April 26, 2020, Simcoe, ON – Haldimand and Norfolk Counties have implemented a multifaceted response plan in the face of an unprecedented public health emergency.

Although recent modelling suggests Ontario may have reached a peak in new cases of COVID-19, a vaccine for the virus has not yet been developed, leaving the population at continued risk of infection.

By taking early action, however, Norfolk remains ready for a possible surge in cases, and will continue to fight the transmission of the virus among local residents.

Key staff from a range of departments have been working since mid-March – when Norfolk activated its Emergency Operations Centre – on the County’s response to the COVID-19 pandemic.

With the guidance of Haldimand-Norfolk Health Unit, staff have enacted a strategic three-step, multi-layered plan:

Step 1: Containing the spread of COVID-19: This includes identifying and testing people who might have the virus. Over the past month, the Health Unit has fielded more than 3,000 calls from community members. Working with health centres and partner hospitals, approximately 1,000 tests have been completed. The Health Unit has a team of experienced nurses with infection control experience in a variety of infection control priorities including monitoring and outbreak management in health care institutions. Success with containment will reduce or eliminate the need for the following two steps.

Step 2: Expanding capacity to treat patients in the community: If the spread of the virus is not contained, hospital capacity could be exceeded. Norfolk County and Haldimand County have each created two interim care centres to support the healthcare system. These facilities can serve a variety of purposes as the pandemic progresses, including providing care for certain in-patients or community-residing patients.

Step 3: Increasing the number of ventilators available to patients in the area: In the worst case scenario, Norfolk County and Haldimand County want to ensure that everyone who needs a ventilator is able to have one.

Combined with Haldimand and Norfolk’s swift actions on operational issues, such as closing facilities to the public and cancelling programming, the plan means the County is in a strong position to deal with the pandemic – and a potential surge in COVID-19 cases.

“Many other areas are looking to build off-site care facilities, or are attempting to increase their supply of ventilators, but we’re already there,” says Kristal Chopp, Mayor of Norfolk County and Chair of the Haldimand-Norfolk Board of Health. “Obviously I hope these efforts are entirely in vain, but should a surge in COVID-19 cases come to our area, we will be ready.”

Step 1: Stopping the spread of COVID-19

The Haldimand-Norfolk Health Unit has implemented strict measures designed to stop the spread of COVID-19.

These early actions (the first of which was ordered on March 16) included: restrictions on food and beverage premises, the prohibition of mass gatherings, the closure of tattoo parlours, barbershops, hair and nail salons, spas, tanning beds and banquet halls, and self-isolation orders for those returning to Canada from abroad and for incoming migrant workers.

“Staying at home for many weeks is not easy. But these measures are critical to preventing the transmission of the virus to older residents and people with underlying health issues,”  says Dr. Nesathurai.

Norfolk County has also stepped up the enforcement of social distancing rules and public health orders, doubling its number of bylaw officers and expanding the amount of time they’re on patrol in the community.

Step 2: Providing support for local hospitals

The Emergency Operations Centre has a plan to provide support for area hospitals in the event that efforts to contain the spread of COVID-19 fail and patient volumes increase.

With the guidance of the Haldimand-Norfolk Health Unit, and working with local healthcare partners, staff quickly developed and implemented a plan to open an off-site, interim care centre located at the Port Dover arena. Haldimand County staff have developed a similar facility, located at the Dunnville arena. These sites expand the capacity of traditional clinical sites, and can be deployed on short notice to help patients with a variety of clinical problems.

Staff have secured personal protective equipment and supplies, signed up volunteers with healthcare experience, and made a number of infrastructure upgrades (such as updates to the electrical and HVAC systems) to the Port Dover arena. The facility is now ready should it be needed. It can be opened with just 48 hours’ notice.

Step 3: Increasing the number of ventilators available in the area

Ventilators, or breathing machines, are necessary to provide care to those most seriously impacted by COVID-19. But there are only approximately ten such machines available at hospitals in Haldimand and Norfolk. In a severe pandemic, with many additional cases, doctors would be forced to make difficult decisions about who would get life-saving treatment and who would not.

Norfolk County was able to identify 15 additional basic ventilators, which were previously used by the paramedic service. The Emergency Operations Centre has been working with three local companies on an innovative plan to increase ventilator capability and supply in the region. Through these unique partnerships, two basic ventilators have been produced.

In addition, a local aerospace firm has made a more sophisticated ventilator, and 50 of these units will be available to residents. This creative solution has been so successful that these devices are of interest to a large US government agency looking to expand their ventilator capacity.

The road ahead

Though it is far too early to know when social distancing measures might be relaxed, Norfolk County is in the early stages of developing plans for gradually returning to normal operations and opening up the area’s economy for business. This plan will be developed in consultation with Dr. Nesathurai, Haldimand-Norfolk Health Unit staff, and a diverse cross-section of local stakeholders.

“We need to consider a plan to lift these restrictions, and allow residents to re-engage with other people. This has to be based on an assessment of where we are in the pandemic, but I hope it is soon,” said Dr. Nesathurai.

“Staff have done a tremendous job, in a very short amount of time, in putting these plans together,” says Norfolk County CAO Jason Burgess. “We’re not out of the woods yet, but residents should feel confident about the team that’s working behind the scenes (and around the clock) to ensure their health and safety.”