►
From YouTube: Board of Health - October 19, 2020
Description
Board of Health, meeting 22, October 19, 2020
Agenda and background materials:
http://app.toronto.ca/tmmis/decisionBodyProfile.do?function=doPrepare&meetingId=17093
A
Well,
good
morning,
everybody,
this
is
joe
cressey,
I'm
the
chair
of
the
board
of
health.
The
board
secretary
has
confirmed
that
we
have
quorum
so
I'll
call
meeting
22
of
the
board
of
health
to
order,
and
I
want
to
welcome
everybody.
Today's
meeting
is
being
held
by
video
conference
city
staff
are
also
connecting
to
the
media.
The
meeting
by
video
conference
as
city
hall
remains
closed
to
the
public.
A
A
City
clerk
staff
have
connected
all
the
speakers
to
the
meeting
by
audio
and
for
members
of
the
board
and
the
public.
The
full
list
of
speakers
can
be
viewed
online
by
visiting
the
board
of
health's
page
at
toronto,
dot,
ca,
slash,
council
and
clicking
the
speakers
box
for
today's
meeting
all
in
person-
and
I
should
note
a
couple
protocols
here-
taking
place
at
city
hall,
all
in
person,
participants
of
which,
from
the
board,
I
am
the
only
one-
have
been
seated
two
meters
apart
when
entering
exiting
or
moving
about
the
room.
A
A
A
Are
there
any
declarations
of
interest
under
the
municipal
conflict
of
interest
act?
If
you
have
an
interest,
if
you
could
raise
your
hand
or
unmute
your
mic
I'll
pause
for
a
moment,
okay,
seeing
none
next,
we
need
a
motion
to
confirm
the
minutes.
From
our
last
meeting,
which
took
place
on
september,
the
21st
first
and
our
special
meetings
on
september,
the
21st
and
october,
the
5th
we
meet
all
the
time.
A
A
It's
worth
acknowledging
the
leadership,
the
commitment
and
the
dedication
of
our
toronto
public
health
staff,
as
well
as
the
frontline
community
organizations
on
the
ground.
All
right.
You
know
I've
thought
a
lot
recently
about
emergencies
and
it
seems
to
me
that
emergencies
are
supposed
to
be
brief.
A
A
A
There
is
a
confidential
attachment
on
this
and
we
will
need
to
go
into
closed
session
after
the
conclusion
of
the
first
item.
So
I
will
hold
that
down
as
well.
So
those
are
our
two
items
in
front
of
us.
We
will
now
return
to
the
first
item
to
kick
this
off,
as
we
have
every
month
for
for
too
long
now
we
will
be
dealing
with
coveted
response
and
resurgence,
and
I
would
like
to
turn
the
floor
over
to
the
people's
doctor
and
her
team
at
tph,
who
have
a
comprehensive
presentation.
B
Thank
you,
mr
chair
and
good
morning,
everybody.
If
I
can.
I
would
like
to
echo
the
chairs
note
of
thanks
to
the
many
community
agencies
and
certainly
to
toronto
public
health
staff,
who
have
been
working
tirelessly
for
several
months
now
to
support
those
most
in
need
in
our
community
and
speaking
of
the
team
at
toronto.
Public
health.
B
They
have
been
working
non-stop
on
the
many
data
aspects
associated
with
the
cobit
19
response,
and
I
think
you're
going
to
find
their
presentation,
informative
and
I'm
sure
you're
going
to
appreciate
in
just
a
matter
of
minutes
why
we
are
so
lucky
to
have
these
incredible
people
working
with
us
at
toronto,
public
health.
So
the
first
part
of
the
presentation
will
be
done
by
effie
gernas,
the
middle
part
of
the
presentation
by
my
colleague,
sarah
collier,
and
then
I
will
wrap
up
the
end
part
of
the
presentation.
C
C
There
we
go.
Thank
you,
okay,
so
this
is
our
infographic.
We've
often
called
coded
at
a
glance
and
we're
starting
here
so
that
we
can
all
be
on
the
same
page
with
our
most
current
numbers
and
our
case
totals
and
some
of
our
most
key
metrics.
Some
of
you
may
have
seen
this
before,
and
I
think
we
have
had
a
chance
to
update
it
with
our
most
current
numbers
and,
as
you
can
see
here,
as
of
2
pm
yesterday,
we
had
an
additional
250
cases
which
has
brought
our
total
in
toronto
to
24.
C
We've
had
over
twenty
thousand
twenty
thousand
eight
hundred
and
three
recover
so
far.
We
are
aware,
at
this
time
of
107
individuals
who
are
ill
enough
to
be
in
hospital
related
to
their
coping
illness
and
26
at
icu
in
the
icu.
My
apologies,
so
disography
also
has
chosen
to
break
down
our
cases
in
two
categories
you
may
have
seen
this
again
before
and
that
is
on
the
right
side
of
our
graphic,
which
are
our
outbreak
cases
and
our
community
cases.
C
This
is
an
important
shift
in
the
evolution
of
covid's
impact
in
our
city,
so
we
can
go
to
the
next
slide.
Please
great.
So
this
slide
is
our
epidemic
or
epi
curve
for
toronto,
and
it
shows
our
best
understanding
of
how
our
cases
have
occurred
over
time.
So
you'll
see
the
term
at
the
bottom
called
episode
date
or
episode
week,
and
I
just
want
to
clarify
that
that
does
refer
to
the
date
that
reflects
the
best
information
we
have
on
when
our
cases
first
got
sick
or
started
to
show
symptoms.
C
Sometimes
you
also
see
reported
date
on
that
axis,
and
this
is
more
that's
a
different
view.
This
is
when
people
most
likely
got
sick.
So
we've
also
shared
a
view
here
that
is
at
a
weekly
level
and
that's
compared
to
the
much
busier
daily
view
that
some
of
you
may
be
used
to
seeing
on
our
dashboard.
C
Each
bar
here
represents
one
week
and
there's
the
usual
caveat
that
the
most
recent
period
is
not
yet
complete.
Due
to
the
known
delay
in
reporting
of
covet
cases,
there
are
many
ways
to
display
fe
curves,
and
this
is
this
one:
we've
chosen
to
further
show
the
distribution
of
outbreak
and
community
cases
or
we've
also
called
them
sporadic
cases
stacked
on
each
bar.
So
you
can
see
how
each
week
is
comprised
of
either
an
outbreak
case
or
a
community
or
sporadic
case.
C
C
This
graph
also
clearly
shows
that
the
most
recent
resurgence
period
and
cases
where
about
35
of
our
total
have
been
reported
since
august
1st
alone,
and
I
will
point
out
that
that
is
the
date
we
are
using
as
our
resurgence
period.
You'll
hear
that
term
from
me
repeatedly,
so
the
first
wave
is
before
august
1st
and
the
resurgence
period
is
after
august
1st,
and
this
graph
shows
that
so
far
the
resurgence
has
been
driven
by
cases
that
are
not
linked
to
an
outbreak
or
what
we
call
sporadic
cases.
C
We
are,
however,
starting
to
see
increases
in
the
outbreak
associated
cases.
You
start
to
see
a
little
blue
curve,
starting
on
that
right
side
in
the
fall
and
some
of
those
are
in
our
institutions
in
the
more
recent
weeks
in
late
september,
we
have
also
we
also
started
to
investigate
a
number
of
outbreaks
in
the
hospitality
sector,
mostly,
but
not
exclusively
downtown
at
businesses
like
restaurants
and
bars.
C
I
do
want
to
point
out
that
all
of
these
trends
show
mostly
lab
confirmed
cases,
and
so
these
are
impacted
by
testing
criteria
and
guidelines
that
are
present
at
that
time.
This
does
suggest
that,
due
to
the
substantial
increase
in
testing
recently
that
the
cases
in
the
recent
resurgence
could
represent
more
of
the
actual
burden
than
those
in
the
spring.
For
this
reason,
comparisons
between
the
spring
and
the
fall
may
not
be
entirely
appropriate.
C
Okay,
great
okay,
so
this
graph
compares
the
spring
or
again,
the
first
wave
to
the
data
since
august
or
the
beginning
of
our
resurgence,
and
specifically,
it
shows
the
proportion
of
cases
in
younger
age
groups.
