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1.
Subst Abuse Treat Prev Policy ; 16(1): 87, 2021 11 29.
Article in English | MEDLINE | ID: covidwho-2214609

ABSTRACT

BACKGROUND: There are preliminary indications that the trajectory of drug overdose-related deaths in North America has been exacerbated due to the novel coronavirus disease pandemic (COVID-19). As such, the impact of COVID-19 on drug overdose-related deaths was examined through a systematic review of the literature and percentage change analyses of surveillance data. METHODS: Systematic searches in electronic databases were conducted, a topical issue brief and bibliography were reviewed, reference lists of included studies were searched and expert consultations were held to identify studies (Registration # CRD42021230223). Observational studies from the United States and Canada were eligible for inclusion if drug overdose-related deaths were assessed in quantitative or qualitative analyses onwards from at least March 2020. In addition, percentage changes comparing drug overdose-related deaths in the second annual quarter (Q2 2020 [April to June]) with the first annual quarter (Q1 2020 [January to March]) were generated using national and subnational data from public health surveillance systems and reports from jurisdictions in the United States and Canada. RESULTS: Nine studies were included in the systematic review, eight from the United States and one from Canada. The maximum outcome assessment period in the included studies extended until September 2020. Drug overdose-related deaths after the onset of COVID-19 were higher compared with the months leading up to the pandemic in 2020 and the comparative months in 2019. In additional percentage change analyses, drug overdose-related deaths increased by 2 to 60% in jurisdictions in the United States and by 58% in Canada when comparing Q2 2020 with Q1 2020. CONCLUSIONS: Drug overdose-related deaths increased after the onset of COVID-19. The current situation necessitates a multi-pronged approach, encompassing expanded access to substance use disorder treatment, undisrupted access to harm reduction services, emphasis on risk reduction strategies, provision of a safe drug supply and decriminalization of drug use.


Subject(s)
COVID-19 , Drug Overdose , Canada/epidemiology , Drug Overdose/epidemiology , Humans , Pandemics , Public Health Surveillance , SARS-CoV-2 , United States/epidemiology
2.
Lancet Gastroenterol Hepatol ; 6(4): 304-314, 2021 04.
Article in English | MEDLINE | ID: covidwho-2184854

