By Kaitlyn Clark
The Haldimand Press
HALDIMAND—The Haldimand Norfolk health district moved into the third of five COVID-19 levels on Monday, October 30, 2020. The region has joined seven other health units in the Orange – Restrict level, which includes intermediate measures that have enhanced restrictions and enforcement while avoiding any further closures. Local Medical Officer of Health, Dr. Shanker Nesathurai, isn’t surprised by this change, although he is hopeful it will be the last time Haldimand Norfolk moves up a level.
“It’s very difficult to predict the future, but I remain optimistic we will be able to blunt the numbers overall (in Ontario),” said Nesathurai. “I hope the level of community engagement with these restrictions will head towards blunting the numbers, but when looking at the data I am concerned we may move to red (the fourth level)…. I would not be surprised if our case count continues to climb, but I’m hopeful with the number of measures that it could stabilize.”
Nesathurai noted that the Province uses a framework with “a number of factors” when considering which level individual districts should fall under, such as weekly new cases, the number of people likely to be infected from one person, outbreaks, the capacity of health resources, and so on.
“There is no intensive care unit at the Dunnville hospital, and I believe they have the ability to ventilate one person who would then be transferred. The Hagersville hospital also doesn’t have an intensive care unit. Norfolk General I believe has five intensive care beds. There are relatively few hospital resources,” said Nesathurai. “This district is also adjacent to Hamilton, which is in red, and near Toronto and Peel which are in grey (lockdown). I think we’re assigned risk in some ways for our regional location.”
He added that the Province also discusses these factors with the local medical officer of health for a “wholistic decision”.
Whether or not the newest changes will slow Haldimand’s new COVID-19 cases is yet to be seen. Nesathurai believes one of the biggest challenges will be getting enough residents to cooperate: “The challenge fundamentally is that the actions recommended disadvantage people who engage in them, and it’s not always those people who will benefit, but maybe the grandparent of someone they don’t know.”
Nesathurai reiterated pleas for people to avoid large gatherings with anyone outside of their household. He urged residents to consider virtual gatherings and communications with extended family over the holidays, such as phone calls, emails, and video chats. Additionally, he urged people to do their holiday shopping online or to do curbside pickup; when this is not possible he suggested people attend stores during less-busy hours to reduce interactions with others.
“In this health district we have seen clusters of cases from family members gathering with other households,” said Nesathurai, adding that dining events pose a particular risk since people must have their masks off, among other factors. “We really need to emphasize people avoid these gatherings.”
HNHU staff saturation
Nesathurai noted that health unit staff have been completing contact tracing within 24 hours, ensuring that any individuals potentially exposed to COVID-19 are quickly informed to lessen the potential spread. However, he noted this has only been possible with staff working seven days a week since March and by pulling staff from various health programs to work on COVID-19 needs.
“It has a significant cost to staff and other programs,” he said. “I worry we won’t be able to sustain this…. We’re getting closer and closer to saturation (of the health unit resources).”
Nesathurai said it’s impossible to say at what point oversaturation could occur: “Individual cases may have one or two contacts (to trace), some may have 15. It’s not just the number of cases but the contacts associated.”
He added that farm outbreaks take an “inordinate number of resources because of the large number needed to self-isolate.”
When asked about the Board of Health’s decision to provide 17 full time equivalent (FTE) staff for a COVID-19 team, and considering that staff requested 32 FTEs, Nesathurai said it’s up to the Board of Health to assign resources and staff to work within what is assigned.
“Having additional resources is always helpful,” he continued. “I am concerned about gaps in (health) programs, especially for women and children, vaccines. We try our best to continue those programs … but part of the public health practice is to set priorities and recognize we can’t do all things at all times.”
Grandview Lodge outbreak over
Grandview Lodge had its outbreak declared over on November 27, 2020.
“While the ultimate goal was to avoid introducing the virus into our home, with the dedication of the entire Grandview team and in collaboration and support from our external partners, we were able to accomplish the next best thing – containment of the virus, no loss of life, and recovery,” said Jennifer Jacob, Administrator. “Thank you to all for doing your part to ensure this successful outcome.”
“Grandview Lodge is concerned with the ongoing daily reports of positive cases within the Haldimand Norfolk Health Unit catchment and the risk this poses to our residents who travel outside the controlled environment of Grandview Lodge,” continued Jacob. “While we are now confident that we have the knowledge and resources to manage an outbreak, I cannot stress enough the importance of mitigating the risks of introducing the virus into our home.”
Jacob reiterated Nesathurai’s previous pleas for residents to stay home if they are feeling unwell, to wear a mask when in public, to remain distanced when possible, and to wash hands frequently.
Multiple companies are now in various phases of testing for a COVID-19 vaccine. Moderna is one such company, which is currently in Phase 3 clinical trials and preliminary data shows it appears to be 94.5% effective. However, the federal government has come under fire since Canada does not have production facilities for these vaccines themselves. While some countries have rolled out plans to begin vaccinations this month, Canada has not provided an exact timeline.
“If a vaccine does become available, obviously we would like it to be available as soon as possible to the people of Haldimand and Norfolk,” said Nesathurai. “Again, it is difficult to predict the future, but I would expect early 2021 hopefully we would have vaccines available.”
Moderna confirmed in a CBC article last week that the Canadian government made an agreement with the company in August for 20 million doses of the vaccine, with an option to purchase 36 million more. This is only a small portion of the agreements made by the Canadian government, who have procured approximately 358 million doses from seven companies. Many countries have ordered more than they need as the vaccine companies are still seeking approval, and therefore some of the agreements may fall through.
Federal officials have stated they expect “high-priority groups” to be vaccinated in early 2021, with Prime Minister Justin Trudeau stating that “the majority” of Canadians could be vaccinated by September 2021.
Migrant workers stranded
Over 100 migrant workers from Trinidad and Tobago are unable to return home from their work placements in the health district due to restrictions imposed by their home country as a protection against COVID-19. Nesathurai said a clear COVID-19 test is just one requirement needed before the workers can board a plane.
“I am very concerned that their return to home is being delayed by these administrative rules related to COVID-19,” said Nesathurai. “It’s obviously concerning to the entire public health service.”
Consular officials are reportedly working to resolve the issues and allow the workers to return home. The workers ultimately fall under the responsibility of the Federal government, although Nesathurai said the health unit has shared information with consular officials on how workers can be “safely repatriated”. He added, “Owners and operators of agricultural enterprises, I think, acknowledge that they have a responsibility to keep their workers safe and the health unit will continue to advocate for safe housing for these individuals.”
The local Board of Health was expected to meet December 1 after press time to discuss some of the above issues.