a Research Associate at the Centre of Excellence on the Canadian Federation at the Institute for Research on Public Policy (IRPP), I collaborated on the development of an index that captures twelve different measures enacted by Canadian provincial governments. The COVID-19 Stringency Index measures the relative stringency of policies in place and can model policy change over time, including gathering sizes, masks, school closures, and travel restrictions. We followed the team at Oxford University’s COVID-19 Government Response Tracker (OxCGRT), which has been tracking the different approaches taken by countries since the beginning of the pandemic. Our work resulted in a joint working paper published by Oxford University in March 2021: Variation in the Canadian provincial and territorial responses to COVID-19.
Using IRPP and OxCGRT data, this brief explores variation in the timing and relative stringency of government responses across 13 Canadian provinces and territories, with a specific focus on Alberta, Ontario, Quebec, and Nova Scotia. The ability to measure the relative stringency of COVID-19 policies deals with the problem that arises when policy goals are neither clear nor explicit, which makes figuring out what exactly was achieved a bit of a subjective exercise. Using relative policy stringency as the basis for objective analysis, we can counter the challenge of continually shifting standards and policy positions developed in response to a highly politicized pandemic environment.
The COVID-19 Stringency Index uses publicly available information to report on 12 measures within provinces’ control. For each measure, we evaluate the level of stringency based on a coding scheme. For more on how the Stringency Index is calculated see the methodology developed by the OxCGRT.
The dataset is available for download on Github and is updated on a weekly basis.
The Canadian Context
Figure 1: Provincial Stringency Index values vs. time
Using OxCGRT data, this chart measures the relative stringency of provinces from the beginning of the pandemic until the end of March 2021. A lower stringency index score indicates more relative openness.
Variation in Provincial and Territorial Response
Figure 2: Where things stand in Alberta as of May 7, 2021
On the recommendation of the Minister of Health and on the advice of the Chief Medical Officer of Health (CMOH), Alberta declared a public health emergency on March 17, 2020. Prior to March 20, 2020, a provincial state of emergency nullified a local state of emergency, but amendments made to the Emergency Management Act meant that local authorities could introduce restrictions in addition to provincial orders.
Following initial lockdowns, the province’s policy response has been characterized by a reluctance to introduce restrictions, focusing more on personal accountability and re-opening the economy. Unlike neighbouring British Columbia, where the government has largely gone along with the recommendations of the public health officials, in Alberta the Premier has taken a more independent approach. He has been slow to adopt recommendations made by public health officials; restrictions were lifted as early as May 15, 2020, and only reintroduced over the December holiday.
Alberta has focused on introducing public health measures that permit businesses to operate with limited restrictions. Gathering size limits have been consistently higher than elsewhere in Canada, and the province stands out for permitting public outdoor gathering of up to 200 beginning in June 2020. Alberta has recommended that residents not leave home except for essential purposes but has hesitated to make this a requirement. Similarly, residents have been asked to limit travel between regions, but intra- or inter-provincial travel has not been restricted.
As early as May 14, 2020, the CMOH recommended that the public wear facial coverings. As the province entered a phase of greater openness beginning June 1, 2020, using municipal bylaws, Calgary and Edmonton (representing about 74 per cent of the province’s population) both mandated public mask-wearing beginning August 1, 2020. Partnering with a network of drive-through retail outlets, the province distributed four non-medical masks to each resident beginning in mid-June, but the government did not extend a province-wide mask mandate until December 8, 2020.
Like elsewhere in Canada, schools closed in mid-March and did not re-open until early September. As early as August 4, 2020, the province announced that returning students were required to wear masks. Since classes resumed in person in early September, students in grades four and above have been obliged to wear masks in situations where physical distancing is not possible, such as high-traffic hallways and common areas. Students are not currently required to wear a mask while seated in a classroom or while playing indoor sports.
