Amy Noise

These are just some of the questions that people commonly have about COVID-19, but finding clear answers isn’t always easy – especially with the Omicron variant having led to changes in public health advice, and causing confusion.

That’s why the 91�Թ�'s Temerty Faculty of Medicine has teamed up with the Ontario College of Family Physicians to launch a website – ConfusedAboutCOVID.ca – that provides the public with reliable and up-to-date information on COVID-19, including potential health impacts and public health guidance.

Tara Kiran (Photo courtesy of Unity Health)

A group of family doctors led by Tara Kiran created the site. She is a professor and vice-chair of quality and innovation in Temerty Medicine’s department of family and community medicine as well as a family doctor at St. Michael’s Academic Family Health Team, Unity Health Toronto.

The plain-language, online guide helps people understand current COVID-19 realities and answers common questions such as:

What do I do about my symptoms?
Can I see my relatives, or do I need to self-isolate?
When should I call my doctor?

The resource addresses seven questions, with more to be added as the Omicron situation evolves. The information is available in English and French, but more languages are due to be added.

“As family doctors, we are constantly fielding questions and trying to help our patients make sense of the latest guidance around COVID-19 and Omicron. These resources answer some of the most common questions from our patients, families and caregivers,” says Danielle Martin, professor and chair of family and community medicine at 91�Թ� as well as a family doctor at Women’s College Hospital.

Liz Muggah, president of the Ontario College of Family Physicians and a family doctor at Bruyère Family Medicine Centre, says Ontarians are increasingly confused and anxious about what they should do if they have been exposed to COVID-19, or tested positive for the virus.

“Throughout the pandemic, family doctors have been a reliable resource for Ontarians and now Ontario’s family doctors are making it even easier for Ontarians to access reliable information to their questions with ConfusedAboutCOVID.ca,” she says.

Navsheer Gill, faculty wellness lead for family and community medicine at 91�Թ�, says she is eager to tell her patients about the site, a one-stop shop for trustworthy and current information.

“Patients are frustrated by the time spent going click to click to click and still not finding what they need to know, and elderly patients face particular barriers,” she says.

Much of the current guidance tends to be long-winded, unclear and spread over many different places, making it hard for patients to get the answers they need, Gill adds. “With these documents, patients finally have a one-stop resource where they can find answers to questions most relevant to their lives,” she says.

Beyond COVID-19: How 91�Թ�'s Temerty Faculty of Medicine supports Indigenous health in Toronto

Christopher.Sorensen — Thu, 30 Sep 2021 17:25:34 +0000

Beyond COVID-19: How 91�Թ�'s Temerty Faculty of Medicine supports Indigenous health in Toronto

Christopher.Sorensen Thu, 09/30/2021 - 13:25

Cutline

The Auduzhe Mino Nesewinong COVID-19 clinic opened in October 2020 to provide integrated testing and case management, contact tracing, outreach supports and referrals (photo courtesy of Auduzhe Mino Nesewinong)

Amy Noise

Topic

Our Community

Coronavirus

Temerty Faculty of Medicine

Dalla Lana School of Public Health

Indigenous

St. Michael's Hospital

Women's College Hospital

As the 91�Թ� marks Orange Shirt Day and the first National Day for Truth and Reconciliation on Sept. 30, faculty members in the department of family and community medicine (DFCM) in the Temerty Faculty of Medicine are working to address the disproportionate impact of infectious diseases on Indigenous communities and dismantle systemic barriers that can prevent them from accessing care.

Toronto is home to more than 95,000 First Nations, Métis and Inuit – the largest population of Indigenous Peoples anywhere in the province. Only one in three of these individuals has a primary care provider, while 38 per cent live with two or more chronic diseases (compared to 15 per cent of adults in Canada) and 87 per cent live below the low-income cutoff.

Facing systemic inequities and ongoing discrimination that prevent access to care, the city’s Indigenous residents have also suffered from higher rates of severe illness from COVID-19 – with hospitalization rates as much as 40 to 80 per cent higher than for Torontonians generally, and twice as high as the general Ontario population.

