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St. James Town – seen here on April 20, 2020 – and Moss Park, two areas with a high proportion of low-income housing, new immigrants and racialized people, have 704 and 683 cases, respectively, of COVID-19 per 100,000 people, according to the Toronto Public Health figures.

Christopher Katsarov/The Globe and Mail

Most of Canada has successfully reined in the coronavirus. The exceptions are Ontario and Quebec, which account for 86 per cent of the country’s cases and 94 per cent of its deaths, according to the most recent figures from the Public Health Agency of Canada.

Ontario saw a worrying uptick in new cases between May 19 and May 25, with the province reporting more than 400 new cases on all but one day that week, despite a significant decrease in testing. The number of new cases has fallen below 400 again for the past three days, but the province continues to struggle to control the virus.

Why? Outbreaks in nursing and retirement homes are only part of the story. They are responsible for the majority of COVID-19 deaths in the province but a minority of cases; only 32 per cent of Ontario’s active coronavirus infections are connected to an institutional outbreak, according to a Globe and Mail analysis.

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Seventy-five per cent of the active infections are in the four public-health units that cover the Greater Toronto Area. The units that include Ottawa and Windsor round out the top of the list.

Here is a look at what seems to be driving spread in four of the province’s hot spots.

Toronto total cases by neighbourhood

York-University

Heights

Morningside

Rosedale-

Moore Park

Weston

Cabbagetown-

S. St. James Town

N. St. James

Town

Cases per 100,000 pop.

Moss Park

As of May 27

100

300

500

700

900

four key areas

Moss

Park

Cabbagetown-

S. St. James Twn

Rosedale-

Moore Park

N. St. James

Town

Cases/100k pop.

698

697

274

72

35.4

36

45

47.8

Median age

Median house-

hold income

$41,016

$52,490

$61,184

$106,740

67%

43%

29%

18%

Visible minority

population

Note: 2,011 cases (about 19% of total cases) are missing address/postal code in the

database and therefore not included in the mapping. Demographic info: 2016 census

JOHN SOPINSKI and chen wang/THE GLOBE AND MAIL

SOURCE: toronto public health; qgis

Toronto total cases by neighbourhood

York-University

Heights

Morningside

Weston

Rosedale-

Moore Park

Cabbagetown-

S. St. James Town

N. St. James

Town

Cases per 100,000 pop.

As of May 27

Moss Park

100

300

500

700

900

four key areas

Moss

Park

Cabbagetown-

S. St. James Twn

Rosedale-

Moore Park

N. St. James

Town

Cases/100k pop.

698

697

274

72

35.4

36

45

47.8

Median age

Median house-

hold income

$41,016

$52,490

$61,184

$106,740

67%

43%

29%

18%

Visible minority

population

Note: 2,011 cases (about 19% of total cases) are missing address/postal code in the

database and therefore not included in the mapping. Demographic info: 2016 census

JOHN SOPINSKI and chen wang/THE GLOBE AND MAIL

SOURCE: toronto public health; qgis

Toronto total cases by neighbourhood

York-University

Heights

Morningside

Weston

Rosedale-

Moore Park

Cabbagetown-

S. St. James Town

N. St. James

Town

Cases per 100,000 pop.

As of May 27

Moss Park

300

100

500

700

900

four key areas

Moss

Park

Cabbagetown-

S. St. James Town

Rosedale-

Moore Park

N. St. James

Town

Cases/100k pop.

698

697

274

72

35.4

36

45

47.8

Median age

Median house-

hold income

$41,016

$52,490

$61,184

$106,740

67%

43%

29%

18%

Visible minority

population

Note: 2,011 cases (about 19% of total cases) are missing address/postal code in the

database and therefore not included in the mapping. Demographic info: 2016 census

JOHN SOPINSKI and chen wang/THE GLOBE AND MAIL

SOURCE: toronto public health; qgis

Toronto

New data released this week by Toronto Public Health shows that low-income neighbourhoods with higher proportions of racialized people and new immigrants are being hardest hit by COVID-19.

The neighbourhood information provided by health officials doesn’t distinguish between COVID-19 cases linked to outbreaks at institutions and those that are the result of community spread. But front-line clinicians and community workers say it’s clear the disease is spreading among people who live in marginalized areas of the city who are less able to practise physical distancing.

“The pattern it’s pointing to is not all that surprising, and I think it does fit with what we’re seeing on the ground,” said Gary Bloch, a family physician at Toronto’s St. Michael’s Hospital who is treating homeless people who have tested positive for COVID-19.

For instance, St. James Town and Moss Park, two areas with a high proportion of low-income housing, new immigrants and racialized people, have 698 and 697 cases, respectively, of COVID-19 per 100,000 people, according to the Toronto Public Health figures. Sandwiched between them is Cabbagetown, a higher-income area, which has 274 cases per 100,000. Directly to the north, the affluent Rosedale-Moore park neighbourhood has 72 cases per 100,000.

Neighbourhoods in the northwest part of the city, which tend to be poorer and more racialized, also have a high proportion of cases. The Glenfield-Jane Heights and Black Creek neighbourhoods have 958 and 791 cases per 100,000, respectively.

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In those neighbourhoods, many people live in high-rise buildings, often with multiple families in one unit, which makes physical distancing almost impossible, said Michelle Dagnino, director of the Jane/Finch Community and Family Centre.

