Author: Emily Holton

An area in the northeast corner of Brampton has a “shocking” 19 per cent COVID-19 test positivity rate — a rate double that of the U.S. — and is leading a list of 30 Greater Toronto neighbourhoods that are seeing alarming numbers of people testing positive for the virus, new data shows.

Peel as a whole is recording a per cent positivity of 9.8 per cent — the highest in the GTA — while neighbourhoods in northwestern Toronto, Scarborough, and southern York Region are also reporting sky-high rates, according to a first-time look at an analysis conducted by the Toronto-based non-profit ICES (formerly the Institute for Clinical Evaluative Sciences). The data covers the first week of November, the most recent time period of which per cent positivity rates are available, and is broken down by postal code to provide a detailed picture of the local severity of the pandemic.

…Epidemiologist Dr. Farah Mawani, of MAP Centre for Urban Health Solutions at Unity Health Toronto, said the ICES data highlights how the current pandemic response is failing.

In early October, COVID-19 testing was limited just as cases were rising and in Toronto, public health dropped all contact tracing except for high-risk settings, such as schools, hospitals and long-term-care homes.

“That combination, while cases were rising, is a recipe for disaster,” Mawani said. “We are now seeing that disaster unfolding. Those are two key tools to stopping the spread.”

Sir William Osler, the Canadian doctor widely regarded as the father of modern medicine, whose name graces schools and medical institutions on both sides of the Atlantic, held racist views that have been swept under the carpet for more than a century, according to an article published in the Canadian Medical Association Journal Monday.

The article, co-authored by Toronto doctor Nav Persaud, argues that Osler continues to be lionized in medical school, a practice that whitewashes his legacy and erases his more offensive statements, which include “I hate Latin Americans,” and “What are we to do when the yellow and brown men begin to swarm over” to Canada, which he considered “a White man’s country.”

“William Osler continues to be held up as an example physicians should follow,” the article states. “As statues of once-revered individuals who participated in racist crimes are being removed around the world, we should change Osler’s place in medical curricula and explicitly address racism in medicine.”

Osler’s outsized presence in medical schools across the English speaking world overshadows the contributions made by lesser-known racialized physicians who practiced during the same era, including Black Civil War veterans Dr. Alexander Thomas Augusta and Dr. Anderson Ruffin Abbott, as well as Indigenous physicians Dr. Oronhyatekha (Burning Sky) and Dr. Peter Edmund Jones.

No hospitals are named after these doctors.

The CMAJ article states that a biographer modified a transcription of an Osler letter, replacing his use of the word “hate” for Latin Americans with “don’t care for.” The statement was ultimately not included in the 1926 Pulitzer Prize-winning biography of the doctor. The CMAJ article includes an undated illustration that depicts the doctor as an angel, complete with halo and wings, floating above Johns Hopkins Hospital in Baltimore, which he helped found.

Featured in The Globe and Mail, The Toronto Star, CBC As It Happens, and CityNews

Federal regulators have approved the first HIV self-test in Canada in a long-awaited move that experts have called critical to reaching people who don’t know they have the virus.

Health Canada granted a medical device licence on Monday to a one-minute, finger-prick blood test manufactured by Richmond, B.C.-based bioLytical Laboratories.

Canada follows dozens of other countries in greenlighting the technology, which has been endorsed by the World Health Organization as a tool to reduce the number of people with undiagnosed HIV.

The principal investigator of a study that was submitted to regulators as part of their review says the approval of HIV self-testing could “open incredible doors” to increasing access to life-extending treatments and preventing the spread of infection in Canada.

Dr. Sean Rourke, a scientist with MAP Centre for Urban Health Solutions at St. Michael’s Hospital in Toronto, says he’s working with community organizations across the country to launch a telehealth program in January that will distribute 60,000 self-tests and connect people with care.

Rourke says the need for self-testing has become even more important as a recent survey of roughly 300 front-line providers suggests the COVID-19 crisis has cut access to clinical HIV testing services nearly in half.

Dr. Katerina Maximova has been named the inaugural Murphy Family Foundation Chair in Early Life Interventions at MAP Centre for Urban Health Solutions, St. Michael’s Hospital, and the University of Toronto.

Dr. Maximova’s research and policy work focuses on children and youth, including social dimensions of health, behaviours that increase future risk of chronic disease risk, misperception of risk, and the effectiveness of early life interventions.

At MAP, Dr. Maximova will focus on solutions-oriented research to improve the early life experiences, development, and well-being of children and youth experiencing poverty.

“I am so pleased to be joining MAP and St. Michael’s,” said Dr. Maximova, “I’m also very grateful to the Murphy Family Foundation for their commitment to addressing upstream determinants of health for children and youth.”

Dr. Maximova received her PhD in epidemiology and biostatistics from McGill University. She is currently an associate professor in the School of Public Health at the University of Alberta, where she is a member of the Population Health Intervention Research Unit. She has played a major role in evaluating the impact of the APPLE Schools (A Project Promoting healthy Living for Everyone in Schools) intervention program targeting physical activity, healthy eating, and mental health of children and youth experiencing marginalization. APPLE Schools reaches more than 21,000 students annually in 75 schools across northern Alberta, British Columbia, Northwest Territories, and Manitoba. Prior to academia, Dr. Maximova spent several years with the Government of Canada working on policy issues focused on poverty in early life, ‘working poor’ families, income support for low-income families, family-friendly policies, affordable housing and homelessness.

Dr. Maximova has received several awards including a Career Development Award in Prevention Research from the Canadian Cancer Society Research Institute. She recently received a CIHR COVID-19 Rapid Research Grant to study the impact of prolonged school closure and social isolation on the mental health and lifestyle behaviours of elementary school children experiencing disadvantage.

