Health Technology Assessment Division, International Federation for Medical and Biological Engineering, Ottawa, Ontario, Canada
Faculty of Medicine & Dentistry, University of Alberta, Edmonton, Alberta, Canada.
BMJ Open. 2021 Mar 9;11(3):e046177. doi: 10.1136/bmjopen-2020-046177.
The main objectives of this study were to synthesise and compare pandemic preparedness strategies issued by the federal and provincial/territorial (P/T) governments in Canada and to assess whether COVID-19 public health (PH) measures were tailored towards priority populations, as defined by relevant social determinants of health.
This scoping review searched federal and P/T websites on daily COVID-19 pandemic preparedness strategies between 30 January and 30 April 2020. The PROGRESS-Plus equity-lens framework was used to define priority populations. All definitions, policies and guidelines of PH strategies implemented by the federal and P/T governments to reduce risk of SARS-CoV-2 transmission were included. PH measures were classified using a modified Public Health Agency of Canada Framework for Canadian Pandemic Influenza Preparedness.
A total of 722 COVID-19 PH measures were issued during the study period. Of these, home quarantine (voluntary) (n=13.0%; 94/722) and retail/commerce restrictions (10.9%; n=79/722) were the most common measures introduced. Many of the PH orders, including physical distancing, cancellation of mass gatherings, school closures or retail/commerce restrictions began to be introduced after 11 March 2020. Lifting of some of the PH orders in phases to reopen the economy began in April 2020 (6.5%; n=47/722). The majority (68%, n=491/722) of COVID-19 PH announcements were deemed mandatory, while 32% (n=231/722) were recommendations. Several PH measures (28.0%, n=202/722) targeted a variety of groups at risk of socially produced health inequalities, such as age, religion, occupation and migration status.
Most PH measures centred on limiting contact between people who were not from the same household. PH measures were evolutionary in nature, reflecting new evidence that emerged throughout the pandemic. Although ~30% of all implemented COVID-19 PH measures were tailored towards priority groups, there were still unintended consequences on these populations.
本研究的主要目的是综合比较加拿大联邦和省级/地区（P/T）政府发布的大流行准备策略，并评估 COVID-19 公共卫生（PH）措施是否针对相关健康决定因素所定义的优先人群进行了调整。
本范围综述于 2020 年 1 月 30 日至 4 月 30 日期间在联邦和 P/T 网站上搜索了每日 COVID-19 大流行准备策略。使用 PROGRESS-Plus 公平视角框架来定义优先人群。纳入联邦和 P/T 政府为降低 SARS-CoV-2 传播风险而实施的所有 PH 策略的定义、政策和指南。使用加拿大大流行性流感防范公共卫生局框架对 PH 措施进行分类。
在研究期间共发布了 722 项 COVID-19 PH 措施。其中，家庭检疫（自愿）（n=13.0%；94/722）和零售/商业限制（10.9%；n=79/722）是最常见的措施。许多 PH 命令，包括保持身体距离、取消大型集会、关闭学校或限制零售/商业，都是在 2020 年 3 月 11 日之后开始实施的。为了重新开放经济，4 月开始分阶段放宽一些 PH 命令（6.5%；n=47/722）。大多数 COVID-19 PH 公告（68%；n=491/722）被视为强制性的，而 32%（n=231/722）为建议性的。一些 PH 措施（28.0%；n=202/722）针对的是各种面临社会产生的健康不平等风险的群体，如年龄、宗教、职业和移民身份。
大多数 PH 措施都集中在限制不同家庭之间的人员接触。PH 措施具有演变的性质，反映了整个大流行期间出现的新证据。尽管所有实施的 COVID-19 PH 措施中有~30%针对优先人群，但这些人群仍存在意外后果。
