Evidence about health-system arrangements

Evidence syntheses on this webpage are organized by:

  1. approach to COVID-19 vaccine roll-out
  2. approach to population-health management for COVID-19 and for those whose care is disrupted by COVID-19
  3. delivery arrangements (service planning for COVID-19 prevention, service planning for COVID-19 treatment, service planning for the ongoing management of other conditions, infrastructure planning and resource allocation, workforce planning and development, and service planning for ‘return to normal’)
  4. financial arrangements
  5. governance arrangements.

To complement the evidence about vaccine roll-out below, COVID-END prepares twice-a-month updates to a living evidence profile covering all vaccine roll-out elements, including supply, allocation, communication, administration, and surveillance.

We continue to add evidence syntheses to this webpage as we harvest and process weekly updates from ‘high-yield, high quality’ sources of evidence syntheses and as we add new sources. More details are available about the context for the inventory, our approach to developing and maintain it, and tips for using it. Similar webpages are available for evidence about public-health measures, the clinical management of COVID-19 and related conditions, and economic and social responses.

Broad and specific decisions Criteria for 'best evidence synthesis'Details to support relevance assessmentAdditional decision-relevant detailsCitation
Date of last search Quality (AMSTAR) rating Evidence-certainty (e.g., GRADE) assessment availableKey findings
Living evidence synthesisType of synthesis             Type of question
 Approach to COVID-19 vaccine roll-out
         
  Securing and distributing a reliable supply of vaccines and ancillary supplies
        
  Allocating vaccines and ancillary supplies equitably
        
  Supporting vaccine confidence and uptake2021-02-035/9NoEvidence shows that negative beliefs about vaccine efficacy and safety were associated with lower vaccination acceptance among healthcare workers, non-physician health professionals were more likely to have lower acceptance rates, and having a history of accepting influenza vaccination was associated with an increase COVID-19 vaccine acceptance rate [Review of studies of unknown quality conducted during the COVID-19 pandemic and before]Yes (row content last checked on 2021-10-18)Rapid reviewOtherCrawshaw, J., Konnyu, K., Castillo, G., van Allen, Z., Grimshaw, JM., Presseau, J. Factors affecting healthcare worker COVID-19 vaccination acceptance and uptake: A living behavioural science evidence synthesis (v2, May 18th, 2021). Ottawa: Ottawa Hospital Research Institute, May 18, 2021.
   2021-04-205/9NoStudies show that vaccination acceptance rates varied in different geographical settings from 40 %to 92%, whereas capability factors, opportunity factors and motivation factors were key important factors driving vaccination acceptance among the general public [Review of studies of unknown quality]Yes (row content last checked on 2021-10-18)Rapid reviewOther
Crawshaw, J., Konnyu, K., Castillo, G., van Allen, Z., Grimshaw, JM., Presseau, J. Factors affecting COVID-19 vaccination acceptance and uptake among the general public: A living behavioural science evidence synthesis (v1.0, Apr 30th, 2021). Ottawa: Ottawa Hospital Research Institute,
Apr 30, 2021
   2021-05-318/10YesModerate certainty evidence shows that the factors that are regarded most important for parents in considering childhood vaccination are trust in healthcare providers or government, concerns around safety and the provision of reliable informationYes (row content last checked on 2021-10-18)Rapid reviewViews and experiencesThe National Collaborating Centre for Methods and Tools. Rapid review: What is known about parents’ considerations for vaccine uptake for children and adolescents? Hamilton: NCCMT. 2021;
   N/A (Protocol)n/aNo[Protocol - results not yet available] A review evaluating vaccine hesitancy in preconception women is currently being conductedYes (row content last checked on 2021-08-30)ProtocolOtherSu X, Lu H, Li X, Li F, Zhang Q, Luo M. COVID-19 vaccine hesitancy in preconception women: A systematic review. PROSPERO. 2021;CRD42021257511.
   N/A (Protocol)n/aNo[Protocol - results not yet available] A review identifying barriers and enablers of vaccination acceptance and uptake is currently being conductedYes (row content last checked on 2021-08-30)ProtocolOtherKonnyu K, Crawshaw J, Castillo G, van Allen Z, Patey A, Presseau J et al. Barriers and enablers of COVID-19 vaccination acceptance and uptake. PROSPERO. 2021;CRD42021253533.
   N/A (Protocol)n/aNo[Protocol - results not yet available] A review exploring perceptions regarding COVID-19 vaccination is currently being conductedYes (row content last checked on 2021-09-07)ProtocolViews and experiencesLekha KS, Vardha J, Chander C, Zaidi I. Perceptions regarding Covid-19 vaccination: A systematic review. PROSPERO. 2021;CRD42021264933.
   2021-04-146/9NoSafety, historical mistrust and accessibility may be important factors for seeking or not seeking vaccination, whereas collaboration with trusted leaders, effective risk-benefit communication from trusted sources and facilitating vaccine access probably encourage vaccine uptake among Indigenous communities, Black, African, Caribbean communities, and people experiencing homelessness [Review of studies conducted during the COVID-19 pandemic and before]NoFull reviewViews and experiencesNational Collaborating Centre for Methods and Tools. Rapid review: What is known about reasons for vaccine confidence and uptake in populations experiencing inequities? McMaster University. 2021.
  Administering vaccines in ways that optimize timely uptake
2020-11-01 8/11 No Evidence suggests that refusal to get vaccinated against COVID-19 has increased over time, while being female, younger, of lower income or education level and belonging to an ethnic minority group are associated with less intention to be vaccinated [Review of studies of unknown quality] No Rapid review Views and experiences Robinson E, Jones A, Lesser I, Daly M. International estimates of intended uptake and refusal of COVID-19 vaccines: A rapid systematic review and meta-analysis of large nationally representative samples. Vaccine. 2020;39(15):2024-2034.
   N/A (Protocol)
n/a No [Protocol - results not yet available] A review exploring practices to design, implement and scale immunization information systems in low-and middle-income countries in response to a pandemic situation is currently being conductedNo Protocol Other Siribaddana P, Hewapathirana R, Sahay S. Best evidence practices in deploying electronic immunization information systems in low and middle income countries in response to COVID-19: a systematic review. PROSPERO. 2021;CRD42021229030. 
   2020-07-014/9NoA review examining the role of community pharmacies in the COVID-19 vaccine roll-out identified barriers for decision-makers, community pharmacists, and pharmacy users [Review of studies of unknown quality conducting during the COVID-19 era and before]NoRapid reviewHow and why it worksMaidment ID, Young E, MacPhee M, Booth A, Zaman H, Breen J, et al. A rapid realist review of the role of community pharmacy in the public health response to COVID-19. BMJ Open. 2021;11:050043.
