Big number: $1 billion, the estimated loss in Toronto GDP from the 2003 SARS crisis, according to a report by the Conference Board of Canada

Things to do during a pandemic: wash your hands. Practise social distancing. Appreciate your municipal public health department.

That last one might not be something a lot of Torontonians are thinking about, but I’ve been closely watching Dr. Eileen de Villa, Toronto’s medical officer of health, give press conferences over the last few weeks and it’s hard to overstate the importance of the job she and Toronto Public Health are doing.

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They’ve provided calm, clear messages as the COVID-19 situation has ramped up. They’ve demonstrated the remarkable ability to be medical detectives and report on the transit travel patterns of an infected person. They’ve supported Mayor John Tory and Coun. Josh Matlow, along with many others, as they self-quarantine.

While I still have lots of questions about the city’s response — I’m particularly concerned about how city hall will keep people safe in Toronto’s overcrowded shelter system – the COVID-19 spread is a textbook example of why a well-staffed and well-funded public health department matters.

That wasn’t always obvious to everyone. About a year ago, Premier Doug Ford’s government released a budget that included deep cuts to municipal public health. De Villa and her team spent the subsequent weeks delivering a different variety of press conference, warning about the ramifications of cutting the province’s share of public health money.

Public health doesn’t always make headlines but it is constantly steering city hall toward policy that makes Toronto safer. It was Toronto Public Health that identified pedestrian and cyclist safety as a looming crisis, calling for lower speed limits in 2012. It was Toronto Public Health that provided the arguments that brought city hall on side with safe-injection sites to help prevent opioid overdoses, saving hundreds of lives.

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And it’s public health, de Villa pointed out after last year’s cuts were announced, that helps cities prevent and control the spread of infectious diseases.

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Her arguments from nearly a year ago look prescient today.

Ford’s government eventually backed down on most of the immediate cuts, leaving city hall to deal with about $4.3 million in reductions in their recent budget. But the notion of cutting public health remains on the table. Instead of cancelling the cuts completely, the Ford government has only delayed them, offering a couple of years of what they call “one-time mitigation funding.”

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That funding, which totalled $9.7 million this year, is still set to vanish after 2021, setting up another scenario where Toronto Public Health needs to justify its importance once again.

It feels a bit gross to talk about dollars right now, when the priority is obviously on keeping people safe at whatever cost, but eventually a bill will come due for this COVID-19 response. It’s going to be big.

For city hall, the best comparison is likely the 2003 response to the outbreak of SARS. Back then, a report to Council pegged direct costs to the city in the first 40 days of the SARS crisis at about $10.5 million. Adjusted for inflation, that works out to approximately $350,000 each day, just in terms of extra expenditures for municipal services like public health, shelters and city-owned seniors’ homes.

That doesn’t account for revenue lost from lower transit ridership and the suspension of recreation and other programs supported by user fees. Plus hefty healthcare and social service costs handled by the provincial and federal government.

And the larger economic impact of SARS was far bigger than just government costs. The Conference Board of Canada estimated that virus alone caused a $1 billion drop in Toronto’s GDP.

If COVID-19 has a similar – or worse – economic and budgetary impact, there will come a time when governments are left trying to figure out how to deal with the fiscal wreckage. As they inevitably look for money-saving cuts, they should stay far away from public health departments.

Remember this time, and the role local government services played. The value of public health is not a lesson that should have to be learned again.