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Research

Heterogeneity in testing, diagnosis and outcome in SARS-CoV-2 infection across outbreak settings in the Greater Toronto Area, Canada: an observational study

Linwei Wang, Huiting Ma, Kristy C.Y. Yiu, Andrew Calzavara, David Landsman, Linh Luong, Adrienne K. Chan, Rafal Kustra, Jeffrey C. Kwong, Marie-Claude Boily, Stephen Hwang, Sharon Straus, Stefan D. Baral and Sharmistha Mishra
October 09, 2020 8 (4) E627-E636; DOI: https://doi.org/10.9778/cmajo.20200213
Linwei Wang
MAP Centre for Urban Health Solutions (Wang, Ma, Yiu, Landsman, Luong, Hwang, Mishra), St. Michael’s Hospital, University of Toronto; ICES (Calzavara, Kwong); Division of Infectious Diseases, Department of Medicine (Chan, Mishra), University of Toronto; Division of Infectious Diseases (Chan), Sunnybrook Health Sciences Centre, University of Toronto; Dalla Lana School of Public Health (Kustra), University of Toronto; Department of Family and Community Medicine (Kwong), Faculty of Medicine, University of Toronto, Toronto, Ont.; MRC Centre for Global Infectious Disease Analysis, Department of Infectious Disease Epidemiology (Boily), Faculty of Medicine, Imperial College, London, UK; Division of General Internal Medicine (Hwang), Department of Medicine, University of Toronto; Department of Medicine (Straus), St. Michael’s Hospital, University of Toronto, Toronto, Ont.; Bloomberg School of Public Health (Baral), Johns Hopkins University, Baltimore, Md.
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Huiting Ma
MAP Centre for Urban Health Solutions (Wang, Ma, Yiu, Landsman, Luong, Hwang, Mishra), St. Michael’s Hospital, University of Toronto; ICES (Calzavara, Kwong); Division of Infectious Diseases, Department of Medicine (Chan, Mishra), University of Toronto; Division of Infectious Diseases (Chan), Sunnybrook Health Sciences Centre, University of Toronto; Dalla Lana School of Public Health (Kustra), University of Toronto; Department of Family and Community Medicine (Kwong), Faculty of Medicine, University of Toronto, Toronto, Ont.; MRC Centre for Global Infectious Disease Analysis, Department of Infectious Disease Epidemiology (Boily), Faculty of Medicine, Imperial College, London, UK; Division of General Internal Medicine (Hwang), Department of Medicine, University of Toronto; Department of Medicine (Straus), St. Michael’s Hospital, University of Toronto, Toronto, Ont.; Bloomberg School of Public Health (Baral), Johns Hopkins University, Baltimore, Md.
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Kristy C.Y. Yiu
MAP Centre for Urban Health Solutions (Wang, Ma, Yiu, Landsman, Luong, Hwang, Mishra), St. Michael’s Hospital, University of Toronto; ICES (Calzavara, Kwong); Division of Infectious Diseases, Department of Medicine (Chan, Mishra), University of Toronto; Division of Infectious Diseases (Chan), Sunnybrook Health Sciences Centre, University of Toronto; Dalla Lana School of Public Health (Kustra), University of Toronto; Department of Family and Community Medicine (Kwong), Faculty of Medicine, University of Toronto, Toronto, Ont.; MRC Centre for Global Infectious Disease Analysis, Department of Infectious Disease Epidemiology (Boily), Faculty of Medicine, Imperial College, London, UK; Division of General Internal Medicine (Hwang), Department of Medicine, University of Toronto; Department of Medicine (Straus), St. Michael’s Hospital, University of Toronto, Toronto, Ont.; Bloomberg School of Public Health (Baral), Johns Hopkins University, Baltimore, Md.
