Prelude: This was a non-thoroughly-prepared written delegation to the September OPH Board meeting. I may add some reference sources or further explanations to a few of the issues mentioned; if so, this prelude will be revised, and the additions will be included within the formal text but in italics. I think it is worthwhile to make this delegation publicly-accessible because OPH doesn’t do so, apparently in violation of their own policy (see my point #1 below); and also it is timely due to the coverage that the external audit of OPH by Dr. Paul Gully is receiving, as well as it being the start of the school year and thus COVID policies are again at the top of many people’s minds. Here is a link to the full meeting video, and to the agenda/minutes page through which Dr. Gully’s full Third-Party Review can be accessed.

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Greetings to the Ottawa Board of Health members and team of Ottawa Public Health,

I welcome and appreciate this opportunity to provide public input on the workings of OPH during the current COVID pandemic and public healthcare crisis we are collectively experiencing.

It is a difficult situation to be in, as the President of the United States just yesterday declared the pandemic over, and we already seem to have many levels of government behaving as though it is.

It isn’t, in my humble opinion (‘IMHO’) and also in the opinion of many people I look to for expert advice, who are more qualified to assess this kind of thing than I am and aren’t in any conflict of interest in making that determination.

There are a few things I would like to address for this meeting and the work of OPH and the Board:

1. How public this input is.
2. COVID in schools p1: Dr. Etches statement of last week downplaying transmission in schools.
3. COVID in schools p2: Current measurement of outbreaks in educational institutions, and elsewhere.
4. OPH’s approach to Long COVID, and to COVID in general.
5. The growing public healthcare / hospital crisis.

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1) The public record for public delegations to the Ottawa Board of Health

In a previous delegation I made to the Board, in June 2022, I made note of the stated policy of these meetings, that written delegations were to be posted online by OPH to be accessible to the public – and asked that this policy be followed through on, since it wasn’t being implemented from what I could see.

I note now two things:

1. The minutes from that meeting are not yet posted (as of 11am today before this next meeting), and thus I am unable to see whether my written delegation or any others are or will be posted as part of those minutes.
   
2. The “Notices to the public and participants regarding Board of Health proceedings” that is now linked from the meeting agenda – as opposed to previously, when the instructions for public delegations were in the agenda itself – has no mention of written delegations being made publicly-accessible. It does still say “Written comments (encouraged): Members of the public may submit written comments by email to the Board Secretary (email address below). Both written and oral comments are given equal consideration by the Board.”

I ask that the Board please consider what is going on with this policy.

And I note that if you are encouraging written delegations in place of spoken delegations, that you please ensure they are treated equally, by making sure to also include them as part of the public record.

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2) COVID in schools p.1: Dr. Etches statement of last week downplaying transmission in schools

In response to a CBC question* about COVID increasing in the fall in relation to school, Dr. Etches stated, “Our experience has been it’s the crowding before school, after school, it’s the social connections, in homes, more visiting, it’s all the different indoor sports activities, all of these things come together, and so it’s not necessarily the classroom itself that is the source of more COVID transmission, but all the activities that come with going to school…”

I think this statement begs the question, how much data do you have to back this statement up?

And also how accurate the implication is, that spread in classrooms isn’t something to be concerned about.

I think responsible messaging is important. And when research is being published saying spread in schools is triple as high when there isn’t mask mandates compared to when there is, I think this messaging is very unhelpful and ask that the Board get OPH to shift the approach to schools.

I ask this in the context of having published a detailed critical analysis of OPH’s report on COVID in schools (Feb 2021; my analysis June 2021) and also having suceeded in getting Dr. Etches to correct her Jan 2022 public statement that inaccurately minimized the levels of COVID in schools.

*Reference: https://www.cbc.ca/news/canada/ottawa/dr-vera-etches-return-to-school-september-2022-ottawa-1.6566446

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3) COVID in schools p2: Current measurement of outbreaks in educational institutions, and elsewhere

Later in the same response to CBC, Dr. Etches stated, “We’ll continue as OPH to let people know what’s happening” with COVID levels.

From the OPH dashboard, I looked this morning at the listing of current outbreaks, and counted 25 locations. They were all Retirement Homes, Long-Term Care Homes, and Hospitals.

However, I have heard informally from teachers and parents in schools, and students and professors at universities, that there does seem to be a lot of COVID spreading around.

What concerns me, is that it appears the main reason that there aren’t any outbreaks reported, is simply because there is no measurement of COVID cases. I hope that this can please be clarified, and discussed whether this is a good place to be.

I understand the view that it is good for students to be in school and to not keep shutting down classes, but I think it is concerning that there is no balance to this policy – how responsible an approach is it, to simply not be measuring something as a way to make it appear there isn’t a problem?

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4) OPH’s approach to Long COVID, and to COVID in general

Long COVID is becoming a wider-known problem. I know one person who had to permanently close the home day-care she and her partner ran, because she has been suffering Long COVID for over a year and is no longer able to do the work she used to. To note, this is also without much of a social safety net. Many others are also experiencing similar things.

The sole mention of Long COVID on the OPH website has this basic message about what to do:

“According to the Centers for Disease Control and Prevention (CDC), the best way to prevent post-COVID conditions is to protect yourself and others from being infected. … The causes and treatments for each person who has longer-term health problems will be different. The long-term effects of COVID-19 infection are still being studied. Have a discussion with your health care provider about your personal situation if you are having problems during your recovery. 

I think this is illustrative of a Public Health approach of telling people they’re basically on their own – a downloading or offloading of responsibility onto the individual rather than implementing robust public health policies.

And I seriously ask that the Board and OPH consider whether this approach is what they want to be known for, and to consider the long-term effects and costs of not implementing better collective preventative measures.

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5) The growing public healthcare / hospital crisis

All of this is linked to what seems to be a very serious crisis in healthcare provision.

I would like OPH to be very clear in communicating the seriousness of this crisis, in an ongoing manner, to the public, and taking appropriate action and advocacy to protect the services that people deserve – and the working conditions of health care professionals.

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Thanks,
– Greg Macdougall