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Since the beginning of COVID-19, more than 13,036,550 people have been infected, and 571,574 died because of the disease by July 13, 2020. Developing new methodologies to predict the COVID-19 pandemic will help policymakers plan to contain the spread of the virus. In this research, we develop a Stochastic Fractal Search algorithm combined with a mathematical model to forecast the pandemic. To enhance the algorithm, we employed a design of the experiments approach for tuning.We applied our algorithm to public datasets to model the COVID-19 pandemic in Canada in the upcoming months. Our algorithm predicts the number of symptomatic, asymptomatic, life-threatening, recovered, and death cases. The outcomes reveal that asymptomatic cases play the main role in the transmission of the virus.Wealso show that increasing the testing capacity would enhance the detection of asymptomatic cases and limit community transmission. Moreover, we performed sensitivity analyses to discover the effects of changes in transmission rates on pandemic growth. The sensitivity analyses provide a realistic overview of the future number of cases if the transmission rates change due to the emergence of new variants or change in social measures. Considering the outcomes, we provide several managerial insights to minimize community transmission. [ABSTRACT FROM AUTHOR]

Background Asymptomatic SARS-CoV-2 infection in children is highly prevalent but its acute and chronic implications have been minimally described. Methods In this controlled case-ascertained household transmission study, we recruited asymptomatic children <18 years with SARS-CoV-2 nucleic acid testing performed at 12 tertiary care pediatric institutions in Canada and the United States. We attempted to recruit all test-positive children and 1 to 3 test-negative, site-matched controls. After 14 days' follow-up we assessed the clinical (ie, symptomatic) and combined (ie, test-positive, or symptomatic) secondary attack rates (SARs) among household contacts. Additionally, post–COVID-19 condition (PCC) was assessed in SARS-CoV-2–positive participating children after 90 days' follow-up. Results A total of 111 test-positive and 256 SARS-CoV-2 test-negative asymptomatic children were enrolled between January 2021 and April 2022. After 14 days, excluding households with co-primary cases, the clinical SAR among household contacts of SARS-CoV-2–positive and –negative index children was 10.6% (19/179; 95% CI: 6.5%–16.1%) and 2.0% (13/663; 95% CI: 1.0%–3.3%), respectively (relative risk = 5.4; 95% CI: 2.7–10.7). In households with a SARS-CoV-2–positive index child, age <5 years, being pre-symptomatic (ie, developed symptoms after test), and testing positive during Omicron and Delta circulation periods (vs earlier) were associated with increased clinical and combined SARs among household contacts. Among 77 asymptomatic SARS-CoV-2–infected children with 90-day follow-up, 6 (7.8%; 95% CI: 2.9%–16.2%) reported PCC. Conclusions Asymptomatic SARS-CoV-2–infected children, especially those <5 years, are important contributors to household transmission, with 1 in 10 exposed household contacts developing symptomatic illness within 14 days. Asymptomatic SARS-CoV-2–infected children may develop PCC. [ABSTRACT FROM AUTHOR]

Various published COVID-19 models have been used in epidemiological studies and healthcare planning to model and predict the spread of the disease and appropriately realign health measures and priorities given the resource limitations in the field of healthcare. However, a significant issue arises when these models need help identifying the distribution of the constituent variants of COVID-19 infections. The emergence of such a challenge means that, given limited healthcare resources, health planning would be ineffective and cost lives. This work presents a universal neural network (NN) computational instrument for predicting the mainstream symptomatic infection rate of COVID-19 and models of the distribution of its associated variants. The NN is based on a mixture density network (MDN) with a Gaussian mixture model (GMM) object as a backbone. Twelve use cases were used to demonstrate the validity and reliability of the proposed MDN. The use cases included COVID-19 data for Canada and Saudi Arabia, two date ranges (300 and 500 days), two input data modes, and three activation functions, each with different implementations of the batch size and epoch value. This array of scenarios provided an opportunity to investigate the impacts of epistemic uncertainty (EU) and aleatoric uncertainty (AU) on the prediction model's fitting. The model accuracy readings were in the high nineties based on a tolerance margin of 0.0125. The primary outcome of this work indicates that this easy-to-use universal MDN helps provide reliable predictions of COVID-19 variant distributions and the corresponding synthesized profile of the mainstream infection rate. [ABSTRACT FROM AUTHOR]

Background There is a need to understand the duration of infectivity of primary and recurrent coronavirus disease 2019 (COVID-19) and identify predictors of loss of infectivity. Methods Prospective observational cohort study with serial viral culture, rapid antigen detection test (RADT) and reverse transcription polymerase chain reaction (RT-PCR) on nasopharyngeal specimens of healthcare workers with COVID-19. The primary outcome was viral culture positivity as indicative of infectivity. Predictors of loss of infectivity were determined using multivariate regression model. The performance of the US Centers for Disease Control and Prevention (CDC) criteria (fever resolution, symptom improvement, and negative RADT) to predict loss of infectivity was also investigated. Results In total, 121 participants (91 female [79.3%]; average age, 40 years) were enrolled. Most (n = 107, 88.4%) had received ≥3 severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) vaccine doses, and 20 (16.5%) had COVID-19 previously. Viral culture positivity decreased from 71.9% (87/121) on day 5 of infection to 18.2% (22/121) on day 10. Participants with recurrent COVID-19 had a lower likelihood of infectivity than those with primary COVID-19 at each follow-up (day 5 odds ratio [OR], 0.14; P <.001]; day 7 OR, 0.04; P =.003]) and were all non-infective by day 10 (P =.02). Independent predictors of infectivity included prior COVID-19 (adjusted OR [aOR] on day 5, 0.005; P =.003), an RT-PCR cycle threshold [Ct] value <23 (aOR on day 5, 22.75; P <.001) but not symptom improvement or RADT result. The CDC criteria would identify 36% (24/67) of all non-infectious individuals on day 7. However, 17% (5/29) of those meeting all the criteria had a positive viral culture. Conclusions Infectivity of recurrent COVID-19 is shorter than primary infections. Loss of infectivity algorithms could be optimized. [ABSTRACT FROM AUTHOR]

Biosurveillance of invasive species is critical for protecting native ecosystems and limiting economic losses. Early detection of pathogens through qPCR methods has recently shown great promise and can potentially slow the spread of devastating diseases. For instance, oak wilt, a disease caused by the fungus Bretziella fagacearum, can kill mature trees within weeks of infection. Originally contained in the USA, oak wilt has finally made its way into Canada, where it was recently observed for the first time in June 2023. This study has laid the foundations for a biosurveillance monitoring programme of B. fagacearum in Eastern Canada. From 2019–2021, insect vectors were baited and captured in Lindgren traps in various locations of interest, namely sawmills importing oak logs from the USA, forested areas containing mature oak trees and strategic sites along the border between the two countries. Insect vectors and collection fluids were analysed with our qPCR detection test for the presence of B. fagacearum. As a positive control to validate this method, we included traps in a known centre of oak wilt infection in Michigan (USA). Our analysis showed only one positive site at the border between Ontario (CA) and the USA, even though oak wilt has never been observed there. This result confirms that DNA from B. fagacearum can be detected with this method even before the appearance of symptomatic trees, which could be crucial in the current containment efforts in Ontario (CA). [ABSTRACT FROM AUTHOR]

