INFORMATION TECHNOLOGY SUB-COMMITTEEAGENDA 821 JUNE 2010 SOUS-COMITÉ DE LA TECHNOLOGIE DE L’INFORMATIONORDRE DU JOUR 8LE 21 JUIN 2010



Board of Health Corporate Seal

Ottawa Board of Health
MINUTES 21
Monday, January 24, 2022, 3:00 PM
By Electronic Participation
Contact for the Ottawa Board of Health:
Diane Blais, Board of Health Secretary
613-580-2424, ext. 21544
[email protected]

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, January 24, 2022 beginning at 3:00 PM.

The Board of Health Secretary presided over the beginning of the meeting, up to and including the confirmation of the Chair.

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


 

 

ROLL CALL

All members participated.

 

REGRETS

No regrets were filed.

 

DECLARATIONS OF PECUNIARY INTEREST (INCLUDING THOSE ORIGINALLY ARISING FROM PRIOR MEETINGS)

No declarations of interest were filed.

 

MOTION TO INTRODUCE REPORTS

Motion 21/1

Moved by Member Tilley

BE IT RESOLVED THAT the report titled Confirmation of the Chair and Vice-Chair for 2022 and the Medical Officer of Health Verbal Report, be received and considered.

CARRIED

 

1.

CONFIRMATION OF THE CHAIR AND VICE-CHAIR FOR 2022

 

ACS2022-OPH-BOH-0001

 

That the Board of Health for the City of Ottawa Health Unit:

1.        Confirm the election of Councillor Keith Egli as Chair for 2022, to be confirmed at the first meeting of each year of its term as required by the Health Protection and Promotion Act; and

2.        Confirm the election of Member Tammy DeGiovanni as Vice-Chair for 2022, to be confirmed at the first meeting of each year of its term as required by the Health Protection and Promotion Act.

 

CARRIED

 

2.

MEDICAL OFFICER OF HEALTH VERBAL REPORT

 

 

ACS2022-OPH-MOH-0001

 

 

That the Board of Health for the City of Ottawa Health Unit receive this verbal report for information.

 

 

RECEIVED, as amended by Motions 21/2 and 21/3

 

 

Dr. Etches began by noting that the goals of the pandemic response remain the same – to decrease morbidity and mortality, to maintain essential services, with a focus on hospital capacity, and to minimize societal disruption. She indicated that the highly transmissible Omicron variant and vaccine protection are changing the context and approaches to the pandemic, with less reliance on testing, case management and contact tracing.

She talked about the various indicators that OPH is monitoring, noting that the Omicron wave peaked in early January, after a rapid rise, and that we have been seeing a somewhat slower decline since then in wastewater signal, test positivity and new hospitalizations. Based on this data, there is reason for hope that the situation is improving, but not enough of a signal that we can stop taking precautions against COVID-19 transmission. Keeping the Omicron wave going downwards is in our hands. Therefore, Dr. Etches recommended maintaining foundational public health measures that have been shown to consistently work well - wearing masks when in close contact with people outside our own household, physical distancing, daily screening for symptoms that could be COVID-19, and staying home when we’re sick.

She explained how OPH is countering the virus by continuing to work on increasing vaccination coverage among various populations and through various means. She noted that two doses of a COVID-19 vaccine drop the risk of hospitalization by 70% and a booster dose drops the risk of hospitalization by 90%. She also talked about how OPH is supporting high risk settings through testing and case and contact management as well as with outbreak prevention and management.

Going forward, Dr. Etches indicated that OPH will be monitoring school absenteeism rates and supporting school and childcare settings where there are concerns about the rate of illness in those facilities. She noted that according to updated provincial guidance, interactions in school and childcare settings are generally not considered high-risk for COVID-19 transmission when preventive measures such as masking and distancing are in place, and that OPH is developing tools to support school and childcare administrators in assessing interactions they are concerned about.

She then talked about OPH’s focus on recovery, including mental health and substance use health supports, supporting businesses, community engagement and reimagining the future of public health.

In closing, Dr. Etches expressed appreciation for how the people of Ottawa have cared for one another throughout the pandemic and she thanked Board of Health Members for their support and guidance. She also thanked OPH’s many healthcare sector, community and City of Ottawa partners for supporting the pandemic response and the entire OPH team for their enormous efforts.

Dr. Etches’ verbal report was accompanied by a PowerPoint presentation, a copy of which is held on file with the Board of Health Secretary.

