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Disability rights groups decry Ford government ‘secrecy’ about COVID-19 triage guidelines

A coalition of disability rights groups is calling on government to make public the directions they plan to give hospitals about how to decide who should be prioritized for life-saving treatment if intensive care units become overwhelmed with patients.

The call comes after the government’s initial COVID-19 triage protocol — which , but was never officially released — was rescinded after it was .

“We write about a life-and-death issue now facing Ontarians,” reads the , signed by more than 60 organizations and sent Thursday to Ford, Health Minister Christine Elliott and Raymond Cho, the minister responsible for seniors and accessibility.

The letter calls on the province to immediately release the latest recommendations from its Bioethics Table — the government-appointed group of physicians and bioethicists advising the ministry on a number of COVID-related issues — and ensure that any new triage guidelines “respect the constitutional and human rights of all patients, including patients with disabilities.”

The purpose of a triage protocol, which would be invoked only if critical care resources needed to be rationed, is to minimize overall mortality by prioritizing patients with the best chance of survival.

Among the concerns raised by disability advocates about the government’s initial protocol was its inclusion of the Clinical Frailty Scale, a nine-point grading tool they said was inherently discriminatory against people with disabilities and could lead to their exclusion from life-saving treatment.

In their letter, the organizations commend the government for rescinding the initial protocol, but the fact that nothing has taken its place also poses a danger.

“If critical care triage becomes necessary, decisions over who gets refused life-saving critical care would be wrongly left to individual hospitals and doctors without safeguards against the serious danger of arbitrary and discriminatory decisions made because of disability,” the letter reads.

Roberto Lattanzio, executive director of the ARCH Disability Law Centre, said the province needs to ensure that any new policy protects the rights of people with disabilities.

“The pandemic doesn’t give governments a pass on ensuring that human rights and constitutional rights are respected,” he said in an interview. “We’ve been advocating for a framework free of discrimination for eight months now and now we find ourselves in a very similar situation as we did from the outset.”

While the number of active COVID-19 cases in Ontario is nearly three times as high as during the peak of the first wave in the spring, hospitalizations and admissions to intensive care units (ICUs) are actually lower now than they were then. On Wednesday, . On May 1, by comparison, there were more than 1,000 COVID patients in hospital, including 225 in ICUs.

The province in April, increasing the number of ICU beds by nearly 1,500 to a total of 3,504. Roughly half of the province’s ICU beds were occupied as of Dec. 1, according to Critical Care Services Ontario’s daily report.

Last month, , Progressive Conservative MPP Robin Martin confirmed the government had rescinded its initial protocol, which she said was only a draft, and that a “revised framework may be shared … should pandemic conditions deteriorate significantly.”

But, Martin said: “We don’t anticipate getting anywhere near having to use such a protocol.”

David Lepofsky, chair of the Accessibility for Ontarians with Disabilities Act Alliance, said cases have steadily increased since Martin’s assurances, and the lack of action by the government is inexcusable.

“They can’t wait until the day where they need triage and then say, ‘By the way, here are the rules.’ ”

The health ministry ignored specific questions for this story and instead sent a 265-word statement, which says, in part, that the ministry asked the Bioethics Table to “ensure that concerns and perspectives of those representing Indigenous people, Black and racialized communities, persons with disabilities, and others who may be disproportionately affected by critical care triage due to systemic discrimination, are meaningfully considered and reflected in a revised protocol.”

A ministry spokesperson did not respond to a follow-up question asking whether the government intended to make the revised protocol public.

Lattanzio and Lepofsky both decried the government’s lack of transparency about the protocol, a criticism that has also been raised by and .

“What’s the secret?” Lepofsky said. “There is no plausible reason for them to keep secret whatever the Bioethics Table recommended. There’s nothing served in the public interest.”

Brendan Kennedy is a Toronto-based social justice reporter for the Star. Follow him on Twitter:

5 things your workplace can do to help prevent COVID-19 outbreaks

Physical distancing measures have proven to significantly reduce the spread of COVID-19, and many people can achieve a safe physical distance from others by working from home.

For those whose jobs involve being in a workplace with other employees, and often the public, the risk of contracting COVID-19 is higher. Employers have a responsibility to put protocols in place that will reduce the likelihood of workplace outbreaks and protect employees.