The goals of this study were to investigate (a) the dyadic relations of mothers' and children's perceptions of children's anxiety symptoms across development, (b) whether maternal perceptions of children's anxiety serve as a mediator of the association between maternal anxiety and child anxiety, and (c) whether sensitive/structured parenting moderates these processes. Participants were 180 mother–child dyads (96 female) recruited from Quebec, Canada, and assessed in preschool, middle childhood, and early adolescence. Mothers and children completed questionnaires on children's anxiety, and mothers additionally completed a questionnaire on their own anxiety. Maternal sensitivity/structuring was assessed from an observed interaction task. Results from an actor–partner interdependence model suggest (a) maternal perceptions of children's anxiety in middle childhood predict children's self-perceptions in adolescence, but not vice versa; (b) maternal perceptions in middle childhood mediate the link between maternal anxiety in early childhood and child self-perceptions of anxiety in adolescence; and (c) the indirect effect of maternal perceptions is moderated by maternal sensitivity/structuring such that mothers who perceived more anxiety in their children and who were observed to show lower levels of sensitivity/structuring in middle childhood tended to have children who perceived more anxiety in adolescence. Findings suggest that maternal awareness of children's anxiety may be one mechanism, in the presence of relationships characterized by lower levels of sensitivity, through which anxiety risk is transferred from parent to child over time. Public Significance Statement: This study suggests that a mother's awareness of their child's anxiety predicts how their child comes to see their anxiety across time, but not vice versa. Anxious mothers see more anxiety in their children and, when they are less sensitive and supportive, have children who perceive experiencing more anxiety. This highlights the importance of targeting parent–child communication about emotions when seeking to understand and intervene in children's anxiety. [ABSTRACT FROM AUTHOR]

The 2022 mpox outbreak predominantly impacted gay, bisexual, and other men who have sex with men (gbMSM). Two models were developed to support situational awareness and management decisions in Canada. A compartmental model characterized epidemic drivers at national/provincial levels, while an agent‐based model (ABM) assessed municipal‐level impacts of vaccination. The models were parameterized and calibrated using empirical case and vaccination data between 2022 and 2023. The compartmental model explored: (1) the epidemic trajectory through community transmission, (2) the potential for transmission among non‐gbMSM, and (3) impacts of vaccination and the proportion of gbMSM contributing to disease transmission. The ABM incorporated sexual‐contact data and modeled: (1) effects of vaccine uptake on disease dynamics, and (2) impacts of case importation on outbreak resurgence. The calibrated, compartmental model followed the trajectory of the epidemic, which peaked in July 2022, and died out in December 2022. Most cases occurred among gbMSM, and epidemic trajectories were not consistent with sustained transmission among non‐gbMSM. The ABM suggested that unprioritized vaccination strategies could increase the outbreak size by 47%, and that consistent importation (≥5 cases per 10 000) is necessary for outbreak resurgence. These models can inform time‐sensitive situational awareness and policy decisions for similar future outbreaks. [ABSTRACT FROM AUTHOR]

Background: Tar spot of corn is a significant and spreading disease in the continental U.S. and Canada caused by the obligate biotrophic fungus Phyllachora maydis. As of 2023, tar spot had been reported in 18 U.S. states and one Canadian Province. The symptoms of tar spot include chlorotic flecking followed by the formation of black stromata where conidia and ascospores are produced. Advancements in research and management for tar spot have been limited by a need for a reliable method to inoculate plants to enable the study of the disease. The goal of this study was to develop a reliable method to induce tar spot in controlled conditions. Results: We induced infection of corn by P. maydis in 100% of inoculated plants with a new inoculation method. This method includes the use of vacuum-collection tools to extract ascospores from field-infected corn leaves, application of spores to leaves, and induction of the disease in the dark at high humidity and moderate temperatures. Infection and disease development were consistently achieved in four independent experiments on different corn hybrids and under different environmental conditions in a greenhouse and growth chamber. Disease induction was impacted by the source and storage conditions of spores, as tar spot was not induced with ascospores from leaves stored dry at 25 ºC for 5 months but was induced using ascospores from infected leaves stored at -20 ºC for 5 months. The time from inoculation to stromata formation was 10 to 12 days and ascospores were present 19 days after inoculation throughout our experiments. In addition to providing techniques that enable in-vitro experimentation, our research also provides fundamental insights into the conditions that favor tar spot epidemics. Conclusions: We developed a method to reliably inoculate corn with P. maydis. The method was validated by multiple independent experiments in which infection was induced in 100% of the plants, demonstrating its consistency in controlled conditions. This new method facilitates research on tar spot and provides opportunities to study the biology of P. maydis, the epidemiology of tar spot, and for identifying host resistance. [ABSTRACT FROM AUTHOR]

BACKGROUND: The COVID-19 pandemic increased demand for app-based platform-based couriers, creating job opportunities for individuals who have lost income because of COVID-19. Through various stages of lockdown, courier workers (e.g., delivering for Uber Eats, Amazon Flex, and Lyft) provide an essential service. At the same time, this form of work poses risks for exposure to the SARS-CoV-2 virus as these workers are highly mobile and in contact with many individuals. OBJECTIVE: To explore how platform-based couriers discuss risks associated with their work during periods of high (first wave, second wave, third wave/rise in concerns regarding variants) and low risk during the COVID-19 pandemic, 2020–2021. METHODS: We provide a narrative analysis of user posts (n = 2,866) on Reddit during periods of interest. RESULTS: Our analysis resulted in three central findings. First, we identified changing patterns in discourse as the pandemic went on. Second, we found that the theme of risk prevailed largely in the first wave, with dialogue dominated by tips and asking for advice about how to manage risk. Third, our findings reveal a growing polarization among users during the latter phases of the study. CONCLUSION: Polarization largely focused on acceptance (or not) of public health measures and the nature of their work as independent contractors and the role/responsibility of courier companies to offer protection. Our study is the first to document risks, from the perspectives of anonymous couriers who may be unwilling to share their honest opinions and thoughts through primary data collection where anonymity is not guaranteed. [ABSTRACT FROM AUTHOR]

Heating, ventilation, and air conditioning (HVAC) systems play a crucial role in either increasing or decreasing the risk of airborne disease transmission. High ventilation, for instance, is a common method used to control and reduce the infection risk of airborne diseases such as COVID-19. On the other hand, high ventilation will increase energy consumption and cost. This paper proposes an optimal HVAC controller to assess the trade-off between energy consumption and indoor infection risk of COVID-19. To achieve this goal, a nonlinear model predictive controller (NMPC) is designed to control the HVAC systems of a university building to minimize the risk of COVID-19 transmission while reducing building energy consumption. The NMPC controller uses dynamic models to predict future outputs while meeting system constraints. To this end, a set of dynamic physics-based models are created to capture heat transfer and conservation of mass, which are used in the NMPC controller. Then, the developed models are experimentally validated by conducting experiments in the ETLC building at the University of Alberta, Canada. A classroom in the building is equipped with a number of sensors to measure indoor and outdoor environmental parameters such as temperature, relative humidity, and CO 2 concentration. The validation results show that the model can predict room temperature and CO 2 concentration by 0.8%, and 2.4% mean absolute average errors, respectively. Based on the validated models, the NMPC controller is designed to calculate the optimal airflow and supply air temperature for every 15 min. The results for real case studies show that the NMPC controller can reduce the infection risk of COVID-19 transmission below 1% while reducing energy consumption by 55% when compared to the existing building controller. [ABSTRACT FROM AUTHOR]

