 Welcome everyone, we're just going to wait until we feel like most people have arrived and then we'll do our introductions. All right, I want to welcome everybody. My name is Martha Painter, I'm a research scholar at the Health Law Institute and it's my great pleasure to get to moderate today's session. Before we begin, I want to acknowledge that we are on the unceded and surrendered land of the Mi'kmaq here at Dalhousie University where the Health Law Institute is located and I'll let Alex do their own land acknowledgement for where they are. This is the first of the health law seminars for 2022. Our theme is flourishing recovery with justice and equity and I want to let everyone know that the session today is being recorded. Alex will speak for about 40 minutes and then we'll have questions for about 20 minutes. You can type your questions into the Q&A into the chat and we'll respond to them that way. There is live captioning available, you should see the link to that in the chat. And now I just want to introduce Dr. Alexander McClelland who is an assistant professor at the Institute of Criminology and Criminal Justice at Carleton University. From 2019 to 2020, he was a banting postdoctoral fellow at the University of Ottawa in the Department of Criminology. His work focuses on the intersection of life, law and disease where he has developed a range of collaborative and interdisciplinary projects to address issues of criminalization, sexual autonomy, surveillance, drug liberation, and the construction of knowledge on HIV. He is a member of the HIV Justice Network Global Advisory Panel. We are so pleased to have you here today, Alex, and I'll give you the floor now. Thank you so much, Martha, for the generous introduction. I'm so excited to have this conversation with you and thank you, Adelina, and thank you everyone at the Healthline Institute at Dalhousie. I'm coming to you from the unceded traditional territory of Algonquin in Ottawa. And I am going to talk to you today about some of my work in relation to policing pandemics. So what I'm going to do is share my screen. I'm not a giant PowerPoint person, but I made a fancy PowerPoint for you today. So hopefully it works. Bear with me. That should hopefully you're just seeing the slide. And so I'm going to talk to you today about policing pandemics and some of my diverse work in relation to that. Just a little overview of what I plan on talking about today. I'm going to give a little introduction of who I am, why I'm talking to you all about this, a little bit about my work. I wanted to just briefly kind of define what I mean by policing. For policing scholars, policing means a very specific thing. For criminologists, policing might be understood more broadly. I'll define it for what I mean. Then I wanted to tell three stories. One, looking to the past from how people responded, how Canada as an early state, early colonial nation state responded to syphilis, the syphilis pandemic or epidemic, how we responded to HIV and then look today for some kind of anecdotes on how we responded to COVID. And when doing this, I want to be really clear that I'm not saying there's any commonalities or similarities between the infections themselves. I'm really looking at how we have responded using forms of police and enforcement and law to these very different and divergent diseases. And from these three stories, I am hoping to share five kind of general lessons that I think are just interesting for us to move forward in understanding policing and pandemics. So that's a little bit of an overview today. So I am a public and critical criminologist. Primarily I do qualitative research and I was actually asked if I could share a specific paper today on my research in relation to policing pandemics. I don't have one specific paper, but throughout I'm going to do a bit of shameless self-promotion, apologies, but sharing some of my diverse work in relation to this issue so that you can read it, share it, find it, that kind of thing. And so there's not one unique paper about this issue that I've written about, but a whole bunch of different things. And so my dissertation research, which I completed at Concordia University, was looking at the lived experiences of people who were criminalized due to allegedly not disclosing their HIV status to sex partners. I examined their firsthand experiences, people who had been criminalized, people who are registered as sex offenders, people who only had their stories told through a dichotomous narrative of victim and perpetrator and whose stories and narratives were often erased and only the dominant understandings of their experience were told through the narratives of the criminal justice system and police and courts and media. And so I worked on documenting people's experiences themselves to highlight the nuances and complexities of their experience. Out of that work, when COVID hit, I started to be really concerned because all of the people I talked to in my HIV criminalization research actually had felt victimized by the criminal justice system themselves. They often didn't feel like they had done anything wrong. And that their experience was misunderstood, that their understanding of risk was hyped up and uneducated police officers and courts who didn't understand how HIV worked amplified risk due to fear and hysteria and ignorance. And so when COVID came about, I started being quite concerned that ongoing racist patterns of policing and the ways in which marginalized and people who are made to have been socially marginalized and oppressed are always targets of police, specifically in the context of one we've seen in the past with HIV and with syphilis. In the context of COVID, I became quite concerned that the same thing would happen. And so I started this project with my colleague, the Policing the Pandemic Mapping Project, where we started taking media sources and placing them on a map across Canada so we could kind of understand how and why or how policing of COVID was manifesting and how forms of enforcement were operating. The project ended last year. We captured a number of different waves of the pandemic or no, sorry, the project ended this year. Or no, last year, it's 2022. Jesus, time moves weirdly. But yes, we ended in 2021, we did one full year of the pandemic, and then it became actually really, really challenging to get accurate information on forms of enforcement. It was not really in the media anymore, and governments themselves were not really collecting accurate information in the way that we could kind of do anything with. So we've transformed the project slightly, but there still is a really solid record in here across Canada of the first year of COVID enforcement. Pretty confident we've documented most