In the context of Dr. Etches’ Verbal Report, the Board heard from the following eight (8) public delegations:

·         Dr. Kwadwo “Kwajo” Kyeremanteng from The Ottawa Hospital

·         Dr. Alan Forster, from The Ottawa Hospital

·         Dr. Gail Beck, from The Royal

·         Chandra Pasma, resident

·         Dr. Kashif Pirzada, Emergency physician from Toronto

·         Greg Macdougall, resident

·         Ryan Smith, resident

·         Dr. Doug Manuel, from the Ottawa Hospital Research Institute

The Board also received the following written submissions, which are held on file with the Board of Health Secretary:

·         Letter from David Prichard

·         Email from Greg Macdougall

·         Letter from Christine Guptill

·         Email from Chris Kamel

Dr. Etches then responded to questions from Board Members after which the Board considered and approved Motions 21/2 and 21/3.

During the Board’s consideration of Motion 21/2, Chair Egli ceded the Chair to Vice-Chair Giovanni. Following approval of the motion, the Chair resumed chairing for the balance of the meeting.

The discussions on this item lasted approximately 3 hours and 30 minutes. The report was then received by the Board, as amended. The attached memo includes the Medical Officer of Health’s Verbal Update.

 

 

Motion 21/2

Moved by Chair Egli

WHEREAS there is increasing evidence that immunity can wane over time and that a third, or booster dose of the COVID-19 vaccine provides greater protection against severe outcomes due to COVID-19, which has led to all levels of government recommending a third, or booster dose to help restore and maintain protection against severe illness, complication or death due to COVID-19; and

WHEREAS providing greater protection against severe illness and complications from COVID-19 also helps reduce the risk of hospitalization, thereby reducing the strain on hospital capacity; and

WHEREAS the Omicron variant continues to circulate and hospital capacity is under pressure such that they are not able to operate as usual or continue to catch up on procedures and surgeries as needed; and

WHEREAS in Ontario, all residents aged 18 and over have been eligible to receive a third, or booster dose of the COVID-19 vaccine since December 20, 2021, with older residents and certain designated groups having been eligible since November 6, 2021 or earlier; and

WHEREAS currently, 58% of Ottawa’s eligible population and 47% of Ottawa’s overall population have received a third, or booster dose of the COVID-19 vaccine and every effort should be made to continue to increase third, or booster dose coverage among the eligible population; and

WHEREAS recent experiences, both in Ontario and in other jurisdictions, have shown that vaccine policies, including proof of vaccination requirements, lead to higher vaccine uptake and therefore higher vaccination coverage overall; and

WHEREAS the Province recently announced a strategy and timetable for reopening Ontario businesses and community settings, which will create more opportunities for COVID-19 to be transmitted in indoor settings where masks are not always used; and

WHEREAS the Province has also indicated that there are no plans to amend proof of vaccination requirements to include a requirement for third, or booster doses of the COVID-19 vaccine for certain indoor settings where masks are not always used;

THEREFORE BE IT RESOLVED That the Board of Health for the City of Ottawa Health Unit request that the Medical Officer of Health work with the province to emphasize a cautious approach to reopening while the healthcare system is still under pressure and work with the province to identify the best approach for its proof of vaccination requirements, in particular whether to include the requirement for people 18 years of age or older (eligible population) to show proof of a third, or booster dose in addition to proof of their first and second doses, to access businesses and community settings where patrons are required to provide proof of vaccination prior to entry, and report back to the Board of Health.

 

CARRIED

 

Motion 21/3

Moved by Member Menard

WHEREAS in response to the arrival of the more transmissible Omicron variant, the Province shifted its approach with respect to COVID-19 PCR testing to focus on highest risk settings in order to manage outbreaks and maintain the critical workforce, which has led to most children and education / childcare workers no longer being eligible for PCR testing; and

WHEREAS the Board of Health recognizes that COVID-19 testing is a responsibility of Ontario Health, that Ottawa’s testing centres are operated by local healthcare partners (hospitals and community health centres) and funded directly by the Ontario Ministry of Health, which sets the guidelines for testing eligibility, and that Ottawa Public Health has no operational oversight of testing criteria; and

WHEREAS the Province has committed to providing rapid antigen tests (RATs) for students and staff in public elementary and secondary schools as well as for children and staff in childcare settings, based on an initial limited supply; and

WHEREAS less robust testing, tracking and containment efforts can be expected to strain capacity elsewhere in our public systems; and

WHEREAS concurrent with this shift in testing strategy we have seen an increasing number of for-profit ‘private’ PCR testing services in Ottawa and elsewhere in the province; and

WHEREAS in addition to getting vaccinated when eligible and staying home when sick, good quality, snug fitting masks also provide and important layer of protection against the potential spread of COVID-19;

