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Movahedi Nia Z, Prescod C, Westin M, Perkins P, Goitom M, Fevrier K, Bawa S, Kong J. Cross-sectional study to assess the impact of the COVID-19 pandemic on healthcare services and clinical admissions using statistical analysis and discovering hotspots in three regions of the Greater Toronto Area. BMJ Open 2024; 14:e082114. [PMID: 38485179 PMCID: PMC10941105 DOI: 10.1136/bmjopen-2023-082114] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/24/2023] [Accepted: 02/28/2024] [Indexed: 03/17/2024] Open
Abstract
OBJECTIVES The COVID-19 pandemic disrupted healthcare services, leading to the cancellation of non-urgent tests, screenings and procedures, a shift towards remote consultations, stalled childhood immunisations and clinic closures which had detrimental effects across the healthcare system. This study investigates the impact of the COVID-19 pandemic on clinical admissions and healthcare quality in the Peel, York and Toronto regions within the Greater Toronto Area (GTA). DESIGN In a cross-sectional study, the negative impact of the pandemic on various healthcare sectors, including preventive and primary care (PPC), the emergency department (ED), alternative level of care (ALC) and imaging, procedures and surgeries is investigated. Study questions include assessing impairments caused by the COVID-19 pandemic and discovering hotspots and critical subregions that require special attention to recover. The measuring technique involves comparing the number of cases during the COVID-19 pandemic with before that, and determining the difference in percentage. Statistical analyses (Mann-Whitney U test, analysis of variance, Dunn's test) is used to evaluate sector-specific changes and inter-relationships. SETTING This work uses primary data which were collected by the Black Creek Community Health Centre. The study population was from three regions of GTA, namely, the city of Toronto, York and Peel. For all health sectors, the sample size was large enough to have a statistical power of 0.95 to capture 1% variation in the number of cases during the COVID-19 pandemic compared with before that. RESULTS All sectors experienced a significant decline in patient volume during the pandemic. ALC admissions surged in some areas, while IPS patients faced delays. Surgery waitlists increased by an average of 9.75%, and completed IPS procedures decreased in several subregions. CONCLUSIONS The COVID-19 pandemic had a universally negative impact on healthcare sectors across various subregions. Identification of the hardest-hit subregions in each sector can assist health officials in crafting recovery policies.
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Affiliation(s)
- Zahra Movahedi Nia
- Africa-Canada Artificial Intelligence and Data Innovation Consortium (ACADIC), Department of Mathematics and Statistics, York University, Toronto, Ontario, Canada
- Resilience Research Atlantic Alliance on Sustainability, Supporting Recovery and Renewal (REASURE2) Network, Toronto, Ontario, Canada
| | - Cheryl Prescod
- Black Creek Community Health Centre, Toronto, Ontario, Canada
| | - Michelle Westin
- Black Creek Community Health Centre, Toronto, Ontario, Canada
| | - Patricia Perkins
- Resilience Research Atlantic Alliance on Sustainability, Supporting Recovery and Renewal (REASURE2) Network, Toronto, Ontario, Canada
- Faculty of Environment and Urban Change, York University, Toronto, Ontario, Canada
| | - Mary Goitom
- Resilience Research Atlantic Alliance on Sustainability, Supporting Recovery and Renewal (REASURE2) Network, Toronto, Ontario, Canada
- School of Social Work, York University, Toronto, Ontario, Canada
| | - Kesha Fevrier
- Resilience Research Atlantic Alliance on Sustainability, Supporting Recovery and Renewal (REASURE2) Network, Toronto, Ontario, Canada
- Department of Geography and Planning, Queen's University, Kingston, New York, Canada
| | - Sylvia Bawa
- Resilience Research Atlantic Alliance on Sustainability, Supporting Recovery and Renewal (REASURE2) Network, Toronto, Ontario, Canada
- Department of Sociology, York University, Toronto, Ontario, Canada
| | - Jude Kong
- Africa-Canada Artificial Intelligence and Data Innovation Consortium (ACADIC), Department of Mathematics and Statistics, York University, Toronto, Ontario, Canada
- Resilience Research Atlantic Alliance on Sustainability, Supporting Recovery and Renewal (REASURE2) Network, Toronto, Ontario, Canada
