Board of Health Meeting
Chair Keith Egli – Verbal report
June 21, 2021
Recognition
of 215 Indigenous children whose remains were found in BC
On May 30th,
flags across the country were lowered
to honour the lives and memories of the 215 Indigenous children whose
remains were found at a former Residential School in Kamloops, British
Columbia. Sadly, we know that there are many more children across the country
whose remains have yet to be recovered.
It
is important that we not only recognize the impacts of colonization, but
that we actively work to raise awareness of the residential
school system, and how its multi-generational impacts are
still felt today. The impacts of residential schools are
long-lasting and while they seem far in the past, they are quite
recent.
It is important that we continue our Reconciliation journey. As
each of us reflects on our individual and collective responsibilities, let us
examine our beliefs, structures, systems and our relationships with Indigenous
Peoples. I encourage everyone to read the Truth and Reconciliation Commission’s
report and Calls to Action and to consider what we can do as a public
health organization to actively address the legacy of colonization and ongoing
systemic racism in Ottawa, and beyond. In doing so, we
will honour Indigenous children and their families who were harmed by
the Residential School System.
Update on
Stigma training to Members of Council and their staff
As part of
my Verbal Report in April, I updated Board Members on Stigma training that
OPH’s Mental Health and Substance Use Unit
provided to Members of Council and their staff titled Stigma: The Power of
Language in Supporting Your Community and how well
received it was.
Board
Members may recall that in April, I reported on the two virtual
sessions held in March. Further to discussions at the April meeting, the
training was offered again in May and an
additional 2 Councillors and 12 Councillors’ assistants
participated.
As explained
in April, this thirty-minute training helped explain what stigma is and
how it might prevent people from seeking proper care. It also provided tips and
suggestions on how to use language that prevents stigma, including concrete
examples that we can all use in our daily interactions.
I would
again like to thank the team for organizing this training – namely, Linda
Cove, Caroline Bala, Chanel Brown and Erin McClelland.
I’m
told that OPH’s mental health team is exploring options to make this training
more broadly available within the City.
Awards
and Recognitions
As
some of you may know, every year for the past 20 years, the Ottawa
Board of Trade and Ottawa Business Journal recognize 40 young entrepreneurs
under the age of 40 for their business achievement, expertise and community
involvement through their Forty Under 40 award.
The Forty Under 40 is one of the most
distinguished and sought-after awards for young business leaders in the
National Capital Region and this year, I’m very happy to share the news that
OPH’s very own Benjamin Leikin, Program Manager of
Mental Health and Substance, will be one of the recipients.
Ben’s drive
and dedication to bringing awareness to improving mental health in our
community is very commendable.
Please
join me in congratulating Ben who, along with the other 39
recipients, will be celebrated on Wednesday
June 23 at 8 pm in a live
streamed presentation.
Rogers subscribers can watch on channel 22 on
YouTube Live. Closer to the broadcast date, a YouTube Live link will be posted
on the Ottawa Board of Trade’s Forty Under 40 webpage, which the Board
Secretary will be happy to share with Board Members.
I
am also proud to share that the International Association of Business
Communicators Ottawa has selected Ottawa Public Health’s
Communications and Community Engagement team as this year’s recipient of
its Communicator of the Year award.
Throughout
the COVID-19 pandemic, OPH’s social media feeds have been a key source of
information, and often humor, for people in Ottawa and beyond. OPH’s
Communications and Community Engagement team has worked hard to keep
abreast of the latest information and to provide clear, engaging and timely
communications to the public, to partners and to
stakeholders. Their approach has focused on
honesty, empathy, relatability and respect while injecting humour and
recommending actions residents and partners could take to restore a
sense of control in an ever-evolving situation. As
such, this is a well-deserved honour and, on behalf of the Board of
Health, I’d like to offer heartfelt congratulations to the entire
team.
Canada
Day
As you all
know, Ottawa’s COVID-19 rates have been slowly coming down over the past
several weeks. At the same time, our vaccine coverage has been
steadily growing.
I want to
thank Ottawa residents for their part in these successes. It’s thanks to your
continued adherence to public health measures that we’ve been able to bend the
curve of COVID-19 in Ottawa and thanks to your willingness and eagerness to
access the vaccine that we’re growing our coverage rates daily.
Decreasing
COVID-19 rates and increasing vaccination coverage coupled with
the beautiful summer weather and
gradual reopening of our economy have me feeling cautiously optimistic – and
I’m sure I’m not alone in feeling this way.