   2021-05-118/9NoEvidence shows that vaccination rollout speed is a key factor to reduce attack rates from variants of concern, and vaccine schedules combined with non-pharmaceutical interventions are expected to limit the number of deaths and preserve ICU capacity [Review of studies of low to moderate quality]Yes (row content last checked on 2021-10-18)Rapid reviewOtherCurran J, Dol J, Boulos L, Somerville M, McCulloch H. Public Health and Health Systems Impacts of SARS-CoV-2 Variants of Concern. Report prepared for the SPOR Evidence Alliance and COVID-END, June 2021.
   2021-04-046/9NoAlthough limited evidence is available on the use of mass vaccination centres in COVID-19 times, the main organizational aspects to consider are the location, layout, staff members, and vaccine transportation and storage [Review of studies of unknown quality conducted during the COVID-19 pandemic and before]NoRapid reviewOtherGianfredi V, Pennisi F, Lume A, Ricciardi GE, Minerva M, Riccò M, et al. Challenges and opportunities of mass vaccination centers in COVID-19 times: A rapid review of literature. Vaccines. 2021;9(6):574.
  Surveillance, monitoring and evaluation, and reporting
        
 Approach to population-health management for COVID-19 and for those whose care is disrupted by COVID-19

        
  Segmenting the population into groups with shared health and social needs N/A (Protocol)n/aNo[Protocol - results not yet available] A review evaluating the symptoms and clinical outcomes of infection with the COVID-19 B.1.1.7 variant across black, asian and minority ethnic groups is currently being conductedYes (row content last checked on 2021-08-30)ProtocolOtherRycroft C & Underwood T. A living systematic review of the symptoms associated with the UK COVID-19 variant B117 and related clinical outcomes across Black, Asian and minority ethnic (BAME) groups. PROSPERO. 2021; CRD42021234358
   N/A (Protocol)n/aYes[Protocol - results not yet available] A review examining the lived experience of individuals with a disability and/or belonging to an ethnic minority and access to health and social care and other essential resources is currently being conductedYes (row content last checked on 2021-09-07)ProtocolViews and experiencesRivas C, Collins L, Anand K. The pandemic-relevant lived experience of disability and/or ethnic minority status with respect to health and social care services and access to essential resources. PROSPERO. 2021;CRD42021262590.
  Re-designing care pathways and in-reach and out-reach services       
  Addressing barriers to implementation of pathways and services N/A (Protocol)
n/aNo[Protocol - results not yet available] A review on the factors affecting compliance with infant feeding practices to prevent respiratory infections is currently being conductedYes (row content last checked on 2021-08-30)Protocol Views and Experiences Bick D, Fisher J, Chang Y, Sutcliffe P, Hillman S, Chien L. Barriers and Facilitators to Optimizing Parents’, Carers’ and Healthcare Workers’ Infant Feeding Hygiene Practices to Prevent Transmission of Respiratory Infectious Diseases, Including COVID-19: a Living Systematic Review. PROSPERO 2020; CRD42020184750.
  Addressing cultural safety in the implementation of pathways and services 2020-05-20
7/10 No Although very little evidence is available to understand the impact of COVID-19 on Indigenous communities, the importance of having culturally appropriate responses to address the impact of the pandemic on this population is increasingly clearYes (row content last checked on 2021-10-18)Rapid review Other National Collaborating Centre for Methods and Tools. Rapid review: What is known about the impact of the COVID-19 pandemic on Indigenous communities in Canada? Hamilton: National Collaborating Centre for Methods and Tools.; 2020.
   N/A (Protocol)n/aYes[Protocol - results not yet available] A review examining the lived experience of individuals with a disability and/or belonging to an ethnic minority and access to health and social care and other essential resources is currently being conductedYes (row content last checked on 2021-09-07)ProtocolViews and experiencesRivas C, Collins L, Anand K. The pandemic-relevant lived experience of disability and/or ethnic minority status with respect to health and social care services and access to essential resources. PROSPERO. 2021;CRD42021262590.
  Maintaining gains made in population-health management (e.g., population segmentation, virtual care) and spreading and scaling them N/A (Protocol)n/aNo[Protocol - results not yet available] A review evaluating the changes in care processes, public health policies, and behaviours at different levels of health systems due to the COVID-19 pandemic is currently being conductedYes (row content last checked on 2021-08-30)ProtocolOtherLau V, Rewa O, Sebastianski M, Lewis K, Kula B, Niven D et al. Coronavirus disease (COVID-19) and outcomes associated with pandemic effects study (COPES): a living systematic review. PROSPERO. 2020;CRD42020201256.
Delivery arrangements         
 Overall service planning for COVID-19 preventing and treatment        
  Leveraging existing health-system arrangements2020-08-10
7/10NoThe COVID-19 pandemic has resulted in an indirect effect of reducing the utilization of needed healthcare services to a greater extent than has been documented in pre-pandemic studies, although most recent studies might show an increasing trend in healthcare utilization [Review of studies of variable quality]NoFull reviewOtherMoynihan R, Sanders S, Michaleff ZA, Scott AM, Clark J, To EJ, et al. Impact of COVID-19 pandemic on utilisation of healthcare services: A systematic review. BMJ Open. 2021;11(3):e045343
 Service planning for COVID-19 prevention        
  Changing emergency-medical service procedures (ambulances, paramedics) 2020-04-06
9/10YesA systematic review of indirect evidence finds uncertainty as to whether chest compression in patients with COVID-19 is aerosol generating or leads to infection transmission in cardiac arrestNoFull reviewOtherCouper K, Taylor-Phillips S, Grove A, Freeman K, Osokogu O, Court R, et al. COVID-19 in Cardiac Arrest and Infection Risk to Rescuers: A Systematic Review. Resuscitation 2020;151: 59-66.
  Re-locating hospital-based ambulatory clinics, cancer treatments, etc.         
  Limiting access to health facilities N/A (Protocol)n/aYes[Protocol - results not yet available] A review exploring hospital visitor policies during the COVID-19 pandemic is currently being conductedYes (row content last checked on 2021-08-30)ProtocolBenefits and harmsIness A, Cockburn C, Cyrus J, Iness C, Duesberg M, Prasad V. Hospital visitor policies during the COVID-19 pandemic: A living systematic review. PROSPERO. 2021;CRD42021248603.
  Changing hospital-discharge procedures         
  Changing long-term care procedures 2020-06-26
7/10 Yes Outbreak investigations show that long-term care facilities are more vulnerable to the COVID-19 pandemic, in terms of disease spread and mortality rate
Yes (row content last checked on 2021-10-18)Full review Other Salcher-Konrad M, Jhass A, Naci H, Tan M, El-Tawil Y, Comas-Herrera A. COVID-19 Related Mortality and Spread of Disease in Long-Term Care: First Findings from a Living Systematic Review of Emerging Evidence. MedRxiv 2020. 
