Chair’s Speaking Notes
April 25, 2022 Board of Health Meeting
Ordre de la pléiade
To begin my verbal update tonight, I am very happy share
that on Monday, April 11th, in a virtual ceremony hosted by the
Assemblée parlementaire de la Francophonie, Ontario Branch, and in the presence
of the Honourable Elizabeth Dowdeswell, Lieutenant Governor of Ontario, Dr.
Etches was one of six Ontarians to receive the Ordre de la Pléiade.
Created in Luxembourg in May 1967, the Assemblée
parlementaire de la Francophonie – or APF - brings together the delegates of 90
sections from parliaments across the five continents. It is the consultative
assembly of the Francophonie. The Ontario Legislative Assembly sat as an
observer from 1981 to 1986, when the Ontario section became a full member.
The APF's actions aim to contribute to the influence of
the French language as well as to the development and reciprocal knowledge of
cultures and civilizations that use it habitually.
The Pléiade, Order of Merit of the Parliamentary Assembly
of la Francophonie, is intended to recognise the remarkable contribution of
personalities who have distinguished themselves by serving the ideals of the
APF.
Dr. Etches was nominated for this award by local MPP
Lucille Collard and she was selected as one of its 2022 recipients by a
cross-party selection committee of Members of Ontario’s Legislative Assembly.
It is an honour that she proudly accepted on behalf of the entire OPH team.
It’s also worth noting that another distinguished Ottawan
was also honoured with this award on April 11th – Marie-Claude
Doucet, Chief Executive Officer of the Mouvement d’implications francophone
d’Orléans – or MIFO – an organization that highlights Francophone culture and
promotes the cultural expression of the Orléans community and its surroundings.
Congratulations to all of the recipients!
Canadian Public Health Week
As we know, public health
is the invisible guardian of our health, though the COVID-19 pandemic has made
public health more visible and its efforts more appreciated.
Earlier
this month, April 4th to 8th, Canada’s public health
associations hosted the inaugural “Canadian Public Health Week”, which provided
an opportunity to recognize the contributions of public health and highlight
issues that are important to improving our health and well-being.
This inaugural Canadian
Public Health Week featured a series of free webinars focusing on topics such
as: public health responsibilities relative to climate change; the impact of
COVID-19 on public health; and income as a social determinant of health and
learning from the Basic Income and Decent Work movements.
I understand that public
health units across Canada were invited to participate. I hope that many were
able to do so given the workloads they continue to shoulder.
New Neighbourhood Wellness Hubs
Since April 5th, OPH has been operating
Neighbourhood Wellness Hubs in five locations across the City as a pilot
project.
To better support
the wellness of Ottawa residents, staff working in the Neighbourhood
Wellness Hubs are promoting mental health and substance use health
directly in our communities and connecting residents with social services
supports.
The 5 locations
are:
o
Rideau Rockcliffe Community Resource Centre, 815 St. Laurent
Boulevard
o
Bellevue Community Centre, 1475 Caldwell Avenue
o
Albion-Heatherington Recreation Centre, 1560 Heatherington Road
o
Boys & Girls’ Club Ron Kolbus Clubhouse, 2825 Dumaurier
Avenue
o
Boys & Girls’ Club Don McGahan Clubhouse, 430 McArthur Avenue
To reduce
stigma and barriers to accessing mental health and substance use supports, the
Hub services provide access to culturally diverse public health staff.
Residents are also able to access strategies, tips and resources on wellness,
support with booking of short-term counselling, system navigation of mental
health and substance use health counselling and programs, and access to social
services through the Community and Social Services
Department’s Employee and Social Services teams.
OPH is proud to be
operating these pilot Neighborhood Wellness Hubs in partnership
with the City
of Ottawa’s Community and Social Services Department, Upstream
Ottawa, AccessMHA, Counselling
Connect and 1Call1Click.
Information about
the services available and their hours of operation can be found at
OttawaPublicHealth.ca/NeighbourhoodWellnessHubs.
COVID-19 Vaccination
In closing, I would like to once again encourage everyone
to get vaccinated for every COVID-19 dose they are eligible for. Everyone aged
12 and up is eligible for a third dose if it has been at least 168 days –
that’s approximately 6 months – since their second dose and, as of April 7th,
the Ontario government has expanded eligibility for fourth doses to anyone aged
60 and over as well as First
Nation, Inuit and Métis individuals and their non-Indigenous household members
aged 18 and over.
