Board of Health
The full agenda, as filed
All 8 items in the clerk’s order. Each carries the city’s own words: the staff recommendation, what the body decided, and its status. Nothing below is written by us.
HL35.1amended
Response to COVID-19 - March 2022 Update
This report provides an update on the response to the COVID-19 pandemic as of March 2022, and responds to Board of Health direction to report back on the impact of the provincial vaccine certificate program. Multiple indicators show that the Omicron wave continues to subside in Toronto after peaking in January. While Omicron wave case counts underestimated the true number of COVID-19 cases due to provincial testing restrictions, there has been a decline in the seven-day moving average of case counts and the test positivity rate for tests that were completed. Other indicators confirm this trend. In recent weeks, there has been a decrease in new hospitalizations and intensive care admissions (ICU). Wastewater surveillance has also shown a decline in COVID-19 levels since their peak in January 2022 across most of Toronto's water treatment plants. The COVID-19 vaccine has proven effective at reducing serious outcomes from Omicron in recent months, with three doses providing the greatest protection. Toronto Public Health, in collaboration with Team Toronto vaccination partners, has continued work to maximize Torontonians' access to the COVID-19 vaccine and has focused its efforts in recent weeks on implementing a data-driven, hyper-local vaccination campaign to promote vaccine uptake in communities with low rates of vaccination. Due to these efforts, a large majority of eligible Toronto residents are now fully-vaccinated with two doses of the COVID-19 vaccine, and over half have received a third dose. There has been a stabilization in COVID-19 indicators across Ontario as well. In light of the current epidemiology and high vaccine coverage, the Province of Ontario (the Province) lifted a number of COVID-19 public health measures effective March 1, 2022, including vaccination certificates, capacity limits, and physical distancing requirements. The Province further shared a plan to remove most indoor masking requirements on March 21, 2022 (with the exception of certain settings including hospitals, shelters and congregate settings, long-term care homes, and public transit), and all remaining COVID-19 restrictions by April 27, 2022. Concurrently, the Medical Officer of Health has lifted a number of COVID-19 orders and letters of instructions, and City Council has amended the City's masking bylaw, ensuring that it will expire when most provincial indoor masking requirements are lifted on March 21, 2022. These measures have proven effective at mitigating the impact of COVID-19 through successive waves of the pandemic, but are no longer necessary as a broad public health intervention in most contexts given the prevailing epidemiology. Toronto Public Health will continue to monitor Toronto's local epidemiological context and is prepared to respond, if needed, should circumstances change. While maintaining support for COVID-19 response, Toronto Public Health is planning for the resumption of public health functions that were paused or scaled back during the COVID-19 pandemic, and developing approaches to address health issues that emerged or were exacerbated as a result of the pandemic, such as mental health, the opioid crisis, and sexually-transmitted infections.
The Board of Health: 1. Requested the Medical Officer of Health to review Toronto Public Health functions and services that were paused or reduced due to the COVID-19 pandemic and report back to the Board of Health in May 2022 with an update on functions and services to be resumed. 2. Requested the Medical Officer of Health to report back to the Board of Health in June 2022 with an update on the development of new approaches to address public health issues and inequities that have emerged over the course of the COVID-19 pandemic, as well as issues that existed prior to the pandemic. 3. Requested the Medical Officer of Health to provide an update to the Board of Health on efforts to build COVID-19 immunization capacity in primary care settings and pharmacies in the second quarter of 2022. 4. Requested the Medical Officer of Health to provide an update to the Board of Health in the second quarter of 2022 on how best to prepare for a potential future surge by employing existing resources to meet other pressing public health needs. 5. Requested the Medical Officer of Health to revise and update the COVID-19 Monitoring Dashboard Indicators (Virus Spread and Containment, Equity, Health System Capacity, Public Health System Capacity) to account for the new phase of the pandemic that the City of Toronto is in, which includes increased individual-level protection due to vaccines and other protective measures at the individual level, and changes to surveillance and equity indicators due to reduced access to Provincial PCR testing. 6. Requested the Province of Ontario to make PCR testing available to a wider range of individuals, especially those at higher risk of serious illness and to put mechanisms in place so that those who test positive have appropriate access to antiviral medications. 7. Requested the Medical Officer of Health to continue to provide updated advice to the public to inform individual assessments of personal risk as new data becomes available, including mask-wearing both for individuals wearing masks and for others in contact with them in indoor settings, recognizing the removal of mask mandates and other public health measures in some settings. 8. Affirmed that wearing a mask continues to be an important tool to keep people safe and help prevent the spread of COVID-19, and individuals who wear masks should be welcomed and accommodated in all public settings. 9. Requested the Medical Officer of Health to work with the Province of Ontario and school boards to achieve the shared goal of create a healthy learning environment for children and report back to the Board of Health in the first quarter of 2023 with an update on actions taken to mitigate the impact of COVID-19 during the 2022-2023 school year. 10. Requested the Province of Ontario and the Government of Canada to continue to review best practices for COVID-19 infection prevention and control in schools, including facility upgrades, and to provide guidance and support to school boards to implement these measures, as required.
