Board of Health Meeting Documents

DATE:

June 2021

SUBJECT:

Recruitment through the COVID-19 Pandemic

BACKGROUND

This report will outline recruitment for the Windsor-Essex County Health Unit throughout the ever-changing COVID-19 Pandemic. The needs of the community required additional staff across the entire Windsor-Essex County Health Unit organization.

CURRENT INITIATIVES

The below information will provide a snapshot of the Windsor-Essex County Health Unit’s staffing numbers in March 2020 and current day information.

As the WECHU moved through the pandemic, there has been increased staffing throughout Non-Union and Management, CUPE and ONA positions.

WECHU has recruited approximately 118 new WECHU staff members between the time periods of March 1, 2020 to June 1, 2021. In addition to this group of individuals WECHU has also organized over 100 volunteer staff members (paid and non-paid positions) to assist with the COVID-19 vaccine clinics. Furthermore WECHU’s recruitment efforts have been supported by the Ministry of Health who hired a consultant, Ian Martin, to bring on over 40 Case Managers and Case and Contact tracing staff to assist with the large volume of COVID-19 cases in the Windsor-Essex area. WECHU has also hired a number of independent consultants to assist with the vaccine clinics. In addition, the WECHU received external assistance from other health units in Summer 2020 due to decreased capacity and increased cases. 

At the end of February 2020, the Windsor-Essex County Health Unit had approximately 230 total staff members in the organization. As of June 1, 2021, there are approximately 320 total staff members representing an increase of 39.13%. At this time, ongoing recruitment continues which will increase the total overall number of WECHU staff.  

  • Non-Union/Management group had approximately 40 staff at the beginning of March 2020 and saw an increase of 47.5% in staffing by June 1, 2021 with a total of 59 permanent and contract employees.
  • CUPE group had approximately 123 staff at the beginning of March 2020 and saw an increase of 15.45% in staffing by June 1, 2021 with a total of 142 permanent and contract CUPE members.
  • ONA group had approximately 82 staff at the beginning of March 2020 and saw an increase of 48.78% in staffing by June 1, 2021 with a total of 122 permanent and contract ONA members. WECHU continues to onboard a number of new graduate nurses which will add to this overall total of contract ONA members.

Overall, the Windsor-Essex County Health Unit’s staffing during the COVID-19 pandemic has been greatly increased due to community needs. The Windsor-Essex County Health Unit has been able to support the community with the increase of staff amongst case and contact management, COVID-19 vaccine roll-out, and the reopening of schools throughout the year. The staff of the Windsor-Essex County Health Unit have been able to adapt and pivot into new programs and services throughout the last 15 months in order to ensure that the residents of Windsor-Essex were able to access the education and resources required throughout the pandemic. The Windsor-Essex County Health Unit has strived to continue other programs that provide resources and services to the community outside of COVID-19.

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DATE:

June 2021

SUBJECT:

COVID-19 Vaccine Rollout in Windsor and Essex County

BACKGROUND

The Windsor-Essex County Health Unit (WECHU) was mandated to lead the COVID-19 vaccine rollout in Windsor-Essex County (WEC). The projected population of eligible individuals for vaccination in WEC in 2021 is 438,001. In order to achieve a 75% threshold coverage rate, approximately 328,501 individuals must be immunized. Based on the two-dose vaccine requirement to complete the COVID-19 vaccine series, this equates to 657,002 doses that will need to be administered. In January of 2021, the WECHU developed a three-stage plan to support the provincial rollout of COVID-19 vaccine in our community.

In April 2021, the provincial government identified seven postal codes in WEC as COVID-19 "hot spots" that were prioritized for phase 2 of Ontario's Vaccine Distribution Plan. Hot spots are categorized as having historic and ongoing high rates of death, hospitalization and transmission of the COVID-19 disease. 

In WEC, the identified areas include: 

  • N8X – South Central Windsor
  • N8Y – Walkerville and East Windsor area
  • N9A – Downtown Windsor
  • N9B – Sandwich Towne and University of Windsor area 
  • N9C – Sandwich Towne
  • N8H – Leamington area
  • N9Y – Kingsville area

As of June 4, 2021, 253,255 (71.7%) WEC adults 18 years or older received at least 1 dose of a vaccine.

CURRENT INITIATIVES

Mass Immunization Clinics

In order to administer the COVID-19 vaccine to a larger proportion of individuals quickly there are 6 mass vaccination clinics supported full time across WEC, three of which are located in “hot spot” postal code areas. These sites are being supported by our municipal partners in both the City and County. In addition, Windsor Regional Hospital (WRH) continues to operate 2 sites. Daily client volumes range between 400 – 1000 and collectively 202,922 individuals have been immunized at one of the 6 clinics (184,767 with first doses, 18,155 with second doses). The mass immunization clinic model was the primary method to support the vaccination of approximately 6,000 temporary foreign workers (TFW) in April and early May and is currently the primary support for youth vaccinations (12-17 years old).

Pop Up Clinics

Pop up vaccination clinics are defined as clinics in the community that target a specific location with the objective of reducing barriers to access, with a time limited operational period. The WECHU has supported 9 single day pop up clinics in various WEC locations targeting specific hot spot communities and high risk populations, youth, and the urban Indigenous community. Pop up clinics have ranged between 400 and 800 individuals in a single day.

Mobile Strategy – Mobile Teams and Delivery

Mobile teams and delivery strategies operate with the objective of reaching a specific targeted priority population, usually in one day, with lists of individuals identified beforehand. WECHU staff, and partner groups including the CRST team, travel to pre-existing sites (some without pre-existing infrastructure) to provide vaccine to designated target populations. The WECHU began leading the first mobile strategy on January 1, 2021 targeting Long Term Care Homes (19) followed by registered Retirement Homes (24). All of these facilities have received both first and second doses for the majority of interested/eligible staff and residents. Maintenance plans to vaccinate new residents and staff on an ongoing basis are being implemented.

Additional mobile strategies have supported 24 locations, primarily high-risk congregate living facilities including:

  • The Southwest Detention Centre
  • Assisted living facilities
  • Private retirement homes
  • Lodging and boarding homes
  • Supportive housing for at risk populations
  • Community Living Windsor and Community Living Essex County locations

In addition, with coordination support from Home and Community Care Services, the WECHU has provided direct immunization support to approximately 200 registered homebound individuals. The WECHU has also provided support for non-registered homebound individuals through collaborations with primary care and the provision of direct client service (as required).

Pharmacy Rollout

WEC was designated as a pilot site for the vaccine rollout of AstraZeneca and 47 pharmacies have collectively administered over 37 000 doses to WEC residents over the age of 40 years.

Currently, 65 pharmacies are providing Pfizer-BioNTech or Moderna vaccines (first doses and second doses) throughout Windsor and Essex County (WEC); as well, 30 pharmacies are providing AstraZeneca 2nd doses throughout WEC. Local pharmacies are actively recruiting and vaccinating individuals aged 12 and older (for those with Pfizer-BioNTech allocations). For those with Moderna allocations, they are actively recruiting and vaccinating individuals 18 years and older. Pharmacies providing Pfizer-BioNTech or Moderna vaccines are also providing second doses to those 70 years of age or older.

Pharmacies who participated in the early pilot project began administering second doses of AstraZeneca to individuals who received their first dose of the AstraZeneca COVID-19 vaccine between March 10th and March 19th. As of June 3, 2021, 5,369 second doses of AstraZeneca have been administered to eligible individuals. The Ministry of Health will be providing 19,300 additional AstraZeneca doses to WEC pharmacies over the coming weeks.  

Health Care Provider Rollout

Starting as an early adopter of the health care provider rollout model, the WECHU engaged 8 primary care partners and locations in a pilot project using the Moderna vaccine in March/April. The pilot project involved strategic partnerships with local Family Health Teams, the Windsor-Essex Community Health Centre (multiple locations), and Nurse Practitioner Led Clinics in WEC.

In addition to the pilot project participants, the WECHU has on-boarded 46 physicians’ offices to administer both the Pfizer-BioNTech and the Moderna vaccines (based on available supply) to rostered patients in their offices and/or to the general public through physician-led clinics. As of June 2, 2021, 14,611 vaccinations had occurred through a physician-led office or clinic – this represents the 6th highest amount in the Province of Ontario. The WECHU continues to onboard new health care providers to the COVID-19 vaccination rollout on a weekly basis.

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DATE:

June 2021

SUBJECT:

COVID-19 Case and Contact Management

BACKGROUND

COVID-19 spreads through direct contact with the respiratory droplets of someone who is infected with the virus. Symptoms include fever, cough, shortness of breath and difficulty breathing.  On December 31, 2019, health authorities identified this novel coronavirus (COVID-19) through a series of reported cases of pneumonia in Wuhan, China. On March 20, 2020, the first confirmed case of COVID-19 was reported to the Windsor-Essex County Health Unit (WECHU).

The WECHU activated its Incident Management System (IMS) which resulted in a graduated redeployment of various staff at all levels to strategize and prioritize the COVID-19 response in our community. This model evolved over time to include a comprehensive COVID Response Team of managers, case Investigators, call centre staff, epidemiology, public health inspectors, school nurses, vaccine staff, IT and administrative assistants. In addition to these internal reassignments, Case Investigators and Contact Tracers were deployed from the centralized team of the Provincial Workforce to support these efforts.

To date, Windsor and Essex County has 16,572 confirmed cases of COVID-19, with 427 deaths. With the introduction of Variants of Concern (VOCs), 1,798 preliminary of confirmed VOCs cases have been identified in this region. With the VOCs currently driving the third wave of the pandemic, youth and young adults have become increasingly more likely to become infected, or hospitalised from COVID-19.

CURRENT INITIATIVES

Based on the extent of cases and outbreaks experienced in Windsor-Essex County, the WECHU continues at the level where re-deployment of staff is required, and case and contact management of COVID-19 remains a priority.

Case and contact management involves interviewing and isolating all suspected and confirmed cases of covid-19 infection, and their contacts, in a timely manner. Objectives are aimed at; identifying and notifying cases and contacts of their exposure, providing education on Covid-19 transmission, offering community supports, and providing symptom monitoring. Furthermore, Case Investigators perform a risk assessment to determine how the case may have acquired the infection and to whom the case may have potentially transmitted the infection. Information is collected on all high-risk contacts connected to the case, while considering exposure settings and the nature and duration of the case’s interaction with the contact. The Contact Tracer communicates testing guidance and verifies compliance with self-isolation. As per Ministry standards, cases should be contacted within 24 hours of receipt of a positive lab result and contacts of cases are to be reached within 24-48 hours of notification to WECHU. Presently, WECHU is reaching 85-93% of cases and contacts within 24 hours, on any given week.