instances. And there's also, it's mapped onto this map, and then we also have a database. Part of the project really was not to question public health regulations necessarily. We are, I am pro public health, I am pro us following appropriate public health guidance that's grounded in human rights. But I wanted to put into question the role of police in this context and how police have been placed as central actors in responding to the pandemic. And so part of what we did was we really did a lot of public criminology work. We were in the media tons. We calculated the amounts of fines to highlight the disproportionate impact on poor people who were being fined and did a lot of work around that. And so I'm coming to you with some of that experience. I'm a critical criminologist, a qualitative researcher. I do some historical work and do lots of public criminology on this issue. So what do I mean by policing? So I use a really broad, when talking at policing of the pandemic, I use a really broad term, a really broad definition inspired by the work of JP Broder, who looks at the police assemblage and how police is a plural enterprise in which many different agents from different public institutions and also the private sector can collaborate together. Broder also outlines that policing can be mobilized as a verb, sorry, and that there also can be a whole range of various different specialized administrative policing agencies. So we're talking not just about the police in uniforms or police departments here. I'm talking about policing in a very broad sense in which a range of different actors are employed or together to work in concert, sometimes collaboratively, sometimes not. And so this might involve public health actors, might involve people in the media, might involve community based organization, institution, actors, a whole bunch of different range of actors and also private security guards in the context of COVID. For example, in Manitoba, it's a private security force who is enforcing COVID. And also in many places, for example, in COVID as well, people, bylaw officers have been tasked with enforcing COVID. So bylaw officers are policing as well. They police aspects of the street and public space already. But so just really using a broad notion of policing and understanding this policing, policing assemblage that Broder talks about. So that's just kind of to define policing. I'm going to tell three stories now. Hopefully, I can kind of power through them. I love all the details of these stories. I won't touch on all of them. But I just want to kind of get them to give us or use these stories to give us some context for the lessons that I want to bring forth. And I find it really helpful. It's a critical criminology approach to look to the past, doing a history of the present, look to the past to understand our present context. And so I find looking to the past often really helpful for understanding where we're at and where we ended up being and why police are so central in disease control responses. So the first story I want to tell is about an 18 year old named Eleanor Patterson, who was detained in Fort Saskatchewan goal, which is still Fort Saskatchewan institution in Alberta. And she was detained, one of the first people detained under the new Alberta Venereal Disease Prevention Act for having syphilis and gonorrhea. And this was around the time when there was a massive and growing syphilis epidemic across Canada. Over 66,000 cases in the Army were documented. And in 1916 and in 1917, at Toronto General Hospital, there was around 13% of all patients had an active case of syphilis. And some statisticians at the time extrapolated that number to be the whole city of Toronto had a rate of syphilis around that high. And so there was a massive syphilis epidemic happening across Canada. This was a disease that people did not talk about and were very terrified about talking about. There was a lot of stigma around it. And so there was a whole kind of coordinated range of legislation that was enacted in the same time. So this one, this one, this new venereal disease legislation that was passed that helped incarcerate and detain Eleanor Patterson as part of a coordinated response across Canada that also included the introduction of a provision in the criminal code, which ended up being repealed in 1985. But there was a whole bunch of other provinces that enacted similar legislation. And this legislation allowed for the forced force testing, detention if tested positive, and incarceration in jail until you and forced treatment until you were, until you were cured. And interestingly here, this is a complaint form, which is what a judge would fill out for whoever's charges they had to, for whatever charge you had in court. And so the judge at the time, who is, was Emily Murphy, who was a famous feminist part of the famous five. The judge at the time, instead of writing, say, for example, was charged, was did a burglary or an assault or whatever, the judge at the time indicated that the offense was just that Eleanor Patterson was infected with venereal disease under the venereal disease legislation. And this is quite interesting because it conflated viral infection with criminality. And she crossed out what the charge was and said just was infected with, which is quite interesting to think about and the consequences of that codifying infection into criminal law and into a common law criminal law proceeding. And so what was also interesting at the time was the project of public health itself was a very new invention. And so there was very limited public health infrastructure, there weren't clinics, there was a small number of hospitals, and people were very terrified of venereal disease. So what they did was rely on criminal justice infrastructure. This was the early days of public health. And the initial reliance was on courts and jails to address criminal, to address the venereal disease. And so this law was instituted, which enabled the incarceration of people who tested positive for venereal disease to keep them away from the rest of society. Just really quickly, this is just kind of an interesting side note about this case of Eleanor Patterson. This is actually a letter she wrote while incarcerated from from jail while she was incarcerated. And you can see at the top that it's kind of reprinted letter by Emily Murphy, who states that she was committed for having syphilis in gonorrhea and classes at her name. But interestingly, because she was incarcerated, this letter outlines that she had, she suffered a lot of social isolation because of being incarcerated. And being held in prison meant that she felt that she was facing a form of impunishment for her behavior, as well as a coercive public health