COVID-related discussions, about vaccination rates, the fourth wave and the province’s regulations, dominated discussion at the Grey Bruce Public Health board meeting on Aug. 23.
Brockton Mayor Chris Peabody referred to the relatively quick recovery from the Delta-related spike in July, and asked whether Grey-Bruce might be able to avoid the fourth wave.
Dr. Rim Zayed of the health unit said she was optimistic that Grey Bruce would “skip this surge,” but nuanced that by saying that there is impact in all areas of the province.
“Hopefully, we will not have the high numbers that we did before,” she said.
Dr. Arra also stepped in to remind members that there is much uncertainty. He said that it is a race to see if 90 percent of those eligible can be reached in September or October.
There is still some uncertainty if that level of vaccination would prevent transmission, he said, and also keep hospitalization from reaching a level that would create a problem.
For one thing, he said authorities will be watching to see in what way the provincial increase in case numbers translates into hospitalization numbers over the next two to three weeks.
Preparing for the worst and hoping for the best is what the health unit must do, Dr. Arra said.
If the rest of the province has difficulty, Grey-Bruce may end up having to share its hospital resources and so be affected, member Helen-Claire Tingling said.
Dr. Arra agreed, and observed that people are tired: there is more non-compliance and Covid fatigue. Past surges have been controlled, he said, but the question remains as to whether cases will be controlled later this year, and how the vaccine rate will increase.
The numbers are definitely lower than the 90 percent desired, Dr. Ian Arra said. Of those eligible in Grey-Bruce, 82 percent have one dose and 76.5 percent have two doses (as of Sept. 2).
But when Brockton mayor Chris Peabody offered that it seemed anecdotally that “anti-vaxxers are winning the battle for that 10 percent” to get from 80 percent to 90 percent, Dr. Arra disagreed.
He said that those committed to opposing all vaccinations is a lot smaller probably two to three percent – perhaps five percent.
He called the situation one of “true hesitancy,” where people have concerns about safety and efficacy the length of time over which data has been collected. Some people may have other barriers, he said.
He agreed that the numbers have not been going up as much as desired, and added that new provincial rules will “definitely up those numbers.”
Dr. Arra pointed out that you can see the “intrusiveness” of the measures increasing in the effort to increase vaccination numbers – first education, and then by policy, with new restrictions.
The Board of Health is asking vaccinated people to become vaccine “champions,” and to talk to others about their own decision and experience.
Ms Tingling said that people who are not being vaccinated are often marginalized people and those who have historic reasons not to trust the government.
She said that most of those people can be reached, but commented that if there is a move to require something like “carding,” the government will be carding many of the same people that there was a movement as a society against carding.
Ms Tingling endorsed instead encouraging people to be vaccinated “with a carrot” (as opposed to a stick, as the old saying goes).
She said the division in the community is concerning, and the issue is complicated. She complimented board members and health unit personnel on their compassion and intelligence.
Following this aspect, the Herald/Advance found that the Public Health Ontario website shows an analysis was done on vaccination rates and both diversity and income, covering the time up to July 31.
The paper found that vaccine uptake in the province is three percent different in relation to neighbourhood diversity taken alone; however, the rate is 10 percent lower in the most poor areas as opposed to the most wealthy.
The study divided the population into five income groups. Among the 20 percent with lowest material wealth about 70 percent have at least one dose, compared with about 80 percent in neighbourhoods with the highest material wealth.
There is variation if the population is broken down by age. In ages over 60, the rates are closer no matter the income level, but as the age gets younger, the difference in vaccination rates increases.
TRACKING LOCAL STATISTICS
Dr. Zayed, who has a doctorate in the area of epidemiology, presented to the board on statistical measures and the decision support team in the health unit.
She has been hired as a GBHU physician consultant, a position which can lead to becoming an associate medical officer of health. Certain responsibilities can only be performed by a medical officer of health or associate medical officers of health.
The board has said that this requirement and Grey-Bruce’s lack of an associate led to tremendous overtime for Dr. Arra. The dramatic 60 percent increase in his earnings led to some public criticism after this year’s “sunshine list” was published.
Dr. Zayed said that GBPH has two full-time data analysts with background in epidemiology, as well as a partnership with Wellington-Dufferin-Guelph Health Unit, with an another full-time equivalent available as a back-up if needed. That partnership also allows the local health unit to expand data analysis on special projects.
Grey-Bruce also has supplementary internal resources of staff with Master’s level epidemiological training, she said.
The data is analysed by the team to be used in decision-making. The team’s role includes data on vaccine uptake and contact management.
She talked about COVID tracking that is being mandated by the ministry for the fall of 2021 in the four areas of disease, vaccine, health system and behaviour (mental health components).
A board member asked who will follow up on the implementation of school air quality measures funded by the province. Dr. Arra suggested that it would be the Ministry of Labour who would supervise questions around workplaces, such as schools.
M.T. Fernandes, Local Journalism Initiative Reporter, Dundalk Herald