   2021-02-018/10 No Community incidence is probably the strongest factor associated with outbreaks in long-term care facilities, and PPE use and cleaning and hygiene measures may be associated with reduced outbreak riskNoRapid review Other National Collaborating Centre for Methods and Tools. Rapid review update 2: What risk factors are associated with COVID-19 outbreaks and mortality in long-term care facilities and what strategies mitigate risk? National Collaborating Centre for Methods and Tools. 2021;
   2020-07-27
9/11 No While mass testing of residents and staff as well as guidance on infection prevention and control measures were frequently implemented in long term care facilities their effects are uncertain [Review mainly based on observational studies of low quality]No Rapid review Other Frazer K, Mitchell L, Stokes D, Lacey E, Crowley E, Kelleher C. A rapid systematic review of measures to protect older people in long term care facilities from COVID-19. medRxiv. 2020. 
   2021-01-26
8/10 No Although evidence shows that for-profit ownership in care homes for older people has not been consistently associated with COVID-19 outbreaks, some studies show that they accounted for a larger proportion of cumulative infections and deaths, which could be explained by less access to personal protection equipment in these facilities [Review of observational studies mainly of low quality] Yes (row content last checked on 2021-10-18)Full review Other Bach-Mortensen AM, Verboom B, Esposti MD. Ownership and COVID-19 in care homes for older people: A living systematic review of outbreaks, infections, and mortalities. medRxiv. 2021.  
   2020-09-289/11NoIn aged-care facilities with a COVID-19 outbreak, an attack rate of 45% and a fatality rate of 23% was found, with limited evidence identified to inform effective prevention and control strategies [Review of studies of low to moderate quality with high heterogeneity among findings]NoFull reviewOtherHashan MR, Smoll N, King C, Ockenden-Muldoon H, Walker J, Wattiaux A, et al. Epidemiology and clinical features of COVID-19 outbreaks in aged care facilities: A systematic review and meta-analysis. EClinicalMedicine. 2021. 
  Changing home and community care procedures         
 Service planning for COVID-19 treatment         
  Scaling up/down testing capacity 2020-12-22
9/11 Yes The effects of mass testing with contact tracing compared to test and trace for effective suppression of COVID-19 are uncertain No Rapid review Benefits and harms Mbwogge M. Mass testing with contact tracing compared to test and trace for effective suppression of covid-19 in the uk: A rapid review. medRxiv. 2021.  
  Scaling up/down emergency-room capacity         
  Scaling up/down ICU capacity2020-05-01
9/11 No A meta-analysis estimated that 62% of COVID-19 patients are required to remain in hospital after initial admission [Review of studies of variable quality and substantial heterogeneity] No Full review Other Jafari A, Falahatkar S, Yekta K, Mohammad H. COVID-19 clinical characteristics, complications and comorbidity: An updated systemic review and meta-analysis. The Lancet. 2020.  
   2021-05-118/9NoWhile some data show that variants of concern have increased hospitalizations and severity, evidence shows that non-pharmaceutical interventions alongside a vaccine strategy may reduce the risk of exceeding optimal hospital capacity due to variants of concern [Review of studies of low to moderate quality]Yes (row content last checked on 2021-10-18)Rapid reviewOtherCurran J, Dol J, Boulos L, Somerville M, McCulloch H. Public Health and Health Systems Impacts of SARS-CoV-2 Variants of Concern. Report prepared for the SPOR Evidence Alliance and COVID-END, June 2021.
  Scaling up/down post-ICU recovery capacity (e.g., hospital beds)         
  Scaling up/down palliative-care capacity N/A (Protocol)
n/aNo [Protocol - results not yet available] A review exploring best practices for supporting persons at end of life during COVID-19 is currently being conductedNo Protocol Other Dowsett L, Clement F, Farkas B, Li J. Best practices for supporting persons at end of life during COVID-19: Rapid review. PROSPERO. 2020; CRD42020210943.  
   N/A (Protocol)
n/a No [Protocol - results not yet available] A review synthesizing mobile applications for helping patients in end-of-life care is currently being conductedNo Protocol Other Longo M, Anomneze-Collins A, Mann M, Nelson A. In light of the COVID-19 pandemic, a realist synthesis of mobile application-enabled communication and care management for patients in end-of-life care. PROSPERO. 2021; CRD42021231535. 
  Scaling up/down COVID-19 sequelae-management capacity 2021-05-276/9NoTwelve international care models have been found to treat long COVID-19 symptoms, including a coordination unit, primary care pathways, multidisciplinary rehabilitation and specialized medical services; no evidence on the impact or costs of these models have been foundYes (row content last checked on 2021-10-18)Rapid reviewOtherDecary S, Dugas M, Stefan T, Langlois L, Skidmore B, Bhéreur A, and LeBlanc A. (2021). Care Models for Long COVID – A Rapid Systematic Review. SPOR Evidence Alliance, COVID-END Network.
  Scaling up/down capacity to manage the pandemic-related impacts on health more generally (e.g., mental health and addictions) N/A (Protocol)n/aNo[Protocol - results not yet available] A review evaluating the impacts of COVID-19 on health-related quality of life among Black, Asian, and minority ethnic groups is currently being conductedYes (row content last checked on 2021-08-30)ProtocolOtherRycroft C, King-Okoye M, Underwood T. A living systematic review of the impacts of COVID-19 on the health-related quality of life across Black, Asian and minority ethnic (BAME) groups. PROSPERO. 2021; CRD42021238645 Available from: https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42021238645
  Surge-management models 2020-07-09
4/10 No Hospital surge capacity planning models differ in their planning horizon, age-stratification parameters, and patient care pathwaysNo Full review Other Klein MG, Cheng CJ, Lii E, Mao K, Mesbahi H, Zhu T, et al. COVID-19 models for hospital surge capacity planning: A systematic review. Disaster Medicine and Public Health Preparedness. 2020:1-17. 
  Triage protocols 2020-03-26
7/9 Yes Key factors affecting adherence to infection prevention and control guidelines among healthcare workers include their design and content, how they are communicated, and whether there is adequate organizational support, training, and access to personal prot  NoRapid review Other Houghton C, Meskell P, Delaney H, et al. Barriers and Facilitators to Healthcare Workers' Adherence with Infection Prevention and Control (IPC) Guidelines for Respiratory Infectious Diseases: a Rapid Qualitative Evidence Synthesis. Cochrane Database Syst Rev 2020;4(4):CD013582. 
   2020-04-21
7/11 No Initial results from attempts to develop a risk stratification and triage tool for patients with comorbid COVID-19 and cardiovascular disease indicate clinical history, physical examination, pulse oxymetry and other laboratory markers can help recognize high-risk patients in a timely manner, although validation of the tool in future studies is still neededNo Full review Other Momtazmanesh S, Shobeiri P, Hanaei S, Mahmoud-Elsayed H, Dalvi B, Malakan Rad E. Cardiovascular disease in COVID-19: a systematic review and meta-analysis of 10,898 patients and proposal of a triage risk stratification tool. Egypt Heart J. 2020;72(1):41. Published 2020 Jul 13. doi:10.1186/s43044-020-00075-z
  Infection prevention and control measures in health facilities2020-06-08 8/10No No evidence was found on the effectiveness of cohorting COVID-19 positive residents to shared rooms in healthcare facilitiesNo Rapid review Benefits and harms Technical Advisory Committee, Health Agency of Canada. Rapid review: What is the effectiveness of cohorting virus-positive residents to shared rooms in care facilities? Hamilton, ON: National Collaborating Centre for Methods and Tools; 2020. 
