Board of Health Meeting Documents

1. Call to Order
2. Agenda Approval
3. Announcement of Conflict of Interest
4. Update (W. Ahmed)
   1. COVID-19 Update
5. Approval of Minutes
   1. Regular Board Meeting: September 17, 2020
6. Business Arising
7. Consent Agenda
   1. INFORMATION REPORTS
      1. Q3 Quarterly Report (L. Gregg)
      2. Influenza Season 2020/2021 (K. McBeth)
      3. Safe Return to School – COVID-19 Engagement, Resources and Collaboration (N. Dupuis)
      4. September Communications Recap
   2. RECOMMENDTION REPORTS – None
8. Board Correspondence – None
9. New Business
10. Other Board of Health Resolutions/Letters – For information
    1. Letter from the Ministry of the Solicitor General – Enforcement and Amendments under the Reopening Act, 2020 24
    2. Letter from Town of Lakeshore – Resolution passed – that Lakeshore Council request that the WECHU notify businesses prior to releasing names of businesses where persons with COVID-19 have attended 28
11. Committee of the Whole (Closed Session in accordance with Section 239 of the Municipal Act)
12. Next Meeting: At the Call of the Chair November 19, 2020 – Via Video
13. Adjournment

1. Call to Order
2. Agenda Approval
3. Announcement of Conflict of Interest
4. Update (W. Ahmed)
   1. COVID-19 Update
5. Approval of Minutes
   1. Regular Board Meeting: July 16, 2020
6. Business Arising
   1. School-Focused Nursing Recruitment (D. Sibley)
7. Consent Agenda
   1. INFORMATION REPORTS
      1. July, August Communications Recap
   2. RECOMMENDTION REPORTS – None
8. Board Correspondence – None
9. New Business
   1. WECHU 2020-21 Public Health Funding (T. Marentette/L. Gregg)
   2. Extraordinary Cost Reimbursement Process (L. Gregg)
10. Other Board of Health Resolutions/Letters
    1. Simcoe-Muskoka District Health Unit – Letter to the Honourable Christine Elliott – urging the immediate provision of the funding allocations to local boards of health regarding the COVID-19 Extraordinary Expenses and for the School-Focused Nurses in order to enable a response by local public health units that is unobstructed by local financial shortfalls
    2. WECHU Response to Town of Kingsville, Town of Essex and Town of Amherstburg – Request for more detailed information and data regarding the spread of COVID-19 in Essex County – For information
11. Committee of the Whole (Closed Session in accordance with Section 239 of the Municipal Act)
12. Next Meeting: At the Call of the Chair October 15, 2020 – Via Video
13. Adjournment

RECORDING SECRETARY:

SUBMITTED BY:

APPROVED BY:

1. Call to Order
2. Agenda Approval
3. Announcement of Conflict of Interest
4. Update (W. Ahmed)
   1. COVID-19 Update
5. Approval of Minutes
   1. Regular Board Meeting: June 18, 2020
6. Business Arising
7. Consent Agenda
   1. INFORMATION REPORTS
      1. Effect of climate change of invasive mosquitoes, Zika Virus, and migrant worker health in Windsor-Essex
         (K. McBeth)
      2. June Communications Recap
   2. RECOMMENDTION REPORTS
      1. 2020 Budget Amendments (T. Marentette/L. Gregg)
8. Board Correspondence – None
9. New Business
   1. COVID-19 Task Force (T. Marentette)
10. Other Board of Health Resolutions/Letters
    1. Resolution from Town of Essex – Spread of COVID-19 in our Farm Worker Population (T. Marentette)
11. Committee of the Whole (Closed Session in accordance with Section 239 of the Municipal Act)
12. Next Meeting: At the Call of the Chair August 20, 2020 – Via Video
13. Adjournment

1. Call to Order
   Board Chair, Gary McNamara, called the meeting to order at 4:03 p.m.
2. Agenda Approval
   Addition to agenda (Requested by Tracey Bailey):
   New Business, Section 9.2 – Resumption of Water Testing and Utilizing a Third Party Contract

   Addition to agenda (Requested by Tracey Bailey):
   Proposed Amendments to Enhance the Section 22 Class Order – to be discussed in-camera in Committee of the Whole
   Moved by: Tracey Bailey
   Seconded by: Ed Sleiman
   That the agenda be approved.
   CARRIED

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

      Dr. W. Ahmed provided an update on the current status of COVID-19 cases in our region. We currently have 1,857 cases with 69 deaths. There are 6 workplace outbreaks, 1 being in manufacturing and 5 in the Agri-sector. There are four farms that have most of the cases amongst those in the Agri-sector with 143 active cases and solutions for isolation and accommodations are being discussed. Community transmission remains low, but it is still important to keep close contacts at a minimum. The messaging will be the same when Windsor-Essex moves to Stage 3.

      There are currently a number of partners (WECHU, OMAFRA, Ministry of Health, Ministry of Labour, Ontario Health, Canadian Red Cross) working together to build a system for testing, isolation and accommodations for the Agri-sector. The Canadian Red Cross is supporting 2 hotels in the region for self-isolation and we are participating in all conversations to provide our public health perspective. We are speaking daily with Dr. David Williams, the Chief Medical Officer of Health at the Ministry of Health, and are hoping to have a good strong system in place, and possibly some new initiatives for Ontario Health testing Agri-farm workers, in the next week.

      Dr. Ahmed noted that Dr. Alex Summers (AMOH, Middlesex-London Health Unit) has joined us in today’s Board of Health meeting and was working with us in Windsor to help support with protocol and assessing the farm situation. As a result of working together, we created an outbreak case and contact management document for our work with the Agri-farm sector and have shared it with the Ministry which they will use as a tool for the rest of the province. On behalf of the Board of Health, G. McNamara thanked Dr. Summers and his team for their assistance with the Agri-sector.

      Moved by: John Scott
      Seconded by: Tracey Bailey
      That the information be received.
      CARRIED

5. Approval of Minutes
   1. Regular Board Meeting: June 18, 2020
      Moved by: John Scott
      Seconded by: Joe Bachetti
      That the minutes be approved as amended.
      CARRIED
6. Business Arising – None
7. Consent Agenda

   That the information reports be received.
   CARRIED

   1. INFORMATION REPORTS
      1. Effects of Climate Change on Invasive Mosquitos, Zika Virus, and Migrant Workers Health in Windsor-Essex (K. McBeth)
         Brought to the Board for information.
      2. June Communications Recap (L. Gregg)
         Brought to the Board for information.

      Moved by: Ed Sleiman
      Seconded by: Judy Lund

   2. RECOMMENDATION REPORTS
      1. 2020 Budget Amendments (T. Marentette/L. Gregg)

         T. Marentette noted that this is an amendment to the 2020 Budget. On March 20, 2020, the WECHU reported its first case of COVID-19, and we now have 1,857 cases and 69 deaths. We continue to have unique challenges in our health unit related to many bunkhouse inspections in farm operations, with 8,000 to 10,000 Temporary Foreign Workers across 176 farms in our region. Our public health inspectors inspect bunkhouses, over 900 so far, in addition to the 44 Long-Term Care Homes and Retirement Homes in our community.

