Board of Health Meeting Documents

DATE:

May 2021

SUBJECT: 

Syphilis and HIV in Windsor-Essex County


BACKGROUND

Syphilis and HIV are sexually transmitted and blood-borne infections (STBBIs) of public health significance. Although they are largely preventable, data for these infections in Windsor and Essex County (WEC) is showing cause for concern. Syphilis cases are steadily increasing at a significantly higher rate when compared to Ontario incidence rate. Between 2017 and 2019, there was a 134% increase in syphilis infection rate in WEC, compared to a 25.6% increase in Ontario. There has also been a recent increase in local HIV cases. From January 1st to March 31st, 2021, there were 9 cases of HIV reported in WEC. In comparison, there was an average of 4.6 cases in the first quarter of the previous 5 years, with a range of 2 to 7 cases.

The majority of syphilis and HIV cases have been found in men, although women are also at risk. Between 2010 and 2019, men comprised 81% of syphilis cases in WEC, and all cases of HIV in the first quarter of 2021 were men. Syphilis can also increase the risk of HIV infection. One-third of the HIV cases diagnosed in the first quarter were found to be co-infected with syphilis. Individuals at highest risk for syphilis and HIV infection share the same common risk factors. These factors include: engaging in unprotected sex (vaginal, anal, and oral), men having sex with men, and having sex with anonymous/multiple partners. Among the recent HIV cases, 78% reported having anonymous sex. This increasing trend of engaging in sex with anonymous partners found on the internet has created challenges in being able to notify contacts of exposure.  

CURRENT INITIATIVES

The Infectious Disease Prevention department is developing a sexual health strategy to address the increased prevalence of syphilis and HIV in WEC. One key part of this strategy was the creation of a Sexual Health Advisory Committee to increase stakeholder collaboration. Membership includes representatives from community partners such as the HIV Care Clinic, the Windsor-Essex Community Health Centre, Pozitive Pathways, as well as WECHU nurses who specialize in sexual health. A survey was recently conducted with the committee to identify factors that have contributed to the increased syphilis rates. Survey findings highlighted a significant lack of knowledge and awareness of syphilis among the general population and local health care providers. Specific barriers to testing, treatment, and safe sex practices were also identified. The data collected from the advisory committee, along with data previously collected from Clinical Services clients, is being used to further direct the sexual health strategy.

Moreover, interventions to increase public awareness are currently in progress. Strategic planning for a social media campaign is underway, and social media posts will soon be shared on the WECHU’s Facebook, Instagram, and Twitter accounts in order to engage our community.  The media campaign will focus on increasing knowledge and awareness regarding risk factors and infection prevention, as well as increasing testing and treatment. The WECHU will also be collaborating with Pozitive Pathways in an upcoming podcast and various webinars to target high-risk individuals. Targeted advertisements for high-risk populations will also be placed on Grindr, an online dating site for men who have sex with men. Furthermore, the Windsor-Essex Pride Fest is held in August and initiatives are underway to actively participate in the community event.  

Currently, all syphilis cases are referred to the WECHU for treatment and follow-up. The Clinical Services Nurse Practitioner will also be providing educational sessions for the testing, treatment, and follow-up of syphilis to key health care providers in the community in an effort to build capacity. Additional strategies to support health care providers and increase capacity in sexual health services are continuing to be explored.

DATE:

May 2021

SUBJECT: 

Consumption and Treatment Services Site – Update 


BACKGROUND

In September of 2019, the WECHU Board of Health passed a resolution supporting the submission of a Consumption and Treatment Services (CTS) application for a site in the City of Windsor. Submission for a proposed site would be made to the Ministry of Health, including the submission of an Exemption for Medical Purposes under the Controlled Drugs and Substances Act for Activities at a Supervised Consumption Site Application required by Health and Canada. 

In Ontario, Consumption and Treatment Services sites provide wrap-around services that connect clients who use drugs to primary care, treatment, and other health and social services, including:

  • Supervised consumption and overdose prevention services,
  • Onsite or defined pathways to addictions treatment services,
  • Onsite or defined pathways to wrap-around services, and
  • Harm reduction services.

To complete the application process, the WECHU must identify a location and complete a comprehensive community consultation. In order to facilitate this process, a CTS Stakeholder Advisory Committee was established and site criteria estblished, complimenting the mandotory requriements under the federal and provinical processes:

  • Site must be 200m from a sensitive land use (e.g. parks, daycare centers, and schools) as well as 600m from other CTS sites OR If  located within 200m of a sensitive land use, application must include plans on how to address community concerns
  • Site must be easily accessible by public transit
  • Site must be within walking distance to areas known to be frequented by people who use drugs
  • Space should be greater than 590ft2 (for six consumption booths) or 385ft2 (for three booths)

In the fall of 2020, using these criteria, and in consultation with the WECHU legal representation and procurement procedures, the WECHU issued a Request for Expressions of Interest (RFEOI) through the MERX Online Public Tenders solicitation database for interested landlords and property owners. No submissions were received. The WECHU issued a second Request for Expressions of Interest (RFEOI) through the MERX Online Public Tenders solicitation database for interested Real Estate agencies to represent the WECHU in the idenfication of a location for a potential CTS. No submissions were received for the second tender.

CURRENT INITIATIVES

In February 2021, the WECHU Substance Use coordinator, utilizing the set criteria for site identification, worked through local real estate listings to identify potential locations for a CTS. Locations for rent or lease meeting the criteria were listed and scored using a matrix relative to the criteria.

Several locations have been identified for onsite review. Environmental audits will be completed by Windsor Police Services in order to determine the safety of the area and guide any mitigating interventions which can improve the safety of the areas surrounding the site and discourage criminal activity. Once sites have all been reviewed and audits complete, next steps to the process include formal recommendation to the board of health and community consultation.

DATE:

May 2021

SUBJECT: 

Beach Water Sampling


BACKGROUND

The Windsor-Essex County Health Unit conducts beach water sampling in accordance with Recreational Water Protocol, 2019 and following the Operational Approaches for Recreational Water Guideline, 2018. The 2020 season of beach water sampling was deferred prior to the season start due to reallocation of Environmental Health Department resources to respond to the COVID-19 pandemic. Beach Water Sampling will resume for the 2021 season. The Environmental Health Department conducts water sampling of all nine (9) public beaches in Windsor and Essex County from June to September. Public beaches that are part of the beach water quality monitoring program include: Cedar Beach; Cedar Island Beach; Colchester Beach; Holiday Beach; Mettawas Beach; Point Pelee North West Beach; Sandpoint Beach; Seacliff Beach; West Belle River Beach. Each week, bacteriological samples are collected across the beach front and tested for Escherichia coli (E. coli). E.Coli exposure can lead to severe stomach cramps, diarrhea, fever and vomiting. Water conditions, weather, and potential pollutants are also monitored and documented by Public Health Inspectors as these factors, among others, impact water sampling results.

CURRENT INITIATIVES

Pre-season Public Beach Assessments will be completed in early June, and beach assessments and sampling will be conducted weekly afterwards and continue until the season end in mid-September. All beach assessments and sampling will be done by 2 PHIs on Monday’s (or Tuesdays if Monday is a holiday).

Beaches with bacteria counts that exceed 1000 E. coli per 100 mLs will be posted with a sign indicating the beach is closed after the initial sampling, and re-sampled on Thursday to permit for re-opening of public beaches before the weekend if satisfactory results were returned. Beaches with bacteria counts exceeding 200 E.Coli per 100 mLs (but less than 1000 E. Coli per 100 mLs) will be posted with a warning sign, but will remain open and not be resampled.

The Environmental Health Department will update the Beach Hotline (519-258-2146 ext. H2O) and the Interactive Beach Map located on the Windsor-Essex County Health Unit website https://www.wechu.org/your-environment/beaches-pools-and-spas/beaches throughout the season once routine weekly sampling begins.  In addition, community agencies are emailed the results.

Board Members Present:

Gary McNamara, Tracey Bailey, Joe Bachetti, Rino Bortolin, Fabio Costante, Gary Kaschak, Judy Lund, Ed Sleiman, Larry Snively

Administration Present:

Theresa Marentette, Dr. Wajid Ahmed, Lorie Gregg, Nicole Dupuis, Dr. Felicia Lawal, Kristy McBeth, Dan Sibley, Lee Anne Damphouse 


QUORUM:  Confirmed

  1. Call to Order
    Board Chair, Gary McNamara, called the meeting to order at 4:33 p.m.
  2. Agenda Approval

    Moved by:  Judy Lund    
    Seconded by:  Rino Bortolin
    That the agenda be approved.
    CARRIED

  3. Announcement of Conflicts of Interest – None
  4. Update (Dr. Ahmed)
    1. COVID-19 Update

      Dr.  W. Ahmed noted the announcement made by the province today.  Today the Premier announced a different pathway to reopen the province, which will occur in three different stages.  In stage 1 various sporting activities will open, i.e. golf, tennis, basketball courts, and gatherings of up to 5 people outdoors will be allowed. Following that, more restrictions will be relaxed with gatherings of up to 10 people permitted, possibly in as early as 10 days.  In stage 3, in about 21 days, outdoor sports leagues, personal services settings, religious services and gatherings will increase to 25 people. More information will follow.

      We are seeing some fluctuations of positive cases in our region, and still have a relatively high number being reported daily.  Cases amongst school age children are averaging five cases per day even with the school closure.

      Most cases, about three-quarters, are coming from the City of Windsor, followed by the other municipalities.  We are seeing most of the cases are occurring within the 0-29 year age group, and we have documented cases of infants less than a year old in our community who have tested positive for COVID-19.

      Adults 18+ are now eligible to receive their first dose, and we have seen a decline in cases amongst other age groups that have already been vaccinated.  Once vaccination rates increase for the younger age group, we expect to see a drop in cases in younger people. Close contact and community transmission are the biggest contributors.

      The Variants of Concern (VOC’s) are a significant driver in our area with more than 70% of our positive cases being VOCs.  The VOCs pose a huge risk, as they spread quickly resulting in the daily fluctuation of cases we are seeing in our community.

      Hospitalizations are declining in the province as more people get vaccinated, and we are seeing the same result in Intensive Care Units.  The older population still has the highest risk and mortality rate.  

      There have been more than 213,000 doses administered in our region, with approximately 3,600 doses per day through pharmacies and primary care providers.  We have immunized as many as 4,800 people in one day.  More than two-thirds of doses administered in Windsor-Essex has been Pfizer, with Moderna and AstraZeneca equally making up the rest.

      Our overall coverage rate is 48.3% and when looking at just adults, it is 62.6%.  Opening up the eligibility to 18+ will help to increase these rates.  We are hoping for at least 70% vaccine coverage for further impact and decrease cases in our community.

      Various hot spots in our region continue to have the lowest coverage rates at 41%, despite having mass immunization sites and pop-up vaccination clinics in those areas. We are working with the City and the CMHA for a more targeted approach.

      G. McNamara said there could be campaigns with community leaders and medical professionals on why you should get the vaccine.  This might be a good opportunity to get messaging to the younger population who are also working in essential services, i.e. restaurants and grocery stores.  Dr. Ahmed said that we have worked with the University of Windsor around vaccine hesitancy, and our team is looking at all options. N. Dupuis is working with community partners for immigrants through the Multicultural Council as well to work through some language barriers.   