Per Provincial guidelines, the recommended interval for
fourth doses is at least 140 days – or 5 months – after receiving the third
dose. However, individuals who wish to receive their fourth dose at a shorter
interval may be able to access it between 84 days (3 months) and 140 days (5
months). In this situation, OPH recommends that clients consult their own
healthcare provider to assess personal risk of the benefits of receiving
vaccination earlier due to high levels of COVID-19 in the community.
Those wishing to get their fourth dose based on the
5-month interval can book an appointment either through the Provincial COVID-19
vaccination portal or the Provincial booking line. Those wishing to get their
fourth dose based on the shorter interval must book an appointment through the
Provincial booking line. The Provincial COVID-19 vaccination portal – that is
the online booking system – will not book appointments on the shorter interval.
Booster doses can also be accessed through participating pharmacies or by
dropping in to one of OPH’s COVID-19 vaccine clinics
Not only do booster doses lower the risk of severe
illness, they also reduce the risk of transmitting COVID-19 to others.
Therefore, not only does this reduce the pressures or potential pressures on
our healthcare system, it also reduces the amount of COVID-19 circulating in
our community, which is particularly important in the
context of a resurgence.
That concludes my verbal
report. I would be happy to take any questions.
Board of Health Meeting
Dr. Vera
Etches – Verbal report
April 25, 2022
Good afternoon, Kwey, Unukut (Oo-new-coot), Taanishi,
Ahnii, Bonjour,
Before I get into my Verbal Report, I would like to
highlight that May 5th is National Day of Awareness for Missing and
Murdered Indigenous Women and Girls – also known as Red Dress Day.
Indigenous Peoples account for 4% of the
national population, yet Indigenous women and girls are 12 times more likely to
be murdered in Canada compared to their non-Indigenous counterparts.
Approximately half of the cases go unsolved. The Native Women’s Association of Canada estimates
there are over 4,000 Missing
and Murdered Indigenous Women and Girls in Canada.
Held annually on May 5th, Red
Dress Day was founded by Métis visual artist Jamie Black in 2010 to shed light on
this national crisis. By wearing red on Red Dress Day, we can demonstrate
allyship and solidarity with Indigenous communities while raising awareness of
this tragedy and injustice. The Board of Health’s Reconciliation Action Plan
includes acting on the Missing and Murdered Indigenous Women and Girls reports’
Calls to Justice and an update will be provided to the Board on the Action Plan
in September.
Budget update
The 2021 year’s budget supported more work than ever to
address the COVID-19 pandemic and restore some core public health programs and
services. The total of expenses incurred in 2021 was $157.8M. This included
$89M of expenses related to the 2021 COVID-19 general response and vaccine
program, and included costs incurred by our City partners for the delivery of
the vaccine program. I would like to thank the Province and Ministry of Health
for their on-going support. On March 31, 2021, they confirmed that Provincial
funding will fully cover all COVID-19 related extraordinary expenditures, which
allowed OPH to balance its 2021 budget. / Je tiens à remercier la province et
le ministère de la Santé pour leur soutien continu. Le 31 mars 2021, ils ont confirmé que
le financement provincial couvrira entièrement toutes les dépenses
extraordinaires liées à COVID-19, ce qui a permis à SPO d'équilibrer son budget
2021.
With this funding, OPH was able to respond to the
pandemic in our community, lead a vaccination campaign that resulted in
vaccination coverage rates higher than any other large city in Ontario, and
maintain and begin to restore essential public health services to improve the
community’s access to mental health and substance use support, parenting
programs, emergency dental treatments for low-income residents, sexual health
and harm reduction services and infection prevention.
COVID-19 update
The goals of the pandemic response continue to be to
limit morbidity and mortality and social disruption. The level of population immunity is
enabling people to have access to more determinants of health, such as
employment, physical activity options and social connections, without causing
the level of severe COVID-19 illness to reach previous heights. / Le niveau
d'immunité de la population permet aux gens d'avoir accès à davantage de
déterminants de la santé, tels que l'emploi, les possibilités d'activité
physique et les liens sociaux, sans que le niveau de maladie grave lié a
COVID-19 atteigne les sommets du passé.
