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March 24, 2022

Information Report
Zoonotic and Vector-borne Diseases Report

SUBMITTED BY:

Environmental Health

DATE:

March, 2022

SUBJECT:

Zoonotic and Vector-borne Diseases Report

BACKGROUND

The Environmental Health Department conducts annual monitoring and testing of tick and mosquito populations in Windsor and Essex County (WEC) as part of the Windsor- Essex County Health Unit’s (WECHU) Zoonotic and Vector-borne Diseases Program. 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. Due to our geography and local climate, the WEC region is more susceptible to vector-borne diseases, as the ecological conditions influence transmission and distribution.

Upon the completion each VBD program season, the WECHU prepares an annual report which highlights surveillance information related to Lyme disease and West Nile Virus (WNV) Illness in WEC. The 2021 Annual VBD report is available on our website Vector-Borne Diseases - WE - 2021 and a high level summary of these findings is included below.

Ticks and Lyme Disease

In the last three years, surveillance data indicated an increase in black-legged ticks (Ixodes scapularis) in WEC. The black-legged tick is the primary vector for Borrelia burgdorferi, the bacteria that causes Lyme Disease. Environmental Health staff conduct active field surveillance at public parks and trails frequently used by residents twice a year to identify areas in WEC that have populations of black-legged ticks.

In 2021, active surveillance was conducted at four sites that included,

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

A total of 33 black-legged ticks were found through tick dragging, with nine of these carrying the infectious agent that causes Lyme disease.

In 2021, there were seven cases of Lyme Disease in WEC. All laboratory-confirmed cases are interviewed to determine activities and locations where exposure may have occurred. This information drives targeted tick awareness initiatives from the health unit.

Mosquito Surveillance and Testing

The WECHU has one of Ontario’s most comprehensive mosquito surveillance programs, including the West Nile Virus Program and Enhanced Mosquito Surveillance initiatives. In 2021, mosquito surveillance began in May and ended in early October. Species-specific traps were 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 region. Invasive mosquito species Aedes aegypti (Yellow Fever Mosquito) and Aedes albopictus (Asian Tiger Mosquito) were also monitored. These species are known carriers of Zika, Dengue, and Chikungunya diseases. The health unit monitors mosquitoes at different stages in their life cycle to determine prevention and control initiatives for the program.

In 2021, the weekly mosquito surveillance data is available on the WECHU’s Mosquito Surveillance Dashboard. The data is updated weekly during the season and is open to the public. During last year’s season:

Total number of traps deployed per week: 47
Total number of mosquitoes trapped: 187,918
Total number of pools tested: 2,291
Number of positive pools for West Nile virus : 17
Number of positive pools for Zika virus: 0
Number of positive pools for EEE virus: 0

Positive pools for WNV were reported in the following municipalities: City of Windsor (11), Town of Essex (3), Municipality of Leamington (2), and the Town of Amhestburg (1).

Over 118,000 treatments of larvicide were applied to roadside catch basins and standing water sites last year to control mosquito populations. All municipalities in WEC have standing water by-laws that municipalities enforce that are an important activity to reduce breeding habitats. Furthermore, property standards enforcement from municipalities continues to be a key factor in controlling invasive mosquito populations in our region, as these mosquitoes are container breeders (mosquitoes that lay eggs in containers).

The WECHU follows up on all reported human cases of WNV. Cases are investigated to assess if additional targeted mosquito control activities are required. In 2021, there were three confirmed cases of WNV in WEC. There have been no human cases of Zika Virus identified in our community to date.

CURRENT INITIATIVES

As previously reported, the WECHU was the successful receipient of the Public Health Agency of Canada’s grant (August 2019 – March 2022) to study the effects of climate change and mosquito populations in our local communities. The final report for the project will be released in March and will include information regarding the types of mosquito species (including invasive species) in the region, the impact of climate change on mosquito-borne diseases, and information regarding the populations in our community that are more vulnerable to these health impacts. The WECHU will begin surveillance and monitoring activities for ticks and mosquitoes in May 2022. In addition to these activities, the WECHU will be launching our annual Fight the Bite public awareness campaign. This campaign 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.

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Information Report
Student Immunization Catch-Up Plan

SUBMITTED BY:

Healthy Schools Department

DATE:

March, 2022

SUBJECT:

Student Immunization Catch-Up Plan

BACKGROUND

In Ontario, the Immunization of Schools Pupils Act (ISPA) R.S.O.1990 requires children and adolescents attending primary or secondary school to be appropriately immunized against measles, mumps, rubella, diphtheria, tetanus, meningococcal, varicella and polio, or have a valid Medical, Conscience or Religious Belief exemption on file at the Health Unit. As outlined in the Ontario Public Health Standards (OPHS), local public health units collect and assess immunization records for every student attending school, and provide provincially funded immunization programs through school-based clinics.

Due to the ongoing COVID-19 pandemic and the impact on local resources, the Windsor-Essex County Health Unit (WECHU) was unable to implement immunization clinics at every school setting as in previous years. In order to support widespread availability of publicly-funded vaccines to protect children from Hepatitis B, Human Papilloma Virus (HPV), and Meningococcal Disease (Men-C-ACYW135), the WECHU has been working collaboratively with local healthcare providers to ensure students continue to have access to these vaccines.

As of January 27, 2022 there are 7,953 ISPA based vaccines overdue for administration in the birth cohort years of 2004, 2008, and 2009. The overdue vaccinations for those in the 2004 birth cohort year (1,910) are of particular significance for catch-up before June 2022 due to the pending graduation from the secondary school making follow-up after this school year more difficult.

CURRENT INITIATIVES

The WECHU began hosting catch-up immunization clinics for eligible students on Tuesday, March 8, 2022 to service families with children born between 2004 and 2009 that were not able to receive their immunizations at a school-based immunization clinic in the fall, or through their primary healthcare provider. Appointments for booking are available during the day, afternoons, evenings and weekends at Sears-Devonshire Mall (3100 Howard Avenue) or WECHUs Leamington office (33 Princess Street).