      E. Sleiman asked if once an individual receives the vaccine are they protected from contracting COVID-19, and if students and teachers are fully vaccinated would they still require a mask when they return to school. Dr. Ahmed said studies have shown that the vaccine protects against severe disease and/or hospitalization from COVID-19.  As to whether those have been vaccinated can still contract the disease, we are not sure and there are still many unknowns.  Dr. Ahmed said that at some point students and teachers will no longer be required to wear masks when attending school, but for that to happen there will need to be sufficient vaccine coverage rates with very low, to no, transmission in the community. 

      J. Lund asked if there was any work being done around anti-viral mediation. Dr. Ahmed said that there are many clinical trials happening around the world, but it is likely too early to determine the outcome.  We continue to hear that Remdesivir is widely used for COVID patients and it does improve recovery time.  Steroids are used as a form of treatment mainly in the UK and has shown some positive benefits in reducing the severity in some cases. There are other medications being used with mixed results and this is still being investigated.

      J. Lund asked about the status of allowing Windsorites to receive second doses of the vaccine across the border in Michigan.  G. McNamara said that the border is a national responsibility.  Some groups are advocating for this along with an exemption of no quarantine when arriving back into Canada but there are still some risks to that.  Windsor-Essex has been immunizing approximately 3,000 – 4,000 people a day, and more vaccine is coming.  WECHU and our partners have been doing an excellent job and we are moving in the right direction.  It might prove to be premature at this time to allow cross-border immunizations. 

      Dr. Ahmed agreed with G. McNamara that there is a risk to this initiative.  Our vaccination coverage rates are almost 63% for those who have received one dose, compared to Detroit at 33%.  Our recommendation to the public is still the same, to travel less to reduce transmission.  The  best option would be to have the extra doses of the vaccine in Michigan brought here, instead of the our residents travelling across the border. 

      G. McNamara asked where our region is in respect to second doses of AstraZeneca.  We have 37,000 residents who have received their first dose, and are we expecting to receive more.  Dr. Ahmed said that we are in conversations currently with the province to plan for second doses.  The province will offer two options, i.e. to receive a second dose of AstraZeneca, or to mix vaccines and receive Pfizer as the second dose.  The product monograph for AstraZeneca ranges from 4-12 weeks and the 12 weeks duration has proven to be more effective.  More details will follow once we have more information on these second doses for AstraZeneca recipients.

      Moved by:  Judy Lund
      Seconded by:  Ed Sleiman 
      That the information be received.
      CARRIED

  5. Approval of Minutes
    1. Regular Board Meeting:  April 15, 2021
      Moved by:  Joe Bachetti
      Seconded by:  Rino Bortolin
      That the minutes be approved.
      CARRIED
  6. Business Arising – None
  7. Consent Agenda
    1. INFORMATION REPORTS
      1. Consumption and Treatment Services Site – Update (T. Marentette)
        T. Marentette said that we are moving forward in the Consumption and Treatment Services Site selection process.  You will likely hear more about community consultation in July around the sites proposed.  All of our consultations will be virtual and we want to ensure that it is inclusive by engaging stakeholders, businesses, neighbours, the BIA and municipal councillors applicable in the area. We are working with our legal representative before any lease is signed, background work is in progress, and we are not comitting to anything until the funding has been secured. More information will be forthcoming. 

      2. Beach Water Sampling (N. Dupuis)
        To be brought to the Board for information.

      3. Vector-Borne Surveillance Report (N. Dupuis)
        To be brought to the Board for information.

      4. Syphillis and HIV in Windsor-Essex County (F. Lawal)
        G. McNamara said that the increasing numbers of infection for Syphillis and HIV from 2017-2019 in our region is concerning, and are higher than the provincial average. F. Lawal said the WECHU is seeing as many as 4 cases of Syphilis a week in our sexual health clinic and the trend definitely is concerning.  We are working hard to create public awareness around the seriousness of contracting these diseases and the impact on health, i.e. vision, demensia, and the congenital piece, and it remains imperative that we continue to identify contacts for infectious diseases druring the pandemic.

      5. March and April Communications Recap
        To be brought to the Board for information.
        Moved by:  Judy Lund
        Seconded by:  Ed Sleiman
        That the above information be received.
        CARRIED

    2. RECOMMENDATION REPORTS
      1. Healthy Babies Healthy Children (N. Dupuis/L. Gregg)
        N. Dupuis noted that the Healthy Babies Healthy Children (HBHC) program is a mandated program under the Ontario Public Health Standards (OPHS), and is funded 100% through the Ministry of Children Community and Social Services (MCCSS). In 2020, due to the COVID-19 pandemic, HBHC program services were significantly altered across the province as staffing resources were redeployed to support the COVID response. 

        In March 2021, the WECHU received communication from the MCCSS requesting the restoration of HBHC services for the 2021-2022 fiscal year. Health Units were asked to submit their service delivery plans and financial forecast to MCCSS by April 14, 2021 for review and consideration. Where staff were redeployed to other services supporting the pandemic, health units were asked to consider alternative staffing models including the use of social workers and other professional staff to support program delivery and identified service goals. 

        L. Gregg advised that the budget for this program for this year is $2,894,841, and is a combination of the HBHC and Nurse Practitioner program previously reported under separate funding.  The Operating Budget has some notable changes.  Professional development costs increased to address the needs of FTEs that are new to the program.  

        There was an increase in program supplies of $66,159 for the Healthy Babies Healthy Children Program Initiative to address the need to review and refresh resources and revitalize the program.  Additionally, there will be an augment in information technology hardware and software to address increased FTEs.  The program area will also continue to review equipment requirements for work-from-home as well as ensuring field staff are more mobile, in that they can document client interactions in the field.

        Therefore, we are requesting that the Board approve the budget for this program of $2,894,841 as presented by Administration for the period April 1, 2021 to March 31, 2022.
        Moved by:  Judy Lund
        Seconded by:  Rino Bortolin
        That the Board approve the Budget as presented by Administration. 
        CARRIED

  8. New Business
    1. Fluoride Update (W. Ahmed)
      Dr. W. Ahmed said that we recently received communication from Enwin regarding fluoride introduction into the WUC water system.  The process has been delayed due to the pandemic but despite these delays, Enwin management is expecting the project to reintroduce fluoride to the drinking water to be accomplished within the allocated budget for 2021.
      Moved by:  Larry Snively 
      Seconded by:  Ed Sleiman
      That the above information be received.
      CARRIED

  9. Other Board of Health Resolutions/Letters
    1. Brian Masse, MPP, Windsor-West – Letter to Windsor-Essex County Health Unit – Vaccination for CBSA Officers at International Borders

    2. Peterborough Public Health – Letter to Honourable Doug Ford – Stay at Home Order Extended to June 2, 2021

    3. Municipality of Lakeshore – Letter to Honourable Doug Ford – Boat Launches to be open in Ontario
      Moved by:    Judy Lund
      Seconded by:  Ed Sleiman
      That the information be received.
      CARRIED

  10. Committee of the Whole (CLOSED SESSION, in accordance with Section 239 of the Municipal Act)

    The Board moved into Committee of the Whole at 5:30pm
    The Board moved out of Committee of the Whole at 5:50 pm

  11. Next Meeting: At the Call of the Chair, or June 17, 2021 – Via Video
  12. Adjournment

    Moved by:  Judy Lund 
    Seconded by:  Gary Kaschak
    That the meeting be adjourned.
    CARRIED

    The meeting adjourned at 5:50 pm.

RECORDING SECRETARY:

SUBMITTED BY:

APPROVED BY:

Board Members Present:

Gary McNamara, Tracey Bailey, Joe Bachetti, Rino Bortolin, Fabio Costante, Gary Kaschak, Judy Lund, Ed Sleiman, Larry Snively

Administration Present:

Theresa Marentette, Dr. Wajid Ahmed, Lorie Gregg, Nicole Dupuis, Dr. Felicia Lawal, Kristy McBeth, Dan Sibley, Lee Anne Damphouse


QUORUM:  Confirmed

  1. Call to Order
    Board Chair, Gary McNamara, called the meeting to order at 4:33 p.m.
  2. Agenda Approval

    Moved by:  Judy Lund    
    Seconded by:  Rino Bortolin
    That the agenda be approved.
    CARRIED

  3. Announcement of Conflicts of Interest – None
  4. Update (Dr. W. Ahmed)
    1. COVID-19 Update

      Dr.  W. Ahmed noted the announcement made by the province today.  Today the Premier announced a different pathway to reopen the province, which will occur in three different stages.  In stage 1 various sporting activities will open, i.e. golf, tennis, basketball courts, and gatherings of up to 5 people outdoors will be allowed. Following that, more restrictions will be relaxed with gatherings of up to 10 people permitted, possibly in as early as 10 days.  In stage 3, in about 21 days, outdoor sports leagues, personal services settings, religious services and gatherings will increase to 25 people. More information will follow.

      We are seeing some fluctuations of positive cases in our region, and still have a relatively high number being reported daily.  Cases amongst school age children are averaging five cases per day even with the school closure.

      Most cases, about three-quarters, are coming from the City of Windsor, followed by the other municipalities.  We are seeing most of the cases are occurring within the 0-29 year age group, and we have documented cases of infants less than a year old in our community who have tested positive for COVID-19.

      Adults 18+ are now eligible to receive their first dose, and we have seen a decline in cases amongst other age groups that have already been vaccinated.  Once vaccination rates increase for the younger age group, we expect to see a drop in cases in younger people. Close contact and community transmission are the biggest contributors.

      The Variants of Concern (VOC’s) are a significant driver in our area with more than 70% of our positive cases being VOCs.  The VOCs pose a huge risk, as they spread quickly resulting in the daily fluctuation of cases we are seeing in our community.

      Hospitalizations are declining in the province as more people get vaccinated, and we are seeing the same result in Intensive Care Units.  The older population still has the highest risk and mortality rate.  

      There have been more than 213,000 doses administered in our region, with approximately 3,600 doses per day through pharmacies and primary care providers.  We have immunized as many as 4,800 people in one day.  More than two-thirds of doses administered in Windsor-Essex has been Pfizer, with Moderna and AstraZeneca equally making up the rest.

      Our overall coverage rate is 48.3% and when looking at just adults, it is 62.6%.  Opening up the eligibility to 18+ will help to increase these rates.  We are hoping for at least 70% vaccine coverage for further impact and decrease cases in our community.

      Various hot spots in our region continue to have the lowest coverage rates at 41%, despite having mass immunization sites and pop-up vaccination clinics in those areas. We are working with the City and the CMHA for a more targeted approach.

      G. McNamara said there could be campaigns with community leaders and medical professionals on why you should get the vaccine.  This might be a good opportunity to get messaging to the younger population who are also working in essential services, i.e. restaurants and grocery stores.  Dr. Ahmed said that we have worked with the University of Windsor around vaccine hesitancy, and our team is looking at all options. N. Dupuis is working with community partners for immigrants through the Multicultural Council as well to work through some language barriers.   

      E. Sleiman asked if once an individual receives the vaccine are they protected from contracting COVID-19, and if students and teachers are fully vaccinated would they still require a mask when they return to school. Dr. Ahmed said studies have shown that the vaccine protects against severe disease and/or hospitalization from COVID-19.  As to whether those have been vaccinated can still contract the disease, we are not sure and there are still many unknowns.  Dr. Ahmed said that at some point students and teachers will no longer be required to wear masks when attending school, but for that to happen there will need to be sufficient vaccine coverage rates with very low, to no, transmission in the community. 

