June 25

Current COVID-19 Situation in Ottawa

Many of our COVID-19 monitoring indicators continue to show a positive trend. Outbreaks and hospitalizations continue to decline, as do the number of people testing positive for COVID-19. Most notably, our weekly COVID-19 rates have gone from 208.5 cases per 100,000 people per week at their peak in mid-April to the current rate of 10.7 per 100,000 people per week. However, we are also seeing testing numbers go down and the COVID-19 wastewater viral signal has been fluctuating. Further, the level of transmission in the community now is much higher than what it was last summer and we are now contending with the more transmissible COVID variants, compared with the original virus last year. We will need to reach higher levels of immunization with two doses before we can rely on vaccines alone to keep COVID-19 at a low, manageable level that does not lead to significant hospitalizations, and this will not happen until closer to the end of the summer. Therefore, we continue to recommend that everyone continue to maintain a distance from those outside their household and wear a mask when they cannot maintain distance, regardless of their vaccination status. We also recommend choosing lower-risk activities – stick with outdoors as much as possible and avoid crowded places. Case and contact management and managing outbreaks  Though we have seen a decrease in outbreak numbers in Ottawa, we continue to see outbreaks in institutional settings and workplaces and we continue work aimed at preventing outbreaks by promoting appropriate infection prevention and control practices. The Ontario Ministry of Health defines a workplace outbreak as “two or more lab-confirmed COVID-19 cases with an epidemiological link in the workplace (for example, same work area, same shift) within a 14-day period where both cases could have reasonably acquired their infection in the workplace”. This means that one person testing positive for COVID-19, or even multiple people testing positive, would not necessarily meet the definition of an “outbreak”. As part of its COVID-19 case and contact management process, OPH communicates with every resident who receives a positive COVID-19 test to identify locations they may have visited while contagious, obtain a list of close contacts, and provide information on measures needed to prevent any further spread of infection. The next step is to notify anyone who is deemed to be a high-risk close contact of someone who has tested positive to provide them with information based on their individual level of risk. OPH investigates all reports of COVID-19 illnesses in workplaces and works directly with the individuals who have tested positive, as well as with the workplace itself, to determine risk of transmission and risk to employee/public health and safety. OPH’s COVID-19 Daily Dashboard contains all publicly available information about the COVID-19 situation locally, including a detailed list of outbreaks. Workplace outbreaks are noted at the bottom of the dashboard under “Community outbreaks” and broken down by type of workplace or setting. Anonymous outbreak-specific data are available regarding workplaces through Open Ottawa. OPH publicly discloses the name of a workplace if there is a known exposure risk to the public and a lack of contact information. In these rare instances, OPH may rely on public advisories and the media to reach the wider public. OPH only orders a premise closed based on public health risk assessment when required to further investigate or address an ongoing risk to people. This is consistent with the practice of other public health units across Ontario. Protecting the privacy of individuals who have tested positive for COVID-19 remains a top priority. It is also important for OPH to maintain positive and trusting relationships with businesses and workplaces as we rely heavily on their cooperation and the general public to provide details about close contacts during the case management process. Racism as a Public Health Issue The World Health Organization had identified “Social inclusion and non-discrimination” as a global social determinant of health and Health Canada has classified race/racism as a determinant of health, noting that “Experiences of discrimination, racism and historical trauma are important social determinants of health for certain groups such as Indigenous Peoples, LGBTQ and Black Canadians.” We know that racism, discrimination, and stigma are associated with poor physical, mental and emotional health and higher mortality rates. We also know that COVID-19 has had a disproportionate impact on racialized communities in Ottawa. In particular, the impact was most severe on communities affected by the intersections of race, immigration, and low-income living. OPH is committed to engaging and working with residents, partners, and communities to develop the conditions to support health and health equity for everyone in Ottawa. Part OPH’s role is to raise awareness about racism and the impact it can have on people’s health and wellbeing, to build buy-in for countermeasures. Racism is a difficult subject to discuss in some formats, like social media, and together we continue to learn about how to speak to racism as a public health issue. The lessons learned about how to discuss racism and health are key to advancing the work with community members as well as with health, social services, education, business and other partners needed to close the gap in health status for racialized populations. Mental Health and Substance Use Based on the latest available data, confirmed opioid overdose-related deaths in Ottawa have approximately doubled, from 65 in 2019 to 123 in 2020 while suspected drug-related overdose deaths have increased by 75%, from 124 in 2019 to 218 in 2020. Opioid-related hospitalizations also increased throughout 2020 and remain at levels alarmingly higher than what we were seeing prior to 2020. OPH has seen that supervised consumption service clients’ needs and challenges have grown, such that more comprehensive approaches are needed to better support complex mental health, substance use and housing and social services needs. Last week, OPH launched a new Ottawa Community Action Plan website, together with the group’s core sponsors: The Community Addictions Peer Support Association, The Royal, The Canadian Centre on Substance Use and Addiction, and The Canadian Public Health Association, to continue to call people to work together to address opioid overdoses and highlight the foundation established for ongoing work. This new page can be accessed at OttawaPublicHealth.ca/OCAP. The website demonstrates how the Ottawa community has been involved and working together to provide varying perspectives and expertise to drive action on:

• addressing stigma related to substance use that still widely exists;
• leading the way in providing access to harm reduction services; and,
• creating a more centralized and simplified way to access substance use and mental health services in Ottawa.

