Month: May 2020

Scientists at MAP Centre for Urban Health Solutions understood as soon as the pandemic was declared that it would present unique issues to the populations they serve.

They began to hear stories of decreased access to important services for their research partners, some of whom are experiencing homelessness, using drugs or alcohol, or living with low incomes.

“Conditions of marginalization are complex and interrelated,” said Dr. Michelle Firestone, a MAP scientist. “These conditions are unfortunately exacerbated during the COVID-19 pandemic, which brought with it rapid change such as economic loss, lack of social supports and barriers to accessing services.”

She and Dr. Ahmed Bayoumi, a scientist at MAP who holds the hospital’s Foundation Baxter & Alma Ricard Chair in Inner City Health, came together to do what MAP does best: evaluate and test solutions to complex urban health issues.

They assembled a group of 35 scientists, people experiencing disadvantage and community partners and providers to lead a research project. Their goal is to evaluate how local efforts to respond to the pandemic have impacted people who are marginalized and determine which efforts are working and what could be improved.

“This project builds on longstanding partnerships between MAP scientists and community service providers and decision makers,” said Dr. Firestone. “It extends across diverse communities within our city, reflecting the scope and interdisciplinary research areas that exist within MAP.”

In fact, the project has the most co-investigators Dr. Bayoumi has ever listed on a project, and that is intentional: the 35 investigators want the study’s findings to be as inclusive and accessible as possible.

This project is structured to be a rapid research evaluation and Dr. Bayoumi and Dr. Firestone hope it will quickly help to improve programs and services. In the long term, they hope it will build stronger collaborations between academics and people with lived experience.

“It’s important for us to build bridges across our own silos,” said Dr. Bayoumi, “and this research project is a good place to start.”

By Dr. Tara Kiran

COVID-19 has exposed so many cracks in our healthcare system. One that has received little attention is how to organize family doctors to provide the best possible care for patients.

As it becomes clear that COVID-19 will be with us for a year or longer, the role family doctors play in preventing and managing chronic health conditions like diabetes and heart disease will be increasingly important. We need to ensure family doctors are organized, paid, and resourced to deliver the care patients need.

Like everyone else, family doctors have had to change how we work to adapt to the COVID-19 pandemic. We have deferred non-urgent visits and are assessing more patients virtually by phone, email, or video. We still see some people in the clinic – pregnant women, kids needing immunizations, and people who need to be examined – and are careful about how we do so. In some large practices, only one doctor is in the clinic at any one time. This approach saves personal protective equipment and reduces the risk of us infecting one another or our patients.

Some family doctors have made these changes with the support of a large team and are getting paid just as much as before the pandemic. But many other family doctors have been alone in navigating these changes and have seen a precipitous drop in their income, threatening their ability to care for patients.

Dr. Naomi Thulien has just received a knowledge synthesis grant from Canadian Institutes of Health Research (CIHR), Canada’s federal funding agency for health research. The application was ranked 2nd in the competition. The project is titled Pandemic-Proof: Synthesizing Real-World Knowledge of Promising Mental Health and Substance Use Practices for Young People Who Are Experiencing or Have Experienced Homelessness.

“This pandemic is negatively affecting the young people we serve,” she says. “Despite this, we are hearing from our colleagues on the front lines that some are trying really innovative things to connect with young people who have experienced or are experiencing homelessness. In fact, we believe that some of these ideas may be really forward thinking and should continue after the pandemic is over. With this grant, we plan to study this work and share this information quickly with folks on the front lines and in government in a way that is easy to understand and helps them make informed decisions.”

By Nav Persaud and Steve Morgan

THE GLOBE AND MAIL

After coining the term “caremongering” during the COVID-19 pandemic, Canadians have shown each other, and the world, that it’s possible to work together to collectively ensure that everyone’s needs are adequately met. Communities are rallying to support neighbours and strangers alike. Celebrities are raising millions of dollars for charities.

But some problems are too big for community mobilization, which is why robust public policies are still needed to support all Canadians during and after this crisis.

One such policy would be the creation of a national pharmacare program. Since the 1960s, five separate national commissions have recommended that medically necessary prescription drugs be included in Canada’s universal public-health insurance system. Just last year, Prime Minister Justin Trudeau’s Advisory Council on the Implementation of National Pharmacare produced an evidence-based and practical implementation plan that would begin this year.

Some might question whether Canada can afford national pharmacare in the wake of the COVID-19 pandemic as governments face massive deficits, but the case for such a program has never been stronger. Canada’s current patchwork of private and public drug plans wastes billions of dollars each year.

