Ottawa Board of Health
MINUTES 14
Monday, November 30, 2020, 5:00 PM
By Electronic Participation
Contact for the Ottawa Board of Health:
Diane Blais, Board of Health Secretary
613-580-2424, ext. 21544
Diane.Blais@Ottawa.ca

Board Members:
Chair: K. Egli
Vice-Chair: T. DeGiovanni
Members: E. Banham, J. Cloutier, E. El-Chantiry, G. Gower, T. Kavanagh, L. Leikin, S. Menard, S. Pinel, P. Tilley

The Ottawa Board of Health met via Zoom, on Monday, November 30, 2020 beginning at 5:00 PM.

Councillor Keith Egli, Chair of the Board of Health, presided over the meeting.

CONFIRMATION OF MINUTES

Confirmation of minutes of the meeting of November 2, 2020.

CONFIRMED

COMMUNICATIONS

Four communication items have been received (held on file with the Board of Health Secretary).

Following a ‘Consent Agenda’ process, the Board considered the held items in the order in which they appear on the Agenda.

At approximately 6:45 p.m. and before moving on to the next Agenda item, the Board approved a motion to extend the time of the meeting beyond 7:00 p.m.

4.		2021 DRAFT OPERATING BUDGET FOR THE OTTAWA BOARD OF HEALTH
		ACS2020-OPH-PCS-0006
	That, at its meeting of November 30, 2020, the Board of Health for the City of Ottawa Health Unit: 3.        Approve the 2021 Draft Operating Budget for the Ottawa Board of Health; 4.        Upon the Board of Health’s approval of the 2021 Draft Operating Budget for the Ottawa Board of Health, direct staff to forward the report to Ottawa City Council, for consideration on December 9, 2020 as part of the City Council’s approval of the City of Ottawa 2021 Draft Operating and Capital budget; and 5.        Upon approval of the 2021 Draft Operating Budget for the Ottawa Board of Health by the Board of Health and Ottawa City Council, direct the Medical Officer of Health (or delegate), on behalf of the Board of Health, to forward the 2021 Annual Service Plan and Budget Submission, to the Ontario Ministry of Health (OMOH) for consideration based on the approved 2021 Operating Budget for the Ottawa Board of Health.
			CARRIED, as amended by Motion 14/3
			Mr. Lou Flaborea, Manager of Performance & Corporate Services, spoke briefly to a PowerPoint presentation, which served to update the Board on the Budget approval process and timelines. A copy of his presentation is held on file with the Board of Health Secretary. Following the presentation, the Board heard from one (1) public delegation: ·         Councillor Mathieu Fleury, Ward 12 – Rideau-Vanier After hearing the public delegation, staff responded to questions from Board members after which, Chair Egli ceded the Chair to Vice-Chair DeGiovanni before the Board proceeded to vote on Motion 14/3. The discussion on this item lasted approximately 45 minutes.
			Motion 14/3 Moved by Member El-Chantiry That the Board of Health for the City of Ottawa Health Unit: 1.    Approve the 2021 Draft Operating Budget for the Ottawa Board of Health, outlined at Document 1, as follows: a.    Page 5 – Ministry of Health and Long-Term Care Programs & Standards:                                   i.    COVID-19 – Base *;                                 ii.    Cost Shared Core Programs *;                                iii.    Ontario Seniors Dental Care Program;                                iv.    Healthy Babies Healthy Children;                                 v.    100% City Programs * **;                                vi.    Miscellaneous Programs;                              vii.    COVID-19 – One Time *; and b.    Page 10 (English version) – User Fees; 2.    Upon the Board of Health’s approval of the 2021 Draft Operating Budget for the Ottawa Board of Health, direct staff to forward the report to Ottawa City Council, for consideration on December 9, 2020 as part of the City Council’s approval of the City of Ottawa 2021 Draft Operating and Capital budget; and 3.    Upon approval of the 2021 Draft Operating Budget for the Ottawa Board of Health by the Board of Health and Ottawa City Council, direct the Medical Officer of Health (or delegate), on behalf of the Board of Health, to forward the 2021 Annual Service Plan and Budget Submission, to the Ontario Ministry of Health (OMOH) for consideration based on the approved 2021 Operating Budget for the Ottawa Board of Health.
			CARRIED
			* DECLARATION OF PECUNICARY INTEREST Member Leikin submitted a deemed pecuniary interest on Ottawa Board of Health Agenda 8, Item 3  -  2020 Draft Operating Budget for the Ottawa Board of Health, Document 1, Page 5 - Ministry of Health and Long-Term Care Programs & Standards - COVID-19 – Base, Cost Shared Core Programs, 100% City Programs and COVID-19 – One Time, as a family member is an Ottawa Public Health employee working in these areas. Member Leikin did not take part in the discussion or vote on these portions of the Budget.
			** DECLARATION OF PECUNICARY INTEREST Chair Egli submitted a potential deemed pecuniary interest on Ottawa Board of Health Agenda 14, Item 4 - 2021 Draft Operating Budget for the Ottawa Board of Health, Document 1, Page 5 - Ministry of Health and Long-Term Care Programs & Standards - 100% City Programs, as he sits on the Board of Directors of the Youth Services Bureau, an organization that will receive funding from, or would be eligible to receive funding from, this budget line item. Chair Egli did not take part in the discussion or vote on this portion of the Budget.