Staff recommendation as filed
The Medical Officer of Health recommends that: 1. The Board of Health request the Medical Officer of Health to review Toronto Public Health functions and services that were paused or reduced due to the COVID-19 pandemic and report back to the Board of Health in May 2022 with an update on functions and services to be resumed. 2. The Board of Health request the Medical Officer of Health to report back to the Board of Health in June 2022 with an update on the development of new approaches to address public health issues and inequities that have emerged over the course of the COVID-19 pandemic, as well as issues that existed prior to the pandemic. 3. The Board of Health request that the Medical Officer of Health provide an update to the Board of Health on efforts to build COVID-19 immunization capacity in primary care settings and pharmacies in the second quarter of 2022. 4. The Board of Health request the Medical Officer of Health to provide an update to the Board of Health in the second quarter of 2022 on how best to prepare for a potential future surge by employing existing resources to meet other pressing public health needs.
HL35.2adopted
Ontario Public Health Standards Risk Management Reporting for 2022
This report provides the Board of Health with an update on the risk management reporting that is part of the Ontario Public Health Accountability Framework. It outlines risks and challenges facing Toronto Public Health (TPH) in 2022, after two years of pandemic response efforts, and identifies the mitigation efforts TPH is undertaking to respond.
The Board of Health: 1. Received the report (March 7, 2022) from the Medical Officer of Health for information.
Staff recommendation as filed
The Medical Officer of Health recommends that: 1. The Board of Health receive this report for information.
HL35.3amended
2022 Board of Health Committees and Appointments
This report outlines two Committees of the Board of Health, along with an external Board, that require reappointment for 2022. Appointments to the following Committees and external Board are needed: the Board of Health - Budget Committee, the Board of Health - Performance Appraisal of the Medical Officer of Health Committee, and the Association of Local Public Health Agencies' (alPHa) Board of Directors and Board of Health Section.
The Board of Health: 1. Appointed the following Board of Health directors to the Board of Health Budget Committee for a term of office ending on November 14, 2022, and until successors are appointed: Director Joe Cressy Director Stephanie Donaldson Director Mike Layton Director Gord Perks Director Ida Li Preti 2. Appointed the following Board of Health directors to the Board of Health Performance Appraisal of the Medical Officer of Health Committee for a term of office ending on November 14, 2022, and until successors are appointed: Director Joe Cressy Director Kate Mulligan Director Stephanie Donaldson 3. Appointed Director Stephanie Donaldson to the Association of Local Public Health Agencies' (alPHa) Board of Directors and Board of Health Section for a term of office ending on November 14, 2022, and agreed to pay expenses for attending alPHa's 2022 meetings and semi-annual meetings/conferences within Toronto Public Health's 2022 Approved Operating Budget. 4. Encouraged all Board of Health directors to attend the Association of Local Public Health Agencies' (alPHa) Board of Health Section meetings and semi-annual meetings/conferences in Toronto and pay expenses for attending alPHa's 2022 meetings and conferences in Toronto within Toronto Public Health's 2022 Approved Operating Budget.