In their “Working in a bubble: How can businesses reopen while limiting the risk of COVID-19 outbreaks?” researchers from the University of Calgary, Queen’s University, the University of Toronto, Toronto General Hospital and Harvard University outlined some of the ways employers can achieve this.

According to the authors, and these are the protocols your employer should have in place.

COHORTING

Just like students in elementary and high school are separated into class cohorts, the employers should place employees into cohorts, or bubbles, consisting of the least number of people necessary to do a given job without needing to interact with other staff outside their cohort.

People working in cohorts should only interact with one another, and there shouldn’t be any interaction between cohorts. These bubbles should kept separate from one another through the creation of a rotating work schedule, through physical separation within the workplace or both. In other words, they should be separate in time, space or both.

If someone needs to move into a different work cohort, there should be a five-day gap between their last day with one cohort and their first day with another, to wait out the incubation period of the virus.

STRATEGIC STAFFING AND SCHEDULING

say employers may need to lower staffing levels at the workplace to maintain appropriate physical distancing, or else look at how they can adjust or stagger employees’ work schedules to support physical distancing while maintaining the same staffing levels.

EMPLOYEE AND VISITOR SYMPTOM SCREENING

Employees should be for COVID-19 symptoms before the start of their shift. An employee experiencing any COVID-like symptoms — fever, cough, etc. — should be told to go home and contact their local public health unit to discuss their testing options. 

In workplaces where staff interact with the public, before entering and should not enter if they have any symptoms.

CONTACT TRACING

As long as workplace cohorts are carefully managed and employers keep logs of when employees worked and who they worked with, an employee who tests positive for COVID-19 can notify their employer, who can

CLEANING

Shared work tools and commonly-touched surfaces after each use.

Radius outbreak linked to SpinCo, restaurant says

Hamilton’s SpinCo outbreak is now linked to a second outbreak, says a nearby downtown restaurant.

On Thursday, Hamilton public health reported an outbreak at Radius restaurant, declared Wednesday after three staff members tested positive. The outbreak comes in the wake of the growing SpinCo outbreak, declared Oct. 5, which hit 72 cases on Thursday.

“Our first case has been linked to the local spin studio outbreak,” Radius confirmed in a statement on Thursday.

Owner Ian Ladd said in an email he did not have additional information on how the case was connected to SpinCo, including if the employee was exposed to the virus at a spin class.

Hamilton public health said it was too soon in their investigation to say if the Radius outbreak was tied to SpinCo.

The news comes as positive cases at climbed to 72 on Thursday, with one new patron infected and two new secondary contacts infected. In total, 45 riders, two staff and 25 secondary contacts — close contacts of primary cases — have tested positive.

SpinCo is located at 80 James St. N., blocks away from Radius at 151 James St. S.

Radius customers who visited the restaurant on Oct. 9 or 10 — when an infected staff member worked without knowing they were sick — are encouraged to contact Hamilton public health directly if they have questions, the restaurant said in the statement.

Radius says Hamilton public health told them the risk to customers is “low.”

“Employees are being tested, and all have been asked to self-isolate at home until test results are known,” the statement reads.

The restaurant closed Oct. 13 and plans to remain closed until Oct. 21.

“While we are closed, we will continue our safety measures; thoroughly cleaning, and sanitizing the entire restaurant,” Radius says.

Meanwhile, McMaster University reported its on campus Wednesday.

The university said a student employee who worked at the campus services building on Oct. 2 has now tested positive. The building has been cleaned and public health is conducting contact tracing.

Over at St. Joseph’s Healthcare, a worker is confirmed to have contracted the virus, the hospital said Thursday.

“A health-care worker exposed in the community provided care at our Charlton site, and contact tracing was initiated right away,” St. Joe’s said in a statement. “As the worker wore appropriate personal protective equipment and followed infection prevention controls and protocol, risk of transmission was very low.”

Seven patients are currently in isolation “out of an abundance of caution” but all tested negative for COVID-19, the hospital said.

