The Agenda with Steve Paikin (Audio) - Is Covid-19 Still Dangerous?

Episode Date: October 5, 2024

The Agenda's week in review featured a conversation with one of the commissioners of the Truth and Reconciliation Commission, the current state of covid-19, Ontario's water infrastructure challenges, and Toronto's congestion nightmare.See omnystudio.com/listener for privacy information.

You were one of three commissioners alongside Justice Murray Sinclair and Chief Wilton Littlechild. Given this challenging undertaking, people probably might be surprised to learn that this is not an appointed role. You applied for this. Why? Well, the issue I already knew about, you know, I was a journalist for most of my professional career and I had worked and lived and reported in a part of Canada that had the highest per capita number of residential school survivors of anywhere in the country. Even though people were not talking about it a lot at that time, you could see all around you the struggles and some of the challenges that flowed from how people felt about each other and how they felt about themselves. I grew up in a family home

where my husband himself was a residential school survivor and I was raised in one of the Christian churches that ran residential schools even though I didn't know about it as a child growing up. And I came from a non-indigenous background so I thought this is work that Canada needs to tackle. I have skills as a journalist, I have insights to the residential school story and I have a perspective that is to the broadest reaches of all of Canada. I should offer that. I'll offer those skills and see what happens. I want to pick up on on on your identity. You are the sole non-Indigenous Commissioner of the three. What did you hope to bring to the table alongside the co-commissioners?

Well it's one of the things that we said throughout the Commission and I repeated in various ways in my book as well is that, you know, the story of residential schools, which we've come to know in this country as having been a really problematic policy framework, a cruel framework in many, many ways and a very disruptive one to the well-being of individuals and families and communities, that those were not things that were set in motion by Indigenous people for themselves. They were set in place by laws that Canadian legislators passed, mostly men at the time, and policies that were put in place and adopted and implemented by four of the largest national church institutions in the country. And so if those things were created and they created harms,

why should it be up to indigenous people on their own to try to figure their way out of that and move beyond that and heal from that? I really felt an onus of shared responsibility and that even though I had nothing to do with any of that historically I do have responsibilities in the present day and I have responsibilities for what comes next as I feel we all do and so I wanted that perspective to be there that we own that that we own the history and that we own the accountability for that and that we own responsibility for

going forward in a good way. In that excerpt that I had read earlier you wrote that you were looking at a hundred and fifty years of history all across this country. How did you know where to begin? Well it was interesting I mean you have to picture there was no guidebook for this Truth and Reconciliation Commission. Indeed there was no guidebook for this truth and reconciliation commission indeed There was no precedent for a national truth and reconciliation commission in a so-called Western developed country If this was the first it was the first in the world ever to be looking at harms that were specifically against children And it was the first to look at harms that happened in the context of state-sponsored

legal decisions, not in the context of military warfare, and not in the short term, but over the timeframe of more than a century. So your question is right. It was huge. And sort of where do we go? So one of the things that's really important for all Canadians to understand, remember if they once knew but certainly not forget, is that this Truth and Reconciliation Commission was not a government-sponsored policy. It was an obligation put on the government and the

churches by the courts as a result of a massive class-action court case. And what that court case said is that among other things there will be a Truth and Reconciliation Commission so that those 80,000 at the time living survivors of those schools who are not going to have their day in court because it's an out-of-court settlement will have a forum where they can come forward and speak their truth of what their experiences were and provide the evidence of their own life experiences as children and So they gave us signposts as to how to do that in our mandate. We didn't make up how are we going to go about this.

And the mandate told us certain things that we had to do. And one of the things they told us we had to do is to hold and support an unspecified number of community events, but also very specifically specifically seven national events. It didn't say where, it didn't describe the nature of them but it said seven national events. So we, I mean the first thing it's important to say is that we worked with a Survivors Advisory Committee and they were representative of all the regions of Canada in the broadest sense. They were from all over the country and so they didn't all have exactly the same residential school experiences but they

had all lived through residential schools. Do you think we, and when I say we I mean not just the public but governments, everybody responsible here, not you, but others, have become somewhat complacent about COVID now because we are not, you know, we haven't shut down schools, we're not shutting down cinemas, malls, and all that. We're kind of sort of back to normal otherwise. I think complacency is a huge problem.

