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Jurisdictional Scan and Cross-Country Comparison, May 19-28, 2021

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Jurisdictional Scan and Cross-Country Comparison, May 19-28, 2021 Provincial COVID-19 guidance in Canada: a jurisdictional scan and cross-country comparison, May 19-28, 2021 Rapid Jurisdictional Scan Date of Literature Search: 5/19-28/2021 Date of Submission: 6/4/2021 Prepared By: Boulos, L; Curran, J; Dol, J; Somerville, M; McCulloch, H Contact: Boulos, L Email: [email protected] Funding Acknowledgement(s) The SPOR Evidence Alliance (SPOR EA) is supported by the Canadian Institutes of Health Research (CIHR) under the Strategy for Patient-Oriented Research (SPOR) initiative. COVID-19 Evidence Network to support Decision-making (COVID-END) is supported by the Canadian Institutes of Health Research (CIHR) through the Canadian 2019 Novel Coronavirus (COVID-19) Rapid Research Funding opportunity. Project Contributors Leah Boulos, Maritime SPOR SUPPORT Unit, Evidence Synthesis Coordinator Janet Curran, Dalhousie University, Co-Investigator Justine Dol, Dalhousie University, Research Coordinator Mari Somerville, Dalhousie University, Postdoctoral Fellow Holly McCulloch, IWK Health Centre, Project Administrator Catie Johnson, Dalhousie University, Research Assistant Danielle Shin, Dalhousie University, Research Assistant Daniel Crowther, Dalhousie University, Research Assistant Allyson Gallant, Dalhousie University, Research Assistant Bearach Reynolds, Mb BCh BAO BA MRCPI, ESI Fellow Lynora Saxinger, University of Alberta, Knowledge User Alexander Doroshenko, University of Alberta, Knowledge User Stephanie Hastings, Alberta Health Services, Knowledge User Third-Party Materials If you wish to reuse non-textual material from this report that is attributed to a third party, such as tables, figures or images, it is your responsibility to determine whether permission is required for such use and to obtain necessary permission from the copyright holder. The risk of claims resulting from infringement of any third-party-owned material rests solely with the user. Provincial COVID-19 guidance in Canada: a jurisdictional scan and cross-country comparison, May 19-28, 2021 2 General Disclaimer This report was prepared by Nova Scotia COVID-END Evidence Synthesis Group on behalf of the SPOR Evidence Alliance and COVID-END. It was developed through the analysis, interpretation and synthesis of scientific research and/or health technology assessments published in peer-reviewed journals, institutional websites and other distribution channels. It also incorporates selected information provided by experts and patient partners with lived experience on the subject matter. This document may not fully reflect all the scientific evidence available at the time this report was prepared. Other relevant scientific findings may have been reported since completion of this synthesis report. SPOR Evidence Alliance, COVID-END and the project team make no warranty, express or implied, nor assume any legal liability or responsibility for the accuracy, completeness, or usefulness of any information, data, product, or process disclosed in this report. Conclusions drawn from, or actions undertaken on the basis of, information included in this report are the sole responsibility of the user. Acknowledgments Thank you to Patrick Archambault, Lola Gushue, and Jessica Harris for providing additional documentation to inform the health systems arrangement section of this report. Provincial COVID-19 guidance in Canada: a jurisdictional scan and cross-country comparison, May 19-28, 2021 3 Table of Contents Abbreviations .................................................................................................................. 5 Introduction ..................................................................................................................... 6 Methods .......................................................................................................................... 7 Results ............................................................................................................................ 7 Public Health Measures ............................................................................................. 11 Health Systems Arrangements .................................................................................. 41 Discussion ..................................................................................................................... 46 Limitations ................................................................................................................. 46 Conclusion .................................................................................................................... 47 References .................................................................................................................... 