Ontario's COVID-19 hot spot problems: The province's selections 'must be done better,' York Region medical officer says

Elianna Lev
·4-min read

Ontario’s hot spots - areas labelled as having a high number of COVID-19 cases - are being monitored closely by medical experts and citizens alike, which has led to some criticism of how they are determined.

Last week, Dr. Karim Kurji, the medical officer of health for the York Region, classified the neighbourhood of East Gwillimbury (L9N), along with another area that will be announced in the coming weeks, as being a hotspot. This area hadn’t initially been included in the 13 additional hot spots determined by the province.

Postal code hot spots: What is missing in the process?

Dr. Kurji tells Yahoo News Canada that this decision was made on his end after reviewing the information provided by the provincial government from the Institute of Clinical Evaluative Scientists (ICES), which included statistics that he felt weren’t up to date.

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“When we started looking into that information we realized it was historical information, based on Stats Canada Census files from 2016,” he says. “Postal codes have changed since then. It was made clear by the province that we could go to neighbouring postal code areas, we could add additional areas. They gave us some liberties there.”

The details Kurji and his team relied on removed institutional cases, meaning those in retirement and long term care homes, and considered variant numbers, which weren’t properly represented in the data. Next, they looked at deaths per 100,000 of the population. While the province relied on the Ontario Marginal Index, which is a measure of socioeconomic status, Kurji and his staff looked at different proportions of different ethnic mixes, which he admits is more or less similar.

“When we looked at our data, we came to the conclusion that we needed to get two more postal code areas to the ones that the province had outlined,” he says.

Since vaccination supplies have been limited, Kurji had to prioritize the highest incident areas, starting with five postal codes, which have just expanded to a sixth one. When vaccine supplies are expected to increase next week, they will be going to 15 hot spots - two additional ones and the 13 that the province had determined.

York Region hot spots and eligibility is as follows:

  • 35 years of age and older who live in six high priority communities:

  • L4L, L6A, L4K, L4J, L3S

  • L4H - NEW, as of April 27, 2021

  • 45 years of age and older in 13 high priority communities can book through the Provincial Booking System:

  • L0J, L3S, L3T, L4B, L4E, L4H, L4J, L4K, L4L, L6A, L6B, L6C or L6E

  • More areas will become eligible for appointments as vaccine supply allows

  • More information can be found at york.ca/covid19vaccine

Kurji says if he were to look at this critically, of the 15 hot spots, he’d consider nine to be the highest, while the others would be “warm spots” relative to the rest of the region.

“If we had the luxury of determining our own hot spots, before they were publicized, we would have chosen nine of theirs, but we would have chosen others for the remainder of the 15,” he says. “Only two thirds of the hot spots are correctly directed.”

Kurji explains the problem is that once it’s been communicated where hot spots are, anyone from those areas can book an appointment to get vaccinated.

“We in the York Region have been restricting our appointments to those we recognize, which is six (hot spots), not 13,” he says. “We have one hospital that’s in the provincial system. The rest are in the wrong systems. There’s room for a lot of confusion to stick with all of this. So we’ve decided to stick with the 13 the province has outlined and it’s simpler for us to add two more. The problem you carry for that is a bit of a communication exercise. You haven’t directed one third of your vaccines to the best places.”

While he admits that vaccines are largely going to appropriate hot spots, there will be some going to areas that are not getting the maximum benefits.

“For us to try to change anything is much too difficult, so we just accept that as collateral damage,” he says. "The hot spot selection must be done better. Because our priority right now is to get case numbers down.”