Minutes - January 20, 2022 - Board of Health Meeting

Members Present: 

Ms. Maureen Cassidy (Outgoing Chair)
Ms. Aina DeViet (Outgoing Vice-Chair)
Mr. Matt Reid (Incoming Chair)
Ms. Kelly Elliott (Incoming Vice-Chair)
Mr. John Brennan
Ms. Tino Kasi
Mr. Mike Steele
Mr. Selomon Menghsha
Ms. Mariam Hamou

Others Present:

Ms. Carolynne Gabriel, Executive Assistant to the Board of Health and Communications Coordinator (Recorder)
Dr. Alexander Summers, Acting Medical Officer of Health
Ms. Emily Williams, Chief Executive Officer/Director, Healthy Organization
Ms. Stephanie Egelton, Senior Executive Assistant to the Medical Officer of Health/Associate Medical Officer of Health
Mr. Dan Flaherty, Communications Manager
Ms. Heather Lokko, Director, Healthy Start/Chief Nursing Officer
Ms. Mary Lou Albanese, Director, Environmental Health and Infectious Disease
Ms. Maureen MacCormick, Director, Healthy Living
Mr. Parthiv Panchal, Information Technology, End User Support Analyst

Chair Maureen Cassidy called the meeting to order at 7:03 p.m.

Chair Cassidy welcomed everyone to the inaugural meeting of the Board of Health and opened the meeting by acknowledging the Indigenous Peoples of this land and the First Nations within Middlesex and London.

Chair Cassidy introduced Mr. Bill Hill, Indigenous Healing Lead at the Indigenous Healing Space at London Health Sciences Centre, to provide a teaching. Due to technical difficulties, Mr. Hill was unable to join the meeting and his presentation was deferred until he was able to join.

Meeting Procedures

Board of Health By-Law No. 3 (Procedural By-Law) and Policy G-270 Amendment (Report No. 01-22)

Chair Cassidy introduced this report. Ms. Emily Williams, CEO outlined the main changes in By-Law No. 3 (Procedural By-Law) and to Policy G-270 and its Appendix C.

It was moved by Mr. Mike Steele, seconded by Mr. Matt Reid that the by-law be now read for the first time.
Carried

It was moved by Mr. John Brennan, seconded by Ms. Kelly Elliott that the by-law be now read for a second time.
Carried

It was moved by Mr. Reid, seconded by Mr. Steele that the by-law be now read for a third time and adopted.
Carried

It was moved by Ms. Elliott, seconded by Mr. Reid to amend Governance Policy G-270, including its Appendix C to note the division of the Secretary and Treasurer roles.
Carried

Election of 2022 Board of Health Executive and Other Procedures (Report No. 02-22)

Ms. Williams introduced this report. In order to appoint committee members, the Board must approve the updated Terms of Reference (TOR) to separate the Secretary and Treasurer roles. As well, it was recommended that the Governance Committee meet 5 times per year, an increase from 3 times per year previously.

It was moved by Ms. Elliott, seconded by Mr. Reid to approve the Terms of Reference for the Finance and Facilities Committee.
Carried

It was moved by Mr. Brennan, seconded by Mr. Steele to approve the Terms of Reference for the Governance Committee.
Carried

Chair Cassidy opened the floor to nominations for the position of Chair of the Board of Health for 2022.

It was moved by Ms. Elliott, seconded by Mr. Brennan, that Mr. Reid be nominated for Chair of the Board of Health for 2022.
Carried

Mr. Reid accepted the nomination.

Chair Cassidy invited further nominations. Hearing none, it was moved by Ms. Elliott, seconded by Mr. Brennan, that Mr. Reid be acclaimed as Chair of the Board of Health for 2022.
Carried

Mr. Reid took over as Chair.

Chair Reid opened the floor to nominations for the position of Vice-Chair of the Board of Health for 2022.

