Board of Health Meeting
Chair Keith Egli – Verbal report
June 15, 2020
For my verbal update this evening, I would like to
highlight some recent accomplishments, provide an update on a Motion approved
by City Council at its meeting of May 27th that has implications for
Ottawa Public Health, and update Members on the City’s response to COVID-19.
"Grandpa’s
Wisdom - An Algonquin Reflection on West Nile Virus and Lyme Disease"
In addition to the three Elders who offered opening
prayers, we are also honoured this evening with the presence of Grand Chief
Verna Polson who is here to represent the Algonquin Anishinabeg
Nation Tribal Council.
We have asked Grand Chief Polson to join
us to receive a new health protection resource on behalf of the Algonquin Anishinabeg
Nation, whose land and people were top of mind
as this resource was being developed.
It is an intergenerational story called "Grandpa’s Wisdom -
An Algonquin Reflection on West Nile Virus and Lyme Disease,” authored and
illustrated by Elder Albert Dumont, who is among other things, an Algonquin
poet, storyteller, artist, traditional teacher and spiritual advisor.
This book is the result of a year-long collaboration
between Ottawa Public Health and Elder Dumont. As a team effort, I would also
like to acknowledge Joan Tenasco for the Algonquin translation, Anishinabe
Printing for graphic layout, and OPH staff including Mike Ferguson, Mackenzie
Allen, Michelle Goulet, Anne Stanton-Loucks, Dr. Monir Taha and Kim Trotter, as
well as Erin Corston, the former Indigenous Engagement Specialist at Wabano and
the Champlain LHIN, who enthusiastically brought the team together.
This project has had many positive impacts that speak to the
principles of reconciliation, including developing a respectful awareness and
understanding of Algonquin history, culture and language; building and
strengthening relationships; sharing and merging Indigenous and western
knowledge; and continuously reflecting on, and learning from, the process and
partnership on this journey together.
In an effort to help restore the Algonquin language,
Elder Dumont’s story is written in Algonquin, English and French. Although
COVID-19 has slowed the process, it is our intention to share printed copies,
when available, with the Algonquin Anishinabeg Nation Tribal Council for
distribution within their communities. Similarly, this innovative resource will
be offered to local schools and libraries in Ottawa as a means to promote
Algonquin knowledge and health protection related to Lyme disease and West Nile
virus.
Chi meegwetch (thank you, merci) to everyone involved in
this project, and for all of the support and guidance that Elder Dumont
provided. Albert, you have truly inspired those that have had the privilege to
work with you.
Grand Chief Polson, we would be honoured if you would
like to share a few words with the Board of Health and others listening to this
meeting, on behalf of the Algonquin Anishinabeg Nation.
Grand Chief Polson will speak
Thank you Grand Chief Polson. Meegwetch!
Esther Moghadam, RNAO Award
Before moving on to the Council update, I would like to
highlight a special honour recently bestowed on one of OPH’s senior leaders.
This past Friday, June 12th, the Registered
Nurses Association of Ontario presented its annual Recognition Awards and I’m
very pleased to share that Esther Moghadam, OPH’s Director of Health Promotion
and Chief Nursing Officer, was presented with the Leadership Award in
Nursing Administration
This award recognizes exemplary nursing
management by a Registered Nurse or Nurse Practitioner who acts as a change
agent, resource and mentor within a professional setting. It is bestowed upon
individuals who actively collaborate with health-care teams to enhance
patient care through the development and implementation of innovative and
creative strategies.
On behalf of the Board of Health and the entire OPH team,
I would like to congratulate Esther on this wonderful and well-deserved
recognition.
Safe Supply motion at
Council
Moving on to the Council update –
Like many North American cities, Ottawa is experiencing a
toxic drug supply, prompting local health care providers to consider adding
safer supply alternatives for their patients.
In September 2019, the Canadian Medical Association
Journal released a national guideline recommending that injectable
opioid agonist treatment - or i-O.A.T. - be considered for individuals who have
not benefited from oral treatment (like methadone or suboxone) and continue to
use opioids by injection. Building on the success of these interventions, safer supply initiatives
seek to offer a lower barrier service model, providing accessibility and
flexibility for clients, including less restrictive eligibility requirements
and additional medication options, which enables reach to a broader population
of people who use drugs.
