The Vancouver Coastal Health agency has no plans to release neighbourhood data on COVID-19 cases, despite the City of Toronto’s move last week to post such data and an interactive map on its website.
Dr. Patricia Daly, the chief medical health officer for Vancouver Coastal Health, said making neighbourhood data available to the public could lead to the identification and stigmatization of people with COVID-19.
“If, for example, there’s only one or two cases in a community, that might be enough for people to identify who has COVID-19,” she said, noting B.C. is seeing its lowest rates of infection since the first case reported in January.
The other concern is having people think they are safe from contracting the virus, if their neighbourhood shows no active cases, Daly said.
“We don’t want people to become complacent and think that they don’t need to follow public health advice,” she said, referring to physical distancing measures.
The Vancouver Coastal Health region includes Vancouver, Richmond, the North Shore, Whistler, Powell River, the Sunshine Coast and Bella Bella and Bella Coola.
Under the Public Health Act, COVID-19 cases and other communicable diseases are automatically reported to health authorities, without consent of the patient.
If people were worried they might be identified publicly in the data, they might not come forward for testing, said Daly, whose views on data release are aligned with those of Provincial Health Officer Dr. Bonnie Henry.
In Toronto, an interactive map posted to that city’s website May 27 allows the public to search the number of cumulative cases in each neighbourhood.
For example, the Beaches neighbourhood reported 13 cases Monday and Downsview-Roding-CFB reported 271 and Glenfield-Jane Heights had 306.
All Toronto neighbourhoods have COVID-19 cases, a point Toronto medical health officer Dr. Eileen de Villa made at a news conference in releasing the data.
“It is important to keep in mind that these maps reflect where people live, and they do not necessarily reflect where they were exposed to the virus,” de Villa said.
“Areas with lower rates of COVID-19 cases are not inherently safer from a COVID-19 perspective.”
The aim of releasing the data, she said, is to encourage proactive testing for the virus and to educate the public about the spread of the disease, not stigmatize people or neighbourhoods with higher rates of infections.
Toronto Mayor John Tory, who spoke at the same news conference, said he believed releasing the information would “help far more than harm,” and hoped the data would encourage people to get tested, even if showing one symptom of COVID-19.
de Villa acknowledged people may mistakenly believe the data presents an elevated risk of infection by going to certain parts of Toronto, which she said contributes to misinformation and “unintended stigma.”
“We all have a shared responsibility to not create unnecessary social, physical or other harms in our community,” de Villa said.
“I have said this many times before, and I think it is important to remind ourselves once again, that these ‘cases’ are our friends, our colleagues and our family members. These numbers represent people in our city.”
More than 800 deaths in Toronto
On the day of her news conference, de Villa reported 152 new COVID-19 infections in Toronto. More than 7,800 people had recovered but more than 800 had died since the outbreak.
The day after de Villa spoke to reporters, Daly provided a public update at city hall on the number of cases in the Vancouver Coastal Health region, with 898 going back to the first case reported in January.
The vast majority of people with the virus, she said, had recovered. A total of 19 per cent were hospitalized, with seven per cent in intensive care.
Eighty-six people had died, with two-thirds of the deaths associated to long-term care facilities. Daly said most of the cases in the region were in Vancouver and the North Shore.
Province-wide, B.C. had a total of 228 actives cases as of Saturday, for a total of 2,573 cases.
Caroline Colijn, Simon Fraser University professor and Canada 150 research chair in mathematics for evolution, infection and public health, described the public health response in B.C. to the coronavirus outbreak as “fantastic.”
She said the response by health workers and government has made the province one of the most successful jurisdictions in the world in combatting the spread of the virus.
Asked whether B.C. should follow Toronto’s lead in releasing neighbourhood data, Colijn echoed Daly’s concern about the information leading to stigmatization and complacency about practising physical distancing.
As an example, Colijn pointed to research related to HIV/AIDS in Uganda, where so-called “hotspots” were misidentified as the source of the disease.
“What they found was that these apparent hotspots were not the sources of transmission, they were actually places people were going home to, having been exposed elsewhere,” Colijn said.
She pointed out that B.C. has fewer COVID-19 cases than Ontario, which would increase the risk of identifying people with the virus, if data were to be released to the public.
“So the risk of the stigmatization part and the complacency part actually is even more,” she said.
“So I think there are good reasons not to release that [data], and we don’t know what the public is going to do with that information.”
At the same time, Colijn said, perhaps the data educates people about the infection rate in their neighbourhoods and their need to continue to follow public health advice.
Also, if a person is anxious and experiencing high levels of fear, maybe seeing data that shows a low or no infection rate in their neighbourhood improves their mental health, she said.
Low-income earners hit hard by virus in Toronto
The Toronto data shows higher infection rates in the northwest and northeast part of the city, where there are higher portions of multi-family residences and low-income residents.
Colijn suggested such data could help inform the public about inequalities and may lead to more public empathy and influence a person’s vote at the ballot box for social change.
“There are pros and cons, and I think there are good reasons for the decisions that B.C. has made in these areas, but you can weigh your pros and cons in different ways,” she said.
Last month, Toronto Public Health released a report that showed the city’s lowest income earners had the highest rate of COVID-19 cases.
It had 165 cases per 100,000 people, compared to the rate in the highest income group, with 90 cases per 100,000 people.
Similar trends were seen in hospitalization rates.
“We found a higher COVID-19 case and hospitalization rate for the group with the highest per cent of people from racialized communities, newcomers to Canada, people with lower education levels and unemployed people compared to the group with the lowest per cent of each,” said the report, titled COVID-19 and The Social Determinants of Health: What Do We Know.
In Vancouver’s Downtown Eastside, where there is a high concentration of low-income people, public health officials will only say there has been no outbreak, and there are very few people in the community who contracted the virus.
In Toronto, data on active outbreaks in homeless shelters is provided on the city’s website. As of May 29, there were 177 active COVID-19 cases reported among 13 shelters, with a total of two deaths and four people in hospital.