THEREFORE BE IT RESOLVED THAT the Ottawa Board of Health recommend that the Medical Officer of Health and the Chair of the Board of Health write to the Premier of Ontario and to the Ontario Minister of Health to recommend that the Province:

·         Expand eligibility for access to COVID-19 PCR testing, based on healthcare partner capacity and on a hierarchy of need and urgency to mitigate outbreaks and transmission in higher risk settings such as household members of ALL forward-facing healthcare workers, and daycare/childcare workers, until such time as RATs become more readily available for this sector;

·         Expand access to a regular supply of rapid antigen testing for children and workers in schools and childcare settings as these provide almost immediate results without adding pressure on the healthcare sector or local laboratories; and

·         Work towards offering free and effective masks for all people with lower income who want them by distributing through local agencies serving these populations;

AND BE IT FURTHER RESOLVED that the Board of Health reiterate its recommendation from February 2021 calling on the Province to provide the necessary funding, fiscal relief, and/or supports to employers so that all workers in Ontario have access to no less than 10 paid sick days annually in the event of a declared infectious disease emergency such as the COVID-19 pandemic, which would support workers in being able to stay home when they are sick. 

 

CARRIED

 

MOTION TO ADOPT REPORTS

Motion 21/4

Moved by Member Tilley

BE IT RESOLVED THAT the report titled Confirmation of Chair and Vice-Chair for 2022 and the Medical Officer of Health Verbal Report, be received and adopted.

CARRIED

 

MOTIONS REQUIRING SUSPENSION OF THE RULES OF PROCEDURE

There were no Motions requiring suspension of the rules.

 

NOTICES OF MOTION (FOR CONSIDERATION AT SUBSEQUENT MEETING)

There were no Notices of Motion (for consideration at a subsequent meeting).

 

CONFIRMATION BY-LAW

 

 

Motion 21/5

Moved by Member Tilley

BE IT RESOLVED THAT Confirmation By-law no. 2022-1, a by-law of the Board of Health for the City of Ottawa Health Unit to confirm the proceedings of the Ottawa Board of Health at its meeting of January 24, 2022, be read and passed.

 

CARRIED

 

INQUIRIES

There were no inquiries filed.

 

ADJOURNMENT

The Board adjourned the meeting at 6:47 p.m.

 

NEXT MEETING

Regular Meeting

Monday, February 14, 2022 - 5:00 PM

_____________________________                    _____________________________

BOARD SECRETARY                                           BOARD CHAIR


MOH Verbal Report
Board of Health Meeting of Monday, January 24, 2022

Slide 1

Bonjour, Kwey. Thank you for coming together for this special meeting so that the Board of Health can continue to provide oversight of the Ottawa Public Health response, consider policy options, and assist with keeping the community of Ottawa informed.

Slide 2

The goals of the pandemic response remain the same – to decrease morbidity and mortality, to maintain essential services, with a focus on hospital capacity, and to minimize societal disruption. / Les objectifs de la réponse à une pandémie restent les mêmes : de réduire la morbidité et la mortalité, de maintenir les services essentiels, en mettant l'accent sur la capacité des hôpitaux, et de minimiser les perturbations sociétales.

The highly transmissible Omicron variant and vaccine protection are changing the context and the approaches to the pandemic. A big change has been, less reliance on testing, case management and contact tracing.

While at present COVID-19's impact is much more serious than seasonal influenza, our goal is to reach a point at which COVID-19 is more like other respiratory illnesses (such as influenza), with a focus on preventing hospitalization and death in those at higher risk of severe disease.  For example, for older people in congregate settings, the focus will be vaccinating, monitoring for symptoms of COVID-19 and keeping isolated when sick.

Omicron’s rapid spread increases the likelihood of being exposed to it. People are most likely to pass on the Omicron variant from two days before the onset of symptoms until three days afterwards. This timeframe means transmission can occur before people know they are positive, even in high-risk settings where PCR testing is available. No one should be shamed for testing positive for COVID-19. We need to support each other through this and people need sick leave options to stay home when sick.

Most people will be able to weather the illness at home. Individuals can prepare for this by staying physically active, taking care of their health conditions, and making sure they have basic supplies and pain relief medication on hand; however, COVID-19 can still be very serious in some, so people need to know when to seek healthcare assessment, such as for chest pain, difficulty breathing, confusion or rapidly worsening symptoms.

I appreciate that for some, the ongoing risk of being exposed to COVID-19 is an unhappy thought after two years of being vigilant against any COVID-19 transmission. The data we have shows that vaccination provides reassuring protection against serious illness and death and that children continue to be unlikely to be hospitalized for COVID-19 treatment. Protecting each other doesn’t depend on testing. We can still be confident that, when we wear our masks, practice physical distancing, increase ventilation, limit close contacts indoors, and stay home when sick, we are helping decrease COVID-19 transmission – these are still very important things to do.

