Published: 2021-01-30

Introduction to 98th volume of the University of Toronto Medical Journal Issue on COVID-19
Yuliya Lytvyn and Maleeha A. Qazi, Editors-in-Chief

The outbreak of COVID-19 caused by a novel severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) in Wuhan City, Hubei Province, China in December 2019 quickly turned into a global pandemic. On January 30, 2020 the World Health Organization declared the outbreak a Public Health Emergency of International Concern. Subsequently, a number of public health measures were instituted by governments to slow the spread of the virus and decrease the burden on health care systems and economies. Despite significant efforts, a year after the outbreak (as of December 31, 2020), 83,113,878 laboratory-confirmed cases of COVID-19 and 1,811,128 deaths have been reported globally. For the past year, the entire world united to achieve a common goal – to reduce the burden of the pandemic on our society. Although the rapid research advancements and collaborations have led to production and approval of vaccines at a record pace, the battle with COVID-19 is ongoing and a number of barriers still need to be overcome.

For our issue on COVID-19, UTMJ invited national and international leaders to reflect on on-going challenges and lessons learned during the world’s response and journey during this pandemic. Dr. Chloe Atkins, Associate Professor in the Department of Political Science at the University of Toronto, and her Postdoctoral Fellow, Dr. Andrea Whiteley, in their commentary, discuss the disproportionate impact the COVID-19 pandemic has had on the vulnerable populations. They urge us to take social determinants of health into account to better equip our society to weather crises, such as the current global pandemic. During the COVID-19 pandemic, a number of injustices received little attention and one of them has been the use of solitary confinement by the U.S. Immigration and Customs Enforcement (ICE) agency in an attempt to slow the spread of COVID-19 in their detention centres. Dr. Wesley Boyd, Associate Professor of Psychiatry and a faculty at the Center for Bioethics at the Harvard Medical School, alongside Dr. Samara Fox, Resident Physician at Beth Israel Deaconess Medical Center, and Ellen Gallagher, former policy adviser at the Department of Homeland Security’s Office of Civil Rights and Civil Liberties who frst blew the whistle on ICE’s use of solitary confinement, cast a light on the medical ethics of this largely undiscussed issue. Finally, Dr. Sadath Sayeed, Assistant Professor of Global Health and Social Medicine at Harvard Medical School, and Dr. Lauren Taylor, Postdoctoral Fellow at NYU Grossman School of Medicine, evaluate the guidance offered by bioethics to address critical care resources during the pandemic. They discuss the potential reasons why bioethics may be poorly equipped to confront the scale of institutional dismantling that might be required to address root causes of social injustice in the United States.

In addition to the invited commentaries, UTMJ had the privilege to interview a number of highly respected leaders in the fields of healthcare advocacy, preventative medicine, and education. Interviewees shared their insights into leadership strategies and the impact COVID-19 pandemic has had on our society. Dr. Jeff Kwong, the Program Leader of the Populations and Public Health Program at ICES, a Scientist at the Public Health Ontario, and a Professor at the University of Toronto, shared his insights into the impact of COVID-19 on health care, public health measures and vaccination. Dr. Andreas Schleicher, the Director for Education and Skills at the Organisations for Economic Co-Operation and Development (OECD), discussed with our team the impact COVID-19 has had on education, educational policies and practices worldwide. Dr. Brian Goldman, a well-known emergency room physician at Mount Sinai Hospital, Toronto, a vivid healthcare advocate and voice for Canadians from coast-to-coast, reflected on his dual role as a physician and a prominent healthcare informer for the Canadian public. He is the host of two popular CBC radio shows, White Coat, Black Art, and The Dose, which have been strong platforms for sharing stories of our fellow Canadians during the pandemic and providing news related to the pandemic in an accessible way. Another interviewee was John Yip, a highly regarded leader in ophthalmology and community health with a number of roles, including CEO of Kensington Health in Toronto and Vice President of Corporate Services for Health Quality Ontario in the past. With his interview, he inspires and urges to redefine leadership during the COVID-19 pandemic. Finally, the UTMJ also interviewed Nancy Schlichting, retired CEO of Henry Ford Health System (HFHS), who pivoted HFHS out of its free-fall through her unconventional leadership and a drive for innovation. She was honored as one of the 100 Most Influential People in Healthcare by Modern Healthcare magazine, as well as named to the Top 25 Women in Healthcare.

