By Kaitlyn Clark
The Haldimand Press
HALDIMAND—Two issues at the forefront for the Haldimand Norfolk Health Unit currently are the increasing numbers of COVID-19 variants locally and the challenges posed from incoming migrant farm workers. Local Medical Officer of Health Dr. Shanker Nesathurai spoke to both issues on Monday.
As of March 22, 2021, Haldimand Norfolk had 27 confirmed cases of variants, with the UK and South African variants being identified at that time. These variants pose a greater concern as they are able to spread more quickly. It is believed these variants are likely a contributing factor to the recent rise in active cases. Nesathurai noted that case and contact management, which is the process of identifying people who have been exposed so they can get tested and self-isolate as needed, is particularly important with these variants to stop the chain of transmission as soon as possible and keep positive cases down.
“We also have to work on reducing outbreaks in congregate settings … where people share bathrooms and kitchens,” he added, noting agricultural bunkhouses as a prime example.
“The substantive challenge is that people arrive at the airport from overseas, they get a test at the airport and the test results are not available before they depart the airport,” explained Nesathurai. Temporary Foreign Workers are exempt from the hotel stop-over program that requires other arrivals to stay at a government authorized hotel upon landing so a test result can be confirmed before they travel to their final destination.
Nesathurai further explained, “(Migrant workers) travel on the bus with many other workers and then those individuals go to multiple farms and get dropped off, and then a few days later the health unit is advised if there were workers who were positive on the bus and, as a result of that, we have to recognize that all the people on the bus now become close contacts and we have outbreaks.”
He said buses pose additional challenges compared to planes, such as the ability to move around more freely and less efficient air filtration.
As of March 22, a total of 22 farms had been affected by COVID-19 exposures related to shuttle services with 10 workers testing positive and 91 workers being identified as close contacts.
Contact and outbreak management are both heavily reliant on human resources. With one significant past farm outbreak requiring 40 staff to manage it, Nesathurai said that if large outbreaks are not avoided, the health unit will be forced to pull staff from the vaccine roll out and other programs.
Nesathurai’s other concerns with farm outbreaks include its ability to spread beyond the farm, which has occurred previously; the cost of managing an outbreak is “tens to hundreds of thousands of dollars”; and “most importantly, outbreaks can lead to people getting sick, going to the hospital, going to the ICU, going on a ventilator, in our own health district we’ve had deaths” related to outbreaks. Additionally, he noted that restrictions may remain longer or be expanded in the face of outbreaks as those cases are included in the statistics used to determine a region’s reopening level.
In order to lessen the impact of potential outbreaks among migrant farm workers, Nesathurai ordered last week that any workers yet to arrive are to use private transportation to reach the farm in groups no larger than their pre-approved self-isolation cohort. The health unit has requested the provincial and/or federal governments provide funding to the farmers to cover the increased costs associated. This has caused additional strain on the affected farmers, but Nesathurai believes it’s necessary for the wellbeing of the region as a whole.
“There are 110,000 people in the health district. There are approximately 4,000 migrant farmers. There are 2,500 farms and of those we estimate about 200 have migrant farm workers,” he explained, noting Haldimand Norfolk has the second highest number of migrant workers per capita of any Ontario region, behind only Windsor. “It’s not an easy balancing act to manage all these competing interests.”
“At the end of the day we want to minimize chances of outbreaks. The Scotlynn outbreak had 18 people evaluated in hospital, 220 infected with 20 of those off-farm, 12 admitted to hospital, seven to the ICU, two on a ventilator, and one died. Migrant farm workers have a higher risk,” continued Nesathurai. “Migrant farm workers are people, and they deserve all the protections residents of Canada are entitled to.”