About MAP Centre for Urban Health Solutions

MAP is a world-leading research centre dedicated to creating a healthier future for all. Through big-picture research and street-level solutions, our scientists tackle complex urban health issues — many at the intersection of health and equity. Internationally recognized for groundbreaking science and innovation, MAP is changing the way the world understands the health consequences of social inequality in cities. Together with our community and policy partners, we are charting the way to the world’s healthiest cities: places where people, communities, and the political, economic, social, environmental, and health infrastructures come together so that everyone can thrive. MAP is part of the Li Ka Shing Knowledge Institute of St. Michael’s Hospital and is fully affiliated with the University of Toronto. St. Michael’s is a site of Unity Health Toronto, which also includes Providence Healthcare and St. Joseph’s Health Centre.

Featured in Hospital News

As a researcher who has studied intimate partner violence for 25 years, Dr. Patricia O’ Campo knows that women experience higher rates of increased violence during epidemics — a troubling and well documented pattern. However, Dr. O’Campo discovered a puzzling gap in academic literature when the COVID-19 pandemic hit: there are no verified strategies women can utilize to promote safety and protect themselves during public health emergencies.

“There’s a lot of opinions about what women might do, but nobody has verified those strategies,” said Dr. O’Campo, Interim Executive Director of the Li Ka Shing Knowledge Institute and scientist at MAP Centre for Urban Health Solutions.

Once the COVID-19 pandemic was declared, Dr. O’Campo and her co-principal investigator, Dr. Nicholas Metheny, a Post-Doctoral Research Fellow at St. Michael’s, began exploring how to redesign the Pathways app — an earlier project which provides women in abusive partnerships with a personalized safety plan.

In a pandemic, women and children living with violence may be forced to shelter with violent partners, unable to access resources outside of the home, while dealing with a reduction in services available to them. Due to public health measures to prevent the spread of COVID-19, service agencies aren’t always able to support women face-to-face, so women experiencing violence may need to consider additional safety strategies.

To fill this gap in research, Dr. O’Campo and her team put together a list of around 35 suggested strategies and asked over 100 service providers and women with lived experience of domestic violence to rate whether the suggestions are “recommended” or “not recommended.” Some of the suggestions were rated by survey responders as having the potential to make violence worse.

“For example, we know that alcohol and substances can make an episode of violence more likely, and one of the recommendations was to hide alcohol or other substances that may make abuse worse,” she continued. “That one was rated by many women with lived experience as being something that would make violence worse.”

Other strategies that were rated as “not recommended” include trying to “keep the peace” and switching to texting or emailing instead of phone calls.

Based on the results of the rapid survey, Dr. O’Campo and her team created factsheets listing verified recommendations for women living in situations of intimate partner violence. The factsheets include tips for online and physical safety planning during public health emergencies. They are being disseminated to women and service providers to help them navigate issues that COVID-19 has exacerbated.

“There are risk factors for violence that are increasing as a result of the pandemic, and the economic pandemic that’s accompanying the infectious pandemic,” Dr. O’Campo said. “For example, an episode of unemployment highly increases household stress and therefore the risk of violence.”

The takeaway from this work, she says, is that there are strategies women can implement — that are recommended by women with lived experience and experienced service providers — to promote safety when they’re sheltering at home. These strategies, however, are not a “one-size fits all.”

“Everything should be tailored to the context in which you’re residing, but you can continue to promote safety even in this very difficult time.”

How has the COVID-19 pandemic impacted people who were released from prisons and require mental health services? What about people who rely on in-person addiction treatment to stop using opioids?

Two MAP scientists have been awarded new funding through the Canadian Institutes of Health Research (CIHR) Operating Grants: COVID-19 Mental Health & Substance Use Service Needs and Delivery to tackle their research questions.

The research and knowledge mobilization supported through these grants will help inform policy and practice in near real-time to respond to crisis-based needs. Congratulations to our researchers and their teams, whose projects are outlined below, for receiving this support.

Longwoods Breakfast Presentation on October 21, 2020. Dr. Rick Glazier, Scientific Director of the Institute of Health Services and Policy Research at the Canadian Institute of Health Research updates us on strategic directions for CIHR-IHSPR and how they are being amplified and modified by the pandemic.

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By Dr. Stephen Hwang, MAP Director

THE GLOBE AND MAIL

As a physician and researcher on homelessness, I’m a witness to the intersecting health crises that affect people who don’t have adequate housing. COVID-19 is only one of them. For years, my colleagues and I have treated infections and overdoses, chronic diseases, injuries and mental health issues among people experiencing homelessness. We have been applying Band-Aids, addressing only the most visible symptoms of a continuing crisis.

The pandemic has forced us to confront the consequences of having allowed homelessness to persist in our cities for far too long. Canadians living on low incomes in crowded conditions have been disproportionally affected by COVID-19. In Toronto alone, more than 500 people experiencing homelessness have been infected with the coronavirus. As case numbers rise and the colder months move us indoors, adequate shelter is more important than ever.

We have seen rapid action on homelessness over the past six months that would have been previously unthinkable. Municipal and provincial governments, health care and service providers, public-health and community agencies have undertaken extraordinary and costly emergency efforts to prevent COVID-19 from spreading rapidly in shelters and encampments. Empty hotels have been quickly turned into temporary housing. Facilities to allow people to safely self-isolate have been created in a matter of weeks. Cities are committing to build new modular housing for people experiencing homelessness.

And now, in last week’s Throne Speech, the federal government announced a new aspiration – to entirely eliminate chronic homelessness in Canada. We must seize this once-in-a-generation opportunity to move beyond short-term, crisis solutions and make lasting change, meet the needs of our communities and end chronic homelessness in our cities. It’s possible, necessary and the right thing to do.