Perceptions of COVID-19 risk, vaccine access and confidence: a qualitative description of South Asians in Canada

Public-engagement strategies of the South Asian COVID-19 Task Force: The role of racialized healthcare workers in COVID-19 mitigation in Ontario

The COVID-19 pandemic began in late 2019 and its uneven impact across different communities globally was quickly evident. In Canada, South Asian communities were disproportionately affected. In response, the South Asian COVID-19 Task Force (SACTF) emerged, seeking to address the unique challenges faced by the South Asian community. The embedded single case study design was employed to explore the role of SACTF in COVID-19 mitigation in Ontario. Informed by critical race theory and a public engagement conceptual framework published by the Canadian Health Services Research Foundation (2010), we analyzed how contexts guided the goals, processes, and outcomes of SACTF activities. We conducted one-on-one semi-structured interviews and focus group discussions with SACTF's Board of Directors and analyzed SACTF-produced knowledge dissemination materials and media coverage of SACTF spanning March 2020 to February 2022. SACTF's success in educating and advocating for South Asians offers important insights into the gaps in public health communication and the inequities in healthcare delivery. It emphasizes the importance of tailoring emergency responses to community-specific needs and the role of racialized healthcare workers in facilitating trust-building within minority communities. By incorporating insights of racialized healthcare workers in health system decision-making, both public engagement and community health outcomes can be improved. This study contributes to a nuanced understanding of community-centric pandemic responses and demonstrates the need for diverse representation in decision-making processes for long-term health system resilience. Both healthcare knowledge and lived experiences made SACTF alert to how pandemics unfold differently and have differential effects on racialized populations. SACTF's responses offer practical recommendations for future pandemic preparedness and emergency responses, emphasizing the role of advocacy groups in addressing public health gaps and serving as crucial allies for communities and governments.

COVID-19 vaccine effectiveness among South Asians in Canada

We evaluated the effectiveness of COVID-19 vaccines among South Asians living in Ontario, Canada compared to non-South Asians and compared the odds of symptomatic COVID-19 infection and related hospitalizations and deaths among non-vaccinated South Asians and non-South Asians. This was a test negative design study conducted in Ontario, Canada between December 14, 2020 and November 15, 2021. All eligible individuals >18 years with symptoms of COVID-19 were subdivided by ethnicity (South Asian vs other) and vaccination status (vaccinated versus not). The primary outcome was vaccine effectiveness as defined by COVID-19 infections, hospitalizations, and deaths, and secondary outcome was the odds of COVID-19 infections, hospitalizations, and death comparing non-vaccinated South Asians to non-vaccinated non-South Asians. 883,155 individuals were included. Among South Asians, two doses of COVID-19 vaccine prevented 93.8% (95% CI 93.2, 94.4) of COVID-19 infections and 97.5% (95% CI 95.2, 98.6) of hospitalizations and deaths. Among non-South Asians, vaccines prevented 86.6% (CI 86.3, 86.9) of COVID-19 infections and 93.1% (CI 92.2, 93.8) of hospitalizations and deaths. Non-vaccinated South Asians had higher odds of symptomatic SARS-CoV-2 infection compared to non-vaccinated non-South Asians (OR 2.35, 95% CI 2.3, 2.4), regardless of their immigration status. COVID-19 vaccines are effective in preventing infections, hospitalizations and deaths among South Asians living in Canada. The observation that non-vaccinated South Asians have higher odds of symptomatic COVID-19 infection warrants further investigation.