         In May, the Ministry asked health units to follow up with positive cases within 24 hours. At that time, we had 656 cases and were already stretched for resources. We knew that as COVID progressed we did not have enough staff to continue with the requirements that were needed for the pandemic, wherein we made decisions under the Medical Officer of Health to defer or reduce some public health programming. We instituted an IMS Structure to respond to the pandemic. Under the Emergency Management and Civil Protection Act,we were able to redeploy approximately 80 staff across different programs and schedules to devote our resources where needed to protect the public, 2 shifts 7 days a week.

         In the last week of June, we reached out to other health units for assistance. Our HR and IT Departments assisted in onboarding and orientation (approximately 11 full time and 10 casual health unit staff). Dr. Alex Summers (Associate Medical Officer of Health, Middlesex London) attended on-site for two weeks and continues to support us remotely with the Agri-sector. In addition, we received the services of a field epidemiologist for three weeks through the Public Health Agency of Canada (PHAC).

         As we move forward with COVID-19, and with the province slowly reopening, it still remains the priority for 2020. With all of our resources stretched to capacity we are submitting a proposal requesting a full time Associate Medical Officer of Health (AMOH), a Manager for the COVID Response Team, Clerical Support, PHNs, RPNs, Public Health Inspectors and an Epidemiologist, to help meet the needs of the pandemic and allow for some staff to support other programs we need to reintroduce. E. Sleiman asked if the request for an AMOH is permanent or just through the pandemic. T. Marentette advised that the request is for a full time permanent AMOH. The work of COVID will not end after this year, and for a health unit of this size, it is in the best interest for our community.

         L. Gregg said that we have compiled our operating budget from September to fiscal 2020 and the total operating costs for 22 FTE is approximately $857,329. These FTEs would be deployed to work from home, so as to not incur infrastructure costs in office space. If the Ministry of Health does not fund any portion of these FTE’s, the increase in costs would be absorbed by municipalities. Contributions would be $466,726 from the City of Windsor; $390,098 from the County of Essex; and $505 from the Township of Pelee. Should the Ministry of Health come forward with funding for this particular initiative, and we use the funding allocation of 70/30, that would decrease contributions from the municipalities to $257,200 for the remainder of 2020.

         On an annual basis, under the scenario that the municipalities would bear the complete burden of the FTEs, the impact would be $2,208,953 resulting in an impact to the City of Windsor of $1,200,000 and $1,000,000 to the County of Essex and $1,300 to the Township of Pelee. Should the Ministry provide funding on the 70/30 basis those costs would decrease to $662,686 broken down to $360,000 to the City of Windsor, $301,000 to the County of Essex, and $390 to the Township of Pelee. In May of 2020, the WECHU submitted a business case to the Ministry similar to the 2020 Budget Amendment.

         T. Bailey said it is her understanding then that there is some surplus available for re-allocation and does the health unit have some sense there will be resources coming their way to take the pressure off municipal funding needed.

         L. Gregg noted there was a letter from the Ministry based on extraordinary costs related to the pandemic, and at some point in the year we would be asked to accumulate and submit those costs. At this time, we are not exactly sure what the Ministry would define as extraordinary costs.

         T. Bailey noted that the health unit has her support.

         R. Bortolin said that under these scenarios has there been any conversation with the Ministry where this shortfall could be made up by support from either the provincial or the federal governments through relief programs. G. McNamara noted that on talks yesterday with the province and other mayors the response was clear from all other jurisdictions around the province, i.e. that municipalities finance public health and other COVID affected areas and if the province wants to soften the burden to municipalities, they need to come through with more funding for health units.

         R. Bortolin asked if the $857,329 is a total surplus or just to cover costs for the new FTEs. Also, what is the overall deficit expected to be by the end of December.

         L. Gregg advised that we are currently working on that estimate and believe it was around mid-May timeframe that we anticipated approximately $1M in deficit factoring in a team such as this. The WECHU is looking to bring a report to the Board at a later date indicating the anticipated deficit.

         R. Bortolin noted to the Chair that he would like to put forward a friendly amendment to the motion included in the 2020 Budget Amendment Recommendation Report, indicating that final deficit numbers be forwarded to the Obligated Municipalities as soon as possible. In addition, a request to the Obligated Municipalities to write a letter to the Province of Ontario and the Ministry of Health for financial support to fund the shortfall.

         Chair, G. McNamara believes that this is a reasonable ask. There is no doubt that the municipalities need to push the provincial and federal governments for assistance and this was an ask by the majority of the municipal sectors, i.e. the Municipal Finance Officers Association (MFOA), the Federation of Canadian Municipalities (FCM) and the Association of Municipalities of Ontario (AMO).

         Moved by: Tracey Bailey
         Seconded by: Rino Bortolin
         That the 2020 Budget Amendment be approved to support the recruitment of 22 FTEs (the reference to 19 FTEs in the report was verbally corrected), including an Associate Medical Officer of Health; that the Windsor-Essex County Board of Health direct Administration to provide notice, as required under section 72(6) of the HPPA, to the Obligated Municipalities of the additional contributions required to fund the COVID-19 Response Team for the remainder of the 2020 fiscal year; that the final deficit numbers be provided to the Obligated Municipalities as soon as possible; that the Obligated Municipalities write to the Province of Ontario and the Ministry of Health requesting financial support for the shortfall.
         CARRIED

8. Board Correspondence – None
9. New Business
   1. COVID-19 Task Force
      T. Marentette noted that during the Committee of the Whole on June 18, 2020, the COVID-19 Task Force was discussed which includes the members of the Executive, namely the Chair, Vice Chair and Treasurer of the Board, the CEO and MOH, as well as Rino Bortolin, representing the City of Windsor. After consulting with legal counsel, it was determined that the formation of the COVID-19 Task Force should be discussed and membership approved by the Board as a whole in open session, similar to how other committees of the Board are formed.
      Moved by: Fabio Costante
      Seconded by: Ed Sleiman
      That the COVID-19 Task Force be approved.
      CARRIED
   2. Resumption of Water Testing and Utilizing a Third-party Contract – Addition to Agenda (T. Bailey)

      With the COVID-19 pandemic and resources at full capacity at the WECHU, the health unit was forced to make decisions on deferring programs, one of those programs being beach testing. T. Bailey put forth that the health unit fulfil their responsibilities for beach testing and contract out those services due to capacity issues. A letter will be forthcoming from the Town of Lakeshore and the Town of Essex who are conducting their own testing. Municipalities do not have the mechanisms for this and is looking for the Board to support moving forward in some way to keep beaches safe. Another barrier for municipalities is the communication piece with messaging to the public.

      Dr. W. Ahmed said that the pandemic has had a significant impact on staff at the WECHU. Our public health inspectors have been working to support the prevention of outbreaks in Long-Term Care Homes and Retirement Homes, supporting restaurants with the opening to Stage 2 and education and enforcement activities and Section 22 Orders if those served are not compliant. This decision was based fully on resources, and the WECHU is one of the few health units that still conducts beach testing. When beach sampling is conducted water samples are sent to the public health lab and it takes 2 days to receive results. This can bring a false sense of security with testing results, as water samples can change daily. G. McNamara asked if there was an opportunity through the Canada Summer Program for Biology Students from the University or College to assist with testing or to reach out to MPP’s for support. T. Marentette advised that we are using students for our vector-borne programs and enhanced surveillance, and beach sampling not only includes students but experienced public health inspectors as well as epidemiologists. All of the information is tracked and posted to our website which involves our communications team, making this a time and resource intensive program. If a sample identifies that we need to close the beach, that also requires resampling as well. To say it can be done easily with students, it’s just not that simple. Municipalities can consider signage on the beaches that they are not currently being tested.