Rooted in research into personality, we propose that the Big Five traits would be related to fear of COVID‐19 (FOC), which in turn would lead to heightened job burnout, reduced job satisfaction, and decreased performance. Utilizing a three‐wave time‐lagged design, we collected our data from employees working in the United States and Canada (N = 300 × 3). We found good support for our hypotheses. Extraversion, neuroticism, and conscientiousness had significant direct effects on FOC. Fear of COVID‐19 was positively related to job burnout and negatively related to job satisfaction and performance. Extraversion, neuroticism, and conscientiousness had significant indirect effects on burnout, job satisfaction, and job performance via FOC. Hence, this study identifies a key mechanism, an individual's worry about losing their valuable resources (e.g. their health, and that of their family members and friends, etc.), through which selected dimensions of personality might affect employees' work outcomes. We discuss our findings and provide suggestions for future research in this domain. [ABSTRACT FROM AUTHOR]

Background: This study describes a SARS-CoV-2 outbreak which was declared in a community hospital, and discusses the lessons learned that could inform future outbreak prevention and control efforts. Methods: The outbreak took place from September 16, 2020 to October 26, 2020 when COVID-19 incidence in the community was low and the COVID-19 vaccine was not yet available. Epidemiological data, patient clinical information, and whole genome sequencing were utilized for the outbreak investigation and analysis. Results: The index case was a patient whose positive status was unknown to staff and whose symptoms on admission did not fit the screening criteria at the time. A total of 19 patients were linked to the outbreak during the study period, with an attack rate of 29%. All-cause mortality for patient cases was 37%. Whole genome sequencing confirmed genetic relatedness of all patient cases. Conclusion: Vigilance for atypical clinical presentation, strategic patient cohorting, and minimizing movement of positive and exposed patients may help limit transmission. Whole genome sequencing can supplement epidemiological data to inform outbreak investigations. [ABSTRACT FROM AUTHOR]

Simple Summary: Toxoplasma gondii is considered one of the most successful parasites in the world, potentially infecting any vertebrates, including humans. Its complex life cycle encompasses many transmission pathways, which remain enigmatic in northern ecosystems. The aim of our study was to assess Canada lynx as potential reservoir of and sentinel for T. gondii by (1) using serological and molecular assays to detect T. gondii, (2) determining if lynx are definitive hosts for the parasite, and (3) identifying potential risk factors that may contribute to lynx exposure. For the first time, T. gondii DNA was found in tissue and feces of Canada lynx, indicating that they can be both intermediate and definitive hosts in northern regions. Our findings would help identify high-risk regions for infections in northern Canada, with lynx serving as indicator for potential human exposure of T. gondii. Toxoplasma gondii is a zoonotic parasite globally infecting a wide range of species, including humans. Felids are the only known hosts that can excrete environmentally resistant oocysts into ecosystems. In boreal regions, Canada lynx (Lynx canadensis) are sought by hunters primarily for their fur, and they are occasionally eaten. We examined carcasses salvaged from trappers from boreal regions of eastern (n = 97) and western (n = 357) Canada. We detected T. gondii antibodies in fluid from thawed heart tissue using an enzyme-linked immunosorbent assay, DNA in brain and heart via magnetic capture and real-time PCR assay, and presence of DNA in feces using a real-time PCR with melt curve analysis. We detected antibodies against T. gondii and DNA in tissues in 24% and 19% of lynx, respectively. One lynx was positive for DNA of T. gondii in feces, which could indicate intestinal infection and potential for shedding oocysts. Our results indicate that lynx may be a useful sentinel species for monitoring environmental circulation of T. gondii in northern boreal regions and may pose a risk for transmission to other wildlife and to people handling or consuming lynx. [ABSTRACT FROM AUTHOR]

Background: Plasmodiophora brassicae is the causal agent of clubroot disease of cruciferous plants and one of the biggest threats to the rapeseed (Brassica napus) and brassica vegetable industry worldwide. Disease symptoms: In the advanced stages of clubroot disease wilting, stunting, yellowing, and redness are visible in the shoots. However, the typical symptoms of the disease are the presence of club‐shaped galls in the roots of susceptible hosts that block the absorption of water and nutrients. Host range: Members of the family Brassicaceae are the primary host of the pathogen, although some members of the family, such as Bunias orientalis, Coronopus squamatus, and Raphanus sativus, have been identified as being consistently resistant to P. brassicae isolates with variable virulence profile. Taxonomy Class: Phytomyxea; Order: Plasmodiophorales; Family: Plasmodiophoraceae; Genus: Plasmodiophora; Species: Plasmodiophora brassicae (Woronin, 1877). Distribution: Clubroot disease is spread worldwide, with reports from all continents except Antarctica. To date, clubroot disease has been reported in more than 80 countries. Pathotyping: Based on its virulence on different hosts, P. brassicae is classified into pathotypes or races. Five main pathotyping systems have been developed to understand the relationship between P. brassicae and its hosts. Nowadays, the Canadian clubroot differential is extensively used in Canada and has so far identified 36 different pathotypes based on the response of a set of 13 hosts. Effectors and resistance: After the identification and characterization of the clubroot pathogen SABATH‐type methyltransferase PbBSMT, several other effectors have been characterized. However, no avirulence gene is known, hindering the functional characterization of the five intercellular nucleotide‐binding (NB) site leucine‐rich‐repeat (LRR) receptors (NLRs) clubroot resistance genes validated to date. Important Link: Canola Council of Canada is constantly updating information about clubroot and P. brassicae as part of their Canola Encyclopedia: https://www.canolacouncil.org/canola‐encyclopedia/diseases/clubroot/. Phytosanitary categorization: PLADBR: EPPO A2 list; Annex designation 9E. [ABSTRACT FROM AUTHOR]

We propose two compartment models to study the disease transmission dynamics, then apply the models to the current COVID-19 pandemic and to explore the potential impact of the interventions, and try to provide insights into the future health care demand. Starting with an SEAIQR model by combining the effect from exposure, asymptomatic and quarantine, then extending the model to the one with ages below and above 65 years old, and classify the infectious individuals according to their severity. We focus our analysis on each model with and without vital dynamics. In the models with vital dynamics, we study the dynamical properties including the global stability of the disease free equilibrium and the existence of endemic equilibrium, with respect to the basic reproduction number. Whereas in the models without vital dynamics, we address the final epidemic size rigorously, which is one of the common but difficult questions regarding an epidemic. Finally, we apply our models to estimate the basic reproduction number and the final epidemic size of disease by using the data of COVID-19 confirmed cases in Canada and Newfoundland & Labrador province. [ABSTRACT FROM AUTHOR]

Background: During the period of monkeypox community transmission and restricted vaccine supply in the summer of 2022, Canadian provinces and territories and a number of vaccine stakeholders indicated the need for consistent national guidance on pre-exposure vaccination (including the identification of priority populations for pre-exposure vaccination programs) and guidance on the potential use of dose-sparing strategies. Methods: The National Advisory Committee on Immunization (NACI) High Consequence Infectious Disease Working Group reviewed data on the status of the monkeypox outbreak along with additional published and non-published evidence regarding the safety, immunogenicity and protection offered by Imvamune®. NACI approved updated recommendations on September 16, 2022, and on September 23, 2022 it released updated interim guidance on the use of Imvamune in the context of the ongoing monkeypox outbreak. Results: During periods of adequate vaccine supply, NACI recommended that Imvamune preexposure vaccination should be offered as a two-dose primary series, with at least 28 days between the two sub-cutaneous doses. When supply is limited, guidance was provided for the use of dose sparing strategies, including extended dosing intervals and fractional intradermal dosing to maximize vaccine coverage for those at highest risk of exposure to the monkeypox virus. Conclusion: The updated NACI recommendations provide additional guidance on the use of Imvamune for the management of the 2022 monkeypox outbreak in Canada and may be considered to maximize vaccine coverage in outbreak settings when supply is limited. [ABSTRACT FROM AUTHOR]

