The war room
In 2009, the Region of Waterloo approved a pandemic survival plan — 11 years later that blueprint has guided the groups that have steered us through this crisis
WATERLOO REGION — On March 11, regional officials pulled out an 11-yearold community pandemic plan and put it into action.
The novel coronavirus was still a new, mostly unknown disease. On March 4, the region had reported its first case of COVID-19. Then a few more cases were confirmed in the span of a few days.
“It wasn’t completely clear at that time how serious this was going to be or what the next steps were going to need to be,” said Mike Murray, chief administrative officer of the Region of Waterloo.
“Things started to really escalate quickly. We basically pulled that plan off the shelf and said ‘we have a blueprint. This can be our framework, our starting point.’”
In 2007, people from 50 different local organizations came together to draft a guide on how to deliver critical services if a health crisis were to hit Waterloo Region. The project — which came out of recommendations to be better prepared following the outbreak of SARS in 2003 — took two years to pull together.
In 2009, the plan was approved, printed and bound, and put away for the day another killer virus emerged.
That day came in March. It was time for Waterloo Region’s ‘war room’ to take shape. The plan was circulated to more than 50 different organizations across the region for revisions.
There was a flurry of activity that week and the next as provincial orders came in one after the other. Local officials scrambled to keep up.
Offices were soon shuttered and meetings moved to video conference calls.
The war room — also known as the regional pandemic control group — consists of five sectors, each responsible for maintaining different parts of the region during the state of emergency:
The health sector co-ordinates health services.
The community supports team makes sure the region’s most vulnerable have shelter and food.
The critical infrastructures sector makes sure garbage is picked up, water and electricity are running and important road work gets done.
The municipal team makes sure facility closures are aligned.
The communications team makes sure everyone is up-to-date on the work the other sectors are doing.
Municipalities and social service organizations are working together like never before, all for a single cause: to make sure the region can respond to residents’ needs during the crisis.
The pandemic control group
It’s seven weeks later and Murray is in his office at regional headquarters. The building is eerily quiet and mostly empty.
The regional pandemic control group reports to him. He spends his days replying to emails and going from one video conference call to the next.
The first few weeks of stay-athome orders were dizzying. It was a challenge trying to keep up with provincial guidelines, Murray said.
Many members of the pandemic control group worked through those first few weekends.
Regional officials would make a decision about which facilities to close in the morning, and by the evening that decision would need to be changed.
“Often the province sends out new guidance late in the day. And so then we’re kind of scrambling in the evening and early morning trying to figure out, OK, what do we need to do with that today?” Murray meets with other chief administrative officers almost daily. He meets with public health and other department heads within the region’s own structure several times a week.
His job is to ensure his organization functions smoothly to be able to provide services to a population of nearly 600,000 residents, and to also keep thousands of employees safe at the same time.
“I would say it’s been one of the most challenging times in my whole career,” Murray said.
Days have been long and indistinguishable, but Murray said he finds solace in keeping in touch with his family through video conference calls whenever he can.
He talks to his adult children, both living across the country, more than he used to.
“That’s one of the silver linings.”
The triad
Dr. Sharon Bal’s phone rings early every morning. At 7:30 a.m., her fellow team members, Dr. Hsiu-Li Wang and Lee Fairclough, are the first people she speaks to outside of her family.
The three women co-ordinate the region’s pandemic health response. From hospitals to primary care physicians and public health, they work together and with Ontario Health to ensure the health services are working together to provide care to those who need it.
“We talk multiple, I mean, multiple times a day,” said Bal, a family physician. “They’re often, at least, one of the last voices I hear at night. Not that I’m complaining,” she said with a laugh.
The team refers to themselves as the triad. In addition to their role co-ordinating health services through the region’s pandemic control group, they also work on behalf of Ontario Health’s western agency, which includes Guelph and Wellington County.
They helped set up COVID-19 assessment centres across these regions. They co-ordinate the efforts of five hospitals, organize virtual visits with physicians at hospitals, and they help problem-solve personal protective equipment shortages.
Right now the triad is focused on how to help long-term-care homes in the region grapple with outbreaks of the deadly virus. One of the most recent decisions to come out of these daily conversations was to move some infected long-term-care residents into local hospitals.
Dr. Bal works to organize the nonhospital health sector, from mental health services to primary care, community care and long-term care. Fairclough works with five hospitals across Waterloo Region, Guelph and Wellington County. Dr. Wang is behind the public health response and three times a week updates on the spread of the virus in our region.
“We all have issues that we are dealing with in terms of addressing the appropriate care of patients, appropriate screening, appropriate testing,” said
Fairclough, president of St. Mary’s General Hospital.
“This is where we are really trying to look at how we can come at these issues together.”
That may include prevention and infection control advice, help getting access to testing, or help with staffing in situations where there is a shortage.
Each woman has daily meetings with their own teams and then come together to share ideas, give each other updates, and problem-solve.
