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October 15, 2020

Meeting held via video.

  1. Call to Order
  2. Agenda Approval
  3. Announcement of Conflict of Interest
  4. Update (W. Ahmed)
    1. COVID-19 Update
  5. Approval of Minutes
    1. Regular Board Meeting: 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

View Document page

Board Members Present:

Gary McNamara, Tracey Bailey, Joe Bachetti, Rino Bortolin, Fabio Costante, Dr.Debbie Kane, Gary Kaschak, Judy Lund, John Scott, Ed Sleiman

Board Member Regrets:

Larry Snively

Administration

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


QUORUM:  Confirmed

  1. Call to Order
    Board Chair, Gary McNamara, relinquished the Chair to Vice-Chair, John Scott, who called the meeting to order at 4:09 p.m. 
  2. Agenda Approval
    Moved by:  Judy Lund
    Seconded by: Fabio Costante
    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 status of COVID-19 cases in our region.  The province has officially declared that it is in the second wave of the virus, notably in the GTA region.  We are seeing case counts of 700-800 cases per day in the Toronto, Peel, Ottawa, York and Hamilton regions, while we are reporting mostly single digits in Windsor-Essex.

      We have declared an outbreak in a bunkhouse at one farm.  The approximately 20 workers are no longer infectious and are going back to work.  The number of cases from close contacts is increasing, suggesting that people continue to gather, despite recommendations and restrictions.

      The Province has moved to testing based on appointments to help clear the current backlog of tests, and conduct direct testing for those who are symptomatic.   COVID testing is also available through three Shoppers Pharmacies in Windsor for residents with symptoms.

      The WECHU will be moving to a more interactive website, which will allow individuals different options on how to view the data.  We will continue to build on answering questions from the public as well as the media.

      School cases are still relatively low compared to other regions.  We are communicating regularly with the school boards and we currently have no outbreaks.  Moving forward we do anticipate there will be more cases in the community and will continue to work with the Agri-Sector and Long-Term Care/Retirement Homes to provide guidance to prevent cases in their high-risk settings.  Our WECHU team is working with about 65 active cases in our region.

      Moved by:    Fabio Costante
      Seconded by:  Judy Lund
      That the information be received.
      CARRIED

  5. Approval of Minutes
    1. Regular Board Meeting:  September 17, 2020
      Moved by:  Judy Lund
      Seconded by:  Rino Bortolin
      That the minutes be approved.
      CARRIED
  6. Business Arising – None
  7. Consent Agenda

    Moved by:  Ed Sleiman
    Seconded by:  Gary Kaschak
    That the information reports be received.
    CARRIED

    1. INFORMATION REPORTS
      1. Q3 Quarterly Report (L. Gregg)
        Brought to the Board for information.
        R. Bortolin asked if there have been further conversations with the Ministry providing coverage for overages around our deficit. T. Marentette said that the WECHU has submitted its extraordinary expenses related to COVID-19 to the Ministry.  The Ministry has responded back to health units with questions for clarity and we are in the process of completing this.  Further discussion on this will continue in Committee of the Whole.
      2. Influenza Season (2020/2021) (K .McBeth)
        Brought to the Board for information.
      3. Safe Return to School – COVID-19 Engagement, Resources and Collaboration (N. Dupuis)
      4. September Communications Recap (L. Gregg)
    2. RECOMMENDATION REPORTS – None
  8. Board Correspondence – None
  9. New Business – None  
  10. Other Board of Health Resolutions/Letters
    1. Letter from the Ministry of the Solicitor General – Enforcement and Amendments under the Reopening Act, 2020               
    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.
       J. Lund asked if the WECHU will notify business when they will be included in a public announcement around possible COVID-19 exposure. T. Marentette advised that this is our practice and the Resolution from Lakeshore Council is likely in response to an earlier notification where the business was not aware of a prior announcement.  Our current practice addresses this issue and we will abide by this Resolution. 

       

       

       

      Moved by:  Gary McNamara
      Seconded by:   Joe Bachetti
      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 4:22 pm
    The Board moved out of Committee of the Whole at 4:45 pm
  12. Next Meeting: At the Call of the Chair, or November 19, 2020 – Via Video
  13. Adjournment
    Moved by:  Joe Bachetti
    Seconded by:  Gary Kaschak
    That the meeting be adjourned.
    CARRIED

The meeting adjourned at 4:46 pm.

RECORDING SECRETARY:

SUBMITTED BY:

APPROVED BY:


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September 17, 2020

Meeting held via video.

  1. Call to Order
  2. Agenda Approval
  3. Announcement of Conflict of Interest
  4. Update (W. Ahmed)
    1. COVID-19 Update
  5. Approval of Minutes
    1. Regular Board Meeting: 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

View Document page

Board Members Present:

Gary McNamara, Tracey Bailey, Rino Bortolin, Fabio Costante, Dr. Debbie Kane, Judy Lund, John Scott, Larry Snively, Joe Bachetti (arrived at 5:05 pm)

Board Member Regrets:

Gary Kaschak, Ed Sleiman

Administration Present:

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


This meeting was held via video conference.

QUORUM:  Confirmed

  1. Call to Order
    Board Chair, Gary McNamara, called the meeting to order at 4:10 p.m.
  2. Agenda Approval
    Moved by: Judy Lund
    Seconded by: Rino Bortolin
    That the agenda be approved.
    CARRIED
  3. Announcement of Conflicts of Interest – None
  4. Update (Dr. W. Ahmed)
    1. COVID-19 Update

      Dr. W. Ahmed provided an update on the status of COVID-19 cases in our region, along with a presentation around the numbers and the increase of cases in the province. Graphs in the presentation show the overall rates, spikes in cases according to age and municipality, how the virus is being transmitted, and capacity in the health care system should we see a surge of cases requiring hospitalization. Our case fatality rate is at 3.0%, which is lower than the provincial average. Approximately 5,000 to 6,000 tests are being conducted weekly across our region, and positive case rates remain relatively low while the GTA and Ottawa regions are spiking.

      One student in a local school tested positive and their cohort was also advised to isolate for 14 days. Our data shows a spike in cases in the 0-19 age group over the last two weeks, and we take this information seriously with our messaging to the various school boards.

      The region seems to be moving in a stable direction in the Agri-sector. Positive cases amongst farm workers are low with some occasional travel related cases after arriving in Canada.

      G. McNamara said that the WECHU Epidemiology Department has done excellent work on the graphing and mapping. The recent roadmap created around the cluster of cases that happened recently was interesting to see, and shows how quickly the virus can spread. The province was impressed at how quickly we addressed the cluster by finding its origins and roots. Information like this is critically important to show residents how quickly the virus can easily get out of control by not following public health measures.

