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May 19, 2022

PREPARED BY

Planning and Strategic Initiatives Department

DATE

May 19, 2022

SUBJECT

2022 Board Self-Assessment Survey


BACKGROUND/PURPOSE

The Ontario Public Health Standards (2021), under the Good Governance and Management Practices Domain, states: “the board of health shall have a self-evaluation process of its governance practices and outcomes that is completed at least every other year. Completion includes an analysis of the results, board of health discussion, and implementation of feasible recommendations for improvement, if any”. 

In order to meet this requirement, the WECHU developed a competency based self-evaluation survey for Board of Health (BOH) members. The survey includes twelve competency areas used to identify the strengths of the BOH, as well as opportunities to provide additional training and support for the BOH.

DISCUSSION

The survey will be sent to current BOH members via email in May 2022. A report will be presented to BOH members in early summer 2022. Upon request, Board members will receive individual reports, which compare their competency scores to the overall group scores, and will identify strengths and areas for potential improvement.


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PREPARED BY

Epidemiology and Evaluation Department

DATE

May 4, 2022

SUBJECT

COVID-19 Surveillance and Epidemiology – April, 2022


BACKGROUND

Overview

The Epidemiology & Evaluation department conducts on-going population health assessment and surveillance. The data and surveillance for COVID-19 plays an integral role in understanding and managing the pandemic locally. The evidence provides information on how the pandemic has and is evolving, assessing the risk and severity, and assists in the development of timely interventions to limit further spread in the community.

Due to the recent surge in Omicron cases and changes in eligibility for testing, testing capacity is limited and case, contact, and outbreak management has been modified to focus on high-risk settings. As a result, case counts in the report are an underestimate of the true number of individuals with COVID-19 in Windsor-Essex County and may impact data completeness. Please interpret these data accordingly. Due to these changes, data from before December 31, 2021 should not be compared to data after the testing changes.

Trends

In the month of April, the health unit reported 3,131 confirmed high-risk cases of COVID-19. As the weeks progressed in April, the weekly high-risk incidence rate decreased from 187.6 cases per 100,000 population (Week 14) to 112.0 cases per 100,000 population (Week 17).  

In-Patient and ICU Admissions

In April, in-patient COVID-19 hospitalizations remained relatively stable in Windsor-Essex County although there was an increase at the beginning of the month. A total of 266 new COVID-19 related patients were admitted to local hospitals.

Percent Positivity

Locally, Windsor-Essex County continued to experience an incremental increase in percent positivity for the first three weeks in April, followed by a decrease during the last week. This is in contrast to week-to-week increase observed in March. The local percent positivity rate for COVID-19 declined to approximately 13.8% in the last week of the month. It is also important to note that these were for high-risk individuals that were eligible for testing.

Wastewater Surveillance

For the month of April, viral signal for COVID-19 in wastewater saw a significant increase for the first two weeks, followed by a decline during the last two weeks. Current levels are beginning to reach levels observed during the onset of the Omicron wave in December 2021.  

Outbreaks

In the month of April, 40 outbreaks were declared in high-risk settings compared to the 21 outbreaks in March. This includes 21 outbreaks in long-term care and retirement homes, 9 in hospital settings, and 10 in other congregate settings. As of April 30th, there were 29 active outbreaks in the Windsor-Essex County region.

Deaths

For the month of April 2022, 17 deaths were reported that were attributed to COVID-19. This is similar to the number of deaths reported in March.

DISCUSSION

With the changes in testing eligibility, and guidance with case, contact, and outbreak management, the health unit has modified its public reporting to better understand the burden of illness locally. New indicators, such as wastewater data, have been included as a proxy indicator for COVID-19 case counts, which are underestimated. The health unit will continue to monitor and provide epidemiological expertise on COVID-19 to internal leadership, community partners, and residents to support evidence-informed decision-making. This includes daily epidemiological updates, weekly epidemiological presentations to the community, and supporting policy decisions through data driven approaches.


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PREPARED BY

Infectious Disease Prevention – COVID Response

DATE

May 19, 2022

SUBJECT

COVID-19 Case and Contact Management- Q1 2022 Report


BACKGROUND/PURPOSE

Due to the unique characteristics of the Omicron variant, the Case and Contact Management (CCM) guidelines and testing eligibility were revised to ensure that workers and families in highest risk settings are protected implementing changes to Ministry guidance documents. As a result of the changes to the provincial guidance in the context of Omicron, the WECHU is only investigated COVID-19 cases associated with highest risk settings (e.g. hospitals, congregate settings, long-term care homes). During Q1, Non-highest risk cases were contacted to ensure isolation was implemented and education and other resources provided. There was a need for redeployment of WECHU staff from various departments to manage this surge associated with the Omicron variant.

DISCUSSION

The Omicron surge brought with it changes to CCM and isolation guidelines to ensure those living, volunteering, and working in the highest risk settings continue to be protected. The CCM Team updated practice to align with the current Ministry guidance, including the creation of CCM tip sheets for various highest risk settings (e.g., Long-term Care Homes/Retirement Homes and hospitalized patients). To help residents navigate the various changes to COVID-19 testing and isolation requirements, the Team collaborated with the Communications Department to provide up-to-date content and guidance changes for the WECHU website. This included changes to workplace and school screening and instructions for non-highest risk settings (e.g., schools, daycares, workplaces).

In January 2022, the Province of Ontario updated its COVID-19 guidance for seasonal IAWs, in order to manage cases and close contacts and control the ongoing transmission of COVID-19 in farm operator-provided accommodations. This guidance required that third-party health assessments be provided for all IAWs exposed to, or testing positive for, COVID-19 and their close contacts. CCM staff collaborated with staff from the EH department to create the COVID-19 Farm Operator Communication Guidance document that summarized the recent changes and resulting process updates. This information was shared during a live webinar for farm operators and provided WECHU an opportunity to address any questions or outstanding issues.

Investigations Conducted

Despite the shift in case and contact management guidance to investigating only cases associated with highest risk settings, staff completed 14, 295 case investigations between January 1, 2022 to March 31, 2022.

Partnerships

Partnerships, both internally and externally, have been integral to CCM and have occurred throughout the pandemic. The WECHU has numerous community partners, including the City of Windsor, the Canadian Red Cross and the Windsor-Essex Emergency Medical Services (EMS) who together, ensure that individuals who need isolation support and health assessments receive these services (e.g., at the Isolation and Recovery Centre [IRC]).

The WECHU partnered with Community Living Windsor and Essex, to build the capacity of their staff to conduct COVID-19 testing on staff and residents. Windsor-Regional Hospital continues to partner in CCM, providing information required to complete case and contact investigations and infection prevention and control measures in outbreaks. Internally, the CCM staff work with the Outbreak Team/Infectious Disease Prevention Department, and the Environmental Health Department (EH) (i.e., Public Health Inspectors) to manage and identify outbreaks related to the highest risk settings.

SUMMARY

The COVID-19 pandemic has created opportunities for WECHU staff to work together to provide support and educational resources to a variety of sectors. The WECHU is committed to working with community partners and conducting CCM in a timely fashion to prevent the spread of COVID-19. The team will continue to revise plans as Ministry guidelines and direction change.


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SUBMITTED BY

Communications Department

DATE

May 19, 2022

SUBJECT

March 15 – April 14, 2022 Communications Update


BACKGROUND/PURPOSE:

Provide regular marketing and communication updates to the Board of Health.