      J. Lund asked if there was any work being done around anti-viral mediation. Dr. Ahmed said that there are many clinical trials happening around the world, but it is likely too early to determine the outcome.  We continue to hear that Remdesivir is widely used for COVID patients and it does improve recovery time.  Steroids are used as a form of treatment mainly in the UK and has shown some positive benefits in reducing the severity in some cases. There are other medications being used with mixed results and this is still being investigated.

      J. Lund asked about the status of allowing Windsorites to receive second doses of the vaccine across the border in Michigan.  G. McNamara said that the border is a national responsibility.  Some groups are advocating for this along with an exemption of no quarantine when arriving back into Canada but there are still some risks to that.  Windsor-Essex has been immunizing approximately 3,000 – 4,000 people a day, and more vaccine is coming.  WECHU and our partners have been doing an excellent job and we are moving in the right direction.  It might prove to be premature at this time to allow cross-border immunizations. 

      Dr. Ahmed agreed with G. McNamara that there is a risk to this initiative.  Our vaccination coverage rates are almost 63% for those who have received one dose, compared to Detroit at 33%.  Our recommendation to the public is still the same, to travel less to reduce transmission.  The  best option would be to have the extra doses of the vaccine in Michigan brought here, instead of the our residents travelling across the border. 

      G. McNamara asked where our region is in respect to second doses of AstraZeneca.  We have 37,000 residents who have received their first dose, and are we expecting to receive more.  Dr. Ahmed said that we are in conversations currently with the province to plan for second doses.  The province will offer two options, i.e. to receive a second dose of AstraZeneca, or to mix vaccines and receive Pfizer as the second dose.  The product monograph for AstraZeneca ranges from 4-12 weeks and the 12 weeks duration has proven to be more effective.  More details will follow once we have more information on these second doses for AstraZeneca recipients.

      Moved by:  Judy Lund
      Seconded by:  Ed Sleiman
      That the information be received.
      CARRIED

  5. Approval of Minutes
    1. Regular Board Meeting:  March 18, 2021
      Moved by: Joe Bachetti
      Seconded by: Rino Bortolin
      That the minutes be approved.
      CARRIED
  6. Business Arising - None
  7. Consent Agenda

    1. INFORMATION REPORTS
      1. Consumption and Treatment Services Site – Update (T. Marentette)

        T. Marentette said that we are moving forward in the Consumption and Treatment Services Site selection process.  You will likely hear more about community consultation in July around the sites proposed.  All of our consultations will be virtual and we want to ensure that it is inclusive by engaging stakeholders, businesses, neighbours, the BIA and municipal councillors applicable in the area. We are working with our legal representative before any lease is signed, background work is in progress, and we are not comitting to anything until the funding has been secured. More information will be forthcoming.

      2. Beach Water Sampling (N. Dupuis)
        To be brought to the Board for information.

      3. Vector-Borne Surveillance Report (N. Dupuis)
        To be brought to the Board for information.

      4. Syphillis and HIV in Windsor-Essex County (F. Lawal)
        G. McNamara said that the increasing numbers of infection for Syphillis and HIV from 2017-2019 in our region is concerning, and are higher than the provincial average. F. Lawal said the WECHU is seeing as many as 4 cases of Syphilis a week in our sexual health clinic and the trend definitely is concerning.  We are working hard to create public awareness around the seriousness of contracting these diseases and the impact on health, i.e. vision, demensia, and the congenital piece, and it remains imperative that we continue to identify contacts for infectious diseases druring the pandemic. 

      5. March and April Communications Recap
        To be brought to the Board for information.
        Moved by:  Judy Lund
        Seconded by:  Ed Sleiman
        That the above information be received.
        CARRIED

    2. RECOMMENDATION REPORTS
      1. Healthy Babies Healthy Children (N. Dupuis/L. Gregg)
        N. Dupuis noted that the Healthy Babies Healthy Children (HBHC) program is a mandated program under the Ontario Public Health Standards (OPHS), and is funded 100% through the Ministry of Children Community and Social Services (MCCSS). In 2020, due to the COVID-19 pandemic, HBHC program services were significantly altered across the province as staffing resources were redeployed to support the COVID response. 

        In March 2021, the WECHU received communication from the MCCSS requesting the restoration of HBHC services for the 2021-2022 fiscal year. Health Units were asked to submit their service delivery plans and financial forecast to MCCSS by April 14, 2021 for review and consideration. Where staff were redeployed to other services supporting the pandemic, health units were asked to consider alternative staffing models including the use of social workers and other professional staff to support program delivery and identified service goals. 

        L. Gregg advised that the budget for this program for this year is $2,894,841, and is a combination of the HBHC and Nurse Practitioner program previously reported under separate funding.  The Operating Budget has some notable changes.  Professional development costs increased to address the needs of FTEs that are new to the program.  

        There was an increase in program supplies of $66,159 for the Healthy Babies Healthy Children Program Initiative to address the need to review and refresh resources and revitalize the program.  Additionally, there will be an augment in information technology hardware and software to address increased FTEs.  The program area will also continue to review equipment requirements for work-from-home as well as ensuring field staff are more mobile, in that they can document client interactions in the field.

        Therefore, we are requesting that the Board approve the budget for this program of $2,894,841 as presented by Administration for the period April 1, 2021 to March 31, 2022.

        Moved by:  Judy Lund

        Seconded by:  Rino Bortolin
        That the Board approve the Budget as presented by Administration. 
        CARRIED

  8. New Business
    1. Fluoride Update (W. Ahmed)
      Dr. W. Ahmed said that we recently received communication from Enwin regarding fluoride introduction into the WUC water system.  The process has been delayed due to the pandemic but despite these delays, Enwin management is expecting the project to reintroduce fluoride to the drinking water to be accomplished within the allocated budget for 2021.

      Moved by: Larry Snively
      Seconded by: Ed Sleiman
      That the information be received.
      CARRIED

  9. Other Board of Health Resolutions/Letters
    1. Brian Masse, MPP, Windsor-West – Letter to Windsor-Essex County Health Unit – Vaccination for CBSA Officers at International Borders

    2. Peterborough Public Health – Letter to Honourable Doug Ford – Stay at Home Order Extended to June 2, 2021

    3. Municipality of Lakeshore – Letter to Honourable Doug Ford – Boat Launches to be open in Ontario

      Moved by:    Judy Lund
      Seconded by:  Ed Sleiman
      That the information be received.
      CARRIED

  10. Committee of the Whole (CLOSED SESSION, in accordance with Section 239 of the Municipal Act)

    The Board moved into Committee of the Whole at 5:30 pm
    The Board moved out of Committee of the Whole at 5:50 pm

  11. Next Meeting: At the Call of the Chair, or June 17, 2021 – Via Video 

  12. Adjournment

    Moved by: Judy Lund
    Seconded by: Gary Kaschak
    That the meeting be adjourned.
    CARRIED

    The meeting adjourned at 5:50 pm.

RECORDING SECRETARY:

SUBMITTED BY:

APPROVED BY:

ISSUE

The Healthy Babies Healthy Children program is a mandated program under the Ontario Public Health Standards (OPHS), and is funded 100% through the Ministry of Children Community and Social Services (MCCSS). In 2020, due to the COVID-19 pandemic, HBHC program services were significantly altered across the province as staffing resources were redeployed to support the COVID response.

The HBHC program is an evidence based early intervention home visiting program designed to improve outcomes for children at risk of poor growth and development. The HBHC program aims to support the most vulnerable and marginalized families in our community through blended home visiting including nursing, social work and peer support. Entry into the HBHC programs occurs through screening and referral at three stages: Prenatal; Postpartum; and Early Identification. The HBHC screen identifies a family experiencing a need, issue or risk that may compromise healthy child development; and/or parenting ability; and who may benefit from a more thorough evaluation and receipt of HBHC program services or other community services. HBHC staff utilize standardized assessments and evidence-based interventions to work on family centred goals and develop a Family Service Plan that monitors the progress and achievement of those goals. The HBHC program staff support families with:

  • healthy pregnancy and prenatal care
  • developing a positive relationship with their child
  • promoting child’s growth and development
  • connecting families to resources and programs within their community
  • working together with families to help give their child the best start in life

BACKGROUND

In March 2021, the WECHU received communication from the MCCSS requesting the restoration of HBHC services for the 2021-2022 fiscal year. Health Units were asked to submit their service delivery plans and financial forecast to MCCSS by April 14, 2021 for review and consideration. Where staff were redeployed to other services supporting the pandemic, health units were asked to consider alternative staffing models including the use of social workers and other professional staff to support program delivery and identified service goals.

The WECHU’s service delivery plan recognizes the continued redeployment of nursing staff to support COVID-19 vaccination and case and contact management well into the 2021 calendar year. As such an alternate model of blended home visiting will be implemented utilizing social workers as the family case coordinators supporting all family service plans and goals. Limited nursing staff, including a registered lactation consultant will be incorporated into blended home visiting related to: prenatal health, healthy attachment, optimal growth and development, and breast feeding goals and will consult as an expert related to screening and assessment. Other supports for blended home visiting include a registered dietician to support nutrition and food security and family home visitors.

The WECHU has retained minimum service levels for HBHC over the course of the pandemic. Key priorities for families in Windsor-Essex remain as mental health, substance use and housing stability. HBHC staff have reported an increase in mental health complexity among clients and increased severity for those with pre-existing anxiety and depression. This may be attributed, at least in part, to the financial strain, isolation, and general uncertainty caused by the pandemic, as reported by some clients. This interim model will allow the WECHU the opportunity to meet full program implementation while maintaining program fidelity and support increased risks associated with substance use and poor mental health.

2021/2022 Budget

The MCCSS funds not only the Healthy Babies Healthy Children Program Initiative but also the Nurse Practitioner Program Initiative.  The MCCSS has combined the budget for these program initiatives for purposes of reporting.  As such, the WECHU will adopt a consistent approach.

To address the continued need to have the WECHU nurses more focused on the COVID-19 case and contact management and vaccination efforts, the FTE composition of the Healthy Babies Healthy Children Program Initiative will change throughout the fiscal year.  Initially, the Program will be more heavily supported by social workers.  This support will shift as nursing support can be reintegrated in the latter part of 2021.

A summary of the FTEs by quarter are as follows:
FTE Q1 Q2 Q3 Q4

Manager

2

2

2

2

Health Promotion Specialist

1

1

1

-

Nutritionist

1

1

1

-

Public Health Nurse

6 grading down to 4

4

9

15

Family Home Visitor

4

4

4

4

Social Worker

2 grading up to 10

10

10

4

Support Staff

1.5

2.5

2.5

2.5

*FTE estimates are approximate and subject to change based on program needs and pressures throughout the year.

Regarding the Nurse Practitioner Program Initiative, one (1) nurse practitioner FTE will be retained throughout the entire year.  This FTE will provide limited support to COVID-19 vaccination efforts.  Quarterly reporting will reflect the reallocation of applicable salaries and benefits for time expended on Ministry of Health Programs.

