"They forgot about us": experiences of the COVID-19 pandemic among people deprived of housing in an urban centre in Ontario, Canada.

OBJECTIVES: People deprived of housing have been disproportionately affected by the COVID-19 pandemic and the public health mitigation measures implemented in response. Emerging evidence has shown the adverse health outcomes experienced by these communities due to SARS-CoV-2 infection; however, the voices of community members themselves have not been widely amplified in the published literature. METHODS: We conducted an interpretive qualitative study. People deprived of housing were involved in study development, recruitment, and data analysis. People deprived of housing or precariously housed were recruited during street outreach from June to July 2020. Participants completed one-on-one semi-structured interviews that were audio-recorded, transcribed, and analyzed thematically. RESULTS: Twenty-one participants were interviewed. Central to participants' experiences of the COVID-19 pandemic were descriptions of access to services, in terms of both changes in service availability and the reality of how accessible existing services were to the community, represented by the theme access. Four other themes were generated from our analysis and include feeling and being unheard, stripped of dignity, I've been broken, and strength and survival (with a subtheme, community care). CONCLUSION: Future emergency response efforts must meaningfully engage people deprived of housing in planning and decision-making in order to minimize adverse impacts of health emergencies and the associated public health responses. There needs to be more careful consideration of the unintended harmful impacts of public health measures implemented in response to pandemics.

RéSUMé: OBJECTIFS: Les personnes sans abri ont été démesurément affectées par la pandémie de COVID-19 et par les mesures sanitaires mises en œuvre en réponse à la pandémie. Des données probantes émergentes montrent les résultats sanitaires indésirables éprouvés par ces communautés en raison de l'infection par le SRAS-CoV-2, mais les voix des membres de ces communautés ne sont généralement pas amplifiées dans les articles publiés. MéTHODE: Nous avons mené une étude qualitative interprétative. Des personnes sans abri ont été mises à contribution dans l'élaboration de l'étude, le recrutement des participants et l'analyse des données. Des personnes sans abri ou au logement précaire ont été recrutées lors d'activités d'approche dans la rue en juin et juillet 2020. Elles se sont prêtées à des entretiens semi-directifs en tête à tête qui ont été enregistrés, transcrits, puis analysés par thèmes. RéSULTATS: Vingt et une personnes ont été interviewées. Leurs expériences de la pandémie de COVID-19 ont été fortement axées sur le thème de l'accès aux services, tant pour ce qui est des changements dans la disponibilité des services que de l'accessibilité réelle des services existants pour les membres de ces communautés. Quatre autres thèmes sont ressortis de notre analyse : le sentiment/le fait de ne pas être entendu, d'être dépouillé de sa dignité, d'avoir été brisé, et la force et la survie (et un thème secondaire : les soins de proximité). CONCLUSION: Les futurs efforts d'intervention d'urgence doivent inclure une véritable collaboration avec les personnes sans abri dans la planification et la prise de décisions afin de réduire les répercussions néfastes des urgences sanitaires et des mesures de santé publique connexes. Il faut examiner plus attentivement les effets pervers des mesures sanitaires mises en œuvre en réponse aux pandémies.

Evaluating Trends in COVID-19 Research Activity in Early 2020: The Creation and Utilization of a Novel Open-Access Database.

Introduction The coronavirus disease 2019 (COVID-19) pandemic has been unprecedented in recent history. The rapid global spread has demonstrated how the emergence of a novel pathogen necessitates new information to advise both healthcare systems and policy-makers. The directives for the management of COVID-19 have been limited to infection control measures and treatment of patients, which has left physicians and researchers alone to navigate the massive amount of research being published while searching for evidence-based strategies to care for patients. To tackle this barrier, we launched CovidReview.ca, an open-access, continually updated, online platform that screens available COVID-19 research to determine higher quality publications. This paper uses data from this review process to explore the activity and trends of COVID-19 research worldwide over time, while specifically looking at the types of studies being published. Materials and Methods The literature search was conducted on PubMed. Search terms included "COVID-19", "severe acute respiratory syndrome coronavirus 2", "coronavirus 19", "SARS-COV-2", and "2019-nCoV". All articles captured by this strategy were reviewed by a minimum of two reviewers and categorized by type of research, relevant medical specialties, and type of publication. Criteria were developed to allow for inclusion or exclusion to the website. Due to the volume of research, only a level 1 (title and abstract) screen was performed. Results The time period for the analysis was January 17, 2020, to May 10, 2020. The total number of papers captured by the search criteria was 10,685, of which 2,742 were included on the website and 7,943 were excluded. The greatest increase in the types of studies over the 16 weeks was narrative review/expert opinion papers followed by case series/reports. Meta-analyses, systematic reviews, and randomized controlled trials remained the least published types of studies. Conclusions The surge of research that accompanied the COVID-19 pandemic is unparalleled in recent years. From our analysis, it is clear that case reports and narrative reviews were the most widely published, particularly in the earlier days of this pandemic. Continued research that falls higher on the evidence pyramid and is more applicable to clinical settings is warranted.