Board of Health Meeting
Chair Keith Egli – Verbal report
April 19, 2021
Good evening, bonsoir,
Kwey,
For my verbal report tonight, I would like to provide
Board colleagues with updates on some recent events.
Stigma Training
Last month, Ottawa Public Health’s Mental Health and
Substance Use Unit offered training to Members of Council and their staff
titled Stigma: The Power of Language in Supporting your Community. Two virtual
sessions were held, on March 16th and 24th.
These sessions were led by Public Health Nurses Linda
Cove and Caroline Bala. Between the two sessions, 11 Members of Council
participated, as did 44 Councillors’ assistants.
This
thirty-minute training provided Members of Council and their staff with
information, resources, and tips on communicating with residents about the
pandemic, mental health and substance use. The goal was to equip participants
with knowledge and tools to communicate with residents about COVID-19, mental
health and substance use in a way that can help residents feel supported and
informed without perpetuating further harm.
Essentially, the
training helped explain what stigma is and how it might prevent people from
seeking proper care. It also provided tips and suggestions on how to use
language that prevents stigma, including concrete examples that we can all use
in our daily interactions. I’m told that OPH is working
with the Community Addictions Peer Support Association (CAPSA) to explore the
development and delivery of in-depth substance use anti-stigma educational
sessions to our community.
Those who
participated in the training in March received several handouts and aids to
support them in applying what they learned into everyday exchanges with
residents. Following these sessions, attendees were also given the opportunity
to register for a 90-minute virtual suicide prevention training, which they
could take at their own convenience.
Following the sessions, participants were invited to
complete an evaluation survey and I’m happy to report that the feedback has
been largely positive.
I personally would like to thank Linda and Caroline for
providing this training opportunity to Councillors and their staff as well as
Erin McClelland and Chanel Brown who helped coordinate the sessions.
March 25 Interfaith Ceremony
Some of you may be aware that on March 25th,
Mayor Watson hosted an interfaith ceremony to honour all City of Ottawa
residents who have lost their lives to COVID-19.
Dr. Etches participated in that ceremony, as did
Algonquins of Pikwakanagan First Nation Chief Wendy Jocko, Mr. François
Couillard of the Bahá’í Community of Ottawa, Reverend Dr. Anthony Bailey from
Parkdale United Church, Rabbi Idan Scher of the Congregation Machzikei Hadas,
and Imam Samyu Metwally from the Islamic Society of Gloucester.
The ceremony was held in front of Ottawa City Hall, next
to the 2017 Cauldron and featured musical performances by local musicians -
cellist Julian Armour and harpist Caroline Léonardelli.
Some of you may have watched the livestream or had an
opportunity to view the video after the fact. It was a touching and fitting ceremony.
If you haven’t seen it yet, I encourage you to watch the video. It is available
on Mayor Watson’s Facebook page.
As Dr. Etches noted in her remarks on that day, March 25th
2020 was a sad day for all of us. It was the day we shared the news of Ottawa’s
first COVID-related death. Since then, 482 Ottawa residents have lost their
lives to this illness. Each one of them was loved, they continue to be missed
and will forever be remembered by their loved ones.
Though I was not able to participate in person on March
25th, I would like to add my condolences and prayers to Ottawa
residents who have lost loved ones to COVID-19.
Vaccination & Back to Basics
As we all know, we have now entered into a new phase of
this pandemic. One that gives us hope – and that is the massive undertaking of
getting people vaccinated.
I am happy to say that on April 6th, I was
able to get my first shot of a COVID-19 vaccine.
After the province announced that those 55+
were eligible to book their appointments at pharmacies to receive the
AstraZeneca vaccine, I took the opportunity to book my appointment. I reached
out to my local pharmacy and took the first appointment I was offered. It was
fast, easy, and I was lucky to only have the mild side effect of a sore arm.
We are hearing reports of people having
concerns about the AstraZeneca vaccine. Everyone should know and understand
that Canada’s leading medical and scientific experts have determined that the
risk of a serious outcome from being infected with COVID-19 is far greater than
the risk of a serious side effect from the AstraZeneca COVID-19 vaccine. Health
Canada continues to reassure Canadians that the AstraZeneca vaccine is safe and
effective.
As we so often hear from doctors and other
medical professionals – the best COVID-19 vaccine is the one you can get. I
encourage everyone to take advantage of the first opportunity available to them
to get vaccinated. So please, if you are eligible for a vaccine, book your
appointment today.
