ObjectivesThe COVID-19 pandemic disrupted healthcare services, leading to the cancellation of non-urgent tests, screenings and procedures, a shift towards remote consultations, stalled childhood ...immunisations and clinic closures which had detrimental effects across the healthcare system. This study investigates the impact of the COVID-19 pandemic on clinical admissions and healthcare quality in the Peel, York and Toronto regions within the Greater Toronto Area (GTA).DesignIn a cross-sectional study, the negative impact of the pandemic on various healthcare sectors, including preventive and primary care (PPC), the emergency department (ED), alternative level of care (ALC) and imaging, procedures and surgeries is investigated. Study questions include assessing impairments caused by the COVID-19 pandemic and discovering hotspots and critical subregions that require special attention to recover. The measuring technique involves comparing the number of cases during the COVID-19 pandemic with before that, and determining the difference in percentage. Statistical analyses (Mann-Whitney U test, analysis of variance, Dunn’s test) is used to evaluate sector-specific changes and inter-relationships.SettingThis work uses primary data which were collected by the Black Creek Community Health Centre. The study population was from three regions of GTA, namely, the city of Toronto, York and Peel. For all health sectors, the sample size was large enough to have a statistical power of 0.95 to capture 1% variation in the number of cases during the COVID-19 pandemic compared with before that.ResultsAll sectors experienced a significant decline in patient volume during the pandemic. ALC admissions surged in some areas, while IPS patients faced delays. Surgery waitlists increased by an average of 9.75%, and completed IPS procedures decreased in several subregions.ConclusionsThe COVID-19 pandemic had a universally negative impact on healthcare sectors across various subregions. Identification of the hardest-hit subregions in each sector can assist health officials in crafting recovery policies.
Monkeypox is an emerging zoonotic disease caused by the monkeypox virus, which is an infectious agent belonging to the
genus Orthopoxvirus
. Currently, commencing from the end of April 2022, an ...outbreak of monkeypox is ongoing, with more than 43,000 cases reported as of 23 August 2022, involving 99 countries and territories across all the six World Health Organization (WHO) regions. On 23 July 2022, the Director-General of the WHO declared monkeypox a global public health emergency of international concern (PHEIC), since the outbreak represents an extraordinary, unusual, and unexpected event that poses a significant risk for international spread, requiring an immediate, coordinated international response. However, the real magnitude of the burden of disease could be masked by failures in ascertainment and under-detection. As such, underestimation affects the efficiency and reliability of surveillance and notification systems and compromises the possibility of making informed and evidence-based policy decisions in terms of the adoption and implementation of
ad hoc
adequate preventive measures. In this review, synthesizing 53 papers, we summarize the determinants of the underestimation of sexually transmitted diseases, in general, and, in particular, monkeypox, in terms of all their various components and dimensions (under-ascertainment, underreporting, under-detection, under-diagnosis, misdiagnosis/misclassification, and under-notification).
Eissa et al argue that clinicians should not only communicate information about the vaccine itself, but also support patients in navigating a complex system. Conflicting messaging about SARS-CoV-2 ...variants, vaccine safety, adverse events, priority groups and vaccination sites has been detrimental to building trust in vaccines. Confidence in the vaccines will not improve if Black communities are told that they are at high risk and should continue to socially distance, while they are also excluded from vaccine priority lists or are not provided greater access to vaccines. Providers should offer accurate, current information to high-risk Black patients about how to access vaccines, given the difficulties in keeping up with changing preregistration criteria at different sites. Black-led health care partnerships play a pivotal role in bridging this gap.
Abstract
Background
Black North American communities have been disproportionately affected by COVID-19. These data have been largely based on case counts, hospitalizations and mortality data. ...Serologic testing enables a more complete determination of infection burden by documenting infection in persons with symptomatic as well as asymptomatic infection. We used serologic testing to determine the extent to which SARS-CoV-2 had penetrated into the Black community. We examined risk factors associated with seropositivity, including the presence of medical comorbidities and the social determinants of health.
Methods
We conducted a cross-sectional survey in a COVID-19 high-prevalence zone in Ontario along with 2 areas that have lower rates of COVID-19 cases. SARS-CoV-2 IgG antibodies were determined using the EUROIMMUN assay. The study samples were collected between August 15, 2020, and December 15, 2020 prior to the deployment of COVID-19 vaccines. Proportions were compared using Fishers Exact test or chi-square; potential risk factors were examined using a multiple logistic regression approach.
