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Broad and specific decisions
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Criteria for 'best evidence synthesis' |
Details to support relevance assessment |
Additional decision-relevant details |
Citation |
| Date of last search
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Quality (AMSTAR) rating
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Evidence profile (e.g., GRADE) available |
Key findings
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Living evidence synthesis |
Type of synthesis |
Type of question
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Approach
to population-health management for COVID-19 and for those whose care is
disrupted by COVID-19
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Segmenting the population into groups with shared health and
social needs
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Re-designing care pathways and in-reach and out-reach services |
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Addressing barriers to implementation of pathways and services
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N/A (Protocol)
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n/a |
No |
[Protocol - no results yet available] A review on the factors affecting compliance with infant feeding practices to prevent respiratory infections is currently being conducted |
Yes (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.
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Addressing cultural safety in the implementation of pathways and
services
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Maintaining gains made in population-health management (e.g.,
population segmentation, virtual care) and spreading and scaling them
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Delivery arrangements
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Service
planning for COVID-19 prevention
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Changing emergency-medical service procedures (ambulances,
paramedics)
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2020-04-06
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9/10 |
Yes |
A 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 arrest |
No |
Full review |
Other |
Couper 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. |
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Re-locating hospital-based ambulatory clinics, cancer
treatments, etc.
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Limiting access to health facilities
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Changing hospital-discharge procedures
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Changing long-term care procedures
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2020-06-26
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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
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Yes (row content last updated on 2020-12-07) |
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. |
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Changing home and community care procedures
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Service
planning for COVID-19 treatment
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Scaling up/down testing capacity
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Scaling up/down emergency-room capacity
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Scaling up/down ICU capacity
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2020-05-01
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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. |
No |
Full 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.
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Scaling up/down post-ICU recovery capacity (e.g., hospital beds)
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Scaling up/down palliative-care capacity
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Scaling up/down COVID-19 sequelae-management capacity
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Scaling up/down capacity to manage the pandemic-related impacts
on health more generally (e.g., mental health and addictions)
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Surge-management models
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Triage protocols |
2020-03-26
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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 |
No |
Rapid 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. |
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2020-04-21
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7/11 |
No |
Risk stratification and triage for patients with comorbid COVID-19 and cardiovascular disease should use clinical history, physical examination, pulse oxymetry and other laboratory markers to recognize high-risk patients in a timely manner |
No |
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
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Infection prevention and control measures in health facilities |
2020-09-24
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6/10 |
No |
No use of PPE by healthcare workers (including masks, gloves, gowns and eye protection) is consistently associated with an increasing risk of coronavirus infection
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Yes (row content last updated on 2020-12-07) |
Full review |
Benefits and harms |
Chou R, Dana T, Buckley D, Selph S, Fu R, Totten A. Epidemiology of and Risk Factors for Coronavirus Infection in Health Care Workers. Ann Intern Med 2020; M20-1632. |
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2020-04-02
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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
|
No |
Full 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. |
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2020-06-08 |
8/10 |
No |
No evidence was found on the effectiveness of cohorting COVID-19 positive residents to shared rooms in healthcare facilities |
No |
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. |
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N/A
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8/11 |
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 |
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Death certification
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Handling dead bodies
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Service
planning for the ongoing management of other conditions
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Changing acute care surgery and trauma-care procedures |
Not specified |
4/9 |
No |
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-19 |
No |
Full review |
Other |
Prato 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. |
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Changing cancer-treatment procedures
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Delaying return visits, elective procedures, etc.
