Environmental Health Resources for the COVID-19 Pandemic

The transmission of SARS-CoV-2, the virus that causes COVID-19, occurs primarily via direct contact with or respiratory droplets from an infected person. However, there is evidence to suggest that transmission via other modes – such as contaminated surfaces, aerosols, or contact with fecal material – is possible. As such, environmental health practitioners have a key role to play in promoting general hygiene measures as well as addressing unique information needs as the pandemic affects all aspect of public and private life.

This topic page has been created to promote key COVID-19 resources to environmental health practitioners and related professions. We are actively collecting and curating resources from more than 50 Canadian and international public health agencies, and will be promoting those resources via social media and by providing the essential resources on this topic page. This information is current to the date at the bottom of the page.

You can also find additional COVID-19 resources on our other topic pages:

• Building Shutdown and Re-opening during the COVID-19 Pandemic
• COVID-19 Management during Public Health Emergencies
• Public Transit and COVID-19
   

The Basics of SARS-CoV-2 Transmission

• The Basics of SARS-CoV-2 Transmission (O'Keeffe, Freeman, and Nicol, March 2021) 
  This NCCEH publication provides a continuously updated synthesis of the basic virology and transmission of SARS-CoV-2 to inform the measures taken to mitigate the spread of the virus.

• NCCEH Environmental Health Research Scans
  The NCCEH produces COVID-19 research scans that highlight new environmental health knowledge and resources, which are posted in the NCCEH Blog.
  • COVID-19 Research Scan (March 1-April 1, 2020)
  • COVID-19 Research Scan: April 2 - April 20  
  • COVID-19 Research Scan: April 23 - May 8  
  • COVID-19 Research Scan: May 9 – June 3
  • July Environmental Health Research Scan (with COVID-19 section)
  • August Environmental Health Research Scan (with COVID-19 section)
  • September Environmental Health Research Scan (with COVID-19 section) 
  • October Environmental Health Research Scan (with COVID-19 section)
  • November Environmental Health Research Scan (with COVID-19 section)
  • December Environmental Health Research Scan (with COVID-19 section) 
  • January, 2021 Environmental Health Research Scan (with COVID-19 section) 
  • February, 2021 Environmental Health Research Scan (with COVID-19 section)
  • March, 2021 Environmental Health Research Scan (with COVID-19 section) 
  • April, 2021 Environmental Health Research Scan (with COVID-19 section) 
  • May, 2021 Environmental Health Research Scan (with COVID-19 section) 
  • June, 2021 Environmental Health Research Scan (with COVID-19 section) 
  • July, 2021 Environmental Health Research Scan (with COVID-19 section) NEW

• What We Know So Far About…. Coronavirus Disease 2019 (COVID-19)  (Public Health Ontario, 2020)
  This series of reports provides succinct brief overviews of the evidence around COVID-19. Topics covered include the effectiveness of wearing masks in public, routes of transmission, asymptomatic transmission, and much more.
   
• COVID-19 Evidence Network to Support Decision-making (McMaster University, 2020)
  This forum aggregates numerous health evidence-informed resources intended to assist both decision makers as well as researchers wishing to direct their efforts into producing useful COVID-19 KT resources.
   
• COVID-19 Rapid Evidence Review (National Collaborating Centre for Methods and Tools, 2020)
  This webpage provides a place for researchers to share their upcoming or recently completed COVID-19 work. This effort is intended to reduce duplication of efforts amongst Canadian and international public health researchers. The results can be searched as well as refined according to topic area, jurisdiction, setting, and population.
   
• State of the Science Reports (CanCOVID, 2020)
  These backgrounder documents are produced by CanCOVID, the network of Canadian COVID-19 researchers, clinical collaborators, and healthcare stakeholders. Topic areas include: Viral Composition and Molecular Fingerprint, COVID Symptoms and Disease, Viral Transmission, and Who is at Risk?

Atmospheric Pollution and COVID-19 Susceptibility

• The impact of outdoor air pollution on COVID-19: a review of evidence from in vitro, animal, and human studies (Bourdrel et al. Mar 2021) 
  This systematic review combines epidemiological, animal, and in vitro studies to examine the complex short- and long-acting effects of air pollution on COVID-19 infection.
   
• An ecological analysis of long-term exposure to PM2.5 and incidence of COVID-19 in Canadian Health Regions (Stieb et al. Dec 2020)
  This peer-reviewed article describes statistically significant positive associations between long-term PM₅ exposure and COVID-19 incidence in Canada’s most densely populated health regions. Similarly, Zhu et al. (2020) reported positive associations between PM₅, PM₁₀, CO, NO₂, and O₃ (but not SO₂) and COVID-19 incidence in China.
   
• Linkages Between Air Pollution and the Health Burden from COVID-19: Methodological Challenges and Opportunities Benmarhnia, July 2020)
  This peer-reviewed article covers some of the key concerns and challenges when investigating the relationship between air pollution and COVID-19 outcomes.
   
• Summer is coming: Wildfire Smoke + COVID-19 (Henderson, Apr 2020)
  This invited NCCEH blog by Dr. Sarah Henderson highlights the ways in which the COVID-19 pandemic may intersect with and amplify the negative health impacts of wildfire smoke, and makes a call to action for both preparedness and addressing climate change as the root cause of intensifying wildfire activity.
   
• Make our communities healthier with better air quality during and post-pandemic: CANUE (Brook, Apr 2020) 
  This invited NCCEH blog by Dr. Jeff Brook highlights the utility of the Canadian Urban Environmental Health Research Consortium (CANUE) in both understanding the impacts of the pandemic on urban air pollution and planning for a more resilient future.