In closing, while we recognize
that vaccines are a vital part of the COVID-19 response, we also know that it
will take months until enough of the population is vaccinated for it to be safe
to relax public health measures.
Meanwhile, we are also keenly aware that
Ottawa is experiencing its biggest resurgence of COVID-19 cases to date.
The fact is, we cannot vaccinate our way out
of this third wave so it is vitally important that each and every one of us
continue to do what we know works to stop the spread of COVID-19 in our
community and that means going back to the basics. Stay home except for
essential trips. Limit contacts to those in your own household. Practice
physical distancing and wear a mask. Wash your hands regularly and don’t touch
your face except with freshly cleaned hands. And stay home if you’re not
feeling well or if you’ve been exposed to someone who has tested positive for
COVID-19.
We also know that this pandemic has been long
and hard. Please remember to be kind - to yourself and to others. Take time for
some self-care and rest. Check in on your own mental health and check in,
virtually, on relatives, friends, neighbours and colleagues.
That concludes my verbal update. I’d be happy to take any
questions.
Board of Health Meeting
Dr. Vera Etches – Verbal report
April 19, 2021
Good evening, Kwey, Aingai, Taanishi, Bonsoir,
In tonight’s Verbal Report, I will provide updates on our
work with Ontario Health Teams, the local COVID-19 situation in Ottawa,
including outreach our team is doing to some of the communities most impacted
by the pandemic, and the local COVID-19 vaccine rollout.
Dans mon rapport verbal de ce soir, je vais faire le
point sur notre travail avec les équipes de santé de l'Ontario, sur la
situation locale relative à la COVID-19 à Ottawa, y compris la sensibilisation
de notre équipe à certaines des communautés les plus touchées par la pandémie,
et sur le déploiement local du vaccin COVID-19.
Ontario Health Teams
As we have shared previously, Ontario
Health Teams (OHTs) were introduced by the province in April 2019 as a new way
of organizing and delivering care and OPH has been an active partner in every
Ottawa area OHT to-date.
In many ways, COVID-19 has accelerated
opportunities to work collaboratively across the health system, which has led
to new approaches to addressing the health of our population and reducing
health inequities. / À bien des égards, la COVID-19 a accéléré les possibilités
de travailler en collaboration dans l'ensemble du système de santé, ce qui a
mené à de nouvelles approches pour aborder la santé de notre population et
réduire les inégalités en matière de santé.
In addition to neighbourhood-level efforts to support
COVID-19 response and vaccine rollout, Ontario Health Teams (or OHTs) continue
their work in other areas.
One of the OHTs we have not talked about a lot to-date,
the Four Rivers OHT, which captures the western parts of Ottawa and extends
into neighbouring health units to the west and southwest of our City, was
invited by the Ministry of Health to submit a Full Application. We will be
receiving this document shortly, with partner sign-off requested by the end of
April. We will keep Board members informed as the status of this OHT evolves.
I’m also happy to share that efforts
to improve access to mental health and addictions services have made important
gains through Ottawa-based OHTs. The Ottawa Health Team’s Counselling
Connect/Counseling on connecte initiative has brought together several
community-based providers under a single booking platform to enable same day or
next day counselling appointments. Thousands of appointments have been booked
since its launch last May. Further, the “One Call/One Click” initiative, led by
the Kids Come First Health Team, will improve access to youth mental health
care across the region. The first phase is expected to launch in the coming
weeks.
As the effects of the pandemic wear on, ensuring timely
and equitable access to supports for mental health and substance use challenges
continues to be an important part of our collective response and we are pleased
to be collaborating with so many of our local OHTs in these efforts.
Current COVID-19 Situation in Ottawa
Moving on to the current COVID-19 situation in Ottawa, I
know that Dr. Moloughney provided a detailed presentation at last Wednesday’s
technical briefing and then he and Mr. Di Monte answered a wide range of
questions from Members of Council and Members of the Board of Health.
Tonight I’m going to focus on what we’ve seen recently
with respect to the data and trends and provide an update on some of our
targeted efforts to reach specific communities. / Ce soir, je vais me
concentrer sur ce que nous avons vu récemment en ce qui concerne les données et
les tendances et faire le point sur certains de nos efforts ciblés pour
atteindre des communautés spécifiques.
