By Kaitlyn Clark
The Haldimand Press
HALDIMAND—Medical Officer of Health for Haldimand and Norfolk, Shanker Nesathurai, is happy to see few to no new cases being confirmed in the health district in recent days, but he notes that this statistic is not the only consideration when declaring the situation under control.
“The public health service is always cautious. It’s always better to have one or zero cases than 20 cases for sure, but the number of cases is not the only signal we would use to make determinations,” said Nesathurai. “Another signal would be the number of people currently on self-isolation, and that number is coming down a bit as well.”
As of press time, 208 individuals were in self-isolation in Haldimand and Norfolk, down from a high of 550 on April 28, 2020. Nesathurai said another important signal is the result of testing changes to the public health strategy, such as the re-opening of trails and parks for walk-through access on May 1: “If our community has practised sufficient social distancing, we should hopefully not see any more cases this week. It’s about a 14-day lag time between the change in intervention and the change in the number of cases presenting.”
Nesathurai has seen push back on some of the orders he deemed necessary to protect the district. This includes restricting agricultural bunkhouses, regardless of their size, to only three migrant workers for their self-isolation. Some farmers are appealing the order as it has greatly reduced their staffing capability without incurring signficant costs; Norfolk farmers have been more seriously affected by this restriction as they receive the bulk of migrant workers each year.
Nesathurai responded that when residents return from outside the country they are expected to self-isolate alone and would only be given exception to self-isolate with close family members.
“I do not feel it’s appropriate that people who come from overseas would have to serve their self-isolation with people they’ve never met before and maybe don’t even speak their language,” said Nesathurai on the “compassionate grounds” to consider. Additionally, Nesathurai noted that the greater reduction of workers means a greater reduction in the risk of an outbreak, making it easier to break the chain of transmission and avoid having to shut down agricultural enterprises because of an outbreak, as has been seen elsewhere in Canada. As of press time, approximately 265 farm-specific applications had been approved.
Some concerns were also raised by identity cards provided for migrant workers. Some suggested the possibility that people could demand to see the cards and that they could be used in a discriminatory manner.
Nesathurai said this was not an issue that he was aware of as the cards are completely voluntary and do not include photos. He said the main use of the cards is that the worker could present it to public health officials during inspections of bunkhouses if they do not speak English as it would relay details to the inspector for them, such as when they entered the country.
“I always worry about the real racism when people are treated differently because of the colour of their skin or their ethnicity or their physical appearance, but when I think of what racism is at its core it’s that level of bigotry that I worry about,” said Nesathurai, adding that there have been a suite of services and mandates put in place to protect migrant workers. “These cards are filled out by the people who choose to fill them out and who choose to carry them or not.”
Norfolk County CAO Jason Burgess sent out a statement about the identity cards on May 11 in response to social media posts “containing signficant misinformation”.
“Specifically, these posts wrongly accuse Health Unit staff and Medical Officer of Health Dr. Shanker Nesathurai of racism and of violating migrant workers’ civil liberties. The posts also compare the Health Unit to the Nazi regime,” explained Burgess, reiterating that the cards are completely voluntary and “meant to help the farmers and the workers themselves keep critical information handy, especially since some of them might be quarantined away from the farm during their mandatory self-isolation period. This is necessary because farmers don’t always know the names of the specific workers coming to their farm for the season until they arrive, and many of these workers are not fluent in English.”
Burgess believes the posts stem from “some farmers being displeased” about the limitation of three workers to a bunkhouse creating additional costs for the farmer to house the workers: “Our Medical Officer of Health created an order that put the health and safety of migrant farm workers at the forefront, going out on a limb to better protect these workers. So to accuse him of racism is beyond the pale. Of all of the complaints I received about the order to limit the number of people being quarantined, none of them related to the health and safety of the migrant workers – they all related to the cost of the program.”
