Abstract

Abstract

Abstract

Background

Climate change (CC) adaptation is considered a priority for Caribbean Small Islands Developing States (SIDS), as these territories and communities are considered particularly vulnerable to climate-related events. The primary health care (PHC) system is an important actor in contributing to climate change adaptation. However, knowledge on how PHC is prepared for CC in Caribbean SIDS is very limited. The objective of this paper is to discuss health adaptation to climate change focusing on the PHC system.

Methods

We explored the perspectives of PHC professionals in Dominica on climate change. Focus group discussions (FGDs) were conducted in each of the seven health districts in Dominica, a Caribbean SIDS, between November 2021 and January 2022. The semi-structured interview guide was based on the Essential Public Health Functions: assessment, access to health care services, policy development and resource allocation. Data coding was organized accordingly.

Results

Findings suggest that health care providers perceive climate change as contributing to an increase in NCDs and mental health problems. Climate-related events create barriers to care and exacerbate the chronic deficiencies within the health system, especially in the absence of high-level policy support. Healthcare providers need to take a holistic view of health and act accordingly in terms of disease prevention and health promotion, epidemiological surveillance, and ensuring the widest possible access to health care, with a particular focus on the ecological and social determinants of vulnerability.

Conclusion

The Primary Health Care system should be a key actor in designing and operationalizing adaptation and transformative resilience. The Essential Public Health Functions should integrate social and climate and ecological determinants of health to guide primary care activities to protect the health of communities. This indicates a need for improved research on the linkages between climate events and health outcomes, surveillance, and development of plans that are guided by contextual knowledge in the SIDS.

Background

Refugees, asylum seekers, and migrants without status experience precarious living and working conditions that disproportionately expose them to coronavirus disease 2019 (COVID-19). In the two most populous Canadian provinces (Quebec and Ontario), to reduce the vulnerability factors experienced by the most marginalized migrants, the public and community sectors engage in joint coordination efforts called intersectoral collaboration. This collaboration ensures holistic care provisioning, inclusive of psychosocial support, assistance to address food security, and educational and employment assistance. This research project explores how community and public sectors collaborated on intersectoral initiatives during the COVID-19 pandemic to support refugees, asylum seekers, and migrants without status in the cities of Montreal, Sherbrooke, and Toronto, and generates lessons for a sustainable response to the heterogeneous needs of these migrants.

Nos membres Naïma Bentayeb et Lara Gautier sont les responsables du dernier numéro de la revue Alterstice sous le thème “Expérience des réfugiés, demandeurs d’asile et migrants sans statut et offre de services de santé et sociaux pendant la pandémie au Québec”. 

Plusieurs autres membres de SHERPA ont contribué à ce numéro dont Janet Cleveland, Jill Hanley, Patrick Cloos, Mélanie M. Gagnon et  Andréanne Dufour, membre de notre équipe.

Abstract

The COVID-19 pandemic highlighted the impact of social inequalities in health (SIH). Various studies have shown significant inequalities in mortality and morbidity associated with COVID-19 and the influence of social determinants of health. The objective of this qualitative case study was to analyze the consideration of SIH in the design of two key COVID-19 prevention and control interventions in France: testing and contact tracing. Interviews were conducted with 36 key informants involved in the design of the intervention and/or the government response to the pandemic as well as relevant documents (n = 15) were reviewed. We applied data triangulation and a hybrid deductive and inductive analysis to analyze the data. Findings revealed the divergent understandings and perspectives about SIH, as well as the challenges associated with consideration for these at the beginning stages of the pandemic. Despite a shared concern for SIH between the participants, an epidemiological frame of reference dominated the design of the intervention. It resulted in a model in which consideration for SIH appeared as a complement, with a clinical goal of the intervention: breaking the chain of COVID-19 transmission. Although the COVID-19 health crisis highlighted the importance of SIH, it did not appear to be an opportunity to further their consideration in response efforts. This article provides original insights into consideration for SIH in the design of testing and contact-tracing interventions based upon a qualitative investigation.

Dès le début de la pandémie de COVID-19, des études, principalement quantitatives, ont mis en lumière les bouleversements importants vécus par les enfants, adolescent.e.s et leurs familles. En effet, les mesures sanitaires instaurées pour contrer la pandémie (ex.: fermeture des écoles et des services de garde éducatifs) ont transformé le quotidien des jeunes et perturbé le fonctionnement de presque tous les systèmes (ex. : soins de santé, éducation) qui permettent d’assurer le bien-être des individus) (Ellis et al., 2020; Gayatri et Irawaty, 2021; Jiao et al., 2020; O’Reilly et al., 2020; Prime, Wade et Browne, 2020). Si les parents, les chercheur.e.s, les intervenant.e.s et les décideur.e.s sont inquiets des impacts de la pandémie sur les jeunes, on ignore si les jeunes sont aussi inquiets pour eux. elles-mêmes. Normal, puisque peu d’études ont questionné les enfants et les adolescent.e.s sur leurs perceptions des impacts de la pandémie.