For every citizen, we spend at least 50 per cent more on pharmaceuticals than countries with universal single-payer pharmacare systems (for example, Britain). These other countries do not save money by using fewer medicines than we do – their collective purchasing power yields lower drug prices for brand-name and generic drugs. Canada could do this, too, while improving access to medicines at the same time.

…In a widely circulated report he co-authored last month, Dr. Andrew Pinto called on all Canadian jurisdictions to begin collecting data on the race of COVID-19 patients using a uniform questionnaire, to be able to compare results nationally.

“We need to recognize that crises don’t affect everybody the same,” he said in an interview. “Without the data, we won’t be able to see that and direct resources and effort to where they’re most needed.”

So far the country is moving toward a clearer picture of ethnic disparities in fits and starts, although the non-profit Canadian Institute for Health Information has endorsed Dr. Pinto’s report, and offered to help compile such data.

Toronto’s Medical Officer of Health, Eileen de Villa, said in an interview that the city’s public health agency will start gathering ethnic data as part of its COVID-19 case investigation process by the week of May 18, once it has the technical capacity. “We’re pretty much ready to go,” she said.

“The best way to do it is by ourselves, for ourselves.”

Dr. Janet Smylie has dedicated much of her over two-decade career as a Métis physician and leader in the field of Indigenous health to shedding light on the injustices Indigenous people face in Canada’s health-care system.

It’s why Indigenous Services Canada will be working with her on short-term and long-term analysis of data on the novel coronavirus pandemic’s impact on Indigenous communities, in an effort to address some of the data gaps that exist between Indigenous populations on and off reserve.

“It’s a broken system,” said Smylie.

“Even though there are all these jurisdictional divides in this health information system where it’s way harder to identify our people with COVID in cities, now people are trying to work together and admit there’s gaps. We need to bring things together.”

Dr. Janet Smylie speaks with CBC News’ Rosemary Barton on the lack of COVID-19 data for urban Indigenous communities in Canada.

“I’m very concerned right now. In fact I’ve been very concerned – and working with others to try to address this complicated problem – since the onset of the pandemic here in Canada… Currently we are faced with a federal and jurisdictional hot potato, and unfortunately it’s not only in the delivery of health services, it’s also in our health information systems. I see an opportunity to bridge that gap.” – Dr. Janet Smylie

The previous week, CBC News reporter Natasha Fatah interviewed Dr. Smylie on the same topic, following an announcement by Indigenous Services Minister Marc Miller that Ottawa was pledging $250,000 to launch Dr. Smylie’s new data modelling platform, to inform the government’s responses to the virus’s spread in Indigenous communities.

Canada's Minister of Indigenous Services highlighted that data gaps exist on COVID-19 cases for Indigenous communities

We speak with Dr. Janet Smylie, Research Chair with Unity Health Toronto, & Dalla Lana School of Public Health at U of T #cdnpolihttps://t.co/5fQvbCco2D pic.twitter.com/1H5hBZ6WYN

— Natasha Fatah (@NatashaFatah) May 9, 2020

Canada must improve its COVID-19 data collection efforts for First Nations, Inuit and Métis communities if it wants to better understand how the novel coronavirus is impacting Indigenous people across the country, Indigenous Services Minister Marc Miller said Saturday.

“We are learning from past experience with responding to pandemics in Canada … that we need to recognize and understand [Indigenous populations] have a higher risk of being disproportionately impacted by COVID-19,” Miller said. “Along with better access to testing, we are acutely aware of the need to do better, more robust and routinely collected disaggregated data.”

Miller said Ottawa has already pledged $250,000 for improved data collection efforts [led by Dr. Janet Smylie] that would lead to more accurate modelling of the virus’s spread in Indigenous communities and better inform the government’s response.

Also mentioned in NOW Toronto: During a press conference, Miller said the federal government is providing $250,000 to a project led by Toronto-based Métis research scientist Janet Smylie at Toronto’s St. Michael’s Hospital to create a tracking and response platform that will allow for better understanding and data modelling of COVID-19 cases in Indigenous populations.

This week, 250 Toronto families received a package of swabs in the mail. Parents will swab their kids and themselves and send the samples back to be tested for COVID-19, and repeat this weekly — a faucet of data to help answer urgent questions about the role children play in driving transmission of the coronavirus.

The TARGet Kids study, which aims to enrol 1,000 families, is one of two major ongoing research projects in Canada that have rapidly pivoted in recent weeks to help answer the many unknowns about COVID-19 and children. Both will help inform policies to determine when it’s safe to reopen schools and daycares, which have been shuttered here since March — a necessary intervention, but also a brutal drag on children’s learning, parents’ mental health, and the economy, since most working parents rely on child care.