Unfortunately, some individuals may still need hospital care - many who are unvaccinated and contract COVID-19, some vaccinated individuals and especially people over the age of 60. The health care system cannot withstand the pressure of too many people acquiring COVID-19 at the same time. Omicron cannot be stopped altogether but we can work to blunt the peak and slow transmission so that hospitals can maintain capacity to deliver care.

For this reason, we still need to be cautious about the number of opportunities for transmission we give COVID-19.

At this time, my best professional advice is to maintain foundational public health measures that have been shown to consistently work well (wearing masks, distancing, screening daily and staying home when sick) while balancing the need to promote our overall wellness. We should chart a middle road where it is too soon to give up being cautious until we see that the levels of COVID-19 in the community can be handled by our healthcare system.

And I am supportive of continually reviewing COVID-19 practices that cause harm, such as the social isolation in Long-Term Care Homes during outbreaks, against the disease control objectives. Bringing back peoples’ access to social connections and extra-curricular activities that promote health is important. People need to be back at school and work for overall well-being. These days will come one step at a time.

Slide 3

Based on the experience in other jurisdictions, Omicron outbreaks appear to peak steeply and rapidly in just over a month from the first reported cases; the declines may be more gradual, but we are still learning about this. Local surveillance is consistent with the daily incidence of new Omicron cases having peaked in early January after a rapid rise. Since then, we have been seeing a somewhat slower decline in wastewater signal, test positivity and new hospitalizations due to COVID-19. There are still many people who have not been infected with Omicron, so maintaining that downward trend will require that we all continue to practice public health measures, particularly masking when interacting with people outside our households. Keeping the Omicron wave going downwards is in our hands.

There are a number of measures that OPH is monitoring to understand where we are in the Omicron wave and what is required at this time.  There are reasons for hope that the situation is improving, but not enough of a signal that we can limit precautions against COVID-19 transmission. / Il y a un certain nombre de mesures que SPO surveille pour comprendre où nous en sommes dans la vague Omicron et ce qui est nécessaire en ce moment.  Nous avons des raisons d'espérer que la situation s'améliore, mais le signal n'est pas suffisant pour que nous puissions limiter les précautions contre la transmission de laCOVID-19.

In Ottawa, the wastewater signal suggests that the amount of COVID-19 in the community (almost 100% due to Omicron) has declined from a peak in early January but has recently been showing a slowing of the decline. Similarly, the percentage of people eligible for COVID-19 testing that test positive has declined from a peak in early January but has also recently slowed its decline. The number of people in hospital may have reached a peak of 127 on January 15, just about the same height as the April 2021 peak, and the number of people in hospital requiring active treatment for COVID-19 continues to be high at 92, with 1 hospitalization at CHEO currently.

It is also important to note that hospitalization is a lagging indicator and our hospitals continue to struggle with hospitalization and staffing pressures, which is why we all need to continue the strategies we know will help to reduce COVID-19 transmission. Provided new cases continue their downward trend, we can expect the numbers of people being treated in hospital to also decrease, but as noted, this takes longer to catch up. Sadly too, is the current surge in deaths, which follow the people testing positive with the most serious illness.

Some of the hospitalizations are related to outbreaks in hospitals and long-term care and retirement home settings. We have typically seen that the peak of outbreaks follows community transmission, as COVID-19 is introduced into homes and hospitals. The percent positivity in LTCH looks to be stabilizing now and the overall number of outbreaks in healthcare settings has started to very slowly drop, although remaining at unprecedented levels. The severity of illness in these settings is strikingly reduced from previous waves, as most residents are vaccinated with their third, booster dose and have been receiving a fourth dose as an additional booster dose. However, with the significant amount of people contracting COVID-19, there have been more people in recent days who have lost a loved one due to COVID-19.  We still aim to keep this worst outcome of COVID-19 as low as possible, as one of our key objectives in this response continues to be to reduce morbidity and mortality.

I get a lot of questions about hospitalization measures, so I would like to describe how OPH measures hospitalizations. We count hospitalizations among Ottawa residents with an active COVID-19 infection.  Following Ministry of Health direction for public health units, the hospitalization must involve treatment for an active COVID-19 infection, or have a hospital stay extended due to COVID symptoms and/or treatment.  This also applies to people who may acquire COVID-19 while in hospital. Because of the broader catchment areas that Ottawa hospitals serve, including people from Quebec, the OPH dashboard is likely to have lower numbers of hospitalizations presented compared to totals reported by hospitals. The consistent way that OPH has measured hospitalizations over the pandemic allows us to accurately look at trends in severity for Ottawa residents.

