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Vaccine Uptake

Rapid Review Update 1: What is known about reasons for vaccine confidence and uptake in populations experiencing inequities?
Across all three equity-deserving populations in this review, a desire to prevent infection and transmission to others, trust in the efficacy and safety of the vaccine, communication of accurate and comprehensive vaccine information through trusted community sources and providing easy and affordable access to the vaccine were all factors supporting the uptake of all vaccines.
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Parental Considerations for Vaccination

Rapid Review Update 1: What is known about parents’ considerations for vaccine uptake for children and adolescents?
Parents consider their trust in health care providers and the government, the perceived safety of vaccines, an assessment of the risks of diseases and vaccines, and any barriers to accessing vaccines when deciding to vaccinate their children. Parents want trustworthy information about vaccines and vaccine-preventable diseases to help them make decisions.
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Physical Distancing

Living Evidence Synthesis: What is the effectiveness of physical distancing in reducing transmission of COVID-19 and other respiratory illnesses (e.g., influenza, respiratory syncytial virus (RSV)) in non-healthcare community-based settings?
Evidence suggests that those who report physical distancing from others have a lower risk of COVID transmission and influenza-like illness. However, distancing policies in school settings may not reduce the risk of transmission.
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Reducing Contacts

Living Evidence Synthesis: What is the effectiveness of measures to reduce contacts in reducing transmission of COVID-19 and other respiratory illnesses (e.g., influenza, respiratory syncytial virus (RSV) in non-healthcare community-based settings?
Gathering restrictions, stay-at-home orders, and initial school closures may have been particularly effective to reduce transmission of COVID-19, particularly during the first wave.
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Risk communication

Rapid Review Update 2: What are best practices for risk communication and strategies to mitigate risk behaviours?
The literature on risk communication from various topic areas emphasizes the importance of clear, repeated, action-oriented messaging by a trusted leader.
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Health Information

Rapid Review: What were the public’s experiences accessing and interacting with public health information during the COVID-19 pandemic?
Using strategies that align with individuals’ experiences engaging with public health information during a public health crisis can help improve the effectiveness of communication, tackle misinformation, and address public needs to maximize uptake of accurate and credible public health information.
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Health Promotion

Rapid Scoping Review: What is known about the application of upstream and midstream health promotion approaches in the context of H1N1, COVID-19, and mpox pandemic preparedness and response?
Pandemic-related upstream health promotion approaches aim to reduce the risk of transmission, increase equitable access to testing/vaccination, and mitigate secondary impacts of the pandemic and its response measures.
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PHN/SAC Response

Rapid Review: What is known about the response of the Public Health Network and Special Advisory Committee in Canada to the COVID-19 pandemic?
This rapid review explores what is known about the Public Health Network (PHN) and the Special Advisory Committee’s (SAC) leadership and performance throughout the COVID-19 pandemic. There is very limited analysis of the role of the PHN and SAC in the COVID-19 pandemic. There is evidence of inter-jurisdictional coordination, reflecting one of the key functions of SAC. Along with coordination, there is also evidence of localized tailoring of messaging to reflect current information and the emerging status of the pandemic.
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Transmission in daycares and schools

Living Rapid Review Update 18: What is the specific role of daycares and schools in COVID-19 transmission?
Evidence shows transmission in schools/daycares is low with strong IPAC measures in place. There is limited data on the impact of either staff or student vaccinations in mitigating risk of transmission in school and daycare settings.
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Routine Childhood Vaccines

Rapid Review: What is the effectiveness of interventions to get school-aged children and youth caught up with routine vaccinations in the context of the COVID-19 pandemic?
Despite limited available evidence, interventions that appear to get school-aged children caught up with routine vaccinations in the context of COVID-19 include notifying parents that their child is behind, providing vaccine education and scheduling prompts, and offering convenient school- or community-based clinics.
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COVID-19 testing in healthcare and long-term care settings

Rapid Review: What COVID-19 testing requirements and/or recommendations do high-income countries currently have in place in healthcare and long-term care settings?
Current national COVID-19 testing policies in healthcare range from universal to context-dependent recommendations based on suspected transmission, vaccination status, presence of symptoms, and/or risk of exposure. National guidance is likely adapted locally with consideration of the trade-off between mitigating spread with available resources, outbreak status, and community rates of COVID-19.
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Changes to public health surveillance