Actions have been implemented in these three areas over the last year, including significant progress on access to mental health and substance use supports for adults through AccessMHA.ca and, for children, youth and families, through the 1 call 1 click portal, recently launched by Kids Come First (see attached toolkit for more information). These new regionally coordinated access points are major milestones, however expanded services are also needed to meet the demand. Community conversations continue to inform new actions under each of the OCAP’s three areas of focus. While decriminalization of people with simple possession of substances was not the top priority surfaced for harm reduction work identified as part of the OCAP, there is a growing understanding that decriminalization may also contribute importantly to addressing the stigma related to substance use as stigma prevents people from accessing the supports that they need. Harm reduction partners have planned a forum to flesh out recommendations specific to Ottawa on this subject at the end of the summer. The pandemic has increased the demand and need for mental health and substance use programs, resources, supports and services more broadly beyond addressing opioid use disorders. Therefore, despite staffing and resource challenges related to the pandemic response, throughout the pandemic OPH has continued to work with school boards, hospitals, community health, workplaces, multicultural and racialized community partners, and the general community in the delivery of mental health and substance use programs and services. OPH recognizes that mental health and substance use needs will remain a high priority post-pandemic. To further inform new actions, OPH team members are engaging with partners and the community over the summer to lead to recommendations in a September report to the Board of Health. New Initiatives 1Call1Click.ca is a new bilingual service designed to match kids, youth and families living in Eastern Ontario with the right mental health and addiction services, at the right time.  Bringing together over two dozen local providers of child and youth mental health and addiction services, this exciting program is the first of its kind in Ontario. www.1call1click.ca Mental health and substance use are important issues that are impacting young people more than ever before.  Ottawa Public Health partnered with YouthNet, the Kids Come First Health Team and The Ottawa Child and Youth Initiative to launch the Your Minute in a Pandemic Video Campaign! We asked local youth groups to share their messages of hope, resilience and coping strategies during the #COVID19 pandemic. This campaign is all about making a difference by sharing stories of hope during this difficult time and ensuring that young people are at the forefront of this conversation. Take a minute and check out what they had to say!

https://www.facebook.com/ottawahealth/videos/506607820392440/

Please consider sharing both these messages on your social media channels. Social Media Updates Additionally, there have been some updates on our website that you may find helpful with your constituents. As we continue to strive toward Community Immunity, we have added a new handout on mRNA (Pfizer and Moderna) vaccines: mRNA Vaccine Handout (pdf – 419 KB). The link is also on our Community Immunity webpage, along with another handout made last week about How to book a COVID-19 vaccine appointment for someone else (pdf – 730 KB) Finally, Parenting in Ottawa has a new Instagram @parentsottawa Looking Ahead Earlier this month, the Province announced that schools would remain closed for in-person learning for the remainder of the school year and we know that, for many children, youth and parents, this was difficult news. We are optimistic that after a summer of carefully easing restrictions and continued progress in our vaccine rollout, students, education workers, parents and caregivers can look forward to a successful return to school in the fall. To that end, Ottawa Public Health nurses have been and continue to work closely with our local schools and school boards, as well as with community partners, to support the mental health of children, youth, and education workers in various ways. We are committed to doing all we can to ensure that children, youth, parents and caregivers have the support of in-person school in the fall. The team is carrying out an assessment of the 2020-2021 school year and identifying ways to ensure that students, parents and education workers will have the information and resources they need to make the upcoming school year as healthy as possible. Their plans include: COVID-19 processes and protocols for cases and contacts; screening, and testing supports; linkages and supports for mental health and substance use; and re-introducing the availability of some essential Ontario Public Health Standards – School Health supports and services, such as school immunization, healthy sexuality, dental health, mental health and resiliency, tobacco, vaping, and substance use programming. OPH is also planning and working closely with the Kids Come First Ontario Health Team, as CHEO and other partners have advocated and collaborated for the health of children and youth throughout the pandemic. We want to thank them for their ongoing commitment and support. Recovery As the pandemic response and COVID-19 vaccine coverage rates continue to advance in Ottawa, OPH is looking ahead to the future and has initiated recovery planning for the organization, which will be informed by employees, partners and yourselves. OPH’s Recovery Planning has one overarching goal: to build a stronger, sustainable local public health system that collaborates across health and social sectors. It includes three key components:

• Rejuvenate: Support employee wellness
• Restore:  Restore prioritized services and programs while supporting the community recover from the pandemic; and
• Reimagine: Identify opportunities to advance and strengthen OPH’s programs, services and processes for the future.

While there are still many unknowns, we do know that the way in which Ottawa Public Health meets its mandate moving forward will look different post-pandemic. OPH will build on the relationships formed, lessons learned from the pandemic, and identify new opportunities for the future – with a focus on health equity, particularly the health of Indigenous, Black, racialized, newcomer and low-income populations, collaboration, innovation and developing sustainable health and social systems. Over the summer, our continued focus will be on COVID-19 immunization, case and contact management, as well as outbreak management – to continue our work to reduce the transmission of COVID-19 in our community to enable more people to be back at work and accessing the supports they need. We will also be working with our partners – planning for the Fall – in which many will be returning to in-person work and school. In the Fall, we will shift more focus towards restoring limited programs, including mental health, substance use, dental, healthy growth and development, and immunization work – all of which will support our community’s recovery from the pandemic, support students’ return to school, reduce further harms in our community and address waitlists for our services. Before the end of the year, we will be able to engage more of OPH in looking at lessons of the past and issues of the future as a catalyst for reimagining what we will be doing and how we will be working in 2022 and beyond.