Breaking down barriers to care: How pop-up COVID-19 testing sites in East Toronto helped the community’s most vulnerable

By Lucy Lau

When Ravi Subramaniam needed a COVID-19 test this summer, he didn’t go to a hospital.

Instead, he went to East York Town Centre, a shopping centre situated within walking distance of his workplace.

There, he visited the TNO Youth Centre, a community hub for youth with a separate entrance on the south side of the mall that typically plays host to sports programs and workshops.

From June to July, the bright space was transformed into a pop-up COVID-19 testing site complete with medical supplies, computers and healthcare practitioners clad in personal protective equipment (PPE).

Ravi was one of more than 1,300 people who went to the mobile COVID-19 testing facility during its one-month run in Thorncliffe Park, which was organized by Michael Garron Hospital (MGH), East Toronto Family Practice Network (EasT-FPN), Health Access Thorncliffe Park (HATP), Flemingdon Health Centre (FHC) and TNO — The Neighbourhood Organization.

“It was super convenient and very easy,” says Ravi, director of strategy partnerships and hub development at TNO, a community-based multiservice agency that works to empower East Toronto neighbourhoods like Thorncliffe Park, Taylor-Massey and Flemingdon Park.

That ease and convenience is one reason why the pop-up COVID-19 testing sites coordinated by MGH and its community partners have been so successful during the pandemic.

From May to July, the temporary facilities conducted more than 2,700 COVID-19 tests across four pop-up sites in Taylor-Massey, Parma Court, Thorncliffe Park and Pape Village.

They’ve been key to addressing the social determinants of health, such as income, education and literacy, and housing, that make it difficult for some people to seek or access care.

“All of our work revolves around breaking down barriers to healthcare access,” says Jennifer Sampson, manager of special projects and the COVID-19 Assessment Centre at MGH during the pop-ups’ run.

While MGH opened a COVID-19 Assessment Centre — the first in the province — at its Coxwell Avenue site in March, the hospital’s infection prevention and control (IPAC) team quickly discovered a need for mobile community testing when they began seeing trends in COVID-19 positivity rates in East Toronto.

Analyzing data related to where patients who were testing positive at MGH’s COVID-19 Assessment Centre live and where patients with COVID-19 concerns in MGH’s Emergency Department (ED) were coming from, the IPAC team was able to determine which communities in East Toronto were seeing a higher number of positive COVID-19 cases.

To improve access to COVID-19 testing, which is a critical public health strategy that prevents and limits the spread of the novel coronavirus, MGH began reaching out to its East Toronto Health Partners (ETHP), as well as other long-time partners in the community, to set up pop-up COVID-19 testing sites in priorirty neighbourhoods.

“It was important that these temporary testing sites be located in the communities we serve,” Jennifer says.

The mobile sites offered free COVID-19 testing to members of these communities by walk-in and appointment.

“I strongly believe that the success of our pop-up COVID-19 testing centres and our ability to be nimble and efficiently offer robust care is due to our community partnerships,” she says.

Test results were available online and by telephone, and a hotline was set up to walk people through how to access their results.

The pop-ups also distributed masks and education materials — available in languages such as Urdu, Bengali and Tagalog — that shared how people can best protect themselves and their community against COVID-19.

“There was a real importance placed on the accessibility of translated materials so we could educate the community about COVID-19 while also correcting any misinformation they may have received,” says Jennifer.

In addition, each pop-up COVID-19 testing site was strategically placed in “natural gathering places” in East Toronto, like community centres and malls, Jennifer says.

The sites also employed community ambassadors and volunteers who helped get the word out about mobile testing and the importance of being tested for COVID-19.

This helped build trust in the community (“When you see your peers advocating for and taking COVID-19 tests, you’re more encouraged to participate,” says Ravi) and was one part of MGH and its East Toronto partners’ multipronged communication approach, which leveraged unconventional avenues for community outreach.

These included connecting with local mosques, tenants’ associations and community WhatsApp groups in East Toronto in an effort to raise awareness about the mobile COVID-19 testing sites.

“A lot of our work involved using traditional and untraditional forums to reach as many community members as possible,” Jennifer says. “We wanted them to know that these pop-up testing sites are safe, accessible and available to them and their families.”

As the team worked to test community members, they also responded to trends they saw while on the ground.

At Thorncliffe Park, this involved conducting outreach to seniors, an at-risk population that is susceptible to COVID-19.

These efforts followed a successful pop-up COVID-19 testing site at a Parma Court high-rise building where 80 per cent of the residents are more than 70 years old.

There, nurses and physicians from MGH and its East Toronto partners went door to door, conducting more than 200 COVID-19 tests over the course of four days in June.

For Jennifer, the rollout of these innovative, people-centred initiatives would not have been possible without the relationships that MGH has built with other East Toronto healthcare and social services organizations over the years.

“I strongly believe that the success of our pop-up COVID-19 testing centres and our ability to be nimble and efficiently offer robust care is due to our community partnerships,” she says.

She sees mobile COVID-19 testing sites as a valuable tool in the fight against COVID-19, especially as the pandemic continues into the fall and fears of a second wave loom.

For Ravi, the pop-ups go beyond providing safe, accessible care to priority communities.

They help mitigate fear and anxiety over COVID-19 and share important information about the virus — all in a place where residents feel at ease and at home.

“They don’t have to take a bus or subway or travel a long distance to get a COVID-19 test or to learn more about how they can protect themselves,” he says. “They can do it right here.”