On April 7th, I joined other Eastern Ontario Medical Officers of Health and the
Champlain region’s hospital Chiefs of Staff to issue a joint special statement noting that
the COVID-19 wastewater signal in Ottawa was at record levels. In that special
statement, we highly recommended the following four things people can do to
protect themselves, their families, and our communities, with the goal of
reducing severe illness and hospitalization:
·
Get
vaccinated with all doses they are eligible for
·
Limit
their close contacts as much as possible
·
Wear
a mask in indoor public spaces
·
Stay
home when sick
On Friday, April 22nd,
the Province announced
that masking requirements that were set to expire on April 27th will
continue until June 11th. This includes the requirement to wear
masks on public transit, in all healthcare settings, in long-term care and
retirement homes as well as in shelters and congregate care settings. We are
working with our partners in these sectors to support employers to have
policies in place to be able to continue with or reinstate protective measures
when the COVID-19 level in the community is high.
With respect to higher risk
environments, such as congregate living settings, OPH also strongly recommends
that they continue to comply with Infection Prevention and Control (IPAC)
measures as part of occupational health and safety policies. These measures would include continued encouragement of
active screening, vaccination and masking.
Given the current high levels of COVID-19 in the community, we
continue to strongly recommend wearing masks in any indoor settings where
physical distancing may be difficult or impossible. I am also supportive of
measures that can be taken to increase mask use during this resurgence,
including policies in specific businesses, workplaces and community settings.
We have created new products for businesses to use, such as signage that
indicates masks continue to be strongly recommended.
We are looking ahead to future resurgences
of the virus and know that we have an ongoing role to help people and employers
understand what the risk from COVID-19 is in our community, what they can do to
decrease risk and how we are also taking action to decrease risk. / Nous
envisageons les futures résurgences du virus et savons que nous avons un rôle
continu à jouer pour aider les individus et les employeurs à comprendre quel
est le risque lié a COVID-19 dans notre communauté, ce qu'ils peuvent faire pour
réduire le risque et comment nous prenons aussi des mesures pour réduire le
risque.
We are continuing to release weekly
animated presentations of key data and messages for the public to provide this
guidance. We’ve also created a webpage that provides more information about
who is at greater risk of severe outcomes from COVID-19 and how to use the
different layers of protection to reduce risk. This helps people understand
their personal risk and the risk to their families as well as how to adjust
their behaviours.
We continue to encourage
vaccination – and recognize that this is National Immunization Awareness Week
that celebrates the difference immunizations have made for the health of the
population. We are promoting third doses for anyone over 12 who hasn’t received
theirs yet and fourth doses for people who are eligible. We also see that
people are still coming forward for first and second doses as recommended. It’s
never too late. / Nous continuons à encourager la vaccination - les troisièmes
doses pour les personnes de plus de 12 ans qui n'ont pas encore reçu la leur et
les quatrièmes doses pour ceux qui sont éligibles. Nous constatons aussi que
les gens continuent à se présenter pour recevoir la première et la deuxième
dose, comme recommandé. Il n'est jamais trop tard.
We know that getting
vaccinated reduces the risk of severe illness or death from COVID-19 and it
helps reduce the risk of spreading the virus to others, especially with three
or more doses. We also know that immunity wanes over time so for those who were
vaccinated months ago, it’s important to get that third or even fourth dose to
help boost their immunity.
We also continue to share
information to raise awareness about the eligibility criteria and availability
of anti-viral treatment for those who get COVID-19 and are at higher risk
of severe illness, such as older adults and those who are immunocompromised. A
key concern for us at Ottawa Public Health is to ensure communities that have
historically faced higher rates of severe COVID-19 illness are reached with the
information that people who may be eligible for treatment can access testing
and treatment, even if they do not have a family physician. The availability of
the antiviral Paxlovid in 211 pharmacies across Ottawa is making the treatment
more accessible as well.
We continue to work with partners, like the
South East Ottawa Community Health Centre to reach high priority neighbourhoods
with various supports. The OPH Community Engagement Team has
been present in all high-priority neighbourhoods to help promote community,
school, and neighbourhood clinics. Activities have included attending community
functions, food distribution programs, and places of worship. Targeted outreach
has been done to reach older adults in high priority neighbourhoods to promote
4th doses and increase 3rd dose boosters. The Community
Engagement Team is working closely with OPH’s mobile vaccine team to prioritize
groups who may face additional mobility or transportation barriers, such as
older adults living in Aging in Place buildings and families and newcomers
living in shelters. Working alongside community partners, these outreach
efforts have also helped dispatch more Rapid Antigen Tests right into
neighbourhoods and are now working collaboratively to help increase access to
antiviral treatment information.
Another protection for people most at risk of
severe COVID, the Evusheld product, which delivers COVID-19 antibodies to
people who are significantly immunosuppressed through two intramuscular
injections, is becoming available in Ontario shortly. Specialist physicians who
are able to identify eligible patients are already generating lists to notify
people who are eligible.