ABSTRACT

BACKGROUND: Colorectal cancer screening programmes worldwide have been disrupted during the COVID-19 pandemic. We aimed to estimate the impact of hypothetical disruptions to organised faecal immunochemical test-based colorectal cancer screening programmes on short-term and long-term colorectal cancer incidence and mortality in three countries using microsimulation modelling. METHODS: In this modelling study, we used four country-specific colorectal cancer microsimulation models-Policy1-Bowel (Australia), OncoSim (Canada), and ASCCA and MISCAN-Colon (the Netherlands)-to estimate the potential impact of COVID-19-related disruptions to screening on colorectal cancer incidence and mortality in Australia, Canada, and the Netherlands annually for the period 2020-24 and cumulatively for the period 2020-50. Modelled scenarios varied by duration of disruption (3, 6, and 12 months), decreases in screening participation after the period of disruption (0%, 25%, or 50% reduction), and catch-up screening strategies (within 6 months after the disruption period or all screening delayed by 6 months). FINDINGS: Without catch-up screening, our analysis predicted that colorectal cancer deaths among individuals aged 50 years and older, a 3-month disruption would result in 414-902 additional new colorectal cancer diagnoses (relative increase 0·1-0·2%) and 324-440 additional deaths (relative increase 0·2-0·3%) in the Netherlands, 1672 additional diagnoses (relative increase 0·3%) and 979 additional deaths (relative increase 0·5%) in Australia, and 1671 additional diagnoses (relative increase 0·2%) and 799 additional deaths (relative increase 0·3%) in Canada between 2020 and 2050, compared with undisrupted screening. A 6-month disruption would result in 803-1803 additional diagnoses (relative increase 0·2-0·4%) and 678-881 additional deaths (relative increase 0·4-0·6%) in the Netherlands, 3552 additional diagnoses (relative increase 0·6%) and 1961 additional deaths (relative increase 1·0%) in Australia, and 2844 additional diagnoses (relative increase 0·3%) and 1319 additional deaths (relative increase 0·4%) in Canada between 2020 and 2050, compared with undisrupted screening. A 12-month disruption would result in 1619-3615 additional diagnoses (relative increase 0·4-0·9%) and 1360-1762 additional deaths (relative increase 0·8-1·2%) in the Netherlands, 7140 additional diagnoses (relative increase 1·2%) and 3968 additional deaths (relative increase 2·0%) in Australia, and 5212 additional diagnoses (relative increase 0·6%) and 2366 additional deaths (relative increase 0·8%) in Canada between 2020 and 2050, compared with undisrupted screening. Providing immediate catch-up screening could minimise the impact of the disruption, restricting the relative increase in colorectal cancer incidence and deaths between 2020 and 2050 to less than 0·1% in all countries. A post-disruption decrease in participation could increase colorectal cancer incidence by 0·2-0·9% and deaths by 0·6-1·6% between 2020 and 2050, compared with undisrupted screening. INTERPRETATION: Although the projected effect of short-term disruption to colorectal cancer screening is modest, such disruption will have a marked impact on colorectal cancer incidence and deaths between 2020 and 2050 attributable to missed screening. Thus, it is crucial that, if disrupted, screening programmes ensure participation rates return to previously observed rates and provide catch-up screening wherever possible, since this could mitigate the impact on colorectal cancer deaths. FUNDING: Cancer Council New South Wales, Health Canada, and Dutch National Institute for Public Health and Environment.


Subject(s)
COVID-19 , Colorectal Neoplasms/diagnosis , Early Detection of Cancer , Occult Blood , Aged , Australia/epidemiology , Canada/epidemiology , Colorectal Neoplasms/epidemiology , Humans , Incidence , Middle Aged , Netherlands/epidemiology
5.
Healthc Pap ; 20(4): 12-29, 2022 Apr.
Article in English | MEDLINE | ID: covidwho-2145322

ABSTRACT

Virtual care has stabilized at about one-third of visits as the sixth wave of the pandemic in Canada ebbs from about twice that at the peak of the first wave but is up more than tenfold from pre-pandemic levels. This has created huge changes and challenges, which the author reviews in an attempt to make workable policy recommendations and find a balance among competing priorities. Falk revisits recommendations from his Health Canada report (Falk 2021), updating and expanding on recommendations concerning remuneration, licensure, equity and access. He introduces newly available data on specialty and primary care use and discusses the practical implications for change management and system development. He expands his recommendations for aggressive regulatory changes and standards for digital health and virtual care.


Subject(s)
COVID-19 , Male , Humans , COVID-19/epidemiology , Pandemics , Canada/epidemiology
6.
Healthc Pap ; 20(4): 77-81, 2022 Apr.
Article in English | MEDLINE | ID: covidwho-2145320

ABSTRACT

The constraints of the COVID-19 pandemic accelerated the adoption of virtual care. The role of virtual care in the mix of healthcare services is being re-examined as the pandemic evolves. For many diverse Indigenous communities (rural, remote, urban), virtual care has the potential to increase access to healthcare and improv health outcomes, or to worsen existing inequities. Thoughtful co-design of virtual care programs, attention to user experience and enabling policy decisions can unlock the potential of virtual care for Indigenous individuals and communities.