Ce rapport technique documente les résultats d’une enquête menée en 2022 auprès du personnel de première ligne des organismes membres de la TCRI, la Table de concertation des organismes au service des personnes réfugiées et immigrantes. Un sondage auprès des gestionnaires fait l’objet d’un rapport distinct. Le sondage a été réalisé en collaboration avec OCASI, l’Ontario Council of Agencies Serving Immigrants, et la TCRI par le biais de Building Migrant Resilience in Cities/ Immigration et résilience en milieu urbain (BMRC-IRMU), un partenariat financé par le Conseil de recherches en sciences humaines (CRSH). Un groupe de travail sur les services d’accueil des nouveaux arrivants composé de membres de la communauté et d’universitaires du BMRC-IRMU ont aidé à orienter la recherche. L’instrument de sondage a été approuvé par le Comité d’examen des participants humains de l’Université York. Du point de vue des travailleurs de première ligne, le sondage examine les impacts de la COVID-19 sur eux, les clients et les organismes québécois au cours de la période de douze mois suivant la première vague de la pandémie. De nombreuses questions sont similaires à un sondage antérieur mené par OCASI et portant sur la première vague de la pandémie.

Accumulation of diverse mutations across the structural and nonstructural genes is leading to rapid evolution of SARS-CoV-2, altering its pathogenicity. We performed whole genome sequencing of 239 SARS-CoV-2 RNA samples collected from both adult and pediatric patients across eastern India (West Bengal), during the second pandemic wave in India (April–May 2021). In addition to several common spike mutations within the Delta variant, a unique constellation of eight co-appearing non-Spike mutations was identified, which revealed a high degree of positive mutual correlation. Our results also demonstrated the dynamics of SARS-CoV-2 variants among unvaccinated pediatric patients. 41.4% of our studied Delta strains harbored this signature set of eight co-appearing non-Spike mutations and phylogenetically out-clustered other Delta sub-lineages like 21J, 21A, or 21I. This is the first report from eastern India that portrayed a landscape of co-appearing mutations in the non-Spike proteins, which might have led to the evolution of a distinct Delta subcluster. Accumulation of such mutations in SARS-CoV-2 may lead to the emergence of “vaccine-evading variants.” Hence, monitoring of such non-Spike mutations will be significant in the formulation of any future vaccines against those SARS-CoV-2 variants that might evade the current vaccine-induced immunity, among both the pediatric and adult populations.

In the fight against infectious diseases, social inequalities in health (SIH) are generally forgotten. Mali, already weakened by security and political unrest, has not been spared by the COVID-19 pandemic. Although the country was unprepared, the authorities were quick to implement public health measures, including a SARS-CoV-2 testing programme. This study aimed to understand if and how social inequalities in health were addressed in the design and planning for the national COVID-19 testing policy in Mali. A qualitative survey was conducted between March and April 2021 in Bamako, the capital of Mali. A total of 26 interviews were conducted with key government actors and national and international partners. A document review of national reports and policy documents complemented this data collection. The results demonstrated that the concept of SIH was unclear to the participants and was not a priority. The authorities focused on a symptom-based testing strategy that was publicly available. Participants also mentioned some efforts to reduce inequalities across geographical territories. The reflection and consideration of SIH within COVID-19 interventions was difficult given the governance approach to response efforts. The urgency of the situation, the perceptions of COVID-19 and the country’s pre-existing fragility were factors limiting this reflection. Over time, little action has been taken to adapt to the specific needs of certain groups in the Malian population. This study (re)highlights the need to consider SIH in the planning stages of a public health intervention, to adapt its implementation and to limit the negative impact on SIH.

La pandémie de maladie à coronavirus 2019 (COVID-19) a exacerbé les inégalités sociales dans les aspects ethniques, raciaux et socio-économiques, avec d’importantes conséquences nocives pour les enfants. En s’appuyant sur les leçons tirées des initiatives communautaires, le présent commentaire propose une réflexion sur les défis de l’équité, de la diversité et de l’inclusion qui sont intégrés dans les campagnes de vaccination des enfants dans un contexte d’urgence. Nous sommes d’avis que la mise en place de pratiques équitables et inclusives liées à la vaccination des enfants des communautés marginalisées est un défi à multiples facettes. Au-delà des bonnes intentions (vouloir protéger les enfants), les risques et les avantages associés à la mise en évidence de la diversité dans chaque intervention doivent être soigneusement examinés, surtout en ce qui concerne une procédure contestée ou polarisée, comme la vaccination avec un nouveau type de vaccin. Souvent, une approche unique réfute et perpétue les inégalités structurelles. Dans d’autres cas, la mise en évidence de la diversité et des inégalités peut par inadvertance accroître la stigmatisation et la discrimination, et nuire davantage ou infantiliser les collectivités ciblées. En offrant des perspectives multiples, une approche transdisciplinaire peut appuyer la prise de décision dans un contexte de crise.

