Decisions

The Board of Health recommends that:

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

2.  City Council:

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

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

The Board of Health:

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

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

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

2.  Requested the Medical Officer of Health to:

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

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

3.  Requested the Medical Officer of Health to:

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

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

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

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

4.  Requested the Medical Officer of Health to:

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

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

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

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

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

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

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

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

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

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

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

The Board of Health:

1.  Appointed the following Board of Health directors to the Board of Health Budget Committee for a term of office ending on December 31, 2020, and until successors are appointed:

Councillor Joe Cressy

Trustee Stephanie Donaldson

Councillor Mike Layton

Councillor Gord Perks
Peter Wong

2.  Appointed the following Board of Health directors to the Board of Health Performance Appraisal of the Medical Officer of Health Committee for a term of office ending on December 31, 2020, and until successors are appointed:

Councillor Joe Cressy

Kate Mulligan

Councillor Kristyn Wong-Tam

3.  Appointed Kate Mulligan to the Association of Local Public Health Agencies' (alPHa) Board of Directors and Board of Health Section for a term of office ending on December 31, 2020, and until a successor is appointed and agreed to pay expenses incurred for attending alPHa's 2020 meetings and semi-annual meetings/conferences within Toronto Public Health's Approved 2020 Operating Budget.

4.  Encouraged all Board of Health directors to attend the Association of Local Public Health Agencies' (alPHa) Board of Health Section meetings and semi-annual meetings/conferences in Toronto and agreed to pay expenses incurred for attending alPHa's 2020 meetings and semi-annual meetings/conferences in Toronto within Toronto Public Health's Approved 2020 Operating Budget.

This report provides the Board of Health with an overview of its current formal and informal committees. The Board of Health is asked to appoint new directors to the Budget Committee and Performance Appraisal of the Medical Officer of Health Committee. The Board of Health is also asked to appoint a director of the Board of Health to the Association of Local Public Health Agencies' Board of Directors and Board of Health Section.

The Board of Health recommends that:

1.  City Council authorize the Medical Officer of Health to award, execute, and amend, on an ongoing annual basis, the purchase of service contracts for the Ontario Seniors Dental Care Program in Appendix E to the report (June 23, 2020) from the Medical Officer of Health, within Toronto Public Health's Approved 2020 Budget and in accordance with established provincial criteria and fee structures.

The purpose of this report is to provide information on the purchase of service contracts awarded and executed by the Medical Officer of Health for 2020, according to the delegation of authority by City Council.

The Board of Health recommends that:

1.  City Council appoint the physicians in Confidential Attachment 1 to the report (June 17, 2020) from the Medical Officer of Health as Associate Medical Officers of Health for the City of Toronto Health Unit.

2.  City Council forward its decision to the Ontario Minister of Health for the approval of the Associate Medical Officer of Health appointments in Recommendation 1 above.

3.  City Council authorize the introduction of the necessary Bill in City Council to appoint the physicians in Confidential Attachment 1 to the report (June 17, 2020) from the Medical Officer of Health as Associate Medical Officers of Health, subject to approval by the Ontario Minister of Health.

4.  City Council authorize the public release of Confidential Attachment 1 to the report (June 17, 2020) from the Medical Officer of Health, once adopted by City Council.

This report recommends the appointment of two public health physicians as Associate Medical Officers of Health (AMOH) for the City of Toronto Health Unit and updates the status of AMOH appointment By-laws.

The Board of Health:

1.  Requested the Medical Officer of Health to report in the fourth quarter of 2020 on advancing a public health approach to community violence in Toronto, including an update on the City Council and Board of Health decisions arising from Item HL11.1, Community Violence in Toronto - A Public Health Approach.

Community violence is a social determinant of health, with physical and mental health impacts for those who are victimized and those who commit acts of violence, as well as friends and family, and whole communities.

As the Medical Officer of Health reported to the Board in 2019, the root causes of community violence include: poverty, racism, racial/ethnic and gender inequities, discriminatory and stigmatizing educational practices such as zero tolerance, counterproductive criminal justice policies including over-incarceration, and a lack of economic opportunity.

It is no coincidence that the root causes of community violence have much in common with two other public health crises that our city is working to overcome today: anti-Black racism and COVID-19. Maps of COVID-19 incidence, neighbourhoods where Black Torontonians live, and community violence will reveal similar, all too familiar patterns.

The Board of Health and City Council endorsed numerous recommendations arising from Item HL11.1, Community Violence in Toronto - A Public Health Approach, this past year, with actions for all levels of government as well as the Medical Officer of Health.

I am writing to recommend that the Board of Health request a status update on this important work to advance a public health approach to community violence.