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Andrew Calzavara
MAP Centre for Urban Health Solutions (Wang, Ma, Yiu, Landsman, Luong, Hwang, Mishra), St. Michael’s Hospital, University of Toronto; ICES (Calzavara, Kwong); Division of Infectious Diseases, Department of Medicine (Chan, Mishra), University of Toronto; Division of Infectious Diseases (Chan), Sunnybrook Health Sciences Centre, University of Toronto; Dalla Lana School of Public Health (Kustra), University of Toronto; Department of Family and Community Medicine (Kwong), Faculty of Medicine, University of Toronto, Toronto, Ont.; MRC Centre for Global Infectious Disease Analysis, Department of Infectious Disease Epidemiology (Boily), Faculty of Medicine, Imperial College, London, UK; Division of General Internal Medicine (Hwang), Department of Medicine, University of Toronto; Department of Medicine (Straus), St. Michael’s Hospital, University of Toronto, Toronto, Ont.; Bloomberg School of Public Health (Baral), Johns Hopkins University, Baltimore, Md.
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David Landsman
MAP Centre for Urban Health Solutions (Wang, Ma, Yiu, Landsman, Luong, Hwang, Mishra), St. Michael’s Hospital, University of Toronto; ICES (Calzavara, Kwong); Division of Infectious Diseases, Department of Medicine (Chan, Mishra), University of Toronto; Division of Infectious Diseases (Chan), Sunnybrook Health Sciences Centre, University of Toronto; Dalla Lana School of Public Health (Kustra), University of Toronto; Department of Family and Community Medicine (Kwong), Faculty of Medicine, University of Toronto, Toronto, Ont.; MRC Centre for Global Infectious Disease Analysis, Department of Infectious Disease Epidemiology (Boily), Faculty of Medicine, Imperial College, London, UK; Division of General Internal Medicine (Hwang), Department of Medicine, University of Toronto; Department of Medicine (Straus), St. Michael’s Hospital, University of Toronto, Toronto, Ont.; Bloomberg School of Public Health (Baral), Johns Hopkins University, Baltimore, Md.
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Linh Luong
MAP Centre for Urban Health Solutions (Wang, Ma, Yiu, Landsman, Luong, Hwang, Mishra), St. Michael’s Hospital, University of Toronto; ICES (Calzavara, Kwong); Division of Infectious Diseases, Department of Medicine (Chan, Mishra), University of Toronto; Division of Infectious Diseases (Chan), Sunnybrook Health Sciences Centre, University of Toronto; Dalla Lana School of Public Health (Kustra), University of Toronto; Department of Family and Community Medicine (Kwong), Faculty of Medicine, University of Toronto, Toronto, Ont.; MRC Centre for Global Infectious Disease Analysis, Department of Infectious Disease Epidemiology (Boily), Faculty of Medicine, Imperial College, London, UK; Division of General Internal Medicine (Hwang), Department of Medicine, University of Toronto; Department of Medicine (Straus), St. Michael’s Hospital, University of Toronto, Toronto, Ont.; Bloomberg School of Public Health (Baral), Johns Hopkins University, Baltimore, Md.
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Adrienne K. Chan
MAP Centre for Urban Health Solutions (Wang, Ma, Yiu, Landsman, Luong, Hwang, Mishra), St. Michael’s Hospital, University of Toronto; ICES (Calzavara, Kwong); Division of Infectious Diseases, Department of Medicine (Chan, Mishra), University of Toronto; Division of Infectious Diseases (Chan), Sunnybrook Health Sciences Centre, University of Toronto; Dalla Lana School of Public Health (Kustra), University of Toronto; Department of Family and Community Medicine (Kwong), Faculty of Medicine, University of Toronto, Toronto, Ont.; MRC Centre for Global Infectious Disease Analysis, Department of Infectious Disease Epidemiology (Boily), Faculty of Medicine, Imperial College, London, UK; Division of General Internal Medicine (Hwang), Department of Medicine, University of Toronto; Department of Medicine (Straus), St. Michael’s Hospital, University of Toronto, Toronto, Ont.; Bloomberg School of Public Health (Baral), Johns Hopkins University, Baltimore, Md.
