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Canada’s Response to the Initial 2 Years of the COVID-19 Pandemic: A Comparison with Peer Countries

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Compared with other G10 countries, Canada handled the first 2 years of the COVID-19 pandemic well by most measures, according to an analysis in CMAJ (Canadian Medical Association Journal)

Canada had some of the most stringent policies to help contain the spread of SARS-CoV-2, such as restrictions on movement and public gatherings, workplace closures, event cancellations, and international travel controls.

"Keeping uncertainties about causation in mind, we can hypothesize that high vaccination percentages and good compliance with sustained public health restrictions explain at least part of Canada's strong performance in limiting SARS-CoV-2–related health burdens," writes Dr. Fahad Razak, Unity Health Toronto, and the University of Toronto, with coauthors.

The analysis looked at the response of 11 countries to the pandemic from February 2020 to February 2022: Belgium, Canada, France, Germany, Italy, Japan, the Netherlands, Sweden, Switzerland, the United Kingdom, and the United States. The authors chose other G10 countries as a comparator group because of similarities in economic and political models, per-capita income, and population size.

Some highlights:

  • Japan was an outlier, with very low rates of SARS-CoV-2 infection and deaths from COVID-19, despite relatively low vaccination rates during the first half of the pandemic, the least stringent public health measures, and an older population compared with peer countries.
  • Among the remaining countries, Canada's rate of COVID-19–related deaths was the lowest (919/million), with all other countries over 1000/million. Canada also had the lowest excess mortality, a measure that includes all COVID-19 and non-COVID-19 deaths.
  • Italy had the highest stringency measures in place, followed by Canada.
  • The US had the highest number of weeks of school closures, followed by Canada.
  • Canada was one of the slowest countries to introduce SARS-CoV-2 vaccination, but as of February 2022, it had the highest proportion of fully vaccinated people (as per the original 2-dose protocol).
  • Canada's economy showed similar inflation and public indebtedness growth, but weaker gross domestic product growth compared with other countries.

Comparison of Canada against countries with the highest burden of COVID-19 shows how different the pandemic experience could have been for Canadians over the first 2 years:

"If the US vaccination rate and COVID-19–related death rate occurred in Canada, about 5.9 million fewer Canadians would have been vaccinated, and about 68 800 more Canadians would have perished from COVID-19," write the authors.

Governments and the public may find lessons from the analysis helpful as the pandemic continues to unfold.

"As the country continues through subsequent phases of the pandemic, careful collection and analysis of data are necessary, while acknowledging the limits of available indicators and comparisons. Leaders should share new findings with the public transparently and swiftly, and make strategic adjustments to reinforce measures that appear to be successful and to modify others as appropriate," the authors conclude.

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Schedule3 Oct 2023