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Infrastructure
planning and resource allocation
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Personal protective equipment under shortage conditions (including N95 respirators for health workers) |
2020-04-11 |
6/9 |
No |
In non-human, non-COVID-19 studies focused on influenza and bacterial infections, ultraviolet germicidal irradiation, moist heat, microwave generated steam, and hydrogen peroxide vapor were found to be effective at disinfecting and maintaining filtration efficiency in surgical and N95 masks |
No |
Full review |
Benefits and harms |
Seresirikachorn K, Phoophiboon V, Chobarporn T, Tiankanon K, Aeumjaturapat S, Chusakul S, et al. Decontamination and reuse of surgical masks and N95 filtering facepiece respirators during COVID-19 pandemic: A systematic review. Infecton control and hospital epidemiology. 2010:1-39. |
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N/A (Protocol)
|
n/a |
No |
[Protocol - no results yet available] A scoping review on decontamination and reuse of N95 and surgical facemasks is currently being conducted
|
Yes (row content last updated on 2020-12-07)
|
Protocol |
Other |
McNally JD, O'Hearn K, Choong K, Zorko DJ, Gertsman S, Agarwal A, et al. Live scoping review of N95 and surgical facemask decontamination and reuse. 2020 |
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N/A (Protocol)
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n/a |
No |
[Protocol - no results yet available] A review on the effectiveness of sterilization techniques for N95 filtering facepiece respirators is currently being conducted
|
Yes (row content last updated on 2020-12-07)
|
Protocol |
Benefits and harms |
Rajaee A, Eshkevari PS, Lenhardt R,Stuart A, Ziegler C. Will Decontamination of N95 Filtering Facepiece Respirators Result in Compromised Performance? A Living Systematic Review. PROSPERO 2020; CRD42020179695.
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Ventilators for sick COVID-19 patients
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Medications and other technologies (under shortage conditions
due to disrupted supply chains)
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Remote monitoring
|
2020-05-31 |
4/9 |
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 2020-12-07) |
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. |
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Virtual visits
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2020-04-30
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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 2020-12-07) |
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. |
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2020-04-08
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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 infection |
No |
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. |
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2020-04-05
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4/9 |
No |
Studies from the COVID-19 era and beyond suggest there is scarce evidence on the use of telemedicine for neurosurgical patients, although some results from resource-constrained settings show promise |
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. |
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2020-05-00
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5/10 |
No |
Studies mainly from the pre-COVID era show that using telemedicine for otolaryngology produces adequate images for diagnosis, and has high acceptability among patients and providers |
No |
Full review |
Other |
Ning AY, Cabrera CI, D'Anza B. Telemedicine in Otolaryngology: A Systematic Review of Image Quality, Diagnostic Concordance, and Patient and Provider Satisfaction [published online ahead of print, 2020 Jul 13]. Ann Otol Rhinol Laryngol. 2020;3489420939590. doi:10.1177/0003489420939590 |
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2020-05-01
|
6/9 |
No |
Studies with variable risk of bias suggest that 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 |
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. |
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Workforce
planning (including workforce shortages management) and development
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Recruitment
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Role extensions
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Training in new procedures
|
2020-03-19
|
8/10 |
No |
A systematic review of observational studies found that disaster-training programs for medical students seems to improve their knowledge, skills and pandemic preparedness. No evidence on clinical performance was identified |
No |
Full review |
Other |
Ashcroft 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. |
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2020-05-18
|
5/9 |
No |
A systematic review found that 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 environment |
No |
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. |
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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 education |
No |
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. |
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Replacements when sick
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Movement-control strategies
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Supports to unpaid caregivers
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Volunteer engagement
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Self-management supports
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Service
planning for ‘return to normal’
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Sequencing of services re-starting, by sector, conditions,
treatments (including diagnostics), and populations
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Wait-lists management
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Financial arrangements
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Financing
health services
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Funding
organizations
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Remunerating
providers
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New or adjusted fee codes for virtual care
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Income replacement when virtual care is not possible (at the
same scale)
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Purchasing
products and services
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Bulk purchasing
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Governance arrangements (who can make what decisions)
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Consumer
and stakeholder involvement
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Professional
authority
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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 committees |
No |
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. |
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Commercial
authority
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Technology approvals, public-private partnerships
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Organizational
authority
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Limits of number of staff sent in
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Policy
authority
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Federal versus provincial
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Adhering to the International Health Regulations
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