Ottawa Public Health COVID Update to City Council

October 27th OPH Update to City Council by Dr. Vera Etches

Dear Mayor and Members of Council,

When I last presented at City Council, I brought your attention to the alarming COVID-19 situation in our city. As you know, on October 10th, the Province moved Ottawa to modified Stage 2 restrictions for 28 days. It is still too early to see the full impact of these restrictions, however in the week following (Oct 11-17), there were 615 people diagnosed with COVID-19 – lower than the previous week (746). We are seeing COVID-19 affecting all age groups across the entire city. Our concern is that we currently have 64 ongoing outbreaks, the majority of which are in long-term care homes, retirement homes, hospitals and other congregate care settings. Over the past two weeks, there were high levels of hospitalizations due to COVID-19 with an average of 50 people in hospital per day. We also saw an increase in deaths, with 19 deaths in that time period.

Moreover, we are seeing the virus transmit, not just among social gatherings and restaurants, but also and amongst sports teams. Any social interactions where distancing and masking are not being implemented put people at risk. For example, for adults aged 40 and over, workplaces are the most common exposure setting after household and healthcare institutions. COVID-19 is hard to slow down given the asymptomatic infections it can cause and the transmission than can occur in the 2 days prior to onset of symptoms. We continue to support the public to be aware of how contagious it can be and what they can do to help prevent transmission.

As the situation is continuously evolving, Ottawa Public Health (OPH) is pleased to provide you with the following updates regarding our response to COVID-19.

Reducing the Spread of COVID-19

OPH’s main goals throughout the COVID-19 response are to minimize hospitalizations and deaths, to reduce societal disruption by keeping schools open and to mitigate economic impacts. It is critical that together, we turn the tide on the recent spikes in people testing positive. To turn the curve again, measures must be aimed at preventing COVID-19 transmission; testing and tracing will not be enough given that these approaches limit spread after infections occur. We have the power to turn the curve in the right direction by sticking to basic COVID Wise guidance: limiting close contacts to those you live with, wearing a mask and wearing it properly, washing your hands, and staying home when sick.

Each component of COVID Wise guidance is aimed at reducing transmission. While washing our hands, limiting our contacts and staying home when we are sick are all simple pieces of guidance, OPH would like to provide further information on the importance of wearing a mask properly.

Wearing a mask around others who are not part of your household is crucial to reduce the spread of COVID-19. However, it’s also important that masks be worn properly. Masks are not all made the same and different styles of masks may fit differently. Finding the right mask that fits your face – covering both your nose and mouth – and learning how to wear your mask, is critical.

To wear a mask properly, OPH offers the following guidance:

• Immediately wash your hands before putting the mask on, before adjusting it, before taking it off and after taking it off. Use soap and water or an alcohol-based hand sanitizer to wash your hands.
• Make sure your mask allows for easy breathing and completely and comfortably covers the bridge of the nose, covers your mouth, fits snugly without gapping under your chin and against the sides of your face. 
• Make sure your mask is secured to your head with ties or ear loops without the need to adjust frequently.
• If your mask has pleats, ensure that the pleats on the outside are facing down.
• If your mask has a metal strip over the nose, gently mold it over the bridge of your nose to ensure a close fit.
• Replace the mask as soon as it becomes damp, dirty, damaged or if it has shrunk after washing and drying. 
• Do not share your mask with others, even within your own household.
• Do not wear your mask around your neck, on your forehead, under your nose, only on your nose, on your chin, one ear, on your arm.

OPH has created a poster and video to assist residents in learning how to wear their mask effectively.

• Poster: Safely putting on & taking off your mask
• Watch: How to Properly Wear a Mask Video

Fewer Ottawa Residents Presenting for COVID-19 Testing

Ottawa’s COVID-19 Testing Taskforce, led by community partners, is investigating why testing volumes in Ottawa have begun to decline. With the demand for testing seen earlier this fall, the Taskforce worked to increase capacity by prioritizing testing for symptomatic residents and providing for additional locations and hours of operation.

Testing is important because it tells us who has the infection, where the virus is spreading in our communities, and the extent to which the virus may be circulating in our communities. OPH can use this information to:

• Find and isolate people who have COVID-19, to prevent further spread and to prevent outbreaks;
• Follow-up with close contacts of people who have tested positive so that they can self-isolate, monitor for symptoms and get tested;
• Know how many people are infected, which helps us understand the level of risk in a community;
• Inform the public health actions that are put in place; and
• Better understand this virus.

OPH wants residents to know that it is easier than ever to get tested if they have any COVID-like symptoms or if they’ve been in contact with someone who has tested positive. Testing is the only way we can confirm if someone has COVID-19 and knowing if someone is infected is important to protect their family and the community.

Ottawa’s COVID-19 Testing Taskforce distributes a daily testing update that provides key highlights about the number of residents who were tested that day (up until 3pm), the average turnaround time for results, and more. The update also includes any new information regarding testing centres, hours of operation and appointment booking.

