Science Brief

epidemiology-public-health-implementation, science-brief

| September 28, 2021

Update on COVID-19 Projections

infectious-diseases-clinical-care, science-brief

| September 14, 2021

Understanding the Post COVID-19 Condition (Long COVID) and the Expected Burden for Ontario

The “post COVID-19 condition” (or long COVID) describes a range of symptoms which can persist for months after severe, mildly symptomatic or asymptomatic SARS-CoV-2 infection. The most common of more than 200 reported symptoms include fatigue, shortness of breath, pain, sleep disturbances, anxiety, and depression. Many people with the post COVID-19 condition have difficulty returning to baseline levels of function and have high rates of health care utilization. A conservative estimate suggests that 57,000 to 78,000 Ontarians have or are currently experiencing the post COVID-19 condition, although prevalence estimates can vary widely depending on the case-definition applied. Vaccination is likely protective against development of the post COVID-19 condition. More research is required to develop a consensus definition of the post COVID-19 condition, understand risk factors including the role of viral variants, quantify the impact on specific populations such as children, and develop strategies for prevention and treatment.

infectious-diseases-clinical-care, science-brief

| September 13, 2021

The Incidence, Severity, and Management of COVID-19 in Critically Ill Pregnant Individuals

The rate of SARS-CoV-2 infection in pregnancy does not appear to be higher than in the general population; however, compared to their non-pregnant counterparts, pregnant individuals have higher morbidity and mortality, with a higher risk of intensive care unit (ICU) admission, mechanical ventilation, and need for extracorporeal membrane oxygenation (ECMO). They also have a higher frequency of pre-eclampsia, Cesarean delivery, and a higher rate of preterm birth. Care of the critically ill pregnant patient with COVID-19 requires a multidisciplinary team that includes obstetrics, neonatology, anesthesia, infectious diseases, medicine, and critical care. Potentially life-saving evidence-based therapies such as corticosteroids and tocilizumab should not be withheld from pregnant individuals with severe COVID-19. Vaccines against SARS-CoV-2 are safe to use among pregnant individuals and vaccination is highly recommended in this population.

infectious-diseases-clinical-care, science-brief

| September 8, 2021

The Impact of the COVID-19 Pandemic on Opioid-Related Harm in Ontario

Rates of opioid-related harms, particularly fatal overdose, have increased significantly in Ontario during the COVID-19 pandemic and have disproportionately impacted marginalized and racialized populations. Strategies to address this crisis include ensuring uninterrupted and equitable access to addiction, mental health, and harm reduction services; incorporating these services into high-risk settings such as shelters, hotels, and encampments; adapting harm reduction services to meet current needs; and promoting access to alternative service delivery methods such as telemedicine programs when in-person services are not available. Leveraging Ontario’s capacity to monitor rates of opioid-related harms can help optimize public health strategies. Data gaps on disparities for those disproportionately impacted by the opioid overdose crisis need to be addressed to improve our understanding of the effectiveness of interventions and guide implementation in high-risk populations.

infectious-diseases-clinical-care, science-brief

| September 3, 2021

Heparin Anticoagulation for Hospitalized Patients with COVID-19

Critically Ill Patients Prophylactic dose low molecular weight or unfractionated heparin are recommended in critically ill patients hospitalized with COVID-19. These patients should not receive therapeutic dose anticoagulation unless they have a separate indication for this treatment. Therapeutic dose anticoagulation in this patient population does not reduce the need for organ support and may increase bleeding events as compared to prophylactic dose anticoagulation. Moderately Ill Patients Therapeutic dose low molecular weight or unfractionated heparin may be considered over prophylactic dose anticoagulation in moderately ill patients who are felt to be at low risk of bleeding. All other patients should receive prophylactic dose anticoagulation, unless they have a separate indication for therapeutic dose anticoagulation. Therapeutic dose anticoagulation may reduce the need for organ support (including the need for high-flow nasal oxygen) and appears to decrease thrombotic events in moderately ill patients compared to lower intensity anticoagulation. Its benefits on survival are unclear, and it may increase major bleeding events. Given the small absolute risk reduction for patient-important outcomes and the known harms, a strong recommendation for therapeutic dose anticoagulation in moderately ill patients cannot be made. Mildly Ill Patients There is insufficient evidence to make a recommendation around anticoagulation for mildly ill patients.