   2020-04-068/11 No Using preprocedural mouth rinse using tempered clorhexidine appears to be the preferred method to reduce the aerosol-related bacterial load in dental practice No Full review Other Koletsi D, Belibasakis GN, Eliades T. Interventions to Reduce Aerosolized Microbes in Dental Practice: A Systematic Review with Network Meta-analysis of Randomized Controlled Trials [published online ahead of print, 2020 Jul 13]. J Dent Res. 2020;22034520943574. doi:10.1177/0022034520943574 
   2020-05-27
6/10 No The evidence available is insufficient to evaluate the effectiveness of aerosol boxes and barrier enclosures for airway management in COVID-19 patientsNo Full review Other Sorbello M, Rosenblatt W, Hofmeyr R, Greif R, Urdaneta F. Aerosol boxes and barrier enclosures for airway management in COVID-19 patients: A scoping review and narrative synthesis. British Journal of Anaesthesia. 2020. 
   2020-06-22
7/9 No The limited number of low-quality studies available makes is difficult to determine which effective infection prevention and control practices can be used in inpatient psychiatric facilities No Rapid review Other National Collaborating Centre for Methods and Tools. What is known about best practices for infection prevention and control in inpatient psychiatric facilities? Hamilton, ON: National Collaborating Centre for Methods and Tools; 2020. 
   2020-10-277/9NoVariable levels of air contamination with SARS-CoV-2 RNA were found in hospital settings, with greater contamination close to public areas (e.g., bathrooms, staff areas, etc.), although viable virus particles were rarely contained in samples [Review of studies of unknown quality]NoFull reviewOtherBirgand G, Peiffer-Smadja N, Fournier S, Kerneis S, Lescure FX, Lucet JC. Assessment of air contamination by SARS-CoV-2 in hospital settings. JAMA Netwwork Open. 2020;3(12):e2033232. 
   2020-08-014/9NoUsing negative pressure, HEPA filters,  dedicated separate rooms, avoiding aerosol-generating procedures, and minimizing the number of staff are some of the risk-mitigation measures taken in orthopaedic operating rooms for treating COVID-19 patients [Review of studies of unknown quality]NoFull reviewOtherTarun V, Anurag T, Yugal K, Raj K, Lalit M. Orthopaedic operating room considerations in covid-19 pandemic: A systematic review. Journal of Arthroscopy and Joint Surgery. 2021.
   2020-10-285/11NoEvidence shows that aerosol-generating procedures (particularly endotracheal intubation, non-invasive ventilation, and administering nebulized medications) increase the risk to healthcare workers of contracting SARS-CoV-2 and other coronaviruses [Review of studies of unclear quality conducted during the COVID-19 pandemic, MERS and SARS outbreaks]NoFull reviewOtherChan VW, Ng HH, Rahman L, Tang A, Tang KP, Mok A et al. Transmission of Severe Acute Respiratory Syndrome Coronavirus 1 and Severe Acute Respiratory Syndrome Coronavirus 2 during aerosol-generating procedures in critical care: A systematic review and meta-analysis of observational studies. Crit Care Med. 2021.
   2021-01-047/10NoUsing PPE, dental suction, air cleaning systems, and mouth rinsing might play a crucial role on mitigating the risk of COVID-19 transmission in orhodontics when performing aerosol generating procedures [Review of studies of low to moderate quality]NoFull reviewOtherSingh H, Maurya RK, Sharma P, Kapoor P, Mittal T. Aerosol generating procedural risks and concomitant mitigation strategies in orthodontics amid COVID-19 pandemic - An updated evidence-based review. International Orthodontics. 2021. 
  Death certification         
  Handling dead bodies         
 Service planning for the ongoing management of other conditions         
  Changing acute care surgery and trauma-care procedures N/A (Protocol)n/aYes[Protocol - results not yet available] A review examining the impact of COVID-19 on maxillofacial surgery practice is currently being conductedNoProtocolOtherPagotto LEC & Pastore GP. Impact of COVID-19 on maxillofacial surgery practice: A systematic review. PROSPERO. 2021; CRD42021241303
   2021-02-288/11NoEvidence shows that the COVID-19 pandemic has delayed timely care for ST-segment elevation myocardial infarction, with an increase in mortality only reported for low-and-middle income countries [Review of studies of unknown quality with important heterogeneity among some of their findings]NoFull reviewOtherChew NW, Ow ZGW, Teo VXY, Heng RRY, Ng CH, Lee CH, et al. The global impact of the COVID-19 pandemic on STEMI care: A systematic review and meta-analysis. Canadian Journal of Cardiology. 2021.
   2020-11-138/11NoEvidence shows that the COVID-19 pandemic has globally impacted stroke care with a reduction in stroke admissions and delays in stroke treatment [Review of studies of unclear quality and substantial heterogeneity among their findings]NoFull reviewOtherReddy ST, Satani N, Beauchamp JES, Selvaraj S, Rajan SS, Rahbar MH, et al. A meta-analysis of the global impact of the COVID-19 pandemic on stroke care & the Houston Experience. Annals of Clinical and Translational Neurology. 2021;8(4):929-937.
   2020-11-016/11NoThe rate of application of non-operative management of acute appendicitis during the COVID-19 pandemic substantially varies across geographical regions, whereas it may be a safe, short-term alternative to surgery [Review of studies of mainly low quality with important heterogeneity among their findings]NoFull reviewOtherEmile SH, Hamid HKS, Khan SM, Davis GN. Rate of Application and Outcome of Non-operative Management of Acute Appendicitis in the Setting of COVID-19: Systematic Review and Meta-analysis. Journal of Gastrointestinal Surgery. 2021:1–11. 
   2021-02-256/10NoA large portion of studies have reported a decrease on hospitalizations for cardiometabolic conditions (e.g., strokes, heart failures) during the COVID-19 pandemic with a less severe presentation [Review of studies of mainly moderate quality]NoFull reviewOtherSeidu S, Kunutsor SK, Cos X, Khunti K. Indirect impact of the COVID-19 pandemic on hospitalisations for cardiometabolic conditions and their management: A systematic review. Primary Care Diabetes. 2021. 
  Changing cancer-treatment procedures 2020-06-20
5/10 No A number of strategies to prevent the spread of COVID-19 among children with cancer have been implemented, but their effects are uncertain [Review mainly based on observational studies of low quality] No Rapid review Other Amicucci M, Mastronuzzi A, Ciaralli I, Piccioni F, Schiopu AC, Tiozzo E, Gawronski O, Biagioli V, Dall'Oglio I. The management of children with cancer during the COVID-19 pandemic: A rapid review. J Clin Med. 2020 Nov 21;9(11):3756. 