“This triad approach is very effective in making sure we have a system response,” said Dr. Wang, acting medical officer of health for Waterloo Region.
“It’s breaking down the barriers between health sector organizations and helps facilitate just everyone working together.”
They also meet with the region’s pandemic control group twice a week.
Bal said while many people in the health sector have always been connected in one way or another, the pandemic has brought the nonhospital sector closer.
“When we find out that another community or region is doing something really clever, it’s just nice for everyone on the phone to hear that and pick up that idea,” she said.
“It’s been so heartening to see primary care, for example, come together with palliative long-term-care doctors and directors and homes and really think about how to work together.”
Wang’s responsibilities as the head of public health are a bit different. She has to monitor the spread of COVID-19, assess the number of cases, deaths and outbreaks on a daily basis and make decisions based on that data.
But this virus is still largely unknown and Wang said it has been a challenge.
“We are learning about coronavirus as we’re responding.”
There are times when the challenge of dealing with the pandemic is overwhelming, and Wang said she is grateful to have a team of supportive people she can talk to to ease the burden.
“It’s great that I get to work with two phenomenal ladies like this. Otherwise it would be really tough.”
Bal agreed. “We rely on each other,” she said.
She has two school-aged children at home, so does Fairclough, and it adds to the strain of trying to manage a health crisis from home.
“There was that bit of push and pull,” Bal said. “But now there is acceptance and pride that mummy is trying to help people.”
Closing the gaps
Two miniature schnauzers snooze on the floor next to Douglas Bartholomew-Saunders’ dining table. The dining room has become his home office. It’s a convenient spot for him because it’s close to the kitchen.
“It’s always good to be close to the coffee,” he laughs.
This designated work room allows Bartholomew-Saunders, the Region of Waterloo’s commissioner of community services, to make sure the rest of his house feels like home.
It is also the room where he hosts video conference calls with 45 to 60 people each week, who all work together to make sure the needs of the community’s most vulnerable people are met.
“It’s quite a well-attended group,” Bartholomew-Saunders said.
This large group of social organizations identifies where the gaps are in local social services and work together to find solutions.
There is a subgroup that works with the homeless, another one that deals with organizing volunteers, one for the region’s food bank supply and another for making psychosocial resources available.
Last week, the community supports sector arranged for volunteers who are able to help farmers who fall ill and do not have family or friends who can help complete work for them.
They are working to make it feasible to have the temporary homeless shelter be a 24-hour operation so the region’s homeless population has somewhere to go.
They delivered 56 food hampers directly to people who needed groceries in the region last week. That’s in addition to the thousands of community meals served and hundreds of food hampers given to local agencies who distribute them.
“Waterloo Region is a community that bands together when there are needs like we’re facing right now,” Bartholomew-Saunders said.
As chair of the community supports sector group, Bartholomew-Saunders helps co-ordinate the work done by local nonprofits, charities and social services.
He said the last time the region came together like this was when 2,000 Syrian refugees arrived in need of homes, clothing, food and other supports.
“We actually use this same pandemic-plan framework for managing the influx and with many of the same partners around the table,” Bartholomew-Saunders said.
“We were able to do it quite successfully in a short amount of time.”
He said he spends more time working with people from local nonprofits than he spends with his own regional staff, and it has been an enlightening experience.
“What I find is that this is a community where people collaborate. They work together, they collaborate, they identify an issue and they work on it together until it’s resolved.”
‘A waiting game’
The whirlwind of activity has levelled off slightly for the region’s eight municipalities, but for Dan Chapman, it’s merely the eye of the storm before chaos returns.
As the chief administrative officer of the City of Kitchener, Chapman is responsible for the city’s own emergency response plan, its workforce and its facilities, as well as helping to coordinate efforts across the region’s other cities and townships as the chair of the pandemic group’s municipal sector.
The first few weeks of the pandemic were quite busy for this team made up of the heads of each of the region’s three cities and four townships.
“This group has a really great working relationship and has always collaborated on a lot of joint projects together. So it’s only natural when the pandemic hit us, that we would collaborate really closely,” Chapman said.
Public spaces were closed one by one. First it was libraries and community centres. Then city halls and administrative office buildings. Then parks and playgrounds.
The region followed provincial orders to close public spaces in an effort to limit large gatherings, but trying to co-ordinate the messaging was up to the pandemic control group’s municipal sector.
The heads of all eight of the region’s municipalities were meeting daily up until quite recently. Now it is known that administrative facilities will be closed until May 31 and recreation facilities will remain closed until the end of June.
“Now we’re sort of playing a bit of a waiting game,” Chapman said.
But this calm state will not last. Chapman and his fellow municipal leads will have to come up with plans to reopen public spaces when the order comes down from the province. He expects those decisions to be made when the province lifts the state of emergency order.
Officials are already mapping out ways physical distancing can be maintained once this happens.
Chapman said some amenities will be simple to open, like playgrounds. Others, like large sports fields, will take a few weeks of preparation to open to the public.
