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Healthcare systems and health professionals are facing a litany of stressors that have been compounded by the pandemic, and consequently, this has further perpetuated suboptimal mental health and burnout in nursing. The purpose of this paper is to report select findings from a larger, national study exploring gendered experiences of mental health, leave of absence (LOA), and return to work from the perspectives of nurses and key stakeholders. Given the breadth of the data, this paper will focus exclusively on the qualitative results from 53 frontline Canadian nurses who were purposively recruited for their workplace insight. This paper focuses on the substantive theme of "Breaking Point," in which nurses articulated a multiplicity of stress points at the individual, organizational, and societal levels that amplified burnout and accelerated mental health LOA from the workplace. These findings exemplify the complexities that underlie nurses' mental health and burnout and highlight the urgent need for multipronged individual, organizational, and structural interventions. Robust and timely interventions are needed to restore the health of the nursing profession and sustain its future. [ABSTRACT FROM AUTHOR]

Building upon two previously published research papers exploring Canadian media reporting of childhood in the first wave of the pandemic, this paper investigates how constructions of childhood evolved from the first wave to the fourth wave of the pandemic. This qualitative research is guided by the central research question: Over the span of 2 years, from 2020 to 2022, what changes are evident in discourses reported within media focused on the impact of the COVID-19 global pandemic on Canadians under the age of 18 years? Findings from this study suggest that in the fourth wave young people were constructed as innocent victims of pandemic restrictions framed through an adult-centric lens; noticeably absent were representations of young people under the age of 18 in their voices. A key recommendation emerged from this study: any future research investigating the impact of the pandemic on young people under aged 18 years must include their full participation. [ABSTRACT FROM AUTHOR]

This paper reviews major structural drivers of place-based health disparities in the context of Canada, an industrialized nation with a strong public health system. Likelihood that the COVID-19 pandemic will facilitate rejuvenation of Canada's northern and remote areas through remote working, advances in online teaching and learning, and the increased use of telemedicine are also examined. The paper concludes by identifying some common themes to address healthcare disparities for northern and remote Canadian residents. [ABSTRACT FROM AUTHOR]

Prior to the COVID–19 outbreak, food insecurity was already a serious public health problem in Canada, impacting 12.7 percent of households. In recent years, activists, practitioners and researchers from a range of health–related disciplines, have debated the legitimacy of food banks and other charitable food programs, contending that policy and programs at the federal level must be prioritized to address the underlying root causes of poverty. This paper challenges the discourse that charitable food programs prevent or distract from Canada's social equity goals. Alternatively, this paper argues that programs and initiatives at the local level can emerge to bring short–term stability and self–sufficiency to local communities while also advocating for longer–term structural change. Drawing upon structuration theory and critical ecologies of anti–Black racism, we examine the work of BlackFoodToronto, a food sovereignty initiative, to illustrate the negotiation of power and agency, and how groups and networks react to and reshape confining and enabling structures through collaborative practice. In addressing Canada's food security crisis, this paper offers an alternative perspective of community–based, nonprofit and charitable programs, which in practice, can help inform future food security policy and related health equity and community development strategies. [ABSTRACT FROM AUTHOR]

Purpose: This research examines the implementation of the Icelandic Prevention Model (IPM) in Canada to identify opportunities revealed by the COVID-19 pandemic to re-design our social eco-system to promote wellbeing. This paper has two objectives: 1) to provide a conceptual review of research that applies the bioecological model to youth substance use prevention with a focus on the concepts of time and physical space use and 2) to describe a case study that examines the implementation of the IPM in Canada within the context of the COVID-19 pandemic. Method: Study data were collected through semistructured qualitative interviews with key stakeholders involved in implementing the IPM. Results: Findings are organized within three over-arching themes derived from a thematic analysis: 1) Issues that influence time and space use patterns and youth substance use, 2) Family and community cohesion and influences on developmental context and time use and 3) Opportunities presented by the pandemic that can promote youth wellbeing. Conclusion: We apply the findings to research on the IPM as well as the pandemic to examine opportunities that may support primary prevention and overall youth wellbeing. We use the concepts of time and space as a foundation to discuss implications for policy and practice going forward. [ABSTRACT FROM AUTHOR]

This paper examines the longitudinal effects of the COVID-19 pandemic on older adults (65+) with multimorbidity on levels of depression, anxiety, and perceived global impact on their lives. Baseline (2011–2015) and Follow-up 1 (2015–2018) data from the Canadian Longitudinal Study on Aging (CLSA), and the Baseline and Exit waves of the CLSA COVID-19 study (April–December, 2020) (n = 18,099). Multimorbidity was measured using: a) an additive scale of chronic conditions; and b) six chronic disease clusters. Linear Mixed Models were employed to test hypotheses. Number of chronic conditions pre-pandemic was associated with pandemic levels of depression (estimate = 0.40, 95% CI: [0.37,0.44]); anxiety (estimate = 0.20, 95% CI: [0.18, 0.23]); and perceived negative impact of the pandemic (OR = 1.04, 95% CI: [1.02, 1.06]). The associations between multimorbidity and anxiety decreased during the period of the COVID-19 surveys (estimate = −0.02, 95% CI: [−0.05, −0.01]); whereas the multimorbidity association with perceived impact increased (OR = 1.03, 95% CI: [1.01, 1.05]). This study demonstrates that pre-pandemic multimorbidity conditions are associated with worsening mental health. Clinicians treating mental health of older adults need to consider the joint effects of multimorbidity conditions and pandemic experiences to tailor counseling and other treatment protocols. [ABSTRACT FROM AUTHOR]