   2020-07-028/9NoEvidence shows the COVID-19 pandemic has resulted in diverse impacts on cancer care, including delays and disruptions in cancer services which has had impacts on treatment, diagnoses and service processes [Review of studies of low to moderate quality]NoFull reviewOtherRiera R, Bagattini AM, Pacheco RL, Pachito DV, Roitberg F, Ilbawi A. Delays and disruptions in cancer health care due to COVID-19 pandemic: Systematic review.  JCO Global Oncology. 2021;7:311-323. 
   2020-07-149/11NoAlthough nine different strategies for mitigating delays and disruptions in cancer care due to COVID-19 were found, the methodological quality of the studies is too low to make certain conclusions [Review of observational studies of low and moderate quality]NoFull reviewOtherPacheco RL, Martimbianco ALC, Roitberg F, Ilbawi A, Riera R. Impact of Strategies for Mitigating Delays and Disruptions in Cancer Care Due to COVID-19: Systematic Review. JCO Global Oncology. 2021 Feb;7:342-352.
   N/A (Protocol)n/aYes[Protocol - results not yet available] A review evaluating the impact of the COVID-19 pandemic on cancer patients using an economic and social perspective is currently being conductedNoProtocolOtherMurphy A, Kirby A, Drummond F, Lawlor A. A systematic review of the impact of COVID-19 pandemic on cancer patients and survivors from an economic and social perspective. PROSPERO. 2021;CRD42021246651.
   2020-12-017/9NoThe COVID-19 pandemic has impacted cancer patients and their caregivers mainly by creating barriers for screening and diagnosis, and increasing anxiety and fear [Review of studies of unknown quality]NoFull reviewViews and experiencesDhada S, Stewart; D, Cheema E, Hadi MA, Paudyal V. Cancer services during the COVID-19 pandemic: Systematic review of patients' and caregivers' experiences. medRxiv. 2021. 
   2020-12-1410/11NoPoorer survival of colorectal cancer patients has been found when delaying elective surgeries (in response to pandemic lockdowns or other contexts), particularly after 3 months [Review of observational studies of low to moderate quality with moderate heterogeneity among their findings]NoFull reviewBenefits and harmsWhittaker TM, Abdelrazek MEG, Fitzpatrick AJ, Froud JLJ, Kelly JR, Williamson JS, et al. Delay to elective colorectal cancer surgery and implications for survival: A systematic review and meta-analysis. Colorectal Disease. 2021. 
   2020-12-284/10NoAn important decrease in cancer screening and biopsy sampling have been reported during the COVID-19 pandemic, which could result in high levels of under-diagnosed cancers [Review of studies of moderate quality]NoFull reviewOtherAlkatout I, Biebl M, Momenimovahed Z, Giovannucci E, Hadavandsiri F, Salehiniya H, et al. Has COVID-19 affected cancer screening programs? A systematic review. Frontiers in Oncology. 2021;11. 
   2020-12-017/11NoAmong patients with glioma, surgical admissions do not differ comparing COVID-19 with non-COVID-19 patients, although overall complications and mortality were higher among non-COVID-19 patients [Review of studies of mainly moderate quality and important heterogeneity among some of their findings]NoFull reviewOtherAzab MA & Azzam AY. Impact of COVID-19 pandemic on the management of glioma patients around the world. An evidence-based review. Brain Disord. 2021;2:100012. 
  Changing reproductive care2021-01-088/11NoEvidence suggests that the COVID-19 pandemic might have increased maternal mortality, still birth, maternal stress and ruptured ectopic pregnancies, and some differences can be seen when comparing high-income countries with low- and middle-income countries [Review of studies of variable quality and substantial heterogeneity]NoFull reviewOtherChmielewska B, Barratt I, Townsend R, Kalafat  E, van der Meulen J, Gurol-Urganci I. Effects of the COVID-19 pandemic on maternal and perinatal outcomes: A systematic review and meta-analysis. Lancet Global Health. 2021.
   N/A (Protocol)n/aYes[Protocol - results not yet available] A review exploring the perceived social support of pregnant women and mothers during the COVID-19 pandemic is currently being conductedNoProtocolOtherUlambayar S, Carandang RR, Sakamoto JL, Karel M, Shibanuma A, Yarotskaya E, et al. Perceived social support of pregnant women and mothers during the COVID-19 pandemic: A systematic review. PROSPERO. 2021;CRD42021246074.
   2020-12-108/11NoEvidence suggests that the highly variable rates of anxiety and depressive symptoms among women in the antenatal and postnatal periods have increased during the COVID-19 pandemic [Review of studies of moderate quality with important heterogeneity among their findings]NoFull reviewOtherShorey SY, Ng ED, Chee CYI. Anxiety and depressive symptoms of women in the perinatal period during the COVID-19 pandemic: A systematic review and meta-analysis. Scand J Public Health. 2021:14034948211011793. 
   2020-10-016/9NoImportant variations were found in the impacts of COVID-19 on sexual and reproductive health globally; family planning services, sexual behavior, and maternal and child health services were found to be affected by the COVID-19 pandemicNoFull reviewOtherBolarinwa OA, Ahinkorah BO, Seidu AA, Ameyaw EK, Saeed BQ, Hagan JE Jr, et al. Mapping evidence of impacts of COVID-19 outbreak on sexual and reproductive health: A scoping review. Healthcare. 2021;9(4):436.
   2021-05-149/11NoCompared to pre-pandemic levels, no differences have been found in the adjusted pre-term birth or maternal mortality rates during the COVID-19 pandemic [Review of studies of moderate quality with important heterogeneity among some of the outcomes]Yes (row content last checked on 2021-10-18)Full reviewOtherYang J, D'souza R, Kharrat A, Fell DB, Snelgrove JW, Murphy KE, et al. COVID-19 pandemic and population-level pregnancy and neonatal outcomes: A living systematic review and meta-analysis. Acta Obstetricia Gynecologica Scandinavica. 2021.
   2021-04-178/11NoMaternity care seeking and provision have been reduced globally during the COVID-19 pandemic [Review of studies of variable quality]NoFull reviewOtherTownsend R, Chmielewska B, Barratt I, Kalafat E, van der Meulen J, Gurol-Urganci I, et al. Global changes in maternity care provision during the COVID-19 pandemic: A systematic review and meta-analysis. EClinicalMedicine. 2021;37:100947.
