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Rapid Scoping Review: What is known about changes to public health surveillance programs, systems and strategies at the population level for governments globally due to the COVID-19 pandemic?
Literature on changes to public health surveillance during the COVID-19 pandemic is dominated by surveillance of COVID-19 infections; additional changes to public health surveillance has occurred in cancer screening, child health assessments, and sexually transmitted infections. Methods of surveillance include digital surveillance and wastewater surveillance.

Risk factors children 0-5

Rapid Review: What are the risk factors associated with severe COVID-19 outcomes in children 5 years and under?
The findings of this review indicate that prematurity, young age, comorbidities, and structural inequities are the greatest risk factors for severe outcomes in children five years and younger.

Post-secondary settings

Living Rapid Review Update 4: What is known about the risk of transmission of COVID-19 within post-secondary institutions and the strategies to mitigate on-campus outbreaks?
Strategies including fast and frequent testing and isolation may help mitigate the risk for COVID-19 transmission within post-secondary institutions.

Risk factors children 0-12

Rapid Review Update 1: What are the risk factors associated with severe COVID-19 outcomes in children 12 years and under?
The evidence suggests children with comorbidities may be more likely to experience severe COVID-19 outcomes.

Intent to leave

Rapid Review: What is known about health care worker intent to leave their occupation in the context of the COVID-19 pandemic?
Across all studies reporting a percentage, 11–42.6% of health care workers employed during the COVID-19 pandemic reported an intent to leave their current role. Between 2–35% of health care workers reported an intent to leave their profession.


Rapid Review Update 1: What is the ongoing effectiveness, immunogenicity, and safety of COVID-19 vaccines in persons who have had a prior, confirmed COVID-19 infection?
Vaccination in individuals with previous COVID-19 infection may be slightly more effective compared to those without previous infection, although the number of breakthrough infections was low in both groups.

Schools & daycares

Living Rapid Review Update 17: What is the specific role of daycares and schools in COVID-19 transmission? (update in progress) (insufficient evidence available as of Nov 12, 2021 to conduct an update)
Evidence shows transmission in schools/daycares is low with strong IPAC measures in place. There is limited data on the impact of either staff or student vaccinations in mitigating risk of transmission in school and daycare settings.

Parental vaccine uptake

Rapid Review: What is known about parents’ considerations for vaccine uptake for children and adolescents?
Parents' considerations in deciding to vaccinate children include trustworthy information about vaccination, assessment of risks of disease and vaccines, and barriers to access.

Food insecurity

Rapid Review Update 2: What is the prevalence of household food insecurity in North America as a result of COVID-19 and associated public health measures?
Food insecurity appears to be more prevalent during the COVID-19 pandemic than before the pandemic, particularly among low-income populations.

Vaccine uptake

Rapid Review: What is known about reasons for vaccine confidence and uptake in populations experiencing inequities?
Approaches to encourage vaccine uptake include collaboration with trusted leaders and community groups, and providing vaccination at convenient, trusted and accessible locations.

Risk communication

Rapid Review Update 1: What are best practices for risk communication and strategies to mitigate risk behaviours?
The literature on risk communication from various topic areas emphasizes the importance of clear, repeated, action-oriented messaging by a trusted leader.

Long-term care facilities

Rapid Review Update 2: What strategies mitigate risk of COVID-19 outbreaks and mortality in long-term care facilities?
Most guideline and guidance document recommendations include comprehensive surveillance, monitoring and evaluation of staff, resident, and visitor symptoms, limiting movement into and between facilities, physical distancing, proper ventilation, and proper provision and use of personal protective equipment (PPE) to reduce transmission amongst residents and staff within facilities.

Surface transmission

Rapid Review Update 1: What is known about how long the virus can survive with potential for infection on surfaces found in community settings?
Viral fragments can be detected on surfaces but these fragments may not be viable to results in transmission.

Musical activities

Rapid Review: What is known about the risk of transmission of COVID-19 during musical activities such as singing or playing a wind instrument, and how can these risks be mitigated?
Available reviews suggest that the risk of transmission through singing and instrument playing could be mitigated through standard public health measures.

Acute care settings

Rapid Review: What is the evidence for COVID-19 transmission in acute care settings?
Most studies include data collected in the early phases of the COVID-19 pandemic, during which lack of access to proper PPE was noted in some jurisdictions.

Substance use: tobacco

Rapid Review: What is the effect of the COVID-19 pandemic on the use and cessation of tobacco and vaping products?
There was no clear direction of effect of the COVID-19 pandemic on use of tobacco or vaping products.

Community transmission

Rapid Review: What is known about the risk of COVID-19 transmission across different indoor settings in the community such as restaurants and gyms?
Factors that increased the risk of transmission include reduced/poor ventilation, lack of physical distancing, length of exposure time, and viral load of the infected source.

