Board of Health Meeting Documents

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

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

1. Regular Board Meeting:  April 15, 2021
   Moved by:  Joe Bachetti
   Seconded by:  Rino Bortolin
   That the minutes be approved.
   CARRIED

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

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

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

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

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

The meeting adjourned at 5:50 pm.

1. COVID-19 Update

1. Regular Board Meeting:  March 18, 2021   

1. INFORMATION REPORTS
   1. March Communications Recap
2. RECOMMENDTION REPORTS – None

1. CEO Quarterly Report (T. Marentette)

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

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

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

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

Consent Agenda

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

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

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

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

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

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

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

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

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

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

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

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

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

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

The meeting adjourned at 5:45 pm.

1. COVID-19 Update

1. Special Board Budget Meeting: March 4, 2021

1. INFORMATION REPORTS
   1. Ontario Active School Travel Fund Awarded to Windsor- Essex County (N. Dupuis)
   2. Risk Management (T. Marentette/M. Frey)
   3. January/February Communications Recap
2. RECOMMENDTION REPORTS – None

1. Kingston, Frontenac & Lennox and Addington Public Health – Letter to Hon. Doug Ford, Premier of Ontario – Mandatory Sick Leave for Ontario Workers
2. Kingston, Frontenac and Lennox & Addington Public Health – Letter to The Right Hon. Justin Trudeau – Land and Water Border Restrictions
3. Peterborough Public Health – Letter to The Hon. Doug Ford, The Hon. Christine Elliott and The Hon. Monte McNaughton – Paid Sick Leave During an Infectious Disease Emergency
4. Letter from the Municipality of Chatham-Kent Public Health – Letter to The Hon. Doug Ford – Paid Sick Leave during COVID-19 Pandemic and Beyond
5. Letter from Queen's Park, Peggy Sattler, MPP, London West – Private Members Bill – Bill 239 – Stay Home if you are Sick Act – Advocating for paid sick days for Ontario workers to alleviate the spread of COVID-19
6. Windsor-Essex County Health Unit – Letter to The Hon. Doug Ford – Mandatory Paid Sick Leave for Ontario Workers

Moved by:  Rino Bortolin
Seconded by: Ed Sleiman
That the agenda be approved.
CARRIED

1. COVID-19 Update

   G. McNamara introduced Dr. Alexa Caturay, AMOH from Toronto Public Heath, who has stepped in as Acting MOH to cover for Dr. W. Ahmed who is on a two-week leave of absence.  Dr. Caturay provided an update of COVID-19 cases in Windsor-Essex, currently averaging about 34 cases a day.  This is a little higher than the entire Southwest Region, but on average with the provincial average.  As we come out of the second wave, the increase in cases is concerning, and we are seeing an increase of 4% in young adults between the ages of 18-34 years.  The Windsor-Essex region is also trending upward for school-aged children when compared to the average population. 

   T. Marentette said that K. McBeth and L. Gregg have been very instrumental in the vaccine rollout. L. Gregg has been keeping track of the vaccine inventory and updating reports to the Ministry of Health, and K. McBeth has been involved on the operational side with the mass and mobile clinics. 

   Currently, there are two main mass vaccination sites, the WFCU Centre in East Windsor and the 
   Nature Fresh Farms Recreation Centre on Sherk Street in Leamington.  The Libro Centre in Amherstburg will come on board on March 29.  Bookings in the county will be scheduled across both Leamington and Amherstburg, based on supply.  

   We are moving forward with the 80+ group and anticipate that there are 16,000 people in this age category. Those that have pre-registered will be vaccinated by late next week.  We then hope to move to the 75+ age group. The Ministry has launched a provincial vaccine booking system, but we are currently using our own.  We are somewhat ahead of the province, as they are still vaccinating the 80+ group, and if we were on that booking system, we would not be able to move out of that priority.