  Delaying return visits, elective procedures, etc. 2020-07-01 6/9 No Surgical practice was affected by hospital lockdown, but no evidence was found on the impact of these surgical practice changes on patient outcomes [Review of studies conducted during COVID-19, Ebola, MERS and SARS outbreaks]Yes (row content last checked on 2021-10-18)Rapid reviewOtherLee Y, Kirubarajan A, Patro N, Sam Soon M, Doumouras AG, Hong D. Impact of hospital lockdown secondary to COVID-19 and past pandemics on surgical practice: A living rapid systematic review. American Journal of Surgery. 2020;S0002-9610(20)30742-X.
   2020-07-20
6/11 No There have been steep declines in certain orthopedic services including elective surgeries and outpatient services due to the impact of COVID-19 pandemic, although this decline hasn't been seen for trauma surgeries [Review of studies of variable quality] No Full review Other Ow ZGW, Cheong CK, Chin YH, Chin BZ. A look at the global impact of SARS CoV-2 on orthopedic services. Journal of Clinical Orthopaedics and Trauma. 2020. 
   2021-02-114/9NoIt is uncertain whether SARS-CoV-2 can be detected in abdominal tissues, fluids and surgical smoke associated with laparoscopies [Review of mainly case reports and series]NoFull reviewOtherCheruiyot I, Sehmi P, Ngure B, Misiani M, Karau P, Olabu B, Henry BM, Lippi G, Cirocchi R, Ogeng'o J. Laparoscopic surgery during the COVID-19 pandemic: detection of SARS-COV-2 in abdominal tissues, fluids, and surgical smoke. Langenbeck's Archives of Surgery. 2021 Mar 6:1–8.
   2020-12-1410/11NoEvidence suggests that delays to elective colorectal cancer surgery may have a negative impact on overall survival [Review of studies of low to moderate quality conducted during the COVID-19 pandemic and before, with moderate heterogeneity among their findings]NoFull reviewOtherWhittaker TM, Abdelrazek MEG, Fitzpatrick AJ, Froud JLJ, Kelly JR, Williamson JS, et al. Delay to elective colorectal cancer surgery and implications for survival: A systematic review and meta-analysis. Colorectal Disease. 2021. 
   2020-07-084/10NoEvidence shows that most patients and caregivers waiting for procedures during the COVID-19 pandemic have experienced anxiety or depression, with women, young people, new immigrants, and those of lower socio-economic status particularly at risk; some strategies to ameliorate these problems are evaluated [Review of studies of unclear quality]NoFull reviewOtherGagliardi AR, Yip CYY, Irish J, Wright FC, Rubin B, Ross H, et al. The psychological burden of waiting for procedures and patient-centred strategies that could support the mental health of wait-listed patients and caregivers during the COVID-19 pandemic: A scoping review. Health Expectations. 2021.
   2021-02-284/9NoA moderate to severe disruption of neurological services has been described during the COVID-19 pandemic, while telemedicine has been the most frequently mentioned strategy to address these disruptions [Review of studies of unclear quality]NoFull reviewOtherGarcía-Azorín D, Seeher KM, Newton CR, Okubadejo NU, Pilotto A, Saylor D, et al. Disruptions of neurological services, its causes and mitigation strategies during COVID-19: A global review. Journal of Neurology. 2021.
 Infrastructure planning and resource allocation         
  Personal protective equipment under shortage conditions (including N95 respirators for health workers)  2020-06-04
7/11No Stockpiling, extending use, and UV decontamination are promising strategies to address mask shortage during pandemics, although their effects remain uncertain [Review of studies conducting during COVID-19, Ebola, H1N1 and SARS outbreaks]
No Full review OtherKirubarajan A, Khan S, Got T, Yau M, Bryan JM, Friedman SM. Mask shortage during epidemics and pandemics: A scoping review of interventions to overcome limited supply. BMJ Open. 2020;10(11):e040547. 
  For reusing or decontaminating PPE, see public-health measures         
  Ventilators for sick COVID-19 patients 2020-05-01 6/9No A number of decision-support tools exist to inform the allocation of ICU beds and ventilators during public-health emergencies including COVID-19No Full review Other Cardona M, Dobler C, Koreshe E, Heyland DK, Nguyen R, Sim JPY, et al. Scoping review supporting decision-making on allocation of ICU beds and ventilators in pandemics. medRxiv. 2020. 
   N/A (protocol)
n/a Yes [Protocol - results not yet available] A review exploring the ethical implications of using severity scores for allocating ICU health resources is currently being conductedNo Protocol Other Santos R, Rego S, Brito L. Micro allocation of health resources and ethical implications: A systematic review. PROSPERO. 2020; CRD42020214029.  
   2020-08-088/11NoEvidence evaluating the outcomes of patients with severe COVID-19 who are being treated with invasive mechanical ventilation showed that a high mortality rate was found among different countries, although it has substantially decreased over time [Review of studies with unclear quality and important heterogeneity among their findings]NoFull reviewBenefits and harmsElsayed HH, Hassaballa AS, Ahmed TA, Gumaa M, Sharkawy HY, Moharram AA. Variation in outcome of invasive mechanical ventilation between different countries for patients with severe COVID-19: A systematic review and meta-analysis. PLoS One. 2021;16(6):e0252760.
  Medications and other technologies (under shortage conditions due to disrupted supply chains) 2020-06-305/9NoMultiple barriers and facilitators related to the provision of safe drug supply during pandemics have been identified [Review of studies of unknown quality conducted during the COVID-19 pandemic and before]NoFull reviewOtherBonn M, Touesnard N, Cheng B, Pugliese M, Comeau E, Bodkin C, et al. Securing safe supply during COVID-19 and beyond: Scoping review and knowledge mobilization. CIHR. 2020;
  Remote monitoring 2020-05-314/9 No Patients who have received respiratory rehabilitation and have ongoing complications as a result of COVID-19 may require telemonitoring during the post-acute phase of their illness
Yes (row content last checked on 2021-10-18)Full review Other de Sire A, Andrenelli E, Negrini F, Negrini S, Ceravolo M. Systematic Rapid Living Review on Rehabilitation Needs Due to Covid-19: Update to April 30th 2020. Eur J Phys Rehabil Med 2020. 
   2020-06-01
6/10 No A number of COVID-19 mobile apps have shown benefits related to patient and provider information provision, and may help facilitate patient monitoring and follow-up [Review mainly based on observational studies of low quality]No Full review Other Kondylakis H, Katehakis DG, Kouroubali A, Logothetidis F, Triantafyllidis A, Kalamaras I, et al. COVID-19 mobile apps: A systematic review of the literature. Journal of Medical Internet Research. 2020.  
  Virtual visits 2020-04-30
4/9 No Patients who have received respiratory rehabilitation and have ongoing complications as a result of COVID-19 may require telerehabilitation during the post-acute phase of their illness
Yes (row content last checked on 2021-10-18)Full review Other de Sire A, Andrenelli E, Negrini F, Negrini S, Ceravolo M. Systematic Rapid Living Review on Rehabilitation Needs Due to Covid-19: Update to April 30th 2020. Eur J Phys Rehabil Med 2020. 
