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
        
  Communicating vaccine-allocation plans and the safety and effectiveness of vaccines
2020-10-207/9NoA universal trend of increased vaccine hesitancy was found across different countries and society groups, although the framing of pandemic-related communications could motivate positive and collective pandemic responses [Review of studies of unknown quality]NoRapid reviewOtherLin C, Tu P, Beitsch LM. Confidence and receptivity for COVID-19 vaccines: A rapid systematic review. Vaccines (Basel). 2020;9(1):E16
   N/A (Protocol)n/aYes[Protocol - results not yet available] A review evaluating the impact of perceived risks and safety of available vaccines to explain vaccine acceptance and uptake is currently being conductedNoProtocolOtherGrieve K, McClatchey K, Jackson T. What is the impact of perceived risks and safety of vaccines and vaccination to vaccine acceptance and uptake? PROSPERO. 2021; CRD42021242148 
  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, 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. medRxiv. 2020. 
   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. medRxiv. 2021. 
  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 updated on 2021-04-27)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
  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 updated on 2020-12-07)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 updated on 2021-05-11)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.
  Maintaining gains made in population-health management (e.g., population segmentation, virtual care) and spreading and scaling them         
Delivery arrangements         
 Overall service planning for COVID-19 preventing and treatment        
  Leveraging existing health-system arrangements
   
   
 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         
  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 updated on 2021-05-11)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 updated on 2021-05-11)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 capacity 2020-05-01
8/11 No Studies show mortality rates among ICU patients is correlated with invasive ventilation, renal failure and acute respiratory distress syndrome, although absolute values have been shown to vary between regions. NoFull review Other Chang R, Elhusseiny KM, Yeh Y, Sun W. COVID-19 ICU and mechanical ventilation patient characteristics and outcomes - A systematic review and meta-analysis. medRxiv 2020.
   2020-05-01
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.  
  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         
  Scaling up/down capacity to manage the pandemic-related impacts on health more generally (e.g., mental health and addictions)        
  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 facilities 2020-04-02
5/9 No The risk of contracting SARS-CoV-2 through surgical smoke cannot be excluded, so healthcare personnel need to adopt all required protective strategies, including preoperative testing
NoFull review Other Pavan N, Crestani A, Abrate A, et al. Risk of Virus Contamination Through Surgical Smoke During Minimally Invasive Surgery: A Systematic Review of Literature on a Neglected Issue Revived in the COVID-19 Pandemic Era. Eur Urol Focus. 2020;S2405-4569(20)30156-5. 
   2020-06-08 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. 
   2020-08-117/10NoA variable level of contamination was found among different droplet- and aerosol-generating procedures in dentistry, with the greatest levels of contamination found during procedures involving powered devices and water [Review of studies of variable quality]NoFull reviewOtherInnes N, Johnson IG, Al-Yaseen W, Harris R, Jones R, Kc S, et al. A systematic review of droplet and aerosol generation in dentistry. Journal of Dentistry. 2020;105:103556.
   2020-10-277/9NoNoVariable 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 (e.g., bathrooms, staff areas, etc.) [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. 
  Death certification         
  Handling dead bodies         
 Service planning for the ongoing management of other conditions         
  Changing acute care surgery and trauma-care procedures Not specified4/9No Conservative treatment, use of disposable instruments and low CO2 insufflation pressuers are all recommended practices for reducing risk of COVID-19 infection among health workers when conducting urgent pediatric surgery for patients with COVID-19NoFull reviewOtherPrato AP, Conforti A, Almstrom M, Van Gemert W, Scuderi MG, Khen-Dunlop N, et al. Management of COVID-19-positive pediatric patients undergoing minimially invasive surgical procedures: Systematic review and recommendations of the Board of the European Society of Pediatric Endoscopic Surgeons. Frontiers in Pediatrics. 2020;8:259.
   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
  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. 
   N/A (protocol)
N/A
No[Protocol - results not yet available] A review evaluating patients, caregivers and healthcare professionals' experiences on cancer screening and care during the COVID-19 pandemic is currently being conducted
NoProtocol Views and experiences Dhada S, Hadi MA, Cheema E, Stewart D, Paudyal V. Cancer screening and care during the COVID-19 pandemic: A systematic review of patients, caregivers and healthcare professionals' experiences. PROSPERO. 2020; CRD42020214906.  
   N/A (protocol)
N/A
No[Protocol - results not yet available] A review evaluating the impact of the COVID-19 pandemic on cancer control and care is currently being conducted
No Protocol Other Ali R, Farah E, El-Zein M, Franco E. A systematic review highlighting the impact of the COVID-19 pandemic on cancer control and care. PROSPERO. 2020; CRD42020190522.  
   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.
  Changing reproductive care
N/A (Protocol)
n/aNo [Protocol - results not yet available] A review evaluating the impact of COVID-19 lockdowns on the incidence of premature birth and stillbirth is currently being conducted No Protocol Other Almonte M, Bennett P, Perry A, Piel F. Indirect impact of COVID-19 lockdowns on incidence of premature birth and stillbirth: a systematic review and meta-analysis. PROSPERO. 2020;CRD42020213509. 
   N/A (Protocol)
n/aNo [Protocol - results not yet available] A review evaluating the effect of the COVID-19 pandemic on maternal, fetal and neonatal outcomes is currently being conductedNo Protocol Other Yang J & Shah P. COVID-19 pandemic and population level pregnancy and neonatal outcomes: A systematic review. PROSPERO. 2021; CRD42021234036 
   N/A (Protocol)n/aYes[Protocol - results not yet available] A review exploring interventions to ensure maternal and child health services during COVID-19 and similar emergencies is currently being conductedNoProtocolOtherPalo SK, Mishra BK, Dubey S, Negi S, Patel K, Bhuyan D et al. Interventions adopted for ensuring MCH (Maternal and Child Health) services including their quality and effectiveness during Covid-19 and any similar health emergencies: A systematic review. PROSPERO. 2021;CRD42021233860.
  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 updated on 2021-05-11)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. 
 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.  
  Medications and other technologies (under shortage conditions due to disrupted supply chains)         
  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 updated on 2021-05-11)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 updated on 2021-05-11)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. 
   2020-04-20
7/9 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. 
 Workforce planning (including workforce shortages management) and development         
  Recruitment 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.
  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.  
  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.  
   2020-05-02
5/9 No A systematic review exploring management strategies and training for the medical-resident workforce during the COVID-19 pandemic found that residents need to be trained in infection prevention methods, and that training methods need to be adapted to alternative virtual teaching methods to maintain all pillars of residency educationNo Full review Other Tolu LB, Feyissa GT, Ezeh A, Gudu W. Managing resident workforce and residency training during COVID-19 pandemic: Scoping review of adaptive approaches. Advances in Medical  Education and Practice. 2020;11:527-535. 
   2021-03-246/10 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 updated on 2021-05-11)Rapid review Other Chou R, Dana T, Buckley D, Selph S, Fu R, Totten A. Update alert 8: 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.  
  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
  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.
  Wait-lists management         
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 workers 2020-05-02
5/9 No A systematic review exploring management strategies and training for the medical-resident workforce during the COVID-19 pandemic found that residency directors need to ease the impact of COVID-19 on the accreditation process by working with accreditation bodies and local clinical competency committeesNo Full review Other Tolu LB, Feyissa GT, Ezeh A, Gudu W. Managing resident workforce and residency training during COVID-19 pandemic: Scoping review of adaptive approaches. Advances in Medical  Education and Practice. 2020;11:527-535. 
 Commercial authority         
  Technology approvals, public-private partnerships         
 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 updated on 2021-05-11)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