With Canada
Day around the corner, many may be thinking about how to celebrate this year.
Although we
are getting closer to our goals, we’re not quite there yet so I would
ask everyone to please celebrate safely if you are
celebrating this Canada Day. If you’re going to get together with a small
group of friends or family, remember that outdoors is much safer than indoors.
Keep physical distancing and wearing a mask in situations where you can’t
maintain physical distancing, keep up with your hand hygiene and stay home if
you’re not feeling well.
It’s
important that we all keep doing everything we can to keep COVID-19 under
control in our community to prevent a resurgence.
That
concludes my Verbal Report. I would be happy to take any questions.
Board of Health Meeting
Dr. Vera Etches – Verbal report
June 21, 2021
Kwey, Ulaakut, Taanishi, Bonsoir, Good evening,
In tonight’s Verbal Report, I will provide updates on our
work with First Nations, Inuit and Métis partners and community members, our
efforts in combatting racism, the local COVID-19 situation and vaccine rollout
in Ottawa, including an update on case and contact and outbreak management, and
a bit of a look ahead to the fall with respect to the Board’s mental health and
substance use strategic priority, the return to school and more in-person work,
and OPH’s rejuvenate, restore and re-imagine planning.
Work with First Nations, Inuit and Métis partners and
community members
Ottawa Public Health recognizes the unique impacts that
the COVID-19 pandemic has had on First Nations, Inuit, and Métis communities,
given pre-existing disparities arising from the experience of colonization. We
have been supporting local Indigenous-led organizations who have been on the
front lines, working to protect community members. And we recognize the
additional grief for many with the news of 215 children’s bodies being found on
the grounds of a BC residential school. Our aim is to support Indigenous
leadership within Ottawa as they help with healing from residential school
trauma and loss.
A key aspect of OPH’s Board-approved Reconciliation
Action plan is to keep learning in relationship with Indigenous partners and
OPH team members. We have been regularly meeting with partners with a focus on
the pandemic response and advancing COVID-19 vaccination together. Team members
and I are reconnecting with other Indigenous leaders this month to listen and
hear what more we could be doing to respond and recover in a way that builds
more access to health and well-being.
We continue to work through the Reconciliation Action
Plan and would normally provide the annual evaluation at this June meeting. We
will be bringing the feedback from partners to you in a September report this
year. It’s important to note that the Reconciliation Action Plan is not a
checklist. It’s about engagement, relationship building and ongoing learning.
We are taking the lead from partners about what’s needed at this time.
Board Members may be aware that Indigenous adults were
identified as a phase one population in Ontario’s vaccine roll-out. OPH has
been working with the Wabano Centre for Aboriginal Health and Akausivik Inuit
Family Health Team, as well as Tungasuvvingat Inuit to offer culturally safe
access to COVID-19 vaccinations for First Nation, Inuit, and Métis community
members in Ottawa. Through these partnerships, nearly 30,000 first and second
doses of the COVID-19 vaccine have been provided to date.
OPH is also partnering with the Ottawa Aboriginal
Coalition’s Research Committee on a study to understand and document First
Nation, Inuit, and Métis peoples’ experience with COVID-19 from the
perspectives of community members as well as urban Indigenous service providers
in Ottawa.
Anti-Racism Work
As previously noted,
COVID-19 has had a disproportionate impact on racialized communities in Ottawa. In particular,
the impact was most severe on communities affected by the intersections of
race, immigration, and low-income living. Black immigrants in low-income
neighborhoods seem to be experiencing the most adverse impacts.
We continue to see the evidence that racism is a public health issue, as was
stated in a motion adopted by the Board at its meeting of June 15, 2020.
Racism, discrimination, and stigma are associated with
poor physical, mental and emotional health and higher mortality rates. / Le
racisme, la discrimination et la stigmatisation sont associés à une mauvaise
santé physique, mentale et émotionnelle et à des taux de décès plus élevés
The World Health Organization had identified “Social
inclusion and non-discrimination” as a global social determinant of health.
According to the WHO, “social determinants of health (SDH) are the non-medical
factors that influence health outcomes. They are the conditions in which people
are born, grow, work, live, and age, and the wider set of forces and systems shaping
the conditions of daily life… Research shows that the social determinants can
be more important than health care or lifestyle choices in influencing
health”. Health Canada has also classified race/racism as a determinant of health,
noting that “Experiences
of discrimination, racism and historical trauma are important social
determinants of health for certain groups such as Indigenous Peoples, LGBTQ and
Black Canadians.”
