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This study assessed needs and outcomes for people with developmental disability (DD) to understand the socioeconomic status of this group prior to implementation of the Accessible Canada Act in June 2019. Through discussion with public health officials and laboratory managers in Quebec, we estimated human resource requirements for each stage of each strategy. These resource and population size estimates are useful for other jurisdictions seeking to implement active testing strategies for SARS-CoV-2. No other competing interests were declared. Sub-district Number. We separately calculated downstream costs of repeat testing and contact tracing and testing for each strategy. We also performed other sensitivity analyses for universal testing. Rwanda. Registres matricules numérisés. Explore the Billion Dollar Startup Club These examples show massive testing programs are possible when governments prioritize efforts, provide adequate funding, involve all sectors and leverage human resources. The most important benefit of an active testing approach is the identification of people infected with SARS-CoV-2 who have minimal or no symptoms and are currently undetected. 10,848 were here. These included costs of materials (e.g., personal protective equipment [PPE], nasopharyngeal swabs, reagents), personnel and transportation. Niger is a developing country, which consistently ranks near the bottom in the United Nations' Human Development Index (HDI); it was ranked 187th of 188 countries for 2015 and 189th out of 189 countries in the 2018 and 2019 reports. Find stories, updates and expert opinion. See related editorial at www.cmaj.ca/lookup/doi/10.1503/cmaj.202120, To suppress the spread of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), the pathogen responsible for coronavirus disease 2019 (COVID-19), many countries have adopted social-isolation measures.1,2 These efforts have been largely successful but have had major economic implications. Changing laboratory capacity requirements across strategies, with attendant changes in total human resources (health care professionals, clerical staff and laboratory staff). The grant also supports the salaries of Aashna Uppal and Mercedes Yanes-Lane. Further detail is shown in Appendix 1. Finally, testing all 6 012 144 students and employees in primary and secondary schools over 1.5 months would require an added 20 956 health care professionals, 22 950 clerical staff and 2462 laboratory staff, costing $816.0 million. We evaluated group sizes of 10 to 1000 with daily risks of infection of 1 per 100 000 to 1 per 100 (assuming a communicability period of 10 days;44 these daily risks approximate population prevalence estimates of 0.01% to 10%, respectively). Nicholas Winters (Award #284837) is funded by a doctoral fellowship from the Fonds de Recherche du Québec — Santé. Les listes nominatives recensent, pour chaque commune, les habitants du bourg puis ceux des hameaux selon un ordre topographique : quartier, rue, maison. Introduction. This question is for testing whether or not you are a human visitor and to prevent automated spam submissions. Much of how SARS-CoV-2 sampling and contact tracing is performed was derived from Quebec during the first wave of the pandemic, although this was validated with other settings.69–73 There is heterogeneity among provincial health systems, and the epidemiology of SARS-CoV-2 is changing rapidly. Pooling samples 4:1 could reduce reagents and laboratory technician time by nearly 70%. This may be supported by engaging medical students,66 leveraging other health care professionals67 and using academic and private laboratories.68 Our sensitivity analyses also highlight other approaches that may expedite scale-up. An active strategy, in which all members of selected groups at increased risk of acquiring SARS-CoV-2 are tested, would act to identify people with infection but minimal or no symptoms. Interpreting diagnostic tests for SARS-CoV-2, Centers for Disease Control and Prevention, Testing in Ottawa now open to anyone with COVID-19 symptoms, Can I get tested for COVID-19? 1. Testing all members of workplaces and schools would support them in safely remaining open. Even if repeated, these costs represent a small fraction of the $169.2 billion in Canadian federal fiscal response to the COVID-19 pandemic (as of June 2020). Listes nominatives de recensement de population numérisées, Registres paroissiaux et de l'état civil numérisés, Plans du cadastre napoléonien et rénové numérisés, Série W. Fonds de l'Institut national de la Statistique et des études économiques (INSEE). This form of sampling would be more acceptable — particularly to children, a key consideration when schools reopen — and has excellent sensitivity.45–50 Saliva samples also eliminate the need for nasopharyngeal swabs, a trained health care professional to perform sampling, and the use of costly and scarce PPE. 63.2 : TOTAL 2001: 40,714.2: 41,368.7-654.5: 2000 : U.S. trade in goods with United Kingdom . There are other potential benefits to our proposed approach. Innovative programs to expand testing, like the Rapid Acceleration of Diagnostics (RADx) program in the United States,63 are also under way. We obtained costs from nationally representative sources. BACKGROUND: Testing for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is largely passive, which impedes epidemic control. Documentation hypothécaire numérisée. See Ricky Martin, Pitbull and more stars onstage at the 2020 Latin Grammy Awards Wonderwall ... 