Ontario’s COVID-19 triage protocol ‘discriminates because of disability,’ advocates say


When Tracy Odell experienced bleeding in her stomach last summer during the first wave of the COVID-19 pandemic, she went to hospital but vowed she would not return.

“I don’t feel safe in hospitals and a lot of people with disabilities similar to mine, where you need this much assistance, don’t feel safe in a hospital,” she said.

Odell was born with spinal muscular atrophy and requires assistance to complete many daily tasks.

Now, amid the third wave and with critical care units filling up, Odell said she fears if she ever needed the care, she would not be able to get it.

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“I, personally, wouldn’t go to a hospital. I would feel it would be a waste of time and I’d feel very unsafe to go thereIt’s a real indictment, I think, of our system, that people who have disabilities, have severe needs, don’t feel safe in a place where everyone’s supposed to be safe,” she said.

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Odell is most concerned about a “critical care triage protocol” that could be activated in Ontario.

It would essentially allow health-care providers to decide who gets potentially life-saving care and who doesn’t.

Under the guidelines, as set out in a draft protocol circulating among hospitals, patients would be ranked on their likelihood to survive one year after the onset of critical illness.

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“Patients who have a high likelihood of dying within twelve months from the onset of their episode of critical illness (based on an evaluation of their clinical presentation at the point of triage) would have a lower priority for critical care resources,” states the document.

Odell says it’s tough to predict who will survive an illness.

“They have to guess who’s going to last a year ... As a child with my disability, my projected life expectancy was like a kid … they didn’t think I’d live to be a teenager and here I am retired, so it’s a very hard thing to judge,” said Odell.

Disability advocates have been raising alarm bells over the triage protocol for months.

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David Lepofsky, of the Accessibility for Ontarians with Disabilities Act Alliance, sent multiple letters to Minister of Health Christine Elliott demanding transparency, arguing “the Ontario government’s pervasive secrecy over its critical care triage plans has made many people with disabilities terrified, angry and distrustful.”

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“People with disabilities have disproportionately had to suffer for the past year from the most severe aspects of COVID … People with disabilities are disproportionately prone to end up in intensive care units and die from the disease,” said Lepofsky.

“Now we face the double cruelty that we are disproportionately prone to get told, ‘No, you can’t have that life-saving care.’”

Lepofsky said the document that is circulating, while not finalized, is problematic, unethical and discriminatory.

“The rules that have been given to intensive care units for deciding who gets critical care and who doesn’t, if they have to ration, may look fine because they’re full of medical jargon, but they actually explicitly discriminate because of disability,” he said.

“We agree there should be a protocol, but it can’t be one that discriminates because of disability. That’s illegal.”

John Mossa, who is living with muscular dystrophy, has been homebound for more than a year, afraid he would contract COVID-19 if he went outside and not survive it.

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“COVID is a very serious disease for me … if I do get COVID, I would probably become very ill and pass away because of my poor respiratory condition. I have about 30 per cent lung capacity due to my muscular dystrophy so COVID is very serious. It’s been a very scary time,” he said.

Never more frightening than right now, Mossa said, amid a surging third wave with a record number of patients in Ontario’s critical care units and the potential for triaging life-saving care.

“The people that would be affected the most are the least considered to get care … I’m afraid, I’m totally afraid to go to hospital right now,” he said.

A few weeks ago, Mossa said, he had a hip accident but he has avoided the hospital, even though he is suffering and should seek medical help.

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“I should be considering going to hospital, but I’m not going to go to hospital because I know that I won’t get the care I need and if it gets any worse. I know that I wouldn’t be given an ICU bed,” he said.

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On Wednesday, when asked about the triage protocol, Elliott said it has not yet been activated.

That was echoed by Dr. James Downar, a palliative and critical care physician in Ottawa who co-wrote Ontario’s ICU protocol.

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“I don’t think that there’s any plan to initiate a triage process in the next couple of days. I think a lot is going to depend on which way our ICU numbers go. They have been climbing at a fairly alarming rate,” he said.

On concerns by advocates that the protocol discriminates against people with disabilities, Downar said, “The only criterion in the triage plan is mortality risk.”

“We absolutely don’t want to make any judgments about whose life is more valuable, certainly nothing based on ability, disability or need for accommodations … If you value all lives equally, that, I think, is the strongest argument for using an approach that would save as many lives as you can,” he said.


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Ontario to allow hospitals to move patients to long-term care, retirement homes to create room for COVID-19 patients


Ontario to allow hospitals to move patients to long-term care, retirement homes to create room for COVID-19 patients





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Group urges province to open COVID-19 vaccine pre-registration to all Ontarians


A Toronto city councillor and a group of health-care professionals are calling on the province to open COVID-19 vaccine pre-registration to all Ontarians in a bid to improve the rollout of shots.

