From TVO’s The Thread
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.
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.
From the CityNews article
Toronto City Council recently voted to celebrate Canada’s first two Black doctors with a pair of plaques close to where they lived, learned and practiced.
Doctors Alexander Augusta and Anderson Abbott lived in Toronto in the 19th century, each overcoming prejudice and racism to become leaders in Ontario’s Black community.
Dr. Nav Persaud, a staff physician at St. Michael’s Hospital, was part of the team that brought Augusta’s story forward to Heritage Toronto.
“The accounts that we have of him as a student indicate he was exemplary,” Persaud said.
“There were accounts of Augusta from some of his professors at the time, and others he had sought reference letters from,” he explained. “We can see the endorsements of Augusta at the time and it seems like there were a number of individuals in Toronto, or Upper Canada at the time, who thought very highly of Augusta and his abilities as a physician.”
Abbott, meanwhile, was born in Toronto in 1837. His parents came to the city three years earlier, from Alabama after their store was ransacked. Abbott went to University College and then to medical school. He apprenticed under Augusta and was licensed in 1862, making him the first Canadian-born Black doctor.
From the Toronto Star article
The Ontario College of Family Physicians (OCFP) recently launched its campaign, “Life Without A Doctor,” to put what it says is the province’s lack of equitable access to a family doctor front and centre in the provincial election.
Currently, 1.3 million Ontarians live without a family doctor, OCFP reported…
Two recent research studies provide insight.
One found double the proportion of family doctors who stopped working in the first six months of the pandemic compared with previous years.
A second study surveyed Toronto family doctors in January 2021 about their practice.
It found 17 per cent of family doctors said they planned to close their current practice within the next five years.
Dr. Tara Kiran, a principal investigator in both research studies and a family doctor in a family health team at St. Michael’s Hospital, called the findings “an important wake-up call” to address Ontario’s family physician shortage.
“Now we know the pandemic has driven some people out of the workforce, and others are burned out and thinking, for various reasons, to potentially stop working,” said Kiran, who is Fidani Chair in improvement and innovation and vice-chair, quality and innovation at the Department of Family and Community Medicine at the University of Toronto.
“So, we have a crisis in being able to sustain the health-care resources needed to be able to provide primary care to serve our population.”
From CBC Ontario Today
Nurses are leaving their jobs. Patients are without family doctors. Dr. Nav Persaud, Canada Research Chair in Health Justice, breaks down for us what the political parties are promising.
From the Toronto Star article
PARIS – Paolo Dinola doesn’t really care who wins the provincial election so long as the next government tries to save others from the fate of his son, who became another statistic last year in Ontario’s surging opioid crisis.
Aaron Dinola died on Nov. 6, 2021, after a fentanyl overdose. He was 32 years old and a father of three.
“He was my beautiful boy, he always had a good heart, but got addicted to painkillers after a car accident,” Paolo Dinola said in an interview. “Three years later he’s dead from fentanyl – the system failed him.”
Opioid deaths and hospitalizations surged significantly across the province after the pandemic hit in early 2020.
The Office of the Chief Coroner shared data on Thursday that showed 2,819 people died from opioid toxicity in 2021. That’s up from 2,460 opioid deaths the year before – a figure that itself was up 58 per cent from fatalities recorded in 2019.
Both the NDP and the Liberals pledged to help tackle the opioid problem on Thursday while Progressive Conservative Leader Doug Ford said a few days earlier that he’d help anyone with an addiction problem.
Dinola was at a cafe in Paris, Ont., where NDP Leader Andrea Horwath made a campaign stop and pledged to reform the mental health system.
Tara Gomes, an epidemiologist at Unity Health, said there’s no urgency from either the province or the federal government.
Gomes said both levels of government need to relax rules on proven opioid treatments like suboxone and methadone, vast expansion of harm reduction, safe spaces to use drugs and decriminalize drugs.
“Even as we’ve seen these waves come and go with the pandemic, opioid-related deaths are just climbing year over year,” Gomes said.
“And this isn’t something that seems to be resolving any time soon.”