Hospitals also count how many people they have in hospital who have tested positive for COVID-19 even when they are not admitted for COVID-19 treatment. This is important because isolation measures are different for people who test positive. They are now being asked to distinguish between who is in hospital because of needing care for COVID-19 and people who test positive while receiving care for another reason. This helps us to know how much severe illness there is in the community as well as the overall burden on hospitals.

We understand that there is public confusion about hospitalization numbers between what public health is reporting and what physicians from hospitals are saying. For this reason, OPH is working with hospital partners to also report about people in hospital with COVID-19 as an incidental diagnosis, versus those who are being treated for COVID-19 illness as the primary cause of admission. This should be publicly available in the next few days.

Slide 4

In addition to the public health control measures put in place by the province, OPH is countering COVID-19 transmission and severe illness by continuing to provide COVID-19 vaccines to people in Ottawa in collaboration with partners in pharmacies, community health centres, hospitals and primary care. / En plus des mesures de contrôle de la santé publique mises en place par la province, SPO lutte contre la transmission de la COVID-19 et la maladie grave en continuant à fournir des vaccins contre la COVID-19 aux habitants d'Ottawa en collaboration avec des partenaires dans les pharmacies, les centres de santé communautaire, les hôpitaux et les soins primaires.

Since we last met at the end of November, the OPH team and partners rallied tremendously, shifting from their regular work and working through the holidays and in the context of virtual learning over the first two weeks of January, to ensure over 406,000 third, booster, doses were given. This work was led by the City of Ottawa’s Emergency Operations Centre in a Unified Command approach, where OPH leaders are key members of the Incident Management Command team. General Manager, Emergency and Protective Services, Kim Ayotte, is here to answer questions about the operations as well. I am thankful to all the OPH and City staff who have acted so urgently to provide this protection against COVID-19 transmission.

Ottawa residents of all ages continue to make significant progress in getting their COVID-19 vaccines, whether it’s their first, second or booster doses. As of last night, 91% of Ottawa residents 5 years or older have their first dose, 85% have had two doses and 59% of the eligible population have had a third, booster dose. This is collective action to improve the COVID-19 situation and I thank everyone who has been and will be vaccinated when eligible.

In particular, I am pleased to see that older adults now have high levels of vaccination with a third, booster dose – 89% for people 80 and older, 87% for people in their 70s and 77% for people in their 60s.

The joint EOC team continues to work on increasing uptake of third, booster doses, with a focus on where coverage rates are lower. Immunization team members are shifting to work in neighbourhoods, schools, and in mobile teams that can be deployed to businesses, places of worship and other settings that will facilitate vaccination.

The community engagement team (CET) continues to provide support in neighbourhoods and populations that have lower vaccine uptake to understand barriers and provide information to enable residents to seek their booster or even their first dose. This work involves promoting the local and familiar vaccine clinics available for residents in various languages and via various channels. The team is also working with partners to provide multilingual virtual presentations about booster doses that speak directly to residents’ concerns, as well as WhatsApp and Facebook communications for newcomers and populations that have language barriers. CET is also working with community partners to guide and dispatch the OPH mobile team to areas and groups who are more isolated and unable to access existing vaccine clinics.

Concerning more high-risk settings, OPH continues to support LTCH/RHs with 3rd and 4th, booster doses, for their residents and enabling LTCH staff to meet the deadline of January 28 for their third, booster dose. OPH has continued partnerships that enable vaccination in other congregate settings like shelters and the Ottawa Carleton Detention Centre.

The immunization program, through our EOC, is aiming for increased coverage rates among children 5-11 as well, though children and youth in Ottawa are to be praised for being among the most vaccinated in the province. OPH is running another round of 49 school-based vaccine clinics over the next few weeks. These clinics are for any doses of the COVID-19 vaccine and welcome to all members of the community, including youth and staff. Targeted promotion will be done with our school board partners to ensure the school community is aware of these clinics.

Older youth, 12-17 are not yet eligible for a third, booster dose in Canada, though we understand that Health Canada and the National Advisory Committee on Immunization are reviewing data about booster doses in this age group.

People are interested in the immunization of four-year-olds and I acknowledge there has been some confusion because provincial policy in later 2021 allowed vaccination of four-year-olds turning five that year. The written direction to OPH to stop vaccinating four-year-olds, and changes to the provincial booking system didn’t come until into the first week of January. The provincial policy is now to wait until children are five to provide the COVID-19 vaccination. This includes waiting until a child is five for a second dose if a four-year-old has had a first dose. We are also looking forward to a vaccine for people 6 months to 4 years of age in the coming months.