      Moved by: Fabio Costante
      Seconded by: John Scott
      That the information be received.
      CARRIED

  5. Approval of Minutes
    1. Regular Board Meeting: July 16, 2020
      J. Lund noted that Beach Testing (water sampling) was discussed at the July 16, 2020 Board meeting and that the WECHU was one of the only health units that still conducts the testing. She asked how other health units do beach testing. Dr. Ahmed said that water testing is done by their municipalities or contracted out to a third party.
      Moved by: Judy Lund
      Seconded by: Fabio Costante
      That the minutes be approved.
      CARRIED
  6. Business Arising
    1. School-focused Nursing Recruitment (D. Sibley)
      D. Sibley said that 18 of the 19 school nursing positions have been filled. Ten internal WECHU staff on lay off filled some of these positions and 8 new staff have been hired over the last couple of weeks. We are recruiting for 1 French speaking position. We have redeployed existing WECHU staff to be ready for the school year and all of these positions should be filled within the next two weeks.
      Moved by: Debbie Kane
      Seconded by: John Scott
      That the information be received.
      CARRIED
    2. Consumption and Treatment Services (CTS) Site Update (Addition to Agenda) R. Bortolin

      T. Marentette said that the health unit continues to work with a dedicated stakeholder group on the application submission for a CTS site in Windsor. The work was delayed for several months due to the pandemic and we recently moved forward around a site location, which is required prior to submitting the application. Criteria for the site was based on requirements in both Health Canada’s and the Ministry of Health’s applications.

      A Request for Expression of Interest (EOI) for interested landlords or property owners for a proposed site went out in August 2020. There was no interest. We reposted the information to the same website, did a media release and extended the timeline to September 4, 2020 and the process still did not generate any interest.

      We have reached out to our legal advisors for guidance on next steps and will reconvene our stakeholder group to determine how to proceed. Steps following the site selection would include a CPTED (Crime Prevention Through Environmental Design) audit on the site, a site inspection and a brief assessment. Consultations with the public would follow with extensive community engagement along with our Board of Health and the municipality of the site location.

      R. Bortolin asked if one submission was received, and the size and technical specifications are reached, would we go that route and what level of consideration is given to those items. T. Marentette said that there is criteria that must be met and we would work with our Environmental Health Department and Windsor Police Services, i.e. acceptable site, meeting mandatory requirements from Health Canada and the Ministry of Health, distancing from sensitive areas, etc., and it would be brought to the Stakeholder Advisory Committee.

      R. Bortolin asked about the public consultation phase and what that would look like when we are at the point of Board of Health approval of the potential site. He has received many questions from residents in his ward about the CTS site being located in the downtown Windsor core. T. Marentette advised that public consultations would occur prior to going to our Board or the municipality for site confirmation and approval. We were hoping to have 2 or 3 sites with extensive community consultation, and feedback, before moving forward. The public would have a say and will have the opportunity to voice their concerns prior to the site being confirmed.

      The process is presenting the sites that meet the criteria as well as meeting the needs of the people who would use the service. With the pandemic, there will be no gatherings in person. We will need to conduct consultations through surveys and virtual discussions, and there was talk of having a virtual Town Hall. All residents in the municipality can participate in the process, not just residents or businesses in that location.

      R. Bortolin said if the process goes through public consultation and is presented to our Board of Health and the municipality, does the municipality have the power to veto, or is it presented to the municipality simply for endorsement.

      T. Marentette noted that under the Health Promotion and Protection Act, (HPPA) the municipality must approve the site. R. Bortolin said that it would likely be through a Motion to the particular municipality’s council.

      R. Bortolin asked if WECHU has considered how many meetings should take place, that they are well publicized and that there are enough people on the calls to hear from residents instead of it being a one-way virtual meeting. T. Marentette said that this was all considered in the planning, we have people dedicated to the process, GANTT charts for timelines and that we recognize the need to make sure it is inclusive of everyone who wants to have a voice.

      R. Bortolin said that since there has been no interest from the EOI has there been any discussion around conversations with municipalities, other agencies or potential partners for space.

      T. Marentette advised that we have consulted with our legal advisors on this to make sure the process is transparent and adheres to any public protocol or disclosure and, based on feedback, we will reconvene the stakeholder group, and expect that the next step is to reach out to potential partners.

  7. Consent Agenda
    1. INFORMATION REPORTS
      1. July and August Communications Recap (L. Gregg)
        Brought to the Board for information.
        Moved by: Rino Bortolin
        Seconded by: Judy Lund
        That the information reports be received.
        CARRIED
    2. RECOMMENDATION REPORTS – None
  8. Board Correspondence – None
  9. New Business
    1. WECHU 2020-21 Public Health Funding (T. Marentette/L. Gregg)

      T. Marentette said that the WECHU received its Public Health Funding and Accountability Agreement for the 2020-2021 funding year on August 21, 2020 which provided our approved base and one-time funding. This includes the changes to the provincial/municipal cost-sharing agreement effective January 1, 2020, one-time mitigation funding and funding for public health programs and services.

      An overview of other one-time funding approvals include:

      • Public Health Inspector Practicum Program (one student) – $10,000
      • Seasonal Farm Contract Tracing under our TB Program – included on-site contact tracing, TB screening, translations services, salaries and mileage – $4,400
      • Vector-Borne Disease Program – this funding initiative is used to support staffing, mileage surveillance activities and an awareness campaign for enhanced surveillance for mosquitos – $40,000
      • Pandemic Pay for eligible nursing staff – this initiative provided additional support for eligible Board of Health employees dependent upon responsibilities for the period April 24, 2020 to August 13, 2020. Total funding received for our health unit was $161,700.

      In addition, an amended agreement was received by the Ministry related to the following:

      • School-focused nurses (19 in total) to support the reopening of schools (August 1, 2020 to March 31, 2021 and April 2021 to March 31, 2022)
      • Funding to support the new public health Case and Contact Management solution (CCM)

      Board of Health member L. Snively left the meeting at 4:59 pm

      L. Gregg advised that on August 21, 2020 the Ministry of Health issued WECHU’s 2020 Budget Approval. Total funding allocation is as follows:

      • $15,981,600 in base funding for the Mandatory programs – funded at a rate of 70% Ministry of Health and 30% Obligated Municipalities
      • $1,674,700 in base funding for the Ontario Seniors Dental Care Program funded 100% by the Ministry of Health

      The Ministry of Health approved mitigation funding of $1,260,800 to be used to offset the increased public health program costs to municipalities as a result of cost-sharing change from what was 75/25 to 70/30. An allotment of mitigation funding was approved for the period January 1, 2020 to December 31, 2020 and a second allotment in the same amount was approved for January 1, 2021 to December 31, 2021.

      Moved by: Judy Lund
      Seconded by: Rino Bortolin
      That the information be received.
      CARRIED

    2. Extraordinary Cost Reimbursement Process (L. Gregg)

      L. Gregg advised that on August 21, 2020 the Ministry of Health initiated a process for public health units to request reimbursements of one-time extraordinary expenses related to COVID-19. The deadline for this submission is September 18, 2020 for the timeframe of January 1, 2020 to December 31, 2020 and includes actual and forecasted costs. As with all submissions to the Ministry, it is subject to review and some expenditures may not be admissible. It is our understanding that additional requests for reimbursement may be available at a later date.