SOURCE

MARCH 15 – APRIL 15

FEBRUARY 15 – MARCH 14

DIFFERENCE

News Releases, Media Advisories and Statements, or Notifications Issued

36

31

+5

Media Requests Received

23

28

-5

Wechu.org page views

302,147

299,865

+2,282

YouTube Channel Subscribers

1,754

1,761

-7

Email Subscribers

8,037

8,133

-96

Emails Distributed

40

33

+7

Facebook Fans

18,648

18,632

+16

Facebook Posts

146

121

+25

Twitter Follower

8,590

8,568

+22

Twitter Posts

141

122

+19

Instagram Followers

1,451

1,440

+11

Instagram Posts

43

29

+14

LinkedIn Followers

1,091

1,079

+12

LinkedIn Posts

83

73

+10

Media Exposure

572

563

+9

Data Notes can be provided upon request.

Media Exposure Overview Graph

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

Website Overview Graph

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

Discussion

Current notable projects that the department is working on.

Graphic of the GOVaxx bus

We are promoting the arrival of the GO-VAXX bus for COVID-19 vaccinations in Leamington on May 2 and 3. This was a collaboration between the WECHU and the Municipality of Leamington through multiple media channels.

Food Handler Certification Examinations news release was issued on Tuesday, April 5.

The Communications department is maintaining marketing and communication efforts regarding COVID-19 vaccinations in the region with our partners. In particular, the COVID-19 pop up clinics in the community and at WECHU offices.

We continue to provide support for the Catch-Up Immunization Clinics for Students in Grades 7 to 12 that will occur until August in multiple locations throughout Windsor and Essex County.


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PREPARED BY

Environmental Health Department

DATE

May 19, 2022

SUBJECT

2022 Vector-borne Surveillance Program


BACKGROUND/PURPOSE

The Environmental Health Department delivers a vector-borne surveillance program to monitor West Nile Virus (WNV), Eastern Equine Encephalitis (EEE), Zika Virus and Lyme disease activity in Windsor and Essex County (WEC). The program is required under the Health Protection and Promotion Act and provides the community with an early warning system for disease transmission through ticks and mosquitoes known as vector-borne diseases. This program is made up of the following components: mosquito larval surveillance and larviciding, adult mosquito trapping, human case surveillance for WNV and Lyme disease, public education, and active tick surveillance. The tasks of mosquito larval surveillance and control, along with mosquito identification and viral testing, are performed by contracted agencies on behalf of the WECHU.

DISCUSSION

Active Tick Surveillance

Lyme disease is a vector-borne disease caused by the bacterium Borrelia burgdorferi. It is transmitted to humans through the bite of infected black-legged ticks. The WECHU's role is to measure and evaluate the risk of this tick-borne disease in our area.

Active surveillance is used to assess the local distribution and incidence of black-legged ticks in WEC. It involves the dragging of a white cloth through grassy areas whereby ticks attach themselves to the fabric and can be easily spotted and identified. Any black-legged ticks identified are sent to an accredited laboratory for testing of Lyme disease. Tick dragging is performed twice yearly in the spring and the fall.

This year tick dragging will be conducted at the following four sites during the months of May and September:

  • Ojibway Prairie Nature Reserve
  • Chrysler Greenway
  • Gesstwood Camp and Education Centre
  • Ruscome Shores Conservation Area

Mosquito Surveillance

Adult mosquito surveillance is an important component of the vector-borne disease program and involves the deployment of black-light CDC traps and BG-Sentinel 2 (BGS-2) traps at various locations throughout WEC.

The CDC traps are equipped with light and dry ice that attracts and traps the mosquitoes. These traps capture mosquitoes for testing to determine the presence of WNV and EEE in our region. BG-Sentinel 2 (BGS-2) traps are species-specific traps set up to catch invasive species of mosquitoes (Aedes albopictus and Aedes aegypti) that were identified during routine WNV surveillance in WEC in 2016. These traps use a scent lure and dry ice to attract daytime mosquitoes and are set up in high-traffic areas (such as near transport routes and industrial cargo areas) as well as in residential homes. The trapped mosquitoes are sent to an accredited laboratory for identification and testing to determine if any of the mosquitoes carry the WNV, EEE or Zika virus.

The trap deployment will start on May 25, 2022, and run until mid-October. Once a week, 50 mosquito traps (26 CDC light traps and 24 BGS 2 traps) will be set up across WEC to collect mosquitoes for identification and viral testing. The weekly mosquito surveillance data will be made available on the WECHU's Mosquito Surveillance Dashboard.

Human case Surveillance

The human case surveillance program identifies human cases of WNV and Lyme disease in WEC to determine the source of the disease. Physicians and hospitals must report all probable and confirmed cases to the WECHU.

The health unit investigates all suspected, probable and confirmed WNV and Lyme disease cases among WEC residents based on case definitions developed by the Ministry of Health (MOH). Standardized medical information, including demographics, symptoms, risk factors (such as travel history or having received blood products) and test results, are entered into the MOH's Integrated Public Health Information System (iPHIS). Through case interviews and GIS mapping, the health unit identifies clusters and geographic areas that may need targeted intervention.

Fight the Bite! Campaign

Fight the Bite! Public awareness campaign will launch in July 2022. It will focus on the prevention of mosquito breeding sites, information on tick removal, signs and symptoms of WNV and Lyme disease, and personal protection. Messages and promotional materials will be developed to reach priority populations and inform the public of hot spots identified through previous monitoring efforts. This event is done in conjunction with health unit external stakeholders such as municipalities and other health units.


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Board Members Present:

Gary McNamara, Joe Bachetti, Tracey Bailey, Rino Bortolin, Fabio Costante, Gary Kaschak, Judy Lund, Robert Maich, Mark Ferrari

Board Member Regrets:

Ed Sleiman, Aldo DiCarlo

Administration Present:

Nicole Dupuis, Dr. Shanker Nesathurai, Lorie Gregg, Felicia Lawal, Kristy McBeth, Eric Nadalin, Dan Sibley, Lee Anne Damphouse


QUORUM: Confirmed

 

  1. Call to Order

    The Chair, G. McNamara called the Regular meeting to order at 4:01 pm.

  2. Welcome – Provincial Appointee to the Board of Health
    Board Chair Gary McNamara advised the Board that the province has appointed a new Provincial Appointee, Mr. Mark Ferrari, to the WECHU Board of Health for a two year term, effective April 14, 2022. 
  3. Agenda Approval
    Motion: That the agenda be approved.
    CARRIED

  4. Announcement of Conflict of interest – None
  5. Update (Dr. S. Nesathurai)
    1. COVID-19 Update

      Dr. Nesathurai said we seem to be in a better state with the COVID-19 virus, but still need to be cautious. We are seeing an increase in influenza cases, but this is likely due to the relaxation of public health measures. 

      Some individuals who have contracted COVID-19 have persistent symptoms and a longer period of recovery, resulting in what is called long COVID.  There are over 200 symptoms of post-COVID phenomenon, such as fatigue, shortness of breath, as well as anxiety related to contracting the disease again. Some individuals have experienced cognitive dysfunction, causing long term impairment and are not functioning as they did before they contracted COVID-19.  Dr. Nesathurai said that those who are vaccinated are less likely to experience severe symptoms or hospitalization, and it may help mitigate the symptoms of long COVID.

