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As cases reach alarming heights in Quebec and Ontario, the East Coast is healthy and thriving under some of the country’s toughest health rules. Here’s how they did it

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Debby Matheson helps a customer at Sharon's Place family diner in Pictou, N.S., as shields help other patrons keep their physical distance.Darren Calabrese/The Globe and Mail

It’s just before the lunch-hour rush and customers are beginning to file into Sharon’s Place, a family diner near the water in Pictou where the kitchen is busy pushing out orders of lobster burgers and butterscotch pie.

They’re greeted by Sharon Stewart, the restaurant’s owner, who calls everyone “honey” or “darlin'” as she points them toward the hand sanitizer. To get a seat in one of her plexiglass-shielded booths, you need to wear a mask, be without COVID-19 symptoms and provide your name and number for contact tracing.

"We don’t have any cases here, and we want to keep it that way,” explained Ms. Stewart, wiping down tables and chairs in between guests.

Across Atlantic Canada, there are many people who share that sentiment.

As other parts of the country struggle with a second wave of COVID-19 that could be more punishing than the first, the four eastern provinces have managed to keep the pandemic at bay and even relaxed a social gathering limit Thursday, with a mixture of good fortune, public co-operation and some of the toughest public-health rules in Canada.

The region has reported just a handful of infections in the past month, all of them tied to people travelling outside Atlantic Canada. There has been little more than 1,610 cases of the disease in the Atlantic provinces since March, compared with more than 154,000 in the rest of Canada.

The death toll has been dramatically smaller, too – COVID-19 has claimed 70 lives in the region, while it has killed more than 9,200 people in the rest of Canada. All but 17 of those deaths in the Atlantic provinces were connected to the same outbreak at Halifax’s Northwood nursing home.

Collectively, the region has some of the lowest infection rates in the world, far better than most developed countries.

New Brunswick and Prince Edward Island, with rates of around 25 and 36 cases per 100,000 people, respectively, are doing better than New Zealand, which is held up as a model for success in controlling COVID-19.

While other parts of the country clamp back down in response to new outbreaks, here restrictions are easing. On Thursday, Nova Scotia changed the rules to allow groups of 50 people to gather without physical distancing for performing arts and sports.

It has not been without sacrifices, however. For months, despite a low rate of infections, almost everyone travelling from outside Atlantic Canada has been required to self-isolate for 14 days upon entry – a rule that has been particularly hard on the tourism and hospitality sectors.

PEI’s tourism association says businesses have been devastated by the drop in visitors, with overnight stays in hotels and campgrounds down 64 per cent in July from 2019. Tourism Nova Scotia estimates tourism revenue could drop by $1.7-billion in 2020 compared with last year. Given the low rates of infection, calls are growing daily in the business community to reduce restrictions that are keeping customers away.

The two-week quarantine rule was brought in by the provinces themselves, in addition to a federal rule that requires visitors from outside Canada to self-isolate. No other part of the country, with the exception of the Northwest Territories, has taken quarantine restrictions that far.

Some people have complained the travel restrictions are heavy-handed, and they’ve prompted at least one legal challenge, from the Canadian Civil Liberties Association, which argued the restrictions violate the Canadian Charter of Rights and Freedoms.

But the results are also hard to argue with. With few local infections, the economies of the Atlantic provinces are reopening at a faster rate than any other part of Canada. Schools have resumed without incident and customers are returning to many restaurants and bars again, albeit at reduced capacities.

“Compared to the rest of Canada, we’re lucky. We have almost a normal life. I can go to the pub, I can go to a restaurant, I can go shopping, and I don’t have to wear a mask,” said Roger Ouellette, a professor of political science at the University of Moncton. “We have had good management of this crisis.”

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A masked pedestrian crosses an empty street in downtown Pictou.Darren Calabrese/The Globe and Mail

In Pictou County, a rural region on Nova Scotia’s North Shore, there hasn’t been a confirmed infection since mid-August.

But people here have still supported sometimes-painful measures to keep COVID-19 out. Organizers of the beloved Lobster Carnival, a sprawling outdoor party that draws thousands to town, cancelled the event for the first time since the Second World War.