Coun. Josh Matlow and health-care professionals from the University Health Network and the University of Toronto, posted an open letter to Premier Doug Ford, Health Minister Christine Elliott, and the co-chairs of the COVID-19 science advisory table on Wednesday.

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“While the vaccine rollout offers an end in sight to the COVID-19 pandemic, too many Ontarians who have yet to be eligible for the current phase of the vaccination plan are left feeling anxious about when, and how they’ll learn that their turn will finally come,” the letter said.

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“That is why we recommend the province offer a specific category on their call-in and online booking systems that gives Ontarians an opportunity to pre-register for the vaccine.”

The letter said residents should be able to enter their date of birth, postal code, and contact information and get onto a registration list.

“Once eligible, Ontarians could receive an email and/or text message outlining the next steps on how to officially book their vaccine appointment and applicable location(s),” the letter said.

They said this could improve the management of vaccine supply, offer insight into vaccine hesitancy, and give residents the feeling of being closer to overcoming the pandemic.





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Phase 2 of Ontario’s vaccine plan to focus on age, neighbourhood and health conditions in April


The Ontario government says there will be a focus on seniors aged 60 and older, those in other congregate settings, hot spot regions and those who cannot work from home in an updated vaccine rollout plan on Friday.

According to the documents, the vaccine rollout firstly targets death prevention, followed by prevention of illness, hospitalization and ICU admission, and transmission reduction.

The province is currently wrapping up Phase 1, in which those living in long-term care homes, retirement homes, as well as staff and front-line workers were targeted. Over 820,000 doses have been administered and over 269,000 Ontarians have been fully immunized with two shots.

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Officials noted that the plan does not factor in the newly approved Johnson & Johnson shot and additional doses of the Pfizer-BioNTech’s vaccine, which was announced on Friday.

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Health officials said timelines are amendable and may change based on vaccine supply.  There are currently four vaccines approved in Canada: Pfizer, Moderna, AstraZeneca and Johnson & Johnson. The first three require two shots several weeks apart while Johnson & Johnson only requires one.

Retired Gen. Rick Hillier, the head of the province’s vaccine rollout said with the approval of the new vaccines, the hope will be that everyone who wishes to be vaccinated will have at least their first dose by the end of June, or potentially by the first day of summer on June 20.

Phase 2 of Ontario’s three-phase rollout plan will see shots administered based on risk factors including age, neighbourhood, existing health conditions and inability to work from home.

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This strategy focuses on the 2.5 million Ontarians between the ages of 60 and 79 years old.

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Residents over the age of 80 will be vaccinated first in March, followed by those over 75 years old, over 70 years old, over 65 years old and over 60 years old with the target end date to be done by the beginning of June.


The Phase 2 sequencing provided by the Ontario government.


Ontario government


Health Conditions and Congregate Settings

This strategy focuses on the 2.9 million Ontarians living with health conditions and the 0.2 million Ontarians living in congregate settings. This group will begin to be vaccinated in April.

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Ontarians living with the following health conditions will be vaccinated in Phase 2:

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Highest-risk (442,000)

  • organ transplant recipients
  • hematopoietic stem cell transplant recipients
  • people with neurological diseases in which respiratory function may be compromised
  • haematological malignancy diagnosed <1 year
  • kidney diseases eGFR<30

High-risk (292,000)

  • Obesity (BMI>40)
  • Other treatments causing immunosuppression
  • intellectual or developmental disabilities

At-risk (2.2 million)

  • immune deficiencies and autoimmune disorders
  • stroke/cerebrovascular disease
  • dementia
  • diabetes
  • liver disease
  • all other cancers
  • respiratory diseases
  • spleen problems
  • heart disease
  • hypertension with end organ damage
  • diagnosis of mental disorder
  • substance use disorders
  • thalassemia
  • pregnancy
  • immunocompromising health conditions
  • other disabilities requiring direct support care in the community.

At-risk staff, essential caregivers and residents in congregate settings will be vaccinated in this category.

  • supportive housing
  • developmental services/intervenor and supported independent living
  • emergency homeless shelters
  • other homeless populations not in shelters
  • mental health and addictions congregate settings
  • homes for special care
  • violence against woman shelters and anti-human trafficking residents
  • children’s residential facilities
  • youth justice facilities
  • indigenous healing and wellness
  • provincial and demonstration schools
  • on-farm temporary foreign workers
  • bail beds and indigenous bail beds
  • adult correctional facilities

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This strategy focuses on the 900,000 Ontarians living in targeted hot spot regions, who have high rates of death, hospitalizations and transmission. These hot spot regions will still focus on older age groups first. The vaccination process will begin in April and is expected to be completed by the end of May.

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The following 13 public health units will receive up to 920,000 additional vaccine doses to target “historic and ongoing hot spots,” according to the documents.

