Royal Society of Canada Task Force on COVID-19 Collection
The Royal Society of Canada has established a task force to equip Canadians with accurate information about our response and recovery to the COVID-19 pandemic. This collection hosts policy briefings that result from the RSC working groups established by the Task Force. While some of the policy briefings fall outside of the normal scope of FACETS, they are being published here due to the extreme nature of the pandemic and the importance of broadly disseminating timely independent expertise to the public. This collection is ongoing, as new policy briefings are added upon completion.
Access all the RSC COVID-19 Resources at https://rsc-src.ca/en/covid-19: A sub-collection of policy briefings on Children and Schools during COVID-19 can be found here: https://www.facetsjournal.com/topic/children-and-schools
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- Vanessa Gruben,
- Elaine Hyshka,
- Matthew Bonn,
- Chelsea Cox,
- Marilou Gagnon,
- Adrian Guta,
- Martha Jackman,
- Jason Mercredi,
- Akia Munga,
- Eugene Oscapella,
- Carol Strike, and
- Hakique Virani
The International Guidelines on Human Rights and Drug Policy recommend that states commit to adopting a balanced, integrated, and human rights-based approach to drug policy through a set of foundational human rights principles, obligations arising from human rights standards, and obligations arising from the human rights of particular groups. In respect of the Guidelines and standing obligations under UN Treaties, Canada must adopt stronger and more specific commitments for a human rights-based, people-centered, and public health approach. This approach must commit to the decriminalization of people who use drugs and include the decriminalization of possession, purchase, and cultivation for personal consumption. In this report, we will first turn to the legal background of Canada's drug laws. Next, we will provide an overview of ongoing law reform proposals from civil society groups, various levels of government, the House of Commons, and the Senate. We end with a three-staged approach to reform and a series of targeted recommendationscr. - OPEN ACCESS
- Linda Rabeneck,
- Chris McCabe,
- Mark Dobrow,
- Arlinda Ruco,
- Melissa Andrew,
- Sabrina Wong,
- Sharon Straus,
- Lawrence Paszat,
- Lisa Richardson,
- Chris Simpson, and
- Andrew Boozary
The purpose of this policy briefing is to examine our health care systems through the lens of the COVID-19 pandemic and identify how we can strengthen health care in Canada post-pandemic. The COVID-19 pandemic has provided compelling evidence that substantive changes to our health care systems are needed. Specifically, the pandemic has emphasized structural inequities on a broad scale within Canadian society. These include systemic racial and socioeconomic inequities that must be addressed broadly, including in the delivery of health care. We make recommendations about what we can do to emerge stronger from the pandemic. While these recommendations are not novel, how they are framed and contextualized differs because of the problems in our health care system that have been highlighted and exacerbated by the pandemic.The evidence is clear that socioeconomic circumstances, intergenerational trauma, adverse early life experiences, and educational opportunities are critical factors when it comes to health over the life course. Given the problems in the delivery of health care that the pandemic has revealed, we need a different approach. How health care was organized prior to the COVID-19 pandemic did not produce what people wanted and needed in terms of health care and outcomes. How do we emerge from COVID-19 with an effective, equitable, and resilient health care system for all Canadians?To address health inequities and emerge from the pandemic with strengthened health care in Canada, we must consider how Amartya Sen's capabilities framework on social well-being can be operationalized to achieve better health care and health outcomes. Specifically, we address the need to: strengthen primary care and improve access to primary care;utilize a community-embedded approach to care; andimplement better integration across the care continuum, including integration between primary care and public health.Coherent governance and leadership that are charged with realizing benefits through collaboration will maximize outcomes and promote sustainability. Only when we provide access to high-quality culturally competent care that is centered around the individual and their needs will we be able to make true headway in addressing these long-standing health inequities. - OPEN ACCESS
- Samira Mubareka,
- John Amuasi,
- Arinjay Banerjee,
- Hélène Carabin,
- Joe Copper Jack,
- Claire Jardine,
- Bogdan Jaroszewicz,
- Greg Keefe,
- Jonathon Kotwa,
- Susan Kutz,
- Deborah McGregor,
- Anne Mease,
- Lily Nicholson,
- Katarzyna Nowak,
- Brad Pickering,
- Maureen G. Reed,
- Johanne Saint-Charles,
- Katarzyna Simonienko,
- Trevor Smith,
- J. Scott Weese, and
- E. Jane Parmley
