The third wave of the COVID-19 pandemic has brought Ontario to a breaking point. Driven by more virulent and transmissible variants of concern, case counts are rising rapidly, and Ontario’s intensive care unit (ICU) occupancy has reached an all-time high.
The health care system is buckling under the weight of the third wave. Hospitals were instructed to ramp down non-urgent care to make room for patients; field hospitals across the province have been or are currently being built to add more capacity; and the province is preparing to redeploy health care workers and transfer large numbers of patients as cases overwhelm local capacity.
As this rages on, health care providers can continue to put out fires as they happen, but they cannot stop new ones from starting. The unprecedented steps taken recently will help to accommodate the deluge of incoming critically-ill COVID-19 patients, but they won’t stop new infections at their source.
As medical students, we are both recipients of what the health care system has to offer and have the unique opportunity to contribute to it too. Through this unique perspective, we can see that Ontario is in a public health crisis that requires urgent action. This is why more than 600 medical students from all of Ontario’s medical schools have signed an open letter urging the provincial government to implement a policy that could make all the difference: provincially legislated paid sick leave.
Workplace outbreaks have been a major source of infections in Ontario throughout the course of the pandemic. Outbreaks in Southwestern Ontario farms were responsible for hundreds of infections this past summer. Warehouses and meat packing plants across the province have been breeding grounds for viral transmission, requiring multiple closures after hundreds of employees tested positive for COVID-19. As of April 6, Toronto Public Health alone has reported 395 outbreaks in workplaces like food processing plants, offices, warehouses, shipping and distribution centres, and construction sites.
Outbreaks like these do not happen by chance; they are most common among essential workers who work in proximity to each other and are unable to work remotely from home. Low-income, racialized and migrant workers are disproportionately representedin these essential jobs and face greater health and economic risks. Without suitable paid sick leave, essential workers who are symptomatic or have been exposed are faced with an impossible decision: follow public health measures by staying home or go to work to put food on the table and bring the virus into their homes and communities.
There is no question that Ontario needs a robust and comprehensive provincial paid sick leave program that is universal to all workers in Ontario, proactive, and easily accessible. Previous iterations of this program were rolled back in 2018, and the emergency federal Canada Recovery Sickness Benefit (CRSB) program has its own limitations.
CRSB is a necessary measure, but it should exist in parallel with a comprehensive and permanent provincial paid sick leave program. Some of these limitations include the stringent eligibility criteria (e.g. missing greater than 50 per cent of the work week), the delay in CRSB payment (which is claimed retroactively and paid several weeks later), and the limited income actually provided. As a result, this program does not meet the needs of vulnerable workers who are living paycheck to paycheck. Continued provincial government inaction will only prolong the pandemic, resulting in longer shutdowns, further long-term economic damage and, ultimately, more preventable deaths.
As medical students, we find ourselves in a strange position during this pandemic. Although we are still in the very early stages of our training, we are close enough to the hospital floors that we know how patients and workers are suffering. The worry, frustration, and despair is palpable in the voices of our preceptors, professors, and mentors. What we can do, however, is listen to expertise and advocate for changes that will improve the lives of providers and patients alike.
If there’s one thing we’ve learned thus far in our training, it’s that a person’s health is significantly influenced by factors like systemic racism, working and housing conditions, and other structural inequities that disproportionately impact low-income and racialized communities. Our education has taught us that policies like paid sick leave which target these structural determinants of health can protect the workers and their families who continue to be the most at-risk as they work in essential roles to keep our society functioning.
We all want to return to the activities that connect us with each other, like eating at restaurants, going to the movies, and hugging our loved ones. In order to do so, a comprehensive paid sick leave program is necessary to mitigate this third wave and save countless lives in the process.
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