Mots-clés : santé et médecine des adolescents, services de santé communautaires, santé des minorités, équité et inclusion

The health context surrounding the COVID-19 pandemic has led to significant individual and social upheaval, which has also affected traditional teaching methods. Art therapy training was not spared, notably at the Université du Québec en Abitibi-Témiscamingue (UQAT). UQAT adopts an experiential teaching approach that engages students in a process that promotes the optimal acquisition of the skills inherent to the ethical exercise of the profession, allowing them to take the position of art therapist, in contact with their peers, while emotionally integrating the learning achieved. As the pandemic context forced a rapid shift to distance learning, the authors wanted to put into perspective the potential effects of virtual art therapy teaching on the development of female art therapy students’ sense of self-efficacy (SSE). To do this, they base their reflection on the results of surveys conducted among students and graduates as part of the evaluation of the master’s program in art therapy. Since experiential distance learning implies limitations in terms of emotional experience and actual contact with peers, it is justified to question the effects that these changes will have on trainees’ SSE.

Abstract Objectives Intimate partner violence and sexual violence organizations such as women’s shelters play a crucial role in advancing gender equality in Canada. COVID-19 has challenged how suchorganizations operate. This study explored how intimate partner violence and sexual violence organizations in Canada have been affected by COVID-19 and the consequences on service delivery. Methods We interviewed 17 frontline and management staff from intimate partner violence and sexual violence organizations and programs across Canada, and analyzed the data using thematic analysis and applying a feminist political economy lens. Results We identified the following themes: (1) Adapting; (2) Struggling financially; (3) Resourcefulness; (4) Troubles connecting; (5) Narrowing scope of work; and (6) Burden of care. Conclusion A feminist political economy framework considers the gendered impact of the pandemic and related measures on the workforce. Both the pandemic and measures to control it have affected intimate partner violence and sexual violence organizations in Canada, the staff working in these organizations, and the quality of relationships between staff and clients. Intimate partner and sexual violence organizations in Canada have been chronically underfunded and their predominantly female staff underpaid, affecting their ability to meet the needs of women. The onset of COVID-19 not only worsened these issues but converged witha shift infocus tomorepandemic-relatedtasks,further limiting the scope and reach of organizations. Whether the adaptations, innovations, and perseverance demonstrated by such organizations and staff can tip the balance in favour of more equitable policy and outcomes remains to be seen.

Cadre de la recherche : La pandémie bouleverse le quotidien des familles depuis plus d’un an. En plus des craintes et des incertitudes liées au virus de la COVID-19, la pandémie a exigé de redéfinir plusieurs routines du quotidien, dont les activités et loisirs, l’accès aux services, le travail, la scolarisation et les relations interpersonnelles. Les enfants, peu susceptibles d’avoir la COVID-19, ont néanmoins vécu les contrecoups des mesures sociosanitaires mises en place pour y faire face.

Objectifs : En se basant sur l’approche centrée sur l’enfant, cet article cherche à comprendre de quelle façon la pandémie de la COVID-19 et les mesures sociosanitaires qui en ont découlées ont bouleversé la vie des familles, principalement la relation grands-parents/petits-enfants.

Méthodologie : Cette étude utilise un devis qualitatif longitudinal en trois temps de mesure en fonction des différents moments clés de la pandémie. Au total, 154 enfants et adolescents ont été rencontrés à trois reprises dans le cadre d’entrevues semi-dirigées via Zoom.

Résultats : Les résultats mettent en lumière les façons dont les petits-enfants et les grands-parents ont su s’adapter pour maintenir leur relation pendant la pandémie. Cette étude nous permet de constater que les petits-enfants s’inquiètent de la santé de leurs grands-parents, mais qu’ils souhaitent quand même avoir des contacts en personne avec eux, malgré les risques.

Conclusions : La relation entre les petits-enfants et leurs grands-parents est une relation affective et durable qui perdure et s’adapte en temps de crise.

Contribution : Cet article rend compte de l’importance des grands-parents dans la vie de leurs petits-enfants, et ce particulièrement en temps de crise. Il permet aussi de mieux comprendre comment les familles ont su s’adapter pendant la pandémie.

