COVID-19 epidemiology in Canada from January to December 2020: the pre-vaccine era

Abstract

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.

Healthcare utilization and adverse outcomes stratified by sex, age and long-term care residency using the Alberta COVID-19 Analytics and Research Database (ACARD): a population-based descriptive study

“…Hospital admissions within 30 days of diagnosis were 5.5% compared to our finding of 5.9% within 60 days of diagnosis, again implying the biggest impact on inpatient healthcare utilization occurs shortly after diagnosis of COVID-19 [ 15 ]. Our finding of time to hospitalization of 7.8 days from diagnosis is in keeping with prior work summarizing the epidemiology of COVID-19 which suggest that if patients require hospitalization it typically occurs within a week of diagnosis and symptoms [ 12 ].…”

“…Much of the previous work on COVID-19 has focused on patients who required hospitalization and subsequent outcomes including readmissions [ 10 , 11 ]. Previous epidemiological summaries suggest differences in geography and patient health demographics influence the impact of COVID-19 [ 12 ], highlighting the importance of local population-based research. Therefore, our study was designed to address this gap in the literature and more broadly assess outcomes associated with COVID-19 cases in Alberta from a population-based perspective, regardless of hospitalization.…”

Comparing Health Workforce Policy during a Major Global Health Crisis: A Critical Conceptual Debate and International Empirical Investigation

“…From a system perspective, the two largest Canadian provinces, Ontario and Quebec, were severely impacted by the pandemic from the beginning, seeing dramatic death tolls in the most vulnerable segments of the population, namely frail elderly residents of long-term care (LTC) homes [ 54 ]. Alberta had considerable trouble confronting subsequent waves of the pandemic; the healthcare system was overwhelmed by the fourth wave of the pandemic.…”

Canadian COVID-19 Outbreak Surveillance System: implementation of national surveillance during a global pandemic

“…On March 11, 2020, the World Health Organization (WHO) declared SARS-CoV-2 a pandemic (Zhao et al, 2020 ). Shortly thereafter, community transmission of SARS-CoV-2 was observed in many regions across Canada (Waldner et al, 2021 ). SARS-CoV-2 outbreaks 1 have been associated with many COVID-19 cases, hospitalizations, and deaths (Akhtar-Danesh et al, 2022 ; Zylke & Bauchner, 2020 ).…”