As part of this strategy, the WECHU prepared tailored communications to update students, families, and school board administrators regarding options available to students who are overdue and eligible for vaccinations. The catch-up clinics in March are the first set of student immunization clinics that the WECHU has planned for the year.

In May 2022, the WECHU will be re-visiting high-risk schools that received the first round of vaccines in the fall. Furthermore, additional community-based and in-house catch-up clinics are being planned for the summer to give families the opportunity to have eligible students immunized before the beginning of the 2022/2023 school year.

As part of this work, the WECHU will also be assessing immunization records for every student in Windsor and Essex County in the beginning of the 2022/2023 school year. Under the ISPA, the Medical Officer of Health may issue suspension orders to students who fail to become immunized and are not exempt as well as those who do not have up to date immunizations. With the successful implementation of this catch up plan, the WECHU is looking forward to returning to schools in the fall of 2022 to complete a single cohort of school-based immunizations.

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Information Report
January 15 – February 15, 2022 - Communications Update

SUBMITTED BY

Communications Department

DATE

March, 2022

SUBJECT

January 15 – February 15, 2022 - Communications Update

Metrics

SOURCE	JANUARY 15 – FEBRUARY 15	DECEMBER 15 –JANUARY 15	DIFFERENCE
News Releases Issued	5	5	0
Media Advisories Issued	2	1	+1
Media Statements or Notifications	34	34	0
Media Requests Received¹	52	51	+1
YouTube Media Briefing Videos²	4	10	-6
Wechu.org page views³	237,805	1,058,322	-820,517
YouTube Channel Subscribers	1,767	1,769	-9
Email Subscribers⁴	8,295	8,222	-73
Emails Distributed	34	30	+4
Facebook Fans⁵	18,619	18,598	+21
Facebook Posts	126	96	+30
Twitter Follower	8,491	8,355	+136
Twitter Posts	115	92	+23
Instagram Followers	1,399	1,381	+18
Instagram Posts	18	3	+15
LinkedIn Followers	1,060	1,042	+18
LinkedIn Posts	89	58	+31
Media Exposure⁶	832	1,334	-502

Media Exposure Overview

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

Website Overview

Social Media Growth

Current Notable Projects

Maintaining marketing and communication efforts regarding ongoing vaccine rollout in the region by public health and our partners. In particular, the numerous pop up clinics in the community and closures of mass vaccination sites at the Grovedale Arts and Culture Centre in Kingsville and Hôtel-Dieu Grace Healthcare
Responding to media and public inquiries through multiple channels including emails, calls, and web form submissions. Social media direct messages are currently redirected to the wechu.org web form.
Significant website updates to mirror provincial easing of public health restrictions.

Data Notes:

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 answer questions may not be captured. In many instances, each request led to multiple interactions with reporters.
YouTube Live videos started on June 23, 2020. Prior Public Health Update videos on YouTube were exported videos recorded through Facebook Live. In July 2021, YouTube Live broadcasts were scaled down to Fridays only from a Monday, Wednesday, and Friday rotation. In September 2021, media briefings were increased to Monday, Wednesdays and Fridays and streamed live. On September 20, 2021, media briefings were recorded and then posted to YouTube.
Website analytics are provided by Siteimprove. The metric provided is for page views to wechu.org. Previously, we were reporting on the local-updates webpage only.
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 for last 30 days.
Social media metrics are provided through Hootsuite.
Media exposure information in this report were generated using Meltwater Media Monitoring Solution. 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.

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Information Report
Ontario Active School Travel Grant – Update and Final Activities

SUBMITTED BY

Chronic Disease and Injury Prevention

DATE

March, 2022

SUBJECT

Ontario Active School Travel Grant – Update and Final Activities

BACKGROUND

Supported by a grant from Green Communities Canada (GCC), the Windsor-Essex County Health Unit in partnership with school boards, transportation services, municipalities, and police services has been developing policies, enviromental supports, and programming to promote active school travel in Windsor and Essex County amidst staff and resource allocation during the pandemic response. The Ontario Active School Travel (OAST) grant was awarded to the health unit in the amount of $60,000 to be used between January 2021 and June 2022. In order to operationalize this grant funding, the health unit created an Active School Travel (AST) Regional Committee which oversees the implementation of activities and use of the OAST grant funds to promote active travel in schools across the City of Windsor and Essex County.

PREVIOUS AND CURRENT INITIATIVES:

To date, funding has supported the hiring of an Active Travel (AT) Planner to assist schools and boards in implementing plans and coordinating community education and outreach. The AT Planner has assisted in the creation of the AST Regional Committee, identification of the initial six pilot schools, and establishing “champions” at each school to liaise with project staff on the implementation of interventions. The AT Planner has created an orientation package for school representatives, conducted a baseline asssessment of active transportation behaviours amongst students in each school, and serves as the Chair for individual school planning meetings.

In addition to maintaining the collaborative functions mentioned above, the AT Planner has also conducted a review of best practices for implementing active school travel interventions and has determined areas of opportunity for policy enhancement through a review of AT policies at the school board and municipal levels. As this is the third round of funding for the OAST grant, the AT Planner reviewed previously developed resources which could be repurposed and distributed to local pilot schools and board representatives. This process also helped to identify gaps which could be addressed through locally developed education materials. These materials (e.g., web based toolkits and seasonal AT safety promotions) were subsequently developed and shared with school board representatives and shared with all local schools.

As part of the grant activities, Windsor Police Service led walk-ability and bike-ability assessments at each pilot school during the 2021 school year. Several members of the AST Regional Committee along with principals, teachers, and parents were present for these assessments. The assessments helped to identify safe and accessible routes to and from school considering the built environment, traffic, and different modes of transportation as contributing factors in promoting active school travel. At the time of writing this report, summaries which highlight the results of these assessments and include tangible suggestions for intervention are being developed to be shared with each of the pilot schools.

