ABSTRACT
The COVID-19 pandemic has driven home the serious vulnerabilities plaguing Canada's long-term care system. We argue for significant new federal investments tied to clear, enforceable quality standards (particularly around staffing); new investments in home care so that more people can "age in place"; and additional support for informal care providers, including respite programs and cash benefits. We explore how to achieve these reforms within the framework of Canadian federalism and call for the creation of a national governance framework - overseen by experts independent of federal and provincial governments - tasked with establishing evidence-based standards for the quality, safety and timeliness of long-term care services.
Subject(s)
COVID-19 , Long-Term Care , Canada , Humans , Pandemics , SARS-CoV-2Subject(s)
COVID-19 Vaccines , COVID-19/prevention & control , Digital Technology , Documentation , Pandemics/prevention & control , Vaccination , COVID-19 Vaccines/supply & distribution , Canada , Documentation/ethics , Freedom of Movement/ethics , Freedom of Movement/legislation & jurisprudence , Humans , SARS-CoV-2 , Travel , Vaccination/ethics , Vaccination/legislation & jurisprudenceABSTRACT
Ontario families are required to provide up-to-date vaccination records as children begin schooling. Exemptions are allowed on both medical and nonmedical (religious or philosophical) grounds. In a recent report, Toronto Public Health (2019) called for an end to nonmedical exemptions - a proposal some allege infringes the Canadian Charter of Rights and Freedoms right to freedom of religion and conscience. This paper explores whether and to what extent vaccine refusal is protected under the Charter and argues that the elimination of nonmedical exemptions can be justified under Section 1 of the Charter. The issue of mandatory vaccination may take on special urgency in the coming months and years, if and when a vaccine is found for COVID-19.
Subject(s)
COVID-19/prevention & control , Health Promotion/organization & administration , Mandatory Programs/legislation & jurisprudence , Public Health/legislation & jurisprudence , Religious Philosophies/psychology , Vaccination Refusal/legislation & jurisprudence , Vaccination Refusal/psychology , COVID-19/epidemiology , Health Policy , Health Promotion/legislation & jurisprudence , Humans , Ontario/epidemiology , SARS-CoV-2 , Vaccination/legislation & jurisprudence , Vaccination/psychologyABSTRACT
The Royal Society of Canada Task Force on COVID-19 was formed in April 2020 to provide evidence-informed perspectives on major societal challenges in response to and recovery from COVID-19. The Task Force established a series of working groups to rapidly develop policy briefings, with the objective of supporting policy makers with evidence to inform their decisions. This paper reports the findings of the CVOID-19 Long-Term Care (LTC) working group addressing a preferred future for LTC in Canada, with a specific focus on COVID-19 and the LTC workforce. First, the report addresses the research context and policy environment in Canada's LTC sector before COVID-19 and then summarizes the existing knowledge base for integrated solutions to challenges that exist in the LTC sector. Second, the report outlines vulnerabilities exposed because of COVID-19, including deficiencies in the LTC sector that contributed to the magnitude of the COVID-19 crisis. This section focuses especially on the characteristics of older adults living in nursing homes, their caregivers, and the physical environment of nursing homes as important contributors to the COVID-19 crisis. Finally, the report articulates principles for action and nine recommendations for action to help solve the workforce crisis in nursing homes.