Over the past week, we have continued to see a high
number of Ottawa residents testing positive for COVID-19 each day. Since
Wednesday’s technical briefing, the daily average has been 288 infections
reported to us. The percent of people testing positive is still very high at
over 10%. Hospitalizations have continued to rise significantly. The median age
for COVID-19 patients currently in Ottawa hospitals is 66.
The majority of people are still testing positive due to
transmission within a household and due to social interactions where people are
in close contact without mask use. While indoor environments pose the greatest
risk for COVID-19 transmission, people are still coming into close contact with
people outside of their household in parks and on trails, for example, and this
risk requires more attention to keeping distanced when outdoors and to wearing
a mask when distance cannot be assured.
While healthcare and school and childcare settings
account for most outbreaks currently reported in Ottawa, COVID-19 transmission
continues to lead to outbreaks in a wide variety of workplaces where people
cannot work from home, such as in restaurant, retail, services and construction
settings. Of 3412 people with active COVID-19 infection, there are 3 childcare
workers who are currently positive related to 3 outbreaks, where the number of
children positive is also 3. Workplaces are currently required to report to OPH
when more than two of their workers have tested positive and the team has been
inundated with calls over the last week. We have also seen outbreaks in offices
where people could have potentially worked from home.
Employers are required to ensure that employees who can
work from home do work from home. A significant reduction in interactions
between people is still critical for turning this resurgence and employees that
can work from home must work from home.
Many workplaces have been working hard to maintain COVID
protocols and requirements, however, recent inspection efforts of a
cross-section of 80+ businesses have highlighted deficiencies in half of those
businesses related to the lack of screening of symptoms in workers and/or a
COVID-19 safety plan. Further, in a small minority some businesses have
received repeated infractions and are making entry and inspection difficult for
enforcement officers to verify compliance with provincial and local
requirements.
As has been previously
reported, there are a number of neighbourhoods and communities in Ottawa that
have been disproportionately impacted by COVID-19. Neighbourhood-based efforts
to increase support for access to COVID-19 testing and self-isolation continue.
For the past several months, OPH has been working with community partners to
advance engagement activities with a focus on building vaccine confidence,
along with the work to promote COVID-wise practices.
OPH’s Community Operations
Branch and the Community Engagement Task Force have partnered with community
organizations to host public town halls in multiple languages, featuring the
voices and perspectives of health professionals from diverse ethnocultural
backgrounds. These town halls, held in Spanish, Arabic, Somali, English and French,
have enabled a dialogue where OPH and partners have listened and addressed
concerns from residents, while highlighting credible sources of information to
assist in building vaccine confidence. Feedback from these sessions continues
to influence our planning, operations and engagement work. This has included
shifting staffing to ensure staff with diverse language abilities are working
at specific pop-ups to support residents in their first language; allocating
additional accessible parking spaces and adapting processes to better support
individuals living with disabilities; and learning new ways to share credible
information with diverse audiences to help build vaccine confidence.
OPH has also been working
with community partners and service providers using a train-the-trainer model
to help build capacity to discuss vaccines with residents and help build
vaccine confidence and support people to access vaccines. This work is
supported through a variety of resources such as FAQs, tips on talking about
vaccines and a “Vaccine 101” presentation.
OPH also partnered with the Ottawa Disability Coalition
and the City of Ottawa’s Accessibility Office to hold a COVID-19 forum for
people with disabilities and recently published COVID-19
Resources in American Sign Language webpage that provides accurate,
reliable and up-to-date COVID-19 resources to Ottawa’s Deaf and hard of hearing
community. The webpage includes several instructional and informational videos
in American Sign Language.
The team overseeing logistics of the vaccine rollout is
also continuously working to diversify and evolve distribution models to reduce
barriers for populations that have been disproportionately impacted by COVID-19
or who face other systemic barriers to accessing health services. We are actively working
with community health centres and other partners, including private housing
providers and Ottawa Community Housing, to launch barrier-free pop-up
vaccination clinics in these neighbourhoods and more specifically, residential
buildings and higher-risk congregate settings. / Nous travaillons activement
avec les centres de santé communautaire et d'autres partenaires, y compris les
fournisseurs de logements privés et Logement communautaire d'Ottawa, pour
lancer des cliniques de vaccination pop-up sans obstacle dans ces quartiers, et
plus particulièrement dans les immeubles résidentiels et les lieux de
rassemblement à risque élevé.