Our region’s experience with Covid-19 has been unique for many reasons, one being our close proximity to the United States, with a large number of essential health-care workers commuting between Ontario and Michigan on a daily basis, and posing a risk for new infection. Another being the number of outbreaks we have experienced within the Agri-Farm sector and other congregate living settings. WECHU’s high-risk priority populations continue to include those affiliated with school cohorts, workplaces with shared workspaces, acute care hospitals, long term care, rest/retirement homes, and those individuals living in congregate living settings; local shelters, correctional facilities, assisted-living facilities, and bunkhouse living situations.

Ongoing collaboration with our healthcare and community partners has been integral in the overall strategy to reduce the spread of infection in WEC. This involves liaising with Infection Control Practitioners in our local hospitals, physicians across the region, laboratories, workplace owners (including farm operators), and our municipal partners in both the City and County. Partnerships with the Canadian Red Cross (CRC) Hotel and the Interim Isolation and Recovery (IRC) Hotel, have worked to eliminate isolation barriers for temporary foreign workers and other vulnerable individuals in the community, such as those without a fixed address. Furthermore, WECHU has supported, in collaboration with community partners such as the Essex-Windsor Emergency Medical Service and the Erie Shores Healthcare Team, onsite monitoring and testing of Agri-Farm workers isolating at the CRC hotel.

Local surveillance testing continues as the WECHU works with assessment centres throughout the region to detect active cases of Covid-19. WECHU have aided in surveillance testing by deploying nursing staff as needed to congregate living settings, mobile drive through clinics, and to a lesser extent individual client homes.

As with other locations in the province, the WECHU has been responsible for overseeing cases within our jurisdiction who are a result of recent travel from overseas and are undergoing mandatory isolation under federal quarantine. Travel has been identified as a risk factor in the transmission of Covid-19 Variants of Concern (VOC) to our community. VOC’s appear to be more contagious and spread quicker.  As such, isolating cases of VOC’s immediately is of great importance. As the pandemic is progressing, isolation compliance is becoming more challenging, with some cases and contacts refusing to participate in isolation efforts. The staff of the WECHU continues to work closely with local enforcement authorities to ensure proper isolation requirements are followed including issuing orders under Section 22 of the Health Protection and Promotion Act.

Vaccination is a key public health measure in reducing the rate of infection in our community. The WECHU continues to work with municipal and hospital partners to provide access to COVID vaccines through mass vaccination clinics across the region. This has involved the hiring of new staff and redeployment of WECHU nursing staff from Case Management to aid in vaccination efforts, with the orienting of additional team members to Case Management on a semi-regular basis.

The Case and Contact Management System (CCM) is a core database for COVID-19 case and contact management developed by the Ministry specifically for use during this pandemic. The CCM database allows for timely reporting of cases, as well as provides a means for WECHU to establish links between cases, their contacts and potential outbreaks. WECHU strives to educate and train its staff in utilizing this new and evolving system by creating ongoing educational material, such as live training sessions and orientation documents including pre-recorded training videos and corresponding tip sheets on individual CCM topics. As Covid-19 infection continues to pivot, the Windsor Essex County Health Unit will continue to keep up-to-date with ministry guidance, thereby making every effort to continue to protect the health and wellbeing of our residents.

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Board Members Present:

Gary McNamara, Tracey Bailey, Joe Bachetti, Rino Bortolin, Fabio Costante, Gary Kaschak, Judy Lund, Ed Sleiman

Border Member Regrets:

Larry Snively

Administration Present:

Theresa Marentette, Dr. Wajid Ahmed, Lorie Gregg, Nicole Dupuis, Felicia Lawal, Kristy McBeth, Dan Sibley, Lee Anne Damphouse

QUORUM:  Confirmed

  1. Call to Order
    Board Chair, Gary McNamara, called the meeting to order at 4:37 p.m.
  2. Agenda Approval

    Moved by:  Judy Lund    
    Seconded by:  Joe Bachetti
    That the agenda be approved.
    CARRIED

  3. Announcement of Conflicts of Interest – None
  4. Update (Dr. Ahmed)
    1. COVID-19 Update

      Dr. W. Ahmed noted that positive cases of COVID-19 are declining, not only in our region but also across the province.  We saw a significant increase in positive cases in the December to January timeframe and since then cases continue to decline overall and we seem to be going in the right direction. 

      Cases were higher in the younger population, likely due to the higher vaccination rate in our older population.  Vaccination has commenced for those 12 -17 years and we should see a decline of cases in this age group as well. Hospitalization rates are also decreasing, and all of these results are due to the benefits from the vaccine.  As case rates continues to decline in our community, we will be in a much better position when the province decides to start relaxing restrictions.  The Delta Variant of Concern (VOC) is still a concern in some regions of the province, but not necessarily in Windsor-Essex.

      From an exposure perspective, 30% of cases are from close contacts, 30% from household contacts, and 30% from community transmission. 

      Data is indicating that Canada has surpassed all other countries in administering first doses of the vaccine and we are in a good position to see the same with second doses.  Windsor-Essex administers, on average, just over 5,000 doses per day and our vaccine coverage rate for individuals 12 years and older for one dose is at 72%.  Coverage rates for individuals 18+ who have received their first and second dose is 27.4%.

      The majority of vaccinations continue to be administered at St. Clair College SportsPlex and Downtown Windsor Hall, followed by other mass sites, pharmacies, primary care providers and targeted mobile clinics.  Overall 70% of doses administered has been Pfizer BioNTech, 15% Moderna and 15% AstraZeneca.  

      R. Bortolin noted some of the comments made in the media yesterday around those who have received their first dose of the Pfizer vaccine might receive Moderna as their second dose, due to the increased amount of Moderna expected in our region.  He also noted that the National Advisory Committee on Immunization (NACI) stated individuals who received AstraZeneca as their first dose, that an mRNA is preferred for the second dose. 

      Dr. Ahmed said there is evidence based on mixing of vaccines.  Based on criteria all mRNA vaccines will react the same way, so mixing Pfizer and Moderna will not reduce the effectiveness of the vaccine.  For those who have received AstraZeneca as their first dose there is strong data that mixing these vaccines will not decrease the effectiveness.  Many countries support the interchangeability.  G. McNamara said we want to ensure we are not creating confusion for our communities around the vaccines.  We need to provide the public with a level of comfort that the messaging from health professionals is uniform and consistent. 

      R. Bortolin noted the 3 Steps for Reopening the province, and since we are seeing the positive results in our region, is there a possibility to move to the next stage sooner, and what are we looking at in terms of numbers.  Dr. Ahmed said that the provincial criteria for Step 2 is to have at least 70% first dose coverage.  Windsor-Essex is ahead of the province with 73% and transmission of the virus and cases are declining. R. Bortolin would like to see Dr. Ahmed advocate to the province, as the Medical Officer of Health for Windsor-Essex, that we move to Step 2 before the provincial reopening date of June 30, 2021. Dr. Ahmed said he could express his interest in our region moving forward earlier.

      J. Lund asked if there are individuals who have contracted the virus after receiving the vaccine.  Dr. Ahmed said that the majority of individuals who have become severely ill from COVID-19 and hospitalized generally have not been vaccinated.  For those who are vaccinated and contract the virus, the likelihood of them becoming very ill is low.  Data from clinical trials is showing that all of the approved vaccines are good in preventing hospitalization, even with one dose. Data is also showing that we have benefited the most by increasing the interval of the vaccine and we are leading in the vaccine rollout.  

      J. Lund asked what we would expect to see in our region once more individuals are fully vaccinated. Dr. Ahmed said we need to look at the province in totality.  When restrictions are relaxed this provides the virus with a transmittable host.  There is always a risk with travel and rates of transmission in various parts of the world. Once our international borders open our local risk will likely increase.  Our vaccine coverage rates are over 70% while Detroit Michigan’s coverage rate is only at 30%.

      Plans continue to consolidate the mass clinics into one site.  Downtown Windsor Hall will be closing on June 23, 2021 and the WFCU Centre will be closing the end of July, transitioning to the Sears location at Devonshire Mall.  We anticipate that the two county sites, Leamington and Amherstburg, will close by the end of August 2021.  Pharmacies and primary care providers will also have access to the vaccines and the Sears location will be able to accommodate both first and second doses. We continue to book by appointment only, with no walk-ins at this time. 

      Moved by:  Rino Bortolin
      Seconded by:  Joe Bachetti
      That the information be received.
      CARRIED

      Moved by:  Rino Bortolin 
      Seconded by:  Gary Kaschak
      That the Board endorse/support the actions of the Medical Officer of Health, Dr. Wajid Ahmed, to advocate on behalf of Windsor-Essex and move into Step 2, at his discretion, ahead of the province’s original date of June 30, 2021.
      CARRIED

  5. Approval of Minutes
    1. Regular Board Meeting:  May 20, 2021

      Moved by:  Judy Lund
      Seconded by:  Gary Kaschak
      That the minutes be approved.
      CARRIED

  6. Business Arising – None
  7. Consent Agenda
    1. INFORMATION REPORTS

      1. Temporary Foreign Workers COVID-19 Vaccination Strategy (N. Dupuis)
        To be brought to the Board for information.

      2. COVID-19 Case and Contact Management (F. Lawal)
        To be brought to the Board for information.

      3. Recruitment Through the COVID-19 Pandemic (D. Sibley)
        To be brought to the Board for information.

      4. COVID-19 Vaccine Rollout in Windsor-Essex (K. McBeth)
        To be brought to the Board for information.

      5. May Communications Recap
        Moved by:  Judy Lund
        Seconded by:  Gary Kaschak
        That the above information be received.
        CARRIED

    2. RECOMMENDATION REPORTS

      1. Consumption and Treatment Services Site Identification and Consultation (T. Marentette)
        T. Marentette said that the WECHU conducted a community consultation approximately two years earlier on establishing a Supervised Injection Site in Windsor-Essex.  This Resolution is being brough to the Board as the situation in our community has not improved. Individuals suffering from overdose and death in our region has increased and is at the point of public crises.  We are in the final stages of completing the Consumption and Treatment Services Site (CTS) applications for both Health Canada and the Ministry of Health for Windsor Essex, which requires the idenfication of a site.  

        This Resolution is being brought to the Board of Health to support the WECHU administration to finalize a site for the CTS, pending no concerns, based on the outcome of the community consultation;  that the Board of Health support administration to continue with the next steps of the consultation process which includes seeking City of Windsor council approval for the proposed site;  and that administration enter into an agreement with the proposed landlord to secure the site for submission of an application.
        Moved by:  Rino Bortolin
        Seconded by:  Fabio Costante
        That the Board support the above Resolution to finalize and enter into an agreement with a proposed landlord to establish a CTS site in Windsor, ON and that WECHU continue with the community consultation process, including seeking City of Windsor approval for such site.
        CARRIED

      2.  