   Windsor Regional Hospital (WRH) is vaccinating health care workers at the St. Clair College SportsPlex, starting with the Highest Priority, Very High Priority, and then High Priority, as well as adult recipients of chronic home care.  In Phase 2, eligibility will include individuals with highest risk and high risk medical conditions.  WRH is also assisting with the 80+ age group and has opened up a site in downtown Windsor at Windsor Hall.

   Windsor-Essex is also part of the Ministry’s AstraZeneca pharmacy rollout.  Locally, we have 57 pharmacies participating, including large corporate pharmacies as well as independents.  The priority group will be for individuals 60-64 years.

   We are also working with Family Health Teams across the region and the Windsor Essex Community Health Centre.   They were instrumental in assisting with COVID testing early on in the pandemic, and have now been provided with a supply of the vaccine for the 80+ within their practices.  They will also be moving to immunize patients with medical conditions.  We are also working with an Allergy Specialist for those at risk for possible adverse effects or allergic reactions. 

   Mobile teams EWEMS are also assisting with reaching the most vulnerable by immunizing in homeless shelters. WECHU has a small mobile team who continue to vaccinate in LTCH/RHs. As well, we are working with Windsor Essex Community Housing Corporation and EMS to vaccinate the 80+ group in seniors’ buildings. 

   We are using all of our allotment of weekly vaccine.  Our current allocation of the Pfizer vaccine is 14,000 doses per week, decreasing to 10,000 a week in a couple of weeks.  We are also receiving 2,000 to 3,000 doses of Moderna each week.  

   Dr. A. Caturay said we are seeing an uptick of cases in the younger 18-34 age group, and we are watching to see if this trend continues.  One-third of cases usually stem from household contacts, another one-third from the community, and one-third are unknown. 

   R. Bortolin asked what the plan is to address congregate living settings.  T. Marentette said that congregate settings are in Phase 2 of the Ministry’s plan. We are still in Phase 1 but are making good progress toward Phase 2.  Phase 1 includes the seniors over 80, congregate settings of the over 80 population, individuals in LTCH/RHs and the highest priority health care workers.  

   Priority will continue to be age-based in 5 year increments and next would be the at risk populations, i.e. medical conditions and congregate settings.  These will be handled by our health unit nurses, via mobile teams with EMS, but congregate settings are not an automatic eligibility at this time. 

   Our farms and greenhouses will also be a priority at some point, and all of this will be based on vaccine supply.  We are also getting questions around those who are unable to attend a clinic and asking if we would attend private homes with EMS to vaccinate.  At this time, we are not able to safely transport the vaccine in individual doses.    

   L. Snively asked if there were any adverse reactions to the AstraZeneca vaccine here in Canada, since Europe has placed a hold on using it.  T. Marentette advised that there have been no adverse reactions reported. All adverse events following immunization are reported to our health unit and Health Canada. 

   Dr. A. Caturay said the best vaccine to receive is the one that is available to you.  All of the vaccine data is reviewed very closely by Health Canada and they are deemed safe and effective.  Europe also came out with a statement that AstraZeneca is safe to use in all of Europe.

   T. Marentette said there is information on our WECHU website on the vaccines and our managers have done an exceptional job updating it daily as information changes.  We continue to share current and relevant information on YouTube, and through questions from the media.  We are actively promoting and answering any questions around vaccine safety.

   E. Sleiman asked if it is possible to contract COVID-19 between first and second doses of receiving the vaccine.  Dr. A. Caturay said that it is possible, but the likelihood is low as the first dose offers some good protection, i.e. upwards towards 80%. 

   E. Sleiman asked if it would be possible at some point for individuals in the same household to book their appointments at the same time.  T. Marentette said as we roll out the booking schedule we are looking at ways to accommodate couples, but for the 80+ age group it was not possible. 

   G. McNamara noted that we are fortunate to have a team in place that has done phenomenal work putting our region farther ahead along in the process than the rest of the province.