Rapid Scoping Review: What is known about changes to public health surveillance programs, systems and strategies at the population level for governments globally due to the COVID-19 pandemic?
Literature on changes to public health surveillance during the COVID-19 pandemic is dominated by surveillance of COVID-19 infections; additional changes to public health surveillance has occurred in cancer screening, child health assessments, and sexually transmitted infections. Methods of surveillance include digital surveillance and wastewater surveillance.
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Severe COVID-19 risk factors in children ages 0-5

Rapid Review: What are the risk factors associated with severe COVID-19 outcomes in children 5 years and under?
The findings of this review indicate that prematurity, young age, comorbidities, and structural inequities are the greatest risk factors for severe outcomes in children five years and younger.
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Transmission in post-secondary settings

Living Rapid Review Update 4: What is known about the risk of transmission of COVID-19 within post-secondary institutions and the strategies to mitigate on-campus outbreaks?
Strategies including fast and frequent testing and isolation may help mitigate the risk for COVID-19 transmission within post-secondary institutions.
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Severe COVID-19 risk factors in children ages 0-12

Rapid Review Update 1: What are the risk factors associated with severe COVID-19 outcomes in children 12 years and under?
The evidence suggests children with comorbidities may be more likely to experience severe COVID-19 outcomes.
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Healthcare Workers’ Intentions to Leave Jobs

Rapid Review: What is known about health care worker intent to leave their occupation in the context of the COVID-19 pandemic?
Across all studies reporting a percentage, 11–42.6% of health care workers employed during the COVID-19 pandemic reported an intent to leave their current role. Between 2–35% of health care workers reported an intent to leave their profession.
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Vaccines in persons with a prior infection

Rapid Review Update 1: What is the ongoing effectiveness, immunogenicity, and safety of COVID-19 vaccines in persons who have had a prior, confirmed COVID-19 infection?
Vaccination in individuals with previous COVID-19 infection may be slightly more effective compared to those without previous infection, although the number of breakthrough infections was low in both groups.
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Prevalence of household food insecurity

Rapid Review Update 2: What is the prevalence of household food insecurity in North America as a result of COVID-19 and associated public health measures?
Food insecurity appears to be more prevalent during the COVID-19 pandemic than before the pandemic, particularly among low-income populations.
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Transmission in long-term care facilities

Rapid Review Update 2: What strategies mitigate risk of COVID-19 outbreaks and mortality in long-term care facilities?
Most guideline and guidance document recommendations include comprehensive surveillance, monitoring and evaluation of staff, resident, and visitor symptoms, limiting movement into and between facilities, physical distancing, proper ventilation, and proper provision and use of personal protective equipment (PPE) to reduce transmission amongst residents and staff within facilities.
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Surface transmission

Rapid Review Update 1: What is known about how long the virus can survive with potential for infection on surfaces found in community settings?
Viral fragments can be detected on surfaces but these fragments may not be viable to results in transmission.
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Transmission during musical activities

Rapid Review: What is known about the risk of transmission of COVID-19 during musical activities such as singing or playing a wind instrument, and how can these risks be mitigated?
Available reviews suggest that the risk of transmission through singing and instrument playing could be mitigated through standard public health measures.
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Transmission in acute care settings

Rapid Review: What is the evidence for COVID-19 transmission in acute care settings?
Most studies include data collected in the early phases of the COVID-19 pandemic, during which lack of access to proper PPE was noted in some jurisdictions.
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Use of tobacco and vaping products

Rapid Review: What is the effect of the COVID-19 pandemic on the use and cessation of tobacco and vaping products?
There was no clear direction of effect of the COVID-19 pandemic on use of tobacco or vaping products.
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Transmission in restaurants and gyms

Rapid Review: What is known about the risk of COVID-19 transmission across different indoor settings in the community such as restaurants and gyms?
Factors that increased the risk of transmission include reduced/poor ventilation, lack of physical distancing, length of exposure time, and viral load of the infected source.
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Indigenous protective factors

Rapid Review: What factors may help protect Indigenous peoples and communities in Canada and internationally from the COVID-19 pandemic and its impacts?
Indigenous peoples and communities have experience with disease outbreaks and have learned effective ways of responding and protecting family and community members, despite socio-economic challenges and pervasive inequities resulting from historic and ongoing colonization.
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Re-infection

Rapid Review Update 3: What is known on the potential for COVID-19 re-infection, including new transmission after recovery?
Most syntheses and studies included in this review find no evidence of COVID-19 re-infection.
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Opioid and substance use and related harms