         

         

        CEO Transition (T. Marentette)
        T. Marentette advised that the WECHU requires a Motion for Board approval of the appointment of Nicole Dupuis as CEO of the organization effective July 1, 2021, and her ability to bind the organization.  

        G. McNamara noted that today is Theresa Marentette’s last Board of Health meeting as the Windsor-Essex County Health Unit’s CEO.  On behalf of all Board members, WECHU staff members and residents of Windsor-Essex we all owe you a great debt for your leadership and professionalism.  Theresa continued to shine through this pandemic while under tremendous pressure.  Through your leadership you proved how important public health is in working toward the end goal in this pandemic.  Compared to other regions, even with our unique challenges, i.e. International Border Crossing, Temporary Foreign Workers, you guided us well and we are finally seeing the light at the end of the tunnel.  We all wish you the very best.  God Bless and we all sincerely thank you for your leadership and friendship over the course of the years.  The Board reiterated their confidence in WECHU administration, and thanked Theresa for her strong leadership over the years and welcomed Nicole Dupuis into the role of CEO. 
        Moved by:  Judy Lund
        Seconded by:  Gary Kaschak
        That the Board approve the appointment of Nicole Dupuis as CEO of the Windsor-Essex County Health Unit, effective July 1, 2021, and her ability to bind the corporation.
        CARRIED

  8. New Business - None
  9. Other Board of Health Resolutions/Letters

    1. The Town of Amherstburg – Letter to the Hon. Doug Ford, Premier of Ontario – COVID-19 Shutdown, Support for Small Businesses – In support of the Town of Essex’s Resolution dated April 14, 2021 regarding same

    2. The Corporation of the County of Essex – Letter to the Hon. Doug Ford, Premier of Ontario – Request for Discretionary Regional Reopening Strategy    
      Moved by:    Rino Bortolin 
      Seconded by:  Gary Kaschak
      That the information be received. 
      CARRIED

  10. Committee of the Whole (CLOSED SESSION, in accordance with Section 239 of the Municipal Act)

    The Board moved into Committee of the Whole at 5:32pm
    The Board moved out of Committee of the Whole at 5:35 pm

     

     

  11. Next Meeting: At the Call of the Chair, or July 15, 2021 – Via Video
  12. Adjournment

    Moved by:   Theresa Marentette 
    Seconded by:  Gary McNamara
    That the meeting be adjourned.
    CARRIED

    The meeting adjourned at 5:40 pm.

RECORDING SECRETARY:

SUBMITTED BY:

APPROVED BY:

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DATE:

June 2021

SUBJECT:

CEO Transition

ISSUE

Theresa Marentette will officially retire from her role as Chief Executive Officer and Chief Nursing Officer of the Windsor-Essex County Health Unit effective June 30, 2021.

Upon Theresa Marentette’s departure, Nicole Dupuis, Director of Health Promotion, will transition to the position of Chief Executive Officer, effective July 1, 2021. In this role, Nicole Dupuis will have a direct reporting line to the Board of Health and have the ability to bind the Board of Health. 

PROPOSED MOTION

Whereas, that the Board of Health approve the appointment of Nicole Dupuis as Chief Executive Officer of the Windsor-Essex County Health Unit, effective July 1, 2021, with a direct reporting line to, and ability to bind, the Windsor-Essex County Board of Health.

Now therefore be it resolved that the Windsor-Essex County Board of Health approve the CEO Transition to Nicole Dupuis take place effective July 1, 2021 as presented by Administration.

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ISSUE

In October 2018, after a provincial review of existing Supervised Consumption Services (SCS) and Overdose Prevention Sites (OPS), the Government of Ontario announced its commitment to fund a re-purposed version of the Consumption and Treatments Services (CTS) Program. Consumption and Treatment Services sites provide wrap-around services that connect clients who use drugs to primary care, treatment, and other health and social services; including:

  • Supervised consumption and overdose prevention services,
  • Onsite or defined pathways to addictions treatment services,
  • Onsite or defined pathways to wrap-around services, and
  • Harm reduction services.

Opioid overdose and opioid related mortality has risen dramatically during the pandemic. Opioid overdose has risen considerably each year in Windsor-Essex from 197 in 2017 to 350 in 2020. As well, in 2020 Windsor-Essex saw the highest number of opioid related deaths since 2007. Of the deaths in 2020 (Jan-Sept), 97.9% were identified as accidental and 52.2% of those individuals were alone at the time of death.

BACKGROUND

In September of 2019, the WECHU Board of Health passed a resolution supporting the submission of a Consumption and Treatment Services (CTS) application for a site in the City of Windsor. The submission for a proposed site will be made to the Ministry of Health, including the submission of an Exemption for Medical Purposes under the Controlled Drugs and Substances Act for Activities at a Supervised Consumption Site Application required by Health Canada. 

In order to facilitate the site location process required for the application, a CTS Stakeholder Advisory Committee was established and site criteria determined, complimenting the mandatory requirements under the federal and provincial processes:

  • Site must be 200m from a sensitive land use (e.g. parks, daycare centers, and schools) as well as 600m from other CTS sites OR If  located within 200m of a sensitive land use, application must include plans on how to address community concerns
  • Site must be easily accessible by public transit
  • Site must be within walking distance to areas known to be frequented by people who use drugs
  • Space should be greater than 590ft2 (for six consumption booths) or 385ft2 (for three booths)

To complete the application process, a location and a comprehensive community consultation on the site are required. The WECHU has identified two potential sites for a CTS within the Downtown area of Windsor, prioritized through the Supervised Injection Services Community Consultations Report. The two sites are located at:

  • 101 Wyandotte Street East, Windsor
  • 628 Goyeau Street, Windsor

Each site was reviewed using a matrix scoring tool. Crime Prevention Through Environmental Design (CPTED) audits were completed on both sites by Windsor Police Services (WPS). The WECHU, with support from the CTS advisory committee is currently engaged in the consultation process on both sites. Consultation will follow similar processes and models conducted in other regions such as Barrie, Waterloo, Toronto. The consultation includes the following:

  • Key informant interviews with stakeholders and businesses in proximity to the proposed sites,
  • Focus groups with key stakeholder groups such as outreach workers, people with lived experience, and neighbourhood groups,
  • An online community survey, and
  • Live town halls held virtually, with special invitation to workplaces and residents within 300 metres of the each location.

PROPOSED MOTION

Whereas, Opioid overdose and opioid related mortality has been declared a public health crisis, and

Whereas, Opioid overdose and opioid related mortality is at an all time high in Windsor-Essex, and

Whereas, Consumption and Treatment Services have the potential to address opioid overdose and opioid related mortality, and

Whereas, the WECHU is required to submit an application for a CTS that includes a site location and an accompanying community consultation, and

Whereas, the CTS advisory committee has identified two potential sites and has engaged in the community consultation on the proposed sites

Now therefore be it resolved that the Windsor-Essex County Board of Health support the WECHU administration to finalize a site for the CTS, pending no concerns, based on the outcome of the community consultation, and

FURTHER THAT, the Board of Health support administration to continue with the next steps of the consultation process which includes seeking City of Windsor council approval for the proposed site, and

FURTHER THAT, administration enter into an agreement with the proposed landlord to secure the site for submission of an application.

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Meeting held via video.

  1. Call to Order
  2. Agenda Approval
  3. Announcement of Conflict of Interest
  4. Update (W. Ahmed)
    1. COVID-19 Update
  5. Approval of Minutes
    1. Regular Board Meeting:  April 15, 2021   
  6. Business Arising
  7. Consent Agenda
    1. INFORMATION REPORTS
      1. Consumption & Treatment Services Site (T. Marentette)

      2. Beach Water Sampling (N. Dupuis)

      3. Vector-Borne Surveillance Report (N. Dupuis)

      4. Syphillis and HIV in Windsor-Essex County (F. Lawal)

      5. March and April Communications Recap

    2. RECOMMENDTION REPORTS
      1. Healthy Babies Healthy Children (N. Dupuis/L. Gregg)
  8. New Business
    1. Fluoride Update (W. Ahmed) 
  9. Other Board of Health Resolutions/Letters
    1. Brian Masse, MPP, Windsor-West – Letter to Windsor-Essex County Health Unit – Vaccination

    2. Peterborough Public Health – Letter to Hon. Doug Ford – Stay at Home Order extended to June 2, 2021

    3. Municipality of Lakeshore – Letter to Hon. Doug Ford – Board Launches to be open in Ontario

  10. Committee of the Whole (Closed Session in accordance with Section 239 of the Municipal Act)
  11. Next Meeting: At the Call of the Chair June 17, 2021 – Via Video
  12. Adjournment
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Please contact us if you require a different version of this report.

Enwin Fluoridation Update Report - PDF
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DATE:

May 2021

SUBJECT: 

Vector-Borne Surveillance Report 

BACKGROUND

The Environmental Health Department conducts annual monitoring and testing of tick and mosquito populations in Windsor and Essex County (WEC) as part of the WECHU’s Zoonotic and Vector-borne Diseases Program. The program is required under the Health Protection and Promotion Act and provides the community with an early warning system for disease transmission through ticks and mosquitoes known as vector-borne diseases. Due to our geography and local climate, the WEC region is more susceptible to vector-borne diseases, as the ecological conditions influence transmission and distribution. 

Ticks and Lyme Disease

The Windsor Essex County Health Unit (WECHU) monitors tick-borne disease risk in our region. In the last three years, surveillance data indicated an increase in black-legged ticks (Ixodes scapularis) in WEC. The black-legged tick is the primary vector for Borrelia burgdorferi, the bacteria that causes Lyme Disease.

Environmental Health staff conduct active field surveillance at public parks and trails frequently used by community members and is done twice yearly to identify areas in WEC that have populations of black-legged ticks. In 2020, active field surveillance was not completed due to the COVID-19 pandemic, but it will resume this year in the following areas,

  • Chrysler Greenway
  • Ojibway Prairie Nature Reserve
  • Gesstwood Camp
  • Ruscom Shores Conservation Area

In 2020, the submission of ticks to the WECHU through passive surveillance was discontinued. The data collected from previous years has allowed the health unit to determine where and how the community have been exposed to ticks. The health unit will continue with suspending passive tick surveillance and will no longer accept tick specimens going forward.  Members of the public are recommended to submit a photograph to etick.ca, a free online service. The service will be promoted this year through WECHU’s website and social media channels.

Human Cases

In 2020, there were four cases of Lyme Disease in WEC.  All laboratory-confirmed cases are interviewed to determine where they may have encountered black-legged ticks. This information drives targeted tick awareness initiatives from the health unit.