“When we talk about who and where essential workers live in the city, a lot of them are living in lower-income neighbourhoods,” she said. “You have potentially two to four adults coming in and out of the household. They’re not able to social distance within their own home, much less when they’re out.”

Peel Region

Over the course of the pandemic, Peel Region has logged more cases of COVID-19 than any other part of Ontario except Toronto.

After reporting 128 new cases on May 22 – Peel’s highest one-day tally since the peak in April – the daily numbers have begun to fall again. But the region’s seven-day rolling average, which smooths out daily blips, shows the case count has been sloping gently upward.

The reason for the increase? The reopening of warehouses and manufacturing plants, some of which shut down voluntarily at the start of the pandemic and took the province’s recent loosening of restrictions as a signal that it was safe to resume operations, according to Lawrence Loh, Peel’s Medical Officer of Health.

Earlier in the pandemic, most of the cases apart from institutional outbreaks – which account for about a third of Peel’s cases and 64 per cent of its deaths – were found in household clusters, he added.

Dr. Loh declined to name any of the workplaces, citing privacy.

What is the reopening plan in my province? A guide

Coronavirus guide: Updates and essential resources about the COVID-19 pandemic

How many coronavirus cases are there in Canada, by province, and worldwide? The latest maps and charts

York Region

Similar to neighbouring Peel, York Region, north of Toronto, has seen a recent rise in workplace outbreaks, said Medical Officer of Health Karim Kurji. York currently has about 45 outbreaks at places such as warehouses and factories, many of them in the city of Vaughan.

“It’s an interesting new front that we are seeing,” Dr. Kurji said.

York’s disease detectives have found that, in some cases, workers are carpooling, then heading off in different directions to unwittingly spread the virus at different plants. “Then from the employees, it goes back into the community as well," Dr. Kurji said. "So you have this cycle that is perpetuating it.”

York recently posted public notices about outbreaks at a UPS warehouse in Vaughan, where 21 people tested positive, and at Aluminum Window Designs, a Vaughan window supplier where 26 people tested positive.

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Of the 47 workers believed to have been infected at the two sites, 38 commute from their homes in Toronto – more evidence that the virus doesn’t respect municipal borders.

York has also reported outbreaks at a Saputo Dairy Products plant, a community centre, a women’s gym, three grocery stores and a produce-distribution centre. Those outbreaks are all over.

Workplace outbreaks are only part of the explanation for what Dr. Kurji called a recent “upswing” in York’s daily case counts. The region is still fighting major outbreaks at two long-term care homes.

Perhaps most concerning, approximately half of York’s recent daily cases are “locally transmitted,” meaning contact tracers have not been able to determine where people acquired the virus, Dr. Kurji said.

Active cases by Ontario public health unit

No. of cases

As of May 27

1-10

10-100

100-1,000

1,000+

0 cases

Thunder Bay

Ottawa

Simcoe-Muskoka

Peel

Toronto

Windsor-Essex

Daily averages

Early May

Late May

Health unit

11.2

13

Windsor-Essex

148.7

167

Toronto

60.4

76.2

Peel

8.4

4.8

Simcoe-Muskoka

0.6

0.2

Thunder Bay

john sopinski and danielle Webb/the globe and

mail, source: Ontario Public health units; qgis

Active cases by Ontario public health unit

No. of cases

As of May 27

1-10

10-100

100-1,000

1,000+

0 cases

Thunder Bay

Ottawa

Simcoe-Muskoka

Peel

Toronto

Windsor-Essex

Daily averages

Early May

Late May

Health unit

11.2

13

Windsor-Essex

148.7

167

Toronto

60.4

76.2

Peel

8.4

4.8

Simcoe-Muskoka

0.6

0.2

Thunder Bay

john sopinski and danielle Webb/the globe and mail

source: Ontario Public health units; qgis

Active cases by Ontario public health unit

Number of cases

As of May 27

1-10

10-100

100-1,000

1,000+

0 cases

Thunder Bay

Ottawa

Simcoe-Muskoka

Daily averages

Early May

Late May

Health unit

11.2

13

Windsor-Essex

Kingston

148.7

167

Toronto

Peel

Toronto

60.4

76.2

Peel

8.4

4.8

Simcoe-Muskoka

Windsor-Essex

0.6

0.2

Thunder Bay

john sopinski and danielle Webb/the globe and mail

source: Ontario Public health units; qgis

Windsor-Essex County

On Monday, the Windsor-Essex County Health Unit reported 36 new cases of COVID-19, its largest single-day increase since the middle of April.

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Thirty-three of the 36 cases were agricultural workers, some of them migrants who live together in bunkhouses on the produce farms that dot the region.

“All of these individuals are at high risk,” said Wajid Ahmed, the medical officer of health for Windsor-Essex County. “They are obviously essential workers. Their living arrangements and the work environment put them in a position where physical distancing is not well maintained.”

Dr. Ahmed said the health unit has been proactively testing for COVID-19 at some of the county’s 70 or so farms, where 8,000 to 10,000 people work.

He stressed that not all of the cases found in the agricultural sector have been among temporary foreign workers, all of whom are required to self-quarantine for 14 days after they arrive in Canada. Local farm staff have been affected, too, he said.

Windsor-Essex had 372 active cases of COVID-19 as of Thursday – a rate of about 87 per 100,000 people, the highest of any health unit in the province. But new cases dropped off again after Monday’s spike.

The county reported seven new cases Thursday, all among agricultural workers.

With files from Danielle Webb

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