It was moved by Ms. Aina DeViet, seconded by Mr. Brennan, that Ms. Elliott be nominated for Vice-Chair of the Board of Health for 2022.
Carried

Ms. Elliott accepted the nomination.

Chair Reid invited further nominations.

It was moved by Ms. Cassidy, seconded by Mr. Steele, that Ms. Tino Kasi be nominated for Vice-Chair of the Board of Health for 2022.
Carried

Ms. Kasi accepted the nomination.

Chair Reid invited the Board of Health members to submit their vote for Vice-Chair of the Board of Health for 2022 through electronic message to Ms. Carolynne Gabriel, Executive Assistant to the Board of Health.

Ms. Gabriel informed Chair Reid that Ms. Elliott received the majority of votes.

At this time, Mr. Hill was able to join the meeting. Chair Reid introduced Mr. Hill who provided a teaching.

It was moved by Ms. Mariam Hamou, seconded by Ms. Cassidy, that
1) Nominations for the position of Vice-Chair be closed; and
2) Ms. Elliott be elected by majority as Vice-Chair of the Board of Health for 2022.
Carried

Chair Reid opened the floor to nominations for the position of Secretary of the Board of Health for 2022.

It was moved by Ms. Cassidy, seconded by Mr. Steele, that Ms. Emily Williams be nominated for Secretary of the Board of Health for 2022.
Carried

Ms. Williams accepted the nomination.

Chair Reid invited further nominations. Hearing none, it was moved by Mr. Steele, seconded by Mr. Brennan that
1) Nominations for the position of Secretary be closed; and
2) Ms. Williams be elected as Secretary of the Board of Health for 2022.
Carried

Chair Reid opened the floor to nominations for the position of Treasurer of the Board of Health for 2022.

It was moved by Ms. Maureen, seconded by Ms. Hamou, that Ms. Williams be nominated for Treasurer of the Board of Health for 2022.
Carried

Ms. Williams accepted the nomination.

Chair Reid invited further nominations. Hearing none, it was moved by Ms. Kasi, seconded by Ms. Cassidy, that
1) Nominations for the position of Treasurer be closed; and
2) Ms. Williams be elected as Treasurer of the Board of Health for 2022.
Carried

Establishment of 2022 Standing Committees

Chair Reid reviewed the terms of reference for the Finance & Facilities Committee. It was remarked that the Chair and Vice-Chair of the Board of Health sit on the Finance & Facilities Committee automatically. This fulfils the requirements for a City Representative and a County Representative.

Chair Reid invited interest for members of the Finance & Facilities Committee for 2022.

Mr. Steele, Mr. Selomon Menghsha, and Ms. Cassidy declared interest in being on the committee.

Chair Reid invited further interested members to be on the committee. Hearing none, it was moved by Mr. Brennan, seconded by Ms. Hamou, that Mr. Steele, Mr. Menghsha, and Ms Cassidy be appointed to the Finance & Facilities Committee for 2022.
Carried

Thus, the membership of Finance & Facilities Committee for 2022 consists as follows:
1) Matt Reid (Chair)
2) Kelly Elliot (Vice-Chair)
3) Selomon Menghsha (Provincial Appointee)
4) Mike Steele (Provincial Appointee)
5) Maureen Cassidy (City Appointee)

Chair Reid reviewed the terms of reference for the Governance Committee. It was remarked that the Chair and Vice-Chair of the Board of Health sit on the Governance Committee automatically. This fulfils the requirements for a City Representative and a County Representative.

Chair Reid invited interest for members of the Governance Committee for 2022.

Ms. DeViet, Ms. Kasi, and Mr. Steele declared interest in being on the committee.