Mosquito Surveillance and Testing

The WECHU, has one of Ontario’s most comprehensive mosquito surveillance programs. In 2020, mosquito surveillance began in May and ended in early October. Species-specific traps were deployed in various locations throughout WEC to capture mosquitoes for testing and identification to determine the presence of West Nile, Eastern Equine Encephalitis (EEE) Virus, and Zika Virus in our region. Invasive mosquito species Aedes aegypti (Yellow Fever Mosquito) and Aedes albopictus (Asian Tiger Mosquito) were also monitored through our Enhanced Mosquito Surveillance Program. These species are known carriers of diseases such as Zika, Malaria, Dengue, and Chikungunya. The health unit monitors mosquitoes at different stages in their life cycle to determine prevention and control initiatives for the program.

During this year’s season:

  • Total number of traps deployed per week: 47
  • Total number of mosquitoes trapped: 205,569
  • Total number of pools tested: 2,052
  • Number of positive pools for West Nile Virus : 30
  • Number of positive pools for Zika Virus: 0
  • Number of positive pools for EEE Virus: 0

The WECHU was the successful recipient for a grant from the Public Health Agency of Canada to study the effects of climate change and mosquito populations in our local communities. For the 2020 season, an additional 14 traps were strategically placed in Leamington to monitor mosquito populations. In addition to surveillance activities, key informant interviews were conducted to better understand the health care needs of the local community and within under-served populations (e.g., Temporary Foreign workers), identify gaps that exist in meeting those needs, and strengthen community involvement to improve health care access. All analysis of interview data has been completed, and an interview summary report will be released in June 2021.

Mosquito Control

Over 135,000 treatments of larvicide were applied to roadside catch basins and standing water sites last year to control mosquito populations. All municipalities in WEC have standing water by-laws that should be enforced due to the high number of positive West Nile Virus (WNV) pools in our region. Furthermore, property standards by-law enforcement is key to controlling invasive mosquito populations in our region, as these mosquitoes are container breeders.

Human Cases

The WECHU follows up on all human cases of WNV. Cases are investigated to assess if additional mosquito control activities are required. In 2020, there were two confirmed and one probable case of WNV in WEC. To date, there have been no human cases of Zika Virus identified in our community.

CURRENT INITIATIVES

The WECHU will begin surveillance and monitoring activities for ticks and mosquitoes in May 2021. In addition to these activities, the WECHU will be launching a Fight the Bite public awareness campaign in June 2021. The awareness campaign will focus on the prevention of mosquito breeding sites, information on tick removal, signs and symptoms of WNV and Lyme Disease, and personal protection. Messages and promotional materials will be developed to reach priority populations and inform the public of hot spots identified through previous monitoring efforts.

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DATE:

May 2021

SUBJECT: 

Syphilis and HIV in Windsor-Essex County

BACKGROUND

Syphilis and HIV are sexually transmitted and blood-borne infections (STBBIs) of public health significance. Although they are largely preventable, data for these infections in Windsor and Essex County (WEC) is showing cause for concern. Syphilis cases are steadily increasing at a significantly higher rate when compared to Ontario incidence rate. Between 2017 and 2019, there was a 134% increase in syphilis infection rate in WEC, compared to a 25.6% increase in Ontario. There has also been a recent increase in local HIV cases. From January 1st to March 31st, 2021, there were 9 cases of HIV reported in WEC. In comparison, there was an average of 4.6 cases in the first quarter of the previous 5 years, with a range of 2 to 7 cases.

The majority of syphilis and HIV cases have been found in men, although women are also at risk. Between 2010 and 2019, men comprised 81% of syphilis cases in WEC, and all cases of HIV in the first quarter of 2021 were men. Syphilis can also increase the risk of HIV infection. One-third of the HIV cases diagnosed in the first quarter were found to be co-infected with syphilis. Individuals at highest risk for syphilis and HIV infection share the same common risk factors. These factors include: engaging in unprotected sex (vaginal, anal, and oral), men having sex with men, and having sex with anonymous/multiple partners. Among the recent HIV cases, 78% reported having anonymous sex. This increasing trend of engaging in sex with anonymous partners found on the internet has created challenges in being able to notify contacts of exposure.  

CURRENT INITIATIVES

The Infectious Disease Prevention department is developing a sexual health strategy to address the increased prevalence of syphilis and HIV in WEC. One key part of this strategy was the creation of a Sexual Health Advisory Committee to increase stakeholder collaboration. Membership includes representatives from community partners such as the HIV Care Clinic, the Windsor-Essex Community Health Centre, Pozitive Pathways, as well as WECHU nurses who specialize in sexual health. A survey was recently conducted with the committee to identify factors that have contributed to the increased syphilis rates. Survey findings highlighted a significant lack of knowledge and awareness of syphilis among the general population and local health care providers. Specific barriers to testing, treatment, and safe sex practices were also identified. The data collected from the advisory committee, along with data previously collected from Clinical Services clients, is being used to further direct the sexual health strategy.

Moreover, interventions to increase public awareness are currently in progress. Strategic planning for a social media campaign is underway, and social media posts will soon be shared on the WECHU’s Facebook, Instagram, and Twitter accounts in order to engage our community.  The media campaign will focus on increasing knowledge and awareness regarding risk factors and infection prevention, as well as increasing testing and treatment. The WECHU will also be collaborating with Pozitive Pathways in an upcoming podcast and various webinars to target high-risk individuals. Targeted advertisements for high-risk populations will also be placed on Grindr, an online dating site for men who have sex with men. Furthermore, the Windsor-Essex Pride Fest is held in August and initiatives are underway to actively participate in the community event.  

Currently, all syphilis cases are referred to the WECHU for treatment and follow-up. The Clinical Services Nurse Practitioner will also be providing educational sessions for the testing, treatment, and follow-up of syphilis to key health care providers in the community in an effort to build capacity. Additional strategies to support health care providers and increase capacity in sexual health services are continuing to be explored.

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DATE:

May 2021

SUBJECT: 

Consumption and Treatment Services Site – Update 

BACKGROUND

In September of 2019, the WECHU Board of Health passed a resolution supporting the submission of a Consumption and Treatment Services (CTS) application for a site in the City of Windsor. Submission for a proposed site would be made to the Ministry of Health, including the submission of an Exemption for Medical Purposes under the Controlled Drugs and Substances Act for Activities at a Supervised Consumption Site Application required by Health and Canada. 

In Ontario, Consumption and Treatment Services sites provide wrap-around services that connect clients who use drugs to primary care, treatment, and other health and social services, including:

  • Supervised consumption and overdose prevention services,
  • Onsite or defined pathways to addictions treatment services,
  • Onsite or defined pathways to wrap-around services, and
  • Harm reduction services.

To complete the application process, the WECHU must identify a location and complete a comprehensive community consultation. In order to facilitate this process, a CTS Stakeholder Advisory Committee was established and site criteria estblished, complimenting the mandotory requriements under the federal and provinical processes:

  • Site must be 200m from a sensitive land use (e.g. parks, daycare centers, and schools) as well as 600m from other CTS sites OR If  located within 200m of a sensitive land use, application must include plans on how to address community concerns
  • Site must be easily accessible by public transit
  • Site must be within walking distance to areas known to be frequented by people who use drugs
  • Space should be greater than 590ft2 (for six consumption booths) or 385ft2 (for three booths)

In the fall of 2020, using these criteria, and in consultation with the WECHU legal representation and procurement procedures, the WECHU issued a Request for Expressions of Interest (RFEOI) through the MERX Online Public Tenders solicitation database for interested landlords and property owners. No submissions were received. The WECHU issued a second Request for Expressions of Interest (RFEOI) through the MERX Online Public Tenders solicitation database for interested Real Estate agencies to represent the WECHU in the idenfication of a location for a potential CTS. No submissions were received for the second tender.

CURRENT INITIATIVES

In February 2021, the WECHU Substance Use coordinator, utilizing the set criteria for site identification, worked through local real estate listings to identify potential locations for a CTS. Locations for rent or lease meeting the criteria were listed and scored using a matrix relative to the criteria.

Several locations have been identified for onsite review. Environmental audits will be completed by Windsor Police Services in order to determine the safety of the area and guide any mitigating interventions which can improve the safety of the areas surrounding the site and discourage criminal activity. Once sites have all been reviewed and audits complete, next steps to the process include formal recommendation to the board of health and community consultation.

View Document Page

DATE:

May 2021

SUBJECT: 

Beach Water Sampling

BACKGROUND

The Windsor-Essex County Health Unit conducts beach water sampling in accordance with Recreational Water Protocol, 2019 and following the Operational Approaches for Recreational Water Guideline, 2018. The 2020 season of beach water sampling was deferred prior to the season start due to reallocation of Environmental Health Department resources to respond to the COVID-19 pandemic. Beach Water Sampling will resume for the 2021 season. The Environmental Health Department conducts water sampling of all nine (9) public beaches in Windsor and Essex County from June to September. Public beaches that are part of the beach water quality monitoring program include: Cedar Beach; Cedar Island Beach; Colchester Beach; Holiday Beach; Mettawas Beach; Point Pelee North West Beach; Sandpoint Beach; Seacliff Beach; West Belle River Beach. Each week, bacteriological samples are collected across the beach front and tested for Escherichia coli (E. coli). E.Coli exposure can lead to severe stomach cramps, diarrhea, fever and vomiting. Water conditions, weather, and potential pollutants are also monitored and documented by Public Health Inspectors as these factors, among others, impact water sampling results.

CURRENT INITIATIVES

Pre-season Public Beach Assessments will be completed in early June, and beach assessments and sampling will be conducted weekly afterwards and continue until the season end in mid-September. All beach assessments and sampling will be done by 2 PHIs on Monday’s (or Tuesdays if Monday is a holiday).

Beaches with bacteria counts that exceed 1000 E. coli per 100 mLs will be posted with a sign indicating the beach is closed after the initial sampling, and re-sampled on Thursday to permit for re-opening of public beaches before the weekend if satisfactory results were returned. Beaches with bacteria counts exceeding 200 E.Coli per 100 mLs (but less than 1000 E. Coli per 100 mLs) will be posted with a warning sign, but will remain open and not be resampled.

The Environmental Health Department will update the Beach Hotline (519-258-2146 ext. H2O) and the Interactive Beach Map located on the Windsor-Essex County Health Unit website https://www.wechu.org/your-environment/beaches-pools-and-spas/beaches throughout the season once routine weekly sampling begins.  In addition, community agencies are emailed the results.

