Toronto Public Health seeks funding boost to address expected respiratory virus 'surge'

Toronto Public Health is seeking millions more in funding to bolster infection prevention and control in the city's long-term care homes and shelters ahead of what's expected to be a difficult flu and respiratory virus season. 

In a report coming to next week's meeting of the Toronto Board of Health, staff are asking the board to endorse a request to the province for $5.1 million in additional funding.

Board chair Chris Moise says data suggests a tough flu season is likely, so Toronto Public Health wants to put additional protections in place for vulnerable populations like seniors and the unhoused.

"We want to make sure these people are protected. And it's our responsibility to do that."

Moise says Toronto Public Health is flagging the situation and the additional costs to the province in advance of respiratory virus season because of concerns that responding  to it could create a staffing and budget crunch.

"Public health funding is very tight," he said.

Ontario's Ministry of Health did not immediately comment on the city report.

The board will consider the request and could ask the city's medical officer of health for an additional update on progress addressing flu and COVID-19 in January in the event that Toronto's strategy needs to pivot. 

Staff point to epidemiological data that suggests that Toronto will experience a high level of respiratory virus activity. The report says recent experience in the southern hemisphere shows an early start to the season. Australia has reported higher than average hospitalizations, especially among children, staff note. 

"We are concerned about influenza this year and COVID-19, as well based on what we've seen in Australia and other places," Moise said. "It's quite serious. So public health is preparing for that."

Last week, Toronto Public Health launched its annual campaign to combat COVID-19 and the flu with the expectation that there will be a "surge" in cases this fall. In addition to the flu shot, It has opened more than 4,250 new appointments for the monovalent COVID-19 vaccine and said it will add an additional 8,500 in the coming days. 

Toronto's associate medical officer of health Dr. Vinita Dubey said last year flu season came early to the city, so public health is ramping up efforts to protect seniors, people in shelters and group homes. 

"We want to make sure that those who are at highest risk have the first access to the vaccine," Dubey said. "The goal of the vaccination is to prevent that serious illness. And we know that they are at higher risk for getting severely ill."

Experts say the layering of COVID-19, influenza and respiratory syncytial virus (RSV) can lead to capacity issues in the province's hospitals, so prevention is important.

Dr. Allison McGeer, an infectious disease physician at Sinai Health, said last year RSV levels in adults were lower than anticipated, which means this year they could rebound as people contract the virus because they have lowered immunity. 

"I'm really worried about RSV being worse because I think we did not catch up with older adults last year," she said. "And we have catching up to do."

McGeer said wearing a mask, staying home when you're sick, and hand-washing are key strategies to prevent the spread of respiratory illness. But the push will be on over the next few weeks for to get people vaccinated against COVID-19 and the flu, she said.

"Preventing viral respiratory illness is a team sport," McGeer said. "If I do it, it offers me some protection. But if we do it together, the protection is greater than the individual protection."