Slide 5

Before moving on from COVID-19 vaccination, I want to share a slide with you from the Ontario Science Table. These graphs show why I am still highly recommending COVID-19 vaccination for people who have not yet been vaccinated.  Being unvaccinated is a major risk factor for severe illness when infected with Omicron. As the graphs show, on January 23, hospital occupancy among people who have been vaccinated with at least 2 doses was 81.5% lower than among unvaccinated people – and intensive care unit occupancy was 91.4% lower.

Other scientific analyses recently published from multiple jurisdictions also reinforce the additional benefit of a third, booster dose.  Two doses of a COVID-19 vaccine drop the risk of hospitalization by 70% and a booster dose drops the risk of hospitalization by 90%. / Deux doses de vaccin contre la COVID-19 réduisent le risque d'hospitalisation de 70% et une dose de rappel le réduit de 90%.

Slide 6

In addition to immunization, testing and tracing and outbreak prevention and management continue to be used to decrease COVID-19 transmission in Ottawa.

This past December 31, the Ministry of Health announced that publicly-funded PCR testing would be available only for high-risk individuals who are symptomatic and/or are at risk of severe illness from COVID-19, including for the purposes of confirming a COVID-19 diagnosis to begin treatment, and workers and residents in the highest risk settings, such as hospitals, health care settings and congregate living settings such as long-term care homes, group homes, and shelters. First Nations, Inuit, and Métis Communities are also eligible for PCR testing. The household members of workers in highest risk settings became eligible on January 13.

The Province has also provided guidance on the different uses for Rapid Antigen Testing, which include testing for people with symptoms, if you are not eligible for a PCR test - using rapid tests to assist early return-to-work in health care settings with critical staffing shortages, as well as ongoing screening of people who are asymptomatic and without known exposure to a COVID-19 case, with the goal of identifying cases that are pre-symptomatic or asymptomatic. In the school and childcare setting, staff and students are being provided with two rapid antigen tests from the Province that they can use when they have symptoms of COVID-19. These are anticipated to be replenished as the provincial supply of rapid antigen tests improves.

Given the currently reduced access to testing for the general public, we need to treat possible COVID symptoms as if they are a COVID-19 infection. In most situations, access to PCR testing would not yield results fast enough to change the typical isolation period of 5 days, as people typically present for testing after a day or two of symptoms and it takes a couple of days to get the results back from the lab.

The most up-to-date guidance for when to use rapid antigen tests, if they are available, and for isolation is found by following the provincial screening tool at Ontario.ca/COVID19.   

The bottom-line message is clear: stay home if you are sick and until symptoms have resolved and stay home if a member of your household is sick. This will help protect people at risk for severe illness and slow the spread of COVID-19. / Le message essentiel est clair : restez chez vous si vous êtes malade et jusqu'à ce que les symptômes aient disparu, et restez chez vous si un membre de votre foyer est malade. Cela permettra de protéger les personnes susceptibles de contracter une maladie grave et de ralentir la propagation de la COVID-19. 

OPH’s Infection Prevention and Control (IPAC) Team is working in close collaboration with many healthcare partners to review outbreak measures and align practices to support the functioning of the health system. OPH continues to work closely with local and regional partners, including those in acute care (The Ottawa Hospital, Queensway Carleton Hospital, Montfort and Bruyère), community health care (Community Health Centres, Ottawa-Inner City Health), and provincial authorities (Ontario Health, Ministry of Long-term Care, Solicitor General, Retirement Homes Regulatory Authority, Home and Community Care Support Services, Ministry of Children Community and Social Services), to ensure coordinated and timely response to help prevent severe illness and death due to COVID-19 in high risk settings.   All settings are reporting staffing pressures and the movement of people from hospital to LTCHs is a key element that OPH is working to facilitate in order to help maintain acute care capacity to meet community needs.

Through the most recent surge, OPH has managed and investigated an unprecedented number of COVID-19 outbreaks. OPH realigned resources across the organization as well as within the IPAC team to support the high volume of outbreaks in high-risk settings. As of last week, the IPAC team was supporting over 240 suspect and confirmed outbreaks across high-risk settings.  Despite the increased number of outbreaks, we are seeing proportionally less severe outbreaks, thanks in part to the preventative IPAC work conducted throughout 2021 by OPH and the regional IPAC team as well as the immunization effort across high-risk settings. The effects of the Omicron wave have continued to impact the physical and mental health of residents/clients in congregate settings as a result of isolation measures, and health human resources (HHR), which have critically strained our health care system. OPH has worked across sectors and with various partners to support and advocate for strategies to address isolation policies, critical staffing shortages and acute care transfers and admissions. Strategies include, but are not limited to, site visits (prevention and outbreak management), development of tools, holding Communities of Practice meetings, and ongoing communication with the sectors/partners.