Chair Reid invited further interested members to be on the committee. Hearing none, it was moved by Mr. Brennan, seconded by Ms. Cassidy, that Ms. DeViet, Ms. Kasi, and Mr. Steele be appointed to the Governance Committee for 2022.
Carried

Thus, the membership of the Governance Committee for 2022 consists as follows:
1) Matt Reid (Chair)
2) Kelly Elliot (Vice-Chair)
3) Aina DeViet (County Representative)
4) Tino Kasi (Provincial Representative)
5) Mike Steele (Provincial Representative)

Disclosure of Conflict of Interest

Chair Reid inquired if there were any disclosures of conflicts of interest. None were declared.

Approval of Agenda

It was moved by Ms. Cassidy, seconded by Mr. Menghsha, that the AGENDA for the January 20, 2022 Board of Health meeting be approved.
Carried

Minutes

It was moved by Ms. Cassidy, seconded by Ms. Elliott, that the MINUTES of the December 9, 2021 Board of Health meeting be approved.
Carried

It was moved by Ms. Hamou, seconded by Mr. Brennan, that the MINUTES of the December 7, 2021 Finance & Facilities Committee meeting be received.
Carried

Reports and Agenda Items

Update on COVID-19 Recovery Recommendations and Planning for 2022: Organizational and Individual Wellness and Sustaining Positive Change (Report No. 03-22)

Ms. Emily Williams, Chief Executive Officer/Director, Healthy Organization introduced Dr. Alexander Summers, Acting Medical Officer of Health to lead this report. Dr. Summers commented that this report was written in collaboration with Ms. Heather Lokko, Director, Healthy Start/Chief Nursing Officer with consultation and input from the entire Senior Leadership Team (SLT).

Dr. Summers noted that the Middlesex-London Health Unit has been responding to the pandemic for almost two years which has created an intense amount of work, both at home and at work, for staff. This has resulted in an intense amount of pressure, resulting in profound fatigue. The SLT, moving into 2022, has two key priorities: to finish the job on this pandemic and to support and heal the staff. This report articulates the beginnings of that process which has been front of mind throughout this pandemic. The recovery work initiated over a year ago informed much of the work in this report. Great progress has been made in some areas and SLT will continue to return to the Board of Health to highlight the work that needs to occur to acknowledge, heal, and sustain the workforce as the Health Unit transitions from the pandemic to doing the work which has been paused. Dr. Summers then introduced Ms. Lokko who outlined the report. Discussion about the report included:

• Ms. Lokko noted that in June 2020 a report was brought to the Board of Health which outlined five objectives SLT wanted to achieve through the recovery planning. Another report in November 2020 outlined recommendations relating to priority and emerging public health issues and a further report in May 2021 articulated 54 recommendations for two of the objectives, which are addressed in this report: individual and organizational wellness and organizational changes, structural or processes, which were implemented during the pandemic that have been positive changes. Of the 54 recommendations, some have been moved forward fully, some partially, and some not at all. Overall, progress has been steady and positive.
• To support employee wellness, SLT has identified using the Institute for Healthcare Improvement’s Framework for Improving Joy in Work. The Framework was introduced to the Management Leadership Team (MLT), using an external consultant to explore how to apply the Framework and what impediments exist to finding joy in work. SLT will use this framework to carry forward the recommendations and to identify additional actions and increase intention for overall workplace wellness. SLT is focused on meaningful action and regular monitoring of progress and recognizes that implementation of the Framework will require commitment across the entire organization.
• No formal evaluation process has been established to look at all of the recommendations, although some of the recommendations are very easy to evaluate. One advantage of the Framework for Improving Joy in Work is that it has existing assessment tools to help with monitoring. Through implementing those tools, there will be opportunities to enhance evaluations as the work progresses. SLT conducted an employee survey as part of the process for establishing the recommendations and will continue to look for opportunities to incorporate employee feedback.
• MLHU is not alone in the pressures it is experiencing; other health units, health services, and probably many other organizations are experiencing them. Resiliency in the public health workforce has been the discussion of many meetings, journal articles, and blogs, and there are concerns about the stability of the public health workforce after the pandemic due to an exodus. These discussions are also not unique to the COVID-19 pandemic and also occurred following SARS, H1N1, and 2019 discussions around budgets and provincial priorities.