Those
under
40
have
been
comprising
a
much
higher
proportion
during
this
resurgence
period
than
during
the
first
wave.
So
you
can
see
those
age
groups
where
the
purple
bar
is
higher
than
the
blue
bar.
In
fact,
the
proportion
of
cases
under
40
years
of
age
has
grown
considerably
to
50
in
the
last
month
from
35
during
that
initial
wave.
C
C
Great,
so
what
has
been
top
of
mind
and
focus
for
many
of
us
is
a
safe
reopening
of
our
schools
and
we've
been
watching
closely
for
any
potential
impact.
This
may
have
on
coded
transmission
in
our
city,
especially
after
seeing
how
this
is
played
out
in
other
countries
as
they
reopen
their
schools
so
based
on
our
data.
So
far,
the
resurgence
does
not
appear
to
be
primarily
driven
by
the
reopening
of
schools
in
toronto.
C
This
graph
specifically
compares
the
overall
trend
line
of
adult
cases,
those
over
18
to
or
18
and
over
to
child
cases
or
children,
those
under
18
as
one
way
to
assess
how
we're
doing
the
specific
evidence
to
support
that
school
reopenings
are
not
significant.
Contributors
to
our
recent
climate
cases
have
include,
has
included
and
is
evident
in
the
map
or
the
graph
that
rising
infections
began
before
schools
were
reopening.
In
fact,
that's
not
on
this
graph,
but
in
our.
C
C
Additionally,
I
will
point
out
that
the
number
of
school
outbreaks
thus
far
has
not
been
has
not
been
huge.
It's
been
relatively
small
and
each
has
had
only
a
few
cases,
usually
less
than
five
students
and
staff,
which
suggests
that
relatively
good
infection,
prevention
and
control
is
happening.
To
date,
however,
as
case
rates
and
toronto
have
increased,
many
schools
have
seen
in
reported
individual
cases
of
covid,
both
in
students
and
in
staff,
but
without
any
evidence
of
transmissions
within
those
schools.
C
Okay,
great,
so
this
graph
shows
a
really
important
view
of
our
epidemic
and
that's
the
view
of
the
severity
of
illness
of
our
cases
across
the
week
since
the
pandemic
was
declared
and
prior
to
that
as
well.
So
it's
important
to
note
that
hospitalizations
and
death,
which
is
deaths
which
are
what
are
captured
here,
are
both
considered
lagging
indicators
which
essentially
means
they
don't
show
up
early
in
an
outbreak
or
an
indicator
of
resurgence
in
disease
activity.
By
the
time
these
have
increased,
notably
disease
activity
is
usually
already
at
a
significant
level.
C
C
As
already
mentioned,
the
resurgence
has
so
far
been
focused
on
younger
cases,
and
so,
while
hospital
admissions
have
been
slowly
increasing
in
the
past
month,
they
do
remain
much
lower
than
during
the
spring,
and
relatively
few
deaths
have
resulted
from
covid19
infections.
So
far
during
this
resurgence,
in
fact,
I
can
tell
you
that
97
are
her
fatalities
and
85
of
our
hospitalizations
were
among
cases
that
were
part
of
wave
1..
C
C
What
this
also
shows
us
is
that
outbreaks
in
the
broader
community
and
workplace
settings
have
been
the
primary
drivers
of
the
increase
in
outbreaks.
Seen
in
september,
much
attention
has
been
given
to
workplaces
such
as
restaurants,
gyms
bars,
adult
entertainment
venues
and
other
businesses
that
bring
people
together
under
conditions
that
are
known
to
favor
transmission
of
coded.
This
is
indoors
bringing
people
in
close
proximity
to
one
another
or
masks
may
not
be
worn.
This
is
a
good
time
to
underscore
one
of
our
important
points
that
the
virus
is
everywhere
and
anywhere.
C
Okay,
great
so
the
next
two
slides
are
actually
intended
to
share
some
of
the
tools
we
use
to
help
us
try
to
understand
what
may
lie
ahead
in
this
pandemic.
Both
slides
are
the
results
of
modeling
that
builds
on
the
current
known
information
to
project
various
scenarios
into
the
future.
While
these
models
are
simply
hypothetical,
some
can
be
quite
useful
here
we
can
see
a
graph
of
the
effective
reproductive
number.
C
As
a
reminder,
this
number
rt
represents
the
average
number
of
new
cases
generated
by
one
current
infectious
case
and
is
used
to
predict
the
growth
of
the
outbreak
for
the
outbreak
to
slow
down.
The
reproductive
number
needs
to
be
less
than
one.
You
can
see
the
dashed
line
where
that
is
anything
above
one
means
the
outbreak
is
growing
and
transmission
activity
continues.
C
This
particular
view
of
the
graph
overlays
and
shows
the
different
stages
of
the
beginning
of
those
stages
in
toronto
and
the
reproductive
number,
just
after
or
during
those
times
to
show
that
stage
one
certainly
was
effective
at
reducing
r
and
it
started
to
increase
just
as
we
entered
stage
three.
Our
most
recent
calculations
show
that
this
number,
which
had
started
to
climb
in
september,
has
come
back
down
and
currently
is
hovering
right
around
one
where
we
are
maintaining
the
same
rate
of
new
cases
each
day.
C
C
I
would
like
to
draw
attention
to
what
I
hope
looks
like
a
dashed
line.
Yes,
it
does
because
sometimes
it
doesn't
show
up
as
a
dashed
line
and
the
relative
placement
of
that
dashed
line
under
the
other
curves.
This
represents
the
lower
trajectory
or
reduction
in
potential
infections
that
are
likely
due
to
our
public
health
actions
that
were
put
into
place
in
early
october
in
more
in
early
october.
C
So
more
specifically
for
those
who,
like
the
numbers,
this
figure
shows
that
given
a
reproductive
number
of
1.1
at
the
end
of
october
and
we're
already
a
little
bit
below
that
according
to
our
calculations
and
that
we
know
it
takes
about
four
weeks
to
see
the
benefits
of
interventions
between
four
and
six
weeks.
Actually
some
of
our
models
have
shown
us.
We
can
expect
that
escalating
public
health
measures
dramatically
reduces
infection,
so
the
model
also
had
considered
three
additional
intervention
dates:
each
with
measures
that
drive
the
reproductive
number
down
to
0.9
by
design.
C
C
C
C
Additionally,
we
are
developing
a
what's
called
a
case
control
study
in
order
to
test
hypotheses
related
to
specific
behaviors,
we
believe
are
leading
to
coded
transmission
in
our
city.
This
becomes
one
of
the
key
ways
to
identify
specific
risks
requiring
coded
when
there
are
several
potential
exposures
by
comparing
the
activities
of
a
group
of
cases
to
those
of
a
similar
so
by
similar
they're
matched
usually
on
age,
and
maybe
some
location
data
like
neighborhood
group
of
individuals
known
to
be
negative
for
the
virus.
C
Those
activities
that
significantly
differ
between
the
two
groups
can
be
identified
while
we're
developing
the
study.
Currently,
our
hope
is
that
the
ministry
of
health
takes
a
similar
approach
to
studying
the
virus
in
order
to
support
future
decision
making,
and
our
last
additional
method
to
share
is
that
we
have
just
acquired
access
to
anonymous
population
level.
C
We
are
quite
excited
by
this
new
source
of
information,
but
we
have
just
begun
and
have
asked
to
have
access
to
it
and
have
not
fully
explored
how
we
will
use
these
indicators
to
answer
these
questions
or
others,
okay
and
then
my
last
slide
is
just
a
quick
shout
out
to
my
team.
If
we
can
put
that
on.
Thank
you
so
much
yeah.
I
just
wanted
to
use
this
opportunity
to
thank
and
share
the
names
of
the
amazing,
talented,
epidemiology
and
data
analytics
team
who
are
behind
the
scenes.
C
So
on
that
note,
one
of
these
very
amazing
individuals
is
actually
up
next,
I
need
to
are
you?
Should
I
introduce
her
okay?
So
I
would
it
takes.
I
have
great
pleasure
in
introducing
our
manager
of
the
surveillance
and
epidemiology
and
someone
who's
contributed
greatly
to
most
of
the
work.
I've
just
summarized,
and
she
will
talk
to
us
about
percent
positivity
over
to
you,
sarah
collier.