With sustainability of the interventions enabled by this funding as a primary priority of both the funding agencies and the health unit, one of the most impactful initiatives contained and actioned as part of this grant was the creation of a Active School Travel Charter (ASTC). The ASTC was developed to serve as a statement of principles to guide schools, school boards, municipalities, student transportation services, and other community partners in decision-making around the built environment. As the ASTC has already been endorsed by the Board of Health and the City of Windsor, the AST Regional Committee will also be seeking endorsement from the County of Essex in the coming weeks.

FUTURE INITIATIVES:

As the project approaches the end of its funding cycle, remaining project activities will be completed prior to June of this year. Project funding will be allocated toward the purchase of new bike racks and other forms of equipment storage so that students attending pilot schools can feel confident that their equipment will be safe during the school day. Pilot schools will be engaging students through a crosswalk painting event to highlight and enhance school crosswalks. Cycling safety and training sessions will be provided through partnership with Bike Windsor-Essex (a local cycling advocacy agency) to teach students proper biking skills and techniques, and a media launch event will also be held concurrently with these sessions in order to acknowledge the activities supported through the grant and implemented through engagement with the schools.

Once all project activities have been completed, the AST Regional Committee will develop the sustainability plan for AST within the community beyond what could be offerred through the one-time grant funding. Post-intervention assessments will also measure changes in attitudes and behaviour toward AT in the pilot schools relative to the baseline assessment as a way in which to detemined the effectiveness of these interventions.

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Information Report
COVID-19 Surveillance and Epidemiology – February, 2022

SUBMITTED BY:

Epidemiology and Evaluation Department

DATE:

March, 2022

SUBJECT:

COVID-19 Surveillance and Epidemiology – February, 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 February, the health unit reported 2,751 confirmed high-risk cases of COVID-19. As the weeks progressed in February, the weekly high-risk incidence rate decreased from 228.1 cases per 100,000 population (Week 5) to 130.3 cases per 100,000 population (Week 8).

In-Patient and ICU Admissions

In February, in-patient COVID-19 hospitalizations continued to decrease in Windsor-Essex County up until the third week of the month. Since then, COVID-19 related hospitalizations has started to trend upwards. However, COVID-19 related ICU admissions has continued to decline throughout the month of February.

Percent Positivity

Locally, Windsor-Essex County continued to experience a week-over-week decline in percent positivity in February. As the month drew to a close, the local percent positivity rate for COVID-19 stabilized to approximately 13.6% 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 February, viral signal for COVID-19 in wastewater declined from levels experienced in the previous month. Current levels are beginning to reach levels observed prior to onset of the recent Omicron wave in December 2021.

Outbreaks

In the month of February, 24 outbreaks were declared in high-risk settings. In comparison, 105 outbreaks were declared in January (a 77% decline in February). This includes nine outbreaks in long-term care and retirement homes, two in hospital settings, five in the agriculture sector and eight in other congregate settings. As of February 28, 2022, there were 20 active outbreaks in comparison to 77 active outbreaks at the end of January.

Deaths

For the month of February 2022, 29 deaths were reported that were attributed to COVID-19. This represents a 45% decline in comparison to the deaths reported in January.

CURRENT INITIATIVES

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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Minutes
March 2022 Board of Health Meeting - Minutes

Board Members Present:

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

Board Member Regrets:

Gary Kaschak

Administration Present:

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

QUORUM: Confirmed

Call to Order
Board Chair, Gary McNamara, called the Regular meeting to order at 4:05 pm.
Agenda Approval
Motion: That the agenda be approved.
CARRIED
Announcement of Conflict of interest – None
Update (Dr. S. Nesathurai)
1. COVID-19 Update
  Dr. Nesathurai noted that the pandemic is not over, but we currently seem to be in a quiescent phase of the pandemic. As we move toward normalization, we need to think about restarting public health programs and services and what our priorities are going forward.
  
  Today, March 24, 2022, happens to be Worldwide TB day. Tuberculosis is a burden in our region and there have been individuals locally who have recently passed away from TB. We work to identify those who may be at risk from TB and our core message would be that TB remains a challenge globally, and raising attention to this disease is important. The WECHU will be lighting up its building today in Red, in recognition of Worldwide TB day.
  
  Vaccination statistics show that only half of our community is protected with 3 doses of the COVID vaccine, and those with only 2 doses likely have waning effectiveness. We have approximately 76,000 individuals unvaccinated in our region, 56,000 of them being adults and approximately 20,000 being children under 5 years. This is concerning, as the unvaccinated are four times more likely to become severely ill or hospitalized from COVID-19.
  
  With masking mandates and physical distancing, we have been relatively unaffected by Influenza but this week we reported our first case in the region. With the relaxation of restrictions this could signal more cases, and it is reasonable to assume that we will see more respiratory disease. This remains a concern going forward and we still encourage that individuals get the flu vaccine.
  
  Motion: That the information be received.
  CARRIED
Approval of Minutes
1. Regular Board Meeting: February 17, 2022
  Motion: That the minutes be approved.
  CARRIED

Business Arising

Annual Service Plan (L. Gregg/N. Dupuis)
N. Dupuis noted that the Annual Service Plan is also included under Section 7.2 Recommendation Reports. The Board of Health for the Windsor-Essex County Health Unit has approved the 2022 Budget and 2022 Budget Amendment which included budget information for Mandatory programs funded by the MOH and the Obligated Municipalities on a cost shared basis, as well as preliminary information on one-time business cases funded at a rate of 100% by the MOH.

The WECHU submitted its Annual Service Plan and Budget Submission to the MOH on March 1, 2022, inclusive of the aforementioned budget approvals as well as additional requests for one-time 100% funded business cases from the MOH.

The WECHU is looking to the Windsor-Essex County Board of Health to approve the following one-time business cases to be funded at a rate of 100% by the MOH:

COVID-19 Vaccine Program Extraordinary Costs	$ 5,348,120
Recovery	2,671,524
Capital	955,987
CTS Operating Costs	655,197
Vector-Borne Disease	128,596
Public Health Inspector Practicum Program	40,000
$10,825,734

Motion: That the Windsor-Essex County Board of Health approve the one-time business cases noted to be funded at a rate of 100% by the MOH
CARRIED

alPHa Winter Symposium Conference Update (N. Dupuis)
N. Dupuis provided a brief update on the Winter Symposium which included presentations from Dr. Tam and Dr. Moore.

