RESUMO
Background: The COVID-19 pandemic highlighted the need for timely, evidence-based rapid risk assessments (RRA) of infectious disease events to inform public health action during rapidly evolving situations with high uncertainty. In 2022, the Public Health Agency of Canada established a coordinated approach to public health risk assessment, including a methodology for qualitative RRA of infectious disease threats. Objective: To describe the RRA methodology and illustrate its use with examples from different infectious hazards of public health concern. Methods: The RRA methodology employs the risk pathway to describe the sequence of events leading from a hazard's source to the adverse event of concern and subsequent impacts; define specific questions to be addressed; and identify relevant knowledge gaps, limitations and recommendations. Qualitative likelihood and impact estimates are derived through integration of evidence review and expert opinion and are communicated together with corresponding levels of uncertainty. The impacts of the event are based on an assessment of the most likely spread scenario within Canada, considering individual-level impact on affected individuals, the impact on the general population and, if relevant, sub-groups at higher risk. Results: This RRA approach aligns with well-established international methods and provides flexibility to accommodate a broad range of risk questions. It has been implemented to estimate the risk of various threats of concern to Canada, including mpox, avian influenza A(H5N1) and measles. Conclusion: Given the broad range and complexity of public health hazards, RRAs provide a timely, coordinated and systematic process for characterizing and communicating the risk to inform risk mitigation and decision-making and to guide appropriate public health response.
RESUMO
Background: The coronavirus disease 2019 (COVID-19) pandemic has led to a rapid surge of literature on severe acute respiratory syndrome coronavirus 2 and the wider impacts of the pandemic. Research on COVID-19 has been produced at an unprecedented rate, and the ability to stay on top of the most relevant evidence is top priority for clinicians, researchers, public health professionals and policymakers. This article presents a knowledge synthesis methodology developed and used by the Public Health Agency of Canada for managing and maintaining a literature surveillance system to identify, characterize, categorize and disseminate COVID-19 evidence daily. Methods: The Daily Scan of COVID-19 Literature project comprised a systematic process involving four main steps: literature search; screening for relevance; classification and summarization of studies; and disseminating a daily report. Results: As of the end of March 2022 there were approximately 300,000 COVID-19 and pandemic-related citations in the COVID-19 database, of which 50%-60% were primary research. Each day, a report of all new COVID-19 citations, literature highlights and a link to the updated database was generated and sent to a mailing list of over 200 recipients including federal, provincial and local public health agencies and academic institutions. Conclusion: This central repository of COVID-19 literature was maintained in real time to aid in accelerated evidence synthesis activities and support evidence-based decision-making during the pandemic response in Canada. This systematic process can be applied to future rapidly evolving public health topics that require the continuous evaluation and dissemination of evidence.