June 2020 Board Meeting - Minutes

Dr. W. Ahmed provided an update on the current status of COVID-19 in our region. We now have more than 1,200 with a significant number in the agri-farm sector. Community spread is decreasing but we are finding challenges within this sector. So far 346 workers have tested positive and we currently have 169 active cases across 8 farms. There have also been two deaths.

Accommodations are a challenge along with compliance for self-isolation and a lack of understanding. From the employer’s end they are screening their workers, but once off the workplace some are not complying, i.e. physical distancing, congregating in numbers. Once in isolation the employers need to supply their workers with nutritious meals and basic supplies.

EMS and ESHC have been attending on various farms and conducting in person health assessments based on referrals from our health unit, noting any further follow up. We issued Section 22 Orders on May 26 to all farms noting they keep their workers designated to working on one farm, as contract and temp agencies transport their workers to different farms, making tracking employees difficult. We strengthened the Section 22 Order on June 13 to include that employers provide access to workers via phone for case and contact management, and access to nutritious food and water. Once they are isolated or confirmed to be a case, the health unit calls them daily as we do with all cases and, if they are identified to need more medical assessment, they are referred to EMS or ESHC for a follow up in-person visit.

There was testing launched by Ontario Health to have the Leamington Assessment Centre (Sherk Complex) bus employees from farms for asymptomatic surveillance testing. Testing numbers were low, as employers did not send their employees, but testing had expanded to farms who had symptomatic cases.

Mandatory testing is not in place anywhere in Canada with any population for COVID-19 or any other diseases like HIV or TB. It is perceived that the recent COVID testing in Long-term care and Retirement Homes was mandatory, but it was not, and some residents and staff declined the testing. Mandatory testing goes into the area of being contradictory to the Human Rights Charter and we have not seen anyone use that authority, at any level, to suggest that a local Medical Officer of Health can use their power to force someone to get tested. This was also validated further by the Province and the Premier that it has to be voluntary. From a public health perspective we conducted random testing throughout all our municipalities, and over the course of 10 days we tested approximately 5,000 people.

The Temporary Foreign Worker (TFW) Program is Federal. Workers are brought in for specific purposes, need to meet certain criteria and follow municipal requirements. Public health’s role is to ensure accommodations are in compliance with guidelines but not specific to COVID. The role for the municipality is to ensure that safety and fire guidelines are maintained. The Ministry of Labour and OGVG also play a role in representing the industry. From a disease perspective, an accommodation strategy to house 8,000 – 10,000 migrant workers is needed, both for the short and long term, to restrict the number of people living in congregate settings, and minimizing interaction. COVID is exposing health, income and housing inequities and a coordinated approach at various levels of government is needed to support them. When TFWs arrived they isolated for 2 weeks, tested negative then began working. Those who contracted COVID-19 were exposed here, they did not bring it here.

From a public health perspective, our team is not immigration. Undocumented workers are treated as residents of Windsor Essex and we do our part through case and contact management to prevent the spread of disease. We spoke this morning with the Federal Health Minister, our Board Chair and other partners, that there has to be clear messaging from all levels of government to ensure that workers in isolation are getting paid either by their employer or through another mechanism.

WECHU is also working with The Ontario Ministry of Agriculture, Food and Rural Affairs (OMAFRA) and the Ontario Greenhouse Vegetable Growers (OGVG). They have been very cooperative in working with the farms to protect their workers, and noted that it is becoming stressful for them from a food chain supply perspective. This is peak time for the agri industry, products are perishable, and it’s not the same as shutting down manufacturing. There needs to be a way to keep farms operational, contain the virus, and isolate those who need to get well.

Moving from Stage 1 to Stage 2 is a provincial decision. We touch base weekly with the Chief Medical Officer of Health for the province and provide indicators for a sense of where we are heading and what the trajectory looks like. Combining that, the Ministry compares us to the rest of the province or other health units, along with health system capacity to manage a possible surge in cases, i.e. ventilators, ICU support. This is not something that WECHU decides.

On sharing information, the WECHU website is updated daily with current numbers, and in addition, Dr. Ahmed and T. Marentette do a Q&A session with the media for 30 minutes daily. Media releases with relevant information is also on our website. Our call centre receives about 150 calls per day on various issues, and our staff does their best to answer any questions.

Under the Emergency Order, the Canada/US Border remains closed except for essential workers, products and trade.

Moved by: John Scott
Seconded by: Rino Bortolin
That the information be received.
CARRIED

N. Dupuis noted WECHU’s Resolution related to the Children Count Tool-kit, which was acknowledged by Dr. David Williams, Chief Medical Officer of Health in Ontario, in a letter to Nicole Dupuis, Director of Health Protection. The Ministry of Education has also reached out to N. Dupuis advising that they will be using the Children Count Tool-kit as a framework for reopening schools in the fall. The WECHU has developed a two-page document for the Ministry to implement their reopening plan.

Moved by: Dr. Debbie Kane
Seconded by: Judy Lund
That the information be received.
CARRIED

1. Cannabis Retail Applications & WECHU Response (N. Dupuis)
   Brought to the Board for information.
2. WECHU Dental Services Restart (N. Dupuis)
   Brought to the Board for information.
3. March, April, May Communications Recap (L. Gregg)
   Brought to the Board for information.

Moved by: Judy Lund
Seconded by: Dr. Debbie Kane
That the information reports be received.
CARRIED

1. 2019 Annual Financial Statement (L. Gregg)
   L. Gregg noted that the Audit Committee met on June 8, 2020 to discuss the Windsor-Essex County Health Unit December 31, 2019 financial statements, the Healthy Babies Healthy Children March 31, 2020 financial statements and the Nurse Practitioner Program March 31, 2020 financial statements and all have been brought to the Board for approval.
   Moved by: Joe Bachetti
   Seconded by: Ed Sleiman
   That the financial statements be approved as presented.
   CARRIED