In this paper, I draw on my research and experience as a disability ethics educator and advocate in order to demonstrate that both Canada􀂶s COVID-19 response and its expansion of eligibility for MAID are symptoms of the medical and systemic ableism that afflicts Canadian society. I conclude with a consideration of the enduring danger that eugenic ableism disguised as autonomy poses for people with disabilities in a Canada where COVID-19 may be waning, but where the contagion of ableism turned lethal through MAID continues to spread. [ABSTRACT FROM AUTHOR]

In this paper, we use intersectionality-based policy analysis (IBPA) to examine how COVID-19 income support policies enacted in Ontario, Canada, affected people living with poverty. We find that the privileging of formal labor market attachment in eligibility requirements systemically excluded constituencies most likely to be living with poverty. More broadly, these exclusions represent a retrenchment of neoliberal logics in social policy, and the rejection of universal social welfare programs. In conclusion, we suggest that the experiences of people living with poverty during the COVID-19 pandemic further highlight the need for comprehensive social welfare programs, including a universal basic income. [ABSTRACT FROM AUTHOR]

The novel Coronavirus (COVID-19) has created a worldwide deadly pandemic that has become a major public health challenge. All semi-urgent and elective medical care has come to a halt to conserve capacity to care for patients during this pandemic. As the numbers of COVID-19 cases decrease across Canada, our healthcare system also began to reopen various facilities and medical offices. The aim for this document is to compile the current evidence and provide expert consensus on the safe return to clinic practice in Otolaryngology – Head & Neck Surgery. These recommendations will also summarize general precaution principles and practical tips for office across Canada to optimize patient and provider safety. Risk assessment and patient selection are crucial to minimizing exposure to COVID-19. Controversial topics such as COVID-19 mode of transmission, duration of exposure, personal protective equipment, and aerosol-generating procedures will be analyzed and discussed. Practical solutions of pre-visit office preparation, front office and examination room set-up, and check out procedures are explored. Specific considerations for audiology, pediatric population, and high risk AGMPs are also addressed. Given that the literature surrounding COVID-19 is rapidly evolving, these guidelines will serve to start our specialty back into practice over the next weeks to months and they may change as we learn more about this disease. [ABSTRACT FROM AUTHOR]

This paper examines the resilience of Canadian cities to the 2020 economic crisis that followed the 2019 coronavirus pandemic. It specifically investigates the resistance and recoverability (i.e., very short‐term recovery) dimensions of resilience. It reveals that Canadian cities exhibited heterogeneous resiliency to the crisis, resulting in economic restructuring. Further, the paper decomposed resilience into an industrial mix effect and local‐specific effect using a shift‐share analysis, to move away from the industrial‐structure dominated focus in the resilience literature by examining the influence of local‐specific effects. The analysis found that local‐specific effects played a dominant role in determining the resiliency of cities, while their industrial mix had a marginal influence. Moreover, the determinants of resilience are complex having different effects and functions depending on the dimension of resilience under examination. Also, the determinants of resilience may change depending on the type of shock cities experience. A key policy implication is that localities' capabilities largely determine their resilience. [ABSTRACT FROM AUTHOR]

Systemic disruptions from COVID-19 have transformed the assessment landscape in Canada and across the world. Alongside repeated shifts to emergency remote teaching, large-scale assessments and summative evaluations were cancelled in many jurisdictions, and repeated concerns were raised about ensuring equity and access to quality education. This paper investigates the rapid – and in many cases innovative – responses teachers offered to these challenges at the height of the pandemic. Drawing on prolonged semi-structured interviews with 17 secondary school teachers in Ontario, Canada, the paper provides a detailed account of Ontario's approach to assessment during COVID-19, exemplified by participants' lived experiences. Results highlight the notion of emergency remote assessment, the vital role of assessment in stemming widening equity and well-being gaps, and emerging consequences from this period. These data offer critical insights into the future of our forever-changed education landscape, and position classroom assessment as a priority player in this work. [ABSTRACT FROM AUTHOR]

Objective: Previous research has evaluated the sources of post-secondary student stress, but has failed to explore whether stressors fluctuate over time. The purpose of this research was to use the Post-Secondary Student Stressors Index to examine whether stressors changed significantly and meaningfully over the course of an academic year. Due to the timing of data collection, results also provide context around students' experiences of stress during the COVID-19 pandemic. Method: Cross-sectional data was collected at 3 time points via online surveys over the course of the 2020–2021 academic year from >10,000 students. Participants attended 15 post-secondary institutions across Canada, representing 9 provinces and 1 territory. Validated instruments were used to assess levels of stress, distress and the severity of student-specific stressors. Kruskal–Wallis ranked tests and multiple pairwise comparison analyses were conducted to assess whether the mean severity of stressors changed over time. Standard effect sizes were calculated using Cohen's d. Results: Mean levels of stress and psychological distress were high at the start of the study and remained high across time points. A similarly high level of stress was observed on average for student-specific stressors. While significant differences in mean severity were observed over time for some stressors, standardized effect sizes were negligible, suggesting little meaningful change and consistent levels of chronic stress over the course of the academic year. Conclusions: This is the first paper to examine trends in student-specific stress using a nationwide sample of Canadian post-secondary students during the first year of the COVID-19 pandemic. Patterns observed in student-specific stressors reflected changes likely to be indicative of the pandemic, including the most severe stress associated with academics, finances and concerns for the future. Implications for future research are discussed, in particular, the importance of examining stressors related to COVID-19 and their impact on student mental health. [ABSTRACT FROM AUTHOR]

