Support for self-isolation is critical in covid-19 response

Çevik, Müge; Baral, Stefan; Crozier, Alex; Cassell, Jackie A

doi:10.1136/bmj.n224

Cited by 39 publications

(33 citation statements)

References 14 publications

(20 reference statements)

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“…(55, 56) These immediate actions continue to challenge the assumption that tackling social determinants can only be addressed in the long-term while passive restrictions to reduce mobility are considered feasible by decision-makers. (57, 58) For example, immediate and actionable measures to control the spread of an infectious disease can still include active, on-the-ground support for infection prevention and control in workplaces and systematically removing barriers to sick leave to support safe, voluntary, and sustainable isolation. (57, 59) Finally, public health agencies and governments can be called upon to actively measure inequities in their COVID-19 response to better understand who their interventions are reaching and who they may be leaving behind.…”

Section: Discussionmentioning

confidence: 99%

Increasing concentration of COVID-19 by socioeconomic determinants and geography in Toronto, Canada: an observational study

Mishra

Moloney

et al. 2021

Preprint

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Background: Inequities in the burden of COVID-19 observed across Canada suggest heterogeneity within community transmission. Objectives: To quantify the magnitude of heterogeneity in the wider community (outside of long-term care homes) in Toronto, Canada and assess how the magnitude in concentration evolved over time (January 21 to November 21, 2020). Design: Retrospective, population-based observational study using surveillance data from Ontario's Case and Contact Management system. Setting: Toronto, Canada. Participants: Laboratory-confirmed cases of COVID-19 (N=33,992). Measurements: We generated epidemic curves by SDOH and crude Lorenz curves by neighbourhoods to visualize inequities in the distribution of COVID-19 cases by social determinants of health (SDOH) and estimated the crude Gini coefficient. We examined the correlation between SDOH using Pearson correlation coefficients. Results: The Gini coefficient of cumulative cases by population size was 0.41 (95% CI: 0.36-0.47) and were estimated for: household income (0.20, 95%CI: 0.14-0.28); visible minority (0.21, 95%CI: 0.16-0.28); recent immigration (0.12, 95%CI: 0.09-0.16); suitable housing (0.21, 95%CI: 0.14-0.30); multi-generational households (0.19, 95%CI: 0.15-0.23); and essential workers (0.28, 95% CI: 0.23-0.34). Most SDOH were highly correlated. Locally acquired cases were concentrated in higher income neighbourhoods in the early phase of the epidemic, and then concentrated in lower income neighbourhoods. Mirroring the trajectory of epidemic curves by income, the Lorenz curve shifted over time from below to above the line of equality with a similar pattern across SDOH. Limitations: Study relied on area-based measures of the SDOH and individual case counts of COVID-19. We cannot infer concentration of cases by specific occupational exposures given limitation to broad occupational categories. Conclusion: COVID-19 is increasingly concentrated by SDOH given socioeconomic inequities and structural racism. Primary Funding Source: Canadian Institutes of Health Research.

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Section: Discussionmentioning

confidence: 99%

Increasing concentration of COVID-19 by socioeconomic determinants and geography in Toronto, Canada: an observational study

Mishra

Moloney

et al. 2021

Preprint

Self Cite

View full text Add to dashboard Cite

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“…The basis for this is the basic public health principle that detection of positive cases on its own is insufficient to disrupt transmission of infection: it must be combined with effective isolation 44 . In the context of COVID-19, the critical importance of ensuring that adequate support is in place to facilitate self-isolation has been repeatedly emphasised [44][45][46] . There is some evidence that adherence to self-isolation is suboptimal, and that practical support and financial reimbursement might improve this 47 .…”

Section: Enabling Isolationmentioning

confidence: 99%

Developing an ethical framework for asymptomatic COVID-19 testing programmes in higher education institutions

Cox¹,

Ansari²,

McLaughlin³

et al. 2021

Wellcome Open Res

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Background: Mass asymptomatic COVID-19 testing programmes are being introduced in a range of settings, including in higher education institutions (HEIs). We aimed to produce an ethical framework to identify the range of ethical considerations relevant to HEI testing programmes and to support organisational decision-making. Methods: We conducted a mixed-method consultation (survey and semi-structured interviews) with students and staff at a case study university that was running a student testing programme. Survey data were analysed descriptively; data analysis for interviews was based on the Framework method. The findings of the consultation were combined with literature review, legal/ethical analysis and expert views to produce an ethical framework. Results: A total of 239 people took part in the consultation: 213 completed surveys (189 students, 24 staff) and 26 (16 students, 7 staff) participated in interviews. The survey identified clear support (99% of survey respondents) for the testing programme. Around two-thirds (62%) supported non-mandatory participation. Over half (54%) felt that the programme would need to be at least moderately effective to be acceptable. Over three-quarters (76%) felt the university had some responsibility to run a testing programme. Synthesis of consultation findings and further analysis identified nine areas of ethical consideration for HEIs looking to implement mass asymptomatic testing programmes: design and operation; goals; properties of the test; enabling isolation; choices about participation; benefits, harms and opportunity costs; responsibilities between students and institutions; privacy, confidentiality and data-sharing; and communication. The ethical framework includes recommendations in each of these areas, with illustrative examples of how they might be put into practice. Conclusions: By identifying ethical considerations relevant to university student testing programmes using analysis and consultation, the framework we developed has potential to facilitate deliberation about ethical aspects of such programmes, as well as informing decision-making about their introduction, design and delivery.

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“…Il sera primordial de bien communiquer les implications et le but des programmes de dépistage. Par ailleurs, il sera important de prévoir des services de soutien additionnels, comme des congés de maladie payés pour les travailleurs et la mise à disposition d'espaces de confinement en cas de résultat positif, pour réduire la résistance au dépistage 22 .…”

Section: Comment Intégrer Les Tests Antigéniques Rapides à La Réponse Des Autorités De Santé Publique Au Canada?unclassified

Le dépistage des personnes asymptomatiques au moyen de tests antigéniques rapides: un outil de santé publique pour lutter contre la COVID-19

Schwartz

McGeer

Bogoch

2021

CMAJ

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Support for self-isolation is critical in covid-19 response

Abstract: Government action needed now to reduce infections and deaths

Cited by 39 publications

References 14 publications

Increasing concentration of COVID-19 by socioeconomic determinants and geography in Toronto, Canada: an observational study

Increasing concentration of COVID-19 by socioeconomic determinants and geography in Toronto, Canada: an observational study

Developing an ethical framework for asymptomatic COVID-19 testing programmes in higher education institutions

Le dépistage des personnes asymptomatiques au moyen de tests antigéniques rapides: un outil de santé publique pour lutter contre la COVID-19

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