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Rafal Kustra
MAP Centre for Urban Health Solutions (Wang, Ma, Yiu, Landsman, Luong, Hwang, Mishra), St. Michael’s Hospital, University of Toronto; ICES (Calzavara, Kwong); Division of Infectious Diseases, Department of Medicine (Chan, Mishra), University of Toronto; Division of Infectious Diseases (Chan), Sunnybrook Health Sciences Centre, University of Toronto; Dalla Lana School of Public Health (Kustra), University of Toronto; Department of Family and Community Medicine (Kwong), Faculty of Medicine, University of Toronto, Toronto, Ont.; MRC Centre for Global Infectious Disease Analysis, Department of Infectious Disease Epidemiology (Boily), Faculty of Medicine, Imperial College, London, UK; Division of General Internal Medicine (Hwang), Department of Medicine, University of Toronto; Department of Medicine (Straus), St. Michael’s Hospital, University of Toronto, Toronto, Ont.; Bloomberg School of Public Health (Baral), Johns Hopkins University, Baltimore, Md.
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Jeffrey C. Kwong
MAP Centre for Urban Health Solutions (Wang, Ma, Yiu, Landsman, Luong, Hwang, Mishra), St. Michael’s Hospital, University of Toronto; ICES (Calzavara, Kwong); Division of Infectious Diseases, Department of Medicine (Chan, Mishra), University of Toronto; Division of Infectious Diseases (Chan), Sunnybrook Health Sciences Centre, University of Toronto; Dalla Lana School of Public Health (Kustra), University of Toronto; Department of Family and Community Medicine (Kwong), Faculty of Medicine, University of Toronto, Toronto, Ont.; MRC Centre for Global Infectious Disease Analysis, Department of Infectious Disease Epidemiology (Boily), Faculty of Medicine, Imperial College, London, UK; Division of General Internal Medicine (Hwang), Department of Medicine, University of Toronto; Department of Medicine (Straus), St. Michael’s Hospital, University of Toronto, Toronto, Ont.; Bloomberg School of Public Health (Baral), Johns Hopkins University, Baltimore, Md.
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Marie-Claude Boily
MAP Centre for Urban Health Solutions (Wang, Ma, Yiu, Landsman, Luong, Hwang, Mishra), St. Michael’s Hospital, University of Toronto; ICES (Calzavara, Kwong); Division of Infectious Diseases, Department of Medicine (Chan, Mishra), University of Toronto; Division of Infectious Diseases (Chan), Sunnybrook Health Sciences Centre, University of Toronto; Dalla Lana School of Public Health (Kustra), University of Toronto; Department of Family and Community Medicine (Kwong), Faculty of Medicine, University of Toronto, Toronto, Ont.; MRC Centre for Global Infectious Disease Analysis, Department of Infectious Disease Epidemiology (Boily), Faculty of Medicine, Imperial College, London, UK; Division of General Internal Medicine (Hwang), Department of Medicine, University of Toronto; Department of Medicine (Straus), St. Michael’s Hospital, University of Toronto, Toronto, Ont.; Bloomberg School of Public Health (Baral), Johns Hopkins University, Baltimore, Md.
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Stephen Hwang
MAP Centre for Urban Health Solutions (Wang, Ma, Yiu, Landsman, Luong, Hwang, Mishra), St. Michael’s Hospital, University of Toronto; ICES (Calzavara, Kwong); Division of Infectious Diseases, Department of Medicine (Chan, Mishra), University of Toronto; Division of Infectious Diseases (Chan), Sunnybrook Health Sciences Centre, University of Toronto; Dalla Lana School of Public Health (Kustra), University of Toronto; Department of Family and Community Medicine (Kwong), Faculty of Medicine, University of Toronto, Toronto, Ont.; MRC Centre for Global Infectious Disease Analysis, Department of Infectious Disease Epidemiology (Boily), Faculty of Medicine, Imperial College, London, UK; Division of General Internal Medicine (Hwang), Department of Medicine, University of Toronto; Department of Medicine (Straus), St. Michael’s Hospital, University of Toronto, Toronto, Ont.; Bloomberg School of Public Health (Baral), Johns Hopkins University, Baltimore, Md.