View Document Page

Board Members Present:

Gary McNamara, Tracey Bailey, Joe Bachetti, Rino Bortolin, Fabio Costante, Gary Kaschak, Judy Lund, Ed Sleiman, Larry Snively

Administration Present:

Theresa Marentette, Dr. Wajid Ahmed, Lorie Gregg, Nicole Dupuis, Dr. Felicia Lawal, Kristy McBeth, Dan Sibley, Lee Anne Damphouse 

QUORUM:  Confirmed

  1. Call to Order
    Board Chair, Gary McNamara, called the meeting to order at 4:33 p.m.
  2. Agenda Approval

    Moved by:  Judy Lund    
    Seconded by:  Rino Bortolin
    That the agenda be approved.
    CARRIED

  3. Announcement of Conflicts of Interest – None
  4. Update (Dr. Ahmed)
    1. COVID-19 Update

      Dr.  W. Ahmed noted the announcement made by the province today.  Today the Premier announced a different pathway to reopen the province, which will occur in three different stages.  In stage 1 various sporting activities will open, i.e. golf, tennis, basketball courts, and gatherings of up to 5 people outdoors will be allowed. Following that, more restrictions will be relaxed with gatherings of up to 10 people permitted, possibly in as early as 10 days.  In stage 3, in about 21 days, outdoor sports leagues, personal services settings, religious services and gatherings will increase to 25 people. More information will follow.

      We are seeing some fluctuations of positive cases in our region, and still have a relatively high number being reported daily.  Cases amongst school age children are averaging five cases per day even with the school closure.

      Most cases, about three-quarters, are coming from the City of Windsor, followed by the other municipalities.  We are seeing most of the cases are occurring within the 0-29 year age group, and we have documented cases of infants less than a year old in our community who have tested positive for COVID-19.

      Adults 18+ are now eligible to receive their first dose, and we have seen a decline in cases amongst other age groups that have already been vaccinated.  Once vaccination rates increase for the younger age group, we expect to see a drop in cases in younger people. Close contact and community transmission are the biggest contributors.

      The Variants of Concern (VOC’s) are a significant driver in our area with more than 70% of our positive cases being VOCs.  The VOCs pose a huge risk, as they spread quickly resulting in the daily fluctuation of cases we are seeing in our community.

      Hospitalizations are declining in the province as more people get vaccinated, and we are seeing the same result in Intensive Care Units.  The older population still has the highest risk and mortality rate.  

      There have been more than 213,000 doses administered in our region, with approximately 3,600 doses per day through pharmacies and primary care providers.  We have immunized as many as 4,800 people in one day.  More than two-thirds of doses administered in Windsor-Essex has been Pfizer, with Moderna and AstraZeneca equally making up the rest.

      Our overall coverage rate is 48.3% and when looking at just adults, it is 62.6%.  Opening up the eligibility to 18+ will help to increase these rates.  We are hoping for at least 70% vaccine coverage for further impact and decrease cases in our community.

      Various hot spots in our region continue to have the lowest coverage rates at 41%, despite having mass immunization sites and pop-up vaccination clinics in those areas. We are working with the City and the CMHA for a more targeted approach.

      G. McNamara said there could be campaigns with community leaders and medical professionals on why you should get the vaccine.  This might be a good opportunity to get messaging to the younger population who are also working in essential services, i.e. restaurants and grocery stores.  Dr. Ahmed said that we have worked with the University of Windsor around vaccine hesitancy, and our team is looking at all options. N. Dupuis is working with community partners for immigrants through the Multicultural Council as well to work through some language barriers.   

      E. Sleiman asked if once an individual receives the vaccine are they protected from contracting COVID-19, and if students and teachers are fully vaccinated would they still require a mask when they return to school. Dr. Ahmed said studies have shown that the vaccine protects against severe disease and/or hospitalization from COVID-19.  As to whether those have been vaccinated can still contract the disease, we are not sure and there are still many unknowns.  Dr. Ahmed said that at some point students and teachers will no longer be required to wear masks when attending school, but for that to happen there will need to be sufficient vaccine coverage rates with very low, to no, transmission in the community. 

      J. Lund asked if there was any work being done around anti-viral mediation. Dr. Ahmed said that there are many clinical trials happening around the world, but it is likely too early to determine the outcome.  We continue to hear that Remdesivir is widely used for COVID patients and it does improve recovery time.  Steroids are used as a form of treatment mainly in the UK and has shown some positive benefits in reducing the severity in some cases. There are other medications being used with mixed results and this is still being investigated.

      J. Lund asked about the status of allowing Windsorites to receive second doses of the vaccine across the border in Michigan.  G. McNamara said that the border is a national responsibility.  Some groups are advocating for this along with an exemption of no quarantine when arriving back into Canada but there are still some risks to that.  Windsor-Essex has been immunizing approximately 3,000 – 4,000 people a day, and more vaccine is coming.  WECHU and our partners have been doing an excellent job and we are moving in the right direction.  It might prove to be premature at this time to allow cross-border immunizations. 

      Dr. Ahmed agreed with G. McNamara that there is a risk to this initiative.  Our vaccination coverage rates are almost 63% for those who have received one dose, compared to Detroit at 33%.  Our recommendation to the public is still the same, to travel less to reduce transmission.  The  best option would be to have the extra doses of the vaccine in Michigan brought here, instead of the our residents travelling across the border. 

      G. McNamara asked where our region is in respect to second doses of AstraZeneca.  We have 37,000 residents who have received their first dose, and are we expecting to receive more.  Dr. Ahmed said that we are in conversations currently with the province to plan for second doses.  The province will offer two options, i.e. to receive a second dose of AstraZeneca, or to mix vaccines and receive Pfizer as the second dose.  The product monograph for AstraZeneca ranges from 4-12 weeks and the 12 weeks duration has proven to be more effective.  More details will follow once we have more information on these second doses for AstraZeneca recipients.

      Moved by:  Judy Lund
      Seconded by:  Ed Sleiman 
      That the information be received.
      CARRIED

  5. Approval of Minutes
    1. Regular Board Meeting:  April 15, 2021
      Moved by:  Joe Bachetti
      Seconded by:  Rino Bortolin
      That the minutes be approved.
      CARRIED
  6. Business Arising – None
  7. Consent Agenda
    1. INFORMATION REPORTS

      1. Consumption and Treatment Services Site – Update (T. Marentette)
        T. Marentette said that we are moving forward in the Consumption and Treatment Services Site selection process.  You will likely hear more about community consultation in July around the sites proposed.  All of our consultations will be virtual and we want to ensure that it is inclusive by engaging stakeholders, businesses, neighbours, the BIA and municipal councillors applicable in the area. We are working with our legal representative before any lease is signed, background work is in progress, and we are not comitting to anything until the funding has been secured. More information will be forthcoming. 

      2. Beach Water Sampling (N. Dupuis)
        To be brought to the Board for information.

      3. Vector-Borne Surveillance Report (N. Dupuis)
        To be brought to the Board for information.

      4. Syphillis and HIV in Windsor-Essex County (F. Lawal)
        G. McNamara said that the increasing numbers of infection for Syphillis and HIV from 2017-2019 in our region is concerning, and are higher than the provincial average. F. Lawal said the WECHU is seeing as many as 4 cases of Syphilis a week in our sexual health clinic and the trend definitely is concerning.  We are working hard to create public awareness around the seriousness of contracting these diseases and the impact on health, i.e. vision, demensia, and the congenital piece, and it remains imperative that we continue to identify contacts for infectious diseases druring the pandemic.

      5. March and April Communications Recap
        To be brought to the Board for information.
        Moved by:  Judy Lund
        Seconded by:  Ed Sleiman
        That the above information be received.
        CARRIED

    2. RECOMMENDATION REPORTS

      1. Healthy Babies Healthy Children (N. Dupuis/L. Gregg)
        N. Dupuis noted that the Healthy Babies Healthy Children (HBHC) program is a mandated program under the Ontario Public Health Standards (OPHS), and is funded 100% through the Ministry of Children Community and Social Services (MCCSS). In 2020, due to the COVID-19 pandemic, HBHC program services were significantly altered across the province as staffing resources were redeployed to support the COVID response. 

        In March 2021, the WECHU received communication from the MCCSS requesting the restoration of HBHC services for the 2021-2022 fiscal year. Health Units were asked to submit their service delivery plans and financial forecast to MCCSS by April 14, 2021 for review and consideration. Where staff were redeployed to other services supporting the pandemic, health units were asked to consider alternative staffing models including the use of social workers and other professional staff to support program delivery and identified service goals. 

        L. Gregg advised that the budget for this program for this year is $2,894,841, and is a combination of the HBHC and Nurse Practitioner program previously reported under separate funding.  The Operating Budget has some notable changes.  Professional development costs increased to address the needs of FTEs that are new to the program.  

        There was an increase in program supplies of $66,159 for the Healthy Babies Healthy Children Program Initiative to address the need to review and refresh resources and revitalize the program.  Additionally, there will be an augment in information technology hardware and software to address increased FTEs.  The program area will also continue to review equipment requirements for work-from-home as well as ensuring field staff are more mobile, in that they can document client interactions in the field.

        Therefore, we are requesting that the Board approve the budget for this program of $2,894,841 as presented by Administration for the period April 1, 2021 to March 31, 2022.
        Moved by:  Judy Lund
        Seconded by:  Rino Bortolin
        That the Board approve the Budget as presented by Administration. 
        CARRIED

  8. New Business

    1. Fluoride Update (W. Ahmed)
      Dr. W. Ahmed said that we recently received communication from Enwin regarding fluoride introduction into the WUC water system.  The process has been delayed due to the pandemic but despite these delays, Enwin management is expecting the project to reintroduce fluoride to the drinking water to be accomplished within the allocated budget for 2021.
      Moved by:  Larry Snively 
      Seconded by:  Ed Sleiman
      That the above information be received.
      CARRIED

  9. Other Board of Health Resolutions/Letters

    1. Brian Masse, MPP, Windsor-West – Letter to Windsor-Essex County Health Unit – Vaccination for CBSA Officers at International Borders

    2. Peterborough Public Health – Letter to Honourable Doug Ford – Stay at Home Order Extended to June 2, 2021

    3. Municipality of Lakeshore – Letter to Honourable Doug Ford – Boat Launches to be open in Ontario
      Moved by:    Judy Lund
      Seconded by:  Ed Sleiman
      That the information be received.
      CARRIED

  10. Committee of the Whole (CLOSED SESSION, in accordance with Section 239 of the Municipal Act)

    The Board moved into Committee of the Whole at 5:30pm
    The Board moved out of Committee of the Whole at 5:50 pm

  11. Next Meeting: At the Call of the Chair, or June 17, 2021 – Via Video
  12. Adjournment

    Moved by:  Judy Lund 
    Seconded by:  Gary Kaschak
    That the meeting be adjourned.
    CARRIED

    The meeting adjourned at 5:50 pm.