I want to take this opportunity to reiterate that OPH is
committed to engaging and working with residents, partners, and communities to
develop the conditions to support health and health equity for everyone in
Ottawa. / Je tiens à répéter que SPO s'engage à collaborer avec les résidents,
les partenaires et les communautés afin de créer les conditions nécessaires
pour favoriser la santé et l'équité en matière de santé pour tous à Ottawa.
We are also committed to respecting the diversity of all residents
and we strive to ensure that the services we provide are free from
discrimination and inclusive and that they are reflective of all we serve. We
embrace diversity at all levels, including race, ethnocultural identity, and
immigrant status.
In terms of work with racialized populations at this
point:
COVID-19 and Sociodemographic Data (SDD):
OPH is continuing to monitor and analyse
socio-demographic data to understand COVID-related inequities. These insights
have been used to guide vaccine allocation decisions y basis and to continue to
support populations that are the most disproportionately impacted by the
pandemic. Progress has been made in diversifying the OPH workforce to better
orient our services for the greatest impact. OPH’s Community Operations Section
has worked to establish a Community Informed Pilot with Somali, Arabic and
French speaking African Caribbean and Black (ACB) populations. OPH team members
continue to engage with partners and residents to identify barriers to
accessing vaccine and tailoring options for various communities.
I am meeting regularly with the Director of the Ottawa
Local Immigration Partnership, Hindia Mahamoud, to advance collaborative work
focused on improving the health of newcomers and the racialized population in
Ottawa. I was invited to participate in a recent Black Health Summit with
Hindia to share ideas for a more equitable vaccination program and I am
continuing to join in Ontario Health’s Black Health Plan Work Group to advance
health system initiatives focused on the health of the Black population in
Ontario. The ongoing work to build meaningful relationships with communities
will further inform OPH’s approaches into the future.
ACB & Diverse Populations Mental Health:
OPH continues to advocate for the implementation of
recommendations from the Mental Health of Ottawa’s Black Community Research
Study while also identifying opportunities to share research
findings. Following the release of the report, OPH completed a needs assessment and developed training for faith
leaders given that findings from the study indicate that faith centres were
among the top 3 locations African, Caribbean and Black participants sought
mental health support. To date, over 400 faith leaders have been reached with
mental health promotion and crisis prevention training. In addition, OPH worked
with Somerset West Community Health Centre to complete an environmental scan of
ACB specific mental health services. OPH is an
active member of Ottawa’s Black Mental Health Coalition and worked with the
coalition to host information sessions to commemorate Black Mental Health Week
2021 (March 1st to 7th). OPH implemented a communications
plan to increase awareness of the significance of Black Mental Health Week, and
to promote ACB specific community mental health services. On the Launch of
Black Mental Health Week (March 1st), OPH participated on the panel
discussion to share findings from The Mental Health of Ottawa’s Black
Community and promote services specifically available for Ottawa’s Black
community. Fifty participants joined on zoom and additional 549 joined on
Facebook.
Anti-Racism Work:
OPH team members have developed an Anti-Racism and
Anti-Oppression workplace policy, which is currently
being reviewed through OPH team member and community partner consultations. OPH
is a member of the Equity Ottawa Community of Practice, focused on internal
capacity building for cultivating inclusive and equitable organizations in
Ottawa.
While OPH has made progress in recruiting and hiring
people who represent the community for the School team, Community Engagement
team and others, the leadership team appreciates the need to be deliberate in
the application of human resources approaches, informed by the City’s
anti-racism secretariat, to retain a diverse workforce and promote more
diversity amongst management.
OPH expanded the haveTHATtalk
campaign to include 3 additional videos on the impacts of racism and
microaggression on mental health and how to talk to and support youth
experiencing racism/discrimination and how to be an ally. Also on this topic,
in April, OPH
teams collaborated with the City of Ottawa’s
Anti-Racism Secretariat, Somerset West CHC and the City’s Community and Social
Services Department to host an information session on Race-Based Stress
for 17 staff from Youth Futures, Neighborhood Ambassadors and the Boys and
Girls club. The interactive session was informed by youth and very well
received. A recording of the session is available to youth program coordinators
to deliver to new staff in order to increase their understanding of impacts of
racism and provide strategies to better cope with stress.
Following the Board’s June
2020 motion, we will make use of an upcoming Board strategic retreat in late
summer to host a learning opportunity on racism as a public health issue and
seek your input on how to further build more anti-racism work into our
strategy.
