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Winter Price Meltdown
by Isabel Mosseler
Local response to the COVID-19 pandemic has been the same as in many other communities across North America: on one hand people panicking and emptying store shelves of toilet paper, and on the other, an outpouring of care between community members and a concerted response on the part of municipal and health officials.
The announcements started pouring in last week, starting with Au Chateau Home for the Aged closing its doors to non-essential visits on Thursday, March 12, to the national and provincial declarations of emergency on March 16 and 17. Then came repeated encouragements to self isolate and practice social distancing, as reports came in of the climbing toll of persons affected across the globe. One establishment after another announced their adjustments, starting with enhanced cleanliness procedures and ending with closures of public and private facilities. With school closures to April 6, it became clear that only a united effort on the part of every person would help “flatten the curve” in the hope that our health system would not be overwhelmed.
It was a real blow when Chief Scott McLeod made a public statement that the Little Native Hockey League tournament, being hosted by Nipissing First Nation, was being cancelled.
On Wednesday, March 11th, when it started to become clear that concerns were deepening across the board, a lot of people were still not taking it quite as seriously as others. Some people were taking planned holidays out of country, while others looked at the news and decided to cancel. Many of those taking spring breaks were people in key positions in the community. Many of those people now returning, after international travel bans had been declared, face 14 days of self-isolation. Initially people scoffed that public statements were excessive, and now people are responding with real concern. Overall the message has been to keep calm, wash your hands, stay a safe distance away from other people, stay home if possible, and get your information from legitimate reliable sources.
Om Friday, March 13th, WN General Hospital CEO Cynthia Desormiers responded to questions concerning the local hospital. If any COVID-19 cases sprout up in West Nipissing, that is the institution that will bear the brunt, and it’s critical that everyone do their part so the local hospital is not overwhelmed. “What we’re doing is encouraging people to call the Telehealth number if they are feeling symptomatic,” she said. “To be tested you need the symptoms, including a fever and the travel history, or a relationship with someone who has tested positive, or be in the environment where there is a case of COVID-19.”
Desormiers said the hospital is not currently under any more stress than usual, “But we have a pandemic plan, and several weeks ago when we noticed a trend of increasing cases, we tweaked it and revised it. This is an outbreak. What comes here, we will manage it the same as an influenza outbreak, the same protocols, same processes.” Like every other public health organization, she is strongly encouraging hand hygiene, “Lots of hand washing, avoid touching your face, which is usually the portal of entry. We’re screening people in Emergency Department. If people come in with respiratory symptoms, we’re screening and asking travel history, just as we did with H1N1 and SARS. And then we’re also monitoring in our Long Term Care, and doing screening as well. As of today, based on directives from the Chief Medical Officer of Health, we’re suspending any kind of social activities, but also encouraging people not to visit our Long Term Care residents who are susceptible.”
COVID-19 attacks the respiratory system in severe cases, and there is no remedy at this time. Asked whether the hospital has enough equipment to respond to respiratory challenges, Desormiers said “As a district we’re well prepared. As of yesterday afternoon, we’re not aware of any positive cases in the district. Of course this is changing by the minute and the hour.” As of Tuesday, March 17th, that news still held. Dr. Jim Chirico, the Chief Medical Officer of the North Bay Parry Sound District Health Unit declared in a joint statement with North Bay Mayor Al McDonald that the district was still free of any confirmed case of COVID-19. On Wednesday morning, March 18, WN hospital officials put out reassurance that there were still no confirmed cases of COVID-19 in West Nipissing, after getting panicked phone calls because of a false rumour on Facebook.
There is still a collective sigh of relief every day, but the edge of concern remains high. “We’re staying prepared. We’re trying to contain it. We’re trying to enhance our measures to do some prevention, using language like “social isolation” and making certain people keep distances,” Desormiers notes. She added that the hospital is paying close attention to the directives of the Ministry of Health on how to manage and avoid a crisis, maintaining “some really good practices and overall emergency preparedness. We’re communicating daily, sometimes hourly with our medical staff and board. We have some great leaders in the Ministry of Health and the Public Health Unit, who are providing really good direction with lots of advice. I think as a district we’re on the right page.” She added that there are continual consultations with municipal leaders as well, as everyone tries to stay ahead of the game.
The figures are alarming, with a projected infection rate of anywhere between 30% and 70% of the population. And while the vast majority will not face dire consequences, the feeling is that it’s a bit of a crap shoot, and the odds get worse as you get older. Officials repeat over and over that the emergency declared is about slowing the rate of infection so medical staff can provide care. So how is the morale of the front line staff at the WNGH heading into this potential nightmare? Desormiers said, “I think they are all good. They are positive, very interested, informing themselves, staying alert and aware. We have PPE (personal protective equipment), the masks, your goggles, your shields and your gowns, to put on. They are good at dressing up, putting on the PPEs to protect themselves. The rate of 80% [of infected] show very mild symptoms. A portion of the population may even go undiagnosed.”
Those undetected COVID-19 people will be a big part of the problem. Desormiers noted, “Social isolation is going to be critical. People need to look where they are going – avoid mass gatherings over 250 people.” Since Friday, that number is decreased down to 50. When the bulletin initially came out, the Ministry of Health immediately suspended all large events, and West Nipissing quickly followed suit with CANO suspending their forthcoming concert, the Club Richelieu cancelling its annual dinner and so on. Others quickly followed. Desormiers added, “I think we all have our own responsibility to make sure we are not congregating in these large gatherings – we postpone or cancel to make sure we keep ourselves healthy.”
