How COVID is devastating public health programs in Hamilton

Shocking drops in childhood vaccination, massive gaps in inspections, abandoned programs and troubling declines in referrals laid bare the high toll of COVID on public health's other responsibilities.

When I think about the virus, we don't know how long it will stay with us in terms of planning our way forward," said medical officer of health Dr. Elizabeth Richardson. We don't know if we'll have a fifth wave, we don't know how often those waves will occur."

The pandemic - now in the midst of a fourth wave - continues to take up so many resources that public health can't bring any more services back.

Unfortunately until we ... are able to reduce the commitment to COVID, we're going to continue to have to make trade-offs in terms of what we can do and what we can't," Richardson told the board of health Monday.

More money wouldn't even help - as staff are burnt out after 18 months of the pandemic and unable to keep up with excessive overtime demands.

Staff are exhausted," said Richardson. They have been doing this work for a very long period of time."

There's no way to get more workers, either, as public health already has over 100 unfilled jobs.

There aren't people to hire," said Richardson. The competition is fierce for the very few resources that remain."

She outlined just some of the toll COVID is taking on public health programs.

Childhood vaccinations

A staggering number of school-age vaccines have been missed.

Vaccine coverage for hepatitis B is down to 18 per cent from 71 per cent in 2019.

At the same time, the meningococcal vaccine rate fell to 24 per cent from 89 per cent.

For the HPV vaccine, it dropped to just seven per cent from 62 per cent.

We're the primary providers of these immunizations," explained Richardson.

In addition, there have been no dental assessments or vision screening in schools since March 2020.

While an increased number of public health nurses are working in schools, their entire focus is COVID, resulting in the services they normally provide being mostly put on hold.

Mental health and addictions

Wait times have significantly increased for kids' mental-health services due to a jump in referrals combined with the challenges of providing care over the pandemic.

Public health can't provide sufficient drop-in supports for alcohol, drug and gambling programs because of COVID restrictions and a lack of staff.

We have done virtual care but this is not always the best for all," said Richardson. Restarting these programs has been difficult."

No tobacco cessation clinics have run since March 2020 compared to 501 people taking part in 2019.

Child development

A troubling drop in referrals for development assessment for children has been seen.

Hence the concern that we're missing a number of kids who would need these assessments and we know that early intervention is very key in these situations," said Richardson.

Only half as many high-risk families are receiving services in 2021 under the Healthy Babies Healthy Children program compared to 2019.

A significant decline in terms of our service volumes there," said Richardson.

Inspections

Public health inspectors have seen their jobs change drastically over the pandemic to focus on infection prevention and control, particularly in seniors' homes and farms with migrant workers.

They've been pulled in many different directions throughout the course of this pandemic, as well as maintaining our highest-risk activities within our food safety and water safety programs," said Richardson.

Hamilton has had no food handler inspection certificates completed since March 2020.

We know these are important not only to ensure safety within the food industry but also it's an important piece around employment," said Richardson.

There have been no standing water inspections since March 2020 to ensure Hamilton doesn't have places where mosquitoes can breed as part of West Nile virus prevention.

There have been no routine compliance inspections of personal service settings. Instead the inspections have been complaint based, resulting in just 43 so far in 2021 compared to over 1,000 in 2019.

Pest control inspections have also been abandoned since March 2020.

I'm getting a lot of complaints about rodents," said Coun. Tom Jackson. People concerned about potential disease, infections, West Nile ... For me to tell them public health is all tied up with the pandemic ... they get it, but they're all saying, What about within our neighbourhoods.'"

There have been no inspections of low-risk food premises or vaccine storage - public health is now working to complete these.

Joanna Frketich is a Hamilton-based reporter covering health for The Spectator. Reach her via email: jfrketich@thespec.com