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- Page navigation anchor for The neglect of multisectoral data in monitoring the COVID-19 pandemicThe neglect of multisectoral data in monitoring the COVID-19 pandemic
We can describe the status of the COVID-19 pandemic in our region by daily counts of cases, ICU admissions and deaths. Yet we struggle to describe how the pandemic has affected other aspects of healthcare or society with the same timeliness or precision. We cannot report current wait-times for cancer surgery, deaths from suicide or overdose, small business closures, housing evictions, or school absences, for example. The COVID-19 pandemic has affected all aspects of society, but a large gap has developed in public communication about the effects of the pandemic. This is because governments regularly report data on only a small number of easy-to-understand metrics and projections that reflect the direct effects of COVID-19, such as COVID-19 cases, testing, vaccination rates, hospitalizations, and deaths. The impact of the pandemic on other domains of healthcare and other aspects of society are reported less regularly, with little standardization of metrics, little use of timely indicators, and often not by a single authoritative source. As policy decisions to manage the COVID-19 pandemic are becoming increasingly complex because of vaccination, uncertainty about immunity and virus variants, and public exhaustion, governments should adopt a broader approach to public communication to inform policy and improve public trust in pandemic management.
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A disproportionate focus on the direct health impact of COVID-19 may have negative consequences. For instance, people are le...Competing Interests: Amol Verma and Fahad Razak are part-time employees of Ontario Health. Fahad Razak and Arthur Slutsky are volunteer members of the Ontario COVID-19 Science Advisory Table.References
- Bavel JJV, Baicker K, Boggio PS, et al. Using social and behavioural science to support COVID-19 pandemic response. Nat Hum Behav. 2020;4(5):460-471. doi:10.1038/s41562-020-0884-z
- C.D. Howe Institute. COVID-19: The C.D. Howe Institute’s Complete Policy Analysis. Published 2020. Accessed November 28, 2020. https://www.cdhowe.org/public-policy-research/covid-19-cd-howe-institute’s-complete-policy-analysis
- Chetty R, Friedman JN, Hendren N, Stepner M. The Economic Impacts of COVID-19: Evidence from a New Public Database Built Using Private Sector Data.; 2020. https://opportunityinsights.org/wp-content/uploads/2020/05/tracker_paper.pdf
- Page navigation anchor for RE: A no more waves strategyRE: A no more waves strategy
Doctors Morris and Mintz propose using public health measure to bring case rates of COVID-19 to 3/100 000 population using a matrix of actions. However appealing it would be to think that we could rid ourselves of COVID-19, this approach is unrealistic and potentially harmful.
Despite the published matrix, the relative efficacy of restrictions remains unquantified. For example, masks are identified as highly effective, yet the data are weak at best. Other measures have also been evaluated in aggregate and none seem to correlate with better outcomes. To date, no intervention has been shown unambiguously effective in controlling COVID-19, and some proposed interventions are untenable (e.g., closing essential retail) or incredibly damaging (e.g., closing schools).
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It is impossible to accurately describe the social and economic impact for all people. As proposed, the matrix downplays impacts on single parents, youth, and workers whose physical presence at work is necessary (e.g., Manufacturing, personal care, service industries). The proposed approach will actively exacerbate existing inequalities, as the people most impacted by restrictions are those least likely to benefit. Furthermore, the proposal ignores unintended health consequences of all measures which are significant, and may exceed the benefits of this proposal.
Finally, the number of cases chosen is arbitrary, and probably not achievable. Many places with initial success, later...Competing Interests: None declared.References
- Andrew M. Morris, Jack M. Mintz. A “No More Waves” strategy for COVID-19 in Canada. CMAJ 2020;10.1503/cmaj.202685.
- Jefferson, Del Mar, Dooley et al., Physical interventions to interrupt or reduce the spread of respiratory viruses, Cochrane Database of Systematic Reviews. November 20 2020. https://doi.org/10.1002/14651858.CD006207.pub5
- Chaudhry R, Dranitsaris G, Mubashir T, et al., A country level analysis measuring the impact of government actions, country preparedness and socioeconomic factors on COVID-19 mortality and related health outcomes. The Lancet. 25(100464): 1 August 2020.
- BCCDC http://www.bccdc.ca/Health-Info-Site/Documents/Public_health_COVID-19_reports/Impact_School_Closures_COVID-19.pdf, accessed Jan 5 2021
- Bilinski A, Emanuel E., COVID-19 and Excess All-Cause Mortality in the US and 18 Comparison Countries. JAMA. 324(20):2100-2102. doi:10.1001/jama.2020.20717