A
D
Great
thanks
so
much
thank
you.
Everyone
for
the
opportunity
to
present
today,
as
effie
mentioned,
I'm
usually
behind
the
scenes
working
on
the
numbers
and
working
with
the
team.
So
it's
a
great
delight
to
get
out
from
the
basement.
If
you
will
and
and
share
with
you
today,
an
update
on
percent
positivity
and
testing
rates
by
neighborhood.
D
Percent
positivity
measures
the
proportion
of
individuals,
testing
positive
out
of
the
number
who
were
tested,
so
the
percent
positivity
for
an
area
should
not
be
used
in
isolation.
It
is
much
more
meaningful
when
considered
in
combination
with
other
indicators
of
pandemic
activity.
This
could
include
the
number
of
cases
case
rates
and
testing
rates
in
combination
with
other
indicators.
D
D
Please,
toronto
public
health
has
been
presenting
the
percent
positivity
for
the
city
on
our
monitoring
dashboard
since
early
in
the
pandemic,
while
the
percent
positivity
has
been
relatively
low
in
toronto
overall,
since
the
summer
time,
we
have
started
to
see
a
slow
increase
since
mid-august
and
now
is
currently
3.1
next
slide.
Please.
D
D
D
Since
releasing
these
maps.
In
april,
we
have
seen
the
geographic
distribution
of
cases
continue
to
change
in
toronto
over
time.
So
this
map
in
front
of
you
is
using
the
most
recent
three
weeks
of
data
and
it's
looking
at
the
neighborhood,
the
neighborhoods,
with
case
rates
and
so
on
this
map.
We
can
see
that
the
three
neighborhoods
with
the
highest
rates
of
reported
cases,
are
maple
leaf.
D
D
D
I
do
want
to
highlight
that,
after
we
evaluated
these
data,
the
most
recent
week
is
often
incomplete
due
to
reporting
delays.
So
we
do
recommend
that
people
look
at
previous
weeks
of
data
for
a
more
accurate
picture
and
these
previous
weeks
will
be
available
on
the
web
page
and
updated
as
new
data
come
in
next
slide.
Please.
D
This
map
shows
the
corresponding
testing
rates
for
that.
For
that
same
time
period,
the
week
of
october,
4th
neighborhood
testing
rate
is
calculated
as
the
number
of
individuals
who
were
tested
for
copic
19
per
1000
people
living
in
the
neighborhood
testing
rates
can
provide
additional
information
that
may
help
to
explain
high
percent
positivity
next
slide.
Please.
D
So
I
just
want
to
take
a
couple
of
minutes
now
to
to
really
look
at
two
different
examples
of
how
we
might
use
percent
positivity
testing
rates
and
other
indicators
in
order
to
help
explain
what
behave
what
might
be
happening
at
a
neighborhood
level.
So
this
slide
that
we're
looking
at
now
illustrates
information
related
to
the
neighborhood
with
the
highest
percent
positivity
the
week
of
september
27th,
and
that
neighborhood
is
rustic
and
it
has
that
week
it
had
a
percent
positivity
of
14.3
percent.
D
Additional
important
indicators
are
listed
here.
We
can
see
that
the
recent
case
rate
from
september
25th
to
october
15th
in
that
neighborhood
was
191
per
100
000
people,
which
is
actually
at
the
lower
end
of
the
range
of
neighborhood
case
rates
within
that
same
time
frame
and
the
testing
rate
in
rustic
was
9.9
per
1000
and
was
one
of
the
lowest
neighborhoods
for
testing
rate
the
week
of
september
27th
so
taken
together.
D
So
this
is
an
example
for
rustic,
but
I
would
like
to
speak
a
little
bit
more
generally
to
the
neighborhoods
in
the
northwest
part
of
the
city
for
for
many
neighborhoods
in
the
northwest.
We
are
seeing
a
high
percent
positivity
and
low
testing
rates
and
case
rates
in
the
high
to
mid
range,
and
there
is
some
variation
over
time,
but
in
general
this
means
that
there
should
be
more
testing
in
these
areas
to
understand
what
may
be
happening
here.
D
So
I'd
like
to
move
an
example
more
towards
the
center
of
the
city
and
in
this
slide
we're
looking
at
the
neighborhood
of
little
portugal
and
the
percent
positivity
in
little.
Portugal
was
high
in
the
week
of
september
27th
over
seven
percent,
but
the
testing
rate
has
been
one
of
the
highest
over
the
last
several
weeks
with
almost
33
tested
per
1000
people
living
in
that
neighborhood.
D
In
recent
weeks,
we
have
seen
the
search
of
cases
in
little
portugal
in
the
most
recent
three
weeks.
This
neighborhood
had
the
second
highest
case
rate
in
the
city
so
taken
together.
These
indicators
suggest
that
testing
is
actually
very
likely
adequate
in
that
area
and
percent
positivity
is
high
due
to
an
increase
in
virus
activity,
and
I
will
say
when
we
go
back
and
we
look
at
testing
rates,
they
gen.
They
generally
tend
to
be
very
high
in
the
center
part
of
the
city.
D
D
Next
slide,
please
so
I'm
very
happy
to
let
you
know
that
you
will
be
able
to
find
percent
positivity
and
testing
rates
by
neighborhood
maps
on
our
cova
19
status
of
cases
in
toronto.
Web
page
the
map
will
be
live
today.
Following
the
board
of
health
meeting.
We
will
be
updating
these
maps
weekly
on
thursday,
and
I
also
want
to
note
that
we
will
continue
to
do
more
analysis
with
these
data
in
combination
with
other
data,
because
alone
percent
positivity
can
lead
to
incorrect
conclusions.
B
B
You've,
seen
here
by
the
excellent
data
presentations
by
my
colleagues
that
you
know
so
much
does
rest
on
our
ability
to
actually
collect
excellent
information
in
respective
cases
and
contacts
and
summarize
them
in
a
fashion
that
helps
us
to
inform
all
the
decisions
that
need
to
be
made
here
at
the
local
level
and
beyond,
and
an
an
important
component
of
being
able
to
do.
That
is
having
a
highly
functional
and
highly
proficient
information
management
system
to
support
these
key
functions.
B
The
second
recommendation
is
listed
here
on
the
slide
speaks
to
a
point
that
effie
nicely
spoke
to
about
the
importance
of
conducting
case
control
studies.
We
certainly
have
every
intention
of
doing
that
here
at
toronto,
public
health,
but
we
would
urge
our
provincial
counterparts
to
take
on
similar
studies
so
that
they
too
can
inform
decision
making
through
the
pandemic,
with
this
type
of
information
readily
available
to
them.
B
B
B
Turning
to
the
next
slide,
looking
now
at
longer
term
actions
longer
term
recommendations,
consultation
participants
did
point
to
existing
city
strategies
which
address
many
of
the
social
determinants
of
health.
I
think
it's
interesting
that
they
noted
that
there
are
no
shortage
or
there
is
no
shortage
of
available
solutions
based
on
decades
of
community
consultations
and
advocacy.
B
Participants
also
support
the
release
of
disaggregated
socio-demographic
data
and
suggested
that
we
provide
information
on
how
the
city
and
the
divisions
around
us
plan
to
take
action
and
collaborate
with
impacted
communities
to
develop
action
plans.
And,
finally,
another
recommendation
was
for
toronto
public
health
to
conduct
additional
consultation
with
the
indigenous
serving
organization's
cluster
table
in
a
manner
that
allows
enough
time
sufficient
time
to
ensure
a
culturally
safe
process.
B
But
I
do
also
very
firmly
believe
that
these
months
will
ultimately
end
with
all
that.
I
think
we
collectively
hope
for
for
now,
though,
we
all
share
the
anxiety
about
this
virus
and
the
frustration
of
what
I
can
only
describe
as
a
life.
That's
interrupted,
as
I
said,
at
a
recent
press
conference
during
my
mark's
remarks.
B
I
should
say
recently
you
know
I
I
wouldn't
wish
on
anyone,
the
stress
and
fear
of
living
through
even
a
mild
case
of
covid19,
and
I
think
that
sometimes
it's
it's
easy
to
forget
how
significant
and
how
enormous
this
situation
is
right.