      T. Bailey asked how challenging the communication piece would be for WECHU if the service was contracted out. T. Marentette advised that they have redeployed a Director for the communication piece for COVID which has taken a significant amount of time. We will need to have internal discussions of what we can and cannot do as the province reopens. We currently have 1,500 people on the waiting list for dental services and cannot go any leaner than we are. As we start to resume these services this will leave a gap in resources for COVID.

      T. Bailey said she would like to put forward a motion.

      Moved by: Tracey Bailey
      Seconded by: Gary Kaschak

      That the WECHU Board of Health make a decision whether or not to go forward to resume beach testing or contract out to a third-party.
      R. Bortolin said that although he understands the desire to reinitiate testing and that it is a valuable resource, he has concerns if we approve this motion as Dr. Ahmed and T. Marentette just mentioned that if we resume beach testing we would need to displace resources. He would like to see what program(s) would be displaced if the WECHU resumes beach testing. He asked T. Bailey as the mover of this motion would she consider an amendment or a deferral to understanding what public health programs will be displaced should beach testing resume before we consider or support this motion, and what the impact would be.

      G. McNamara noted that staff resources are also his concern. All public health programs are important, but if staff are working 7 days a week and the WECHU is saying that it needs 22 FTEs to deal with services to meet the challenges of the pandemic, adding more programs would create more challenges. G. McNamara agrees with what R. Bortolin is stressing, such as a good compromise or an amendment to the motion, and to continue the conversation to see what programs would need to be deferred should beach testing resume. Contracting out would likely be the solution if testing would resume, as WECHU cannot afford to pull away resources from COVID support.

      E. Sleiman asked what the cost would be to resume the testing. T. Marentette said she would not know the cost of contracting out beach sampling, as the costs for testing is embedded in the program where there are protocols and procedures, and getting samples securely to the public health lab. The public health inspectors are trained to do that. When recruiting public health inspection students we recruit them early on in the year, as they are in high demand across health units. Even if municipalities took on the responsibility of testing, public health would still need to be involved. E. Sleiman said it would be too difficult to vote on something without knowing the cost.

      G. McNamara said that if municipal water divisions sample the water and send it out for testing (as they do under the Safe Drinking Act), the health unit would still need to be involved at some point when results are received.

      T. Marentette let the Board know that the public health inspectors did an initial assessment of all the beaches at the beginning of the season, which typically runs from May to September. G. Kaschak said with only 6 weeks to the end of the season, that he would support that the public health inspectors resume the services of testing.

      J. Bachetti said that in terms of the motion this is a fair ask of the health unit and a decision needs to be made, but notes that COVID-19 is currently the priority and whatever the board decides on testing, the municipalities can inform their residents. Dr. Ahmed noted that most health units do not conduct beach testing and samples can change quickly. Some beaches are open, but it is “swim at your own risk”. In August, the health unit will be very much involved in plans for reopening schools and staff are currently working 24/7 on the pandemic. There are still a lot of unknowns to come. Even if the municipalities conduct their own testing, public health will still need to be involved. It is “all hands on deck” now for the health unit with COVID-19. He feels that going to the beach is a leisure activity, and is concerned about using health unit resources for this.

      J. Lund agreed with J. Bachetti and R. Bortolin that without knowing the cost and what programs will be displaced, she cannot support the resumption of beach testing. The WECHU needs to look at its priorities, which is the pandemic, and they are already looking at increasing staff to meet their current needs.

      F. Costante asked Dr. Ahmed and T. Marentette if the health unit resumed beach testing would that take away resources from COIVD-19 and is beach testing a priority over COVID. T. Marentette said that under the Emergency Management and Civil Protection Act, which has been extended to July 29, 2002, it notes that health units can cancel or postpone services that are not related to responding to, preventing or alleviating the outbreak of the virus. All of WECHU’s resources are focused on the virus, and the order talks about reallocation of resources and prioritization for COVID-19. The WECHU continues to work with many farms across Essex County to decrease the transmission of COVID-19 which includes our nursing staff, our public health inspection staff and our management staff so, yes, it will take away resources from COVID-19, and that beach testing is not a priority over the pandemic.

      F. Costante said that it is clear where the priorities are and may we have a vote on this.

      G. McNamara said that the Board would vote on R. Bortolin’s amendment to T. Bailey’s Motion, and then the Motion itself. That information would need to be brought back to WECHU’s August Board meeting. R. Bortolin said that he will rescind his amendment to T. Baily’s Motion as deferring until the August Board meeting will be untimely to resume testing beaches. He will let T. Bailey’s Motion stand as is.

      Moved by: Tracey Bailey
      That the WECHU Board of Health vote on whether to go forward to resume beach testing or contract out to a third-party.
      All in favour: 3
      Opposed: 7
      DEFEATED

10. Other Board of Health Resolutions/Letters
    1. Resolution from Town of Essex – Request for Raw Data on Positive COVID-19 Cases in Essex County – That the Windsor Essex County Health Unit provide a detailed breakdown of data reporting on positive COVID-19 cases in our municipality and the region, based on classification relating to Travel, Close Contact, Community Contact and Agri-Farm as examples.
       Moved by: Rino Bortolin
       Seconded by: John Scott
       That the information be received.
       CARRIED
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 5:15 pm
    The Board moved out of Committee of the Whole at 5:50 pm
12. Next Meeting: At the Call of the Chair, or August 20, 2020 – Via Video
13. Adjournment
    Moved by: Tracey Bailey
    Seconded by: Rino Bortolin
    That the meeting be adjourned.
    CARRIED

The meeting adjourned at 5:51 pm.

1. Call to Order
2. Agenda Approval
3. Announcement of Conflict of Interest
4. Update (W. Ahmed)
   1. COVID-19 Update
   2. Children Count Update (N. Dupuis)
5. Approval of Minutes
   1. Regular Board Meeting: May 21, 2020
6. Business Arising
7. Consent Agenda
   1. INFORMATION REPORTS
      1. Cannabis Retail Applications & WECHU Response (N. Dupuis)
      2. WECHU WECHU Dental Services Restart (N. Dupuis)
      3. March, April, May Communications Recap
   2. RECOMMENDATION REPORTS
      1. 2019 Annual Financial Statements (L. Gregg)
8. Board Correspondence – None
9. New Business
   1. Environmental Health – Mosquito Tracking, Beach Testing (K. McBeth)
   2. Pandemic Pay (T. Marentette)
10. Other Board of Health Resolutions/Letters
    1. Letter to CAO’s – Bars/Restaurants Outdoor Patio Space (N. Dupuis)
11. Committee of the Whole (Closed Session in accordance with Section 239 of the Municipal Act)
12. Next Meeting: At the Call of the Chair July 16, 2020 – Via Video
13. Adjournment

1. Call to Order
   Board Chair, Gary McNamara, called the meeting to order at 4:06 p.m.
2. Agenda Approval
   Moved by: Fab Costante
   Seconded by: Rino Bortolin
   That the agenda be approved.
   CARRIED
3. Announcement of Conflicts of Interest – None
4. Update (W. Ahmed)
   1. COVID-19 Update

      Dr. W. Ahmed provided an update on the current status of COVID-19 in our region. We now have more than 1,200 with a significant number in the agri-farm sector. Community spread is decreasing but we are finding challenges within this sector. So far 346 workers have tested positive and we currently have 169 active cases across 8 farms. There have also been two deaths.

