COVID-19 exposes need for more collaborative, community-based health care

When Adil Butt's body started to ache, he immediately isolated himself in a small bedroom for a month to keep his young family safe from COVID-19.

The 42-year-old lives in Thorncliffe Park, a tightly knit community of apartment buildings in Toronto's east end. Neighbours have been hit hard by the coronavirus.

Butt phoned to inquire about testing at a local pop-up site on Saturday,Dec. 5, got tested and received his positive result the following Monday.

He went above and beyond public health guidelines to avoid passing on the virus to his wife and children, ages 10, seven, six and three."Nobody got it," he said. "It was very hard, especially [for] my small kid."

This week marks the one-year anniversary of the first quarantine measures to control COVID-19. When CBC News canvassed some doctors and scientists across Canada on what's fundamentally changed in health care during the pandemic, what stood out was the need for more collaborative care similar towhat Butt received.

Primary care providers help prevent people from coming to hospital with damaging and costly complications of diabetes or infections.

Deaths and policy failures

Dr. Andrew Boozary, executive director of social medicine at Toronto's University Health Network, said community health centres such aswhere Butt was tested offer a one-stop shop of services, including prescription medications, healthy foods and connections to housing and jobs for people living on the margins across Canada.

"There's actually systemic discrimination in the way we pay for primary care and the way we fund our health-care system," he said.

Boozary said the pandemic has exposed public policy failures, not only in long-term care homes but also in neighbourhoods where essential workers, many who are racialized, bear a disproportionate burden.

"Our failure orlack of policy has really determined who lives and who dies," Boozary said. "When you go back to look at things like primary care, if you put the map of where primary care funding was and the map of where COVID was, there's a complete mismatch."

Boozary draws hope from community health centres, which he said have been a leader for decades in gaining patients' trust by working with them regularly where they are.

Caring for all to stop coronavirus

Cheryl Prescod, executive director of Black Creek Community Health Centre in the city's northwest, said their service is priceless and underestimated.

"Throughout this past year, I believe we saw our value," she said.

Asked about the need for stable funding beyond the pandemic, Prescod said, "We feel invisible compared to larger hospitals or larger health-care institutions. The small community health centres are the distant cousins."

But the coronavirus that causes COVID-19 will not discriminate between someone who earns a high income and someone who doesn't.

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"The virus will not be stopped unless we take care of everybody," Prescod said.

Paulina Aghedo works as one of the centre's community ambassadors, sharing safety tips to stop the spread in her neighbourhood.

Now, Aghedo hands out flyers and sparks conversation, all to raise awareness of testing sites in apartment complexes, lobbies and parking lots. It's home to many personal support workers and grocery clerks who work long hours and may still struggle to make ends meet.

She recalled knocking on doors in her crowded building to distribute flyers when a friend called to say someone needed to know about testing right away.

"She is just coughing in her working place and they told her if she doesn't bring that COVID-19 test [result] she shouldn't come back to work," Aghedo said.

The flyer reached the woman, who tested negative and no longer feared losing her job.

"I was very happy I could help someone,"Aghedo said.

For his part, Butt gave up his job as an Uber driver during COVID-19. He temporarily lost his sense of smell, even for perfume that was pungent to his wife, as well as sense of taste.

During self-isolation, the food delivery volunteer relied on friends from his neighbourhood to return the gesture. For Butt, seeingneighbours helping each other to cope and recover resembles how doctors and nurses care for patients in hospitals.

"He [a friend] was bringing the food for me and leaving it outside my door and this is how we survived," Butt said of his neighbour.

Butt's fever broke after a few days and he's fully recovered.