Background: Estimates of the number of hepatitis C virus (HCV) infections are important for monitoring efforts aimed at preventing disease transmission, especially following the introduction of a highly effective treatment. This report provides updated estimates of HCV incidence, prevalence, undiagnosed proportion and treatment in Canada. Methods: A combination of back calculation modelling and a modified version of the workbook method were used to estimate the incidence and prevalence of anti-HCV positive persons, the prevalence of chronic HCV infection and the undiagnosed proportion. The number of people treated for chronic HCV was estimated using administrative pharmaceutical data. Results: An estimated 9,470 new infections occurred in 2019, corresponding to an incidence rate of 25 per 100,000 population, a 7.7% decrease since 2015. The estimated prevalence of anti-HCV antibodies in the Canadian population was 1.03% (plausible range: 0.83%-1.38%), and the estimated prevalence of chronic HCV was 0.54% (plausible range: 0.40%-0.79%). The overall proportion of anti-HCV positive persons who were undiagnosed was estimated at 24% of all infections, with individuals born between 1945 and 1975 being the priority population the most likely to be undiagnosed. An estimated 74,500 people with chronic HCV have been treated since the introduction of direct-acting antivirals in 2014. Conclusion: Estimates of HCV incidence and prevalence are key metrics to guide interventions and resource allocation. While our estimates show that HCV incidence has decreased in Canada in recent years and treatment of chronic HCV has continued to increase, ongoing efforts are required to reduce the burden of HCV in Canada. [ABSTRACT FROM AUTHOR]

The article focuses on the work and evolution of Wellness Within: An Organization for Health and Justice, which began as a doula project for incarcerated individuals and grew into an abolitionist movement advocating for the rights and experiences of women, trans, and nonbinary people in pregnancy and parenting in the Canadian prison system.

Elimination of bloodborne viruses including HIV and hepatitis C virus from prisons requires high coverage of evidence-based interventions that prevent bloodborne virus transmission, including needle and syringe programs. Canada launched a Prison Needle Exchange Program (PNEP) in nine federal prisons in 2018; however, uptake among people who inject drugs in prison remains low. We aimed to explore barriers and facilitators to improving PNEP uptake identified by correctional officers and healthcare workers. Participants from nine federal prisons with PNEP completed focus groups using nominal group technique, a rapid mixed-method consensus strategy. Responses were generated, rank-ordered, and prioritized by each stakeholder group. We identified the highest-ranking responses (≥10 % of the overall votes) to questions about barriers and facilitators to PNEP uptake. Between September 2023 and February 2024, 16 focus groups were conducted with 118 participants (n = 51 correctional officers; n = 67 healthcare workers). Among correctional officers, the top perceived barriers were bullying from peers (22 %), fear of being targeted by correctional officers (14 %), and fear of repercussions due to drug use (13 %). The top facilitators were safe injection sites (30 %), provision of wrap-around services (16 %), and education of correctional officers (10 %). Among healthcare workers, the top perceived barriers were lack of confidentiality (16 %), fear of being targeted by correctional officers (12 %), and a long and complex application process (11 %). The top facilitators were education of correctional officers (29 %), delivery of PNEP by an external provider (15 %), automatic approval for participation in the PNEP (13 %), and safe injection sites (12 %). Multiple modifiable barriers and solutions to improving PNEP uptake in Canadian federal prisons were identified by correctional employees. Both participant groups identified the potential for safe injection sites and education to correctional officers as enabling PNEP uptake. These data will inform Canadian efforts to improve engagement and to expand PNEP coverage. [ABSTRACT FROM AUTHOR]

Background: The COVID‐19 pandemic brought about the immediate need for enhanced safety protocols in health care centers. These protocols had to evolve as knowledge and understanding of the disease quickly broadened. Aims: Through this study, the researchers aimed to understand the experiences of pediatric anesthesiologists at the Montreal Children's Hospital and the Shriners' Hospital Canada as they navigated the first wave of COVID‐19 at their institutions. Methods: Nine participants from the Montreal Children's Hospital and the Shriners' Hospital were interviewed. Interviews were recorded, transcribed verbatim, and then analyzed using an applied philosophical hermeneutics approach. Findings: Participants expressed their wish for simple and easy‐to‐apply protocols while recognizing the challenge of keeping up with evolving knowledge on the disease and its transmission. They pointed to some limitations and unintended consequences of the safety protocols and the system‐wide flaws that the COVID‐19 pandemic helped bring to light. They described their frustrations with some aspects of the safety protocols, which they at times felt could be more efficient or better suited for their daily practice. Conclusions: The findings of this study highlighted the importance of listening to and empowering anesthesiology staff working in the field during crises, the implications of shifting from patient‐centered care to community‐centered care, and the fine line between sharing as much emerging information as possible and overwhelming staff with information. [ABSTRACT FROM AUTHOR]

This paper proposes a novel fractional-order epidemic model for the COVID-19 outbreak using the Caputo derivative that incorporates various intervention policies to manage the spread of the disease. A total of eight state variables were considered in this nonlinear model, namely, susceptible, exposed, infected, quarantined, hospitalized, recovered, deceased, and insusceptible. Two possible outbreak scenarios were considered to control the disease before and after vaccine discovery. The proposed system was designed using the feedback linearization method, allowing to develop a suitable controller for reducing susceptible, exposed, and infected populations. A comparative study with previous work was conducted based on Canada's reported cases to demonstrate the advantages and disadvantages of the proposed COVID-19 outbreak control strategy using this model. The simulation results confirmed that the proposed fractional controller could effectively track the desired goals, including an exponential decrease in infected, exposed, and susceptible populations. [ABSTRACT FROM AUTHOR]

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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]

Children’s active transportation (AT) and independent mobility (IM) can provide benefits for health and social development. Using data from two national surveys, we assessed parent-perceived changes in AT and IM among 5- to 17-year-olds in Canada since the outbreak of COVID-19. About half of parents reported no changes, but two to three times more parents reported declines compared to increases in AT and IM. We explored many potential correlates of changes in AT and IM. Changes in IM were the strongest correlate of changes in AT. Strategies to minimize unintended negative impacts on children’s physical activity from policies to prevent infectious disease transmission should be developed. [ABSTRACT FROM AUTHOR]

Background Infections with human papillomaviruses (HPVs) may enter a latent state, and eventually become reactivated following loss of immune control. It is unclear what proportion of incident HPV detections are reactivations of previous latent infections vs new transmissions. Methods The HPV Infection and Transmission among Couples through Heterosexual activity (HITCH) cohort study prospectively followed young newly formed heterosexual partners recruited between 2005 and 2011 in Montréal, Canada. We calculated the fraction of incident HPV detections nonattributable to sexual transmission risk factors with a Bayesian Markov model. Results are the median (2.5th-97.5th percentiles) of the estimated posterior distribution. Results A total of 544 type-specific incident HPV detection events occurred in 849 participants; 33% of incident HPV detections occurred in participants whose HITCH partners were negative for that HPV type and who reported no other sex partners over follow-up. We estimate that 43% (38%–48%) of all incident HPV detections in this population were not attributable to recent sexual transmission and might be potentially reactivation of latent infections. Conclusions A positive HPV test result in many cases may be a reactivated past infection, rather than a new infection from recent sexual behaviors or partner infidelity. The potential for reactivation of latent infections in previously HPV-negative women should be considered in the context of cervical cancer screening. [ABSTRACT FROM AUTHOR]