Restrictions on public gatherings significantly ramped up in late October, 2020, but residents were not limited solely to gathering with their individual households until the December provincial shutdown began. Beginning December 13, 2020, the province entered a period of heightened restriction that temporarily closed some services such as hair salons, movie theatres, gyms, and libraries, and reduced retail services and mall capacity to 15 per cent occupancy. Beginning May 2, 2020, Alberta emphasized that workers who can work from home should do so. It was not until December 13, 2020, that all employees who could work from home were required to do so.
Indoor dining resumed on June 1, 2020, and was maintained until December 13 at which point service was limited to curbside pick-up or delivery. Alberta began to ease holiday shutdown measures on January 18, 2021, which included permitting indoor dining.
Faced with rising variant cases, Alberta reverted back to Step 1 on April 6, 2021, which reduced capacity in businesses and closed gyms, but kept outdoor patio dining open. Places of worship were limited to 15 per cent indoor capacity, a requirement that has frequently and dramatically been violated by outspoken church leaders. This health order violation has led RCMP to physically close some churches. As of the end of April, 2021, Alberta has the highest cases per capita in Canada.
Figure 3: Where things stand in Ontario as of May 7, 2021
With a population of more than 14.5 million, Ontario is home to about two in five Canadians, more than 85 per cent of whom live in urban centres. It was the site of Canada’s first presumptive case of COVID-19 which was detected in a traveller returning from Wuhan, China on January 25, 2020. To date, Ontario has the largest number of confirmed cases in Canada. More than half of Ontario’s COVID-related deaths have occurred in long-term care homes, yet the province’s pandemic response has been incremental and slower relative to other provinces.
In 2003, outside of Asia, Canada was the country hardest hit by Severe Acute Respiratory Syndrome (SARS), a novel coronavirus that originated in China and spread by respiratory droplets. The majority of SARS cases and deaths were concentrated in the Greater Toronto Area. Ontario declared a state of emergency in March, 2003, and the province lifted it in May, 2003, when viral transmission diminished.
Subsequent public health evaluations undertaken by the SARS Commission identified many systemic deficiencies in Ontario’s level of preparedness and pandemic response. This included a lack of surge capacity in the clinical and public health systems, difficulties with timely access to lab testing, inadequate institutional outbreak management protocols, and weak links between public health care and other care providers. Fifteen years later, many of the Commission’s recommendations to address the weaknesses in public health infrastructure have not been acted on, and Ontario’s reactive and muddled early pandemic response suggested that little had been learned little from past mistakes.
On March 2, 2020, Ontario established a command table as a single point of oversight providing strategic direction to guide the pandemic response. At the time, the risk to Ontarians was determined to be low. The command table reported to the Minister of Health and included Ontario’s Chief Medical Officer of Health (CMOH). Five regional planning and implementation tables led by Ontario Health and local public health units reviewed and implemented regional plans. In total, there are 34 health regions in Ontario.
Ontario issued a ministerial order to close all public schools on March 14 and declared a state of emergency on March 17, 2020. Gatherings were restricted to 250 people on March 13, 50 people on March 16, and five people on March 28. On March 24 all non-essential workplaces closed. Although initially scheduled to re-open on April 4, 2020, schools did not resume in-person instruction until early September.
From the beginning of the pandemic, Premier Doug Ford has been the spokesperson of Ontario’s response. On July 21, 2020, the Reopening Ontario Act shifted the authority to extend or amend some emergency orders from the legislature to Cabinet. The Act allows for unrevoked emergency orders to be extended for 30 days at a time, for a maximum of two years, without consulting the legislature.
Ontario’s level of policy stringency has incrementally changed with directives targeted to specific regions, many of which were modified soon after implementation. Restrictions began to lift when Ontario entered Stage 1 of its reopening framework. Businesses gradually re-opened beginning May 4, with retail stores opening May 19, 2020.
Restrictions were significantly relaxed beginning June 12, 2020, when most regions of Ontario entered Stage 2, but many densely populated areas, including the Toronto, York, and Peel regions, remained at Stage 1. Ontarians were encouraged to establish a social circle of no more than ten people whom one could contact without physical distancing. Restaurants and dining re-opened on June 19, 2020, but operating hours were limited beginning September 26 due to a significant increase in cases in the 20-39 age group. Gatherings increased to 50 for some regions beginning July 13, 2020, but were significantly reduced beginning in early September.