Built Environment

• COVID-19 and indoor air: Risk mitigating measures and future-proofing (O’Keeffe and Eykelbosh, June 2021) NEW
  Sections 4 and 5 of this evidence review look at some of the most important strategies for mitigating COVID-19 risks, and identifies avenues for future-proofing buildings in the post-pandemic era.
   
• The pandemic and the public realm: Global innovations for health, social equity, and sustainability (Urban Land Institute, 2021) NEW
  This report details the work done by large urban centers across the world to address the challenges of COVID-19 in creating safe and equitable public spaces. The report relies on extensive consultation with city officials, non-profits and other stakeholders in more than 30 cities.
   
• Accessibility for persons with disabilities during the COVID-19 pandemic (Chow, Mar 2021) 
  This NCCEH blog will discuss the considerations of accessibility for people with disabilities on their health and safety, and research on the experience of populations with disabilities during the COVID-19 pandemic , followed by implications for future planning.
   
• Revisiting the built environment: 10 potential development changes and paradigm shifts due to COVID-19 (Cheshmehzangi, Feb 2021)
  This peer-reviewed articles details an expert-led synthesis of the ways in which COVID-19 will impact the design of neighbourhoods, indoor spaces, and numerous other dimensions of the built environment.
   
• Access to Nature in a Post Covid-19 World: Opportunities for Green Infrastructure Financing, Distribution and Equitability in Urban Planning (Mell and Whitten, Feb 2021)
  This commentary examines how the pandemic experience will or must impact green spaces in urban landscapes, with the long-term objective of providing more equitable access to these resources.
   
• Design for Distancing Ideas Guidebook (City of Baltimore, June 2020)
  This document contains design and public health guidance on how to adapt public spaces for safe, physically distant usage during the pandemic. Complementary information can be found within NACTO’s recent guidebook, Streets for Pandemic Response and Recovery.

Cleaning and Disinfection in Community Settings

• List of hard-surface disinfectants for use against coronavirus (COVID-19)(Health Canada, July 2021) UPDATED
  This webpage provides a means for consumers to determine whether a given product is believed to be effective against SARS-CoV-2, virus that causes COVID-19. Check your product for its Drug Identification Number (DIN) and enter it into the search box.
   
• Environmental Cleaning and Disinfection Recommendations(Centres for Disease Control and Prevention, June 2021) UPDATED
  This web page provides general guidance on cleaning and disinfection of rooms that may have been occupied by COVID-19-infected individuals in non-healthcare community settings.
   
• Fomites and the COVID-19 pandemic: An evidence review on its role in viral transmission (Chen, Mar 2021) 
  This NCCEH reviewexamines current evidence on factors that influence SARS-CoV-2 transfer to and from fomites, as well as how environmental factors may influence the persistence of SARS-CoV-2 on fomites.
   
• A rapid review of disinfectant chemical exposures and health effects during COVID-19 pandemic(Chen, Oct 2020)
  This NCCEH field inquiry highlights some of the acute and chronic health impacts of common disinfectants, and provides suggestions to balance potential health risks from exposure to disinfectants and the risk of SARS-CoV-2 transmission via fomites. 
   
• Nanomaterials as Disinfectants in the Time of SARS-CoV-2(Freeman, Aug 2020)
  This NCCEH blog discusses applications of nanotechnology to the self-disinfection of personal protective equipment and frequently touched (high-touch) surfaces in public spaces. 
   
• Reducing COVID-19 Transmission Through Cleaning and Disinfecting Household Surfaces(Chen, Apr 2020)
  This guidance document provides information to public health professionals who may be consulted on the appropriate use of cleaning and disinfection products as well as frequency of cleaning and disinfecting in homes to protect the health of the public.
   
• Cleaning and disinfection of environmental surfaces in the context of COVID-19(World Health Organization, May 2020)
  This guidance document discusses appropriate cleaning and disinfection of environmental surfaces. It is intended for public health and healthcare professionals, as well as public health agencies responsible for developing related policies and procedures. 

Death Care

• Guidance for care of the deceased with suspected or confirmed coronavirus (COVID-19) (Public Health England, Apr 2021) NEW
  This guidance document provides wide-ranging advice to professionals who may come into contact with the deceased in various healthcare and non-healthcare settings.
   
• COVID-19 risks from handling the deceased(O'Keeffe, Feb 2021) 
  This field inquiry updates the evidence since our previous review in May 2020 on the SARS-CoV-2 transmission risks from handling of decedents known or suspected to be infected with COVID-19 at the time of death.
   
• Interim guidance: Death care services and handling of dead bodies during the coronavirus disease (COVID-19) pandemic(Public Health Agency of Canada, Sept 2020)
  This guidance document provides information on safe handling of bodies, mourning services, repatriation of bodies, and bereavement and grief support.
   
• Death care during the COVID-19 pandemic: understanding the public health risks(O'Keeffe, May 2020)
  This NCCEH publication provides an overview of SARS-CoV-2, the virus responsible for COVID-19 and what is known about the relative risks of transmission across various stages of the death care process from the point of death through to cremation or burial.
   
• Considerations related to the safe handling of bodies of deceased persons with suspected or confirmed COVID-19 (European Centre for Disease Prevention and Control, Mar 2020)
  This guidance document provides a European perspective on the possible risks associated with handling of bodies of deceased persons with suspected or confirmed COVID-19. Safe handling practices, appropriate PPE and disinfection practices are explained for various settings in which persons may come in contact with the deceased, including the site of death, transportation to burial or cremation sites, storage and preparation for burial/cremation, and during burial/cremation.