Following the vote on item 4, Chair Egli resumed chairing the meeting.

5.		UPDATE AND NEXT STEPS ON COVID-19 RESPONSE
		ACS2020-OPH-MOH-0009
	That the Board of Health for the City of Ottawa Health Unit receive this report for information.
	RECEIVED
	The Board heard from one (1) public delegation and received one (1) written submission on this item: ·         Elizabeth Whitmore, GottoGo Campaign (public delegation) ·         Eve-Marie Chamot (written submission) After hearing the public delegation, Board Members voted to receive the report. The discussion on this item lasted approximately 10 minutes.

6.		ONTARIO PUBLIC HEALTH STANDARDS - 2020 ACTIVITY REPORTS - RISK MANAGEMENT
		ACS2020-OPH-KPQ-0007
	That the Board of Health for the City of Ottawa Health Unit receive this report for information.
	RECEIVED

ADDITIONAL ITEM

A	COMMUNITY SAFETY AND WELL-BEING PLAN – INTERIM REPORT
	ACS2020-OPH-HPP-0008-IPD

NEXT MEETING

Regular Meeting

Monday, February 8, 2021 – 5PM

_____________________________                    _____________________________

BOARD SECRETARY                                           BOARD CHAIR

Board of Health Meeting
Chair Keith Egli – Verbal report
November 30, 2020

Good evening, bonsoir, Kwey,

As indicated in the COVID-19 update report listed on tonight’s Agenda, in mid-November, the Government of Ontario introduced an updated COVID-19 Response Framework for Keeping Ontario Safe and Open. It provides a colour-coded system – Green, Yellow, Orange, Red and Gray – with different levels of restriction in each colour classification and indicators and thresholds for regions to move from one level to the next.

Ottawa is currently in the ‘Orange’ or ‘Restrict’ zone and we’ve seen a recent decline in local COVID-19 rates of transmission. This is good news. However, since the provincial framework’s introduction, we saw some Ontario jurisdictions move into lockdown whereas others were moved from Orange to Red and several others went from Green to Yellow.

This serves as a reminder that a rapid rise in COVID-19 infection rates is always possible, therefore we cannot rest on our laurels. It’s important that we continue to practice public health measures to keep decreasing the level of the virus in our community, which will help us avoid hospitalizations and deaths and the closure of businesses.

I want to thank Ottawa residents for their continued efforts to slow the spread of infection in our community. The fact that we are seeing a slow decline in COVID-19 transmission locally is due to everyone’s collective efforts.  