      Total forecasted salaries and benefits related to COVID-19 for calendar 2020 are $10,728,391. This excludes the School Nurse initiative, which will be funded through separate approval. R. Bortolin noted that many WECHU staff are unionized and eligible for overtime. He asked if this amount takes into account a provision for the WECHU Leadership Team who have been unable to take vacation or time off due to the workload with the pandemic. Their working ratio is likely 15%-30% higher than what they are receiving in salaries.

      L. Gregg advised there was a provision for vacations not taken by the WECHU Leadership Team but there was no augment in the number of hours the team has worked, and continues to work, in this analysis. The provision just includes their base salaries. There was a line-by-line analysis for all staff so there was a detailed review.

      R. Bortolin asked if WECHU should increase the ask in the submission to the Ministry to help cover compensation to the WECHU Leadership Team for unused vacations.

      T. Marentette said that there was no provision for compensation for the Leadership Team during the pandemic and if it is deemed not admissible by the Ministry it would likely fall on the municipalities and is included in this ask. R. Bortolin asked if WECHU can balance its budget for 2020 if the submission was approved. T. Marentette said that close to $3M has been submitted and if that is received from the Ministry than WECHU should be able to balance its budget. To our understanding, the province is not saying this is a 70/30 split.

      Moved by: Joe Bachetti
      Seconded by: John Scott
      That the information be received.

    3. Request from Ontario Health Team (W. Ahmed)

      Dr. W. Ahmed said that many Board of Health members are aware that the province, through Ontario Health, is creating Ontario Health Teams (OHT) to provide patient centered care in various regions of the province. OHTs are groups of health care providers and organizations that are clinically and fiscally accountable for delivering a full and coordinated continuum of care to a defined geographic population.

      The expectation is that the OHTs will enable patients, families, community agencies and healthcare providers to work together in a new way. Over time, it is expected that OHTs will develop innovative and locally driven solutions to meet the healthcare needs of their defined geographic population and will be accountable for the health outcomes and healthcare costs of that population.

      OHTs are being introduced to provide a new way of organizing and delivering care that is more connected to patients in their local communities. Under OHTs, health care providers (including hospitals, doctors and home and community care providers) work as one coordinated team. Public Health supported the local collaborative work to create a Windsor-Essex Ontario Health Team. The next stage of the OHTs development is a full application, which is currently being submitted.

      In the application, the OHT has to identify a priority population and the group decided to work with individuals with chronic diseases living in a congregate settings. There are 155 congregate living setting in our region and the team is planning to prioritize them based on the risk to these settings. For example, using EMS data to identify top 10 congregate living facilities in our region that receive the bulk of calls in the past 12 months.

      The OHT is leveraging on the existing relationship and partnership developed for COVID response in the region.

      The Windsor Essex OHT is comprised of over 45 local healthcare program and services providers including the three hospitals, primary care and community support providers, public health, municipalities, mental health and addictions agencies, Long-term care, and others social service providers in Windsor Essex.

      The Windsor Essex OHT is requesting their partner agencies submit a letter of support along with a sign off from their Board. WECHU is in support of the Windsor Essex OHT but we also recognize that the public governance and accountability are very different. We are governed under the HPPA and are accountable to our Board of Health.

      We are recommending that the WECHU submit a letter of support from the Medical Officer of Health and the CEO that we will continue to support and collaborate with the OHT. Due to our mandate and accountability, we do not believe that we require a formal board sign off and are looking to the Board for direction and support.

      Moved by: Tracey Bailey
      Supported: Rino Bortolin
      That the WECHU Medical Officer of Health and CEO submit a Letter of Support to continue to support and collaborate with the OHT and that formal Board of Health sign off is not required.
      CARRIED

  10. Other Board of Health Resolutions/Letters

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

    1. Simcoe-Muskoka District Health Unit – Letter to 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 – For information
    2. WECHU Response to Town of Kingsville, Town of Essex and Town of Amherstburg – Response to their 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)
    The Board moved into Committee of the Whole at 5:14 pm
    The Board moved out of Committee of the Whole at 5:20 pm
  12. Next Meeting: At the Call of the Chair, or October 15, 2020 – Via Video
  13. Adjournment
    Moved by: Rino Bortolin
    Seconded by: Tracey Bailey
    That the meeting be adjourned.
    CARRIED

The meeting adjourned at 5:21 pm.

RECORDING SECRETARY:

SUBMITTED BY:

APPROVED BY:


View Document page

July 16, 2020

Meeting held via video.

  1. Call to Order
  2. Agenda Approval
  3. Announcement of Conflict of Interest
  4. Update (W. Ahmed)
    1. COVID-19 Update
  5. Approval of Minutes
    1. Regular Board Meeting: 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

View Document page

SUBMITTED BY:

Epidemiology and Evaluation Department

DATE:

July 16, 2020

SUBJECT:

Effect of climate change on invasive mosquitoes, Zika virus, and migrant worker health in Windsor and Essex County


BACKGROUND

Between 1941 and 2012, the annual average temperature for the City of Windsor increased by almost 1°C (City of Windsor, 2012). Windsor and Essex County (WEC) also experienced a 1-3% increase in rainfall per decade from 1970 to 2000 (City of Windsor, 2012), with level of precipitation and humidity expected to continue to increase in southern Canada in the coming decades (Ng et al., 2019).

One potentially dangerous effect of these climatic changes in Windsor and Essex County (WEC) is the proliferation of invasive mosquitoes. The past four years have seen the introduction of Aedes albopictus and Aedes aegypti, both carriers of the Zika virus, to WEC, and climatic changes are expected to encourage greater numbers of these mosquitoes in the coming decades (Ng et al., 2019). More specifically, rising temperatures combined with stagnant water from flooding are expected to facilitate the survival and proliferation of these species (Kovats et al., 2003). Indeed, the Aedes albopictus population in WEC (identified from trapping) increased from 17 in 2016 to 1,129 adult mosquitoes in 2018, thus demonstrating that these mosquitoes can reproduce rapidly. Furthermore, these mosquitoes spread out from one to seven different trapping locations from 2016-18.

One particular population that may be at risk for exposure to these mosquitoes are migrant farm workers. Leamington has over 8,000 migrant workers during the summer season who are housed in over 600 bunkhouses (Hennebry, McLaughlin & Preibisch, 2016). The majority of these migrant workers are from Mexico and nearby Caribbean countries, which are endemic for mosquito-borne diseases such as Zika. A recent survey in Ontario, however, found that less than a quarter of migrant farm workers saw a doctor for any health symptoms (Hennebry et al., 2016). Therefore, it is imperative that surveillance of Aedes mosquitoes and incidence of the Zika virus be increased in this area, not only to protect the health and well-being of migrants, but also the well-being of WEC as a whole.

CURRENT INITIATIVES

Funding for a three-year exploratory study (2019-2022) of invasive mosquito species in Leamington, Ontario was awarded to the Windsor-Essex County Health Unit by the Public Health Agency of Canada (PHAC) via the Infectious Disease and Climate Change Fund. The primary goal of the study is increased surveillance of invasive mosquito species in Leamington, including coordination with Parks Canada for surveillance and viral testing in Point Pelee National Park. An additional objective is to assess potential risks to the Leamington community, with special attention paid to vulnerable populations, such as migrant farm workers.

