No evidence to suggest multigenerational households responsible for Brampton’s rise in COVID cases

Romana Siddiqui’s grandmother was her best friend growing up. The two shared a special bond. 

Whenever her grandmother would come to Canada, home was wherever Siddiqui and her family were. She grew up with three generations living under one roof, and continued that practice occasionally throughout her life. When she got married, her mother-in-law resided with her and her husband. After moving around for a couple of years, the family settled with Siddiqui’s parents, eventually buying a home only five doors down from them.

This new home mainly acts as sleeping quarters for the family. A majority of the day’s activities and meals customarily occur at her parent’s home. The eldest of four, she says upwards of 15 people can be in the home when everyone gets together.

Family dinners were common for Romana Siddiqui’s family before the COVID-19 pandemic.  

As it is for a lot of people around the world, multigenerational living has been part of her life since she was a child. For some it is a cultural norm, others may see it as the only way to afford housing. 

According to the 2016 Census, Brampton had 24,140 multigenerational households and Mississauga had 16,500. These households have three or more generations of the same family living under one roof, according to Statistics Canada.  

Brampton has the highest average number of people per household in Ontario, and one of the highest numbers for any large city in the country. Households here had an average of 3.5 residents, compared with a national average of 2.4 and an Ontario average of 2.6, as of the Census. That means the average Brampton household had 46 percent more people living in it than the average Canadian home. 

Some 42,060 Brampton residential units housed five or more people. It's the only municipality in the GTA where this Census category outnumbered all the others, and a sharp contrast to Toronto, where one-person households were the largest category. 

While Siddiqui acknowledges living in a home with so many people can have its downsides, the traditions, culture and sense of love that is fostered among family living under the same roof, are hard to replace.

“It's an experience that can't be replicated. In a way, it's like a safety net,” she said. 

Over the last week, a disturbing narrative has emerged. Fingers are being pointed at specific cultural groups and practices to explain the increasing COVID-19 case count in Brampton. This includes blaming multigenerational families for contributing to the rise in new cases. 

Early in the week, Brampton Mayor Patrick Brown made unsubstantiated claims, appearing to deflect comments made by Premier Doug Ford recently, who called Brown out during a press conference September 4, pointing out that the city was responsible for almost 40 percent of Ontario’s cases a couple days earlier, part of an alarming trend over the past three weeks.

Instead of addressing dreadfully low testing rates in his city, and the failure to enact stricter reopening measures, which Mississauga imposed, Brown chose another target to explain Brampton’s sky-high COVID-19 numbers.

"I can tell you in Brampton, it's quite common to have multiple generations of the same family living together," Brown told CBC.

"If you have a young person going to school and infects the family, it could be 15 people that are affected. And so there's a greater risk of a more extensive spread."

Brampton Mayor Patrick Brown

While Brown is right about common multigenerational living in Brampton, the second part of his claim has not been proven, and even if it might be a factor, it’s unclear how significant it is. 

After being singled out by Ford, Brown also pointed to residents returning from Pakistan and India, and to international students from those countries in his city, as factors behind the disturbing case figures.

Instead of addressing one obvious reason for Brampton’s problems, the fact it only has one testing centre and its overall per capita screening figures have been far below the provincial target, throughout the pandemic the mayor has provided misleading testing figures. He has repeatedly claimed the testing numbers from Etobicoke’s two facilities (only one was kept open starting in August) were for “our hospital”, telling residents that the city’s health system has conducted more tests than any other place in Ontario. This is misleading, and he has continued to use the Etobicoke figures. 

More recently, since coming under fire, he has pointed a finger at the city’s South Asian-Canadian community.

In Peel, data has shown that Canadians who identify as having South Asian, African, and Latino backgrounds are over-represented among COVID-19 sufferers, compared to their share of the overall population. 

South Asian-Canadians represent 45.1 percent of the region’s COVID-19 cases, but only account for 31.6 percent of Peel Region’s population. African-Canadian residents represent 13.6 percent of the cases but make up 9.5 percent of the population. Latino-Canadian residents represent 4.6 percent of COVID-19 cases, yet make up just 2.3 percent of the region’s population. 

But trying to connect the numbers and specific cultural traditions with the city’s alarming increase in COVID-19 cases since the start of August, raises serious concerns over the lack of evidence, the effect of possible stigmatization and the distraction from the real issues behind the city’s problem, namely its alarming lack of testing and contact tracing capacity.

There’s no sound evidence to back up the claim that multigenerational living arrangements are a significant factor. In Peel Public Health’s September 11 epidemiology report, 250 cases in the region were reported from households or close contacts over the last two weeks. But this information is not specific to multigenerational households. Dr. Lawrence Loh, Peel’s medical officer of health, told The Pointer specific information on the topic hasn’t been shared publicly at this time.