Introduction: The COVID‐19 pandemic has had an impact on all aspects of the health system. Little is known about how the activities and experiences of patient, family and caregiver partners, as a large group across a variety of settings within the health system, changed due to the substantial health system shifts catalysed by the pandemic. This paper reports on the results of a survey that included questions about this topic. Methods: Canadian patient, family and caregiver partners were invited to participate in an online anonymous survey in the Fall of 2020. A virtual snowballing approach to recruitment was used. Survey invitations were shared on social media and emailed to health system and governmental organizations with the request that they share the survey with patient partners. This paper focuses on responses to two questions related to patient partner experiences during the COVID‐19 pandemic. Results: The COVID‐19 questions were completed by 533 respondents. Over three quarters of respondents (77.9%, n = 415) indicated their patient engagement activities had been impacted by COVID‐19. The majority (62.5%, n = 230) experienced at least a temporary or partial reduction in their patient engagement activities. Some respondents did see increases in their patient engagement activities (11.4%, n = 42). Many respondents provided insights into their experience with virtual platforms for engagement (n = 194), most expressed negative or mixed experiences with this shift. Conclusions: This study provides a snapshot of Canadian patient, family and caregiver partners' perspectives on the impact of COVID‐19 on their engagement activities. Understanding how engagement unfolded during a crisis is critical for our future planning if patient engagement is to be fully integrated into the health system. Identifying how patient partners were engaged and not engaged during this time period, as well as the benefits and challenges of virtual engagement opportunities, offers instructive lessons for sustaining patient engagement, including the supports needed to engage with a more diverse set of patient, family and caregiver partners. Patient Contribution: Patient partners were important members of the Canadian Patient Partner Study research team. They were engaged from the outset, participating in all stages of the research project. Additional patient partners were engaged to develop and pilot test the survey, and all survey respondents were patient, family or caregiver partners. The manuscript is coauthored by two patient partners. [ABSTRACT FROM AUTHOR]

Introduction: East Toronto Health Partners (ETHP) is a network of organizations that serve residents of East Toronto, Ontario, Canada. ETHP is a newly formed integrated model of care in which hospital, primary care, community providers and patients/ families work together to improve population health. We describe and evaluate the evolution of this emerging integrated care system as it responded to a global health crisis. Description: This paper begins by describing ETHP’s pandemic response mapping out over two years of data. To evaluate the response, semi-structured interviews were conducted with 30 decision makers, clinicians, staff, and volunteers who were part of the response. The interviews were thematically analyzed, and emergent themes mapped onto the nine pillars of integrated care. Discussion: The ETHP pandemic response evolved rapidly. Early siloed responses gave way to collaborative efforts and equity emerged as a central priority. New alliances formed, resources were shared, leaders emerged, and community members stepped forward to contribute. Interviewees identified positives as well as many opportunities for improvement post-pandemic. Conclusion: The pandemic was a catalyst for change in East Toronto that accelerated existing initiatives to achieve integrated care. The East Toronto experience may serve as a useful guide for other emerging integrated care systems. [ABSTRACT FROM AUTHOR]

Simple Summary: This paper looks at changes in weight, physical activity, and food/dietary intake during the first year of the COVID-19 pandemic in undergraduate students enrolled in a Canadian university. The investigation used an online survey format to collect data at the end of the two lockdown periods over one year. Participants were recruited from universities across Canada. The results show a modest weight gain accompanied by a decrease in physical activity and an unhealthy change in diet. Specifically, students reported that their engagement in specific physical activities and overall activity levels decreased during the lockdowns. The number of calories also decreased over time, while the foods consumed decreased in nutritional value. Thus, the modest weight gain observed may have resulted from the decrease in physical activity and diet quality. In conclusion, Canadian food and physical activity recommendations were not met during the lockdowns caused by the pandemic, which highlights the physical and nutritional implications of confinement. This study examined changes in body mass and body mass index (BMI), physical activity, and dietary intake in Canadian university students during the first year of the COVID-19 pandemic. Two self-reported recall surveys were conducted: after the first lockdown in September 2020 (T1) and following the second lockdown in March 2021 (T2). Eligible participants were full-time undergraduate students attending a Canadian university and residing in Canada during the first year of the pandemic. At T1, 510 students (99 male, 411 female) completed the survey, and of those, 135 (32 males, 103 females) completed the survey at T2 (73% attrition). At both T1 and T2, most participants were 18–24 years of age (93% and 90%, respectively), Caucasian (73% and 78%, respectively), and resided in the province of Ontario (79% and 80%, respectively). Body mass increased from T1 to T2 (+0.91 ± 3.89 kg t(132) = −2.7, p = 0.008). BMI also increased from T1 to T2 (+0.30 ± 1.33 kg/m2 [t(130) = −2.5, p = 0.012), with a greater number of participants within the overweight range (19.8% versus 24.4%, respectively). At T1, 38% of the participants reported a decrease in physical activity, while the number of students reporting a decrease in activity increased to 56% at T2. Dietary energy intake decreased from 1678 ± 958 kcal/day at T1 to 1565 ± 842 kcal/day at T2 [c2(1) = 7.2, p = 0.007]. Diet quality also decreased, with participants not meeting the recommended daily allowance for essential macro and micronutrients. A decrease was observed in daily servings of fruits (−27%, p < 0.001), vegetables (−72%, p < 0.001), and grains (−68%, p < 0.001). In conclusion, despite a small decrease in dietary energy intake, a modest weight gain occurred during the first year of the COVID-19 pandemic in this cohort of Canadian university students, which was potentially related to decreased physical activity and diet quality. [ABSTRACT FROM AUTHOR]