Prior to mosquito surveillance (scheduled to begin May 2020), a scoping review of all literature relating to climate change, Aedes mosquitoes, the Zika virus, and migrant workers was completed. From over 65,000 reviewed records, 88 were chosen to address the specific scoping review objectives. About two-thirds (65/88) of these records were empirical studies, and 23% (20/88) were done in Canada.

Results of the review revealed extensive information on Aedes mosquitoes, the Zika virus, and climate change in the United States and other parts of the world affected by these mosquitoes. However, there are gaps in the literature regarding how Aedes mosquitoes, Zika, and climate change may affect vulnerable populations. Empirical work, such as WECHU’s current PHAC grant, that examines how Aedes mosquitoes, Zika, and climate change interact in their effect on migrant workers in Canada is greatly needed.


View Document page

Board Members Present:

Gary McNamara, Joe Bachetti, Tracey Bailey, Rino Bortolin, Fabio Costante, Dr. Debbie Kane, Gary Kaschak (4:41 pm) Judy Lund, John Scott, Ed Sleiman

Board Member Regrets:

Larry Snively

Administration Present:

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


This meeting was held via video conference.

QUORUM:  Confirmed

  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.

RECORDING SECRETARY:

SUBMITTED BY:

APPROVED BY:


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ISSUE 

On March 11, 2020, the World Health Organization (WHO) declared the global outbreak of COVID-19 a pandemic. On March 20, 2020, the Windsor-Essex County Health Unit (WECHU) announced its first confirmed case of COVID-19. Since then, Windsor and Essex County (WEC) has seen confirmed cases rise to one thousand eight hundred (1,800) (as at July 12, 2020), with sixty-eight (68) deaths.

WEC is home to one of the busiest border crossings in North America. Approximately six thousand (6,000) residents in WEC work in the state of Michigan, and in particular, seventeen hundred (1,700) in the health care industry. In addition, WEC is home to eight thousand (8,000) to ten thousand (10,000) seasonal workers, one hundred seventy-six (176) farms and over seven hundred (700) seasonal accommodations. WEC has forty-four (44) long-term care and retirement homes. These characteristics make our community unique and create dynamics that are challenging to manage from a public health perspective. Adding to this, are the complexities of the Ministry of Health (MoH) requirements and performance targets.

Approximately eighty (80) staff with the WECHU, of varying roles, have been redeployed to address the response to COVID-19 within our WEC region. Programs and services, which had previously been halted, are now restarting, as our community moves through the stages of reopening. It is imperative that the WECHU formulate a strategy that will not only return staff to their originating programs, but responsibly address the continuing needs of COVID-19, within our community. To that end, Administration is proposing an amendment to the 2020 Budget to account for the additional FTE requirements. 

BACKGROUND

In May of 2020, the MoH, in a memo regarding Case and Contact Management, required that public health units address certain questions. The following is a summary of the WECHU’s responses. 

  • If you believe you are currently able to connect with new cases within 24 hours of referral – Yes, initial contact with ALL positive cases of COVID-19 is completed within 24 hours. Since our first case of COVID-19 until now, the average number of new cases per day is 13.9. In situations where a positive case cannot be located by phone within 24 hours, a letter is delivered by WECHU staff under the signature of the Medical Officer of Health providing notification of positive test result with mandate to contact public health. (Response as at May 2020) 

  • If you believe you are currently able to connect with new contacts within 24 hours of referral or identification – Not for all contacts of confirmed cases. The ability to complete all contact tracing interviews within 24 hours is dependant upon how many contacts each case has. On average, each case in Windsor-Essex has 2 close contacts, others can have upwards of 10. The WECHU makes every effort to complete this within 24 hours. (Response as at May 2020) 

  • If you believe that your health unit can sustain that capacity within the near term for case management – No, the WECHU would not be able to absorb the additional/current COVID-19 case management work within the current complement of staff allotted to infectious disease management in conjunction with resumed operations of other areas within the health unit (i.e. school based immunization, UIIP). The WECHU currently has 656 positive cases of COVID-19. Since our first case of COVID-19 until now, the average number of new cases per day is 13.9. (Response as at May 2020) 

  • If you believe that your health unit can sustain that capacity within the near term for contact tracing - No, the WECHU would not be able to absorb the additional/current COVID-19 contact tracing work within the current complement of staff allotted to infectious disease management in conjunction with resumed operations of other areas within the health unit (i.e. school based immunization, UIIP). The WECHU currently has 656 positive cases of COVID-19. Since our first case of COVID-19 until now, the average number of new cases per day is 13.9. Applying an average factor of 2 contacts per case that requires approx. 28 people to be contacted in regards to COVID-19 follow-up per day. (Response as at May 2020) 

  • The WECHU provided the MoH with a summary of the staff complement dedicated to the WECHU’s COVID19 response. 

    In order to support the COVID-19 response in Windsor-Essex, a number of public health activities have been deferred/reduced including but not limited to: 

    • School based immunization 
    • Oral health programming (non-emergency) 
    • Health promotion programming and planning 
    • Vaccine Distribution Programming (i.e. routine inspections) 
    • Healthy Families programming (non-critical) 
    • Breastfeeding support 
    • Food Safety and other Environmental Health program training (in person courses) 

    In addition, other internal support programs have all had staff seconded to work exclusively on COVID-19 in the areas of epidemiology and evaluation, IT, communications, and planning. All of these come at a cost of progress and backlog in a number of public health programming areas. 
    The current COVID-19 response team, which was formed to supplement the Infectious Disease Team that existed prior to the pandemic (13 public health nurses, 3 clerical staff and 1 manager) consists of the following cohorts of staff to support direct case and contact management activities including contact tracing, daily PUI monitoring, testing and assessment, iPHIS entry and other COVID-19 client based work: 

    • 8 managers (health promotion and protection programing) 
    • 2 NPs (seconded from clinical services and family health programming) 
    • 35 RNs (seconded from healthy schools, healthy families, HBHC, and vaccine programming) 
    • 7 RPNs (seconded from vaccine programming) 
    • 2 Health Promotion Specialists (seconded from health promotion programming) 
    • 11 Dental Hygienists/Assistants (seconded from oral health programming) 
    • 1.5 Epidemiology Supports (seconded from health promotion and protection programming) 
    • 9 clerical staff (seconded from health promotion and protection programming) 
    • 3 Public Health Inspectors (seconded from environmental health programming) 

    The COVID-19 response for the WECHU is a 7 day per week operation that consists of 2 weekday shifts per day and one shift per day on the weekend. It is supported 24/7 by the WECHU’s on-call program.

Implementation of Public Health Mutual Assistance Agreements

Due to a significant increase in cases and contacts related to the agri-farm sector in WEC and associated demands on WECHU resources, the WECHU implemented its Public Health Mutual Assistance Agreements with the following health units: 

  • Chatham-Kent Public Health 
  • Sarnia-Lambton Health Unit 
  • Southwest Public Health 
  • Grey Bruce Health Unit 
  • Huron Perth Public Health 
  • Middlesex-London Health Unit 

Nursing staff from these health units were oriented and supported to work remotely to assist with contact management including daily monitoring of cases/contacts. Overall, approximately 11 FTEs and 10 casual nurses have been assisting our health unit since late June. In addition, Public Health Ontario has been working with our health unit to support iPHIS data entry requirements related to COVID-19.