  • Durham
  • Halton
  • Hamilton
  • Niagara
  • Ottawa
  • Peel
  • Simcoe Muskoka
  • Waterloo
  • Wellington Dufferin Guelph
  • Windsor Guelph
  • Windsor Essex
  • York
  • Toronto
  • South West

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This strategy focuses on the almost 2.5 million Ontarians who cannot work from home amid the pandemic. These residents are broken into two groups and those who fall under this category will be vaccinated at the end of Phase 2 expected to be around June.

The first group contains 730, 000 people:

  • elementary/secondary school staff
  • workers responding to critical events (police, fire, compliance, funeral, special constables)
  • childcare and licensed foster care workers
  • food manufacturing workers
  • agriculture and farm workers

The second group contains 1.4 million people:

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  • high-risk and critical retail workers (grocery and pharmacies)
  • remaining manufacturing labourers
  • social workers
  • courts and justice system workers
  • lower-risk retail workers
  • transportation, warehousing and distribution
  • energy, telecom, water and wastewater management
  • financial services
  • waste management
  • mining, oil and gas workers

Over 400,000 essential caregivers will be vaccinated at the same time (at the end of Phase 2), with the focus being on those who take care of residents living with the highest-risk conditions including organ transplants recipients and hematopoietic stem cell transplant recipients.

Ontario will be launching its online vaccination booking system and call centre on March 15. Certain public health units have launched their own system including in Peel Region and Guelph.


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Ontario pharmacies added to COVID-19 vaccine rollout


Ontario pharmacies added to COVID-19 vaccine rollout

The Ontario government said it is also working with all 34 public health units in the province to create mass immunization clinics. According to the document, “it is expected that approximately 80 per cent of total provincial vaccine allocations will be administered through mass immunization clinics during Phase 2 and 3.”

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Vaccinations will also be made available through certain pharmacies and family health centres.

“It is expected that the majority of the first shipment of AstraZeneca in March and in Phase 2 will be supported by the addition of retail pharmacies and primary care,” the documents read.

— With files from The Canadian Press





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Ontario looking to introduce digital ID program, seeking public input


The Ontario government says it is looking for the public’s input on a possible digital ID program that would allow for people to prove who they are online much easier.

The hope is that the program will be introduced by the end of 2021.

The program will allow for people to “securely and conveniently prove their identity online,” according to the Ford government. It will also help people to be able to access things online rather than have to travel to do things in-person, the government said, such as a small business applying for a license or a parent looking for information on their child’s immunization records.

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“We want to assure people that a digital ID will not only offer simpler and easier access to services, but it will be safe and secure, encrypted and harnessing the latest technology to protect your information and credentials,” said Peter Bethlenfalvy, minister responsible for Digital and Data Transformation.

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The government said it will also help with COVID-19 safety protocols, as it limits in-person contact.

The public can weigh in online through surveys provided by the government here from now until Feb. 26.

The government said the program will also help to combat identity fraud and protect Ontarians data. They also said it has the potential to add $4.5 billion of value to the “small-and-medium-size enterprises sector nationally.”

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“By using this innovative technology, users will be in full control of what identity information is shared and with whom,” the statement read.

The digital ID program will be voluntary and for those who do not wish to participate, they can still use physical documents to prove identity.

“As we develop this initiative, we want to hear directly from the people to ensure their priorities are reflected in this innovative, digital approach,” Bethlenfalvy continued. “No one has a monopoly on good ideas and we are prepared to listen.”




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‘People are being shown no mercy’: Online evictions raise alarm in Ontario


Tenant after tenant addressed the virtual meeting, describing how COVID-19 has wreaked havoc on their lives and finances over the last year.

A Toronto mother said she struggled to keep up with bills after losing work in the restaurant industry. A Hamilton man behind on rent payments said he was staying in touch with his landlord about his financial situation after being laid off.

“It’s COVID, people struggle,” he appealed to Landlord and Tenant Board member John Mazzilli during the Dec. 18 block of hearings — all of which involved non-payment of rent.

Similar scenes playing out over the last several weeks have raised concern among Ontario advocates who say the pickup of evictions in the pandemic’s second wave coincides with a shift to online-only hearings that stack the deck against tenants.

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“These people are being shown no mercy,” Kenn Hale with the Advocacy Centre for Tenants Ontario said in a recent interview. “They’re expected to pay and pay now or get out.”

Hale, director of advocacy and legal services at ACTO, said it’s “absurd” to evict people during a health crisis that has left many unable to pay rent due to lost income.

“It’s bad enough in normal times for people to lose their homes and to be treated unfairly an administrative proceeding. But it can be life or death in the kind of situation we’re in now,” Hale said in a recent interview.

Evictions were suspended until late summer and the Landlord and Tenant Board is now working through a backlog of cases that observers say predated the pandemic, and has grown this year as more people lose income.


