HEALTH UNIT STRUGGLES
Rise in COVID-19 cases puts squeeze on programs
Dental care and school immunizations may have to be suspended. The application for a drug consumption and treatment site to stem opioid deaths has been delayed months.
As Windsor and Essex County face tighter COVID-19 restrictions for the second time in a week, public health staff are struggling to grapple with the surge in cases.
“Case counts in our region are increasing at a rapid rate, much higher than what public health can handle,” medical officer of health Dr. Wajid Ahmed told a public briefing Friday.
Staff are supposed to contact people who test positive for the virus within one day of receiving the result. It's critical to not only ensure they get proper treatment but to ensure they isolate to stop the spread. Yet it's happening only 75.4 per cent of the time now.
They're also supposed to contact, within one day, all the people with whom the infected person has had close contact. That's happening 95.6 per cent of the time.
“We're meeting that most of the time, but you can see it's taking us a little bit longer,” CEO Theresa Marentette said at the briefing.
There were almost 500 people involved in one school outbreak this week. Nurses had to call every family. They made most of the calls in two days.
“It's pretty impressive,” Marentette said. “They're doing an amazing job, but I think it's very stressful.”
These case interviews can take more than an hour or longer. Nurses have to provide information and counselling about testing and isolating. They have to get a list of all the people with whom the person has had close contact. Some people have more than 10 close contacts. Sometimes public health staff can't reach people, so they have to keep trying. And they have to check on people who are isolating.
Staff who run other important programs may have to be redeployed — again — to help with the case management and contact tracing. Dental staff are doing some of the calls. Nurses conducting Grade 7 vaccinations may have to be reassigned to help — “putting a hold on the vaccinations,” Marentette said. New staff are being added.
Meetings this week have focused on how to keep up. There have been long days and late nights.
“The surge so quickly has really impacted their (nurses') ability to do all of the work in a timely fashion,” Marentette said. “They're carrying many, many cases and many more contacts as well.”
Staff were dealing with 230 active cases Friday morning.
The reproductive number is 1.7, that is, every infected person is infecting 1.7 more people.
Cases have been jumping by double digits, almost daily, for more than two weeks. There were 45 new cases and seven outbreaks Friday. They're coming from everywhere — from close contact with infected people, from farms, travel and just somewhere in the community. Some are health-care workers.
“Widespread community risk and transmission,” Ahmed concluded.
And with that, there is also the potential for more severe illness and death.
Public health staff, who deal with infectious disease, are at the centre of the pandemic here. They've been on the hot seat for eight months. That's not a marathon. That's an ultra-marathon.
After eight months, in the middle of a severe worldwide second wave, they must dread when the latest test results come in every day. It must be extraordinarily difficult to look at the trajectory — potentially 6,500 cases a day in Ontario, 20,000 a day in Canada within weeks — and not feel overwhelmed.
Already, during the first wave, programs like school immunizations, breastfeeding support and oral health had to be curtailed or deferred so about 80 staff could be redeployed to help with the pandemic.
An associate medical officer of health had to be seconded from London, and other staff from health units across Ontario also had to help with contact tracing.
Daily, for eight months, except for a brief respite in the summer when there were few new cases, Ahmed and Marentette have conducted live video briefings updating the situation, providing charts and graphs and taking all the media's questions.
Almost daily, Ahmed has recited, reminded, urged, cajoled, pleaded with, lectured and threatened — he calls the current enforcement blitz “disincentives” — people to follow public health measures to contain the virus.
Many people have followed the rules. Too many have not. They don't want to hear Ahmed announce more restrictions.
But they won't follow even the minimum rules to avoid more restrictions. It's believed the current surge may have started, in part, with Halloween parties. It must drive public health officials berserk with frustration.
Ahmed revealed at a briefing this week that he has had to call police about threatening messages to the health unit, that his 13-year-old son “gets upset” when he reads “mean comments” about his father online. Ahmed's response? He preached kindness and respect. It was a class act.
In all, the health unit has handled 3,210 COVID-19 cases since March. They've had to report 77 deaths. Every time Ahmed reported a death, he reminded people that this was someone's loved one.
And, oh yeah, they're also dealing with the opioid epidemic.
There have been battles and criticism over the health unit's approach at times. But there's no doubting the enormity of what they've faced and will continue to face for who knows how long.
Someone should paint a mural honouring public health, too. Though the health unit would probably be happy if everyone just did what they're supposed to do to protect the community.