The 2021/2022 expenditure budget for all programs funded by the MCCSS is detailed below:
  April 1, 2021 to March 31, 2022 April 1, 2020 to March 31, 2021 Change
Salaries and benefits 2,639,041 2,722,600 (83,559)
Operating expenditures:      
    Mileage 60,000 63,000 (3,000)
    Professional development 25,000 10,400 14,600
    Program supplies 150,000 83,841 66,159
    Purchased services 20,800 15,000 5,800
Total operating expenditures 255,800 172,241 83,559
Total budget 2,894,841 2,894,841 -

For the 2021/22 fiscal year, the fluent staffing complement results in a change in the salaries and benefits financial statement caption of $83,559.  Offsetting this are is an increase in the operating budget, most notably the following financial statement captions:

  • Professional development of $14,600 – Increase in professional development to address the needs of FTEs that are new to the Healthy Babies Healthy Children Program Initiative as well as the needs of those returning to this program in the latter part of 2021.
  • Program supplies of $66,159 – Increases in program supplies for the Healthy Babies Healthy Children Program Initiative to address the need to review and refresh resources and revitalize the program.  Additionally, there will be an augment in information technology hardware and software to address increased FTEs.  The program area will also continue to review equipment requirements for work-from-home as well as ensuring field staff are more mobile, in that they can document client interactions in the field.

PROPOSED MOTION

Whereas, the Windsor-Essex County Health Unit receives grants from the Ministry of Children, Community and Social Services to fund the Healthy Babies Healthy Children and Nurse Practitioner Program Initiatives, and

Whereas, the total budget for the Healthy Babies Healthy Children Program Initiative and the Nurse Practitioner Program Initiative combined is $2,894,841 for the period April 1, 2021 to March 31, 2022,

Now therefore be it resolved that the Windsor-Essex County Board of Health approve the budget as presented by Administration for the period April 1, 2021 to March 31, 2022.

Meeting held via video.

  1. Call to Order
  2. Agenda Approval
  3. Announcement of Conflict of Interest
  4. Update (W. Ahmed)
    1. COVID-19 Update
  5. Approval of Minutes
    1. Regular Board Meeting:  March 18, 2021   
  6. Business Arising
  7. Consent Agenda
    1. INFORMATION REPORTS
      1. March Communications Recap
    2. RECOMMENDTION REPORTS – None
  8. New Business
    1. CEO Quarterly Report (T. Marentette)
  9. Other Board of Health Resolutions/Letters
    1. Town of Kingsville – Letter to Hon. Doug Ford – Resolution - Health and Safety of our Communities 
  10. Committee of the Whole (Closed Session in accordance with Section 239 of the Municipal Act)
  11. Next Meeting: At the Call of the Chair May 20, 2021 – Via Video
  12. Adjournment

Board Members Present:

Gary McNamara, Tracey Bailey, Joe Bachetti, Rino Bortolin, Fabio Costante, Gary Kaschak, Ed Sleiman, Larry Snively 

Board Member Regrets:

Judy Lund

Administration Present:

Theresa Marentette, Dr. Wajid Ahmed, Lorie Gregg, Nicole Dupuis, Dr. Felicia Lawal, Kristy McBeth, Dan Sibley, Lee Anne Damphouse


QUORUM:  Confirmed

  1. Call to Order
    Board Chair, Gary McNamara, called the meeting to order at 4:03 p.m.
  2. Agenda Approval

    Moved by:  Larry Snively
    Seconded by:  Rino Bortolin
    That the agenda be approved.
    CARRIED

  3. Announcement of Conflicts of Interest – None
  4. Update (Dr. Ahmed)
    1. COVID-19 Update

      Dr.  Ahmed noted the increase of COVID-19 cases across the province with approximately 4,700 reported in Ontario today. Windsor-Essex has seen an increase with 93 cases reported today and the Variants of Concern (VOC) pose an even bigger threat.  

      We are still seeing increases amongst school-aged children but it seems to be stabilizing.  We are hoping numbers will decrease over the next few weeks with the provincial mandated school closures. The majority of cases in children are through their family and household contacts and not from attending school. 

      Cases have decreased in the senior population due to the vaccine, with a shift to the younger population in the 0-19 and 20-29 year age groups. Household contacts and community transmission are the significant drivers, with more VOC being reported every day. 

      The province is seeing a sharp increase in hospitalizations and ICU admissions.  We are monitoring our ICU cases, but Windsor-Essex is not seeing the same trend as the province.  With the VOC contributing up to 30-50% of cases, this could lead to more hospitalization.  

      The case fatality rate is 1.9% across the province. Windsor-Essex’s case fatality rate is 2.8%, with the majority of fatalities coming from the community.  Our LTCH/RH fatality rate is lower than the provincial average.  R. Bortolin asked if there is any data showing if the vaccine is effective to the VOCs.  Dr. Ahmed said that PHO is analyzing that data at the provincial level and he can share that when received. 

      Our region has administered 124,578 doses of vaccine, with 112,027 residents receiving at least one dose.  The province has noted various hot spots in our region, some requiring more attention, i.e. the downtown Windsor core and the west area of Windsor where we would like to offer more opportunities to receive the vaccine. 

      J. Bachetti asked about the 80+ group of individuals who cannot leave their homes. What plans are in place to help vaccinate them. Dr. Ahmed said that adults in chronic home care who are registered with the LHIN will be vaccinated.  For others who are not, we are hoping to have primary care providers come onboard to help vaccinate these individuals. T. Marentette said  starting Monday there will be two teams that will assist with vaccinating between 100-300 home bound individuals, starting in hot spots, that are registered with the LHIN.  

      Dr. Ahmed advised that our current allotment of the Pfizer vaccine is 10,500 doses a week until at least mid-May, with 2,000 of Moderna earmarked for other priorities.  We have also received a large shipment of AstraZeneca which will flow through the pharmacy channels.
       
      R. Bortolin asked about individuals outside of Windsor-Essex booking vaccinations in our region, and is there a way to divert that.  Dr. Ahmed said that under the provincial booking system people can book anywhere across Ontario and there is nothing we can do to avoid that. There is also nothing stopping individuals from Windsor-Essex booking elsewhere across the province. 

      E. Sleiman asked if doses of the vaccine can be mixed, i.e. if you receive the AstraZeneca can you receive the Pfizer as the second dose.  Also, some of his constituents have been asking him about their second dose appointments.  Dr. Ahmed said there has been no recommendations yet around mixing doses.  T. Marentette said that second doses will begin the end of June, and we are working on a system internally to accommodate for this.

      Moved by:    Ed Sleiman
      Seconded by:  Rino Bortolin
      That the information be received.
      CARRIED

  5. Approval of Minutes
    1. Regular Board Meeting:  March 18, 2021
    2. Special Board Meeting:  Board Elections:  April 1, 2021

      Moved by:  Joe Bachetti
      Seconded by:  Larry Snively
      That the minutes be approved.
      CARRIED

  6. Business Arising – None
  7. Consent Agenda
    1. INFORMATION REPORTS - None
    2. RECOMMENDATION REPORTS - None
  8. New Business
    1. CEO Quarterly Report (T. Marentette)

      T. Marentette said that the WECHU is seeing consistent challenges as we continue to operate under a pandemic.  Many of our staff remain redeployed to Case and Contact Management, Vaccine Clinics and Outbreak. 

      Moved by:  Rino Bortolin
      Seconded by:  Larry Snively 
      That the above information be received.
      CARRIED

  9. Other Board of Health Resolutions/Letters
    1. Town of Kingsville – Letter to the Hon. Doug Ford – Resolution – Health and Safety of our Communities 
      G. McNamara said what the Town of Kingsville is looking for around inspections is related to fire and building code safety, and is beyond the scope of the health unit.  

      T. Marentette explained the health unit’s process around migrant housing.  When Temporary Foreign Workers arrive on the farm premises, our WECHU Public Health Inspectors (PHI) inspect the bunkhouses in those congregate settings. Most of them are located in the vicinity of Leamington and Kingsville.  Our PHIs inspect and approve congregate settings based on public health requirements, but they may not pass building and fire regulations.  They have their own guidelines that must be followed.

      About a year ago, we collaborated with the municipalities and agreed to align our inspections if possible, but that does not always happen due to resources and/or scheduling.  If we conduct our inspection prior to fire or building inspections, we provide our report to the municipality.  We did speak to the CAO in Kingsville and were advised at that time that there were no issues.  

      R. Bortolin noted that even from a restaurant perspective they need various inspections, but they generally do not happen at the same time.  G. McNamara agreed that scheduling all inspections at the same time would be a daunting task, especially with seven municipalities in our region.
      Moved by:  Rino Bortolin 
      Seconded by: Ed Sleiman
      That the information be received.
      CARRIED

    2. Town of Essex – Letter to the Hon. Doug Ford, the Hon. Christine Elliott, Dr. Wajid Ahmed, Theresa Marentette – Letter in Support of Small Business
      Moved by:   Rino Bortolin 
      Seconded by:  Tracey Bailey
      That the information be received. 
      CARRIED

  10. Committee of the Whole (CLOSED SESSION, in accordance with Section 239 of the Municipal Act)

    The Board moved into Committee of the Whole at 4:52pm
    The Board moved out of Committee of the Whole at 5:40 pm

  11. Next Meeting: At the Call of the Chair, or May 20, 2021 – Via Video
  12. Adjournment

    Moved by:  Rino Bortolin
    Seconded by:  Ed Sleiman
    That the meeting be adjourned.
    CARRIED

    The meeting adjourned at 5:45 pm.

RECORDING SECRETARY:

SUBMITTED BY:

APPROVED BY:

Board Members Present:

Gary McNamara, Tracey Bailey, Joe Bachetti, Rino Bortolin, Fabio Costante, Gary Kaschak, Ed Sleiman, Larry Snively

Board Member Regrets:

Judy Lund

Administration Present:

Theresa Marentette, Dr. Wajid Ahmed, Lorie Gregg, Nicole Dupuis, Dr. Felicia Lawal, Kristy McBeth, Dan Sibley, Lee Anne Damphouse


QUORUM:  Confirmed

  1. Call to Order
    Board Chair, Gary McNamara, called the meeting to order at 4:03 p.m.
  2. Agenda Approval

    Moved by: Larry Snively
    Seconded by:  Rino Bortolin
    That the agenda be approved.
    CARRIED

  3. Announcement of Conflicts of Interest – None
  4. Update (Dr. Ahmed)
    1. COVID-19 Update

      Dr.  Ahmed noted the increase of COVID-19 cases across the province with approximately 4,700 reported in Ontario today. Windsor-Essex has seen an increase with 93 cases reported today and the Variants of Concern (VOC) pose an even bigger threat.  

      We are still seeing increases amongst school-aged children but it seems to be stabilizing.  We are hoping numbers will decrease over the next few weeks with the provincial mandated school closures. The majority of cases in children are through their family and household contacts and not from attending school. 

      Cases have decreased in the senior population due to the vaccine, with a shift to the younger population in the 0-19 and 20-29 year age groups. Household contacts and community transmission are the significant drivers, with more VOC being reported every day. 

      The province is seeing a sharp increase in hospitalizations and ICU admissions.  We are monitoring our ICU cases, but Windsor-Essex is not seeing the same trend as the province.  With the VOC contributing up to 30-50% of cases, this could lead to more hospitalization.  

      The case fatality rate is 1.9% across the province. Windsor-Essex’s case fatality rate is 2.8%, with the majority of fatalities coming from the community.  Our LTCH/RH fatality rate is lower than the provincial average.  R. Bortolin asked if there is any data showing if the vaccine is effective to the VOCs.  Dr. Ahmed said that PHO is analyzing that data at the provincial level and he can share that when received. 