RECORDING SECRETARY:

SUBMITTED BY:

APPROVED BY:

View Document Page

Board Members Present:

Gary McNamara, Tracey Bailey, Joe Bachetti, Rino Bortolin, Fabio Costante, Gary Kaschak, Judy Lund, Ed Sleiman, Larry Snively

Administration Present:

Theresa Marentette, Dr. Wajid Ahmed, Lorie Gregg, Nicole Dupuis, Dr. Felicia Lawal, Kristy McBeth, Dan Sibley, Lee Anne Damphouse

QUORUM:  Confirmed

  1. Call to Order
    Board Chair, Gary McNamara, called the meeting to order at 4:33 p.m.
  2. Agenda Approval

    Moved by:  Judy Lund    
    Seconded by:  Rino Bortolin
    That the agenda be approved.
    CARRIED

  3. Announcement of Conflicts of Interest – None
  4. Update (Dr. W. Ahmed)
    1. COVID-19 Update

      Dr.  W. Ahmed noted the announcement made by the province today.  Today the Premier announced a different pathway to reopen the province, which will occur in three different stages.  In stage 1 various sporting activities will open, i.e. golf, tennis, basketball courts, and gatherings of up to 5 people outdoors will be allowed. Following that, more restrictions will be relaxed with gatherings of up to 10 people permitted, possibly in as early as 10 days.  In stage 3, in about 21 days, outdoor sports leagues, personal services settings, religious services and gatherings will increase to 25 people. More information will follow.

      We are seeing some fluctuations of positive cases in our region, and still have a relatively high number being reported daily.  Cases amongst school age children are averaging five cases per day even with the school closure.

      Most cases, about three-quarters, are coming from the City of Windsor, followed by the other municipalities.  We are seeing most of the cases are occurring within the 0-29 year age group, and we have documented cases of infants less than a year old in our community who have tested positive for COVID-19.

      Adults 18+ are now eligible to receive their first dose, and we have seen a decline in cases amongst other age groups that have already been vaccinated.  Once vaccination rates increase for the younger age group, we expect to see a drop in cases in younger people. Close contact and community transmission are the biggest contributors.

      The Variants of Concern (VOC’s) are a significant driver in our area with more than 70% of our positive cases being VOCs.  The VOCs pose a huge risk, as they spread quickly resulting in the daily fluctuation of cases we are seeing in our community.

      Hospitalizations are declining in the province as more people get vaccinated, and we are seeing the same result in Intensive Care Units.  The older population still has the highest risk and mortality rate.  

      There have been more than 213,000 doses administered in our region, with approximately 3,600 doses per day through pharmacies and primary care providers.  We have immunized as many as 4,800 people in one day.  More than two-thirds of doses administered in Windsor-Essex has been Pfizer, with Moderna and AstraZeneca equally making up the rest.

      Our overall coverage rate is 48.3% and when looking at just adults, it is 62.6%.  Opening up the eligibility to 18+ will help to increase these rates.  We are hoping for at least 70% vaccine coverage for further impact and decrease cases in our community.

      Various hot spots in our region continue to have the lowest coverage rates at 41%, despite having mass immunization sites and pop-up vaccination clinics in those areas. We are working with the City and the CMHA for a more targeted approach.

      G. McNamara said there could be campaigns with community leaders and medical professionals on why you should get the vaccine.  This might be a good opportunity to get messaging to the younger population who are also working in essential services, i.e. restaurants and grocery stores.  Dr. Ahmed said that we have worked with the University of Windsor around vaccine hesitancy, and our team is looking at all options. N. Dupuis is working with community partners for immigrants through the Multicultural Council as well to work through some language barriers.   

      E. Sleiman asked if once an individual receives the vaccine are they protected from contracting COVID-19, and if students and teachers are fully vaccinated would they still require a mask when they return to school. Dr. Ahmed said studies have shown that the vaccine protects against severe disease and/or hospitalization from COVID-19.  As to whether those have been vaccinated can still contract the disease, we are not sure and there are still many unknowns.  Dr. Ahmed said that at some point students and teachers will no longer be required to wear masks when attending school, but for that to happen there will need to be sufficient vaccine coverage rates with very low, to no, transmission in the community. 

      J. Lund asked if there was any work being done around anti-viral mediation. Dr. Ahmed said that there are many clinical trials happening around the world, but it is likely too early to determine the outcome.  We continue to hear that Remdesivir is widely used for COVID patients and it does improve recovery time.  Steroids are used as a form of treatment mainly in the UK and has shown some positive benefits in reducing the severity in some cases. There are other medications being used with mixed results and this is still being investigated.

      J. Lund asked about the status of allowing Windsorites to receive second doses of the vaccine across the border in Michigan.  G. McNamara said that the border is a national responsibility.  Some groups are advocating for this along with an exemption of no quarantine when arriving back into Canada but there are still some risks to that.  Windsor-Essex has been immunizing approximately 3,000 – 4,000 people a day, and more vaccine is coming.  WECHU and our partners have been doing an excellent job and we are moving in the right direction.  It might prove to be premature at this time to allow cross-border immunizations. 

      Dr. Ahmed agreed with G. McNamara that there is a risk to this initiative.  Our vaccination coverage rates are almost 63% for those who have received one dose, compared to Detroit at 33%.  Our recommendation to the public is still the same, to travel less to reduce transmission.  The  best option would be to have the extra doses of the vaccine in Michigan brought here, instead of the our residents travelling across the border. 

      G. McNamara asked where our region is in respect to second doses of AstraZeneca.  We have 37,000 residents who have received their first dose, and are we expecting to receive more.  Dr. Ahmed said that we are in conversations currently with the province to plan for second doses.  The province will offer two options, i.e. to receive a second dose of AstraZeneca, or to mix vaccines and receive Pfizer as the second dose.  The product monograph for AstraZeneca ranges from 4-12 weeks and the 12 weeks duration has proven to be more effective.  More details will follow once we have more information on these second doses for AstraZeneca recipients.

      Moved by:  Judy Lund
      Seconded by:  Ed Sleiman
      That the information be received.
      CARRIED

  5. Approval of Minutes
    1. Regular Board Meeting:  March 18, 2021
      Moved by: Joe Bachetti
      Seconded by: Rino Bortolin
      That the minutes be approved.
      CARRIED
  6. Business Arising - None

  7. Consent Agenda

    1. INFORMATION REPORTS
      1. Consumption and Treatment Services Site – Update (T. Marentette)

        T. Marentette said that we are moving forward in the Consumption and Treatment Services Site selection process.  You will likely hear more about community consultation in July around the sites proposed.  All of our consultations will be virtual and we want to ensure that it is inclusive by engaging stakeholders, businesses, neighbours, the BIA and municipal councillors applicable in the area. We are working with our legal representative before any lease is signed, background work is in progress, and we are not comitting to anything until the funding has been secured. More information will be forthcoming.

      2. Beach Water Sampling (N. Dupuis)
        To be brought to the Board for information.

      3. Vector-Borne Surveillance Report (N. Dupuis)
        To be brought to the Board for information.

      4. Syphillis and HIV in Windsor-Essex County (F. Lawal)
        G. McNamara said that the increasing numbers of infection for Syphillis and HIV from 2017-2019 in our region is concerning, and are higher than the provincial average. F. Lawal said the WECHU is seeing as many as 4 cases of Syphilis a week in our sexual health clinic and the trend definitely is concerning.  We are working hard to create public awareness around the seriousness of contracting these diseases and the impact on health, i.e. vision, demensia, and the congenital piece, and it remains imperative that we continue to identify contacts for infectious diseases druring the pandemic. 

      5. March and April Communications Recap
        To be brought to the Board for information.
        Moved by:  Judy Lund
        Seconded by:  Ed Sleiman
        That the above information be received.
        CARRIED

    2. RECOMMENDATION REPORTS

      1. Healthy Babies Healthy Children (N. Dupuis/L. Gregg)
        N. Dupuis noted that the Healthy Babies Healthy Children (HBHC) program is a mandated program under the Ontario Public Health Standards (OPHS), and is funded 100% through the Ministry of Children Community and Social Services (MCCSS). In 2020, due to the COVID-19 pandemic, HBHC program services were significantly altered across the province as staffing resources were redeployed to support the COVID response. 

        In March 2021, the WECHU received communication from the MCCSS requesting the restoration of HBHC services for the 2021-2022 fiscal year. Health Units were asked to submit their service delivery plans and financial forecast to MCCSS by April 14, 2021 for review and consideration. Where staff were redeployed to other services supporting the pandemic, health units were asked to consider alternative staffing models including the use of social workers and other professional staff to support program delivery and identified service goals. 

        L. Gregg advised that the budget for this program for this year is $2,894,841, and is a combination of the HBHC and Nurse Practitioner program previously reported under separate funding.  The Operating Budget has some notable changes.  Professional development costs increased to address the needs of FTEs that are new to the program.  

        There was an increase in program supplies of $66,159 for the Healthy Babies Healthy Children Program Initiative to address the need to review and refresh resources and revitalize the program.  Additionally, there will be an augment in information technology hardware and software to address increased FTEs.  The program area will also continue to review equipment requirements for work-from-home as well as ensuring field staff are more mobile, in that they can document client interactions in the field.

        Therefore, we are requesting that the Board approve the budget for this program of $2,894,841 as presented by Administration for the period April 1, 2021 to March 31, 2022.

        Moved by:  Judy Lund

        Seconded by:  Rino Bortolin
        That the Board approve the Budget as presented by Administration. 
        CARRIED

  8. New Business

    1. Fluoride Update (W. Ahmed)
      Dr. W. Ahmed said that we recently received communication from Enwin regarding fluoride introduction into the WUC water system.  The process has been delayed due to the pandemic but despite these delays, Enwin management is expecting the project to reintroduce fluoride to the drinking water to be accomplished within the allocated budget for 2021.

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

  9. Other Board of Health Resolutions/Letters

    1. Brian Masse, MPP, Windsor-West – Letter to Windsor-Essex County Health Unit – Vaccination for CBSA Officers at International Borders

    2. Peterborough Public Health – Letter to Honourable Doug Ford – Stay at Home Order Extended to June 2, 2021

    3. Municipality of Lakeshore – Letter to Honourable Doug Ford – Boat Launches to be open in Ontario

      Moved by:    Judy Lund
      Seconded by:  Ed Sleiman
      That the information be received.
      CARRIED

  10. Committee of the Whole (CLOSED SESSION, in accordance with Section 239 of the Municipal Act)

    The Board moved into Committee of the Whole at 5:30 pm
    The Board moved out of Committee of the Whole at 5:50 pm

  11. Next Meeting: At the Call of the Chair, or June 17, 2021 – Via Video 

  12. Adjournment

    Moved by: Judy Lund
    Seconded by: Gary Kaschak
    That the meeting be adjourned.
    CARRIED
    The meeting adjourned at 5:50 pm.