measure. So her incarceration was not solely about curing her of venereal disease, it was also about remedying the morally repugnant behavior that led her to her infection in the first place. They were targeting young, vagrant women who were often single, often sex workers. And so there was the act of incarcerating someone within the criminal justice infrastructure enabled a dichotomous narrative of victim and perpetrator and moral wrongdoing. And so this was also just a really interesting case, because if you're a lawyer, it betrayed habeas corpus, this act of detaining someone without a trial against their will, where there was no trial or actually no real charge, betrayed habeas corpus. And this is a letter that Emily Murphy wrote, where she was saying that this is a test case, it was kind of sketchy, she was going to see if she could move forward with it, and defense lawyers at the time contested these cases, often believing that the men were equally as responsible for their infections. And one stated in court, it takes two to have sexual intercourse, are you a decent man to the man who was complaining against a woman who was going to be incarcerated. Many of the women who were incarcerated were, as I mentioned, sex workers, single working class and indigenous women, they were often targets. And Emily Murphy at the time, who was recorded herself of charging in one year 75 cases and 66 cases the next year. And so in a local, and what happened was the local prison population tripled. So as a result of this among women, as a result of this legislation, prior to this legislation, there was around 20 people, 20 women in the Fort Saskatchewan goal. And after this legislation, you can see the number skyrocketed. And so it actually became a concern, because there was no other place to put these women. And Emily Murphy started questioning her approach of incarcerating women for venereal disease and publicly came out and said, there's no place of refuge for girls over 16 to have to have who have made the fatal mistake, their mistake of getting venereal disease, accept the jail. And she actually started calling for another institution because the jail wasn't working. Women were still getting infected, women were still getting incarcerated. And it wasn't successful. Indeed, the only thing that abated the massive syphilis epidemic was the introduction of penicillin in 1943. And so this incarcerating approach was actually a complete failure and ended up stopping and the introduction of effective, effective medication and prevention as a result was the thing that addressed or ended the syphilis epidemic in Canada, not incarcerating and targeting young women. But this just gives us insight into one of kind of the first proto responses to one of Canada's first epidemics or pandemics and health challenges and how people responded. So I'll move on quickly to the second case study, the second story that I want to tell. And so this is a story of a tear gas case. So fast forward to 1987. And so George Smith, a founding member of AIDS Action Now, a group that I've been part of for quite a number of years, Canada's answer to ACT UP, which was formed actually in 1987, wrote an article in a queer periodical where he stated, it looks as though the police in Toronto will continue to shape the politics of AIDS in this city for some time to come. And what he was referring to was an incident where Toronto police services were responding to a complaint of a man who looked visibly ill and was gay, who was wandering around Toronto's east gay village and making a public disturbance. It was concerned, people were concerned that he had AIDS and had dementia. This was at a time before available antiretroviral medications and where there was a lot of AIDS related panic. And so police went to his house, knocked on his door, he was home alone, and they shot tear gas into his house and tied him to a gurney and arrested him under mental health legislation in the province and detained him. The case got a lot of public outcry. There was a lot of constant contestation about calling on police about misuse of force, police perpetrating disease panic, lack of police training on health issues, and one psychiatrist from the Toronto General Hospital wrote a letter to the Toronto Star, tear gas, on AIDS victim unjustified and said the excessive response by the police was a result of uninformed fear of AIDS contagion. At the time, Toronto police services responded and apologized stating that they would work on education programs for their officers. And what was interesting is a few years later, two years later after the tear gas case, so George Smith who said police will come to govern responses to AIDS for some years to come. He was correct because some years, only two years later we started to see an influx of HIV related complaints to police where people started to call the police because they were, had potentially been exposed to HIV by their sex partner or someone had not allegedly told them they had HIV. And since then, Canada has become one of the leading countries in the world for criminalizing HIV, non-disclosure, transmission or exposure with upwards of 200 criminal cases relating to primarily non-disclosure. And the primary targets of this approach are black, migrant men, gay men, indigenous women and sex workers. And so this tear gas case just kind of gives us an insight into how police respond at times of disease panic where kind of solutions aren't really established yet. So quickly, fast forward 30 years later in 2017, so that was 1987. In 2017, Toronto Police Services are videoed tasering a black man in downtown Toronto in the middle of the street. He had allegedly kicked a car and spit at police. Police were videoed saying to onlookers, watch out, he's going to spit in your face, you're going to get AIDS. They again faced public critique for excessive use of force, for lack of knowledge on HIV, because you cannot get HIV from spitting, you can't get AIDS from spitting, you can't get, that's not AIDS is a virus that's transmittable at all that way. HIV is the virus and HIV is not transmittable through saliva. And so Toronto Police Services came out and apologised, said they would institute sensitivity training for police officers. And just as a reminder, there are over 65,000 people living with HIV in Canada. And so we can think about this story of the tear gas case and the apology and the sensitivity training and look at today or a couple of years ago and think about whether institutions like policing can change and whether such kind of training actually does anything. That's kind of an interesting reflection over time. And so that is the tear gas case. I'll tell one other story, which is a group of little stories, and then I'm