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

1. Regular Board Meeting:  Special Board Budget Meeting: March 4, 2021

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

1. INFORMATION REPORTS
   1. Ontario Active School Travel Fund Awarded to Windsor-Essex County (N. Dupuis)
      Brought to the Board for information.
   2. Risk Management (T. Marentette/M. Frey)

      T. Marentette said that the Risk Management summary is sent to the Ministry of Health along with our budget submission. 

      M. Frey, Manager of Planning and Strategic Initiatives, walked through the Risk Management presentation, explained the Scoring and went through each category. He also discussed some of the impacts the pandemic had on WECHU’s Strategic Plan.

   3.  January/February Communications Recap
      Brought to the Board for information.

       

      Moved by: Tracey Bailey
      Seconded by:  Ed Sleiman
      That the information reports be received.
      CARRIED

2. RECOMMENDATION REPORTS - None

1. Kingston, Frontenac & Lennox and Addington Public Health – Letter to Hon. Doug Ford – Mandatory Sick Leave for Ontario Workers

2. Kingston, Frontenac & Lennox and Addington Public Health – Letter to The Right Hon. Justin Trudeau – Land and Water Border Restrictions 

3. Peterborough Public Health – Letter to Hon. Doug Ford, the Hon. Christine Elliott and the Hon. Monte McNaughton – Paid Sick Leave During an Infectious Disease Emergency

4. Letter from the Municipality of Chatham-Kent Public Health – Letter to the Hon. Doug Ford – Paid Sick Leave during COVID-19 Pandemic and Beyond

5. Letter from Queen’s Park, Peggy Sattler, MPP, London West – Private Members Bill – Bill 239 – Stay Home if you are Sick Act – Advocating for paid sick days for Ontario workers to alleviate the spread of COVID-19

6. Windsor-Essex County Health Unit – Letter to the Hon. Doug Ford – Mandatory Paid Sick Leave for Ontario Workers

Moved by:  Tracey Bailey
Seconded by: Ed Sleiman
That the information be received.
CARRIED

The Board moved into Committee of the Whole at 5:20pm
The Board moved out of Committee of the Whole at 5:40 pm

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

The meeting adjourned at 5:44 pm.

1. COVID-19 Update

1. Regular Board Meeting: December 17, 2020

1. INFORMATION REPORTS
   1. Mosquito Surveillance and Control Program 2020 (K. McBeth)
   2. First Responder Curriculum Project – Mental Health Literacy and Resiliency – Building (N. Dupuis)
   3. December Communications Recap
2. RECOMMENDATION REPORTS

1. Budget Timing (T. Marentette/L. Gregg)
2. CTS Update – Next Steps (T. Marentette)
3. W-E Vaccine Rollout Plan (T. Marentette)

1. Town of Kingsville – Letter to The Hon. Doug Ford, The Hon. Minister Christine Elliott, Medical Officer of Health, Dr. Wajid Ahmed and the Windsor-Essex County Board of Health – Resolution in Support of Small Businesses to remain open
2. Town of Essex – Letter to The Hon. Doug Ford, The Hon. Minister Christine Elliott, Chief Medical Officer of Health, Dr. David Williams, Medical Officer of Health, Dr. Wajid Ahmed, and CEO Theresa Marentette, Windsor-Essex County Health Unit – Resolution requesting that immediate action be taken to deem Small Businesses as Essential Services

BOARD ELECTIONS

Nominations for Chair

G. McNamara relinquished the Chair to T. Marentette, Board Secretary, to begin the election process. T. Marentette opened the floor for nominations for the position of Chair noting that Administration had received four (4) written nominations for Gary McNamara.  T. Marentette asked for further nominations from the floor (three times). Given that there were no further nominations, nominations for the position of Chair were closed. G. McNamara, having accepted the nomination, was appointed Chair by acclamation.

Nominations for Vice-Chair

The Chair opened the floor for nominations for the position of Vice-Chair noting that Administration had received four (4) written nominations for John Scott.  The Chair asked for further nominations from the floor (three times). Given that there were no further nominations, nominations for the position of Vice-Chair were closed. John Scott, having accepted the nomination, was elected Vice-Chair by acclamation. 