We know that part of the OPH role is to raise awareness
about racism and the impact it can have on people’s health and wellbeing, to
build buy-in for countermeasures. Racism is a difficult subject to discuss in
some formats, like social media, and together we continue to learn about how to
speak to racism as a public health issue.
The lessons learned about
how to discuss racism and health are key to advancing the work with community
members, health, social services, education, business and other partners needed
to close the gap in health status for racialized and Black populations, as well
as Indigenous peoples. / Les leçons apprises sur la façon de parler du racisme
et de la santé sont essentielles pour faire avancer le travail avec les membres
de la communauté, les services de santé, les services sociaux, l'éducation, les
entreprises et les autres partenaires nécessaires pour combler les écarts dans
l'état de santé des populations racialisées et noires, ainsi que des peuples indigènes.
Current COVID-19 Situation in Ottawa
Moving on to the current COVID-19 situation in Ottawa –
On June 11th, the Province moved to Step 1 of
its reopening plan. As both residents and business owners celebrated this move,
it was refreshing to see Ottawa coming alive again.
The pandemic has been especially difficult for local and
small businesses so we are pleased to see the gradual reopening and some return
to normalcy. I want to thank businesses for their perseverance and their
continued commitment to implementing public health measures within their
facilities as things reopen. We
know this is important to protect themselves, their wokers and their clients. /
Je veux remercier les entreprises de leur persévérance et de leur engagement
continu à adopter des mesures de santé publique dans leurs locaux pendant la
réouverture. Nous savons que c'est important pour leur protection, celle de
leurs employés et de leurs clients
I also want to thank Ottawa residents for continuing to
respect public health measures when visiting local businesses. We encourage
everyone to keep supporting local businesses whenever and however they can.
With
respect to the data -
Many of our indicators continue to show a positive trend.
Outbreaks and hospitalizations continue to decline, as do the number of people
testing positive for COVID-19. Most notably, our weekly COVID-19 rates have
gone from 208.5 cases per 100,000 people per week at
their peak in mid-April to the current rate of 13.7 per 100,000 people per
week.
However,
we are also seeing testing numbers go down and the COVID-19 wastewater viral signal has been fluctuating. I am also mindful that the level of transmission in
the community now is much higher than what it was last summer. And we
are now contending with the more transmissible COVID variants compared with the
original virus last year.
We will
need to reach higher levels of immunization with two doses before we can
rely on vaccines alone to keep COVID-19 at a low, manageable level that does
not lead to significant hospitalizations, and this will not happen until closer
to the end of the summer.
We can
expect further guidance from the federal and provincial level for
those at different stages of the vaccination process. For now, my advice is the
same for everyone regardless of your vaccine status: continue to maintain a
distance from those outside your household. Wear a mask when you cannot
maintain distance. Choose lower-risk activities; stick with outdoors as much as
possible and avoid crowded places.
With respect to our
vaccination efforts, as of last night, 76% of Ottawa’s adult population has
received at least 1 dose and 20% have received 2 doses. As for Ottawa’s overall
population, 65% or residents have received 1 dose and 16% have been fully
vaccinated.
OPH and the City of Ottawa continue to operate community
clinics at locations across the City and pop-up clinics in priority
neighbourhoods. COVID-19 vaccines are also available at pharmacies in and
around Ottawa, as well as in some primary care settings. The website
Ontario.ca/COVIDVaccine provides residents with information on appointment
booking options, including a list of participating pharmacies. Our own website
- OttawaPublicHealth.ca/COVID19Vaccine is also regularly updated with clinic
information and a variety of Frequently Asked Questions about COVID-19 vaccines
– including information about vaccine safety and efficacy.
The vaccine rollout continues to incorporate
neighbourhood-based approaches, which includes supporting individuals
disproportionately impacted by COVID-19 and who may face increased
barriers to access the vaccine. In addition, with the expansion of eligibility
to include the 12 to 17-year old age group we are building confidence and
promoting youth access to the vaccine with a focus on having eligible youth
fully vaccinated before the start of school.
I want to take a moment to thank Mr. Anthony DiMonte for
his leadership, for the support of the City’s Senior Leadership Team, the
Emergency Operations Centre team and all involved in the continuously adapting
vaccination program. There is no question that you have made a significant
difference in the health of our population.
Case and contact management and managing outbreaks
Other ways OPH learns about the local
COVID-19 situation, and is working to promote a low, manageable level of
COVID-19, are through follow-up with people who test positive and their
contacts, as well as recognizing and managing outbreaks.