going to get into some lessons. So the next one is a few little kind of anecdotes. It's not one specific story, but a few little anecdotes about homelessness and COVID. And so the first one is about Ontario's Emergency Management and Civil Protection Act, which introduced a whole range of rules on physical distancing, on self-isolation, on non-essential businesses. It also enabled legalized carding, which was quite controversial, asking anyone for ID in public. And it also enabled for a short period of time the sharing of all COVID positive data with police. And so this is the provision that allowed for that sharing of data. And this happened in April of 2020. So the order allowed for the sharing of an individual's name, address, birth date, and whether they had a COVID positive test. And it specified specific, specified custodians, excuse me, such as laboratory public health personnel. And they were able to share data, sorry, with police officers and staff, firefighters and staff, paramedics and communicable disease communications officers, through a specified portal to get access to this data. The interesting thing was that it didn't indicate the date of COVID infection. So the database ended up housing people's names and information even after they had cleared COVID and were no longer infectious. And the other thing that was quite confusing about the purpose of this, or the purpose of this portal was quite confusing, is because everyone should be engaging with PPE and assuming that anyone they encounter has COVID positive. So it's quite confusing why this provision was enacted. And the same month that it was enacted, there was this thing that happened where across the TTC, this message got displayed to all, which is Toronto Transit Commission, Toronto's public transportation system. This message got relayed to broadcast to all TTC bus drivers, subway drivers and anyone working for the TTC at the time, all across Toronto, stating all runs in any area of Jane and Alliance, please do not pick up female Black 40 plus years identifying information about her clothes, person is homeless and confirmed to be positive of COVID. In addition, note that through the portal, it shared data with Ontario Provincial Police, 15 municipal police services and nine First Nation police services in Canada. It is not known where this information came from or if it came from that portal. TTC apologized, but it happened at the same time of the launching of the portal and the TTC apologized that they wouldn't do that again, wouldn't share public information about someone and identifying information and their COVID status. And the emergency management and civil protection rule was actually repealed shortly after because there was much public outcry, a public letter signed by many social justice organizations in Toronto, including Ontario Coalition Against Poverty and Black Lives Matter, and then there was a legal action launched by the Black Legal Action Clinic, Aboriginal Legal Services and HIV Legal Clinic of Ontario, among others. And so the Ontario government backed down. It was revealed shortly after that there was massive abuse of the use of the portal and there was over 95,000 searches in the database while it was active, much of it people looking up, police looking up people in their neighbourhoods, police looking up ex-girlfriends, police looking up relatives, that kind of thing. And but one of the first people we see attacked by this betrayal of privacy is a black homeless woman who wanted to get on the subway to get somewhere. And remember this is prior to having access to vaccines because this was last year or the beginning of the pandemic. And so what we see next is even more attacks on homeless people. Massive fines enacted across Canada and many people, many homeless people targeted by those fines and many homeless people targeted for non-physically distancing and were issued tickets of almost $1,000 all across Ontario, across Montreal and other places as well. And then what we all have come to see these images of and all know very well, probably is the ways in which then homeless people who sought refuge and protection from congregate settings, from services they were barred from, from congregate settings where there was not appropriate PPE and people taking their safety into their own hands in the best way they know how, built houses in public spaces and those public, those houses were destroyed by militarized police forces in extremely violent and harsh ways which were on display publicly and millions of dollars were spent to displace people who often ended up in a park just down the street. And so here's another image of that. And so three kind of different divergence stories. We have the story of Eleanor Patterson who was incarcerated because she was infected with venereal disease, venereal disease, sexually transmitted infection of syphilis and gonorrhea. Often one thing I didn't know is women who were incarcerated at that time were forced, were put under forced treatment. Forced treatment at the time was arsenic injections and a mercury rub for the wounds. So often people would go into toxic shock and die as a result of the forced medication. But we have that experience which was enabled as a potentially sketchy but legal process which betrayed habeas corpus to detain people who were considered infectious and dangerous. We have the tear gassing of a gay man who was experiencing dementia because of police hysteria who trumped up and amplified the risk associated with engaging with him. And we have the breaching of privacy and the sharing of public health information or actually not public health information. We have the sharing of sensitive private health information publicly where healthcare information gets translated into other realms to act in the service of enforcement. And we also see through all of this that socially marginalized people come to be the targets of these responses. And so some lessons just kind of sketching the surface of some things that I think we can reflect on in relation to these three different experiences are during times of disease crisis decision makers and policy actors will rely on policing and criminal justice infrastructure. And indeed the two have been intertwined since the inception of public health. The inception of public health is deeply rooted in and dependent on the criminal justice system for its workings and has been since its inception. So I think that's something to note and think through when we think of making distinctions between public health and the criminal justice system. If we look to the past and understand Eleanor Patterson's case the criminal justice system and public health infrastructure were one in the same. And so this is a fortunate this lesson