National West Nile virus (WNV) surveillance was established in partnership with the federal, provincial and territorial governments starting in 2000, with the aim to monitor the emergence and subsequent spread of WNV disease in Canada. As the disease emerged, national WNV surveillance continued to focus on early detection of WNV disease outbreaks in different parts of the country. In Canada, the WNV transmission season occurs from May to November. During the season, the system adopts a One Health approach to collect, integrate, analyze and disseminate national surveillance data on human, mosquito, bird and other animal cases. Weekly and annual reports are available to the public, provincial/territorial health authorities, and other federal partners to provide an ongoing national overview of WNV infections in Canada. While national surveillance allows a jurisdiction-by-jurisdiction comparison of data, it also helps to guide appropriate disease prevention strategies such as education and awareness campaigns at the national level. This paper aims to describe both the establishment and the current structure of national WNV surveillance in Canada. [ABSTRACT FROM AUTHOR]

Background: Gay, bisexual, and other men who have sex with men (gbMSM) experience disproportionate risks of HIV acquisition and transmission. In 2017, Montréal became the first Canadian Fast-Track City, setting the 2030 goal of zero new HIV infections. To inform local elimination efforts, we estimate the evolving role of prevention and sexual behaviours on HIV transmission dynamics among gbMSM in Montréal between 1975 and 2019.Methods: Data from local bio-behavioural surveys were analyzed to develop, parameterize, and calibrate an agent-based model of sexual HIV transmission. Partnership dynamics, HIV's natural history, and treatment and prevention strategies were considered. The model simulations were analyzed to estimate the fraction of HIV acquisitions and transmissions attributable to specific groups, with a focus on age, sexual partnering level, and gaps in the HIV care-continuum.Results: The model-estimated HIV incidence peaked in 1985 (2.3 per 100 person years (PY); 90% CrI: 1.4-2.9 per 100 PY) and decreased to 0.1 per 100 PY (90% CrI: 0.04-0.3 per 100 PY) in 2019. Between 2000-2017, the majority of HIV acquisitions and transmissions occurred among men aged 25-44 years, and men aged 35-44 thereafter. The unmet prevention needs of men with > 10 annual anal sex partners contributed 90-93% of transmissions and 67-73% of acquisitions annually. The primary stage of HIV played an increasing role over time, contributing to 11-22% of annual transmissions over 2000-2019. In 2019, approximately 70% of transmission events occurred from men who had discontinued, or never initiated antiretroviral therapy.Conclusions: The evolving HIV landscape has contributed to the declining HIV incidence among gbMSM in Montréal. The shifting dynamics identified in this study highlight the need for continued population-level surveillance to identify gaps in the HIV care continuum and core groups on which to prioritize elimination efforts. [ABSTRACT FROM AUTHOR]

Environmental and geographical factors are known to influence the number, distribution, and combination of species that coexist within ecological communities. This, in turn, should influence ecosystem functions such as biomass conservation, or the ability of a community to sustain biomass from small to large organisms. We tested this hypothesis by assessing the role of environmental factors in determining how biomass is conserved in over 600 limnetic fish communities spread across a broad geographic gradient in Canada. Comprehensive and accurate information on water conditions and community characteristics such as taxonomy, abundance, biomass, and size distributions were used in our assessment. Results showed that species combinations emerge as one of the main predictors of biomass conservation among the effects of individual species and abiotic factors. Our study highlights the strong role that geographic patterns in the distribution of species can play in shaping key ecosystem functions, with consequences for ecosystem services such as the provision of harvestable fish biomass. [ABSTRACT FROM AUTHOR]

Background and aim: The novel coronavirus disease 2019 (COVID-19) not only threatens physical health but also psychological well-being. As a result of the pandemic, increased mental health burdens have been recorded in young adults around the world. We sought to understand the association of stressors related to the COVID-19 pandemic with symptoms of psychological and emotional distress in young Canadian adults. Method: Questionnaire respondents were asked about the extent to which they were personally impacted by COVID-19, and symptoms related to depression, anxiety, post-traumatic disorder, and emotional distress. Results: Of 84 respondents, most identified as female (74%; 62/84). Overall, 61% (51/84) reported experiencing symptoms of psychological distress related to depression, anxiety, or post-traumatic stress disorder (PTSD); specifically, 43% (36/84) reported anxiety-related symptoms, 33% (28/84) reported depression-related symptoms, and 6% (5/84) reported PTSD-related symptoms. Individuals with family in settings high risk for COVID-19 infection and individuals who received government aid with a reduction in income were 4.30-fold and 2.80-fold more likely, respectively, to experience symptoms of psychological distress (95% CI 1.31–14.14; p =.013 and 95% CI 1.08–7.25; p =.038, respectively). Visits to social media daily to hourly for COVID-19 related news resulted in a 3.24-fold increase in the likelihood of experiencing depression-related symptoms (95% CI 1.26–8.35; p =.020). Conclusion: We demonstrate a necessity to focus on alleviating the mental health burdens and contributing stressors within young Canadian adults. Though the mental health burdens are currently exacerbated by the effects of the COVID-19 pandemic, they may persist after the pandemic ends if left unaddressed. [ABSTRACT FROM AUTHOR]

This study explored social service providers' perceptions of risk and resilience while caring for their vulnerable clients during COVID-19. Participants (N = 68) from two agencies completed an online survey. Over half of participants had shifted to virtual service delivery; about 30% continued to have direct contact with clients. Using regression modeling, we found that age, gender, confidence in providing COVID-related care, worries about spreading SARS-CoV-2, and information and supports explained 36% of variance (Adjusted R2 =.357) in provider resilience. Social service agencies need to address provider worries, which may contribute more to resilience than providing information. [ABSTRACT FROM AUTHOR]

Objectives: We assessed the prevalence and correlates of sexual concerns and associated distress among women living with HIV in Canada. Methods: We analyzed cross-sectional survey data from the Canadian HIV Women’s Sexual and Reproductive Health Cohort Study (2017–2018). Self-identified women living with HIV were asked about sexual concerns post-HIV diagnosis and associated distress (none, mild, moderate, severe). Five areas of concern were assessed, including difficulties related to sexual self-esteem, sexual function, relationships, and emotional and behavioral aspects of sex. Logistic regression analyses identified correlates of reporting any sexual concerns and severe distress about these concerns. Results: Of 906 participants (median age 48, Q1–Q3=41–55), 596 (65.8%) reported sexual concerns post-HIV diagnosis. We found a high prevalence of concerns related to relationships (43.3%), sexual self-esteem (49.4%), and emotional aspects of sex (45.4%), relative to sexual functioning (38.4%) and behavioral aspects (33.7%). Of those with sexual concerns, 36.7% reported severe distress. Reports of severe distress were the highest for relationship difficulties (32.5%), relative to other areas of concern (21.4%–22.8%). In adjusted analyses, women reporting sexual dissatisfaction and high HIV-related stigma had significantly higher odds of reporting sexual concerns. Conversely, those reporting higher resilience, better mental health, African, Caribbean, and Black identity, and sex as somewhat unimportant, not at all important, or neutral to their lives had lower adjusted odds. Factors associated with severe distress about sexual concerns included older age, body dissatisfaction, sexual dissatisfaction, and high HIV-related stigma, while better mental health and getting support from someone living with HIV were protective. While 84.4% of women had discussed with a provider how viral load impacts transmission risk, only 40.6% had conversations about sexual wellbeing. Conclusion: More attention to women’s sexual wellbeing within social and relational contexts is critical to ensure the sexual rights of women living with HIV are upheld. [ABSTRACT FROM AUTHOR]