Motion: That the information be received.
CARRIED

Consent Agenda
1. INFORMATION REPORTS
  1. 2021 Summary – Infectious Disease Prevention
    The Report is attached and presented to the Board for information.
  2. Student Immunization Catch-up Plan
    The Report is attached and presented to the Board for information.
  3. Zoonotic and Vector-Borne Disease Report
    The Report is attached and presented to the Board for information.
  4. Ontario Active Transportation Grant
    R. Bortolin asked if any information could be shared with the various municipalities. E. Nadalin noted the walk-ability and bike-ability assessments targeted six pilot schools, and the Active School Travel (AST) Regional Committee identified Champions at each school to liaise with project staff on the implementation. He will bring R. Bortolin’s request back to the AST Regional Committee on how to best share the information with the City and the County. G. McNamara said that the county is looking to entrench public health priorities into its official plan as they move forward.
  5. COVID-19 Surveillance and Epidemiology (N. Dupuis)
    The Report is attached and presented to the Board for information.
  6. Communication Update (January 15 – February 15, 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 Annual Service Plan (L. Gregg/N. Dupuis)
    Discussed in Section 6.1 Annual Service Plan.
    
    Motion: That the Windsor-Essex County Board of Health approved the one-time business cases noted above in Section 6.1 Annual Service Plan to be funded at a rate of 100% by the MOH
    CARRIED
New Business
1. Board of Health – Paperless Meetings N. Dupuis)
  
  N. Dupuis advised that the WECHU is moving toward holding paperless Board of Health meetings by way of secure iPads. Board members will each be assigned an iPad, where board meeting packages and other relative information will be downloaded safely and securely. Brief training and instructions for use will be provided and we will pilot with the Board Executive before rolling out to the entire Board of Health. Once we resume in-person meetings, board members would need to bring these iPads to meetings, and there will no longer be the need to email Board of Health packages or print off any documentation.
  
  Motion: That the information be received.
  CARRIED
2. Board By-Laws – Review and Revision (N. Dupuis)
  
  N. Dupuis noted we are in the process of reviewing and revising our Board By-laws which, at this time, is one large document approximately 170 pages in length. This is something we need to review every couple of years, and there have been changes in legislation which need to be updated. We will break By-laws into sections, i.e. Governance, Finance, Human Resources, to make it simpler to read and easier to list on our website. There currently is no clear delineation of what should be a By-law and what should be a written policy or procedure. We will bring forward various sections for Board of Health review beginning in April through to June. Once completed our By-laws will be downloaded to the iPads assigned to the Board and they will be available on our website for easy access to the public.
  
  Motion: That the information be received.
  CARRIED
Correspondence
1. AOPHBA – Letter to CMOH, Dr. Kieran Moore – Work Deployment Measures for Board of Health - for support
  
  Motion: That the WECHU Board of Health support the letter from the AOPHBA to the CMOH, Dr. Kieran Moore, requesting that Work Deployment Measures for Boards of Heath be extended for the duration of public health units’ response to the COVID-19 pandemic.
  CARRIED
2. Sudbury & Districts Public Health – Letter to alPHa President, Dr. Paul Roumeliotis – Health and Racial Equity: Denouncing Acts and Symbols of Hate – for support
  
  Motion: That the WECHU Board of Health support the letter from Sudbury & Districts Public Health to Dr. Paul Roumeliotis, President, Association of Local Public Health Agencies (alPHa), endorsing the January 31, 2022 statement of the Ontario Public Health Association Denouncing Acts and Symbols of Hate
Committee of the Whole (CLOSED SESSION, in accordance with Section 239 of the Municipal Act)
The Board commenced with the Committee of the Whole session at the opening of the board meeting.
The Board moved into Committee of the Whole at 4:39 pm
The Board moved out of Committee of the Whole at 4:55 pm
Next Meeting: At the Call of the Chair, or April 21, 2022 – Via Video
Adjournment
Motion: That the meeting be adjourned.
CARRIED
The meeting adjourned at 4:56 pm.