Get your flu shot!

Getting the flu vaccine is recommended every year, but given the current COVID-19 pandemic, it is especially important this year to avoid pressure on our healthcare system from COVID-19 and influenza viruses circulating at once. 

If residents don’t normally get a flu vaccine, OPH is urging them to get one this year. Adequate levels of influenza vaccination in our community will help reduce the spread of illness, thereby protecting our vulnerable population and keeping flu-related hospital admissions low. More people getting their flu vaccine reduces the risk of the flu virus spreading.

This year, there are several ways residents can access the flu vaccine:

• by making an appointment with your family doctor or other primary care provider;
• by visiting a participating pharmacy (a map of participating pharmacies can be found here);
• or by making an appointment at an OPH Flu clinic.

Symptoms of the flu can be similar to those of COVID-19. OPH continues to encourage anyone who is exhibiting symptoms of COVID-19 to present for testing. OPH is also asking residents to please refrain from going to get the flu vaccine when they are feeling unwell with symptoms of flu or COVID-19.

Ottawa is currently at the highest level of alert for COVID-19, therefore it is critically important that we all follow public health measures including wearing a mask, physical distancing, self-isolating when ill and exercising proper hand hygiene. Fortunately, all of these measures are also be very effective in preventing the transmission of influenza.

OPH Community Flu Vaccination Clinics

This year, as a result of COVID-19, OPH’s flu clinics will be at 6 fixed locations as opposed to roaming clinics throughout the city. These clinics will operate 7 days a week, including evenings and weekends.

The 6 locations are:

• Notre-Dame-Des-Champs Community Hall in Navan;
• Ottawa Public Library Orleans Branch;
• Lansdowne Horticulture Building in the Glebe; 
• Mary Pitt Centre in Nepean;
• Chapman Mills Community Building in Barrhaven; and,
• Eva James Memorial Centre in Kanata.

To prevent crowding and line ups, OPH cannot accommodate walk-ins at the clinics. Residents can book their appointments online or by phone at 613-580-6744.

OPH has already seen significant interest in this year’s flu clinics, with appointments fully booked for the week of October 29 to November 4. Information regarding the release dates of future appointments is available on OPH’s website. Appointment time slots will be released every Thursday for the upcoming week. The goal is to steadily increase the number of residents who are immunized over the coming weeks and months.

To ensure everyone’s the safety while COVID-19 is present in our community, and to encourage all residents to get the vaccine, this year’s clinics will include COVID-19 infection prevention control measures such as: screening staff, volunteers and clients for illness or exposure to COVID-19, physical distancing in terms of clinic layout and the number of clients allowed in the clinic at any given time, Personal Protective Equipment for staff and nurses, increased environmental cleaning, the use of an online appointment system to control client flow and avoid crowding, and enhanced communications.

To help residents know what to expect at the flu clinics this year, we have created a walk-through video to show them what a typical flu clinic will look like.  We encourage residents to review the video prior to their appointment. We ask that Members of Council share the video widely within your community.

COVID-19 What We Heard Phase III Public Engagement Survey

OPH, in collaboration with the City of Ottawa, is continuing a phased public engagement strategy to better understand the impact of COVID-19 on residents and help inform response efforts. The information received from residents will help to ensure a plan is developed that aligns with Ontario’s framework for reopening the province and meets the needs and expectations of the community as much as possible.

This third phase of engagement was available from August 21 to September 18, 2020. Its objectives were to assess public perceptions and understanding of:

• The Temporary Mandatory Mask By-law and other COVID-19 control measures,
• Social circles and indoor/outdoor gathering restrictions, and
• Reopening of higher risk sectors. 

It also aimed to collect ideas on innovative safety practices in local businesses and to assess long-term aspirations and concerns while living with COVID-19. Ottawa residents were asked to share their thoughts through a new survey and forum questions available on the City’s Engage Ottawa website in English or Participons Ottawa website in French. 

The 21 survey questions garnered 416 responses, and three forum questions got 36 responses. Questions were organized by themes: mandatory mask by-law, social circles and gatherings, Stage 3 reopening, workplaces, schools, City facilities, looking ahead and innovations in business.

The report’s key findings are as follows:

• Eighty-nine (89%) per cent of residents said they are supportive of the Temporary Mandatory Mask By-law because masks are scientifically proven to be effective and are an easy way to protect others from COVID-19.
• Residents indicated it is challenging to maintain a 10-person (or less) social circle where all members are exclusive to each other for many reasons, which included large families and having children in school.
• Eighty-eight (88%) per cent of residents who are parents/guardians said that they have concerns about the 2020-2021 school year, which included large class sizes and the exemptions for the use of masks in schools.
• Residents shared what they are doing to stay positive in difficult times during the pandemic. Virtual and physically distanced conversations with friends and family was mentioned by many, as well as being active and focusing on mental health. 

The full version of the report is available here.