Ethics and the Pandemic

• Public health ethics and COVID-19: Selected resources(National Collaborating Centre for Healthy Public Policy, Mar 2021) UPDATED
  This periodically updated research scan aggregates relevant resources on ethical guidance for responding to the pandemic and provides a brief synthesis of each response.
   
• Public health ethics framework: A guide for use in response to the COVID-19 pandemic in Canada(Government of Canada, Feb 2021) UPDATED
  This guidance document provides decision-makers with tools to make considered and ethically sound choices during the pandemic response,

Food Safety and Food Security

• Exposure Profile of SARS-CoV-2 in Canadian Food Sources (Rose-Martel et al., Aug 2021) NEW
  This peer-reviewed article uses the literature to evaluate the risk of foodborne transmission of SARS-CoV-2 in Canadian food sources, through both ingestion and contact with food packaging.
   
• Food businesses(BC Centre for Disease Control, July 2021) UPDATED
  This web page provides food safety and COVID-19-related information for grocery stores, restaurants, and other food premises based on current federal and provincial guidance. The drop down menus answers to queries around handling money, cards, and containers, as well as general sanitation and how to use disinfectants safely. The BCCDC has also created resources for food banks and farmer’s markets.
   
• Growing resilience and promoting health through urban agriculture(Chow, June 2021) NEW
  During the COVID-19 pandemic, people turned to urban agriculture for stress relief, social connection and food security. The benefits and public health considerations of food gardening, including a discussion of soil and water contaminants in this NCCEH blog, can be addressed by public health professionals in their practice.
   
• FAQs for the Food Industry(Institute for Food Safety at Cornell University, June 2021) UPDATED
  This webpage addresses frequently asked questions about food safety issues associated with COVID-19. It also provides tools and resources to help food services and food industry operators to reduce risk of transmission and improve the safety of their staff and premises.
   
• Coronavirus Disease (COVID-19): CFIA information for industry(Canadian Food Inspection Agency, Feb 2021)
  This webpage provides information regarding the integrity of Canada’s food supply, best practices for those working in any food, plant, or animal production or processing, and other key concerns.
   
• Home Food Gardening in Canada in Response to the COVID-19 Pandemic (Mullins et al., Jan 2021) NEW
  This peer-reviewed article reports survey data in which Canadians provide insight into their gardening and home food production practices in response to the pandemic.
   
• Community refrigerators in the time of a pandemic: food-sharing safety (Van Osch, Jan 2021)
  This NCCEH blog looks at food-sharing during the COVID-19 pandemic and considerations for mitigating potential food safety risks.

Health Equity

• Health Equity: Promoting Fair Access to Health(US Centers for Disease Control and Prevention, Apr 2021) UPDATED
  This webpage explains the relationship between COVID-19 and the longstanding health inequities that are disproportionately impacting racialized groups. The webpage also provides a useful, high-level guide to developing a health equity strategy.
   
• ‘Back to better’: Amplifying health equity and determinants of health perspectives during the COVID-19 pandemic (Ndumbe-Eyoh et al., Mar 2021) NEW
  This peer-reviewed article reports on the results of a survey of Canadian practice, policy, research and community leaders regarding COVID-19 and its interactions with gender, racism, homelessness, Indigenous health and knowledge, household food insecurity, disability, ethics and equitable futures post-COVID-19.

• Best Brains Exchange Proceedings Report: Strengthening the Structural Determinants of Health Post-COVID-19 (Public Health Agency of Canada, Mar 2021) 
  This report summarizes the proceedings of the virtual Best Brains Exchange (BBE) held in July 2020 to help inform the CPHO 2020 Annual Report on COVID-19.
   
• Measuring Health Inequalities: A Toolkit (Canadian Institute for Health Information, 2021) NEW
  This toolkit aims to help analysts and researchers with measuring and reporting on health inequalities, and is supplemented with videos and free online courses to assist with planning the analyses, analyzing the data, and reporting findings. 

• Equity-informed responses to COVID-19(National Collaborating Centre for Determinants of Health, 2021)
  This webpage provides numerous resources to help practitioners apply an equity lens to the pandemic response, which is critically important given the exacerbating effect of the pandemic on many of the stressors already impacting vulnerable populations.
   
• From risk to resilience: An equity approach to COVID-19(Public Health Agency of Canada, Oct 2020)
  This report from Canada’s Chief Public Health Officer highlights the disproportionate negative impacts on marginalized communities that have been exacerbated by the pandemic. It also outlines the strategies and opportunities to address these health inequities and emerge from this crisis as a more resilient nation.
   
• Environmental public health professionals can support health equity in the time of COVID-19(Rideout, Apr 2020)
  This NCCEH blog from invited contributor Dr. Karen Rideout highlights the critical role that environmental public health professionals can play in mitigating the enormous health equity impacts due to the pandemic.
   
• Measuring what counts in the midst of the COVID-19 Pandemic: Equity Indicators for Public Health(National Collaborating Centre for Infectious Disease, 2020)
  This guidance document reviews past experiences with the effect of pandemics on health equity in Canada and seeks to help public health practitioners and organization integrate healthy equity into emergency preparedness, response, and recovery.

Indigenous Communities

• Concrete lessons: Policies and practices affecting the impact of COVID-19 for urban Indigenous communities in the United States and Canada (Howard-Bobiwash et al. Apr 2021) NEW
• This peer-reviewed article examines policies and practices that impacted the ability of urban Indigenous communities in the US and Canada to cope with the COVID-19 pandemic.
   