      Our region has administered 124,578 doses of vaccine, with 112,027 residents receiving at least one dose.  The province has noted various hot spots in our region, some requiring more attention, i.e. the downtown Windsor core and the west area of Windsor where we would like to offer more opportunities to receive the vaccine. 

      J. Bachetti asked about the 80+ group of individuals who cannot leave their homes. What plans are in place to help vaccinate them. Dr. Ahmed said that adults in chronic home care who are registered with the LHIN will be vaccinated.  For others who are not, we are hoping to have primary care providers come onboard to help vaccinate these individuals. T. Marentette said  starting Monday there will be two teams that will assist with vaccinating between 100-300 home bound individuals, starting in hot spots, that are registered with the LHIN.  

      Dr. Ahmed advised that our current allotment of the Pfizer vaccine is 10,500 doses a week until at least mid-May, with 2,000 of Moderna earmarked for other priorities.  We have also received a large shipment of AstraZeneca which will flow through the pharmacy channels.
       
      R. Bortolin asked about individuals outside of Windsor-Essex booking vaccinations in our region, and is there a way to divert that.  Dr. Ahmed said that under the provincial booking system people can book anywhere across Ontario and there is nothing we can do to avoid that. There is also nothing stopping individuals from Windsor-Essex booking elsewhere across the province. 

      E. Sleiman asked if doses of the vaccine can be mixed, i.e. if you receive the AstraZeneca can you receive the Pfizer as the second dose.  Also, some of his constituents have been asking him about their second dose appointments.  Dr. Ahmed said there has been no recommendations yet around mixing doses.  T. Marentette said that second doses will begin the end of June, and we are working on a system internally to accommodate for this.

      Moved by: Ed Sleiman
      Seconded by: Rino Bortolin
      That the information be received.
      CARRIED

  5. Approval of Minutes
    1. Regular Board Meeting:  March 18, 2021
    2. Special Board Meeting:  Board Elections:  April 1, 2021
      Moved by: Judy Lund
      Seconded by: Joe Bachetti
      That the minutes be approved.
      CARRIED

  6. Business Arising - None
  7. Consent Agenda

    1. INFORMATION REPORTS - None
    2. RECOMMENDATION REPORTS - None

     

  8. New Business
    1. CEO Quarterly Report (T. Marentette)
      T. Marentette said that the WECHU is seeing consistent challenges as we continue to operate under a pandemic.  Many of our staff remain redeployed to Case and Contact Management, Vaccine Clinics and Outbreak. 

      Moved by: Rino Bortolin
      Seconded by: Larry Snively
      That the information be received.
      CARRIED

  9. Other Board of Health Resolutions/Letters
    1. Town of Kingsville – Letter to the Hon. Doug Ford – Resolution – Health and Safety of our Communities

      G. McNamara said what the Town of Kingsville is looking for around inspections is related to fire and building code safety, and is beyond the scope of the health unit.  

      T. Marentette explained the health unit’s process around migrant housing.  When Temporary Foreign Workers arrive on the farm premises, our WECHU Public Health Inspectors (PHI) inspect the bunkhouses in those congregate settings. Most of them are located in the vicinity of Leamington and Kingsville.  Our PHIs inspect and approve congregate settings based on public health requirements, but they may not pass building and fire regulations.  They have their own guidelines that must be followed.

      About a year ago, we collaborated with the municipalities and agreed to align our inspections if possible, but that does not always happen due to resources and/or scheduling.  If we conduct our inspection prior to fire or building inspections, we provide our report to the municipality.  We did speak to the CAO in Kingsville and were advised at that time that there were no issues.  

      R. Bortolin noted that even from a restaurant perspective they need various inspections, but they generally do not happen at the same time.  G. McNamara agreed that scheduling all inspections at the same time would be a daunting task, especially with seven municipalities in our region.

      Moved by:  Rino Bortolin 
      Seconded by: Ed Sleiman
      That the information be received.
      CARRIED

    2. Town of Essex – Letter to the Hon. Doug Ford, the Hon. Christine Elliott, Dr. Wajid Ahmed, Theresa Marentette – Letter in Support of Small Business

      Moved by:   Rino Bortolin 
      Seconded by:  Tracey Bailey
      That the information be received. 
      CARRIED

  10. Committee of the Whole (CLOSED SESSION, in accordance with Section 239 of the Municipal Act)

    The Board moved into Committee of the Whole at 4:52 pm
    The Board moved out of Committee of the Whole at 5:40 pm

  11. Next Meeting: At the Call of the Chair, or May 20, 2021 – Via Video 

  12. Adjournment

    Moved by: Rino Bortolin
    Seconded by: Ed Sleiman
    That the meeting be adjourned.
    CARRIED

    The meeting adjourned at 5:45 pm.

RECORDING SECRETARY:

SUBMITTED BY:

APPROVED BY:

  1. Period covered by this report:  January 1, 2021 to March 31, 2021
  2. For the period covered by this CEO Quarterly Compliance Report:
    1. The undersigned has personal knowledge of the matters herein reported or has made due inquiry with respect to the same.
    2. Except as reported in any previous CEO Quarterly Compliance Report, the undersigned reports as follows:
      1. that the Health Unit has been in material compliance with all laws, regulations, orders, judgments or decrees applicable to it.  Without limiting the generality of the foregoing the Health Unit is current in respect of all tax and related withholding and remittances required by law;
      2. the Health Unit has been in material compliance with its By-laws;
      3. the Health Unit has been in material compliance with all other Board resolutions;
      4. the Health Unit has been in material compliance with all contracts and commitments to which the Health Unit is a party including without limitation all funding and accountability agreements;
      5. the Health Unit is current with respect to the payment of all remuneration (including salary and benefits) to its employees;
      6. there are no material variances between what is contemplated by the Operational Plan and what in fact transpired or appears likely to transpire
      7. more specifically, no material changes are required in respect of financial resource allocation plans to address shifts in need and capacity
      8. no material adverse change has occurred in the operations of the Health Unit or its assets and liabilities taken as a whole
      9. there have been no material breaches of the Ethics Code of Conduct by anyone who is subject to it;
      10. there have been no unplanned terminations of any Health Unit employees;
      11. there have been no claims made pursuant to any insurance policies maintained by the Health unit; and,
      12. nothing has come to the attention of the undersigned which would materially adversely change any previous CEO Quarterly Compliance Report, except as detailed below:

Items (vi), (vii), and (viii) have been revised due to the COVID -19 pandemic as follows:

On March 17, 2020, the Province of Ontario enacted the Emergency Management and Civil Protection Act, R.S.O. 1990, c. E.9. (“the Act”), to support efforts to contain the spread of COVID-19, in our communities.  The Act supports public health units to, regardless of their collective bargaining agreements, suspend services, redeploy staff as deemed appropriate, modify hours of work, cancel and or defer vacations, utilize part-time/contract staff to perform the duties and responsibilities of bargaining unit staff and suspend the grievance process. 

The WECHU, in its response to COVID-19 within the communities of Windsor and Essex County has:

  • Redeployed staff as considered appropriate to facilitate our response to the pandemic;

Date:   April 15, 2021

Theresa Marentette, CEO

Meeting held virtually.

  1. Call to Order
  2. Agenda Approval
  3. Announcement of Conflict of Interest
  4. Board Elections - Vice Chair
  5. Committee of the Whole (Closed Session in accordance with Section 239 of the Municipal Act)
  6. Next Meeting: At the Call of the Chair April 15, 2021 – Via Video
  7. Adjournment

Meeting held via video.

  1. Call to Order
  2. Agenda Approval
  3. Announcement of Conflict of Interest
  4. Update (W. Ahmed)
    1. COVID-19 Update
  5. Approval of Minutes
    1. Special Board Budget Meeting: March 4, 2021
  6. Business Arising
  7. Consent Agenda
    1. INFORMATION REPORTS
      1. Ontario Active School Travel Fund Awarded to Windsor- Essex County (N. Dupuis)
      2. Risk Management (T. Marentette/M. Frey)
      3. January/February Communications Recap
    2. RECOMMENDTION REPORTS – None
  8. New Business
  9. Other Board of Health Resolutions/Letters
    1. Kingston, Frontenac & Lennox and Addington Public Health – Letter to Hon. Doug Ford, Premier of Ontario – Mandatory Sick Leave for Ontario Workers
    2. Kingston, Frontenac and Lennox & Addington Public Health – Letter to The Right Hon. Justin Trudeau – Land and Water Border Restrictions
    3. Peterborough Public Health – Letter to The Hon. Doug Ford, The Hon. Christine Elliott and The Hon. Monte McNaughton – Paid Sick Leave During an Infectious Disease Emergency
    4. Letter from the Municipality of Chatham-Kent Public Health – Letter to The Hon. Doug Ford – Paid Sick Leave during COVID-19 Pandemic and Beyond
    5. Letter from Queen's Park, Peggy Sattler, MPP, London West – Private Members Bill – Bill 239 – Stay Home if you are Sick Act – Advocating for paid sick days for Ontario workers to alleviate the spread of COVID-19
    6. Windsor-Essex County Health Unit – Letter to The Hon. Doug Ford – Mandatory Paid Sick Leave for Ontario Workers
  10. Committee of the Whole (Closed Session in accordance with Section 239 of the Municipal Act)
  11. Next Meeting: At the Call of the Chair April 15, 2021 – Via Video
  12. Adjournment

SUBMITTED BY

Marc Frey, Manager, Planning and Strategic Initiatives Department

DATE

March 18, 2021

SUBJECT

Risk Management


BACKGROUND

The Windsor-Essex County Health Unit (WECHU) maintains a corporate risk registry. The Ministry of Health (MOH) requires yearly reporting on the ten (maximum) highest residual risks to the organization and the related operations. Residual risks are defined as the assessed risk level after consideration of associated mitigation strategies. The MOH requires the use of a specific template and consistent language to harmonize efforts in tracking risks across the province.

CURRENT INITIATIVES:

The WECHU enterprise risk registry monitors 29 risks across 14 risk categories. Based on the categorization and reporting requirements by the MOH, 8 of these risks were identified as being high residual risks. The high risks reported to the MOH are related to: funding, health system transformation, disasters/hazards, planning information and evaluation, work stoppage, privacy breaches, and local health disparities.

Each identified high risk includes documentation of current and future mitigation approaches. Some of the mitigation approaches are anticipated to be delayed due to the impact of the ongoing COVID-19 pandemic. The WECHU enterprise risk registry will be updated in the current year, based on the reported risk information to the MOH, with adjustments to the current status of risks and mitigation strategies.

RISK REPORTING

1: Funding

Description

CAUSE: Funding uncertainties.

EVENT: Hampered financial planning, monitoring, and decision making processes. Recent exogenesis factors, including the COVID-19 pandemic and the municipal cost-sharing changes have exacerbated funding uncertainties.

CONSEQUENCES:

  1. Inability to satisfy the WECHU's objectives (Strategic and Operational)
  2. Inability to meet the requirements of the Ontario Public Health Standards
  3. Cost reduction measures (i.e. headcount reductions; prioritization of expenditures) and resulting impact on staff morale
  4. If late approval or approval in excess of budget, lost opportunities if the WECHU is unable to act on plans
  5. Organization’s reputation is at risk
  • CATEGORY: Financial
  • IMPACT: 4
  • LIKELIHOOD: 5
  • OVERALL RATING: 20 - High

Key Risk Mitigations

CONTROL STRATEGY:

  1. Quarterly variance analysis comparing budget to actual financial results reviewed by Leadership Team and Board of Health (BOH) with forecast (Q3 and or Q4 only).
  2. Responsible budget process that balances finite resources with program/departmental priorities
  3. Identification of priorities (i.e. contract positions, operating expenditures) to be strategic with budget/planning reallocation when positive budget variances are realized
  4. Forecasting of expenditures on a quarterly basis

ACTION REQUIRED:

  1. Evaluation of budget (process and quality)

2: Health System Transformation

Description

CAUSE: Ministry mandated public health system changes.