RECORDING SECRETARY:

SUBMITTED BY:

APPROVED BY:

View Document Page

ISSUE

The Healthy Babies Healthy Children program is a mandated program under the Ontario Public Health Standards (OPHS), and is funded 100% through the Ministry of Children Community and Social Services (MCCSS). In 2020, due to the COVID-19 pandemic, HBHC program services were significantly altered across the province as staffing resources were redeployed to support the COVID response.

The HBHC program is an evidence based early intervention home visiting program designed to improve outcomes for children at risk of poor growth and development. The HBHC program aims to support the most vulnerable and marginalized families in our community through blended home visiting including nursing, social work and peer support. Entry into the HBHC programs occurs through screening and referral at three stages: Prenatal; Postpartum; and Early Identification. The HBHC screen identifies a family experiencing a need, issue or risk that may compromise healthy child development; and/or parenting ability; and who may benefit from a more thorough evaluation and receipt of HBHC program services or other community services. HBHC staff utilize standardized assessments and evidence-based interventions to work on family centred goals and develop a Family Service Plan that monitors the progress and achievement of those goals. The HBHC program staff support families with:

  • healthy pregnancy and prenatal care
  • developing a positive relationship with their child
  • promoting child’s growth and development
  • connecting families to resources and programs within their community
  • working together with families to help give their child the best start in life

BACKGROUND

In March 2021, the WECHU received communication from the MCCSS requesting the restoration of HBHC services for the 2021-2022 fiscal year. Health Units were asked to submit their service delivery plans and financial forecast to MCCSS by April 14, 2021 for review and consideration. Where staff were redeployed to other services supporting the pandemic, health units were asked to consider alternative staffing models including the use of social workers and other professional staff to support program delivery and identified service goals.

The WECHU’s service delivery plan recognizes the continued redeployment of nursing staff to support COVID-19 vaccination and case and contact management well into the 2021 calendar year. As such an alternate model of blended home visiting will be implemented utilizing social workers as the family case coordinators supporting all family service plans and goals. Limited nursing staff, including a registered lactation consultant will be incorporated into blended home visiting related to: prenatal health, healthy attachment, optimal growth and development, and breast feeding goals and will consult as an expert related to screening and assessment. Other supports for blended home visiting include a registered dietician to support nutrition and food security and family home visitors.

The WECHU has retained minimum service levels for HBHC over the course of the pandemic. Key priorities for families in Windsor-Essex remain as mental health, substance use and housing stability. HBHC staff have reported an increase in mental health complexity among clients and increased severity for those with pre-existing anxiety and depression. This may be attributed, at least in part, to the financial strain, isolation, and general uncertainty caused by the pandemic, as reported by some clients. This interim model will allow the WECHU the opportunity to meet full program implementation while maintaining program fidelity and support increased risks associated with substance use and poor mental health.

2021/2022 Budget

The MCCSS funds not only the Healthy Babies Healthy Children Program Initiative but also the Nurse Practitioner Program Initiative.  The MCCSS has combined the budget for these program initiatives for purposes of reporting.  As such, the WECHU will adopt a consistent approach.

To address the continued need to have the WECHU nurses more focused on the COVID-19 case and contact management and vaccination efforts, the FTE composition of the Healthy Babies Healthy Children Program Initiative will change throughout the fiscal year.  Initially, the Program will be more heavily supported by social workers.  This support will shift as nursing support can be reintegrated in the latter part of 2021.

A summary of the FTEs by quarter are as follows:
FTE Q1 Q2 Q3 Q4
Manager 2 2 2 2
Health Promotion Specialist 1 1 1 -
Nutritionist 1 1 1 -
Public Health Nurse 6 grading down to 4 4 9 15
Family Home Visitor 4 4 4 4
Social Worker 2 grading up to 10 10 10 4
Support Staff 1.5 2.5 2.5 2.5

*FTE estimates are approximate and subject to change based on program needs and pressures throughout the year.

Regarding the Nurse Practitioner Program Initiative, one (1) nurse practitioner FTE will be retained throughout the entire year.  This FTE will provide limited support to COVID-19 vaccination efforts.  Quarterly reporting will reflect the reallocation of applicable salaries and benefits for time expended on Ministry of Health Programs.

The 2021/2022 expenditure budget for all programs funded by the MCCSS is detailed below:
Item April 1, 2021 to March 31, 2022 April 1, 2020 to March 31, 2021 Change
Salaries and benefits 2,639,041 2,722,600 (83,559)
Operating expenditures:      
    Mileage 60,000 63,000 (3,000)
    Professional development 25,000 10,400 14,600
    Program supplies 150,000 83,841 66,159
    Purchased services 20,800 15,000 5,800
Total operating expenditures 255,800 172,241 83,559
Total budget 2,894,841 2,894,841 -

For the 2021/22 fiscal year, the fluent staffing complement results in a change in the salaries and benefits financial statement caption of $83,559.  Offsetting this are is an increase in the operating budget, most notably the following financial statement captions:

  • Professional development of $14,600 – Increase in professional development to address the needs of FTEs that are new to the Healthy Babies Healthy Children Program Initiative as well as the needs of those returning to this program in the latter part of 2021.
  • Program supplies of $66,159 – Increases in program supplies for the Healthy Babies Healthy Children Program Initiative to address the need to review and refresh resources and revitalize the program.  Additionally, there will be an augment in information technology hardware and software to address increased FTEs.  The program area will also continue to review equipment requirements for work-from-home as well as ensuring field staff are more mobile, in that they can document client interactions in the field.

PROPOSED MOTION

Whereas, the Windsor-Essex County Health Unit receives grants from the Ministry of Children, Community and Social Services to fund the Healthy Babies Healthy Children and Nurse Practitioner Program Initiatives, and

Whereas, the total budget for the Healthy Babies Healthy Children Program Initiative and the Nurse Practitioner Program Initiative combined is $2,894,841 for the period April 1, 2021 to March 31, 2022,

Now therefore be it resolved that the Windsor-Essex County Board of Health approve the budget as presented by Administration for the period April 1, 2021 to March 31, 2022.

View Document Page

Meeting held via video.

  1. Call to Order
  2. Agenda Approval
  3. Announcement of Conflict of Interest
  4. Update (W. Ahmed)
    1. COVID-19 Update
  5. Approval of Minutes
    1. Regular Board Meeting:  March 18, 2021   
  6. Business Arising
  7. Consent Agenda
    1. INFORMATION REPORTS
      1. March Communications Recap
    2. RECOMMENDTION REPORTS – None
  8. New Business
    1. CEO Quarterly Report (T. Marentette)
  9. Other Board of Health Resolutions/Letters
    1. Town of Kingsville – Letter to Hon. Doug Ford – Resolution - Health and Safety of our Communities 
  10. Committee of the Whole (Closed Session in accordance with Section 239 of the Municipal Act)
  11. Next Meeting: At the Call of the Chair May 20, 2021 – Via Video
  12. Adjournment
View Document Page

Board Members Present:

Gary McNamara, Tracey Bailey, Joe Bachetti, Rino Bortolin, Fabio Costante, Gary Kaschak, Ed Sleiman, Larry Snively 

Board Member Regrets:

Judy Lund

Administration Present:

Theresa Marentette, Dr. Wajid Ahmed, Lorie Gregg, Nicole Dupuis, Dr. Felicia Lawal, Kristy McBeth, Dan Sibley, Lee Anne Damphouse

QUORUM:  Confirmed

  1. Call to Order
    Board Chair, Gary McNamara, called the meeting to order at 4:03 p.m.
  2. Agenda Approval

    Moved by:  Larry Snively
    Seconded by:  Rino Bortolin
    That the agenda be approved.
    CARRIED

  3. Announcement of Conflicts of Interest – None
  4. Update (Dr. Ahmed)
    1. COVID-19 Update

      Dr.  Ahmed noted the increase of COVID-19 cases across the province with approximately 4,700 reported in Ontario today. Windsor-Essex has seen an increase with 93 cases reported today and the Variants of Concern (VOC) pose an even bigger threat.  

      We are still seeing increases amongst school-aged children but it seems to be stabilizing.  We are hoping numbers will decrease over the next few weeks with the provincial mandated school closures. The majority of cases in children are through their family and household contacts and not from attending school. 

      Cases have decreased in the senior population due to the vaccine, with a shift to the younger population in the 0-19 and 20-29 year age groups. Household contacts and community transmission are the significant drivers, with more VOC being reported every day. 

      The province is seeing a sharp increase in hospitalizations and ICU admissions.  We are monitoring our ICU cases, but Windsor-Essex is not seeing the same trend as the province.  With the VOC contributing up to 30-50% of cases, this could lead to more hospitalization.  

      The case fatality rate is 1.9% across the province. Windsor-Essex’s case fatality rate is 2.8%, with the majority of fatalities coming from the community.  Our LTCH/RH fatality rate is lower than the provincial average.  R. Bortolin asked if there is any data showing if the vaccine is effective to the VOCs.  Dr. Ahmed said that PHO is analyzing that data at the provincial level and he can share that when received. 

      Our region has administered 124,578 doses of vaccine, with 112,027 residents receiving at least one dose.  The province has noted various hot spots in our region, some requiring more attention, i.e. the downtown Windsor core and the west area of Windsor where we would like to offer more opportunities to receive the vaccine. 

      J. Bachetti asked about the 80+ group of individuals who cannot leave their homes. What plans are in place to help vaccinate them. Dr. Ahmed said that adults in chronic home care who are registered with the LHIN will be vaccinated.  For others who are not, we are hoping to have primary care providers come onboard to help vaccinate these individuals. T. Marentette said  starting Monday there will be two teams that will assist with vaccinating between 100-300 home bound individuals, starting in hot spots, that are registered with the LHIN.  

      Dr. Ahmed advised that our current allotment of the Pfizer vaccine is 10,500 doses a week until at least mid-May, with 2,000 of Moderna earmarked for other priorities.  We have also received a large shipment of AstraZeneca which will flow through the pharmacy channels.
       
      R. Bortolin asked about individuals outside of Windsor-Essex booking vaccinations in our region, and is there a way to divert that.  Dr. Ahmed said that under the provincial booking system people can book anywhere across Ontario and there is nothing we can do to avoid that. There is also nothing stopping individuals from Windsor-Essex booking elsewhere across the province. 

      E. Sleiman asked if doses of the vaccine can be mixed, i.e. if you receive the AstraZeneca can you receive the Pfizer as the second dose.  Also, some of his constituents have been asking him about their second dose appointments.  Dr. Ahmed said there has been no recommendations yet around mixing doses.  T. Marentette said that second doses will begin the end of June, and we are working on a system internally to accommodate for this.

