- by Anne Finlay-Stewart, Editor

200 years of knowledge, skill and experience. Gone.

Over the past sixteen months, more than two centuries of accumulated education, training, experience and community connections have been lost from our Grey Bruce Heath Unit, more than half of it before Covid-19 reached our region.  Many of these women are the people who saw us through the Walkerton water crisis and SARS.

Laying off the Senior Epidemiologist with 21 years at our Health Unit (25 years in Public Health)  just ten weeks before a global pandemic is declared might simply be unfortunate timing. Speaking to an epidemiologist, I was told that their role in a public health setting is really to provide the best data during a situation just like this.  "If you can make yourself useful between crises, so much the better.”

But now we are thirteen months in to a pandemic with no clear end in sight, and we have had an epidemiologist on contract for less than half of it – currently no one holds that position. While Dr. Arra may have a Masters degree in Epidemiology and Biostatistics, surely the Board does not expect him to do the full-time work of an epidemiologist as well as being Medical Officer of Health and Chief Executive Officer of the Health Unit?

Of the eight public health managers on the March 4 Organizational Reporting Chart, one has been promoted to Director, one has retired, and five are new to their jobs within the past 16 months. Some current staff have had as many as 4, 5 or 6 different managers over the past 16 months.

Health Board Chair Sue Paterson has stated publicly that Dr.Arra's 24/7 hours of work are a result of being unable to delegate his on-call responsibilities to anyone for over a year. According to staff, Dr. Lenna Li had scheduled on-call MOH shifts throughout her tenure with Grey Bruce Public Health. Dr. Arra himself named Dr. Li Acting Medical Officer of Health in a memo to fifteen senior staff dated February 26, 2020 - “As we discussed in Management meeting. I will be on vacation between Feb 27 - Mar 11 (included). Dr Li will be fulfilling the MOH portfolio.”

Dr. Arra was still out of the country for the Bruce County Council meeting of March 5, 2020, when Dr. Li and Denna Leach, Public Health Manager for Infectious Disease, provided an update for the Council on Covid-19. Later that day, they also presented information about Covid to “external stakeholders including community partners” for Grey County.

Neither of these women, who developed the early education and strategies around this pandemic, remain with the Health Unit.

None of these departures, hires or promotions, since the lay-offs in January 2020, have warranted a public announcement – perhaps not meeting the threshold for public information about Health Unit activities.

The Board of Health knew, or ought to have known, about all of these departures. Their policies include annual recognition of years of service by the Board, and Policy Number V-527 requires the Chair to present retirement/resignation gifts to those with more than 10 years of service. All gifts come from the Board budget.

For those who did not voluntarily choose to leave, a “separation of employment” gift for long-serving staff is “at the discretion of the Board”, which would require a Board discussion and decision. At least two staff members with over fifty years of experience between them would fit this category.

Both had annual performance reviews, increasing responsibilities and promotions throughout their tenure.

One of them, a 32-year staff member who was serving as a Director at the time she left, filed suit against the Board Of Health for Grey Bruce Health Unit in Ontario's Superior Court of Justice this January. The filing is a public document - issued case No. CV-21-00000006-0000; no defence has been filed to date and the allegations have not been proven in court.

Dr. Arra has repeatedly expressed concern that questions asked of the Board of Health about HR issues or their financial decisions will damage public trust in Public Health. At Grey County council, Dr. Arra said “...and the third person who died in Grey Bruce – could we have done differently if everyone was around the table pushing in the same direction instead of undermining?”

We respectfully disagree.

Transparency and accountability should be the standards in all public institutions, even – perhaps especially - during a crisis.

We do not believe that any of the questions posed to the Board of Health or the communications team by the four signatories to the letter earlier this year, this publication, or members of the public, will deter the Medical Officer of Health nor any member of the Public Health staff from their continued commitment, long hours and hard work to protect the health and safety of the residents of Grey Bruce.

Nor do we believe that any of our questions will make members of the public change their minds about respecting masking, washing and distancing directives from Public Health and seeking Covid-19 vaccines when they are eligible.

What we do believe is that Public Health has a far broader range of responsibilities than one virulent virus that has drawn all the focus. Many staff have been understandably re-deployed as programs have been temporarily suspended; others await such a call or continue with their daily duties in facility inspections, water quality testing, parental support, rabies and other vector-borne diseases. We invite you to remind yourself of all that our Health Unit does in “normal” times. Here is the most recent Annual Report we can find.

As we continue to do what is necessary to get past the Covid pandemic, we must remember that we are in the middle of a more lethal epidemic that has taken the lives of more of our Grey-Bruce neighbours in 2021 than the Covid-19 virus has since it was identified. From March of 2020 to March of 2021, there has been an average of approximately 9 Emergency Department visits due to opioid poisoning per month by Grey Bruce residents.

One day Covid-19 will be gone, or will have become endemic, a disease with periodic outbreaks for which we may require booster shots. The Public Health Agency of Canada has had to review its decisions. The provincial government will be revisiting its approach to Public Health and its structure and financing. Amalgamating 34 Public Health Units into 10 may be back on the table, along with the subsequent decisions about governance, leadership, and staffing.

This could happen suddenly, requiring pivoting every bit as dramatic as the pandemic itself.

Far from being a distraction for the Board of Health, answering the questions now being asked can only make us better prepared for this process.