      Motion: That the information be received.
      CARRIED

  6. Approval of Minutes

    1. Regular Board Meeting: April 21, 2022

      Motion: That the minutes be approved.
      CARRIED

  7. Business Arising
    1. alPHa AGM June 14 (virtually) and the alPHa Fitness Challenge (N. Dupuis)
      Nicole Dupuis and Board Member Mark Ferrari will attend the annual alPHa AGM in June, and noted the alPHa fitness challenge as a friendly reminder.  There are 3 Resolutions that N. Dupuis and M. Ferrari will be able to vote upon at the AGM and these Resolutions are:
      - Race-Based inequities in Health
      - Public Health Modernization and COVID-19
      - Provincial Cooling Tower Registry for the Public Health Management of Legionella Outbreaks

       

      It was noted that Board Chair G. McNamara will also be available to attend the AGM.

    2. Board of Health By-laws (N. Dupuis/L. Gregg)

      1. By-Law #2 – Finance
        N. Dupuis noted that we are in the process of revising the Board By-Laws as discussed. They will be brought back for formal approval and adoption once all of the By-Laws have been revised.

        L. Gregg noted some of the highlights in the Finance By-Law.  There is also a Procurement Policy which will be brought back to the board for review every 3 years.

      2. By-Law #3 – Management of Real Property 
        L. Gregg noted this proposed By-Law outlines the CEOs responsibility as it relates to the care and maintenance of all properties, ensure properties are in accordance with applicable lease agreements, that properties comply with applicable laws, and adopting policies with respect to the acquisition, sale and disposition of properties.

        Motion: That the information be received.
        CARRIED

  8. Consent Agenda

    1. INFORMATION REPORTS

      1. Renewal and Transformation:  A Short-term Vision for Public Health Priorities and Planning in Windsor-Essex (N. Dupuis)
        The Report is attached and presented to the Board for information.

      2. Vector-Borne Surveillance Program (K. McBeth)
        The Report is attached and presented to the Board for information.

      3. Case and Contact Management / Q1 2022 Updates (F. Lawal)
        The Report is attached and presented to the Board for information.

      4. 2022 Board Self-Assessment Survey (N. Dupuis)
        The Report is attached and presented to the Board for information.

      5. COVID-19 Surveillance and Epidemiology (N. Dupuis)
        The Report is attached and presented to the Board for information.

      6. Communications Update (March – April 2022)
        The Report is attached and presented to the Board for information.

        Motion: That the information be received.
        CARRIED

    2. RESOLUTIONS/RECOMMENDATION REPORTS

      1. 2022/23 Budget for Programs Funded by the Ministry of Children, Community and Social Services (L. Gregg)
        L. Gregg noted this budget includes the Healthy Baby Health Children Program and the Pre-Natal and Post-Natal Nurse Practitioner program. Total budget expenditures for the Programs for the period April 1, 2022 to March 31, 2023 is $2,894,941.

        Motion: That the Board approve the operating budget as presented by Administration for the period April 1, 2022 to March 31, 2023 in the amount of $2,894,941.
        CARRIED

  9. New Business

    1. 2022 Budget Approvals (N. Dupuis/L. Gregg)

      N. Dupuis said we received 2022 budget approvals from the Ministry on May 2, 2022.  L. Gregg highlighted the Mandatory Programs approved budget, the MOH/AMOH Compensation Initiative and the Ontario Senior Dental Care Program.

      L. Gregg highlighted and noted the details of the 2022 One-Time Funds, consisting of:
      - Cost-Sharing Mitigation
      - Needle-Exchange Program
      - Public Health Inspector Practicum Program
      - Vaccine Program
      - School-focused Nurse Initiative
      - Temporary Retention Incentive for Nurses
      - Vector-Borne Diseases
      - Capital (All locations)
      - Recovery (All)
      - CTS Operating Costs

      G. McNamara inquired about the status of the $1.4M funding for the additional 19 nurses for the School-focused Nurse Initiative and what is the risk in 2023-24 should that funding cease.  N. Dupuis advised that we had posted 19 permanent positions in 2020, and through various leaves and attrition throughout the pandemic we should balance out with staffing.  This initiative has been extended to the end of this year. 

      L. Gregg noted that we have updated the ministry about the WECHU Capital Project and its requirements and the need for capital funding for this project.  The WECHU proposes that it retain the 2022 mitigation funding to support costs to be incurred on account of the Windsor Office Redevelopment Project.  By doing so, the WECHU will reduce the burden of the cost of leasehold improvements on future operating budgets.  The WECHU’s approved mitigation funding is $1,260,800.

      The WECHU has expressed the need to access capital funding through the Ministry of Health, more specifically the Community Health Capital Program through the Health Capital Investment Branch of the MOH, however no funds are available at this time.

      MOTION: That the Windsor-Essex County Board of Health approve that the 2022 mitigation funding of $1,260,800 be retained by the WECHU to fund capital costs on account of the Windsor Office Redevelopment Project
      CARRIED

    2. Whistle-Blowing Policy (N. Dupuis)

      N. Dupuis brought forward this policy which was initiated in 2017.  Minor changes were made to titles of roles and no other changes were made.  This policy was originally drafted by our legal representatives and will be updated annually.

      MOTION: That the Board accept the Whistle Blowing Policy as presented.
      CARRIED

    3. Renewal and Transformation:  A Short-term Vision for Public Health Priorities and Planning in Windsor-Essex (N. Dupuis)

      N. Dupuis said that we recognize that we are still in a pandemic but there are services that we need to resurrect.  Our goal is to renew public health services to address immediate local public health needs and address service backlogs as the COVID-19 pandemic stabilizes, and to develop a foundation for sustained long-term support for public health transformation based on local priorities.

      N. Dupuis identified and highlighted some priorities in our post COVID Renewal Plan Outline:
      - Health Assessment and surveillance
      - Addressing the Backlog of Services
      - Priority Areas – Mental Health and Substance Use and Healthy Growth and Development, specifically HBHC
      - Capacity Building within WECHU staff 

      Priorities for 2023 and beyond:
      - Implementation of a 3-year Strategic Plan
      - Preparation for WECHU move – Q4 2023
      - Refining Organizational Processes
      - Using assessment information to inform of future priorities
      - Creating plans to address post-COVID local public health priorities

    4. 2022 Board Self-Assessment (N. Dupuis)
      N. Dupuis reminded the Board of the yearly requirement of the Board Self-Assessment survey.  As a follow up to this meeting, Board members will be provided a link to complete the Board of Health Self-Assessment Survey.  The survey will be reviewed and a report will be presented to Board of Health members in summer 2022. 

    5. Vaccine Surge Planning (K. McBeth)
      K. McBeth shared a presentation with the Board around Surge Capacity Planning for vaccinations. Surge capacity planning is about supply and demand and ensuring we are ready to pivot based on the increase in demand. The past 18 months has required an overwhelming use of resources, and health units played a big part of vaccine delivery along with Health Care Providers and Pharmacies.  We are assuming additional vaccine eligibility for boosters and increased eligibility to other age groups is expected throughout 2022.

      WECHU has includes all possible vaccination strategies utilized/coordinated at the health unit level including mobile/pop-up clinics and mass immunization clinics. Four planning scenarios were developed based on the vaccine administration numbers for first, second and third doses. 

      Going forward, the WECHU will plan for the support of 2 community sites, one in the City of Windsor and one in the County of Essex.  Both sites would over COVID and Influenza vaccines with co-administration supported for individuals 12 years and older.