Subject(s)
COVID-19 , Humans , COVID-19/epidemiology , Pandemics , Rural Population , Canada/epidemiology
7.
J Rheumatol ; 49(10): 1077-1078, 2022 10.
Article in English | MEDLINE | ID: covidwho-2143926
8.
JMIR Public Health Surveill ; 8(5): e31968, 2022 05 31.
Article in English | MEDLINE | ID: covidwho-2141354

ABSTRACT

BACKGROUND: There is mounting evidence that the third wave of COVID-19 incidence is declining, yet variants of concern (VOCs) continue to present public health challenges in Canada. The emergence of VOCs has sparked debate on how to effectively control their impacts on the Canadian population. OBJECTIVE: Provincial and territorial governments have implemented a wide range of policy measures to protect residents against community transmission of COVID-19, but research examining the specific impact of policy countermeasures on the VOCs in Canada is needed. Our study objective was to identify provinces with disproportionate prevalence of VOCs relative to COVID-19 mitigation efforts in provinces and territories in Canada. METHODS: We analyzed publicly available provincial- and territorial-level data on the prevalence of VOCs in relation to mitigating factors, summarized in 3 measures: (1) strength of public health countermeasures (stringency index), (2) the extent to which people moved about outside their homes (mobility index), and (3) the proportion of the provincial or territorial population that was fully vaccinated (vaccine uptake). Using spatial agglomerative hierarchical cluster analysis (unsupervised machine learning), provinces and territories were grouped into clusters by stringency index, mobility index, and full vaccine uptake. The Kruskal-Wallis test was used to compare the prevalence of VOCs (Alpha, or B.1.1.7; Beta, or B.1.351; Gamma, or P.1; and Delta, or B.1.617.2 variants) across the clusters. RESULTS: We identified 3 clusters of vaccine uptake and countermeasures. Cluster 1 consisted of the 3 Canadian territories and was characterized by a higher degree of vaccine deployment and fewer countermeasures. Cluster 2 (located in Central Canada and the Atlantic region) was typified by lower levels of vaccine deployment and moderate countermeasures. The third cluster, which consisted of provinces in the Pacific region, Central Canada, and the Prairies, exhibited moderate vaccine deployment but stronger countermeasures. The overall and variant-specific prevalences were significantly different across the clusters. CONCLUSIONS: This "up to the point" analysis found that implementation of COVID-19 public health measures, including the mass vaccination of populations, is key to controlling VOC prevalence rates in Canada. As of June 15, 2021, the third wave of COVID-19 in Canada is declining, and those provinces and territories that had implemented more comprehensive public health measures showed lower VOC prevalence. Public health authorities and governments need to continue to communicate the importance of sociobehavioural preventive measures, even as populations in Canada continue to receive their primary and booster doses of vaccines.


Subject(s)
COVID-19 , SARS-CoV-2 , COVID-19/epidemiology , COVID-19/prevention & control , COVID-19 Vaccines , Canada/epidemiology , Cluster Analysis , Humans , Public Health , Vaccination
9.
Ann Fam Med ; 20(6): 548-550, 2022.
Article in English | MEDLINE | ID: covidwho-2140353

ABSTRACT

Our objective was to externally validate 2 simple risk scores for mortality among a mostly inpatient population with COVID-19 in Canada (588 patients for COVID-NoLab and 479 patients for COVID-SimpleLab). The mortality rates in the low-, moderate-, and high-risk groups for COVID-NoLab were 1.1%, 9.6%, and 21.2%, respectively. The mortality rates for COVID-SimpleLab were 0.0%, 9.8%, and 20.0%, respectively. These values were similar to those in the original derivation cohort. The 2 simple risk scores, now successfully externally validated, offer clinicians a reliable way to quickly identify low-risk inpatients who could potentially be managed as outpatients in the event of a bed shortage. Both are available online (https://ebell-projects.shinyapps.io/covid_nolab/ and https://ebell-projects.shinyapps.io/COVID-SimpleLab/).