Following
the spring surge, OPH has since resumed full contact tracing investigations
with all people who test positive. The team is using digital tools to collect
information at times and is also working with the provincial contact tracing
team for assistance with collecting socio-demographic information. Most known
exposures continue to be from household contacts and social contacts (51%),
followed by outbreaks (9%) and rarely travel (<1%). Case and contact management
team investigators are on the look-out for the origins of people testing
positive, as well as preventing onward spread, yet the percent of situations
where someone is unable to identify a source continues to be about 28% of the
time, a figure that suggests undetected community spread.
The
voluntary isolation centre’s initial funding from the federal government is
dated to the end of this month and because the centre continues to be used, the
team is seeking an extension to the service, which can be assessed on a
month-by-month basis.
Though
we have seen a decrease in outbreak numbers, we continue to see outbreaks in
institutional settings and workplaces and we continue work aimed at preventing
outbreaks through promotion of appropriate infection prevention and control
practices with our partners at the Regional IPAC Hub.
With respect to workplaces, the Ontario
Ministry of Health defines an outbreak as “two or more lab-confirmed
COVID-19 cases with an epidemiological link in the workplace (for example, same work area,
same shift) within a 14-day period where both cases could have reasonably
acquired their infection in the workplace”. This means that one person testing
positive for COVID-19, or even multiple people testing positive, would not
necessarily meet the definition of an “outbreak”.
As part of its COVID-19 case and contact
management process, OPH communicates with every resident who receives a
positive COVID-19 test to identify locations they may have visited while
contagious, obtain a list of close contacts, and provide information on
measures needed to prevent any further spread of infection. The next step is to
notify residents who are deemed to be a high-risk close contact of someone who
has tested positive to provide them with information based on their individual
level of risk.
OPH investigates all reports of COVID-19 illnesses in
workplaces and works directly with the individuals who have tested positive as
well as with the workplace itself to determine risk of transmission and risk to
employee/public health and safety. / SPO fait enquête sur tous les
rapports de maladies liées au COVID-19 dans les lieux de travail et travaille
directement avec les personnes qui ont été testées positives ainsi qu'avec le
lieu de travail lui-même pour déterminer le risque de transmission et le risque
pour la santé et la sécurité des employés et du public.
OPH’s COVID-19 Daily Dashboard
contains all publicly available information about the COVID-19 situation
locally, including a detailed list of outbreaks. Workplace outbreaks are noted
at the bottom of the dashboard under “Community outbreaks” and broken down by
type of workplace or setting. Anonymous outbreak-specific data are available
regarding workplaces through Open Ottawa.
OPH publicly discloses the
name of a workplace if there is a known
exposure risk to the public and a lack of contact information. In these rare
instances, OPH may rely on public advisories and the media to reach the wider
public. OPH only orders a premise closed based on public health risk assessment
when required to further investigate or address an ongoing risk to people. This
is consistent with the practice of other public health units across Ontario.
Protecting
the privacy of individuals who have tested positive for COVID-19 remains a top
priority. It is also important for OPH to maintain positive and trusting
relationships with businesses as we rely heavily on the cooperation of business
owners and the general public to provide details about close contacts during
the case management process.
When it comes to workplaces and
institutional settings, OPH’s role is to support infection prevention and
control practices and outbreak management.
Regarding other working conditions,
Members will recall that as a result of a February 2021 report on the Lessons
Learned from COVID-19, the Board took a position on the issue of paid sick
leave and through that report, OPH and the Board of Health recognized the
importance of a living wage, paid sick leave, stable employment and job
security in order to ensure that workers have safe work environments and that
they are able to stay home when sick – thereby reducing the risk of bringing illness
into the workplace.
Outbreak at the Ottawa Carleton
Detention Centre
The largest institutional outbreak in Ottawa last week
was at the Ottawa Carleton Regional Detention Centre, and that outbreak has now
been declared over.
OPH worked closely with the detention centre and met with
representatives of its outbreak management team daily. Employees and people in
the centre are provided with personal protective equipment as needed and the
facility follows recommendations for the management of symptomatic or COVID-19
positive staff and inmates.
OPH led an on-site vaccine clinic at the facility during
the week of May 17 for people in the centre and assisted in coordinating an
additional staff vaccination clinic on June 12th. The Ministry of the Solicitor
General is now working with provincial correctional facilities to provide
inmates the opportunity for COVID-19 vaccinations, including new admissions, on
an ongoing basis. The Ministry also provided all frontline corrections staff
with an online booking link from the local public health unit to encourage them
to attend a community vaccination clinic.