      Motion: That the reports be received as presented.    
      CARRIED

  10. Correspondence

    1. Grey-Bruce Public Health – Letter to Hon. Christine Elliott and Hon. Mike Tibollo – Mental Health and Addictions – for information only
    2. Greater Essex County District School Board – Letter to Hon. Stephen Lecce and Dr. Kieran Moore, CMOH – Reinstatement of Public Health Measures for Schools – for information only
  11. Committee of the Whole (CLOSED SESSION, in accordance with Section 239 of the Municipal Act)

    The Board moved into Committee of the Whole at 4:57 pm
    The Board moved out of Committee of the Whole at 5:04 pm

  12. Next Meeting: At the Call of the Chair, or June 16, 2022 – Via Video

  13. Adjournment
    Motion: That the meeting be adjourned.
    CARRIED
    The meeting adjourned at 5:05 pm.


RECORDING SECRETARY: L. Damphouse

SUBMITTED BY: N. Dupuis

APPROVED BY: The Board of Health - June 16, 2022
 


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A SHORT-TERM VISION FOR LOCAL PUBLIC HEALTH PRIORITIES AND PLANNING IN WINDSOR-ESSEX

The COVID-19 pandemic has dramatically influenced the focus of local public health efforts and resources. COVID-19 has disrupted public health programing, created a backlog of public health services, and impacted established partnerships. As well, the pandemic has furthered existing health inequities and depleted health care capacity, expanding the health disparity gap for those most in need of support. Immediate plans and services will ensure a focus on those disproportionately affected by the pandemic. 

While public health must continue to remain vigilant in response to the pandemic, it is necessary for local public health efforts to shift toward other pressing public health concerns. The WECHU will proceed cautiously, balancing the continued COVID-19 emergency response with incremental and strategic steps forward. This will include ongoing assessment of health needs and public health capacity. Longer-term renewal and transformation efforts will require internal capacity building, ongoing assessment and surveillance to ensure that resources align with the needs of residents. This will include addressing organizational readiness and capacity building to achieve community-based goals. This short-term focused set of priorities will direct our planning and actions in specific areas, providing the most value to the community.

The Windsor-Essex County Health Unit (WECHU) will work towards re-establishing and catching up on mandated program areas where the WECHU is the sole or a primary service provider. These programs include services such as health inspections, dental services (for qualifying children and adults), new parent supports (for qualifying parents), required school-aged immunizations, and infection prevention and control supports for the community. Beyond these core programs and services, the WECHU has identified mental health, substance use, and healthy growth and development as priorities for immediate response. These priorities will set the direction for the Windsor-Essex County Health Unit for the 2022 year.

Goal

Renew public health services to address immediate local public health needs and address service backlogs as the COVID-19 pandemic stabilizes. Development of a foundation for sustained long-term support for public health transformation based on local priorities.

Short-Term Priorities

Health Assessment and Surveillance

  • Assessing the impact of COVID-19 on local population health outcomes to inform long-term priorities.
  • Assessing partner resources and direction to support local public health priorities while the COVID-19 pandemic stabilizes.
  • Providing data and support to the community based on assessments to support long-term planning for program renewal and transformation.

Addressing Backlog of Services

  • Restart dental health screenings in schools with increased supports for high and moderate risk schools.
  • Increasing support for qualifying dental service groups (i.e., children and seniors).
  • Routine support for school-age vaccinations.
  • Completing all infectious disease investigations in a timely manner.
  • Completing all outstanding inspections across the community in a timely manner.
  • Enrolling and engaging all qualifying parents in the Healthy Babies, Healthy Children program.
  • Providing community support for infection prevention and control practices.

Mental Health and Substance Use

  • Development of long-term plans/supports based on the assessment of local needs, partner service plans, and evidence-based interventions.
  • Mental health and substance supports for school-aged children and youth, families, and workplaces.
  • Enhanced support for existing mental health programs/services provided by the Windsor-Essex County Health Unit.
  • Enhanced support for existing substance use programs/services provided by the Windsor-Essex County Health Unit.

Healthy Growth and Development

  • Increased support for positive parenting.
  • Support for maternal mental health through new or existing programs and services.
  • Breastfeeding support for new mothers.

Capacity Building

  • Staff re-orientation, training, and preparation for response to long-term local public health priorities.
  • Assessing and providing internal support for burnout and mental health considerations because of the COVID-19 pandemic response.
Renewal and Transformation - PDF - ENG (PDF)
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Recommendation/Resolution Report
2022/23 Budget for Programs Funded by the Ministry of Children, Community and Social Services

MAY 19, 2022


ISSUE/PURPOSE

The Windsor-Essex County Health Unit (WECHU) administers the Healthy Babies Healthy Children Program and the Pre-natal and Post-natal Nurse Practitioner Program (collectively referred to as the Programs).  These Programs are funded entirely by the Ministry of Children, Community and Social Services (MCCSS).  The operating budget for the fiscal year April 1, 2022 to March 31, 2023, requires approval by the Board of Health prior to submission to the MCCSS.

BACKGROUND

For fiscal 2022/23, these Programs support twenty-five and three quarters (25.75) FTEs comprised of one (1.0) manager FTE, one-quarter (0.25) director FTE,  sixteen (16.0) public health nursing FTEs, one (1.0) nurse practitioner FTEs, four (4) family home visitor FTEs, one (1.0) social worker FTE, two and one-half (2.5) support staff FTEs.

The 2022/23 operating budget is detailed below:

 

April 1, 2022 to March 31, 2023

April 1, 2021 to March 31, 2022

Change

Salaries and benefits

2,768,049

2,639,041

129,008

Other operating expenditures:

 

 

 

Mileage

50,000

60,000

(10,000)

Professional development

13,400

25,000

(11,600)

Program supplies

48,392

150,000

(101,608)

Purchased services

15,000

20,800

(5,800)

Total operating expenditures

126,792

255,800

(129,008)

Total budget

2,894,941

2,894,841

-

Significant changes in the operating budget include the following:

  • Increase in Salaries and Benefits $129,008 - The 2021/22 fiscal year contemplated a more fluid staffing complement to support the WECHU’s COVID-19 Pandemic response, including case and contact management and vaccinations.  For example, in Q1 and Q2 of 2021/22, the public health nursing FTE complement was 6 and 4 respectively, grading upward in Q3 and Q4.  Conversely, the social worker FTE complement in Q1 and Q2 of 2021/22, was 2 and 10 respectively, grading downward in Q3 and Q4.  The 2022/23 budget contemplates staffing to return to pre-pandemic levels. 
  • Reduction in Mileage of $10,000 – The 2022/23 fiscal year contemplates staff re-orienting to the Programs.  In addition, it is anticipate that client visits will be a hybrid of in-person and virtual.
  • Reduction in Professional development of $11,600 – The 2021/22 fiscal year contemplated substantially higher professional development costs due to the fluctuation in the staffing complement throughout the fiscal year.
  • Reduction in Program Supplies of $101,608 – The fiscal 2021/22 budget contemplated expenditures being incurred on account of information technology hardware and software to address increased FTEs. 
  • Reduction in Purchased Services of $5,800 – The fiscal 2021/22 budget contemplated the costs of the annual financial statement audit.  For 2022/23, it is anticipated that these costs will be borne by the Cost-Share Budget. 

