April 2022 Board of Health Meeting

Meeting held via video: https://youtu.be/3wmW8cdpJW4

SUBMITTED BY

Communications Department

DATE

April 21, 2022

SUBJECT

February 15 – March 14, 2022 Communications Update

BACKGROUND/PURPOSE:

Provide regular marketing and communication updates to the Board of Health.

Data Notes can be provided upon request.

Media Exposure Overview Graph

Website Overview Graph

Discussion

Current notable projects that the department is working on.

We promoted World TB Day on March 24 - Shining a Red Light for World TB Day through multiple media channels.

The First Case of Influenza A Confirmed in Windsor-Essex news release was issued on Tuesday, March 22.

The Communications department is maintaining marketing and communication efforts regarding COVID-19 vaccinations in the region with our partners. In particular, the COVID-19 pop up clinics in the community continue to be promoted and we are working on messages around the Devonshire Mall Vaccination Centre To Cease Operations Saturday, April 2nd.

We are providing support for the Catch-Up Immunization Clinics for Students in Grades 7 to 12 that will occur until August in multiple locations throughout Windsor and Essex County.

SUBMITTED BY

Epidemiology and Evaluation Department

DATE

April 21, 2022

SUBJECT

COVID-19 Surveillance and Epidemiology – March, 2022

BACKGROUND

Overview

The Epidemiology & Evaluation department conducts on-going population health assessment and surveillance. The data and surveillance for COVID-19 plays an integral role in understanding and managing the pandemic locally. The evidence provides information on how the pandemic has and is evolving, assessing the risk and severity, and assists in the development of timely interventions to limit further spread in the community.

Due to the recent surge in Omicron cases and changes in eligibility for testing, testing capacity is limited and case, contact, and outbreak management has been modified to focus on high-risk settings. As a result, case counts in the report are an underestimate of the true number of individuals with COVID-19 in Windsor-Essex County and may impact data completeness. Please interpret these data accordingly. Due to these changes, data from before December 31, 2021 should not be compared to data after the testing changes.

Trends

In the month of March, the health unit reported 2,353 confirmed high-risk cases of COVID-19. As the weeks progressed in March, the weekly high-risk incidence rate increased from 124.0 cases per 100,000 population (Week 9) to 145.1 cases per 100,000 population (Week 13).  

In-Patient and ICU Admissions

In March, in-patient COVID-19 hospitalizations began to increase in Windsor-Essex County. A total of 155 new COVID-19 related patients were admitted to local hospitals.

Percent Positivity

Locally, Windsor-Essex County continued to experience a week-over-week increase in percent positivity in March after observing the opposite for February. As the month drew to a close, the local percent positivity rate for COVID-19 rose to approximately 19.3% in the last week of the month. It is also important to note that these were for high-risk individuals that were eligible for testing.

Wastewater Surveillance

For the month of March, viral signal for COVID-19 in wastewater intensified as the month drew to a close. Current levels are beginning to reach levels observed during the onset of the Omicron wave in December 2021.  

Outbreaks

In the month of March, 21 outbreaks were declared in high risk settings compared to the 24 outbreaks in February. This includes seven outbreaks in long-term care and retirement homes, four in hospital settings, and ten in other congregate settings. As of March 31st, there were 16 active outbreaks in the Windsor-Essex County region.

Deaths

For the month of March 2022, 16 deaths were reported that were attributed to COVID-19. This represents a 45% decline in comparison to the deaths reported in February.

DISCUSSION

With the changes in testing eligibility, and guidance with case, contact and outbreak management, the health unit has modified its public reporting to better understand the burden of illness locally. New indicators, such as wastewater data, have been included as a proxy indicator for COVID-19 case counts, which are underestimated. The health unit will continue to monitor and provide epidemiological expertise on COVID-19 to internal leadership, community partners, and residents to support evidence-informed decision-making. This includes daily epidemiological updates, weekly epidemiological presentations to the community and supporting policy decisions through data driven approaches.

PREPARED BY

Records Coordinator & Privacy Officer

DATE

April 21, 2022

SUBJECT

2021 IPC Annual Statistical Reporting 

BACKGROUND

The WECHU is a “health information custodian (HIC)” in accordance with section 3 of the Personal Health Information Protection Act (PHIPA), and an “institution” in accordance with section 2 of the Municipal Freedom of Information and Protection of Privacy Act (MFIPPA). Under this legislation the WECHU has obligations to ensure the rights of individuals with respect to privacy, access and correction of records of personal information (PI) and personal health information (PHI), and access to general records that pertain to the WECHU operations and governance.

All institutions under MFIPPA, and HICs under PHIPA, are required to provide statistical reports to the Information and Privacy Commissioner of Ontario (IPC) on an annual basis with respect to:

• Confirmed privacy breaches under PHIPA (Appendix A)
• Access and correction requests under PHIPA (Appendix B)
• Access and correction requests under MFIPPA (Appendix C)

The WECHU submitted statistical reports for each category by the required deadline of March 1st for PHIPA reports and March 31st for MFIPPA.