I also want to thank residents for continuing to do everything they can to support local businesses and I thank businesses for their ongoing efforts to create a safer shopping experience for their clients and a safer workplace for their employees.

Ottawa Community Action Plan Virtual Summit 

In my November 2^nd Verbal Report, I talked about the Ottawa Community Action Plan Virtual Summit, scheduled for November 20th, and encouraged Members to participate. Tonight I would like to provide an update on that event.

The Virtual Summit, jointly hosted by Ottawa Public Health (OPH), The Royal, the Community Addictions Peer Support Association (CAPSA), the Canadian Centre on Substance Use and Addiction (CCSA), and the Canadian Public Health Association (CPHA), brought together over 150 individuals representing a cross-section of national and community organizations, agencies and individuals from healthcare, municipal government (including law enforcement and first responders), and various other community organizations. 

Since the previous Summit, in February of 2019, many strides have been made to advance the Ottawa Community Action Plan. These achievements have included improving coordinated access and creating innovative ways of delivering services while also focusing on subgroups of the population that have been underserved. The successes in Ottawa are being shared on a national level through the partnership with Canadian Centre on Substance Use and Addiction so that other jurisdictions can learn and implement similar programs and processes.  

While there has been much success, mental health and substance use continue to be top concerns for Ottawa residents. Current challenges, as cited by keynote speakers during the Virtual Summit, included: a lack of resources, requiring a focus on partnerships for real change; the public not knowing how to access services; and a number of at-risk groups, such as the Black and Indigenous communities, continuing to be underserved. Challenges also remain in terms of ensuring that people with lived experience are at the forefront of the conversation and are engaged as an integral part of the solution. Understanding these challenges, there was a consensus that collaboration was an important focus and something that provided hope to participants. 

A full report is being prepared and will be shared with the participants, the Board of Health and the community when it is ready early new year. In the interim, I would like to thank all those who participated in the Virtual Summit and those who continue to work to advance the Ottawa Community Action Plan.

Upcoming Holidays

Lastly, with the holiday season just around the corner, I know a lot of people have questions about how to safely celebrate Hanukkah, Christmas or Kwanzaa this year given the ongoing risk of COVID-19 transmission.

Last week, the Province released guidance for safer holiday celebrations. Like us, they are recommending that people only celebrate in person with the people they live with and, for those who live alone, exclusively celebrating with one additional household.

We know that some activities are safer whereas others carry more risk. Ottawa Public Health has begun messaging tips and ideas on safer ways to celebrate this holiday season and will continue to do so in the weeks ahead. I encourage Board Members to share those messages broadly to help residents can make informed decisions for themselves and their families.

That concludes my verbal update. I’d be happy to take any questions.

Board of Health Meeting
Dr. Vera Etches – Verbal report
November 30, 2020

Good evening, Kwey, Aingai, Taanishi, Bonsoir,

In tonight’s Verbal Report, I will provide updates on this fall’s influenza immunization campaign and preparations for an eventual COVID-19 vaccine, the reopening of some of our dental clinics, our focus on mental health supports and a recent report on COVID-19 and Racial Identity in Ottawa.

Influenza Immunization

Starting with this season’s influenza immunization campaign – 

As indicated in my November 2^nd Verbal Report, OPH began operating its flu clinics on October 29^th at 6 fixed locations across the City.  We have since merged the two Orléans clinics into one location in order to free up resources to start mobile clinics. The decision to operate in fixed locations was to ensure our ability to incorporate COVID-related safety measures such as appointments to manage client flow and avoid crowding, physical distancing in terms of the clinic layout, enhanced environmental cleaning, staff and client screening, and more.

Initially, we experienced very high demand, with appointments filling up within hours of opening up for bookings, and we have seen a decrease in demand in the past week or so. To date, OPH has vaccinated over 48,000 clients through our different clinics whereas last year, during the entire flu season, which is November to February, we had immunized 11,300 residents.

The OPH mobile clinics will continue to operate for the next 2-3 weeks across the city.  Mobile clinics consist of an RV and buses that are deployed in specific neighborhoods and communities to address barriers in accessing the vaccine. 

