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Research

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 and Benjamin Fine; for the COVID-19 Canada Open Data Working Group: Non-Pharmaceutical Interventions
August 31, 2020 8 (3) E545-E553; DOI: https://doi.org/10.9778/cmajo.20200100
Liam G. McCoy
Faculty of Medicine (McCoy, Harish, Lam) and Institute of Health Policy, Management and Evaluation (McCoy, Harish), University of Toronto; Layer 6 AI (Smith, Yi), Toronto, Ont.; Cumming School of Medicine (Anchuri, Hu), University of Calgary, Calgary, Alta.; Dalla Lana School of Public Health (Berry, Harish, Rosella) and the Department of Computer Science (Pineda), University of Toronto; Ontario Institute for Cancer Research (Pineda); Operational Analytics Lab, Institute for Better Health (Fine), Trillium Health Partners; Department of Medical Imaging (Fine), University of Toronto, Toronto, Ont.
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Jonathan Smith
Faculty of Medicine (McCoy, Harish, Lam) and Institute of Health Policy, Management and Evaluation (McCoy, Harish), University of Toronto; Layer 6 AI (Smith, Yi), Toronto, Ont.; Cumming School of Medicine (Anchuri, Hu), University of Calgary, Calgary, Alta.; Dalla Lana School of Public Health (Berry, Harish, Rosella) and the Department of Computer Science (Pineda), University of Toronto; Ontario Institute for Cancer Research (Pineda); Operational Analytics Lab, Institute for Better Health (Fine), Trillium Health Partners; Department of Medical Imaging (Fine), University of Toronto, Toronto, Ont.
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Kavya Anchuri
Faculty of Medicine (McCoy, Harish, Lam) and Institute of Health Policy, Management and Evaluation (McCoy, Harish), University of Toronto; Layer 6 AI (Smith, Yi), Toronto, Ont.; Cumming School of Medicine (Anchuri, Hu), University of Calgary, Calgary, Alta.; Dalla Lana School of Public Health (Berry, Harish, Rosella) and the Department of Computer Science (Pineda), University of Toronto; Ontario Institute for Cancer Research (Pineda); Operational Analytics Lab, Institute for Better Health (Fine), Trillium Health Partners; Department of Medical Imaging (Fine), University of Toronto, Toronto, Ont.
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Isha Berry
Faculty of Medicine (McCoy, Harish, Lam) and Institute of Health Policy, Management and Evaluation (McCoy, Harish), University of Toronto; Layer 6 AI (Smith, Yi), Toronto, Ont.; Cumming School of Medicine (Anchuri, Hu), University of Calgary, Calgary, Alta.; Dalla Lana School of Public Health (Berry, Harish, Rosella) and the Department of Computer Science (Pineda), University of Toronto; Ontario Institute for Cancer Research (Pineda); Operational Analytics Lab, Institute for Better Health (Fine), Trillium Health Partners; Department of Medical Imaging (Fine), University of Toronto, Toronto, Ont.
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Joanna Pineda
Faculty of Medicine (McCoy, Harish, Lam) and Institute of Health Policy, Management and Evaluation (McCoy, Harish), University of Toronto; Layer 6 AI (Smith, Yi), Toronto, Ont.; Cumming School of Medicine (Anchuri, Hu), University of Calgary, Calgary, Alta.; Dalla Lana School of Public Health (Berry, Harish, Rosella) and the Department of Computer Science (Pineda), University of Toronto; Ontario Institute for Cancer Research (Pineda); Operational Analytics Lab, Institute for Better Health (Fine), Trillium Health Partners; Department of Medical Imaging (Fine), University of Toronto, Toronto, Ont.
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Vinyas Harish