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 Pre-natal and Post-natal Nurse Practitioner Programs,

Whereas, the total budgeted expenditures for the Programs for the period April 1, 2022 to March 31, 2023 is $2,894,941, and

Now therefore be it resolved that the Windsor-Essex County Board of Health approve the operating budget as presented by Administration for the period April 1, 2022 to March 31, 2023


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April 21, 2022

Meeting held via video: https://youtu.be/3wmW8cdpJW4

  1. Call to Order
  2. Agenda Approval
  3. Announcement of Conflict of Interest
  4. Update
    1. COVID-19 Update (Dr. S. Nesathurai)
  5. Approval of Minutes
    1. Regular Board Meeting: March 24, 2022
  6. Business Arising
  7. Consent Agenda
    1. INFORMATION REPORTS
      1. 2021 IPC Annual Statistical Reporting (N. Dupuis)
      2. COVID-19 Surveillance and Epidemiology
      3. Communications Update (February – March 2022)

    2. RESOLUTIONS/RECOMMENDATION REPORTS – None

  8. New Business
    1. Strategic Plan (N. Dupuis)
    2. Annual Report (N. Dupuis)
    3. CEO Quarterly Report – January 2022 – March 2022 (N. Dupuis)
    4. alPHa Annual General Meeting – June 14, 2022 (Virtual)
      1. alPHa Fitness Challenge (N. Dupuis)
  9. Correspondence
    1. Simcoe-Muskoka Public Health – Letter to Hon. Christine Elliott - Response to the Opioid Crisis – for support
  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 19, 2022 – Via Video
  12. Adjournment


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PREPARED BY

Records Coordinator & Privacy Officer

DATE

April 21, 2022

SUBJECT

2021 IPC Annual Statistical Reporting 


BACKGROUND

The WECHU is a “health information custodian (HIC)” in accordance with section 3 of the Personal Health Information Protection Act (PHIPA), and an “institution” in accordance with section 2 of the Municipal Freedom of Information and Protection of Privacy Act (MFIPPA). Under this legislation the WECHU has obligations to ensure the rights of individuals with respect to privacy, access and correction of records of personal information (PI) and personal health information (PHI), and access to general records that pertain to the WECHU operations and governance.

All institutions under MFIPPA, and HICs under PHIPA, are required to provide statistical reports to the Information and Privacy Commissioner of Ontario (IPC) on an annual basis with respect to:

  • Confirmed privacy breaches under PHIPA (Appendix A)
  • Access and correction requests under PHIPA (Appendix B)
  • Access and correction requests under MFIPPA (Appendix C)

The WECHU submitted statistical reports for each category by the required deadline of March 1st for PHIPA reports and March 31st for MFIPPA.

DISCUSSION

Privacy breaches

In 2021, the WECHU had eight confirmed breaches, compared to thirteen in 2020. Privacy breaches in 2021 predominantly included incidents where PI and/or PHI was emailed or faxed to the wrong person and/or organization.

The WECHU is looking at various ways to prevent breaches of this manner through training and investigating additional email security options.

MFIPPA Access and correction to information requests

In 2021, the WECHU received thirty-eight formal MFIPPA access requests, compared to thirty-five in 2020, and zero correction requests during the reporting year. One of the requests was transferred to Statistics Canada. Thirty-one of the requests were completed within the reporting year and six of the requests carried over to the 2022 reporting year.

Of the thirty-eight access requests completed in 2021, the majority of requests came from an “individual by agent” or lawyer (48%). This was followed by “individual/public” (29%), “business” (13%), and “media”, “government” and “other” (3% each).

Year

Number of MFIPPA Requests

Access

Correction

2020

35

0

2021

38

0

PHIPA Access and correction to information requests

In 2021, the WECHU received five formal PHIPA access requests and sixty-two formal correction requests during the reporting year. This was a significant increase from 2020 due to the WECHU’s involvement in supporting the proof of COVID-19 vaccination certificate program, as well as in the implementation of a COVax client access and correction process.

Year

Number of PHIPA Requests

Access

Correction

2020

0

0

2021

5

62

CONCLUSION

In summary, 81% of all MFIPPA requests and 100% of all PHIPA requests were completed within the statutory time limits, despite the operational impacts of the pandemic. Priorities for the coming year will include continued dedication of resources for the access to information and privacy program, including additional training, and class customization within the WECHU’s M-Files system. These actions will improve records and information management (RIM) within the program, and allow the WECHU to respond with increased efficiency to information requests.


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PREPARED BY

Oral Health Department

DATE

April 21, 2022

SUBJECT

WECHU Oral Health Services and Oral Health Month


BACKGROUND

April is Oral Health Month. Oral health is a critical component of overall health and well-being. Oral Health month highlights the importance of good oral health practices and the role of dental professionals in improving community oral health.

In Ontario, one in every three people do not have access to dental insurance, requiring  them to pay out of pocket for ongoing and urgent oral health needs (StatsCan, 2018). We know in Windsor-Essex, to avoid the high cost of dental bills, many individuals forgo treatment impacting their overall quality of life (WECHU, 2018).  The Healthy Smiles Ontario (HSO) program, offered for qualifying children under the age of 18,  the Ontario Seniors Dental Care Program (OSDCP) for qualifying seniors 65 years and older, offer opportunities for routine, emergency and urgent dental services at no cost. The provincial Ministry of Health’s Oral Health Protocol (2021) provides direction to local public health units for the delivery of these oral health services, as well as oral health screening, and oral health promotion and education.

DISCUSSION

Oral Screening, Assessment and Surveillance

In 2021, COVID-19 impacted many public health programs and services, including the WECHU’s oral health program. While clinical services offered through HSO and OSDCP experienced some setbacks and delays through 2021, the WECHU was unable to complete school dental screening.   As part of the Oral Health Protocol (Ministry of Health, 2021), all public health units implement dental screening for all students in Junior Kindergarten (JK), Senior Kindergarten (SK), and Grade 2. Screenings are completed by registered dental hygienists and certified dental assistants during the school day. Oral health screening requires the collection of the total number of decayed, missing and filled teeth (DMFT). Data on DMFT is used to determine if additional grades are also to be screened. Following the Oral Health Protocol, schools that are identified as medium risk also receive screening for all Grade 7 students and for schools identified as high risk, Grades 4 and 7 are screened in addition to the standard grades for screening.

Despite dental screening not occurring in 2021, the WECHU Oral Health department sent out screening information to parents and families and offered virtual and on-site screening at one of our two oral health clinics. Parents who wanted their children screened were able to book an appointment and choose the option that best suited their needs.

Oral health screening is not only an important part of overall oral health surveillance for Windsor-Essex, it provides an opportunity to identify oral health concerns early and to provide parents with information about the Healthy Smiles Ontario program and options for a dental home. With schools reopening for additional visitors the Oral Health department at the WECHU has developed an ambitious and comprehensive plan to resume oral health screening over last three months of the 2021-2022 school year. The oral health team will focus on schools identified as high risk and medium risk from previous years to ensure that we are able to reach all students most in need of oral health screening, prevention and support. The oral health screening teams have already reached out to these schools and screening will commence in April, running through June of this year.  

WECHU Healthy Smiles Ontario (HSO) Program

Over the course of 2021,there were 1,572 children/youth screened at one of the WECHU’s dental clinics and referred into either the HSO-Emergency and Essential Services Stream (EESS), or the HSO-PSO (preventive services only) program. The EESS program is provided to child/youth identified with an emergency or essential dental condition such as infection, haemorrhage or pathology that requires immediate clinical treatment. The PSO stream is delivered through public health unit clinics only and identified through health unit screening activities. Treatments covered under the PSO stream include topical fluoride, pit and fissure sealants, scaling, and some interim stabilization therapies.

Ontario Seniors Dental Care Program (OSDCP)

In 2021, the WECHU oral health department supported 3,349 clinic visits across all clients enrolled in the OSDCP. This includes 398 new patient exams, for an average of 1.6 new patients added to our client roster every working day. New dentures have been provided to 117 clients at the WECHU, with 1,311 appointments with a dentist or denturist to be fitted for these new dentures. The oral health department supports the OSDCP at both clinic sites (Windsor and Leamington). Clinic hours of operation are Monday to Friday from week day from 8:30 a.m. to 8 p.m in Winsor and 8:30 a.m. to 4:30 p.m. in Leamington.