Public health officials recommended Ontario residents wear masks as early as May 19, 2020, but they were not mandated until October 3, 2020. On July 30, 2020, Ontario announced that all returning students in grades four and above would be required to wear masks in classrooms, hallways, and entrances.
As a result of higher-than-average rates of transmission in September and October, 2020, many areas shifted to modified Stage 2. Ontario introduced a new reopening framework on November 7, 2020, which categorized regions based on five levels: Green-Prevent, Yellow-Protect, Orange-Restrict, Red-Control, and Grey-Lockdown.
A November, 2020, report from the Ontario Auditor General characterized the province’s pandemic response as slower to react relative to other provinces, with a cumbersome command structure that was not led by public health expertise. The province was operating with outdated emergency plans and a complex structure (there are now more than 500 people involved in the Health Command Table) that resulted in delays and confusion.
A key finding of the AG report focuses on testing, which was initially reserved for high-risk groups such as health-care workers and long-term care residents. On May 24, 2020, Premier Ford opened up asymptomatic testing to the general public, which went against advice that this would overwhelm the province’s lab capacity. In February, 2021, testimony made by the Minister of Health to Ontario’s Long-Term Care COVID-19 Commission – an independent commission with a mandate to investigate how and why COVID-19 had devastating effects in long-term care homes – highlighted that Premier Ford overrode the advice of officials by opening up testing. Though he claimed to be following public health advice, he was aware of the systemic impacts this change would have. It resulted in significant testing backlogs and further burdened the pandemic response. Ontario transitioned to appointment-based testing beginning October 6, 2020.
On December 26, 2020, a province-wide shutdown began, which included stay-at-home orders and heighted restrictions on retail outlets and services. In late January, 2021, Ontario projected that the B.1.1.7 variant would become the dominant viral strain beginning in March. Students returned to classrooms on January 25, 2021, but were moved to remote learning beginning April 15, 2021. Beginning February 10, 2021, three public health regions entered Green-Prevent, and subsequent relaxations began February 16, 2021. As of April 8, 2021, the entire province was under a stay-at-home order under Grey: Lockdown. Ontario has not issued intra-provincial travel restrictions. On April 19, 202,1 the borders with Manitoba and Quebec were closed to travellers.
Figure 4: Where things stand in Quebec as of May 7, 2021
At the onset of the COVID-19 pandemic, Quebec was the hardest hit province in Canada. The first case, related to travel in Iran, was detected in the Montreal metro area on February 27, 2020, where about half of the province's eight million residents live. Quebec students went on spring break from February 29 to March 9, 2020, a week before other provinces, which researchers have linked to the significant rise in early case numbers, relative to other provinces. Quebec closed schools March 13, 2020, and was the first province to declare a public health emergency on March 14, 2020. The government later announced that according to a Google study, Quebec was the first jurisdiction in North America to enter a period of confinement.
Due to high early viral transmission and limited preparedness, Quebec’s pandemic response has been quicker to introduce reactive and markedly more restrictive measures relative to other provinces. The response has been led by Premier François Legault, the Health Minister, and the National Director of Public Health. In the first wave, the phrase << Ça va bien aller >>, translated to “everything will be alright,” was widely adopted at a moment when Quebec had some of the highest mortality rates in the world. Early on, Quebec had 721 deaths per million, comparable to Spain (743 deaths) and higher than the USA (680) and Italy (618). The Canadian average was 263 deaths per million.
Government-funded long-term care homes – Centres d’hébergement de soins de longue durée (CHSLD) – were the site of widespread transmission and of over 70 per cent of Quebec’s COVID-19 deaths. Canadian Armed Forces members were sent to CHSLDs in mid-April 2020 to assist medical staff. A subsequent military report attributed systemic failures and high mortality to staff shortages, inadequate personal protective equipment, and widespread disorganization.