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Allen UD, Barton M, Upton J, Bailey A, Campigotto A, Abdulnoor M, Julien JP, Gubbay J, Kissoon N, Litosh A, La Neve MR, Wong P, Allen A, Bailey R, Byrne W, Jagoowani R, Phillips C, Merreles-Pulcini M, Polack A, Prescod C, Siddiqi A, Summers A, Thompson K, Thompson S, James C. Disproportionate Rates of COVID-19 Among Black Canadian Communities: Lessons from a Cross-Sectional Study in the First Year of the Pandemic. J Racial Ethn Health Disparities 2024:10.1007/s40615-023-01903-z. [PMID: 38253978 DOI: 10.1007/s40615-023-01903-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2023] [Revised: 12/14/2023] [Accepted: 12/20/2023] [Indexed: 01/24/2024]
Abstract
BACKGROUND Racialized communities, including Black Canadians, have disproportionately higher COVID-19 cases. We examined the extent to which SARS-CoV-2 infection has affected the Black Canadian community and the factors associated with the infection. METHODS We conducted a cross-sectional survey in an area of Ontario (northwest Toronto/Peel Region) with a high proportion of Black residents along with 2 areas that have lower proportions of Black residents (Oakville and London, Ontario). SARS-CoV-2 IgG antibodies were determined using the EUROIMMUN assay. The study was conducted between August 15, 2020, and December 15, 2020. RESULTS Among 387 evaluable subjects, the majority, 273 (70.5%), were enrolled from northwest Toronto and adjoining suburban areas of Peel, Ontario. The seropositivity values for Oakville and London were comparable (3.3% (2/60; 95% CI 0.4-11.5) and 3.9% (2/51; 95% CI 0.5-13.5), respectively). Relative to these areas, the seropositivity was higher for the northwest Toronto/Peel area at 12.1% (33/273), relative risk (RR) 3.35 (1.22-9.25). Persons 19 years of age or less had the highest seropositivity (10/50; 20.0%, 95% CI 10.3-33.7%), RR 2.27 (1.23-3.59). There was a trend for an interaction effect between race and location of residence as this relates to the relative risk of seropositivity. INTERPRETATION During the early phases of the pandemic, the seropositivity within a COVID-19 high-prevalence zone was threefold greater than lower prevalence areas of Ontario. Black individuals were among those with the highest seroprevalence of SARS-CoV-2.
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Affiliation(s)
- Upton D Allen
- Division of Infectious Diseases, Department of Paediatrics, The Hospital for Sick Children, 555 University Avenue, Toronto, ON, M5G 1X8, Canada.
| | - Michelle Barton
- Division of Infectious Diseases, Department of Paediatrics, London Health Sciences Centre, London, ON, Canada
| | - Julia Upton
- Division of Allergy and Immunology, Department of Paediatrics, The Hospital for Sick Children, Toronto, ON, Canada
| | - Annette Bailey
- Toronto Metropolitan University, Toronto, Ontario, Canada
| | - Aaron Campigotto
- Division of Microbiology, Department of Paediatric Laboratory Medicine, The Hospital for Sick Children, Toronto, ON, Canada
| | - Mariana Abdulnoor
- Division of Infectious Diseases, Department of Paediatrics, The Hospital for Sick Children, 555 University Avenue, Toronto, ON, M5G 1X8, Canada
| | | | | | - Niranjan Kissoon
- Department of Paediatrics, University of British Columbia, Vancouver, Canada
| | - Alice Litosh
- Division of Infectious Diseases, Department of Paediatrics, The Hospital for Sick Children, 555 University Avenue, Toronto, ON, M5G 1X8, Canada
| | - Maria-Rosa La Neve
- Division of Infectious Diseases, Department of Paediatrics, The Hospital for Sick Children, 555 University Avenue, Toronto, ON, M5G 1X8, Canada
| | - Peter Wong
- Department of Paediatrics, The Hospital for Sick Children, Toronto, ON, Canada
| | - Andrew Allen
- Division of Infectious Diseases, Department of Paediatrics, The Hospital for Sick Children, 555 University Avenue, Toronto, ON, M5G 1X8, Canada
| | - Renee Bailey
- Toronto Metropolitan University, Toronto, Ontario, Canada
| | - Walter Byrne
- Division of Infectious Diseases, Department of Paediatrics, The Hospital for Sick Children, 555 University Avenue, Toronto, ON, M5G 1X8, Canada
| | - Ranjeeta Jagoowani
- Division of Infectious Diseases, Department of Paediatrics, The Hospital for Sick Children, 555 University Avenue, Toronto, ON, M5G 1X8, Canada
| | - Chantal Phillips
- Division of Infectious Diseases, Department of Paediatrics, The Hospital for Sick Children, 555 University Avenue, Toronto, ON, M5G 1X8, Canada
| | - Manuela Merreles-Pulcini
- Division of Infectious Diseases, Department of Paediatrics, The Hospital for Sick Children, 555 University Avenue, Toronto, ON, M5G 1X8, Canada
| | - Alicia Polack
- Division of Infectious Diseases, Department of Paediatrics, The Hospital for Sick Children, 555 University Avenue, Toronto, ON, M5G 1X8, Canada
| | - Cheryl Prescod
- Black Creek Community Health Centre, Toronto, Ontario, Canada
| | - Arjumand Siddiqi
- Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada
| | | | - Kimberly Thompson