      Moved by:    Ed Sleiman
      Seconded by:  Rino Bortolin
      That the information be received.
      CARRIED

  5. Approval of Minutes
    1. Regular Board Meeting:  March 18, 2021

    2. Special Board Meeting:  Board Elections:  April 1, 2021

      Moved by:  Joe Bachetti
      Seconded by:  Larry Snively
      That the minutes be approved.
      CARRIED

  6. Business Arising – None
  7. Consent Agenda
    1. INFORMATION REPORTS - None
    2. RECOMMENDATION REPORTS - None
  8. New Business
    1. CEO Quarterly Report (T. Marentette)

      T. Marentette said that the WECHU is seeing consistent challenges as we continue to operate under a pandemic.  Many of our staff remain redeployed to Case and Contact Management, Vaccine Clinics and Outbreak. 

      Moved by:  Rino Bortolin
      Seconded by:  Larry Snively 
      That the above information be received.
      CARRIED

  9. Other Board of Health Resolutions/Letters

    1. Town of Kingsville – Letter to the Hon. Doug Ford – Resolution – Health and Safety of our Communities 
      G. McNamara said what the Town of Kingsville is looking for around inspections is related to fire and building code safety, and is beyond the scope of the health unit.  

      T. Marentette explained the health unit’s process around migrant housing.  When Temporary Foreign Workers arrive on the farm premises, our WECHU Public Health Inspectors (PHI) inspect the bunkhouses in those congregate settings. Most of them are located in the vicinity of Leamington and Kingsville.  Our PHIs inspect and approve congregate settings based on public health requirements, but they may not pass building and fire regulations.  They have their own guidelines that must be followed.

      About a year ago, we collaborated with the municipalities and agreed to align our inspections if possible, but that does not always happen due to resources and/or scheduling.  If we conduct our inspection prior to fire or building inspections, we provide our report to the municipality.  We did speak to the CAO in Kingsville and were advised at that time that there were no issues.  

      R. Bortolin noted that even from a restaurant perspective they need various inspections, but they generally do not happen at the same time.  G. McNamara agreed that scheduling all inspections at the same time would be a daunting task, especially with seven municipalities in our region.
      Moved by:  Rino Bortolin 
      Seconded by: Ed Sleiman
      That the information be received.
      CARRIED

    2. Town of Essex – Letter to the Hon. Doug Ford, the Hon. Christine Elliott, Dr. Wajid Ahmed, Theresa Marentette – Letter in Support of Small Business
      Moved by:   Rino Bortolin 
      Seconded by:  Tracey Bailey
      That the information be received. 
      CARRIED

  10. Committee of the Whole (CLOSED SESSION, in accordance with Section 239 of the Municipal Act)

    The Board moved into Committee of the Whole at 4:52pm
    The Board moved out of Committee of the Whole at 5:40 pm

  11. Next Meeting: At the Call of the Chair, or May 20, 2021 – Via Video
  12. Adjournment

    Moved by:  Rino Bortolin
    Seconded by:  Ed Sleiman
    That the meeting be adjourned.
    CARRIED

    The meeting adjourned at 5:45 pm.

RECORDING SECRETARY:

SUBMITTED BY:

APPROVED BY:

View Document Page

Board Members Present:

Gary McNamara, Tracey Bailey, Joe Bachetti, Rino Bortolin, Fabio Costante, Gary Kaschak, Ed Sleiman, Larry Snively

Board Member Regrets:

Judy Lund

Administration Present:

Theresa Marentette, Dr. Wajid Ahmed, Lorie Gregg, Nicole Dupuis, Dr. Felicia Lawal, Kristy McBeth, Dan Sibley, Lee Anne Damphouse

QUORUM:  Confirmed

  1. Call to Order
    Board Chair, Gary McNamara, called the meeting to order at 4:03 p.m.
  2. Agenda Approval

    Moved by: Larry Snively
    Seconded by:  Rino Bortolin
    That the agenda be approved.
    CARRIED

  3. Announcement of Conflicts of Interest – None
  4. Update (Dr. Ahmed)
    1. COVID-19 Update

      Dr.  Ahmed noted the increase of COVID-19 cases across the province with approximately 4,700 reported in Ontario today. Windsor-Essex has seen an increase with 93 cases reported today and the Variants of Concern (VOC) pose an even bigger threat.  

      We are still seeing increases amongst school-aged children but it seems to be stabilizing.  We are hoping numbers will decrease over the next few weeks with the provincial mandated school closures. The majority of cases in children are through their family and household contacts and not from attending school. 

      Cases have decreased in the senior population due to the vaccine, with a shift to the younger population in the 0-19 and 20-29 year age groups. Household contacts and community transmission are the significant drivers, with more VOC being reported every day. 

      The province is seeing a sharp increase in hospitalizations and ICU admissions.  We are monitoring our ICU cases, but Windsor-Essex is not seeing the same trend as the province.  With the VOC contributing up to 30-50% of cases, this could lead to more hospitalization.  

      The case fatality rate is 1.9% across the province. Windsor-Essex’s case fatality rate is 2.8%, with the majority of fatalities coming from the community.  Our LTCH/RH fatality rate is lower than the provincial average.  R. Bortolin asked if there is any data showing if the vaccine is effective to the VOCs.  Dr. Ahmed said that PHO is analyzing that data at the provincial level and he can share that when received. 

      Our region has administered 124,578 doses of vaccine, with 112,027 residents receiving at least one dose.  The province has noted various hot spots in our region, some requiring more attention, i.e. the downtown Windsor core and the west area of Windsor where we would like to offer more opportunities to receive the vaccine. 

      J. Bachetti asked about the 80+ group of individuals who cannot leave their homes. What plans are in place to help vaccinate them. Dr. Ahmed said that adults in chronic home care who are registered with the LHIN will be vaccinated.  For others who are not, we are hoping to have primary care providers come onboard to help vaccinate these individuals. T. Marentette said  starting Monday there will be two teams that will assist with vaccinating between 100-300 home bound individuals, starting in hot spots, that are registered with the LHIN.  

      Dr. Ahmed advised that our current allotment of the Pfizer vaccine is 10,500 doses a week until at least mid-May, with 2,000 of Moderna earmarked for other priorities.  We have also received a large shipment of AstraZeneca which will flow through the pharmacy channels.
       
      R. Bortolin asked about individuals outside of Windsor-Essex booking vaccinations in our region, and is there a way to divert that.  Dr. Ahmed said that under the provincial booking system people can book anywhere across Ontario and there is nothing we can do to avoid that. There is also nothing stopping individuals from Windsor-Essex booking elsewhere across the province. 

      E. Sleiman asked if doses of the vaccine can be mixed, i.e. if you receive the AstraZeneca can you receive the Pfizer as the second dose.  Also, some of his constituents have been asking him about their second dose appointments.  Dr. Ahmed said there has been no recommendations yet around mixing doses.  T. Marentette said that second doses will begin the end of June, and we are working on a system internally to accommodate for this.

      Moved by: Ed Sleiman
      Seconded by: Rino Bortolin
      That the information be received.
      CARRIED

  5. Approval of Minutes
    1. Regular Board Meeting:  March 18, 2021

    2. Special Board Meeting:  Board Elections:  April 1, 2021
      Moved by: Judy Lund
      Seconded by: Joe Bachetti
      That the minutes be approved.
      CARRIED

  6. Business Arising - None

  7. Consent Agenda

    1. INFORMATION REPORTS - None
    2. RECOMMENDATION REPORTS - None

     

  8. New Business

    1. CEO Quarterly Report (T. Marentette)
      T. Marentette said that the WECHU is seeing consistent challenges as we continue to operate under a pandemic.  Many of our staff remain redeployed to Case and Contact Management, Vaccine Clinics and Outbreak. 

      Moved by: Rino Bortolin
      Seconded by: Larry Snively
      That the information be received.
      CARRIED

  9. Other Board of Health Resolutions/Letters

    1. Town of Kingsville – Letter to the Hon. Doug Ford – Resolution – Health and Safety of our Communities

      G. McNamara said what the Town of Kingsville is looking for around inspections is related to fire and building code safety, and is beyond the scope of the health unit.  

      T. Marentette explained the health unit’s process around migrant housing.  When Temporary Foreign Workers arrive on the farm premises, our WECHU Public Health Inspectors (PHI) inspect the bunkhouses in those congregate settings. Most of them are located in the vicinity of Leamington and Kingsville.  Our PHIs inspect and approve congregate settings based on public health requirements, but they may not pass building and fire regulations.  They have their own guidelines that must be followed.

      About a year ago, we collaborated with the municipalities and agreed to align our inspections if possible, but that does not always happen due to resources and/or scheduling.  If we conduct our inspection prior to fire or building inspections, we provide our report to the municipality.  We did speak to the CAO in Kingsville and were advised at that time that there were no issues.  

      R. Bortolin noted that even from a restaurant perspective they need various inspections, but they generally do not happen at the same time.  G. McNamara agreed that scheduling all inspections at the same time would be a daunting task, especially with seven municipalities in our region.

      Moved by:  Rino Bortolin 
      Seconded by: Ed Sleiman
      That the information be received.
      CARRIED

    2. Town of Essex – Letter to the Hon. Doug Ford, the Hon. Christine Elliott, Dr. Wajid Ahmed, Theresa Marentette – Letter in Support of Small Business

      Moved by:   Rino Bortolin 
      Seconded by:  Tracey Bailey
      That the information be received. 
      CARRIED

  10. Committee of the Whole (CLOSED SESSION, in accordance with Section 239 of the Municipal Act)

    The Board moved into Committee of the Whole at 4:52 pm
    The Board moved out of Committee of the Whole at 5:40 pm

  11. Next Meeting: At the Call of the Chair, or May 20, 2021 – Via Video 

  12. Adjournment

    Moved by: Rino Bortolin
    Seconded by: Ed Sleiman
    That the meeting be adjourned.
    CARRIED
    The meeting adjourned at 5:45 pm.

RECORDING SECRETARY:

SUBMITTED BY:

APPROVED BY:

View Document Page
  1. Period covered by this report:  January 1, 2021 to March 31, 2021
  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;

Date:   April 15, 2021

Theresa Marentette, CEO

View Document Page

Meeting held virtually.

  1. Call to Order
  2. Agenda Approval
  3. Announcement of Conflict of Interest
  4. Board Elections - Vice Chair
  5. Committee of the Whole (Closed Session in accordance with Section 239 of the Municipal Act)
  6. Next Meeting: At the Call of the Chair April 15, 2021 – Via Video
  7. Adjournment
View Document Page