In addition, OPH has recommended that the Ministry of the
Solicitor General establish practices to monitor the vaccination coverage rates
of staff and inmates on a weekly basis to guide on-site immunization efforts.
Looking Ahead
Given that this is the last Board of Health meeting
before the fall, and some teams are slowly growing their capacity for
non-COVID-19-related work, I wanted to highlight some of the work OPH is doing
over the summer months, particularly with respect to mental health and
substance use and in preparation for the return to school and more in-person
work for many in September.
On June 2nd, the Province announced that
schools would remain closed for in-person learning for the remainder of the
school year. We know that school closures have had a negative impact on the
mental health of children, youth, parents, and caregivers so the news was
difficult for many to hear.
I am hopeful that after a summer of carefully easing
restrictions and progress with our vaccine rollout, that students, education
workers, parents and caregivers will be in for a successful return to school in
the fall. / Je garde l'espoir qu'après un été de levée prudente des
restrictions et de progrès dans la vaccination, que les élèves, les
travailleurs de l'éducation, les parents et les soignants pourront reprendre
l'école avec succès à l'automne
Ottawa Public Health nurses have been and continue to
work closely with our local schools and school boards as well as with community
partners to support the mental health of children, youth, and education workers
in various ways.
We are committed to doing all we can to ensure that
children, youth, parents and caregivers have the support of in-person school in
the fall. The team is carrying out an assessment of the 2020-2021 school year
and identifying ways to ensure that students, parents and education workers
will have the information and resources they need to make the upcoming school
year as healthy as possible.
I know the team will present their findings to the Board
in September and their plans include: COVID-19 processes and protocols for
cases and contacts; screening, and testing supports; linkages and supports for
mental health and substance use; and re-introducing the availability of some
essential Ontario Public Health Standards - School Health supports and services,
such as school immunization, healthy sexuality, dental health, mental health
and resiliency, tobacco, vaping, and substance use programming.
In addition to working closely with local school boards,
OPH is also planning and working closely with the Kids Come First Ontario
Health Team, as CHEO and other partners have advocated and collaborated for the
health of children and youth throughout the pandemic. We want to thank them for
their ongoing commitment and support.
With our Kids Come First partners, we reached out and
asked local youth groups to share a 1-minute video describing how they are
coping with the COVID-19 Pandemic as part of our #YourMinute video campaign.
The goal of this for-youth, by-youth messaging is to inspire others and
normalize experiences by sharing stories and coping strategies, while fostering
hope and resilience. These youth groups have put together some wonderful
messages that promote mental health and provide practical coping tips.
Alongside our partners at CHEO we will be launching the videos this coming
Wednesday. I encourage you to check out our Social Media Platforms on Wednesday
to be inspired and to help share these messages with the youth and young people
in your lives!
With respect to mental health and substance use more
broadly, I want to thank
Member Menard for reaching out to OPH recently with an inquiry about overdose
data in Ottawa and the topic of decriminalization of people who use drugs. Based on the latest available data, confirmed opioid
overdose-related deaths in Ottawa have approximately doubled, from 65 in 2019
to 123 in 2020 while suspected drug-related overdose deaths have increased by
75%, from 124 in 2019 to 218 in 2020. Opioid-related hospitalizations
also increased throughout 2020 and remain at levels alarmingly higher than what
we were seeing prior to 2020. Board members and OPH team members know that each
person behind these figures is grieved by friends and family and that more must
be done to prevent deaths due to problematic substance use.
A May 2021 report published on behalf of Public Health
Ontario, the Provincial Coroner and others, points to a rise in opioid-related
deaths in almost all areas of the province over the pandemic period compared to
2019, with the vast majority being accidental deaths. Across Ontario, males,
people 25-64, and people unemployed stand out as groups disproportionately
represented in the statistics. Of people employed, the construction industry
accounted for 29% of people dying from opioid overdose. As well, although the
vast majority of people dying were living in a private dwelling at the time of
their death (71%), the number of opioid-related deaths among people
experiencing homelessness more than doubled to account for 16% of all
opioid-related deaths in Ontario.