RECORDING SECRETARY: L. Damphouse

SUBMITTED BY: N. Dupuis

APPROVED BY: The Board of Health - April 21, 2022

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February 17, 2022

Agenda
February 2022 Board of Health Meeting - Agenda

Meeting held via video: https://youtu.be/C8Dnxn2T01k

Call to Order
Board Elections
Agenda Approval
Announcement of Conflict of Interest
Update
1. COVID-19 Update (Dr. S. Nesathurai)
Approval of Minutes
1. Regular Board Meeting: January 20, 2022
Business Arising
Consent Agenda
1. Project Governance Committee Meeting Minutes–Jan 14/22
2. INFORMATION REPORTS
  1. Ontario Naloxone Program: Distribution and Utilization of Naloxone Kits in the Community (E. Nadalin)
  2. COVID-19 Vaccination Update (N. Dupuis)
  3. COVID-19 Surveillance and Epidemiology (N. Dupuis)
  4. January Communications Recap (E. Nadalin)
3. RESOLUTIONS/RECOMMENDATION REPORTS
  1. Consumption and Treatment Services Site Premises (N. Dupuis)
  2. Amendment to 2022 Budget Submission (L. Gregg)
New Business
1. Project Governance Committee Update (J. Lund/N. Dupuis)
2. City of Windsor – Auditor General Request (N. Dupuis)
3. Vaccine Planning Update (K. McBeth)
4. alPHa Winter Symposium, February 25, 2022
Correspondence
1. Greater Essex Catholic District School Board – Letter to Hon. Minister Stephen Lecce – Resumption of a supported plan for tracking and public reporting of COVID-19 in schools
2. Halliburton, Kawartha, Pine Ridge Public Health – Letter to Hon. Christine Elliott – Support for Local Public Health
3. Peterborough Public Health – Letter to Hon. Christine Elliott – Support for Local Public Health
4. Peterborough Public Health – Letter to Hon. Christine Elliott – Support for Local Public Health - Support for the Windsor-Essex County Health Unit’s Resolution to the Province of Ontario to amend the Immunization of School Pupil’s Act (ISPA) to include COVID-19 as a designated disease
5. Conseil Scolaire Catholique Providence – Letter to the Hon. Stephen Lecce – Support for the Windsor-Essex County Health Unit's Resolution to the Province of Ontario to amend the Immunization of School Pupil's Act (ISPA) to include COVID-19 as a designated disease
6. City of Windsor – City Council Decision CR22/2022 – January 17, 2022 – that the City of Windsor Council Support the WECHU in establishing a Consumption and Treatment Services Site in the City of Windsor post-approval from the provincial and federal governments
7. Ministry of Health – Letter from Hon. Christine Elliott – to Windsor-Essex County Health Unit advising of one-time funding up to $369,900 for the 2021-22 funding year and one-time funding up to $945,600 for 2022-23 funding year to support the provision of public health programs and services in our community, an extension to one-time mitigation funding to ensure municipalities do not experience any increase as a result of cost-sharing change for 2022, and funding to support the Ontario Seniors Dental Care Program for eligible low-income seniors
8. Ministry of Health – Letter from Chief Medical Officer of Health, Dr. Kieran Moore – to Windsor-Essex County Health Unit as a follow up to the Letter from the Hon. Christine Elliott noting that WECHU’s maximum total funding under the Accountability Agreement with the Ministry of Health for 2021-22 to be $29,363,300 ($17,684,500 in base funding and $11,678,800 in one-time funding)
Committee of the Whole (Closed Session in accordance with Section 239 of the Municipal Act)
Next Meeting: At the Call of the Chair March 24, 2022 – Via Video
Adjournment

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Minutes
February 2022 Board of Health Meeting - Minutes

Board Members Present:

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

Board Member Regrets:

Robert Maich

Administration Present:

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

QUORUM: Confirmed

Call to Order

Board Chair, Gary McNamara, called the Regular meeting to order at 4:03 pm.

The Board moved into Committee of the Whole at 4:03 pm
The Board moved out of Committee of the Whole at 4:15 pm
Board Nomination: Treasurer
The Chair noted that at the last meeting of the Board, annual elections took place and the role of Treasurer was left vacant. The Chair asked former Treasurer, Tracey Bailey, if she would continue to stand as Treasurer for the remainder of the year. Tracey Bailey having accepted was elected Treasurer by acclamation.

Motion: That the nomination for Tracey Bailey as Treasurer stands
CARRIED
Agenda Approval
Motion: That the agenda be approved.
CARRIED
Announcement of Conflict of interest – None
Update (Dr. S. Nesathurai)
1. COVID-19 Update
  As we move forward, we will have to monitor the effects of relaxation, as COVID is not likely to be eradicated in the near future. We need to consider hospital capacity, masking, continuing with social distancing and to start thinking of vaccination as a semi or annual event, along with medications as they become available. As time progresses, around 6 months or so, the vaccine becomes less effective and the core message is for those who are vaccinated to get their 3rd dose, and for those who are not vaccinated to consider doing so. The level of immunity provided by vaccines reduces over time and additional vaccination provides enhanced immunity. COVID-19 is a new disease and we will learn more as time goes on. His sense is that the mRNA vaccine will be tailored around Variants of Concern, the same as the influenza vaccine which is targeted to different strains. We are also hoping for new classes of medications in the future to fight COVID-19.
  
  G. Kaschak noted the recent news of an Ontario Health Team for Windsor-Essex and what does that mean for the health unit going forward. N. Dupuis said that this was an exciting announcement for Windsor-Essex to have our own Ontario Health Team for the region. N. Dupuis is on their Steering Committee and they are at the point of redefining different partnerships for various sectors. We will bring updates on the OHT to the board in the future. The focus and intent of Ontario Health Teams is on coordination of health services.
  
  Motion: That the information be received.
  CARRIED
Approval of Minutes
1. Regular Board Meeting: January 20, 2021
  Motion: That the minutes be approved.
  CARRIED
Business Arising - None
Consent Agenda
1. Project Governance Committee Meeting Minutes – January 14, 2022
  The minutes of the Project Governance Committee of January 14, 2022 were brought to the Board for information.
  Motion: That the information be received.
  CARRIED
2. INFORMATION REPORTS
  1. Ontario Naloxone Program: Distribution and Utilization of Naloxone Kits in the Community (E. Nadalin)
    The Report is attached and presented to the Board for information.
  2. COVID-19 Vaccine Update (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. January Communications Recap
    The Report is attached and presented to the Board for information.
    
    Motion: That the information be received.
    CARRIED
3. RESOLUTIONS/RECOMMENDATION REPORTS
  1. Consumption and Treatment Services Site Premises (N. Dupuis)
    The WECHU is in the final stages of completing the application to both Health Canada and the Ministry of Health for a Consumption and Treatment Services site in the City of Windsor. On January 17, 2022, the WECHU obtained approval from Windsor City Council to move forward with a property located at 628 Goyeau Street in Windsor. A Lease Agreement was drafted by WECHU’s legal council and is presently under review by the landlord.
    This Resolution is begin brought forward to the Board of Health to approve the Lease Agreement between the WECHU and the landlord, and that the Chief Executive Officer be able to enter into an agreement with the landlord on behalf of the organization.
    Motion: That the Board approve the above noted Lease Agreement and that the CEO enter into an agreement with the landlord at 628 Goyeau Street, Windsor, on behalf of the organization
    CARRIED
  2. Amendment to 2022 Budget Submission (L. Gregg)
    As discussed at the January Board of Health meeting, L. Gregg noted the financial impacts of circumstances that arose in the latter part of 2021, all of which would have a continuing impact on 2022, specifically:
    - Redeployment nursing staff and certain administrative staff to support vaccination
    - Establishment of a Mass Vaccination site in Leamington
    - Redeployment of non-nursing staff to support case and contact management, and outbreaks
    In preparation for the 2022 Annual Service Plan and Budget Submission to the Ministry of Health, the WECHU has prepared a 2022 Budget Amendment to quantify those impacts. Additionally, provisions are included for COVID-19 vaccination activities beyond March 2022, assuming that the WECHU will be involved with the immunization of the 0 to 4 age group as well as other COVID-19 vaccination priorities.
    The 2022 Budget Amendment specific to the COVID-19 program will result in an increase in expenditures of $1,907,007. Salaries and benefits, mileage, program expenditures such as rent and supplies, and purchased service account for these expenditures. This amendment will go in the ASP and one time funding with no obligation to municipalities. The Annual Service Plan and Budget Submission is due to the Ministry of Health on March 1, 2022. This Resolution is being brought to the Board to approve the 2022 Budget Amendment requiring an increase of $1,907,007 to the one-time business case to be funded by the Ministry of Health at a rate of 100% for those dollars in excess of the 2022 Mandatory Program Budget.
    Motion: That the Board approve the 2022 Budget Amendment as presented.
    CARRIED
New Business
1. Project Governance Committee Update (J. Lund/N. Dupuis)
  Board member, J. Lund and Co-chair on the Project Governance Committee, provided the Board with a brief update.
  
