Seven months have passed since the beginning of the COVID-19 pandemic, and its social and public health impacts are beginning to come to light. Recently published and ongoing studies from University of Toronto researchers examine the impacts of COVID-19 on seniors, students, and marginalized communities.

Since March, it has become increasingly apparent that society’s most vulnerable are bearing the brunt of this virus. The effects of the pandemic are continuously oppressing those facing socioeconomic hardship, illness, and systemic racism. The need for physical distancing is weighed against possible consequences on mental health and quality of life, particularly in older adults.

Effects of physical distancing on seniors’ mental health

Older adults are widely recognized as the age group most vulnerable to COVID-19, with the highest mortality rate. As of May, over 80 per cent of COVID-19 related deaths in Canada were from long-term care homes, according to a report from the Canadian Institute for Health Information. As such, physical distancing is crucial for this demographic — but the consequences on older adults’ mental health are largely unexplored.

An editorial article co-authored by Dr. Charlene Chu, Assistant Professor at the University of Toronto’s Faculty of Nursing, and colleagues at McMaster University, Grand River Hospital, and St. Mary’s Hospital, raises concerns about the impact of physical distancing on the autonomy, quality of life, and mental health of older adults in long-term care.

Social isolation can increase morbidity rates by increasing risks for mental health disorders and other illnesses, and may even exacerbate neurodegenerative diseases like dementia. In long-term care specifically, strict visitor policies and lack of technology for virtual visits can deprive residents of much-needed social interactions.

An ongoing University of Toronto-affiliated study is investigating the mental health, resilience, and coping of older adults in Toronto during the pandemic. The study is led by Dr. Benoit Mulsant and Dr. Linda Mah, in collaboration with the Baycrest Centre, the Centre for Addiction and Mental Health, and several Toronto hospitals.

In the coming months, this research will provide much-needed information on the emotional and mental impacts of the pandemic on older adults, which will guide decisions on physical distancing for COVID-19 and future pandemics.

At the same time, the prevalence of deaths from long-term care home residents has prompted research into how their medical needs can be met in a safer way.

Researcher Dr. Fahad Razak and his colleagues at U of T and St. Michael’s College’s Li Ka Shing Institute sought to develop a method for virtually diagnosing patients, avoiding unnecessary hospitalizations that may be a COVID-19 risk. Razak and his colleagues found that outpatient care services and a central virtual hub for physicians could manage long-term care medical needs.

Social isolation and mental health

One particular area of interest is the mental health of students learning in a new age.

One study from the University of Toronto and McGill University followed up with 773 university students who participated in a mental health survey from May 2019 and reassessed their mental health in May 2020.

By comparing students’ mental health before and during the pandemic, the researchers observed varied effects of COVID-19 on mental health. For students without pre-existing mental health conditions, their social isolation increased and their mental health declined compared to pre-pandemic times. Surprisingly, students with pre-existing mental health conditions reported similar or improved mental health.

These findings suggest that beyond supporting students with pre-existing conditions, universities and colleges should implement prevention and intervention programs for students who are experiencing increased mental health issues and stress during the pandemic.

Shortly after the pandemic was declared, The Varsity interviewed Dr. Steve Joordens, a professor of psychology at UTSC, about his opinion on mental health and adapting to the pandemic.

Joordens described how the pandemic produces feelings of worry because anxiety tends to come when “we feel like we’re under threat and… we’re either not equipped or we don’t have the power to do anything about it.”

“In such situations, your sympathetic nervous system activates the fight-or-flight response, making you feel on edge,” Joordens said.   

He added that the pandemic has resulted in a loss of organization, structure, and human contact that school would otherwise provide. As such, feelings of anxiety and confusion might develop in students as they feel this loss.

Dr. Greg Dubord, an assistant professor of psychiatry at U of T, also emphasized the need to reassert structure into one’s life and adopt beneficial habits.

Both Joordens and Dubord suggested balancing the intake of news and social media, maintaining a clean and organized environment, listening to music, singing, and reading a favourite book to help cope with anxiety.

Joordens later launched a free course on Coursera aimed at helping students maintain a healthy mental state in lockdown, divided into four modules that take a total of three hours to complete.

How systemic racism affects access to health care in Indigenous communities

Marginalized communities, including racialized individuals, immigrants, and those with lower income or education levels are at higher risk for COVID-19. Statistics from Toronto Public Health reveal that racialized populations account for 83 per cent of COVID-19 cases but only make up 52 per cent of the Toronto population.

The rate of COVID-19 cases for Latin American, Arab, Middle Eastern, and West Asian populations was found to be nine times higher, and the rate for Black populations six times higher, than white populations.

There has also been research conducted at U of T that specifically examines the impact of COVID-19 on Indigenous communities.

A recent paper by Dr. Lisa Richardson of the Faculty of Medicine and Allison Crawford, professor in the Department of Psychiatry, closely examined the relationship between the decolonization of Indigenous peoples and COVID-19. Both Richardson and Crawford contended that the medical practices of settlers in North America are but one of many aspects of life that was imposed upon Indigenous peoples during colonization.

As such, many of the healing practices of Indigenous peoples were suppressed and ignored. This history of colonization has not only led to barriers in the health care available to Indigenous communities, but also deficiencies in their social determinants of health.

Both authors maintained that addressing the social determinants of health in both short and long terms “will require the decolonizing of health care at individual, organizational and policy levels.”

Dr. Michael Anderson, an Indigenous physician and a member of the Tyendinaga Mohawk Territory, Dalla Lana School of Public Health, and Waakebiness-Bryce Institute for Indigenous Health, led a study into the data collection for COVID-19 cases among Indigenous communities.

Anderson explained that the health care system is centred around a history of systemic racism and discrimination. This not only results in lower health care funding for Indigenous communities, but the health care system’s history also makes it difficult for Indigenous people to trust the system. As such, Indigenous communities are not seeking medical attention, and accurate data examining the impact of COVID-19 on Indigenous communities cannot be collected.

The gendered impact of the pandemic

On July 28, the Rotman School of Management’s Institute for Gender and the Economy and the Young Women’s Christian Association Canada released a report titled, “A Feminist Economic Recovery Plan for Canada: Making the Economy Work for Everyone.”

As the report discussed, the effects of the pandemic have been unequal, to say the least. Although the Canadian economy has suffered greatly as a result of COVID-19, these effects have been felt by some much more than others.

Women, in particular, have endured worse labour outcomes than men during the pandemic. According to the report, women made up 70 per cent of job losses among working-age adults in March, the first month of most provincial-wide lockdowns. These job losses included a reduction in hours or dismissal from a position entirely, affecting up to one in five women nationwide.

LGBTQ+ health and HIV prevention

University of Toronto experts express concerns about challenges faced by the LGBTQ+ community during COVID-19. In an article published with collaborators at the University of Victoria and the Community Based Research Centre in Vancouver, Dr. David J. Brennan and PhD candidate David Collict in the Factor-Inwentash Faculty of Social Work describe the possible effects of physical distancing on the mental, social, and sexual health of LGBTQ+ men and non-binary individuals.

Additionally, Dr. Peter A. Newman from the University of Toronto and Dr. Adrian Guta from the University of Windsor have commented on potential challenges in HIV prevention during the pandemic, as marginalized communities face challenges such as discrimination and barriers to accessing condoms and HIV testing.

Newman and Guta also mention the importance of positive, community-based engagement as strategies for HIV prevention, instead of strategies that stigmatize sex, which fail to account for the complexities of individuals’ sex lives and have been shown to be ineffective.