As the local health unit and the core harm reduction
program for Ottawa, Ottawa Public Health fully supports Safer Supply
initiatives, as was noted in a report to the Board of Health last fall.
I am happy to report that on May 27th, City
Council unanimously approved a motion calling on upper levels of government to
assist in implementing and funding the expansion of Safe Supply in Ottawa in
order to provide immediate supports to people who use drugs and to decrease
burdens on communities experiencing the impacts of addition.
Pursuant to that motion, the Mayor has written to both
the federal government and provincial governments – specifically to Prime
Minister Trudeau and federal Minister of Health, Patty Hajdu as well as to
Premier Ford and provincial Minister of Health, Christine Elliott, asking for
their support on moving forward with these life-saving programs.
We eagerly await their responses and look forward to
being able to move ahead with such initiatives, in collaboration with community
partners.
Update on City’s response to COVID
Last Wednesday, the City Manager presented the City’s
reopening plan to City Council. This was an important milestone in the City’s
ongoing response to COVID-19.
The
situation remains fluid and the City continues to be in a State of Emergency in
order to be able to react quickly to a changing environment, access critical
resources and to respond to evolving community needs.
The City
also continues to closely follow the advice of Ottawa Public Health and to take
its cues from the Province of Ontario in terms of our reopening plans.
With this in
mind, some of the City’s programs and services are cautiously starting to
reopen in a gradual, phased approach from now until the end of August.
The
Reopening Plan prioritizes programs and services that promote a safe and
strategic expansion of Ottawa’s economy, with ongoing support for our most
vulnerable communities.
Above all,
the City is prioritizing the health and safety its staff and of the community,
in general. Accordingly, the plan focuses on three key areas:
·
Safety
·
Services
and
·
People
In terms of
safety, the City will be providing personal protective equipment to some staff,
on a priority basis, and otherwise promoting the use of cloth masks in
situations where that is warranted, such as on public transit.
They are
installing engineered sneeze guards at 55 public-facing service
counters as well as physical distancing signs, floor decals, and directional
markings in City facilities. Site-specific cleaning and disinfecting protocols
are being implemented at each facility, as are client screening protocols based
on risk assessment in specific service areas.
City
services will gradually resume, based on a phased approach.
The reopening Plan
prioritizes public transit, recreation and child care services, to support
residents returning to work and to provide relief during the warm summer
months.
The City will also continue
to support our most vulnerable populations and help restart Ottawa’s economic
recovery by supporting local businesses.
Many City facilities may
look different and some programs and services will be delivered in new or
modified ways to help keep everyone safe. This includes more virtual and online
services, reduced group sizes for programming, appointment-based in-person
counter services and contactless document drop off.
In addition
to the safety measures listed above, the City is taking steps to protect and
preserve its workforce.
Employees
who are currently working from home will continue to do so for the short-term
while the City assesses its facilities to determine what redesigns or retrofits
may be needed to workstations and floor plans to ensure that employees can
safety return to these spaces.
A
formal work-from-home program is being developed to ensure those working
remotely have all the resources and supports required to continue to do so.
A
comprehensive health and safety policy is being finalized that will include
self-screening requirements, personal protective equipment and other
preventative measures for employees.
Employee
training is being developed with respect to new safety protocols and standards
related to COVID-19 and a number of other health and wellness resources are
being augmented to support employees.
Reopening
services takes a significant amount of coordination, planning and execution and
overcoming these new and unique challenges will require require patience,
flexibility and the combined efforts of staff, residents and community
partners.
More detailed information
about the City’s phased reopening of its various programs and services can be
found under the “City News” banner on Ottawa.ca
Board of Health Meeting
Dr. Vera Etches – Verbal report
June 15, 2020
Good evening, Kwey, Aingai, Taanishi, Bonsoir,
I would also like to begin by honouring the Algonquin
Anishinabe people, on whose unceded traditional territory the City of Ottawa is
located, and on which we are virtually gathered this evening, and by
recognizing that this land has been a gathering place for many peoples for a
long time.
I would like to thank the Elders who offered prayers and
words of wisdom in opening today’s meeting. I especially want to thank them for
their willingness to adapt to the current situation by participating via
electronic means.