• What we heard: Indigenous Peoples and COVID-19: Public Health Agency of Canada’s companion report(Public Health Agency of Canada, Mar 2021) 
  This independent report, written by an Indigenous scholar and her team, summarizes discussions from two community engagement sessions with Indigenous partners in August and September 2020.
   
• Sharing the harvest during the pandemic(First Nations Health Authority, 2020)
  This guidance document provides some additional measures and information resources to minimize the risk of disease transmission between community members who wish to share traditional foods within their community.
   
• Infectious questions: Pandemic preparedness in First Nations communities(National Collaborating Centre for Infectious Diseases, 2020)
  This podcast series looks at various public health aspects of the COVID-19 pandemic, including community preparedness in First Nations and evacuation in northern and remote communities.
   
• Novel coronavirus (COVID-19)(First Nations Health Authority, 2020)
  This webpage contains numerous provincial and federal resources aimed at supporting Indigenous communities and individuals during the pandemic.

Indoor Environments

• COVID-19 and indoor air: Risk mitigating measures and future-proofing (O’Keeffe and Eykelbosh, June 2021) NEW
  This evidence review synthesizes the evidence on transmission risks in indoor environments, the implications of the new variants for indoor transmission, and risk mitigating measures addressing both the current reality, as well as strategies for future-proofing buildings in the post-pandemic era. A summary of the key findings can also be found in this blog.
   
• Indoor CO₂ sensors for COVID-19 risk mitigation: Current guidance and limitations(Eykelbosh, May 2021)
  This NCCEH field inquiry reviews the public health guidance around CO₂ monitoring as a means to assess ventilation adequacy and reduce COVID-19 transmission risk. This work was also the subject of an NCCEH webinar.
   
• Contextualizing the risks of indirect COVID-19 transmission in multi-unit residential buildings (Eykelbosh, Mar 2021) 
  This NCCEH evidence reviewscans the literature for MURB outbreaks that may have involved indirect or environmental transmission, and to examines how transmission routes were investigated and what was found.
   
• At home: Using ventilation and filtration to reduce the risk of aerosol transmission of COVID-19(Public Health Agency of Canada, Apr 2020) 
  This guidance document shows some of the simple ways families can increase fresh air exchange and use air cleaning technologies to reduce the risk of aerosol accumulation in the home environment.
   
• Roadmap to improve and ensure good indoor ventilation in the context of COVID-19 (World Health Organization, Mar 2021)
  This guidance document provides details advice on how to assess and improve indoor air quality through a variety of technical and non-technical means.
   
• Reducing wood smoke and protecting indoor air quality is more important than ever during the COVID-19 pandemic(Langille, Feb 2021) 
  This NCCEH blog examines the wood smoke in indoor environments and its health consequences during the COVID-19 pandemic.
   
• Can CO₂ sensors be used to assess COVID-19 transmission risk? (Eykelbosh, Jan 2021) 
  This NCCEH blog examines the notion of using inexpensive CO₂sensors to monitor ventilation in indoor spaces and their use as a proxy for SARS-CoV-2 transmission risk. ​
   
• Understanding the uses and limitations of ventilation and air cleaning in COVID-19-risk mitigation(Eykelbosh and O’Keeffe, Jan 2021) 
  This webinar, which was presented as part of BCCDC’s Grand Rounds, discusses some of the recommendations around ventilation and air cleaning, as well as some of the limitations of these technologies and the need for broader COVID-19 risk awareness.
   
• COVID-19: Guidance on indoor ventilation during the pandemic(Public Health Agency of Canada, Jan 2021) 
  This guidance document provides practical tips on how to improve indoor air, ventilation and filtration to help reduce the spread of COVID-19.
   
• Air cleaning technologies for indoor spaces during the COVID-19 pandemic(O'Keeffe, Dec 2020) 
  This NCCEH blog provides an overview of the types of air cleaning devices, how they work and the potential risks and considerations for anyone using them.
   
• High-humidity Environments and the Risk of COVID-19 Transmission(Eykelbosh, Oct 2020)
  This NCCEH field inquiry did not identify an elevated transmission risk for showers, steam rooms, or hot tubs as a result of high temperature (>30°C) and/or high humidity (>80% relative humidity).
   
• Role of heating, ventilation, and air conditioning systems and technologies in the public health response to COVID-19(Eykelbosh, Sept 2020)
  This webinar by NCCEH environmental health scientist Dr. Angela Eykelbosh addresses what is known regarding virus transmission over short distances and the role for ventilation and other technologies in mitigating that risk. This webinar was hosted by the UBC School of Population and Public Health Occupational and Environmental Health Seminar Series.
   
• Public washrooms in the time of COVID-19: Facility features and user behaviours can influence safety(Nicol, Sept 2020)
  This NCCEH blog provides an overview of the factors that can influence the transmission of SARS CoV-2 virus in public facilities is warranted.
   
• COVID-19 in indoor environments — Air and surface disinfection measures(Chen and O'Keeffe, July 2020)
  This NCCEH publication provides an overview of commonly used approaches to mitigate the transmission of SARS-CoV-2 indoors and presents three additional control measures based on disinfection — ultraviolet germicidal irradiation (UVGI), electrostatic spraying of disinfectants and disinfectant fogging.
   
• The role of ventilation in influencing the COVID-19 Pandemic(Eykelbosh, July 2020)
  This NCCEH blog discusses the role of ventilation systems in exacerbating or mitigating the spread of COVID-19.
   