The
virus,
though,
as
we
know
it
right
covet
19,
is
a
fact
of
life
and
it
affects
every
aspect
of
our
lives
and
we
forget
that
at
our
peril,
but
as
it
turns
out,
we
do
not
all
share
equally
in
the
burdens
of
living
through
this.
B
B
B
B
They
are
the
people
that
you've
heard
today
analyzing
the
data
that
we
have
in
order
to
identify
risks
resulting
from
the
pandemic
and
the
means
to
move
through
it
with
as
little
damage
as
possible,
and
these
examples
are
far
from
capturing
the
work
of
the
entire
organization
that
is,
toronto.
Public
health.
A
Well,
thank
you,
dr
davila,
and
as
well.
Thank
you
to
effie
and
sarah
members
of
the
public
and
the
board.
You
got
a
little
window
into
the
exceptional
team
that
is
toronto,
public
health.
With
that
collective
presentation
there
we're
now
going
to
move
this
to
to
hear
from
the
three
registered
speakers
before
bringing
it
into
committee
for
questions
our
first
speaker
registered
deputy
is
gary
thompson.
A
E
Thanks
for
the
good
work
on
the
covoid
issue,
I
read
a
letter
september
15
2020,
signed
by
the
chair
and
counselor
gord
perks
to
the
medical
officer
of
health,
interesting
for
several
months:
overdose
deaths
rates
higher
than
covoid,
what's
being
left
out
and
hidden
needless
non-overdose
deaths
on
a
regular
basis.
I
am
pulling
off
family
and
friends,
giving
chest
compressions
to
loved
ones
who
are
alive,
fly
on
the
wall,
circa
2011.
E
A
E
A
E
E
A
E
E
A
A
A
F
F
So
the
first
strategy
being
follow,
follow
through
on
commitment
to
the
collection
of
socio-demographic
data
and
eileen
chief
medical
officer,
medical
officer
of
health
identified
that
there
was
a
pause
october.
The
second
to
october.
The
ninth
and
toronto
announced
the
suspension
of
this
data
collection
due
to
the
pressure
exerted
by
the
surge
in
cases.
F
F
Public
health
must
uphold
commitments
to
make
to
collect
and
both
to
both
collect,
but
also
to
use
the
data
to
inform
strategies,
and
that
leads
to
the
second
point.
Using
the
data
to
inform
health
system
planning
and
resource
allocation
toronto
has
not
meaningfully
used
the
data
to
address
health
inequalities,
communities
and
workplace
setting
outbreaks
are
contributing
to
an
accelerating
community
spread
in
hot
spots.
F
We
know
that
workers
in
essential
roles,
contract,
kovit,
19
in
workplaces
and
bring
back
into
communities
where
factors
such
as
overcrowded
housing
and
crowded
public
buses,
where
physical
distancing
cannot
cannot
be
observed,
are
the
norm.
Increased
regulations
for
employers
mandating
better
protection
for
workers
in
their
places
of
employment,
reduces
the
risk
of
continued
transmission
to
home
communities.
F
Second,
I
would
say
that
we
need
to
increase
the
bus
routes
in
those
neighborhoods.
We
all
know
the
dufferin
bus.
We
all
know
the
jain
bus.
They
were
crowded
pre-covered
in
covid.
They
are
still
crowded,
so
increasing
the
bus
routes
on
those
increasing
buses
on
those
routes
need
to
be
enhanced
even
beyond
what
we
had
pre-covered.
F
The
third
strategy
is
integrating
health
equity
based
targets
and
frameworks
and
sorry
and
public
health.
I
think
we
feel
it
is
imperative
to
address
these
disparities
by
advancing
those,
and
I
think
the
recommendations
that
eileen
identified
in
recommendations,
three
and
four,
I
think-
can
advance
that
recommendation.
Four
strategy.
Four
is
rebuild
trust
in
public
health
by
implementing
and
updating
the
pandemic
response
plan,
and
this
means
that
we
need
to
ensure
that
what
we
say
we're
going
to
do
and
what
community
has
asked
us
to
do.
F
We
will
do
as
part
of
the
community
consultation
process
and,
lastly,
we
need
to
follow
through
on
the
commitment
to
recognize
anti-black
racism
as
a
public
health
crisis.
In
june,
this
commitment
was
declared,
and
it
was
unanimously
agreed
by
this
board,
and
I
think
we
need
to
see
strategies
that
seeks
to
advance
that
direction
and
that
commitment.
A
A
Okay,
seeing
none
from
the
committee
angela,
I
do
have
a
couple
if,
if
you're
still
there,
I'm
still
here
great
one
of
your
recommendations,
you
called
for
a
health
equity
strategy
to
guide
the
toronto
public
health
and
cities
pandemic
response
plan.
Could
you
speak
to
what
that
looks
like
how
such
an
accountability
document
could
be
developed
and
what
it
would
look
like.
F
F
The
differentiated
engagement
with
those
communities
are,
I
would
say,
some
of
the
ways
in
which
that
could
happen.
I
think
the
other
recommendation
is,
I
think,
in
the
recommendation.
Three
and
four
that
was
presented
by
eileen
is
that
there
is
a
requirement
or
a
call
for
better
collaboration
with
the
province
and
the
feds,
but
maybe
more
locally
or
provincial
government
is
around
how?
A
Thank
you
for
that.
I
guess
one
follow-up
would
be
looking
to
other
jurisdictions.
I
believe
our
metric
for
success
should
not
be
based
on
what
others
have
done.
Rather,
we
should
seek
to
lead
the
way
in
an
equitable
response.
That
being
said,
would
you
point
to
or
suggest
any
other
jurisdictions
that
have
embedded
equity
in
their
covert
response
as
a
model
for
which
we
should
follow
or
seek
to
improve
upon.
A
G
Thank
you
very
much,
mr
chair
and
angela.
Thank
you
for
your
deputation.
I
think
many
of
the
points,
all
five
of
them
that
you
raise,
are
extremely
legitimate
and
valuable
to
this
board.
With
respect
to
point
number
four,
you
you
talk
about
rebuilding
trust
and
and
not
to
place
the
onus
on
on
community
organizations
or
frontline
workers
or
groups,
but
recognizing
that
the
the
collection
of
this
aggregated
data
during
that
particular
period
of
time
of
august
2
to
august
9..
G
And
and
to
that
further
point,
recognizing
that
there's
there's
been
some
push
and
pull
tensions
between
front
line
health
agencies
such
as
the
one
that
you
you
work
at
and
the
connection
and
the
collection
of
agencies
that
you
you
are
networked
with.
Are
you
feeling
a
sense
of
partnership
that
is
working
in
in
the
right
spirit,
and
the
reason
I
ask
this
is
because
I
I
recognize
that
trial
board
of
toronto
board
of
health
public
health
is
also
struggling
with
the
pandemic.
F
I
would
say:
definitely
we
have
had,
I
think,
a
history
of
brilliant
collaboration
and
that
toronto
public
health
has
been
the
ally
with
community
and
in
fact,
community
was
therefore
quite
heartened
and
pleased
when
it
was
toronto.
Public
health
who
took
the
step
the
bold
step
about
the
collection
of
race-based
data,
which
basically
also
set
the
trend
for
other
public
health
institutions
across
the
province.
To
do
the
same.
F
So
I
think
that
has
been
there
has
been
great
and
continues
to
be
great
collaboration.
And
hence
it
was
because
of
that
why
there
was
a
bit
of
a
are
taken
aback
when
the
pause
happened,
without
necessarily
an
engagement
with
community
that
had
been
so
much
behind
and
in
allyship,
with
public
health
with
the
race-based
data
collection.
But
in
spite
of
that,
there
continues
to
be
good
collaboration.
G
That's
very
very
good
to
hear
very
encouraging.
Finally,
my
my
question
is:
if
we
were
to
to
to
prevent
what
has
happened
during
the
the
the
stoppage
of
collecting
of
data,
what
would
need
to
change
recognizing
how
solid
the
relationship
is
already
with
agencies
with
public
health,
with
agencies
with
the
public
health
unit?
What
else
can
we
do
to
further
enhance
and
strengthen
that
relationship
and
partnership?
So
we
don't
have
a
repeat
incident
of
where
we
went
ahead
and
did
something
without
consultation
and
connection
with
the
community.
