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by Eden Debebe

The golden rule of staying safe through the pandemic is to keep your distance from large groups and self-isolate at the first signs of any COVID-19 symptoms, but how do you do that if you are a family of five living in a three-bedroom apartment with your grandparents? 

That is the tough reality for many Canadians right now, and data shows the disproportionate risk is falling on racial and ethnic minorities.

According to the 2016 Statistics Canada census, 6.3 per cent of Canadians in private households were living with three generations under one roof. Some of the highest numbers of multigenerational households are in Ontario and British Columbia which are also the two provinces with the highest proportion of immigrants. Statistics Canada attributes part of the increase to a “changing ethnocultural composition”, “the high cost of living in some regions of the country” and an aging population.

Peel Region, west of Toronto, is home to the largest percentage of immigrants in the Greater Toronto Area and according to recent public health reports, household transmission there is one of the leading causes of COVID-19 spread in the region, accounting for nearly 44 per cent of cases in March.

Peel Region also has one of the lowest capacities for remote work in the GTA with 53 per cent of the 608,000 workers in the region needing to be on-site; a factor Peel Region medical officer of health Dr. Lawrence Loh said makes stopping COVID-19 outbreaks in the workplace key to curbing household transmission.

“Workplaces have always been a challenge for transmission in the region of Peel,” Loh said.

“If you look at our plateau between November and the end of February, you saw that the curve flattened out, but it never really went down despite having really restrictive measures in place and that has represented our ongoing transmission between workplaces to home and then back into other workplaces.”

Loh and other health officials agree that paid sick leave is one of the most important ways to protect those on marginal or minimal incomes who don’t have the financial flexibility to take an unpaid day off work. After lots of back and forth on strategy, the Ontario government announced a ‘Worker Protection Benefit’ on April 28 which will give eligible workers three paid days off. The program is aimed at addressing outbreaks that have plagued the essential factories and warehouses where many people living in multigenerational homes work, but opposition leaders say it doesn’t go far enough.

NDP Leader Andrea Horwath was among many critics to voice their frustrations with the new plan on social media, saying the Ford government is giving too little, too late.

“In the year it took the Ford govt to capitulate on #PaidSickDays, 455,000 people were infected and nearly 8,000 died of COVID-19,” Horwath wrote.

“This comes far too late. Too late to stop COVID-19 from getting out of control, and too late for workers who already got sick.”

While official advice from public health is to self-isolate at the first sign of any symptom of COVID-19, limited space and financial constraints mean that option isn’t always possible for those in multigenerational homes.

Isolation hotels were introduced in Peel Region as a free option for people working on the frontlines to quarantine in a hotel, away from vulnerable family members. 

While the idea may seem good on paper, social activist and professor of epidemiology and social & behavioural health sciences at the Dalla Lana School of Public Health Dr. Chandrakant Shah points out not everyone can afford to leave.

“When you are resource rich you have options,” said Shah.

“But if you live on a marginal income or minimal income, you don’t have many choices, so you have to go to work. You have to do whatever needs to be done. You can’t hire somebody else to come and look after you.”

For those caring for older relatives and children or working as the sole provider for the household, leaving for two weeks is not always feasible. The tragic death of Emily Viegas, the 13-year-old girl from Brampton who died from COVID-19 while her father, an essential warehouse worker, reportedly tried to care of her in the family apartment showcases the impossible choices some families are forced to make. 

“The reality is we do our best and we make the offerings that we can,” Loh said.

“But there are some situations for which there are impossible choices And I think that really speaks to the need to really just try to control this disease as much as possible in our community.”

Many multigenerational households have frontline workers living alongside their school-age children and elderly grandparents. Because these families are so connected to different parts of their communities, Shah said the simplest and most efficient way to curb the spread of COVID-19 is to get everyone vaccinated.

“Our health depends on other people being healthy,” Shah said.

“And whether they may be a front line grocery store worker or somebody working as a truck driver or somebody is working as a human, invisible agriculture migrant worker; we are all interdependent.”

Even if an outbreak happens in the home, doctors say most vaccines are 100 per cent effective at preventing severe symptoms of COVID-19, meaning the most at-risk elderly family members are kept safe.

While he agrees vaccinations are also important, Loh said successfully curbing the spread of COVID-19 is going to take a joint effort between all strategies.

“It’s a big puzzle and you need to have all the pieces,” Loh said.

“So, yes, you need to address paid sick leave. You need to address worker protections. You need to address getting more vaccines into hotspots so that we can ensure our mass clinics continue to vaccinate a hundred thousand people a week.”

With files from Sumeet Dhami