It was moved by Ms. Cassidy, seconded by Mr. Steele, that the Board of Health receive Report No. 03-22 re: “Update on COVID-19 Recovery Recommendations and Planning for 2022: Individual and Organizational Wellness, and Sustaining Positive Changes” for information.
Carried

Verbal COVID-19 Disease Spread and Vaccine Campaign Update

Dr. Summers provided an update about the current state of COVID-19 in the community and the COVID-19 vaccine campaign and shared PowerPoint slides. This discussion included the following:

• The incidence of COVID-19 is decreasing nationally, but this must be interpreted within the context of changing and more restrictive testing eligibility criteria.
• The percent positivity of COVID-19 tests has decreased from 27.5% between January 4 and January 10 to 22.3% currently, nationally.
• The rates of hospitalization, ICU occupancy, and deaths continued to increase in the past seven days; these are lagging indicators.
• Severe outcomes from COVID-19 are highest in the elderly with increased mortality in individuals aged 80 and above.
• Rates of COVID-19 cases in those who are vaccinated and those who are unvaccinated are similar, which is not surprising since the second dose does not provide strong protection against symptoms. The booster dose does help; however, insufficient numbers of people had been eligible for a booster dose before the Omicron wave started.
• Hospitalization rates do differ between individuals who are vaccinated and those who are unvaccinated. The rate of hospital admission is higher among those who are unvaccinated. Proportionally, those who are unvaccinated are higher in number.
• The percent positivity is plateauing locally. Similarly, local waste water data is declining, which is a lagging indicator.
• Local case counts are trending downwards. Absolute case counts need to be interpreted with caution due to the change in testing guidance; however, with the new testing guidance in place for approximately a month, a trend can be detected and the trend is going down. Absolute case counts are still higher than at any other time during the pandemic.
• Locally, a higher number of deaths have been reported in recent weeks. The proportion of deaths would have been dramatically higher without the vaccine.
• Locally there is a decreasing number of outbreaks in highest risk settings. More outbreaks are being resolved than are being declared.
• Stopping the transmission of the Omicron variant is no longer the objective because it spreads too quickly. Public health measures are trying to slow down the spread in order to buy more time for providing booster doses and to protect the health care system.
• MLHU was notified mid-December, 2021, in light of mounting Omicron numbers, to accelerate the booster dose campaign. In response, MLHU pivoted its resources and conducted a mass hiring campaign. Last week MLHU announced over 1 million doses of COVID-19 vaccine had been administered in the Middlesex-London region.
• Demand for booster doses is starting to plateau although it remains brisk. MLHU will need to pivot from trying to manage the line ups to creating the line ups, which requires different strategies.
• As the eight-week interval for children between their first and second doses comes due, there is an expectation that more appointments will be booked.
• The third dose strategy for COVID-19 vaccines was not intended to minimize the impact of the Omicron wave; rather, other public health strategies were used to slow down the wave and buy time for more people to get their booster doses. The booster doses are intended to prevent more hospitalizations and deaths.
• The COVID-19 vaccine campaign continues to provide increasing access to mass vaccination clinics, pivoting its strategy to more mobile efforts to meet people where they are. Partnering with the Middlesex-London Paramedic Services, successful clinics have occurred in Middlesex County and will be pivoting to support the City of London as well. MLHU is administering vaccine in shelters and congregate settings, including visiting two shelters this week with over 65 doses administered. This week, MLHU will also be visiting the SOAHAC clinic and attending the temporary winter shelter on Fanshawe Golf Course. Furthermore, mobile clinics organized as community hubs in schools will be starting January 31, 2022 and the Health Unit will continue to partner with other equity-deserving and equity-seeking groups.
• Next steps consist of continuing to weather the COVD-19 storm, managing cases as they come, focusing on high-risk settings, preparing for endemicity, transitioning to mobile outreach while maintaining capacity in mass vaccination clinics and having capacity in place for the remainder of 2022, needing to get vaccination coverage higher in children aged 5 to 11, and maintaining and stabilizing staffing to minimize deployments.
• In line with the Provincial direction, MLHU will scale back public health measures as soon as January 31, 2022, easing restrictions, contingent on ongoing improvements in metrics.
• MLHU is seeking clarity on youth sports starting January 31, 2022 but will try to align as much as possible with the Provincial directive. If the local situation requires local adjustments and intervention, they will be explored including, for example, requiring vaccination to participate in youth sports. Regardless of what the guidance is, given the ongoing risk of Omicron, MLHU continues to emphasize that all families and individuals should minimize non-essential activities so that essential activities can be protected.
• The Public Health Agency of Canada has not yet made an announcement about booster doses for youth 12 to 17 years of age although an announcement is anticipated in the next few weeks.
• MLHU is ahead of the provincial and national curve with regards to the rates of first and second doses of COVID-19 vaccine. Key variable contributing to the high rates of vaccination are the community’s willingness to get vaccinated and mandatory vaccination policies. With more booster doses being available, those policies will evolve to change what it means to be “fully vaccinated.”
• Assessing the vaccination coverage within a community can inform the mobile campaign, for example, particular neighbourhoods with lower rates of vaccination.
• Early investigations and analysis have demonstrated a preference for the Pfizer-BioNTech vaccine over the Moderna vaccine; this has been seen at local mass vaccination clinics. The trend is one MLHU tries to address through messaging about interchangeability. The majority of people, even if they have misgivings about receiving Moderna, will willingly take the vaccine that is available to them. For individuals who have not yet received a booster dose because they will only accept the Pfizer vaccine, more Pfizer doses are expected to come and the Health Unit will inform the public.