is just an unfortunate reality. And one of the consequences is that relying on the criminal justice system infrastructure and forms of policing is that we are we employ the logic of that institution. A logic of wrongdoing a punitive and carceral logic which is often caught up with notions of morality and notions of wrongdoing. And it falls into this individualizing victim versus perpetrator logic of the criminal justice system to respond to something that is a collective and community phenomenon not an individualizing phenomenon. And so that's kind of one of the consequences of of this unfortunate outcome for this unfortunate reality for lesson one. Lesson two is that pandemic policing blurs what we think are institutional lines between police actual police and public health actors. And in this line blurring there's a mission creek that takes place and we see the policeification of social problems of social of social issues. So police come to be the primary and sole actor for addressing a whole range of social problems that should be held by other people. One of the consequences of this is that actual police are trained police and uniforms are trained to respond to social problems with force force being a word for violence and actual police have lay knowledge of infection transmission disease containment how infections and transmission transmission of diseases works yet they are deputized as one of the front front line of the response. Private and health sensitive health information can be translated across institutions once there's this blurring of the lines and used for other purposes for them for what it was collected or intended such as enforcement. So information about someone's health care can be taken out of context and used to enact enforcement or against them and there's very big consequences for that we see that in the criminalization of HIV where people's medical files are subpoenaed and used in court against them and so that puts people in a precarious context with their health care providers and when a public health risk or a health related risk comes to be translated into by police into a risk the that risk can be amplified it can be heightened it can be misunderstood it can be lead lead to greater violence like we see with the tasering and the tear gassing of those two individuals they received more intense responses from police because there was a risk that they also had a disease as well as being just a general nuisance or causing a problem in public. And in the context of COVID we've had a lot of talk about togetherness working together across Canada and empathy and how we need to all be working together in this but policing pandemics actually works across purposes for a strong collective response that's rooted in ethics or care and ethics of care or any but how best practices related to public health so there's just kind of conflicting policy goals that happen here. And so to share a few things that I've written in relation to this with wonderful colleagues if you're interested in the sharing of police sharing of data with police we've developed paper on alternative to sharing COVID positive data with law enforcement recommendations for stakeholders one of them if you work in public health is to decline to share that information do not and not make it possible for police to have access to it. Lesson number three is despite many appeals by policy actors for pandemic responses to be evidence-based we see here lots and lots of needs for everything to be evidence-based punitive and policing responses such as fines or incarceration lack any evidence in their effectiveness to address infection transmission so we see the rollout of fine after fine after fine in the context of COVID there is no evidence space that those will lead to people changing their behavior and the evidence that does exist in relation to responding that way with punitive punitive measures is that those result in forms of violence and social marginalization. So the only thing that had an impact on the syphilis pandemic was not incarceration it was the development of penicillin HIV itself has only been exacerbated by forms of criminalization and public health objectives have been undermined because people are have created there's a context of fear and uncertainty where people do not go to access services because services are understood as an arm of the criminal justice system that part of that police assemblage where they will report on people if they tell them things that they're not supposed to and strong conclusive evidence to support the deterrent effectiveness is fine of fines is also lacking in many contexts if you look at drunk driving for example or speeding there's very there's evidence that shows the higher the fine high raising fines higher doesn't stop people from speeding or drunk driving and that fines in general don't deter that behavior and and so it is not we don't have and we have no data on the use of fines in the context of a pandemic to deter people from doing things we don't want them to do or to encourage people to do things we don't want to do so there is not an evidence base here about these responses such responses are based on retribution they are based on forms of violent deterrence and they are only evidenced at promoting stigma forms of discrimination creating contexts of fear and uncertainty and precarity and lack of security and violence and again conflicting policy goals so here's two little pieces out of the policing the pandemic project we did some public criminology work highlighting the lack of evidence base on fines and that fines are will only result in a burden on socially marginalized people and poor people who don't have the ability to pay thousand dollar fines there's also a lot of work happening contesting the constitutionality of the use of fines in the context of COVID but here we've developed a report outlining the lack of evidence base and conflicting policy goals in relation to the use of fines in the context of COVID and also here's a paper in the Canadian Journal of Public Health outlining with a number of wonderful colleagues who primarily work on HIV who have translated their work on human human rights based HIV responses to the context of COVID and we outlined some general principles on grounding COVID responses in human rights lesson four and then there's one more lesson after this is that socially marginalized people will bear the brunt of punitive responses existing in an equal patterns of enforcement will just be reproduced people who are already considered risky by public health will that risk will be amplified in the context of pandemics and they will be targets of increased surveillance and increased punitive responses and here is an important it is