Dr. Nitin Mohan, a physician epidemiologist and professor at Western University, believes such messaging, blaming multigenerational houses, specifically within particular ethno-cultural communities, was highlighted with racial undertones, saying it was “problematic” for anyone to frame the issue this way. 

Siddiqui, who The Pointer has spoken with frequently during the pandemic because of her public advocacy and work with various provincial groups to ensure a safe and responsible return to schools, echoed Dr. Mohan’s concerns, saying obvious undertones of racism and ethnocentrism were present. The Mississauga resident doesn’t understand how family units could be blamed for any significant increase in cases. 

Regardless of the structure, anyone can catch and transmit the virus, as it’s not specific to larger family households, Dr. Mohan said. “Simply saying that multigenerational housing is just causing transmission rates, this is not really an accurate depiction of what's happening,” he told The Pointer. 

According to Public Health Ontario, gender, socioeconomic position, race/ethnicity, and occupation are among a list of components that play a role in increasing the risk of COVID-19 infection. “Workers deemed essential can be at increased risk of COVID-19 infection, particularly if they are unable to work from home or practice physical distancing and do not have access to personal protective equipment,” PHO documents state. This is often seen in service occupations, where women, and racialized workers are overrepresented. 

Truck drivers, factory workers, and grocery store employees can be included here, frontline positions that are extremely important in ensuring the economy keeps running.

When examining the risk threshold, which looks at how far people are willing to go to complete a task, despite its risk, different answers can be expected based on one’s socioeconomic status. Those higher on the socioeconomic ladder have the ability to minimize the risk threshold, and complete tasks such as working from home or ordering groceries online. Those in a lower status, such as front line workers, often don’t have the choice to stop working, despite their risk of exposure to the novel coronavirus increasing.

Dr. Mohan believes it’s important to have an “equitable distribution of testing,” to the population, as not everyone can afford to wait long hours in line to get tested, he said. Lineups at Brampton’s assessment centre are leading to complaints from residents, some saying more than five hours have been spent trying to get tested, recently.

It has been a long-standing issue in a city where case counts continue to rise and there has only been one permanent assessment centre. On September 15, Brampton represented 18 percent of Ontario’s cases. On the 2nd and 6th of the month it had 37 percent of Ontario’s cases each day, and has had about 20 percent of the province’s new infections over the past three weeks. The city has 75 cases per capita for every 10,000 residents since the beginning of the pandemic. Comparatively, the provincial rate is 31 and Mississauga’s is 42 per 10,000. 

“It’s the case that in Brampton, more cases are showing up per capita than in Toronto, that is a message. That is a signal that the government has to provide more resources to Brampton or Peel Public Health,” NDP Opposition Leader Andrea Horwath said in the provincial legislature Thursday.

Yet, testing has remained low, with about 9.8 people being tested per 10,000 residents. William Osler, which manages Brampton’s COVID-19 assessment centre, said it conducts 635 tests a day.

In Ontario, the rate recently sat at 22 tests daily for every 10,000 residents, with between 28,000 and 35,000 tests conducted each day over a recent five-day period into this week. Based on Ontario’s daily target of 20,000 tests, Brampton needs to conduct approximately 890 tests daily to meet its per capita target. It has never come close to this.

Without increased support, Brampton will continue to fall behind. In about a month, the provincial testing target will increase to 50,000 tests a day, Health Minister Christine Elliott said earlier this week. The city’s per capita target will be 2,300 tests every day, almost four times the amount the city is currently doing.

While a pop-up testing centre is coming to Brampton’s Greenbriar Recreation Centre over the weekend, it’s not a permanent fixture. 

Leaders have done little to bring more testing to the city, and it’s unclear if the province even understands the city’s need, as seen through comments that seem oblivious. “If we find that there is a need for another testing centre in Brampton, of course, we will take a look at that,” Elliott said Monday.

In an effort to change this, Brampton NDP MPP Kevin Yarde tabled an emergency motion Thursday, asking the province to bring more resources for testing and contact tracing to the region. “Brampton bears the brunt of these climbing cases, with this motion what it would do…it would help Peel Public Health to do a number of things like hire more staff [and] do more testing,” Yarde told The Pointer. While the motion was passed, details around when help will get to the region remain unclear. 

To confront the rising cases, Premier Ford announced new gathering restrictions for Peel Region, Toronto, and Ottawa. Starting Friday, only groups of 10 will be allowed to gather indoors and 25 outdoors, compared to the previous limit of 50 and 100. Gatherings held in facilities with designated staff, such as restaurants, bars and banquet halls, won’t be subjected to the limit. Events in these facilities are supervised and have strict protocols, Ford said, excluding them from the new rules.

In order to address cases and risk in her community, Siddiqui believes instead of blaming certain groups, officials should look at what they can do to help the most vulnerable people in society. “We have to be addressing some of these inequalities,” she said, noting policies such as paid sick leave and affordable, available childcare should be the norm, if we want to prevent further spread of the virus by focusing on the actual factors that cause it.

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