“COVID-19 has exposed long-standing unequal distribution of health and social resources in our communities,” says Professor Janet Smylie, Indigenous health research lead in family and community medicine who is cross-appointed to the Dalla Lana School of Public Health and a scientist at Unity Health. “We need to address these inequities in concrete, tangible ways. But to do this we need to witness and track the scale of the issues. What’s counted, counts.”

With limited resources, Smylie, who is also a scientist at Unity Health, and Suzanne Shoush, the department family and community medicine's Indigenous health faculty lead and a physician at St. Michael’s Hospital, have been working with community organizations to build trust in the health system, support COVID-19 testing and vaccination, and collect data to inform research and policy changes.

The Auduzhe Mino Nesewinong COVID-19 clinic opened in October 2020 to provide integrated testing and case management, contact tracing, outreach supports and referrals. The Indigenous community-led centre is a collaboration between Na-Me-Res, Seventh Generation Midwives Toronto, Well Living House at St. Michael’s Hospital and the Centre for Wise Practices in Indigenous Health at Women’s College Hospital.

Meaning “Place of Healthy Breathing” in the Anishinaabe language, the Auduzhe Mino Nesewinong team has conducted more than 1,100 COVID-19 tests and administered over 6,800 COVID-19 vaccinations at Auduzhe and partnered clinics.

“We knew at the beginning of the pandemic that there was dire need to have a for-Indigenous by-Indigenous comprehensive COVID-19 response,” says Steve Teekens, executive director of Na-Me-Res, an emergency shelter and housing organization. “Our team has been able to provide culturally safe services in a warm inviting space, while providing quality services to our community members.”

Auduzhe Mino Nesewinong runs in tandem to We Count COVID-19, an Indigenous community-owned database about First Nations, Inuit and Métis COVID-19 spread led by Smylie, who is also the director of Well Living House.

“Community is the foundation of both the clinic and our research,” says Smylie. “The clinic is a critical part of the COVID-19 response. But looking ahead, we need the research component to challenge the policies that have led us to this point and make lasting change. The two go hand-in-hand.”

Given historic and ongoing abuse and discrimination that Indigenous Peoples experience within the Canadian health system, creating safe spaces with trusted partners has been key.

“The importance of this project is profound, in particular because it is a combination of service and research that is community-led. All systems are informed by the urban Indigenous community and designed specifically for that community – and the outreach and supports are based on Indigenous kinship systems of inclusion, care and self-determination,” said Cheryllee Bourgeois, exemption Métis midwife at Seventh Generation Midwives Toronto, speaking with Women’s College Hospital last year.

“To date, 50 per cent of Toronto’s First Nations, Métis and Inuit population has had two doses of a COVID-19 vaccine, leaving 50 per cent vulnerable to the disease,” says Smylie, who is Canada Research Chair in Indigenous Health. “Some days feel overwhelming, but other days I feel hugely optimistic – especially when I see colleagues across DFCM stepping up to staff our swabbing and vaccination clinics.”

Beyond COVID-19 and throughout the Canadian health-care system, Smylie and colleagues say there is significant work needed to eradicate anti-Indigenous discrimination, work to which we can all contribute.

“We need to recognize and fight [anti-Indigenous discrimination in hospitals] the same way we do infection,” they wrote in the Globe and Mail last year. “We need leaders who label it as a preventable and life-threatening organizational challenge, and who promote cross-system extermination, ongoing vigilance and prevention. We need action, including co-ordinated systems-level responses that hold individuals and institutions accountable.”

In an effort to overcome hesitancy, 91�Թ� physicians lead Black Health Vaccine Initiative

Christopher.Sorensen — Wed, 05 May 2021 15:48:55 +0000

In an effort to overcome hesitancy, 91�Թ� physicians lead Black Health Vaccine Initiative

Christopher.Sorensen Wed, 05/05/2021 - 11:48

Cutline

91�Թ�'s Onye Nnorom (left) and Duate Adegbite (right) are helping lead the Black Health Vaccine Initiative (photo by Onye Nnorom)

Amy Noise

Topic

Our Community

Coronavirus

Temerty Faculty of Medicine

Black

Vaccines

The COVID-19 pandemic has had a disproportionate impact on racialized groups, with Black communities among the hardest hit.