Oral Health Resources for Educators

The Ontario Public Health Standards outline the requirement for health units to support health related curriculum and health needs in schools. Oral health education programs can help to build skills of young children, in terms of their oral health knowledge and practices and are a key area of need for children and youth in Windsor-Essex. In 2021, oral health resources for educators were updated and posted to the WECHU website. These included lesson plans and resources intended to help teach students from Kindergarten to Grade 8 about oral health and how students can keep their teeth and mouth healthy. Presentations are also available to schools and community programs at request.

Baby Oral Health Program (BOHP)

The Canadian Dental Association and the Canadian Pediatric Society recommend children see a dentist by their first birthday, even before they have all of their teeth. The BOHP provides free screening for all children, aged 0 to 4, in Windsor-Essex County. A screening by a registered dental hygienist includes a check for signs of cavities, education on supporting a healthy mouth and teeth, and a fluoride treatment, if needed. These screenings are important as they offer an opportunity for early intervention. During a BOHP visit families are also encouraged to visit a dentist or make a follow-up appointment at the WECHU if they do not have a home dental office. Children who present with urgent dental needs are enrolled into the HSO program, if eligible, or receive outside referrals for dental treatment. In 2021, 138 infants and toddlers were screened through the BOHP.


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SUBMITTED BY

Communications Department

DATE

April 21, 2022

SUBJECT

February 15 – March 14, 2022 Communications Update


BACKGROUND/PURPOSE:

Provide regular marketing and communication updates to the Board of Health.

SOURCE

FEBRUARY 15 – MARCH 15

JANUARY 15 – FEBRUARY 14

DIFFERENCE

News Releases, Media Advisories and Statements, or Notifications Issued

31

31

0

Media Requests Received

28

50

-22

Wechu.org page views

262,164

505,880

-183,133

YouTube Channel Subscribers

1,761

1,767

-6

Email Subscribers

8,133

8,295

-162

Emails Distributed

33

33

0

Facebook Fans

18,632

18,628

+4

Facebook Posts

121

121

0

Twitter Follower

8,568

8,491

+76

Twitter Posts

122

115

+7

Instagram Followers

1,440

1,399

+43

Instagram Posts

29

18

+11

LinkedIn Followers

1,079

1,060

+19

LinkedIn Posts

73

85

-12

Media Exposure

563

810

-247

Data Notes can be provided upon request.

Media Exposure Overview Graph

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

Website Overview Graph

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

Discussion

Current notable projects that the department is working on.

Light it up RED for TB - photo of WECHU office with red lights for TB Awareness

We promoted World TB Day on March 24 - Shining a Red Light for World TB Day through multiple media channels.

The First Case of Influenza A Confirmed in Windsor-Essex news release was issued on Tuesday, March 22.

The Communications department is maintaining marketing and communication efforts regarding COVID-19 vaccinations in the region with our partners. In particular, the COVID-19 pop up clinics in the community continue to be promoted and we are working on messages around the Devonshire Mall Vaccination Centre To Cease Operations Saturday, April 2nd.

We are providing support for the Catch-Up Immunization Clinics for Students in Grades 7 to 12 that will occur until August in multiple locations throughout Windsor and Essex County.


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SUBMITTED BY

Epidemiology and Evaluation Department

DATE

April 21, 2022

SUBJECT

COVID-19 Surveillance and Epidemiology – March, 2022


BACKGROUND

Overview

The Epidemiology & Evaluation department conducts on-going population health assessment and surveillance. The data and surveillance for COVID-19 plays an integral role in understanding and managing the pandemic locally. The evidence provides information on how the pandemic has and is evolving, assessing the risk and severity, and assists in the development of timely interventions to limit further spread in the community.

Due to the recent surge in Omicron cases and changes in eligibility for testing, testing capacity is limited and case, contact, and outbreak management has been modified to focus on high-risk settings. As a result, case counts in the report are an underestimate of the true number of individuals with COVID-19 in Windsor-Essex County and may impact data completeness. Please interpret these data accordingly. Due to these changes, data from before December 31, 2021 should not be compared to data after the testing changes.

Trends

In the month of March, the health unit reported 2,353 confirmed high-risk cases of COVID-19. As the weeks progressed in March, the weekly high-risk incidence rate increased from 124.0 cases per 100,000 population (Week 9) to 145.1 cases per 100,000 population (Week 13).  

In-Patient and ICU Admissions

In March, in-patient COVID-19 hospitalizations began to increase in Windsor-Essex County. A total of 155 new COVID-19 related patients were admitted to local hospitals.

Percent Positivity

Locally, Windsor-Essex County continued to experience a week-over-week increase in percent positivity in March after observing the opposite for February. As the month drew to a close, the local percent positivity rate for COVID-19 rose to approximately 19.3% in the last week of the month. It is also important to note that these were for high-risk individuals that were eligible for testing.

Wastewater Surveillance

For the month of March, viral signal for COVID-19 in wastewater intensified as the month drew to a close. Current levels are beginning to reach levels observed during the onset of the Omicron wave in December 2021.  

Outbreaks

In the month of March, 21 outbreaks were declared in high risk settings compared to the 24 outbreaks in February. This includes seven outbreaks in long-term care and retirement homes, four in hospital settings, and ten in other congregate settings. As of March 31st, there were 16 active outbreaks in the Windsor-Essex County region.

Deaths

For the month of March 2022, 16 deaths were reported that were attributed to COVID-19. This represents a 45% decline in comparison to the deaths reported in February.

DISCUSSION

With the changes in testing eligibility, and guidance with case, contact and outbreak management, the health unit has modified its public reporting to better understand the burden of illness locally. New indicators, such as wastewater data, have been included as a proxy indicator for COVID-19 case counts, which are underestimated. The health unit will continue to monitor and provide epidemiological expertise on COVID-19 to internal leadership, community partners, and residents to support evidence-informed decision-making. This includes daily epidemiological updates, weekly epidemiological presentations to the community and supporting policy decisions through data driven approaches.


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Board Members Present:

Gary McNamara, Joe Bachetti, Tracey Bailey, Fabio Costante, Aldo DiCarlo, Gary Kaschak, Judy Lund, Robert Maich, Ed Sleiman

Board Member Regrets:

Rino Bortolin

Administration Present:

Nicole Dupuis, Dr. Shanker Nesathurai, Lorie Gregg, Felicia Lawal, Kristy McBeth, Eric Nadalin, Dan Sibley, Lee Anne Damphouse


QUORUM: Confirmed

 

  1. Call to Order

    In the Chair’s absence, Board Treasurer, Tracey Bailey, called the Regular meeting to order at 4:15 pm.

  2. Agenda Approval
    Motion: That the agenda be approved.
    CARRIED
  3. Announcement of Conflict of interest – None
  4. Update (Dr. S. Nesathurai)
    1. COVID-19 Update

      Dr. Nesathurai noted that we continue to see a rise in cases of COVID-19 in our region, including health care workers, putting a strain on our health care system.  We are averaging 2-4 COVID-19 deaths in our region a week.  We have surpassed 600 deaths locally, and the pandemic is not yet over.  Dr. Nesathurai shared a local map showing the deprivation in various areas of our region and where the number of deaths were concentrated.  Most of the deaths occurred in the urban core of Windsor and downtown Leamington.  In areas where there were little or no deprivation, no deaths have occurred.   Premature deaths means that people die before we expect them to, and it is our best estimate that approximately 50% of COVID related deaths are premature.