OPH’s work to mitigate harms from problematic substance
use in the course of the pandemic included adapting our supervised consumption
service to pandemic conditions, supporting supervised consumption services for
people who are homeless who needed to isolate, increasing access points for
naloxone, and coordinating implementation of a safer supply program with five
partners to increase access to prescribed opioids where indicated. Harm
reduction work that OPH was not able to advance as much in the context of the
pandemic included work with hospitals and primary care providers to address
stigma and increase harm reduction approaches within institutions as well as
work with employers, including building on connections with the construction
industry.
OPH has seen that supervised consumption service clients’
needs and challenges have grown, such that more comprehensive approaches are
needed to better support complex mental health, substance use and housing and
social services needs.
The Board is aware that OPH has been working on the
systemic change required to reduce harms from substance use through
collaboration across organizations and sectors through the Ottawa Community
Action Plan, which was reaffirmed in 2020.
Last week, OPH launched a new Ottawa Community Action
Plan website, together with the group’s core sponsors: The Community Addictions Peer Support
Association, The Royal, The Canadian Centre on Substance Use and Addiction, and
The Canadian Public Health Association, to continue to call people to work together
to address opioid overdoses and highlight the foundation established for
ongoing work. This new page can be accessed at OttawaPublicHealth.ca/OCAP –
that’s O. C. A. P.
The plan is intended to be inclusive and
has been shaped and led by engagement with a broad range of individuals,
agencies and existing networks representing people with living experience and
expertise, Indigenous Peoples, newcomers, visible minorities, women, LGBTQ++
and priority populations.
The website demonstrates how the Ottawa community has
been involved and working together to provide varying perspectives and
expertise to drive action on:
·
addressing
stigma related to substance use that still widely exists;
·
leading
the way in providing access to harm reduction services; and,
·
creating
a more centralized and simplified way to access substance use and mental health
services in Ottawa.
Actions have been implemented in these three areas over
the last year, including significant progress on access to mental health and
substance use supports for adults through AccessMHA.ca led by the Regional
Coordinated Access team, and as well for children, youth and families through
the 1 call 1 click portal, recently launched by Kids Come First. These
new regional coordinated access points are major milestones, however, expanded
services to meet the demand are also needed.
OPH has also been supporting a greater municipal role as
the City’s services can help make a difference with respect to mental health
and substance use, and this community priority will be advanced with the
Community Safety and Well-being work led by the City. OPH will continue to
participate in the Community Safety and Well-being initiatives to align efforts
for the greatest impact.
And, community conversations continue to inform new
actions under each of the Community Action Plan’s three areas of focus. While
decriminalization of people with simple possession of substances was not the
top priority surfaced for harm reduction work identified at the 2020 Summit,
understanding is growing that decriminalization may also contribute importantly
to addressing the stigma related to substance use. Stigma prevents people from
accessing the supports that they need. Harm reduction partners have planned a
forum to flesh out recommendations specific to Ottawa on this subject at the
end of the summer.
Also on the topic of harm reduction services, this month,
the Ministry of Health released an updated Consumption and Treatment Services
Compliance and Enforcement Protocol, 2021, required under the Ontario Public
Health Standards, which will require Ottawa Public Health to conduct
inspections and post the results for all supervised consumption services and
consumption and treatment services in our jurisdiction, on an annual basis and
based on complaints. The Ministry will identify a body responsible for
inspecting OPH’s supervised consumption service. This is a new accountability
for OPH and we will be working with partners to make clear the provincial
expectations for sites, including extending to a 15 metre perimeter arounds
sites.
As the Ottawa Public Health Board assisted with a culture
shift from viewing problematic substance use as a crime towards understanding
of the health condition, and with the community conversation about how
supervised consumption services are one element of the supports needed to
address problematic substance use, OPH will bring information forward for the
Board to consider their role on the subject of decriminalization. OPH is also committed to the meaningful involvement
of people with lived and living experience as part of these ongoing dialogs and
throughout all phases of potential drug policy reform. Broader community
engagement and consultation will also play an important role to address
questions and concerns, such as are still arising related to supervised
consumption services, and to build solutions. Addressing stigma and
discrimination related to substance use and expanding access to harm reduction,
mental health, substance use and social services relevant to the local context
and needs are crucial components of the required response. All areas of the
Ottawa Community Action Plan must be advanced to be able to significantly
reduce the loss of life from overdoses and promote healthy communities.
The pandemic has increased the demand and need for mental
health and substance use programs, resources, supports and services more
broadly beyond addressing opioid use disorders. Therefore, despite staffing and
resource challenges related to the pandemic response, throughout the pandemic OPH has continued to work with school boards, hospitals, community
health, workplaces, multicultural and racialized community partners, and the
general community in the delivery of mental health and substance use programs
and services.