OPH continues to update our COVID-19
Dashboard daily Monday to Friday. With respect to the current
COVID-19 situation in Ottawa, the wastewater signal continues to point to very
high levels of COVID-19 in the community, though a slight down-turn in the
7-day average level looks to have begun on April 11. The percent of people
eligible for testing that test positive, is relatively stable.
As the number of new
hospitalizations for people requiring active COVID-19 treatment has been stable
for a couple of weeks, the total in hospital is up this week from last
week, and we understand that staff absenteeism at some Ottawa hospitals has
also stabilized. There continues to be a challenge in recruiting nurses with
specialized experience and Ontario Health is working with local hospitals to
assist with managing the situation, which has been worsening over the two years
of the pandemic and is expected to remain a challenge into the future.
The number of new outbreaks
is relatively stable and it is encouraging to see that the protection from
fourth doses is leading to fewer people testing positive and less
hospitalization amongst residents in Long-term Care and Retirement Homes in
outbreak.
Look ahead
As provincial guidance for response to
the COVID-19 continues to evolve, and we see the protection against severe
illness that has been achieved with vaccination and exposure to the virus, we
are continuing to return to more public health work that doesn’t directly
involve COVID-19. Looking ahead to the remainder of the year, I would like to
highlight some key initiatives that will be the focus of OPH’s work for the
next 8 months.
Of course, OPH is still very much
responding to many of the community needs from the current COVID-19 pandemic,
including the most recent resurgence. At this point, key areas of our pandemic
response include communications to the public to ensure they receive accurate
and timely health information, delivery of immunizations, infection prevention
and control supports in congregate settings, long-term care homes and
retirement homes, and ongoing surveillance effort such as assessing vaccine
coverage across Ottawa and in high-priority neighborhoods. I anticipate that
much of this work will need to continue at various levels for the remainder of
the year.
Despite this, some of our COVID-19
related work will continue to gradually decrease into the next several months.
This includes some of our case management work to align with provincial
direction, reducing some of our immunization clinics to match the community
demand, and some reduction in our infection prevention and control work when
outbreaks subside. We are doing these demobilizations while maintaining some
capacity to respond to future surges. These reductions will help us align to
the budgetary plan that was submitted for 2022, which has some key targets of
decreasing our COVID-19 related work to 75% by May, 50% by July and down to 30%
by the Fall 2022, yet we will be mindful to maintain capacity to respond to
future variants.
The province and Science Table are
monitoring the level of immunity after vaccination over time and this
information will guide any recommendations for additional COVID-19 vaccinations
recommended in the fall. OPH is planning to maintain some capacity for COVID-19
immunization, such as additional booster doses for people at greatest risk for
severe illness.
Gradually reducing some our COVID-19
work also allows the organization to focus on other important priorities and
strategic work for the remainder of the year. / La réduction progressive d'une
partie de notre travail sur COVID-19 permet aussi à l'organisation de se
concentrer sur d'autres priorités importantes et sur le travail stratégique
pour le reste de l'année.
I am pleased to say that many of our
core services continue to ramp up, including harm reduction (90%), healthy
growth and development (90%), our mental health and substance use team
(currently at 75%), our dental health services (75%), chronic disease and
injury prevention (25%) and some of our non-COVID immunization work. Other work
has been maintained, such as policy work that addresses the built environment
and climate change, the follow-up of non-COVID infectious diseases, and the
focus on the mental health strategy and Ottawa community action plan. For the
remainder of the year, we will aim to restore other key parts of our core work
including moving beyond risk-based approaches to safe food and water, and
personal service setting inspections and our supports for schools heading into
next year’s school year.
In 2022, OPH will also be driving
forward with our strategic work and action plans, which includes our six
strategic goals. One of the key areas of our strategy includes our approach to
diversity and inclusion. OPH has focused efforts on diversity and inclusion
training for our employees and leaders, which is ongoing. An independent
diversity and inclusion audit of our approaches is informing further actions
and I look forward to seeing those results and bringing forward any
recommendations back to the Board. We are in the process of adding a new
position of Program Manager, Health Equity, Diversity and Inclusion, that will
report to me and bring more lived experience to the OPH Senior Leadership Team’s
decision-making.
At our last Board of Health meeting, I
shared OPH’s Recovery Roadmap, and I can confirm that it is being used to align
our strategic initiatives, COVID-19 response, and restoring some of our core
public health services.
