Author: Samira Prasad

From the Toronto Star article

All workers, especially those in low-wage and precarious employment, need 10 permanent paid sick days or their health will suffer, diseases such as COVID-19 will be more likely to spread — and more people will end up in the hospital.

That’s the message more than 160 physicians, nurses and other health-care workers are sending to the province with an open letter published Friday, calling on the government to legislate 10 paid sick days for all workers, public or private.

The letter was created by the Decent Work and Health Network, a health and labour rights advocacy group operated by health-care workers.

Health workers and advocates who signed the letter told the Star it’s unacceptable the province has not already made the change, two years into a pandemic that has disproportionately led to the hospitalization of racialized and low-income workers who do not have sick leave.

Ahead of a seventh wave that could come in the fall, all workers need as much protection as they can get, they said.

Workers not only need paid sick days for themselves, they need to be able to stay home with their children if they get sick, said Dr. Shazeen Suleman, a pediatrician at St. Michael’s Hospital who signed the letter.

Young children will have 10 to 15 colds a year, and often when children are very young, they will get severely ill, she said.

“A child doesn’t have any choice of when they are getting sick,” said Suleman. “If their parent doesn’t have access to a paid sick day they are having to either send them to school sick and go to work to put food on the table, or take care of their child.

From the Wired article

On Tuesday, May 31, the Canadian government made a ruling that was the first of its kind for the country. Starting on January 31, 2023, the province of British Columbia will conduct a trial—lasting three years—in which people over the age of 18 will be able to possess up to 2.5 grams of opioids, cocaine, methamphetamine, and MDMA without arrest, seizure, or charge. Canada joins a handful of countries with existing decriminalization policies; others include Portugal, the Czech Republic, the Netherlands, and the United States (Oregon decriminalized possessing small amounts of hard drugs back in 2020).

A decriminalized drug resides in a constitutional no-man’s land, neither legal nor illegal. The policy essentially entails that possession won’t result in handcuffs and that a substance use disorder won’t be treated as a crime. “This is long overdue,” says Daniel Werb, director of the Center on Drug Policy Evaluation at St. Michael’s Hospital in Toronto. “This is something that people have understood for a really long time—that you can’t arrest your way out of this problem.”

And a problem it is indeed. The war on drugs has waged on for half a century, and the writing’s on the wall: It’s clearly not working. “The record is clear that the global war on drugs has been a total catastrophic policy failure,” says Ben Perrin, a law professor at the University of British Columbia and author of Overdose: Heartbreak and Hope in Canada’s Opioid Crisis. Criminalizing drug use disproportionately targets the marginalized, including Black and Indigenous communities, the unhoused, and people with mental illness. And the stigma stemming from criminalization means that people are less likely to seek help, and more likely to use drugs alone, which contributes to higher rates of overdose.

Related: Read MAP’s open letter to Tribunals Ontario

From the Toronto Star

The body responsible for resolving disputes between tenants and landlords in Ontario will be permanently holding virtual hearings.

The move has raised alarms for lawyers, physicians and advocates of tenants’ rights, who say defaulting to remote hearings at the Landlord and Tenant Board of Ontario will shut out marginalized people in the province from having a fair hearing. The board, however, says digital hearings will increase efficiency and access in a backlogged system.

Dania Majid, a lawyer with the Advocacy Centre for Tenants Ontario, said she fears the move will especially affect those who face language barriers, low-income people who don’t have adequate technology, and those with mental and physical illnesses that bar them from sitting through lengthy virtual hearings.

And without access to a fair hearing, Majid said, she worries more vulnerable people in Ontario will be facing evictions and the threat of homelessness.

“We’ve just created an eviction machine,” Majid said, as opposed to a meaningful dispute resolution process.

Like most adjudicating bodies, the Landlord and Tenant Board moved to offer remote hearings by default in 2020 amid restrictions to curb the spread of COVID-19. Since the lifting of restrictions earlier this year, however, the board has continued to exclusively hold hearings remotely, often by Zoom or telephone. In a statement to the Star, Tribunals Ontario said the majority of people have preferred remote hearings, as travelling to an in-person hearing can be inconvenient.

This digital-first approach now applies to all 13 bodies under Tribunals Ontario, including the Human Rights Tribunal and the Social Benefits Tribunal. But with the Ontario Court of Justice moving instead to offer a mix of in-person and online hearings, advocates argue that Tribunals Ontario should do the same to meet people’s unique needs, and have raised questions about what access to justice will look like post-COVID.