The Ministry of Health also expanded the assistance available to the WECHU through a call out on June 28th to all health units in Ontario. In addition, Dr. Alexander Summers, Associate Medical Officer of Health, was seconded from Middlesex-London Health Unit, to assist in the short term and has been on-site for the past 2 weeks. He will continue to support remotely. Our health unit also received epidemiological support from a Field Epidemiologist through the Public Health Agency of Canada (PHAC). The Field Epi has been assigned to our health unit for approximately 4 weeks and is working with our manager of Epidemiology and Evaluation to support the work of COVID-19.

Both the Emergency Operations Centre (Minister of Solicitor General) and the Emergency Operations Centre (Ministry of Health) continue to support the work of COVID-19 in coordinating the measures needed to address the agri-farm sector outbreaks in WEC.

COVID-19 Response Team

To address the MoH’s requirements, including performance goals related to case and contact management (24-hour action timeline) and iPHIS contact and case management data entry requirements, the WECHU would require additional staff directly allocated to COVID-19 response to work within the current complement of infectious disease management and prevention. This includes: 

  • 1 FTE, Associate Medical Officer of Health 
  • 1 FTE, Program Manager 
  • 3 FTEs, Clerical Support Staff;
  • 2 FTEs, Public Health Nurses; 
  • 10 FTEs, Registered Practical Nurses; 
  • 4 FTEs, Public Health Inspectors; 
  • 1 FTE, Epidemiologist.

The following is a summary of the annual operating budget for the remainder of 2020 and one-time capital costs to support the proposed COVID-19 Response Team. 

  2020 Operating Budget
Salaries and benefits $679,337
Operating costs (mileage, program supplies, licensing) 73,602
Total 2020 Operating Costs $752,939
One-time capital costs $104,390
Financial impact – 2020 $857,329

This budget assumes a September 7, 2020, start date to allow for appropriate recruitment. One-time capital costs include the cost of information technology infrastructure, both to expand current system capacity, as well as support the COVID-19 Response Team. Augments in building occupancy costs as well as furniture and fixtures have not be contemplated as this staff would work-from-home.

Funding

The WECHU has not received any communications for the MoH regarding the funding of a COVID-19 Response Team. If the WECHU assumes that funding will not be received to support the COVID-19 Response Team, the contributions from the Obligated Municipalities for the remainder of 2020 would be as follows:

Municipality Funding ($)
Corporation of the City of Windsor $466,726
Corporation of the County of Essex 390,098
Corporation of the Township of Pelee 505
  $857,329

If the MoH does provide funding for a COVID-19 Response Team using a 70%/30% funding formula for this specific initiative, the contributions from the Obligated Municipalities for the remainder of 2020 would be as follows:

Municipality Funding ($)
Corporation of the City of Windsor $140,018
Corporation of the County of Essex 117,030
Corporation of the Township of Pelee 152
  $257,200

For information purposes, Administration quantified the annual operating costs for the COVID-19 response team. 

  2021 Operating Budget
Salaries and benefits $2,077,971
Operating costs (mileage, program supplies, licensing) 130,982
Total 2020 Operating Costs $2,208,953

Increase in contributions from the Obligated Municipalities for 2021 related to the addition of a COVID-19 
Response Team, assuming no funding is received from the MoH:  

Municipality Funding ($)
Corporation of the City of Windsor $1,202,543
Corporation of the County of Essex 1,005,109
Corporation of the Township of Pelee 1,301
  $2,208,953

Increase in contributions from the Obligated Municipalities for 2021 related to the addition of a COVID-19 response team, assuming this specific initiative is funded by the MoH at a rate of 70%/30%. 

Municipality Funding ($)
Corporation of the City of Windsor $360,763
Corporation of the County of Essex 301,533
Corporation of the Township of Pelee 390
  $662,686

PROPOSED MOTION

Whereas, the WHO declared the global outbreak of COVID-19 a pandemic on March 11, 2020, and

Whereas, the growing number of confirmed cases of COVID-19, the absence of a vaccine, coupled with movement of WEC through the stages of reopening and restarting of the WECHU programs and services, and

Whereas, the Windsor-Essex County Health Unit is responsible for promoting, protecting and improving the health and well-being of the community of WEC as required by the Health Protection and Promotion Act, R.SO. 1990 (the HPPA).

Now therefore be it resolved that the Windsor-Essex County Board of Health approve the amendment to the 2020 budget, resulting in the recruitment of a COVID-19 Response Team with an addition of 22 full-time equivalents, including an Associate Medical Officer of Health.

FURTHER 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.


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June 18, 2020

Meeting held via video.

  1. Call to Order
  2. Agenda Approval
  3. Announcement of Conflict of Interest
  4. Update (W. Ahmed)
    1. COVID-19 Update
    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

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Board Members Present:

Gary McNamara, Joe Bachetti, Tracey Bailey, Fabio Costante, Dr. Debbie Kane, Judy Lund, John Scott, Ed Sleiman, Larry Snively, Rino Bortolin

Board Member Regrets:

Gary Kaschak

Administration Present:

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


This meeting was held via video conference.

QUORUM:  Confirmed

  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.

RECORDING SECRETARY:

SUBMITTED BY:

APPROVED BY:


View Document page

May 21, 2020

Board Members Present:

Gary McNamara, Joe Bachetti, Tracey Bailey, Fabio Costante, Dr. Debbie Kane, Judy Lund, John Scott, Ed Sleiman, Larry Snively, Gary Kaschak, Rino Bortolin

Administration Present:

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


QUORUM:  Confirmed

  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.

RECORDING SECRETARY:

SUBMITTED BY:

APPROVED BY:


View Document page

April 16, 2020

This meeting was held via Teleconference.

Board Members Present:

Gary McNamara, Joe Bachetti, Tracey Bailey, Fabio Costante, Dr. Debbie Kane, Judy Lund, John Scott, Ed Sleiman, Larry Snively, Gary Kaschak, Rino Bortolin

Administration Present:

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


QUORUM:  Confirmed

  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.

RECORDING SECRETARY:

SUBMITTED BY:

APPROVED BY:


View Document page

February 20, 2020

  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


View Document page

PREPARED BY:

Lora Piccinin, Manager of Infectious Disease Prevention/Talaya Harrold, PHN/HPS

DATE:

February 20, 2020

SUBJECT:

Syphilis in Windsor and Essex County


BACKGROUND

Sexually transmitted and blood-borne infections (STBBI) account for the largest burden of all Diseases of Public Health Significance (DOPHS) in Windsor and Essex County (WEC), representing 71% of all reported cases. According to the Health Protection and Promotion Act (HPPA), health care providers have a duty to report cases of STBBI’s to public health, including HIV/AIDS, Chlamydia, Gonorrhea, Hepatitis B, Hepatitis C, and Syphilis.

