North American COVID-19 Policy Response Monitor: Prince Edward Island July 27, 2020 What is the North American COVID-19 Policy Response Monitor? The North American COVID-19 policy monitor has been designed to collect and organize up-to-date information on how jurisdictions are responding to the crisis. It summarizes responses of health systems as well as wider public health initiatives. The North American policy monitor is an offshoot of the international COVID-19 Health System Response Monitor (HSRM), a joint undertaking of the WHO Regional Office for Europe, the European Commission and the European Observatory on Health Systems and Policies. Canadian content to HSRM is contributed by the North American Observatory on Health Systems and Policies (NAO). Contents List of Acronyms and Abbreviations ............................................................................................................. 2 1. Preventing transmission ........................................................................................................................... 3 2. Ensuring sufficient physical infrastructure and workforce capacity ....................................................... 18 3. Providing health services effectively....................................................................................................... 20 4. Paying for services .................................................................................................................................. 23 5. Governance ............................................................................................................................................. 24 6. Measures in other sectors ...................................................................................................................... 29 References .................................................................................................................................................. 35 Appendix A. Key Resources ......................................................................................................................... 45 List of Acronyms and Abbreviations CPHO Chief Public Health Officer EMO Emergency Measures Organization F/P/T Federal/Provincial/Territorial ICU Intensive care unit IT Information technology LTC Long-term care NAAT Nucleic acid amplification tests NESS National Emergency Strategic Stockpile NML National Microbiology Laboratory PCH Prince County Hospital PEI Prince Edward Island PHN Public Health Nurses PPE Personal protective equipment PUI Person under investigation QEH Queen Elizabeth Hospital ROE Record of Employment 2 1. Preventing transmission This section includes information on key public health measures that aim to prevent the further spread of the disease. It details how jurisdictions are advising the general public and people who (might) have the disease to prevent further spread, as well as measures in place to test and identify cases, trace contacts, and monitor the scale of the outbreak. 1.1 Health communication The provincial government of Prince Edward Island (PEI) communicates health information and guidance about COVID-19 through provincial government news releases, COVID-19 website and social media pages (Facebook, Twitter, and YouTube). The Chief Public Health Officer (CPHO), Dr. Heather Morrison, started providing updates about the COVID- 19 pandemic on February 28, via the provincial government news website (Prince Edward Island, 2020a). At the time, the provincial government states that the risk to PEI residents (“Islanders”) was low and that they were working closely with federal, provincial and territorial governments to assess public health risk (Prince Edward Island, 2020a). Prevention measures to stay healthy against respiratory viruses were also described, including(Prince Edward Island, 2020a): • Washing hands frequently with soap and water • Coughing and sneezing into elbows or tissues • Staying home when ill with acute respiratory symptoms • Limiting touching eyes, nose, and mouth • Avoiding sharing drinking glasses and water bottles • Frequently cleaning surfaces such as taps, doorknobs and countertops On March 11, the provincial government launched the PEI COVID-19 information line (1-833-533-9333) for Islanders to contact with questions about COVID-19 (Prince Edward Island, 2020d). The information line is available 24-hours a day, 7 days a week, and individuals leaving messages receive call backs within 24 hours from the CPHO (Prince Edward Island, 2020d). The first positive case of COVID-19 in PEI was confirmed on March 14 by the CPHO (Prince Edward Island, 2020an). Shortly after on March 16, Premier Dennis King declared a public health emergency to ensure the province could further steps to prepare for and prevent the impacts of COVID-19 (Prince Edward Island, 2020i). On March 19, the COVID-19 online self-assessment tool for PEI that was developed by Alberta Health Services (AHS) and the Government of Nova Scotia went live (Prince Edward Island, 2020ap). On April 6, the CPHO began discussing the use of non-medical masks and face coverings with Islanders (Prince Edward Island, 2020ab). She stated that homemade cloth masks were not proven to protect the person wearing it, and should not be used in replacement of public health measures; however, wearing a mask in public where physical distancing is not possible such as on public transit was suggested as appropriate to ensure the safety of those around the person wearing the mask (Prince Edward Island, 2020ab). 3 On April 16, Premier King extended the state of public health emergency by another 30 days and the Minister of Justice and Public Safety, Minister Thompson, confirmed that the state of emergency would be declared across the province until the end of the month to ensure efficient deployment of resources to assist in the public health response (Prince Edward Island, 2020av). More information about declared state of emergencies can be found in Section 6.1. On June 11, the Minister of Justice and Public Safety urged Islanders to be careful and vigilant about potential financial scams, and fraudulent financial activity especially in the context of the global pandemic (Prince Edward Island, 2020bk). 1.2 Physical distancing Schools, childcare facilities and youth camps On March 10, the Department of Education and Lifelong Learning cancelled all Public Schools Branch sanctioned school trips to Europe for the March Break period (March 16 to March 20), and all school- planned travel abroad for the rest of March (Prince Edward Island, 2020c). They stated that the future student travel opportunities would be reviewed at an appropriate time by the Public School Branch (Prince Edward Island, 2020c). The Department referred Islanders to the provincial website for up to date information about travelling and COVID-19 and advised that students and school staff returning from trips abroad who were feeling well could return to school, while those who were experiencing symptoms should stay home and refer to 811 for instructions (Prince Edward Island, 2020c). Effective March 17, all public licensed child care centres were closed until further notice and all public schools were closed (initially for two weeks following March Break - March 23 to April 3) (Prince Edward Island, 2020g). For child care centres that could remain open, children who had travelled outside the country or whose parents or caregivers had travelled outside the country were asked not to attend child care centres and to self-isolate for 14 days regardless of whether they are symptomatic or not (Prince Edward Island, 2020f). On March 27, the CPHO extended closures to schools, daycares, non-essential government services and non-essential businesses (Prince Edward Island, 2020s). Schools and daycares would remain closed for in- person classes and services until May 11, at which point closures would be re-evaluated (Prince Edward Island, 2020s). On April 30, the provincial government announced several updates for education and schools (Prince Edward Island, 2020ai): • Effective May 11, designated schools will open to some students who receive individualized supports from educational assistants and youth services workers; • For the week of June 22, students transitioning to intermediate and high school in Fall 2020 would be able to attend small group tours and activities at schools; • All school services would be required to adhere to public health guidelines including physical distancing, hygiene protocols and proper cleaning of schools; and • School bus services would not be available, however, alternative transportation arrangements would be made for families requiring accommodation. 4 Transition Measures On May 15, the provincial government announced its plan for expanding and reopening childcare on May 22 as part of Phase 2 of the reopening plan (see Section 5.2 for an overview of the reopening plan) (Prince Edward Island, 2020be). These changes increased the number of licensed childcare centres from 22 to 155; allowed for groups of 5 people, with not more than 20 people in a single centre; and allowed private home-based child care centres to re-open to their full capacity of up to 7 children. On May 28, Minister of Education and Lifelong Learning, Brad Trivers, announced that public health restrictions for child care and schools would be further relaxed effective June 1 (Prince Edward Island, 2020bg), including the following changes: • Ending the 20 person per licensed child centre cap; • Increasing