/Public health inspectors following Four ‘E’s approach to enforcement
Dr. Natalie Bocking, medical officer of health for the Haliburton, Kawartha Lakes, Pine Ridge district health unit, speaks with reporters in a virtual press briefing held Oct. 13. /Screenshot from HKPRDHU media briefing

Public health inspectors following Four ‘E’s approach to enforcement

By Sue Tiffin

The following are brief reports from a Haliburton, Kawartha, Pine Ridge district health unit press conference held Oct. 13 with medical officer of health Dr. Natalie Bocking.

To date, the health unit has received 296 COVID-related complaints this year, have issued 33 warnings to businesses not complying with the Reopening Ontario Act requirements and have issued 11 part one tickets to seven establishments: four in Northumberland County, two in City of Kawartha Lakes and one in Haliburton County. The health unit will not provide the names of those ticketed establishments or individuals. 

Under the Health Protection and Promotion Act, the health unit has issued 145 warning letters to individuals for not isolating, and three charges have been laid under the act, part one tickets for “fail to comply with a Section 22 order in respect of a communicable disease.” 

“All of the different partner agencies that are involved in the enforcement of the Reopening Ontario act, so this includes public health inspectors employed by health units, bylaw officers, police officers, all working together in the field of enforcement for these regulations, are all following what’s called a progressive approach to enforcement,” said Bocking. The “Four ‘E’s” approach, said Bocking, is “to engage, explain, educate, and then to enforce.” 

Through the HKPRD health unit, public health inspectors typically already are engaged in ongoing routine inspections at food premises, and personal service settings and have added “aspects of compliance with different COVID restrictions apart of provincial legislation,” as part of those inspections.

The health unit is currently being notified by concerns of the public through a call centre.

“When we receive a complaint, we start with the ‘Four ’E’s’ and we engage with that premise,” said Bocking. “Every complaint, we engage with the operator or the premise owner to discuss what the requirements are and what their current status is. If we’re seeing more complaints related to that premise, then we will send out a public health inspector if it is one of the sites that public health inspects. If it’s not, it might be referred to bylaw or another enforcement partner agency.”

Public health inspectors then have a discussion with the owner/operator of the premise, ensure they understand the requirements, and ask that they can demonstrate how they are going to come into compliance with regulations. After follow-up, if the premise continues to not follow regulations, there is a warning, or a ticket issued.

The part one tickets issued to the seven establishments are reported as follows: seven were issued for lack of compliance with masking and face coverings, one was for permitted method of sale that allowed patrons to enter the indoor area during shut down, one was for providing service during shut down, one was for failure to comply with proof of vaccination requirements and one was for obstructing any person performing a duty in accordance with an order made during a declared emergency.

“I’m sharing this broader description with you because I have heard that sometimes when the public doesn’t see our public health inspectors in action, they wonder what we’re doing, and they wonder what’s happening with those premises that are sometimes publicly stating that they won’t come into compliance with the regulations, so I’m sharing this to help individuals understand what our process is, and reassure individuals that we are following up,” said Bocking. “Our enforcement is consistent with all of our neighbouring health units, and unfortunately in some circumstances we have had to issue tickets and will be continuing to do so in collaboration with our partner enforcement agencies.”

Aiming for 90 per cent

As of last week, the coverage rate of individuals aged 12 and over across the health unit who have received one dose of COVID-19 vaccine is 86.3 per cent, while 81.5 per cent have received two doses of vaccine. 

“So continuing to see steady incremental, inch-by-inch progress of vaccination coverage rate,” said Bocking. “The province had reset goals to be 90 per cent of the population that’s eligible to be fully vaccinated and I think we’re slowly creeping towards that. We’re continuing to see an increase, so we are continuing to make vaccine available and continuing to encourage anyone that has yet to be vaccinated to seek out a clinic or a pharmacy or your primary care provider to access that vaccine.”

The health unit continues to offer mobile, pop-up and school-based clinics. For more information visit https://www.hkpr.on.ca/2021/09/01/vaccination-clinics/. 

Characteristics of cases over the past 14 days

In the last 14 days, of 31 cases identified in the past two weeks, 25.8 per cent were aged 20 to 29, which is consistent with the last several months of case reporting during the pandemic. Of these 31 cases, a few were among those aged 70 to 79 but in general the virus is predominantly impacting young adults and youth under the age of 20 said Bocking. In transmission patterns, 32 per cent of the cases have no known source of transmission, 32 per cent are household contacts, and 32 per cent identify as close contacts, “through social gathering or something similar that has brought people together.”

Vaccination status of local COVID-19 cases

Since July 1, 306 cases of COVID-19 have been identified throughout the health unit region. Of those individuals, 63.1 per cent were not vaccinated; 20 per cent were partially vaccinated with one dose or with two doses but still within two weeks of their second dose and 17 per cent were fully vaccinated.

“So we’re consistently seeing that the majority of cases identified among those individuals that are not fully protected by COVID vaccine,” said Bocking.