From SARS to pandemic influenza: the framing of high-risk populations

Abstract

The 2003 global outbreak of severe acute respiratory syndrome (SARS) was a wake-up call for health systems in Canada, with realization of occupational health risks faced by health care workers and first responders in public health emergency response. The need for investment in critical social infrastructure-including explicitly articulated plansbecame a priority for managing future pandemics. Over the past 15 years, pandemic planning has evolved with the adoption of a whole-of-society approach to disaster risk reduction. There is recognition of the social gradient of risk, which emerges from the interaction between social determinants of health, risk of exposure, and adverse impacts from a pandemic. Additionally, there is better understanding of the benefits of planning according to functional needs, rather than deficit-oriented labelling. In this paper, we reflect on how the framing of vulnerable or high-risk populations has evolved since SARS. Looking to the future, we present the imperative for the creation of institutional space for engagement of high-risk populations in pandemic planning processes, including participatory governance. Innovative consultation strategies are needed to enhance collective asset literacy and ensure planning is adaptive to the changing social fabric. Progressive pandemic planning in the next decade must be inclusive and sensitive to modern definitions of family, varied abilities, cultural practices and gender and sexual diversity, thereby reflecting a whole-ofsociety approach to disaster risk reduction.

The Functional Impacts of the Covid-19 Pandemic: A Rapid Review

“…Several patient groups are reported to experience poorer overall bodily function outcomes from pandemic coronaviruses, including those who are older; immune-compromised; pregnant; indigenous; people with diabetes, cancer and renal failure; and those experiencing severe symptoms, intensive care unit (ICU) admissions and high dose or prolonged steroid treatment (32,35,40,63,71,72). Patients admitted to ICU are likely to experience post intensive care unit syndrome (62, 69), including neuromuscular, cardiovascular, sensory and mental function complications from prolonged periods of immobilization and prone positioning (64).…”

“…O'Sullivan (72) discussed the important distinction between being 'medically' at risk (which focuses on bodily function) and 'functionally' at risk (which focuses on activity and participation). People experiencing disability, older age, low health literacy, language barriers, homelessness, unemployment, poverty, substance abuse, frailty, and migration or asylum seekers are all identi ed in the reviewed literature as being at signi cant functional risk during pandemics (72,82,84).…”

“…Overcrowded community environments which offer poor housing conditions and limited access to clean water have a particularly negative impact on their residents ability to manage the impacts of pandemics (72). People living in rural and remote areas may also experience additional disadvantage, due to both travel and service restrictions (82).…”

Protocol for a Systematic Review and Meta-analysis of Racial, Ethnic, and Socioeconomic Disparities in COVID-19

“…respectively. Studies will be categorized in quality of good [with the scores of [34][35][36][37][38][39][40][41][42][43][44], moderate [17][18][19][20][21][22][23][24][25][26][27][28][29][30][31][32][33], and poor [0][1][2][3][4][5][6][7][8][9][10][11][12][13][14][15][16].…”

“…This calls for research studies to identify and understand the status of disparities across different population groups [7,12]. Because their speci c SES could in uence the incidence and severity of the disease in a variety of ways [6], low-SES and racial/ethnic minority groups need to be considered as high-risk populations during epidemics of infectious diseases [13].…”