COVID-19 hotspot Brampton, Ont., chronically underfunded in community health services, local advocate says
Many residents are essential workers who are more likely to come in contact with the virus
Brampton, Ont., didn't get to be a pandemic hotspot because residents flout the rules, says the head of a local non-profit. It's the poor funding of local health services as well as cultural and economic factors that put the community at high risk.
Gurpreet Malhotra, of Indus Community Services, which provides health services and other supports to seniors and runs programs for new Canadians in their preferred languages, said there's "almost a willful ignoring of the fact that this is a community that's on the front lines of taking care of everyone else, and itself has been on the back burner of receiving health-care support...."
The city about 40 kilometres northwest of Toronto has one of the highest rates of COVID-19 in Ontario. In one neighbourhood here last month, nearly one in five COVID-19 tests were positive, according to data compiled by Toronto-based research group ICES. That's five times the provincial average.
Malhotra said the area's local health authority — or LHIN, which stands for Local Health Integration Network — has the poorest per-capita funding in the province.
"When you examine the numbers, the average individual here receives [just over] $900 for those types of health services, but the average Ontarian receives $2,000," he said. "So we're short $1 billion in health care every year. That's a lot of missing diabetes programs. That's a lot of missing cancer screening programs. That's a lot of missing supports around mental health and other early diagnosis tools."
Malhotra told Dr. Brian Goldman, host of CBC Radio's White Coat, Black Art, that the pandemic has revealed this and other systemic issues that have "contributed to significant illness and suffering."
The community's large South Asian and Black populations have been disproportionately affected by COVID-19, a pattern that has emerged elsewhere as well. Data compiled by Toronto Public Health in the summer showed that 83 per cent of COVID-19 cases occurred in racialized people, for example.
Malhotra notes that the funding gap exists despite the increased COVID-19 and other health risks faced by the South Asian, Black and Latino populations in the area.
"Why is this such, a multicultural area, the one that has been chronically, the least funded? We're paying our taxes. We're not getting our service, and it's getting worse. And that can't be allowed to continue."
In an email to CBC Radio, a spokesperson for the Ministry of Health said it is expanding testing and assessment sites in Brampton, adding up to 70 additional case and contact management staff, investing $42 million for additional hospital beds in the area and reallocating resources from 10 other health units to help Peel Region cope.
COVID-19 vulnerability in Brampton stems partly from the kind of work residents can find in the area, Malhotra explained to Goldman and producer Sujata Berry on a tour of the suburban city this week.
In part because of its proximity to Toronto Pearson Airport and the surrounding network of major highways, many Brampton residents work in transportation or at distribution centres for Amazon, FedEx, Canadian Tire and Wayfair.
"Amazon is a major employer in the city and as people are encouraged to buy online, I don't think there's any elves putting that together."
The warehouses are set up as assembly lines, making it harder to physically distance and increasing the likelihood of COVID-19 exposure compared to working at home.
"Truck driving, airport support and distribution logistics all become touch points for a large amount of interactions between people…. And then by distributing the item, they're also potentially distributing a virus," Malhotra said.
Crowded living conditions
That's especially the case where there are numerous people sharing a home. People "are not working as a cleaner at the airport because they're independently wealthy," said Malhotra. "So it is fairly likely that they'd have other people living with them."
He added that "it is a cultural norm to have a multigenerational home. We take care of our grandparents, in part because there ... are no culturally appropriate or linguistically appropriate, long-term care or seniors housing options available."
Job precarity is also an issue, he said. "If I have an employer that will dismiss me or not hire me back because I'm a temp because of [a positive] COVID test, I will not tell the health authorities where I work. So contact tracing starts to collapse."
Asked to respond to accusations that the community is to blame for its high rate of COVID-19 infections because of things like Diwali celebrations, Malhotra shares a different take.
"I say it's because of the fruit and vegetables that you insist on having on your shelves, the toilet paper and paper towel that you insist on having there. As you go through that store, who do you think stocked it? Who's at the cashier's desk? Who trucked it in?"
A missed opportunity
He said health authorities missed the opportunity to prepare in the summer for the second wave. Indus Community Services approached the region's medical officer of health, as well as Ontario Health, to explain the need for "community health ambassadors," people who interact with locals — in their own language — in parks, temples, mosques and at grocery stores, to distribute information and resource materials on preventing the spread of COVID-19.
This also needed to include distributing culturally-appropriate face masks that fit over a turban or a hijab, he said.
Dr. Lawrence Loh is the medical officer of health for Peel Region, where Brampton is located, and one of the public health leaders Gurpreet Malhotra reached out to.
He said the region has been working closely with community organizations and takes care to ensure communications around COVID-19 are available in the area's preferred languages.
"Certainly the importance of community ambassadors is something that I absolutely agree with…. But again, these things take time. We don't want to rush into ill-considered engagement with the community. We want to come in a manner that is appropriate, that is humble, that is respectful...."
Loh said that while the messaging and education is important, advice alone isn't going to address other factors that need to change in order to stop the spread of COVID-19.
"Which is why myself and public health have been advocating for better worker protections, better workplace inspections, more workplace inspections, paid sick days, rental protection and eviction protection."
Dinner, with a side of support
In the absence of these and better local health services, grassroots organizations are moving in to try to help fill the gap however they can.
One of these is SEVA Food Bank, which provides food for 1,000 families in the area. It also runs a Langar on Wheels program — a community kitchen that provides culturally appropriate meals for 45 seniors. The program fills the gap that traditional Meals on Wheels programs are unable to support, said executive director Rasheeda Qureshi.
"One lady who called said, 'Hey, I've got COVID and my husband and I have been told to isolate, but we've got two kids in school, so we're isolated from them. But who's going to take care of them? Can you actually get us food at home, please?' So this is the kind of thing that we are encountering."
The work of these community organizations is becoming about more than just dropping off food — it's about providing a support system.
Taran Singh, an outreach worker for Punjabi Community Health Service, has also been delivering food for SEVA Food Bank throughout the crisis.
"It's very rewarding when you see when you deliver the food, because some of them really need the help," he said. When one of his regulars recently had a heart attack, Singh was in touch with her son to find out her condition and recovery.
To keep frail clients like her safe, he's developed a fastidious routine, never touching the food packages with the hand he uses to open doors, for example. "Especially in apartment buildings, I try to stay away from the elevators, just take the stairs, because it's just, again, less crowded and less people are using it."
Living at home with his family, he's also concerned about protecting his 60-year-old father.
"So I just come home, shower, throw everything in the laundry, to make sure that, like, my family is safe, as well as the people I'm coming in contact with."
Written by Brandie Weikle. Produced by Sujata Berry.