      4:22 pm – G. McNamara joined the meeting and assumed the role of Chair

      Motion: That the information be received.
      CARRIED

  5. Approval of Minutes

    1. Regular Board Meeting: March 24, 2022

      Motion: That the minutes be approved.
      CARRIED

  6. Business Arising - None
  7. Consent Agenda

    1. INFORMATION REPORTS

      1. Oral Health Report and Oral Health Month (E. Nadalin)
        The Report is attached and presented to the Board for information.
      2. 2021 IPC Annual Statistical Reporting (N. Dupuis)
        The Report is attached and presented to the Board for information.
      3. COVID-19 Surveillance and Epidemiology (N. Dupuis)
        The Report is attached and presented to the Board for information.

      4. Communication Update (February – March, 2022)
        The Report is attached and presented to the Board for information.
        Motion:  That the information be received.   
        CARRIED

    2. RESOLUTIONS/RECOMMENDATION REPORTS - None

  8. New Business

    1. Strategic Plan (N. Dupuis)

      N. Dupuis advised that our previous Strategic Plan has expired at the end of 2021.  We will move forward with a Plan with a shorter 3-year term instead of 5 years, allowing us to go through the pandemic transition phase around renewal and recovery.  In 3 years time, will can look at our Strategic Plan and renew for a longer term.  N. Dupuis introduced Mr. Harold Schroeder from Schroeder and Schroeder, who has been retained as a Consultant to assist us with Strategic Planning and an Organizational Review. 

      Mr. Schroeder introduced himself and briefly talked about the components and framework of Strategic Planning. The process should involve the Board and Senior Executive Leadership when looking at the organization’s vision and roadmap.  The real benefits will be getting everyone on the same page throughout the process.

      Motion: That the information be received.
      CARRIED

    2. Annual Report (N. Dupuis)
      N. Dupuis noted that our WECHU Communications team supported the preparation of the 2021 Annual Report, and it is now live on our website. 

      There was a significant amount of work in 2021 regarding COVID Response with over 17,000 positive cases in Windsor-Essex and approximately 33,000 contacts for Case and Contact Management.  There were 351 deaths, 456 outbreaks and 1,112 cohorts dismissed due to COVID-19.  Our call centre responded to over 20,000 phone calls in 2021, and we collaborated with our hospital partners, primary care, pharmacies, EMS, and CRST to administer 792,385 vaccinations.

      With efforts mainly directed to COVID-19, we still managed to focus on other public health concerns, including mental health for example. Our Environmental Health department continued with inspections, food handler training and work continued in our Infectious Diseases Department.

      Opioid response is big part of our work, and site consultations for a Consumption & Treatment Services Site was completed.  There was continuation of the Naloxone Program, with 4 new agencies on-boarded for a total of 18 agencies now part of the program.  The Ontario Senior Dental Care Program was launched in 2020, and 2021 was the first full year that this program was in operation.  We hired two full time dentists, have expanded our dental clinic hours to 8:00 pm, and welcomed 870 seniors to our roster of clients.

      N. Dupuis said the Ministry has indicated to us that funding for COVID Vaccine and COVID Response will be extended for 2022 and we have included that in our budget.  Our Annual Service Plan submitted to the Ministry in March included a request for extraordinary costs, including COVID Vaccination.  The second quarter of 2022 will allow us to provide the Ministry with updated costs around COVID-19.   We have not received information around whether there will be funding for COVID-19 related costs for 2023, but that discussion will evolve over the next few months.

      E. Sleiman said that the WECHU has done a good job managing COVID-19 with limited resources.  He asked N. Dupuis if the organization has done an evaluation and if we would do anything different should we experience another pandemic. N. Dupuis said given the pace of the pandemic we have been in constant response mode and have not completed a fulsome evaluation.  Every Director consistently evaluates our strategies and we adjust and implement change when needed. We would certainly do a review/debrief at some point and move those learnings into a playbook for the future.   Keep in mind that guidance and directional changes came quite frequently from the Ministry.
       

    3. CEO Quarterly Report (January – March 2022) (N. Dupuis)
      N. Dupuis reviewed the report and variances.
       

    4. alPHa Annual General Meeting (Virtual) June 14, 2022 (N. Dupuis)
      Registration is now open for the alPHa AGM and conference in June.  Any Board of Health members who would like to participate can contact L. Damphouse for registration.   We are encouraging any Board members who wish to attend to do so.

      1. alPHa Fitness Challenge
        The alPHa fitness challenge is designed to get people moving.  This year, the challenge is only 30 minutes of exercise in the month of May.  We will be following up with board members to promote during May

        Motion: That the information be received.
        CARRIED

  9. Correspondence

    1. Simcoe-Muskoka Public Health – Letter to Hon. Christine Elliott – Response to the Opioid Crisis –    for support  
      Motion: That the WECHU Board of Health support the letter from Simcoe-Muskoka Public Health to the        
      Hon. Christine Elliott in response to the Opioid Crisis

      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 4:55 pm
    The Board moved out of Committee of the Whole at 5:10 pm

  11. Next Meeting: At the Call of the Chair, or May 19, 2022 – Via Video

  12. Adjournment
    Motion: That the meeting be adjourned.
    CARRIED
    The meeting adjourned at 5:15 pm.


RECORDING SECRETARY: L. Damphouse

SUBMITTED BY: N. Dupuis

APPROVED BY: The Board of Health - May 19, 2022
 


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  1. Period covered by this report:  January 1, 2022 to March 31, 2022
  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 including transition of staff from case and contact management to support the vaccination efforts as directed by the province.
  • Increased expenses related to vaccination to support resources required for implementing booster/third doses across the population.

Item (x) the CEO reports the following:

In January 2022, the WECHU had an unplanned termination of a single non-union staff person.

Date: March 31, 2022

Signature: Nicole Dupuis, Chief Executive Officer


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March 24, 2022

Meeting held via video

  1. Call to Order
  2. Agenda Approval
  3. Announcement of Conflict of Interest
  4. Update
    1. COVID-19 Update (Dr. S. Nesathurai)
  5. Approval of Minutes
    1. Regular Board Meeting:  February 17, 2022
  6. Business Arising
    1. Annual Service Plan (L. Gregg/N. Dupuis)
    2. alpHa Winter Symposium Conference Update
  7. Consent Agenda
    1. INFORMATION REPORTS
      1. 2021 Summary – Infectious Disease Prevention
      2. Student Immunization Catch-up Plan
      3. Zoonotic and Vector-Borne Diseases Report
      4. Ontario Active Transportation Grant
      5. COVID-19 Surveillance and Epidemiology
      6. Communications Update (Jan 15-Feb 15, 2022)
    2. RESOLUTIONS/RECOMMENDATION REPORTS 
      1. ​​​​​​​2022 Annual Service Plan
  8. New Business
    1. Board of Health – Paperless meetings (N. Dupuis)
    2. Board By-laws – Review and Revisions (N. Dupuis)
  9. Correspondence
    1. AOPHBA – Letter to CMOH, Dr. Kieran Moore – Work Deployment Measures for Board of Health – for support
    2. Sudbury & Districts Public Health – Letter to alPHa President, Dr. Paul Roumeliotis – Health and Racial Equity: Denouncing Acts and Symbols of Hate – for support
  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 21, 2022 – Via Video
  12. Adjournment


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SUBMITTED BY:

Infectious Disease Prevention

DATE:

March, 2022

SUBJECT:

2021 Summary – Infectious Disease Prevention Department


BACKGROUND

The Health Protection and Promotion Act 1990 (HPPA), R.S.O., 1990, and Ontario Reg. 135/18, outlines the requirements for physicians, practitioners, and institutions to report any disease of public health significance (DOPHS) to the Medical Officer of Health (MOH). The Ontario Public Health Standards (OPHS) describe the mandatory programs and services that are to be delivered by the board of health, which includes infectious and communicable diseases prevention and control.

