Deferred Care Outcomes in Canadian Children and Youth: Measuring and Mitigating Risk during COVID-19

Early data from Canada and other countries around the world suggest that children are less likely to be directly affected by COVID-19 compared to adults. However, there are concerns that children may suffer important health implications related to efforts to control the spread of COVID-19, such as limited or suspended in-person physician appointments as well as parental concerns about contracting the virus in doctor's offices or Emergency Departments. The areas of highest concern are missed immunizations and important primary care visits such as those for newborns directly after birth, and delayed care for illnesses which result in children being critically ill. Currently, there are no data or studies that have investigated these unintended consequences of the pandemic in Canada. Using the well-established health data systems in Ontario and Manitoba, the goal of this project is to provide a robust and timely understanding of whether such responses to the pandemic have negatively impacted the health of children in these provinces. This assessment will include outcomes such as a reduction in routine vaccination and increases in serious illness and death. We will also examine whether specific subgroups of children, such as those with complex medical conditions and recently arrived refugee and immigrant children are at particularly increased risk of poor outcomes. We will prepare reports of these outcomes by local health regions and public health units and work with policymakers in both provinces to inform mitigation strategies. We will develop a core set of measures that we will report on over the course of the pandemic and its related restrictions. We will share data definitions and codes for conducting these analyses with national organizations such that other provinces may conduct similar analyses.