Ms. Stewart’s restaurant also lost seating for about 30 people, to abide by distancing rules. Her business is down, and she took a hit with fewer visitors this summer.

But as she watches outbreaks spread in Ontario, Quebec and elsewhere, she’s anxious to keep tourists at a distance, and maintain travel restrictions and border checkpoints to protect the “Atlantic bubble" of Nova Scotia, New Brunswick, Prince Edward Island and Newfoundland and Labrador.

“To be honest, I’m petrified,” Ms. Stewart said.

“Every case we’re getting is travel-related. Let’s just leave the border the way it is for the winter. Let’s leave them there.”

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Sarah Bell has her hair cut by Maram Kalhor at Grand Senses in Charlottetown. Prince Edward Island's COVID-19 rules are among the strictest in Canada.

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At Charlottetown's Kettle Black café, patrons are encouraged to write their names and phone numbers in a book for contact tracing purposes. Dine-in restaurant service returned to the island on June 1.

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Members of Charlottetown's Crossfit 782 keep their distance after a workout. Masks are not mandatory in indoor public places in PEI, though the province recommends their use.John Morris/The Globe And Mail

Geographic advantage

With 2.4 million people, Atlantic Canada benefits from smaller, less dense urban centres and travel patterns that make it easier to control the spread of the coronavirus. People here use less public transit, and the region has fewer points of entry than Saskatchewan or Manitoba, which have higher rates of infection with a similar combined population.

But the Atlantic “miracle” can’t be explained away by just by looking at population.

“They certainly have a geographic advantage, and a smaller population that works in its favour. But we still can’t ignore smart policy and good leadership there. That’s been a fundamental factor,” said Isaac Bogoch, an infectious-disease specialist with the University of Toronto.

“It’s really an underdiscussed success story.”

The most effective policy, he said, is the requirement that people coming from outside the Atlantic provinces self-isolate for two weeks. It’s largely credited with keeping a second wave from appearing east of Quebec.

When six temporary foreign workers tested positive for COVID-19 in New Brunswick in August, they didn’t cause an outbreak like those seen in other provinces because they were still in isolation when they were identified. Provincial officials have been able to trace all recent infections to flights from outside the region – proof, they say, that quarantines are working and preventing community spread.

“That’s doing the heavy-lifting. You’re just not introducing or reintroducing infection into your area,” Dr. Bogoch said. “I think it may be too soon to celebrate, but not too soon to acknowledge they’ve been doing a wonderful job to date.”

All four provinces monitor out-of-region visitors, using people at call centres and digital daily check-ins during their two-week quarantine period to make sure they’re following the rules. If someone repeatedly doesn’t respond to those calls, they can be charged under public-health laws, and fined $1,000 for a first offence.

If you slip up a second time, you could be fined up to $10,000 and face a year in prison. Workers in services deemed essential, such as mining, commercial truckers and the military are exempt from self-isolating, however.

New Brunswick allows those who work in other provinces to come back without self-isolating, while those “rotational workers” do not need to self-isolate in PEI but must be tested on a regular basis. Newfoundland allows rotational workers to end their isolation after one week if they have a negative test. In Nova Scotia, rotational workers still have to self-isolate for 14 days when they come home.

The region’s universities have also enforced provincial mobility restrictions for students from outside the region, in at least four cases expelling those who breached their self-isolation in their first 14 days of arrival.

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A sign warns of a COVID-19 checkpoint on the Confederation Bridge to PEI this past March.Andrew Vaughan/The Canadian Press

Prince Edward Island has laid more than 50 charges under its Public Health Act in recent months, mostly related to quarantine violations. PEI also tests commercial truckers upon entry at the Confederation Bridge, allowing them to get results within days rather than wait two weeks. The island requires international students and foreign travellers to self-isolate in government-approved quarantine hotels for two weeks, instead of private residences.

Those measures may seem harsh, but they appear to be working. The island, while it had a much-reduced tourism season by relying only on visitors from within the region, has had just 59 cases since the pandemic began.

