Background: Globally, the education of students at primary and secondary schools has been severely disrupted by the implementation of school closures to reduce the spread of coronavirus disease 2019 (COVID-19). The effectiveness of school closures in reducing transmission of COVID-19 and the impact of re-opening schools are unclear. Methods: Research criteria for this rapid review included empirical studies, published or pre-published worldwide before January 25, 2021, that assessed the effectiveness of school closures in reducing the spread of COVID-19 and the impact of school re-openings on COVID-19 transmission. Results: Twenty-four studies on the impact of school closures and re-openings on COVID-19 transmission were identified through the seven databases that were searched. Overall the evidence from these studies was mixed and varied due to several factors such as the time of implementation of public health measures, research design of included studies and variability among the levels of schooling examined. Conclusion: Preliminary findings suggest that school closures have limited impact on reducing COVID-19 transmission, with other non-pharmaceutical interventions considered much more effective. However, due to the limitations of the studies, further research is needed to support the use of this public health measure in response to the COVID-19 pandemic.

Background: The Laboratory Incident Notification Canada surveillance system monitors laboratory incidents reported under the Human Pathogens and Toxins Act and the Human Pathogens and Toxins Regulations. The objective of this report is to describe laboratory exposures that were reported in Canada in 2020 and the individuals who were affected. Methods: Laboratory incident exposures occurring in licensed Canadian laboratories in 2020 were analyzed. The exposure incident rate was calculated and the descriptive statistics were performed. Exposure incidents were analyzed by sector, activity type, occurrence type, root cause and pathogen/toxin. Affected persons were analyzed by education, route of exposure sector, role and laboratory experience. The time between the incident and the reporting date was also analyzed. Results: Forty-two incidents involving 57 individuals were reported to Laboratory Incident Notification Canada in 2020. There were no suspected or confirmed laboratory acquired infections. The annual incident exposure rate was 4.2 incidents per 100 active licenses. Most exposure incidents occurred during microbiology activities (n=22, 52.4%) and/or were reported by the hospital sector (n=19, 45.2%). Procedural issues (n=16, 27.1%) and sharps-related incidents (n=13, 22.0%) were the most common occurrences. Most affected individuals were exposed via inhalation (n=28, 49.1%) and worked as technicians or technologists (n=36, 63.2%). Issues with standard operating procedures was the most common root cause (n=24, 27.0%), followed by human interactions (n=21, 23.6%). The median number of days between the incident and the reporting date was six days. Conclusion: The rate of laboratory incidents were lower in 2020 than 2019, although the ongoing pandemic may have contributed to this decrease because of the closure of non-essential workplaces, including laboratories, for a portion of the year. The most common occurrence type was procedural while issues with not complying to standard operating procedures and human interactions as the most cited root causes.

Background: Multisystem inflammatory syndrome in children (MIS-C) associated with coronavirus disease 2019 (COVID-19) is an emerging condition that was first identified in paediatrics at the onset of the COVID-19 pandemic. The condition is also known as pediatric inflammatory multisystem syndrome temporally associated with severe acute respiratory syndrome coronavirus 2 (PIMS-TS or PIMS), and multiple definitions have been established for this condition that share overlapping features with Kawasaki Disease and toxic shock syndrome. Methods: A review was conducted to identify literature describing the epidemiology of MIS-C, published up until March 9, 2021. A database established at the Public Health Agency of Canada with COVID-19 literature was searched for articles referencing MIS-C, PIMS or Kawasaki Disease in relation to COVID-19. Results: A total of 195 out of 988 articles were included in the review. The median age of MIS-C patients was between seven and 10 years of age, although children of all ages (and adults) can be affected. Multisystem inflammatory syndrome in children disproportionately affected males (58% patients), and Black and Hispanic children seem to be at an elevated risk for developing MIS-C. Roughly 62% of MIS-C patients required admission to an intensive care unit, with one in five patients requiring mechanical ventilation. Between 0% and 2% of MIS-C patients died, depending on the population and available interventions. Conclusion: Multisystem inflammatory syndrome in children can affect children of all ages. A significant proportion of patients required intensive care unit and mechanical ventilation and 0%–2% of cases resulted in fatalities. More evidence is needed on the role of race, ethnicity and comorbidities in the development of MIS-C.

