Lower income people, new immigrants at higher COVID-19 risk in Toronto, data suggests

New numbers from Toronto Public Health seem to suggest the COVID-19 pandemic is more adversely affecting people with lower incomes in Toronto, alongside newcomers to the city.

The city's figures, which include cases spread within the community recorded up until the morning of April 27, found the group with the highest percentage of people living below the poverty line has the highest rate of COVID-19 cases.

The group — or quintile, as public health refers to it in its data — has 113 cases per 100,000 people, compared to 73 cases per 100,000 people in the highest-income group.

The difference between the highest and lowest income group is similarly pronounced when looking at hospitalizations. There were 20 hospitalizations per 100,000 people in the group including those living in the lowest income areas, compared to nine per 100,000 in the highest income areas, according to the data.

Toronto Public Health applied the same process to newcomer data, and found similar results.

The group with the highest percentage of recent immigrants also had the highest rate of COVID-19 cases, with 104 per 100,000 people. The group with the lowest percentage of recent immigrants had the lowest rate, with 69 cases per 100,000 people.

Again, a similar trend concerning immigrants emerged for hospitalizations. The group with the highest percentage of recent immigrants had the highest rate of hospitalizations with 18 cases per 100,000 people, while the group with the lowest percentage of recent immigrants had the lowest rate, with 8 cases per 100,000 people.

"An important component of the data story is to understand if COVID-19 is affecting certain groups in our community more so than others, so we can then better inform prevention strategies," said Dr. Vinita Dubey, associate medical officer of health, in an email.

"This would allow public health to collaborate with communities to support the development of prevention strategies by the community for the community."

The city's figures are similar to provincial data collected by non-profit research institute ICES, which analyzed COVID-19 testing data in Ontario up to April 30.

ICES found that when compared with Ontarians who had not been tested for COVID-19, those who had been tested and those confirmed positive were more likely to live in lower income neighbourhoods.

People who tested positive were also more likely to live in neighbourhoods with a "relatively greater concentration of immigrants and visible minorities," according to the report.

The province hasn't been collecting race-based data for COVID-19 infections. When asked last month if Ontario planned to collect such data, the province's Chief Medical Officer of Health Dr. David Williams replied that the groups identified to be most at risk are the elderly, people with underlying conditions and those with compromised immune systems.

"So those are all priorities to us, regardless of race, ethnic or other backgrounds. They're all equally important to us," Williams answered.

Toronto announced it was developing its own system to collect new data sets for COVID-19, including race-based data, in April.

622 now dead of COVID-19 in Toronto

At a news conference at city hall on Tuesday, Dr. Eileen de Villa reported that 622 people have died of COVID-19 in Toronto.

A total of 5,449 people have recovered from the disease, an increase of 109 from Monday, the city's medical officer of health said.

The city has a cumulative total of 7,775 cases, 218 of which are new.

De Villa reminded Toronto residents the "next normal" in the city will include physical distancing.

"I think it's important to remind everyone that easing our public health measures will continue to be a gradual process until we have a vaccine, or effective treatments for this virus.Until that time, physical distancing will be part of our everyday lives — in all settings," she said.

She told reporters that when Ontario moves toward reopening, it will become even more important for Toronto residents to continue to practise physical distancing.

And she encouraged people to wear face masks in cases where they cannot keep two metres apart.

"In situations where you are in close contact with others and physical distancing is difficult to maintain, I recommend for people to wear a cloth mask, or face covering to prevent the spread of your germs to others, even if you are not experiencing symptoms," she said.

De Villa added that she doesn't yet know when the city will be able to ease its restrictions.

"Unfortunately, I do not have specific timelines on when our local situation will change, but I know that it will depend on our collective actions and our ability to maintain good physical distancing and public health practices like frequent hand washing. Based on your commitment, I am hopeful that we will continue to move in the right direction," she said.

Ontario Premier Doug Ford has indicated the province will share more details in Stage 1 of its reopening plan on Thursday. 

City queried about COVID-19 risk from grocery stores

De Villa added that she is receiving many questions about the health risk of acquiring COVID-19 from grocery store employees. 

"Because there is community spread of COVID-19, not all infections among store employees were acquired from their workplace," she said.

"This virus continues to spread in many different locations in our city, but the highest risk is from close household contact with someone who is infected with COVID-19. This is why it is important for everyone to keep six feet away from others when they are outside and to wash your hands often," she added.

As for local grocery stores, pharmacies and other businesses, she said she continues to recommend routine infection prevention and control measures, including regular cleaning and disinfection of surfaces and objects that are frequently touched.