The COVID-19 pandemic has left no area of human life unaffected and the food system in its global, regional, or micro manifestations is not an exception. The images of empty store shelves caused by lockdowns stirred a lot of anxiety among consumers in the so-called First World. At the same time, thousands of miles away, in the developing and underdeveloped countries, where having a meal is never taken for granted, people suffered the harshest consequences of any pandemic-related instability in the food system. Both these realities deserve intellectual reflection, with the former being far more intricate than its media portrayals and therefore will be explored further in this work. This paper aims to study the COVID-19 impact on food systems in developed countries such as the United States and Canada, as well as the challenges to the food security they face during the pandemic. It offers a top-down approach, starting with the definition of food security, and highlighting some crucial aspects of food access and food availability, which has been compromised by the spread of coronavirus in the two countries. Detailed analysis of responses to the pandemic-related food security problems in both countries will be offered as well. The right to food is presented here as a human right, and the links between that right and the concept of food security are brought out. The pandemic wreaked havoc on food security in many parts of the world, including the affluent, but at the same time revealed its fragility and the need for continuous monitoring, re-assessment, and improvement through more effective food programs. The emerging sliver of hope for a more just postpandemic food system should not be ignored. [ABSTRACT FROM AUTHOR]

The COVID-19 outbreak has caused two waves and spread to more than 90% of Canada's provinces since it was first reported more than a year ago. During the COVID-19 epidemic, Canadian provinces have implemented many Non-Pharmaceutical Interventions (NPIs). However, the spread of the COVID-19 epidemic continues due to the complex dynamics of human mobility. We develop a meta-population network model to study the transmission dynamics of COVID-19. The model takes into account the heterogeneity of mitigation strategies in different provinces of Canada, such as the timing of implementing NPIs, the human mobility in retail and recreation, grocery and pharmacy, parks, transit stations, workplaces, and residences due to work and recreation. To determine which activity is most closely related to the dynamics of COVID-19, we use the cross-correlation analysis to find that the positive correlation is the highest between the mobility data of parks and the weekly number of confirmed COVID-19 from February 15 to December 13, 2020. The average effective reproduction numbers in nine Canadian provinces are all greater than one during the time period, and NPIs have little impact on the dynamics of COVID-19 epidemics in Ontario and Saskatchewan. After November 20, 2020, the average infection probability in Alberta became the highest since the start of the COVID-19 epidemic in Canada. We also observe that human activities around residences do not contribute much to the spread of the COVID-19 epidemic. The simulation results indicate that social distancing and constricting human mobility is effective in mitigating COVID-19 transmission in Canada. Our findings can provide guidance for public health authorities in projecting the effectiveness of future NPIs. [ABSTRACT FROM AUTHOR]

Despite the large number of immigrant adolescents in Canada, research on their knowledge of sexual and reproductive health and rights (SRHR) and information needs is nearly nonexistent. A scoping review was undertaken following the PRISMA-ScR statement to identify and assess the existing literature regarding SRHR needs of immigrant adolescents in Canada. Of the 1514 articles retrieved from our search strategy, 15 studies met our inclusion criteria. The results from our review identifies three unique themes related to immigrant adolescents' SRHR needs: knowledge needs, access to SRHR education and services, and approaches to SRHR education and services. Immigrant adolescents' knowledge needs includes needs on HIV/STI transmission and protection, unintended pregnancy, sexual activity, family planning, pubertal education, navigating the health care system, and confidentiality legislations. Our results revealed that immigrant adolescents' access SRHR education and services through both school-based and community-based settings. Lastly, approaches to SRHR education and services for immigrant adolescents should include cultural sensitivity, an intersectional approach, interactive learning, a strength-based approach, and reassuring confidentiality rights. The multi-faceted SRHR needs of immigrant adolescents in Canada demonstrates that future research, program development, and policymaking requires careful consideration of these intersecting forces. Inclusive SRHR education and services can be achieved through the employment of a critical cultural approach and intersectional strategies. [ABSTRACT FROM AUTHOR]

Foci of high seroprevalence against Toxoplasma gondii are observed in Nunavik, the Inuit land of Northern Quebec (Canada). Considering the rare occurrence of felids in the region, exposure is suspected to be driven by water‐ and food‐borne transmission routes. Hypotheses were that drinking untreated water from natural sources and eating country food mostly raw increased the risk of exposure to the parasite. Data from 1,300 Inuit participants of the 2017 Nunavik Health Survey were included in three weighted robust Poisson regression models. The effect of three types of exposure variables: (1) water treatment (yes/no) and if country food was mostly eaten raw (yes/no); (2) main source of drinking water (bottled/municipal/natural) and frequency of country food consumption (continuous) and (3) drinking water risk (low/intermediate/high) and frequency of a raw country food consumption (continuous), on the presence of Toxoplasma antibodies were estimated. Models were adjusted for age, sex and ecological region, with multiple sensitivity analyses being performed. Toxoplasma gondii seroprevalences were consistently correlated with age quadratically, sex (prevalence ratio = PRwoman/man ranged from 1.18 to 1.22), ecological region (PRHudsonBay/HudsonStrait ranged from 2.18 to 2.41; PRHudsonBay/UngavaBay ranged from 1.52 to 1.59) and consuming bivalve mollusc/urchin (PR varied from 1.02 to 1.21) across all three models. Each increase of two consumptions per month of beluga (PR ranged from 1.01 to 1.03), seal liver (PR ranged from 1.01 to 1.02) and goose (PR ranged from 1.01 to 1.02) were also associated with seropositivity, albeit more clearly in models 2 and 3, while drinking water mainly from natural (PR of 1.47) or municipal (PR = 1.42) sources compared to bottled water, was correlated with seroprevalence, although results were compatible with the null. Our results suggest that both the oocyst‐ (mollusc/urchin, drinking water) and cyst‐borne (walrus, seal liver and goose) transmission pathways could be present in Nunavik. [ABSTRACT FROM AUTHOR]