To address this inequity, the Black Physicians’ Association of Ontario (BPAO) is leading the Black Health Vaccine Initiative, which includes family doctors from the 91�Թ�’s department of family and community medicine (DFCM) in the Temerty Faculty of Medicine.

The initiative aims to support advocacy, education and vaccination efforts in Ontario’s Black communities.

“Black people are over-represented in front-line roles – in factories, as personal support workers and other essential services,” says Onye Nnorom, BPAO president and the department of family and community medicine’s equity, diversity and inclusion lead.

“Many don’t have the luxury of working from home, or the housing conditions to isolate when needed.”

The BPAO recently shared City of Toronto data from December 2020 that showed COVID-19 rates and hospitalizations were three times higher for Black people who live in Toronto, compared with white people.

A Statistics Canada report from March 2021, meanwhile, indicates that 49 per cent of Canadians say they are not likely to get a vaccine. For Black Canadians, the figure rises to 77 per cent.

Systemic health gaps and social inequities have put Black Canadians at higher risk of contracting COVID-19 and underpin education, employment and income disparities, Nnorom says.

She adds that a distrust of the COVID-19 vaccine – and public services in general – stems from centuries of anti-Black racism that has resulted in a systemic inequity of power, resources and opportunities that discriminates against people of African descent.

A key component of the Black Health Vaccine Initiative is the Network of Black Vaccinators (NBV): Black and BIPOC physicians working closely with community partners to build vaccine confidence and increase vaccine uptake in Black communities.

Duate Adegbite has been performing vaccinations at TAIBU Community Health Centre, as part of a clinic that officially launched in April with support from Scarborough Health Network and 91�Թ�’s department of family and community medicine. The clinic serves primarily Black, Indigenous and francophone communities, as well as the local Malvern community.

“The clinic has been a culturally safe space for people to get vaccinated,” says Adegbite, a lecturer in the department of family and community medicine and physician NBV lead at TAIBU.

“We’ve had many patients come in and say they’ve never seen so many Black doctors. This creates a level of comfort because people see themselves reflected in who’s providing their care – from administrative staff, to doctors and nurses,” says Adegbite, who is also a family doctor with Toronto Western Family Health Team.

Dominick Shelton, an assistant professor in the department of family and community medicine and co-lead for the Black Vaccinators Network, says the response to vaccinations at TAIBU has been overwhelming.

“Black and other racialized physicians are helping to overcome vaccine hesitancy in Black communities,” says Shelton, an emergency physician at Sunnybrook Health Sciences Centre. “We are having important conversations with people and our mere presence as a vaccinator is sending a message of confidence in the COVID vaccine.”

The Black Health Vaccine Initiative is currently focused on pop-up clinics in hot-spot neighbourhoods. The first of these pop-ups will be hosted with the Jamaican Canadian Association on May 8 and 9 in partnership with Black Creek Community Health Centre. Future pop-ups are planned across the city, in Peel Region and beyond.

To reach and vaccinate those that are hardest hit, community partnerships are key, say those involved in the project.

“Community health centres already have established relationships and are trusted by the communities they serve,” says Adegbite, who has been a BPAO member since being in the 91�Թ� MD program over 10 years ago.

“Getting information from someone who you trust helps to dispel vaccine hesitancy. Working at community centres, we have more time to sit and talk with people who have questions.”

David Esho, an assistant professor in the department of family and community medicine, is leading the mobile and pop-up vaccine clinics in Toronto as part of the Black Health Vaccine Initiative.

“We are very aware of vaccine distrust and hesitancy in Black communities, so we’re working to recruit Black health professionals to act as vaccinators and educators,” says Esho, who is also a family physician with the Toronto Western Family Health Team.

“I am very proud of the work we are doing at BPAO. We have focused on the importance of relationship building in our vaccination efforts and utilized our links with community agencies, DFCM and our hospital partners to bring vaccines to members of our community who may not otherwise have been able to access them.”