We are still in Step 2 of our recovery
plan, which includes engaging and hearing from key stakeholders such as
partners, community members and employees on how OPH can learn from COVID-19
and apply these lessons into our work, and also how OPH can best meet the
public health needs of Ottawa residents. For community partners and community
engagement, we are being deliberate in ensuring that we are working with other
City of Ottawa departments, such as Community and Social Services, to co-design
and co-create a community engagement and recovery plan with the community so
that actions and recommendations can inform future plans for both OPH and the
City’s, since city services can affect the social determinants of health?. This
work with partners and the community will continue for the remainder of this
year and it will guide future strategic plans and priorities for OPH.
A key component of our Recovery work
is ensuring that we also focus on employee recovery. Our employees have done
amazing work over the last two years, which I am thankful for – yet I know they
are tired from this prolonged response. / Un élément clé de notre travail de
rétablissement est de veiller à ce que nous nous concentrons aussi sur le
rétablissement des employés. Nos
employés ont fait un travail extraordinaire au cours des deux dernières années,
et pour cela je suis reconnaissante, mais je sais qu'ils sont fatigués par
cette réponse prolongée.
We are emphasizing the importance of
rest, taking vacation and time off when possible. We have identified a full-time
Organizational Development Consultant to ensure we advance our Wellness@Work
Action Plan, which includes helping supervisors and managers best support their
teams with flexibility, effective 2-way communications and how to encourage and
promote social connection. We are also promoting trauma informed leadership
training in how to handle difficult situations, mental health group debriefs
and peer supports for employees that need additional assistance. OPH will be
part of the City of Ottawa’s employee engagement pulse check in May and this is
always an important way to hear from employees about how they are feeling in
the workplace and what additional supports are required.
We have also heard very clearly from
employees about their concerns for their own employment and job security,
especially as some of our COVID-19 related work demobilizes. As a reminder,
before COVID-19, OPH had approximately 700 employees and we hired approximately
3,500 additional employees, including 600 full-time at the peak of the
response, to ensure we had capacity to meet the needs in the community such as,
immunization, following up with people who test positive and their contacts,
help manage outbreaks, support the school community and reach the community in
different way through our Community Engagement Team. We have committed to
employees that there will be regular communication about their roles and any
changes. Also, future positions will be posted for competition to fill
positions, in compliance with collective agreements and to ensure a transparent
process. There will not be enough positions to retain all temporary employees
and many employees that were hired temporarily to support our COVID-19 work
will see their assignment end by the end of the year. I want to take this
opportunity to thank all temporary employees for their valuable contribution in
supporting our response to the pandemic. We could not have protected and
supported the population without their work.
Lastly, a key project underway is an
independent review of how OPH has responded to the COVID-19 pandemic and what
we may need to reflect on for the future. This work will provide another
perspective from an external reviewer on how we can learn from COVID-19 and
apply these learnings into our future work. The goal is for this work to be
complete before this summer ends and I anticipate bringing the findings and
recommendations to the Board.
Dr. Funnell’s Departure from OPH
Before I take questions, I would like to recognize Dr.
Sarah Funnell who, earlier this month, left her position as Associate Medical
Officer of Health with OPH to work full time at the University of Ottawa’s
Centre for Indigenous Health Research and Education where she is pursuing her
passion and working to establish collaborative approaches for research and
education with Indigenous communities and organizations. / Plus tôt ce mois-ci,
la Dre Sarah Funnell a quitté son poste de médecin hygiéniste associée à SPO
pour travailler à temps plein au Centre de recherche et d'éducation en santé
des Autochtones de l'Université d'Ottawa, où elle poursuit sa passion et
travaille à l'établissement d'approches collaboratives pour la recherche et
l'éducation avec les communautés et les organisations autochtones.
During her time with OPH, Dr. Funnell was a tremendous
asset to the organization. She played a major leadership role for OPH’s
Reconciliation work in partnership with First Nations, Inuit, and Métis peoples
and communities to advance Indigenous health equity. She also took on the role
of Manager of OPH’s COVID-19 Case and Contact Management team at a critical
time in the pandemic when the need for case and contact management massively
increased and OPH rapidly expanded its work in this area.
I know that she will be greatly missed by
the team here at OPH and that we will have opportunities to continue to work
with Dr Funnell in her new role. I hope you will all join me in wishing her
well and thanking her for her contributions to our organization and to the
health of Ottawa’s population. A recruitment process has started to find
another Associate Medical Officer of Health.
I would be happy to take any questions. / Cela conclut
mon rapport verbal. Il
me fera plaisir de répondre à vos questions.