Objective: This guideline provides an update on the care of pregnant women living with HIV and the prevention of perinatal HIV transmission. This guideline is a revision of the previous guideline, No. 310 Guidelines for the Care of Pregnant Women Living With HIV and Interventions to Reduce Perinatal Transmission, and includes an updated review of the literature with contemporary recommendations., Target Population: Pregnant women newly diagnosed with HIV during antenatal screening and women living with HIV who become pregnant. This guideline does not include specific guidance for girls/women of reproductive age living with HIV who are not pregnant., Outcomes: Prevention of perinatal HIV transmission is a key indicator of the success of a health care system and requires multidisciplinary care of pregnant women living with HIV. Intended outcomes include guidance on best practice in perinatal management for Canadian health care providers for pregnant women living with HIV; reduction of perinatal transmission of HIV toward a target of eradication of perinatal transmission; provision of optimal antenatal care for pregnant women to ensure the best maternal health outcomes and HIV suppression; and evidence-based support and recommendations for pregnant women living with HIV, maintaining awareness and consideration of the complex psychosocial impacts of living with HIV., Benefits, Harms, and Costs: The perinatal transmission of HIV has significant morbidity and mortality implications for the child, with associated lifelong health care costs. Pregnancy presents an emotionally and physically vulnerable time for pregnant women as well as an opportunity to engage them in health promotion. This guidance does not include recommendations with additional costs to health care facilities compared with the previous guideline. Application of the recommendations is aimed at health benefits to both mother and child by optimizing maternal health and preventing perinatal HIV transmission., Evidence: Published and unpublished literature was reviewed with a focus on publications post-2013. OVID-Medline, Embase, PubMed and the Cochrane Library databases were searched for relevant publications available in English or French for each section of this guideline. Results included systematic reviews, randomized controlled trials, and observational studies published from 2012 to 2022. Searches were updated on a regular basis and incorporated in the guideline until May 2023. Unpublished literature, protocols, and international guidelines were identified by accessing the websites of health-related agencies, clinical practice guideline collections, and national and international medical specialty societies., Validation Methods: The authors rated the quality of evidence and strength of recommendations using the Grading of Recommendations Assessment, Development and Evaluation (GRADE) approach. See Appendix A (Tables A1 for definitions and A2 for interpretations of strong and conditional recommendations)., Intended Audience: The intended users of this guideline include obstetric care providers and infectious disease clinicians who provide care for pregnant women living with HIV., Social Media Summary: Updated Canadian HIV in pregnancy guideline informed by global research and tailored to Canadian healthcare needs and goals for pregnant women living with HIV and their families., Summary Statements: RECOMMENDATIONS., (Copyright © 2024. Published by Elsevier Inc.)

Objective: To analyze workplace outbreaks by industry sector in the first wave of the pandemic, and associated household cases. Methods: Number, size, and duration of outbreaks were described by sector, and outbreak cases were compared to sporadic cases in the same time frame. Address matching identified household cases with onset ≥2 days before, ≥2 days after, or within 1 day of the workplace outbreak case. Results: There were 199 outbreaks with 1245 cases, and 68% of outbreaks and 80% of cases belonged to (1) Manufacturing, (2) Agriculture, Forestry, Fishing, Hunting, (3) Transportation and Warehousing. There were 608 household cases associated with 339 (31%) outbreak cases, increasing the burden of illness by 56%. Conclusions: Workplace outbreaks primarily occurred in three sectors. Prevention measures should target industry sectors at risk to prevent spread in and out of the workplace. [ABSTRACT FROM AUTHOR]

Background: Workers supporting adults with intellectual disabilities (ID) experience significant stress in their essential role during COVID‐19 due to the high risk of their clients contracting COVID‐19 and having adverse outcomes. The purpose of the current study was to describe the attitudes of workers towards COVID‐19 vaccination prior to vaccination rollout, with a view to informing strategies to promote vaccine uptake within this high‐risk sector. Methods: An online survey was sent via email to workers supporting adults with ID in Ontario, Canada, between January 21 and February 3, 2021 by agency leadership and union representatives. Results: Three thousand and three hundred and seventy‐one workers, representing approximately 11.2% of Ontario workers supporting adults with ID completed an online survey. Most reported that they were very likely (62%) or likely (20%) to get a COVID‐19 vaccine (vaccination intent) although 18% reported they were less likely to do so (vaccination nonintent). Workers with vaccination nonintent were younger and were more likely to endorse the beliefs that (1) it will not benefit them or those around them, (2) it was not part of their job, (3) rapid development confers uncertainties and risks, and (4) they were scared of potential vaccine side effects. Conclusions: There is need to address common misconceptions among workers supporting adults with ID to help activate them as vaccine advocates in the communities they serve. Partnered efforts between workers, unions and agency leadership with public health experts to address concerns are required. [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]

The new Coronavirus Disease 19, officially known as COVID-19, originated in China in 2019 and has since spread worldwide. We presented an age-structured Susceptible-Latent-Mild-Critical-Removed (SLMCR) compartmental model of COVID-19 disease transmission with nonlinear incidence during the pandemic period. We provided the model calibration to estimate parameters with day-wise COVID-19 data, i.e., reported cases by worldometer from 15th February to 30th March 2020 in six high-burden countries, including Australia, Italy, Spain, the USA, the UK, and Canada. We estimate transmission rates for each country and found that the country with the highest transmission rate is Spain, which may increase the new cases and deaths than the other countries. We found that saturation infection negatively impacted the dynamics of COVID-19 cases in all the six high-burden countries. The study used a sensitivity analysis to identify the most critical parameters through the partial rank correlation coefficient method. We found that the transmission rate of COVID-19 had the most significant influence on prevalence. The prediction of new cases in COVID-19 until 30th April 2020 using the developed model was also provided with recommendations to control strategies of COVID-19. We also found that adults are more susceptible to infection than both children and older people in all six countries. However, in Italy, Spain, the UK, and Canada, older people show more susceptibility to infection than children, opposite to the case in Australia and the USA. The information generated from this study would be helpful to the decision-makers of various organisations across the world, including the Ministry of Health in Australia, Italy, Spain, the USA, the UK, and Canada, to control COVID-19. [ABSTRACT FROM AUTHOR]

The 2019 coronavirus disease (COVID-19) cases that are being confirmed in Canada provide an opportunity to expand the epidemic model for the simulation of disease infection spread: Susceptible- Exposed-Infectious-Recovered (SEIR). This paper develops a SEIRCRT |ˈsəːkrɪt | model that integrates the Institute for Disease Modeling's SEIR model and Critical Race Theory (CRT) to answer the question: What is in a SEIRCRT model? SEIRCRT provides a basic modeling structure from a CRT lens to simulate, predict and forecast COVID-19 cases, comorbidities affecting African Canadians, and deaths through predictive modeling. Knowledge of SEIRCRT is critical to characterize the severity of COVID-19 in this early stage. To this end, the purpose of this paper is to describe SEIRCRT's model and summarize its key characteristics. SEIRCRT as a public health framework provides insight into the conclusions drawn about race and COVID-19, and expands our thinking about what health disparities mean for African Canadian communities. [ABSTRACT FROM AUTHOR]

It has been well documented that COVID-19 does not affect all populations equally; the pandemic disproportionately impacts racialized, ethnic minority, low-income, and underserved communities. To further this conversation, this paper examines three adjacent, yet very distinct, neighbourhoods in the downtown core of Toronto, Ontario: St. James Town, Cabbagetown, and Rosedale. The socioeconomic positions of each neighborhood vary from low to high, and their respective COVID-19 positive case counts are inversed. After laying out the COVID-19 case data for each region, we examine the stark demographic and socioeconomic inequalities of these neighborhoods. Finally, we frame this information through the lens of the social determinants of health to identify gaps as well as steps toward meaningful solutions. [ABSTRACT FROM AUTHOR]

