Item - 2020.HL18.1

The Board of Health recommends that:

1.  City Council request the City Manager to engage the Public Health Agency of Canada, Public Health Ontario, and the Ontario Ministry of Health to support Toronto Public Health's work on the establishment of a volunteer isolation/quarantine centre system as well as other methods to achieve effective isolation for individuals who are unable to safely and effectively isolate at home.

2.  City Council:

a.  urge the Ontario Ministry of Health and the relevant Local Health Integration Networks to provide the necessary resources and supports for proactive mobile COVID-19 testing in neighbourhoods where data shows a high incidence of COVID-19, including northwest Toronto, and for demographic groups suspected of being at higher risk due to the social determinants of health, including occupation; and

b.  request the Chair, Board of Health, to communicate the position in Recommendation 2.a. above to the Ontario Ministry of Health and the relevant Local Health Integration Networks, on behalf of City Council and the Board of Health.

The Board of Health:

1.  Requested the Medical Officer of Health to continue working with the General Manager, Transportation Services, on the ActiveTO program, in particular to:

a.  support vulnerable individuals and communities who have limited access to space for physical activity; and

b.  expand ActiveTO measures that provide a safe and physically distanced alternative to public transit.

2.  Requested the Medical Officer of Health to:

a.  provide data and analysis on how the City of Toronto's most vulnerable populations have been adversely affected by the COVID-19 pandemic to the Toronto Office of Recovery and Rebuild to inform the recovery strategy; and

b.  in partnership with Health Commons Solutions Lab, consult with groups that have been disproportionately affected by COVID-19, identify the detailed impacts being experienced by these groups, and recommend actions for the City of Toronto and its governmental partners to reduce these impacts.

3.  Requested the Medical Officer of Health to:

a.  work with the City Manager to support City Divisions and the Toronto Office of Recovery and Rebuild on the design and implementation of ways to address the social determinants of health for the City of Toronto's most vulnerable populations who have been adversely affected by the COVID-19 pandemic;

b.  report to the Board of Health at its meeting in September 2020 with recommendations for:

1.  immediate short-term preventative actions and long-term policy changes to protect those who are at heightened risk for COVID-19 including, but not limited to, people with low incomes, people from racialized communities, newcomers to Canada, people living in unaffordable or inadequate housing, and people working in certain occupations overrepresented in areas with a higher COVID-19 case rate, including sales and service, trades and transportation, and manufacturing; and

2.  the implementation of social needs screening and referrals for people screened or tested for COVID-19.

4.  Requested the Medical Officer of Health to:

a.  work with community partners, the City of Toronto's Confronting Anti-Black Racism Unit, the Toronto Food Policy Council, and City Divisions, including Parks, Forestry and Recreation, Economic Development and Culture, and Social Development, Finance and Administration, to explore the creation of the City of Toronto's Black Food Sovereignty Plan; and

b.  report to the Board of Health in the fourth quarter of 2020, in consultation with the Executive Director, Social Development, Finance and Administration, on:

1.  ensuring that the COVID-19 recovery improves and expands access to affordable, healthy, and culturally-appropriate food; and

2.  progress on the creation of the City of Toronto's Black Food Sovereignty Plan.

5.  Urged the Ontario Ministry of Health and the relevant Local Health Integration Networks to provide the necessary resources and supports for proactive mobile COVID-19 testing in neighbourhoods where data shows a high incidence of COVID-19, including northwest Toronto, and for demographic groups suspected of being at higher risk due to the social determinants of health, including occupation, and requested the Chair, Board of Health, to communicate the position in Part 5 to the Ontario Ministry of Health and the relevant Local Health Integration Networks, on behalf of the Board of Health.

6.  Requested the Medical Officer of Health, in consultation with the General Manager, Parks, Forestry and Recreation, and the General Manager, Children's Services, to review and consider Communication HL18.1.3 from Josh Fullan, Director, Maximum City, for guidance on the City of Toronto's response to the COVID-19 pandemic.

The Medical Officer of Health and the Supervisor, Health Status and Epidemiology, Toronto Public Health, gave a presentation on An Update on COVID-19.

This report responds to the request from the Toronto Board of Health for the Medical Officer of Health to report on the status of COVID-19 recovery planning and a potential second wave outbreak in 2020 and beyond.

This report also explains the context in which Toronto Public Health's response is influenced by uncertainty concerning COVID-19, its effects, and the effects of mitigation measures. Specifically, Toronto Public Health must make evidence-based decisions, often urgently, despite having incomplete and/or conflicting information. It is challenging to distinguish between real effects and those which are the result of confounding information. Planning and communications must be adjusted frequently to accommodate the changing reality.

In addition, this report highlights Toronto Public Health's steps taken in the response to COVID-19 to date, including recommendations to support the most vulnerable, a COVID-19 monitoring dashboard, and the release of public health guidance documents. The guidance documents are intended to support the City of Toronto, its businesses, and community organizations to mitigate the risk of COVID-19 transmission associated with their activities.

Lastly, this report also includes an overview of how multiple areas of Toronto Public Health's work have developed since the beginning of the COVID-19 crisis in January 2020. These include: Outbreak Management; Surveillance and Data Management; Media and Communications; Stakeholder and Issues Management; and Policy Development. These core public health functions are being continuously tailored to address the containment of the COVID-19 crisis, recovery, and the gradual restoration of programs addressing other public health needs.