F
And
therefore,
if
those
commitments
are
not
followed
through
on
and
or
if
directions
are
changed
without
engagement,
then
we
are
disheartened
and
it
feeds
the
mistrust
that
existed
previous
to
those
actions.
So
I
would
say
proactive
engagement
before
those
kinds
of
strategies
are
taken
so
that
we
in
community
can
understand
the
rationale
and
so
that
we
in
community
can
also
be
potential
allies.
F
Because
the
shift
that
happened,
I
think,
happened
because
there
was
a
significant
surge
that
resources
and
capacity
was
stretched.
And
if
that
is
the
case,
and
we
in
community
need
to
be
an
ally
with
our
public
health
institution
to
call
for
additional
resource
so
that
these
commit
commitments
can
be
kept,
then
we
would
want
that
opportunity.
A
F
E
Thank
you
angela.
I
just
have
one
more
question.
You
talked
about
a
a
generally
strong
and
trusting
relationship
between
community
organizations
and
toronto
public
health.
How
is
the
partnership
going
at
federal
or
provincial
levels?
Are
there
appropriate
structures
and
supports
in
place
to
ensure
expertise
from
community
and
from
structurally
marginalized
neighborhoods
and
populations
is
part
of
decision
making.
F
I
don't
believe
the
same
exists
at
those
levels
and
hence-
and
hence
it
does
mean
that
yes,
there
is
a
differential
burden
on
public
health
to
be
that
entry
point
for
communities
to
then
filter
through
those
messages
to
both
the
province
and
the
federal,
the
federal
government.
So
I
think
really
for
the
community.
We
see
our
entry
point.
Our
door
of
of
access
to
those
spaces
is
through
toronto,
public
health.
A
D
A
A
H
Thank
you,
mr
chair.
I
mean
I've
been
listening
attentively
to
the
information
shared
by
dr
davila
and
her
team
this
morning
and
the
previous
speakers,
but
I'm
not
entirely
sure
if,
if
my
remarks
should
be
shared
now
or
perhaps
later
in
the
meeting,
my
comments
are
about
the
pandemic:
wage
enhancement.
H
Okay,
great
okay,
great
so
good
morning,
mr
chair,
dr
davila
and
other
members
of
the
board
of
health
and
and
visiting
counselors,
my
name
is
jasmine.
Ramsay
rizzai,
I'm
the
advocacy
and
communications
director
at
waidu
state
toronto.
Thank
you
for
having
me
as
the
city's
largest
multi-service
women's
organization.
Why
do
you
say
toronto
helps
women
escape
violence,
move
out
of
poverty
and
access
safe
and
affordable
housing?
We
work
tenaciously
to
break
down
barriers
that
hold
women
and
girls
back
from
achieving
equality
annually.
H
Our
association
serves
over
13
000
people,
including
trans
and
non-binary
community
members,
we're
here
this
morning
to
support
the
proposed
motion
for
the
province
to
reinstate
the
pandemic,
wake
enhancement,
but
really
to
talk
about
the
necessity
to
reinstate
the
pandemic
wage
enhancement.
The
covet
19
pandemic
has
exacerbated
gender
and
racial
inequalities.
H
As
you
all
know,
we
are
tremendously
concerned
about
the
communities
we
serve
and
the
unequal
impacts
of
the
pandemic
on
low-income
individuals
and
families,
particularly
women,
who
are
precariously
housed
and
survivors
of
gender-based
violence.
We're
also
concerned
about
how
the
pandemic
is
impacting
frontline
workers
in
our
organization
and
across
the
sector.
H
The
pandemic
pay
premium
was
a
powerful
financial
acknowledgement
of
the
dedication,
long
hours
and
health
risks
assumed
by
frontline
workers,
but
the
province
ended
it
in
august.
Although
personal
support
workers
continue
to
re,
receive
a
wage
enhancement,
frontline
workers
in
our
sector
no
longer
receive
a
top-up.
H
H
Our
frontline
workers
need
our
support.
They
perform
critical
labor
to
keep
our
shelter
program
safe
and
women
in
vulnerable
situations
off
the
streets
and
away
from
violence
friendly
workers
have
never
really
had
the
option
to
work
from
home.
They've
been
going
into
work
day
in
and
day
out
during
this
pandemic.
A
G
G
There
there's
going
to
be
a
request
and
a
real
and
continued
reliance
on
making
sure
that
the
provincial
government
steps
in
to
provide
some
of
this
support,
and
yet
some
of
the
services
that
you
identify
are
also
municipally
funded.
So
therefore-
and
there
may
not
necessarily
be
cost
sharing
involved-
is
the
suggestion
or
perhaps
recommendation
from
the
trump
sorry
the
ywca.
H
Thank
you
for
the
question
and
that's
a
very
that's,
a
very
great
question
and
I
think
I
think
ultimately
that's
a
scenario
that
isn't
ideal,
but
it
would
mean
a
lot
to
the
frontline
workers,
regardless
of
who
pays
that
they
do
have
this
additional
top-up.
So
if
the
province
isn't
able
to
meet
its
commitment
to
support
gender
and
racial
equality
in
our
province
or
to
support
frontline
workers,
then
it
would
be
really
fantastic
if
the
city
could
could
step
in
to
provide
this
additional
support
in
terms
of
wage
enhancement.
H
G
H
Need
thank
you
for
the
question.
I
mean
to
be
very
frank:
it's
been
a
very
challenging
time.
As
you
may
know,
why
did
we
see?
Toronto
is
actually
one
of
the
larger
non-profit
organizations
in
the
city.
We
have
a
budget
of
about
40
million
dollars
and
this
year
we're
facing
about
a
two
million
dollar
deficit
and
we're
really
struggling
to
understand
how
we
can
meet
the
the
challenges
before
us
and
it
is
related
to
several
things.
H
H
H
But
it's
coming
at
an
enormous
cost
to
our
organization
and
we're
really
struggling
to
really
keep
some
of
our
programs
open
in
the
next
year
or
so,
and
what's
more
frightening
about
this
counselor.
Is
that
with
a
large
non-profit,
the
smaller
non-profits
in
our
city
are
either
temporarily
closing
up
shop
or
permanently
doing
so,
and
the
long-term
ramifications
of
of
this
aspect,
the
the
impact
on
the
non-profit
sector
and
the
services
that
we
provide
to
the
communities
who
need
these
services
at
a
heightened
level.
H
A
Okay,
seeing
none
jasmine.
Thank
you
very
much
for
your
for
attending
and
speaking
to
us.
At
this
point,
we
we've
heard
from
our
registered
speakers
we're
going
to
move
this
into
committee
for
for
questions
of
dr
davila
and
team.
So
if,
by
way
of
a
show
of
hands,
I
can
make
a
pull
a
list
here
together
members
of
the
board
with
questions
looking
for
any,
I
see
director
mulligan,
any
others
who
wish
to
be
put
on
the
list
and
counselor
wong
tam.
E
Thank
you
chair,
dr
davil.
I
really
want
to
thank
you
for
how
quickly
you
have
added
percent
positivity
in
other
neighborhood
measures
of
not
only
the
impact
of
covid
but
on
how
well
we're
doing
with
our
testing
and
support
strategies.
For
example,
I
wonder
if
you
could
comment
at
all
on
california's
approach
at
this
stage.
B
So,
thank
you
and
through
the
chair.
I
think
those
are
that's
an
excellent
suggestion.
It's
certainly
one
place
that
we've
heard
of
and
we
are
looking
at
and
I
can
let
perhaps
sarah
and
effie
to
speak
and
allow
them
to
speak
in
greater
detail
as
to
what
we're
looking
at,
but
certainly
open
to
hearing
from
from
you
and
from
other
members
of
the
board
of
health
and
members
of
the
community
around.
Are
there
other
practices
that
we're
seeing
from
other
jurisdictions?
B
That
may
help
to
inform
our
efforts
here,
certainly
we're
interested
in
making
sure
that
we
do
bring
forward
a
very
equity
focused
approach
to
covert
response
in
both
in
all
aspects,
short
term,
medium
term
and
long
term.
So
I
don't
know
how
much
we've
been
able
to
do
with
respect
to
or
really
get
into
details
around
what
california
is
doing,
but
certainly
happy
to
look
sarah
effy
anything
to
add
or
I'm
sorry,
kate.