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Sharon Straus
MAP Centre for Urban Health Solutions (Wang, Ma, Yiu, Landsman, Luong, Hwang, Mishra), St. Michael’s Hospital, University of Toronto; ICES (Calzavara, Kwong); Division of Infectious Diseases, Department of Medicine (Chan, Mishra), University of Toronto; Division of Infectious Diseases (Chan), Sunnybrook Health Sciences Centre, University of Toronto; Dalla Lana School of Public Health (Kustra), University of Toronto; Department of Family and Community Medicine (Kwong), Faculty of Medicine, University of Toronto, Toronto, Ont.; MRC Centre for Global Infectious Disease Analysis, Department of Infectious Disease Epidemiology (Boily), Faculty of Medicine, Imperial College, London, UK; Division of General Internal Medicine (Hwang), Department of Medicine, University of Toronto; Department of Medicine (Straus), St. Michael’s Hospital, University of Toronto, Toronto, Ont.; Bloomberg School of Public Health (Baral), Johns Hopkins University, Baltimore, Md.
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Stefan D. Baral
MAP Centre for Urban Health Solutions (Wang, Ma, Yiu, Landsman, Luong, Hwang, Mishra), St. Michael’s Hospital, University of Toronto; ICES (Calzavara, Kwong); Division of Infectious Diseases, Department of Medicine (Chan, Mishra), University of Toronto; Division of Infectious Diseases (Chan), Sunnybrook Health Sciences Centre, University of Toronto; Dalla Lana School of Public Health (Kustra), University of Toronto; Department of Family and Community Medicine (Kwong), Faculty of Medicine, University of Toronto, Toronto, Ont.; MRC Centre for Global Infectious Disease Analysis, Department of Infectious Disease Epidemiology (Boily), Faculty of Medicine, Imperial College, London, UK; Division of General Internal Medicine (Hwang), Department of Medicine, University of Toronto; Department of Medicine (Straus), St. Michael’s Hospital, University of Toronto, Toronto, Ont.; Bloomberg School of Public Health (Baral), Johns Hopkins University, Baltimore, Md.
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Sharmistha Mishra
MAP Centre for Urban Health Solutions (Wang, Ma, Yiu, Landsman, Luong, Hwang, Mishra), St. Michael’s Hospital, University of Toronto; ICES (Calzavara, Kwong); Division of Infectious Diseases, Department of Medicine (Chan, Mishra), University of Toronto; Division of Infectious Diseases (Chan), Sunnybrook Health Sciences Centre, University of Toronto; Dalla Lana School of Public Health (Kustra), University of Toronto; Department of Family and Community Medicine (Kwong), Faculty of Medicine, University of Toronto, Toronto, Ont.; MRC Centre for Global Infectious Disease Analysis, Department of Infectious Disease Epidemiology (Boily), Faculty of Medicine, Imperial College, London, UK; Division of General Internal Medicine (Hwang), Department of Medicine, University of Toronto; Department of Medicine (Straus), St. Michael’s Hospital, University of Toronto, Toronto, Ont.; Bloomberg School of Public Health (Baral), Johns Hopkins University, Baltimore, Md.
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    • Appendix 1: Literature review and data extraction to estimate the population size of persons using shelters in the Greater Toronto Area
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Heterogeneity in testing, diagnosis and outcome in SARS-CoV-2 infection across outbreak settings in the Greater Toronto Area, Canada: an observational study
Linwei Wang, Huiting Ma, Kristy C.Y. Yiu, Andrew Calzavara, David Landsman, Linh Luong, Adrienne K. Chan, Rafal Kustra, Jeffrey C. Kwong, Marie-Claude Boily, Stephen Hwang, Sharon Straus, Stefan D. Baral, Sharmistha Mishra
Oct 2020, 8 (4) E627-E636; DOI: 10.9778/cmajo.20200213

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Heterogeneity in testing, diagnosis and outcome in SARS-CoV-2 infection across outbreak settings in the Greater Toronto Area, Canada: an observational study
Linwei Wang, Huiting Ma, Kristy C.Y. Yiu, Andrew Calzavara, David Landsman, Linh Luong, Adrienne K. Chan, Rafal Kustra, Jeffrey C. Kwong, Marie-Claude Boily, Stephen Hwang, Sharon Straus, Stefan D. Baral, Sharmistha Mishra
Oct 2020, 8 (4) E627-E636; DOI: 10.9778/cmajo.20200213
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