Aside from Radius and SpinCo, other ongoing include Salvation Army Lawson Ministries Assisted Living, which has one case in a staff member; Dundurn Place Care Centre’s fourth floor, which has one case in a staff member and a second case; Sacred Heart of Jesus Elementary School, which has two staff infected; Shannen Koostachin Elementary School, which has two staff infected; and Kushies Baby store, which has three staff infected.

Hamilton’s COVID-19 cases increased by 30 Thursday, bringing the city’s cumulative case tally to 1,466. There are 196 active cases. Of all cases, 83 per cent are considered resolved.

Katrina Clarke is a Hamilton-based reporter at The Spectator. Reach her via email:

Suspected impaired driver crashes into parked vehicles in Innisfil

A 51-year-old Innisfil woman is charged with impaired driving after her vehicle collided with two parked cars, then veered off the road into a ditch Nov. 17.

She was not injured.

South Simcoe Police say the vehicles sustained “significant” damage in the collision on 25th Sideroad at about 11:30 p.m.

The driver was arrested at the scene and taken to the North Division station in Innisfil where she was charged.

Her licence was suspended for 90 days and her vehicle impounded for seven days.

Penetanguishene tightens entry to arena and museum

Heeding advice from Dr. Charles Gardner, The Town of Penetanguishene is restricting access to the Penetanguishene Memorial Community Centre and Penetanguishene Centennial Museum.

Earlier this week, Gardner, the Simcoe Muskoka District Health Unit’s medical officer of health, issued an advisory letter to municipalities strongly recommending they prohibit access to their recreational facilities to anyone whose primary home is within the ‘red’ (control) and ‘grey’ (lockdown) levels on Ontario’s colour-coded COVID-19 restriction framework.

Simcoe Muskoka in is in the ‘orange’ (restrict) level.

In response, Penetanguishene has put in place the following measures:

Penetanguishene Memorial Community Centre: Starting immediately, people who live in ‘red’ or ‘grey’ classified communities cannot enter the arena.

Penetanguishene Centennial Museum: As of Nov. 28, all visitors to the museum must book an appointment to visit, access the gift shop, or utilize the genealogy and history research room. Appointments can be made by calling the museum at or through email at . The museum also asks that all individuals whose primary residence lies within the ‘red’ and ‘grey’ areas not visit the museum at this time. 

For more information about Ontario’s colour-coded COVID-19 restriction framework visit:

Simcoe Muskoka Catholic school board gets new director

A new director is taking over the top spot at the Simcoe Muskoka Catholic District School Board.

The trustees have selected Frances Bagley as the new director of education.

Bagley is currently the associate director of education with the York Catholic District School Board.

“We have every confidence that her strong strategic leadership skills, experience and commitment to collaboration, will serve our system very well in the years ahead,” board chairperson Joe Zerdin said in a press release.

For the past three months, the Catholic board was led by Catherine McCullough, who was serving in an interim role after Brian Beal retired.

“One of my key areas of focus will be serving the students entrusted to our care through community-engagement opportunities that focus on student achievement, well-being and success,” Bagley said.

Navigating through the COVID-19 pandemic will present opportunities and challenges, she added.

“I know that the collaborative work of many minds, hands and hearts will continue to guide us in a proactive, innovative and supportive manner.”

Bagley begins her new role Nov. 1.

Boat launch bust for Innisfil driver

Parking at the Innisfil Beach Park boat launch turned into a costly decision for an Innisfil woman.

South Simcoe police were on patrol in the area Dec. 1 at 9:52 p.m. and approached a vehicle, which was still running.

After speaking with the 57-year-old driver, an officer gave her a roadside breath test, which she allegedly failed. She was taken to the Innisfil police station for further testing.

However, the woman refused, and was charged with failure or refusal to comply with demand. Her licence was suspended for 90 days and car impounded for a week.

Sketch of Barrie sexual assault suspect released

Barrie police has released an artist’s rendition of a sexual assault suspect and created a dedicated tip line.

Investigators are looking for any information in connection with sexual assault in Hurst Park on Oct. 1 between 9 and 10 p.m.

The tip line is .

Police say a woman was walking her dog in the park located at when she was attacked by a male stranger. 

Police are releasing few details, including whether the victim was physically injured.

Officers have already done a door-to-door canvas of the immediate neighbourhood looking for information.