• Physical Barriers for COVID-19 Infection Prevention and Control in Commercial Settings(Eykelbosh, May 2020)
  This NCCEH blog discusses best practices, gathered from industry and public health, for designing, installing, and cleaning physical barriers. Barriers or partitions are being widely utilized to reduce COVID-19 transmission risk in settings where maintaining physical distance and/or masking is not feasible.
   
• Reducing COVID-19 Transmission Through Cleaning and Disinfecting Household Surfaces(Chen, Apr 2020)
  This NCCEH publication provides information to public health professionals who may be consulted on the appropriate use of cleaning and disinfection products as well as frequency of cleaning and disinfecting in homes to protect the health of the public.
   
• COVID-19 Precautions for Multi-unit Residential Buildings(Eykelbosh, Mar 2020)
  This NCCEH publication synthesizes the evidence on COVID-19 transmission as a means to understand how people in multi-unit residential buildings might be affected and how to best prevent the spread of the virus. Additional resources include:
  • A recordingof the NCCEH seminar. 
  • A printable posteron Using Shared Laundry Facilities During the COVID-19 Pandemic that is also available in French, Arabic, Chinese, and Spanish.
  • A podcast(Episode 18) on preventing COVID-19 transmission in MURBS, as part of NCCID’s podcast series Infectious Questions: What health professionals should know about COVID-19. 

Mental health

• Mental Health during the first year of the COVID-19 pandemic: A review and recommendations for moving forward (Aknin et al., July 2021) NEW
  This report from the Lancet’s COVID-19 Commission Mental Health Task Force presents some surprising findings regarding population mental health during the pandemic.
   
• Covid-19 recovery and resilience: what can health and care learn from other disasters?(The King's Fund, Mar 2021) 
  This report based on research undertaken by The King’s Fund, in collaboration between the University of York and the National Institute for Health Research (NIHR) Policy Research Programme, to inform policy development and program implementation for community recovery and building resilience from disasters.
   
• Mental health and the COVID-19 pandemic(Centre for Addiction and Mental Health, 2021)
  This webpage provides a reliable source of information on the potential mental health impacts of the pandemic and a variety of resources for coping with anxiety and stigma related to COVID-19.
   
• Psychological impacts of the COVID-19 pandemic: Results of a broad investigation in Quebec. Phase 2 of the survey(Généreux and Landaverde, Dec 2020) 
  This report presents data regarding the psychological and behavioural responses during the pandemic, along with its associations with various risk and protection factors, some related to communication strategies and media discourse.
   
• L’anxiété et la dépression : une deuxième catastrophe au Québec(Université de Sherbrooke, Sept 2020)
  This webpage describes current research involving NCCEH collaborator Dr. Mélissa Généreux regarding the psychosocial impacts of the pandemic on various populations within Quebec. The study draws on data collected international and potential measures to mitigate this secondary disaster are discussed.
   
• Multiple COVID-19 risk factors Increase the likelihood of experiencing anxiety symptoms in Canada(Elton-Marshall et al., Aug 2020)
  This peer-reviewed article used survey data from May 2020 to understand some of the root causes affecting the mental health of Canadians.
   
• COVID-19 home confinement negatively impacts social participation and life satisfaction: A worldwide multicenter study(Ammar et al., Aug 2020)
  This peer-reviewed article pooled data from 35 research centers worldwide to gain insight into the impacts of the pandemic on individual behavior and lifestyle.

Outdoor Environments

• Risk mitigation tool for outdoor recreation spaces and activities operating during the COVID-19 pandemic(Government of Canada, June 2021) UPDATED
  This tool addresses risks associated with the use of parks and outdoor recreational spaces during the coronavirus disease (COVID-19) pandemic, and provide examples of strategies that may be implemented to reduce potential risks.
   
• Regional differences in access to the outdoors and outdoor play of Canadian children and youth during the COVID-19 outbreak (de Lannoy et al., Dec 2020) NEW
  This peer-reviewed article describes a survey that suggested regional differences in outdoor play among Canadian children and how those might have been affected by differences in local policy.
   
• Cities for all seasons – Considerations for using outdoor urban spaces during the winter(Freeman, Dec 2020) 
  This NCCEH blog discusses some options for encouraging activities in outdoor public urban spaces during the winter, while minimising the risks of community transmission of COVID-19.
   
• Outdoor winter dining during the COVID-19 pandemic(Eykelbosh, Nov 2020)
  This NCCEH field inquiry discusses some of the challenges and possible solutions for creating safer winterized patios for use in the restaurant industry.
   
• Bike Sharing during COVID-19(Freeman, June 2020)
  This NCCEH blog overviews some of the measures that bike-sharing programs have employed to continue operations while protecting worker safety and that of the public.
   
• Safety Considerations for Cycling during the COVID-19 Pandemic(Freeman, May 2020)
  This NCCEH blog considers some of the measures that have been implemented to prevent the spread of COVID-19 to and from cyclists. 
   
• COVID-19 and outdoor safety: Considerations for use of outdoor recreational spaces (Freeman, Eykelbosh, Apr 2020)
  ThisNCCEH publication synthesizes the available evidence on COVID-19 transmission its relevance for outdoor recreational areas. Considerations and options for managing park use are presented.  

Performing Arts

• COVID-19 Resources for the Canadian Choral Community (Choral Canada, 2021)
  This website offers a number of health and other resources related to singly safely together during the COVID-19 pandemic, including a recent webinar entitled We can sing safely with contributions from NCCEH KT scientist Dr. Juliette O’Keeffe.

• Bioaerosol emissions and exposures in the performing arts: A scientific roadmap for a safer return from COVID-19 (Volckens et al. 2021)
  This presentation provides an updated look at research into bioaerosol emission from male, female, and minor singers, as well as brass and wind instruments with or without mitigation measures, like the use of masks or bell covers for instruments.

