RESUMO
We pursue an evidence-informed argument that interpersonal relationships in childhood and adolescence are central to achieving learning outcomes and that school closures across various parts of Canada during the COVID-19 pandemic have compromised these critical relationships, jeopardizing educational attainment. We highlight how the centrality of relationships with peers and educators in achieving learning goals is well established in the literature. So too is the importance of peers in creating stable mental health and wellness for children and youth. The pandemic context has drastically interfered with ongoing wellness, exacerbating feelings of loneliness and social isolation, which takes a toll on what children and youth can achieve in the virtual classroom. In the interest of reducing harm, we call on provincial/territorial governments to move quickly to ensure schools are open in the fall and to think carefully and consult effectively before any further closure decisions are made. We understand that safety is paramount and as such offer a framework for planning a safe return where necessary. Now more than ever there is a need to prioritize social-emotional learning opportunities to protect young people from the lasting effects of social isolation and threats to the fundamental need to belong that have been induced or exacerbated by the pandemic.
RESUMO
COVID-19 vaccine acceptance exists on a continuum from a minority who strongly oppose vaccination, to the "moveable middle" heterogeneous group with varying uncertainty levels about acceptance or hesitancy, to the majority who state willingness to be vaccinated. Intention for vaccine acceptance varies over time. COVID-19 vaccination decisions are influenced by many factors including knowledge, attitudes, and beliefs;social networks;communication environment;COVID-19 community rate;cultural and religious influences;ease of access;and the organization of health and community services and policies. Reflecting vaccine acceptance complexity, the Royal Society of Canada Working Group on COVID-19 Vaccine Acceptance developed a framework with four major factor domains that influence vaccine acceptance (people, communities, health care workers;immunization knowledge;health care and public health systems including federal/provincial/territorial/indigenous factors)-each influencing the others and all influenced by education, infection control, extent of collaborations, and communications about COVID-19 immunization. The Working Group then developed 37 interrelated recommendations to support COVID vaccine acceptance nested under four categories of responsibility: 1. People and Communities, 2. Health Care Workers, 3. Health Care System and Local Public Health Units, and 4. Federal/Provincial/Territorial/Indigenous. To optimize outcomes, all must be engaged to ensure co-development and broad ownership. [GRAPHICS] .
RESUMO
BACKGROUND: Early reports of COVID-19 in pregnancy described management by caesarean, strict isolation of the neonate and formula feeding. Is this practice justified? OBJECTIVE: To estimate the risk of the neonate becoming infected with SARS-CoV-2 by mode of delivery, type of infant feeding and mother-infant interaction. SEARCH STRATEGY: Two biomedical databases were searched between September 2019 and June 2020. SELECTION CRITERIA: Case reports or case series of pregnant women with confirmed COVID-19, where neonatal outcomes were reported. DATA COLLECTION AND ANALYSIS: Data were extracted on mode of delivery, infant infection status, infant feeding and mother-infant interaction. For reported infant infection, a critical analysis was performed to evaluate the likelihood of vertical transmission. MAIN RESULTS: Forty nine studies included information on mode of delivery and infant infection status for 655 women and 666 neonates. In all, 28/666 (4%) tested positive postnatally. Of babies born vaginally, 8/292 (2.7%) tested positivecompared with 20/374 (5.3%) born by Caesarean. Information on feeding and baby separation were often missing, but of reported breastfed babies 7/148 (4.7%) tested positive compared with 3/56 (5.3%) for reported formula fed ones. Of babies reported as nursed with their mother 4/107 (3.7%) tested positive, compared with 6/46 (13%) for those who were reported as isolated. CONCLUSIONS: Neonatal COVID-19 infection is uncommon, rarely symptomatic, and the rate of infection is no greater when the baby is born vaginally, breastfed or remains with the mother. TWEETABLE ABSTRACT: Risk of neonatal infection with COVID-19 by delivery route, infant feeding and mother-baby interaction.