At work, Jean-Géthro Joseph was known as the one who was always willing to offer help when needed and was fond of telling his co-workers about his children’s latest achievements. He was also a major presence in his community: before his daughter in law, Daphney Attis-Joseph, met his son Clifford, her parents already knew Joseph. When they’d moved from Haiti to Ottawa in the early ’90s, not too long after Joseph had made the same trip, he’d been there to help them settle in.
“He was a very giving person,” says Daphney. “Whether it was big or small, he was always eager to give a little something, no matter what.”
As a personal support worker at Madonna Care Community in Orléans, a suburb of Ottawa, Joseph had an up-close view of the devastation COVID-19 had wreaked in nursing homes. He warned his family over the phone to stay at home. “He was a very private person, so he was always trying to protect us without telling us too much,” Daphney says. “He would always say, ‘Just be careful. Don’t go out, and try to stay at home as much as possible.’ And he just kept working as he was supposed to do like it was his duty.”
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When the home struggled with staffing in spring 2020, Joseph picked up extra shifts. A COVID-19 outbreak was declared on April 6. Daphney and Clifford aren’t sure exactly when he got sick but recall Joseph’s younger son telling them on April 30 that their usually boisterous father had stopped eating and was losing his voice. Clifford says that, when Joseph’s sister called to check in on him, she became convinced that this wasn’t just another illness, as Joseph wanted her to believe. She insisted he go to the hospital, but Joseph did not want to leave his family behind.
Clifford remembers Joseph saying, “I don’t want to go to the hospital, because I heard people were dying. And I don’t want to die at the hospital without you all around me.” Joseph arrived at the hospital on May 1, and, on May 3, tested positive for COVID-19. He died on May 7, a few months shy of his 65th birthday. His family said their final goodbyes over FaceTime.
“It is very tough to not have him around,” says Clifford. “He was not just a father but a teacher as well.”
Over the past 10 months, PSWs such as Joseph have been on the front lines of the pandemic — and experts say that health workers of colour are bearing an outsize share of its effects.
Data shows that visible minorities are over-represented in the sector; the 2016 census indicates that immigrants, the majority of them Black and Filipino, make up more than 40 per cent of nurses’ aides, orderlies, and patient-services associates in Ontario.
Some numbers are available that suggest COVID-19 is dispoproporiately affecting health-care workers of colour. A report released by Ottawa Public Health in November, for example, states that “out of 100,000 people in Ottawa who are employed in a health occupation and have been diagnosed with COVID-19 —2,169 people are racialized compared to 703 people per 100,000 people working in a health occupation who are not racialized (white).”
And a study by Astrid Guttmann and other researchers from the Institute for Clinical Evaluative Sciences Canada found that being a health-care worker accounted for a very high percentage of positive COVID-19 cases among women who had immigrated from Nigeria, Jamaica, and the Philippines as economic caregivers.
As of June 22, according to an epidemiological summary from Public Health Ontario, 13 health workers had died. More recent, although unofficial, tallies, such as this list curated by journalist Nora Loreto, put the number at 21; of those, 12 were visible minorities.
But there are no official provincewide statistics indicating how many health workers of colour have contracted COVID-19 or died. For the first few months of the pandemic, health units were not required to collect race-based data. After Leonard Rodriques, a Black PSW, was discharged from a Toronto hospital in May after exhibiting COVID-19 symptoms, only to die two days later, there were increased calls to collect demographic data. On June 15, the government announced it was “proposing a regulatory change to mandate the reporting of data on race, income, language and household size for individuals who have tested positive for COVID-19.” A spokesperson from the Ministry of Health told TVO.org via email that “public health units have been required to collect data on race and other sociodemographic characteristics of people with COVID-19 infection since July, and they have collected these data for thousands of cases.”
TVO.org reached out to Toronto and Peel, two public-health regions that began collecting race-based and socio-demographic data before the provincial mandate, to ask whether they could provide a racial breakdown of health-care workers who have tested positive for COVID-19 since they started collecting this information. Both said that they are not currently analyzing that data. A spokesperson for Toronto Public Health told TVO.org via email that “at this time, we are not analyzing or reporting out these data specifically given our current focus on our high COVID-19 case numbers and COVID-19 reporting on our dashboard here. However, we may reassess feasibility of expanding our reporting once the current case resurgence subsides and we have meaningful data to analyze and share.”