Nominations for Treasurer

The Chair opened the floor for nominations for the position of Treasurer noting that Administration had received four (4) written nominations for Tracey Bailey.  The Chair asked for nominations from the floor (three times). Given that there were no further nominations, nominations for the position of Treasurer were closed. Tracey Bailey, having accepted the nomination, was appointed Treasurer by acclamation.

Moved by:  Rino Bortolin
Seconded by: Ed Sleiman
That the agenda be approved.
CARRIED

1. COVID-19 Update

   Dr. Ahmed provided a presentation, and an update of positive COVID-19 cases in our community.  Dr. Ahmed noted that the WECHU has established a Vaccine Task Force to oversee parts of the rollout strategy and a Prioritization Committee for our community plan.

   With the current restrictions, lockdowns and the Stay at Home Order, we are seeing a slight downward trend resulting from these measures, and hope that people will take this as a sign to continue to follow public health measures. Our Percent Positivity Rate (PPR) was the highest in the province with a slight decline at 8.4% for our region.  We are still averaging about 10,000 tests per week in our community.  Cases broken down by municipality show the highest number of cases reported in Windsor, followed by Leamington, between the ages of 20 years to 60 years.  Case rates in the 0-19 ages range have decreased, due to school closures.

   The majority of residents in Long term Care Homes have received their first dose of the Moderna vaccine and we are hoping to start first rounds of the vaccine in Retirement Homes today. These settings have experienced the highest burden of outbreaks, and there are currently 19 homes in outbreak.

   We are expecting to receive another shipment of the Moderna vaccine on February 1, 2021. Without this shipment, we would not have a sufficient amount to administer all of the required second doses.  We have withheld some vials to ensure we can provide some of the second doses while awaiting the shipment. Our focus currently is on residents, staff and essential caregivers in LTCH/RHs. The hospital has been allocated the Pfizer vaccine and their shipment dates have also been impacted.

   R. Bortolin asked when the next shipment can be expected and what is Windsor-Essex’s allotment of the vaccine. Would this allotment cover remaining second doses and would it be enough for the next round of vaccinations. 

   T. Marentette said that due to security agreements this is some of the information that the health unit was asked not to disclose.  We should be able to complete all second doses for individuals that received their first dose, and there should be enough supply to complete both first and second doses in LTCH/RHs. For homes in outbreak residents and staff will need to be immunized once their outbreak has been rescinded.  We need to work together to protect this group, and will likely continue addressing LTCH/RHs into mid or late February 2021. 

   J. Lund inquired as to why our region has higher rates of the positive cases than other areas of the province, i.e. are individuals continuing to go to work while they have symptoms.  Dr. Ahmed noted we have been looking at the data. Once we pass a significant threshold of community spread, it can get out of control. There could be a number of reasons for the numbers, i.e. do individuals follow public health guidelines, do they have access to PPE, do they stay at home and isolate when required and do they have benefits through their workplace to accommodate this.  During case and contact management investigation, our team continues to provide education around mitigating the spread. 

   Dr. Ahmed said that there is a definite need for support from the Federal and Provincial government, and without it, it creates challenges for many. 

   E. Sleiman noted that the City is getting inquiries from individuals with disabilities dependent on PSWs for assistance, and are asking if they are in Phase 1 to receive the vaccine, but direction on prioritization is coming from the province. 

   G. McNamara asked where PSW’s who are not tied to LTCH/RHs would be in the queue, as many individuals in the community are depending on them for support. 

   Dr. Ahmed said this is a bigger discussion we are having with the province as well as our colleagues.  Adults receiving chronic home care will come after individuals in high risk settings.  The most significant predictor for people impacted by COVID-19 is their age.  If the vaccine were prioritized by age that would be the simplest solution, but we are going through this with a limited vaccine supply and recommendations by province.  Dr. Ahmed would like to prioritize immunizations by age, and believes this is the only way to protect individuals suffering the most severe complications.   There are no simple answers and we are speaking with the province to help the most vulnerable in the community.