The suspect is described as:

• A white male between the ages of 16 and 26, about 5-feet, 8 inches tall, with a slim build and shaved blond hair.

• Wearing an Under Armour top of unknown colour.

Anyone with information is asked to call or , ext. 2700, send an email to , by contacting Crime Stoppers at (8477), or leave an anonymous tip online at .

Our essential workers are burning out. Advocates say a lack of basic job protections is to blame

Stephanie Walker returned to work in early childhood education in March, not long before the COVID-19 pandemic forced her child-care centre to temporarily close.

She had taken several months off from the industry to recover from burnout — time off she doesn’t think she would have needed if she’d had better wages and access to supports like paid sick days.

“It would have made a world of a difference,” she says.

She’s not alone. Long before the COVID-19 pandemic highlighted the precarity of care work in Canada, the child-care sector was seeing high rates of turnover. Many early childhood educators and child-care workers don’t have paid vacation or sick days and earn just above minimum wage, says Walker, adding that pay and benefits are often slightly better at not-for-profit child-care centres.

Walker, 24, of Richmond Hill, feels the work she does is systematically undervalued, evidenced by the instability of jobs in child care — the majority of which are filled by women.

“Just because we choose a role in a care industry like early childhood doesn’t mean that we don’t deserve to be paid appropriately,” she says.

Early childhood educator Kim Bradley agrees.

She sees her field of work continuously misunderstood, often dismissed as “child-minding” or “babysitting.” The pandemic is increasing rates of burnout in an industry that already sees high turnover, she says.

“We’re done. We’re exhausted.”

What is precarious work?

Experts and advocates agree, more or less, that precarious work means having no control over hours or wages, resulting in unpredictable earnings. It also involves a lack of basic worker protections such as paid sick leave and health benefits.

The precarity of work is shaped by the relationship between a person’s employment status, form of employment and social location, such as their gender, race or immigration status, says Leah Vosko, a York University political scientist and co-author of the 2020 book “Closing the Enforcement Gap: Improving Employment Standards Protection for People in Precarious Jobs.”

Though precarious work can occur in any industry, it’s most common in accommodation and food service, retail, agriculture and care work, Vosko says. It’s also much more common among workers between 15 and 24.

And precarious workers are more likely to be women, people of colour, or recent immigrants, she says.

Alana Powell, executive co-ordinator for the Association of Early Childhood Educators of Ontario, defines precarious work based on precisely what the workers she represents don’t have: competitive wages, full-time and stable employment, benefits and pensions.

“They feel like their work is invisible,” Powell says.

Workers’ Action Centre executive director Deena Ladd says the pandemic has shone a spotlight on “essential work,” from child care to cleaning to workers on the front lines in grocery stores. And yet not much has changed about these jobs since the pandemic began, she says.

“These are all superheroes, they’re on the front lines, but unfortunately that hasn’t translated into systemic changes.”

Vosko says COVID-19 has shown deficiencies in many workers’ access to paid sick leave and caregiving leave, as well as the fact that anyone considered self-employed is more likely to have limited access to benefits and supports.

“Because so many social benefits and entitlements flow from the presence of an employment relationship between the worker and employer, that means that people who are engaged as self-employed often … lack social benefits and statutory entitlements,” Vosko says.

Armine Yalnizyan, an economist and the Atkinson Fellow on the Future of Workers, says COVID-19 has specifically highlighted the precariousness of care work, such as in long-term care.

“Personal care, particularly for the elderly, is an industry that is marked by the most inhumane human-resource standards, because it is so dominated by for-profit considerations,” she says.

If someone can’t afford to miss a day of work, they’re less likely to stay home when COVID-19 symptoms appear, she says. “People are dying because of this.”

Some provinces have addressed this better than others, says Katherine Scott, senior researcher with the Canadian Centre for Policy Alternatives. For example, British Columbia prevented workers from working in multiple homes early in the pandemic, but also temporarily guaranteed full-time hours to workers and boosted wages, something the provincial NDP pledged to continue if re-elected.

‘This isn’t liberation’

Gig workers, freelancers and the self-employed are often subject to precarious work, and usually don’t qualify for the same government supports as traditional employees.