This week contains the Summer Solstice and National Indigenous
Day is this coming Sunday, June 21st. This is a time of celebration
of Indigenous culture and resilience. That resilience is all the more evident
this year given that celebrations will be proceeding virtually.
We also realize that Indigenous people still experience
discrimination, which was highlighted in tonight’s report to the Board of
Health on Reconciliation, Indigenous Health Equity and COVID-19. Ottawa Public
Health is committed to continuous improvement in public health actions that
promote reconciliation and the health and well-being of First Nations, Inuit
and Métis peoples and communities.
In tonight’s Verbal Report, I will talk about the ongoing
risks of vector-borne illnesses, our work to review, reconsider and resume
regular operations as we move into Stage 2 of the pandemic response, some of
the unintended impacts of the pandemic, and I will provide an update on our
COVID-19 response.
Beginning with Vector-borne Illnesses
Much of our recent focus has been on COVID-19 and our
efforts to ‘flatten the curve’. However, as the season progresses, we do need
to keep in mind there are other infections that pose risks to our health –
those spread by black-legged ticks and mosquitos. Just as people in Ottawa are
taking measures to protect themselves from COVID-19 infection, residents’
efforts to make tick-checks and avoiding mosquito bites part of our daily
routines will avoid unwanted infections.
It is worth noting that, like with all other respiratory
viruses, there is no evidence to suggest that COVID-19 is spread by mosquitoes
or ticks. The main way that COVID-19 spreads is from person to person by
respiratory droplets or direct contact.
While most mosquitoes are just a nuisance, some can pose
a health risk as carriers of West Nile virus. Residents can protect themselves
and prevent bites by using an insect repellant containing DEET or icaridin,
wearing tightly-woven but loose-fitting, light-coloured clothing, long pants
and long sleeves and keeping screens in good repair.
Alors que la plupart des moustiques ne sont qu'une
nuisance, certains peuvent poser un risque à la santé en tant que porteurs du
virus du Nil occidental. Les gens peuvent se protéger et prévenir les piqûres
en utilisant un insectifuge contenant du DEET ou de l'icaridine, en portant des
vêtements clairs, tissés serrés mais amples, des pantalons longs et des manches
longues et en gardant les moustiquaires en bon état.
Because these mosquitos like to live in proximity to
human habitat and they breed in standing water, it’s important to eliminate
pooled water locations around the home, such as old cans and jars, tires, old
plastic toys, flower pot saucers and so on, and to change the water in your
bird bath every 7 days.
If you live adjacent to outdoor areas suitable for ticks,
such as woodlots or areas with tall grasses, or if you visit these areas while
on walks or hikes, you also need to be aware of the risk of Lyme disease.
Si vous vivez à proximité de zones propices aux tiques,
telles que des bois ou des zones à herbes hautes, ou si vous visitez ces zones
lors de promenades ou de randonnées, vous devez également être conscient du
risque de la maladie de Lyme
The blacklegged tick that is known to carry the bacterium
causing Lyme disease is present in the Ottawa area, across Eastern Ontario, and
the Outaouais region of Quebec. OPH is monitoring this and providing
information to residents and physicians to help prevent and reduce Lyme
disease-related health risks in our community. We have seen an increase in the
number of cases of Lyme disease reported in the Ottawa area over time, as well
as an increase in the number of cases of Lyme disease likely acquired in the
Ottawa area.
Residents are asked to do their best to stay on cleared
paths, but if your trek brings you into tall grass or forests, tuck your pants
into your socks and apply insect repellant to discourage ticks from crawling up
the outside of your pants. Most importantly, perform a “full body” check on
yourself, your children and your pets for ticks at the end of any excursion.
Pay careful attention around toes, knees, groin, armpits and scalp. If you do
find a tick on your skin, carefully remove it following instructions available
at ottawapublichealth.ca/lyme.
Residents should immediately contact their family
physician if they experience flu-like symptoms following a mosquito or tick
bite; if they have a bull’s eye type rash or other rash after a tick bite; or
if a tick has been attached for 24 hours or more, if it looks partially or
fully engorged, or if unsure of the length of time the tick has been
attached.