OPH recognizes that mental health and
substance use needs will remain a high priority post-pandemic. To further
inform new actions for our evolving context under the Board’s strategic
priority related to mental health and substance use, OPH team members are engaging
with partners and the community over the summer to lead to recommendations in a
September report.
Recovery
As the pandemic response
and COVID-19 vaccine coverage rates continue to advance in Ottawa, OPH is
looking ahead to the future. / Alors que la réponse à la pandémie et les taux
de couverture vaccinale par le COVID-19 continuent de progresser à Ottawa, SPO
se tourne vers l'avenir.
OPH has initiated Recovery
Planning for the organization. This plan will be informed by employees,
partners and yourselves.
OPH’s Recovery Planning has
one overarching goal: to build a stronger, sustainable local public health
system that collaborates across health and social sectors. It includes three
key components:
·
Rejuvenate:
Support employee wellness
·
Restore:
Restore prioritized services and programs while supporting the community
recover from the pandemic; and
·
Reimagine:
Identify opportunities to advance and strengthen OPH’s programs, services and
processes for the future.
While there are still many
unknowns, we do know that the way in which Ottawa Public Health meets its
mandate moving forward will look different post-pandemic as many teams have
already changed how they do things. OPH will build on the relationships formed,
lessons learned from the pandemic, and identify new opportunities for the
future – with
a focus on health equity, particularly the health of Indigenous, Black,
racialized, newcomer and low-income populations, collaboration, innovation and
developing sustainable health and social systems.
While many employees are
still working under ever-changing circumstances, a critical component of the
recovery plan includes a focus on employee wellness – addressing the needs of
employees to spend time with their family and friends and have a better work-life
balance. Employees are seeking certainty, stability and reduced workloads. In
addition, we recently received results from the City’s Spring Employee Pulse
Check. There are many positive improvements from the Fall survey including:
·
Significantly
more employees feel supported by their leader and feel their leader embodies
servant leadership behaviours more than they did in the fall.
·
Most
employees feel supported by their leaders and have the tools that they need
·
Employees who feel supported by
the person they report to and who have regular coaching/feedback conversations
are doing better than employees who aren’t.
And we have identified areas for
action, including to address that:
- General well-being has
deteriorated for almost half (47%) of employees since the pandemic started
- Work demands have increased
for 83% of employees
- OPH’s Program Managers in
particular reported deterioration of their general well-being, managing
work-life balance, being extremely or very concerned about their mental health,
and feeling overwhelmed in March.
- Consequently, as an update
to the report in front of you today - OPH’s Strategic Plan for 2019-2022 –
Update from Quarter 1 of 2021 – which notes that Goal 4 – A healthy workplace and
workforce – is grey – based on the results that we have received, since
publishing the report, I would update that status to red
The OPH Senior Leadership
team is meeting with managers to identify actions that have made and that can
continue to make a difference in their wellbeing. We are also working with
employees to update our Wellness@Work plan to address concerns identified in
the survey, including efforts to address workload and to communicate about
OPH’s future workforce plans as soon as we have more clarity regarding ongoing
needs and catch-up initiatives.
Over the summer, our continued focus will be on COVID-19
immunization, case and contact management, as well as outbreak management – to
continue our work to reduce the transmission of COVID-19 in our community to
enable more people to be back at work and accessing the supports they need. We
will also be working with our partners – planning for the Fall – in which many
will be returning to in-person work and school.
In the Fall, we will continue our COVID-19 response,
while focusing on restoring limited programs – including mental health,
substance use, dental, healthy growth and development, and immunization work.
These programs will support our community’s recovery from the pandemic, support
students’ return to school, reduce further harms in our community and address
waitlists for our services. There will be catch-up work that extends into 2021.
While there are many unknowns, which may impact our
strategic priorities, , including changes in operations of our local healthcare
partners as well as possible changes in municipal, provincial and national
post-pandemic healthcare and social services sector planning, funding and
strategies, we will engage closely with our partners to help inform our future
planning.
Before the end of the year, demand for COVID-19
immunizations will be tapering, and we will be able to engage more of OPH in
looking at lessons of the past and issues of the future as a catalyst for
reimagining what we will be doing and how we will be working in 2022 and
beyond.
That concludes my verbal report. I would be happy to take
any questions. / Cela conclut mon rapport verbal. Il me fera plaisir de répondre à vos
questions.