Health

COVID-19 exposes need for more collaborative, community-based health care

When CBC News canvassed some doctors and scientists across Canada on what's fundamentally changed in health care during the pandemic, what stood out was the need for more collaborative care.

Advantages of Canada's community health centres became apparent during COVID-19 pandemic

Adil Butt tested positive for coronavirus in the first week of December 2020 in Toronto. He chose to self-isolate longer than recommended to protect his family. (CBC)

When Adil Butt's body started to ache, he immediately isolated himself in a small bedroom for a month to keep his young family safe from COVID-19.

The 42-year-old lives in Thorncliffe Park, a tightly knit community of apartment buildings in Toronto's east end. Neighbours have been hit hard by the coronavirus.

Butt phoned to inquire about testing at a local pop-up site on Saturday, Dec. 5, got tested and received his positive result the following Monday.

He went above and beyond public health guidelines to avoid passing on the virus to his wife and children, ages 10, seven, six and three."Nobody got it," he said. "It was very hard, especially [for] my small kid."

This week marks the one-year anniversary of the first quarantine measures to control COVID-19. When CBC News canvassed some doctors and scientists across Canada on what's fundamentally changed in health care during the pandemic, what stood out was the need for more collaborative care similar to what Butt received.

Adil Butt said staying away from his young children was especially difficult after he received a positive test result. (Submitted by Adil Butt)

Primary care providers help prevent people from coming to hospital with damaging and costly complications of diabetes or infections.

Deaths and policy failures 

Dr. Andrew Boozary, executive director of social medicine at Toronto's University Health Network, said community health centres such as where Butt was tested offer a one-stop shop of services, including prescription medications, healthy foods and connections to housing and jobs for people living on the margins across Canada.

"There's actually systemic discrimination in the way we pay for primary care and the way we fund our health-care system," he said.

Boozary said the pandemic has exposed public policy failures, not only in long-term care homes but also in neighbourhoods where essential workers, many who are racialized, bear a disproportionate burden.

The Black Creek Community Health Centre, in Toronto’s Jane and Finch neighbourhood, serves an area with high case rates of COVID-19 but few resources. (Evan Mitsui/CBC)

"Our failure or lack of policy has really determined who lives and who dies," Boozary said. "When you go back to look at things like primary care, if you put the map of where primary care funding was and the map of where COVID was, there's a complete mismatch."

Boozary draws hope from community health centres, which he said have been a leader for decades in gaining patients' trust by working with them regularly where they are.

Caring for all to stop coronavirus

Cheryl Prescod, executive director of Black Creek Community Health Centre in the city's northwest, said their service is priceless and underestimated.

"Throughout this past year, I believe we saw our value," she said.

Asked about the need for stable funding beyond the pandemic, Prescod said, "We feel invisible compared to larger hospitals or larger health-care institutions. The small community health centres are the distant cousins."

Cheryl Prescod said small community health centres are seen as distant cousins of hospitals. Their value to the health-care system, however, is priceless, she said. (CBC)

But the coronavirus that causes COVID-19 will not discriminate between someone who earns a high income and someone who doesn't.

WATCH | Community volunteers ease vaccine roll out: 

The community volunteers helping B.C. seniors get COVID-19 vaccines

The National

5 months ago
2:03
Several community and religious groups in British Columbia are armed with computers and phones, ready to help local seniors sign up for COVID-19 vaccinations. 2:03

"The virus will not be stopped unless we take care of everybody," Prescod said.

Paulina Aghedo works as one of the centre's community ambassadors, sharing safety tips to stop the spread in her neighbourhood.

Paulina Aghedo hands out flyers promoting COVID-19 testing for the Black Creek Community Health Centre in Toronto. Her efforts helped a woman get tested so she could return to work. (CBC)

Now, Aghedo hands out flyers and sparks conversation, all to raise awareness of testing sites in apartment complexes, lobbies and parking lots. It's home to many personal support workers and grocery clerks who work long hours and may still struggle to make ends meet.

She recalled knocking on doors in her crowded building to distribute flyers when a friend called to say someone needed to know about testing right away.

"She is just coughing in her working place and they told her if she doesn't bring that COVID-19 test [result] she shouldn't come back to work," Aghedo said.

The flyer reached the woman, who tested negative and no longer feared losing her job.

"I was very happy I could help someone," Aghedo said.

For his part,  Butt gave up his job as an Uber driver during COVID-19. He temporarily lost his sense of smell, even for perfume that was pungent to his wife, as well as sense of taste.

During self-isolation, the food delivery volunteer relied on friends from his neighbourhood to return the gesture. For Butt, seeing neighbours helping each other to cope and recover resembles how doctors and nurses care for patients in hospitals.

"He [a friend] was bringing the food for me and leaving it outside my door and this is how we survived," Butt said of his neighbour.

Butt's fever broke after a few days and he's fully recovered.

ABOUT THE AUTHOR

Amina Zafar

Health writer

Amina Zafar has reported on SARS, H1N1 flu, Ebola and other medical and science topics for CBC News.

With files from CBC's Melanie Glanz and Christine Birak

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