“What’s been remarkable and encouraging is the high degree of understanding from the public,” Chapman said. “You know, it’s unprecedented for valued recreational facilities and libraries to close in this way.”
He feels the burden of the closures himself with four schoolaged children at home and no home office.
Working from home has been “a blessing and curse,” Chapman said.
Even though it can be chaotic at times, he likes to look for bright spots in his current situation. The biggest one: he can eat lunch with his family almost everyday.
“I’ve never been able to do that before.”
Always prepared
Emergencies are not an unusual thing for Thomas Schmidt. The Region of Waterloo’s commissioner of infrastructure and transportation is always prepared for a crisis, like the power outage of 2004.
“For a lot of people that was an opportunity for them to meet their neighbours and have street parties,” he said. “For the people on the essential services side, we were scrambling to get generators out to have electricity, to continue to provide wa
ter.”
This crisis is no different for Schmidt. He is in charge of ensuring critical services like water, power and garbage collection, to name a few, continue despite the pandemic.
“This is the stuff everyone sees as part of normal life. When you get up, you expect to have the electricity on, you expect the water to be running, you expect the roads to be plowed.”
The critical infrastructure control group that Schmidt leads has representatives from the Grand River Conservation Authority, utility companies, telecommunication providers, and regional sectors like transit and waste management working together.
The danger for Schmidt’s team is if the people who do this critical work get sick. Engineers who have to work in control rooms cannot work from home, Schmidt said.
Physical distancing is crucial in ensuring these workers are able to do their jobs and that was the first thing put in place for staff in the water works department.
“It is difficult for us to backfill. They have specialized skills and abilities,” Schmidt said.
There are other areas where critical services need to be provided by workers who cannot do their work from home, such as waste management, transit operators and road construction crews.
Schmidt said it is important to make sure these workers are safe in what they do, which is why these services have seen some changes during the pandemic.
Grand River Transit is free and service has been reduced to limit the number of people congregating on buses and to keep transit operators safe. Schmidt said these changes may stay in place until September, with ridership levels down to 30 per cent.
The amount of garbage and recycling being collected by the region is up by 50 per cent, Schmidt said. He thinks it’s because more people are at home.
“Maybe some of the things that they would normally have done at the office they’re doing at home and we’re collecting the waste and the recyclables from that,” he said.
Bulky items are also not getting picked up because most large items require two people to lift.
“From the perspective of trying to maintain physical distancing and the safety of our workers, we just have put a pause on the large items,” he said.
The season for road improvements is also about the begin. With traffic down by 50 per cent, road closures shouldn’t have too much of an impact on people’s commutes, Schmidt said.
Big projects like the one along Fischer-Hallman Road can take years of planning and are often needed because of the condition of the existing road, he said.
“If we change one project today that can end up impacting and project three or four or five years out because they’re all linked together. So it’s, it’s important for us to try and maintain our schedule.”
But what will road work look like during a pandemic?
Schmidt said he expects physical distancing and the supply chain may slow down road work this summer, but it is too early to say.
“Contractors are innovative. I’m sure they will come up with good ways to ensure they have the physical distancing and get the work done as quickly as possible.”
“Our real fear is we don’t want to get into a winter situation where we have a road closed or we have a road that doesn’t have a pavement.”
‘We don’t have weekends anymore’
Bryan Stortz works out of his den these days. He helps crafts press releases and co-ordinates public health media briefings with a team of communication experts from across the region’s other departments and municipalities.
They make sure to get the news out on the work being done in every other sector.
Stortz, the director of communications for Region of Waterloo, said the communications plan set out in 2009 needed some tweaking because of how rapidly the news cycle has changed in the past decade. With news organizations moving online, it changes the need to have press releases ready before a newspaper’s print deadline or an evening newscast.
“It’s much more dynamic and much more changeable. It just means we have to be more nimble,” Stortz said.
The communications team has been swift and adaptable. Directives from the province were rapid and unpredictable in the first few weeks of the pandemic. Then decisions were made by the region’s pandemic control group, so the communications team had to be at the ready to get the word out.
“Those first few days were crazy, just crazy. We were on conference calls into the evening. We were drafting media releases late into the night,” Stortz said.
“We don’t have weekends anymore.”
Now, the team is split into two groups that rotate every three days. It helps prevent burnout when we are working such long days, he added.
The communications team organizes public health’s live media briefings that happen online on Mondays, Wednesdays and Fridays. They work on any media releases that need to be sent out. They update social media feeds and information on the Region of Waterloo’s website.
Social media has helped make their job easier. It was also something Stortz didn’t predict would be such a useful tool back in 2009 when he helped coauthor part of the pandemic plan.
But he did predict the need for regular media updates to inform the public on the spread of the virus.
“It is unbelievably eerie. It’s remarkably prescient in how we thought a pandemic would roll out and how we would communicate,” Stortz said.
“We were very fortunate that as a community we had a really solid plan when we went into this.”