Given the enormous global impact of the COVID-19 pandemic, outbreaks of highly pathogenic avian influenza in Canada, and manifold other zoonotic pathogen activity, there is a pressing need for a deeper understanding of the human-animal-environment interface and the intersecting biological, ecological, and societal factors contributing to the emergence, spread, and impact of zoonotic diseases. We aim to apply a One Health approach to pressing issues related to emerging zoonoses, and propose a functional framework of interconnected but distinct groups of recommendations around strategy and governance, technical leadership (operations), equity, education and research for a One Health approach and Action Plan for Canada. Change is desperately needed, beginning by reorienting our approach to health and recalibrating our perspectives to restore balance with the natural world in a rapid and sustainable fashion. In Canada, a major paradigm shift in how we think about health is required. All of society must recognize the intrinsic value of all living species and the importance of the health of humans, other animals, and ecosystems to health for all. - OPEN ACCESS
- Steve E. Hrudey,
- Heather N. Bischel,
- Jeff Charrois,
- Alex H. S. Chik,
- Bernadette Conant,
- Rob Delatolla,
- Sarah Dorner,
- Tyson E. Graber,
- Casey Hubert,
- Judy Isaac-Renton,
- Wendy Pons,
- Hannah Safford,
- Mark Servos, and
- Christopher Sikora
Wastewater surveillance for SARS-CoV-2 RNA is a relatively recent adaptation of long-standing wastewater surveillance for infectious and other harmful agents. Individuals infected with COVID-19 were found to shed SARS-CoV-2 in their faeces. Researchers around the world confirmed that SARS-CoV-2 RNA fragments could be detected and quantified in community wastewater. Canadian academic researchers, largely as volunteer initiatives, reported proof-of-concept by April 2020. National collaboration was initially facilitated by the Canadian Water Network.Many public health officials were initially skeptical about actionable information being provided by wastewater surveillance even though experience has shown that public health surveillance for a pandemic has no single, perfect approach. Rather, different approaches provide different insights, each with its own strengths and limitations. Public health science must triangulate among different forms of evidence to maximize understanding of what is happening or may be expected. Well-conceived, resourced, and implemented wastewater-based platforms can provide a cost-effective approach to support other conventional lines of evidence. Sustaining wastewater monitoring platforms for future surveillance of other disease targets and health states is a challenge. Canada can benefit from taking lessons learned from the COVID-19 pandemic to develop forward-looking interpretive frameworks and capacity to implement, adapt, and expand such public health surveillance capabilities. - OPEN ACCESS
- R.T. Noel Gibney,
- Cynthia Blackman,
- Melanie Gauthier,
- Eddy Fan,
- Robert Fowler,
- Curtis Johnston,
- R. Jeremy Katulka,
- Samuel Marcushamer,
- Kusum Menon,
- Tracey Miller,
- Bojan Paunovic, and
- Teddie Tanguay
The COVID-19 pandemic has exposed the precarious demand-capacity balance in Canadian hospitals, including critical care where there is an urgent need for trained health care professionals to dramatically increase ICU capacity.The impact of the pandemic on ICUs varied significantly across the country with provinces that implemented public health measures later and relaxed them sooner being impacted more severely. Pediatric ICUs routinely admitted adult patients. Non-ICU areas were converted to ICUs and staff were redeployed from other essential service areas. Faced with a lack of critical care capacity, triage plans for ICU admission were developed and nearly implemented in some provinces.Twenty eight percent of patients in Canadian ICUs who required mechanical ventilation died. Surviving patients have required prolonged ICU admission, hospitalization and extensive ongoing rehabilitation. Family members of patients were not permitted to visit, resulting in additional psychological stresses to patients, families, and healthcare teams. ICU professionals also experienced extreme psychological stresses from caring for such large numbers of critically ill patients, often in sub-standard conditions. This resulted in large numbers of health workers leaving their professions.This pandemic is not yet over, and it is likely that new pandemics will follow. A review and recommendations for the future are provided. - OPEN ACCESS
- Gail Tomblin Murphy,
- Tara Sampalli,
- Lisa Bourque Bearskin,
- Nancy Cashen,
- Greta Cummings,
- Annette Elliott Rose,
- Josephine Etowa,
- Doris Grinspun,
- Esyllt W. Jones,
- Mélanie Lavoie-Tremblay,
- Kathleen MacMillan,
- Cindy MacQuarrie,
- Ruth Martin-Misener,
- Judith Oulton,
- Rosemary Ricciardelli,
- Linda Silas,
- Sally Thorne, and
- Michael Villeneuve