Lastly, the province has informed us that we will be receiving flumist, the nasal spray influenza vaccine, this week.  The vaccine will be available in pharmacies, physicians’ offices and at all OPH clinics, starting December 4, for people ages 2-59.  Communications have been shared with primary care providers and public messaging will be added to our website to inform the public. 

Pharmacies and doctors’ office also continue to be an option for residents to access their flu shot.

Preparing for a COVID-19 Vaccine

The COVID-19 vaccine campaign will build on the experience public health units have in leading immunization strategies for the population.  / La campagne de vaccination contre la COVID-19 profitera de l'expérience des unités de santé publique dans la mise en œuvre de stratégies d'immunisation de la population.

A lot remains unknown about the eventual availability and distribution of a COVID-19 vaccine in Canada, including: Health Canada approvals, official recommendations on sequencing of vaccination within the priority groups identified by the National Advisory Committee on Immunization, and what conditions may be needed to keep approved vaccines active as they are shipped across Canada.

However, once vaccine is available for use in Canada, the priority is to ensure people are vaccinated without delay. To that end, on November 16^th the City announced the establishment of a COVID-19 Vaccine Distribution Task Force to develop a comprehensive plan for vaccine distribution in Ottawa.

This Task Force, which is being led by the City Emergency and Protective Services Department, will ensure that all City resources are optimized and available to support the immunization of our community against COVID-19 as vaccines become available in the coming months.

The City’s Task Force is leveraging expertise from across the organization and includes consideration of internal and external partners, such as hospitals and those serving populations at higher risk linked to the ongoing work of the City’s Human Needs Task Force. The Task Force will include public health leadership and the collaboration will optimize resources and avoid duplication of effort in the local context.

Last week, the Province announced a similar Vaccine Distribution Task Force for Ontario, which will include cross-government and external representation with diverse expertise in operations and logistics, federal-provincial relations, health and clinical domains, public health and immunization, information technology and data. The Provincial Task Force is being led by retired General Rick Hillier.

As indicated in the COVID-19 update report on today’s Agenda, OPH is learning from its ongoing experience of operating influenza vaccination clinics in the context of a pandemic and preparing for its role in ensuring a critical mass of Ottawa’s population is able to access the vaccine in a safe and timely manner.

Dental Clinics

In recent COVID updates we have been highlighting the unintended consequences of the pandemic response, particularly the impact on some less-advantaged populations. OPH continues to reinstate and adjust some of our most crucial public health services to try to support populations with lower income.

Tonight, I am pleased to share that as of November 23^rd, OPH has re-opened the St. Laurent dental clinic for emergency dental services. And in addition, the Wabano clinic will re-open part-time starting this Thursday, December 3^rd, also for emergency dental services.

During these challenging times OPH has needed the support of our partners and we greatly appreciate the Ottawa Dental Society's willingness to work with us to identify dentists who can treat our most vulnerable residents while OPH services have been reduced due to the pandemic response. Their continued work in providing emergency dental care throughout the pandemic has undoubtedly kept many out of hospital emergency departments. / Leur travail continu pour fournir des soins dentaires d'urgence, tout au long de la pandémie, a sans doute permis à de nombreuses personnes à éviter les services d'urgence des hôpitaux.

Mental Health

Another repercussion of the pandemic relates to the impact on the mental health of our community, which is of particular concern. 

In June we presented some initial results from a population-level survey on the status of mental health in our community. The June survey found that Ottawa residents were reporting worsened mental health and emotional well-being, loneliness and weaker community connectedness. Further, many Ottawa residents were reporting that they had wanted to talk to someone about their emotional state or mental health but did not know where to turn. 

We repeated this population-level survey in October, after schools had been opened and just as the province announced the modified Stage 2 restrictions. For context, we also compared this data with comparable 2017 Canadian Community Health Survey (CCHS) data.