48 Provincial COVID-19 guidance in Canada: a jurisdictional scan and cross-country comparison, May 19-28, 2021 4 Abbreviations AB: Alberta BC: British Columbia MB: Manitoba NB: New Brunswick NL: Newfoundland and Labrador NS: Nova Scotia NT: Northwest Territories NU: Nunavut ON: Ontario PE: Prince Edward Island PPE: personal protective equipment QC: Quebec SK: Saskatchewan YT: Yukon VOC: variant of concern Provincial COVID-19 guidance in Canada: a jurisdictional scan and cross-country comparison, May 19-28, 2021 5 Introduction The COVID-19 pandemic has been a global phenomenon and its effects have been far- reaching. Canadians' experiences of the pandemic, however, have been very different depending on the provinces or territories in which they live. Although federal guidance has been recommended throughout the pandemic by the Public Health Agency of Canada, ultimately each province and territory has been responsible for issuing guidance to their own residents. As a result, the Canadian pandemic landscape has been governed by a patchwork quilt of policies that may or may not be influenced by decisions made in other provinces. An additional complication to creating COVID-19 guidance came with the emergence of the SARS-CoV-2 variants of concern (VOC) in late 2020 and early 2021. Three VOC— Alpha (B.1.1.7, UK variant), Beta (B.1.351, South Africa variant), and Gamma (P.1, Brazil variant)—were identified in late 2020, and an additional VOC, Delta (B.1.617, Indian variant) was identified in May 2021. VOC can potentially cause changes in transmissibility, clinical presentation, and severity, and they may have an impact on countermeasures. The purpose of this cross-country jurisdictional scan was to provide a snapshot of Canadian provincial and territorial guidance as it existed at the end of May 2021. The scan retrieved publicly available government and health authority guidance documents related to public health measures, including those that had potentially changed as a result of VOC, such as vaccination approaches, reopening plans, infection control guidance, self-isolation and quarantine requirements, testing requirements, household bubbles, school closures, and provincial or territorial border restrictions. Additionally, it retrieved guidance documents related to health systems arrangements that had potentially changed as a result of VOC such as staff and visitor personal protective equipment (PPE) requirements, other infection control measures in acute care settings, and cohorting guidelines. This jurisdictional scan is a companion document to our team's rapid scoping review, Public Health and Health Systems Impacts of SARS-CoV-2 Variants of Concern,1 which is available through COVID-END and the SPOR Evidence Alliance. Provincial COVID-19 guidance in Canada: a jurisdictional scan and cross-country comparison, May 19-28, 2021 6 Methods Provincial and territorial guidance documents were retrieved beginning on May 19, 2021 by running a series of targeted Google searches of government and health authority websites using the search engine's site: advanced search function. Searches were designed and overseen by an experienced information specialist (LB). The following four searches were executed for each province and territory, with a site: command added for each website of interest: covid-19 variants covid-19 restrictions covid-19 guidance covid-19 public health For example, a full search string of the Government of Saskatchewan's website was run as follows: covid-19 variants site: https://www.saskatchewan.ca/. Included resources were limited to documents or webpages produced by governments, health authorities, or other central health organizations. Only the most recent guidance documents at the time of the search were included. The title, author organization, URL, date last updated, and access date were recorded for all relevant resources using Excel. The resources were then used to populate the tables included in this report. To keep the results as up to date as possible, additional resources were added up to and including May 28, 2021. To provide additional context for the guidelines, visual representations of the rate of active cases per 100,000 population since January 31, 2020 were taken from the Public Health Agency of Canada’s Public Health Infobase on May 31, 2021. Results 182 provincial and territorial guidance documents are referenced in this report. Most are government documents, and some have been issued by health authorities and other provincial health organizations. Figure 1 is a composite of 14 graphs, one for all of Canada and one for each of the provinces and territories, released by the Public Health Agency of Canada’s Public Provincial COVID-19 guidance in Canada: a jurisdictional scan and cross-country comparison, May 19-28, 2021 7 Health Infobase.2 The
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