• COVID-19 transmission from singing and playing wind instruments – What we know so far (Public Health Ontario, Nov 2020) 
  This evidence review provides a review of the current evidence concerning the potential for transmission of COVID-19 during singing and playing of wind instruments. Public Health Ontario also recently updated their environmental scan on Singing and Playing Wind Instruments (Jan 2021).
   
• COVID-19 Risks and precautions for the performing arts(O’Keeffe, Sept 2020)
  This NCCEH publication synthesizes available evidence to date on transmission risks of SARS-CoV-2, the virus responsible for COVID-19, associated with performing arts activities. A recording of the NCCEH seminar on this topic is also available.
   
• COVID-19 Risks and Precautions for Choirs(O’Keeffe, Jul 2020)
  This NCCEH publication provides an overview of the key risks associated with singing in groups and the suite of precautions that can be considered to minimize these risks. A recording of Choral Canada’s webinar featuring Dr. O’Keeffe is also available.

Personal Protection: Masking and Hand Sanitizers

• Recalls highlight importance of hand sanitizer safety (Nicol, Apr 2021) NEW
  This article reflects on how the market responded to the sudden demand for hand sanitizer and the subsequent issues with product safety, adverse health events, and product recalls.

• Masking during the COVID-19 pandemic(O'Keeffe, Mar 2021) UPDATED
  This NCCEH publication synthesizes the evidence on the use of masks as a control measure to impede the transmission of SARS-CoV-2. This document outlines the main types of masks, their effectiveness in providing protection against pathogenic hazards, and considerations for the safe use.
   
• Masking and un-masking during the COVID-19 pandemic and beyond(O'Keeffe, Mar 2021) NEW
  This NCCEH blog provides an overview of updates to our new "Masking during the COVID-19 pandemic" document including new information on materials, mask fit and double-masking. Looking ahead we consider the impact of more transmissible variants, vaccination and reopening plans and what the future of mask-wearing might look like.
   
• SARS-CoV-2: eye protection might be the missing key (Coroneo and Collignon, Feb 2021) 
  This commentarydiscusses the insufficiently explored additional effect of adding eye protection to masking on COVID-19 transmission.
   
• Non-medical masks (Health Canada, Feb 2021)
  This web page highlights some of the concerns related to the use of cloth masks, alone or over top of respirators to conserve PPE supplies, and points to further health Canada guidance on optimizing the use of masks and respirators during the pandemic.
   
• Face shields in public: better than nothing, but not good enough(Eykelbosh, Dec 2020) 
  This NCCEH blog looks at the some of the recent research on face shields as source control and personal protection, and provides a brief overview of some of the mask and shield alternatives being devised for specialized activities.
   
• Hand sanitizers contamination prompts more recalls during COVID-19(Nicol, Aug 2020) 
  This NCCEH blog explains the safety concerns underpinning recent recalls of a hand sanitizer products being sold in the US and Canada.
   
• Evidence of harm from mask use for specific populations(Alberta Health Services, Aug 2020).
  This evidence brief examined the literature to determine whether there is a scientific basis for excluding certain individuals from masking mandates, and if so, what should be done if physical distancing can’t be maintained.
   
• Face shields for source control of COVID-19(Public Health Ontario, July 2020)
  This evidence brief provides a summary of the limited evidence available for using face shields as a substitute for masks.
   
• When hand washing is not handy: Cautions for hand sanitizer use(Nicol, Apr 2020)
  This NCCEH blog provides some cautionary points on how to source, use, and safely handle sanitizer products.

Persons Experiencing Homelessness

• Interim guidance for responding to coronavirus disease 2019 (COVID-19) among people experiencing unsheltered homelessness(Centres for Disease Control and Prevention, June 2021) UPDATED
  This guidance document applies what is known about COVID-19 transmission to the management of camps or other informal settlements of those experiencing homelessness.
   
• Seeking shelter: Homelessness and COVID-19 (Turnbull et al., Feb 2021)
  This policy brief, carried out on behalf of the Royal Society of Canada, using literature review, jurisdictional review and expert consultation to identify strategies and interventions to protect this vulnerable population.
   
• Environmental public health guidance for encampments during the COVID-19 pandemic(Yehia, July 2020)
  This NCCEH publication provides operational considerations for hygiene, cleaning, and physical distancing to reduce transmission risk in encampments. A recording of the NCCEH webinar, When shelter in place isn't an option, is also available.
   
• Infection prevention and control resources for homelessness service settings(Toronto Public Health, 2019)
  This detailed guidance document provide infection prevention and control advice for staff and managers of settings that either provide shelter or services to people experiencing homelessness. 

Public Transit, Taxis, and Ride Sharing

• Public transit and COVID-19 (NCCEH, June 2021) NEW
  This NCCEH topic page deals specifically with public transit during the pandemic, providing curated resources that deal specifically with transmission risks, pandemic impacts on ridership, risk mitigation, and recovery.

• Transitioning from COVID-19 restrictions to new norms: Innovating strategies to restore trust and transit ridership(Chen, June 2021) NEW
  Public transit ridership decline dramatically in the wake of the COVID-19 pandemic, due to perceived risk of SARS-CoV-2 transmission in enclosed spaces and shifts to remote work and learning models. This NCCEH blog describes selected strategies to restore public trust and bring riders back to transit as pandemic restrictions are lifted.
   
• COVID-19 information for travellers within Canada(Transport Canada, 2021) UPDATED
  This webpage provides frequently updated advice for those travelling by air, water, road, rail or public transit.
   
