Brampton has emerged as one of Ontario's COVID-19 hotspots, but experts urge caution on where to lay blame

With Ontario's new daily COVID-19 infection rate roaring back to levels not seen since June, Peel Region has emerged as one of the epicentres of the virus, with the highest proportion of cases anywhere in the province — the lion's share in the city of Brampton. 

But while everything from international travel to multigenerational housing to social gatherings have been blamed for the disproportionate number of infections there, those who know Brampton well warn laying blame there risks overlooking other key factors that make its residents vulnerable.

"You have an area that's under-resourced, under-supported and then you throw a pandemic at it," Gurpreet Malhotra, executive director of Indus Community Services, told CBC Radio's Metro Morning on Tuesday.

"And then people act surprised that we have more cases here. One would assume less healthcare, less health resources, less health, but it doesn't seem to be computing."

Mayor Patrick Brown, meanwhile, points out Brampton receives approximately nearly a thousand dollars less in health care funding per capita than elsewhere in Ontario — approximately $1,000 compared to the $1,800 in other parts of the province.

The city, together with Malton and northwest Toronto together make up the Central West Local Health Integration Network (LHIN), which has received the lowest per capita health funding in Ontario for "years and years," Malhotra says.

• LISTEN | Gurpreet Malhotra on what's made Peel Region vulnerable to COVID-19

More than half of all of Peel Region cases in Brampton

According to provincial data, as of Friday, Peel had the largest number of active cases of the novel coronavirus per 100,000 people, surpassing both Toronto and Ottawa, which together make up the three hardest-hit regions in Ontario.

On Monday, 22 per cent of the province's COVID-19 cases were in Peel Region, an area that makes up less than 10 per cent of the population of Ontario.

Part of the recent spike stemmed from an outbreak at a manufacturing business that saw some 61 infections. Many of the employees were Brampton residents. Peel Public Health hasn't named the workplace, saying the outbreak poses no risk to the public. 

From February to September, 58 per cent of Peel's cases have been in Brampton. The city has seen an infection rate of 711 per 100,000 people, while its more populous neighbour, Mississauga, has seen just 390 infections per 100,000 people, making up some 39.2 per cent of the region's cases.

Meanwhile, Brampton has thus far had just one testing centre for a population of approximately 600,000 — a second one is finally set to open Tuesday — while Mississauga has three. 

As for what accounts for the city's relatively high infection rate, Brampto's mayor on CBC Radio's Metro Morning Monday pointed to a number of factors, including: Brampton's significant trucking sector; the fact that one of its largest employers is Pearson International Airport, which thousands move through every day; international travellers to India and Pakistan, which are combating their own COVID-19 outbreaks; and multi-generational housing. 

"I can tell you in Brampton, it's quite common to have multiple generations of the same family living together," Brown said.

"If you have a young person going to school and infects the family, it could be 15 people that are affected. And so there's a greater risk of a more extensive spread."

Confusion over federal quarantine enforcement

Brown also pointed to what he called "huge gaps" in enforcing federal quarantine regulations.

"As of last week, the Peel police didn't even know it was their responsibility until the federal health minister said it," he said, referring to enforcement of the Federal Quarantine Act. Ontario Premier Doug Ford expressed similar frustration on Thursday, calling Canada's quarantine system "broken."

Federal Health Minister Patty Hajdu said on Friday that Ford may simply be "unaware" that the Ontario Provincial Police can fully enforce the act, adding Canada has had "very few cases related to importation from other countries.

"In fact, what we're seeing is community spread," she said on CBC Radio's The Current.

Risk of 'racial gaslighting'

But some critics point out the focus on large families living under the same roof risks laying blame and creating a stigma against communities, largely of colour, where those arrangements are more common.

More than 73 per cent of Brampton's population is made up of visible minorities, with South Asians making up about half of the total population of Peel Region, according to 2016 data.

For Dr. Naheed Dosani, a physician and health-justice advocate, the conversation around multi-generational housing amounts to "racial gaslighting."

"[It's] actually blaming people of colour, South Asian, and people living in multigenerational homes for the situation that they're in and the high rates of COVID-19," he said.

"My feeling on this is that we should try to better understand how people's vulnerabilities are shaping their circumstances ... To me, this is what public health is really all about."

Dr. Ripudaman Minhas, a developmental physician at St. Michael's Hospital, had a similar concern, worrying over-emphasizing travel to specific countries and multi-generational households glosses over the more important socio-economic factors that can increase the risk of infection.

"When we highlight particular racial groups, their travel patterns, and their day-to-day lifestyles as being problematic, we risk inciting conflict and racism. The focus really needs to be on solutions that work for higher-risk communities, taking into account their health behaviours and their lived reality," he told CBC News. 

Adding to that, Malhotra points out the recent focus on large weddings has also unfairly targeted the South Asian communities.

At a news conference last week, Ford, commenting on the rising number of COVID-19 cases said: "I understand that a lot of cultures have massive weddings, bringing people from all over the world. You just can't do it."

"I felt a little put out that this is being targeted this way," Malhotra said of Ford's comments, pointing out there have been large gatherings in several major cities across the province. "I don't think it can be something lain at the feet at Brampton, specifically, or the South Asian community."

• 23 cases of COVID-19 now confirmed after large wedding in Markham and Whitchurch-Stouffville

No work-from-home option in trucking, manufacturing 

Indeed, Brampton is home to the largest trucking sector of any big city in Canada, Brown pointed out Monday. In Peel Region more broadly, manufacturing and distribution make up a significant proportion of jobs, where employees often don't have the luxury of staying away from the workplace, said Peel Region's Medical Officer of Health Dr. Lawrence Loh.

"We certainly have an employment profile in many parts of the region where people don't have the option to work from home and don't have the option to work remotely," he told CBC News. 

Add the increased social gatherings in Stage 3 of reopening, and there's a cyclical effect, he says.

"People are maybe going to gatherings when they might be slightly sick or they don't think it's anything, and then they pass it to a number of people there," Loh said. 

With Ontario's new confirmed case count surging past the 300-mark Monday, whether municipal or provincial governments will roll back the allowable limits on indoor and outdoor gatherings remains to be seen.

Neither level of government has committed to doing so just yet, though Ford told reporters on Monday officials from Toronto, Ottawa and Peel have all pointed to social gatherings as one of the key reasons for the uptick. 

Should the province need to tighten up the rules, officials say, they hope to take a regional approach.

Asked if he thinks a second wave of the virus is coming, Ford replied: "Yeah, I believe it's coming, sure as I'm standing here. I hope to God I'm wrong."