Public health measures to reduce the risk of SARS-CoV-2 transmission in Canada during the early days of the COVID-19 pandemic: a scoping review

Julie Polisena; Maria Ospina; Omolara Sanni; Brittany Matenchuk; Rachel Livergant; Sana Amjad; Igor Zoric; Nisrine Haddad; Andra Morrison; Kumanan Wilson; Isaac Bogoch; Vivian A Welch

doi:10.1136/bmjopen-2020-046177

Public health measures to reduce the risk of SARS-CoV-2 transmission in Canada during the early days of the COVID-19 pandemic: a scoping review

BMJ Open. 2021 Mar 9;11(3):e046177. doi: 10.1136/bmjopen-2020-046177.

Authors

Julie Polisena¹, Maria Ospina², Omolara Sanni³, Brittany Matenchuk³, Rachel Livergant³, Sana Amjad³, Igor Zoric³, Nisrine Haddad⁴, Andra Morrison⁵, Kumanan Wilson^{4

6}, Isaac Bogoch⁷, Vivian A Welch^{4

8}

Affiliations

¹ Health Technology Assessment Division, International Federation for Medical and Biological Engineering, Ottawa, Ontario, Canada jpolis22@hotmail.com.
² Faculty of Medicine & Dentistry, University of Alberta, Edmonton, Alberta, Canada.
³ School of Public Health, University of Alberta, Edmonton, Alberta, Canada.
⁴ School of Epidemiology and Public Health, University of Ottawa, Ottawa, Ontario, Canada.
⁵ Canadian Agency for Drugs and Technologies in Health, Ottawa, Ontario, Canada.
⁶ Clinical Epidemiology Program, Ottawa Hospital Research Institute, Ottawa, Ontario, Canada.
⁷ Divisions of General Internal Medicine and Infectious Diseases and Department of Medicine, University Health Network, Toronto, Ontario, Canada.
⁸ Centre for Global Health, Bruyere Research Institute, Ottawa, Ontario, Canada.

Abstract

Objective: The main objectives of this study were to synthesise and compare pandemic preparedness strategies issued by the federal and provincial/territorial (P/T) governments in Canada and to assess whether COVID-19 public health (PH) measures were tailored towards priority populations, as defined by relevant social determinants of health.

Methods: This scoping review searched federal and P/T websites on daily COVID-19 pandemic preparedness strategies between 30 January and 30 April 2020. The PROGRESS-Plus equity-lens framework was used to define priority populations. All definitions, policies and guidelines of PH strategies implemented by the federal and P/T governments to reduce risk of SARS-CoV-2 transmission were included. PH measures were classified using a modified Public Health Agency of Canada Framework for Canadian Pandemic Influenza Preparedness.

Results: A total of 722 COVID-19 PH measures were issued during the study period. Of these, home quarantine (voluntary) (n=13.0%; 94/722) and retail/commerce restrictions (10.9%; n=79/722) were the most common measures introduced. Many of the PH orders, including physical distancing, cancellation of mass gatherings, school closures or retail/commerce restrictions began to be introduced after 11 March 2020. Lifting of some of the PH orders in phases to reopen the economy began in April 2020 (6.5%; n=47/722). The majority (68%, n=491/722) of COVID-19 PH announcements were deemed mandatory, while 32% (n=231/722) were recommendations. Several PH measures (28.0%, n=202/722) targeted a variety of groups at risk of socially produced health inequalities, such as age, religion, occupation and migration status.

Conclusions: Most PH measures centred on limiting contact between people who were not from the same household. PH measures were evolutionary in nature, reflecting new evidence that emerged throughout the pandemic. Although ~30% of all implemented COVID-19 PH measures were tailored towards priority groups, there were still unintended consequences on these populations.

Keywords: COVID-19; health policy; infection control; public health.

Publication types

Research Support, Non-U.S. Gov't
Review

MeSH terms

COVID-19 / prevention & control*
COVID-19 / transmission*
Canada / epidemiology
Communicable Disease Control / methods*
Crowding
Humans
Pandemics* / prevention & control
Physical Distancing
Quarantine