“I’m certainly concerned about what’s happening outside the Atlantic bubble, and it reinforces to me some of the things we’ve been doing may be helping us,” said Heather Morrison, PEI’s Chief Health Officer.

“These decisions made a lot of sense, to try to protect the island. But we also know the unintended impacts of COVID have touched many people in a province that relies on tourism.”

With only three points of entry, PEI’s public-health officials have the ability to easily monitor everyone coming into the province, which they do through self-declaration forms. It would be much more difficult to control travel in and out of larger provinces such as Ontario, Dr. Morrison acknowledged.

The four Atlantic provinces were also credited with acting quickly in the early days of the pandemic, shutting down schools days ahead of much of the rest of Canada. They were the only provinces to temporarily close their borders to non-residents, with an exception for essential workers, something that hadn’t happened since Confederation.

The provincial borders remained almost fully closed until July, when they formed an Atlantic bubble that allows people from the region to travel freely without self-isolating, while non-residents were allowed in as long as they quarantine.

New Brunswick, where there is currently no one in hospital as a result of COVID-19, turns away several dozen vehicles every day from the Quebec and Maine border checkpoints because they don’t have proof of residence or don’t have a credible self-isolation plan.

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The St. Stephen lighthouse looks out from New Brunswick to Calais, Maine, on the other side of the Canada-U.S. border.John Morris/The Globe and Mail

The provinces' response to COVID-19 has evolved over time, as understanding of the pandemic has grown, said Jennifer Russell, New Brunswick’s Chief Medical Officer of Health.

Her province’s decision to require outsiders’ self-isolation came from studying outbreak modelling in other jurisdictions, including Singapore, New York and China’s Wuhan province, she said. New Brunswick, with limited numbers of intensive-care beds and ventilators, realized a quarantine policy would be the best way to keep the medical system from being overwhelmed.

“Every province has their own comfort level when it comes to risk tolerance,” Dr. Russell said. “We know what our capacity is, and the goal is to never exceed that. … If those resources were exhausted, we would quickly be overwhelmed."

Many Atlantic Canadians, who often live in smaller, more rural communities, also tend to be community-minded rule followers who haven’t pushed back much against restrictions on travel. There has been none of the mask protests or economic-reopening rallies that have popped up elsewhere.

They’re also seeing the benefits of following the rules, as infections drop and restrictions are loosened.

“We have a population that’s been very adherent to public-health measures, and I think that’s helped a lot,” Dr. Morrison in PEI said.

“People want to protect their families, and their broader communities. And they can see we’ve made great steps in reopening because we don’t have the cases that other places have seen.”

Newfoundland and Nova Scotia both require masks to be worn in public spaces. PEI and New Brunswick don’t have mandatory mask orders, although New Brunswick’s largest city, Moncton, now requires them inside city buildings. Most people, however, are wearing them anyway on the advice of public-health officials.

In Nova Scotia, when Premier Stephen McNeil urged people to “stay the blazes home,” his province embraced the slogan, making physical distancing into an act of community spirit. People put the slogan on T-shirts and turned it into songs, and weren’t afraid to call out those who ignored its message.

“People here are a pretty deferential lot,” said Tom Bateman, a professor of political science at St. Thomas University in Fredericton.

“That may be changing, but Maritimers in general have more trust in their governments. And when they’re asked to follow public-health rules, they usually listen. Here it’s worked like a charm.”

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Physically distanced ferry passengers wear masks on the open-air deck as they cross Halifax Harbour. The pandemic led to strict passenger limits on ferries across Atlantic Canada, and Nova Scotia's high-speed ferry from Yarmouth to Maine was cancelled for the rest of the 2020 season.

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Gary Williams of Halifax is shown in self-isolation at home this past March after his return from Germany. The Atlantic provinces created their bubble about three months later.