Throughout the pandemic, OPH has been and continues to work with the Ottawa Carleton Detention Centre and the Solicitor General of Ontario to manage outbreaks. IPAC is meeting with the facility daily and providing outbreak consultation around cohorting to minimize close contacts and their need to isolate to balance mental health and safety of people residing in the institution. OPH works in collaboration with SOLGEN to support and facilitate the immunization of people residing in the institution, and various strategies have helped increase COVID-19 vaccine confidence and advance vaccine equity. However, OPH remains concerned about the relatively low uptake of vaccines among people residing in the institution and staff and our inability to understand vaccine coverage within OCDC, due in part to the transient nature of this population.  OPH continues to support OCDC in the implementation of strategies to increase COVID-19 vaccine confidence and advance vaccine equity, including leveraging stakeholders to use peers to promote vaccination and has recommended that they monitor vaccination coverage rates of staff and people residing in the institution on a weekly basis to guide on-site immunization efforts.

Slide 7

Going forward.

We’ve consistently said that schools should be the last to close and the first to re-open as they are an essential service for children, youth and their families. Therefore, the return to in-person learning was welcome news. This is supported by the Science Table, as well as others in the health care sector.

With respect to schools, OPH will be monitoring absenteeism rates, which schools are now required to report daily to the Ministry of Education. For any absenteeism rate more than 30% above their baseline, schools and childcare centres are required to report directly to the health unit and send a notification to the school or childcare community. Whenever an increased absenteeism rate is reported or a school or childcare administrator advises OPH of concerns about the rate of illness in their facility, our team will provide support and review public health measures to ensure that preventive measures are in place. We are just starting to get the absenteeism data and will be reaching out proactively where rates are higher. Further, OPH will continue to support schools and childcare for any increased illness in a cohort and for all other concerns or questions they may have. / Lorsqu'une augmentation du taux d'absentéisme est signalée ou qu'un administrateur d'école ou de garderie fait part à SPO de ses inquiétudes quant au taux de maladie dans son établissement, notre équipe apportera son soutien et examinera les mesures de santé publique pour s'assurer que des mesures préventives sont en place. De plus, SPO continuera de soutenir les écoles et les garderies en cas d'augmentation du taux de maladie dans une cohorte et pour toute autre préoccupation ou question qu'elles pourraient avoir.

According to updated provincial guidance, interactions in school and childcare settings are generally not considered high-risk for COVID-19 transmission when preventive measures are in place. OPH is developing tools to support school and childcare administrators in assessing interactions they are concerned about with a person that has tested positive, particularly when preventive measures such as masking and distancing are not maintained. Considering the extent of transmission in the community, daily screening for all children and staff, as well as vaccination for all who are eligible, are the best ways to prevent COVID-19 from being introduced into school and childcare settings.

Last week the province announced plans for the gradual reopening of businesses and lifting of public health measures, based on key public health and health care indicators. The reopening of businesses and community settings will increase the number of opportunities for close contact indoors. Like our Provincial partners, we will be monitoring key indicators locally. Notably, we will be looking for hospital capacity and outbreaks to stabilize and for the viral levels in our wastewater and percent positivity rates to continue their downward trend and we will maintain close communication with healthcare partners and the office of the Chief MOH to share what we are seeing. As the province moves along with their framework for reopening, we will need to remain cautious, and evaluate the situation as we go.

Slide 8 - Recovery

You heard in November that OPH was planning to move into a period of re-imagining our future in 2022. On one hand, the Omicron wave has depleted the energy of our workforce even further, but on the other, the experience of people having to be redeployed again has strengthened our resolve to define what work we need to prioritize into the future.

The team has never lost sight of the importance of supporting mental health and substance use health, though with the Omicron wave even this team re-contributed to the immunization effort and overall COVID response last month, along with other program areas previously restored like the sexual health clinic, dental health and healthy growth and development. As the mental health of people in our community continues to be impacted by the pandemic, OPH and community partners continue to work together to increase awareness and access to supports, including: 

o        Supporting families with increased vulnerabilities during the prenatal period, and new families up until the transition to school through the healthy growth and development program.

o        Increasing accessibility to parents who are expecting and for parents of children up to 6 years old by operating the Baby Help Line, seven days a week, at 613-580-2424 ext. 23774.

o        Helping community members navigate the mental health and substance use health systems of care through promotion of Access MHA and 1 call 1 click.

o        Increasing services and supports to diverse communities by building the capacity of community leaders through training for faith leaders and service providers reaching diverse populations. 

o        Working directly with targeted communities to offer mental health and substance use health system navigation support in low-income neighbourhoods.

o        Supporting the health of youth in the community by promoting OPH’s and YouthNet’s collaboration resulting in a new online mental health promotion portal, for youth by youth.

o        Advancing suicide prevention work through training of intermediaries and partners and ongoing collaborations with local and national suicide prevention partners on a variety of initiatives.