      Accommodations are a challenge along with compliance for self-isolation and a lack of understanding. From the employer’s end they are screening their workers, but once off the workplace some are not complying, i.e. physical distancing, congregating in numbers. Once in isolation the employers need to supply their workers with nutritious meals and basic supplies.

      EMS and ESHC have been attending on various farms and conducting in person health assessments based on referrals from our health unit, noting any further follow up. We issued Section 22 Orders on May 26 to all farms noting they keep their workers designated to working on one farm, as contract and temp agencies transport their workers to different farms, making tracking employees difficult. We strengthened the Section 22 Order on June 13 to include that employers provide access to workers via phone for case and contact management, and access to nutritious food and water. Once they are isolated or confirmed to be a case, the health unit calls them daily as we do with all cases and, if they are identified to need more medical assessment, they are referred to EMS or ESHC for a follow up in-person visit.

      There was testing launched by Ontario Health to have the Leamington Assessment Centre (Sherk Complex) bus employees from farms for asymptomatic surveillance testing. Testing numbers were low, as employers did not send their employees, but testing had expanded to farms who had symptomatic cases.

      Mandatory testing is not in place anywhere in Canada with any population for COVID-19 or any other diseases like HIV or TB. It is perceived that the recent COVID testing in Long-term care and Retirement Homes was mandatory, but it was not, and some residents and staff declined the testing. Mandatory testing goes into the area of being contradictory to the Human Rights Charter and we have not seen anyone use that authority, at any level, to suggest that a local Medical Officer of Health can use their power to force someone to get tested. This was also validated further by the Province and the Premier that it has to be voluntary. From a public health perspective we conducted random testing throughout all our municipalities, and over the course of 10 days we tested approximately 5,000 people.

      The Temporary Foreign Worker (TFW) Program is Federal. Workers are brought in for specific purposes, need to meet certain criteria and follow municipal requirements. Public health’s role is to ensure accommodations are in compliance with guidelines but not specific to COVID. The role for the municipality is to ensure that safety and fire guidelines are maintained. The Ministry of Labour and OGVG also play a role in representing the industry. From a disease perspective, an accommodation strategy to house 8,000 – 10,000 migrant workers is needed, both for the short and long term, to restrict the number of people living in congregate settings, and minimizing interaction. COVID is exposing health, income and housing inequities and a coordinated approach at various levels of government is needed to support them. When TFWs arrived they isolated for 2 weeks, tested negative then began working. Those who contracted COVID-19 were exposed here, they did not bring it here.

      From a public health perspective, our team is not immigration. Undocumented workers are treated as residents of Windsor Essex and we do our part through case and contact management to prevent the spread of disease. We spoke this morning with the Federal Health Minister, our Board Chair and other partners, that there has to be clear messaging from all levels of government to ensure that workers in isolation are getting paid either by their employer or through another mechanism.

      WECHU is also working with The Ontario Ministry of Agriculture, Food and Rural Affairs (OMAFRA) and the Ontario Greenhouse Vegetable Growers (OGVG). They have been very cooperative in working with the farms to protect their workers, and noted that it is becoming stressful for them from a food chain supply perspective. This is peak time for the agri industry, products are perishable, and it’s not the same as shutting down manufacturing. There needs to be a way to keep farms operational, contain the virus, and isolate those who need to get well.

      Moving from Stage 1 to Stage 2 is a provincial decision. We touch base weekly with the Chief Medical Officer of Health for the province and provide indicators for a sense of where we are heading and what the trajectory looks like. Combining that, the Ministry compares us to the rest of the province or other health units, along with health system capacity to manage a possible surge in cases, i.e. ventilators, ICU support. This is not something that WECHU decides.

      On sharing information, the WECHU website is updated daily with current numbers, and in addition, Dr. Ahmed and T. Marentette do a Q&A session with the media for 30 minutes daily. Media releases with relevant information is also on our website. Our call centre receives about 150 calls per day on various issues, and our staff does their best to answer any questions.

      Under the Emergency Order, the Canada/US Border remains closed except for essential workers, products and trade.

      Moved by: John Scott
      Seconded by: Rino Bortolin
      That the information be received.
      CARRIED

   2. Children Count Update (N. Dupuis)

      N. Dupuis noted WECHU’s Resolution related to the Children Count Tool-kit, which was acknowledged by Dr. David Williams, Chief Medical Officer of Health in Ontario, in a letter to Nicole Dupuis, Director of Health Protection. The Ministry of Education has also reached out to N. Dupuis advising that they will be using the Children Count Tool-kit as a framework for reopening schools in the fall. The WECHU has developed a two-page document for the Ministry to implement their reopening plan.

      Moved by: Dr. Debbie Kane
      Seconded by: Judy Lund
      That the information be received.
      CARRIED

5. Approval of Minutes
   1. Regular Board Meeting: May 21, 2020
      E. Sleiman asked that the May 21, 2020 minutes be revised to show that he was present for the entire meeting. The minutes will be updated to reflect this change.
      Moved by: Judy Lund
      Seconded by: Ed Sleiman
      That the minutes be approved.
      CARRIED
6. Business Arising – None
7. Consent Agenda
   1. INFORMATION REPORTS
      1. Cannabis Retail Applications & WECHU Response (N. Dupuis)
         Brought to the Board for information.
      2. WECHU Dental Services Restart (N. Dupuis)
         Brought to the Board for information.
      3. March, April, May Communications Recap (L. Gregg)
         Brought to the Board for information.

      Moved by: Judy Lund
      Seconded by: Dr. Debbie Kane
      That the information reports be received.
      CARRIED

   2. RECOMMENDATION REPORTS
      1. 2019 Annual Financial Statement (L. Gregg)
         L. Gregg noted that the Audit Committee met on June 8, 2020 to discuss the Windsor-Essex County Health Unit December 31, 2019 financial statements, the Healthy Babies Healthy Children March 31, 2020 financial statements and the Nurse Practitioner Program March 31, 2020 financial statements and all have been brought to the Board for approval.
         Moved by: Joe Bachetti
         Seconded by: Ed Sleiman
         That the financial statements be approved as presented.
         CARRIED
8. Board Correspondence – None
9. New Business
   1. Environmental Health – Mosquito Tracking, Beach Testing (K. McBeth)
      K. McBeth advised that Environmental Health is in its fourth week of implementing its vector borne program tracking and larviciding of mosquitos. Beach testing will not be conducted by the health unit this summer due to capacity issues, but all nine beach have received an initial risk assessment. R. Bortolin said that municipalities may pay for testing if they are willing.
      Moved by: John Scott
      Seconded by: Judy Lund
      That the information be received.
      CARRIED
   2. Pandemic Pay (T. Marentette)
      T. Marentette noted that WECHU received $161,000 for this initiative but we are awaiting more information and guidance from the Ministry on how these funds will be applied. Health Units are listed as eligible organizations and RN’s, RPN’s and NP’s are listed as eligible employees to receive pandemic pay based on their risk of exposure of COVID-19. Some of our nursing staff work have worked extensively on random drive through testing, attending at long-term care homes, migrant farm testing and congregate settings. Environmental health also attended at these initiatives on the front lines, although public health inspectors are not identified as eligible. J. Lund requested that a letter be sent to the Ministry communicating that other public health staff worked on the front lines with COVID-19. T. Bailey said that the Ministry is still determining what pandemic pay will look like and feels a letter to the Ministry at this time may be premature.
      Moved by: Judy Lund
      Seconded by: John Scott
      That the Board follow up with a letter to the Ministry of Health on eligibility of pandemic pay.
      Opposed: Tracey Bailey
      CARRIED
      Moved by: Judy Lund
      Seconded by: Dr. Debbie Kane
      That the information be received.
      CARRIED
10. Other Board of Health Resolutions/Letters
    1. Letter to CAO’s – Bars/Restaurants Outdoor Patio Space (N. Dupuis)
       The letter outlines the Province’s announcement to expanding outdoor patios for licensed establishments. This will require more signage and education and the health unit is here for support. R. Bortolin will continue conversations off-line with K. McBeth around various requirements and guidelines that will need to be followed.
       Moved by: Rino Bortolin
       Seconded by: Judy Lund
       That the information be received.
       CARRIED
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 6:15 pm
    The Board moved out of Committee of the Whole at 7:27 pm
12. Next Meeting: At the Call of the Chair, or July 16, 2020 – Via Video
13. Adjournment
    Moved by: Tracey Bailey
    Seconded by: Rino Bortolin
    That the meeting be adjourned.
    CARRIED
    The meeting adjourned at 7:27 pm.