The COVID-19 pandemic highlighted the importance of immigrant health workers in OECD nations, and intensified debates about the current and future supply and distribution of such workers, particularly nurses. This review paper considers internationally educated nurses in the case of Ontario, Canada, and the policy responses developed during the pandemic to address the increased utilization of immigrant health workers. To further consider the evolving place of migrant workers within health, the broader issue of the future of health care work is examined to imagine what a sustainable and resilient health workforce agenda that integrates internationally educated nurses might look like. [ABSTRACT FROM AUTHOR]

This paper discusses the experiences during COVID-19 of mothers who have young children, are survivors of domestic violence and who share parenting to highlight the further unsafe situations survivors of violence and their children were placed in during the pandemic. Part of a larger mixed methods study, these participants (n = 19) from three Canadian provinces, Alberta, Manitoba and Ontario, engaged in virtual individual one-on-one interviews via zoom. Using thematic analysis, four themes emerged from the data: 1) increased use of coercive controlling behaviors; 2) fear of the unknown; 3) lack of supports; and, 4) finding balance. Direct quotes are used to highlight the meaning of each theme. We outline the challenges these women have that are in addition to those experienced by many during COVID-19 times (increased stress, isolation, disconnect from supports, financial challenges). These include managing the shared parenting arrangements with a former abusive partner who used the pandemic as a further opportunity for coercive controlling behaviors under the guise of the public health order. The mothers were left to manage the difficult exchanges with a former abusive partner and unknown circumstances of the pandemic without guidance and support from legal actors. There will need to be a prioritization of the safety of mothers and their children in post-divorce parenting arrangements both during times of a community lockdown such as during the pandemic and also during non-pandemic times. [ABSTRACT FROM AUTHOR]

Background: The COVID-19 pandemic has been pervasive in its impact on all aspects of Canadian society. Along with its pervasiveness, the disease provided unprecedented complexity to the Canadian healthcare infrastructure, eliciting varying responses from the afflicted healthcare systems in Canada. However, insights into the various parameters and complexities endured by Canadian rural physicians and rural healthcare institutions during the pandemic have been scarce. Objective: This paper explores the conditions and complexity of living and working of Rural Family Physicians (RFPs) in rural healthcare in Canada during the pandemic. Methods: Community-based participatory research was utilized as a collaborative and partnership approach, equitably engaged community members in all aspects of research, ranging from designing the research question to analyzing data. Participants of this study include RFPs with at least one year of experience working in rural Canada. Data were collected through telephone interviews and analyzed according to the six-phase guide for the data's inductive thematic analysis. Data collection halted upon saturation. Results: Five significant compiled categories reflect the lived experiences of Rural Family Physicians. 1- virtual care as a challenge or forward progress; 2- canceling in-person visits and interrupting the routine; 3- shortage of health care providers and supporting staff; 4-ongoing coping process with the pandemic guidelines; 5-COVID-19 combat fatigue. Discussion: The inception of COVID-19 has significantly impacted rural physicians across several interconnected issues. This study illuminates the lesser-known effects of the COVID-19 pandemic, which heavily impacts rural healthcare. [ABSTRACT FROM AUTHOR]

COVID-19 had an unprecedented impact on transit demand and usage. Stiff and vigilant hygiene safety requirements changed travellers' mode choice preferences during the COVID-19 pandemic. Specifically, transit modal share is radically impacted. Therefore, quantitative measurements on transit demand impact are urgently needed to facilitate evidence-based policy responses to COVID-19. Thus, we collected 1000 random samples through a web-based survey in the Greater Toronto Area (GTA), Canada, on traveler's modal choices behavior during the COIVD-19 pandemic. The paper presents an analysis with this firsthand dataset to understand transit users' behavioral adaptation resulting from the spreading of COVID-19 in 2020. We found that the transit frequency dropped by 21% to 71% for various socioeconomic groups in the GTA during the pandemic. The transit modal share dipped for all trip purposes. For private vehicle owners, around 70% of transit users switched to their private vehicles. More than 60% of those without cars switched to active transport for all travel purposes. Also, ride-hailing services are the second most popular substitution of transit for them. More than 80% of the respondents agreed with all transit safety policies, such as mandatory face-covering listed in the survey. Moreover, a similar proportion of the respondents agreed to return to public transit in the future. Multinomial, nested, and mixed logit models are estimated to capture relationships between modal choices and various factors. We found that the daily number of new COVID-19 cases impacts the choice of transit negatively. However, vaccine availability and mandatory face-covering onboard positively affect travellers' choices of riding transit during the pandemic. [ABSTRACT FROM AUTHOR]