EVENT: The WECHU may be at risk of significant disruptions and high opportunity costs related to health system transformation including the possibility of regionalization.

CONSEQUENCES:

  1. Inability to meet the requirements of the Ontario Public Health Standards
  2. Hampered ability to effectively respond to COVID-19 requirements/expectations
  3. Confusion of purpose
  4. Confusion within partnerships and working relationships
  5. The organization’s reputation is at risk
  • CATEGORY: Governance / Organizational
  • IMPACT: 5
  • LIKELIHOOD: 4
  • OVERALL RATING: 20 - High

Key Risk Mitigations

CONTROL STRATEGY:

  1. Working with regional leadership groups to identify local priorities
  2. Engaging with regional leadership groups to establish working relationships for priority areas

ACTION REQUIRED:

  1. Monitoring public health modernization developments
  2. Engagement in public health modernization efforts
  3. Change management planning based on public health modernization information

3: Disasters/Hazards

Description

CAUSE: Epidemiological, natural, and anthropogenic disasters or hazards. This current risk assessment incorporates consideration of the ongoing COVID-19 pandemic, as well as other potential disasters/hazards.

EVENT: The WECHU may be at risk of disrupted service delivery, modified program/service priorities, and/or novel requirements due to a disaster/hazard occurrence.

CONSEQUENCES:
1. Inability to meet the requirements of the Ontario Public Health Standards
2. Inability to satisfy the WECHU's objectives (strategic and operational)
3. Increased capital and human resource requirements, beyond budgeted allocations
4. Capacity constraints based on current assets and required actions
5. The organization’s reputation is at risk

  • CATEGORY: Environment
  • IMPACT: 5
  • LIKELIHOOD: 4
  • OVERALL RATING: 20 - High

Key Risk Mitigations

CONTROL STRATEGY:

  1. The WECHU works closely with community partners and the Ministry of Health (Emergency Management Branch) for any emergency notification and response
  2. A Continuity of Operations Plan (COOP), a Hazard Identification Risk Assessment (HIRA), and an Emergency Response Plan (ERP) have been developed
  3. N-95 Respiratory fit-testing occurs on regular intervals

ACTION REQUIRED:

  1. Long-term COVID-19 response plan development
  2. Increased resource allocation to address protracted COVID-19 response
  3. Forecasting for resource expectations for future disaster/hazard scenarios

4: Planning Information and Evaluation

Description

CAUSE: Capacity constraints and/or inability to access/collect information/data resources to inform program planning/operations.

EVENT: The inability to collect local data/information resources due to competing priorities (e.g., COVID-19 pandemic response) and the inability to access federal data resources (e.g., CCHS dataset access) affect organizational capacity to make evidence-based regarding program and service plans. Decreased capacity to plan and evaluate program/service operations to inform decision-making.

CONSEQUENCES:

  1. Programs and services that do not align with the needs of the community
  2. Inability to meet the requirements of the Ontario Public Health Standards
  3. Inability to address local emerging public health concerns (e.g., secondary impacts of COVID-19 on local health outcomes)
  4. Increased health disparity/inequity in Windsor-Essex health outcomes
  5. The organization’s reputation is at risk
  • CATEGORY: Information/Knowledge
  • IMPACT: 4
  • LIKELIHOOD: 5
  • OVERALL RATING: 20 - High

Key Risk Mitigations

CONTROL STRATEGY:

  1. Annual Service Plan development and submission to the Ministry of Health
  2. Program review based on COVID-19 requirements/expectations in 2021
  3. Existing data resources (e.g., the Windsor-Essex County Health Unity Community Needs Assessment 2019 Update)

ACTION REQUIRED:

  1. Development of standard program effectiveness measures to ensure fidelity of implementation with program plans/operations
  2. Program review and prioritization of interventions/services during the COVID-19 pandemic
  3. Ongoing collection and review of program effectiveness data to adjust program/service delivery based on community needs

5: Work Stoppage

Description

CAUSE: The WECHU and internal labour groups are unable to reach collective bargaining agreements.

EVENT: An extended work stoppage involving internal labour groups.

CONSEQUENCES:

  1. Service delivery to residents of Windsor-Essex County is negatively impacted
  2. Delivery of goods and services is impeded
  3. The organization’s reputation is at risk
  • CATEGORY: People/Human resources
  • IMPACT: 4
  • LIKELIHOOD: 3
  • OVERALL RATING: 12 - High

Key Risk Mitigations

CONTROL STRATEGY:

  1. Routine review of contingency plans to align with the expiration of labour agreements
  2. Routine review of plans with external stakeholders for outside services (e.g., deliveries)
  3. Established plans for work stoppage response (e.g., communication with WECHU staff, communication with vendors, and arrangements for service requirements)

ACTION REQUIRED:

  1. Review and update existing contingency plans
  2. Review and update work stoppage response plans

6: Strategic Priorities

Description

CAUSE: External pressures and resource uncertainty.

EVENT: The WECHU may be at risk of not accomplishing its strategic priorities.

CONSEQUENCES:

  1. The organization’s reputation is at risk
  2. Service delivery to residents of Windsor - Essex County is negatively impacted
  3. Inability to meet the requirements of the Ontario Public Health Standards (2018)
  • CATEGORY: Strategic/Policy
  • IMPACT: 3
  • LIKELIHOOD: 5
  • OVERALL RATING: 15 - High

Key Risk Mitigations

CONTROL STRATEGY:

  1. Implementation of 2017-2021 Strategic Plan and quarterly progress reporting (NB. These actions have been deferred throughout the COVID-19 pandemic)
  2. Completion and reporting on the Annual Service Plan (NB. Some of these actions have been deferred throughout the COVID-19 pandemic)
  3. Monitoring and review of changes to legislation, protocols, and guidelines
  4. Annual review and update of key policies and procedures

ACTION REQUIRED:

  1. Annual review of strategic plan and implementation of its objectives
  2. Prioritization of strategic plan efforts based on organizational capacity
  3. Review the impact of the COVID-19 pandemic on strategic priorities and directions

7: Privacy Breach

Description

CAUSE: Lack of knowledge, experience, and accountability related to personal information or personal health information of clients.

EVENT: Inappropriate collection, use, or disclosure of personal information or personal health information.

CONSEQUENCES:

  1. Risk of litigation and related financial consequences
  2. The organization’s representation is at risk
  3. Non-compliance with data sharing agreements
  • CATEGORY: Privacy
  • IMPACT: 4
  • LIKELIHOOD: 4
  • OVERALL RATING: 16 - High

Key Risk Mitigations

CONTROL STRATEGY:

  1. Established protocols for some databases that hold personal health information
  2. Privacy policies and procedures
  3. Annually required privacy training
  4. Privacy Impact Assessment process and documentation
  5. Annual reporting to the Information Privacy Commission

ACTION REQUIRED:

  1. Privacy audits (NB. These actions have been deferred due to COVID-19 pandemic response)
  2. Training/standard operating procedures for newly implemented systems that hold personal health information
  3. Expand auditing procedures to new electronic systems

8: Local Health Disparities

Description

CAUSE: A decreased emphasis on local priority populations in program/service delivery due to operational pressures, capacity, and prioritization because of the COVID-19 pandemic.

EVENT: The WECHU may be at risk that its programs and services do not address the health disparities amongst local priority populations.

CONSEQUENCES:

  1. Inability to meet the requirements of the Ontario Public Health Standards
  2. Increased health disparity among local priority populations
  3. Increased burden of illness and poorer local health outcomes
  4. Decreased credibility/influence with local priority population groups
  5. The organization’s reputation is at risk
  • CATEGORY: Equity
  • IMPACT: 4
  • LIKELIHOOD: 4
  • OVERALL RATING: 16 - High

Key Risk Mitigations

CONTROL STRATEGY:

  1. Past corporate training/capacity building related to social determinants of health
  2. Health Equity Impact Assessment process for programs and services
  3. Annual Service Plan/operational planning includes identification of local priority populations

ACTION REQUIRED:

  1. Identification of health inequities/disparate health outcomes for local priority populations
  2. Language service provision plans/implementation to serve community language needs
  3. Development of standard priority population engagement approaches
  4. Development of indicators of success related to interventions targeting local priority populations
  5. Local planning for priority populations due to a protracted COVID-19 response

9: Program/Service Implementation

Description

CAUSE: Some programs/services may not occur as anticipated due to operational pressures, capacity, and prioritization of the COVID-19 pandemic response.

EVENT: The WECHU may be at risk that its programs and services do not occur as anticipated based on operational plans and the requirements specified in the Ontario Public Health Standards.

CONSEQUENCES:

  1. Inability to meet the requirements of the Ontario Public Health Standards
  2. Decreased effectiveness of long-term interventions on local health outcomes
  3. Increased burden of illness and poorer local health outcomes
  4. Potential damage to partner relationships related to program/service delivery
  5. Potential opportunity cost related to lack of intervention during periods of time where individuals are seeking public health support (i.e., due to reallocation of resources to support the COVID-19 pandemic response)
  6. The organization’s reputation is at risk
  • CATEGORY: Operational/Service Delivery
  • IMPACT: 4
  • LIKELIHOOD: 4
  • OVERALL RATING: 16 - High

Key Risk Mitigations

CONTROL STRATEGY:

  1. Annual Service Plan development and submission to the Ministry of Health
  2. Program review based on COVID-19 requirements/expectations in 2021
  3. Identification of program/service implementation based on priority areas/legal requirements
  4. Monthly engagement with the Board of Health regarding service expectations during the COVID-19 pandemic

ACTION REQUIRED:

  1. Development of standard program effectiveness measures to ensure fidelity of implementation with program plans/operations
  2. Program review and prioritization of interventions/services during the COVID-19 pandemic
  3. Ongoing collection and review of program effectiveness data to adjust program/service delivery based on community needs

MOH Risk Category:

  • Compliance Legal
  • Environment
  • Equity
  • Financial
  • Governance / Organizational
  • Information / Knowledge
  • Operational / Service Delivery
  • People / Human resources
  • Political
  • Privacy
  • Security
  • Stakeholder / Public Perception
  • Strategic / Policy
  • Technology

SUBMITTED BY

Nicole Dupuis, Director of Health Promotion

DATE

March 18, 2021

SUBJECT

Ontario Active School Travel Fund Awarded to Windsor-Essex County 


BACKGROUND

Active school transportation (AST) plays an important role in helping to increase students’ activity levels and associated improvements in mental and physical health. Common modes of active school transportation include walking, cycling, skateboarding, or scootering to and from school. Using active transportation for school travel can add two bouts of physical activity to a student’s day, helping them accumulate the recommended 60 minutes of activity daily from the Canadian 24 hour movement guidelines. Additionally, when more families use active transportation, there are fewer vehicles accessing the school zone leading to improvements in safety and air quality in the school community. 