1. Call to Order
   Board Chair, Gary McNamara, called the meeting to order at 4:04 p.m.
2. Agenda Approval
   Moved by: Fabio Costante
   Seconded by: Tracey Bailey
   That the agenda be approved.
   CARRIED
3. Announcement of Conflicts of Interest – None
4. Update (W. Ahmed)
   1. Coronavirus COVID-19 Update
      Dr. W. Ahmed provided an update noting there are currently 826 cases of COVID-19 in our community and 63 deaths, the majority in Long-Term Care Homes (LTCH). There are currently 9 LTCHs in outbreak, and a number have been rescinded. HThere has been a soft reopening of retail stores and some facilities across the province, but there is always the concern about a second wave and the public not following protective measures. We will be keeping a close eye on the number of cases in next 2-3 weeks for a better picture of the impact on openings.

      We have done presentations on the importance of testing the right people at the right time and many are finding it difficult what testing means and the results of those tests. We struggle with the community as well as some partners who want to test asymptomatic individuals, which can provide inappropriate data. We have completed testing in LTCHs and Retirement Homes in Windsor Essex, and there may be more interest in testing other congregate settings, i.e. migrant farms. We have seen about 50 cases so far and a good number are resolved, but there are still some active cases. This Saturday we will be doing enhanced testing at a local farm that has many cases with our team in collaboration with EMS. Many of you are aware that since the onset of the pandemic, our work here has significantly increased. We are working at double and triple capacity. Thanks to T. Marentette and our directors, we are increasing our capacity for case and contract tracing. From a testing perspective, we are planning to expand the role of our primary care providers. We will note for the media tomorrow how we are moving forward making tests accessible through primary care providers, and we will identify who these providers are. We are also working on a plan to do random testing in all of our municipalities (WECHU in partnership with EMS) to get a better idea of what is happening in each community. There are numerous businesses and organizations reaching out to us for guidance, i.e. University of Windsor, St. Clair College, and others as they plan on opening up services.

      G. McNamara said that as things open up the messaging must be that this is not over. Physical distancing still needs to happen. Dr. W. Ahmed agreed and said that we make it part of our daily messaging that opening up does not mean the virus is gone but increases changes of spreading. Testing is one snapshot of time, but distancing and handwashing are important to protect yourself and your family.

      J. Bachetti asked in terms of testing LTCH is there a plan concerning community home care where Personal Support Workers take care of patients in their home. Dr. W. Ahmed said that we are doing risk based testing and would rather reinforce that everyone take the appropriate precautions not to contact or spread the disease. If they are using PPE, and using it properly, it will not be transmitted to others. Just getting tested is not a defense.

      J. Lund asked about the status on testing the general population to see if they have already had the virus. Dr. W. Ahmed said that is the antibody test and would indicate if individuals were exposed to the virus and fought off the infection. Although not yet ready to release, the test has been recently approved in Canada.
      Moved by: Rino Bortolin
      Seconded by: Ed Sleiman
      That the information be received.
      CARRIED

5. Approval of Minutes
   1. Regular Board Meeting: February 20, 2020, April 16, 2020
      R. Bortolin asked that the February 20, 2020 minutes be revised to show that he was present for the meeting, via telephone, until 5:20 pm. The minutes will be updated to reflect this change.
      Moved by: Larry Snively
      Seconded by: Dr. Debbie Kane
      That the minutes be approved.
      CARRIED
6. Business Arising – None
7. Consent Agenda
   1. INFORMATION REPORTS
      1. 2020 Board of Health Competency Self-Evaluation Results and accompanying 2020 Report Card (T. Marentette)
         Brought to the Board for information.
      2. Consumption and Treatment Services Site – Location Consultation and Application Status (T. Marentette)
         The initial work involved getting the advisory committee together and determining criteria for next steps. We consulted with other sites and were advised to choose locations on set criteria followed by community engagement strategies to ensure all concerns are identified and mitigation plans discussed. This would need to go to our Board and the municipalities chosen for a location(s) for approval, and we still need to submit an application. WECHU has hired an individual on a contract basis to the end of the year.

         As things reopen, we believe we can go forward safely and create a site that will adhere to physical distancing requirements, but will look different than originally thought. The majority of our staff is currently dedicated to COVID work at this time, but we are moving forward with some programs and initiatives.

      3. Vaping Regulations and Legislation (N. Dupuis)
         Brought to the Board for information.
      4. WECHU COVID-19 Response and Program Updates (All)
         Brought to the Board for information.

      Moved by: Fabio Costante
      Seconded by: Rino Bortolin
      That the information reports be received.
      CARRIED

   2. RECOMMENDATION REPORTS
      1. 2020-21 Budget for Programs Funded by the Ministry of Children, Community and Social Services – Healthy Babies Healthy Children Program and Nurse Practitioner Program (L. Gregg)
         L. Gregg noted that funding by the MCCSS remained consistent from prior years. HBHC Programs are down from 27 FTE’s to 26.

         The NP program has a budget of 139k with an actual cost of $154k. The overage will be covered from cost-shared programming to support the salary of one FTE.
         Moved by: Ed Sleiman
         Seconded by: Tracey Bailey
         That the budget be approved as received.
         CARRIED

8. Board Correspondence – None
9. New Business
   1. Re-opening Businesses in W-E Webinar with Windsor-Regional Chamber of Commerce, May 28, 2020 (W. Ahmed)
      Dr. W. Ahmed noted we are planning a webinar/Q&A session in partnership with the Windsor-Regional Chamber of Commerce on how businesses can safely open and operate. The Chamber will provide us question in advance and we will prepare slides and documents for support. We are hoping that the session can be recorded and shared if anyone needs answers to their concerns on how to safely open up their business.