Local data shows that Syphilis is a significant concern. Syphilis is transmitted through oral, genital, and anal sex with an infected person. Syphilis can also be passed on to an unborn child, sometimes causing birth defects or death. Syphilis is normally diagnosed through a blood test and is treated with penicillin or other antibiotics. If left untreated, syphilis can progress through four stages of infection, with symptoms ranging from sores and rash to multi-organ system damage. Before 2001 syphilis cases in Ontario were rare, but rates have been on the rise. As noted in the Summary of Syphilis in Windsor and Essex County report, from 2017 to 2019, there has been a 134% increase in the crude incident rate of local Syphilis cases. During this same period, there was a 25.6% provincial increase, although the overall rate in Ontario remains higher than in WEC.

Infection of the brain and spinal cord, known as Neurosyphilis, has also been found to be of significant concern as noted in the Summary of Neurosyphilis in Windsor and Essex County report. This complication of Syphilis can result in symptoms such as headaches, dizziness, dementia, a change in personality, and difficulty coordinating muscle movements. In 2019, Neurosyphilis cases comprised nearly 10% of all Syphilis cases in WEC. This number has been steadily growing, with 5.5% and 3% of cases in 2018 and 2017 respectively. In addition to the increased number of Neurosyphilis cases, there has also been a shift in the age of those being diagnosed. From 2010 to 2018, all Neurosyphilis cases were over 45 years of age, however in 2019, half of the cases were diagnosed in individuals 20-44 years of age. 

Individuals at a higher risk of contracting Syphilis and Neurosyphilis include those engaging in unprotected sex, men having sex with men, and individuals having sex with anonymous/multiple partners. To reduce the risk of contracting and transmitting Syphilis and other STBBI’s, individual are encouraged to engage in safer sex practices such as wearing a condom and are further encouraged to get tested.

CURRENT INITIATIVES

Currently, nurses in the Infectious Disease Prevention and Clinical Services departments provide follow up of all laboratory confirmed cases of Syphilis in WEC through the provision of direct clinical services and/or by working with primary health care providers in the treatment of cases. In addition to testing and treatment, nursing staff facilitate the process of contact tracing and confidential partner notification in an effort to decrease further transmission of Syphilis and other STBBI’s.

The WECHU continues to increase community awareness of the risks associated with contracting Syphilis and other STBBIs, especially among those who engage in unprotected sex and also through physician engagement strategies that support our local health care providers in the testing, diagnosis, and treatment of Syphilis cases. Initiatives to date include media segments led by our Nurse Practitioner (NP) and educational sessions for health care providers at various Windsor Essex County Community Health Centre sites.  Additional NP led sessions are planned for the University of Windsor and St. Clair College student health services as well as Family Health Teams. In addition, Dr. Ahmed (MOH) provided an educational session at the Windsor Essex County Medical Society 2019 Annual Meeting,

A public awareness campaign is also under development. Currently data is being collected to explore clients’ baseline knowledge, risk factors and perceived barriers to engaging in safer sex practices in relation to Syphilis. This data will be utilized to direct our public messaging and communication strategy moving forward.

Approved by:

Theresa Marentette, CEO


View Document page

PREPARED BY:

Karen Lukic, Health Promotion Specialist

DATE:

February 20, 2020

SUBJECT:

The WECHU Taking Action on Climate Change


BACKGROUND

Climate change is a long-term shift in weather conditions. It can impact average temperatures, precipitation, wind, and other indicators. It is also linked to more frequent, extreme weather events such as storms that produce torrential rain and tornadoes.  Windsor and Essex County (WEC) have experienced the impacts of climate change in recent years, such as record levels of precipitation which have led to widespread flooding events. There have also been periods of extended heat and the annual blue-green algae bloom in our lakes.  These changes have also created ideal conditions for the survival of invasive mosquito species and a greater presence of insects that carry diseases not historically found in our region. WEC is the first region in Canada to identify adult Aedes aegypti mosquitoes, and have had evidence of the presence of Aedes albopictus mosquitoes since 2016.  Both of these mosquitoes are vectors for viruses not normally seen in Canada, such as Zika, Dengue fever, and Chikungunya.  These climate impacts are expected to persist and worsen as a result of past and present-day emissions (Government of Canada, 2017).

It has become necessary to take action on climate change globally and locally. These actions can have positive impacts on both the environment, and on the health and well-being of WEC residents. Initiatives and policies needed to address climate change can also help to protect human health, reduce health care costs, and improve health equity within our community. Examples include investments to protect current infrastructure from climate-related disasters, and implementing changes to building codes to increase the resiliency of buildings (Government of Canada, 2017). Changes can also be made to reduce the amount of energy we use, and the amount of waste that we generate to reduce our carbon foot print both at an individual and organizational level.

CURRENT INITIATIVES

The WECHU has taken a number of actions to address, manage, and respond to the effects of a changing climate. On November 21, 2019 the Windsor-Essex County Board of Health passed a Local Response to Climate Change Resolution that supports ongoing advocacy efforts and public health interventions to support climate change action locally. These initiatives and programs, implemented in collaboration with key community partners, will support municipalities, local organizations, and individuals to take action and raise awareness levels about the health impacts of climate change.

The WECHU has also conducted a Climate Change and Health Vulnerability Assessment which will be used to identify and understand the impacts that a changing climate will have on the health of the WEC population, and identify those populations most vulnerable to negative health effects. Data from this assessment will be used to develop action plans for the various health impacts affecting our region.

In addition to these broader initiatives, internally, the Health Unit has implemented several changes in recent years to reduce our organization’s environmental impact. Examples include:

  • Creation and implementation of policies that reduce the number of vehicles on the road (e.g. staff carpooling, the use of web conferencing technology)
  • Reduction of energy consumption through conversion of office lighting to LED, and the use of power-saving modes for office equipment
  • Reduction of single-use plastics, and supporting staff to drink more water and less sugar sweetened beverages through the installation of water bottle filling stations within our buildings and removal of beverage vending machines
  • Reduction in office waste by providing ample resources for staff to recycle paper, plastics, glass, and batteries
  • Installation of bike racks at each of the 3 Health Unit offices to encourage active transportation

Looking ahead, the organization will continue to consider its environmental impacts and updates that can be made to our policies, procedures and programs with our new workspace to reflect our organizational commitment. Examples include:

  • Implementation of environmentally friendly purchasing policies that encourage buying local, recyclable goods, reducing waste from food/single-use plastics and put an emphasis on reducing the organizations carbon footprint
  • A building design that conserves energy and water (e.g. LED lighting, use of natural lighting, solar panels, light sensors, power save features on office equipment, low flow toilets and faucets)
  • Allowing for natural, green spaces where possible in the design and incorporating building infrastructure that support staff and client active transportation such as biking and walking

Approved by:

Therese Marentette, CEO

References

Government of Canada (2017) Adapting to the effects of climate change.  Retrieved on January 13, 2020. https://www.canada.ca/en/services/environment/weather/climatechange/climate-action/adapting-to-effects.html


View Document page

Prepared By:

Communications Department

Date:

February, 2020

Subject:

January Media Relations Recap Report

January Media Coverage

Total Media Coverage

59

Interview Requests

30

Mentions (In the news without direct interviews)