A preliminary snapshot of the October data reveals that overall, Ottawa residents continue to report worsened mental health and emotional well-being, loneliness and weaker community connectedness / Un aperçu préliminaire des données d'octobre révèle que dans l'ensemble, les résidents d'Ottawa continuent de faire état d'une détérioration de leur santé mentale et de leur bien-être émotionnel, de leur solitude et d'un affaiblissement des liens avec la communauté :

·         In October, 40% of Ottawa residents reported their overall mental health and emotional well-being as ‘fair’ or ‘poor’ in the 2 last weeks, similar to 38% in the June survey and higher than 9% in 2017.

·         51% of Ottawa residents indicated their sense of belonging to the local community was ‘somewhat weak’ or ‘very weak’ in the past 2 weeks, similar to 52% in June and higher than 30% in 2017

·         Approximately 60% of residents continue to express feeling some sense of loneliness over the past 14 days, similar to 58% in June.

One quarter of Ottawa residents continue to report that there have been times when they wanted to talk to someone about something on their mind, including their emotional state or mental health, but did not know where to turn, compared to 29% in June, which is not statistically different but suggests there is room for improving communications about the available resources.

With schools and many more childcare centres open, Ottawa parents are showing some indication of coping better, with 86% reporting that they were handing the day to day demands of raising children during the COVID-19 pandemic very or somewhat well, compared to 70% in June. We have also seen some small improvements among surveyed parents over concern for children missing out on social interactions and school supports in October, as compared to June.

However, some parents report that they are coping less well. Generally, these include parents with lower household income and parents with a disability.

We are working to analyze the complete results of the October survey to see which populations are most affected. We will continue to share these results and use them to inform and drive our work, as well as help inform work with our community partners who provide vital services and supports to our residents. 

As noted in the COVID-19 Update report on tonight’s Agenda, we are working with partners to address gaps and barriers to providing in-person services as not all clients may be best served virtually. We are also working on new messaging to provide residents with information and resources to help get through the coming winter months, a time when we know that shorter days can have an impact on our mental health.

Report on COVID-19 and Racial Identity in Ottawa

The pandemic is highlighting how inequities in peoples’ experiences of racism, housing, education and employment are creating different barriers to health that pre-existed COVID-19 and is underlining the need for immediate health and social services supports and long-term solutions.

Last week OPH, in collaboration with community partners, published a report on COVID-19 and Racial Identity in Ottawa. Some of the key findings are that:

·         Racialized populations (particularly those who identify as Black) are over-represented among people diagnosed with COVID-19 in Ottawa.

·         Across most groups, females are more likely to be diagnosed with COVID-19 compared to males.

·         In general, close contact is the greatest source of COVID-19 infection, and more pronounced among people who are racialized.

·         People working in the health sector are the most impacted by COVID-19, particularly among people who are racialized.

Racialized communities may have difficulty limiting exposure to COVID-19 due to factors such as higher density housing that makes physical distancing difficult and/or employment in essential work and that is often more ‘precarious’.

OPH continues to work with affected communities to understand people’s lived experience to inform solutions to improve access to health and social services and prevent further transmission. OPH is supporting the work to modify and orient interventions and services to reduce inequities, with an understanding of the unique needs of populations that experience marginalization.

This is work OPH is undertaking through various partnerships and initiatives, including: working with the Ottawa Local Immigration Partnership (OLIP) and other partners to help us understand the situations giving rise to the different numbers; working with the Ottawa Health Team for neighbourhood outreach activities; and supporting the Neighbourhood Ambassador Program with the Boys and Girls Club of Ottawa and the Integrated Neighbourhood Service Team to facilitate connections with youth in identified neighbourhoods.

OPH’s overarching goal is to enable everyone to do their best to limit COVID-19 transmission, recognizing we are all connected and that some communities require higher levels of support given the social and environmental elements that increase risk.

Consistency in our efforts to protect one another and care for each other will carry us through the winter. / La régularité de nos efforts pour nous protéger les uns les autres et prendre soin les uns des autres nous permettra de passer l'hiver.

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.