I
don't
want
to
take
up
your
time.
E
B
I
I
think
you
know
to
answer
the
question
through
the
chair.
I
I
am
supportive
of
that
in
principle,
and
I
wonder
about
whether
you
know
is
it
at
the
neighborhood
level?
Is
it
regions
I
mean
what
is
the
most
useful
level
of
analysis?
I
don't
know
that
we
know
quite
yet,
and
I
think
that's
why
it's
important
that
we
take
that
time
to
investigate
the
data.
We
have
other
data
that
we
might
have
access
to
and
think
about
it.
In
that
context,
with
better
information
in
front
of
us.
A
G
G
I
want
to
just
lean
into
the
the
comments
that
came
from
our
deputies
today
and
and
largely
around
two
issues.
One
is
around
restoring
and
building
and
strengthening
trust
between
those
community
organizations
who
are
obviously
on
the
ground
and
struggling,
but
to
what
angela
robertson
had
spoken
about.
G
Is
there
anything
further
that
you
can
add
to
how
the
toronto
public
health
unit
can
continue
to
build
stronger
relationships
with
those
local
agencies?
So
we
don't
have
necessarily
a
repeat
incident
of
what
happened
when
there
was
a
decision
made
to
stop
the
collection
of
disaggregated
data
for
that
week.
B
B
These
are
the
fundamentals
of
public
health,
and
it
must
be
done
in
that
trusting
relationship
with
those
community
partners
who
we
hold
extremely
dear
and
think
are
are
absolutely
essential
to
us
getting
our
work
done
and
in
advancing
our
goals.
I
think
that
you
know
I
would
ask
our
partners
to
recognize
that
we
know
we.
We
are
not
perfect
by
any
stretch
of
the
imagination
and
in
this
particular
situation,
where
we
are
learning
every
single
day
right
every
minute.
Practically
we
recognize
that
we
will
make
this.
B
So
you
know
I
would
ask
the
forgiveness
of
our
of
our
partners
and
understanding
that
we
had
no
intention
of
of
you
know
breaching
trust
that
was
the
furthest
thing
from
our
minds.
We
were
trying
to
respond
to
a
very
significant,
a
really
unbelievable
situation
in
respect
of
a
surge
in
cases,
and
we
regret
any.
You
know
mistrust
that
may
have
formed
and
we
will
work
very
very
hard
to
regain
that
trust
on
the
part
of
our
community
partners.
B
So
that's
my
heartfelt
apology
to
our
community
partners
and
a
really
really
heartfelt
intent
and
expressed
intent
that
will
be
backed
up
by
action
that
we
will
continue
to
work
with
them
if
they
will
have
us-
and
we
will
do
everything
in
our
power
to
make
sure
that
they
recognize
that
we
are
there
for
them
that
we
are
worthy
of
that
trust
and
that
we
do
have
their
best
interests.
You
know
really
at
heart.
G
Thank
you
for
that
that
very
helpful
explanation
and
also
comment
with
respect
to
the.
I
think
what
we
we
now
know
and
we've
been
learning
this
throughout
the
the
weeks
and
the
months
that
that
led
to
where
we
are
today.
Obviously,
certain
populations
have
fallen
behind
and
that's
not
necessarily
just
by
sheer
bad
luck.
There's
structural
inequities
that
have
to
be
addressed
and
and
considering
that
the
city
of
toronto
doesn't
have
the
ability
to
do
it
all
and
number
one
because
of
perhaps
legislative
purview
number
two,
perhaps
of
limited
resources.
G
So
we
rely
very
heavily
meeting
after
meeting
at
the
trump
board
of
health
here,
pleading
asking
requesting
politely
of
the
other
orders
of
government
to
to
do
step
up
and
do
their
part
and
and
no
one
government
is
going
to
be
able
to
do
it
well
and
perfectly
all
the
time.
But
at
some
point
in
time
because
of
the
resurgence
of
the
second
wave,
and
perhaps
there
will
be
a
third
or
perhaps
the
second
wave
will
continue
to
heighten.
G
When
do
we
decide
that
we
just
have
to
pick
up
the
pieces
and
fill
the
service
gaps
where
we
have
to
unlock
perhaps
further
the
banks,
the
reserves
of
the
city,
to
address
these
social
inequities
where
we
perhaps
take
on?
If,
if
it,
if
it's
even
possible,
the
the
scale
of
mobile
testing
units
that
have
to
go
into
those
communities
have
been
a
disproportionate
impact
where
we
have
to
just
be
able
to
provide,
perhaps
grant
programs
to
for
pandemic
pay.
G
And
how
do
we
define
the
the
covet
health
equity
response
that
we
are
now
asking
the
other
order
governments
to
do
when
perhaps
they
haven't
necessarily
done
that
work
so
far
like
what
would
be
the
breaking
point
for
us
and
is
there
or
or
do
we
just
continue
to
ask
very
politely?
Please
please
continue
to
do
your
job,
the
province
of
ontario
and
the
federal
government.
B
B
The
next
level
of
conversation
clearly
has
to
occur
with
city
council,
given
that
our
our
budgets
and
our
resources
are
very
much
tied
within
that
which
occurs
at
city
council.
But
briefly,
let
me
say
this
one.
I
think
that
we
have
taken
that
initiative
and
made
those
decisions
in
those
specific
instances
where
that's
been
required.
B
The
challenge,
of
course,
is
that
when
there
are
specific
actions
that
are
required-
and
I'm
just
going
to
give
one
example-
things
like
testing,
we
may
not
have
the
fulsome
resources
in
order
to
do
this,
and
it's
not
just
about
the
finances
it
may
be
about
access
to
equipment.
It
may
be
about
access
to
human
resources
and
the
skill
sets
that
are
necessary
in
order
to
support
those
endeavors
in
a
a
proper
fashion,
and
you
know
it
may
be
around
some
of
the
logistics
issues
as
well.
B
A
Thank
you
counselor.
Now.
Let
me
open
it
up.
Are
there
any
other
members
of
the
board
who
have
questions?
I
could
I
could
just
see
the
screen
for
people's
hands.
Please
thank
you!
Clerks
trustee,
donaldson
and
then
start
visiting
member
count.
Peruta
I'll,
come
to
you
right
after
so
trustee,
donaldson,
followed
by
visiting
members
perusa
and
then
ainsley.
I
see
trustee
donaldson
when
you're
ready.
E
Thank
you
chair.
I
I
want
to
echo
councillor
wong
tams
comments
about
the
gratitude
that
I
also
share
for
for
everyone
on
this
team
and
particular
thanks
to
the
opportunity
to
hear
from
effie
and
sarah
today
that
was
really
valuable
and
really
meaningful
for
us
to
be
able
to
hear
from
them
directly
about
their
incredible
work.
So
thanks
for
that,
I
have
some
questions
about
schools.
I
just
want
to
make
sure
that
my
understanding
of
the
report
is
clear
so
on
the
we're
one
month
in
now
to
return
to
school.
B
C
E
C
The
truth
is
we,
don't
we
can't
know
without
doing
a
genomic
study,
that
transmission
has
happened
in
the
school.
However,
I
think
we,
that
is
the
best
hypothesis
when
you
have
more
than
one
individual
in
overlapping
in
place
and
time,
but
they
are
related
to
each
other.
So
when
we
have
more
than
one
case
in
a
school,
we
they
are
treated
as
an
outbreak
and
they're
investigated
as
an
outbreak.
E
B
So
through
the
chair,
we
are
doing
everything
possible,
of
course,
in
partnership
with
with
school
boards
and
and
school
communities
themselves.
To
avoid
that
at
this
point,
the
last
data
that
I
saw,
which
was
this
morning,
put
us
at
about
12
outbreaks
in
total
in
schools,
and
we
have
1200
schools
throughout
the
city
of
toronto.
B
So
I
think
overall,
as
effie
tried
to
describe
earlier
in
her
presentation,
you
know
we're
doing
reasonably
well
one.
Never
I'm
knocking
wood
here
right,
because
we
really
do
see
the
benefit
of
keeping
our
schools
open
as
much
as
possible,
and
we
are
doing
everything
humanly
possible
to
continue
that.
So
you
know
we
ask,
for
you
know
ongoing
collaboration
and
partnership.