24
Requests for Information 5

January 2020 Media Relations Recap - Media Coverage

January 2020 Media Relations Recap - Story Source

Media Coverage

Media Outlet

Number of Requests/Stories

AM 800

11

Blackburn

7

CBC

14

CBC Radio-Canada

2

Chatham Daily News

1

CTV

6

Harrow News

1

St. Clair College/Mediaplex

3

St. Thomas Time-Journal

1

Strathroy Age Dispatch

1

Sudbury Star

1

The London Free Press

1

Toronto Star

1

Windsor Star

8

Yahoo News

1

TOTAL

59

News Release, Media Advisories and Media Statements

Date Type Headline Response

January 8, 2020

News Release

First Confirmed Influenza Death in Windsor and Essex County

6 Stories Reported

January 8, 2020

News Release

Boil Water Advisory Issued for All Users of the Wheatley Water System

4 Stories Reported

January 11, 2020

News Release

Boil Water Advisory Rescinded - Wheatley Water System

2 Stories Reported

January 14, 2020

Media Advisory

Windsor-Essex County Health Unit Board of Health Meeting

8 Stories Reported

January 16, 2020

News Release

Are You Prepared? Potassium Iodide (KI) Pill Pick Up Sessions

5 Stories Reported

January 20, 2020

News Release

Start Your Quit Story this National Non-Smoking Week

1 Story Reported

Stories Reported by the Media

AM 800

Publish Date

Title

January 2, 2020

Increased Demand For Naloxone Says Local Pharmacist

January 8, 2020

First Confirmed Flu Death In Windsor-Essex

January 8, 2020

Boil Water Advisory Issued For Parts Of Wheatley And Leamington

January 9, 2020

First Flu Death Confirmed This Season In Windsor-Essex

January 9, 2020

Student Immunization Deadline Approaching

January 16, 2020

Local Health Unit Making KI Pills Available

January 16, 2020

Pick-Up Sessions Planned For Windsor-Essex Residents To Get Anti-Radiation Pills

January 17, 2020

Local Health Unit Wants To Make Pilot Project Permanent

January 26, 2020

Radon Study Could Result In New Building Code For Essex County

January 31, 2020

Coronavirus Risk Remains Low In Windsor-Essex

January 17, 2020

The Dan MacDonald Show - Breastfeeding Is On The Decline

Blackburn News

Publish Date

Title

January 7, 2020

Respiratory Illness Prompts Local Hospitals To Enact Visitor Restrictions

January 8, 2020

First Flu Death Confirmed In Windsor-Essex

January 8, 2020

Tilbury Area Boil Water Advisory Remains In Place, New One Issued For Wheatley

January 17, 2020

Health Unit Raising Radon Awareness

January 19, 2020

Breastfeeding Rates Remain Low In Windsor-Essex

January 20, 2020

KI Pill Available For Pick-Up In Windsor And Leamington

January 28, 2020

Catholic Board Responds To Coronavirus

CBC News

Note: Digital stories were not available for five of CBC’s requests.

Publish Date

Title

January 8, 2020

Hospitals In Windsor-Essex Being Strained By Spike In Flu-Related Illness

January 8, 2020

Hospitals In Windsor-Essex Being Strained By Spike In Flu-Related Illness

January 8, 2020

First Flu-Related Death In Windsor Area Confirmed By Health Unit

January 8, 2020

Boil Water Advisory Expanded To All Wheatley Water System Users

January 12, 2020

Boil Water Advisory Issued For Wheatley Water System Cancelled

January 14, 2020

How Windsor-Essex Would React To A Nuclear Emergency In Michigan

January 16, 2020

False Alarm Triggers Demand For KI Pills In Windsor Essex

January 17, 2020

Breastfeeding Rates Continuing To Decline, According To WECHU Report

January 20, 2020

A 2-Month Wait To Fix His 2 Front Teeth: The Problem With The Ontario Seniors Dental Program

Chatham Daily News

Publish Date

Title

January 15, 2020

CK Public Health Adding Voices To Its Submission On Amalgamating Health Units

CTV Windsor News

Note: Digital stories were not available for one of CTV’s requests.

Publish Date

Title

January 8, 2020

First Flu Death Confirmed This Season In Windsor-Essex

January 16, 2020

Pick-Up Sessions Planned For Windsor-Essex Residents To Get Anti-Radiation Pills

January 17, 2020

Residents, Businesses And Schools Encouraged To Test For Radon

January 23, 2020

Windsor-Essex Residents Pick Up KI Pills

January 28, 2020

High Number Of KI Pills Picked Up By Windsor-Essex Residents

The London Free Press

Publish Date

Title

January 1, 2020

More Than 47,000 Naloxone Kits Handed Out By Pharmacies in Region

St. Thomas Times-Journal

Publish Date

Title

January 1, 2020

More Than 47,000 Naloxone Kits Handed Out By Pharmacies in Region

Strathroy Age Dispatch

Publish Date

Title

January 1, 2020

More Than 47,000 Naloxone Kits Handed Out By Pharmacies in Region

Sudbury Star

Publish Date

Title

January 1, 2020

More Than 47,000 Naloxone Kits Handed Out By Pharmacies in Region

Windsor Star

Note: Digital stories were not available for one of Windsor Star’s requests.

Publish Date Title

January 7, 2020

Local ERs Cope With 'Surge' In Flu, Respiratory Cases

January 8, 2020

Windsor-Essex Health Unit Confirms Region's First Flu Death Of The Season

January 9, 2020

Boil Water Advisory Issued For Users On Wheatley Water System

January 16, 2020

Percentage Of Local Moms Breastfeeding Drops To 16.3 At Six Months

January 22, 2020

Thousands Of Local Homes Likely Have Dangerous Radon Levels: 'You've Got To Test For It'

January 20, 2020

Health Units Promote National-Non-Smoking Week With Interactive Web Page

January 23, 2020

Medical Officer Of Health Talks About Opioids Awareness

January 27, 2020

Windsor Regional Hospital Remains Vigilant With Coronavirus Protocols

January 12, 2020

Boil Water Advisory Issued For Wheatley Water System Cancelled

Note: Digital stories were not available for CBC Radio-Canada (2), Harrow News (1), St. Clair College/Mediaplex (3), or the Toronto Star (1). 

The following individuals contributed to this report: Jennifer Jershy, Marc Tortola, and Michael Janisse.


View Document page

Board Members Present:

Gary McNamara, Joe Bachetti, Tracey Bailey, Rino Bortolin (via phone until 5:20 pm), Fabio Costante, Dr. Debbie Kane, Judy Lund, John Scott, Ed Sleiman, Larry Snively

Board Member Regrets:

Gary Kaschak

Administration Present:

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


QUORUM:  Confirmed

  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.