      G. McNamara asked Dr. W. Ahmed his advice regarding personal use of masks as businesses reopen, and what his recommendation would be when patronizing businesses. Dr. W. Ahmed made the recommendation last week that when businesses open up and distancing cannot be maintained a cloth mask should be worn if used appropriately. There has been some research done and cloth masks can be 50% -80% effective depending on the type of material. If using inappropriately, such as in a public setting and people touching surfaces touch their mask this can increase the risk of infection by transferring the virus onto their face.
      Moved by: John Scott
      Seconded by: Rino Bortolin
      That the information be received.
      CARRIED

10. Other Board of Health Resolutions/Letters
    1. WECHU Advocacy Letter for Radon Funding (K. McBeth)
       The letter outlines what the Board requested back in January from an Information Report on Radon. The letter was addressed to the Minister of Finance, the Honourable Bill Mourneau.
       Moved by: Judy Lund
       Seconded by: Fabio Costante
       That the information be received.
       CARRIED
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 4:59 pm
    The Board moved out of Committee of the Whole at 5:26 pm
12. Next Meeting: At the Call of the Chair, or June 18, 2020 Via Video
13. Adjournment
    Moved by: Rino Bortolin
    Seconded by: John Scott
    That the meeting be adjourned.
    CARRIED
    The meeting adjourned at 5:28 pm.

1. Call to Order
   Board Chair, Gary McNamara, called the meeting to order at 4:00 p.m. G. McNamara will relinquish the chair to Vice-Chair, John Scott, approximately 15 minutes into the meeting, due to another commitment.
2. Agenda Approval
   Moved by: Larry Snively
   Seconded by: Tracey Bailey
   That the agenda be approved.
   CARRIED
3. Announcement of Conflicts of Interest – None
4. Approval of Minutes
   1. Regular Board Meeting: February 20, 2020
      Moved by: Judy Lund
      Seconded by: Ed Sleiman
      That the minutes be approved.
      CARRIED
5. Business Arising
   1. Coronavirus (COVID-19) Overview
      1. Incident Management Report (Dr. W. Ahmed)
         Dr. W. Ahmed reported on the status of positive COVID-19 cases in the Windsor-Essex region noting that there are over 400 positive cases and 18 deaths to date. Testing is actively occurring at high risk Long-Term Care Homes to identify cases early. The case-doubling rate is slightly improving, but since we still have cases, we all need to continue to reinforce the messaging on physical distancing, washing your hands, and staying home if you are sick. We are participating on a number of tables at both the regional and provincial levels and are working with various partners in our community. From an Incident Management System perspective, our processes are working well and new documents continue to be released from the Ministry. As things progress we will continue to update the Board and the community.
         R. Bortolin asked if there was a sufficient amount of testing supplies available for the general public as well as front line workers. W. Ahmed advised that there are now two local Assessment Centres (Windsor and Leamington). Although there are enough tests, only those that are presenting with symptoms, or are suspect for COVID-19, will be tested. False positives and false negatives can result if the timing is not right for swabbing.
         F. Constante noted that Dr. Theresa Tam, Chief Public Health Officer of Canada, said that non-medical masks might slow down the spread of COVID-19. He asked where the health unit stood on this.
         Dr. W. Ahmed said that Dr. Tam’s and the WECHU’s messages on the use of non-medical masks align, but there are some risks, as well as some benefits, to wearing them. His concern is it may provide a false sense of security. There is the risk of touching the mask and contaminating it. He is not recommending that everyone wear them, but if anyone chooses to there is a proper way of donning and doffing them. 4:14 pm - Chair G. McNamara relinquished the chair to Vice Chair, J. Scott
         E. Sleiman asked if there are advantages of one mask over the other, i.e. n95, Surgical or homemade masks.
         Dr. W. Ahmed advised that there are different purposes for different masks.

         Surgical Mask
         If worn properly, a surgical mask is meant to help block large-particle droplets, splashes, sprays, or splatter that may contain germs (viruses and bacteria), keeping it from reaching your mouth and nose. Surgical masks may also help reduce exposure of your saliva and respiratory secretions to others but does not filter or block very small particles in the air that may be transmitted by coughs, sneezes, or certain medical procedures.

         N95 Respirators
         N95 respirators achieve a minimum filtration efficiency of 95% when worn properly. The edges of the mask form a seal around the nose and mouth. N95 respirators (not medical masks) are designed to reduce the risk of inhaling hazardous airborne particles and aerosols.

         Homemade Masks
         Homemade masks have some level of permeability and some viruses may not be filtered. The effectiveness depends on the type of material and the concern is the risk that people are not wearing them properly and touching their face, creating a false sense of security.

         J. Lund inquired about the supply of PPE for health care workers.
         Dr. W. Ahmed advised that we do not have the answers for all of the facilities, but we are providing masks, gloves and gowns wherever we can. The shortage of supply is everywhere. Supplies are coming in at a reduced rate, quantity and frequency, and we are advising the health care facilities to continue to order supplies through their regular supplies. Any healthcare workers who have concerns about PPE should discuss this with their employer. If they continue to have concerns, they can contact the Ministry of Labour who will look at the risk level and conduct an assessment.

         Dr. W. Ahmed said that there is the risk of another spike in cases, and we need to look at how the virus is spreading in the community.
         Moved by: Ed Sleiman
         Seconded by: Judy Lund
         That the information be received.
         CARRIED

      2. Communications (N. Dupuis)
         N. Dupuis noted that WECHU has a good relationship with the media and there is a considerable amount of communication in respect to COVID-19. The WECHU conducts its media conference every weekday morning (9:00 am) on Facebook Live. Dr. W. Ahmed and Theresa Marentette provide information and presentations in respect to the virus both globally and in our own region. We have received good feedback from the public watching live each day.

          

         The WECHU Homepage has been revamped and any information related to COVID-19 has been set up for easy navigation and is translated into various languages. We will be adding more resources and links to what is available in the community and there have been mail-outs, posters in grocery stores, and ads on the radio and in Saturday’s Windsor Star targeting seniors. Our HPS’s have been redeployed and are reaching out to our community partners to see if they need support.
         Moved by: Ed Sleiman
         Seconded by: Judy Lund
         That the information be received.
         CARRIED

      3. Safety (T. Marentette on behalf of D. Sibley)
         T. Marentette noted that there has been a lot of background work being done in regard to OH&S and HR issues, return to work, giving guidance and deploying staff as needed in relation to COVID-19. There has been no issues in work refusal and/or issues concerning safety in the workplace or staff noting concern about their safety.

         There are still a lot of staff working in the office, and 73 are working from home, i.e. health inspectors, finance and IT staff. We have offered masks for staff who cannot distance or have concerns, and are asking those who are sick to stay home.
         F. Costante thanked everyone at the health unit for the good leadership and clear and concise communication. If there was ever a time to recognize and realize how important public health is this is the time. Dr. W. Ahmed thanked the Board on behalf of the WECHU team.
         Moved by: Judy Lund
         Seconded by: Ed Sleiman
         That the information be received.
         CARRIED

      4. Liaison (T. Marentette)
         WECHU continues to have its weekly meeting with the City and County Chief Administrative Officers to discuss local concerns across all municipalities. We are working on a Homeless Shelter Plan, i.e. shelters, missions, group homes, residential homes, hospice, and are working with the local hospitals to provide guidance as needed. We are also working closely with Windsor Police, LaSalle Police, Regional OPP, Windsor Fire and Rescue and EMS. We are testing in Long Term Care and Retirement Homes due to current COVID-19 outbreaks and the health unit is providing consistent messaging daily to support our community at this time.
         Moved by: Ed Sleiman
         Seconded by: Fabio Costante
         That the information be received.
         CARRIED
      5. Operations (K. McBeth)
         Our Infectious and Prevention Department (IDP) normally has a compliment of 15 staff. With COVID-19, we now have 8 WECHU Managers and roughly between 75-100 people, working 7 days a week in IDP. Our Dental team is supporting the call center, the bulk of the work being in case and contact management.