The UTMJ takes pride in supporting manuscript submission by trainees all over the world. In this issue, Jack G. Underschultz from the Faculty of Medicine and Dentistry, University of Alberta received the first prize trainee submission award. His paper, entitled “What Drives Resistance to Public Health Measures in Canada’s COVID-19 Pandemic? An Online Survey of Canadians’ Knowledge, Attitudes, and Practices,” may help inform public health policy and individual behaviour.

This is the first issue of the University of Toronto Medical Journal’s 98th volume. We would like to sincerely thank our dedicated editorial team for all the hard work that went into preparing this issue, and their continued efforts in upcoming issues. We are grateful for the patrons and faculty that continue to support the University of Toronto Medical Journal and the authors that have allowed us to showcase their important work and provided insight into the rapidly evolving advancements made during COVID-19 pandemic. We hope that you find this issue informative and thought-provoking.


Vulnerability, social triage and the COVID-19 pandemic

Chloe G K Atkins, Andrea Whiteley

Page 6-9

A Pandemic Induced Reckoning: Bioethics and Justice

Sadath A Sayeed, Lauren Taylor

Page 13-16

The Hailing Heroes Myth: Understanding Stigma Faced By Healthcare Workers During COVID-19

Mishaal Qazi, Sabrin Salim, Shannon Leung, Angie Puerto-Nino

Page 17-20

Are App-based Platforms Safe for Communicating Patient Health Information?

Klaudiusz Stoklosa, Roberto V P Ribeiro, Alun Ackery, Bobby Yanagawa

Page 21-24

Deconstructing and Strengthening Canada’s Health Human Resource Strategy

Justin Shapiro, Raumil V Patel, Kaesavan Selvakumaran

Page 25-27

COVID-19: A Psychological Nightmare

Rachelle A. Ho, Aleeza Sunderji , Divya Prasad, Kyle Gauder, Geoffrey B. Hall

Page 28-29

Canada’s infant mortality: a developing world within its borders

Peter D Wong, Murtala Abdurrahman, Anna Banerji, Rosemary G Moodie

Page 31-34

Primary Research

Case Report

Familial Adenomatous Polyposis: an adolescent with refractory iron deficiency anemia and a mandibular mass

Wayne F Leung, Carol Durno, Ibrahim Al-Hashmi, Yousef Etoom, Rosemary G Moodie, Peter D Wong

Page 91-92

Asymptomatic Accelerated Idioventricular Rhythm in a 5-Year-Old Girl

Rawan Abdelhaq, Yousef Etoom, Peter Wong

Page 93-94

Acting fast on late-onset abdominal and back pain

Priyank Bhatnagar, Vishalini Sivarajah, Roshan Uruthirakumar, Jonathan P. Wong, Yousef Etoom, Farah Siam, Peter D Wong , Rosemary G. Moodie

Page 95-96

Primary extranodal laryngeal lymphoma: description of two cases

Geng Ju Tuang, Jeyasakthy Saniasiaya, Jennifer Peak Hui Lee, Marina Mat Baki

Page 97-99

Inflammatory myofibroblastic tumour of the urinary bladder: a rare entity

Theebanraja Ramalingam, Ikhwan Mohamad, Nik Mohd Nurhafizi Nik Anuar, Mohamed Ashraf Mohamed Daud, Anani Aila Mat Zin

Page 103-105

Medical Education


Interview with Dr. Jeff Kwong

Huaqi Li, Raumil Patel

Page 108-110

Interview with Dr. Andreas Schleicher

Monish Ahluwalia, Sabrina Campbell

Page 111-112

Interview with Dr. Brian Goldman

Ryan Daniel, Grace Lee

Page 113-118

Interview with John Yip

Prem Nichani

Page 119-120

Interview with Nancy Schlichting

Justin Shapiro

Page 121-122


Tuberculosis and COVID-19: an overview of two health emergencies

Karen Jazmín Cevallos Salazar, Ana Patricia Jiménez

Page 53-60

Early trial results of SARS-CoV-2 vaccines: a review

Cheng En Xi, Peter Anto Johnson, John Christy Johnson, Austin Mardon

Page 61-67

The ABCs of COVID-19 in Children

Joanna Deng, Jasrita Singh, Austin Mardon

Page 76-81