A year ago, Dr. Lawrence Loh could not have predicted how 2020 would play out.
At the time, Loh was serving as associate medical officer of health for the Region of Peel under Dr. Jessica Hopkins. She was responsible for environmental health programs, immunization records and working with chronic disease and injury prevention.
That mandate evolved rapidly.
In March, just as the pandemic’s first wave formed, Hopkins departed the Region to take up a role as a deputy chief with Public Health Ontario, leaving Loh with big shoes to fill as a global crisis landed at his feet. By July, he dropped the ‘interim’ label from his title and was officially named Peel’s medical officer of health.
Any new job is a challenge; Loh’s baptism by fire was heated further by the learning curve faced by all public health units. In particular, the rapidly evolving spread of COVID-19 meant experts, the media and public heard about new developments almost simultaneously.
Loh found himself in front of the cameras at least twice per week at press conferences, presenting councillors and the public with updates and advocating to the Province for policy considerations such as paid sick days. Infectious diseases themselves are not new to public health officials, but COVID-19, and the novel coronavirus that causes it, has constantly confused even seasoned epidemiologists.
The approval by Health Canada of two vaccines (Moderna and Pfizer) means the path toward immunity has been opened. After a year of unfamiliar territory, Loh and his team at Peel Public Health find themselves on slightly more familiar ground.
The logistics involved in vaccine distribution on its current scale are new to public health units, but the basics are not. Every year, local health professionals oversee flu vaccine campaigns. Loh himself has experience at the federal level as a medical specialist in vaccine safety between 2012 and 2013.
“Immunization is bread and butter public health,” Loh told councillors at the Region Thursday, saying lessons had been learned in the past. “This is something that we’ve done year in and year out.”
The pandemic complicates matters, meaning Peel Public Health is balancing its roles in contact tracing, communication, outbreak management and testing with the plans to vaccinate. The task may be simpler than managing a pandemic blind, but it remains no small feat.
The goalposts of vaccine rollout have been set by the federal government, the order and eligibility decided at the provincial level and, in Ontario, local public health units are in charge of making it happen. In Peel Region, long-term care has been identified by the Province as a particular priority, with a deadline of January 21 to inoculate the most vulnerable.
Ashleigh Hawkins, a spokesperson for Peel Public Health, confirmed “all consenting residents” at 28 long-term care and 15 at-risk retirement homes in the region have received their first dose of vaccine.
In its first phase, Peel is concentrating on a few select groups. Long-term care residents and staff, frontline healthcare workers, including paramedics, and adult recipients of chronic home health care are among the first to receive their vaccines in Peel.
Around March, when the supply of vaccines is expected to pick up, the second phase will begin. It will offer access to seniors who live in the community, teachers and some essential frontline workers, including those who work in food processing, many of whom live and work in Peel. The third and final stage of the rollout will inoculate anyone who wants to be vaccinated. It is voluntary.
Peel Region is completing a rollout plan to submit to the Province by Wednesday. Janice Baker, the Region’s CAO, told councillors the task will require around 700 people to deliver the full vaccine rollout. “Council [must] understand the enormity of the task,” she said, saying active recruitment was ongoing and that Peel, “really will be mobilizing an army to get this done”.
A key to the vaccine rollout in Peel will be community clinics. The first will open at the Region’s large Service building at 7120 Hurontario Street (Mississauga) and its headquarters at 10 Peel Centre Drive (Brampton) with more to follow between February and April as public health scales up. Brampton and Mississauga are weighing which facilities they can offer for vaccination efforts to expand access and get needles in arms as quickly as possible.
“It is anticipated that these sites will be able to vaccinate thousands of people per day, as supplies allow, over as many hours as possible,” a Region of Peel press release explains. “Additional community clinics will be set up once vaccine becomes readily available.”
It is unclear how recent delays to the Pfizer vaccine delivery in Canada could affect Peel’s plan.
Mississauga Mayor Bonnie Crombie, with the support of her Brampton and Caledon counterparts, has been pushing for the Province to greenlight a mass vaccination centre in Peel. The first such space opened in Toronto Monday to pilot the approach before it is rolled out across Ontario.
“We know that Toronto is getting a vaccination centre with their 230 cases per 100,000, so it is only fair that our region, with 261 cases per 100,000, also has a mass vaccination centre,” she said at a press conference last Wednesday. “Mississauga and all of Peel Region has suffered greatly from this pandemic and I am doing everything I can to make sure we move past this COVID nightmare as soon as possible.”
A spokesperson for the Ministry of Health acknowledged a request for comment Monday, but did not respond in time for publication.
One unique discrepancy in Peel Region is among firefighters. In Mississauga, they’re a frontline group, but in Brampton firefighters will have to wait longer. Brampton Regional Councillor Rowena Santos pointed out the difference at regional council last week, saying she had “some concerns”.
A Christmas COVID-19 outbreak within the Mississauga Fire and Emergency Service, which led 90 firefighters to isolate, means staff have been bumped into the first phase. Mississauga has been sending 20 to 25 firefighters per day to receive their first dose of the COVID-19 vaccine for roughly the last week, according to Shari Lichterman, commissioner community services.
“There was a concern — a public safety concern — that was identified by the prioritization team and so that is why Mississauga Fire was prioritized… recognizing, of course, that if they didn’t have that outbreak, they would be probably waiting the same way the rest of the fire services in the region are,” Loh explained.
Peel Public Health will also demonstrate the lessons it learned testing residents for close to a year by planning drive-thru and mobile vaccination clinics as well.
“Our team is working day and night,” Baker added.
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