COVID-19 Vaccination Rollout
With respect to the local COVID-19 vaccine rollout, as
Board Members are aware, OPH has been working with the City’s Emergency
Operations Centre on planning and coordinating the local vaccination campaign.
At this time, there are multiple channels for eligible
Ottawa residents to access the vaccine, including through OPH community
clinics, pharmacies and primary care settings, pop-up clinics in “hot spots”
and high priority neighbourhoods. / À l'heure actuelle, les résidents d'Ottawa
admissibles peuvent accéder au vaccin de diverses façons, notamment par
l'entremise des cliniques communautaires de SPO, des pharmacies et des
établissements de soins primaires, ainsi que des cliniques spontanées dans les
" points chauds " et les quartiers prioritaires.
We also have mobile teams bringing vaccines to homebound
residents and people living and working in congregate care settings, and our
hospital partners are operating clinics for healthcare workers, some essential
caregivers in congregate care settings, faith leaders, special education
teachers and individuals with the highest-risk health conditions and a
caregiver.
To date, a total of 267,982 doses of COVID-19 vaccines
were administered in Ottawa, including over 20,000 doses administered in
pharmacies. Eighty nine percent of the inventory distributed to OPH, the Ottawa
Hospital and Queensway Carleton Hospital has been administered and we have
approximately 51,650 appointments booked through to April 30. All large
community clinics are fully booked with people over 60 until this date. Much
more data about the vaccination program in Ottawa is publicly available on our
website at Ottawa Public Health dot ca backslash vaccine dashboard. That
dashboard is updated every Monday, Wednesday and Friday.
OPH and the City of Ottawa are following the Ontario Provincial ethical framework and three-phased
vaccine distribution plan to guide the local COVID-19 vaccine roll-out.
The ethical framework is based on the
principals of stewardship, trust, equity and transparency. It evaluates the
patient population risk of exposure, the risk of severe disease or outcomes,
and health system capacity to ensure ongoing care to the population.
There is a limited number of vaccines
available and therefore, the vaccine distribution framework helps guide
decisions to ensure equitable distribution. It also supports the goal of
reducing the risk for people more severely impacted by COVID-19 in Ottawa. / Le
nombre de vaccins disponibles est limité et, par conséquent, le cadre de
distribution des vaccins aide à orienter les décisions pour assurer une
distribution équitable. Il soutient également l'objectif de réduire le risque pour les
personnes plus sévèrement touchées par le COVID-19 à Ottawa.
While significant progress has been made in vaccinating
Phase 1 populations, not all individuals who are eligible to be vaccinated in
Phase 1 have received their first dose. At this
point, 60% of people in their 60s remain to be vaccinated, and 75% of people in
their 50s have not yet been immunized. These age-based populations are a
priority because over 80% of hospitalizations and ICU admissions are of people
over 50 and the rate of death per 100,000 in their age-group for people in
their 60s is over 230 times that of people under 40; for people in their 50s,
their rate of death is over 40 times that of people under 40. At this time
preventing each hospitalization possible is important as hospitals are already
pressed to provide intensive care for current and projected COVID-19 patients.
Notwithstanding that
vaccination of some Phase 1 populations is ongoing, on April 6, 2021, the
Government of Ontario announced that it was moving to Phase 2 of its COVID-19
Vaccine Distribution Plan, which places primary and initial priority on: Older adults;
Individuals in "hot spot" communities
where COVID-19 has disproportionately impacted certain neighbourhoods;
Individuals with the highest risk health conditions and their caregiver; and
People who live and work in congregate settings and some essential caregivers.
We continue to ramp up our vaccination
efforts as we receive additional vaccine supply. As the large community clinics
booked through the provincial booking system are booked until April 30, we
expect that the target of 75% of people over age 60 will have been reached by
this date, which will enable a pivot in the strategy to start to offer more
vaccine to workers who cannot work from home after this date. The supply of
vaccine expected to be received from the federal government, however, is then
lower for a couple of weeks, with a significantly larger volume of vaccine
expected to arrive in May and into June. Therefore, we are in a period of
planning for the pivot from using the large community clinics for older adults
to using them for the other Phase 2 priority populations, including workers who
cannot work from home.
The Ottawa approach is to continue to focus
on neighbourhoods with less advantage and higher rates of COVID-19, where many
people who cannot work from home live, because the larger clinics require a
booking system and more transportation and neighbourhood-based approaches are
more barrier-free. Therefore, as vaccine supply grows, neighbourhood-level initiatives
will continue to grow.