DISCUSSION

Privacy breaches

In 2021, the WECHU had eight confirmed breaches, compared to thirteen in 2020. Privacy breaches in 2021 predominantly included incidents where PI and/or PHI was emailed or faxed to the wrong person and/or organization.

The WECHU is looking at various ways to prevent breaches of this manner through training and investigating additional email security options.

MFIPPA Access and correction to information requests

In 2021, the WECHU received thirty-eight formal MFIPPA access requests, compared to thirty-five in 2020, and zero correction requests during the reporting year. One of the requests was transferred to Statistics Canada. Thirty-one of the requests were completed within the reporting year and six of the requests carried over to the 2022 reporting year.

Of the thirty-eight access requests completed in 2021, the majority of requests came from an “individual by agent” or lawyer (48%). This was followed by “individual/public” (29%), “business” (13%), and “media”, “government” and “other” (3% each).

PHIPA Access and correction to information requests

In 2021, the WECHU received five formal PHIPA access requests and sixty-two formal correction requests during the reporting year. This was a significant increase from 2020 due to the WECHU’s involvement in supporting the proof of COVID-19 vaccination certificate program, as well as in the implementation of a COVax client access and correction process.

CONCLUSION

In summary, 81% of all MFIPPA requests and 100% of all PHIPA requests were completed within the statutory time limits, despite the operational impacts of the pandemic. Priorities for the coming year will include continued dedication of resources for the access to information and privacy program, including additional training, and class customization within the WECHU’s M-Files system. These actions will improve records and information management (RIM) within the program, and allow the WECHU to respond with increased efficiency to information requests.

PREPARED BY

Oral Health Department

DATE

April 21, 2022

SUBJECT

WECHU Oral Health Services and Oral Health Month

BACKGROUND

April is Oral Health Month. Oral health is a critical component of overall health and well-being. Oral Health month highlights the importance of good oral health practices and the role of dental professionals in improving community oral health.

In Ontario, one in every three people do not have access to dental insurance, requiring  them to pay out of pocket for ongoing and urgent oral health needs (StatsCan, 2018). We know in Windsor-Essex, to avoid the high cost of dental bills, many individuals forgo treatment impacting their overall quality of life (WECHU, 2018).  The Healthy Smiles Ontario (HSO) program, offered for qualifying children under the age of 18,  the Ontario Seniors Dental Care Program (OSDCP) for qualifying seniors 65 years and older, offer opportunities for routine, emergency and urgent dental services at no cost. The provincial Ministry of Health’s Oral Health Protocol (2021) provides direction to local public health units for the delivery of these oral health services, as well as oral health screening, and oral health promotion and education.

DISCUSSION

Oral Screening, Assessment and Surveillance

In 2021, COVID-19 impacted many public health programs and services, including the WECHU’s oral health program. While clinical services offered through HSO and OSDCP experienced some setbacks and delays through 2021, the WECHU was unable to complete school dental screening.   As part of the Oral Health Protocol (Ministry of Health, 2021), all public health units implement dental screening for all students in Junior Kindergarten (JK), Senior Kindergarten (SK), and Grade 2. Screenings are completed by registered dental hygienists and certified dental assistants during the school day. Oral health screening requires the collection of the total number of decayed, missing and filled teeth (DMFT). Data on DMFT is used to determine if additional grades are also to be screened. Following the Oral Health Protocol, schools that are identified as medium risk also receive screening for all Grade 7 students and for schools identified as high risk, Grades 4 and 7 are screened in addition to the standard grades for screening.

Despite dental screening not occurring in 2021, the WECHU Oral Health department sent out screening information to parents and families and offered virtual and on-site screening at one of our two oral health clinics. Parents who wanted their children screened were able to book an appointment and choose the option that best suited their needs.

Oral health screening is not only an important part of overall oral health surveillance for Windsor-Essex, it provides an opportunity to identify oral health concerns early and to provide parents with information about the Healthy Smiles Ontario program and options for a dental home. With schools reopening for additional visitors the Oral Health department at the WECHU has developed an ambitious and comprehensive plan to resume oral health screening over last three months of the 2021-2022 school year. The oral health team will focus on schools identified as high risk and medium risk from previous years to ensure that we are able to reach all students most in need of oral health screening, prevention and support. The oral health screening teams have already reached out to these schools and screening will commence in April, running through June of this year.  

WECHU Healthy Smiles Ontario (HSO) Program

Over the course of 2021,there were 1,572 children/youth screened at one of the WECHU’s dental clinics and referred into either the HSO-Emergency and Essential Services Stream (EESS), or the HSO-PSO (preventive services only) program. The EESS program is provided to child/youth identified with an emergency or essential dental condition such as infection, haemorrhage or pathology that requires immediate clinical treatment. The PSO stream is delivered through public health unit clinics only and identified through health unit screening activities. Treatments covered under the PSO stream include topical fluoride, pit and fissure sealants, scaling, and some interim stabilization therapies.

