COVID-19 infection and vaccination rates in healthcare workers in British Columbia, Canada: A Longitudinal Urban versus Rural Analysis of the Impact of the Vaccine Mandate

Purpose: Healthcare workers (HCWs) play a critical role in responding to the COVID-19 pandemic. Early in the pandemic, urban centres were hit hardest globally; rural areas gradually became more impacted. We compared COVID-19 infection and vaccine uptake in HCWs living in urban versus rural locations within, and between, two health authorities in British Columbia (BC), Canada. We also analyzed the impact of a vaccine mandate for HCWs. Methods: We tracked laboratory-confirmed SARS-CoV-2 infections, positivity rates, and vaccine uptake in 29,021 HCWs in Interior Health (IH) and 24,634 HCWs in Vancouver Coastal Health (VCH), by occupation, age, and home location, comparing to the general population in that region. We then evaluated the impact of infection rates as well as the mandate on vaccination uptake. Results: By October 27, 2021, the date that unvaccinated HCWs were prohibited from providing healthcare, only 1.6% in VCH yet 6.5% in IH remained unvaccinated. Rural workers in both areas had significantly higher unvaccinated rates compared with urban dwellers. Over 1,800 workers, comprising 6.4% of rural HCWs and 3.3% of urban HCWs, remained unvaccinated and set to be terminated from their employment. While the mandate prompted a significant increase in second doses, the impact on the unvaccinated was less clear. Conclusions: As rural areas often suffer from under-staffing, loss of HCWs could have serious impacts on healthcare provision as well as on the livelihoods of unvaccinated HCWs. Greater efforts are needed to understand how to better address the drivers of rural-related vaccine hesitancy as the pandemic continues.

Paleoecological Investigation of Vegetation, Climate and Fire History in, and Adjacent to, Kootenay National Park, Southeastern British Columbia, Canada

Paleoecological investigation of two montane lakes in the Kootenay region of southeast British Columbia, Canada, reveal changes in vegetation in response to climate and fire throughout the Holocene. Pollen, charcoal, and lake sediment carbon accumulation rate analyses show seven distinct zones at Marion Lake, presently in the subalpine Engelmann Spruce-Subalpine Fir (ESSF) biogeoclimatic (BEC) zone of Kootenay Valley, British Columbia. Comparison of these records to nearby Dog Lake of Kootenay National Park of Canada in the Montane Spruce (MS) BEC zone of Kootenay Valley, British Columbia reveals unique responses of ecosystems in topographically complex regions. The two most dramatic shifts in vegetation at Marion Lake occur firstly in the early Holocene/late Pleistocene in ML Zone 3 (11,010–10,180 cal. yr. B.P.) possibly reflecting Younger Dryas Chronozone cooling followed by early Holocene xerothermic warming noted by the increased presence of the dry adapted conifer, Douglas-fir (Pseudotsuga menziesii) and increasing fire frequency. The second most prominent change occurred at the transition from ML Zone 5 through 6a (∼2,500 cal. yr. B.P.). This zone transitions from a warmer to a cooler/wetter climate as indicated by the increase in western hemlock (Tsuga heterophylla) and subsequent drop in fire frequency. The overall cooling trend and reduction in fire frequency appears to have occurred ∼700 years later than at Dog Lake (∼43 km to the south and 80 m lower in elevation), resulting in a closed montane spruce forest, whereas Marion Lake developed into a subalpine ecosystem. The temporal and ecological differences between the two study sites likely reflects the particular climate threshold needed to move these ecosystems from developed forests to subalpine conditions, as well as local site climate and fire conditions. These paleoecological records indicate future warming may result in the MS transitioning into an Interior Douglas Fir (IDF) dominated landscape, while the ESSF may become more forested, similar to the modern MS, or develop into a grassland-like landscape dependent on fire frequency. These results indicate that climate and disturbance over a regional area can dictate very different localized vegetative states. Local management implications of these dynamic landscapes will need to understand how ecosystems respond to climate and disturbance at the local or ecosystem/habitat scale.