In October 2020, Green Communities Canada (GCC) a leading organization promoting active school travel, invited communities in Ontario to apply for their third round of grants under the Ontario Active School Travel Fund (OAST).  The OAST fund was created in 2018 to support active travel initiatives in selected communities across the province and has previously supported the following regions with grants under the previous two funding cycles:

  • Ajax
  • Hamilton
  • Sarnia
  • Ottawa
  • Niagara
  • London
  • Toronto
  • Stratford

Funded prrojects are expected to have a significant and lasting impact in their communities by establishing a foundation for continuing growth in the area of active school travel. Between 2018-2020, Green Communities Canada awarded $2.1 million from the OAST Fund, supporting a number of projects across the province.  Previous applications for In Windsor and Essex County, led by community groups and organizations have been unsuccessful in securing funding in previous rounds. In response to the call for applications for the third round of funding, the Windsor-Essex County Health Unit (WECHU) worked with key community partners to develop and submit an application for the OAST Fund in November 2020. As the lead applicant and coordinating organization, the WECHU submitted the grant on behalf of the partnership which involved the following organizations and community groups:

  • The Greater Essex County School Board
  • Windsor Essex Student Transportation Services
  • The City of Windsor
  • Windsor Police Services
  • Bike Windsor Essex
  • County of Essex – County Wide Active Transportation System (CWATS) program

In December 2020, the WECHU was notified by the OAST fund that the application was successful and would be receiving funding in the amount of $60,000 to be used toward active transportation initiatives for schools throughout Windsor-Essex County during 2021 into early 2022. 

CURRENT INITIATIVES:

The WECHU is in the initial stages of planning and establishing a Transfer Payment Agreement with Green Communities Canada. Upon finalizing the transfer of funding partners will reconvene to discuss project timelines, assign roles and select pilot sites. The committee’s work will focus on policy development and collaboration with pilot schools to implement interventions and assess their impact, with the ultimate goal of establishing sustainable policy and facilitating a more supportive environent for active school travel across the region. Specific projects associated with the grant application for which the funding will be utilized are described below:

  • Hiring and training of a Active Travel Planner to assist schools and boards in implementing plans and coordinate community education and outreach.
  • Establishing pilot school sites and create working groups to engage school community in planning of school-focused interventions.
  • Conducting walkability and safe route checks at each pilot school led by Windsor Police Services.
  • Conducting a scan of built environment and other policy initiatives related to each school community and determine existing resources.
  • Implementing safe active school travel training sessions with students through CAN Bike Safety and Education sessions led by Bike Windsor Essex.
  • Hosting AT community education events to highlight safe routes surrounding each pilot school and creative initiatives to engage students in active school travel.

Conducting baseline and post-intervention evaluation to determine intervention effectiveness in pilot schools and opportunities to scale up for board-wide implementation.

SUBMITTED BY

Communications Department

DATE

March 18, 2021

SUBJECT

February 2021 - Communications Update


February Metrics

SOURCE DECEMBER JANUARY DIFFERENCE

News Releases Issued

1

5

+4

Media Advisories Issued

2

1

-1

Media Statements or Notifications

32

35

+5

Media Requests Received1

71

47

-24

AM 800 Morning Segments2

11

11

0

YouTube Live Media Briefing Videos3

21

18

-3

Wechu.org/cv/local-updates page views4

451,327

298,116

-153,211

YouTube Channel Subscribers

1,269

1,381

+112

Email Subscribers5

3,466

4,237

+771

Emails Distributed

38

44

+6

 

Facebook Fans

17,207

17,392

+185

Facebook Posts

114

154

+40

Twitter Follower

5,943

6,161

+218

Twitter Posts

111

149

+38

Instagram Followers

1,027

1,052

+25

Instagram Posts

10

19

+9

LinkedIn Followers

745

775

+30

LinkedIn Posts

79

74

-5

Media Exposure8

1,146

937

-208

Media Monitoring Highlights

This is a complex graphical representation of data. Please contact us for detail

Trending Themes

This is a complex graphical representation of data. Please contact us for detail

Top Sources

This is a complex graphical representation of data. Please contact us for detail

Media Participating in Teleconference for YouTube Live

  • AM 800 CKLW, Blackburn News, CBC Windsor, CTV Windsor and The Windsor Star join every day.

Current Notable Projects

  • Developing weekly communication plans for ongoing vaccine rollout in the region.
  • We continue to make improvements to our daily COVID-19 public health updates for the community.
  • Regular communication with the Ministry of Health about provincial initiatives and their planned launch dates.

Data Notes:

Most requests are related to the local COVID-19 pandemic.

1. Media requests received is a compiled list of documented requests we captured for interviews, data clarification, or general request for information from the media. Given the volume of requests during COVID-19, many exchanges with the media through text messages or quick phone calls to correct errors may not be captured. In many instances, each request led to multiple interactions with reporters.

2. Dr. Ahmed joined Mike and Lisa on the AM 800 Morning Drive every morning at 8:06 a.m. starting on Wednesday, March 17. On August 17, we went to a Monday, Wednesday, and Friday schedule with holidays off. He continues to do join Mike and Lisa every other morning to keep the community informed.

3. We changed the platform we broadcasted live videos from Facebook to YouTube at the end of June. YouTube Live videos started on June 23, 2020. Prior Public Health Update videos on YouTube were exported videos recorded through Facebook Live.

4. Website analytics are provided by Siteimprove. The metric provided is for page views to COVID-19 Local Updates Page. During the COVID-19 pandemic, changes were made to landing pages. For consistency in reporting, the most popular page was selected.

6. Email subscribers are those individuals who signed up to receive promotional emails from the Windsor-Essex County Health Unit over the last 30 days. The analytics are provided through Mailchimp.

7. Social media metrics are provided through Hootsuite.

8. Graphs and media exposure information in this report were generated using Meltwater Media Monitoring Solution. Significant changes in numbers can be partially attributed to configuration changes made to the new service to better monitor and report media activity. News stories may be duplicates or missing as the platform is currently being optimized to better track Windsor-Essex County Health Unit mentions in the media landscape.

SUBMITTED BY

Communications Department

DATE

March 18, 2021

SUBJECT

January 2021 - Communications Update


January Metrics

SOURCE DECEMBER JANUARY DIFFERENCE

News Releases Issued

6

1

-5

Media Advisories Issued

1

2

+1

Media Statements or Notifications

42

32

-10

Media Requests Received1

71

71

0

AM 800 Morning Segments2

11

11

0

YouTube Live Media Briefing Videos3

19

21

+2

Wechu.org/cv/local-updates page views4

478,984

451,327

-27,657

YouTube Channel Subscribers

1,094

1,269

+175

Email Subscribers5

1,549

1,734

185

Emails Distributed

52

38

-14

 

Facebook Fans

16,848

17,207

+359

Facebook Posts

157

114

-43

Twitter Follower

5,563

5,943

+380

Twitter Posts

156

111

-45

Instagram Followers

969

1,027

+58

Instagram Posts

27

10

-17

LinkedIn Followers

719

745

+26

LinkedIn Posts

96

79

-17

Media Exposure8

2,024

1,146

-878

Media Monitoring Highlights

This is a complex graphical representation of data. Please contact us for detail

Trending Themes

This is a complex graphical representation of data. Please contact us for detail

Top Sources

This is a complex graphical representation of data. Please contact us for detail

Media Participating in Teleconference for YouTube Live

  • AM 800 CKLW, Blackburn News, CBC Windsor, CTV Windsor and The Windsor Star join every day. On occasion, Radio Canada will also join the briefing.

Current Notable Projects

  • Developing a marketing and communications campaign for the vaccine rollout as the region moves through each phase of the provincial COVID-19 vaccine rollout plan.
  • Website updates will be coming with more information on the COVID-19 vaccines and the Windsor and Essex County moving to the Red-Control level of the provincial framework.
  • We continue to make improvements to our daily COVID-19 public health updates for the community.

Data Notes:

Most requests are related to the local COVID-19 pandemic.

1. Media requests received is a compiled list of documented requests we captured for interviews, data clarification, or general request for information from the media. Given the volume of requests during COVID-19, many exchanges with the media through text messages or quick phone calls to correct errors may not be captured. In many instances, each request led to multiple interactions with reporters.

2. Dr. Ahmed joined Mike and Lisa on the AM 800 Morning Drive every morning at 8:06 a.m. starting on Wednesday, March 17. On August 17, we went to a Monday, Wednesday, and Friday schedule with holidays off. He continues to do join Mike and Lisa every other morning to keep the community informed.

3. We changed the platform we broadcasted live videos from Facebook to YouTube at the end of June. YouTube Live videos started on June 23, 2020. Prior Public Health Update videos on YouTube were exported videos recorded through Facebook Live.

4. Website analytics are provided by Siteimprove. The metric provided is for page views to COVID-19 Local Updates Page. During the COVID-19 pandemic, changes were made to landing pages. For consistency in reporting, the most popular page was selected.

6. Email subscribers are those individuals who signed up to receive promotional emails from the Windsor-Essex County Health Unit. The analytics are provided through Mailchimp.

7. Social media metrics are provided through Hootsuite.

8. Graphs and media exposure information in this report were generated using Meltwater Media Monitoring Solution. Significant changes in numbers can be partially attributed to configuration changes made to the new service to better monitor and report media activity. News stories may be duplicates or missing as the platform is currently being optimized to better track Windsor-Essex County Health Unit mentions in the media landscape.

Board Members Present:

Gary McNamara, Tracey Bailey, Joe Bachetti, Rino Bortolin, Fabio Costante, Judy Lund, Gary Kaschak, Ed Sleiman, Larry Snively

Administration Present:

Theresa Marentette, Dr. Alexa Caturay (AMOH, Toronto Public Health), Lorie Gregg, Nicole Dupuis, Dr. Felicia Lawal, Kristy McBeth, Dan Sibley, Lee Anne Damphouse

Administration Regrets:

Dr. Wajid Ahmed


QUORUM:  Confirmed

  1. Call to Order
    Board Chair, Gary McNamara, called the meeting to order at 4:07 p.m.
  2. Agenda Approval

    Moved by:  Rino Bortolin
    Seconded by: Ed Sleiman
    That the agenda be approved.
    CARRIED

  3. Announcement of Conflicts of Interest – None
  4. Update (Dr. A. Caturay)
    1. COVID-19 Update

      G. McNamara introduced Dr. Alexa Caturay, AMOH from Toronto Public Heath, who has stepped in as Acting MOH to cover for Dr. W. Ahmed who is on a two-week leave of absence.  Dr. Caturay provided an update of COVID-19 cases in Windsor-Essex, currently averaging about 34 cases a day.  This is a little higher than the entire Southwest Region, but on average with the provincial average.  As we come out of the second wave, the increase in cases is concerning, and we are seeing an increase of 4% in young adults between the ages of 18-34 years.  The Windsor-Essex region is also trending upward for school-aged children when compared to the average population. 

      T. Marentette said that K. McBeth and L. Gregg have been very instrumental in the vaccine rollout. L. Gregg has been keeping track of the vaccine inventory and updating reports to the Ministry of Health, and K. McBeth has been involved on the operational side with the mass and mobile clinics. 

      Currently, there are two main mass vaccination sites, the WFCU Centre in East Windsor and the 
      Nature Fresh Farms Recreation Centre on Sherk Street in Leamington.  The Libro Centre in Amherstburg will come on board on March 29.  Bookings in the county will be scheduled across both Leamington and Amherstburg, based on supply.  

