Search

The opioid overdose crisis in Canada has dramatically worsened during the current COVID-19 pandemic. People who use opioids are dying at unprecedented rates, and a rapid expansion of available treatments for opioid use disorder (OUD) is needed. Injectable opioid agonist therapy (iOAT) is an evidence-based treatment for OUD with a superior retention rate. However, iOAT is currently only available in seven specialized clinics across British Columbia, and many people who may benefit from iOAT cannot access it. In this commentary paper, we discuss evidence behind iOAT, outline barriers preventing greater access, and make suggestions around how to improve access to iOAT. [ABSTRACT FROM AUTHOR]

Background: The COVID-19 pandemic disproportionately impacted long-term care and assisted living (LTC/AL) facilities in Canada, where infection prevention and control (IPAC) programs had been suboptimal. We aimed to identify barriers affecting healthcare workers' (HCW) adherence to IPAC practices during the pandemic in British Columbia in LTC/AL compared to acute care settings. Methods: We conducted a web-based survey of direct care providers and IPAC professionals across BC from August to September 2021, focused on knowledge and attitudes toward IPAC within the context of the COVID-19 pandemic, and barriers that affected respondents' abilities to follow IPAC practices throughout the pandemic. Results: The final analysis included 896 acute care respondents and 441 from LTC/AL. More LTC/AL respondents reported experiencing the following barriers: following IPAC guidance was of lower priority compared to other tasks (29.1% vs. 14.7%, FDR = 0.001) and not their responsibility (28.0% vs. 11.2%, FDR = 0.001); limited supplies for personal protective equipment (PPE) (49.0% vs. 33.6%, FDR = 0.001), hand hygiene products (42.2% vs. 28.8%, FDR = 0.001), and cleaning/disinfection products (44.1% vs. 30.3%, FDR = 0.001); deficits in IPAC leadership support (46.2% vs. 38.9%, FDR = 0.012), IPAC education and training (46.9% vs. 32.0%, FDR = 0.001), and patient care knowledge for managing COVID-19 infections (46.6% vs. 36.0%, FDR = 0.001). Conclusions: This survey found that barriers to HCWs' adherence to IPAC practices during the COVID-19 pandemic were different in LTC/AL settings compared to acute care. Improvement efforts should focus on strengthening IPAC programs in LTC/AL, particularly enhanced IPAC staffing/leadership, increased training and education, and improving access to PPE, hand hygiene, and cleaning products. [ABSTRACT FROM AUTHOR]

This community-based research examines the impact of the coronavirus disease of 2019 (COVID-19) pandemic on service provision to people experiencing homelessness and concurrent disorders (PEHCD) in British Columbia, Canada. Using mixed methods, 119 service providers from across BC participated in a survey, and of those, 25 participated in semi-structured interviews. Several gaps emerged in service delivery to PEHCD during the COVID-19 pandemic. Despite these challenges, service providers adapted to support their clients' needs, which included supporting new and expanding service groups: (a) people who were experiencing homelessness for the first time due to pandemicrelated job loss, (b) people who receive low incomes and are experiencing food insecurity, (c) more complex mental health needs, (d) seniors, (e) youth/students, and (f) family members fleeing violence in the home (e.g., intimate partner violence and child abuse). In the absence of Point-in-Time Counts in Canada during the COVID-19 pandemic as per physical distancing protocols, this data on new and expanding service groups highlights the critical need to embed considerations for social vulnerabilities and secondary impacts into pandemic planning and response efforts. [ABSTRACT FROM AUTHOR]