  The goal of the committee is to secure another space for the Windsor-Essex County Health Unit’s Windsor office. This process commenced in 2016. The lease for the current Windsor office expires at the end of 2023. The committee had taken a hiatus from the process due to the pandemic and has recently reconvened. The project is currently planned in 4 phases:
  Phase 1 – Space Needs and Selecting Consulting Partners (December 2021 to March 2022)
  Phase 2 – Site Selection Process (March 2022 to August 2022)
  Phase 3 – New Location Design and Fit out (September 2022 to October 2023)
  Phase 4 – Move in (October 2023 to December 2023)
  In Phase 1 an RFQ was published for a Space Needs Assessment which has been awarded to Architecttura.
  Motion: That the information be received.
  CARRIED
2. City of Windsor – Audit (N. Dupuis)
  
  N. Dupuis brought forward a letter from the City of Windsor Auditor General inviting the WECHU to participate in their annual audit. For context, F. Costante added that this was passed as a resolution at city council that this invite be sent to all Board and Committees, and not exclusively to the health unit. It was recommended that we respectfully decline the offer as we have our own auditor as well as our provincial audit by the Ministry of Health.
  
  Motion: That the Board support the recommendation to decline.
  CARRIED
3. Vaccine Planning Update (K. McBeth)
  
  K. McBeth provided an update and a presentation on Vaccination Planning for COVID-19 and other immunizations. The priority for COVID-19 vaccination for February is the 5-11 year age group. The provincial target for this age group is 70% and Windsor-Essex is at 43.5%. Targeted vaccination clinics will be available in schools and throughout communities, immunizations are available at 39 pharmacies who have adjusted hours to accommodate families, and more than 20 after school clinics are currently planned through February and March in both elementary and secondary schools to encourage vaccine uptake.
  
  Mass vaccination sites are not considered long-term and mobile clinics are the most crucial. Our partners at CRST (ESHC/EMS) will continue to provide these mobile vaccination services. The Sears site will remain open for COVID-19 vaccination on a smaller scale and WECHU will offer ISPA vaccinations for students who are overdue. There are approximately 8,000 students who are overdue and require catch-up immunizations. The WECHU will also offer community immunization clinics for students from April 2022 to August 2022 and we are willing to support Primary Care Providers to administer vaccines to their patients free of charge.
  
  Starting tomorrow, February 18, the 12-17 year age group will be eligible for 3rd doses if they are 6 months post their second shot. Vaccine approvals for the 0-4 year age group will likely come at the end of the second quarter of this year.
  
  J. Lund questioned the consent process for children between 12-17 years and the fact that they can be vaccinated without parental permission. Dr. S. Nesathurai noted that in medicine consent is not defined by age but by the individual’s ability to understand the risk versus the benefit around treatment, but his preference would be for young people to have this dialogue with their parents or guardians. N. Dupuis said that there is no age of consent under the Health Care Consent Act, and it is up to the health practitioner to determine if an individual, of any age, has an understanding of the treatment provided. All health units provide the same messaging, as does the Ministry of Health as it relates to the rollout of vaccine, to encourage young individuals to have this dialogue with their parent or guardian. This is not specific to COVID and we would not refuse health care services to a young person who is capable and has consented for themselves. We appreciate this is a challenging topic. All of our school-based clinics are after hours making it more flexible for families to attend together.
  
  Motion: That the information be received.
  CARRIED
4. alPHa Winter Symposium, February 25, 2022
  
  The alPHa Winter Symposium is taking place virtually on Friday, February 25 and Board members are encouraged to attend if they wish to do so. The deadline to register is tomorrow, February 18, 2022.
  