I think one of the things that I wish we'd done differently during the pandemic is we reported so much about deaths and hospitalizations. I work a lot with older adults, and for older adults, sometimes dying is not the scariest thing. It's losing independence and the ability to live a good life. When I see those hospitalization stats, every number there to me is a family

who's gonna struggle to help their loved one get back to the level they were. When you're middle-aged and older and you're in the hospital with a serious infection, COVID or any other infection, the chance of going back to the life you once had is small and we don't have the resources to do that. It's estimated that only 2% of Ontarians get rehabilitation care, which is evidence-based practice for recovering from a serious hospitalization. Our family practices are completely overwhelmed because one of the things that happens post-hospitalization

is what's called increased medical complexity. You might have a heart attack next. You might need some help getting mobile again. So the complacency here upsets me because it's straining so many of the other systems and we're not putting two and two together and attributing the stress in our family practices, the stress in our hospitalization, our healthcare worker burnout to the fact that we have a lot of hospitalizations still for COVID because there's a lot of COVID going around. Who do you blame for the complacency?

I think I will put some blame on government policies. It's hard for people to know how serious it is. And we discussed earlier how hard it is to get a vaccine. As I always say as an immunologist, actually any COVID vaccine provides some protection. So when somebody is starting chemotherapy, maybe they're going to the hospital for a major surgery. There are lots of good reasons why you should get vaccinated

right now if you have something like that coming up and you can't. And as well, we don't have access to testing. COVID's an unusual infection because we actually have a treatment that helps keep people out of Hawke's Hospital, which is Paxlovin. But it only works in the first day or two that you have COVID. So without the testing, without the public knowledge about that, without any of us being

able to say how much COVID is there around, it's difficult for people to make that risk calculation. Feels, Isaac, like the provincial government. And I, OK, I'm going to be careful how I say this. us being able to say how much COVID is there around. It's difficult for people to make that risk calculation. Feels, Isaac, like the provincial government and I, okay, I'm gonna be careful how I say this, but they're reading the room. They're pretty good at public opinion. And public opinion is we're done with this.

So do you blame them for not leading the way? I wanna politely push back on a few items. Sure. Think about the levers we have to pull. Okay. Said another way. What are you gonna do different? We're well past the era of mandates for vaccines and for masks. Like that should not even enter the equation. Okay. We know this virus is never going away. We know that we can improve the indoor air quality and that's a that's a that's a

there's a big push to do that and that's a good thing. We know that many people can choose to wear masks but again like I said we're well past the the air of mandates. We know that vaccines do not block infection and transmission nearly to what they did earlier on in the pandemic. They still have some capacity to do that, to a lesser extent and for a shorter duration, but the heavy lifting of the vaccine is to significantly reduce the risk of severe manifestations like hospitalization and death. We know that the therapeutics, Paxlovid,

based on the most recent data, probably, keyword probably, helps those only at greatest risk for severe infection and doesn't really have much utility in a vaccinated or infected and recovered population that's younger with fewer risk factors. So like this virus is here and this virus is going to continue to circulate and we of course can take steps to protect ourselves and protect those around us. I just have to, I think we have to be realistic about what tools we have and the utility of those tools, which is kum si kum sa. And, you know, to one other point that's semi-related, thinking that an infectious

disease specialist, an immunologist, an ethics expert are going to navigate this, yeah, we're helpful, but we really need behavioral scientists. And the integration of behavioral scientists into communication, epidemic management, pandemic management is extremely important. Because to your point, how do you read the room? How do you reflect doing the best you

can to protect individual and population health with what is the will of the people you're working with? Because that's going to be different in different populations. Well, let me ask you about what was- About behavior science, because I'm a psychiatrist. I was actually going to ask you about long-term care homes, because that was ground zero for many people

when COVID was at its worst. Have we learned enough? Are we employing what we have learned to ensure that long-term care homes are safer today? So I'll come to that in just one second but just want to pick up on something that Isaac said. One of the things we know about COVID at the moment is it's not the same as most infections. It increases the risk of a number of physical illnesses and there's a risk of long COVID. And the more often you get COVID, the more likely you are to get long COVID. So if this virus isn't going away, then part of the calculation we have to do on risk, and also the calculation we have to do on public policy, is around what happens over a period of time where more and more people have been infected more times, and therefore we have an escalating number

of people with long COVID. If you do the math that way, you start thinking that some of the public health measures that are in our arsenal are things that we should be employing more now to prevent the long-term problem. People think COVID is just like having a cold. It's not. And that is our public policy problem at the moment. Michelle, start us off here. What are the chances that a community in Ontario could experience the same kind of large water main failures

that were all over the news in places like Calgary and Montreal earlier this year? Certainly the possibility exists. We have, you know, lots of aging infrastructure in the province. The one advantage we do have here in Ontario is the drinking water quality management system, which involves a very comprehensive risk assessment process that each municipality has to undertake on a routine basis. And as a result of those risk assessments, they do have to develop emergency plans and emergency response strategies to ensure that the catastrophic failures that we see can be mitigated or prevented. Keely, let's do some real, you know, water management 101 here.