The Windsor-Essex County Health Unit (WECHU) Infectious Disease Prevention (IDP) department includes a multidisciplinary team of professionals including Public Health Nurses (PHNs), Health Promotion Specialist, Infection Control Practitioner (ICP) and clerical support. The IDP team delivers programs and services addressing sexually transmitted blood-borne infections (STBBI)/Sexual Health Clinic; tuberculosis (TB); and communicable diseases (CD).

STBBI/Sexual Health:

Results of the 2020 Syphilis Survey Report, released in 2021 via the Sexual Advisory Committee, identified a gap in both knowledge and awareness of syphilis amongst the general population and local healthcare practitioners (HCPs).  Case numbers for the human immunodeficiency virus (HIV) in WEC in the 1st quarter of 2021 increased from previous years. Nine cases of HIV were reported in WEC from January 1 to March 31, 2021 compared to an average of 4.6 cases in the first quarter of the previous 5 reporting years. The HIV rate in WEC leveled as 2021 progressed to a total of 17 HIV cases. A comparison of the previous 5 years showed a yearly average of 21.8 HIV cases per year in WEC.  While the HIV rate in WEC was lower in 2021 than previous years, the crude rate averaged 4.0 HIV cases per 100,000 residents in WEC whereas the provincial crude rate was 3.7.

In response to the increased incidences of HIV cases that were observed in the initial part of 2021, a HIV Alert was posted on the Canadian Network for Public Health Intelligence (CNPHI) website, operated by the Public Health Agency of Canada in April of 2021. A comprehensive social media campaign was consequently developed to improve sexual health and well-being within WEC. The communication campaign included the development of syphilis awareness posters, banners, billboards, and social media messaging. Syphilis awareness banners were adapted and published in the WE Pride magazine (2021/2022) and as part of the 2021 WEC Pride Fest. Additionally, billboards were also posted in three WEC locations that shed light on the spread of STIs and promoted the use of condoms.

In order to engage our community, social media platforms, Facebook, Grindr, and Instagram were also utilized to increase STI awareness. PHNs were also involved in Pozitive Pathways podcasts (two episodes: syphilis and gonorrhea) and as AM800 guest speakers (two events: oral sex and syphilis).

PHNs continue to support resources, capacity building efforts for HCPs and community partners to support the appropriate diagnosis, treatment, and knowledge dissemination as it pertains to STIs. As a result of the change to the WECHU service delivery model, updates were made to our syphilis reporting form, and WECHU website. WECHU’s STI Guide was also updated to align with provincial/national STI guidelines and provides information about ordering STI medications. HCPs are able to request Bicillin-LA and other STBBI medications from the WECHU (free of charge).

Tuberculosis:

In 2021, there was a total of 17 active TB cases, and 146 cases of Latent TB Infections (LTBI) in WEC, as well as a TB cluster investigation identified at a local farm, crossing two sites and 4 cases. Services for both active and latent TB cases were delivered at either the client’s home, in-person at the WECHU clinic, or virtually. To increase awareness of TB, and TB reporting requirements among community partners (e.g. Shoppers Drug Mart, Tecumseh Medical Clinic), an outreach campaign was undertaken in 2021. Communication outlining updated HIV testing recommendations for individuals with active TB and LTBI, and a revised TB reporting form was distributed to physicians and pharmacists in WEC. Reminder magnets were also included to compliment the letter (Appendix A). The reminder magnets highlighted the need to call the health unit before dispensing TB medication and informing the health unit if a positive TB skin test has been identified.

CD:

The WECHU reported zero cases of influenza in 2021. IDP PHNs noted an increase of uncommon diseases reported in 2021, including Creutzfeldt-Jakob Disease (CJD), Echninococcus, and Acute Flaccid Paralysis. In addition, the IDP PHNs worked with the ICP in a number of outbreak situations (gastroenteritis and respiratory) in institutions and hospitals.

Refer to Appendix B for the DOPHS [diseases of public health significance] 2021 case numbers that were retrieved from iPHIS.

Appendix A: TB Reminder Magnets

Photo of TB Fridge magnets

Appendix B: DOPHS 2021 Case Numbers

Note: The table below includes the number of confirmed cases (and probable cases, depending on the DOPHS) from 2021. The date of extraction from iPHIS was on February 16, 2022.

Disease of Public Health Significance # of confirmed cases
  2020 2021
Acute Flaccid Paralysis 0 1
AIDS 0 0
Amebiasis (includes confirmed and probable) 7 4
Anthrax 0 0
Blastomycosis 1 0
Botulism 0 0
Brucellosis 0 0
Campylobacter Enteritis 63 76
Carbapenemase-producing Enterobacteriaceae (CPE) 3 4
Chancroid 0 0
Chlamydial Infections 747 741
Cholera 0 0
Creutzfeldt-Jakob Disease, All Types 0 0
Cryptosporidiosis 3 2
Cyclosporiasis 2 2
Diptheria 0 0
Echinococcus Multilocularis Infection 0 0
Encephalitis 3 1
Encephalitis/Meningitis 0 2
Food Poisoning, All Causes 0 0
Giardiasis 12 11
Gonorrhoea (All Types) 184 249
Group A Streptococcal Disease, Invasive 44 24
Group B Streptococcal Disease, Neonatal 0 2
Haemophilus Influenzae Disease, All Types, Invasive
(includes confirmed and probable)
2 5
Hantavirus Pulmonary Syndrome 0 0
Hemorrhagic Fevers 0 0
Hepatitis A 5 1
Hepatitis B, acute 7 6
Hepatitis B, chronic 23 14
Hepatitis C 80 118
HIV 17 17
Influenza (2019/2020 & 2020/2021) 179 0
Lassa Fever 0 0
Legionellosis 6 9
Leprosy 0 0
Listeriosis 5 1
Lyme Disease (includes confirmed and probable) 5 7
Malaria 0 0
Measles 0 0
Meningitis 4 3
Meningococcal Disease, Invasive
(includes confirmed and probable)
0 0
Mumps (includes confirmed and probable) 0 0
Ophthalmia Neonatorum 0 0
Paralytic Shellfish Poisoning 0 0
Paratyphoid Fever 0 1
Pertussis (Whooping Cough)
(includes confirmed and probable)
1 0
Plague 0 0
Poliomyelitis, Acute 0 0
Psittacosis/Ornithosis 0 0
Q Fever 0 0
Rabies 0 0
Rubella 0 0
Rubella, Congenital Syndrome 0 0
Salmonellosis 46 24
Severe Acute Respiratory Syndrome (SARS) 0 0
Shigellosis 0 0
Smallpox 0 0
Streptococcus Pneumoniae, Invasive 9 10
Syphilis, Early Congenital 0 0
Syphilis, Infectious 57 46
Syphilis, Latent 22 22
Syphilis, Other 5 12
Tetanus 0 0
Trichinosis 0 0
Tuberculosis 11 10
Tuberculosis infection, Latent 173 150
Tularemia 0 0
Typhoid Fever 0 0
Varicella (Chickenpox) 8 5
Verotoxin Producing E. Coli including HUS 1 5
West Nile Virus Illness
(includes confirmed and probable)
4 3
Yellow Fever 0 0
Yersiniosis 4 3

 


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