HALDIMAND/NORFOLK—This chart summarizes the number of cases per day since the identification of the first case. Of note, there is some variability in the cases reported on any particular day (dark green bars). The light green line represents the cumulative frequency; this is the number of total cases as the pandemic progresses. For up-to-date statistics locally, visit hnhu.org/covid-19.
The Long Point Ratepayers Association (LRA) is appealing the order prohibiting those outside the region from residing at their secondary residences in Haldimand or Norfolk. The order carries a fine of up to $5,000 per day, which is consistent with other orders from Nesathurai, and which he has previously noted is a last resort after speaking with those involved. Homeowners are still allowed to do maintenance on the property as required but cannot reside there. While the province requests people avoid travel to secondary residences and has prohibited places like trailer parks from operating, it has not gone so far as to legally prohibit the use of secondary residences. LRA believes Haldimand and Norfolk should follow the rest of the province, but Nesathurai believes his order is consistent with the province.
“The public health management plan, throughout the province and country, is that unless you have a compelling reason to leave your house, stay home,” said Nesathurai. “If you’re leaving without a compelling reason, then you’re not following the plan.”
“The order merely codifies what has always been recommended,” continued Nesathurai, noting that any additional caution from Haldimand and Norfolk stems from its unique situation that combines a lack of intensive care beds and other medical resources with a number of at-risk populations.
Nesathurai continues to ask people to practice social distancing and to avoid all unnecessary travel, particularly with a long weekend coming up: “I am very worried…. If you’re planning to come to Haldimand or Norfolk for the weekend, please stay home.”
While he remains vigilant, Nesathurai is “optimistic we’ll get control and hopeful we won’t have any additional deaths.”
As of press time, the district’s death toll remained steady at 30 individuals. Of this, 27 were residents of Anson Place, which are the only deaths in Haldimand. Two more individuals with positive COVID-19 tests had passed away at Anson Place, but their doctor determined the cause of death was not related to the virus. May 8 Anson Place announced that “the majority of our retirement residents and staff have received two consecutive negative test results and have been cleared of COVID-19. We anticipate receiving our (long-term) care centre retesting results from public health next week.”
There are now only four retirement residents and 28 care home residents still considered to be infected. Executive Director Lisa Roth stated May 10, “We remain cautiously optimistic and have our local public health unit and our hardworking staff to thank for this positive news.”
“I am fortunate to report that the COVID-19 outbreak at Anson Place Care Centre appears to be stabilizing and our residents continue to show signs of recovery,” said Roth on May 11. “With the positive signs of improvement in our home, we are seeking guidance from our medical officer of health so that we can reintroduce exercise and allow residents to leave their rooms to go for walks throughout our hallways. The reintroduction of any activity or program will be closely monitored and adapted to ensure all infection control and prevention protocols remain in place.”
Edgewater Gardens had tested all of its residents as a precautionary measure and all tests came back negative.
“As a doctor we loath to predict the future, we’re always cautious, but I think we’re moving in the right direction for sure,” concluded Nesathurai. “The real issue for us moving forward is to try to prevent any secondary spikes. That keeps me up.”
Updates
May 13, 2020 – Haldimand Numbers
Lab-confirmed, negative cases: 2,165
Lab-confirmed, positive cases: 203
Recovered: 77
Deaths: 30
May 13, 2020 – Anson Place Testing
From Lisa Roth: “We received the test results of 12 residents from our care centre from Public Health. I am pleased to report that each of these results came back negative, which means 12 care centre residents are now cleared of COVID-19. We will receive further retesting results for our care centre residents and our retirement residents in the coming days and will continue to update active case counts accordingly.
As the COVID-19 outbreak in our home continues to improve, today also marks 21 days since we last reported a COVID-19 related death. COVID-19 positive cases in our retirement residence remain unchanged at 4, while COVID-19 cases in our care centre have decreased to 16. COVID-19 related deaths at Anson Place Care Centre remain unchanged at 27.”