63° 43° Sat. 1,598 Followers, 356 Following, 316 Posts - See Instagram photos and videos from Auto Moto Officiel (@automotoofficiel) This would detect individuals who might otherwise contribute to transmission and provide important epidemiologic information on how SARS-CoV-2 is affecting these populations. This strategy also appears affordable compared with the $169.2 billion committed by the federal government as a response to the pandemic as of June 2020. Systematic contact tracing and testing would increase personnel needs 1.2-fold and monthly costs to $78.9 million. Dans le cadre des mesures de lutte contre la propagation du coronavirus SARS-CoV-2, Role of the funder: All funders had no role in the design and conduct of the study; collection, management, analysis and interpretation of the data; preparation, review, or approval of the manuscript; and decision to submit the manuscript for publication. In Canada, the populations targeted for active testing are large — some 4 million people in hospitals, community health care, long-term care and essential businesses, and 6 million within schools — but others have advocated for a similarly ambitious approach.57–59 In other countries, such as South Korea,60 Hong Kong61 and Germany,62 testing capacity was rapidly expanded to help control the initial epidemic wave. For at-risk populations, incremental laboratory capacity needs are shown, assuming systematic tracing and testing of contacts is implemented and continued; total personnel are shown for these same at-risk populations assuming systematic tracing and testing of contacts is implemented and continued. Surveillance testing — for which capacity already exists — is an important and less costly approach to understanding the extent and dynamics of SARS-CoV-2 in at-risk populations. Therefore, we report the monthly cost associated with systematic tracing and testing contacts. The region became a crossroads of civilizations. In 2011, 1.2 million people (2% of the population) identified themselves with a mixed or multiple ethnicity, increasing from 660,000 (1%) in 2001. Les listes nominatives recensent, pour chaque commune, les habitants du bourg puis ceux des hameaux selon un ordre topographique : … W. Alton Russell is funded by a Stanford Interdisciplinary Graduate Fellowship. We conducted sensitivity analyses applicable to other scenarios, such as epidemic resurgence, and new approaches — such as the approval of accurate, inexpensive point-of-care tests — can be implemented with the tool we developed.74 We did not, however, estimate potential epidemiologic impacts of active testing, although we expect increased testing and contact tracing would help reduce community transmission, resulting in substantial downstream health system savings. Deux possibilités de recherche : - Dans la rubrique "Consulter les archives numérisées", bouton "État civil numérisé" : un formulaire de recherche vous permettra d'interroger la base en indiquant les informations en votre possession. Jonathon Campbell (Award #258907, Award #287869) and Stephanie Law (Award #258467) are funded by a postdoctoral fellowship from the Fonds de Recherche du Québec—Santé. The cost of universal testing for at-risk populations would be $1.3 billion for 1 round of testing. Additionally, unused capacity could be diverted to testing entire groups with higher prevalence more frequently and rapidly. Scientists hunt most effective policies, German coronavirus testing capacity increases to 900,000 a week, Rapid scaling up of COVID-19 diagnostic testing in the United States: the NIH RADx Initiative, Diagnostic accuracy of serological tests for covid-19: systematic review and meta-analysis, COVID-19 Immunity Task Force: helping to guide Canada’s epidemic response [main page], Medical students for health-care staff shortages during the COVID-19 pandemic, The role of medical students during the COVID-19 pandemic, Manitoba boosts COVID-19 testing capacity — but still falls shy of mark set by premier, Drive-through screening center for COVID-19: a safe and efficient screening system against massive community outbreak, Interrupting transmission of COVID-19: lessons from containment efforts in Singapore, A midpoint perspective on the COVID-19 pandemic, Impfstatus der Kinder und Jugendlichen in Deutschland, STIKO: Influenzaimpfungen in der COVID-19-Pandemie, ALM — Akkreditierte Labore in der Medizin e. V. [main page], An interactive Excel file to estimate costs of expanded testing for COVID-19 by RT-PCR and/or serologic tests. Pour en savoir plus, consultez les informations pratiques. Costs, human resources and laboratory capacity for each strategy implemented across Canada are shown in Table 1 and Table 2, and for each province in Appendix 1 (Table e8). We assumed 1 complete round of testing would take 28 days for hospitals, community health care workers, long-term care facilities and essential businesses, and 42 days for the larger population in schools. Even small plots of land - whether rural or urban - growing fruit, vegetables or some food animals count if $1,000 or more of such products were raised and sold, or normally would have been sold, during