COVID-19 economic impact payments and opioid overdose deaths

Putting the capital in recovery capital: An exploration of universal basic income and the impacts for people who use drugs in Canada

Many nations and communities have reinvigorated discussions around universal basic income (UBI) as a means to address growing inequity. Research to date suggests that such systems can have profound positive public health and social impacts. Substance use, however, has not been explored as an area that may be impacted by UBI. This essay explores the current UBI literature and suggests how such a program could impact substance use health concerns within the Canadian context. Specifically, a UBI program in Canada could significantly reduce the negative health concerns of substance use and reduce the nation's current expenditures on healthcare interventions. Canada and other nations should consider UBI as a means to address substance use concerns and future research should include reviewing substance use data as part of any basic income intervention.

SARS-CoV-2 (COVID-19) Experience at an Academic Medical Examiner's Office

Introduction

The coronavirus disease of 2019 (COVID-19) pandemic has resulted in a great deal of morbidity and mortality worldwide. Since most deaths related to COVID-19 are currently considered natural, and they tend to occur following a clinically recognized illness, many medical examiner/coroner offices within the United States do not take jurisdiction over the majority of COVID-19 deaths.

Methods

In this review, we present the experience of a medium-sized medical examiner's office affiliated with an academic medical school institution, over the first 15 months of the COVID-19 pandemic.

Results

Compared to a 15-month period that immediately preceded the pandemic, our office experienced a significant increase in the total number of reported deaths, scene investigations, full autopsies, natural deaths, accidents, homicides, and drug-related deaths, but a decrease in the number of suicides. Overall, our office performed 5 autopsies during the study period where COVID-19 was considered the primary cause of death, 4 cases where COVID-19 was considered a contributory cause of death, and 28 cases where COVID-19 testing was positive, but COVID-19 was not contributory to death.

Discussion

The COVID-19 pandemic was accompanied by a sizeable increase in work volume within our academic medical examiner's office. Although this increased workload was not related to a large number of COVID-19-related deaths investigated by the office, there were numerous areas of increased workload that were likely secondarily related to the conditions associated with the pandemic.

An ecological study of the correlation between COVID-19 support payments and overdose events in British Columbia, Canada

BACKGROUND

Pandemic income support payments have been speculatively linked to an increased incidence of illicit drug poisoning (overdose). However, existing research is limited.

METHODS

Collating Canadian Emergency Response Benefit (CERB) payment data with data on paramedic attended overdose and illicit drug toxicity deaths for the province of British Columbia at the Local Health Area (LHA) level, we conducted a correlation analysis to compare overdose rates before, during and after active CERB disbursement.

RESULTS

There were 20,014,270 CERB-entitled weeks identified among residents of British Columbia for the duration of the pandemic response program. Approximately 52 % of all CERB entitled weeks in the study were among females and approximately 48 % were among males. Paramedic-attended overdoses increased uniformly across the pre-CERB, CERB and post-CERB periods, while illicit drug toxicity deaths sharply increased and then remained high over the period of the study. Correlation analyses between overdose and CERB-entitled weeks approached zero for both paramedic-attended overdoses and illicit drug toxicity deaths.

CONCLUSIONS

These findings suggest that attributing the pandemic increase in overdose to income support payments is unfounded. Sustained levels of unacceptably high non-fatal and fatal drug poisonings that further increased at the start of the pandemic are reflective of complex pre-existing and pandemic-driven changes to overdose risk.

Racial And Ethnic Disparities In Pandemic-Era Unemployment Insurance Access: Implications For Health And Well-Being

Research demonstrates that receiving unemployment insurance decreases mental health problems. But researchers have also found racial and ethnic disparities in unemployment insurance receipt resulting from differences in work history and location. We examined a population disproportionately affected by job loss and unemployment insurance exclusions, using a survey of service workers from a single city who were parents of young children and who overwhelmingly had eligible work histories. During the COVID-19 pandemic, workers not identifying as White non-Hispanic in our sample were more likely to get laid off than White workers. Among those who were laid off, these workers and White workers experienced similar increases in material and mental health difficulties and similar gains when they received unemployment insurance. However, these workers were less likely than White workers to receive unemployment insurance at all. These results indicate that unemployment insurance has unrealized potential to reduce material and health disparities. Policies should be implemented to make this coverage more effective and equitable through increased access.