Ontario Auditor General praises KFL&A Public Health for COVID-19 response

On Wednesday, Nov. 25, 2020, the Auditor General of Ontario, Bonnie Lysyk, released her COVID-19 Preparedness and Management Special Report, and while much of the report was critical of the provincial response to COVID-19, the Auditor General singled out and commended KFL&A Public Health in several parts of her report for its response to the pandemic.

According to the report, KFL&A Public Health, led by Dr. Kieran Moore, was one of only four public health units who met a target of 80 per cent positive tests completed within two days. KFL&A Public Health was joined by the public health units of Hastings and Prince Edward Counties; Leeds, Grenville and Lanark District; and Ottawa in meeting that threshold.

The report was also effusive in its praise of KFL&A Public Health for championing several best practices, such as conducting an annual influenza preparedness workshop with health-care providers (including long-term-care home staff), and performing compliance health audits at each long-term-care home in early March 2020 to ensure that proper infection prevention and control procedures were in place.

In addition, the auditor’s report states, KFL&A Public Health prepared a manual for long-term-care homes to guide them in implementing necessary precautions during a viral outbreak. The manual contained information and resources to guide the homes in their response efforts, such as an explanation of the criteria for when a home should declare an outbreak and a checklist that includes steps to take during such an outbreak. This manual outlines important information such as who to notify, what precautions to implement, what cleaning measures to take, what restrictions and measures to put in place for residents, staff, and visitors, as well as instructions on how to administer the collection and delivery of a specimen for COVID-19 testing.

According to Lysyk, KFL&A Public Health outperformed most other public health units in several ways, including one of the lowest rates of COVID-19 cases in the province despite the majority of its population living in urban regions. KFL&A Public Health had 53 cases per 100,000 residents (or 112 total cases) as of August 31, 2020, and had no deaths due to COVID-19.

Additionally, while KFL&A Public Health has 11 long-term-care homes and 19 retirement homes in its region, as of August 31, 2020, only one staff member at a long-term-care home had tested positive for COVID-19 (on April 1, 2020), and no residents had contracted COVID-19 at that time.

“The low rate of COVID-19 cases in the region can be at least partially attributed to Kingston Public Health Unit’s early preparation,” said Lysyk. “The unit began preparing the community before COVID-19 became a crisis in the province, and focused on infection and prevention control practices in long-term-care homes.”

The Auditor General lamented that some of KFL&A Public Health’s best practices had not been shared and adopted more widely. “Having implemented such practices prior to and in the early stages of the pandemic, the Kingston, Frontenac, Lennox & Addington Public Health Unit had not reported any long-term-care residents diagnosed with COVID-19 (as of August 31, 2020). However, these practices were not in place at other public health units. For example, 71 per cent of the public health units that responded to our survey (20 of 28) said that they do not hold annual influenza preparedness workshops with health-care providers,” her report notes.

According to the report, Ontario’s 34 local Medical Officers of Health and the Chief Medical Officer of Health participated in weekly calls beginning on January 23, 2020, and continued twice weekly since February 11, 2020, to share information about the ongoing pandemic response. “Despite these opportunities for information-sharing, not all public health units followed the best practices or lessons learned from other public health units with better performance, like Kingston Public Health Unit,” said Lysyk. “Public health units implement and share provincial policy and guidance, but as independent entities they are not required to put these into practice in a consistent fashion. This results in variations among public health units in their outbreak and emergency responses.”