L’étude Réactions a pour but de comprendre de façon longitudinale l’expérience des enfants et adolescents d’âge scolaire de la pandémie de la COVID19 ainsi que ses effets sur eux-mêmes et leurs parents. Démarrée dès les premières semaines de la pandémie, l’étude repose sur un devis mixte longitudinal. Quatre temps de mesure combinant des méthodes qualitatives et quantitatives ont permis de rejoindre plus de 600 participants (enfants, adolescents et parents) lors de moments charnières de la pandémie : pendant le 1er confinement (avril-mai 2020), lors du déconfinement de l’été 2020, pendant la 2e vague (novembre 2020) et lors de la 3e vague de la pandémie (mai 2021).
Ce rapport final vise à rendre compte des principaux résultats de l’étude. Deux angles ont été ciblés pour le présent rapport, soit l’évolution du fonctionnement individuel, familial et social des participants au fil du temps, ainsi que les impacts globaux de la pandémie tels que perçus par les jeunes.
Ce rapport contient quatre sections. Le contexte de l’étude ainsi que l’état des connaissances actuelles sur l’expérience des familles de la pandémie seront d’abord brièvement
présentés. La deuxième section rappelle les balises méthodologiques de l’étude, qui sont détaillées dans les rapports précédents. La troisième section présente les résultats et décrit l’évolution du fonctionnement individuel, familial et social des familles pendant la première année de la pandémie ainsi que les retombées de individuelles, collectives et sur l’avenir de la pandémie selon les jeunes rencontrés. Finalement, la dernière section discute des résultats et formule certaines recommandations pour soutenir les familles en contexte de pandémie.

Purpose: The COVID-19 pandemic may increase risk of intimate partner and sexual violence and make relevant services less accessible. This study explored the perspectives of intimate partner and sexual violence workers across Canada on how the COVID-19 pandemic has affected the survivors with whom they work.

Methods: Using a qualitative descriptive design, we interviewed 17 management and frontline staff of organizations supporting survivors of intimate partner and sexual violence across Canada. Results: We identified 4 themes that describe the impacts of COVID-19 on IPV and SV survivors, from the perspective of service providers: 1) No escape; 2) Isolation; 3) Tough decisions; and 4) Heightened vulnerability. These narrative findings are presented first, followed by an analysis within a social determinants of health framework. Interpreting our findings against such a framework revealed a complex interplay of social determinants, notably social support, access to services, and poverty, that produced several challenges for IPV and SV survivors during COVID-19

Conclusion:  According to service providers, IPV and SV survivors in Canada faced several challenges during the pandemic, including reduced ability to escape their situations, increased isolation, increasingly complex decisions, and heightened vulnerability. Our findings demonstrate the critical need to adopt a broader, more holistic approach in tackling IPV and SV by also addressing socioeconomic issues such as poverty and marginalization. 

Purpose

Social adversity experiences have increased during the pandemic and are potential risk factors for both depression and support for violent radicalization (VR). However, the cumulative and independent effects of various social adversity experiences on support for VR have yet to be explored. This paper examines the cumulative and independent effects of COVID- and non-COVID-related discrimination, exposure to violence, traditional and cyberbullying victimization on support for VR. In addition, we investigate whether depression mediates the relationship between these forms of social adversity and support for VR.

Methods

A total of 6003 young adults (M_age = 27, SD_age = 4.40, range 18–35) living in metropolitan areas in Canada responded to an online survey. We used multivariable regression models, controlling for socio-demographic characteristics, to infer covariate adjusted associations between social adversity measures and support for VR. Additionally, we conducted a formal mediation analysis to estimate the proportion mediated by depression.

Results

There was a cumulative relationship between experiences of social adversity and support for VR (β = 1.52; 95% CI: 1.32, 1.72). COVID-related discrimination and cyberbullying victimization were independently associated with stronger support for VR. Depression partially mediated the effect of cumulative social adversity, COVID-related discrimination and cyberbullying on support for VR.

Conclusion

Prevention programs during the present pandemic should prioritize decreasing discrimination and providing psychosocial support to depressed young adults who experience social adversity. Practitioners should prioritize developing programs that foster digital literacy skills and critical thinking among young adults to address the concerning impact of cyberbullying on support for VR.