Events of over 250 people were cancelled March 12, 2020. All indoor and outdoor gatherings were restricted beginning March 21, 2020. Restaurant capacity was cut to 50 per cent on March 15 and limited to pick up and delivery on March 23, 2020. Non-essential retail and services closed on March 23, 2020, and those remaining open closed on Sundays beginning in April 2020. Libraries, museums, and cultural venues were ordered closed on March 15, 2020.
Quebec shut down and residents were ordered to stay at home beginning March 24, 2020.Government first advised against non-essential travel between regions beginning March 19, 2020, with checkpoints between regions added March 28 and expanded April 1, 2020. Checkpoints were extended to the neighbouring provinces of Ontario, Newfoundland, and New Brunswick, but the border was reopened May 18, 2020.
Quebec’s Director of National Health recommended on March 18, 2020 that medical masks be reserved for health care workers and patients. This position was reversed on May 12, 2020, when Premier Legault encouraged residents to wear masks in public, though this was not made mandatory until July 18, 2020. On August 10, 2020, the Education Minister announced that students in grades five and above were required to wear masks in high-traffic areas, such as hallways, but not in classrooms. Individual school boards were not permitted to introduce more strict mask mandates. It was not until schools returned on March 8, 2021, after spring break, that all were required to wear medical masks in all settings.
Quebec emphasized per capita daily test quotas as it introduced deconfinement measures beginning in May, 2020. Businesses outside the Montreal region began to re-open May 4, and within Montreal beginning May 25, 2020. Groups of ten or fewer were permitted outdoors beginning May 22, 2020. Indoor gatherings of no more than ten people were permitted outside Montreal beginning June 15, and in the city after June 22, 2020. Festivals and events of up to 250 people were permitted as of August 5, 2020.
On September 8, 2020 a progressive regional alert system was introduced to tailor restrictions based on healthcare capacity. At the end of September, 2020, Quebec introduced stay-at-home orders and more strict restrictions for a period of four weeks. This was extended by four weeks on October 26, and renewed in November, until the province introduced a “holiday pause” beginning on December 25, 2020. Leading up to the holidays, the province proposed a “moral contract” with citizens to permit small, indoor, in-person gatherings between December 24-27, 2020, with periods of voluntary confinement before and after. The province initially promised two gatherings during that period, then reduced it to one, and then cancelled the holiday exemption all together.
Quebec is the only province to have introduced a curfew. Beginning January 9, 2021, residents were not permitted to leave their homes between 5:00 a.m. and 8:00 p.m. Hours have been extended to 9:30 p.m. in some regions as of February 26, 2021, but some form of curfew remains in effect province-wide. Special measures were introduced in certain regions in early April, 2021, with exceptional public health closures undertaken in response to gyms in the National Capital Region that have violated public health orders and created “superspreader” events.
Figure 5: Where things stand in Nova Scotia as of May 7, 2021
The Atlantic provinces have experienced more freedoms and relative normalcy over the course of the pandemic than the rest of the country. On March 19, 2020, Nova Scotia closed non-essential businesses, restaurants, and bars, and required remote work where possible. Most retail resumed by June 5, 2020, until a localized restriction on Halifax and Hants Counties in late November, 2020, ending by January 4, 2021. By early June all of Atlantic Canada had opened in-person dining for at least 50 per cent capacity.
Prior to declaring a state of emergency, all four Atlantic provinces had begun to recommend cancelling large and public events. Nova Scotia relaxed its gatherings restrictions on June 18, 2020 by allowing up to 50 people to gather (indoors or outdoors) with social distancing in place. With the most relaxed guidelines in Atlantic Canada, on July 3, 2020, Nova Scotia permitted gatherings of 250 people outdoors and 200 indoors. By July 15, 2020, two households were allowed to form a bubble together without social distancing.
Nova Scotia relaxed its stay-at-home requirement to a recommendation on May 1, 2020, and by June 5 stay at home was no longer mentioned in public health updates. However, during a surge in cases in late November, 2020, the Nova Scotia Premier called for residents to “stay the blazes home,” reinstating the recommendation to stay at home until December 21, 2020. When cases surged in late February, 2021, residents were once again advised to stay home.