         We are receiving a high volume of calls daily, and most are returned in 24 hours. We follow up on every lab result we receive, whether positive or negative, with a phone call to the individual. Positive cases receive case management with a daily follow up.

         Long Term Care and Retirement Homes is a significant focus, involving nurses and public health inspectors for infection prevention and control. Our TEO’s are working on a COVID response around provincial orders for complaints around non-compliance. Our entire WECHU staff is, in some way, working on the pandemic.
         Moved by: Judy Lund
         Seconded by: Tracey Bailey
         That the information be received.
         CARRIED

      6. Finance and IT (L. Gregg)
         We continue to monitor our cash flow and the status of our bank accounts, and our cash flow is currently at $4.3M. At March 31, we had $89,000 of COVID related expenses, i.e. supplies, communication, computer hardware (working from home) and various PPE.
         Our payroll notes that we have 90 employees designated to supporting COVID, but the actual number of employees working on the pandemic is higher. From the last payroll in March, we have $390k in payroll focusing on the core team only, i.e. this does not include senior management or the public health inspection support for the outbreak piece. As we track all expenses we await direction from the Ministry on what reporting will look like in 2020, as it is not business as usual. The Annual Service Plan will differ from what we have previously submitted.
         Moved by: Ed Sleiman
         Seconded by: Debbie Kane
         That the information be received.
         CARRIED

      D. Kane said that the messaging from the health unit continues to be driven by science and has been extremely consistent. The health unit has done a great job staying calm and reassuring the public, and we will all get through this as a community.

6. Committee of the Whole (CLOSED SESSION, in accordance with Section 239 of the Municipal Act)
   1. The Board did not move into Committee of the Whole.
7. Next Meeting: At the Call of the Chair, or May 21, 2020 in Windsor, Ontario
8. Adjournment
   Moved by: Debbie Kane
   Seconded by: Tracey Bailey
   That the meeting be adjourned.
   CARRIED
   The meeting adjourned at 5:00 pm.

1. Call to Order
2. Agenda Approval
3. Announcement of Conflict of Interest
4. BOARD ELECTIONS
5. Presentations (W. Ahmed)
   1. Syphilis in Windsor Essex County
   2. Coronavirus
6. Approval of Minutes
   1. Regular Board Meeting: January 16, 2020
7. Consent Agenda
   1. INFORMATION REPORTS
      1. Syphilis in Windsor and Essex County (Appendices) (W. Ahmed)
      2. The WECHU Taking Action on Climate Change (K. McBeth)
      3. Media Recap
   2. RECOMMENDTION REPORTS
      1. Seasonal Housing Compliance Inspections – Fee for Service Program Introduction (K. McBeth)
8. Business Arising – None
9. Board Correspondence – Circulated
10. New Business
    1. Climate Change and Health Vulnerability Report (W. Ahmed)
    2. Public Health Modernization Consultation (T. Marentette)
11. Other Board of Health Resolutions/Letters
    1. Peterborough Public Health – Letter to Hon. Caroline Mulroney and Hon. Christine Elliott – Off Road Vehicle and Bills 107 and 132 – For Support
    2. Letter from Dr. David Williams, Chief Medical Officer of Health, Ministry of Health to Nicole Dupuis, WECHU – The Children Count Pilot Study Program – For Information
12. Committee of the Whole (Closed Session in accordance with Section 239 of the Municipal Act)
13. Next Meeting: At the Call of the Chair or March 19, 2020 – Essex

14. Adjournment

1. Call to Order
   Board Chair, Gary McNamara, called the meeting to order at 4:09 p.m.
2. Agenda Approval
   Moved by: John Scott
   Seconded by: Ed Sleiman
   That the agenda be approved.
   CARRIED
3. Announcement of Conflicts of Interest – None
4. Board Elections
   Nominations for Chair
   G. McNamara relinquished the Chair to T. Marentette, Board Secretary, to begin the election process. T. Marentette opened the floor for nominations for the position of Chair noting that Administration had received two (2) written nominations for Gary McNamara. T. Marentette asked for further nominations from the floor (three times). Given that there were no further nominations, nominations for the position of Chair were closed. G. McNamara, having accepted the nomination, was appointed Chair by acclamation.

    

   Nominations for Vice-Chair
   The Chair opened the floor for nominations for the position of Vice-Chair noting that Administration had received three (3) written nominations for John Scott and one (1) nomination for Tracey Bailey. The Chair asked for further nominations from the floor (three times). Given that there were no further nominations, nominations for the position of Vice-Chair were closed. The Chair asked John Scott if he accepted the nomination – John Scott accepted. The Chair asked Tracey Bailey if she accepted the nomination – Tracy Bailey declined. John Scott, having accepted the nomination, was elected Vice-Chair by acclamation.

   Nominations for Treasurer
   The Chair opened the floor for nominations for the position of Treasurer noting that Administration had received two (2) written nominations for Tracey Bailey. The Chair asked for nominations from the floor (three times). Given that there were no further nominations, nominations for the position of Treasurer were closed. Tracey Bailey, having accepted the nomination, was appointed Treasurer by acclamation.

   Nominations for Audit Committee Member
   The Chair opened the floor for nominations for a Member of the Audit Committee, noting that Administration had received one (1) written nomination for Rino Bortolin. The Chair asked for nominations from the floor (three times). Given that there were no further nominations, nominations for an Audit Committee Member were closed. Rino Bortolin was appointed as a Member of the Audit Committee by acclamation.

5. Presentations (W. Ahmed)
   1. Syphilis in Windsor-Essex
      Dr. Ahmed provided information to the Board on the increase of cases of Syphilis in Windsor-Essex. Syphilis is a systemic disease caused by T. pallidum bacteria that is transmitted during sex. Rates of Syphilis in Ontario are going up, in 2010 there were 32 cases and in 2019 there were 81. The age distribution and who’s most affected by it has also changed as the average age has changed from 44-64 years to 20-44. Various risk factors for the disease are:
      • Unsafe sex without a condom
      • Sex with same sex partners
      • Numerous sexual partners
      If left untreated, tertiary syphilis (serious damage to other organs including the brain) may result in Neurosyphilis. In 2015 we had 1 case, and in 2019 we had 8. Those with high risk are taking medication to avoid contracting HIV.
      WECHU’s role from public health perspective is to 1) follow up on all lab confirmed cases of syphilis through the provision of direct clinical services and/or by working with local health care providers; 2) facilitate contact tracing and confidential partner notification, and 3) facilitate local data collection to explore clients’ baseline knowledge, risk factors and perceived barriers to engage in safer sex practices in relation to syphilis. The WECHU follows every case, and the WECHU works to engage healthcare providers.
   2. Coronavirus Update
      Dr. Wajid Ahmed provided the Board with an update of a new Novel Coronavirus, first identified in December 2019 in Wuhan, China. When compared to SARS (Severe Acute Respiratory Syndrome), this is the largest outbreak of Novel Coronavirus in the world with over 75,000 cases and over 2,000 deaths. The numbers are changing daily, with most cases (98%) in China.
      The virus has spread to 28 countries, with 8 confirmed cases in Canada, 3 in Ontario. So far, there have been no confirmed cases in the Windsor Essex region, with 10 people testing negative. Of these 10, 5 individuals had influenza and 2 had rhinovirus. Today, coronavirus is not in our community, and people should still pay attention to local cases of Influenza.
      The novel coronavirus is a family of viruses which, over time, tends to mutate and create something different. This is what happened with SARS and MERS (Middle East Respiratory Syndrome), they are not necessarily new, but mutate and change and detect different types of proteins. It is unlikely that this virus existed before and most people recover. Those that are most at risk are the elderly (over 65 years) and individuals whose immune systems have already been compromised.
      For local response, all suspected cases are reportable to the Medical Officer of Health, Dr. Wajid Ahmed. We have developed a local response plan in collaboration with our hospitals, EMS and primary care providers, along with our health unit Infectious Disease, Epidemiology and Environmental Health departments, and we have informative and credible information on our WECHU website.
      We currently have 117 cases of Influenza and WECHU produces a weekly flu report on line. We have noticed a spike in cases in the last month and also need to be concerned and take precautions such as hand washing and using hand sanitizers. Anyone visiting the ER who wishes to be tested for the coronavirus must meet case definition, or they will not be tested.
      There have been two Canadians infected with dengue fever (mosquitos) while travelling to the Caribbean and WECHU will consider including the Government of Canada’s link on their website in regard to precautions while travelling outside of Canada.
6. Approval of Minutes
   1. Regular Board Meeting: January 16, 2020
      Moved by: Joe Bachetti
      Seconded by: Ed Sleiman
      That the minutes be approved.
      CARRIED
7. Consent Agenda
   1. INFORMATION REPORTS
      The following information reports were presented to the Board.
      1. Syphilis in Windsor and Essex County (W. Ahmed)
         Brought to the Board for information.
      2. The WECHU Taking Action on Climate Change (K. McBeth)
         Brought to the Board for information.
      3. Media Recap
         Brought to the Board for information.

