Toronto has long had a deficiency of safe indoor public spaces for those experiencing homelessness to access during the cold winter season, and a new study demonstrates just how much this issue has been exacerbated by the COVID-19 pandemic.
The project, called Changes in informal access to selected indoor public spaces in Toronto and carried out by MAP Centre For Urban Health Solutions, looks at five different types of public indoor spaces — 24-hour restaurants, warming centres, libraries/community centres, drop-ins, and Out of the Colds — and uses maps to show how many were lost during the 2020/2021 winter season.
“There is a severe lack of access to indoor public space, even during cold weather alerts. The City of Toronto’s ‘Winter Plan for People Experiencing Homelessness’ does not address this lack of access,” reads a summary of the study.
“Although the situation has been exacerbated by the pandemic, the lack of safe, accessible, indoor space in Toronto, in particular during the winter, is a longstanding issue.”
The first two maps, which compare 24-hour chain coffee shops and restaurants open during the winter of 2019/2020 with those in 2020/2021, show that there were 105 restaurants and coffee shops open all night and located close to 24-hour transit in Toronto last year…
The pandemic has radically changed the way Ontarians get appointments with their family doctors, with office visits dropping by almost 80 per cent and virtual-care visits jumping by a whopping 5,600 per cent, a new study shows.
“The change in care from personal to virtual was expected but the magnitude was a surprise, especially the precipitous decline in in-person visits,” said lead author Dr. Rick Glazier.
To get a sense of the pandemic’s impact on primary care, researchers from ICES, an independent, non-profit research institute, and Unity Health Toronto compared billing data from 2020 to 2019, looking specifically at the time period from March to July in both years.
They found that the number of office visits per 1,000 per day went to 1.57 from 7.53, for a drop of 79.1 per cent.
The number of virtual visits per 1,000 people per day went to 3.92 from .07, for an increase of 5,608 per cent.
Total primary care visits — including those done in-person and virtually — decreased by 28 per cent. The number of visits per 1,000 people per day went to 5.51 from 7.66.
Senior author Dr. Tara Kiran said it was reassuring to see that those with the highest care needs maintained higher levels of care.
“Sadly the pandemic has generally widened gaps in equity and many people are not getting the support they need. But our findings suggest that primary care was preserved for those who needed it most. We found the people who were older and sicker had the smallest reduction in overall primary care visits,” she said.
Medical Post journalists reached out to talk off-the-record to doctors in the power structure and asked them which doctors they think have power. Congratulations to MAP scientists Drs. Tara Kiran and Kamran Khan, who were named numbers 12 and 19 on the Medical Post’s 2021 Power List.
Dr. Stephen Hwang, a physician with St. Michael’s Hospital who holds a weekly clinic at Seaton House with Toronto’s Inner City Health Associates, told the Star the site had a “significant number” of older men, and residents who dealt with medical conditions that increased their risk for severe COVID-19 infections.
While the shelter houses fewer seniors with acute medical needs than it did a few years ago, as many moved to a separate site, Hwang said there was still a high prevalence of chronic lung disease and cardiovascular disease among residents, as well as a high prevalence of mental health and substance use issues, muscular-skeletal injuries and chronic conditions impairing mobility.
“If 65 per cent of all workers in the GTA are doing essential work that doesn’t enable them to stay at home, clearly that’s not a sufficient strategy to prevent further spread illness and death,” said Farah Mawani, a social epidemiologist at Unity Health’s MAP Centre for Urban Health Solutions.
“Essential work should not be a death sentence.”
“We Canadians have passed the initial phase of ‘cannabis is going to destroy us, cannabis is going to radically change our culture.’ It’s pretty evident that hasn’t happened,” said Daniel Werb, an epidemiologist and drug policy analyst at St. Michael’s Hospital in Toronto and an assistant professor of public health at the University of California, San Diego. “One of the greatest outcomes is that it was absolutely boring. Now the initial wave of kind of euphoria and awe has passed, we understand that it’s OK to make changes to this market without things radically falling apart.”