Early Impacts of the COVID-19 Pandemic on Public Health Systems and Practice in 3 Canadian Provinces From the Perspective of Public Health Leaders: A Qualitative Study

Abstract

Context:The COVID-19 pandemic has impacted health systems worldwide. Studies to date have largely focused on the health care system with less attention to the impact on public health systems and practice. Objective: To describe the early impacts of COVID-19 on public health systems and practice in 3 Canadian provinces from the perspective of public health system leaders and synthesize lessons learned. Design: A qualitative study using semistructured virtual interviews with public health leaders between October 2020 and April 2021. The World Health Organization's essential public health operations framework guided data collection and analysis.Setting: This study involved the Canadian provinces of Alberta, Ontario, and Québec. These provinces were chosen for their large populations, relatively high COVID-19 burden, and variation in public health systems. Participants: Public health leaders from Alberta (n = 21), Ontario (n = 18), and Québec (n = 19) in organizations with a primary mandate of stewardship and/or administration of essential public health operations (total n = 58). Results: We found that the COVID-19 pandemic led to intensified collaboration in public health systems and a change in workforce capacity to respond to the pandemic. This came with opportunities but also challenges of burnout and disruption of non-COVID-19 services. Information systems and digital technologies were increasingly used and there was greater proximity between public health leaders and other health system leaders. A renewed recognition for public health work was also highlighted. Conclusions:The COVID-19 pandemic impacted several aspects of public health systems in the provinces studied. Our findings can help public health leaders and policy makers identify areas for further investment (eg, intersectoral collaboration, information systems) and develop plans to address challenges (eg, disrupted services, workforce burnout) that have surfaced.

The COVID‐19 impact and characterization on substance use‐related emergency department visits for adolescents and young adults in Canada: Practical implications

“…Resource challenges in Canada. 56 Our findings also indicate an increase in the frequency of substance use-related ED visits referred to the ED from legal services compared to self/family referrals during the pandemic. We speculate that this trend may reflect the difficulty of providing medical services for substance-related presentations within legal services such as correctional institutions in the face of COVID-19 outbreaks during the pandemic 57 and perhaps an increased rate of violence involving substance use in our society, 40 ED visits contributes to one of the most challenging issues currently facing the Canadian healthcare system: ED overcrowding.…”

“…Further, more substance use‐related ED patients tended to stay longer during the pandemic (over 6 h). This is likely due to a combination of increased complexity at the outset of the pandemic, including staff illness, COVID disease burden and new Health Human Resource challenges in Canada 56 …”

Analysis of problems and potentials for increasing pandemic resilience in public health administrations in Saxony-Anhalt, Germany—a mixed-methods approach

“…Nonetheless, the study’s outcomes may offer valuable insights, given the diverse mix of rural and urban public health offices within the sample, contributing to a nuanced understanding of pandemic preparedness across different settings. In light of PHSs around the world struggling with pandemic preparedness and response,46 47 and identifying similar problems to their health services, this study can provide transferable outcomes in the fields of organisational strategy and organisational behaviour under crisis circumstances.…”

The impact of the COVID-19 pandemic on the use of restraint and seclusion interventions in Ontario emergency departments: A population-based study

“…In line with the global response to the emergence of the novel coronavirus 2019 (COVID- 19), the Ontario Provincial Government declared COVID to be a Public Health Emergency on March 17, 2020 [1]. Predictably, the implementation of a number of public health measures to reduce the spread of infection greatly impacted the Ontario healthcare system [2][3][4][5][6], which, in turn, greatly impacted patient treatment options and experiences [7][8][9]. Emergency departments (EDs), in particular, saw a substantial decrease in the number of patients accessing emergency services, largely due to public health restrictions and fears of COVID exposure in hospital settings [4,[10][11][12].…”