Unaccompanied minors (UMs) are children under the age of 18 who settle in a foreign country without a legal representative. In France, many UMs are left unprotected from child welfare services because assessment systems evaluate that they are not minors. In Paris, the non-governmental organization Médecins du Monde (MdM) offers unprotected UMs medical, psychological, and social care. In March 2020, the lockdown policy to contain COVID-19 constrained MdM to adapt its care provision model. This case study sought to answer the following question: how did volunteers and employees of MdM respond to the social and health needs of unprotected UMs during the spring 2020 lockdown in Paris? We analyzed a cohort of 58 UMs for eight weeks of lockdown using secondary quantitative data. We further explored the UMs’ needs and the experience of phone consultations, through 15 interviews with MdM’s program volunteers and employees. Time series showed a steady increase in UMs’ needs. The program’s adapted care provision likely contributed to reducing UMs’ feeling of isolation. It also had several negative consequences for unprotected UMs, volunteers, employees, and Médecins du Monde’s institution. This study highlights the role of non-governmental organizations in providing a particularly vulnerable migrant population – unprotected UMs – care and support, despite operational challenges in crisis times.

Information is needed on the relationship between coronavirus disease (COVID-19) social distancing restrictions and their relationship with mental health. In particular, there is limited investigation into how COVID-related adversities have positively mobilized individuals. We use latent class analysis (LCA) to identify subtypes of positive and negative aspects of the experience of COVID-19 social distancing and the association of these subtypes with mental health. We conduct an online survey of COVID-19 and mental health with 3,183 adults residing in Quebec, Canada, during the first wave of the epidemic. We use LCA to identify subtypes of positive and negative aspects of social distancing. We use logistic and linear regression to estimate the associations between class membership and self-reported impact of COVID-19 on mental health and scores on the Hopkins Symptom Checklist-10 (HSCL-10). We identify five classes of individuals in regards to perceived positives and negatives of social distancing related to COVID-19, named Low Impact, Freedom/Flexibility, Safety, Family/Home, and Hardships. Sociodemographic variables including age, gender, race/ethnicity, and self-reported mental health prior to COVID are associated with class assignment. Latent classes are associated with both outcomes (p < .001). Individuals in the Hardships class have greater odds of reporting a significant impact of COVID-19 on mental health, OR = 2.09, 95% CI = [1.53, 2.86], p < .001, and have higher scores on the HSCL-10, β = .32, 95% CI = [.23, .42], p < .001, than those individuals in the Low Impact group after adjusting for sociodemographic characteristics. Gender, age, and self-reported mental health prior to COVID-19 are independently associated with both outcomes (p < .001). We discuss study implications for public health programming and interventions to promote the mental health of at-risk populations during the pandemic. (PsycInfo Database Record (c) 2021 APA, all rights reserved)

Ce chapitre s’attarde à la manière dont certains enfants, adolescents et parents du Québec ont vécu le confinement et les différentes mesures sociosanitaires misent en place au cours des premiers mois de la pandémie de la COVID-19. Ces expériences serviront à illustrer comment se manifeste ce que plusieurs appellent la vulnérabilité ordinaire.

Abstract

Introduction: As elsewhere in the world, Quebec (Canada) is currently facing the COVID-19 pandemic. Approximately 92% of deaths have occurred among people aged over 70, and approximately 100 long-term care (LTC) centers (termed CHSLDs in Quebec) were contaminated. This alarming situation is prompting stakeholders from healthcare networks to investigate the socio-economic repercussions of COVID-19. To the best of our knowledge, there is no valid and reliable tool to measure the costs associated with the management of COVID-19 in CHSLDs. Objectives: This research protocol aims to: i) adapt and validate for use in CHSLDs a combined guide, Cout-COVID19-SLD, developed from 2 guides used in acute care; ii) pilot the Cout-COVID19-SLD guide in CHSLDs and test its feasibility and afterwards resolve any barriers to its administration, and to conduct a partial estimate of costs brought about by COVID-19. Methods: A two-part prospective study will be conducted. Phase 1 will use a Delphi approach with 14 to 17 experts to validate the content of the Cout-COVID19-SLD guide. Phase 2 will pilot test the guide in a cross-sectional study in two CHSLDs. Discussion and conclusion: This study will provide a validated guide for the systematic measurement of costs associated with the management of COVID-19 (costs of preventive measures and costs of illness) in CHSLDs. Finally, this guide will serve as a valid and reliable instrument with which to better plan future research surrounding the socio-economic impacts of COVID-19 in CHSLDs.

Purpose:
The objective of this study is to identify the relationship between COVID-19 experiences, perceived COVID-19 behavioral control, social norms and attitudes, and future intention to follow social distancing guidelines.

Design:
This is a cross-sectional study.

Setting:
Participants responded to an on-line survey in June 2020.

Subjects:
The study included 3,183 residents within Quebec, Canada aged 18 and over.

Measures:
Measures include perceived COVID-19 related discrimination, fear of COVID-19 infection, prior exposure to COVID-19, and prior social distancing behavior. Participants self-reported attitudes, perceived behavioral control, and perceived norms related to social distancing. Finally, we measured social distancing behavioral intention.