Faculty of Medicine (McCoy, Harish, Lam) and Institute of Health Policy, Management and Evaluation (McCoy, Harish), University of Toronto; Layer 6 AI (Smith, Yi), Toronto, Ont.; Cumming School of Medicine (Anchuri, Hu), University of Calgary, Calgary, Alta.; Dalla Lana School of Public Health (Berry, Harish, Rosella) and the Department of Computer Science (Pineda), University of Toronto; Ontario Institute for Cancer Research (Pineda); Operational Analytics Lab, Institute for Better Health (Fine), Trillium Health Partners; Department of Medical Imaging (Fine), University of Toronto, Toronto, Ont.
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Andrew T. Lam
Faculty of Medicine (McCoy, Harish, Lam) and Institute of Health Policy, Management and Evaluation (McCoy, Harish), University of Toronto; Layer 6 AI (Smith, Yi), Toronto, Ont.; Cumming School of Medicine (Anchuri, Hu), University of Calgary, Calgary, Alta.; Dalla Lana School of Public Health (Berry, Harish, Rosella) and the Department of Computer Science (Pineda), University of Toronto; Ontario Institute for Cancer Research (Pineda); Operational Analytics Lab, Institute for Better Health (Fine), Trillium Health Partners; Department of Medical Imaging (Fine), University of Toronto, Toronto, Ont.
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Seung Eun Yi
Faculty of Medicine (McCoy, Harish, Lam) and Institute of Health Policy, Management and Evaluation (McCoy, Harish), University of Toronto; Layer 6 AI (Smith, Yi), Toronto, Ont.; Cumming School of Medicine (Anchuri, Hu), University of Calgary, Calgary, Alta.; Dalla Lana School of Public Health (Berry, Harish, Rosella) and the Department of Computer Science (Pineda), University of Toronto; Ontario Institute for Cancer Research (Pineda); Operational Analytics Lab, Institute for Better Health (Fine), Trillium Health Partners; Department of Medical Imaging (Fine), University of Toronto, Toronto, Ont.
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Sophie Hu
Faculty of Medicine (McCoy, Harish, Lam) and Institute of Health Policy, Management and Evaluation (McCoy, Harish), University of Toronto; Layer 6 AI (Smith, Yi), Toronto, Ont.; Cumming School of Medicine (Anchuri, Hu), University of Calgary, Calgary, Alta.; Dalla Lana School of Public Health (Berry, Harish, Rosella) and the Department of Computer Science (Pineda), University of Toronto; Ontario Institute for Cancer Research (Pineda); Operational Analytics Lab, Institute for Better Health (Fine), Trillium Health Partners; Department of Medical Imaging (Fine), University of Toronto, Toronto, Ont.
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Laura Rosella
Faculty of Medicine (McCoy, Harish, Lam) and Institute of Health Policy, Management and Evaluation (McCoy, Harish), University of Toronto; Layer 6 AI (Smith, Yi), Toronto, Ont.; Cumming School of Medicine (Anchuri, Hu), University of Calgary, Calgary, Alta.; Dalla Lana School of Public Health (Berry, Harish, Rosella) and the Department of Computer Science (Pineda), University of Toronto; Ontario Institute for Cancer Research (Pineda); Operational Analytics Lab, Institute for Better Health (Fine), Trillium Health Partners; Department of Medical Imaging (Fine), University of Toronto, Toronto, Ont.
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Benjamin Fine
Faculty of Medicine (McCoy, Harish, Lam) and Institute of Health Policy, Management and Evaluation (McCoy, Harish), University of Toronto; Layer 6 AI (Smith, Yi), Toronto, Ont.; Cumming School of Medicine (Anchuri, Hu), University of Calgary, Calgary, Alta.; Dalla Lana School of Public Health (Berry, Harish, Rosella) and the Department of Computer Science (Pineda), University of Toronto; Ontario Institute for Cancer Research (Pineda); Operational Analytics Lab, Institute for Better Health (Fine), Trillium Health Partners; Department of Medical Imaging (Fine), University of Toronto, Toronto, Ont.
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  • Figure 1:
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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.