The creation of the “Atlantic Travel Bubble” on July 3, 2020, allowed the Atlantic provinces to enjoy increased freedoms compared to the majority of Canada for much of the second half of 2020. Due to low cases and deaths across Atlantic Canada, the travel bubble meant residents could travel without the requirement to self-isolate if they had already been in one of the four provinces for the previous 14 days. The Atlantic Travel Bubble existed from July 3 to November 24, 2020 when PEI left due to increased cases of COVID-19 in New Brunswick and Nova Scotia. Newfoundland left the travel bubble on November 25, and New Brunswick on November 27, 2020. Nova Scotia never officially left the travel bubble and did not reinstate 14-day quarantine requirements for travellers until April 19, 2021. Due to the relatively small populations and geography of the Atlantic provinces, epidemiological contact tracking appears to have been significantly easier to implement than it was for the larger provinces. Citing rising cases, Nova Scotia entered a province-wide lockdown on April 27, 2021
One year into the pandemic, it is clear that provincial policy responses and outcomes have been highly divergent and that the coordination benefits of federalism have been unevenly leveraged. At the same time, provinces have learned from one another and introduced innovative policy responses such as the creation of the “Atlantic bubble” and lockdown triggers responding to case level trends. Less populous provinces and territories created the conditions for greater freedom of movement and normalcy as compared to larger provinces. With the creation of regional zones and tiered policy triggers, most regions have adopted reactive policies and restrictions, often too late, and not without unintended confusion.
While all provinces took a hardline approach in the first wave, the relative stringency of third wave restrictions may appear similarly strict, but they are rich in loopholes. Even under the strictest lockdown measures in the provinces of BC and Alberta, outdoor patio dining persists. Indoor worship in Ontario and Manitoba, though limited and subject to masking and social distancing, continues to bring groups together from different households in most provinces. Quebec’s enduring curfew may have reduced transmission but requires further study.
By measuring the relative stringency of pandemic policies, our goal is to provide an accurate snapshot of restrictions in place at a given time. We capture what is enforced, not recommendations or advice given by public health officials or politicians. The primary voice of policy responses has varied significantly across provinces. Some were led primarily by public health officials, such as in British Columbia by Dr. Bonnie Henry and PEI by Dr. Heather Morrison, while others have been led by members of the executive such as Ontario Premier Doug Ford or Alberta Premier Jason Kenney. Other provinces have used a combination of both, such as Quebec where Premier Legault has almost always appeared alongside the head of the province’s public health agency. Regardless of who is seen as leading the public health response, the language around restrictions matters. Too often, decision-makers have been forced to either backtrack or clarify what was meant by their latest policy intervention. One avenue for future research is investigating whether these varied approaches to public health communication impacted compliance with public health measures.
As regions shift focus to delivering vaccines, the dramatic rise in variant cases makes clear that the pandemic is not over for a large part of the country. Economic support and public health restrictions are likely to be required for some time, but given the highly uncoordinated provincial pandemic response to date, it would not be surprising if some regions reached a ‘new normal’ well before others. As it stands now, renewed attention needs to be given to those policy loopholes that may be driving viral transmission: outdoor dining, mixing of groups indoors, and workplaces deemed essential, particularly in Ontario. This brief accompanies the publication of the continually updated and publicly available IRPP Covid-19 Stringency Index and OxCGRT Canadian subnational dataset. As the pandemic continues to evolve, we hope that this modelling supports policy decision-making grounded in reality and rigorous policy evaluation.
About the Author
Paisley Sim is a Research Associate focused on Canadian federalism at the Institute for Research on Public Policy. Her experience includes working for Alberta Premier Rachel Notley, as special adviser to Alberta’s Minister of Justice, and for an international music and arts festival for nearly a decade. She holds a conservatory diploma, a bachelor of fine arts from Concordia University, and a master in public policy from McGill University’s Max Bell School of Public Policy.