Analysis:
We evaluated a theory of planned behavior (TPB) measurement model of social distancing using confirmatory factor analysis (CFA). The association between COVID-19 perceived discrimination, fear of infection, previous social distancing behavior, exposure to COVID-19, TPB constructs and behavioral intentions to social distance were estimated using SEM path analysis.

Results:
TPB constructs were positively associated with intention to follow social distancing guidelines. Fear of COVID-19 infection and prior social distancing behavior were positively associated with behavioral intentions. In contrast, perceived discrimination was negatively associated with the outcome. Associations between fear of COVID-19, perceived COVID-19 discrimination and behavioral intentions were partially mediated by constructs of TPB.

Conclusions:
COVID-19 prevention efforts designed to emphasize positive attitudes, perceived control, and social norms around social distancing should carefully balance campaigns that heighten fear of infection along with anti- discrimination messaging.

La pandémie liée à la COVID-19 met en lumière les inégalités sociales de santé. À l’instar de ce qui est observé ailleurs(1), les données montréalaises  disponibles suggèrent que les groupes racisés, particulièrement les  populations noires, sont plus durement touchés par le contexte de pandémie  de la COVID-19 et des effets collatéraux qui en découlent(2,3). En effet, les  quartiers les plus défavorisés sur le plan matériel et économique ainsi que ceux présentant une proportion plus importante de personnes issues  de  groupes racisés/minorités visibles sont particulièrement affectés par la  pandémie. Relativement à cela, les organisateurs communautaires du CIUSSS  du Nord-de-l ‘île-de-Montréal et des membres des cellules de crise ont  demandé à la cellule « communautés ethnoculturelles » de la Direction  régionale de la santé publique de Montréal (DRSP) de dresser un portrait des initiatives et innovations développées par les acteurs locaux ainsi que les défis  présents sur leur territoire respectif afin de mieux appréhender la deuxième  vague.

La pandémie liée à la COVID-19 met en lumière les inégalités sociales de santé. À l’instar de ce qui est observé ailleurs(1), les données montréalaises  disponibles suggèrent que les groupes racisés, particulièrement les  populations noires, sont plus durement touchés par le contexte de pandémie  de la COVID-19 et des effets collatéraux qui en découlent(2,3). En effet, les  quartiers les plus défavorisés sur le plan matériel et économique ainsi que ceux présentant une proportion plus importante de personnes issues  de  groupes racisés/minorités visibles sont particulièrement affectés par la  pandémie. Relativement à cela, les organisateurs communautaires du CIUSSS  du Nord-de-l ‘île-de-Montréal et des membres des cellules de crise ont  demandé à la cellule « communautés ethnoculturelles » de la Direction  régionale de la santé publique de Montréal (DRSP) de dresser un portrait des initiatives et innovations développées par les acteurs locaux ainsi que les défis  présents sur leur territoire respectif afin de mieux appréhender la deuxième  vague.

La pandémie liée à la COVID-19 met en lumière les inégalités sociales de santé. À l’instar de ce qui est observé ailleurs(1), les données montréalaises  disponibles suggèrent que les groupes racisés, particulièrement les  populations noires, sont plus durement touchés par le contexte de pandémie  de la COVID-19 et des effets collatéraux qui en découlent(2,3). En effet, les  quartiers les plus défavorisés sur le plan matériel et économique ainsi que ceux présentant une proportion plus importante de personnes issues  de  groupes racisés/minorités visibles sont particulièrement affectés par la  pandémie. Relativement à cela, les organisateurs communautaires du CIUSSS  du Nord-de-l ‘île-de-Montréal et des membres des cellules de crise ont  demandé à la cellule « communautés ethnoculturelles » de la Direction  régionale de la santé publique de Montréal (DRSP) de dresser un portrait des initiatives et innovations développées par les acteurs locaux ainsi que les défis  présents sur leur territoire respectif afin de mieux appréhender la deuxième  vague.

La pandémie liée à la COVID-19 met en lumière les inégalités sociales de santé. À l’instar de ce qui est observé ailleurs(1), les données montréalaises  disponibles suggèrent que les groupes racisés, particulièrement les  populations noires, sont plus durement touchés par le contexte de pandémie  de la COVID-19 et des effets collatéraux qui en découlent(2,3). En effet, les  quartiers les plus défavorisés sur le plan matériel et économique ainsi que ceux présentant une proportion plus importante de personnes issues  de  groupes racisés/minorités visibles sont particulièrement affectés par la  pandémie. Relativement à cela, les organisateurs communautaires du CIUSSS  du Nord-de-l ‘île-de-Montréal et des membres des cellules de crise ont  demandé à la cellule « communautés ethnoculturelles » de la Direction  régionale de la santé publique de Montréal (DRSP) de dresser un portrait des initiatives et innovations développées par les acteurs locaux ainsi que les défis  présents sur leur territoire respectif afin de mieux appréhender la deuxième  vague.