Ontario Seniors Dental Care Program (OSDCP)

In 2021, the WECHU oral health department supported 3,349 clinic visits across all clients enrolled in the OSDCP. This includes 398 new patient exams, for an average of 1.6 new patients added to our client roster every working day. New dentures have been provided to 117 clients at the WECHU, with 1,311 appointments with a dentist or denturist to be fitted for these new dentures. The oral health department supports the OSDCP at both clinic sites (Windsor and Leamington). Clinic hours of operation are Monday to Friday from week day from 8:30 a.m. to 8 p.m in Winsor and 8:30 a.m. to 4:30 p.m. in Leamington.

Oral Health Resources for Educators

The Ontario Public Health Standards outline the requirement for health units to support health related curriculum and health needs in schools. Oral health education programs can help to build skills of young children, in terms of their oral health knowledge and practices and are a key area of need for children and youth in Windsor-Essex. In 2021, oral health resources for educators were updated and posted to the WECHU website. These included lesson plans and resources intended to help teach students from Kindergarten to Grade 8 about oral health and how students can keep their teeth and mouth healthy. Presentations are also available to schools and community programs at request.

Baby Oral Health Program (BOHP)

The Canadian Dental Association and the Canadian Pediatric Society recommend children see a dentist by their first birthday, even before they have all of their teeth. The BOHP provides free screening for all children, aged 0 to 4, in Windsor-Essex County. A screening by a registered dental hygienist includes a check for signs of cavities, education on supporting a healthy mouth and teeth, and a fluoride treatment, if needed. These screenings are important as they offer an opportunity for early intervention. During a BOHP visit families are also encouraged to visit a dentist or make a follow-up appointment at the WECHU if they do not have a home dental office. Children who present with urgent dental needs are enrolled into the HSO program, if eligible, or receive outside referrals for dental treatment. In 2021, 138 infants and toddlers were screened through the BOHP.

Board Members Present:

Gary McNamara, Joe Bachetti, Tracey Bailey, Fabio Costante, Aldo DiCarlo, Gary Kaschak, Judy Lund, Robert Maich, Ed Sleiman

Board Member Regrets:

Rino Bortolin

1. Period covered by this report:  January 1, 2022 to March 31, 2022
2. For the period covered by this CEO Quarterly Compliance Report:
   
   1. The undersigned has personal knowledge of the matters herein reported or has made due inquiry with respect to the same.
   2. Except as reported in any previous CEO Quarterly Compliance Report, the undersigned reports as follows:
      
      1. that the Health Unit has been in material compliance with all laws, regulations, orders, judgments or decrees applicable to it.  Without limiting the generality of the foregoing the Health Unit is current in respect of all tax and related withholding and remittances required by law;
      2. the Health Unit has been in material compliance with its By-laws;
      3. the Health Unit has been in material compliance with all other Board resolutions;
      4. the Health Unit has been in material compliance with all contracts and commitments to which the Health Unit is a party including without limitation all funding and accountability agreements;
      5. the Health Unit is current with respect to the payment of all remuneration (including salary and benefits) to its employees;
      6. there are no material variances between what is contemplated by the Operational Plan and what in fact transpired or appears likely to transpire
      7. more specifically, no material changes are required in respect of financial resource allocation plans to address shifts in need and capacity
      8. no material adverse change has occurred in the operations of the Health Unit or its assets and liabilities taken as a whole
      9. there have been no material breaches of the Ethics Code of Conduct by anyone who is subject to it;
      10. there have been no unplanned terminations of any Health Unit employees;
      11. there have been no claims made pursuant to any insurance policies maintained by the Health unit; and,
      12. nothing has come to the attention of the undersigned which would materially adversely change any previous CEO Quarterly Compliance Report, except as detailed below:

Items (vi), (vii), and (viii) have been revised due to the COVID -19 pandemic as follows:

On March 17, 2020, the Province of Ontario enacted the Emergency Management and Civil Protection Act, R.S.O. 1990, c. E.9. (“the Act”), to support efforts to contain the spread of COVID-19 in our communities.  The Act supports public health units to, regardless of their collective bargaining agreements, suspend services, redeploy staff as deemed appropriate, modify hours of work, cancel and or defer vacations, utilize part-time/contract staff to perform the duties and responsibilities of bargaining unit staff and suspend the grievance process. 

The WECHU, in its response to COVID-19 within the communities of Windsor and Essex County has:

• Redeployed staff as considered appropriate to facilitate our response to the pandemic including transition of staff from case and contact management to support the vaccination efforts as directed by the province.
• Increased expenses related to vaccination to support resources required for implementing booster/third doses across the population.

Item (x) the CEO reports the following:

In January 2022, the WECHU had an unplanned termination of a single non-union staff person.

Date: March 31, 2022

Signature: Nicole Dupuis, Chief Executive Officer

Please contact us if you require this document in an alternate format.

Appendix A - Confirmed privacy breaches under PHIPA (PDF)

Please contact us if you require this document in an alternate format.

Appendix B - Access and correction requests under PHIPA (PDF)

Please contact us if you require this document in an alternate format.

Appendix C - Access and correction requests under MFIPPA (PDF)