The number of cases, hospitalizations, and deaths due to COVID-19 have been increasing in Quebec since August 2020. In addition to the suffering of those infected and their friends and family, caring for patients and their contacts creates a significant burden for healthcare workers, who are frequently infected, threatening the integrity of our healthcare system. The way the pandemic develops in the coming months will depend on the population’s compliance with the recommendations to minimize contacts, maintain physical distancing, wear a mask, and wash hands. It will also depend on the general measures enacted by the government. Unless there is dramatic improvement in the population’s compliance or there are much stricter measures implemented, we cannot expect a swift decline in the...
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December-22-20COVID-19: Evaluation of Disinfection Options for N95 Filtering Facepiece Respirators in the Context of the Pandemic
Given the COVID-19 pandemic and the potential shortage of N95 FFRs, the CERDM evaluated the available options for disinfecting these N95FFRs. This effort is aimed at identifying alternative strategies that can be added to the measures already available, to provide the best possible protection for health care workers in the event of a shortage. Thus, control measures that differ from those which are usually accepted may be implemented alone or in combination. These measures are unprecedented and highlight the need for the various authorities to develop solutions to respond proactively to an anticipated shortage of N95 FFRs and to be able to distribute them to workers during a real shortage of N95 FFRs.
Given this context, the Comité des infections nosocomiales du Québec (CINQ)...
The CERDM evaluated the available options for disinfection of FFRs in the context of a potential shortage of filtering facepiece respirators (FFRs) in health care facilities due to the COVID-19 pandemic (INSPQ, 2020a). This represents a solution of last resort to be applied when there is an anticipated shortage in order to be able to distribute them to workers only during a real shortage and when all other strategies for addressing the shortage of N95 FFRs are insufficient. In fact, this solution is not consistent with the guidelines of regulatory authorities regarding the reprocessing of single-use medical devices (SUMDs). This effort is being undertaken with the aim of identifying alternative strategies that can be added to the measures already available, to provide the best possible...
December-21-20Policy Approaches to Reducing Health Inequalities: Social Determinants of Health and Social Determinants of Health Inequalities
“The social determinants of health are the circumstances in which people are born,grow up, live, work and age, and the systems put in place to deal with illness. These circumstances are in turn shaped by a wider set of forces: economics, social policies, and politics” (World Health Organization’s Commission on Social Determinants of Health [CSDH WHO], 2016).
“The underlying social structures and processes that systematically assign people to different social positions and distribute the social determinants of health unequally in society are the social determinants of health inequities” (VicHealth, 2015, p. 6).
This paper is part of a series of short documents based on the longer Briefing Note, Policy Approaches to Reducing Health...
This document is intended to enable public health actors to more easily distinguish between the most widespread policy approaches that have been proposed to reduce health inequalities. The approaches that we will discuss are:
- Political economy,
- Macro social policies,
- Life course approach,
- Settings approach,
- Approaches that aim at living conditions,
- Approaches that target communities, and
- Approaches aimed at individuals.
Health inequalities1 are understood to be unfair and systematic differences in health among and between social groups – differences which need to be addressed through action. These result from social and political circumstances...
Intersectionality is a way to think about and act upon social inequality and discrimination. It offers a promising approach to these issues within public policy and within public health. This briefing note briefly explains intersectionality and explores the potential of an intersectional approach to reducing health inequalities.1
Work in the field of public health has recognized for some time that the social location2 of groups and individuals has a significant impact on health. When health outcomes are compared by income, gender, race or education, to name just a few, a picture emerges that clearly shows that these factors play key roles in determining health and well-being. People living in poverty, for example, have...
It is commonly acknowledged that the circumstances surrounding birth and the early years of life have an impact on the learning, behaviour and health of individuals throughout their lives. To help readers to learn more about interventions that support the healthy development of children from birth to five years old, we have compiled this bibliography.
This document aims to open pathways of study to public health actors interested in developmental health and the well-being of children. It is intended as a guide to research, but makes no claim to be exhaustive. The documents (books, journals, etc.) and websites listed (English and French) were selected based on criteria of accessibility, relevance and scientific rigour. Although there are many quality resources for parents or the...
In this second1 of three briefing notes2 on public health ethics, we provide an overview of various philosophical and theoretical perspectives that have informed the development, evolution, and application of public health ethics throughout its short history. We believe it is important for public health practitioners to understand these ideas because they inform, either explicitly or implicitly, ethical decision making in public health practice. They also provide a foundation for the public health ethics frameworks that are presented and discussed in our third briefing note.3
A broad range of ethical and political philosophies and theories have been used to provide justification for...
December-21-20The Principle of Reciprocity: How Can it Inform Public Health and Healthy Public Policies? – Summary
This paper provides a very short summary of a longer paper of the same name. The longer work, including full references, is available online at:
Whether considered as a value or formulated as a principle to guide actions, reciprocity is commonly appealed to in public health to help ensure that certain obligations due to others – or to be expected from others – may be taken into account and acted upon by public authorities or by individuals. It is one of the values commonly considered when applying an ethical lens to decisions and actions linked to public health or healthy public policies.
Reciprocity can be applied in the ethics of...
December-21-20COVID-19: Collection, Disinfection and Storage Processes for Single-Use N95 Filtering Facepiece Respirators
This publication uses the term "disinfection" of N95 filtering facepiece respirators (FFRs) (also referred to as N95 masks) to refer to the chemical or physical process that inactivates infectious agents. It should be noted that the various reference publications and documents on the subject consulted by the Centre d’expertise en retraitement des dispositifs médicaux (CERDM) use the terms "decontamination," "disinfection," or both. The CERDM has chosen the term "disinfection" to conform to the reprocessing nomenclature that is generally accepted in Canada (CSA Z314.18).