What public health inspections were missed over the pandemic?

Thousands of inspections were missed over the course of the pandemic as Hamilton public health drastically shifted resources to manage COVID.

We were trying to decide, how do we use the few resources we have in a way to have the biggest impact on the community and with the populations most impacted by COVID," said Michelle Baird, director of epidemiology, wellness and communicable disease control. Whenever you take on new work, something else has to stop."

The inspections that were reduced or halted altogether in 2020 include: personal-services settings, low-risk food premises, enforcement of the Smoke-Free Ontario Act, food safety at licensed child-care centres and pest control complaints.

The longer we don't do some of our routine work, the deficit becomes greater and the impacts greater, so we're very much trying to bring some of this back online ... while still trying to maintain our response to COVID," said Baird.

Public health did manage to keep up with 14 of the 22 different types of inspections it does yearly by doing the work seven days a week, adding evening hours and having staff work overtime.

It also added a new kind of inspection - infection prevention and control at housing for temporary foreign farm workers. In addition, every long-term care and retirement home, shelter and residential care facility was audited for its ability to control COVID spread.

Making the choice to shift resources to a place that the impacts were catastrophic at the time, if you think of what was happening in long-term care," said Baird. We were having these discussions about how many people we have, where are the people and where can we move them. Very difficult decisions, but I think the right decisions in the end."

The biggest decline was in response to pest control complaints that went from 1,118 in 2019 to zero once the pandemic began.

Because there is no immediate risk to health, the decision was to pause those complaints," said Baird. In many cases, these are nuisance complaints."

Personal-service settings also saw a significant drop from 1,002 inspections in 2019 to 92 in 2021. Normally hair salons, barbershops, tattoo parlours, spas and other businesses that provide esthetic services require an annual inspection to check on infection prevention and control. But during the pandemic, inspections were only done at new businesses or in response to complaints. Part of the reason was that these businesses spent a good part of the pandemic closed due to lockdowns. But the decision was also based on risk.

We had, before COVID, been into all of our personal-services settings consistently," said Baird. For the most part, these facilities operate quite well and are very good to adhere to guidelines."

Some food inspections also saw major decreases because they were deemed low risk. For these premises, inspections went down to 613 in 2021 from 980 in 2019. For licensed child-care settings, it dropped to seven in 2021 from 147 in 2019.

Normally food inspections for the lowest risk are done every two years, but during the pandemic it was based on complaints or new openings. To be in this category there must be little chance of food-borne illness such as serving prepackaged food.

Inspections for higher-risk food premises were done as normal except in licensed child-care settings, where fewer than half went ahead. These child-care centres normally require two to three food inspections a year but public health pulled it back to one. One factor was that they were closed at times during the pandemic - especially centres located in schools. But the main reason was that the inspectors were needed in congregate settings vulnerable to COVID.

It's the same reason enforcement of the Smoke-Free Ontario Act was drastically reduced to 175 inspections in 2020 from 1,267 in 2019.

It was a decision that they were not prioritized during the pandemic in order to move resources to the infection control work," said Baird. Tobacco continues to be a significant issue for us. We want to ensure that youth are not having access to tobacco and not starting smoking and that smoking is only happening in designated areas. So this one is a critical piece of work for us to get going again now that we're back transitioning to more usual business."

Joanna Frketich is a health reporter at The Spectator. jfrketich@thespec.com