Subject(s)
COVID-19 , Humans , Prognosis , Canada/epidemiology , Inpatients , Outpatients
10.
Harm Reduct J ; 19(1): 126, 2022 Nov 18.
Article in English | MEDLINE | ID: covidwho-2139316

ABSTRACT

BACKGROUND: The overdose crisis in Canada has worsened since the emergence of the COVID-19 pandemic. Although this trend is thought to be driven in part by closures or reduced capacity of supervised consumption services (SCS), little is known about the factors that may impede access to such services during the COVID-19 pandemic among people who use drugs. This study sought to characterize the prevalence and correlates of having difficulty accessing SCS during the COVID-19 pandemic among people who use drugs in Vancouver, Canada. METHODS: Cross-sectional data from two open prospective cohorts of people who use drugs were collected via phone or videoconferencing interviews conducted between July 2020 and November 2020. Multivariable logistic regression analyses were used to examine factors associated with experiencing difficulty accessing SCS. RESULTS: Among the 428 people who use drugs who participated in the study, 223 (54.7%) self-identified as men and the median age was 51 years (1st to 3rd quartile: 42-58). A total of 58 (13.6%) participants reported experiencing difficulty accessing SCS. In a multivariable analysis, factors positively associated with difficulty accessing SCS included daily crystal methamphetamine use (Adjusted odds ratio [AOR] = 2.60; 95% confidence interval [CI] 1.28-5.30), active injection drug use (AOR = 4.06; 95% CI 1.38-11.90), recent non-fatal overdose (AOR = 2.45; 95% CI 1.24-4.85), and unstable housing (AOR = 2.14; 95% CI 1.08-4.23). Age was inversely associated with the outcome (AOR = 0.96; 95% CI 0.93-0.99) in multivariable analyses. The most commonly reported reasons for experiencing difficulty accessing SCS were: COVID-19-related site closure or shortened hours (42.9%) and having to wait too long to use a site (39.3%). CONCLUSIONS: We found that people who use drugs with markers of structural vulnerability and drug-related risk were more likely to experience difficulty accessing SCS during the COVID-19 pandemic. These findings point to the need for strategies to support access to such services as part of pandemic response efforts.


Subject(s)
COVID-19 , Drug Overdose , Male , Humans , Middle Aged , Pandemics , Prospective Studies , Cross-Sectional Studies , Canada/epidemiology , Drug Overdose/epidemiology
11.
BMC Health Serv Res ; 22(1): 1434, 2022 Nov 28.
Article in English | MEDLINE | ID: covidwho-2139271

ABSTRACT

BACKGROUND: Little is known about the experience of receiving in-person and virtual clinical health care services during the COVID-19 pandemic for Canadian children with developmental disabilities and delays facing multiple layers of vulnerability (e.g., low income, low educational attainment families). We examined the relationship between socio-demographic factors and the receipt of these services (physical and mental health services) during COVID-19 for Canadian children with these conditions. METHODS: Data collected in Canada for the Global Report on Developmental Delays, Disorders and Disabilities were used. The survey: (1) was developed and disseminated in collaboration with caregivers of children with disabilities, (2) included topics such as response to the pandemic and receipt of services and supports, and (3) documented the experiences of a non-random convenience sample of caregivers of children (any age) with these conditions during and prior to the pandemic. We used four logistic regression models to assess the association between socio-demographic factors and receipt of services. RESULTS: Being a single parent, having low educational attainment (high school or less), having low income (making less than $40,000 per year), working less than full time (working part-time, working reduced hours due to COVID, retired, stay home parent or student), as well as male gender and older age of the child with disability were factors associated with decreased likelihood of receiving services. CONCLUSION: Our findings point to the need for tailoring services for families of children with disabilities, particularly low socioeconomic status families, to ensure continuity of care during public health emergencies.