  Motion: That the information be received.
  CARRIED
Correspondence
1. Greater Essex Catholic District School Board – Letter to Hon. Minister Stephen Lecce – Resumption of a supported plan for tracking and public reporting of COVID-19 in schools
2. Halliburton, Kawartha, Pine Ridge Public Health – Letter to Hon. Christine Elliott – Support for Local Public Health
3. Peterborough Public Health – Letter to Hon. Christine Elliott – Support for Local Public Health
4. Peterborough Public Health – Letter to Hon. Christine Elliott – Support for the Windsor-Essex County Health Unit’s Resolution to the Province of Ontario to amend the Immunization of School Pupil’s Act (ISPA) to include COVID-19 as a designated disease
5. Conseil Scolaire Catholique Providence – Letter to the Hon. Stephen Lecce – Support for the Windsor-Essex County Health Unit's Resolution to the Province of Ontario to amend the Immunization of School Pupil's Act (ISPA) to include COVID-19 as a designated disease
6. City of Windsor – City Council Decision CR22/2022 – January 17, 2022 – that the City of Windsor Council Support the WECHU in establishing a Consumption and Treatment Services Site in the City of Windsor post-approval from the provincial and federal governments
7. Ministry of Health – Letter from Hon. Christine Elliott – to Windsor-Essex County Health Unit advising of one-time funding up to $369,900 for the 2021-22 funding year and one-time funding up to $945,600 for 2022-23 funding year to support the provision of public health programs and services in our community, an extension to one-time mitigation funding to ensure municipalities do not experience any increase as a result of cost-sharing change for 2022, and funding to support the Ontario Seniors Dental Care Program for eligible low-income seniors
8. Ministry of Health – Letter from Chief Medical Officer of Health, Dr. Kieran Moore – to Windsor- Essex County Health Unit as a follow up to the Letter from the Hon. Christine Elliott noting that WECHU’s maximum total funding under the Accountability Agreement with the Ministry of Health for 2021-22 to be $29,363,300 ($17,684,500 in base funding and $11,678,800 in one-time funding)
9. Peterborough Public Health – Letter to Hon. Christine Elliott – Enhancing Uptake of 3rd COVID-19 Vaccine Doses and Proof of Vaccine Record – For Support
10. City of Windsor – Council Report C 27/2022 – Updates regarding the Operation of the IRC serving Temporary Foreign Workers, city-wide
Committee of the Whole (CLOSED SESSION, in accordance with Section 239 of the Municipal Act)
The Board commenced with the Committee of the Whole session at the opening of the board meeting.
Next Meeting: At the Call of the Chair, or March 24, 2022 – Via Video
Adjournment
Motion: That the meeting be adjourned.
CARRIED
The meeting adjourned at 5:10 pm.

RECORDING SECRETARY: L. Damphouse

SUBMITTED BY: N. Dupuis

APPROVED BY: WECHU Board of Health, March 24, 2022

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January 20, 2022

Agenda
January 2022 Board of Health Meeting - Agenda

Meeting held via video: https://youtu.be/wPLC3gHLecA

Call to Order
Board Elections
Agenda Approval
Announcement of Conflict of Interest
Update (Dr. S. Nesathurai)
1. COVID-19 Update (Dr. S. Nesathurai)
2. WECHU Operations Update (N. Dupuis)
Approval of Minutes
1. Regular Board Meeting: December 16, 2021
Business Arising
1. Consumption and Treatment Services Update (E. Nadalin)
Consent Agenda
1. INFORMATION REPORTS
  1. Smoking Cessation Programing and Vaping Supports (E. Nadalin)
  2. Influenza Vaccine Update (K. McBeth)
  3. COVID-19 Surveillance and Epidemiology (N. Dupuis)
  4. December Communications Recap (E. Nadalin)
2. RESOLUTIONS/RECOMMENDATION REPORTS – None
New Business
1. Fluoride Update – ENWIN Report (N. Dupuis)
2. CEO Quarterly Compliance Report (N. Dupuis)
3. Project Governance Committee – December 10, 2021 Meeting Minutes (J. Lund/N. Dupuis)
Correspondence
1. Town of Kingsville – Letter to Windsor-Essex County Health Unit CEO, Nicole Dupuis, and Acting MOH, Dr. Shanker Nesathurai – Resolution for WECHU to withdraw its Letter of Instruction for capacity limits for restaurants and bars; that WECHU fully enforce current requirements of their section under the ROA to ensure those who are not in compliance with regulations are addressed; and that WECHU increase opportunities for youth vaccination in the county
2. Grey Bruce Public Health – Letter of Support for the Windsor-Essex County Health Unit – for the province to provide one-time funding to support recovery and catch up efforts over a multi-year period (2022-2024) for communities negatively impacted by the COVID-19 pandemic
3. City of Windsor – Resolution in Support of the Windsor-Essex County Health Unit – In support of the Windsor-Essex County Health Unit's Resolution dated November 23, 2021 recommending that the Province of Ontario amend the Immunization of Student Pupils Act (ISPA) where students are required to be immunized against designated diseases, and to include COVID-19 as a designated disease
4. City of Windsor – Resolution in Support of correspondence from Windsor-Essex EMS, Erie Shores Health Care and Chatham-Kent MP Dave Epp – that City of Windsor Administration write to the Federal Government regarding Temporary Foreign Agriculture Workers requesting changes be made as soon as possible around mandatory immunization immediately upon entry into Canada, as well as extending funding for the Isolation and Recovery Centre (IRC) for migrant workers beyond March 31, 2022
Committee of the Whole (Closed Session in accordance with Section 239 of the Municipal Act)
Next Meeting: At the Call of the Chair February 17, 2022 – Via Video
Adjournment

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Information Report
Influenza Vaccine Update

SUBMITTED BY:

Healthy Schools Vaccine Department

DATE:

January 20, 2022

SUBJECT:

Influenza Vaccine Update

BACKGROUND

The Windsor-Essex County Health Unit (WECHU) plays a key role in the implementation of the Ministry of Health’s Universal Influenza Immunization Program (UIIP) which offers influenza vaccine free of charge each year to all individuals six months of age and older who live, work, or attend school in Ontario. The WECHU receives influenza vaccine shipments from the Ontario Government Pharmacy (OGP) and is responsible for the distribution to local health care providers and approved facilities in the community. Allocation to providers is based on total community allocation, number of clients to be served, past usage by the provider, available fridge space, and the proportion of high-risk clients the provider is responsible for. As of December 7, 2021 there were no laboratory-confirmed cases of influenza in Windsor and Essex County (WEC).

SUMMARY OF VACCINE ALLOCATION & DISTRIBUTION

The WECHU received initial shipments of the influenza vaccine on September 21, 2021. In total, the WECHU received 110,990 doses of the vaccine from the Ministry. Of these, 27,430 doses were the High-Dose Quadrivalent Inactivated Vaccine (HD-QIV) for individuals 65 and over; and 10,000 doses were the standard dose Adjuvanted Trivalent Vaccine (TIV-adj) for individuals 65 and over.