   G. Kaschak asked if there were any concerns around the agri-sector and that he receives questions around housing/living conditions.  T. Marentette said there are currently cases among 11 farms and there are workers in isolation. There are 57 active cases in the agri-sector that we continue to follow, and numbers increase.  One case can spread to an entire bunkhouse.  F. Lawal is working directly with the farms and our public health inspectors are working with the Ministry of Labour when cases are identified. Dr. Ahmed said when a farms is ready for temporary foreign workers to come in and work, the farmers comply with public health regulations. Our public health inspectors do the inspection from a public health perspective, but the overall housing strategy is not something that the health unit can answer too.  G. Kaschak said he wants a better update at the next Board meeting. 

   J. Lund said individuals can be eligible for government support, but only if they have completed their income tax returns. The Canada Revenue Agency has a list of local agencies that can assist people in completing their tax returns to see if they are eligible for programs or grants. 

   Moved by:    Rino Bortolin
   Seconded by:  Judy Lund
   That the information be received.
   CARRIED

1. Regular Board Meeting: December 17, 2020

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

1. INFORMATION REPORTS
   1. Mosquito Surveillance and Control Program 2020 (K. McBeth)
      Brought to the Board for information.
   2. First Responder Curriculum Project – Mental Health Literacy and Resiliency – Building (N. Dupuis)
      Brought to the Board for information.
   3. December Communications Recap (L. Gregg)
      Brought to the Board for information.

      Moved by:  Joe Bachetti
      Seconded by:  John Scott
      That the information reports be received.
      CARRIED

2. RECOMMENDATION REPORTS - None

1. Budget Timing (T. Marentette/L. Gregg)
   T. Marentette said the WECHU typically brings its annual budget to the Board for approval in October.  As we continue to focus on the pandemic and work to meet the needs of the Ministry and the community, we are asking that a Special Board Budget meeting be scheduled to present the Budget.  The Budget is due to the Ministry on March 1, 2021

2. CTS Update – Next Steps (T. Marentette)

   N. Dupuis said as we continue to update the Board, we anticipated we would be further along in the process at the end of 2020.  We have assigned a Coordinator to use the criteria for site selection to start looking at listings in priority areas.  We are hoping to start this process in the next week or so and are reaching out to landlords and leaseholders and will lead the search for a potential property.

   R. Bortolin asked if WECHU is successful in finding a location and a conditional lease could be agreed upon, how long would you anticipate it would be before public consultation would begin. N. Dupuis said once a possible site is narrowed down we will revisit what public consultation would look like during COVID, and it will likely take a couple of months for us to get to the point of consultation. T. Marentette said that it’s hard to predict timelines due to the pandemic.  R. Bortolin noted that it could realistically take another year when looking at all the steps involved.

3.  

   W-E Vaccine Rollout Plan (T. Marentette)
   T. Marentette said that the WECHU submitted its Vaccine Rollout Plan to the Ministry, which was due on January 20, 2021.

   We have been administering our allotment of vaccine in our community to LTCH/RHs and would like to acknowledge our staff in support of these homes.  It was quite an accomplishment and Windsor-Essex was one of the pilot sites.  The impact of the pandemic to LTCH/RHs in our region has been devastating and we are glad to be moving forward with immunizations for this vulnerable group.  

   Healthcare providers, physicians, nurse practitioners, walk-in clinics, family health teams have been administering the flu vaccine with over 104,000 doses this flu season, and pharmacies with 53,000 doses.  As the supply of COVID vaccine is received in our region we are anticipate that these healthcare providers will be actively involved in the roll out plan.  Other priorities in our plan include vaccine deliver models for the agri-sector, congregate settings, prioritized neighbourhoods and other groups considered at risk.  Mass immunization clinics will also be needed when there is a steady and reliable supply of vaccine. 

   With our strategy comes some challenges, one being the distribution of the vaccine. Once received, primary care providers and pharmacies need to maintain the cold chain to sustain effectiveness and to ensure every dose is used to mitigate vaccine wastage.  The other challenge is the Ministry’s reporting system, COVax, and we are working with the province as a pilot site to note issues and efficiencies.