- Division of Infectious Diseases, Department of Paediatrics, The Hospital for Sick Children, 555 University Avenue, Toronto, ON, M5G 1X8, Canada
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Bragazzi NL, Woldegerima WA, Iyaniwura SA, Han Q, Wang X, Shausan A, Badu K, Okwen P, Prescod C, Westin M, Omame A, Converti M, Mellado B, Wu J, Kong JD. Knowing the unknown: The underestimation of monkeypox cases. Insights and implications from an integrative review of the literature. Front Microbiol 2022; 13:1011049. [PMID: 36246252 PMCID: PMC9563713 DOI: 10.3389/fmicb.2022.1011049] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2022] [Accepted: 09/06/2022] [Indexed: 11/23/2022] Open
Abstract
Monkeypox is an emerging zoonotic disease caused by the monkeypox virus, which is an infectious agent belonging to the genus Orthopoxvirus. Currently, commencing from the end of April 2022, an outbreak of monkeypox is ongoing, with more than 43,000 cases reported as of 23 August 2022, involving 99 countries and territories across all the six World Health Organization (WHO) regions. On 23 July 2022, the Director-General of the WHO declared monkeypox a global public health emergency of international concern (PHEIC), since the outbreak represents an extraordinary, unusual, and unexpected event that poses a significant risk for international spread, requiring an immediate, coordinated international response. However, the real magnitude of the burden of disease could be masked by failures in ascertainment and under-detection. As such, underestimation affects the efficiency and reliability of surveillance and notification systems and compromises the possibility of making informed and evidence-based policy decisions in terms of the adoption and implementation of ad hoc adequate preventive measures. In this review, synthesizing 53 papers, we summarize the determinants of the underestimation of sexually transmitted diseases, in general, and, in particular, monkeypox, in terms of all their various components and dimensions (under-ascertainment, underreporting, under-detection, under-diagnosis, misdiagnosis/misclassification, and under-notification).
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Affiliation(s)
- Nicola Luigi Bragazzi
- Laboratory for Industrial and Applied Mathematics (LIAM), Department of Mathematics and Statistics, York University, Toronto, ON, Canada
- *Correspondence: Nicola Luigi Bragazzi,
| | - Woldegebriel Assefa Woldegerima
- Laboratory for Industrial and Applied Mathematics (LIAM), Department of Mathematics and Statistics, York University, Toronto, ON, Canada
| | - Sarafa Adewale Iyaniwura
- Theoretical Biology and Biophysics Group, Los Alamos National Laboratory, Los Alamos, NM, United States
| | - Qing Han
- Laboratory for Industrial and Applied Mathematics (LIAM), Department of Mathematics and Statistics, York University, Toronto, ON, Canada
| | - Xiaoying Wang
- Department of Mathematics, Trent University, Peterborough, ON, Canada
| | - Aminath Shausan
- School of Mathematics and Physics, University of Queensland, Saint Lucia, QLD, Australia
| | - Kingsley Badu
- Vector-borne Infectious Disease Group, Theoretical and Applied Biology, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | | | - Cheryl Prescod
- Black Creek Community Health Centre, Toronto, ON, Canada
| | | | - Andrew Omame
- Department of Mathematics, Federal University of Technology, Owerri, Nigeria
- Abdus Salam School of Mathematical Sciences, Government College University, Lahore, Pakistan
| | | | - Bruce Mellado
- School of Physics and Institute for Collider Particle Physics, University of the Witwatersrand, Johannesburg, South Africa
- Subatomic Physics, iThemba Laboratory for Accelerator Based Sciences, Somerset West, South Africa
| | - Jianhong Wu
- Laboratory for Industrial and Applied Mathematics (LIAM), Department of Mathematics and Statistics, York University, Toronto, ON, Canada
| | - Jude Dzevela Kong
- Laboratory for Industrial and Applied Mathematics (LIAM), Department of Mathematics and Statistics, York University, Toronto, ON, Canada
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Eissa A, Lofters A, Akor N, Prescod C, Nnorom O. Augmenter le taux de vaccination contre le SRAS-CoV-2 parmi la population noire au Canada. CMAJ 2021; 193:E1513-E1515. [PMID: 34580149 PMCID: PMC8486474 DOI: 10.1503/cmaj.210949-f] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Affiliation(s)
- Azza Eissa
- Département de médecine familiale et communautaire (Eissa, Lofters, Nnorom) et École de santé publique Dalla Lana (Eissa, Lofters, Nnorom), Université de Toronto; Centre Peter Gilgan pour les cancers féminins (Lofters), Hôpital Women's College; centre de santé communautaire TAIBU (Akor); centre de santé communautaire Black Creek (Prescod), Toronto, Ont.