Purpose: Social adversity experiences have increased during the pandemic and are potential risk factors for both depression and support for violent radicalization (VR). However, the cumulative and independent effects of various social adversity experiences on support for VR have yet to be explored. This paper examines the cumulative and independent effects of COVID- and non-COVID-related discrimination, exposure to violence, traditional and cyberbullying victimization on support for VR. In addition, we investigate whether depression mediates the relationship between these forms of social adversity and support for VR. Methods: A total of 6003 young adults (Mage = 27, SDage = 4.40, range 18–35) living in metropolitan areas in Canada responded to an online survey. We used multivariable regression models, controlling for socio-demographic characteristics, to infer covariate adjusted associations between social adversity measures and support for VR. Additionally, we conducted a formal mediation analysis to estimate the proportion mediated by depression. Results: There was a cumulative relationship between experiences of social adversity and support for VR (β = 1.52; 95% CI: 1.32, 1.72). COVID-related discrimination and cyberbullying victimization were independently associated with stronger support for VR. Depression partially mediated the effect of cumulative social adversity, COVID-related discrimination and cyberbullying on support for VR. Conclusion: Prevention programs during the present pandemic should prioritize decreasing discrimination and providing psychosocial support to depressed young adults who experience social adversity. Practitioners should prioritize developing programs that foster digital literacy skills and critical thinking among young adults to address the concerning impact of cyberbullying on support for VR. [ABSTRACT FROM AUTHOR]

International retirement migration involves the seasonal relocation of older adults to destinations abroad. For Canadians, this is typically done to escape winter at home in favour of warmer weather elsewhere. In this paper, we explore how Canadian newspapers chronicled the changes associated with managing the COVID‐19 pandemic in Canada, including border measures and calls to avoid non‐essential travel, and how they impacted international retirement migrants and their movements. We specifically present the findings of a framing analysis conducted of 187 newspaper articles published in 2020, identified through the Canadian Newsstream Database. The framing analysis identified three ways in which Canadian international retirement migrants were discussed in relation to the pandemic and the changed spatio‐temporal realities that affected their transnational movements. First, they are a group who altered their consumer practices, which had economic impacts at home and in their usual seasonal destinations. Second, they are a group who faced considerable uncertainty with regard to travel and movement, among other things, as the pandemic unfolded in 2020. Finally, Canadian international retirement migrants sought stability in a number of ways, both in terms of their social networks and living arrangements at home and abroad. Key Messages: The lives and seasonal movements of Canadian international retirement migrants were greatly impacted by the COVID‐19 pandemic and measures put in place to manage the spread of the virus.Newspaper coverage of Canadian international retirement migrants from 2020 framed them as altering consumer practices, facing uncertainties, and seeking stability in response.These responses form an interesting dualism because the COVID‐19 pandemic introduced both challenges and opportunities for Canadian international retirement migrants in 2020. [ABSTRACT FROM AUTHOR]

Background: COVID-19 has significant impact on long-term care (LTC) residents and staff. The purpose of this paper is to report the data gathered during a COVID-19 outbreak in a Canadian LTC home regarding staff experiences, challenges, and needs, to offer lessons learned and implications. Methods: A total of 30 staff from multiple disciplines participated in the study, including nurses, care workers, recreational staff, and a unit clerk. Focus groups (n = 20) and one-on-one interviews (n = 10) were conducted as part of a larger participatory action research (PAR) study in a Canadian LTC home. All data collection was conducted virtually via Zoom, and thematic analysis was performed to identify themes. Results: Four main themes were identified: We are Proud, We Felt Anxious, We Grew Closer to Residents and Staff Members, and The Vaccines Help. Conclusions: This research details the resilience that characterizes staff in LTC, while highlighting the emotional toll of the pandemic, particularly during an outbreak. LTC staff in this study found innovative ways to connect and support residents and this resulted in stronger connections and relationships. Leadership and organizational support are pivotal for supporting team resilience to manage crisis and adapt positively in times of COVID-19 pandemic, especially during the period of outbreak. [ABSTRACT FROM AUTHOR]

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]

The COVID-19 pandemic has heightened and made visible the embodied consequences of water, sanitation and hygiene (WASH) inequalities and the relationalities of health in place. This paper combines insights from relational geographies and embodied epidemiology to explore psychosocial concerns among Ghanaian migrants in Canada due to their multiple and simultaneous roles in the WASH space in Ghana, particularly during the COVID-19 pandemic. We explored this using narratives from in-depth interviews with 27 participants (16 women and 11 men) residing in Ontario, Canada. The case of Ghana offers insight into how social ties with home communities could provide a safety net during emergencies but could also affect the psychosocial wellbeing of migrants. Results revealed four interrelated psychosocial stressors, including social stressors, financial stressors, stressors related to perceived inequality and stressors related to the fear of infection during WASH access. The paper underscores the urgent need for research to move beyond local health implications of WASH inequalities and begin to prioritize how these social inequalities are embodied at distant locations. • The COVID-19 pandemic has highlighted the global health interconnectedness • Embodied subjectivities of WASH insecurity span across space and time • Migrants embody multidimensional WASH psychosocial stressors because of their social connections with home • Policy responses must address WASH subjectivities beyond the local [ABSTRACT FROM AUTHOR]

Background: Public health services and systems research is under-developed in Canada and this is particularly the case with respect to research on local public health unit operational functioning and capacity. The purpose of this paper is to report on a study that will collect retrospective information on the local public health response to COVID-19 throughout Canada between 2020 and 2021. Methods/Design: The goal of the study is to develop and implement a study framework that will collect retrospective information on the local public health system response to the COVID-19 pandemic in Canada. This study will involve administering a mixed-method survey to Medical Health Officers/Medical Officers of Health in every local and regional public health unit across the country, followed by a process of coding and grouping these responses in a consistent and comparable way. Coded responses will be assessed for patterns of divergent or convergent roles and approaches of local public health across the country with respect to interventions in their response to COVID-19. The Framework Method of thematic analysis will be applied to assess the qualitative answers to the open-ended questions that speak to public health policy features. Discussion: The strengths of the study protocol include the engagement of Medical Health Officers/Medical Officers of Health as research partners and a robust integrated knowledge translation approach to further public health services and systems research in Canada. [ABSTRACT FROM AUTHOR]