      We are moving forward with the 80+ group and anticipate that there are 16,000 people in this age category. Those that have pre-registered will be vaccinated by late next week.  We then hope to move to the 75+ age group. The Ministry has launched a provincial vaccine booking system, but we are currently using our own.  We are somewhat ahead of the province, as they are still vaccinating the 80+ group, and if we were on that booking system, we would not be able to move out of that priority.

      Windsor Regional Hospital (WRH) is vaccinating health care workers at the St. Clair College SportsPlex, starting with the Highest Priority, Very High Priority, and then High Priority, as well as adult recipients of chronic home care.  In Phase 2, eligibility will include individuals with highest risk and high risk medical conditions.  WRH is also assisting with the 80+ age group and has opened up a site in downtown Windsor at Windsor Hall.

      Windsor-Essex is also part of the Ministry’s AstraZeneca pharmacy rollout.  Locally, we have 57 pharmacies participating, including large corporate pharmacies as well as independents.  The priority group will be for individuals 60-64 years.

      We are also working with Family Health Teams across the region and the Windsor Essex Community Health Centre.   They were instrumental in assisting with COVID testing early on in the pandemic, and have now been provided with a supply of the vaccine for the 80+ within their practices.  They will also be moving to immunize patients with medical conditions.  We are also working with an Allergy Specialist for those at risk for possible adverse effects or allergic reactions. 

      Mobile teams EWEMS are also assisting with reaching the most vulnerable by immunizing in homeless shelters. WECHU has a small mobile team who continue to vaccinate in LTCH/RHs. As well, we are working with Windsor Essex Community Housing Corporation and EMS to vaccinate the 80+ group in seniors’ buildings. 

      We are using all of our allotment of weekly vaccine.  Our current allocation of the Pfizer vaccine is 14,000 doses per week, decreasing to 10,000 a week in a couple of weeks.  We are also receiving 2,000 to 3,000 doses of Moderna each week.  

      Dr. A. Caturay said we are seeing an uptick of cases in the younger 18-34 age group, and we are watching to see if this trend continues.  One-third of cases usually stem from household contacts, another one-third from the community, and one-third are unknown. 

      R. Bortolin asked what the plan is to address congregate living settings.  T. Marentette said that congregate settings are in Phase 2 of the Ministry’s plan. We are still in Phase 1 but are making good progress toward Phase 2.  Phase 1 includes the seniors over 80, congregate settings of the over 80 population, individuals in LTCH/RHs and the highest priority health care workers.  

      Priority will continue to be age-based in 5 year increments and next would be the at risk populations, i.e. medical conditions and congregate settings.  These will be handled by our health unit nurses, via mobile teams with EMS, but congregate settings are not an automatic eligibility at this time. 

      Our farms and greenhouses will also be a priority at some point, and all of this will be based on vaccine supply.  We are also getting questions around those who are unable to attend a clinic and asking if we would attend private homes with EMS to vaccinate.  At this time, we are not able to safely transport the vaccine in individual doses.    

      L. Snively asked if there were any adverse reactions to the AstraZeneca vaccine here in Canada, since Europe has placed a hold on using it.  T. Marentette advised that there have been no adverse reactions reported. All adverse events following immunization are reported to our health unit and Health Canada. 

      Dr. A. Caturay said the best vaccine to receive is the one that is available to you.  All of the vaccine data is reviewed very closely by Health Canada and they are deemed safe and effective.  Europe also came out with a statement that AstraZeneca is safe to use in all of Europe.

      T. Marentette said there is information on our WECHU website on the vaccines and our managers have done an exceptional job updating it daily as information changes.  We continue to share current and relevant information on YouTube, and through questions from the media.  We are actively promoting and answering any questions around vaccine safety.

      E. Sleiman asked if it is possible to contract COVID-19 between first and second doses of receiving the vaccine.  Dr. A. Caturay said that it is possible, but the likelihood is low as the first dose offers some good protection, i.e. upwards towards 80%. 

      E. Sleiman asked if it would be possible at some point for individuals in the same household to book their appointments at the same time.  T. Marentette said as we roll out the booking schedule we are looking at ways to accommodate couples, but for the 80+ age group it was not possible. 

      G. McNamara noted that we are fortunate to have a team in place that has done phenomenal work putting our region farther ahead along in the process than the rest of the province.

      Moved by:    Rino Bortolin
      Seconded by:  Larry Snively
      That the information be received.
      CARRIED

  5. Approval of Minutes
    1. Regular Board Meeting:  Special Board Budget Meeting: March 4, 2021

      Moved by:  Rino Bortolin
      Seconded by:  Larry Snively
      That the minutes be approved.
      CARRIED

  6. Business Arising – None
  7. Consent Agenda
    1. INFORMATION REPORTS
      1. Ontario Active School Travel Fund Awarded to Windsor-Essex County (N. Dupuis)
        Brought to the Board for information.
      2. Risk Management (T. Marentette/M. Frey)

        T. Marentette said that the Risk Management summary is sent to the Ministry of Health along with our budget submission. 

        M. Frey, Manager of Planning and Strategic Initiatives, walked through the Risk Management presentation, explained the Scoring and went through each category. He also discussed some of the impacts the pandemic had on WECHU’s Strategic Plan.

      3.  January/February Communications Recap
        Brought to the Board for information.

         

        Moved by: Tracey Bailey
        Seconded by:  Ed Sleiman
        That the information reports be received.
        CARRIED

    2. RECOMMENDATION REPORTS - None
  8. New Business - None
  9. Other Board of Health Resolutions/Letters
    1. Kingston, Frontenac & Lennox and Addington Public Health – Letter to Hon. Doug Ford – Mandatory Sick Leave for Ontario Workers
    2. Kingston, Frontenac & Lennox and Addington Public Health – Letter to The Right Hon. Justin Trudeau – Land and Water Border Restrictions 

    3. Peterborough Public Health – Letter to Hon. Doug Ford, the Hon. Christine Elliott and the Hon. Monte McNaughton – Paid Sick Leave During an Infectious Disease Emergency

    4. Letter from the Municipality of Chatham-Kent Public Health – Letter to the Hon. Doug Ford – Paid Sick Leave during COVID-19 Pandemic and Beyond

    5. Letter from Queen’s Park, Peggy Sattler, MPP, London West – Private Members Bill – Bill 239 – Stay Home if you are Sick ActAdvocating for paid sick days for Ontario workers to alleviate the spread of COVID-19

    6. Windsor-Essex County Health Unit – Letter to the Hon. Doug Ford – Mandatory Paid Sick Leave for Ontario Workers

    Moved by:  Tracey Bailey
    Seconded by: Ed Sleiman
    That the information be received.
    CARRIED

  10. Committee of the Whole (CLOSED SESSION, in accordance with Section 239 of the Municipal Act)

    The Board moved into Committee of the Whole at 5:20pm
    The Board moved out of Committee of the Whole at 5:40 pm

  11. Next Meeting: At the Call of the Chair, or April 15, 2021 – Via Video
  12. Adjournment

    Moved by:  Rino Bortolin
    Seconded by:  Ed Sleiman
    That the meeting be adjourned.
    CARRIED

    The meeting adjourned at 5:44 pm.

RECORDING SECRETARY:

SUBMITTED BY:

APPROVED BY:

Meeting held via video.

  1. Call to Order
  2. BOARD ELECTIONS
  3. Agenda Approval
  4. Announcement of Conflict of Interest
  5. Update (W. Ahmed)
    1. COVID-19 Update
  6. Approval of Minutes
    1. Regular Board Meeting: December 17, 2020
  7. Business Arising
  8. Consent Agenda
    1. INFORMATION REPORTS
      1. Mosquito Surveillance and Control Program 2020 (K. McBeth)
      2. First Responder Curriculum Project – Mental Health Literacy and Resiliency – Building (N. Dupuis)
      3. December Communications Recap
    2. RECOMMENDATION REPORTS
  9. New Business
    1. Budget Timing (T. Marentette/L. Gregg)
    2. CTS Update – Next Steps (T. Marentette)
    3. W-E Vaccine Rollout Plan (T. Marentette)
  10. Other Board of Health Resolutions/Letters – For information
    1. Town of Kingsville – Letter to The Hon. Doug Ford, The Hon. Minister Christine Elliott, Medical Officer of Health, Dr. Wajid Ahmed and the Windsor-Essex County Board of Health – Resolution in Support of Small Businesses to remain open
    2. Town of Essex – Letter to The Hon. Doug Ford, The Hon. Minister Christine Elliott, Chief Medical Officer of Health, Dr. David Williams, Medical Officer of Health, Dr. Wajid Ahmed, and CEO Theresa Marentette, Windsor-Essex County Health Unit – Resolution requesting that immediate action be taken to deem Small Businesses as Essential Services
  11. Committee of the Whole (Closed Session in accordance with Section 239 of the Municipal Act)
  12. Next Meeting: At the Call of the Chair February 18 , 2021 – Via Video
  13. Adjournment

DATE

January 21, 2021

SUBJECT

Mosquito Surveillance and Control Program 2020


BACKGROUND

The Environmental Health Department conducts annual monitoring and testing of mosquito populations in Windsor and Essex County (WEC) as part of the WECHU’s Zoonotic and Vector-borne Diseases Program.

Mosquito Surveillance and Testing

Adult mosquito surveillance runs from May to early October every year and may extend depending on the weather and temperatures. Species-specific traps are deployed in various locations throughout WEC to capture mosquitoes for testing and identification to determine the presence of West Nile, Eastern Equine Encephalitis (EEE) Virus, and Zika Virus in our community. Invasive mosquito species Aedes aegypti (Yellow Fever Mosquito) and Aedes albopictus (Asian Tiger Mosquito) are also monitored each year through our Enhanced Mosquito Surveillance Program. These species are known carriers of diseases such as Zika, Malaria, Dengue, and Chikungunya. The WECHU received a federal grant from the Public Health Agency of Canada’s Infectious Disease and Climate Change Program (August 2019 to March 2022)  to study the effects of climate change and mosquito populations in our local communities. For the 2020 season, an additional 14 traps were placed in Leamington to monitor mosquito populations as part of this grant.

During this year’s season:

  • Total number of mosquitoes trapped: 205,569
  • Total number of pools tested: 2,052
  • Number of positive pools for West Nile virus : 30
  • Number of positive pools for Zika virus: 0
  • Number of positive pools for EEE virus: 0

Mosquito Control

The mosquito control program involves applying larvicide to catch basins and standing water sites such as ditches and lagoons that hold water. All municipalities in WEC have standing water by-laws in place. In 2020, over 135,000 treatments of larvicide were applied to roadside catch basins and standing water sites.

Human Cases

The WECHU follows up on all human cases of West Nile Virus. Cases are investigated to assess if additional mosquito control activities are required. In 2020, there were two confirmed and one probable case of WNV in WEC. To date, there have been no human cases of Zika Virus identified in WEC.

Education and Awareness Raising Activities

Fight the Bite public awareness campaign was launched in June and included key messages that focused on preventing mosquito bites, removal of standing water and the cause and symptoms of West Nile Virus. These messages were communicated through the WECHU website, radio, billboard and bus shelter ads, social media, and print materials.

CURRENT INITIATIVES

All activities, including monitoring and testing mosquitoes and education regarding personal protection from mosquito bites and removing standing water, will continue in 2021.  Targeted promotion and messaging will be used to reach priority populations and inform the public of hot spots identified through previous monitoring efforts.