Subject(s)
COVID-19 , Disabled Children , Mental Health Services , Child , Male , Humans , COVID-19/epidemiology , Pandemics , Canada/epidemiology , Demography , Delivery of Health Care
12.
Sci Rep ; 12(1): 20345, 2022 Nov 27.
Article in English | MEDLINE | ID: covidwho-2133604

ABSTRACT

To determine if lockdown measures imposed during the first wave of the COVID19 pandemic affected trauma patterns, volumes, and outcomes in a western Canadian level 1 trauma center, we performed a retrospective cohort study assessing level 1 and 2 trauma patients presenting to our center during the initial COVID19 "lockdown" period (March 15-June 14, 2020) compared to a similar cohort of patients presenting during a "control" period 1 year prior (March 15-June 14, 2019). Overall, we saw a 7.8% reduction in trauma volumes during the lockdown period, and this was associated with a shorter average ED length of stay (6.2 ± 4.7 h vs. 9.7 ± 11.8 h, p = 0.003), reduced time to computed tomography (88.5 ± 68.2 min vs. 105.1 ± 65.5 min, p < 0.001), a reduction in intensive care unit admissions (11.0 ± 4.9% vs. 20.0 ± 15.5%, p = 0.001), and higher injury severity score (6.5 ± 7.6 vs. 6.2 ± 9.5, p = 0.04). Our findings suggest that lockdown measures imposed during the first wave of the COVID19 pandemic had a significant impact on trauma patients.


Subject(s)
COVID-19 , Humans , COVID-19/epidemiology , Retrospective Studies , Length of Stay , Canada/epidemiology , Communicable Disease Control
14.
JAMA Health Forum ; 3(11): e224160, 2022 Nov 04.
Article in English | MEDLINE | ID: covidwho-2127434

ABSTRACT

This Viewpoint discusses Canada's experience and response to COVID-19 pandemic­related events during the fourth through seventh waves.


Subject(s)
COVID-19 , Humans , Risk Factors , Canada/epidemiology
15.
J Prim Care Community Health ; 13: 21501319221138426, 2022.
Article in English | MEDLINE | ID: covidwho-2139060

ABSTRACT

PURPOSE: Effective communication is a key component to managing an event such as a global pandemic. In Canada, federal/provincial reports indicated that effective communication was a challenge in the early days of the COVID-19 pandemic. The purpose of this study was to examine the communication strategies used within long term care facilities in the Canadian province of New Brunswick. METHODS: Online surveys were used to collect data from administrators, staff, and individuals with family members living in long-term care facilities. RESULTS: The findings show an overall satisfaction with the information received by staff and families, however the frequency and format in which information was communicated were inconsistent. All participants indicated that too much information and poor quality information was a challenge. The importance of digital platforms to provide COVID-19 information was consistently identified as a successful communication strategy. CONCLUSION: The findings of this study reveal that the quantity and quality of information provided during the pandemic created challenges for administrators, staff, and families. This is in line with reports from Canadian provincial/federal reports on COVID-19 and long-term care. Recommendations have been made that would benefit the long-term care sector, not only for pandemics, but for communication in general.


Subject(s)
COVID-19 , Pandemics , Humans , Canada/epidemiology , Long-Term Care , New Brunswick , Communication
16.
BMC Public Health ; 22(1): 2062, 2022 11 11.
Article in English | MEDLINE | ID: covidwho-2119158

ABSTRACT

BACKGROUND: The COVID-19 pandemic that has resulted in social distancing, lockdowns, and increase in media posts has taken a toll on the mental health of many people especially those living with Generalized Anxiety Disorder (GAD). The main objective of this study is to understand whether the source of information people use to receive information about COVID-19 and increase or decrease in personal weekly habits during the pandemic were associated with severity of GAD.  METHODS: This study was a cross sectional design and was based on data from Canada. The Canadian Perspective Survey Series (CPSS) 4, 2020: Information Sourced Consulted During the Pandemic was used for the study. The outcome variable was severity of GAD. Multivariate logistic regression was carried out using STATA IC 13. RESULTS: Severity of GAD was significantly associated with being a female, the type of information source used to find out about COVID-19 and change in weekly habits (consuming alcohol, consuming cannabis spending time on the internet and eating junk foods or sweets). CONCLUSION: The results indicate that getting information from credible sources about the pandemic, staying connected with family and friends, seeking virtual mental health services, and learning positive coping strategies can help reduce the severity of GAD.