Results
Among 387 evaluable subjects, the majority, 274 (70.8%) were enrolled from northwest Greater Toronto Area (GTA) and adjoining suburban areas of Peel, Ontario with a high proportion of Black residents. The seropositivity rates for the lower prevalence areas (Oakville and London, Ontario) were comparable (3.3% (2/60; 95% CI 0.4-11.5) and 3.9% (2/51; 95% CI 0.5-13.5), respectively). The seropositivity rate for the northwest GTA was 12.6% (26/206); RR 3.5, 95% CI 1.3-9.8). Persons under the age of 19 years had the highest seropositivity rate (10/50; 20.0%, 95% CI 10.3-33.7%). Front-line workers were greater than 3 times more likely to be seropositive compared with non-frontline workers (13.0 vs 3.2%; p=.01; RR 3.3 (95% CI 1.3 – 8.3). There was an interaction effect between race and location of residence as this relates to the relative risk of seropositivity.
Conclusion
During the pre-vaccine phase of the COVID-19 pandemic, the seropositivity rate for SARS-CoV-2 within a COVID-19 high-prevalence area was 3-fold greater than lower prevalence areas of Ontario, Canada. The data help to define the burden of COVID-19 within a community with a high proportion of Black residents compared with other communities.
Disclosures
All Authors: No reported disclosures
Racialized communities, including Black Canadians, have disproportionately higher COVID-19 cases. We examined the extent to which SARS-CoV-2 infection has affected the Black Canadian community and ...the factors associated with the infection.
We conducted a cross-sectional survey in an area of Ontario (northwest Toronto/Peel Region) with a high proportion of Black residents along with 2 areas that have lower proportions of Black residents (Oakville and London, Ontario). SARS-CoV-2 IgG antibodies were determined using the EUROIMMUN assay. The study was conducted between August 15, 2020, and December 15, 2020.
Among 387 evaluable subjects, the majority, 273 (70.5%), were enrolled from northwest Toronto and adjoining suburban areas of Peel, Ontario. The seropositivity values for Oakville and London were comparable (3.3% (2/60; 95% CI 0.4-11.5) and 3.9% (2/51; 95% CI 0.5-13.5), respectively). Relative to these areas, the seropositivity was higher for the northwest Toronto/Peel area at 12.1% (33/273), relative risk (RR) 3.35 (1.22-9.25). Persons 19 years of age or less had the highest seropositivity (10/50; 20.0%, 95% CI 10.3-33.7%), RR 2.27 (1.23-3.59). There was a trend for an interaction effect between race and location of residence as this relates to the relative risk of seropositivity.
During the early phases of the pandemic, the seropositivity within a COVID-19 high-prevalence zone was threefold greater than lower prevalence areas of Ontario. Black individuals were among those with the highest seroprevalence of SARS-CoV-2.
Most analyses of the success and sustainability of community-university engagement initiatives focus on the university environment. We explore the impact of changes in the larger social and political ...systems on the community as well as those within the university on the meaning and use of a shared community space. The York University-TD Community Engagement Centre (CEC) is a storefront facility for research and teaching shared by York University and the Jane-Finch/Black Creek community, a richly diverse, suburban, underserved neighbourhood in Toronto, Canada. The physical space facilitates and sustains the community-university partnership in this region. As representatives of the community and/or university with strong ties to the engagement centre, we review changes in both the institution and the larger political context in which the university and community navigate their relationship. We also reflect on how these changes play a role in determining community and university priorities, the value of their relationship, and the availability of resources. Community-university initiatives emerge in environments that provide opportunities for shared activities and the development of a shared vision. However, the sustainability of a community-university initiative is strongly influenced by broad environmental changes, requiring self-reflection, trust, communication and innovation.
In this paper we describe the Inclusive Mosaic project, a community–university partnership in an outer-city community in a large Canadian metropolis aimed at promoting diversity in nursing. The ...project brought together nursing student mentors with middle school and high school youth from diverse backgrounds in a mentoring program aimed at increasing participants’ interest in, and confidence in pursuing, higher education and a career in nursing or other health profession. The concepts of emancipatory education, self-efficacy, and possible selves provided the theoretical foundation. Project processes, activities, and outcomes are described, and a post-hoc evaluation encompassing the project’s strengths, challenges, limitations, and successes is presented. Recommendations to inform future research and education are also provided.
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