• Carpooling precautions during COVID-19 (Freeman, Feb 2021)
  This NCCEH publication looks at some of the evidence for COVID-19 transmission risk in vehicles and assembles some public health guidance for car poolers.

• COVID-19 Guidance for Taxi/Ride Share Employers, Drivers, Vehicle Owners(Toronto Public Health, 2020)
  This fact sheet provides tips on hygiene, respiratory etiquette, maintaining physical distancing within vehicles, and cleaning.

Risk Communication

• Rapid reviews of virus risk communication intervention: Directions for COVID-19 (Winograd et al., 2021) NEW
  This peer-reviewed article reviews risk communication interventions and their effectiveness with respect to various previous viral outbreaks.
   
• Health Canada and Public Health Agency of Canada social media resources: COVID-19(Government of Canada, June 2021) UPDATED
  This webpage offers guidance, messages and free images to support organizations wanting to promote COVID-19 messaging via social media.
   
• Infodemic resources(World Health Organization, June 2021) UPDATED
  This webpage provides a range of resources on COVID-19 messaging and risk communication. It also provides resources for the “Infodemic,” which refers to the overabundance of mis-and disinformation related to the pandemic and its societal impacts.
   
• Evaluating crisis communication. A 30-item checklist for assessing performance during COVID-19 and other pandemics (Jong, Jan 2021) NEW
  This peer-reviewed article offers a comprehensive checklist for assessing the effectiveness of crisis communications during a pandemic. Based on the crisis communication literature, the checklist identified and expands upon five domains of sense making, public leadership, public health and expert voices, and providing instructions to the public.

• Rethinking risk communication: Lessons from a pandemic(Mitchell and Beanlands, Fall 2020)
  This peer-reviewed article provides a thought-provoking discussion of risk communication as a field of practice, and the need to incorporate new insights from cultural studies regarding how power, inequality and culture affect public risk perception and behavior in a time of crisis.
   
• COVID-19 language guide(BC Centre for Disease Control, July 2020)
  This guidance document aims to assist with COVID-19 messaging and content development by using positive, acknowledging, and inclusive, rather than (potentially) stigmatizing language that may provoke fear.
   
• COVID-19: How to include marginalized and vulnerable people in risk communication and community engagement(Inter-Agency Standing Committee, Mar 2020) 
  This guidance document focuses on inclusion of women, the elderly, children, youth and adolescents, persons with disabilities, Indigenous populations, minorities, refuges and migrates who experience more vulnerability and socio-economic marginalization in emergencies and disasters.

Schools and Daycares

• COVID-19 in children and the role of school settings in COVID-19 transmission – second update (European Centre for Disease Prevention and Control, July 2021) UPDATED
  This evidence review reports on the occurrence of COVID-19 in children in the EU/EEA and the UK, and the evidence on transmission in school settings in these countries.
   
• Living Rapid Review Update 16: What is the specific role of daycares and schools in COVID-19 transmission?(NCCMT, June 2021) UPDATED
  This evidence brief updates a previous review of the impact of school/daycare on pediatric transmission.
   
• Episode 22 (Update 2): Children and COVID-19 (National Collaborating Centre for Infectious Disease, Apr 2021) UPDATED
  This podcast covers some of the essential information regarding children’s health and wellbeing during the pandemic, and is a follow-up to last year’s Episode 11: Children and COVID-19 in April 2020.
   
• Left Out: Children and youth with special needs in the pandemic (BC’s Representative for Children and Youth, Dec 2020) 
  This report looks at the under-served population of children and youth with special needs who have been disproportionately impacted by the disruption to services during the pandemic.
   
• School closures impact on learning, child and family well-being (BCCDC, Sept 2020)
  This evidence review seeks to understand some of the developmental, mental health and other impacts of children being unable to attend school. A webinar was also presented as part of BCCDC Grand Rounds.
   
• School closure and management practices during coronavirus outbreaks including COVID-19: a rapid systematic review (Viner et al., May 2020)
  This peer-reviewed article provides a systematic review of the effect of school closures on coronavirus (SARS, MERS, and SARS-CoV-2) transmission.
   
• Safer disinfectant use during COVID-19 for early childcare providers (Leonard, 2020)
  This presentation outlines some of the environmental health concerns for exposures to cleaning products in childcare settings, with recommendations on how to clean surfaces and equipment more safely.

Screening and Sampling

• Looking for COVID clues in our sewers (O'Keeffe, Jan 2021) 
  Wastewater based epidemiology (WBE), has been proposed as a tool for monitoring the occurrence, spread or resurgence of COVID-19 in the community by detecting viral signals in pooled samples of sewage. This NCCEH blog outlines the potential application of the technology, current research, and potential challenges for widespread deployment of WBE as a public health tool for pandemic management.
   
• Environmental Surface and Air Sampling in the Context of COVID-19 Pandemic (Chen, 2020) 
  This NCCEH field inquiry provides an overview of sampling techniques and analysis methods of SARS-CoV-2 on surfaces and in the air, as well as considerations for interpreting the results in various settings and contexts during the COVID-19 pandemic. 

• Are temperature scanners just a lot of hot air? (O'Keeffe, 2020)
  This NCCEH blog examines the use of temperature scanners in previous pandemics and the limitations of the practice in controlling transmission of infectious diseases.

Smoking, Vaping, and Cannabis

• Tobacco and E-Cigarettes(Public Health Ontario, 2020)
  This webpage features general health promotion resources for tobacco, as well as two specific products addressing the public health impacts of COVID-19 and vaping (Oct 2020), as well as exposure to tobacco products (July 2020).
   
