Search

The COVID‐19 pandemic has highlighted the importance of childcare to national economies in general and women's economic participation in particular, spurring renewed interest in childcare policy in many countries that have implemented lockdowns. This paper adopts a circle of care framework to analyzes how COVID‐19 has affected paid childcare, unpaid childcare and other paid work, and the relationship between these sectors. Analysis is grounded in the lived experiences of parents and childcare educators, documented through 16 semi‐structured interviews during the initial lockdown (March–June 2020) in British Columbia, Canada. Experiences from educators suggest their safety was not prioritized, and that their contributions were undervalued and went unrecognized. Mothers, who provided the majority of unpaid care, not only lost income due to care demands, but struggled to access necessities, with some reporting increased personal insecurity. Those attempting to work from home also experienced feelings of guilt and distress as they tried to manage the triple burden. Similarities of experiences across the circle of care suggest the COVID‐19 childcare policy response in BC Canada downloaded care responsibilities on to women without corresponding recognition or support, causing women to absorb the costs of care work, with potential long‐term negative effects on women's careers and well‐being, as well as on the resilience of the circle of care. Pandemic recovery and preparedness policies that aim to promote gender equality must consider all sectors of the circle of care and the relationships between them. [ABSTRACT FROM AUTHOR]

As the present Covid – 19 pandemic moves through Indigenous communities in Canada, it has been argued that continued mineral extraction or pipeline construction will potentially exacerbate the virus' spread among Indigenous people residing near work camps or construction areas. Listing these operations as essential puts an onus on local Indigenous people to take part in consultation with extractive industries. British Columbia is one province that listed extractive operations as essential during the pandemic. It also recently enacted consultation protocols meant to guide concerned Indigenous communities and extractive industries on proper consultation procedure to limit Covid - 19's spread while ensuring these projects continue. Nonetheless, the paper argues that British Columbia's consultative guidelines adhere to a necropolitical dynamic through which Indigenous people are required to take part in government policy meant to limit their own independence. The Crown holds license to decide when Indigenous communities are given a reprieve from taking part in consultation and when they are obligated to participate once again. This is done without "consulting" with Indigenous peoples themselves and how they view a process that limits their logistical and regulatory strength. This paper argues that Self Determined independence is being diminished through multilayered repression. [ABSTRACT FROM AUTHOR]

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: Previous studies have shown reductions in the volume of emergency department visits early in the COVID-19 pandemic, but few have evaluated the pandemic's impact over time or stratified analyses by reason for visits. We aimed to quantify such changes in British Columbia, Canada, cumulatively and during prominent nadirs, and by reason for visit, age and acuity. Methods: We included data from the National Ambulatory Care Reporting System for 30 emergency departments across BC from January 2016 to December 2022. We fitted generalized additive models, accounting for seasonal and annual trends, to the monthly number of visits to estimate changes throughout the pandemic, compared with the expected number of visits in the absence of the pandemic. We determined absolute and relative differences at various times during the study period, and cumulatively since the start of the pandemic until the overall volume of emergency department visits returned to expected levels. Results: Over the first 16 months of the pandemic, the volume of emergency department visits was reduced by about 322 300 visits, or 15% (95% confidence interval 12%–18%), compared with the expected volume. A sharp drop in pediatric visits accounted for nearly one-third of the reduction. The timing of the return to baseline volume of visits differed by subgroup. The largest and most sustained decreases were in respiratory-related emergency department visits, visits among children, visits among oldest adults and non-urgent visits. Later in the pandemic, we observed increased volumes of highest-urgency visits, visits among children and visits related to ear, nose and throat. Interpretation: We have extended evidence that the impact of the COVID-19 pandemic and associated mitigation strategies on emergency department visits in Canada was substantial. Both our findings and methods are relevant in public health surveillance and capacity planning for emergency departments in pandemic and nonpandemic times. [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]