A January 2021 report found that two in five of Toronto households don’t have access to internet that is up to speed with Canada’s national targets, and two per cent have no internet access. Cost is the biggest barrier to access, with low-income, newcomer, single parent, Latin American, South Asian, Black and Southeast Asian residents worrying the most about paying their internet bill.

“What’s concerning to us is that, of the people who do ask (for an in-person hearing), that group of tenants is disproportionately low-income, racialized people with disabilities,” Majid said.

Dr. Nav Persaud, a physician with the MAP Centre for Urban Health Solutions at Unity Health in Toronto, said some of his patients have had trouble accessing their LTB hearings virtually. Some, he said, are older adults who have trouble hearing. Others have internet issues, resorting to calling in to their hearings by phone.

Registration now includes access to COVID-19 antigen tests and KN95 masks.

June 7th , TORONTO – The I’m Ready program – the first of its kind in Canada led by REACH Nexus at MAP Centre for Urban Solutions – continues its roll-out of 50,000 free HIV self-test kits to reach undiagnosed individuals and connect them to appropriate care and supports. Starting today, participants will also have access to free COVID-19 rapid antigen testing kits and KN95 masks when they access the I’m Ready, Test mobile app on an iOS or Android smart phone. These rapid tests and masks are being provided through the Stop the Spread and Stay Safe program, thanks to the Canadian Red Cross and Health Canada.

I’m Ready wants to ensure low barrier access to home testing so that participants and their partners can make the best decisions about when and where to access care. Individuals have the option of delivery or can pick up items at over 80 locations across Canada. The program has already registered 3,672 participants who have ordered a total of 9,085 HIV self-test kits – with 31% individuals identified as this being their first-time testing.

“I’m Ready is working – we’re reaching the undiagnosed and learning more about who we are able to reach and support. Being able to monitor and evaluate progress in real time is key. As part of the work moving forward, we’re now working with community groups to tailor the messaging and outreach to engage and support more people from the key populations we serve.” shared Dr. Sean B. Rourke, I’m Ready’s principal investigator and a scientist at MAP Centre for Urban Health Solutions at St. Michael’s Hospital.
Participants, who must be 18 years of age or older, create an anonymous profile, answer surveys, can order up to 3 free HIV self-tests for delivery or pick-up at community sites, take the test, and share results. An additional resource, delivered in partnership with Women’s Health in Women’s Hands (WHIWH) and the Community-Based Research Centre (CBRC), includes the option to connect with direct peer navigator support at any time through the I’m Ready,Talk telehealth platform. In Canada, an estimated 70,000 people live with HIV as of today, the virus that causes AIDS, and 13 per cent of those (which is >8,000 people) are unaware of their status. HIV also disproportionately impacts men who have sex with men, African, Caribbean and other Black people, Indigenous Peoples, and people who use substances and inject drugs.

This is why the program’s technology and research-based approach to reach and support these communities – including those who are marginalized because of systemic racism, the legacy of colonization and residential schools, and stigma and discrimination in various forms including gender-based and against LGBTQ2+ communities is so important.

“We have incorporated a direct peer navigator support system representative of these key populations to support those who need help testing through the program,” said Wangari Tharao, Director of Research and Programs (WHIWH). “It is imperative that every Canadian should have access, choice and support for HIV testing and care, regardless of who they are or where they live.”
The I’m Ready research program is funded by the Canadian Institutes of Health Research (CIHR), the Canadian Foundation for AIDS Research (CANFAR)’s Strategic Initiatives, and the St. Michael’s Foundation. We are thrilled to be working with Women’s Health in Women’s Hands (WHIWH), the Canadian HIV/AIDS Black, African & Caribbean Network (CHABAC), and the Community-Based Research Centre (CBRC) as inaugural partners, among other partners across Canada.

“We’ve made significant progress from the time Health Canada approved this country’s first HIV self-test in November 2020,” said Dr. Rourke. “And with the continued support of our partners and funders, we know we can continue to sustain and scale this program and continue to provide targeted efforts to reach those who are undiagnosed with HIV.”
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About REACH Nexus‍

REACH Nexus is an ambitious national research group working on how to address HIV, Hepatitis C and other STBBIs (sexually transmitted and blood-borne infections) in Canada. Our focus is on reaching the undiagnosed, implementing and scaling up new testing options, strengthening connections to care, improving access to options for prevention (PrEP and PEP) and ending HIV stigma. REACH Nexus is part of MAP Centre for Urban Health Studies at St. Michael’s Hospital, Unity Health Toronto, and is funded by the Canadian Institutes of Health Research. Learn more at reachnexus.ca.