Kwame McKenzie, CEO of Wellesley Institute, a policy think-tank based in Toronto, says it’s vital to study and use the information to create an equitable public-health response to the pandemic, which would include addressing what led to such wide health disparities: “We have to think about how we got into the mess in the first place, and put in position things such as better pay, proper workplace protections, and proper access to sick days.” Recently, Premier Doug Ford said that there is no need for the province to offer paid sick days, as support is already available through the federal government’s Canada Recovery Sickness Benefit.
But McKenzie says that Ontario could offer extra support: “I do think it’s important to be clear that it is possible for the province to legislate paid sick days. And they may choose not to, but they can’t say it’s not their responsibility — it actually is.”
When looking at the higher rates of COVID-19 in racialized communities more generally, researchers say, it’s important to look at structural determinants — the root causes of health inequities. “Social issues, economic issues, political issues, environmental issues are all structural determinants of health that impact people’s well-being,” says Ingrid Waldron, associate professor in the School of Nursing at Dalhousie University.
McKenzie notes that taking such factors into consideration, health-care workers of colour
are disadvantaged on multiple levels. “They’re at risk because of their job; they’re at risk because they’ve travelled to their job; they’re at risk because of their communities, because they are living in communities with lots of other essential workers; and they’re at risk because of their housing, because they’re more likely to be overcrowded. Then they’re at risk because of their level of pay.”
Racism, which people of colour are likely to deal with in and outside of the workplace, also plays a crucial role, says Ciann Wilson, an associate professor of community psychology at Wilfrid Laurier University: “It tangibly impacts how you physically are able to respond to your environment and therefore puts you at risk for so many things. You can think about it this way: racial violence, in essence, makes you sick.”
Since the pandemic began, health-care workers of colour who’ve been grappling with long-standing issues of racial discrimination have been speaking out. In early January, nine health-care workers from SEIU Healthcare union filed a complaint with the Human Rights Tribunal of Ontario against Responsive Group’s Rykka Care Centres, which operates 14 long-term-care homes and 18 retirement communities in the province. On January 6, the union released a statement listing the names of the four members it had lost to COVID-19 — all women of colour — and calling for an end to discriminatory and exploitative systems of for-profit care across Canada.
“There have been systemic problems in this industry for decades,” says Sharleen Stewart, president of SEIU Healthcare.
According to Raymond Seelen, counsel to SEIU Healthcare for the complaints against Rykka Care Centres, the workers are asking for the HRTO to order an Ontario Human Rights Commission investigation into the facilities and to have the commission produce a public report on its findings. They are also requesting that the tribunal issue an order to the employer to renegotiate wages and to increase health and safety measures for workers.
“What we’re hoping to achieve is change,” says Seelen. “We’re hoping to get a decision from the Human Rights Tribunal that recognizes the contributions of these workers and that recognizes the struggles that they deal with on a day-to-day basis.”
At Madonna Care Community, where Joseph worked, 97 residents and 60 staff members tested positive between April 6 and June 8. Inspection reports from Ontario’s Ministry of Long-Term Care, released in October, revealed that several health-care violations had been reported there since April 2020; some staff members, for example, had allegedly not worn PPE during the outbreak.
That doesn’t surprise Joseph’s family members. “My uncle was a victim of mediocre health-care [service],” says Joseph’s nephew Soh Tchinda. “And that is not uncommon for Black people to be victims of mediocre health-care [service].”
A spokesperson for Sienna Senior Living, which operates Madonna and 36 other long-term-care homes in Ontario, tells TVO.org via email that “we continue to grieve the loss of our team member and again extend our deepest sympathies to their family and friends. We will never forget their heroic contributions, and we are grateful for the dedication of all our frontline team members. Their safety and that of our residents is at the forefront of every decision we make.” From the beginning of the pandemic, they write, “We worked closely with public health to ensure all protocols were in place and followed consistently. We also took additional actions early on, such as requiring team members to work at a single residence and provided full-time hours to those seeking this type of opportunity.”
Joseph’s family wants people to remember him not simply as a PSW who lost his life to COVID-19 — but also as a doting father, husband, uncle, and grandfather. Daphney says that the last message she sent her father-in-law was a picture of her and Clifford’s two-year-old daughter, Demaya, who last saw Joseph in February. “She was starting to recognize who he was, and it was a very loving moment,” says Daphney. “He didn’t have daughters of his own, but he had a granddaughter. And we’re blessed that he at least got a chance to meet her.”