Background The ongoing coronavirus disease 2019 (COVID-19) pandemic has resulted in implementation of public health measures worldwide to mitigate disease spread, including; travel restrictions, lockdowns, messaging on handwashing, use of face coverings and physical distancing. As the pandemic progresses, exceptional decreases in seasonal respiratory viruses are increasingly reported. We aimed to evaluate the impact of the pandemic on laboratory confirmed detection of seasonal non-SARS-CoV-2 respiratory viruses in Canada. Methods Epidemiologic data were obtained from the Canadian Respiratory Virus Detection Surveillance System. Weekly data from the week ending 30 th August 2014 until the week ending the 13 th March 2021 were analysed. We compared trends in laboratory detection and test volumes during the 2020/2021 season with pre-pandemic seasons from 2014 to 2019. Findings We observed a dramatically lower percentage of tests positive for all seasonal respiratory viruses during 2020-2021 compared to pre-pandemic seasons. For influenza A and B the percent positive decreased to 0•0015 and 0•0028 times that of pre-pandemic levels respectively and for RSV, the percent positive dropped to 0•0169 times that of pre-pandemic levels. Ongoing detection of enterovirus/rhinovirus occurred, with regional variation in the epidemic patterns and intensity. Interpretation We report an effective absence of the annual seasonal epidemic of most seasonal respiratory viruses in 2020/2021. This dramatic decrease is likely related to implementation of multi-layered public health measures during the pandemic. The impact of such measures may have relevance for public health practice in mitigating seasonal respiratory virus epidemics and for informing responses to future respiratory virus pandemics. Funding No additional funding source was required for this study.

Context Hip fractures are a public health concern because they are associated with significant morbidity, excess mortality, and the majority of the costs directly attributable to osteoporosis. Objective To examine trends in hip fracture rates in Canada. Design, Setting, and Patients Ecologic trend study using nationwide hospitalization data for 1985 to 2005 from a database at the Canadian Institute for Health Information. Data for all patients with a hospitalization for which the primary reason was a hip fracture (570 872 hospitalizations) were analyzed. Main Outcome Measures Age-specific and age-standardized hip fracture rates. Results There was a decrease in age-specific hip fracture rates (all P for trend Ͻ.001). Over the 21-year period of the study, age-adjusted hip fracture rates decreased by 31.8% in females (from 118.6 to 80.9 fractures per 100 000 person-years) and by 25.0% in males (from 68.2 to 51.1 fractures per 100 000 person-years). Joinpoint regression analysis identified a change in the linear slope around 1996. For the overall population, the average age-adjusted annual percentage decrease in hip fracture rates was 1.2% (95% confidence interval, 1.0%-1.3%) per year from 1985 to 1996 and 2.4% (95% confidence interval, 2.1%-2.6%) per year from 1996 to 2005 (PϽ.001 for difference in slopes). Similar changes were seen in both females and males with greater slope reductions after 1996 (PϽ.001 for difference in slopes for each sex). Conclusions Age-standardized rates of hip fracture have steadily declined in Canada since 1985 and more rapidly during the later study period. The factors primarily responsible for the earlier reduction in hip fractures are unknown.

Approximately 1,450 new cases and 430 deaths from cervical cancer were estimated to occur among Canadian women during 2000, resulting in an estimated incidence rate of 8.4 per 100,000 women. 1 Observed declines in cervical cancer incidence and mortality rates in previous years are largely attributed to the widespread adoption of Pap screening. 1 Current Canadian guidelines recommend women receive annual Pap tests once sexually active or at age 18 with a reduction in screening frequency to every three years after two normal smears to the age of 69, in the presence of an organized screening program. 2,3 Currently, there are no comprehensive screening programs in Canada, although several provinces have programs with several of the required elements. [4][5][6] Although cervical cancer is almost completely preventable through regular screening, Pap tests remain underused by some women. Studies consistently show that among new cases, a relatively high proportion of women report no or poor participation in a Pap screening program. 7,8 As the early stages of cervical cancer (non-invasive) are asymptomatic, routine screening can result in better prognosis for the patient. 9,10 If cervical cancer is detected when symp-toms are apparent, the five-year survival rate is only 10%, but with early detection exceeds 90%. 2 Research has illustrated the relative importance of several sociodemographic, health and lifestyle factors to Pap screening among North American women. [11][12][13][14][15][16] Significant predictors of under-utilization include older age, lower education, non-English language, ethnic background, single marital status and poor preventive health behaviours.This study examines the consistency of findings regarding sociodemographic, health and lifestyle factors that promote appropriate cervical cancer screening among different age groups of Canadian women in the 1996-97 National Population Health Survey (NPHS). Questions regarding reasons for not obtaining a Pap test were added to this survey cycle; thus, a secondary objective was to examine the relative importance of personal and system barriers to Pap test participation among this sample. METHODSThe NPHS is an ongoing survey conducted by Statistics Canada involving the collection of cross-sectional and longitudinal data on the health of Canadians. Data from the second cycle (1996-97) of the household component, obtained primarily through telephone interviews, were used to examine the relation of sociodemographic, health and lifestyle factors to Pap test participation in a representative sample of the non-institutionalized population.Of the 36,667 female respondents aged 18+ years, 34,832 consented to share their

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