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Coronavirus: Federal government announces new rent subsidy support for small businesses


Coronavirus: Federal government announces new rent subsidy support for small businesses – Nov 23, 2020

Tribunals Ontario doesn’t keep track of evictions, but according to ACTO, the board heard more than 7,000 cases in November. Ninety-six per cent of those were filed by a landlord against a tenant, the ACTO said. As of Dec. 14, 4,597 hearings were scheduled for the month.

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Hale said the shift to an online-only hearing model has made it harder for tenants to present their circumstances or access legal advice, including through ACTO’s duty counsel program.

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Lawyers must now introduce themselves to tenants in the virtual session, in front of all other participants, and both need to exit the meeting to speak privately.

Hale said such introductions don’t always run smoothly, with lawyers are entering “chaotic” hearing situations where they struggle to make themselves heard.

There’s also concern about changes under Bill 184, which became law in the summer. It allows landlords to offer repayment agreements without appearing before the Landlord and Tenant Board, so some tenants are signing on to potentially unreasonable repayment terms without fully understanding their rights, Hale said.


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Calgary landlord offers tenants rent relief with new ‘COVID clause’ in leases


Calgary landlord offers tenants rent relief with new ‘COVID clause’ in leases – Dec 15, 2020

A group of Ontario legal clinics, including ACTO, wrote to Tribunals Ontario in October with proposed guidelines for adjudicators considering evictions cases during the pandemic — including the public health risk and pressures on people’s finances.

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Hale said the group had not received a response as of mid-December.

The Progressive Conservative government has not yet acted on an Opposition motion supporting a freeze on evictions that passed unanimously this month, days before the legislative assembly adjourned until February.

NDP MPP Suze Morrison, who introduced the motion, said the online hearing format isn’t accessible for people with visual impairments or those who don’t have stable internet access, among other challenges.

“I’m deeply concerned that there are human rights violations happening here,” Morrison said by phone.

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A statement from Ford’s office this month said the government “is continuing to explore ways to further support Ontarians during this difficult time.”

Tribunals Ontario, meanwhile, said it’s pursuing “a digital-first strategy to meet the diverse needs of Ontarians and enhance the quality of our dispute resolution services.”

It said requests for in-person hearings would be considered on a case-by-case basis to ensure people are accommodated under the Human Rights Code. As of mid-December, Tribunals Ontario had not confirmed if any in-person hearings had been approved.

Sam Nithiananthan, an organizer with People’s Defence Toronto, said the online hearings have been a “double-edged sword” in the evictions process, as allies can now tune in and support their neighbours.

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Nithiananthan said the crisis has exposed longstanding issues renters face in the city, and it’s motivated tenants to organize in larger numbers than he’d seen before.

“What has been shifting is tenants are now standing up,” he said.

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Tenant organizer Bryan Doherty with Keep Your Rent Toronto said his group and others have called for rent relief that goes beyond a moratorium on evictions, arguing that simply pausing evictions would leave cases to pile up.

“We knew that a moratorium at the beginning of the COVID crisis would actually just produce an eviction blitz midway through the crisis, which is what we’re seeing now,” he said by phone in a mid-December interview.

Rents have long been unaffordable in Ontario’s largest city and Doherty said “COVID kind of threw gasoline on that fire.”

He said pressure needs to be applied to landlords and governments to address the housing crisis affecting working-class tenants during the pandemic and beyond.

“I don’t think it’s going to be the same. The question is whether or not it will be worse or slightly better,” he said.





© 2020 The Canadian Press





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Ontario ends police access to coronavirus database after legal challenge


TORONTO — Ontario has ended police access to a COVID-19 database after a legal challenge was filed by a group of human rights organizations.

Aboriginal Legal Services, the Black Legal Action Centre, the Canadian Civil Liberties Association and HIV & AIDS Legal Clinic Ontario were all parties to the lawsuit.

The groups argued that allowing police to access personal health records violates individuals’ constitutional rights to privacy and equality.

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A statement from the CCLA says that the lawsuit against the province has been dropped with the news that the government has ended police access to the database.

The human rights organizations say they are now calling on local police services to destroy the personal health information that has already been accessed.

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They also ask that local police conduct audits to ensure the data access to date complied with policy and legal requirements.

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Coronavirus: Civil liberties group concerned as Ontario cops get IDs of those who test positive

In early April, the Ontario government passed an emergency order under the Emergency Management and Civil Protection Act that allowed police to obtain the names, addresses and dates of birth of Ontarians who had tested positive for COVID-19.

The human rights organizations said they wrote to the government expressing concerns about the utility and legality of sharing sensitive personal health information.

When they didn’t hear back, the groups said they filed an urgent court application challenging Ontario’s decision to release this information to police because they argued it breached provincial health privacy protections and violated individuals’ constitutional rights to privacy and equality.


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© 2020 The Canadian Press






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