always important for us to ask or important for me to ask and this is the question I always ask and my students to ask and I get communities I work with to ask when we're talking about public health we have to ask the question who's health and who is the public and often for example in the context of the syphilis epidemic Eleanor Patterson was not the public she was considered a risk that the public had to be protected from that man who is tear gas was not considered a member of the public he was considered a risk that the public had to be protected from and contained under violent circumstances in the use of tear gas homeless people are not considered the public and public health when we look at how we are responding to encampments and how that woman was barred from accessing the TTC because of fears around infection and so always ask in the context of public health responses who is the public and whose health and socially marginalized people are never considered the public and public health and in order to reorient our thinking public health has to do really big work internally to figure itself out to stop paternalizing logic stop targeting specific communities the ways that it does and start working to address responses that value all members of society and so we I wrote a paper with a couple friends of mine looking at colleagues of mine at the American Journal of Public Health looking at a research agenda for researchers who in public health looking at examining HIV and COVID and criminalization and we laid out a short research plan that said that research in this area must attend to issues of racism and the racist patterns of policing and public health surveillance but that we also might must really understand do more work to understand how police and public health operate and work together a lot of it's a black box we don't know how these things happen and we as social scientists need to do a better job of understanding how these surveillance systems work how the work of public health practitioners and police happens in concert and what are the consequences so that we can put that stuff into question lastly my last question here and I'm getting up to the 40-ish minute mark so we'll wrap up in time lesson number five there have always been resistance and debate to the use of police and the application of punitive responses to respond to communicable diseases this is not a given while it is unfortunately police have been cemented as central actors in responses to pandemics there is constant debate and it is constantly contested and we need to keep that up and so if we look back to the 1919 and 1920 and 1920 the architect of putting women in jail Emily Murphy who worked a lot with Gordon Bates who was a public health doctor who was actually one of the founding members of the Canadian Public Health Association and the Canadian Journal of Public Health who also worked on with this on her they became concerned about putting women in jail after a while for syphilis and actually outlined that there was a disproportionate incarceration rate of women between women and men in relation to these into in in this approach and they themselves thought it was causing more harm than good and started to work on ways to move forward and also interestingly the criminal code provision which they helped introduce which criminalized reckless transmission of syphilis and gonorrhea and herpes was repealed from the criminal code in 1985 because at the time politicians thought there should be no criminal code provision around a public health issue there should be something that's dealt with not by the criminal courts but by public health actors um also in relation to HIV criminalization this uh this issue is very much in flux and in reform Jodi Wilson-Weibald former minister of health outlined in 2017 that there was a concern of the over-criminalization of HIV and feds and some provinces have now changed their response and will not prosecute if someone is virally suppressed or undetectable that has created concerns of course for who is people who are not virally suppressed can still be subject to the criminal law and that has created a dividing line and often people who aren't on medication are more socially made to be more socially marginalized people who have been released from prison people who are non-status people who don't have a house to live in or a fixed address often may not be on medication and so they could be in a more precarious state as a result of that but what these reforms have done is dramatically reduce the people the amount of people that are entering the criminal justice system in relation to complaints due to HIV alleged HIV non-disclosure and so that has happened and that has been due to massive advocacy on behalf of hundreds of people across Canada legal experts human rights experts people living with HIV have been relentless in their pushing of the government to change that so that has been constantly contested um the law enabling COVID positive data sharing was rescinded after much public outcry and a legal challenge and there's been a widespread debate around the policing of hopelessness in the context of COVID and so these are not given these are things that are constantly contested and I think that's really important for us to keep pushing it for someone who thinks that the role of police in the pan in a pandemic or in managing disease needs to be put further into question so we need to keep doing all of this work finally I just wanted to show these two pictures this is a picture from a venereal disease hall of fame of women who are infected with venereal disease during world war two put up in a military barracks in Canada and this next word for so soldiers would not have sex with those women I guess and then this is a picture from a couple years ago from Vancouver of a police manhunt for this man David Hind who was living with HIV who was alleged to not be taking his HIV medications and the consequence from public health actors was to call the police put his name in the media and enact a full-on manhunt to search for him and harkens back to kind of very similar approaches from back in the day of publicly shaming and putting people's headshots out into the world so there we have five lessons on policing pandemics three kind of divergent stories and I would be happy to have a conversation and talk more with you about all of this that's how you can reach me thank you so much Alex what a fascinating and infuriating presentation I wanted to get us started you leave on the note of the the policing of COVID positive people and just two days ago there was a poll because we are now in the vaccine era right and there was a poll showing that 27% of respondents in Canada believe that people who remain