Staff recommendation as filed
The Medical Officer of Health recommends that: 1. The Board of Health review the current directorship of the Board of Health - Budget Committee and the Board of Health - Performance Appraisal of the Medical Officer of Health Committee and appoint Board of Health directors for a term of office ending November 14, 2022, and until successors are appointed. 2. The Board of Health appoint a Board of Health director to the Association of Local Public Health Agencies' (alPHa) Board of Directors and Board of Health Section for a term of office ending November 14, 2022, and until a successor is appointed and pay expenses for attending alPHa's 2022 meetings and semi-annual meetings/conferences within Toronto Public Health's 2022 Approved Operating Budget. 3. The Board of Health encourage all Board of Health directors to attend the Association of Local Public Health Agencies' (alPHa) Board of Health Section meetings and semi-annual meetings/conferences in Toronto and pay expenses for attending alPHa's 2022 meetings and conferences in Toronto within Toronto Public Health's 2022 Approved Operating Budget.
HL35.4adopted
City Council Approved Toronto Public Health 2022 Operating Budget
This report provides the Board of Health (BOH) with an update on the Toronto Public Health (TPH) 2022 Operating Budget approved at the City Council meeting of February 17, 2022. On October 25, 2021, the BOH recommended a 2022 TPH Operating Budget of $362,678.1 thousand gross and $128,753.0 thousand net. This budget included seven proposals for new and enhanced services in the amount of $4,193.0 thousand gross and $247.8 thousand net for resources for the collection, analysis and visualization of public health data to inform public health outcomes and support City divisions engaged in programs and services that impact on health, as well enhanced resources for the Toronto Drug Strategy Secretariat, enhanced programming for The Works, an expanded Outreach Overdose Team, an expansion of the Injectable Opioid Agonist Treatment (iOAT), resources to improve data sharing to inform work on addressing the opioid poisoning crisis, and Mobile Consumption Services. City Council approved a TPH 2022 Budget Committee Recommended Operating Budget of $361,684.1 thousand gross and $128,345.8 thousand net. The Council approved budget provides an increase of $16,940.0 thousand gross (4.9 per cent increase in gross expenditures) and $3,954.4 thousand net (3.2 per cent increase in net expenditures) over the 2021 Approved Operating Budget.
The Board of Health: 1. Received the report (March 7, 2022) from the Medical Officer of Health for information.
Staff recommendation as filed
The Medical Officer of Health recommends that: 1. The Board of Health receive this report for information.
HL35.5adopted
City Council Approved Toronto Public Health 2022-2031 Capital Budget and Plan
This report provides an update to the Board of Health (BOH) on the Toronto Public Health (TPH) 2022 Capital Budget and 2023-2031 Capital Plan as approved by City Council on February 17, 2022.
The Board of Health: 1. Received the report (March 7, 2022) from the Medical Officer of Health for information.
Staff recommendation as filed
The Medical Officer of Health recommends that: 1. The Board of Health receive this report for information.
HL35.6adopted
Request for an Update on TOsupports
From the beginning of the COVID-19 pandemic, Toronto Public Health and the City of Toronto have been fully committed to identifying and addressing inequities in health outcomes and social impacts for Torontonians. In December 2020, the Board of Health endorsed TOsupports: COVID-19 Equity Action Plan and 25 equity actions and targeted and enhanced equity measures. And with the roll-out of vaccines in 2021, this work further expanded to include an all-hands campaign to ensure vaccine equity, including Vaccine Engagement Teams from more than 155 community groups and agencies, taking vaccines door to door, and to community centres and shopping malls and bus stops, in neighbourhoods across Toronto where vaccine uptake was slower than average. We are requesting a report in April with an update on TOsupports, including a presentation to the Board.
The Board of Health: 1. Requested the Medical Officer of Health, in consultation with the Executive Director, Social Development, Finance and Administration, report to the Board's meeting on April 11, 2022, with an update on TOsupports, accompanied by a presentation that includes updates on TOsupports, Vaccine Engagement Teams, and the Community Ambassador program.
Staff recommendation as filed
Councillor Joe Cressy recommends that: 1. The Board of Health request the Medical Officer of Health, in consultation with the Executive Director, Social Development, Finance & Administration, to bring a report to the Board's meeting on April 11, 2022, with an update on TOsupports, accompanied by a presentation that includes updates on TOsupports, Vaccine Engagement Teams, and the Community Ambassador program.
