Canada’s top health officials are debating whether to expand a new travel policy and ask anyone coming into the country from China to voluntarily quarantine themselves in order to reduce the risk of spreading the coronavirus.

It’s a major decision that health experts say must be weighed carefully, as voluntary quarantines are disruptive to the people facing them and could even risk eroding public trust in the country’s health-care leadership.

Last week, federal and provincial health officials began asking anyone coming to Canada from the Hubei province of China, the epicentre of the coronavirus outbreak, to “self-isolate” for two weeks to reduce the risk of spreading the virus.

But as the outbreak continues to grow in China and beyond, officials may expand that advice to travellers from other parts of China, according to Theresa Tam, Canada’s Chief Public Health Officer.

“We’re weighing that, together with provinces and territories, on a very real-time basis,” Dr. Tam said on a conference call with reporters this week. “It is limiting someone’s movements, so we have to do that in a balanced way.”

The voluntary advice to “self-isolate” is distinct from federally mandated quarantines. Hundreds of Canadians airlifted from the Hubei region are currently under a mandatory quarantine order at the Canadian Forces Base in Trenton, Ont.

Before last week, travellers from China were screened at international airports in Vancouver, Toronto and Montreal. Anyone coming from Wuhan, the city where the outbreak began, were asked about their symptoms and travellers were told to monitor themselves and contact health authorities if any fever, cough or other signs of illness developed. The screening shows that about 70 to 80 people from the Hubei area are arriving in Canada each day, Dr. Tam said.

The ramping up of travel advisories in recent weeks suggests Canadian officials are growing more concerned about the possibility of human-to-human transmission of the virus, which the World Health Organization has warned poses a serious threat.

Last week, B.C. officials said a Vancouver-area woman who was hosting visitors from Wuhan tested positive for the virus. Days later, two of the visitors also tested positive for the virus.

Michael Curry, an emergency physician and professor at the University of British Columbia, said it’s likely just a matter of time before officials decide to broaden the self-isolation policy.

“I suspect as the disease spreads, [self-isolation policies will] probably expand to other regions,” he said.

Canada’s policies don’t go as far as other countries, such as the United States, Japan and Australia, which have imposed total or partial travel bans on travellers coming from China. Evidence shows that closing borders may delay the spread of a virus, but won’t stop it.

The major deciding factor for Canadian officials will likely be the rate of human-to-human transmission throughout China and in other parts of the world, said Jason Kindrachuk, assistant professor and Canada Research Chair in emerging viruses at the University of Manitoba. But for now, health officials have to watch and wait to see how the situation unfolds.

“We’re at a little bit of an impasse trying to figure out what is going to be the next step,” Dr. Kindrachuk said.

But officials need to proceed with caution, as quarantines impose economic, social and other strains on individuals and, if done incorrectly, can undermine trust in the health-care system. Dr. Kindrachuk, who was in Liberia during the Ebola outbreak, said government quarantines and other heavy-handed measures led to panic, fear and misinformation in the general public.

It’s unclear whether individuals under self-isolation would be eligible to apply for employment insurance or receive other supports. On Tuesday, federal Health Minister Patty Hajdu said those who are struggling under self-isolation should reach out and as the government assesses the situation, it can determine what action to take.

“As we understand those situations more clearly, we’ll definitely have a better sense of what supports are needed,” Ms. Hajdu said Tuesday.

Nelson Lee, an infectious-diseases professor at the University of Alberta, said the unprecedented mass quarantines in China are clearly leading to “a lot of social disruption … as well as a huge impact on the economy.”

By contrast, Dr. Kindrachuk said the Canadian approach appears to be working so far. After he returned from Liberia in 2014, he had to self-isolate for three weeks and said the voluntary approach worked well.

“It allows you to keep more stringent control while also maintaining trust,” he said.

The Globe and Mail, February 11, 2020