AMO – Academic Medical Organization of Southwestern Ontario
AMO-21-002 – The Impact of Novel Coronavirus (COVID-19) Outbreak on Physicians in Ontario
As of September 3, 2021, over 1.5 million Canadians have tested positive for COVID-19 and 27,000 have died. Monitoring COVID-19 testing, infections, outcomes, and vaccinations among healthcare workers is not only important for protecting their own physical and mental health, but also the patients they care for. Information on COVID-19 infection rates, outcomes, and vaccination rates among physicians in Ontario remain unknown.
Using linked administrative healthcare databases housed at ICES, we were able to conduct 3 population-based studies of physicians in Ontario. The first study examined the percentage of physicians tested for COVID-19, the percentage testing positive, and how testing and infections varied by physician age, sex, practice location, specialty, and whether they provided care in a long-term care home. The second study examined changes in outpatient visits related to mental health and substance use among physicians during the COVID-19 pandemic. The final study examined COVID-19 vaccination rates among all active physicians in Ontario.
Among the 41, 208 physicians in our first study, nearly half (46%) were tested at least once for COVID-19, and 358 tested positive (0.9% of all physicians and 1.9% of those tested). No physicians died within 30 days of testing positive, although 5.6% were hospitalized and less than 2% were in the intensive care unit. By age, the percentage of physicians tested, and the percentage testing positive were highest among those younger than age 40. The percentage testing positive was highest among internal medicine practitioners (1.2%) and family physicians (0.9%). These estimates are lower than those reported in other countries and may reflect comprehensive public health measures implemented in Ontario early in the pandemic.
In our second study examining changes in outpatient physician health care visits related to mental and substance use (MHSU), the annual crude rate of MHSU visits in the first 12 months of the pandemic period increased by 27% from 816.8 visits per 1000 physicians during the pre-pandemic period to 1037.5 visits per 1000 physicians during the COVID pandemic period. After adjusting for demographic and physician characteristics and prior history of mental health, MHSU visits increased on average by 13% per physician (RR=1.13, 95%CI: 1.07-1.19). These findings suggest that the mental health of physicians was negatively impacted by the pandemic.
In our final study examining vaccination rates among physicians, we found that in the first 6 months of vaccine availability, 93.4% of physicians received at least one COVID-19 dose, and 89.9% were fully vaccinated. Among physicians who were fully vaccinated, the average number of days between the first and second dose was 56.1 days [SD 31.3]. By specialty, anesthesiologist and emergency physicians were the first to receive their COVID-19 vaccine, whereas family physicians were more delayed in comparison. By age younger physicians aged 21 to 29 years were the first to receive the vaccine, and we found no significant differences by sex. Our findings suggest that Ontario physicians demonstrated a high degree of participation in the provincial vaccination program.
In summary, our studies provided reliable, population-based estimates of COVID-19 testing, infection, outcomes, and vaccinations among physicians in Ontario. Future work will include examining long-term outcomes of COVID-19 infections, and changes in vaccination rates with the introduction of vaccine mandates.
Risks and Complications
Primary Project Lead for Contact
Dr. Amit Garg