Background: Care aides (certified nursing assistants, personal support workers) are the largest workforce in long‐term care (LTC) homes (nursing homes). They provide as much as 90% of direct care to residents. Their health and well‐being directly affect both quality of care and quality of life for residents. The aim of this study was to understand the impact of COVID‐19 on care aides working in LTC homes during the first year of the pandemic. Methods: We conducted semi‐structured interviews with a convenience sample of 52 care aides from 8 LTC homes in Alberta and one in British Columbia, Canada, between January and April 2021. Nursing homes were purposively selected across: (1) ownership model and (2) COVID impact (the rate of COVID infections reported from March to December 2020). Interviews were recorded and analyzed using inductive content analysis. Results: Care aides were mainly female (94%) and older (74% aged 40 years or older). Most spoke English as an additional language (76%), 54% worked full‐time in LTC homes, and 37% worked multiple positions before "one worksite policies" were implemented. Two themes emerged from our analysis: (1) Care aides experienced mental and emotional distress from enforcing resident isolation, grief related to resident deaths, fear of contracting and spreading COVID‐19, increased workload combined with staffing shortages, and rapidly changing policies. (2) Care aides' resilience was supported by their strong relationships, faith and community, and capacity to maintain positive attitudes. Conclusions: These findings suggest significant, ongoing adverse effects for care aides in LTC homes from working through the COVID‐19 pandemic. Our data demonstrate the considerable strength of this occupational group. Our results emphasize the urgent need to appropriately and meaningfully support care aides' mental health and well‐being and adequately resource this workforce. We recommend improved policy guidelines and interventions. [ABSTRACT FROM AUTHOR]

The dynamic nature of the COVID-19 pandemic has demanded a public health response that is constantly evolving due to the novelty of the virus. Many jurisdictions in the USA, Canada, and across the world have adopted social distancing and recommended the use of face masks. Considering these measures, it is prudent to understand the contributions of subpopulations—such as "silent spreaders"—to disease transmission dynamics in order to inform public health strategies in a jurisdiction-dependent manner. Additionally, we and others have shown that demographic and environmental stochasticity in transmission rates can play an important role in shaping disease dynamics. Here, we create a model for the COVID-19 pandemic by including two classes of individuals: silent spreaders, who either never experience a symptomatic phase or remain undetected throughout their disease course; and symptomatic spreaders, who experience symptoms and are detected. We fit the model to real-time COVID-19 confirmed cases and deaths to derive the transmission rates, death rates, and other relevant parameters for multiple phases of outbreaks in British Columbia (BC), Canada. We determine the extent to which SilS contributed to BC's early wave of disease transmission as well as the impact of public health interventions on reducing transmission from both SilS and SymS. To do this, we validate our model against an existing COVID-19 parameterized framework and then fit our model to clinical data to estimate key parameter values for different stages of BC's disease dynamics. We then use these parameters to construct a hybrid stochastic model that leverages the strengths of both a time-nonhomogeneous discrete process and a stochastic differential equation model. By combining these previously established approaches, we explore the impact of demographic and environmental variability on disease dynamics by simulating various scenarios in which a COVID-19 outbreak is initiated. Our results demonstrate that variability in disease transmission rate impacts the probability and severity of COVID-19 outbreaks differently in high- versus low-transmission scenarios. [ABSTRACT FROM AUTHOR]

Background: The COVID-19 pandemic is impacting the physical and emotional health of older adults living with dementia and their care partners.Objective: Using a patient-centered approach, we explored the experiences and needs of people living with dementia and their care partners during the COVID-19 pandemic as part of an ongoing evaluation of dementia support services in British Columbia, Canada.Methods: A survey instrument was developed around the priorities identified in the context of the COVID-19 and Dementia Task Force convened by the Alzheimer Society of Canada.Results: A total of 417 surveys were analyzed. Overall, respondents were able to access information that was helpful for maintaining their own health and managing a period of social distancing. Care partners reported a number of serious concerns, including the inability to visit the person that they care for in long-term or palliative care. Participants also reported that the pandemic increased their levels of stress overall and that they felt lonelier and more isolated than they did before the pandemic. The use of technology was reported as a way to connect socially with their loved ones, with the majority of participants connecting with others at least twice per week.Conclusion: Looking at the complex effects of a global pandemic through the experiences of people living with dementia and their care partners is vital to inform healthcare priorities to restore their quality of life and health and better prepare for the future. [ABSTRACT FROM AUTHOR]