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A message board warns motorists about COVID-19 on a Halifax highway this past April. Weeks earlier, Premier Stephen McNeil's warning to 'stay the blazes home' gave Nova Scotians a popular slogan in their efforts to contain the virus.Photos: Darren Calabrese/The Globe and Mail

Economic impacts

In Sydney, N.S., there are signs everywhere that the city is rebounding from the pandemic. The local casino is reopening, churches are filling up again, and crowds of up to 800 people will soon be allowed into the Centre 200 to watch the local junior hockey team, the Cape Breton Eagles, play. Teams in the same league from Quebec, meanwhile, will play in empty rinks.

But one of the more surprising indicators of an economic rebound may be in housing sales – including from buyers based outside Atlantic Canada. Many of them are ex-Maritimers returning home, leaving larger urban centres because of COVID-19, drawn back to the relative safety and affordability of the Atlantic region. “This whole pandemic has made people have another look at where they’re living, and asking whether they want to be some place safer,” said Ryan O’Donnell, Cape Breton regional director with the Nova Scotia Association of Realtors. “If a good home comes up around here, if you’re not writing an offer within a day or two, you’ll lose it.”

Because of travel restrictions, some out-of-province buyers are making offers on homes based on virtual tours alone, and jumping into bidding wars, he said. That’s a new phenomenon in the normally slow-paced Cape Breton real estate market, where the average price of a home is $148,000. “I’ve never seen a market like this,” Mr. O’Donnell said. “As realtors, it takes some adjusting to, because this wasn’t something we had dealt with before.”

Realtors in cities around the region are relaying similar stories. In New Brunswick, home sales were up 25 per cent in June from the previous year, according to the Canadian Real Estate Association. In Fredericton, the province’s leafy capital, sales were up more than 50 per cent from the year before, although numbers on out-of-region buyers weren’t available.

Moving companies in Newfoundland, meanwhile, say they’ve been overwhelmed by calls from people relocating back to the province after years away in Alberta or Ontario. The question remains whether it’s a just “COVID blip,” or a permanent reversal of the province’s historic out-migration patterns.

There have been obvious economic hardships from the protective measures brought in to slow the coronavirus, too, particularly in the tourism and hospitality sectors that rely on visitors from outside the region.

In Halifax, hotels are operating at about 10-per-cent capacity, and some restaurants aren’t expected to reopen. With infection rates remaining so low, calls are growing to ease more restrictions to help those businesses survive. “We’re in a pretty special place in North America,” said Patrick Sullivan, president and chief executive officer of the Halifax Chamber of Commerce. “So if we’re living in a bit of a walled garden right now, can we not enjoy some of the benefits? We’ve put in a lot of hurdles to limit the spread of COVID in Atlantic Canada, and yet our restaurants are still facing many of the same requirements that restaurants elsewhere are facing.”

He’d like to see faster testing at Nova Scotia’s borders, so that out-of-region visitors can return, and easing limits on indoor gathering for restaurants so they can serve more customers. Office towers in Halifax still allow only two people in an elevator at a time, which Mr. Sullivan says feels like overkill when masks are mandatory and cases of the disease remain so low.

While Atlantic Canadians did what they could to support local businesses this summer, those so-called “bubble vacations” typically benefited rural businesses instead of urban ones, as people took the opportunity to get out of cities, he said.

At the Cabot Cape Breton golf resort in Nova Scotia, where in a normal year 80 per cent of visitors come from outside Atlantic Canada, it’s been a challenging time. The luxury golf destination, which often caters to international guests who fly in to the Sydney airport on private jets, had to trim its work force, reduce fees and pivot to attract locals this summer.

That’s meant empty fairways some days, quiet patios and hotel rooms going unused. As the pandemic rages in other parts of the country, staff here are just trying to remain optimistic the crowds will come back in 2021.

“Once everybody realized the severity of this thing, cancellations started pouring in,” said Andrew Alkenbrack, the resort’s general manager. “We just have to see how this thing plays out.”

Harriet, 6, and June, 3, watch Haligonians line up on the sidewalk to get food from a mobile delivery service. How we stayed the blazes home

In the pandemic’s initial months, photojournalist Darren Calabrese documented his family’s isolation and the changing world around their Halifax home. This is their story.

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