unvaccinated should be jailed right vis-a-vis the outbreaks in jails vis-a-vis the problems we've had with encouraging vaccination in jails because of the abuse that prisoners have experienced so where do you see in the vaccine era the policing of COVID how is it going to be manifesting it's quite interesting I don't have a solid answer for you on this but one of the things that I have been in just kind of referencing or thinking back to HIV one of the things that's quite interesting is now we have injectable prep which is something that's been coming for quite some time which is injectable prophylactics which can prevent HIV transmission if someone has sex with someone else and injectable prep is being treated on prisoners so they're in the US and has been given to prisoners in the US against their will where they are injected every month with it and so that they just won't get whether it doesn't address any of the social social context of why someone might be at risk for HIV but it just stops them from getting it against their will and I the the anti-vax situation is so complicated I have no answers for anyone on that but I think that I think we have to think always about bodily autonomy and human rights and putting people in jail in this context is never the right solution specifically when jails are jails or prisons are super hubs of infection and so that's obviously the wrong social response but interestingly if you do it's all about how you do also ask questions so for example if I go around without explaining all of my research on the harms of criminalizing people due to HIV if I go around and I say oh should someone who doesn't tell their sex partner that they have HIV go to jail yes or no and I don't don't provide any other context people have done that research it's shoddy research but they've done that research and we get horrible statistics that say a majority of the general population thinks people living with HIV should go to jail what you don't hear are that women living with HIV who are sexually assaulted by their partners are the ones who end up and who didn't use a condom are the ones who end up in jail and are the ones who end up registered as sex offenders you don't hear the ways in which those people when they're incarcerated are assaulted on a daily basis by the rest of the prison population under the watch of guards because the guards share their health information with everyone in the prison against the law and what you don't hear is about is all of the various ways in which people actually tried to protect their sex partner and do the right thing but that was taken out of context or the nuance was erased because once they entered the criminal justice system you enter this dichotomous logic of victim and perpetrator there's no room for any nuance so even when a person had told their partner if their partner went to the police that partner was believed over the HIV positive person and so um entering anything into the realm of should this be a criminal justice system issue erases any complexity it's a giant hammer that just flattens any complexity or nuance to these issues where often we need much more complex um empathetic um and empathetic supports for people to understand where they're at and what they're doing so doesn't answer that question but it gives you some context as to why I can't answer that question it's a great answer um and kind of following on that uh Constance Dr. Constance McIntosh from the Institute has asked do you think that they defund the police slash retask the police movement might change the story going forward and I don't know Alex if you're familiar but we just last week had um the defining defunding the police report launched here in Halifax so it's really top of everyone's minds um and a great read if you haven't had a chance to read it yet so I'll let you respond to Constance yeah thank you Constance really wonderful report I have not read all of it it's quite long but congrats to Elle Jones and all the people who are leading that report and excellent excellent work and um uh one of the things I would like people to consider who are working in the defund the police movement is to um not default to uh just like oh something's a public health issue we should just make this a public this should no longer be under the purview of police one of the things I try and talk about is the porous and intertwining nature of social institutions and uh that um uh for example just relying on social workers or just relying on nurses isn't going to solve your problem because public health nurses and public health departments have acted like police and are a form of police um and so defunding the police will end a certain forms of violence in society but um uh could result in a diversification of uh of problems for the ways in which we deal with other social issues so I think there needs to be a broader think around the within the defund the police movement to defund carceral and coercive institutions which result in oppression and so if you're someone living with hiv or um uh you'll know that public health institutions often don't have your back they treat you like you are essentially parapathological on the verge of committing a crime at any time you're under suspicion and under surveillance and essentially act as a form of police over your life and so um defunding the police will do one thing but it could bolster and give more power to institutions uh that already act in a policing way using the logic of the criminal justice system even further so wonderful amazing work just needs to be extended to look at other social institutions as a nurse I really appreciate that response and agree with you very strongly the next question is do you have any comments on the lack slash underfunding of public health officers that is usually four to six years training and assessment slash response throughout the course of the pandemic um so yeah I guess the other young asks that about our funding of public health yeah I mean I think I I'm quite concerned about public health uh the way in which public health I mean you know public health the the ways in which public health operates is different in every province highly decentralized in Ontario we have 34 different health units each health unit is governed by one specific medical officer of health whose essential essentially whatever that medical officer of health states can become law and the um the oversight in relation to what they say um is quite limited uh it's criminal law for example you have a court you might have a judge and maybe even a jury um in uh and there's evidentiary requirements and certain rules of evidence that you have to follow in the context of uh public health legislation it's really the word of the of