Characterizing early Canadian federal, provincial, territorial and municipal nonpharmaceutical interventions in response to COVID-19: a descriptive analysis

Liam G. McCoy; Jonathan Smith; Kavya Anchuri; Isha Berry; Joanna Pineda; Vinyas Harish; Andrew T. Lam; Seung Eun Yi; Sophie Hu; Laura Rosella; Benjamin Fine

doi:10.9778/cmajo.20200100

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Figure 1:
Temporal distribution of nonpharmaceutical interventions implemented across Canada from Jan. 1 to Apr. 19, 2020, in response to the coronavirus disease 2019 (COVID-19) pandemic (n = 2517).
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Figure 2:
Oxford Stringency Index8 in Canada by province and territory over time (n = 841). Note: COVID-19 = coronavirus disease 2019, WHO = World Health Organization.
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Figure 3:
Variation in time-to-implementation for 2 major nonpharmaceutical interventions (NPIs) — declaration of state of emergency and school closure — shown relative to 2 descriptors of the local coronavirus disease 2019 (COVID-19) outbreak (dates of first case and first death) by Canadian province and territory. Note: WHO = World Health Organization.
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Figure 4:
Implementation of 10 most frequently reported nonpharmaceutical interventions (NPIs) at the municipal level in Canada by census metropolitan areas (ranked by population size) over time.
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Figure 5:
Public event size restrictions over time in Canada reported by census metropolitan area. Lines connect nonpharmaceutical interventions from the same municipality. Overlapping points indicate the same value as the lowest point. Census metropolitan areas that did not announce event size restrictions at the municipal level are excluded.

Tables

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Table 1:

Summary of nonpharmaceutical intervention counts and sources by region

Region	No. of total interventions	No. of unique intervention categories	No. of unique Oxford categories8	No. of unique reporting organizations	Government source, no. (%)	Accredited news source, no. (%)	Social media source, no. (%)
Federal
Canada	42	18	8	3	40 (95.2)	2 (4.8)	0
Province or territory
Alberta	58	28	8	2	48 (82.8)	10 (17.2)	0
British Columbia	214	46	10	33	211 (98.6)	3 (1.4)	0
Manitoba	116	32	9	8	114 (98.3)	2 (1.7)	0
New Brunswick	151	41	10	1	150 (99.3)	1 (0.7)	0
Newfoundland and Labrador	50	30	9	5	45 (90.0)	4 (8.0)	1 (2.0)
Northwest Territories	76	33	11	19	76 (100.0)	0	0
Nova Scotia	103	30	9	0	103 (100.0)	0	0
Nunavut	64	28	7	13	64 (100.0)	0	0
Ontario	136	42	9	21	135 (99.3)	1 (0.7)	0
Prince Edward Island	81	24	7	4	81 (100.0)	0	0
Quebec	103	32	10	12	97 (94.2)	6 (5.8)	0
Saskatchewan	78	36	10	3	77 (98.7)	1 (1.3)	0
Yukon	58	30	8	1	57 (98.3)	1 (1.7)	0
Census metropolitan area
Calgary	26	15	4	7	10 (38.5)	14 (53.8)	2 (7.7)
Edmonton	18	13	5	3	17 (94.4)	1 (5.6)	0
Kelowna	134	33	7	10	23 (17.2)	81 (60.4)	30 (22.4)
Vancouver	65	22	7	9	59 (90.8)	6 (9.2)	0
Victoria	35	23	5	5	19 (54.3)	12 (34.3)	4 (11.4)
Winnipeg	30	19	5	2	30 (100.0)	0	0
St. John’s	11	8	4	1	11 (100.0)	0	0
Halifax	31	13	5	1	31 (100.0)	0	0
Hamilton	77	29	6	4	70 (90.9)	7 (9.1)	0
Kitchener-Waterloo	98	32	10	22	39 (39.8)	53 (54.1)	6 (6.1)
London	36	15	3	4	28 (77.8)	8 (22.2)	0
Niagara	33	19	4	5	32 (97.0)	0	1 (3.0)
Oshawa	19	10	2	1	19 (100.0)	0	0
Ottawa	126	26	5	2	126 (100.0)	0	0
Toronto	101	28	5	1	101 (100.0)	0	0
Windsor	66	27	6	2	66 (100.0)	0	0
Québec City	45	20	6	4	44 (97.8)	1 (2.2)	0
Montréal	111	25	11	53	73 (65.8)	38 (34.2)	0