epidemiology-public-health-implementation, science-brief

| September 1, 2021

Update on COVID-19 Projections

epidemiology-public-health-implementation, science-brief

| August 26, 2021

The Role of Wastewater Testing for SARS-CoV-2 Surveillance

Wastewater testing for SARS-CoV-2 is relatively new; however, it builds on existing public health surveillance infrastructure. There is a limited but growing evidence base for its use, despite notable interpretation challenges. Wastewater testing results have helped to inform public health policy and interventions during the COVID-19 pandemic in Ontario and other jurisdictions. Wastewater testing for SARS-CoV-2 is useful for early detection of outbreaks and surges as well as population-wide surveillance of COVID-19 that is complementary to clinical testing. Further, it offers an efficient means of SARS-CoV-2 surveillance for specific settings such as correctional facilities, shelters, and university residences. Wastewater testing can also be used for the detection and monitoring of variants of concern (VOCs).

infectious-diseases-clinical-care, science-brief

| August 24, 2021

Clinical Practice Guideline Summary: Recommended Drugs and Biologics in Adult Patients with COVID-19

public-policy-economic-impact, science-brief

| July 21, 2021

COVID-19 Vaccine Certificates: Key Considerations for the Ontario Context

Many jurisdictions are developing and implementing COVID-19 vaccine certificates as falsification-proof, verifiable proof of immunization in secure digital or paper-based formats. Vaccine certificates can be used to regulate entry into discretionary settings that pose a high risk for SARS-CoV-2 transmission (e.g., indoor dining, bars, gyms, cultural and sports events). Vaccine certificates can also be used in non-discretionary settings (e.g., schools, universities, congregate settings, and workplaces), especially in settings that require mandatory vaccination. On a short-term basis, vaccine certificates could enable the re-opening of high-risk settings sooner and/or at increased capacity. Vaccine certificates will be of particular importance to maintain economic and societal reopening if public health measures need to be reintroduced. Some jurisdictions are also implementing vaccine certificates with the goal of incentivizing COVID-19 vaccination. On a longer-term basis, vaccine certificates can serve as a verifiable, secure, standardized, accessible and portable records of immunization. There is currently no scientific evidence of the direct impact of COVID-19 vaccine certificates on SARS-CoV-2 transmission or population vaccination rates, and there are important ethical, legal, accessibility, and privacy considerations concerning their development and implementation.

public-policy-economic-impact, science-brief

| July 19, 2021

School Operation for the 2021-2022 Academic Year in the Context of the COVID-19 Pandemic

In-person learning is essential for the learning and overall well-being of children and youth. Therefore, barring catastrophic circumstances, schools should remain open for in-person learning. The level of community COVID-19 burden should inform the degree of school-based measures: the provided framework should be implemented at the regional level by public health units, considering local vaccination coverage rate and metrics of COVID-19 disease severity and to a lesser extent, SARS-CoV-2 transmission rate. Permanent measures that support the ongoing operation of schools, irrespective of the COVID-19 pandemic, include vaccination of all eligible individuals, exclusion of sick students and staff, hand hygiene, adequate ventilation, and environmental cleaning. Temporary measures (e.g., masking, physical distancing, cohorting) implemented in response to changes in COVID-19 disease burden should take into consideration student age, grade, and vaccination status. Re-initiation and maintenance of extracurricular activities (e.g., music, sports, clubs) is an important component of return-to-school plans.

« Previous 1 … 4 5 6 7 8 … 13 Next »