Nurses represent the highest proportion of healthcare workers globally and have played a vital role during the COVID-19 pandemic. The pandemic has shed light on multiple vulnerabilities that have impacted the nursing workforce including critical levels of staffing shortages in Canada. A review sponsored by the Royal Society of Canada investigated the impact of the pandemic on the nursing workforce in Canada to inform planning and implementation of sustainable nursing workforce strategies. The review methods included a trend analysis of peer-reviewed articles, a jurisdictional scan of policies and strategies, analyses of published surveys and interviews of nurses in Canada, and a targeted case study from Nova Scotia and Saskatchewan. Findings from the review have identified longstanding and COVID-specific impacts, gaps, and opportunities to strengthen the nursing workforce. These findings were integrated with expert perspectives from national nursing leaders involved in guiding the review to arrive at recommendations and actions that are presented in this policy brief. The findings and recommendations from this policy brief are meant to inform a national and sustained focus on retention and recruitment efforts in Canada. - OPEN ACCESSThe drivers of the harassment and intimidation of researchers are complex, widespread, and global in their reach and were being studied across many disciplines even before COVID-19. This policy briefing reviews some of the scholarship on this wide-ranging problem but focuses on what can be done to help ensure that Canadians fully benefit from the work of Canada’s researchers while also preserving the security and safety of those researchers. It identifies policies and actions that can be implemented in the near term to gather information on the problem, better frame public research communications, and ensure that mechanisms are readily available to support researchers who are threatened. The policy briefing is concerned with researchers, but these behaviours are also harming journalists, politicians, public health communicators, and many others more fully in the public eye than researchers. Some recommendations here may help to address this wider problem.
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The origins of this report, and of the Mental Health and Policing Working Group, can be traced to the unique situation Canadians have faced as a result of the COVID-19 pandemic. The unique circumstances of this global outbreak, which have for many Canadians resulted in serious illness and death, intensified economic uncertainties, altered family and lifestyle dynamics, and generated or exacerbated feelings of loneliness and social dislocation, rightly led the Royal Society of Canada’s COVID-19 Taskforce to consider the strains and other negative impacts on individual, group, and community mental health. With the central role that police too often play in the lives of individuals in mental and (or) emotional crisis, we were tasked with exploring what can be reasonably said about the state of our current knowledge of police responses to persons with mental illness. - OPEN ACCESS
- Annette Majnemer,
- Patrick J. McGrath,
- Jennifer Baumbusch,
- Chantal Camden,
- Barbara Fallon,
- Yona Lunsky,
- Steven P. Miller,
- Genevieve Sansone,
- Tim Stainton,
- John Sumarah,
- Donna Thomson, and
- Jennifer Zwicker
The COVID-19 pandemic has impacted the lives and well-being of all people globally, with consequences being observed across all domains from physical and mental health, to education and employment outcomes, to access to community supports and services. However, the disproportionate impact of the COVID-19 pandemic and its associated public health restrictions on individuals with intellectual and developmental disabilities (IDD) has largely been overlooked. Not only do people with IDD have a greater risk of severe complications and death from the virus as shown in large-scale studies, but they also face significant short- and long-term consequences of COVID-related public health measures on their mental health and well-being. At a time when this vulnerable population is already feeling undervalued, ignored, and forgotten, it is imperative that the risks facing adults and children with IDD—as well as their families and caregivers—are recognized, valued, and addressed through a disability-inclusive approach to Canada’s pandemic policy response planning. This requires both a mainstreaming of disability inclusion into all COVID-19 response and recovery policies as well as disability-specific policies to address the unique barriers and challenges encountered by people with IDD during the pandemic. The recommendations in this policy briefing aim to achieve a more inclusive, accessible, and sustainable Canada for people with IDD both during and after the pandemic—an approach that will result in benefits for all of society. - OPEN ACCESS
- Noni E. MacDonald,
- Jeannette Comeau,
- Ève Dubé,
- Janice Graham,
- Margo Greenwood,
- Shawn Harmon,
- Janet McElhaney,
- C. Meghan McMurtry,
- Alan Middleton,
- Audrey Steenbeek, and
- Anna Taddio
