Item - 2022.HL35.1

The Board of Health:

1. Requested the Medical Officer of Health to review Toronto Public Health functions and services that were paused or reduced due to the COVID-19 pandemic and report back to the Board of Health in May 2022 with an update on functions and services to be resumed.

2. Requested the Medical Officer of Health to report back to the Board of Health in June 2022 with an update on the development of new approaches to address public health issues and inequities that have emerged over the course of the COVID-19 pandemic, as well as issues that existed prior to the pandemic.

3. Requested the Medical Officer of Health to provide an update to the Board of Health on efforts to build COVID-19 immunization capacity in primary care settings and pharmacies in the second quarter of 2022.

4. Requested the Medical Officer of Health to provide an update to the Board of Health in the second quarter of 2022 on how best to prepare for a potential future surge by employing existing resources to meet other pressing public health needs.

5.  Requested the Medical Officer of Health to revise and update the COVID-19 Monitoring Dashboard Indicators (Virus Spread and Containment, Equity, Health System Capacity, Public Health System Capacity) to account for the new phase of the pandemic that the City of Toronto is in, which includes increased individual-level protection due to vaccines and other protective measures at the individual level, and changes to surveillance and equity indicators due to reduced access to Provincial PCR testing.

6.  Requested the Province of Ontario to make PCR testing available to a wider range of individuals, especially those at higher risk of serious illness and to put mechanisms in place so that those who test positive have appropriate access to antiviral medications.

7.  Requested the Medical Officer of Health to continue to provide updated advice to the public to inform individual assessments of personal risk as new data becomes available, including mask-wearing both for individuals wearing masks and for others in contact with them in indoor settings, recognizing the removal of mask mandates and other public health measures in some settings.

8.  Affirmed that wearing a mask continues to be an important tool to keep people safe and help prevent the spread of COVID-19, and individuals who wear masks should be welcomed and accommodated in all public settings.

9.  Requested the Medical Officer of Health to work with the Province of Ontario and school boards to achieve the shared goal of create a healthy learning environment for children and report back to the Board of Health in the first quarter of 2023 with an update on actions taken to mitigate the impact of COVID-19 during the 2022-2023 school year.

10.  Requested the Province of Ontario and the Government of Canada to continue to review best practices for COVID-19 infection prevention and control in schools, including facility upgrades, and to provide guidance and support to school boards to implement these measures, as required.

The Medical Officer of Health gave a presentation on Response to COVID-19 - March 2022 Update.

This report provides an update on the response to the COVID-19 pandemic as of March 2022, and responds to Board of Health direction to report back on the impact of the provincial vaccine certificate program.

Multiple indicators show that the Omicron wave continues to subside in Toronto after peaking in January. While Omicron wave case counts underestimated the true number of COVID-19 cases due to provincial testing restrictions, there has been a decline in the seven-day moving average of case counts and the test positivity rate for tests that were completed. Other indicators confirm this trend. In recent weeks, there has been a decrease in new hospitalizations and intensive care admissions (ICU). Wastewater surveillance has also shown a decline in COVID-19 levels since their peak in January 2022 across most of Toronto's water treatment plants.

The COVID-19 vaccine has proven effective at reducing serious outcomes from Omicron in recent months, with three doses providing the greatest protection. Toronto Public Health, in collaboration with Team Toronto vaccination partners, has continued work to maximize Torontonians' access to the COVID-19 vaccine and has focused its efforts in recent weeks on implementing a data-driven, hyper-local vaccination campaign to promote vaccine uptake in communities with low rates of vaccination. Due to these efforts, a large majority of eligible Toronto residents are now fully-vaccinated with two doses of the COVID-19 vaccine, and over half have received a third dose.

There has been a stabilization in COVID-19 indicators across Ontario as well. In light of the current epidemiology and high vaccine coverage, the Province of Ontario (the Province) lifted a number of COVID-19 public health measures effective March 1, 2022, including vaccination certificates, capacity limits, and physical distancing requirements. The Province further shared a plan to remove most indoor masking requirements on March 21, 2022 (with the exception of certain settings including hospitals, shelters and congregate settings, long-term care homes, and public transit), and all remaining COVID-19 restrictions by April 27, 2022. Concurrently, the Medical Officer of Health has lifted a number of COVID-19 orders and letters of instructions, and City Council has amended the City's masking bylaw, ensuring that it will expire when most provincial indoor masking requirements are lifted on March 21, 2022.

These measures have proven effective at mitigating the impact of COVID-19 through successive waves of the pandemic, but are no longer necessary as a broad public health intervention in most contexts given the prevailing epidemiology. Toronto Public Health will continue to monitor Toronto's local epidemiological context and is prepared to respond, if needed, should circumstances change.

While maintaining support for COVID-19 response, Toronto Public Health is planning for the resumption of public health functions that were paused or scaled back during the COVID-19 pandemic, and developing approaches to address health issues that emerged or were exacerbated as a result of the pandemic, such as mental health, the opioid crisis, and sexually-transmitted infections.