RECORDING SECRETARY:

SUBMITTED BY:

APPROVED BY:


View Document page

January 16, 2020

  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

View Document page

Prepared By:

Jennifer Jacob, Nutritionist

Date:

January 16, 2020

Subject:

Breastfeeding in Windsor-Essex

BACKGROUND

The World Health Organization and Health Canada recommend exclusive breastfeeding for an infant’s first six months of life, with continued breastfeeding up to two years and beyond (WHO, 2019). Promotion and support of breastfeeding is an important part of healthy growth and development, providing unique benefits for both the infant and mother. Some of the benefits of breastfeeding include a decrease in risk for Sudden Infant Death Syndrome (SIDS); reduced risk of many childhood illnesses; healthy brain growth and development; and also contributes to a lower risk of chronic diseases for both the infant and mother in later ages.

Despite the benefits of breastfeeding and recommendation for exclusive breastfeeding to 6 months, rates remain consistently low in Windsor-Essex County (WEC) with just 16.3% of women reporting exclusive breastfeeding at six months post-partum (BORN, 2018). Exclusive breastfeeding rates at hospital discharge have remained low over the past years. In 2017, 57.4% of women were exclusively breastfeeding at hospital discharge, significantly lower than the provincial average at 61.2%; in 2018, this rate declined a further 5%. At two months post-partum rates of exclusive breastfeeding in WEC drops to 25.7% (BORN, 2018). 

In 2018, the WECHU received its Baby-Friendly Initiative (BFI) designation. As part of maintaining this designation and requirements in the Ontario Public Health Standards (OPHS), ongoing monitoring of local breastfeeding rates has been established using BORN and our internally administered infant feeding survey.  Additionally, the Windsor-Essex County Health Unit (WECHU) in 2019, committed to reviewing all breastfeeding services provided by the Healthy Families department to ensure programs and services best met the needs of the community. This included an Environmental Scan, in partnership with the Windsor Essex-County Children and Youth Planning Committee, and a Literature Review. Based on the results from our findings, the following initiatives were identified to address the decline in exclusive breastfeeding rates and improve supports for expecting mothers and new parents.

CURRENT INITIATIVES

Collaborating with local hospitals to improve breastfeeding rates at hospital discharge: In 2020, the health unit and Windsor Regional Hospital will offer monthly prenatal breastfeeding classes to prepare women to navigate common breastfeeding challenges within the first 24 hours and beyond. Additionally, the Health Unit will also offer Family Birthing Centre nursing staff with breastfeeding training to improve their ability to assist mothers with breastfeeding initiation and help to build mothers’ breastfeeding self-efficacy, a key predictor of breastfeeding duration (RNAO, 2018).

Policy and Supportive environments: Using the RNAO Breastfeeding Practice Guidelines (2018), the health unit will provide recommendations to Family Birthing Centres to create or improve policies, protocols and procedures to better support a women’s intention to breastfeed.

Improving access to in-person lactation consultation: In 2020, the health unit Lactation Consultant’s (LC) in addition to providing in-house clinic support will also provide home visits for women who have significant barriers to accessing services at the health unit offices. Such barriers may include, mothers who are geographically isolated, have multiple children, and or suffer from a physical ailment or mental health concern. Furthermore, WECHU has added a third LC position to help promote and support exclusivity rates for our breastfeeding families.

Increasing awareness about breastfeeding services in Windsor-Essex County: In 2020, a targeted awareness campaign will be launched to improve awareness about our services among priority populations. In addition to targeted bus and social media ads, the health unit will send promotional material to doctors’ offices and community groups in priority neighbourhoods. Evaluation will be incorporated into existing services to ensure priority groups are accessing these services.

CONSULTATION:

The following individuals were consulted in the development this report: Felicia Lawal, Manager, Healthy Families, Amanda Ryall, Manager, Healthy Families, Nicole Dupuis, Director of Health Promotion.

APPROVED BY:

Theresa Marentette, CEO

References:

Newhook, Newhook, Midodzi et al. (2017). Poverty and Breastfeeding: Comparing Determinants of Early Breastfeeding Cessation Incidence in Socioeconomically Marginalized and Privileged Populations in the FINal Study. Health Equity, 1(1).

Registered Nurses’ Association of Ontario (RNAO)(2018). Breastfeeding - Promoting and Supporting the Initiation, Exclusivity, and Continuation of Breastfeeding for Newborns, Infants, and Young Children. 3rd Edition. Toronto, ON. 


View Document page

Prepared By:

Karen Lukic, Health Promotion Specialist, Environmental Health

Date:

January 16, 2020

Subject:

Radon Gas Initiatives in Windsor-Essex County

BACKGROUND

Radon is a radioactive gas produced when naturally occurring uranium, found in soil and rock, decays. It can’t be seen, smelled or tasted and is in nearly every home across Canada. According to Health Canada (2014), long-term exposure to radon is the second leading cause of lung cancer after smoking and the primary cause for non-smokers. Health Canada has set the Canadian guideline for radon levels in the home at 200 Bequerels per cubic metre (Bq/m3).

In a cross-Canada study released by Health Canada in 2012, 13.8% of homes tested in Windsor-Essex County (WEC) had radon levels at or above 200 Bq/m3 (Health Canada, 2012). This number was comparable to results from the 3-year Radon: Know Your Level study conducted by the WECHU’s Environmental Health Department that found 11% of homes tested in Windsor-Essex County (n=2,364) had levels at or above 200 Bq/m3 (WECHU, 2018).

The WECHU coordinates the monitoring and surveillance of environmental exposures of public health significance, such as radon, and provides the public with education and mitigation options. These activities are required in the Health Hazard Response Protocol, 2018 and Healthy Environments and Climate Change Guideline, 2018.

In February 2019, the WECHU Board of Health passed a recommendation resolution that included a number of progressive public health activities to reduce exposures and risks related to radon exposure in our community including advocating for municipal and public policy updates on testing and mitigation systems and increases to provincial requirements related to acceptable radon levels in newly built homes and buildings.

CURRENT INITIATIVES

Using results from the Radon: Know Your Level study, the WECHU conducted a radon education and advocacy session with members of the Sun Parlour chapter of the Ontario Building Officials Association (OBOA). The Sun Parlour chapter membership is comprised of the Chief Building Officials from the City of Windsor, and 8 municipalities in Windsor-Essex and Chatham-Kent County. The session included a presentation on our study findings and the WECHU’s recommendations for action such as:

  • Changes to municipal building code to include rough-ins for radon mitigation systems in all new residential builds.
  • Radon testing in municipally owned public buildings or buildings with on-site municipal staff.
  • Partnering with school boards, licensed child care centres, and public libraries to encourage radon testing.

As a result of this education and advocacy session, the City of Windsor and all municipalities represented in the Sun Parlour chapter unanimously agreed to adopt a radon rough-in requirement for all new residential construction starting January 1, 2020.
All new home builders will have to comply with this requirement in order to receive approval from the municipal building inspector.  The WECHU, in partnership with the Sun Parlour Chapter, will design radon information labels for distribution to building contractors. These labels will be attached to the radon rough-in pipe system to inform new homeowners of the existence of the roughed-in system and provide direction to homeowners if action is required.

Residents of WEC continue to receive education about radon and its risks, where to purchase testing kits, as well as information about mitigation options for homes with high radon levels. This information is currently available on the WECHU’s website and reinforced each November in recognition of Radon Action Month through a variety of free and social media methods.

APPROVED BY:

Theresa Marentette, CEO


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