| | - Aisha Lofters
- Département de médecine familiale et communautaire (Eissa, Lofters, Nnorom) et École de santé publique Dalla Lana (Eissa, Lofters, Nnorom), Université de Toronto; Centre Peter Gilgan pour les cancers féminins (Lofters), Hôpital Women's College; centre de santé communautaire TAIBU (Akor); centre de santé communautaire Black Creek (Prescod), Toronto, Ont
| | - Nancy Akor
- Département de médecine familiale et communautaire (Eissa, Lofters, Nnorom) et École de santé publique Dalla Lana (Eissa, Lofters, Nnorom), Université de Toronto; Centre Peter Gilgan pour les cancers féminins (Lofters), Hôpital Women's College; centre de santé communautaire TAIBU (Akor); centre de santé communautaire Black Creek (Prescod), Toronto, Ont
| | - Cheryl Prescod
- Département de médecine familiale et communautaire (Eissa, Lofters, Nnorom) et École de santé publique Dalla Lana (Eissa, Lofters, Nnorom), Université de Toronto; Centre Peter Gilgan pour les cancers féminins (Lofters), Hôpital Women's College; centre de santé communautaire TAIBU (Akor); centre de santé communautaire Black Creek (Prescod), Toronto, Ont
| | - Onye Nnorom
- Département de médecine familiale et communautaire (Eissa, Lofters, Nnorom) et École de santé publique Dalla Lana (Eissa, Lofters, Nnorom), Université de Toronto; Centre Peter Gilgan pour les cancers féminins (Lofters), Hôpital Women's College; centre de santé communautaire TAIBU (Akor); centre de santé communautaire Black Creek (Prescod), Toronto, Ont
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5
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Affiliation(s)
- Azza Eissa
- Department of Family and Community Medicine (Eissa, Lofters, Nnorom) and Dalla Lana School of Public Health (Eissa, Lofters, Nnorom), University of Toronto; Peter Gilgan Centre for Women's Cancers (Lofters), Women's College Hospital; TAIBU Community Health Centre (Akor); Black Creek Community Health Centre (Prescod), Toronto, Ont.
| | - Aisha Lofters
- Department of Family and Community Medicine (Eissa, Lofters, Nnorom) and Dalla Lana School of Public Health (Eissa, Lofters, Nnorom), University of Toronto; Peter Gilgan Centre for Women's Cancers (Lofters), Women's College Hospital; TAIBU Community Health Centre (Akor); Black Creek Community Health Centre (Prescod), Toronto, Ont
| | - Nancy Akor
- Department of Family and Community Medicine (Eissa, Lofters, Nnorom) and Dalla Lana School of Public Health (Eissa, Lofters, Nnorom), University of Toronto; Peter Gilgan Centre for Women's Cancers (Lofters), Women's College Hospital; TAIBU Community Health Centre (Akor); Black Creek Community Health Centre (Prescod), Toronto, Ont
| | - Cheryl Prescod
- Department of Family and Community Medicine (Eissa, Lofters, Nnorom) and Dalla Lana School of Public Health (Eissa, Lofters, Nnorom), University of Toronto; Peter Gilgan Centre for Women's Cancers (Lofters), Women's College Hospital; TAIBU Community Health Centre (Akor); Black Creek Community Health Centre (Prescod), Toronto, Ont
| | - Onye Nnorom
- Department of Family and Community Medicine (Eissa, Lofters, Nnorom) and Dalla Lana School of Public Health (Eissa, Lofters, Nnorom), University of Toronto; Peter Gilgan Centre for Women's Cancers (Lofters), Women's College Hospital; TAIBU Community Health Centre (Akor); Black Creek Community Health Centre (Prescod), Toronto, Ont
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Pilkington FB, Singh MD, Prescod C, Buettgen A. Inclusive mosaic: promoting diversity in nursing through youth mentorship. Int J Nurs Educ Scholarsh 2013; 10:/j/ijnes.2013.10.issue-1/ijnes-2012-0012/ijnes-2012-0012.xml. [PMID: 23759511 DOI: 10.1515/ijnes-2012-0012] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
In this paper we describe the Inclusive Mosaic project, a community-university partnership in an outer-city community in a large Canadian metropolis aimed at promoting diversity in nursing. The project brought together nursing student mentors with middle school and high school youth from diverse backgrounds in a mentoring program aimed at increasing participants' interest in, and confidence in pursuing, higher education and a career in nursing or other health profession. The concepts of emancipatory education, self-efficacy, and possible selves provided the theoretical foundation. Project processes, activities, and outcomes are described, and a post-hoc evaluation encompassing the project's strengths, challenges, limitations, and successes is presented. Recommendations to inform future research and education are also provided.
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Affiliation(s)
- F Beryl Pilkington
- School of Nursing, York University, HNES 345, 4700 Keele Street, Toronto, ON M3J1P3,Canada.
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