Over the past several years, there has been a growth in the gig economy, through apps such as Uber or DoorDash, and websites including Fiverr or TaskRabbit.

As the country emerges from the recession caused by the pandemic, reliance on these workers will only rise, Yalnizyan says.

After every recession, there is a spike in on-demand, task-based labour with employers wanting to save money, and more people looking for work or extra cash, she says. This time, that spike in demand will be met with labour over apps and websites, she said.

Jim Stanford, director of the Centre for Future Work, says the gig economy is just the latest version of what’s been happening for centuries: on-demand labour hired through an intermediary who takes some of the profit.

This “triangular relationship” allows companies to classify workers as “independent contractors” instead of employees relieving them of the responsibility to provide benefits and stability, Stanford says.

People will turn to this kind of work when they have no choice, he says.

“This isn’t liberation. This isn’t flexibility. This is desperation.

“And I’m worried because of this big shock that we’ve experienced in our labour market … especially among marginalized communities, that level of desperation is going to get worse.”

What needs to change?

Experts and advocates say existing safety nets such as Employment Insurance need to be permanently broadened to include precarious workers, and that the definition of a worker, or an employee, needs to change.

The EI system — currently bolstered by a suite of temporary supports for those who wouldn’t otherwise qualify — was created based on a now-outdated idea of what most jobs look like, says Scott.

“The fact that we had to roll out emergency programs is testament to that fact,” she says.

Workers need better safety nets, such as health-care coverage, so they’re not reliant on jobs that treat them poorly, Yalnizyan says. She wants to see a program that would help people with the costs of moving for work, as well as tighter regulations for gig economy companies such as defining gig workers as employees.

New immigrants to Canada should be able to get residency status much faster so they don’t have to rely on low-paid, unstable work and become vulnerable to labour-law abuses, Ladd says.

Vosko agrees.

“When people are engaged doing jobs that are essential for a long period of time, it’s a shame that they don’t have access to pathways to permanency,” says Vosko. Improving overall working conditions such as raising the minimum wage, broadening access to income supports and expanding the definition of a worker, would benefit recent immigrant workers as well, she adds.

The national child-care strategy recently promised by the federal government needs to make care work a “viable career choice” so that workers remain in the field longer, says Powell.

This will benefit not just the workers, but the children as well, agrees Bradley.

Right now, she said, “The field is losing valuable early educators … the children are losing that support.”

This is part three of an ongoing series looking at the pandemic’s devastating effect on women in the workforce.

Rosa Saba is a Calgary-based business reporter for the Star. Follow her on Twitter:

Wearing a mask triggers flashbacks of rape. Woman says her refusal to wear one led to her being denied treatment in Ottawa hospital

Melanie Mills wore a face shield when she went to the Ottawa Hospital for a routine epidural to treat chronic pain in her lower back and legs.

Despite a posted policy specifically asking visitors to wear face masks during the , Mills had no problem getting into the hospital or making her way up to the neurology department for her appointment last August. But when the 58-year-old met her doctor, she says, he denied her the epidural unless she swapped her face shield for a mask. She struggled to explain why she couldn’t wear one, she says, but the doctor insisted and kept saying, “I don’t know what to tell you.”

The conversation frazzled Mills so much she couldn’t stop herself from telling the doctor exactly why she couldn’t wear a mask: that decades ago she was raped, her face pushed to the bed, and the feeling that she would suffocate remains so severe that her post-traumatic stress dampens every day of her life.

“I couldn’t think about this, talk about this, without crying,” says Mills of her interaction with the doctor, which she’s anxiously been replaying in the lead-up to her next scheduled appointment.

Face masks are one of the most visible symbols of the pandemic, proven to be one of the in curbing transmission rates even as they’ve become a individual freedoms. Debates still rage over whether businesses have the to unmasked customers. But even in places like Toronto that have adopted mandatory mask policies, those policies for people with medical conditions.

And yet, when it comes to underlying conditions, asthma is more likely to come to mind. Rape is not.

But sexual violence is common and women like Mills should not be put in a position where they have to defend their need for an accommodation, says Megan Walker, executive director of the London Abused Women’s Centre, in London, Ont. “The automatic response should be, ‘OK, how can we help you?’”