Fortunately, Lyme disease is treatable with antibiotics,
unlike West Nile virus or COVID-19. However, prevention is the best approach
with these, as with all, infectious diseases.
For more information on West Nile virus and Lyme disease,
residents are encouraged to visit ottawapublichealth.ca/westnilevirus or
ottawapublichealth.ca/lyme.
On reviewing, reconsidering and resuming
regular operations
Much like the rest of the City of Ottawa, Ottawa Public
Health is also looking at resuming some of the programs, services and
initiatives that were put on hold or scaled back when we shifted our focus to
the pandemic response. We are also taking the opportunity to review what may
benefit from a different approach and to reconsider priorities as the COVID19
response continues.
Tout comme le reste de la ville d'Ottawa, Santé publique
Ottawa envisage également de reprendre certains des programmes, services et
initiatives qui ont été mis en suspens ou réduits lorsque nous avons réorienté
notre attention vers la réponse à la pandémie. Nous profitons également de
l'occasion pour examiner ce qui pourrait bénéficier d'une approche différente
et pour reconsidérer les priorités à mesure que se poursuit la réponse à la
COVID19
To support the ramp up of OPH services, a new temporary
Core Services Branch has been established, led by Esther Moghadam and supported
by Dr. Robin Taylor, as Associate Medical
Officer of Health.
Andrew Hendriks will continue as Incident Commander
leading the COVID-19 ongoing response. In a sense, there are two
inter-connected OPH organizations operating.
In our response to Covid-19, core critical services continued,
however much of our regular service delivery was interrupted and had to
decrease or stop all together.
I want to thank Mike Ferguson for his contribution as
Acting Director of Health Protection over the past few months. He has been an
exceptional leader, supporting teams to carry on with critical core services
and adapt under extraordinary circumstances.
We currently have a window of opportunity to rebuild
capacity and deliver much needed services to our community. Under the new
temporary Core Services Branch, we will fully or partially restore or renew
services under our Continuity of Operations Plan, including: Healthy
Growth and Development, Dental Health Services, Sexual Health Services, Harm
Reduction, Sexually-transmitted infections/Blood-borne infections (STI/BBI),
Mental Health, Immunization, Safer Food and Water, Health Hazards Response,
Communicable disease/Enteric and Zoonotic Infections, as well as work with the
City’s Planning & Development.
The fifth goal under our Strategy – to continuously
improve our core work to maximize impact - is rated as off-track in the
quarterly update included in tonight’s meeting package because not all teams
were able to report on Q1 data. However, the work Esther is leading will
advance this goal as teams are reviewing work to determine how to have the most
impact given limited resources and new circumstances.
Moving on to some of the unintended impacts of the
public health interventions to address the COVID-19 pandemic. COVID-19 has
led to the death of 258 Ottawa residents, and without the public health
interventions, this tragedy would be much worse.
And, we know that the response to the pandemic has had
some unintended consequences for many – whether due to the isolation people
have felt as a result of physical distancing measures, or due to stress and
anxiety over their employment or financial situation, or a combination of
factors, including increased substance use.
Nous savons que la réponse à la pandémie a eu des
conséquences imprévues pour plusieurs, que ce soit en raison de l'isolement que
les personnes ont ressenti à la suite de mesures de distanciation physique, ou
en raison du stress et de l'anxiété liés à leur emploi ou à leur situation
financière, ou encore d'une combinaison de facteurs, y compris une consommation
accrue de substances
Ottawa Public Health is very sensitive to these issues
and has been working hard to provide resources and coordinate supports wherever
possible, such as with the Human Needs Task Force of the City of Ottawa.
From the onset of
the COVID-19 response, OPH team members have continued to work with school
boards, hospitals, mental health and substance use partners, community
partners, multicultural and racialized community partners, and the general
community in the area of mental health promotion, suicide prevention and
reduction of harms from substance use.