   2020-04-08
5/9 No Studies from the pre-COVID era show that telehealth has been succesfully used to provide ongoing care for a number of urologic conditions, including prostate cancer and urinary infectionNo Full review Other Novara G, Checcucci E, Crestani A, Abrate A, Esperto F, Pavan N, et al. Telehealth in urology: A systematic review of the literature. How much can telemedicine be useful during and after the COVID-19 pandemic? European Urology. 2020;S0302-2838(20)30454-1. 
   2020-04-05
4/9 No The use of telemedicine might be feasible for use in neurosurgical patients, although some results from resource-constrained settings show promise [Review of studies conducted during the pre-COVID era and beyond]No Full review Other Eichberg DG, Basil GW, Di L, Shah AH, Luther EM, Lu VM. Telemedicine in neurosurgery: Lessons learned from a systematic review of the literature for the COVID-19 era and beyond. Neurosurgery. 2020;nyaa306. 
   2020-05-01
6/9No Telemedicine for orthopaedics consultations can be safe, cost-effective, and be used to accurately diagnose patients, while having good acceptability among both patients and providers [Review based on studies of variable quality]No Full review Benefits and harms Haider Z, Aweid B, Subramanian P, Iranpour F. Telemedicine in orthopaedics and its potential applications during COVID-19 and beyond: A systematic review. Journal of telemedicine and telecare. 2020;1357633X20938241. 
   2020-06-015/9 No Virtual care interventions appear most effective as a supplement to or facilitator of in-person trauma-focused care for psychological therapies to reduce the psychological symptoms associated with domestic violence or sexual assault [Review based on studies of unknown quality]No Rapid review Benefits and harms Montesanti S, Silverstone P, Wells L, Ghidei W. Examining the use of virtual care interventions to provide trauma-focused treatment to domestic violence and sexual assault populations. Edmonton, AB: Canadian Institutes of Health Research; 2020. 
   2020-05-044/10NoWhereas limited evidence is available about impact of teleophtalmology during the COVID-19 pandemic, some studies have evaluated the implementation of the approach on multiple aspects of patient care [Review of studies of variable quality conducted during the COVID-19 pandemic and before] NoFull reviewOtherChong JC, Tan CHN, Chen DZ. Teleophthalmology and its evolving role in a COVID-19 pandemic: A scoping review. Annals of the Academy of Medicine. 2021;50(1):61-76.
   2020-05-317/9NoEvidence has shown that genetic counseling using videoconferencing was equivalent to receiving face to face counselling in terms of patient satisfaction, knowledge, and psychosocial outcomes, while limited evidence is available on the effects on provider satisfaction and behavioral outcomes [Review of studies of low quality conducted during the COVID-19 pandemic and before]NoFull reviewOtherBrown EG, Watts I, Beales ER, Maudhoo A, Hayward J, Sheridan E et al. Videoconferencing to deliver genetics services: A systematic review of telegenetics in light of the COVID-19 pandemic. Genet Med. 2021:1–12. 
   2020-04-017/11NoEvidence shows that virtual testing and assessment for cognitive conditions might have acceptable diagnostic accuracy compared to in-person assessment, while insufficient evidence was found on telephone assessment [Review of studies of unknown quality]NoFull reviewOtherWatt JA, Lane NE, Veroniki AA, Vyas MV, Williams C, Ramkissoon N et al. Diagnostic accuracy of virtual cognitive assessment and testing: Systematic review and meta-analysis. J Am Geriatr Soc. 2021.  
 Workforce planning (including workforce shortages management) and development         
  Recruitment        
  Role extensions N/A (protocol)
n/a No [Protocol - results not yet available] A review evaluating the role of assistant in medicine for a workforce planning response to the COVID-19 pandemic is currently being conductedNo Protocol Other Davids J, Monrouxe L, Hockey P, OMara D, Khanna P, Klinner C, et al. Assistant in medicine as a workforce planning response to the COVID-19 pandemic in New South Wales: Protocol for a realist approach to evaluation. PROSPERO. 2020; CRD42020210585.  
   2020-05-265/9NoA number of different roles have been identified for medical students during pandemics and other global health emergencies, and they are often willing to provide support to the healthcare workforce in these contexts [Review of studies of unclear quality conducted before the COVID-19 pandemic]NoRapid reviewOtherMartin A, Blom IM, Whyatt G, Shaunak R, Viva MIF, Banerjee L. A rapid systematic review exploring the involvement of medical students in pandemics and other global health emergencies. Disaster Medicine and Public Health Preparedness. 2020;1-30.
  Training in new procedures 2020-03-19
8/10NoDisaster-training programs for medical students seems to improve their knowledge, skills and pandemic preparedness; no evidence on clinical performance was identified [Review of observational studies]NoFull reviewOtherAshcroft J, Byrne MHV, Brennan PA, et al Preparing medical students for a pandemic: a systematic review of student disaster training programmes. Postgraduate Medical Journal Published Online First: 09 June 2020.
   2020-05-18
5/9 No Online learning in medical education can be facilitated by using video conferencing synchronolousy, and giving instructors enough tools to adapt existing teaching strategies that enable the creation of a supportive learning environmentNo Rapid review Other Gordon M, Patricio M, Horne L, Muston A, Alston SR, Pammi M, et al. Developments in medical education in response to the COVID-19 pandemic: A rapid BEME systematic review: BEME Guide No. 63. Medical Teacher. 2020;1–14.  
   2021-04-246/10 No Training in infection prevention and control has consistently been associated with a decreased risk of coronavirus infection among healthcare workers [Review of studies conducted during COVID-19, MERS and SARS outbreaks]Yes (row content last checked on 2021-10-18)Rapid review Other Chou R, Dana T, Buckley D, Selph S, Fu R, Totten A. Update alert 9: Epidemiology of and risk factors for coronavirus infection in health care workers. Ann Intern Med 2021; L21-0034.
   2020-12-01
7/10 No A review describes and reports the results of different approaches to training redeployed staff during the COVID-19 pandemic [Review of studies of observational studies of unknown quality]No Full review Other San Juan NV, Camilleri M, Jeans JP, Monkhouse A, Chisnall G, Vindrola-Padros C. Redeployment and training of healthcare professionals to intensive care during COVID-19: A systematic review. medRxiv. 2021.  
   2020-06-016/10NoResident medical education has been heavily affected by the COVID-19 pandemic, particularly in surgical specialties [Review of studies of unknown quality]NoFull reviewOtherChasset F, Barral M, Steichen O, Legrand A. Immediate consequences and solutions used to maintain medical education during the COVID-19 pandemic for residents and medical students: A restricted review. Postgraduate Medical Journal. 2021. Epub ahead of print. 