How does a water main fail? How does a water main fail? How does a water main fail? Typically, it's a break in a water main where you have our water mains are encased in fill to protect them. They can be either plastic or they can be concrete and when that fails you get a break and when that break happens our water mains are under pressure because you're pushing a lot of water through them at obviously a high pressure. And when that break happens, it can be catastrophic.

Nick, is it simply a case of old age most of the time? It can be, but not always. Corrosion plays a factor, underground metallic pipes, certainly there's pressure spikes less frequently that can cause damage to water infrastructure and in some cases it is absolutely old age. And Barbara how big a deal is leakage in water mains across our province? Yeah so whenever we have leakage in our engineering systems whether sewer or water main residents

are paying for that for the for the are paying to treat that water and try to convey it and so it's very very costly to have water main breaks. And also, I estimate about 60% of the water, when a water main fails, 60% of the water is getting down into the sanitary sewer and showing up as leakage into the sewer. And if the water doesn't go up, it goes down. And the right of way is all built at the same time,

so there are favorable flow paths. So it costs us double. Now we're doing a program on this, so obviously we think this is a bit of a big deal. Is this a bit of a big deal? Yeah absolutely, certainly. Well because I guess I would say Canadians we've come to expect that we're gonna have a hundred percent water at our house a hundred percent of the time the morning noon night no matter the temperature of the weather. We take it for granted don't we? It's called level of service. I think's reasonable. I think we need to start thinking about perhaps the level of service we come to expect from

our infrastructure cannot meet these beautiful ideals or whatever. Maybe the odd break where you have to use bottled water for a few days. Maybe we need to learn to tolerate that because we certainly are way behind on funding our infrastructure, way, way behind. Okay, let me go to Keely on that. You are in a part of the province that has been growing by leaps and bounds over the last, well, let's say 10, 25 years or so. What's a bigger priority for you in Peel?

Is it fixing what you've got right now or building new stuff to accommodate all the new development that's happening? Wow, that's a good question. I would say historically, the focus has been on maintaining our existing infrastructure system. We've got over $28 billion in assets in just the water and wastewater infrastructure.

So that's a massive program just to maintain it. But more recently, it's the growth infrastructure that's really become priority for us. In our upcoming budget for 2025, we're looking at 80% of our capital budget is going to be for growth infrastructure, that new infrastructure. If you don't mind, Steve, you have to do both. And this is the really difficult balancing act for municipalities is given our limited resources, financial resources and people too.

I mean, there's only so many people in the industry. How do you do both? How do you deal with your areas of largest risk while you're making sure that you're still providing the ability for the community to grow as well, because both are important. Well, you've got an even bigger problem, I would suspect, in Hamilton than Brampton, in as much as,

Hamilton's a city that's more than 200 years old. You've got some real old stuff there, presumably. We absolutely do, and I would say it's a different challenge. I mean, we have, in Hamilton, the second oldest water system in Canada, the third oldest wastewater system. And when you think of relying, in some cases, on infrastructure that is as much as 120 years old, ironically, sometimes that's your most robust infrastructure,

because there were different manufacturing practices and things historically. But it does carry an element of risk. And know as I said to our own City Council just this past Monday, when you're in the water business running a utility it is very much about risk management and where can you tolerate risk, where do you have operational programs in place that allow you to mitigate things and where do you absolutely have to move forward with a fast-tracked or preferably a planned capital intervention? Michelle we have, I shouldn't say we, the

province of Ontario has set a very ambitious goal to build a million and a half homes by the year 2031 and that means all of you are sort of on the hook to make sure that we've got water systems that can accommodate that kind of growth. Talk to us about the biggest challenges that people who do for a living what you folks do for a living have in order to accommodate that future growth. It's multifaceted in terms of how the municipalities are being tasked to approach this. We tend to forecast out 20 to 30 years with the master

plans and the capital plans and when those targets are moving very quickly there's not always enough money in the bank to do it and so we need to look at other funding tools or financing tools to allow municipalities to quickly deliver the infrastructure that's needed to support that growth. I think there's an opportunity for better alignment with developers and timing of when those expansions are actually needed and when the municipality is able to start collecting on those rates, water user rates and property taxes, and also better alignment with some of the other water users, big business, the province itself in terms of education and

healthcare because those can all pose significant demands on a water and waste water system in terms of supporting that growth. This capital city is getting quite the reputation and I guess I want to know is there anything truly that can be done about this or are we just screwed? Well firstly I have to think about why we're here and how we got here. And we have under-invested for so long in the city. And we have amazing investments that are happening,