B
I
can
certainly
speak
on
behalf
of
many
of
my
colleagues
here
at
toronto,
public
health,
who
have
more
direct
connection
with
school
communities
and
partners
to
say
that
the
partnership
has
been
really
amazing
and
we
hope
for
that
continued
partnership
so
that
we
can
continue
with
our
schools
operating
so
far.
So
good,
though.
A
I
I
So
so
please,
I
I
I
know
I'm
asking
it
as
a
question,
but
really
what
I'm
doing
is
I'm
I'm
asking
you
to
to
to
help
us
get
more
pop-up
testing
in
in
in
these.
You
know
what
we're
what
you're
now
calling
disproportionately
impacted
areas?
Okay,
please
we
need.
We
need
a
little
more
that
and
by
the
way,
the
the
the
ones
that
you've
that
you've
done
they've
been
incredibly
successful.
From
my
perspective,
once
you've
been
your
experience
with
it.
B
So
council
counselor
through
the
chair,
I
would
say
that
we
have
also
you
know,
had
very
positive
feedback
in
respect
of
pop-up
testing
efforts.
Thus
far,
there
is
always
room
for
improvement.
Always
room
for
improvement.
Happy
to
you
know,
receive
feedback
to
try
to
make
sure
that
we
are
reaching
all
the
right
people
as
quickly
and
in
as
accessible
a
fashion
as
possible.
I
Second
question
I've
been
approached,
and
I
know
that
counselor
cressie
has
got
a
motion
today.
That
includes
this,
but
I
wanted
to
know
what
what
your,
what
your
feedback
is
on
it,
because,
without
your
support,
it's
not
going
to
work
drive
through
flu
shots.
I
drive
through
flu
shot
stations
in
the
city.
I
I
I've
had
this
request
from
a
number
of
people
who
are,
you
know,
concerned
about
going
out
concerned
about
you
know
going
to
a
doctor's
office
concerned
about
you
know
that
kind
of
contact
and
they
would
like
to
be
able
to
do
it
as
a
you've.
Seen
on
television,
for
example,
where
people
are,
you
know,
drive
and
get
tested
same
kind
of
thing.
You
know
you
stay
in
your
car.
You
roll
up
your
sleeve,
you
you
get
your
shot.
You
drive
on
right,
very
little
contact
with
people.
I
B
B
It's
now
a
question
of
figuring
out
locations
and
staffing
and
resourcing-
and
you
know
we
want
to
make
sure
our
and
I,
by
we
I
mean
the
the
large
community.
We
would
want
to
make
sure
that
such
endeavors
are
done
in
as
safe
and
appropriate
a
fashion,
as
is
possible,
and
that
requires
some
exploration,
but
I
don't
see
any
harm
in
actually
exploring
new
and
innovative
ways
to
deliver
services
whatsoever.
I
Okay,
thank
you
for
that.
Lastly,
in
in
areas
where
you
have
you
know
this
proportional
impact
earlier
on-
and
I
just
wanted
to
know
if
you're,
if
the
statistics
are
still
current
earlier
on,
fewer
people
were
sending
their
kids
to
school,
were
keeping
their
kids
at
home
more
because
they
didn't
feel
that
the
schools
could
keep
their
kids
safe.
I
I
And,
conversely,
is
there
anything
in
the
pipeline?
That
would
provide
some
supports
to
these
families
of
these
kids,
who
are
just
keeping
their
kids
at
home
just
because
they
don't,
they
don't
feel
that
sending
them
to
to
school
in
a
in
a
in
an
area.
That's
that's
got
a
higher
rate
of
covet
circulating
amongst
the
population
that
they
feel
safe.
B
Okay,
thank
you,
mr
chair.
So
counselor
I
don't
have
specific
data
on
whether
we're
seeing
a
differential,
or
you
know,
a
change
in
practice
over
time
from
particular
neighborhoods
with
taking
kids
out
of
school
or
keeping
them
more
at
home
than
other
neighborhoods.
I
know
that.
Certainly
there
have
been
opportunities
for
families
to
make
switches
in
respect
of
how
they
choose
to
or
what
choices
they're
making
around
in-person
schooling
versus
online
schooling
versus
hybrid
forms
of
of
education
again,
depending
on
the
variety
of
schools
and
the
locations
of
those
schools.
B
That
being
said,
it's
my
understanding
premised
on
the
consultations
that
we've
done
thus
far,
and
certainly
premised
on
all
the
information
that
we
know
about
neighborhoods
throughout
the
city.
There
is
no
shortage
of
need
on
a
variety
of
different
supports,
and
you
saw
some
of
those
in
the
presentation
that
was
provided
earlier.
B
Everything
from
better
income
supports
and
protections
for
workers
to
supports
to
help
people
be
more
successful
in
maintaining
their
housing,
which
is
not
just
for
individuals
but
clearly
for
families
with
children
as
well.
So
I
think
there
are
a
number
of
different
programs
and
services
that
collectively
we
as
a
community
need
to
bring
and
wrap
around
those
communities
that
are
disproportionately
impacted
by
covet
19
and,
frankly,
have
been
disproportionately
impacted
by
lack
of
access
to
the
social
determinants
of
health
that
pre-existed
even
before
copig
19
was
part
of
our
vocabulary.
B
So
I
think
there
are
a
number
of
things
that
we
have
done
in
the
past
need
to
continue
to
do
more
of
and
to
do
so
with
even
greater
focus
and
precision
on
those
who
would
benefit
most
from
those
supports.
I
think
this
is
where
we
need
to
put
our
our
time,
our
energies
and
our
efforts,
and
you
can
expect
to
see
that.
A
I
B
So
through
the
chair,
thank
you
counselor
for
the
question
you
know
at
a
very
high
level.
The
issue
is
within
the
context
of
restaurants
and
bars
and
those
types
of
facilities
where
people
gather
together
and
as
the
weather
gets
colder
it.
It
becomes
more
of
an
indoor
gathering
site
with
people
in
relatively
close
contact.
B
What
is
good
hygiene
practice
if
you
will,
from
a
covet
19
perspective
these
kinds
of
circumstances,
we
do
not
see
in
quite
the
same
way
within
the
retail
environment.
People
tend
to
be
with
mask
on
no
real
reason
to
remove
it
able
to
maintain
physical
distance
and
if,
if
they're,
not
it's
usually
for
very
short
periods
of
time
as
you
pass
somebody
so
not
really.
The
circumstances
that
give
rise
to
cobit,
19
transmission,
indoors,
close
proximity
congregations
without
a
mask
and
and
where
physical
distancing
for
extended
periods
of
time
is
just
not
maintained.
B
Yeah
I'll
try
to
stay
away
from
you
know
I'll
leave
that
to
my
colleagues
at
mls
for
sure
they're
they're
more
than
capable
in
that
arena.
I
would
say
this,
though.
I
think
that
the
issue
is
is
that
where
we
have
seen
transmission
happen,
it's
not
always
been,
or
necessarily
been
as
a
result
of
of
bad
behavior
or
not
following
the
rules.
B
There
are
probably
some
circumstances
where
that
is
the
case,
but
oftentimes
it's
just
around
the
circumstances
and
the
nature
of
the
activity,
as
I
said,
close
space
with
congregation
some
degree
of
crowding
where
people
are
close
to
each
other
and
engaged
in
activities
where
it
is
either
extremely
difficult
or
impossible
to
physically
distance
or
to
wear
a
mask.
These
are
the
types
of
conditions
that
just
give
rise
to
covet
19
transmission-
and
you
know
until
such
time
as
we
get
effective
treatments
or
effective
vaccines.
I
A
A
A
Okay?
So
if
we
do
we'll
come
back
to
you,
but
so
so,
dr
davila,
for
you
or
for
effie.
This
is
I
I
have
two
questions
on
behalf
of
director
director
bowery.
So
I'll
just
read
it
here,
since
there
has
been
an
adjustment
on
contact
tracing
due
to
resources
and
the
increase
in
case
counts.
How
does
this
affect
the
data
on
community
transmission
that
was
presented
earlier
by
effie?
C
Be
hi
yeah,
so
that
is
that's
a
really
good
question
and
obviously
for
a
subset
of
our
cases
and
our
con
and
our
contacts.