• Tobacco and waterpipe use increases the risk of COVID-19(World Health Organization, 2020)
  This webpage addressed frequently asked questions regarding the effect of concurrent tobacco use and COVID-19 severity, as well as the inherent risk of social practices like hookah in amplifying transmission.

Variants of Concern

• Coronavirus disease 2019 (COVID-19): Epidemiology update.(Public Health Agency of Canada, July 2021) UPDATED
  This epidemiological update on COVID-19 from the Public Health Agency of Canada includes daily (Sun-Thurs) updates on the cumulative number of cases of variants of concern circulating in Canada by Province and Territory. 
   
• SARS-CoV-2 variant classifications and definitions (US Centers for Disease Control and Prevention, July 2021) UPDATED
  This website provides an overview of the definitions of variants of concern, variants under investigation and variants of high consequence, and details of variants currently assigned to each classification.
   
• COVID-19 and indoor air: Risk mitigating measures and future-proofing (O’Keeffe and Eykelbosh, June 2021) NEW
  Section 2 of this report looks at the literature regarding the variants of concern circulating up until April 2021, with addition sections on strategies for mitigating COVID-19 risk and avenues for future-proofing buildings in the post-pandemic era.

• COVID-19 variants of concern (Public Health Ontario, June 2021) UPDATED
  Public Health Ontario has produced "What we know so far" synopses for each of three main variants of concern circulating in Canada, alpha (1.1.7), beta (B.1.351), gamma (P.1), and delta (B.1.617) summarizing current knowledge of key characteristics including epidemiology, transmissibility, immunity.
   
• Transmission characteristics of SARS-CoV-2 variants of concern (Curran et al., SPOR Evidence Alliance, Mar 2021)
  This research brief summarizes evidence as of March 2021 on transmission characteristics of the three SARS-CoV-2 variants of concern alpha (B.1.1.7), beta (B.1.351), and gamma (P.1).

Water and Wastewater

• Wastewater surveillance of COVID-19 (Public Health Ontario, Apr 2021) NEW
  This rapid review provides and summary of wastewater surveillance activities globally and aims to help practitioners and policy makers with the interpretation and application of this technology.
   
• Looking for COVID clues in our sewers(O’Keeffe, January 2021)
  Wastewater based epidemiology (WBE), has been proposed as a tool for monitoring the occurrence, spread or resurgence of COVID-19 in the community by detecting viral signals in pooled samples of sewage. This blog outlines the potential application of the technology, current research, and potential challenges for widespread deployment of WBE as a public health tool for pandemic management.
   
• Ethics and communications guidance for wastewater surveillance(Canadian Water Network, Sept 2020) 
  This guidance document sets out the ethical considerations and guidance for communication about wastewater-based epidemiology, as an application of public health surveillance.
   
• CanCOVID Speaker Series: Recent presentations on wastewater (CanCOVID, 2020)
  CanCOVID’s speaker series, which is available in its entirety on their YouTube channel, includes two wastewater talks, Canadian wastewater surveillance – Where are we now?(Oct 2020) and Wastewater detection: the next COVID frontier (June 2020).
   
• Comparison of approaches to quantify SARS-CoV-2 RNA in wastewater(Canadian COVID-19 Wastewater Coalition, Nov 2020)
  This report summarizes the findings of an inter-laboratory study conducted Jul-Sep 2020 to compare methods and recommend quality assurance and quality control practices for monitoring COVID-19 in wastewater. The document highlights challenges and considerations for measurement of viral RNA in wastewater.
   
• Water, sanitation, hygiene, and waste management for SARS-CoV-2, the virus that causes COVID-19(World Health Organization, July 2020)
  This guidance document provides advice on wastewater and solid waste management where SARS-CoV-1 may be present in waste streams. It is available in multiple languages.
   
• Computational analysis of SARS-CoV-2/COVID-19 surveillance by wastewater-based epidemiology locally and globally: Feasibility, economy, opportunities and challenges(Hart and Halden, Aug 2020)
  This peer-reviewed article reports on a computational modeling study and cost analysis to evaluate the effectiveness of wastewater based epidemiology for tracking SARS-CoV-2 infection in the community. 

Zoonotic Transmission

• SARS-CoV-2 infection in farmed minks – an overview of current knowledge on occurrence, disease and epidemiology (Pomorska-Mol et al., July 2021) NEW
  This peer-reviewed article provides the most recent synthesis of research findings related to the numerous SARS-CoV-2 outbreaks in mink and the potential for human-to-mink and mink-to-human transmission.

• A call for One Health in medical education: How the COVID-19 pandemic underscores the need to integrate human, animal, and environmental health (Dykstra and Baitchman, July 2021) NEW
  This peer-reviewed article introduces the collaborative, transdisciplinary One Health approach to public health, using COVID-19 to demonstrate how One Health could help to mitigate the risks of pandemics, pre- and post-recovery..

• Reducing public health risks associated with the sale of live wild animals of mammalian species in traditional food markets – Interim guidance (World Health Organization, Apr 2021) NEW
  This guidance document outlines the health risks associated with live wild animal handling and recommends measures to mitigate the risk of zoonotic pathogen transmission.

• Mink farming and SARS-CoV-2: Staying vigilant at the human-animal interface(Lee, Jan 2021) 
  This NCCEH blog looks at what is known about the risks posed by SARS-CoV-2 transmission among farmed mink and what can be done to reduce the risks.

This list is not intended to be exhaustive. Omission of a resource does not preclude it from having value.