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 community health issues — many at the intersection of health and equity. Internationally recognized for ground breaking science and innovation, MAP has changed the way the world understands the health consequences of social inequality in Canada. 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.

Media contact‍

Adriana Suppa, Senior Communications Advisor, REACH Nexus
Adriana.Suppa@unityhealth.to
Mobile: 416-268-7642

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From TVO’s The Thread

Watch the episode here.

Nearly five million Canadians don’t have a family doctor. Dr. Tara Kiran, family physician at St. Michael’s Hospital, speaks about the importance of primary care and what can be done to address the family physician shortage.

From the CBC News article

Ontario’s New Democrats would work with Ottawa on decriminalizing drugs for personal use if the party is elected to form government this week, but the provincial Liberals aren’t considering a similar move.

The issue emerged on the last day of the election campaign in Ontario, following the announcement of a three-year agreement between British Columbia and the federal government that means people won’t be charged for possessing up to 2.5 grams of some illicit drugs in an effort to curb overdose deaths.

Ontario has not submitted a proposal to follow suit, but Toronto’s top doctor did earlier this year.

NDP Leader Andrea Horwath said decriminalizing simple possession of drugs is part of her party’s plan to address the overdose crisis, along with lifting a cap on safe drug consumption sites and improving access to treatment.

“It is about saving lives, and that’s what we have to do,” Horwath said at a Wednesday campaign event in Brampton, Ont.

“We have to do better, and we can do better, so yes, absolutely, making sure that we have a safe drug supply, that we decriminalize simple possession, but most importantly, that we provide the services that people need to try to help them get well.”

Horwath also noted that it was a New Democrat government in British Columbia that made the first-in-Canada decriminalization policy happen.

Ontario’s New Democrats have also promised to declare the opioid crisis a public health emergency. Horwath said conversations around the limit of drugs exempted under a decriminalization policy — whether she would ask for a 4.5 gram limit as B.C. did — would have to happen with experts before making a submission to the federal government.

A spokeswoman for the Liberal campaign said the party isn’t considering decriminalizing drugs.

At an afternoon media event in Toronto, Liberal Leader Steven Del Duca said decriminalization is “not in our plan right now” but pointed to other things his party is proposing to fight the overdose crisis.

The Liberal party has said it will restart an opioid task force, expand access to the overdose reversal medication naloxone and lift the cap on new consumption and treatment sites that was brought in by the Progressive Conservative government.

But Dr. Tara Gomes, a researcher at Unity Health in Toronto and lead of the Ontario Drug Policy Research Network, said taking a localized approach to decriminalization isn’t the best way forward.

“There’s a real concern if just Toronto decriminalizes drug use people who move outside of those boundaries, or are visiting Toronto, aren’t going to always understand the complexities of that,” Gomes said.

“So I think that these really localized approaches are really challenging and we need to broaden it across the country.”

Op-ed in the Toronto Star by Daniel Bierstone and Shazeen Suleman

“I eat whatever is leftover, so my children can eat enough.”

“I can’t afford their therapy anymore so we had to stop.”

With nearly one in five children in Canada living in poverty, Canada scores poorly compared to other countries, ranking 24th out of 35 industrialized nations. In Toronto — dubbed the “child poverty capital of Canada” — nearly 25 per cent of children live in poverty. A damning report in 2017 found that racialized children in Toronto were twice as likely to be living in poverty compared to non-racialized children. Many of these children have caregivers earning low-wages or in precarious employment, worsened by the COVID-19 pandemic.

Inadequate income has deep and wide-ranging impacts on a child’s well-being, from their physical health to their educational outcomes. Families in poverty may struggle to afford healthy and nutritious food choices; childhood food insecurity can lead to obesity and malnutrition.

Children and families in poverty face rising rent prices across the province, and may be forced to live in poor housing conditions with limited access to outdoor spaces or opportunity for physical activities, both crucial for physical and mental health. The education gap between low- and high-income students is growing, as low-income students face significant barriers to completing high school and pursuing post-secondary opportunities.

From the CityNews article

With at least one confirmed monkeypox case in Toronto, efforts are ramping up to address any early misconceptions about the virus and reduce potential stigma.

“I think what we’re really hearing really spans from curiosity, plenty of questions,” Dane Griffiths, the director of the Gay Men’s Sexual Health Alliance, said when asked about how members of the LGBTQ2S+ community say they’re feeling.

He is among those on the frontlines working on getting factual information about monkeypox as it’s being learned out in the community.

“We’re really just saying that this is something to pay attention to. There’s certainly a lot that we know about monkeypox, but there are plenty of outstanding questions with regards to the current dynamics of transmission within our community,” Griffiths said.

