Dr Vera Etches on the Learnings from the COVID-19 Pandemic and Ideas for the Way ForwardDecember 30, 2021
Dr. Vera Etches, Ottawa Medical Officer of Health, shared her unique vantage point as the medical officer of health on what the pandemic has revealed about Ottawa’s weaknesses and strengths. She also spoke about OPH’s early plans on improving community outcomes beyond COVID.
Outlined below are some of the ideas Dr. Etches spoke about at the 6th Biennial Ottawa Immigration Forum, held on November 22 and 23rd, 2021.
Five Takeaways from Dr. Etches’ Reflection
- Reflective Leadership
Etches reflected on how her background as a settler in Canada, and her early experiences when growing up in Gitxsan Territories in Northwestern British Columbia shaped her work as Ottawa’s Medical Officer of Health during the pandemic. From her parents and from the community where she grew up, Dr. Etches learned sense of curiosity, the need to never stop learning, and the value of social justice. Gitxsan is famous for being the first community in Canada that accepted oral history and traditional stories as acceptable evidence in court. As a settler, Dr. Etches was conscious of limitations in her perspectives – conscious of what she might not know about the communities experiencing disproportionate impacts of the Pandemic.Dr. Etches spoke about the value of reflecting with other leaders to analyze the situation and draw learning. She & Hindia Mohamoud, director of OLIP, met every two weeks to reflect on the pandemic experiences of immigrants and racialized populations, the meaning of what the COVID pandemic was revealing about inequities, and how we might go about transforming the system in a good way, to not go back on the pre-COVID conditions that created the deep inequities we are observing throughout the pandemic.
- Systemic Racism is the Root Cause of Root Causes
Racism was recognized by Ottawa Board of Health as a public health issue that underlies all other social determinants of health (education, employment, housing, early childhood development, etc). This recognition is different from what tends to be taught in schools that racism and discrimination are among the social determinants of health. Instead, the big COVID learning is that racism and discrimination are the root cause of inequities in all determinants of health – the root cause of root causes behind the disproportionate impact of COVID.
- Disaggregated Socio-Demographic Data
Ottawa Public Health was probably the first health unit to collect disaggregated socio-demographic data on the Ottawa population who contracted the COVID-19 virus. It was clear from the data that the black community was disproportionately affected by the pandemic. The data was clear, we could see it – the numbers were clear. But why was this the case? What is behind the data?
- The Importance of Partnerships & Community Relationships
To understand what was behind this impact, the OPH relied on relationships with OLIP and with civic groups to understand what was beneath the data. Through the work of OLIP and others, the OPH saw the links to economic injustice, the types of roles available to immigrants were putting people at higher risk. The housing conditions, the neighborhood conditions, living in shelters, working in long-term care homes where mass protection was slow to arrive. OLIP was always advising us on challenges and solutions, and this was very valuable and appreciated. Thus, the two capabilities Ottawa Public Health’s efforts were: 1) data; and 2) relationships. These are great anchors that resonate well, which can help in the way forward in a better way.
- Acting on COVID Learning to Design Equity-Focused Protections & Supports
Ottawa Public Health drew from data and community knowledge gained through OLIP and other partners to design COVID responses that could address the challenges. The solutions resulting from the new understanding included:
- Moving testing and vaccination to be closer to people in disproportionately affected communities – we implemented mobile testing, testing facilities in key neighborhoods, walk-in clinics, vaccination hubs. OPH was the first unit to use postal codes to prioritize vaccination.
- But having services closer to the people most in need is not enough! For example, despite our early efforts, data showed acute vaccination inequities. We are addressing vaccination disparities through our community operations teams, with staff being from the affected communities. This way we leveraged the communities’ channels of communication to provide COVID education. With data, partnerships, and community engagements our efforts helped close disparities in vaccination rates. OLIP was very helpful in labeling challenges, guiding solutions, and then measuring whether we are making progress.
Four Ideas for the Way Forward
The role of public health units is focused on upstream issues. Our work is to help everyone healthy by addressing the conditions that may affect people’s health.
- Commitment to Equity
At Ottawa Public Health, we want to be an organization that learns from the community and works with the Community. We commit to respecting community input as real evidence and knowledge that we will use to be effective in our role.
- Transforming Vaccination Hubs as Neighborhood Public Health Service Hubs
We are looking to use vaccination hubs created to respond to the pandemic as presence in neighborhoods to offer more services on a regular basis – services like mental health counselling and addressing substance use challenges.
- Improving Access to Primary Care
We have seen that many newcomers do not have access to a family doctor. We are asking ourselves what can we do to improve access to healthcare? What can we do to draw from community strengths, knowing that there are a lot of strengths that are not being leveraged? Moving forward, we will be leveraging a lot of peer-to-peer service planning supports and community engagement to address challenges.
- Disaggregated Data & On-going Community Engagement
We need to find ways to measure how we are doing in terms of equity, and we need to do this with the community, otherwise we will stigmatize communities experiencing poorer outcomes. OLIP has been very helpful in labeling what the needs are; and then measuring whether we are making any progress.
- We are exploring the creation of data dashboards on specific health issues, like mental health and substance abuse for example, but we now know that we need to do that in ways that make sense to community. Related to this is the need to harmonize how Socio-demographic data is being collected at a provincial systems level. One of the proposed solutions in Ontario is to have the data included in the provincial health card that way it would be easier to evaluate people’s pathways and access through the health system.