   N/A (Protocol)n/aYes[Protocol - results not yet available] A review exploring health worker education during the COVID-19 pandemic is currently being conductedYes (row content last checked on 2021-08-30)ProtocolOtherDedeilia A, Papadopoulos A, Papapanou M, Sideris M, Johnson EO, Fitzpatrick S et al. Health worker education during the COVID-19 pandemic: Shallenges, responses and lessons for the future - A living systematic review. PROSPERO. 2021;CRD42021256629.
  Replacements when sick         
  Re-deployment2020-12-01 7/10 No Evidence shows that developing staff work groups based on skills rather than specialty,  maximizing the use of transferable skills, having a supportive environment, and developing flexible arrangements are key strategies to successful redeployment of staff to intensive care during the COVID-19 pandemic  [Review of studies of observational studies of unknown quality]No Full review Other San Juan NV, Camilleri M, Jeans JP, Monkhouse A, Chisnall G, Vindrola-Padros C. Redeployment and training of healthcare professionals to intensive care during COVID-19: A systematic review. medRxiv. 2021.  
  Supports to unpaid caregivers N/A (Protocol) n/a No [Protocol - results not yet available] A review addressing technology-based health solutions for cancer caregivers is currently being conductedNoProtocol Other Su Z, McDonnell D, Liang B, Kue J, Li X, Segalo S, et al. Technology-based health solutions for cancer caregivers to better shoulder the impact of COVID-19: A systematic review protocol. Research Square. 2020. 
   N/A (Protocol)n/aNo[Protocol - results not yet available] A review examining the effects of COVID-19 on caregivers of patients with chronic diseases is currently being conductedNoProtocolOtherRuksakulpiwat S, Zhou W, Phianhasin L, Benjasirisan C, Fan Y, Su T. Effects of COVID-19 on caregivers of patients with chronic diseases: A systematic review. PROSPERO. 2021; CRD42021241081
   N/A (Protocol)n/aNo[Protocol - results not yet available] A review evaluating psychological interventions to support caregivers during the COVID-19 pandemic is currently being conductedNoProtocolBenefits and harmsBertuzzi V, Bruno D, Usubini AG, Semonella M, Giusti EM, Cattivelli R, et al. Psychological interventions to support caregivers during COVID-19 pandemic: A systematic review. PROSPERO. 2021; CRD42021237827
   2021-03-155/9NoThe COVID-19 pandemic has negatively impacted the health and well-being of informal caregivers of people with dementia, with anxiety and depression being particularly prevalent [Review of studies of unclear quality]NoRapid reviewOtherHughes MC, Liu Y, Baumbach A. Impact of COVID-19 on the health and well-being of informal caregivers of people with dementia: A rapid systematic review. Gerontology & Geriatric Medicine. 2021;7:23337214211020164. 
  Volunteer engagement         
  Self-management supports         
  See Clinical management of pandemic-related impacts on health more generally/Burn-out and trauma in essential workers        
 Service planning for ‘return to normal’         
  Sequencing of services re-starting, by sector, conditions, treatments (including diagnostics), and populations 2020-06-08 4/9 No A review evaluating the evidence regarding the resumption of elective surgery only found modelling studies estimating the time needed to clear the backlog of deferred and cancelled procedures, and no assessments of the options available to efficiently resume these services were identifiedNo Rapid review Other Health, N., 2020. Resuming Elective Surgery. [ebook] NSW Government. Available at: <https://www.aci.health.nsw.gov.au/__data/assets/pdf_file/0003/594516/20200713-Evidence-Check-Resume_Elec-Surg.pdf> [Accessed 23 July 2020]. 
   2020-07-149/11NoAlthough nine different strategies for mitigating delays and disruptions in cancer care due to COVID-19 were found, the methodological quality of the studies is too low to make certain conclusions [Review of observational studies of low and moderate quality]NoFull reviewOtherPacheco RL, Martimbianco ALC, Roitberg F, Ilbawi A, Riera R. Impact of Strategies for Mitigating Delays and Disruptions in Cancer Care Due to COVID-19: Systematic Review. JCO Global Oncology. 2021 Feb;7:342-352.
   2021-03-304/9NoWhereas COVID-19 vaccination has been required for patients undergoing an elective surgery, timing of surgery, vaccine prioritization and disease prevalence need to be considered when deciding to resume elective surgeries [Review of studies of unknown quality]NoRapid reviewOtherNSW government- COVID-19 Critical Intelligence Unit. COVID-19 vaccine and elective surgery. 2021.
  Wait-lists management 2020-07-084/10NoEvidence shows that most patients and caregivers waiting for procedures during the COVID-19 pandemic have experienced anxiety or depression, with women, young people, new immigrants, and those of lower socio-economic status particularly at risk [Review of studies of unclear quality]NoFull reviewOtherGagliardi AR, Yip CYY, Irish J, Wright FC, Rubin B, Ross H, et al. The psychological burden of waiting for procedures and patient-centred strategies that could support the mental health of wait-listed patients and caregivers during the COVID-19 pandemic: A scoping review. Health Expectations. 2021.
Financial arrangements         
 Financing health services         
 Funding organizations         
 Remunerating providers         
  New or adjusted fee codes for virtual care         
  Income replacement when virtual care is not possible (at the same scale)         
 Purchasing products and services         
Governance arrangements (who can make what decisions)         
 Consumer and stakeholder involvement         
 Professional authority         
  Licensure changes to accommodate out-of-jurisdiction or retired health workers2020-08-316/10NoEvidence reports that the COVID-19 pandemic has impacted surgical training by reducing operative and clinical experience [Review of studies of unknown quality]NoFull reviewOtherHope C, Reilly JJ, Griffiths G, Lund J, Humes D. The impact of COVID-19 on surgical training: A systematic review. Techniques in Coloproctology. 2021;1-16. 
 Commercial authority         
  Technology approvals, public-private partnerships 2020-11-017/9NoTelemedicine is a useful tool to prevent contagion and overwhelmed health services during pandemics, whereas legislation remains a limitation to the implementation of telemedicine in different health systems [Review of studies of unknown quality]NoFull reviewOtherde Oliveira Andrade A, Soares AB, de Andrade Palis A, Cabral AM, Barreto CGL, de Souza DB, et al. On the use of telemedicine in the context of COVID-19: Legal aspects and a systematic review of technology. Research on Biomedical Engineering. 2021:1–19.
 Organizational authority         
  Limits of number of staff sent in         
  Ownership
2021-01-26 8/10 No Although evidence shows that for-profit ownership in care homes for older people has not been consistently associated with COVID-19 outbreaks, some studies show that they accounted for a larger proportion of cumulative infections and deaths, which could be explained by less access to personal protection equipment in these facilities [Review of observational studies mainly of low quality]Yes (row content last checked on 2021-10-18)Full review Other Bach-Mortensen AM, Verboom B, Esposti MD. Ownership and COVID-19 in care homes for older people: A living systematic review of outbreaks, infections, and mortalities. medRxiv. 2021. 
 Policy authority         
  Strengthening health-system governance        
  Federal versus provincial         
  Adhering to the International Health Regulations