Furthermore, substance use health has also been significantly impacted by the pandemic. To address these health issues, in collaboration with many community partners, OPH continues to make progress on the Ottawa Community Action Plan, including:

o        Active development, with partners, of a local dashboard of mental health and substance use health needs within the community.

o        Addressing stigma experienced by people who use substances in collaboration with the Community Addiction Peer Support Association through training, workshops and outreach to healthcare and social services partners as well as the general community.

o        Preventing and responding to overdoses in the community through naloxone training and distribution, both directly through OPH and in partnership with others, including a focus on training, services, and tools for people in the construction industry.

o        Maintaining access to critical frontline harm reduction services by partners and OPH by adapting programs and services like supervised consumption services, needle and syringe program, take-home naloxone kits and ensuring access to COVID-19 testing and vaccination for people who use drugs and are experiencing homelessness/precarious housing.

o        Supporting the substance use health needs of clients in hospital by exploring what can be done in the hospital setting, including access to opioid agonist treatment, harm reduction services and continuity of care.

o        Striving to meet the needs of different communities through targeted interventions such as the collaboration on a pilot project with City and community partners to support the well-being of people living in Lowertown and collaborating on the Guiding Council to establish a new mental health and addiction crisis response system.

We have maintained sector-specific supports to business and have worked closely with the City’s Economic Recovery Table. We will build on the partnership with the Ottawa Board of Trade and others to foster healthy workplaces.

While we have work to do to re-build and re-imagine how specifically OPH will function and look in the future, we know now that there are key ways of working that we are looking to strengthen and expand as top priorities. The OPH Strategy remains a good guide as it points to the need to address inequities in health and engage with community leaders, organizations and partners to inform this work.

Team members are now preparing for more meaningful dialogue about our community-informed anti-racism and anti-oppression policy across OPH teams. We are working on options for a third-party audit of our diversity, equity and inclusion initiatives and will be looking for dedicated leadership for this work.

We have also learned that we need to take more time through transitions to hear from all types of employees in the planning stage. There was a dramatic drop in demand for vaccination last August, just before a Delta surge and more demands in schools. An evaluation of this transition has identified ways we can approach our current situation more effectively.

Therefore, as we look to restore health promotion work, we will be seeking to listen to employees, communities with greater barriers to health, business partners and others to start with an assessment of our changed community health needs and shape new health promotion services together.

The pandemic has shone a light on the health inequities in our community, and we have shown that we can make an impact by working in partnership with community leaders, multi-sectoral partners and by building on the strengths in neighbourhoods and communities. In addition, the pandemic has underlined that our work can be most effective when focused where needs are greatest. We look forward to getting back to supporting our community for more non-COVID-related work –through building resiliency and capacity, connecting people to services that they need, promoting positive mental health, and addressing behavioural risk factors for chronic diseases that have increased during the pandemic, including decreased social connections, physical activity and healthy eating.

I am so proud of the teams’ work in the stressful environment of the pandemic. I am proud of the professionalism that they have maintained in the face of people who are experiencing challenges that make communications negative. And, the extraordinary effort employees have put in means we also need to continue to keep focused on employee wellness.  We are monitoring overtime, supporting vacation requests, supporting employees to take breaks, encouraging employees to be off when they are sick, identifying back-ups and reducing work. While we still have work to do in this area, we are continuing to identify ways to support employee wellness, while still working through a global pandemic.

Slide 9

In concluding, I must say that I am so impressed with how the people of Ottawa have cared for one another throughout what has become an exhausting pandemic. / Je suis très impressionnée par la façon dont les habitants d'Ottawa ont pris soin les uns des autres tout au long de ce qui est devenu une pandémie épuisante.

At times, the differing perspectives – from wanting “COVID-19 Zero” through to wanting no restrictions or mask requirements at all – create conflict and concern. Yet, so many individuals doing their part has added up to getting us this far and will see us through. OPH remains in a stance of learning and adapting to the changing circumstances and science and thankful for your guidance as Board of Health members. I also want to thank our many healthcare sector, community and City of Ottawa partners for supporting the pandemic response and the OPH team for their enormous efforts.