Subject(s)
COVID-19 , Female , Humans , COVID-19/epidemiology , Pandemics , Cross-Sectional Studies , Canada/epidemiology , Communicable Disease Control , Anxiety Disorders/epidemiology , Anxiety/psychology
17.
Health Rep ; 33(11): 16-26, 2022 Nov 16.
Article in English | MEDLINE | ID: covidwho-2118428

ABSTRACT

Background: Individuals with chronic conditions have higher levels of health care usage and may be at higher risk of more severe outcomes from COVID-19. Therefore, they may have experienced greater difficulty accessing health care during the pandemic because of restrictions on health care services. Data and methods: Data from the Survey on Access to Health Care and Pharmaceuticals During the Pandemic were used to estimate the proportion of individuals in Canada, with and without chronic conditions, who experienced difficulties accessing health care services during the pandemic. Multivariate analyses examined associations between demographic, socioeconomic and health characteristics and the likelihood of experiencing difficulties accessing health care during the pandemic. Results: Nearly one-third (32.0%) of individuals who self-reported having one or more chronic conditions and 24.2% of those who reported no conditions had one or more medical appointments cancelled, rescheduled or delayed because of COVID-19. Smaller proportions of individuals with (19.5%) and without (16.8%) chronic conditions delayed contacting a medical professional because of fear of exposure to COVID-19 in health care settings. Individuals who were younger or had a disability were also more likely than older individuals or those without a disability, respectively, to have had a medical appointment cancelled, rescheduled or delayed because of the pandemic. Women, immigrants, and individuals with multiple chronic conditions were more likely than their counterparts (men, Canadian-born individuals, and individuals with no chronic conditions, respectively) to have delayed contacting a medical professional because of fear of exposure to COVID-19. Interpretation: Individuals with chronic conditions were more likely than those with no chronic conditions to have experienced difficulties accessing health care during the pandemic. Consequently, these individiuals may be at greater risk of experiencing health challenges in the future.


Subject(s)
COVID-19 , Male , Humans , Female , Pandemics , Canada/epidemiology , Chronic Disease , Health Services Accessibility
18.
Health Rep ; 33(11): 27-34, 2022 Nov 16.
Article in English | MEDLINE | ID: covidwho-2118338

ABSTRACT

Introduction: The Statistics Canada Biobank (Biobank) is a valuable source of nationally representative health information. It contains biospecimens collected from the Canadian Health Measures Survey (CHMS) and the Canadian COVID-19 Antibody and Health Survey (CCAHS). Both surveys are voluntary and aim to collect a variety of important health information from Canadians to create nationally representative estimates. This information is collected through questionnaires, physical measures, and self-administered sample collection. Biospecimens collected as part of the CHMS and CCAHS from consenting participants include whole blood, plasma, serum, urine, DNA samples, and dried blood spots. These samples are stored as part of the Biobank for future health research. Canadian researchers can apply to the Biobank program to use this nationally representative source of biospecimens. Results obtained from their research can also be combined with a wide variety of health and lifestyle information collected as part of the CHMS and CCAHS, making the Biobank a rich source of health-related information that can fill data gaps on the health concerns that are important to Canadians. This data resource profile provides an overview of the Biobank to inform researchers and data users about the program and how it can be used as a resource for the advancement of health-related research.