La pandémie liée à la COVID-19 met en lumière les inégalités sociales de santé. À l’instar de ce qui est observé ailleurs(1), les données montréalaises  disponibles suggèrent que les groupes racisés, particulièrement les  populations noires, sont plus durement touchés par le contexte de pandémie  de la COVID-19 et des effets collatéraux qui en découlent(2,3). En effet, les  quartiers les plus défavorisés sur le plan matériel et économique ainsi que ceux présentant une proportion plus importante de personnes issues  de  groupes racisés/minorités visibles sont particulièrement affectés par la  pandémie. Relativement à cela, les organisateurs communautaires du CIUSSS  du Nord-de-l ‘île-de-Montréal et des membres des cellules de crise ont  demandé à la cellule « communautés ethnoculturelles » de la Direction  régionale de la santé publique de Montréal (DRSP) de dresser un portrait des initiatives et innovations développées par les acteurs locaux ainsi que les défis  présents sur leur territoire respectif afin de mieux appréhender la deuxième  vague.

Background

This article reports the results of a rapid scoping review of the literature on COVID-19 transmission risk to workers in essential sectors such as retail, health care, manufacturing, and agriculture, and more particularly the experiences of workers in precarious employment and social situations.

Methods

Following scoping review methods, we included 30 studies that varied in terms of methodology and theoretical approaches. The search included peer-reviewed articles and grey literature published between March and September 2020.

Results

Based on the studies reviewed, we found that COVID-19 infection and death rates increased not only with age and comorbidities, but also with discrimination and structural inequities based on racism and sexism. Racial and ethnic minority workers, including migrant workers, are concentrated in high-risk occupations and this concentration is correlated to lower socioeconomic conditions. The COVID-19 pandemic appears in the occupational health and safety spotlight as an exacerbator of already existing socioeconomic inequalities and social inequalities in health, especially in light of the intersection of issues related to racism, ethnic minority status, and sexism.

Conclusions

This review provides early evidence about the limitations of institutions’ responses to the pandemic, and their capacity to provide a safe and decent working environment for all workers, regardless of their employment status or the social protections they may enjoy under normal circumstances. It is also important to think about these issues in the postpandemic context, when conditions of precariousness and vulnerability persist and possibly worsen.

La Direction régionale de santé publique (DRSP) de Montréal a effectué une consultation des acteurs terrain à l’initiative du milieu communautaire afin de mieux documenter, légitimer et améliorer la réponse communautaire à la COVID-19 pour les personnes immigrantes et racisées. Cet exercice a été réalisé en collaboration avec le Centre de recherche et de partage des savoirs InterActions et l’Institut universitaire SHERPA : 397 réponses à un questionnaire en ligne pour les acteurs terrain ont été recueillies. Nous avons également mené des entrevues semi-dirigées auprès de huit experts issus du milieu de l’humanitaire afin de compléter et valoriser les initiatives locales montréalaises existantes, mais aussi de proposer des pistes d’action pour mieux appréhender la seconde vague. Finalement, nous avons validé les résultats avec presque 100 acteurs concernés (ex. groupes communautaires, Centre intégré universitaire de santé et de services sociaux [CIUSSS], bailleurs de fond) lors des deux séances délibératives.

This paper addresses the well-being of children in Switzerland, Canada and Estonia, as they experienced the lockdown imposed by governments after the state of international public health emergency, declared by the World Health Organization on 30 January 2020. Suspension of school or starting with distance learning, cessation of extracurricular activities, closure of playgrounds, parks, shopping centres and loss of daily contacts with friends completely transformed children’s lives. The surveys conducted by the authors in individual ways, were all inspired by their membership to the Children’s Understandings of Well-Being network and involved the participation of 403 children aged 7–17 years old (229 girls and 174 boys). They present the emerging trends from the children’s narratives focusing on their experience of the lockdown in relation to family life, school life, contacts with friends, and in relation to space, time and self. During the lockdown leisure activities and hobbies, followed by life with friends and school life challenged relational well-being the most, while family life opened up new perspectives and generational solidarity. Staying at home and decreased physical activity impacted on the physical health of children, missing direct contacts with friends and teachers put social relations to test, fear of the virus decreased feeling safe and secure, and the lockdown restricted participation in society. The findings underline the relational nature of their well-being. More in-depth studies are needed to highlight the widening of inequalities and the balance between protection and participation of children.

