These 'hot spots' getting vaccine priority are less hard-hit by COVID-19 than Ontario average

Ontario is giving priority access to COVID-19 vaccines to some neighbourhoods that have been far less affected by the pandemic than other areas not designated as hot spots, data analysis by CBC News reveals.

Five postal code zones declared as hot spots have rates of COVID-19 cases, hospitalization and death that are actually below the provincial averages, according to data compiled by ICES, a research institute focused on health issues in Ontario.

The designation of hot spot gives people in those areas higher priority for vaccinations, despite their lower-than-average pandemic burden. More than 175,000 people live in the five postal codes zones, four of them in ridings represented by Progressive Conservative MPPs.

CBC's review of the data identified seven postal code zones that have felt a greater impact from COVID-19 as measured by the province's official criteria, yet are not classed as hot spots. All are located in ridings held by the opposition parties.

The findings raise questions about why certain neighbourhoods are being given preferential access to vaccines even though they have experienced less impact from COVID-19 than many other parts of of the province.  

The provincial government last Tuesday released a list of 114 postal code zones designated as hot spots, and announced the start of targeted vaccinations in those areas for people aged 50 and up.

The next day, Premier Doug Ford announced that all adults in those hotspots would be eligible to get vaccinated immediately.

More than 4.2 million people live in the hotspots, according to 2016 census data. There's concern that by giving the hot spot designation to too large a swathe of the population, the province risks diverting vaccination resources away from the areas and people that need them most.

"If you're not able to ensure that there's a more targeted approach and that there's actually mobilization out to people, those who we are trying to reach, who we know are in neighbourhoods on fire, will continue to be at risk," said Dr. Andrew Boozary, director of University Health Network's social medicine program.   

"You've got some people within a postal code that are relatively well inoculated from COVID because of their job status, income, living arrangements," Boozary said in an interview Sunday. "They're not the ones who are at risk of spreading it or ultimately the ones who are at the highest risk of hospitalization or death." 

Both the NDP and Liberals questioned the province's list of hot spots at Queen's Park Monday.

"Can the premier explain to Ontarians how these four postal codes were selected despite not meeting criteria to be deemed a hot spot?" Liberal MPP John Fraser asked.

In response, Health Minister Christine Elliott defended the list and said the areas were strictly determined based on expert medical advice.

"Any suggestion that any postal codes were selected for any reason other than that the fact they were hot spots and experiencing high rates of transmission is really beneath you," Elliott said.

"These communities were identified based not only on high rates of COVID-19, but also outbreak data, research and analysis conducted by Ontario's COVID-19 Science Advisory Table, low testing rates and sociodemographic barriers that may result in vaccine hesitancy," said Elliott's press secretary, Alexandra Hilkene, in a statement Monday.

The Ministry of Health's official document on vaccine prioritization says the communities to be designated as hot spots are those where data show "historic and ongoing high rates of COVID-19, death and severe illness (e.g. hospitalization)." 

The data from ICES shows that 95 per cent of the postal codes designated as hot spots have reported at least 2.2 cases of COVID-19 per 100 people and at least 0.95 hospitalizations and deaths per 1,000 people. 

However, the five postal codes with the questionable designations as hotspots reach neither of those benchmarks. 

Here's a closer look at each of the postal code zones in question. 

L6C Markham

This part of Markham, north and east of Buttonville Airport, is home to around 51,000 people. It has the lowest cumulative rate of COVID-19 cases among all the hotspots: just 1.24 per cent of its population has had a confirmed case since the pandemic began. More than 200 postal code zones not designated as hotspots report higher infection rates.

Its death and hospitalization rate is 0.57 per 1,000 people, which is roughly one-tenth of the rate of the M3N postal code, the hard-hit Jane and Finch neighbourhood in northwest Toronto.

L4B Richmond Hill

Just west of L6C, on the other side of Highway 404, is a postal code zone that covers the southeastern corner of Richmond Hill, with a population of around 36,000. Just 1.4 per cent of its population has had a confirmed case of COVID-19, and its death and hospitalization rate is 0.66 per 1,000 people, well below the provincial average. 

L4B did report a higher-than-average positivity rate for COVID-19 tests (10.55 per cent) in the most recent week for which the data is available. However, the government has not indicated that a high test positivity rate alone would qualify a location to be labelled a hot spot. 

K2V Kanata 

This area is located south of The Queensway, along Terry Fox Drive. The latest census figures show just 2,435 people living in K2V, making it one of Ottawa's least-populated postal code zones. The area is largely light industrial and home to several large employers, including Honeywell Aerospace, Lockeed Martin Canada and a Ford Motor Company office, as well as outlets of Costco and Home Depot.

The data show that K2V has the lowest hospitalization and death rate among the 114 designated hotspots, at just 0.35 per 1,000. That's lower than the rate in some 300 postal code zones not designated as hot spots. 

M5V Toronto

Condo towers make up the bulk of this postal code zone centred around Spadina Avenue, between Queen Street and the Toronto waterfront. The average income of a person living in this neighbourhood is about 50 per cent higher than the Ontario average, according to Statistics Canada data.

While there have been a large number of infections reported in this densely-populated part of the city, the infection rate (1.96 per cent) is less than the Ontario average (2.5 per cent). The hospitalization and death rate is also well below average, likely a function of the neighbourhood's generally young demographic.   

L6E Markham 

This area north of 16th Ave and east of McCowan Road covers the neighbourhoods of Wismer and Greensborough. Its case rate (1.85 per cent) and its rate of hospitalizations and deaths (0.88 per 1,000 people) are below those of dozens of postal code zones that do not have the hot spot designation and the priority access to vaccinations that comes with it.

Hamilton hotspots left out

Despite its ranking as the fifth-most-affected public health unit in Ontario (in terms of COVID-19 cases per population), only two postal code zones in Hamilton — L8W and L9C —  were designated as hot spots, making just 12 per cent of its population eligible for priority vaccination access. 

In York Region, more than 600,000 people live in postal code zones designated as hot spots, roughly half of the population. 

Last week, after the province announced the postal codes getting prioritized for vaccinations, Hamilton's medical officer of health Dr. Elizabeth Richardson publicly called on the government to add three more of the city's neighbourhoods to the list. 

The government did not comply. Richardson took matters into her own hands and declared Hamilton's north end (L8L), the Stinson neighbourhood (L8N) and part of Ancaster (L9K) as places where all residents aged 50 and up would eligible to be vaccinated at city clinics on the weekend.

Ottawa selective within hot spots

The province designated three Ottawa postal codes — K1T, K1V and K2V — as hot spots. Ottawa's medical officer of health Dr. Vera Etches is signalling that not  everyone who happens to live within these postal codes will get priority access to COVID-19 vaccines

"These are large geographic areas that have more advantaged and less advantaged populations within them," Etches said in a statement Friday.

Etches said Ottawa would create pop-up vaccination clinics in the hot spots, but only in a few high-priority neighbourhoods within two of the three postal code zones,and none in K2V. 

Meanwhile, some politicians in Ottawa and the surrounding area are calling on the province to expand the number of COVID-19 hot spots in the hopes of improving vaccine access to people living in hard-hit areas. 

The neighbourhoods in Ontario worst-hit by COVID-19 are showing far lower vaccination rates compared with wealthier areas where the virus has had little impact, according to research by ICES. 

In all designated hot spots across Ontario, only those aged 50 and up can make vaccination appointments through the provincial booking system right now. For those younger than 50, the government indicated that access will be through pop-up clinics and mobile vaccination teams, starting in Toronto and Peel.