November 2020 Board Meeting - Minutes

1. COVID-19 Update

   Dr. W. Ahmed provided an update on the status of COVID-19 cases in our region and noted that cases are increasing worldwide. Canada is responding well to the pandemic compared to some countries, but there is a lockdown in Europe, and we seem to be heading in that direction. Ontario case counts were close to 650 per day, but has now more than doubled up to approximately 1,500 per day. Data around hospitalizations and admissions to ICU is showing that we are moving in the wrong direction in respect to morbidity and mortality rates.

   Locally, we saw an increase in cases in November, likely due to Halloween parties and social gatherings, and are averaging about 20 cases a day. The virus is spreading in different sectors likely now through community spread, and we are coming closer to numbers that we have seen in the first wave. Hospitalization was more manageable through the first wave, but admissions to hospitals and ICU due to COVID-19 is increasing.

   From an exposure perspective the highest number of cases is through close contact, followed by community transmission and then travel related. Transmission through close contacts is higher than in the first wave and is a concerning trend, likely related to social gatherings. We currently have three Long-Term Care homes in outbreak, two schools and one farm, the trend is showing that the positivity rate is also increasing. As of November 14, 2020, our positivity rate is at 2.9%, which is considered high for our region.

   Our health system capacity is at 92%. Recognizing that most COVID patients admitted are placed in isolation rooms this is increasing pressure on hospitals. The ICU is close to 80%, triggering a shift in the acute care system and ventilator capacity is currently at 40%. Public health is running at 86% capacity in contacting cases within 24 hours, but with the surge in cases, there is now a slight decline sometimes taking up to 48 hours, signaling pressures on our health unit.

   Dr. Ahmed said that if there is a case in the school and a cohort is dismissed home they are advised to self-isolate. Anyone else in the household or cohort is deemed high risk and is advised to self-monitor. Testing is recommended 5-7 days later or if an individual becomes symptomatic. Parents of student cohorts would be considered a contact of a contact and unless they become a case would not be of concern.

   J. Bachetti said when school started in September there was a lot of anxiety and wanted to compliment the public health staff assigned to the school. They did a fabulous job with school staff, parents and children and he wanted to say thank you.

   F. Costante asked when the province determines regional status, how much emphasis is place on the capacity of the health care system.

   Dr. Ahmed said the first thing the province looks at is the case counts and moving averages. Based on that they look at the Person Positivity Rate then the Effective Reproduction Rate, i.e. meaning how many cases occur from one positive case. If that data is pointing to any pressure in any of these areas, they then look at capacity.

   Dr. Ahmed said that the WECHU does get some notice from the province if our region is changing levels. The province will reach out for more information and details if they see a concerning trend and ask for our local perspective. With this framework they know what the thresholds are and we have specific conversations on how it affects us locally. Decisions made are forwarded to Cabinet and then to the Premier to make an announcement.

   We are currently in Yellow status and if we move to Orange, the extra restrictions would commence this coming Monday at 12:01 am. Just looking at the increase in the number of cases in our region, I believe we will be moved up another level to Orange, but that decision is ultimately made by the province. Before any announcement is made, they will connect with us for our perspective.

   Moved by: Ed Sleiman
   Seconded by: Larry Snively
   That the information be received.
   CARRIED

1. Regular Board Meeting: October 15, 2020
   Moved by: John Scott
   Seconded by: Joe Bachetti
   That the minutes be approved.
   CARRIED

1. INFORMATION REPORTS
   1. Student Immunization Catch-up Plan (Grade 7/8) (K. McBeth)
      Brought to the Board for information.
   2. Potassium Iodide (KI) Tablet Distribution Continues during COVID-19 Pandemic (K McBeth)
      Brought to the Board for information.
   3. Consumption and Treatment Services Site – Application Status (T. Marentette)
      Brought to the Board for information. R. Bortolin asked if there were any discussion around working with partners on a possible location. T. Marentette said that WECHU emailed WECOSS partners to determine if there was any interest in a shared space or other location. WECHU will be working with legal to move forward to next steps in securing a real estate agent.
   4. October Communications Recap (L. Gregg)
      Brought to the Board for information.

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

2. RECOMMENDATION REPORTS – None

1. CEO Quarterly Reports (T. Marentette)
   T. Marentette said that the 2020 CEO Quarterly Reports are up to date, highlight issues around the pandemic, and note that most public health programs have been suspended. Most WECHU staff has been redeployed to work on COVID-19 and the CEO Report has identified these circumstances. G. McNamara commended the MOH and CEO and the entire WECHU staff for their efforts.
   Moved by: Rino Bortolin
   Seconded by: Judy Lund
   That the information be received.
   CARRIED
2. 2021 Board of Health Meeting Schedule (T. Marentette)
   Gary McNamara advised that the WECHU is planning Board of Health meetings for 2021 and is looking to the Board for approval to commence holding monthly Board meetings every 3rd Thursday of the month.
   Moved by: Debbie Kane
   Seconded by: Ed Sleiman
   That the WECHU Board of Health monthly meetings for 2021 be held on the 3rd Thursday of each month.

1. WECHU Letter to The Right Honourable Justin Trudeau and The Right Honourable Chrystia Freeland – Basic Income During and After the COVID-19 Pandemic

   G. McNamara said that this has been on the Board’s radar prior to the pandemic. R. Bortolin said that this might tie into something not directly related to public health but more political. He asked if we are advocating because other health units are leading the charge and would this happen at a Board level or be lead by Dr. Ahmed. N. Dupuis said that our Board has supported a Resolution on this in the past and has formally endorsed. We have a Resolution standing and have sent letters in the past. Food insecurity has a common link with social determinants of health.

   G. McNamara said that social determinants are nutrition, living capabilities, etc. and all play into building a healthy society. It can difficult for many to properly feed their families. Basic income is to support the basic requirements of society to sustain themselves in better way. The Board of Health has supported this pre-COVID so that people living in poverty can get to a level where they can get proper nutrition and we advocate for that. Social determinants have a reflection on public health and we would support moving people out of poverty the best we can. This is a basic need and is in everyone’s best interest, and should be supported by all health units.

2. Grey-Bruce Public Health Unit – Letter to The Honourable Patty Hajdu, The Honourable Marilee Fullerton and Ontario’s Long-Term Care COVID-19 Commission – COVID-19 and Long-Term Care Reform – Supporting Simcoe Muskoka District Health Unit’s letter regarding same
3. Grey-Bruce Public Health Unit – Letter to The Honourable Patty Hajdu and The Honourable Christine Elliott – Municipal Drug Strategy Coordinators Network Ontario, Safe Supply

Moved by: Rino Bortolin
Seconded by: Debbie Kane
That the information be received.
CARRIED