The City of Toronto will move to the Red Zone restriction level Saturday after multiple days of record-breaking case counts across the province.

In hard-hit areas like Ontario Premier Doug Ford’s riding of Etobicoke North, however, worrying trends emerged long before this week’s announcement.

The latest test positivity rate in Toronto is 5.8 per cent, but across Etobicoke North neighbourhoods, those numbers have been well above the city average since the beginning of October. In the Mt. Olive-Silverstone-Jamestown neighbourhood there, the latest data shows a 12.1 per cent test positivity rate. Three weeks prior it was 17.6 per cent.

“We’re bearing the brunt of this pandemic,” says Habon Ali, a graduate student who lives with her family there.

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“There’s no reason why there should be such high positivity rates in this part of the city, but it’s the same neglect that we faced before the pandemic … it’s willful neglect.”

“There’s no reason why there should be such high positivity rates in this part of the city, but it’s the same neglect that we faced before the pandemic … it’s willful neglect.”

Nearly a quarter of Toronto’s total case count stems from the city’s northwest corridor, which includes Etobicoke North and two other ridings. Ford’s riding is home to a high number of racialized and low-income residents, essential workers and high density apartment complexes.

Ali recalls being perplexed by an Oct. 28 press conference when Ford said Ontario’s curve was “trending down,” while his own riding was seeing the opposite trajectory.

“It seems like he’s lying to us while we’re at risk,” says Ali. “Because we’re a racialized, low-income neighbourhood, our lives are seen as disposable. That’s the messaging I’m getting.”

HuffPost Canada reached out to Ford’s office for comment on the transmission rates in Etobicoke North. A spokesperson for the Ministry of the Health provided a statement saying in part, “The government has taken immediate action to enhance the local public health response to COVID-19, such as providing additional locations to increase access to testing, including for vulnerable communities. We will continue to work with our local partners in the coming days and weeks to provide additional targeted supports in Toronto.”

More testing access

After repeated calls for more targeted strategies, the Rexdale Community Health Centre in Ford’s riding received approval to provide COVID-19 testing on site starting Nov. 6. Along with Toronto Public Health and fellow community partners, the agency has also organized a series of pop-up testing sites at local community centres.

Executive director Safia Ahmed says hospital testing was inaccessible during the first COVID-19 wave for residents who rely on transit. Others were discouraged from getting tested because they feared the financial cost of having to isolate without sick pay.

“The messaging that was coming from public health authorities was not something that reflected the experiences of people who live in Etobicoke North,” says Ahmed.

Health Commons Solutions Lab spent months studying the area’s COVID-19’s response, starting in May. Executive director Sophia Ikura says that while the bulk of funding for testing has gone to hospitals, community health centres also need more resources, especially in areas like Etobicoke North which has a lower number of primary care services compared to other parts of the city.

Ikura says while the main objective has been to increase testing capacity as quickly as possible, the challenge of the second wave will be ensuring those resources are distributed to the communities that need them most.

“Not every test is worth the same amount in our effort,” she explains. “If you test 3,000 people in an area with low positivity rates, each one of those tests is worth a lot less than they would be in a community with very high spread.”

Systemic barriers

Along with the need for more testing, residents in Etobicoke North are confronting additional obstacles as they navigate the pandemic.

“Anti-Black racism and social determinants of health make communities like the one that I live in at higher risk,” says Paul Bailey, a resident there and the interim executive director of the Black Health Alliance. Bailey says some residents avoid getting tested at hospitals because of the racism they’ve experienced in the health-care system.

It’s an issue Semir Bulle is reckoning with as a third year medical student at the University of Toronto who also grew up in Etobicoke. As he pursues a career in health care, he says many of his neighbours have long felt ignored or mistreated by the institutions he is now a part of.

“Medicine has to understand its role in this,” he says. “Why are some people more vulnerable? What did medicine have to do with that? Why are these people the ones who are dying?”

According to Sané Dube, a policy expert at University Health Network’s Social Medicine program, acknowledging racial bias in health care is key to crafting policy responses to COVID-19 which has disproportionately impacted the city’s racialized communities.

As the team at Health Commons Solution Lab continued their community engagement, Ikura says those inequities became clear in the anxieties she heard from local residents. As families prepared for back to school, there was a rumour that parents would be reported to Children’s Aid Society if their child had a cough.

“In those rumours, what you detect is a heavy mistrust of formal systems,” says Ikura, “and a population of people that feel largely left behind by the system response.”

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The Rexdale Community Health Centre is trying to reduce those structural barriers by making public health messaging more accessible.

“The message has to be one that reflects their realities and it has to be delivered by people the community trusts.” The agency has trained approximately 10 local residents to work as community ambassadors, to share information about COVID-19 with their neighbours.

These ambassadors have helped identify local outbreaks, clusters and families in need of support. When a positive case has been confirmed, Rexdale CHC staff do a follow-up call to see if the resident needs food, space to isolate or psychosocial support.

“COVID has highlighted these longstanding, entrenched, structural inequities, says Ahmed. “And now that it’s out in the open, I think there is an opportunity for all levels of government to come together and actually address them.”

The city of Toronto is currently working on a COVID-19 Response Equity Action Plan that will be presented to city council in December.

For Habon Ali, she says constituents in Etobicoke North are paying attention to how their political leaders handle the COVID-19 crisis. “This is definitely something I know a lot of people in my community will not forget when the time comes for an election.”