Key focus areas of
the mental health and substance use work have included:
1) Mental Health
surveillance, data collection and supporting research
2) Mental Health and COVID
resource and programming development, including Webpage development, a Mental
Health Education Series titled “Protecting Your Mental Health”, in partnership
with the Royal Ottawa, and much more
3) Supporting the
coordination and outreach of mental health and substance use crisis,
counselling and treatment services
4) Substance Use
resource development, in partnership with the Canadian Centre on Substance use
and Addiction and others, such as an Alcohol harm reduction video, education
resources and coping strategy tools
5) Supporting school
boards with resource development for teachers, students and parents
6) Developing a
Toolkit and Guide for City of Ottawa organizations and employers titled
“Managing Through COVID-19 – Employer Mental Health Guide”
7) Working with
partners to contribute to a strategy to protect those experiencing violence and
neglect at home and
8) Working with
partners and the community to develop a mental health strategy for outreach to
diverse communities, including the launch of webcasts with Councillor King,
development of multilingual resources, and continued work on the African,
Caribbean, Black Mental Health research study
As restrictions are
lifted and people are able to resume activities, some sources of stress may
improve. With provincial announcements about expanding social circles, people
will have more opportunities to connect with others and to access the supports
they need. However, experience from previous major impacts on the economy
suggest that the risk to health will be ongoing and OPH will continue to
investigate impacts on health and work with partners to mitigate harm.
Lastly, OPH’s response to COVID-19 continues
Board Members have been receiving regular updates and are
aware of much of the work Ottawa Public Health has been doing in responding to
COVID-19. As such, tonight I will focus on new developments.
The Province has announced that an exposure notification
app will be launched in July as well as improved information systems for a
centralized case and contact management, among other provincial improvements.
The Digital Solutions team has been contributing to the provincial plans, based
on our experience with our local case and contact management solution to date.
Kevin Neil and I were able to meet with Dr. Jane Philpott last week to
highlight directions that would help modernize public health practice. While
implementation of an electronic public health record, goal 3 of OPH’s Strategy,
is delayed, we conveyed readiness to proceed and support province-wide
solutions.
Last week OPH launched a new COVID-19 Dashboard on
OttawaPublicHealth.ca. This is a new, dynamic platform that provides up-to-date
information on COVID-19 cases, outbreaks and core indicators to assess the
situation in Ottawa. It also provides a comprehensive snapshot of information
that was previously housed in more than one place on our website.
To facilitate access and promote transparency, OPH has
streamlined information into one interactive daily report and a weekly
supplement.
Looking at the latest data, the trends are positive across all the
dimensions of our dashboard, though we are still finding cases that have no
known exposure, that is, they are not linked to travel, an outbreak or another
known case / Les tendances sont positives dans toutes les dimensions de notre
tableau de bord, bien que nous trouvions encore des cas qui n'ont pas
d'exposition connue.
As part of our case management and contract tracing
practices, we have also started gathering NEW data about the people infected by
COVID19 in order to understand how race and income are affecting risk of
infection with covid-19. / Nous recueillons de NOUVELLES données sur les
personnes infectées par la COVID19 afin de comprendre comment la race et le
revenu influent sur le risque d'infection par la COVID-19.
We are working with groups such as the Ottawa Local
Immigration Partnership and with health system partners to not only collect
race data in order to better understand the barriers to health and healthcare
in Ottawa, and health outcomes for people who are racialized, but to also
ensure it is analyzed, interpreted and used appropriately.
With respect to race-based data, we are just starting to
look at it, bearing in mind that, at this point, we only have data from May 9
onwards so don't have enough data for definitive statements yet.
As we analyze the data, we will seek community input on
understanding the information and contextualizing the implications. / Au fur et
à mesure que nous analysons les données, nous chercherons à obtenir l'avis de
la communauté sur la compréhension des informations et la contextualisation des
implications.
Still on the subject of data, it’s important to
understand that there is still a risk of increase in level of COVID19 infections beyond our
hospital capacity to manage them. Hospitals have improved their capacity, but
ongoing supplies of personal protective equipment, PPE, still require careful
management and significant efforts to source. We each need to continue to do our
part to prevent transmission of the virus. / Il existe toujours un risque
d'augmentation du niveau des infections COVID19 au-delà de la capacité de nos
hôpitaux à les gérer. Nous devons tous continuer à faire notre part pour
prévenir la transmission du virus
With the very small percent of the population likely
infected to date, we are very, very far from the 60-70% herd immunity that
would slow the virus down without the physical distancing, mask wearing,
hand-washing and efforts to limit our close contacts that are in place now.
