5 times the Windsor-Essex health unit went beyond provincial restrictions to fight COVID-19

As COVID-19 cases continue to mount across the province and in Windsor-Essex, some might wonder whether or not more restrictions could be coming down the line. 

According to the Windsor-Essex County Health Unit (WECHU), it's done all it can in terms of restrictions, with the region being in lockdown and schools remaining closed until at least late January. 

"For me, I did what I could in terms of taking a stand with respect to the schools, but I'm glad, I'm really happy to see that the province came out and then made that decision about the schools for the province," said Dr. Wajid Ahmed, the medical officer of health. This was something the health unit had called for Thursday morning.

"Those are the things that I can do. Any kind of further restrictions and imposing of stricter measures, that's beyond public health's domain."

But a number of times during the pandemic, the health unit did go beyond provincial regulations — from halting in-person learning back in December to adding extra restrictions at the start of the second wave, local health officials have stepped in to curb the spread of the disease. 

One expert in public health says this signals that the province should be taking more action.

"When you see local public health units like Windsor-Essex taking stricter measures regularly, it's a sign that the province isn't being responsive to the need," said Kate Mulligan, a director of policy and communications at Alliance for Healthier Communities and an assistant professor at the School of Public Health at the University of Toronto. 

She added that these decisions are also reflective of the important role local public health plays. 

"Sometimes there are local circumstances that are just different from what's happening around the province, and that's okay. Our system should be able to accommodate regional differences in what's happening with COVID and how we respond to it."

WECHU isn't the only health unit that has done this. Mulligan, who sits on the Toronto Board of Health, said that they too have taken more action than has been mandated by the province.

She said those decisions are a combination of defiance and public health officials working within their powers.

"I think there is room in the system for a local adaptation and change, but for many health units and boards of health, it's also a bit of an expression of frustration with the lack of leadership being shown at the provincial level," she said. 

CBC News took a closer look at some of the decisions WECHU has made. 

School closures

WECHU has been one step ahead of the province not once, but twice when it comes to decisions around in-person learning in schools. 

On Dec. 10, Ahmed announced the suspension of all in-person learning across Windsor-Essex in response to the growing number of cases and increased community spread. Schools were ordered to move to online learning for the week leading up to the holiday break.

This came at a point when Windsor-Essex was still in the red-control COVID-19 zone. It was a bold move, given that other parts of the province that were already in lockdown were still continuing with in-person learning. 

Directives from the province on schools didn't come until Dec. 21st.

That's when, under new widespread lockdown measures, the province decided that all schools in southern Ontario would switch to remote learning until at least Jan. 11 for elementary schools and Jan. 25 for secondary schools. 

As Jan. 11 approached, and COVID numbers continued to soar across parts of Ontario, questions were mounting over whether or not the province would extend that deadline. Earlier this week, the province stood firm. 

On Thursday morning, the health unit said it recommended that all schools remain closed until at least Jan. 25 and that it would be issuing an order by Friday if the province didn't make that call. 

By Thursday afternoon, the province followed suit.

Measures at start of second wave

Following two months of low case counts in Windsor-Essex throughout September and October, in early November, the tides started to turn. 

The health unit started to grow weary and predicted it was time for Windsor-Essex to move from the province's green- prevent COVID-19  zone to the yellow- protect zone. At the time, Ahmed had said that if the province didn't bump Windsor-Essex up to that next category, he was prepared to go above provincial recommendations. 

The bump in status was announced as predicted on Nov.13, but even with that in place, the health unit chose to implement tighter restrictions that were "above and beyond" provincial regulations. 

The health unit ordered a limit of 50 people inside retail businesses and gyms, restrictions on personal care services without a mask, and a promise of enhanced enforcement moving forward. 

Mulligan said when health units make choices like these, they're usually sticking their necks out, potentially putting relationships with local businesses and people in their communities at risk. 

"Those relationships with local people really matter. And so if you're seeing public health put those relationships on the line by taking significant action, you know that they think it's important and that it's not happening where it ought to be happening at the provincial level," she said. 

Farm regulations

During the summer of 2020, COVID-19 hit the agri-food sector in Windsor-Essex hard, with more than 1,000 migrant workers catching the virus leading to the deaths of two workers. 

While the temporary foreign worker program is run by the federal government, the local health unit took it upon itself to issue orders to fight COVID-19 on the farms. 

A significant order was announced July 1st shutting down a farm in Essex County after nearly 200 cases of COVID were identified there. Nature Fresh was ordered to isolate employees and temporarily cease work.

In June, the health unit issued a class action order to agricultural farms, requiring owners to ensure meals are provided to temporary foreign workers undergoing isolation. Workers must have access to portable water tanks and a communication device. 

Face coverings

Back in June, WECHU issued an order that all commercial establishments implement a policy that requires everyone to wear a face covering upon entry. 

Around that time, on June 29, the Ontario government had said that a provincial policy making face masks mandatory wasn't necessary.

Other steps taken

The health unit says in addition to the above, Ahmed raised concerns about border traffic in March before the federal government closed the border to non-essential travel.

Public health says it also directed staff at long-term care and retirement homes and hospitals to only work in one facility, before the restriction was implemented provincially, and directed the closure of bars and restaurants for St. Patrick's Day in March before the province shut things down across the province.

Mulligan said she's been impressed with Ahmed and the health unit's leadership. 

"I think it takes courage to take more significant action in a time when it might not be very popular," she said. 

As the public waits to see if more restrictions could come down from the province, Mulligan says WECHU and other health units should consider doing more to fight the spread should it become necessary. 

"I don't think they can count on provincial action," she said. 

Friday morning, Ahmed said he thinks the province has done a great job in making the right decisions at the right time. 

But Mulligan pointed out, it's not really in the health unit's interest or in its nature to criticize the government. 

"They're trying to maintain good relationships with the province at a very fraught time," she said. "They're trying to do what they can, given the constraints and resources that they have."