Indigenous protective factors

Rapid Review: What factors may help protect Indigenous peoples and communities in Canada and internationally from the COVID-19 pandemic and its impacts?
Indigenous peoples and communities have experience with disease outbreaks and have learned effective ways of responding and protecting family and community members, despite socio-economic challenges and pervasive inequities resulting from historic and ongoing colonization.


Rapid Review Update 3: What is known on the potential for COVID-19 re-infection, including new transmission after recovery?
Most syntheses and studies included in this review find no evidence of COVID-19 re-infection.

Substance use: opioids

Rapid Review Update 1: What is the effect of the COVID-19 pandemic on substance use, overdoses, and substance-related deaths?
There was no clear pattern of opioid-related overdoses & deaths in Canada during the COVID-19 pandemic, although supply and services are known to be affected during pandemics.

Infection during pregnancy

Rapid Review Update 1: Is there an increased risk of adverse maternal or fetal outcomes in women diagnosed with COVID-19 during pregnancy?
Available evidence shows a high rate of cesarean delivery and a low risk of negative maternal and neonatal outcomes among moms with COVID-19 infection.

Congregate living settings

Rapid Review Update 1: What factors increase the risk of COVID-19 outbreaks in congregate living settings? Do people who contract COVID-19 from outbreaks in congregate living setting have worse outcomes than community-dwelling adults?
There is no direct evidence for specific factors that affect risk of a COVID-19 outbreak in congregate living settings.

Wastewater surveillance

Rapid Review Update 1: What is known about using wastewater surveillance to monitor the COVID-19 pandemic in the community?
Retrospective analyses of wastewater showed that the presence of the virus could be detected before community transmission had been identified.

Impact on families

Rapid Review: What is known about the impact of the pandemic on families with children?
Evidence points to strain on families, especially for female caregivers and children. Women with children experienced reduced working hours and children experienced negative mental health outcomes.

Psychiatric facilities

Rapid Review: What is known about best practices for infection prevention and control in inpatient psychiatric facilities?
There is very little evidence on effective infection control practices specific to inpatient psychiatric facilities and no guidelines informed by research evidence are available.

Substance use: alcohol

Rapid Review: What is the effect of the COVID-19 pandemic on alcohol use, poisonings, and alcohol-related deaths? What strategies have been used to mitigate alcohol abuse during the COVID-19 pandemic?
Global trends in changes to alcohol intake during the pandemic are unclear.

Copper to reduce virus transmission

Rapid Review: What is known about the efficacy and cost-effectiveness of copper materials to reduce transmission of viruses?
This review found no evidence on the efficacy or cost-effectiveness of copper-treated PPE in hospital or public settings to reduce transmission of any viruses.

Cohorting in long-term care

Rapid Review: What is the effectiveness of cohorting virus-positive residents to shared rooms in care facilities?
No research evidence was identified related to the effectiveness of cohorting COVID-19 virus-positive residents to shared rooms in long-term care facilities.

Isolation policies

Rapid Review: Are any other jurisdictions using isolation periods other than 14 days in response to COVID-19? If yes, what is their rate of COVID-19 cases?
Most jurisdictions recommended or required a 14-day quarantine for people exposed or at risk of exposure to COVID-19.

Incubation period

Rapid Review: What is known about the duration from exposure to symptoms or diagnosis for COVID-19?
Precise calculation of the incubation period was more feasible early in the pandemic, when cases were limited and a precise exposure time was known. With widespread community transmission, accurate identification of exposure is challenging.

Reinfection policies

Rapid Review: How have affected jurisdictions handled previously positive cases in the context of re-exposure/re-infection?
Very few jurisdictions have described policy approaches related to previously positive cases who are considered recovered and subsequently test positive.

Serological tests

Rapid Review: What serological tests are available, and what are their sensitivities and specificities?
Many serological tests for the detection of antibodies to the virus that causes COVID-19 are available from different manufacturers. The sensitivity of these tests is highly variable, with estimates ranging 18.4% - 100.0%.


Rapid Review: What is known about stigmatization related to COVID-19 in Canada? Who is experiencing stigma? To what extent is stigma experienced and what is the impact?
No studies conducted in Canada specifically related to stigma were found. Discrimination and stigma associated with COVID-19 infection is a concern for those infected and those with infected family members.

Indigenous communities

Rapid Review: What is known about the impact of the COVID-19 pandemic on Indigenous communities in Canada?
Plans to address the impact of COVID-19 emphasize the importance of collaborative responses that are culturally appropriate and locally sensitive.

Mental health

Rapid Review: How does physical distancing impact mental health?
Outbreaks prior to the COVID-19 pandemic show an association between adverse mental health effects and quarantine.



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