COVID-19 vaccine acceptance exists on a continuum from a minority who strongly oppose vaccination, to the “moveable middle” heterogeneous group with varying uncertainty levels about acceptance or hesitancy, to the majority who state willingness to be vaccinated. Intention for vaccine acceptance varies over time. COVID-19 vaccination decisions are influenced by many factors including knowledge, attitudes, and beliefs; social networks; communication environment; COVID-19 community rate; cultural and religious influences; ease of access; and the organization of health and community services and policies.Reflecting vaccine acceptance complexity, the Royal Society of Canada Working Group on COVID-19 Vaccine Acceptance developed a framework with four major factor domains that influence vaccine acceptance (people, communities, health care workers; immunization knowledge; health care and public health systems including federal/provincial/territorial/indigenous factors)—each influencing the others and all influenced by education, infection control, extent of collaborations, and communications about COVID-19 immunization. The Working Group then developed 37 interrelated recommendations to support COVID vaccine acceptance nested under four categories of responsibility: 1. People and Communities, 2. Health Care Workers, 3. Health Care System and Local Public Health Units, and 4. Federal/Provincial/Territorial/Indigenous. To optimize outcomes, all must be engaged to ensure co-development and broad ownership. - OPEN ACCESS
- Stefan Baral,
- Andrew Bond,
- Andrew Boozary,
- Eva Bruketa,
- Nika Elmi,
- Deirdre Freiheit,
- S. Monty Ghosh,
- Marie Eve Goyer,
- Aaron M. Orkin,
- Jamie Patel,
- Tim Richter,
- Angela Robertson,
- Christy Sutherland,
- Tomislav Svoboda,
- Jeffrey Turnbull,
- Alexander Wong, and
- Alice Zhu
Those experiencing homelessness in Canada are impacted inequitably by COVID-19 due to their increased exposure, vulnerability of environment and medical comorbidities, and their lack of access to preventive care and treatment in the context of the pandemic. In shelter environments one is unable to effectively physically distance, maintain hygiene, obtain a test, or isolate. As a result, unique strategies are required for this population to protect them and those who serve them. Recommendations are provided to reduce or prevent further negative consequences from the COVID-19 pandemic for people experiencing homelessness. These recommendations were informed by a systematic review of the literature, as well as a jurisdictional scan. Where evidence did not exist, expert consensus from key providers and those experiencing homelessness throughout Canada was included. These recommendations recognize the need for short-term interventions to mitigate the immediate risk to this community, including coordination of response, appropriate precautions and protective equipment, reducing congestion, cohorting, testing, case and contact management strategies, dealing with outbreaks, isolation centres, and immunization. Longer-term recommendations are also provided with a view to ending homelessness by addressing the root causes of homelessness and by the provision of adequate subsidized and supportive housing through a Housing First strategy. It is imperative that meaningful changes take place now in how we serve those experiencing homelessness and how we mitigate specific vulnerabilities. These recommendations call for intersectoral, collaborative engagement to work for solutions targeted towards protecting the most vulnerable within our community through both immediate actions and long-term planning to eliminate homelessness. - OPEN ACCESS
- Jennifer Brennan,
- Frank Deer,
- Roopa Desai Trilokekar,
- Leonard Findlay,
- Karen Foster,
- Guy Laforest,
- Leesa Wheelahan, and
- Julia M. Wright
Post-secondary education (PSE) is a vital part of civil society and any modern economy. When broadly accessible, it can enable socioeconomic mobility, improve health outcomes, advance social cohesion, and support a highly skilled workforce. It yields public benefits not only in improved well-being and economic prosperity, but also in reduced costs in health care and social services. Canada also relies heavily on the PSE sector for research. During the COVID-19 pandemic, PSE has supported research related to the pandemic response and other critical areas, including providing expert advice to support public health and government decision-making, while maintaining educational programs and continuing to contribute to local and regional economies. But the pandemic effort has stretched already strained PSE resources and people even further: for decades, declining public investment has driven increases in tuition and decreases in faculty complement, undermining Canada’s research capacity and increasing student debt as well as destabilizing the sector through a growing reliance on volatile international education markets. Given the challenges before us, including climate change, reconciliation, and the pandemic, it is imperative that we better draw on the full range of experience, knowledge, and creativity in Canada and beyond through an inclusive, stable, and globally engaged PSE. Supporting PSE’s recovery will be key to Canada’s ongoing pandemic response and recovery. The recommendations in this report are guided by a single goal—to make the post-secondary sector a more effective partner and support in building a more equitable, sustainable, and evidence-driven future for Canada, through and beyond the COVID-19 pandemic. - OPEN ACCESS