The need to get out as much accurate information as possible is escalating amid reports several of the confirmed and suspected monkeypox cases involve men who have sex with men, something that has fueled intolerance before.

“I think our histories as gay men and queer people, of course, lived and living through the HIV and AIDS epidemic, have plenty of experience with stigma, with discrimination, with connecting our sex or our sexual health with notions of danger and of risk broader public,” Griffiths said.

“I think that sensitivity is to be expected. It goes without saying as many health officials even here in Ontario will say, illnesses, viruses and diseases like monkeypox don’t have a sexual orientation.

Those who are a part of, and work with, the LGBTQ2S+ community said we’re hearing about this connection now likely because of a commitment to sexual health testing and assessments.

“There are folks in our community who are seeking out testing, getting assessed, that continues I think a long history of health-seeking behaviour by gay and bisexual men to engage with public health and with our sexual health clinics and we certainly want to see that continue,” Griffiths added.

“The folks who are presenting at the sexual health clinics as was the case in Montreal just happened to be gay and bisexual men. There is nothing to suggest that monkeypox won’t impact other populations and other communities, that just remains to be seen.”

It’s a sentiment Dr. Darrell Tan, an infectious diseases physician and clinician-scientist at St. Michael’s Hospital, said he agrees with.

“Sexual minority communities… have a history of resilience, of self-reliance, of looking out for each other, of creativity in the face of adversity that I think we can really lean on in a very uncertain time like we find ourselves right now with monkeypox,” he told CityNews.

Tan recently met with LGBTQ2S+ community organizations to address questions, but said he and other medical professionals are trying to quickly learn more about.

“As a scientist and as a physician, I feel it really, really acutely just how much we don’t know. We know some things, but there’s an awful lot that we still don’t know,” he said.

“It’s been literally since the beginning of this month, really just a couple of weeks, since reports anywhere in these non-endemic countries have even come out recognizing this was happening.”

From the TVO Today article

HAMILTON — When it comes to preventing homelessness and supporting unhoused people in Ontario, “we’ve known what the solutions are for a very long time,” says Jesse Jenkinson, a postdoctoral fellow at MAP Centre for Urban Health Solutions. “It’s just whether or not anyone’s going to finally do something about it.” And the need for action, experts say, is great.

In March, Hamilton reported that 1,596 people had been actively homeless in the past three months. That number has climbed after COVID-19 — it sat at 1,105 as of April 1, 2020. The pandemic exacerbated homelessness by limiting shelter occupancy, reducing the availability of supports, and increasing the cost of living.

But even before then, homelessness had been on the rise in the province. A 2021 Statistics Canada study looking at data from 2010 to 2017 concluded that “homelessness in Ontario has been worsening over time, has been affecting younger cohorts, and has shifted geographically to smaller but rapidly growing municipalities.” A 2019 study in the medical journal BMJ Open estimated that, in 2016, about 60,000 Ontarians experienced homelessness. That was about 67 per cent higher than in 2007.

TVO.org speaks with experts about what the province needs to do to combat homelessness — and asks Ontario’s four major political parties to weigh in on their plans to address this worsening crisis.

From the Toronto Star article

In a narrow crevice between the soft earth of the Rosedale ravine and a concrete bridge just below Bloor Street, a 32-year-old man has lived in a makeshift camp, on and off, for months.

The man, who identified himself only as John, sometimes turns to Toronto’s shelter network to take a shower. He was once offered a shelter hotel spot, but kept feeling like there’d be a catch.

A handful of others live around John’s camp — six or seven lately, he estimates. He believes the ravine specifically draws in those who’ve struggled with living around other people.

As summer begins, they’re among the dozens of people weathering life under Toronto’s bridges, and in its parks, trails and ravines.

One year after encampments in high-profile locations such as Trinity Bellwoods Park and Lamport Stadium Park were thrust to the forefront of public debate, the number of camps citywide is down. Trinity Bellwoods is now empty of tents, but you can find makeshift structures and slung-up tarps in Toronto’s quieter, more concealed corners — with many remaining camps, like John’s, existing out of plain sight.

“I think it’s so important that people understand what’s happening,” said Dr. Stephen Hwang, a physician with St. Michael’s Hospital with a research focus on homelessness. That people still choose to live in ravines suggests Toronto is falling short of offering the help people need, he argued.

“The risk is not just that people will continue to be homeless on the street, or numbers will grow, but that we’ll become anesthetized to the problem — that we’ll stop seeing it as a human tragedy, and more as just a nuisance to be gotten rid of,” Hwang said.