Michaela Schreiter, a spokesperson for the Ottawa Hospital, said she couldn’t comment on specific cases, but noted that when people are unable to wear a mask “staff will work with the patient to evaluate all options and find a manageable alternative solution.” Variations of that policy are in place at major hospitals across the province, including the University Health Network in Toronto and Hamilton General Hospital.

Walker notes that with help, sexual assault survivors might be able to cope, but for Mills “to have to defend to a complete stranger why she’s not able to wear a mask because of that… [it] can do great damage to that woman’s psychological and emotional health.”

Given that there’s no indication people are faking accommodation needs to avoid a mask, Walker says health-care providers should be taking women like Mills at face value when they say they need it and make a new plan. In the U.K., a sexual assault survivor whose PTSD is similarly triggered by having her mouth and nose covered, is advocating for clearly labelled that people could wear in public to avoid having to repeatedly justify why they aren’t wearing a mask.

Mills knows masks work and she knows face shields don’t provide equal protection. Indeed, numerous studies so far indicate face shields are not as effective as masks in preventing droplet transmission, although as a stopgap measure in cases where a person’s underlying medical condition makes mask-wearing impossible.

After being turned away at the hospital in August, Mills, who lives in Lanark County outside of Ottawa, received an alternative pain treatment from a local doctor, but says it’s “maybe 40 per cent as effective” to treat the spinal stenosis she’s had for 22 years.

Mills doesn’t work because of her disability, which requires her to use a cane, and a pain flare-up sometimes confines her to a wheelchair. The epidural offered at the Ottawa Hospital, which , typically provides pain relief within a few days that can last for months at a time.

When she is feeling well, Mills spends as much time as she can helping with community projects, everything from disability advocacy to food security and women’s issues, especially sexual violence. She says she was raped by someone she had previously been in a relationship with and that her rapist never faced any repercussions.

Mills is supposed to go back to the Ottawa Hospital for the specialized treatment in December, but first wants assurances they’ll accommodate her.

After her August appointment, Mills sent an email to patient relations: “I cannot negotiate a mask,” she wrote. “If there is no other way, I will forego treatment.”

In response, a triage co-ordinator wrote back to apologize “for the added stress the situation caused [her]” and said the office would set up a meeting to speak further.

Mills says her three children are some of her fiercest advocates. Her daughter, Meghan Valvasori, responded on her behalf, saying that while she understood the safety considerations, she urged patient relations to advocate for those with mental health disabilities who need medical care.

“[My mother’s] trauma is rooted in feelings of helplessness and entrapment,” Valvasori wrote. “This trauma is triggered, as she also details below, in response to activities that restrict her breathing, involve her mouth or face, or — and with respect, I gently point this out to you — when a detailed description of her disability is described as ‘concerns’ and her response as ‘added stress.’”

That was more than two months ago and Mills says a meeting has yet to happen.

Jennifer Hollinshead, a clinical counsellor who works with victims of sexual assault at the practice she founded, , says health-care providers sometimes need a reminder that mental health is not a sidenote to physical health and putting people into positions where they feel they need to justify their trauma response can have ripple effects.

“It can worsen physical health outcomes because the person might not want to engage with the medical system,” says Hollinshead, who is based in Vancouver.

It’s a human rights issue full-stop, says Walker.

Broadly requiring people to wear masks for legitimate health reasons is not a human rights violation, according to Rosemary Parker, a spokesperson for the Ontario Human Rights Commission. However, she says that “unless it would amount to undue hardship based on cost or health and safety,” organizations have a duty to accommodate individuals who cannot wear masks because of a disability, be it physical, developmental or mental.

“An inability to use a mask or other equipment must not lead to automatic negative consequences such as complete denial of service,” Parker says.

Mills says her pain cuts into her sleep and limits how much she can do. She’s hoping she’ll be able to go back for an epidural next month, but she meant what she said in her email to the hospital: if they can’t accommodate her, she’ll stomach the pain.

“As a woman who has experienced a lifetime of trauma and a lifetime of being dismissed as not important… I had to fight really, really hard to make myself believe that I’m not worthless,” she says.

“[That doctor] immediately dismissed me and it put me right back down to that place.”