This paper summarizes COVID-19 disease epidemiology in Canada in the pre-vaccine era—from January through to December 2020. Canadian case numbers, risk factors, disease presentations (including severe and critical disease), and outcomes are described. Differences between provinces and territories in geography, population size and density, health demographics, and pandemic impact are highlighted. Key concepts in public health response and mitigation are reviewed, including masking, physical distancing, hand washing, and the promotion of outdoor interactions. Adequate investment in public health infrastructure is stressed, and regional differences in screening and testing strategies are highlighted. The spread of COVID-19 in Canadian workplaces, long-term care homes, and schools is described and lessons learned emphasized. The impact of COVID-19 on vulnerable populations in Canada—including Indigenous Peoples, ethnic minorities and newcomers, people who use drugs, people who are homeless, people who are incarcerated, and people with disabilities—is described. Sex and gender disparities are also highlighted. Author recommendations include strategies to reduce transmission (such as test–trace–isolate), the establishment of nationally standardized definitions and public reporting, the protection of high risk and vulnerable populations, and the development of a national strategy on vaccine allocation. - OPEN ACCESS
- Victoria Esses,
- Jean McRae,
- Naomi Alboim,
- Natalya Brown,
- Chris Friesen,
- Leah Hamilton,
- Aurélie Lacassagne,
- Audrey Macklin, and
- Margaret Walton-Roberts
Canada has been seen globally as a leader in immigration and integration policies and programs and as an attractive and welcoming country for immigrants, refugees, temporary foreign workers, and international students. The COVID-19 pandemic has revealed some of the strengths of Canada’s immigration system, as well as some of the fault lines that have been developing over the last few years. In this article we provide an overview of Canada’s immigration system prior to the pandemic, discuss the system’s weaknesses and vulnerabilities revealed by the pandemic, and explore a post-COVID-19 immigration vision. Over the next three years, the Government of Canada intends to bring over 1.2 million new permanent residents to Canada. In addition, Canada will continue to accept many international students, refugee claimants, and temporary foreign workers for temporary residence here. The importance of immigration for Canada will continue to grow and be an integral component of the country’s post-COVID-19 recovery. To succeed, it is essential to take stock, to re-evaluate Canada’s immigration and integration policies and programs, and to expand Canada’s global leadership in this area. The authors offer insights and over 80 recommendations to reinvigorate and optimize Canada’s immigration program over the next decade and beyond. - OPEN ACCESSThe influenza pandemic of 1918–1920, which killed 50 000 Canadians, spurred the creation of a federal department of public health. But in the intervening century, public health at all levels has remained, as Marc Lalonde put it in 1988, the “poor cousin” in the health care system (Lalonde 1988, p. 77). Punctuated by sporadic investment during infectious disease crises, such as polio in the early 1950s, public health is less of a priority as the cost of tertiary health interventions rises. While public health potentially involves a broad range of interventions, this paper focuses on the history of public health interventions around infectious disease. COVID-19 has forced us to relearn the importance of maintaining basic infectious/communicable disease control capacity and revealed the cost of our failure to do so. It has also drawn our attention to the intersection between social inequality, racism, and colonialism and vulnerability to disease. In addition to investing in our capacity to contain disease outbreaks as they occur, we must plan now for how to achieve greater health equity in the future by addressing underlying economic and social conditions and providing meaningful access to preventive care for all. This is how we build a truly resilient society. Governments at all levels have recognized the importance of social factors in shaping health and illness for decades. But greater health equity will result only from genuine action on this knowledge. Action will arise from public advocacy in support of prevention, and a new level of engagement and collaboration between affected individuals and communities, public health experts, and governments.