Contexte : La Loi sur les agents pathogènes humains et les toxines et le Règlement sur les agents pathogènes humains et les toxines exigent que les incidents de laboratoire soient signalés au système de surveillance de déclaration des incidents en laboratoire au Canada de l’Agence de la santé publique du Canada. L’objectif du présent rapport est de décrire les incidents de laboratoire concernant des expositions survenues au Canada en 2020 et les personnes affectées par ces incidents. Méthodes : Les incidents survenus en laboratoire en 2020 dans des laboratoires canadiens autorisés ont été analysés. Le taux d’incidents d’exposition a été calculé et des statistiques descriptives ont été effectuées. Les incidents d’exposition ont été analysés selon le secteur, type d’activité, type d’événement, cause fondamentale et agent pathogène ou toxine. Les personnes affectées ont été analysées selon l’éducation, la voie d’exposition, le secteur, le rôle et l’expérience en laboratoire. Le temps écoulé entre l’incident et la date du rapport a également été analysé. Résultats : Quarante-deux incidents touchant 57 personnes ont été signalés au système de surveillance de déclaration des incidents en laboratoire au Canada en 2020. Aucune infection contractée en laboratoire n’a été soupçonnée ou confirmée. Le taux d’exposition annuel était de 4,2 incidents pour 100 permis en vigueur. La plupart des cas d’exposition sont survenus pendant les activités de microbiologie (n = 22, 52,4 %) ou ont été signalés par le secteur hospitalier (n = 19, 45,2 %). L’erreur de procédure (n = 16, 27,1 %) et les incidents liés à un objet tranchant ou pointu (n = 13, 22,0 %) étaient les incidents les plus fréquemment signalés. La plupart des personnes touchées ont été exposées par inhalation (n = 28, 49,1 %). Ils travaillaient à titre de techniciens ou de technologues (n = 36, 63,2 %). Les problèmes liés aux procédures opératoires normalisées étaient la cause fondamentale la plus courante (n = 24, 27,0 %), suivie des interactions humaines (n = 21, 23,6 %). Le nombre médian de jours entre les cas d’exposition et la date de déclaration était de six jours. Conclusion : Le taux d’incidents en laboratoire était plus faible en 2020 qu’en 2019, quoique la pandémie en cours ait pu contribuer à cette diminution en raison de la fermeture de lieux de travail non essentiels, notamment des laboratoires, pendant une partie de l’année. Le type d’incident le plus fréquent était l’erreur de procédure, tandis que les problèmes liés au non-respect des procédures opératoires normalisées et les interactions humaines étaient les causes fondamentales les plus citées.

Laboratory incidents that result in an exposure to human pathogens and toxins can lead to laboratory-acquired infections or intoxications (LAIs). These infections can pose a risk to the public as well, should person-to-person transmission occur outside the laboratory after an LAI. Understanding factors that contribute to exposure incidents involving LAIs may contribute to ways to mitigate future occurrences to ensure the safety of laboratory workers and the communities in which they work. This paper describes nine exposure incidents resulting in LAIs that occurred in Canada from 2016 to 2021. Of the nine cases, most affected people had both high level of education and years of experience working with pathogens. There were varying laboratory types and activities where Salmonella spp. and Escherichia coli accounted for six out of the nine cases. Procedural issues, personal protective equipment issues and sharp-related incidents were the most cited root causes. From this information, it is clear that regular training (even of experienced staff), clear and accurate standard operating procedures, proper hygiene (especially with Salmonella spp. and E. coli) and recognition of exposure incidents at the time of occurrence are important in preventing future LAIs. Only regulated laboratories working with risk group 2 or higher organisms are required to report exposures and LAIs to the Laboratory Incident Notification Canada surveillance system. Because of the small sample size, results and inferences are based on descriptive analyses only.