Real People, Real Stories, COVID-19 Communications Campaign

OPH will soon be launching the Real People, Real Stories, COVID-19 communications campaign, and is looking for ‘real life stories’ of Ottawa residents who have tested positive for the virus in Ottawa, including:

• those who became very ill after contracting the virus;
• those who may not have had symptoms at all and may have spread the virus to others;
• those who know they likely made others sick, such as a grandparent or a child, because they didn’t follow public health guidance; and,
• those who simply want to share their experience with COVID no matter the circumstances.

By sharing residents’ stories, OPH hopes to increase awareness of the very real impact that COVID-19 can have on people’s lives. Ultimately, the goal is to reinforce the importance of public health measures and help reduce the spread of the virus in our community. By sharing their stories, residents can help others better understand COVID’s real impact. For those choosing to participate in this project, their story will be shared on OPH’s various channels.  

OPH is also working with the Children’s Hospital of Eastern Ontario (CHEO) to access a pool of participants through a CHEO research project. These are individuals who have already expressed interest in sharing their stories for research purposes.

COVID-19 School Support Team Update

As we approach the third month since schools in Ottawa reopened, we have seen over 224 persons with COVID-19 in schools during their period of communicability, resulting in over 639 high-risk contacts needing to isolate. With continued high community transmission of COVID-19, the virus continues to make its way into our schools. OPH is working to support our school partners, parents, guardians and students to help reduce the risks and impacts.

The COVID-19 School Support Team is focused on continuously improving OPH’s approach and response to support our school community. As a positive test result is identified, often by the principal, first the individual with the positive test result is confirmed to be isolating at home. Then we confirm the lab result and immediately begin our assessment with the school to identify high-risk contacts. We strive to communicate with the entire school community and the high-risk contacts as soon as possible.  Our current experience is that it takes between 4 and 24 hours, depending on when the laboratory result is confirmed, ensuring that people who need to stay home and isolate can do that right away.

We always welcome and continue to learn from feedback received from teachers, school staff, principals, parents and students. We would like to thank the entire school community for their ongoing feedback, which helps us identify gaps and provides opportunities to continuously improve our approach.

The COVID-19 School Support Team continues to assess its staffing capacity and how the Public Health Nurses (PHN) can expand the supports they are providing to school communities. We are in the process of working with our school board partners to determine how we can increase efforts on prevention and education for all ages and stages, and to support residents and schools to keep children safe.

Winter Activities

November is fast approaching, and it will not be long before we start to see snow on the ground. With colder weather on the way, more people will be tempted to socialize indoors instead of outdoors. We know that outdoor activities are good for both physical and mental health and are usually safer than indoor activities in terms of reducing the risk of COVID-19 transmission.

The safest option is to choose activities that can be done with just household contacts or, if residents live alone, with one or two chosen social support persons. If residents get together with others, OPH is asking that they wear a mask, maintain physical distancing, don’t share snacks or drinks and, if traveling to destinations, carpool only with people in your household.

Here are some ideas to have fun this winter while reducing the risk of COVID-19:

• Outdoor play and leisure:
  • Building a snowman
  • Building a snow fort
  • Going for a walk to look at holiday lights
• Ice Skating – Tips:
  • Sit on a bench outside to put your skates on instead of inside a changing hut.
  • Choose open spaces where it is easier to maintain a 2 metres distance from other people.
• Downhill Skiing – Tips:
  • Share lifts only with members of your household or, if you live alone, with your chosen social support persons.
  • Stay outdoors and on the slopes to avoid the ski resort lodge and crowded places.
• Tobogganing – Tips:
  • Stay with your household members or, if you live alone, with your chosen social support persons.
  • Avoid crowded hills – come back at a different time.
• Cross Country Skiing, Hiking or Snowshoeing – Tips:
  • Find a multi-use winter trail to enjoy but keep a 2 metre distance from people outside of your household or chosen social support persons.

OPH asks people to consider their own individual risk factors before participating in any outdoor group activity. For an older person or someone with chronic medical problems, the best decision may be not to participate in group activities at all, and instead focus on individual activities.  OPH recommends the CDC website to all persons wishing to better understand their personal risks from COVID-19 infection.

There is no doubt that this winter will be challenging as a result of the pandemic. OPH has already begun to share messaging encouraging Ottawa residents to remain COVID Wise throughout the winter months. You can find it on our Be Social Wise – Guidance for Social Gatherings During COVID-19 webpage.

Thank You 

OPH continues to encourage Ottawans to care for one another, by each of us doing our part to mitigate the spread of COVID-19 and by supporting people who are negatively impacted. City Council has been instrumental in helping us achieve that goal. We know it’s hard for residents to hear that we must stick with our COVID prevention measures for a while longer, especially when it feels like there is no end in sight. We are asking them to please, hold on with us. One lesson from the past is that health crises do pass, and this one will too. When we work together to decrease COVID in the community, economic recovery can come more quickly.

Thank you, 
Vera Etches MD, MHSc, CCFP, FRCPC

Medical Officer of Health, Ottawa Public Health / Santé publique Ottawa