April’s Board of Health meeting for Wellington-Dufferin-Guelph brings you sex and drugs, but no rock and roll. Or, to be more precise, it’s bringing you an update on fighting the opioid epidemic as well as an update on fighting sexually transmitted infections, which are both very serious issues despite the above joke. Also on the agenda is information about COVID-19 and flu vaccine distribution for this past cold and flu season!
NOTE #1: This meeting will be in-person at the Public Health office on Chancellors Way and it will also be available to watch online. To get the link you will have to send a request to join the meeting via an online form that you can find here. Deadline to send in the request is Wednesday April 5 at 11 am.
NOTE #2: The meeting begins at 2 pm.
MOH Update(s)– Medical Officer of Health Dr. Nicola Mercer will deliver her verbal report on current matters facing Public Health.
PRESENTATION: Opioid Related Harms – This presentation will be tied to the Opioid Surveillance Update, which says that in 2022 the rate of emergency room visits related to opioids was down from 67 per 100,000 in 2021 to 59.1 in 2022; this marks the first time since 2019 that there’s been a decrease year-over-year.
Statistics about opioid mortality are incomplete as of this report, but between January and September of 2022 there were 31 confirmed opioid-related deaths in the region compared to 31 in the same period in 2021 and 17 in 2020. For people who take opioids along with other drugs, meth is the most common substance found in people who died from opioid-related fatalities 53 per cent of the time. That was followed by cocaine at 37 per cent and Benzodiazepines and alcohol tied for third at 7 per cent.
There are now additional concerns around Xylazine, the so-called “zombie drug” that makes revival through naloxone impossible. Xylazine was detected in 2-4 per cent of opioid toxicity deaths in Ontario between Q4 2021 and Q3 2022.
Public Health says in the report that there continues to be a need for a community response to opioid-related harms and supports the ongoing community partnerships and the creation to new ones in order to find the best ways to reduce those harms across the region.
Influenza and COVID Vaccinations – Cold and flu season wraps up (unofficially) with a recap of the vaccine roll-out this year including the COVID-19 vaccine, of which 220,850 doses were delivered in 2022. Interestingly, nearly a thousand more doses of the flu shot were given out in the region during the 2022-23 flu season versus the 2021-22 season. Between public health clinics and pharmacies, 59, 529 flu shots were given out this year versus 50, 135 in 2022-23.
Naloxone Distribution – This is an update about how public health is implementing the Ontario Naloxone Program, which, among other things, sees naloxone kits distributed to community partners who qualify including health organizations, drug programs, shelters and outreach programs, police, emergency medical services (EMS), St. John’s Ambulance, and hospitals with emergency departments. Although the kits were distributed to four new locations this year, the request to give one to the main branch of the Guelph Public Library was denied by the ONP. Training will naloxone will expand to other departments beyond Community Health laster this year.
Sexual Health Program 2023 – This report will set up the first presentation of the meeting, and provides an overview of how public health addresses the three main standards of community sexual health which are immunization, infectious and communicable diseases prevention and control, and substance use and injury prevention. Public health provides testing and case management for STIs like gonorrhea, chlamydia and syphilis, plus vaccines if people quality. Public health plans on expanding to family planning and pregnancy counselling in 2023 including access to contraception for residents of the region who can’t afford medication.
Trends in Reported Sexually Transmitted Infections in Wellington-Dufferin-Guelph: 2022 – The Sexual Health Program is going to be getting a good work out because the annual rates of chlamydia and syphilis increased in 2022 versus 2021.
The number of syphilis cases only went up by three cases in 2022 when compared to 2021, so the real problem is chlamydia, which went up by 111 cases year-over-year. Now granted, this is lower than the provincial rate, but rates of chlamydia are higher in women when compared to men. In terms of looking at the glass half-full, chlamydia rates are down when compared to 2018 and 2019.
The rate of gonorrhea remained steady in 2022, but in this instance it’s the men that are over represented in new cases versus the women, and there were also fewer new cases of HIV infection in 2022 when compared to 2021. At the same time, the Mpox outbreak never really seemed to happen with fewer than 10 total cases in the region.
Public health intends to expand STI testing in 2023 with extended clinic hours and by adding more physicians. Testing and counselling on sexually transmitted infections was scaled way back until last summer for obvious reasons.
Long-Term Care Home/Retirement Home COVID-19 and Influenza Vaccination Rates 2022 – Separate from the above report about community-wide vaccination, this report focuses exclusively on the staff and residents of the region’s long-term care and retirement homes. On that count, between 90 and 93 per cent of residents on average got their flu shot and nearly 82 per cent got their COVID-19 fall booster.
The bigger issues was employees getting their flu shot with nearly 69 per cent of workers in long-term care homes getting their shot on average versus 58.5 per cent of retirement home workers. The most vaccinated long-term care home for the flu vaccine, in terms of both residents and staff, was Wellington Terrace in Fergus (93.6 per cent and 89 per cent respectively), while the Elliott Community and Fox Run are the most vaccinated for retirement homes with over 95 per cent of staff and residents each getting their flu shot.
The numbers in the report are current as of mid-December 2022.
Oral Health (Oral Screening and Healthy Smiles Ontario) – Oral health is among the most common non-communicable disease globally, which is why its bad news to hear that 70 per cent of low-income Guelph residents who were recommended to seek dental treatment, couldn’t afford to follow up.
This where programs like Health Smiles Ontario – government-funded dental program that provides free preventive, routine, and emergency dental services to eligible children and youth 17 years and younger to families with limited income – comes in, but like a lot of government programs it’s being taxed by the amount of demand.
Some of that demand is determined by the Oral Screenings at school, which has found a 43 per increase in the number of school students in the region who have an urgent need to get dental care so far this school year compared to the last year that the program was run in 2018/2019. There are still 40 schools left to screen before summer vacation this June.
Addressing the need will be tricky because the HSO program is having a hard time finding private dental providers to do the job, and may dentists are seeing an increase in overhead costs because of supply chains and other pandemic issues. Public health says that they’re continuing their efforts to find new community partnerships to increase equal access to dental care around the region.
Opioid Surveillance Update – This report will be presented to the board as part of the “Opioid Related Harms” presentation. (See above.)
Committee (Verbal) Report(s)– There is nothing from either the Executive Committee of the the Finance + Audit Committee, but there will be items from the Human Resources Committee that will all need to be discussed in Closed Session.
Annual Health and Safety Activities Report – This item will be referred to in-camera because it involves personal matters about an identifiable individual, including Board of Health employees.
Annual Key Human Resources Activity Report – This item will be referred to in-camera because it involves personal matters about an identifiable individual, including Board of Health employees.
Labour Relations Update (2023)- Matters of labour relations and/or employee negotiations have to be discussed in closed session.