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    Table 1:

    Summary of nonpharmaceutical intervention counts and sources by region

    RegionNo. of total interventionsNo. of unique intervention categoriesNo. of unique Oxford categories8No. of unique reporting organizationsGovernment source, no. (%)Accredited news source, no. (%)Social media source, no. (%)
    Federal
     Canada42188340 (95.2)2 (4.8)0
    Province or territory
     Alberta58288248 (82.8)10 (17.2)0
     British Columbia214461033211 (98.6)3 (1.4)0
     Manitoba1163298114 (98.3)2 (1.7)0
     New Brunswick15141101150 (99.3)1 (0.7)0
     Newfoundland and Labrador50309545 (90.0)4 (8.0)1 (2.0)
     Northwest Territories7633111976 (100.0)00
     Nova Scotia1033090103 (100.0)00
     Nunavut642871364 (100.0)00
     Ontario13642921135 (99.3)1 (0.7)0
     Prince Edward Island81247481 (100.0)00
     Quebec10332101297 (94.2)6 (5.8)0
     Saskatchewan783610377 (98.7)1 (1.3)0
     Yukon58308157 (98.3)1 (1.7)0
    Census metropolitan area
     Calgary26154710 (38.5)14 (53.8)2 (7.7)
     Edmonton18135317 (94.4)1 (5.6)0
     Kelowna1343371023 (17.2)81 (60.4)30 (22.4)
     Vancouver65227959 (90.8)6 (9.2)0
     Victoria35235519 (54.3)12 (34.3)4 (11.4)
     Winnipeg30195230 (100.0)00
     St. John’s1184111 (100.0)00
     Halifax31135131 (100.0)00
     Hamilton77296470 (90.9)7 (9.1)0
     Kitchener-Waterloo9832102239 (39.8)53 (54.1)6 (6.1)
     London36153428 (77.8)8 (22.2)0
     Niagara33194532 (97.0)01 (3.0)
     Oshawa19102119 (100.0)00
     Ottawa1262652126 (100.0)00
     Toronto1012851101 (100.0)00
     Windsor66276266 (100.0)00
     Québec City45206444 (97.8)1 (2.2)0
     Montréal11125115373 (65.8)38 (34.2)0
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    Table 2:

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

    Intervention categoryDefinitionCountSample intervention summary
    Public announcementAny announcement or recommendation that does not fit elsewhere298Recommendation for residents to be vigilant, to refer to Santé Montréal (https://tinyurl.com/CANNPI-public-announcement)
    General case announcementAny announcement on a COVID-19 case that is not the first case announcement in a region217Announce 9 new cases, total 73 in BC (https://tinyurl.com/CANNPI-general-case)
    Emergency economic fundingStimulus or funding to mitigate the economic effects of COVID-19166Government to pay Alberta Energy Regulator industry levy for 6 months, totaling $113 million (https://tinyurl.com/CANNPI-emergency-econ)
    Social distancing announcementAny announcement of a social distancing policy130Government of Saskatchewan “strongly recommends” companies take travel and distancing measures (https://tinyurl.com/CANNPI-social-dist)
    Emergency social services fundingStimulus or funding to enhance social service capacity104$3-million Arts and Culture Resilience Supplement to be administered by the British Columbia Arts Council (https://tinyurl.com/CANNPI-emergency-soc)
    Administrative flexibilityAny relaxation of government, bureaucratic or other regulations90Deferral 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 closureAny decision or order closing workplaces deemed “nonessential”83Dominion Diamond Mines voluntarily suspends activity (https://tinyurl.com/CANNPI-work-close)
    Public event or meeting cancellation or postponementCancellation of any public events76All March Break programming, camps and drop-in activities are cancelled in Oshawa (https://tinyurl.com/CANNPI-event-cancel)
    Health care facility restrictionsAny changes in or restrictions on the functioning or processes of health care facilities75Whitehorse General Hospital will suspend any nonurgent surgery procedures starting Mar. 23, 2020 (https://tinyurl.com/CANNPI-healthcare-restrict)
    Recreational or entertainment facility closureThe closure of any nonretail recreational or entertainment facility74GoodLife Fitness clubs close across Kelowna (https://tinyurl.com/CANNPI-rec-closure)
    Emergency health care fundingFunding to enhance health care service capacity69Government of British Columbia announces $5-million funding to expand virtual mental health access during pandemic (https://tinyurl.com/CANNPI-emergency-health)
    Recommended self-isolationRecommendation from public health authorities for certain groups or individuals to isolate for 2 weeks64Nunavut 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 closureAnnouncement of class cancellations and ongoing suspension of in-person events60Newfoundland 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 body57Declaration of state of emergency in Manitoba (https://tinyurl.com/CANNPI-declare-emerg)
    Government building closureAnnouncement of closure of workplaces related to government organizations55Closure of recycling centres in Québec City until further notice (https://tinyurl.com/CANNPI-govt-bldg-close)
    • Note: COVID-19 = coronavirus disease 2019.

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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
Jul 2020, 8 (3) E545-E553; DOI: 10.9778/cmajo.20200100

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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
Jul 2020, 8 (3) E545-E553; DOI: 10.9778/cmajo.20200100
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