What about supports for medical staff, especially those with children during school closures? “We want to make sure our medical staff and our professionals have a plan B for their kids so they can come to work and look after the patients. We are very grateful to have an amazing chief of ED, Dr. Yves Vaillancourt, and he’s on top of this, communicating with all his colleagues, doing a great job working closely with medical staff.”
So as not to overwhelm local medical staff, Desormiers asks people to use the public health network, the Telehealth number. “Put in the phone call, let them guide you and talk you through your symptoms. They will provide you with the proper information, they are the experts. I think it’s important people don’t just land in the Emergency Department. They should be calling these public health numbers and get good advice on how to manage their symptoms, because there’s also influenza out there. Nevertheless we’ve really stepped up, super stepped up, our cleanliness protocols here. Our housekeeping staff is doing an amazing job here on all the high touch points with extra cleaning. It’s a big team effort.”
What touch points should the public be concerned about at home and at work? “Cell phones, doorknobs, your top surfaces where you work, and have hand hygiene stations all over.” Some Canadians have been watching the proceedings in the United States with grave concern, especially when reading about thefts of masks and hand sanitizer. Is theft a problem at the WNGH? “Not that I’m aware of,” said Desormiers, “but I have to be honest - we are monitoring our inventory very closely, because it’s been reported in other areas of the province.”
Canadians feel a bit safer because we have an integrated health system, and the system has been tested through H1N1 and SARS. Desormiers noted, “I think we have a strong public health system. I think there are some really good leaders in public health, and collectively many people have been through SARS, many have been through H1N1, and we are using that experience to build a better experience this time.”
West Nipissing Municipal response
During the same period between Thursday of last week and Tuesday of this week, the municipal response has gone from “being alert” to a comprehensive shutdown of public non-essential services and moves to protect both staff and public. On Monday March 16, WN CAO Jay Barbeau said, “We’ve sent emails and memos to everybody. The plan is evolving after talking to staff about social distancing, and the staff at the front [desk] are getting a little antsy. We’re trying to mitigate reasons for anyone to come to the front– people are still coming for marriage licenses and stuff.”
Barbeau added that the entire process is a new experience for everyone. He has been working with IT personnel to move front desk staff to the former police station at the rear of the building. That station has a glass protective enclosure and Barbeau feels that is safer for both staff and public. “We may have to close the front of the building and have people go to the back.”
“Right now council has decided to shut down non-essential services – these are recommendations I get from the Health Unit. We don’t want any of our employees or residents getting sick. We’ve shut down our arenas and community services areas as of noon Monday. The library, a separate board, separate decision, shut down 4pm Monday. We are limiting interpersonal contact with and between our staff. Any applications will be done online and be handled electronically.”
While safety measures are being put into place, Barbeau added, “We are a municipality and a public service organization – we need to continue to offer essential services to the public. Everybody has had a safety talk – despite what you hear about gathering and practice social distancing, as public servants they need to be held to an even higher standard. If this gets worse, and it shall get worse, it’s our employees who will need to continue to have the community operate emergency care and facilities. We impressed on all the managers to have the networking talks. They have all received documentation and been spoken to.”
Barbeau reiterated several times that the learning curve for an entirely unheralded situation is steep and continuous, but close attention is being paid to all health directives. “Different areas are disinfected continually, and staff are all practicing hygiene, being very mindful. But they are not in control of people coming off the street and coming up to them. There are a significant number of people here, and while our people are limiting their social interaction, they can’t be 100% sure the people that they are interacting with are doing the same. That’s the rub.” It is worrisome for municipal staff. That’s why everyone is being encouraged to conduct business online or by phone.
Barbeau himself had to isolate to a higher degree, being medically high risk; he has taken over a back office. “The other part of it is I run a critical function in our community emergency plan – I have to be kept to a higher standard. I have a professional requirement… I’m very isolated from the rest of the world, by appointment only and limiting my interaction. If I get sick I don’t like what I’m hearing.”
The community emergency coordinator is Fire Chief Richard Maranda. On top of those health concerns for key leaders, a number of senior staff have been on holidays in places like Mexico and Florida. As they return, they face 2 weeks of self-isolation. “Well that’s what happens,” said Barbeau. “When they come back they have to self isolate. Shawn Remillard is self quarantined for 2 days, Steph [Poulin of Community Services] is in Mexico and Janice [Dupuis, Deputy Clerk] is in Florida. The more senior people have technology to connect remotely.” Barbeau briefly reflects, “It’s an interesting thing – watching CNN a couple of months ago with a bunch of people getting sick in China from an obscure disease, and wow! – so foreign to us… and then here it comes, to the little community of West Nipissing… The healthy have to have a consideration for the more at risk people.”
Council meetings have been cancelled, which also affects the decision-making process. “I had a conversation with the mayor. What we’re doing if I need a decision, like on the tax issue, is send an email to council and mayor. If there’s a debate then we’ll have a proper debate – but if there are 5 in favour we’ll just go with it.” The decision was taken to defer property tax payments to a later date to ease the financial pressures on citizens. “That is properly an amendment to a bylaw, but in these times we’ll do the next best thing. Any decisions like that will be public.” Barbeau indicated that council and staff are working hand in glove at this time, and it is working well.
“I’ve been around a few years; this is a first for me and very many people all over the province. We’re looking at best practices, we’re reading, we’re on the websites, we’re figuring it out, and we’re happy to get advice and input from everybody who gives it. We’re all in this together, so it’s not one or two or six people. If people have advice, the more the merrier. It’s a community solution that’s going to get us through this. There’s going to be an internal organizational thing; what is our role in terms of community leadership and advocacy, and who should be on those committees? It’s not just municipal leaders. If we don’t stay on top of it… things could change at the drop of a dime if you take something for granted. There isn’t a serious risk right now, but the idea is to put measures in place to maintain that. We’re on it.”
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