As Canada braces for what officials are predicting could be a second wave of COVID-19 cases, some public health experts say the federal government should shift its focus to rolling out supports for subpopulations of the Canadian public, but be careful to not step on the jurisdictional toes of its provinces and territories.

Dr. Farah Mawani, a Canadian Institutes of Health Research health system impact fellow, who works at Unity Health Toronto, said that Ottawa has funded rapid research that covers so many different aspects in response to the pandemic.

Moving into the summer and fall, she said, the government should use findings from such studies to guide its response in supporting subpopulations like precarious workers, those working and living in long-term care sites, racialized Canadians, and communities that have been harder hit by the pandemic.

We now have a bit of time to develop and communicate a strategic approach to preparing for a second wave, as researchers begin to share evidence from their studies, Dr. Mawani said. Ottawa announced in March, for example, $27-million in coronavirus research funding in areas like diagnostics, therapeutics, vaccines, and social consequences of public health responses.

[During] the early stages, a lot of communication had been at a very blanket population level, Dr. Mawani said, noting officials encouraged most Canadians to stay at home and to observe physical distancing. But people live in very different contexts, and thats how were seeing inequities in the cases, and the serious consequences of, COVID-19.

The World Health Organization on Wednesday said that, with India and Brazil registering a high number of infections, the world has yet to pass the first wave of the pandemic.

Since the pandemic, there have been numerous outbreaks in long-term care homes, with Ontario and Quebec bearing the brunt of the infections in Canada. The two provinces had to enlist the help of the military to manage the outbreaks in those facilities.

As of Thursday, there were close to 88,000 cases in Canada and more than 6,700 deaths from the virus. According to the National Institute on Aging, up to 82 per cent of all COVID-19 deaths in Canada, as of early May, were of those living in long-term care sites.

In Ontario, officials said 142 outbreaks at such sites have been resolved, while 150 remain active. Given that there are 626 homes in the province, that means almost half have either had an outbreak or are still experiencing one.

Dr. Curtis Cooper, president of the Canadian Foundation for Infectious Diseases, agreed that Ottawa should look at the quality of care and safety within long-term homes for the elderly, as thats been one of the key casualties as far as COVID-19 numbers in the country.

But Dr. Cooper cautioned the feds from considering taking over operations or governance of some long-term care sites, a move that Ontario Premier Doug Ford announced Wednesday.

It seems more like a provincial responsibility, but the federal government, just like public health, can serve as the facilitators to bring together key stakeholders, he said in an interview.

Canadian Armed Forces were recently deployed to five of Ontarios homes described conditions they observed in a report that has been described by Prime Minister Justin Trudeau (Papineau, Que.) as deeply disturbing. News reports have noted military members observing cockroach infestations, expired medications, staff reusing supplies, and residents left in dirty diapers.

Ontario has already launched an independent commission into its long-term care system, which will begin in July, a timeline that has been moved up from September following the militarys report. Mr. Ford said this week that a probe has also been launched by the chief coroners office to see if criminal charges can be filled.

He announced Wednesday that his government is taking over the management of five sites, four of which are privately owned.

For its part, Ottawa has said such conditions are unacceptable and had pledged to support jurisdictions in improving the situation on the ground at such sites. Treasury Board President Jean-Yves Duclos (Qubec, Que.) told reporters Wednesday that we need to have a very serious and collaborative discussion on how we look after our seniors in the weeks, the months, and the years to come.

Mr. Trudeau added Wednesday that he will raise the matter on his weekly call with premiers on Thursday to offer our governments support as they try to get the situation under control.

Dr. Juliet Guichon, an associate professor studying the intersection of law, health care, and ethics at the University of Calgary, said that Ottawa will continue to have to work with provinces to protect the health of Canadians.

She said that provinces like Quebec, over the years, have zealously guarded its jurisdiction with respect to health, challenging the feds in situations where it feels Ottawa is impeding on its domain.

The Assisted Human Reproduction Act is one of those, she said, as the province felt Ottawa was overstepping by wanting to mandate issues around treatments for fertility, but did not challenge it wanting to legislate other areas like human cloning. The constitutional challenge garnered the support of provinces like Saskatchewan, New Brunswick, and Alberta, and parts of it were eventually struck down in 2010 by the Supreme Court of Canada.

They want the jurisdiction over the issue, on health, so presumably they want to pay for it, said Dr. Guichon, noting the vast majority of transfers from the feds to provinces already tend to go toward the education and health files.