the Census year. Greece, officially the Hellenic Republic, is located in southeastern Europe with the mainland at the south end of the Balkan Peninsula. We do not capture any email address. We estimated sample sizes at the 95% confidence level, adjusting for finite sample size,43 and assuming the cluster size was 10% of individuals from each school or facility. Les rendez-vous des 4 et 5 janvier sont à prendre avant le 22 décembre à midi. Documentation de l'enregistrement numérisée. The earliest of these were the legendary Sao, known from artifacts and oral histories.The Sao fell to the Kanem Empire, the first and longest-lasting of the empires that developed in Chad's Sahelian strip by the end of the 1st millennium AD. The Regional Municipality of Peel (also known as the Region of Peel or Peel Region) is a regional municipality in Southern Ontario, Canada.It consists of three municipalities to the west and northwest of Toronto: the cities of Mississauga, Brampton, and the town of Caledon, each of which spans its full east-west width. independently classified occupations as essential using Quebec’s stringent definition from March 2020.38 Using a published algorithm,39 validated with O*Net,40 we classified essential occupations as those not able to be performed at home. To inform implementation of active testing strategies, we developed a conceptual framework for testing that consisted of 6 stages, which was used for each of the 5 groups: 1) scheduling, 2) sampling, 3) test transport, 4) laboratory RT-PCR analysis, 5) communication of results and 6) acting on results (e.g., contact tracing). www.sanslimitesn.com S'informer Pour Informer Plans du cadastre napoléonien et rénové numérisés. All provinces had sufficient laboratory capacity (Appendix 1, Table e8). Jonathon Campbell, Aashna Uppal, Dick Menzies analyzed the data. 2. Emerg Infect Dis . Sub-district Name. In brief, we estimated the number of health care professionals, clerical and laboratory personnel required per day (1 d was 8 h; we considered part-time staff) for each strategy. For more than 2,000 years, the Chadian Basin has been inhabited by agricultural and sedentary people. All of the authors revised it critically for important intellectual content, gave final approval of the version to be published and agreed to be accountable for all aspects of the work. For contacts, other studies have estimated impacts.75–77 It is possible some people in our strategies are already being tested (e.g., some contacts) and other groups that may require testing (e.g., travellers, visitors to long-term care) were not considered. Costs, testing capacity and human resource needs for conducting SARS-CoV-2 surveillance testing across Canada over 14-day intervals. NOTE: All figures are in millions of U.S. dollars on a nominal basis, not seasonally adjusted unless otherwise specified. What the rules are in each province and territory, Effectiveness of isolation, testing, contact tracing, and physical distancing on reducing transmission of SARS-CoV-2 in different settings: a mathematical modelling study, Substantial undocumented infection facilitates the rapid dissemination of novel coronavirus (SARS-CoV-2), Interventions to mitigate early spread of SARS-CoV-2 in Singapore: a modelling study, Reconstruction of the full transmission dynamics of COVID-19 in Wuhan, Pathophysiology, transmission, diagnosis, and treatment of coronavirus disease 2019 (COVID-19): a review, Temporal dynamics in viral shedding and transmissibility of COVID-19, Presumed asymptomatic carrier transmission of COVID-19, Asymptomatic and human-to-human transmission of SARS-CoV-2 in a 2-family cluster, Xuzhou, China, Delivery of infection from asymptomatic carriers of COVID-19 in a familial cluster, Public Health–Seattle and King County and CDC COVID-19 Investigation Team, Presymptomatic SARS-CoV-2 infections and transmission in a skilled nursing facility, COVID-19 provincial testing guidance update, Ontario’s contact tracing efforts are falling short, experts say, Data tables, 2016 Census: structural type of dwelling (10) and household size (8) for occupied private dwellings of Canada, provinces and territories, census divisions and census subdivisions, 2016 Census — 100% data [tables], 1,500 close contacts for positive COVID-19 cases in Ottawa: Dr. Etches, Coronavirus disease 2019 (COVID-19): epidemiology update, Health care and social assistance: 6221 — General medical and surgical hospitals, Innovation, Science and Economic Development Canada, 623 — Nursing and residential care facilities, Businesses — Canadian Industry Statistics, Data tables, 2016 Census: Industry — North American Industry Classification System (NAICS) 2012 (427A), class of worker (5A), labour force status (3), age (13A) and sex (3) for the labour force aged 15 years and over in private households of Canada, provinces and territories, census metropolitan areas and census agglomerations, 2016 Census — 25% sample data [tables], Data tables, 2016 Census: type of collective dwelling (16), age (20) and sex (3) for the population in collective dwellings of Canada, provinces and territories, 2016 Census — 100% data, Table 17-10-0009-01: Population estimates, quarterly [table], Community health workers in Canada and other high-income countries: a scoping review and research gaps, Community health workers: part of the