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Treatment of rifampin-monoresistant/multidrug-resistant Tuberculosis (RR/MDR-TB) requires long treatment courses, complicated by frequent adverse events and low success rates. Incidence of RR/MDR-TB in Canada is low and treatment practices are variable due to the infrequent experience and challenges with drug access. We undertook a retrospective cohort study of all RR/MDR-TB cases in Alberta, Canada from 2007–2017 to explore the epidemiology and outcomes in our low incidence setting. We performed a descriptive analysis of the epidemiology, treatment regimens and associated outcomes, calculating differences in continuous and discrete variables using Student's t and Chi-squared tests, respectively. We identified 24 patients with RR/MDR-TB. All patients were foreign-born with the median time to presentation after immigration being 3 years. Prior treatment was reported in 46%. Treatment was individualized. All patients achieved sputum culture conversion within two months of treatment initiation. The median treatment duration after culture conversion was 18 months (IQR: 15–19). The mean number of drugs utilized during the intensive phase was 4.3 (SD: 0.8) and during the continuation phase was 3.3 (SD: 0.9) and the mean adherence to medications was 95%. Six patients completed national guideline-concordant therapy, with many patients developing adverse events (79%). Treatment success (defined as completion of prescribed therapy or cure) was achieved in 23/24 patients and no acquired drug resistance or relapse was detected over 1.8 years of median follow-up. Many cases were captured upon immigration assessment, representing important prevention of community spread. Despite high rates of adverse events and short treatment compared to international guidelines, success in our cohort was very high at 96%. This is likely due to individualization of therapy, frequent use of medications with high effectiveness, intensive treatment support, and early sputum conversion seen in our cohort. There should be ongoing exploration of treatment shortening with well-tolerated, efficacious oral agents to help patients achieve treatment completion. [ABSTRACT FROM AUTHOR]

Recently resettled refugee populations may be at greater risk for exposure to severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), a virus that causes coronavirus 2019 (COVID-19), and face unique challenges in following recommendations to protect their health. Several factors place resettled refugees at elevated risk for exposure to persons with COVID-19 or increased severity of COVID-19: being more likely to experience poverty and live in crowded housing, being employed in less protected, service-sector jobs, experiencing language and health care access barriers, and having higher rates of co-morbidities. In preparing for and managing COVID-19, resettled refugees encounter similar barriers to those of other racial or ethnic minority populations, which may then be exacerbated by unique barriers experienced from being a refugee. Key recommendations for resettlement and healthcare providers include analyzing sociodemographic data about refugee patients, documenting and resolving barriers faced by refugees, developing refugee-specific outreach plans, using culturally and linguistically appropriate resources, ensuring medical interpretation availability, and leveraging virtual platforms along with nontraditional community partners to disseminate COVID-19 messaging. [ABSTRACT FROM AUTHOR]

Microbial and viral pathogen contamination of touch surfaces contributes to the rapid transmission of diseases. It has been known for decades that microbes and viruses are rapidly inactivated when exposed to copper and its alloys. Consequently, the use of thermal spray technologies to coat surfaces in healthcare and public settings has been receiving a considerable amount of interest during recent viral pandemics and particularly now with COVID-19. This review is focused on recent successes using thermal spray technology to uniformly coat metal and organic surfaces, providing a rapid and economical means of inhibiting fomite transmission of pathogens on diverse surfaces with complex topographies. Emphasis is placed on the influence of lamella structure, porosity, and roughness of the coatings as it pertains to biocidal activity and the implications of using this knowledge to optimize the ability of copper coatings to irreversibly inactivate viral pathogens, regardless of their genomic mutation rates. Results of the long-term performance of the copper alloy coatings in real hospital settings in Canada and Peru are also presented. [ABSTRACT FROM AUTHOR]

This paper explains the epidemic spread using social network analysis, based on data from the first three months of the 2020 COVID-19 outbreak across the world and in Canada. A network is defined and visualization is used to understand the spread of coronavirus among countries and the impact of other countries on the spread of coronavirus in Canada. The degree centrality is used to identify the main influencing countries. Exponential Random Graph Models (ERGM) are used to identify the processes that influence link creation between countries. The community detection is done using Infomap, Label propagation, Spinglass, and Louvain algorithms. Finally, we assess the community detection performance of the algorithms using adjusted rand index and normalized mutual information score. [ABSTRACT FROM AUTHOR]

Background Since the outbreak of COVID-19, how to reduce the risk of spreading viruses and other microorganisms while performing aerosol generating procedures (AGPs) has become a challenging question within the dental and dental hygiene communities. The purpose of this position paper is to summarize the existing evidence about the effectiveness of various mitigation methods used to reduce the risk of infection transmission during AGPs in dentistry. Methods The authors searched six databases, MEDLINE, EMBASE, Scopus, Web of Science, Cochrane Library, and Google Scholar, for relevant scientific evidence published in the last ten years (January 2012 to December 2022) to answer six research questions about the the aspects of risk of transmission, methods, devices, and personal protective equipment (PPE) used to reduce contact with microbial pathogens and limit the spread of aerosols. Results A total of 78 studies fulfilled the eligibility criteria. There was limited literature to indicate the risk of infection transmission of SARS-CoV-2 between dental hygienists and their patients. A number of mouthrinses are effective in reducing bacterial contaminations in aerosols; however, their effectiveness against SARS-CoV-2 was limited. The combined use of eyewear, masks, and face shields are effective for the prevention of contamination of the facial and nasal region, while performing AGPs. High volume evacuation with or without an intraoral suction, low volume evacuation, saliva ejector, and rubber dam (when appropriate) have shown effectiveness in reducing aerosol transmission beyond the generation site. Finally, the appropriate combination of ventilation and filtration in dental operatories are effective in limiting the spread of aerosols. Conclusion Aerosols produced during clinical procedures can potentially pose a risk of infection transmission between dental hygienists and their patients. The implementation of practices supported by available evidence are best practices to ensure patient and provider safety in oral health settings. More studies in dental clinical environment would shape future practices and protocols, ultimately to ensure safe clinical care delivery., (Copyright © 2024 The American Dental Hygienists’ Association.)

Background: Since the outbreak of COVID-19, how to reduce the risk of spreading viruses and other microorganisms while performing aerosolgenerating procedures (AGPs) has become a challenging question within the dental and dental hygiene communities. The purpose of this position paper is to summarize the evidence of the effectiveness of various mitigation methods used to reduce the risk of infection transmission during AGPs in dentistry., Methods: The authors searched 6 databases-MEDLINE, EMBASE, Scopus, Web of Science, Cochrane Library, and Google Scholar-for relevant scientific evidence published between January 2012 and December 2022 to answer 6 research questions about the risk of transmission, methods, devices, and personal protective equipment (PPE) used to reduce contact with microbial pathogens and limit the spread of aerosols., Results: A total of 78 studies fulfilled the eligibility criteria. The literature on the risk of infection transmission including SARS-CoV-2 between dental hygienists and their patients is limited. Although several mouthrinses are effective in reducing bacterial contaminations in aerosols, their effectiveness against SARS-CoV-2 is also limited. The combined use of eyewear, masks, and face shields is effective in preventing contamination of the facial and nasal region while performing AGPs. High-volume evacuation with or without an intraoral suction, low-volume evacuation, saliva ejector, and rubber dam (when appropriate) have shown effectiveness in reducing aerosol transmission beyond the generation site. Finally, the appropriate combination of ventilation and filtration in dental operatories is effective in limiting the spread of aerosols., Discussion and Conclusion: Aerosols produced during clinical procedures can pose a risk of infection transmission between dental hygienists and their patients. The implementation of practices supported by available evidence will ensure greater patient and provider safety in oral health settings. More studies in oral health clinical environments would shape future practices and protocols, ultimately to ensure the delivery of safe clinical care., Competing Interests: The authors have no conflicts of interest to declare., (Copyright © 2024 American Dental Hygienists' Association and the Canadian Dental Hygienists Association.)

In the article, the authors discuss the intrinsic social dilemmas that emerged during the COVID-19 pandemic and pandemic planning, as well as the invisibility of the personal support workers (PSW) despite the key role they play in healthcare systems. Also cited are the gendered dynamics of risks that were seen during the pandemic, and how the pandemic showed the limits of biomedicine and the fragility of the for-profit healthcare systems.