I am, and Ottawa Public Health is, grateful for the
critical work people who cannot work from home are doing and we are encouraging
essential workers to access vaccine as soon as it becomes available them –
whether that’s by age, by neighbourhood, by virtue of their job or because they
are a caregiver to a loved one in long-term care or living with a highest risk
health condition.
I will be providing written direction to primary care
providers to use the opportunity of providing AstraZeneca vaccine to people in
the 40s and over to reach people who cannot work from home, to create another
channel for vaccine access, as long as this fits within the provincial
direction about the change in age-eligibility.
As the Chair has noted, we
cannot vaccinate our way out of this third wave. We will continue to vaccinate
residents as quickly and effectively as we can, based on the Provincial
framework and vaccine supply, to build up herd immunity for prevention of
future resurgences of COVID-19. / Comme l'a noté le président, nous ne pouvons
pas nous sortir de cette troisième vague par la vaccination. Nous
continuerons à vacciner les résidents aussi rapidement et efficacement que
possible, en fonction du cadre provincial et de l'approvisionnement en vaccins,
afin de renforcer l'immunité collective pour prévenir les futures résurgences
du COVID-19.
In the interim, prevention is key. We need to
keep doing the things that we know work to prevention transmission.
Adherence to public health measures continues to be
largely achieved with a focus on encouragement, sharing information and raising
awareness.
This weekend, representatives of the Ottawa Public
Health, the City of Ottawa By-law and Regulatory Services and the Ottawa Police
Service met to discuss any new measures and how they might be administered for
a positive health impact. Whenever new enforcement measures are considered, we
need to take a deliberate and careful approach that emphasizes equity,
legality, and efficacy in the application of these authorities with the
specific and exclusive purpose to support public health measures.
We are currently seeing community spread in situations
where effective enforcement measures already exist. Egregious violations of
public health orders are covered by enforcing existing measures. Therefore, a
coordinated enforcement approach to situations creating public health risk will
continue to use the existing tools.
At this time, the current public health risk assessment
shows that different enforcement or action by police authorities could create
challenges with compliance to public health orders and may actually set
COVID-19 control measures back. Current medical literature and professional
study reinforces the opinion that homeless populations and other disadvantaged
communities, in particular, require support to be able to increase protection
from COVID-19.
We will continue to work closely with our many
communities and public partners to ensure that all community members in Ottawa
remain safe, respected and are informed and supported to decrease COVID-19
transmission in the community.
We recognize that not everyone is able to stay home.
Workers who cannot work from home don’t have that choice. At this time, a
critical review must be undertaken by the provincial government to limit the
number of people who are at risk of COVID-19 transmission in the workplace when
their work is not directly providing an essential product or service such as
food, medicine and services required for health and safety, such as medically
necessary care.
Section 22 Order
I know that during last week’s technical briefing there
was mention of a Section 22 order to mandate mask use and set capacity limits
on and near outdoor recreational amenities. That was put on hold Friday after the
Province announcements and has been re-evaluated given further changes to
provincial regulation on the weekend.
We know that outdoors is safer than indoors in terms of
the risk of COVID-19 transmission. We continue to encourage people to get
outside for fresh air, play, and physical activity. However, as mentioned
above, it is important, even outdoors, that people maintain physical distancing
from people outside of their own household and wear a mask in situations where
physical distancing may be difficult.
Il est important, même à l'extérieur, de maintenir une
distance physique avec les personnes extérieures à son foyer et de porter un
masque dans les situations où la distance physique peut être difficile.
Given that the Province is now allowing playgrounds to be
open, I will be issuing a Section 22 order to ensure appropriate mask use and
physical distancing when using and near playgrounds.
Further provincial restrictions are necessary to limit
COVID-19 transmission in Ottawa and across Ontario. I welcome the Board of
Health’s support in calling on the Premier to enact stronger measures to limit
workplace transmission.
And, I want to be very clear that, unless we as
individuals do all we can to limit the close contacts we have with others, we
will not be successful in turning this curve and preventing deaths as we
vaccinate to build up the protection we need against any future resurgence.
That concludes my verbal report. I would be happy to take
any questions. / Cela conclut mon rapport verbal. Il me fera plaisir de répondre à vos
questions.