As of December 9, the WECHU has distributed 83% (92,240 doses) of our total allocation of the influenza vaccine, 85% (62,580 doses) of the QIV, 100% (27,430 doses) of the HD-QIV, and 22% (2,230 doses) of the TIV-adj to the community. This includes 37 long-term care facilities and registered retirement homes, 4 hospitals, and approximately 200 healthcare providers. The OGP distributed the influenza vaccine directly to 124 pharmacies in WEC that were approved by the Ministry of Health and at the time this report was written, pharmacies have administered 35,714 doses to WEC residents.

	QIV	High Dose - QIV	Adjuvanted TIV	Total
# of doses of flu vaccine the WECHU has received from the Ministry	73,560	27,430	10,000	110,990
# of doses of flu vaccine the WECHU has distributed to the Community	62,580	27,430	2,230	92,240

HIGH DOSE-QIV

Although the WECHU is out of stock of the HD-QIV, and will not be available for the remainder of the season, the TIV-adj is still available for individuals 65 and over. There is no preferential recommendation for HD-QIV over TIV-adj or QIV. National Advisory Committee on Immunization (NACI) states that all three vaccines protect against influenza, the most important thing is for seniors to be vaccinated.

LONG-TERM CARE/RETIREMENT HOMES

The initial supply of influenza vaccine was prioritized for the immunization of high-risk individuals, such as residents and staff of long-term care homes and retirement homes. Overall, the WECHU has distributed 5,140 influenza vaccine doses to 19 long-term care homes, and 2,480 doses to 18 registered retirement homes in WEC. A further breakdown is provided below:

	QIV	High Dose – QIV	Total
# of doses of flu vaccine the WECHU has distributed to Long-Term Care Homes	2,690	2,450	5,140
# of doses of flu vaccine the WECHU has distributed to Registered Retirement Homes	920	1,560	2,480

CURRENT INITIATIVES

The WECHU continues to support widespread availability of the influenza vaccine in our community by working collaboratively with many community partners, including those in primary care, to identify service gaps and promote vaccine uptake.

The WECHU continues to raise awareness of the risks of contracting influenza (especially for high-risk groups), and the importance of being vaccinated amongst the COVID-19 pandemic through our social media platforms (i.e., Facebook, Twitter, and Instagram).

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Information Report
Smoking Cessation Programing and Vaping Supports

SUBMITTED BY:

Chronic Disease and Injury Prevention Department (CDIP)

DATE:

January 20, 2022

SUBJECT:

Smoking Cessation Programing and Vaping Supports

BACKGROUND

Tobacco remains the leading cause of preventable disease and death in Canada. Tobacco use and exposure to second-hand smoke are linked to cancer, heart disease, and several other diseases. Locally the burden of premature illness and death caused by smoking remains high in Windsor and Essex County with one in five adults (19.6%) reporting that they currently smoke tobacco.¹

In addition to tobacco smoking, the rise of vaping or e-cigarette use, particularly in youth, has been a concern from both health officials and local schools in Windsor-Essex. In Windsor-Essex, 6% of grade 9 to 12 students are current smokers and 26% of students have used an e-cigarette.² In Ontario, while the rate of past year use of tobacco cigarettes has been declining (from 7% to 5% from 2017-2019), the past year use of e-cigarettes doubled from 11% to 23% in the same period.³ Vaping can expose youth to chemicals that could negatively impact their health in several ways, such as lung damage, nicotine dependence, and negative effects on brain development, including memory and concentration.⁴

CURRENT INITIATIVES

Tobacco and Vaping Cessation

The health unit has continued to provide eligible Windsor-Essex County residents with individual cessation programming throughout the pandemic, where clients enter the program by self-referral, or by referral from a community partner. Through a one-on-one cessation program, clients are provided with behavioural counseling sessions and up to 16 weeks of nicotine replacement therapy (NRT) such as patches or gum. Follow-up counseling sessions are also provided to active clients for additional support and adjustment of their NRT dosing as needed.

In 2021, 107 new clients were added to the program with nearly 600 counselling sessions completed. Currently, there are 53 active clients enrolled in the program who meet with the counsellor on a weekly or bi-weekly basis to ensure goals are being met, challenges are being addressed, and NRT dosage remains appropriate.

Tobacco and Vaping Prevention with Local School Boards

To address rising rates of vaping among youth, the WECHU Chronic Disease and Injury Prevention Department and Healthy Schools Department developed a toolkit for educators. This toolkit includes a presentation for high school students, posters, and educational handouts. This toolkit will continue to be promoted to schools and community partners in 2022.

With limitations to in-person school access in 2021, health promotion support related to tobacco and vaping moved to a virtual format. Health unit staff provided virtual trainings for parents and staff as well as smoking and vaping presentation to students led by Tobacco Vaping Enforcement Officers and Healthy Schools Department Public Health Nurses. Assistance in education and enforcement was also provided by Tobacco and Vaping Enforcement Officers to address concerns of smoking and vaping in and around school property. Ongoing support of these initiatives will continue to be prioritized in the current school year as staffing allows.

References

The Windsor-Essex County Health Unit. (2019). Community needs assessment: June 2019 update. Retrieved from https://www.wechu.org/sites/default/files/edit-resource/em-community-needs-assessments-report-2019/cnareport2019.pdf
University of Waterloo. (2018). COMPASS Study data (Cannabis use, Obesity, Mental health, Physical activity, Alcohol use, Smoking, Sedentary behavior).
Centre for Addiction and Mental Health. (2020). Ontario Student Drug Use and Health Survey Data Brief. Retrieved from https://camh.ca/-/media/files/pdfs---ebulletin/osduhs_databrief_march2020_drugusehighlights-pdf.pdf
Health Canada. (2020). Risks of vaping. Retrieved from https://www.canada.ca/en/health-canada/services/smoking-tobacco/vaping/risks.html
Centre for Addiction and Mental Health. (2020). Ontario Student Drug Use and Health Survey Data Brief. Retrieved from https://camh.ca/-/media/files/pdfs---ebulletin/osduhs_databrief_march2020_drugusehighlights-pdf.pdf

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Information Report
December 2021 - Communications Update

SUBMITTED BY

Communications Department

DATE

January 2022