Only one Southwestern Ontario health region, Grey-Bruce, has defied the odds and not had one COVID-19 death seven months into the pandemic.
The Owen Sound area's public health office is one of only five in Ontario that hasn't recorded a deadly case of the virus.
But that shouldn’t be chalked up to the area’s rural settings or sheer good fortune, says Grey-Bruce Public Health’s (GBPH) top doctor, Ian Arra.
“We do have a relatively positive position in managing the outbreak,” he said. “Is it the luck of the draw? No.”
After all, Arra said there are urban centres in his region — including Owen Sound, population about 21,000 — and activities there are similar to those in mid-sized cities like London.
So, what has led to Grey-Bruce’s success?
In mid-January, Arra was already planning for the pandemic. He met with the board of health and recommended forming a pandemic emergency response team.
“In January and February, some people didn’t even hear about the coronavirus,” Arra said. “I said, ‘This is coming, and we need to prepare every resource.’ ”
By April, a partnership with local EMS saw first responders out in the community administering COVID-19 swabs.
Grey-Bruce also set up three field hospitals, none of which have been used yet.
So far, GBPH has logged only two hospitalizations, both of which Arra characterized as minor.
“The health-care system in Grey-Bruce, really it has been our insurance policy,” he said. “You need to beef it up, but you hope you will never use it. In this case, we never used it.”
The region saw minimal cases in the spring, with Arra calling Grey-Bruce's epidemic curve “flat as a hockey puck.”
When the world faced a personal protective equipment shortage in March and April, Arra leveraged supply chains through Bruce Power, the province's largest nuclear generating plant.
He estimated the region would need about 200,000 masks to help flatten the pandemic curve. Bruce Power delivered two million.
They were distributed to hospitals, long-term care homes and community living centres, giving them a six-month stockpile.
Bruce Power also provided supplies for the field hospitals, offered up phone lines for town hall conferences and helped configure the region’s online COVID-19 dashboard.
“You cannot ask for a more community-oriented business,” Arra said. “That horsepower provided so much.”
When someone tests positive for COVID-19, provincial guidelines aim to have 90 per cent of contacts traced within 24 hours.
Grey-Bruce is tracing 100 per cent of contacts within hours.
There’s a team of 48 contact tracers in the region, but through a partnership with a local nursing college, Grey-Bruce can double that within a week, if needed.
The team follows up with about 100 close contacts of positive cases daily.
In August, Grey-Bruce hired five additional public health nurses for schools to augment the five they were assigned by the province to help manage back to school.
“We planned for a projected need down the road,” Arra said. “Being proactive is what will probably help us manage the second wave.”
It’s a “privilege” to practise health care in Ontario, Arra said, applauding provincial measures to help curb COVID-19's spread.
But since provincial guidelines are universal, that can’t account for why Grey-Bruce has been largely spared from the coronavirus, he said.
Perhaps then, ample communication has been a game-changer for the region.
“Usually, public health is a victim of our own success. if we do everything right, nobody hears from us,” Arra said. “But in an emergency, 50 per cent of our work is communication.”
He credits effective communication from his team with winning public support and stamping out coronavirus outbreaks.
Grey-Bruce has tracked seven outbreaks in long-term care settings, Arra said. In all but one instance, the outbreaks stopped at just one case.
In long-term care homes, he schedules calls with front-line workers, managers and directors to help manage outbreaks.
“If that redundancy is built in, we won’t drop the ball,” Arra said. “Prevention is the word for public health.”
Effective communication has spilled over from health-care settings into the community.
“In Grey-Bruce, during this emergency, the public has been engaged, informed, but not afraid,” Arra said.
He holds weekly calls with 17 mayors, two county wardens and fire and EMS leaders, and daily calls with area MPPs to brief them on the pandemic’s status.
And the transparency of releasing when and where cases arise has fostered public trust and compliance with public health guidelines, such as wearing masks and social distancing, Arra said.
“Truly, it is the community and the fabric of it,” Arra said. “It’s the way people are part of a group. They’re not individuals here.”
Grey-Bruce’s success so far hasn’t prompted Arra to take pause.
He’s still putting in 15-hour days, weekends included, pausing only for dinner breaks and to spend time with his three-year-old daughter.
“Since mid-March, it’s been non-stop,” he said. “It’s good to feel in demand, but my only regret is my daughter is missing out on her dad.”
But he hopes that the effort will be worth it.
If Grey-Bruce residents keep up the "three W's" — washing hands, wearing masks properly and watching their distance — the trend of low cases and zero deaths could continue, even as the pandemic's second wave washes over Ontario, Arra said.
“Are we going to be in the grip of it or will we have a grip on it, that’s the question.”
The Local Journalism Initiative is funded by the Government of Canada.
Figures as of Oct. 6
Max Martin, Local Journalism Initiative Reporter, London Free Press