TORONTO -- Canadians should not be striving for a return to normal after the first wave of the COVID-19 pandemic, according to a mental health physician who argues that weak public and health services allowed the virus to take a deadly toll on certain segments of the population.

Dr. Kwame McKenzie, a psychiatrist and the director of health equity at the Centre for Addiction and Mental Health (CAMH), says the pandemic has exposed serious underlying problems in healthcare and social services, the economy, and the long-term care sector.

“When people say, ‘Hey, let’s just open it up and go back to normal.’ I say, ‘Just a second, normal was the problem. We actually need a new normal,’” he told during a telephone interview on Thursday.

According to McKenzie, an international expert on the social causes of illness and the CEO of the Wellesley Institute, the “old normal” consisted of a business model where many people struggled to get by in low-paying, precarious work with no benefits or pensions. Even before the pandemic struck, he said it was well known that there is a higher risk of illness and a shorter life expectancy for poorer people.

McKenzie said the many outbreaks of COVID-19 in homeless shelters, where people are crammed together in close quarters, demonstrates how economic disparity and poverty put certain groups more at risk for contracting the virus.

The swelling number of homeless using the shelter system is the result of a number of factors, McKenzie said, including low-paying precarious work, a lack of affordable housing, particularly in large cities like Toronto, as well as inadequate funding for mental health services.

As in the homeless shelters, McKenzie said low-paying, precarious work led to the tragedy in long-term care homes because personal support workers (PSWs) were forced to work in multiple facilities to make a living, which allowed the coronavirus to spread quickly among homes. What’s more, due to the demanding nature of the work, there were a high number of resignations that left homes understaffed and more vulnerable when the health emergency hit.

“All of this stuff was making us vulnerable to pandemics. It was making us weak. We weren’t looking after our most vulnerable people,” he said.

McKenzie acknowledged there are regional differences across the country and some provinces, particularly those that have invested in their health and social services, have fared better than others during the pandemic.

He said B.C., for example, appears to be acting quickly to address the problems in the long-term care system, and new rates of infection in that province have been steadily decreasing in recent weeks.

Ontario and Quebec, on the other hand, have seen fluctuating rates of new infections, even as both provinces begin to gradually reopen.

McKenzie, whose research focuses primarily on Ontario, says the province was particularly vulnerable to the pandemic thanks to decades of austerity measures by provincial governments dating back to Ontario Premier Mike Harris. He said years of cuts to spending for public healthcare and social services has put the province in a “difficult situation.”

McKenzie said Ontario’s healthcare difficulties have been exemplified in its problems with testing for coronavirus. The province has struggled to meet daily testing targets and McKenzie says it has the one of the lowest testing rates per capita in the country.

“That testing and contact tracing is the basis of the public health response as well as the lockdown,” he said. “So if you can’t do up to capacity on your testing and your contact rates, then you've got a problem.”


While the pandemic may have exacerbated some of these societal problems, McKenzie said it has also presented governments with the opportunity to act now to be more prepared for a second wave of infections.

“Things have not gone as badly as they could have, the problem is, they haven’t gone as well as they should have,” he said. “If we had been stronger to start off with and if we’d had a quicker response, we would have saved more lives. That’s my problem with old normal. We got used to having weak public services, weak health services, and not thinking about people first, but thinking about profit first.”

McKenzie also said he believes the second wave of infections will likely occur in the fall when schools are resuming and the flu season returns. He said governments should be investing in their health-care systems to increase capacity, addressing problems in long-term care homes, finding housing solutions for the homeless, preparing schools for students’ return, and looking at how to provide good jobs and benefits.

“We’ve got a race against time now,” he said. “And the question we have to ask ourselves is, do we want to be in exactly the same shape going into the second wave that we were when we went into the first wave?

“All of these things can be done by government. We can actually make a new normal that works better for people. It’s not blue-sky thinking.”