HL35.7adopted
Request for Update on the Impact of the COVID-19 Pandemic on Children and Youth
During the past two years of the COVID-19 pandemic, Toronto Public Health has worked non-stop to support children and youth through challenging and unprecedented circumstances. It is important at this time to take stock of the impact that the COVID-19 pandemic has had for school-age children and youth, so we can make effective recovery and support plans going forward. We are requesting that the Medical Officer of Health report back in April with an update to the Board.
The Board of Health: 1. Requested the Medical Officer of Health report to the Board's meeting on April 11, 2022, with an update on the impact of the COVID-19 pandemic on school-age children and youth, outline current programs operated by Toronto Public Health to support this population, and any recommendations for the Board's consideration.
Staff recommendation as filed
Councillor Joe Cressy and Trustee Stephanie Donaldson recommends that: 1. The Board of Health request the Medical Officer of Health to bring a report to the Board's meeting on April 11, 2022, with an update on the impact of the COVID-19 pandemic on school-age children and youth, outline current programs operated by Toronto Public Health to support this population, and any recommendations for the Board's consideration.
HL35.8adopted
Bringing a Public Health Lens to Indoor Ventilation Requirements
One of the consequences of the COVID-19 pandemic has been a widened appreciation for the importance of adequate indoor ventilation as a tool to reduce the spread of respiratory infectious diseases. There is value in taking a closer look at how we construct and operate buildings, and the possibility that improved standards and practices can have broad public health benefits. Many dimensions of indoor ventilation are outside of the direct jurisdiction of local public health or municipalities. In addition, Toronto Public Health is not currently positioned with extensive in-house technical expertise on the matter. Support on this issue, and specifically updated guidance to municipalities and local public health, is needed from authorities such as Public Health Ontario and the Public Health Agency of Canada. The City of Toronto is currently undertaking a review of the Property Standards By-law, and the Municipal Licensing and Standards division anticipates reporting to City Council later this spring to kick off Phase Two of the work. This is a near-term opportunity to put evolving knowledge into practice, and we are recommending that ventilation requirements be added to the work plan for review.
The Board of Health recommends that: 1. City Council request the Executive Director, Municipal Licensing and Standards and the Chief Building Official and Executive Director, Toronto Building to review the latest knowledge and best practices for air ventilation to reduce the transmission of agents of infectious disease through the air and consider updates to the Property Standards By-law in future phases of the Property Standards By-law Review, in consultation with the Medical Officer of Health. 2. City Council request the Executive Director, Housing Secretariat, to consider opportunities to leverage improvements to ventilation and air quality to reduce airborne transmission of disease as part of future implementation of the Tower Renewal Program.
Staff recommendation as filed
Dr. Kate Mulligan and Councillor Joe Cressy recommends that: 1. City Council request the Executive Director, Municipal Licensing and Standards and the Chief Building Official and Executive Director, Toronto Building to review the latest knowledge and best practices for air ventilation to reduce the transmission of agents of infectious disease through the air and consider updates to the Property Standards By-law in future phases of the Property Standards By-law Review, in consultation with the Medical Officer of Health. 2. City Council request the Executive Director, Housing Secretariat, to consider opportunities to leverage improvements to ventilation and air quality to reduce airborne transmission of disease as part of future implementation of the Tower Renewal Program. 3. The Board of Health request the Government of Canada and the Province of Ontario to continue to review evidence on the transmission of agents of infectious disease, including SARS-CoV-2, through the air and to provide guidance and support to municipalities to implement ventilation upgrades and other measures proven to reduce airborne transmission of disease. 4. The Board of Health request that the Medical Officer of Health, in consultation with the Executive Director, Municipal Licensing and Standards and the Chief Building Official and Executive Director, Toronto Building to provide an update to the Board of Health on any proposed changes to ventilation standards in the Property Standards By-law in 2023, including updates on any new guidance and support from the Government of Canada and the Province of Ontario on measures to reduce airborne transmission of disease.