Table 2:

The 15 most frequently recorded nonpharmaceutical intervention categories by count with descriptive examples

Intervention category	Definition	Count	Sample intervention summary
Public announcement	Any announcement or recommendation that does not fit elsewhere	298	Recommendation for residents to be vigilant, to refer to Santé Montréal (https://tinyurl.com/CANNPI-public-announcement)
General case announcement	Any announcement on a COVID-19 case that is not the first case announcement in a region	217	Announce 9 new cases, total 73 in BC (https://tinyurl.com/CANNPI-general-case)
Emergency economic funding	Stimulus or funding to mitigate the economic effects of COVID-19	166	Government to pay Alberta Energy Regulator industry levy for 6 months, totaling $113 million (https://tinyurl.com/CANNPI-emergency-econ)
Social distancing announcement	Any announcement of a social distancing policy	130	Government of Saskatchewan “strongly recommends” companies take travel and distancing measures (https://tinyurl.com/CANNPI-social-dist)
Emergency social services funding	Stimulus or funding to enhance social service capacity	104	$3-million Arts and Culture Resilience Supplement to be administered by the British Columbia Arts Council (https://tinyurl.com/CANNPI-emergency-soc)
Administrative flexibility	Any relaxation of government, bureaucratic or other regulations	90	Deferral of timber dues for 6 months by Government of Alberta to help ensure forestry companies can continue operations (https://tinyurl.com/CANNPI-admin-flex)
Nonessential workplace closure	Any decision or order closing workplaces deemed “nonessential”	83	Dominion Diamond Mines voluntarily suspends activity (https://tinyurl.com/CANNPI-work-close)
Public event or meeting cancellation or postponement	Cancellation of any public events	76	All March Break programming, camps and drop-in activities are cancelled in Oshawa (https://tinyurl.com/CANNPI-event-cancel)
Health care facility restrictions	Any changes in or restrictions on the functioning or processes of health care facilities	75	Whitehorse General Hospital will suspend any nonurgent surgery procedures starting Mar. 23, 2020 (https://tinyurl.com/CANNPI-healthcare-restrict)
Recreational or entertainment facility closure	The closure of any nonretail recreational or entertainment facility	74	GoodLife Fitness clubs close across Kelowna (https://tinyurl.com/CANNPI-rec-closure)
Emergency health care funding	Funding to enhance health care service capacity	69	Government of British Columbia announces $5-million funding to expand virtual mental health access during pandemic (https://tinyurl.com/CANNPI-emergency-health)
Recommended self-isolation	Recommendation from public health authorities for certain groups or individuals to isolate for 2 weeks	64	Nunavut Department of Health recommends self-monitoring for returning travellers from conference in Toronto where there was a sick contact (https://tinyurl.com/CANNPI-self-isolation)
School closure	Announcement of class cancellations and ongoing suspension of in-person events	60	Newfoundland and Labrador English School District suspends all in-school class instruction (https://tinyurl.com/CANNPI-school-close)
Declaration of emergency (or similar)	Announcement of state of emergency by organizational body	57	Declaration of state of emergency in Manitoba (https://tinyurl.com/CANNPI-declare-emerg)
Government building closure	Announcement of closure of workplaces related to government organizations	55	Closure of recycling centres in Québec City until further notice (https://tinyurl.com/CANNPI-govt-bldg-close)