It was moved by Ms. Cassidy, seconded by Ms. Elliott, that the Board of Health receive the verbal report on COVID-19 disease spread and vaccine campaign update for information.
Carried

Acting Medical Officer of Health Activity Report for December (Report No. 04-22)

Dr. Summers highlighted that both Ms. Williams as Chief Executive Officer and himself in the Acting Medical Officer of Health role have formatted their activity reports to mimic the categories in the performance appraisal. It was commented by Ms. DeViet that this format does break up the months between the different categories, which dilutes the impact of the number of activities done in one day.

It was moved by Ms. Hamou, seconded by Mr. Steele, that the Board of Health receive Report No. 04-22 re: “Acting Medical Officer of Health Activity Report for December” for information
Carried

Chief Executive Officer Activity Report for December (Report No. 05-22)

It was moved by Ms. Cassidy, seconded by Ms. Elliott, that the Board of Health receive Report No. 05-22 re: “Chief Executive Officer Activity Report for December” for information.
Carried

Correspondence

It was moved by Ms. Elliott, seconded by Ms. Cassidy, that the Board of Health receive items a) and b) for information.
Carried

Other Business

The next meeting of the Middlesex-London Board of Health is Thursday, February 17, 2022 at 7:00 p.m.

It was moved by Mr. Steele, seconded by Ms. Hamou, that the electronic ballots used in the election for the Vice-Chair be destroyed.
Carried

Confidential

At 7:58 p.m., it was moved by Ms. Elliott, seconded by Ms. Cassidy, that the Board of Health will move in-camera to consider matters regarding identifiable individuals, including Board employees and to approve previous confidential Board of Health minutes.
Carried

At 9:27 p.m., it was moved by Ms. Elliott, seconded by Ms. Hamou, that the Board of Health return to public session from closed session.
Carried

Adjournment

At 9:27 p.m., it was moved by Ms. Elliott, seconded by Ms. Hamou, that the meeting be adjourned.
Carried

Matt Reid
Chair

Emily Williams
Secretary