- OPEN ACCESSCOVID-19 presents an opportunity to preserve a rich and diverse historical record—one intended to honour all experiences and voices and in recognition of ongoing systemic inequalities shaping the pandemic. But policy changes are necessary in three key areas: how memory institutions are funded and supported, the gaps in our capacity to preserve the digital records that reflect how we communicate with one another today, and how to preserve and make accessible valuable scholarly research into the societal impact of COVID-19. Our goal is to begin a conversation about priorities for archival preservation, the need for greater equity and justice in our preservation practices, and ways to safeguard the existence of historical records that will allow us in future to bear witness, with fairness and truth and in a spirit of reconciliation, to our society’s response to COVID-19.
- OPEN ACCESSCorrectional services, both institutional and within the community, are impacted by COVID-19. In the current paper, we focus on the current situation and examine the tensions around how COVID-19 has introduced new challenges while also exacerbating strains on the correctional system. Here, we make recommendations that are directly aimed at how correctional systems manage COVID-19 and address the nature and structure of correctional systems that should be continued after the pandemic. In addition, we highlight and make recommendations for the needs of those who remain incarcerated in general, and for Indigenous people in particular, as well as for those who are serving their sentences in the community. Further, we make recommendations for those working in closed-custody institutions and employed to support the re-entry experiences of formerly incarcerated persons. We are at a critical juncture—where reflection and change are possible—and we put forth recommendations toward supporting those working and living in correctional services as a way forward during the pandemic and beyond.
- OPEN ACCESSSignificant public discourse has focused recently on police–civilian interactions involving with persons with mental illness (PMI). Despite increasing public attention, and growing demands for policy change, little is actually known about the myriad of ways in which Canadian police encounter PMI in the context of routine police work. To assist policymakers in developing evidence-informed policy, this paper attempts to shed light on present difficulties associated with addressing fundamental questions, such as the prevalence of mental health related issues in police calls for service. To do this, we attempt to map the size and scope of police calls for service involving PMI, drawing on both the available scientific data and the limited knowledge to be gleaned from available police reports. Our focus is on two broad categories of police interactions with citizens: public safety concerns (wellness checks, suicide threats, missing persons, mental health apprehensions) and crime prevention and response (encountering PMI as victims–complainants and (or) as potential suspects). We also explore the challenges policy-makers face in relying on police data and the importance of overcoming weaknesses in data collection and sharing in relation to the policing of uniquely vulnerable groups. This paper concludes with some key recommendations for addressing gaps highlighted.
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The need for a federal Basic Income feature within any coherent post-COVID-19 economic recovery plan
COVID-19 has shone a harsh light on the extent of poverty in Canada. When normal economic activity was interrupted by the exigencies of public health driven lockdowns, the shutdown disproportionately affected people who, before the pandemic, were living on incomes beneath the poverty line or dependent upon low-paying hourly remunerated jobs, usually part time and without appropriate benefits. Those living beneath the poverty line in Canada, three million of welfare poor and working poor, include a disproportionately large population of Black and Indigenous people and people of colour. This paper addresses the challenge of inclusive economic recovery. In particular, we propose that the federal government introduce a Basic Income guarantee for all residents of Canada as part of a comprehensive social safety net that includes access to housing, child care, mental and physical health care, disability supports, education, and the many other public services essential to life in a high-income country. Residents with no other income would receive the full benefit that would be sufficient to ensure that no one lives in poverty, while those with low incomes would receive a reduced amount. - OPEN ACCESS
COVID science is being both done and circulated at a furious pace. While it is inspiring to see the research community responding so vigorously to the pandemic crisis, all this activity has also created a churning sea of bad data, conflicting results, and exaggerated headlines. With representations of science becoming increasingly polarized, twisted, and hyped, there is growing concern that the relevant science is being represented to the public in a manner that may cause confusion, inappropriate expectations, and the erosion of public trust. Here we explore some of the key issues associated with the representations of science in the context of the COVID-19 pandemic. Many of these issues are not new. But the COVID-19 pandemic has placed a spotlight on the biomedical research process and amplified the adverse ramifications of poor public communication. We need to do better. As such, we conclude with 10 recommendations aimed at key actors involved in the communication of COVID-19 science, including government, funders, universities, publishers, media, and the research communities.
Curators
Tom Marrie
Guest Editor