Abstract
The coronavirus diseases 2019 (COVID-19) pandemic has presented an unprecedented public health challenge. Prior to vaccination, non-pharmaceutical interventions, including closures, were necessary to help control the epidemic. With the arrival of variants of concern and insufficient population vaccination coverage, ongoing evaluation of transmission risk in settings and the use of non-pharmaceutical interventions are necessary to help control the epidemic. This study aimed to produce a framework for evaluating transmission risk in settings where individuals gather and inform decision-making. A multi-criteria decision analysis process was used to structure the framework. Fifteen criteria were identified as important to consider for COVID-19 transmission risk based on the literature. This list was ranked by experts and then categorized. The analysis was structured by the consensus list of criteria and relative positioning of each criteria within the list to produce sets of factors to consider when assessing transmission risk at gatherings. Fifteen experts from across Canada participated in ranking the criteria. Strong consensus was found on the relative importance of criteria and this relative consensus was used to create four categories: critical (3 criteria); important (6 criteria); good to consider (5 criteria); and if time permits (1 criterion). The resulting consensus list and categories constitutes a set of important elements that can be applied to any setting as an objective and transparent framework to assess transmission risk in the venue. In conjunction with further consideration of the local epidemiology of COVID-19, an overall risk of transmission assessment can be established and uniformly implemented.
Highlights
The emergence of the novel coronavirus severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and the associated disease was initially observed as an outbreak in Wuhan, China in late 2019, and resulted in the ongoing pandemic (1)
While the potential cascading effects of closures are numerous and still being studied, characteristics of a setting contributing to transmission risk remains independently important to evaluate, even as vaccination is being rolled out since the presence of variants of concern continues to pose an important transmission risk. The objective of this project was to produce a framework to assist in ranking settings by the risk they pose for COVID-19 transmission, and potentially identify areas where mitigating measures can be targeted to help reduce transmission risk in these same settings in order to help inform decision-making
Fifteen experts returned rankings by the deadline, and while the number of respondents was low, the respondents represented the geographic regions in Canada most affected by COVID-19 at the time
Summary
The emergence of the novel coronavirus severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and the associated disease (coronavirus disease 2019; COVID-19) was initially observed as an outbreak in Wuhan, China in late 2019, and resulted in the ongoing pandemic (1). The SARS-CoV-2 is a highly transmissible respiratory virus that can cause a range of symptoms from none to mild or severe disease and death (3) This has created an unprecedented disease management challenge for public health and numerous public health measures have been implemented with variable stringency in an attempt to slow the epidemic and reduce its impact. When and where transmission is high, a range of restrictive closures have been imposed by provincial and local governments, including closures of schools, universities and non-essential businesses, bans or limitations on gatherings, limitations on travel within and between jurisdictions and encouragement of teleworking in an attempt to limit transmission opportunities Together these actions helped to minimize person-to-person contacts in Canada and resulted in the epidemic coming under control with low reported case incidence during summer 2020. This study aimed to produce a framework for evaluating transmission risk in settings where individuals gather and inform decision-making
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