This paper presents the approach adopted at Statistics Canada to produce timely and accurate estimates of excess mortality during the ongoing COVID-19 pandemic. It focuses primarily on the two models involved in the estimation of excess mortality: the model used to estimate the expected number of deaths in the absence of the pandemic (baseline mortality), and the model used to adjust provisional death counts for undercoverage. We describe both, including how the models were adapted to fit our specific criteria as well as the various limitations they both possess. We conclude by presenting selected results from Statistics Canada's official release of excess mortality estimates from February 8 th , 2021. [ABSTRACT FROM AUTHOR]

The COVID-19 global pandemic has disrupted economies around the world, and rural Canada is no exception. In this paper, we explore the economic development impacts of the pandemic on rural communities across Canada. We seek to provide a deeper and more comprehensive understanding of how rural communities have responded to this crisis and the extent to which they are able to build long-term rural resilience through their responses and plans for recovery. To do so, we draw upon novel data derived from a survey of rural economic development practitioners from across Canada. Our findings are structured around three main themes: economic development and business impacts, economic development responses, and resources needed for recovery. The study highlights the geographic unevenness of impacts, responses, and resource needs to address the challenges introduced by the COVID-19 pandemic. Overall, our research underscores the importance of capacity and context as rural economic development practitioners and other rural leaders have responded to these challenges. Finally, this research provides important insights into the tools and strategies that could build long-term rural resilience. [ABSTRACT FROM AUTHOR]

Rural communities are often portrayed in the research literature and popular media as being disadvantaged and 'vulnerable'. This paper examines the extent to which rural health regions in Canada are more vulnerable than other health regions in terms of contracting COVID-19 and developing serious illness from this virus that leads to death. Data include published numbers of cases of and deaths from COVID-19 in each health region across Canada. Other data from Statistics Canada's Canadian Community Health Survey (CCHS) documents the higher rates of 'vulnerability' in rural health regions, according to (a) their socio-demographic conditions (income, education, age), and (b) the rates of 'underlying health conditions' which would make individuals more susceptible to serious illness from COVID-19. Despite these vulnerabilities, which are consistent with other research on rural areas in Canada, COVID-19 rates are found to be higher in metropolitan areas--although there is some variation in this pattern by province. In no provinces is the rate of death per case of COVID-19 highest in rural areas. Overall, in Canada, deaths per case from COVID-19 are higher in metropolitan than in rural health regions, challenging the notion of rural areas being only and always disadvantaged. [ABSTRACT FROM AUTHOR]

Purpose: People experiencing homelessness are uniquely vulnerable to the impacts of a pandemic, such as COVID-19. Therefore, governments across Canada have been implementing a patchwork of responses to address the needs of those who are homeless at this time. The purpose of this study is to both compile and assess the varying responses by exploring the breadth of actions presented in print and social media. Design/methodology/approach: Rapid review methodology is a means of compiling a breadth of information to compare and contrast policy implementations. Herein, the authors provide a comprehensive rapid review of responses to homelessness considered through a health equity lens. Findings: Based on policy implementations to date, the authors offer eight recommendations of potentially promising practices among these responses. Situated within a capabilities approach, the authors call upon governments to provide a full breadth of responses to ensure that both health and housing are better protected and obtained during the COVID-19 pandemic. Originality/value: This paper presents the first comprehensive review of local government responses to homelessness in the context of COVID-19. [ABSTRACT FROM AUTHOR]

This paper presents a review of social distancing measures deployed by transit agencies in the United States and Canada during the COVID-19 pandemic and discusses how specific operators across the two countries have implemented changes. Challenges and impacts on their operations are also provided. Social distancing is one of the community mitigation measures traditionally implemented during influenza pandemics and the novel coronavirus pandemic. Research has shown that social distancing is effective in containing the spread of disease. This is applicable to the current situation with the novel coronavirus, given the lack of effective vaccines and treatments in the United States and Canada in the first eight months of the pandemic. Moreover, social distancing is particularly useful in settings where community transmission is substantial. Directives for social distancing were issued in several states and public transit operators were charged with how to provide for physical distance of six feet between passengers on their property including physical infrastructure such as station buildings and rolling infrastructure (rolling stock) including trains, subway cars and buses. Operational changes were also required due to physical distancing, e.g. adding train cars to provide for opportunities to physically distance on the train. Examples of some measures discussed in this research includes taping off every other seat on buses, increasing the total length of trains by adding cars, separating bus drivers from passengers with plastic sheeting, rear door boarding, etc. This research also analyzes long-term impacts for transit operators and challenges to encourage passengers to return to public transit after lockdown requirements ordered by government officials are lifted. A section on the policies that are being explored by government to continue to sustain public transportation is also included. • We review the interventions deployed by public transit operators to comply with social distancing measures. • We explore operational changes recommended to facilitate physical distancing. • We analyze the impacts for transit operators and challenges for passengers to return to public transit post pandemic. • We discuss the challenges for transit to return to pre-pandemic conditions and some solutions explored. [ABSTRACT FROM AUTHOR]