Health is a shared jurisdiction, only insofar as there is a criminal or product safety issue, said Dr. Guichon. The doctor added the feds would be on the hook if Canada is bringing in defective products under its jurisdiction around consumer protection.

Mr. Trudeau acknowledged Tuesday that there has been a rise in counterfeit products and products that dont meet a rigorous Canadian standard. He said the feds have signed agreements with Canadian companies to ramp up domestic supply as a result.

As economies reopen and people begin eyeing a return to work, Dr. Mawani said the feds should share clear messaging around what to do if you dont have a choice about going to work, or how [it can] support you to stay healthy under those circumstances.

Earlier this week, Mr. Trudeau cited ongoing discussions with jurisdictions about how to create a program that will allow workers 10 days of paid sick leave, a push the NDP had been making for weeks. The NDP wanted the commitment in exchange for the partys support for a Liberal motion on how parliamentary proceedings would move forward throughout the pandemic. The motion ultimately passed without the support of the Bloc Qubcois and the Conservatives.

Dr. Cooper said that the feds role so far has been one of a safe keeper of the nations population, through their messaging around public health measures and various programs to offer people financial support. I dont see a major shift in that as necessary except to nuance some of the public health and financial programs, now that we have more information and we know whats working with these programs and what needs some tweaking.

Ottawa has frequently said it will take stock of the outbreak and respond or modify its programs accordingly. Deputy Prime Minister Chrystia Freeland (University-Rosedale, Ont.) told reporters in March that the speed at which things are changing could mean the government will make announcements without being able to fill in all the details in the moment that we make the announcement.

For example, Since unveiling the Canada Emergency Response Benefit in March, Ottawa has expanded the criteria to help those who have seen their hours change because of the pandemic, instead of only focusing on those who have lost their income entirely.

As months go by, there will be a fatigue factor for people who will say, Ive had enough of this, and be tempted to abandon all these measures that have kept us safe for the last three months, added Dr. Cooper. He said the feds will need to look at ways to keep people engaged and willing to participate in physical distancing measures moving forward.

His comments come on the heels of last weekend, when an estimated 10,000 people flocked to Torontos Trinity Bellwoods park, a move that led to Mr. Ford condemning the congregation as reckless. City officials are now considering painting circles on the grass at parks to show how to safely physically distance while people are out and about, which will be piloted at Trinity Bellwoods.

According to Dr. Mawani, hesitations that Ontario might have around revealing hot spots in the province by identifying areas down to the postal code are valid, because they might stigmatize some communities, rather than focusing on improving the social determinants of those regions. Such determinants can include low-income housing, a higher concentration of precarious workers, access to adequate transit options, and systemic racism, she said.

Often, the government and researchers focus on race as a characteristic of individuals, and that is very dangerous in terms of putting the responsibility for increased risk and impact on individuals who are racialized, rather than looking at what are the systemic causes of inequities that racialized people experience, she said.

While Ontario expressed that hesitation, Toronto unveiled geographical information about the virus spread Wednesday, with Mayor John Tory saying he believes this information, and releasing it to the public, will do far more help than it will do harm. The citys stats show the highest concentration of cases is in areas like northern Etobicoke and northern Scarborough, areas that tend to have lower-income residents, some of whom may be living in cramped quarters.

Mr. Ford previously said the Peel Region and Windsor-Essex County were among those areas harder hit, and added on Wednesday that includes areas of Brampton.

Dr. Mawani added that those communities experiencing inequities should either be leading, or partners in, research that guides government responses, so that we know were not only addressing the gaps in the response, but were doing it in a way that is going to have an impact on reducing inequities.

According to Canadian Heritage spokesperson Martine Courage, in recognition of how COVID-19 disproportionately affects racism-impacted communities, the anti-racism secretariat has set up an equity-seeking communities & COVID-19 taskforce.

The secretariat, which has six staff, co-chairs the taskforce and its 85 members who meet regularly and represent 24 federal organizations, including the Treasury Board Secretariat, Finance Department, Public Health Agency of Canada, and Employment and Social Development Canada, Ms. Courage wrote in a May 19 email.

The secretariat is part of the feds anti-racism strategy, unveiled last June, and was established in October. Its annual report is expected in the fall, Ms. Courage said.

Editors note: This story has been updated to reflect the full name of the department Employment and Social Development Canada, and to correct Dr. Mawanis affiliation and better reflect her comments.

The Hill Times

See the rest here:
Narrow focus to supporting 'subpopulations,' says expert, in preparation for second wave of the pandemic - The Hill Times