solution, Occupational employment and wages, May 19: 21-1094 — Community health workers, A summary of the National Community Health Advisor study: weaving the future, Center for Rural Health, University of Arizona, Data tables, 2016 Census: occupation — National Occupational Classification (NOC) 2016 (693A), industry — North American Industry Classification System (NAICS) 2012 (23A), labour force status (3), age (5) and sex (3) for the Labour Force aged 15 years and over in private households of Canada, provinces and territories, census metropolitan areas and census agglomerations, 2016 Census — 25% sample data, Government of Quebec communicates the list of essential services and commercial activities, Becker Friedman Institute for Economics at UChicago, Table 37-10-0109-01: Number of students in elementary and secondary schools, by school type and program type, WHO consolidated guidelines on tuberculosis: Module 1 — Prevention: tuberculosis preventive treatment [guideline], Practical sample size calculations for surveillance and diagnostic investigations, Coronavirus disease (COVID-19): summary of assumption, Consistent detection of 2019 novel coronavirus in saliva, Saliva is a reliable tool to detect SARS-CoV-2, Saliva as a non-invasive specimen for detection of SARS-CoV-2, Saliva is more sensitive for SARS-CoV-2 detection in COVID-19 patients than nasopharyngeal swabs, Saliva sample as a non-invasive specimen for the diagnosis of coronavirus disease 2019: a cross-sectional study, Toronto Invasive Bacterial Diseases Network COVID-19 Investigators, Sensitivity of nasopharyngeal swabs and saliva for the detection of severe acute respiratory syndrome coronavirus 2, Evaluation of saline, phosphate buffered saline and minimum essential medium as potential alternatives to viral transport media for SARS-CoV-2 testing, An alternative workflow for molecular detection of SARS-CoV-2 – escape from the NA extraction kit-shortage, Copenhagen, Denmark, March 2020, Fast SARS-CoV-2 detection by RT-qPCR in preheated nasopharyngeal swab samples, Massive and rapid COVID-19 testing is feasible by extraction-free SARS-CoV-2 RT-qPCR, Assessment of specimen pooling to conserve SARS CoV-2 testing resources, Pooling of samples for testing for SARS-CoV-2 in asymptomatic people, COVID-19 Rapid Response Impact Initiative, White Paper 6, National COVID-19 Testing Action Plan: pragmatic steps to reopen our workplaces and our communities, COVID-19: the case for health-care worker screening to prevent hospital transmission, Tacklling COVID-19: health, quarantine and economic measures — Korean experience [press release], Whose coronavirus strategy worked best? As of July 17, 2020, there were 488 SARS-CoV-2 testing sites; the estimated RT-PCR laboratory capacity was 80 750 tests per day. Olivia Oxlade reports being Associate Scientific Director (Management) for the COVID-19 Immunity Task Force. Depending on epidemic stage and population prevalence, testing all people in at-risk populations may not be necessary, and surveillance-based testing — in which random samples of the population are tested — may be preferable. Testing the larger population within schools over 6 weeks would require 46 368 added personnel and cost $816.0 million. We defined the status quo based on the testing performed between July 8 and 17, 2020, which includes testing of symptomatic people and limited testing of asymptomatic people (e.g., some individuals with exposure or at high risk of exposure). Interventions addressing inefficiencies, including saliva-based sampling and pooling samples, could reduce costs by 40% and personnel by 20%. We examined changes in costs and human resource needs if testing uptake (consent) was 90%, 80% or 60%. Testing all 2 568 496 essential employees with major interpersonal or public contact over a month would require 11 550 health care professionals and 12 837 clerical staff and cost $321.7 million. As workplaces such as bars and fitness centres reopen, and industries such as air travel see increasing customer volumes, more workers will be at increased risk of acquiring SARS-CoV-2. We defined active testing strategies for SARS-CoV-2 using reverse transcription polymerase chain reaction (RT-PCR) for groups at increased risk of acquiring SARS-CoV-2 in all Canadian provinces. Thank you for your interest in spreading the word on CMAJ. Timothy Evans is Executive Director of the COVID-19 Immunity Task Force. We estimated additional costs and human resource needs if whole-blood sampling for serologic testing with an enzyme-linked immunosorbent assay was done concurrently with sampling for RT-PCR. All editorial matter in CMAJ represents the opinions of the authors and not necessarily those of the Canadian Medical Association or its subsidiaries. RESULTS: During July 8–17, 2020, across all provinces in Canada, an average of 41 751 RT-PCR tests were performed daily; we estimated this required 5122 personnel and cost $2.4 million per day ($67.8 million per month). Statistics Canada data41 and provincial reports provided estimates of the number of primary and secondary schools and number of students and employees. Details may not equal totals due to rounding. Six NBER working papers distributed this week investigate the economic and health consequences of the COVID-19 pandemic.

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