When the Board of Health (BOH) for Kingston, Frontenac, Lennox & Addington (KFL&A) convened virtually for their first meeting of the new year on Wednesday, Jan. 26, 2022, the status of COVID-19 in the region was, unsurprisingly, the focal point or the strong undercurrent of most topics of discussion.
Omicron in KFL&A, effects of immunization on hospitalizations, and easing of provincial restrictions
The meeting began with a COVID-19 update by Dr. Janice Mok, Public Health and Preventive Medicine Resident from Queen’s University, who reviewed the local rise of the Omicron variant, beginning with the first confirmation of Omicron in the KFL&A region via lab results on Tuesday, Dec. 7, 2021. She explained that investigation revealed that the local instances of this COVID-19 variant could be traced back to as early as Thursday, Nov. 25, suggesting that there had already been significant transmission of this variant in KFL&A by the time its presence was officially recognized.
She reiterated that, due to the early wave of Omicron variant, “KFL&A had the highest rate of COVID cases in Canada for a short time, and [local] measures were put in place to curb the severity of the spread… Shortly after, Ontario put into place 50per cent capacities for dining and events on December 19, and then after that, on the 31st, a number of changes were also implemented limiting social gatherings… [and] remote learning was put into place until January 17.”
Dr. Mok’s report delved into the severity of COVID-19 using data from the Ontario Science Table, which demonstrated that a much larger proportion of those who are hospitalized due to the virus and who require ICU care are unvaccinated, compared to those who are vaccinated with at least two doses.
However, it now looks as though Omicron activity in the region has peaked, and there are some points of good news for the region. “KFL&A has among the highest vaccination coverage for both [3rd dose adult] boosters and for kids [age 5 to 11],” said Dr. Mok. “Our vaccination strategy will continue to be nimble and adapt to the changing circumstances. As well, we can see that there is low community prevalence overall… And overall, we can tell you that KFL&A remains one of the safest places to live and go to school.”
Dr. Mok indicated that the “tentative plan” for Ontario Public Health is to ease restrictions, beginning Monday, Jan. 31, 2022. Following that date, she noted, “the plan is to relax measures every 21 days depending on our indicators.”
Following Dr. Mok’s report, the Public Health team of doctors opened the floor for questions.
Kingston City Councillor Jim Neill asked about requirements for additional vaccinations. “I know that some European countries and Israel have gone to a fourth shot being available. Is there any forecast that that may happen in Ontario or in Canada?”
The question was answered by Dr. Hugh Guan, Associate Medical Officer of Health (AMOH), who explained, “Currently, fourth doses are reserved for higher risk individuals, those in LTCs (long term care facilities) and retirement homes, as well as those who are moderately to severely immunocompromised — so folks who are on chemotherapy for cancer or things like that… Currently, we don’t have enough evidence to show what the additional benefit of fourth doses are on a population level.”
Councillor Neill also asked about the availability of an Omicron-specific vaccine, to which Guan replied, “Yes, that is currently being developed… it’s hard to provide a timeline, just because I think they are only in the initial phases of the trials, but I would hope that it comes sometime before the end of this year.”
Ontario Cannabis Legalization Funds
The BOH also received a memo from KFL&A Public Health’s Susan Stewart, Director of Community Health & Well-Being Portfolio, and Daphne Mayer, Manager of Substance Use, Mental Health, Injury Prevention, with regard to the cannabis public education campaign funded by the Ontario Cannabis Legalization Fund.
In the memo, Stewart and Mayer requested that the Board approve the retaining of the $59,000 remaining from funding received from the Ontario Cannabis Legalization Implementation Fund (OCLIF), with the goal to support future work related to planning and implementation of a renewed cannabis campaign.
The OCLIF was announced in 2018 as a two-year initiative to help municipalities with the implementation costs of adapting to recreational cannabis laws. In May 2018, the Cannabis Communication Partnership was formed to plan public education strategies related to cannabis. The partnership included representatives from KFL&A Public Health, Kingston Police, the City of Kingston, Frontenac County, and Frontenac Paramedic Services.
“Emerging evidence on cannabis consumption demonstrates an increase in use over the course of the pandemic in Canada,” the memo stated. “The prevalence of self-reported increased cannabis consumption was most pronounced for males, non-immigrants, those who reported that their income had decreased, and individuals who self-reported that their mental health was much worse or somewhat worse since the start of the pandemic. This increase is also supported by a study that looked at national retail sales of cannabis during the COVID-19 pandemic.”
“There is work to be done to better understand changes in cannabis use locally and to assess any health equity issues associated with these changes. Once this planning work is completed, a new and revised cannabis strategy can be implemented. At that time, the OCLIF funds will be instrumental to implementing this campaign. Given the unpredictable nature of COVID-19, there is no clear timeline for the resumption of this work, but it is anticipated that planning will begin in 2022,” stated Stewart and Mayer.
In response to the memo, the BOH unanimously supported the retention of the $59,000 remaining Ontario Cannabis Legalization Implementation Fund (OCLIF) funding to support future work related to future planning and implementation of a renewed cannabis campaign.
Medical Officer of Health’s Report
Dr. Piotr Oglaza, Medical Officer of Health for the KFL&A Public Health region, presented his monthly report to the BOH. KFL&A Public Health’s activities and priorities continue to be dominated by the changing demands of the COVID-19 pandemic, he said, but he added, “We are also mindful of some of the essential work that’s not related to COVID-19 that needs to continue, and that’s also reflected in some of the items featured in this report.”
In particular, Dr. Oglaza drew the BOH’s attention to what he called “our rapidly changing environments and updates related to the school reopening that took place on January 17.”
First, he thanked the community for their commitment to getting children immunized and to continued implementation of the various infection prevention control measures, and reiterated Dr. Mok’s earlier statement. “This community is one of the safest places in Ontario to go to work or go to school, based on our high immunization rates, as well as relatively low COVID-19 [activity].”
“I do recognize that the return to in-person learning has caused mixed feelings among students, staff, and families, and this is something that I want to address,” he said, explaining that “while individuals that are between the ages of five and 19 appear to be in lower risk of severe disease from Omicron, that risk can be further reduced through immunization.”
Dr. Oglaza also advocated for continued vigilance in managing COVID-19 in schools. “The Omicron variant can spread very quickly, and the way we manage COVID-19 in the school setting has to change to reflect that reality.”
Specifically, he noted that instead of focusing on where the virus already is by sending home entire cohorts of fellow students, different proactive methods may be more effective. “We need to predict where it will be going and minimize transmission with Public Health measures. And that’s really the key to this change… We also recognize that in-person learning remains the best choice for healthy child development and significant health benefits.”
The key to this, Dr. Oglaza stated, is symptom screening and staying home when sick, noting that, “Whether that individual knows for certain that they have COVID-19 or another respiratory illness, it does not change the management. It does not change the essential need to stay home when sick and avoid spreading of that pathogen. And that’s really the cornerstone; we ask those who are symptomatic to stay home.”
The BOH moved their meeting in-camera following Dr. Oglaza’s detailed report, noting that details discussed in the remainder of the meeting would be addressed at the Board’s next meeting.