Since December 2019, there has been a global explosion of research on COVID-19. In Canada, the six National Collaborating Centres (NCCs) for Public Health form one of the central pillars supporting evidence-informed decision making by gathering, synthesizing and translating emerging findings. Funded by the Public Health Agency of Canada and located across Canada, the six NCCs promote and support the use of scientific research and other knowledges to strengthen public health practice, programs and policies. This paper offers an overview of the NCCs as an example of public health knowledge mobilization in Canada and showcases the NCCs' contribution to the COVID-19 response while reflecting on the numerous challenges encountered. [ABSTRACT FROM AUTHOR]

Background The COVID-19 pandemic has led to large proportions of the labour market moving to remote work, while others have become unemployed. Those still at their physical workplace likely face increased risk of infection, compared to other workers. The objective of this paper is to understand the relationship between working arrangements, infection control programs (ICP), and symptoms of anxiety and depression among Canadian workers, not specifically working in healthcare. Methods A convenience-based internet survey of Canadian non-healthcare workers was facilitated through various labour organizations between April 26 and June 6, 2020. A total of 5180 respondents started the survey, of which 3779 were assessed as employed in a full-time or part-time capacity on 2 March 2020 (prior to large-scale COVID-19 pandemic responses in Canada). Of this sample, 3305 (87.5%) had complete information on main exposures and outcomes. Anxiety symptoms were measured using the Generalised Anxiety Disorder screener (GAD-2), and depressive symptoms using the Patient Health Questionnaire screener (PHQ-2). For workers at their physical workplace (site-based workers) we asked questions about the adequacy and implementation of 11 different types of ICP, and the adequacy and supply of eight different types of personal protective equipment (PPE). Respondents were classified as either: working remotely; site-based workers with 100% of their ICP/PPE needs met; site-based workers with 50–99% of ICP/PPE needs met; site-based workers with 1–49% of ICP/PPE needs met; site-based workers with none of ICP/PPE needs met; or no longer employed. Regression analyses examined the association between working arrangements and ICP/PPE adequacy and having GAD-2 and PHQ-2 scores of three and higher (a common screening point in both scales). Models were adjusted for a range of demographic, occupation, workplace, and COVID-19-specific factors. Results A total of 42.3% (95% CI: 40.6–44.0%) of the sample had GAD-2 scores of 3 and higher, and 34.6% (95% CI: 32.–36.2%) had PHQ-2 scores of 3 and higher. In initial analyses, symptoms of anxiety and depression were lowest among those working remotely (35.4 and 27.5%), compared to site-based workers (43.5 and 34.7%) and those who had lost their jobs (44.1 and 35.9%). When adequacy of ICP and PPE was taken into account, the lowest prevalence of anxiety and depressive symptoms was observed among site-based workers with all of their ICP needs being met (29.8% prevalence for GAD-2 scores of 3 and higher, and 23.0% prevalence for PHQ-2 scores of 3 and higher), while the highest prevalence was observed among site-based workers with none of their ICP needs being met (52.3% for GAD-2 scores of 3 and higher, and 45.8% for PHQ-2 scores of 3 and higher). Conclusion Our results suggest that the adequate design and implementation of employer-based ICP have implications for the mental health of site-based workers. As economies re-open the ongoing assessment of ICP and associated mental health outcomes among the workforce is warranted. [ABSTRACT FROM AUTHOR]

On 11 March 2020, the World Health Organization officially declared COVID-19 a pandemic. The new physical distancing rules have had many consequences, some of which are felt throughout the justice system. Courts across the world limited their operations. Nonetheless, given that justice delayed is justice denied, many jurisdictions have turned to technologies for urgent matters. This paper offers an evidence-based comment and caution for lawyers and judges who could be inclined, for concerns such as cost and time saving, to permanently step aside from in-person trials. Using nonverbal communication research, in conjunction with American and Canadian legal principles, we argue that such a decision could harm the integrity of the justice system. [ABSTRACT FROM AUTHOR]

The COVID-19 pandemic has brought unprecedented shifts to higher education globally, including Canadian universities. In this paper I utilize an extended photo essay method and narrative response to document the changes seen in my local university environment during the months of April through September 2020. Emerging literature and survey results concerning the Canadian academic condition during the pandemic are discussed alongside research diary entries and policy excerpts. [ABSTRACT FROM AUTHOR]

Purpose: The novel coronavirus disease (COVID-19) pandemic has swept the globe, with a domino effect on medical education and training. In this study, we surveyed Canadian radiology residents to understand the impact of the pandemic on their residency training, strategies utilized by the residency programs in mitigating those impacts, and factors important to residents in the selection of educational resources on COVID-19. Methods: A 10-item questionnaire was distributed to 460 resident members of the Canadian Association of Radiologists. The survey was open for 2 weeks, with a reminder sent at half-way mark. Results: We received 96 responses (response rate: 20.9%). The 4 highest affected domains of training were daytime case volumes (92.4%), daytime schedules (87.4%), internal and external assessments (86.5%), and vacation/travel (83.3%). Virtual teaching rounds (91.7%), change in schedules to allow staying home (78.1%), and virtual/phone readouts (72.9%) were the most utilized strategies by the Canadian radiology residency programs. Overall stress of exposure to the disease was moderate to low (86.5%). A minority of the residents were redeployed (6.2%), although most (68.8%) were on standby for redeployment. Residents preferred published society guidelines (92.3%), review papers (79.3%), video lectures (79.3%), and web tools (76.9%) for learning about COVID-19 imaging manifestations. Conclusion: The COVID-19 pandemic has had a significant impact on various domains of the Canadian radiology residency programs, which has been mitigated by several strategies employed by the training programs. [ABSTRACT FROM AUTHOR]

