Mueller, M; Howell-Spooner, B. How are other jurisdictions distributing COVID-19 vaccines in non-healthcare worker environments and what is the rationale for those distribution models? 2021 Jan 15; Document no.: PH011401-01 ESR. In: COVID-19 Rapid Evidence Reviews [Internet]. SK: SK COVID Evidence Support Team, c2020. 15 p. (CEST evidence search report).
· Recommended to use existing vaccination structures and delivery services as much as possible for distribution of the COVID-19 vaccines
· Important to consider cold-chain requirements when developing distribution plans
· Should consider alternate locations for hard-to-reach populations that are easily accessible and familiar
· Consider branching out to mobile vaccination (e.g. home visits, door-to-door), pharmacies, workplaces, congregate living facilities, walk-up/drive-through mechanisms for vaccine delivery
Badea, A; Groot, G; Mueller, M; Howell-Spooner, B. How are other jurisdictions distributing COVID-19 vaccines in non-healthcare worker environments and what is the rationale for those distribution models? 2021 Jan 19; Document no.: PH011401 RR. In: COVID-19 Rapid Evidence Reviews [Internet]. SK: SK COVID Evidence Support Team, c2020. 17 p. (CEST rapid review report)
Miller, L; Howell-Spooner, B. What are the vaccination strategies for vulnerable populations? 2021 Mar 04; Document no.: PH030401-01 ESR. In: COVID-19 Rapid Evidence Reviews [Internet]. SK: SK COVID Evidence Support Team, c2020. 33 p. (CEST evidence search report)
Vulnerable populations such as those experiencing homelessness are 20 times more likely to be hospitalised due to COVID-19, 10 times more likely to require intensive care for COVID-19 and 5 times more likely to die within 21 days of a positive test for COVID-19
Many organizations advocate for socially vulnerable populations to be considered priority populations due to their oftencomplex health needs and inability to fully execute best practices for infection prevention and control
Past experiences from Hepatitis vaccination (requiring 3 injections) and H1N1 pandemic influenza vaccination indicate that partnering with community organizations to provide vaccinations in shelters, community centers and other frequently accessed places along with education and access to known, trusted healthcare providers greatly increase the uptake of vaccination among socially vulnerable populations
Beyond sheltered populations experiencing homelessness, considerations for equitable vaccination programs for the general population should include plans for accessibility for all, including underserved geographic regions
Badea, A; Reeder, B; Hanson, L; Miller, L; Howell-Spooner, B. What are the vaccination strategies for vulnerable populations? 2021 Mar 12; Document no.: PH030401 RR. In: COVID-19 Rapid Evidence Reviews [Internet]. SK: SK COVID Evidence Support Team, c2020. 33 p. (CEST rapid review report)
Dalidowicz, M; Mueller, M. What is the sensitivity and specificity of screening checklists and temperature checks for detecting the presence of COVID-19 in individuals? 2020 Apr 27; Document no.: PH042401-01 ESR. In: COVID-19 Rapid Evidence Reviews [Internet]. SK: SK COVID Evidence Support Team, c2020. 12 p. (CEST evidence search report)
Screening tools commonly include fever, respiratory symptoms (cough, shortness of breath), and epidemiological risk factors.
· The sensitivity and specificity of screening questionnaires depends considerably on the items used in the questionnaire. The limited published literature demonstrates great variability in the performance of different screening tools: sensitivity ranges from 0 – 48.6 – 84.3 – 100%; specificity ranges from 64.8 – 71.3 – 89.6 – 96%).
· The standard WHO symptom checklist performs poorly, with a sensitivity of 48.6%, and specificity of 89.6%. As such, half of individuals who have SARS-CoV-2 present at the time of testing will be missed by the symptom questionnaire (being either asymptomatic or presymptomatic). Depending on the population being screened the prevalence of the virus may vary widely. Given the sensitivity and specificity of the WHO symptom checklist in a population with prevalence ranging from 0.1% to 1% to 10% the positive predictive value (PPV) will be poor, range from 0.4% to 4.8% to 35%, respectively. Furthermore, the performance characteristics of the screening questionnaire may be poorer than reported if used in a setting or time of year when other respiratory viruses with similar symptoms are circulating.
Fick, F; Neudorf, C; Reeder, B; Dalidowicz, M; Mueller, M. What is the sensitivity and specificity of screening checklists and temperature checks for detecting the presence of COVID-19 in individuals? 2020 Apr 28; Document no.: PH042401 RR. In:
COVID-19 Rapid Evidence Reviews [Internet]. SK: SK COVID Evidence Support Team, c2020. 20 p. (CEST rapid review report)
Miller, L; Howell-Spooner, B. What public health interventions are effective in reducing the burden of COVID-19 disease in comparable jurisdictions to Saskatchewan? 2020 Nov 13; Document no.: PH111001-01 ESR. In: COVID-19 Rapid Evidence Reviews [Internet]. SK: SK COVID Evidence Support Team, c2020. 25 p. (CEST evidence search report)
A recent comprehensive examination of international experience [17] provides a hierarchy of effectiveness of public health interventions. The most effective interventions, as measured by the change in the effective reproduction number (Rt), include the cancellation of small and mass gatherings, closure of educational institutions, border restrictions, lockdowns, restrictions on individual movement, and increased availability and use of PPE such as face masks. Less effective are testing restrictions, public transportation restrictions, airport health checks, and environmental cleaning and disinfection (Figure 1).
Shelter-in-place, lockdown, and curfew orders have a substantial impact on the burden of COVID-19, having reduced Rt from 6.9 to 0.8 over the course of a month in Spain, for example. In an international comparison, stay-at-home orders reduced the percent daily increase in new cases from baseline from 26.9% at baseline to 20.3%, 12.8%, 7.3% at 7, 14, 21 days, respectively.
Closure of schools and workplaces are associated with a modest reduction in the incidence of COVID-19, in the order of 13%.
Travel restrictions lead to a moderate reduction COVID-19 disease burden. A study of 13 European countries found that voluntary reduced mobility occurring prior to government policies decreased the percent change in deaths per day by 9.2%, whereas subsequent government closure policies decreased deaths per day by 14.0%.
An extensive systematic review of SARS, MERS, and SARS-CoV-2 demonstrates that physical distancing of 1 m is associated with a relative risk (RR) of disease transmission = 0.18. The RR decreases two-fold for each additional m increase in distance.
A ban on public gatherings reduces COVID-19 transmission; however, evidence supporting specific gathering size limits is weak. In Germany, gathering restrictions and voluntary behaviour changes had the single greatest effect on the epidemic, reducing Rt by 9.7% per day and the growth rate from 30 to 12% within 2 weeks. Findings from the UK lockdown indicate that the average daily number of contacts decreased from 10.8 before to 2.8 after the lockdown. This was associated with a decrease in Rt from 2.6 to 0.62.
In a systematic review and in modelling studies, mask use by the public is estimated to reduce COVID-19 incidence and deaths by 38% and 47%, respectively.
McCarron, M; Karreman, E; Okpalauwaekwe, U; Henderson, R; Reeder, B; Muhajarine, N; Neudorf, C; Groot, G; Miller, L; Howell-Spooner, B. Which public health interventions are (most) effective in reducing the burden of COVID-19 disease in predominately OECD countries? 2021 Jan 11; Document no.: PH111001 RR. In: COVID-19 Rapid Evidence Reviews [Internet]. SK: SK COVID Evidence Support Team, c2020. 54 p. (CEST rapid review report)