the um medical officer of health that is law and there's less the bar is lower for evidentiary requirements and there's less oversight there's no jury or anything um and often there's no sunset clause so these uh public health orders can just it be issued forever and don't go away um depending on which province you're in and uh can cause a lot of harm in people's lives so actually um I'm not sure if more funding of that same process that same that same approach would work I think maybe a rethinking of that approach needs to happen for example um Richard Shabis who uh is uh no longer with us but he was working as a medical officer of health in Ontario up until just a number of years ago and had been since the 1990s and in 1989 he called for the full on quarantine of people living with HIV and he when he was the medical officer of health of Toronto and he publicly called for HIV to be labeled a virulent disease which would mandate all people living with HIV to be quarantined there was the one of the largest AIDS action now demonstrations to counter his calls happened um he was actually uh they called for him to resign he didn't resign he was just moved to Prince Edward County and continued to operate as a medical officer of health in the province for many many years um and so uh when we're dealing with one specific person's point of view and with that point person's point of view is uh it doesn't have a lot of oversight or is not able to be contested because what they say is the law that's a problem so I think we need to rethink not more funding necessarily but rethink approaches to how we address public health issues sort of related to that in in terms of uh uh tools of public health Sean Harmon who's also from the institute asks it's incredible that they could achieve any sort of effective data sharing and a common or central portal relating to the COVID data when we cannot even efficiently or effectively share vaccine status data across health platforms in routine settings many of us have been calling for a national vaccine registry linked to electronic health records so relevant epidemiologic data can be brought to bear in decision making and treatment based on your research what are the dangers of such a tool and do they outweigh the benefits how do we avoid its misuse in the ways that you have described um yeah I think there is like there's lots of benefits to data sharing um but I would ensure that any data like that cannot be shared with police so you make it interoperable with police databases and you have strong protocols about how that information will will not be shared for example uh as evidence in a criminal trial um that people would resist its its uh seizure or subpoena if it was going to be and that there was no access to it for police agencies and that's what we wrote about in that article I shared we kind of have six potential alternative steps and kind of proposed ways forward and I would adopt those okay this is probably going to be our last question uh Alicia Landers asks how would you reconcile the constitutional notion of infringing on individual rights for the purpose of protecting public health while also considering the detrimental effects that these infringements may have on society as a whole where should the line be drawn yeah this is a foundational debate in public health um we must uh we must um it is justified to suspend certain individual rights for the greater good and this is often the thing that I get caught up against is this logic that underwrites a lot of public health practices oh we don't have to ask anyone for their consent to share their data because sharing their data is the is in the benefit of public health so that outweighs that person's individual rights um we and this is happening right now in in many different ways but in the context of molecular HIV surveillance which is a whole other thing I don't need to get into but um it's a it's a disease surveillance um uh approach which is happening in BC in Quebec where people's uh people's HIV related information is shared uh secondarily out of a care context for public health purposes without people's consent and it's used to surveil people create create uh understand clusters of infection and risk networks and actually then target interventions at people who are labeled as risky and this is all information collected at a health in a healthcare setting and then repurposed for uh surveillance and um public health practitioners justify this use of repurposing without consent because of um the public good and so one of the things I have been working for working on is uh we have to again reconsider who is the public in public health is the portrayal of people living with HIV's rights beneficial to the public if we see the public as public health is creating a sense of precarity and lack of safety and security for a whole sector of society beneficial to the public if those people are they are the public they're taxpayers so what does that do we need to re we need new models of thinking through ethics and public health because the current ones are no longer working specifically in the ways in which big data can mean that all these data sets can be shared more widely we need a new way of thinking about ethics and making ethical decisions in the context of public health because that justification no longer works and it's not an argument that sells for anybody for me anyways if you view certain people as risks that need to be managed and not as autonomous actors with dignity that we need to care for and figure out what the issue is if you employ a paternalizing logic that people are objects of risk that you need to intervene in and manage um then that's not going to work it's not working and what it does is create forms of violence othering surveillance lack of precarity and lack of trust people do not want to engage with public health institutions because they are not considered the public and public health they are treated as other and so in order to actually figure out in a response that engages everyone we need to rethink the logic that underwrites public health thank you that's a fantastic way to close really strong really glad you could join us alex incredible work that you're doing for everyone who's on the zoom this session was recorded so if you didn't quite transcribe verbatim alex's great quotations you can do so later um and i want to invite you all to join us um for our our next seminar it's going to be on february 11 it's marina morrow who will be speaking about realizing human rights and social justice in mental health um a lot of crossover there with what alex has been talking about thank you all so much um yeah thank you martha so great to talk to you and thanks everyone at the health law institute