   Other priorities we will focus on are adults in First Nations communities, Chronic Home Care, Low German Communities, Homeless individuals, Newcomers and workers in the Agri-Sector.  Next steps will include working with our partners to further develop our plans.  R. Bortolin asked how the priority would work, will individuals be put on the list and how will this be communicated. 

   T. Marentette said that this is a misconception, there is no list.   We would like to utilize our primary care provider network and stakeholders.  Physicians and pharmacies have their own lists of patients and they can prioritize by age through their existing networks to get these individuals vaccinated.  We are looking at mass immunizations sites once we receive more vaccine supply.  There is a lot of work that still needs to be done to ensure that all priority groups get included. Our efforts have focused on the vaccination or residents, staff and essential caregivers in LTCH/RHs. We are also working on a broader communication strategy regarding the vaccine rollout in WEC.

   T. Marentette noted that we have had meetings with the local municipal CAO’s around identifying possible mass immunization site locations in the county.  Leamington has been identified as one of the municipalities and Windsor will also require a mass clinic site.  More details will come, and this is all dependent on vaccine supply, but we will ensure that the process is in place and we are ready should supplies be shipped earlier than expected.  We were expecting to receive approximately 10,000 doses in February, but with delays in shipments, this is not going to happen.  We were also planning on allocations of the vaccine to double each month until June, and are still hoping for that.  

   In terms of inventory and supplies for immunizations, some supply is on hand and other various ancillary supplies will be ordered from the Ministry. 

   R. Bortolin said that this is a huge undertaking and understands how complicated this is.  The WECHU team has been working non-stop since March 2020, some with no days off.  The entire team merits a huge thank you.  This is an emotional issue as the vaccine is seen as “the end” of a difficult time, and the WECHU team has already proven they are ahead of the curve.

   Moved by:   Tracey Bailey
   Seconded by:  Ed Sleiman
   That the information be received. 
   CARRIED

1. Town of Kingsville – Letter to The Hon. Doug Ford, The Hon. Minister Christine Elliott, Medical         Officer of Health, Dr. Wajid Ahmed and the Windsor-Essex County Board of Health – Resolution in Support of Small Businesses to remain open
2. Town of Essex – Letter to The Hon. Doug Ford, The Hon. Minister Christine Elliott, Chief Medical Officer of Health, Dr. David Williams, Medical Officer of Health, Dr. Wajid Ahmed, and CEO Theresa Marentette, Windsor-Essex County Health Unit – Resolution requesting that immediate action be taken to deem Small Business as Essential Services

Moved by:  Tracey Bailey
Seconded by: Gary Kaschak
That the information be received.
CARRIED

The Board moved into Committee of the Whole at 5:34 pm
The Board moved out of Committee of the Whole at 5:50 pm

Moved by:  Rino Bortolin
Seconded by:  Joe Bachetti
That the meeting be adjourned.
CARRIED

The meeting adjourned at 5:52 pm.

1. COVID-19 Update

1. Regular Board Meeting: November 19, 2020

1. INFORMATION REPORTS
   1. Healthy Families Department and Healthy Babies, Healthy Children Program Updates (N. Dupuis)
   2. Oral Health Program Update (N. Dupuis)
   3. Influenza Vaccine Update (K. McBeth)
   4. Q2 Financial Report (L. Gregg)
   5. November Communications Recap
2. RECOMMENDTION REPORTS
   1. Bill 216 – An Act to amend the Education Act – Food Literacy (N. Dupuis)

1. Long-term Service Awards (T. Marentette)
2. Records Management (L. Gregg)

1. WECHU Letter to The Honourable Justin Trudeau – Federal Government Supervision of Self-Isolation Period for Arriving Migrant Workers
2. Grey-Bruce Public Health Unit – Letter from Board Chair Mitch Twolan – Public Health Regionalization
3. Timiskaming Health Unit – Letter to The Honourable Stephen Lecce, The Honourable Christine Elliott, The Honourable Ernie Hardeman – Bill 216 Food Literacy for Students Act 2020