      Moved by: John Scott
      Seconded by: Larry Snively
      That the Information Reports be received.
      CARRIED

   2. RECOMMENDATION/RESOLUTION REPORTS
      1. Seasonal Housing Compliance Inspections – Fee for Service Program
         K. McBeth brought forward a cost recovery program, for annual inspections, for Seasonal Housing Compliance Inspections for Board approval. This program is managed by our Environment Health department and dramatically increased over the last few years. This Resolution outlines, in addition with the work, significant coordination with municipalities. The workload has increased and our WECHU Leamington clerk is spending 60% of her time on seasonal housing coordination, along with water safety, and other environmental health programs. Not all health units have implemented a fee, but some health units do charge a fee of approximately $80-$100. Our cost recovery program would be used to cover the increase in clerical support.
         The nature of inspections include worker accommodations, i.e. air space, and number of individuals that can stay in a bunkhouse. The WECHU works together with municipal building departments on building codes. Inspections have increased 2-3 times per year, with additional inspections required when workers move from one bunkhouse to another. This increase in inspections has been imposed by Service Canada. The owners are greenhouse growers, and food processing, and we will likely see substantial increases in a continually growing industry.
         Moved by: Fabio Costante
         Seconded by: Larry Snively
         That the Recommendation/Resolution Report be supported.
         CARRIED
8. Business Arising – None
9. Board Correspondence – Circulated
10. New Business
    1. Climate Change and Health Vulnerability Report (W. Ahmed)
       Dr. W. Ahmed referenced the Climate Change and Health Vulnerability Report and the Local Response to Climate Change Resolution, passed by the Board of Health in November 2019, supporting ongoing advocacy efforts and public health interventions to support climate change action locally. This report provides data on impacts of climate change, adaptation actions already in place, and policies to respond to climate change. The WECHU, City of Windsor, County of Essex, Essex Regional Conservation Authority (ERCA) as well as all of the local municipalities are working together to reduce the environmental impacts of climate change, with ERCA taking the lead. G. McNamara noted that agriculture (the food industry) is a $3B industry and this report identifies that this is not a Windsor Essex issue, but a global one.
       Moved by: Debbie Kane
       Seconded by: Larry Snively
       That the above information be received.
       CARRIED
    2. Public Health Modernization Consultation (T. Marentette)
       T. Marentette noted that our Public Health Modernization Consultation (Public Health, Municipalities, EMS) with the Ministry of Health originally scheduled for February 19, 2020, was moved to March 30, 2020. The consultation will still take place at the WFCU Centre. T. Marentette will send Board members our completed responses to public health modernization compiled over the last couple of months. Board Chair, G. McNamara, encouraged all Board members to attend, as this is our opportunity to have our say on how important public health is to our communities and to put our best foot forward. He noted that Jim Pine, CAO of Hastings County and AMO member, will be the facilitator.
       Moved by: Debbie Kane
       Seconded by: Larry Snively
       That the above information be received.
       CARRIED
11. Other Board of Health Resolutions/Letters – For Support
    1. Peterborough Public Health – Letter to Hon. Caroline Mulroney and Hon. Christine Elliott – Off Road Vehicles and Bills 107 and 132
    2. Letter from Dr. David Williams, Chief Medical Officer of Health, Ministry of Health, to Nicole Dupuis, WECHU – The Children Count Pilot Study Program – For Information
       G. McNamara took the opportunity to congratulate N. Dupuis and her team.
       Moved by: John Scott
       Seconded by: Tracey Bailey
       That the above correspondence be supported as noted.
       CARRIED
12. Committee of the Whole (CLOSED SESSION, in accordance with Section 239 of the Municipal Act)
    The Board moved into Committee of the Whole at 5:14 pm
    The Board moved out of Committee of the Whole at 5:35 pm
13. Addition to Agenda – Various Costs
    The Ministry provided the template for one-time funding requests, i.e. vaccine fridges and extraordinary costs. We proposed four extraordinary costs that we would like to include in our Annual Service Plan:
    • Coronavirus – more resources will continue to be required – extra costs for this month – $18k
    • Public Health Inspection Students (3) for Vector-Borne Program – to cover wages, mileage and additional awareness campaign – $77k
    • Migrant Farms – Communicable Diseases – utilizing staff for skin testing, etc. – $4k
    • Public Health Practicum Students – to build capacity for future Environmental Health Inspectors – asking for 2 students – $10k
    • What we do not receive in funding we will have to absorb.
    Moved by: Tracey Bailey
    Seconded by: Ed Sleiman
    That the above be received.
    CARRIED
14. Next Meeting: At the Call of the Chair, or March 19, 2020 in Essex, Ontario
15. Adjournment
    Moved by: Joe Bachetti
    Seconded by: Debbie Kane
    That the meeting be adjourned.
    CARRIED
    The meeting adjourned at 5:41 pm.

1. Call to Order
2. Agenda Approval
3. Announcement of Conflict of Interest
4. Approval of Minutes
   1. Regular Board Meeting: December 19, 2019
5. Consent Agenda
   1. INFORMATION REPORTS
      1. Breastfeeding in Windsor-Essex (N. Dupuis)
      2. Radon Gas Initiatives in Windsor-Essex County (K. McBeth)
      3. Media Recap (Handout)
   2. RECOMMENDTION REPORTS
      1. Children Count Pilot Project (N. Dupuis)
6. Business Arising – None
7. Board Correspondence – Circulated
8. New Business
   1. Public Health Modernization Update (T. Marentette) (Handout)
   2. Board of Health Elections (February 20, 2020 Board meeting)
9. Other Board of Health Resolutions/Letters – For Support
   1. Leeds, Grenville and Lanark District Health Unit – Letter to Hon. Minister Patty Hajdu, Minister of Health – National Pharmacare Program
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 or February 20, 2020 – Windsor
12. Adjournment