Rapid Review Update 1: What is the effect of the COVID-19 pandemic on substance use, overdoses, and substance-related deaths?
There was no clear pattern of opioid-related overdoses & deaths in Canada during the COVID-19 pandemic, although supply and services are known to be affected during pandemics.
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Infection during pregnancy

Rapid Review Update 1: Is there an increased risk of adverse maternal or fetal outcomes in women diagnosed with COVID-19 during pregnancy?
Available evidence shows a high rate of cesarean delivery and a low risk of negative maternal and neonatal outcomes among moms with COVID-19 infection.
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Transmission in congregate living settings

Rapid Review Update 1: What factors increase the risk of COVID-19 outbreaks in congregate living settings? Do people who contract COVID-19 from outbreaks in congregate living setting have worse outcomes than community-dwelling adults?
There is no direct evidence for specific factors that affect risk of a COVID-19 outbreak in congregate living settings.
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Wastewater surveillance

Rapid Review Update 1: What is known about using wastewater surveillance to monitor the COVID-19 pandemic in the community?
Retrospective analyses of wastewater showed that the presence of the virus could be detected before community transmission had been identified.
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Impact on families with children

Rapid Review: What is known about the impact of the pandemic on families with children?
Evidence points to strain on families, especially for female caregivers and children. Women with children experienced reduced working hours and children experienced negative mental health outcomes.
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Infection prevention and control in inpatient psychiatric facilities

Rapid Review: What is known about best practices for infection prevention and control in inpatient psychiatric facilities?
There is very little evidence on effective infection control practices specific to inpatient psychiatric facilities and no guidelines informed by research evidence are available.
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Alcohol use and related harms

Rapid Review: What is the effect of the COVID-19 pandemic on alcohol use, poisonings, and alcohol-related deaths? What strategies have been used to mitigate alcohol abuse during the COVID-19 pandemic?
Global trends in changes to alcohol intake during the pandemic are unclear.
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Copper to reduce virus transmission

Rapid Review: What is known about the efficacy and cost-effectiveness of copper materials to reduce transmission of viruses?
This review found no evidence on the efficacy or cost-effectiveness of copper-treated PPE in hospital or public settings to reduce transmission of any viruses.
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Cohorting in long-term care

Rapid Review: What is the effectiveness of cohorting virus-positive residents to shared rooms in care facilities?
No research evidence was identified related to the effectiveness of cohorting COVID-19 virus-positive residents to shared rooms in long-term care facilities.
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Policies for isolation periods

Rapid Review: Are any other jurisdictions using isolation periods other than 14 days in response to COVID-19? If yes, what is their rate of COVID-19 cases?
Most jurisdictions recommended or required a 14-day quarantine for people exposed or at risk of exposure to COVID-19.
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Incubation period

Rapid Review: What is known about the duration from exposure to symptoms or diagnosis for COVID-19?
Precise calculation of the incubation period was more feasible early in the pandemic, when cases were limited and a precise exposure time was known. With widespread community transmission, accurate identification of exposure is challenging.
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Policies for COVID-19 reinfection

Rapid Review: How have affected jurisdictions handled previously positive cases in the context of re-exposure/re-infection?
Very few jurisdictions have described policy approaches related to previously positive cases who are considered recovered and subsequently test positive.
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Serological tests

Rapid Review: What serological tests are available, and what are their sensitivities and specificities?
Many serological tests for the detection of antibodies to the virus that causes COVID-19 are available from different manufacturers. The sensitivity of these tests is highly variable, with estimates ranging 18.4% - 100.0%.
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Stigmatization

Rapid Review: What is known about stigmatization related to COVID-19 in Canada? Who is experiencing stigma? To what extent is stigma experienced and what is the impact?
No studies conducted in Canada specifically related to stigma were found. Discrimination and stigma associated with COVID-19 infection is a concern for those infected and those with infected family members.
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Impact on Indigenous communities

Rapid Review: What is known about the impact of the COVID-19 pandemic on Indigenous communities in Canada?
Plans to address the impact of COVID-19 emphasize the importance of collaborative responses that are culturally appropriate and locally sensitive.
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Physical distancing and mental health

Rapid Review: How does physical distancing impact mental health?
Outbreaks prior to the COVID-19 pandemic show an association between adverse mental health effects and quarantine.
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COVID-19 UPDATES

 

Latest information and updates about COVID-19 from The Rapid Evidence Service

Submit your questions to the NCCMT’s Rapid Evidence Service team at nccmt@mcmaster.ca.

Please note, questions are prioritized and completed as our capacity allows.

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