The coronavirus pandemic (COVID-19) has altered the undergraduate learning experience for many students across Canada. Medical education is no exception; clinical programs, in-person lectures, and mandatory hands-on activities have been suspended to adhere to social distancing guidelines. As remote teaching becomes the forefront of education, medical curricula have been forced to adapt accordingly in order to fulfill the core competencies of medical training and to provide quality education to medical students. With that in mind, the COVID-19 crisis offers a unique opportunity to evaluate the current "continuity plans" in medical education as they stand. This paper provides the perspective of medical students on how medical education is changing for both pre-clerkship and clerkship students, using their experience at McGill University as an example for the Canadian medical education system. Additionally, we discuss the accommodations put forth by the undergraduate medical education (UGME) office, and reflect on the limitations and sustainable solutions in supporting quality medical education. [ABSTRACT FROM AUTHOR]

The hallmark of a great leader is courageous leadership during a crisis. COVID-19 plunged educational leaders into an unprecedented calamity. The situation required strong, decisive, and courageous leadership. Worldwide, universities decided to take the classroom online to facilitate emergency remote teaching. For many educational leaders, this was unchartered territory. Apart from the ambiguity surrounding COVID-19, higher educational leaders were confronted with the magnified issues of equity, access to technology, teacher training, resources, financing, and the well-being of students and staff. This conceptual paper will critically examine how educational leaders managed the initial phase of the COVID-crisis in Barbados and Canada. We will emphasise the leadership strategies that were used to address myriad challenges that emerged during this time. The authors will also examine the lessons learnt and important implications for education leaders on how to lead during a crisis. [ABSTRACT FROM AUTHOR]

The coronavirus pandemic (COVID-19) has altered the undergraduate learning experience for many students across Canada. Medical education is no exception; clinical programs, in-person lectures, and mandatory hands-on activities have been suspended to adhere to social distancing guidelines. As remote teaching becomes the forefront of education, medical curricula have been forced to adapt accordingly in order to fulfill the core competencies of medical training and to provide quality education to medical students. With that in mind, the COVID-19 crisis offers a unique opportunity to evaluate the current "continuity plans" in medical education as they stand. This paper provides the perspective of medical students on how medical education is changing for both pre-clerkship and clerkship students, using their experience at McGill University as an example for the Canadian medical education system. Additionally, we discuss the accommodations put forth by the undergraduate medical education (UGME) office, and reflect on the limitations and sustainable solutions in supporting quality medical education. [ABSTRACT FROM AUTHOR]

In late January 2020, the first COVID-19 case was reported in Canada. By March 5, 2020, community spread of the virus was identified and by May 26, 2020, close to 86,000 patients had COVID-19 and 6,566 had died. As COVID-19 cases increased, provincial and territorial governments announced states of public health emergency between March 13 and 20, 2020. This paper examines Canada's public health response to the COVID-19 pandemic during the first four months (January to May 2020) by overviewing the actions undertaken by the federal (national) and regional (provincial/territorial) governments. Canada's jurisdictional public health structures, public health responses, technological and research endeavours, and public opinion on the pandemic measures are described. As the pandemic unravelled, the federal and provincial/territorial governments unrolled a series of stringent public health interventions and restrictions, including physical distancing and gathering size restrictions; closures of borders, schools, and non-essential businesses and services; cancellations of non-essential medical services; and limitations on visitors in hospital and long-term care facilities. In late May 2020, there was a gradual decrease in the daily numbers of new COVID-19 cases seen across most jurisdictions, which has led the provinces and territories to prepare phased re-opening. Overall, the COVID-19 pandemic in Canada and the substantial amount of formative health and policy-related data being created provide an insight on how to improve responses and better prepare for future health emergencies. [ABSTRACT FROM AUTHOR]

The COVID-19 pandemic is producing significant economic and social cost globally. As a cure or a treatment is yet unavailable, social distancing is considered the key way to prevent it. Mobility restrictions and confinement measures implemented across the world are considered to help reduce air pollution. However, empirical examination of the link between public mobility changes and air pollution during the COVID-19 period remains unavailable. This paper examines the short and long run impacts of mobility changes on carbon monoxide (CO) emissions by employing three dynamic estimators on a panel of 35 countries covering daily data from 15 February to April 17, 2020 - a period when most countries went into strict lockdowns. Findings show a consistent evidence at the all-countries level and across regions that long-run indoor mobility increases reduce CO emissions, while outdoor mobility increases across places such as transit stations, workplaces, grocery & pharmacies, retail & recreation, and parks drive up emissions. Among the regions studied, Europe excluding the EU and the UK (−8.4%), followed by East Asia and the Pacific (−4.3%), sees a larger emissions reduction from increased indoor mobility. While short-run effects are limited in general, emissions in US-Canada respond to indoor and outdoor mobility changes in both the short (1.1%) and long run (−1.4%). Findings overall indicate that reducing unnecessary outdoor mobility could help in maintaining air quality in the post-pandemic world. [Display omitted] • Longer term lockdowns and mobility restrictions slow down CO emissions globally. • Europe experiences the largest declines in air pollution due to mobility restrictions in the long run. • Emissions decline due to mobility restrictions in the US and Canada in both short and long run. • Curbing people movement through more work-from-home could save the environment. [ABSTRACT FROM AUTHOR]