Minorities and marginalized groups have increasingly become the target of discriminatory actions related to the COVID-19 pandemic. Detailed information about the manifestation of COVID-related discrimination is required to develop preventive actions that are not stigmatizing for such groups. The present study investigates experiences of perceived discrimination related to COVID-19 and its socio-cultural correlates in a culturally diverse sample of adults in Quebec (Canada). An online survey was completed by 3273 Quebec residents (49 % 18−39 years old; 57 % female; 49 % White). We used multivariate binomial logistic regression models to assess prevalence of COVID-related discrimination and to investigate socio-cultural correlates of reasons and contexts of discrimination. COVID-related discrimination was reported by 16.58 % of participants. Non-white participants, health-care workers and younger participants were more likely to experience discrimination than White, unemployed and older participants, respectively. Discrimination was reported primarily in association with participants’ ethno-cultural group, age, occupation and physical health and in the context of public spaces. Participants of East-Asian descent and essential workers were more likely to report discrimination because of their ethnicity and occupation, respectively. Although young people experienced discrimination across more contexts, older participants were primarily discriminated in the context of grocery stores and because of their age. Our findings indicate that health communication actions informed by a social pedagogy approach should target public beliefs related to the association of COVID-19 with ethnicity, age and occupation, to minimize pandemic-related discrimination. Visible minorities, health-care workers and seniors should be protected and supported, especially in public spaces.

La télésanté connait un essor fulgurant en ce contexte de pandémie. Or, en cette période d’insécurité mondiale, la santé préventive reprend ses droits. En période de déconfinement, la discipline et la cohésion sociale peuvent se relâcher. Cette enquête sociale vise à décrire un programme d’intervention à distance, réalisé en partenariat avec des locataires de logement communautaire, des infirmières et des étudiantes pour soutenir la littératie en santé au temps de la COVID-19. Le Programme de déconfinement en toute sécurité vise à renforcer les mesures préventives et de soutien avec des groupes en contexte de vulnérabilités économiques et sociales à l’aide de la télésanté. Les infirmières ont développé des pratiques cliniques et psychosociales et renforcé la littératie en santé, soutenant les mesures de santé publique post-COVID-19, surveillant l’éclosion de nouveaux foyers et apaisant les souffrances issues du confinement. À l’aide de cibles de performance des systèmes de santé et d’une perspective de justice sociale, nous avons documenté les défis, les leviers et les menaces à l’usage des pratiques à distance en prévention. Vecteur d’une approche intégrée, la télésanté préventive peut cibler simultanément, la lutte contre les maladies non transmissibles et transmissibles et les inégalités. La pandémie de COVID-19 renvoie à un nouvel équilibre des enjeux qui exige un accompagnement et des pratiques de santé communautaire engagées et critiques.

The combined forces of economic globalization and international migration have resulted in specific challenges to palliative care systems. The COVID-19 pandemic has and is still greatly affecting elder populations as well as those across the age continuum living with long-standing chronic conditions or with pre-existing diverse unmet needs. While health promotion and palliative care may appear to be conceptually opposing fields, we argue that palliative care can and should fit under the umbrella of the health promotion continuum. This commentary seeks to discuss the importance of linguistic literacy and communication imperatives in the context of access to palliative care, given the broad, diversified and sensitive scope of care. While the pandemic has demonstrated that the public health responses of migrant host societies are deeply intertwined with policies as well as local rules and constraints, the promotion and provision of safe, timely and appropriate palliative care can be achieved through a sensitive assessment of differential contexts of diversity. The pandemic has painfully illustrated the need for a strong, respectful and equitable working partnership within the professions as well as with the civic society in order for the palliative needs of those exposed to a sustained risk not to be forgotten.

Unaccompanied minors (UMs) are children under 18 who arrive on the territory  of a foreign country without the care of a guardian. In many countries their access to social and health care services depends on their legal recognition as minors. For instance, in France, high rejection rates of minor status place unprotected UMs in social precarity, such that in Paris, civil society organizations (CSOs) have stepped in to offer social, medical, and psychological care to unprotected UMs. In the context of the COVID-19 pandemic however, CSOs had to adapt their care provision.

We review promising CSO-led initiatives to ensure continuity of care for this population. In doing so, we highlight how, by promoting UMs’ healthy behaviors in the context of the pandemic, continued social interactions between CSO members and unprotected UMs may have contributed to disease prevention among UMs. In addition, CSOs have continued to advocate for sheltering unprotected UMs, calling on public authorities to take action.

This article presents a synthesis of literature on social intervention in the context of bereavement and the pandemic in Québec. Based on this literature, we note the way in which this knowledge could be mobilized in order to develop and implement innovative intervention tools and practices, particularly in the Greater Montreal Area. Among these emerging practices, we showcase a recently implemented project designed to establish a virtual practice community — a practical guide for stakeholders and intervention tools adapted to the situation in Montreal and Québec.