unfortunately, all at once. We have 200 cranes in the sky building housing that's much needed. Sometimes they use the lane of traffic. We have over $30 billion in transit being constructed. That's a good thing. And the city of Toronto spends about $1 billion in construction, fixing our roads, our sewers and all that

important infrastructure every year. But we need to manage it better. We know we need to manage better. We are trying hard. We're taking congestion seriously and next week we're going to debate our congestion management plan at City Council that is looking at all those great things that we have underway to get Toronto moving. That's really the question, if I can follow up, is there is a lot going here. The city's on steroids in terms of being built right now. But can we be managing how we're doing all this better,

in your view? Absolutely. First of all, we need to understand the causes of congestion before we start thinking about how to fix them. So there are three basic causes of congestion. The obvious one is that you have too many cars that don't fit in the road.

Take the Gardner, for instance, capacity 6,000 vehicles per hour. If you throw at it 7,000 or 8,000 vehicles per hour, it will not move. The second less obvious cause is when you try to push your luck with traffic, capacity itself drops. So the Gardner will no longer be operating at 6,000

because per hour it will drop to 5,000, which doubles the congestion. And then the third cause is events, such as construction and incidents and so on. Each one of these causes has different approach to solving it. Which would, I mean, can we be doing this better? I guess Giles is the main question. Yeah, I think, and I be doing this better? I guess, Giles, is the main question.

Yeah, I think, and I think the deputy mayor put it very well in terms of, we sort of sat on our hands for a long time. This region grew by 2.5 million people in the last 20 years. We have 1.1 million more cars on the road, and we didn't really build very much at all. We lived off the fat of the land for a long time, and now, thank heavens, we're doing a lot of building of infrastructure, but it's going to take another,

it's going to take another six or seven or eight years till we see even the build out of the Ontario line, which will be a game changer, I think. We're seeing the electrification of gold, again, it'll take another bunch of years. That's another game changer. So there are solutions on the way, but I still think it's going to take a whole bunch of years, that's another game changer. So there are solutions on the way, but I still think it's going to take a whole bunch of

different solutions. It's a very layered problem and I think we have to look at each aspect of it. The city started to do that actually with the traffic management plan update that was released a week or so ago. They're making significant steps. I think they need to go a lot farther and a lot faster. But I'll give you one example. The way people are driving, it's the Wild West

on the roads of Toronto now. People are so frustrated that you've got all kinds of people breaking every traffic rule in the book, running red lights, parking illegally during rush hour. And I think there needs to be a much greater focus on enforcement and probably electronic enforcement like you have in the UK, like you have in Washington, BC, because you can't have policemen everywhere.

But even curbing, so I'm just picking one element of this, it's part of the tapestry of the problem, is I think much better enforcement so that drivers are more disciplined. That's just one element. There are many others. I think you look at our major arteries, arterial roads, they become very, very clogged. And the reason is we've put too many things into those arterial roads. Now you've got often one lane each way on roads that were designed to bring people

in and out of the city and across. Yeah, we'll come back to this. I want to sort of tap into your experience on this because you what, moved here maybe 25 years ago almost? Oh, geez. Let's go 20. Let's go 20. 20 years ago, okay.

And give us a comparison. What was. Let's go 20. 20 years ago. Yeah. Okay. And give us a comparison. What was it like when you were here 20 years ago when you first got here compared to today? Right. So 20 years ago I was car dependent. I moved from Mississauga. I would, you know, come and go on the Gardner to the west side of Mississauga within 25 minutes. It was nice, manageable, you could do it. That doesn't happen anymore. My mom is in her mid-70s right now. She is more or less given up on driving to the city,

but she wants to see her grandchildren and doesn't need to see me. Needs to make sure that her grandchildren see her on a weekly basis. And she's taking the GO train from Mississauga. She'll take a bus down to Clarkson, hop on the GO, come downtown, we'll pick her up at Maine, and she's spending the entire weekend with us. It's a complete game-changing scenario where car dependency has kind of brought us to a near just impossible way of moving. We've got to start looking at options that don't necessarily put us in cars.

I'm not trying to make trouble here with this question, but you've heard this expression before that sometimes this city feels like it's having a war on the car. Do you buy that? No, not at all. A good city relies on all modes of transportation coming together so that people can get where they need to go effectively, efficiently, with the mode of their choice. And I think one of the things we need to remember in the city is

not all trips are also from car to car, like from beginning to end or from bike to bike or from walking to walking. People use multiple modes sometimes in one trip. In my community in Scarborough East, you might drive to the GO train and then take the GO train downtown and then walk up. So we have to have all modes of transit available, efficient and working well and we have plans for all of them.