Hamilton public health staff shortages an ‘urgent issue’ holding up pandemic catch-up

It will take until at least the end of 2023 for Hamilton public health to catch up on backlogs created by the pandemic.

Wow - 18 more months to fully get caught up," said Coun. Tom Jackson. Let's hope there is not another serious wave of COVID."

The province is likely already in a summer wave driven by the Omicron BA.5 subvariant, the Ontario COVID-19 Science Advisory Table announced Wednesday. The city also changed Hamilton's COVID transmission status to increasing for the first time since April.

Both came on the same day Hamilton's board of health was advised of program backlogs and severe staff shortages already created by two-years of pandemic response.

It is an urgent issue," medical officer of health Dr. Elizabeth Richardson told the board specifically about the staffing crisis. It's been an urgent issue in terms of the degree of the response that we can undertake and now in the degree of catch-up and the speed of catch-up that we can do as we move forward across those issues."

Public health hasn't yet been able to bring all of its programs back fully because it's so short-staffed and still managing the ongoing pandemic.

We are still not at the point of getting back to our pre-pandemic program targets and service levels," Richardson told the board. We're still concerned about the backlogs in service and worsening of public health issues due to the lack of capacity we have."

She named some of the areas of greatest concern where the backlogs can have long-lasting effects.

Immunization of our teens, which are so critical as they embark on the next stage of their life," she said. Support to young families and young kiddies, where we know those first years are so important to the rest of their lives. Dental health - we know oral health-wise that we've had significant declines."

Public health didn't put an exact number on how many jobs remain unfilled but it was at 100 in September 2021. The unit is having serious recruitment and retention issues despite Hamilton having a number of competitive advantages.

We have made significant attempts to increase our workforce to address our service backlogs, that has been very challenging to do," said Richardson. There are more people that are needed across the public health system than there are people available to fill those slots. You are seeing significant competition between health units, between parts of the health system in terms of attracting people."

In addition, the pandemic has decimated the existing workforce over two years of redeployment, overtime and working short-staffed.

The fatigue and burnout that have been experienced has been extreme," said Richardson. We have seen people who have decided to retire earlier than they otherwise planed, we have seen people on sick leave as a result of the stress and burnout. We have seen people decide to change careers."

It's an issue across the health-care system, the province and beyond.

This is not just a city of Hamilton issue," said Coun. Brad Clark. It seems to be provincewide and possibly national. But it will impact our services here."

Jackson said Hamiltonians are starting to get anxious about the amount of time programs have been on hold or significantly scaled back.

I am getting now traditional calls of complaints where people would love to see public health involved," Jackson told Richardson. I just worry it may be a much longer time before you are fully reinvigorated in doing what you were doing full-time, in pre-pandemic times."

Public health is still having to make hard calls on what services matter most because it doesn't have the capacity to meet pre-pandemic program targets and service levels. It also can't yet fully address service backlogs, as well as worsening and emerging public health issues.

As we work to reengage with all of our programs and services and get them up and running we still have to prioritize," said Richardson. As we're doing that work, we're also trying to continue to respond to COVID and understand it, understand what we're supposed to do, have people as well positioned as we can."

The vaccine rollout is expected to soon be expanded to children under age five. In addition, eligibility for fourth COVID shots will be expanded at some point.

Hamilton's rollout has been sluggish for months, so kick-starting booster doses will also be a priority during the summer wave.

The third vaccine dose is critical to protect against severe disease," the science table stated in its advisory.

In addition, public health has been trying to shore up seniors' homes against the current and future waves of COVID.

We have worked to identify the long-term care facilities and retirement homes that were at highest risk, seem to have the largest challenges as we went through COVID-19," said Richardson. Working with them to ensure they are well prepared as we move forward."

In addition, public health is trying to get work back on track that was put on hold in 2019 to create better information management that would see the unit switch from a paper to an electronic system.

The board of health may be at risk due to unreliable information management systems and practices," stated a report to the board. Varying information management practices and absence of a formalized records management platform could lead to loss of information, privacy breaches or noncompliance with records retention schedule, and could prevent staff from accessing information."

Despite the ongoing challenges, the unit has made some headway in the last few months.

We're in a significantly better place than we were through the pandemic and especially in the first quarter of this year," said Richardson. But we're still having to prioritize and make sure we're addressing the things that are highest risk."

There are also the unknowns of what will happen with the current wave and in the fall when respiratory viruses typically increase.

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