We
are
not
able
to
get
the
data
and
the
information
we
are
used
to
getting
or
have
had
been
acquiring
until
that
point,
so
the
community
cases
really
refer
to
cases,
not
contacts,
and
so
the
understanding
is
that
the
information
related
to
the
community
cases
should
not
be
impacted
by
our
change
in
our
contact
tracing
process.
C
B
Hopefully,
we'll
respond
in
the
way
we
would
like
them
to.
We
are
actively
incorporated
incorporating,
excuse
me
and
we'll
speak
with
our
community
partners
around
how
we
bring
more
of
an
equity
focus
to
that
to
that
reintroduction
and
move
back
to
ultimately,
what
will
be
more
folsom
case
in
contact
management,
as
we
were
doing
at
the
beginning,.
A
A
B
B
You
know
with
respect
to
what
is
happening
on
our
contacts
in
particular,
given
our
current
approach
and
the
approach
that
we
had
to
adopt
in
response
to
very
very
high
case
counts,
and
yes,
it
is.
I
think
we
have
to
admit
upfront
that
this
is
a
challenge
for
us.
Hence
we
are
really
working
hard
on
those
public
health
measures
to
bring
the
case
that
counts
down
to
a
more
manageable
level.
A
A
Clerks
have
circulated
a
confidential,
an
amendment
to
the
confidential
item
coming
up
on
hl
22.2,
that's
the
next
item,
and
so
I
I'd
ask
board
members
if
you
want
to
take
a
look
at
that,
because
I,
after
this
item,
unless
it's
members
wish
to
go
in
camera,
we
may
be
able
to
deal
with
this
in
public
without
having
to
have
an
in-camera
session.
So
there's
a
confidential
amendment,
that's
been
circulated
and
I'll
just
want
to
bring
your
attention
to
that.
A
Okay.
So
now
we'll
move
into
this
item
for
speakers
can
I
just
see
a
show
of
hands
for
who
wishes
to
speak
I'll,
see
if
they're
visiting
counselors
they
they
are
they've
left,
okay.
So
members
of
the
board
who
who'd
like
to
speak
on
this
item-
okay,
final
call
for
speakers
and
then
I'm
going
to
put
myself
on
the
list
to
speak
last
all
right.
Let
me
kick
it
off
then.
First,
let
me
begin
by
moving
the
staff
recommendations
that
are
in
front
of
us.
A
Second,
let
me
move
a
comprehensive
motion
here
and
in
doing
so
and
I'll
speak
to
each
point,
but
in
doing
so
let
me
first
of
all
thank
members
of
the
board,
and
especially
I'd
like
to
single
out
directors,
mulligan
and
councillor
wang
tam
for
their
assistance
and
support
developing
this
as
well
as
toronto.
Public
health
staff
and
community
partners
who,
from
the
beginning,
have
have
been
on
the
front
lines
in
both
advocating
for
a
better
response,
but
also
in
helping
to
ensure
an
equitable
response.
A
So
the
motion
in
front
of
us
here
and
I'll
summarize
it
briefly
and
then
speak
to
it
in
a
more
folsom
manner.
It
calls
on
all
levels
of
government
to
immediately
establish
covert
response.
Equity
action
plans
calls
on
the
city
of
toronto
and
toronto
public
health
to
develop
and
publish
our
own
equity
action
plan
to
bring
together
existing
work,
that's
underway,
but
also
build
off
the
data
that
has
been
collected
and
the
consultations
with
community
partners
to
inform
that
work
and
to
report
back
to
the
board
on
the
response.
A
A
The
that
we
urge
the
the
ttc
to
continue
to
take
all
steps
necessary
to
ensure
and
support
and
facilitate
safe
physical
distancing,
especially
on
routes
that
have
that
are
moving
in
high
transmission.
Neighborhoods,
that
we
call
on
the
province
to
implement
a
stay
on
residential
evictions
and
to
restore
pandemic
pay
for
front-line
workers,
including
public
health
staff.
A
And
then
the
final
here
and
I'd
like
to
thank
councillor
perutza
for
his
support
on
this
is
in
partnership
with
the
province
to
ask
our
city
manager
to
consider
making
city
facilities
available
to
support
this
year's
flu
vaccine
efforts,
including
the
consideration
with
the
province
of
potential
drive-through
options
and
once
again,
as
we
have
done
relentlessly
now,
to
call
on
the
province
to
make
testing
truly
accessible
and
available
in
neighborhoods
of
high
transmission.
And
so
that
is
the
the
motion
there
and
again.
A
A
There
is
great
optimism
to
be
found,
I
believe
in
the
science
and
the
rapid
development
that
is
proceeding
towards
a
hopeful
vaccine.
So
we
will.
We
will-
and
I
believe
this
beat
cobot,
but
right
now
we
are
in
the
midst
of
the
second
wave
and
in
so
many
ways
the
second
wave
is
more
complicated
than
the
first,
it's
in
part
more
complicated,
because,
whereas
in
the
first
wave
in
the
spring,
we
had
clear
objectives
to
save
lives,
to
preserve
the
capacity
of
the
health
care
system
and
to
minimize
social
and
economic
harms.
A
But
we
know
that
with
lockdowns
come
other
impacts
on
people's
health
and
mental
health
and
our
economic
health.
And
we
know
that
whether
it's
reopening
or
lockdowns
both
have
disproportionate
impacts
on
marginalized
and
vulnerable
communities,
and
so
it's
on
the
topic
of
equity,
which
we've
seen
addressed
in
a
in
a
in
a
detailed
presentation
today
and
we've
heard
from
deputies.
A
That's
where
we
have
to
do.
We
have
to
learn
from
the
first
wave,
because
we
know
that
covid
preys
on
poverty,
and
we
know
that
without
further
action
by
all
levels
of
government
it
will
continue
to,
and
so
since
day
one.
The
focus
of
this
board
has
been
to
ensure
a
truly
equitable
response,
and
I
will
tell
you
that
I'm
deeply
proud
of
much
of
the
work.
A
That's
been
done
by
whether
it's
toronto
public
health
becoming
one
of
the
first
in
the
country
to
collect
disaggregated
data
and
to
use
it
to
inform
our
response,
whether
it
was
establishing
the
isolation,
centers
or
advocating
for
mobile
testing.
And
so
too.
I
will
tell
you
that
I'm
proud
by
a
great
deal
of
our
city's
response,
whether
it's
on
food
security
work,
the
establishment
of
rapid
housing
initiatives
or
the
community
cluster
coordination
on
the
ground.
A
But
as
the
data
shows-
and
I
will
tell
you
as
the
consultation
with
more
than
140
community
organizations
this
summer
demonstrated,
we
all
collectively
need
to
do
more
to
embed
equity
in
our
response,
and
so
it's
in
that.
It's
on
that
basis
and
with
that
principle
in
mind
that
the
recommendation
in
front
of
us
here
is
to
create
an
immediate
covert,
19
response,
equity
action
plan
to
pull
the
work
together.
That's
underway
now
to
identify
the
gaps
to
hold
us
accountable
and
to
improve
our
response.
A
A
Any
opposed
seeing
none
that
carries
unanimously.
Thank
you
very
much.
That
brings
us
to
our
next
item
and
final
item
today,
which
is
hl,
22.2
early
identification
and
intervention
services
for
preschool
children
in
toronto.
This
is
the
item
I
referred
to.
There
is
a
confidential
report
with
it
and,
as
was
circulated,
a
confidential
amendment
I
had
on
that.
Is
there?
Are
there
any
members
of
committee
who
wish
to
go
in
camera
to
ask
questions
or
speak
on
this
item?.
A
A
Okay,
that
has
been
moved.
Let
me
now
all
those
in
favor,
okay,
any
opposed,
seeing
none
that
carries.
That
concludes
the
items
for
for
today's
board
of
health
meeting
members
of
the
board.
Thank
you,
as
always
for
your
for
your
leadership,
attention
and
commitment
and
to
members
of
our
toronto
public
health
team.
The
work
never
stops.
It
just
never
stops,
but
thank
you.
Thank
you.
Thank
you,
okay,
and
to
our
clerks,
who
ran
a
safe,
healthy
and
efficient
meeting.
Thank
you
all.
Thank
you.
Everybody
we'll
talk
to
you.