Subject(s)
Biological Specimen Banks , COVID-19 , Humans , COVID-19/epidemiology , Canada/epidemiology , Health Surveys , Life Style
19.
J Med Internet Res ; 24(11): e39662, 2022 Nov 16.
Article in English | MEDLINE | ID: covidwho-2118080

ABSTRACT

BACKGROUND: Access to mental health treatment across Canada remains a challenge, with many reporting unmet care needs. National and provincial e-Mental health (eMH) programs have been developed over the past decade across Canada, with many more emerging during COVID-19 in an attempt to reduce barriers related to geography, isolation, transportation, physical disability, and availability. OBJECTIVE: The aim of this study was to identify factors associated with the utilization of eMH services across Canada during the COVID-19 pandemic using Andersen and Newman's framework of health service utilization. METHODS: This study used data gathered from the 2021 Canadian Digital Health Survey, a cross-sectional, web-based survey of 12,052 Canadians aged 16 years and older with internet access. Bivariate associations between the use of eMH services and health service utilization factors (predisposing, enabling, illness level) of survey respondents were assessed using χ2 tests for categorical variables and t tests for the continuous variable. Logistic regression was used to predict the probability of using eMH services given the respondents' predisposing, enabling, and illness-level factors while adjusting for respondents' age and gender. RESULTS: The proportion of eMH service users among survey respondents was small (883/12,052, 7.33%). Results from the logistic regression suggest that users of eMH services were likely to be those with regular family physician access (odds ratio [OR] 1.57, P=.02), living in nonrural communities (OR 1.08, P<.001), having undergraduate (OR 1.40, P=.001) or postgraduate (OR 1.48, P=.003) education, and being eHealth literate (OR 1.05, P<.001). Those with lower eMH usage were less likely to speak English at home (OR 0.06, P<.001). CONCLUSIONS: Our study provides empirical evidence on the impact of individual health utilization factors on the use of eMH among Canadians during the COVID-19 pandemic. Given the opportunities and promise of eMH services in increasing access to care, future digital interventions should both tailor themselves toward users of these services and consider awareness campaigns to reach nonusers. Future research should also focus on understanding the reasons behind the use and nonuse of eMH services.


Subject(s)
COVID-19 , Mental Health Services , Humans , Mental Health , Cross-Sectional Studies , COVID-19/epidemiology , Pandemics , Canada/epidemiology
20.
PLoS One ; 17(11): e0276791, 2022.
Article in English | MEDLINE | ID: covidwho-2117901

ABSTRACT

According to the World Health Organization, pandemic fatigue poses a serious threat for managing COVID-19. Pandemic fatigue is characterized by progressive decline in adherence to social distancing (SDIS) guidelines, and is thought to be associated with pandemic-related emotional burnout. Little is known about the nature of pandemic fatigue; for example, it is unclear who is most likely to develop pandemic fatigue. We sought to evaluate this issue based on data from 5,812 American and Canadian adults recruited during the second year of the COVID-19 pandemic. Past-year decline in adherence to SDIS had a categorical latent structure according to Latent Class Analysis, consisting of a group adherent to SDIS (Class 1: 92% of the sample) and a group reporting a progressive decline in adherence to SDIS (i.e., pandemic fatigue; Class 2: 8% of the sample). Class 2, compared to Class 1, was associated with greater pandemic-related burnout, pessimism, and apathy about the COVID-19 pandemic. They also tended to be younger, perceived themselves to be more affluent, tended to have greater levels of narcissism, entitlement, and gregariousness, and were more likely to report having been previously infected with SARSCOV2, which they regarded as an exaggerated threat. People in Class 2 also self-reported higher levels of pandemic-related stress, anxiety, and depression, and described making active efforts at coping with SDIS restrictions, which they perceived as unnecessary and stressful. People in Class 1 generally reported that they engaged in SDIS for the benefit of themselves and their community, although 35% of this class also feared they would be publicly shamed if they did not comply with SDIS guidelines. The findings suggest that pandemic fatigue affects a substantial minority of people and even many SDIS-adherent people experience emotionally adverse effects (i.e., fear of being shamed). Implications for the future of SDIS are discussed.


Subject(s)
Burnout, Professional , COVID-19 , Adult , Humans , United States , Pandemics , COVID-19/epidemiology , SARS-CoV-2 , Latent Class Analysis , RNA, Viral , Canada/epidemiology , Fatigue/epidemiology , Burnout, Professional/epidemiology
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