COVID-19 requires public health response for foreseeable future: board chair

By James Matthews
Local Journalism Initiative Reporter

Dealing with the ongoing COVID-19 pandemic and the coronavirus’ evolution is a business case of sorts that illustrates the need for more provincial support of regional public health agencies.
David Marshall, board of health chairperson for the Haliburton, Kawartha, Pine Ridge District Health Unit, said in a letter to Premier Doug Ford that investing in public health infrastructure will ultimately save the provincial health care system money.
The letter was written as the health board’s input for the 2023 provincial budget. It was forwarded to Haliburton County council and included as part of the March 22 meeting agenda package.
Traditionally, just two per cent of the annual provincial health care funding has gone to public health infrastructure. The pandemic has shown how important public health resources are to protecting communities. It’s also shown that two per cent of the health budget falls short of the needs.
“Since 2020, the provincial government has provided boards of health with one-time funding to support the ongoing work of responding to COVID-19,” Marshall wrote.
That money had to be stretched to cover outbreak management, surveillance and data management, COVID-19 immunization clinics, vaccine storage and handling support for COVID-19 vaccines, public and health-care provider communication and education, and supporting infection prevention and control in highest-risk settings.
“Due to the one-time nature of this funding, however, we are unable to recruit and retain the qualified health professionals required to ensure the sustainability of these supports,” he wrote. “This means that we continually need to draw on permanent staff from other program areas.”
That staff redeployment contributes to backlogs in other programs.
Marshall said it’s become clear over the last year that the coronavirus will need a long-term public health response.
He said the province needs to provide boards of health with increased permanent base funding to ensure capacity to support the public health response associated with COVID-19 added to the list of Diseases of Public Health Significance.
Permanent money is needed for Infection Prevention and Control Hubs and to support the boards of health School Focused Nurses Initiative.
“Boards of Health have yet to receive any funding to address the backlog of public health services that were created through the course of the pandemic,” Marshall wrote. “This is equivalent to the often-cited list of delayed surgeries in the acute care system.”
He urged the province to include a one-time financial contribution to alleviate the backlog.
Preventing illness is one way to lessen the burden on the health care system and, Marshall said, that’s the bread-and-butter of public health agencies.
“Continuing to fund boards of health at pre-COVID-19 levels means that we will be unable to adequately respond to emerging concurrent public health crises,” he said.
Before the pandemic, the provincial government announced a decrease in the grant contribution for cost-shared programs to a 70-30 ratio. For the region’s health unit, that change meant a loss of about $1.2 million. The province has provided mitigation funding since 2020 because of the pandemic.
Had that change gone ahead, health boards would not have been able to meet the challenges of COVID-19, he said.
Boards had to divert 60 per cent to 90 per cent of their base resources to pandemic response in 2020 and 2021. Should mitigation funding cease, this would amount to a significant cut in base budget resources.
“On the heels of a global public health emergency, in which there remains significant uncertainty regarding the emergence of new variants of concern, cutting board of health budgets would weaken local public health infrastructure at a time that it is needed most,” Marshall said.