OPH’s work to follow-up with every case and contact reported is also helping to
break transmission, but that occurs after the fact, after the delay involved in
getting tested. Many vaccines are in development, but whether one will be
effective remains unknown and the timeline required to make a vaccine available
to the population around the world means we will still not have a vaccine for
the fall, when we are concerned about COVID-19 activity on top of Influenza
virus circulating. Prevention is still required. Our objective is that we can
keep COVID19 to a manageable level in our community with a return to more
economic activity.
When it comes to the COVID19 testing approach in Ottawa,
and across Ontario, OPH is continuing to work with the Champlain Health Region
Incident Command to adjust access to testing.
There are essentially 3 reasons for diagnostic testing:
·
to diagnose people who have
COVID-19 symptoms, so that they have access to the care and advice they need;
·
to perform contact tracing and
investigate outbreaks, to limit the spread of the virus throughout the
community, to ensure that anyone who has been exposed to COVID-19 is aware of
their risks and options and protects others; and
·
to proactively identify cases
amongst high-risk populations, such as in long-term care homes and other
congregate care settings.
In terms of community access to testing, to date, Ontario
Health has provided funding and resources to the Champlain Health Region
Incident Command (CHRIC) for the Brewer Park Arena Assessment Centre as the
primary testing site for Ottawa residents and for two (2) additional COVID-19
Care Clinics to offer out-of-hospital care and diagnostic testing for people
experiencing symptoms of respiratory illness – one on Moodie Drive, operated in
partnership with the Queensway Carleton Hospital, and one on Heron Road,
operated in partnership with l’Hôpital Montfort. Two mobile services are also
available by referral.
As the capacity for testing continues to grow, the
Regional Testing Strategy Working Group is developing its recommendations and a
funding proposal is being developed with respect to increasing community access
to testing and using the capacity in the most effective way - taking into
account the competing demand for limited resources.
We hope to be able to announce more, or different,
testing options in the near future.
As Board Members are aware, in March, OPH completed the
first wave of a population-level survey looking at perceptions and practices in
Ottawa during the COVID-19 response.
OPH recently completed a second wave of questions for the
public about mask use, hand hygiene and physical distancing practices.
By self-report, 60% of Ottawans report wearing masks
indoors, 79% washing their hands before eating, and over 90% maintaining a
distance of 2 metres from others when indoors almost always or always. These
measures will prevent transmission of COVID19 in our community and are
important to continue and grow. By learning more about how Ottawa residents
are managing through this time, we are better equipped to work with the
community to provide supports where needed.
Lastly, as the City of Ottawa is gradually reopening
workplaces and services, Ottawa Public Health launched its COVIDWise campaign.
This campaign aims to encourage residents to take their
health into their own hands by understanding their own risk factors, the levels
of risk associated with various types of activities and environments, making
informed decisions regarding their health and COVID-19.
Ottawa Public Health is promoting this website on social
media using the hashtag #COVIDWise. Ottawa Public Health is asking residents to
go about their daily activities in a smart way to keep COVID-19 pinned down.
It’s important for people to realize that COVID is still
in our community. By following the COVIDWise campaign, residents can learn what
actions may lead to a higher risk of transmission versus what may be a safer
option. For example, we know that indoor spaces pose a higher risk than
outdoors, that larger gatherings of people and greater numbers of contacts pose
a higher risk, and that older adults and those who are immunocompromised are at
higher risk of severe outcomes, if infected.
I would be remiss if I did not take this opportunity to
thank Michael Allen and his team at United Way East Ontario. When we approached
them recently for assistance in getting cloth masks to vulnerable individuals
in our community who could not afford to purchase one or make their own, the
United Way East Ontario responded in a big way.
I could not be more pleased with their Facing Forward
campaign and their incredible partnership. I am particularly grateful to
Dennise Taylor-Gilhen and Jessica Smith who worked with OPH to quantify the
need, consider options, formulate a strategy and ensure coordination with other
partners. While they have been our main points of contact, we know that several
other members of the United Way team were involved to make something of this
magnitude happen.
I want to thank them for all their work in making this
important initiative such a success.
Lastly, to you, our Board Members and to the media, thank
you for doing your part to keep the community informed. Merci, meegwetch, qujannamiik.