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SMDHU Annual Report 2020-2021

The Simcoe Muskoka District Health Unit is a champion of health for all. We work with individuals and families, agencies and communities in Simcoe Muskoka to promote and protect health, and to prevent disease and injury of the people we serve. We achieve this by providing a variety of public health programs and services, as well as working in collaboration with community partners on policies and initiatives that protect and promote health and well-being.

The health unit is governed by the Board of Health and is funded municipally and provincially. We are guided by the Ontario Public Health Standards and our own core values to work toward achieving our mission and vision. This Annual Report highlights the health unit’s work and achievements in 2020 and 2021.

Mission SIZE2

With our communities, we prevent disease and injury, and promote and protect health for all in Simcoe Muskoka.

Vision SIZE2

Healthy People. Healthy Places.

Values SIZE2

RESPECT We believe that respect for all people is embedded within our relationships with each other, and is reflected in our work.

COLLABORATION We believe that by working with others we can achieve the best health outcomes for all.

ACCOUNTABILITY We believe in being transparent and responsible to the public and out stakeholders by using ethical and sustainable organizational practices.

EQUITY We believe that all people are entitled to achieve their full health potential.

EXCELLENCE We believe in providing the highest quality programs and services to achieve our vision.

POSITIVE WORKPLACE We believe in a work environment where our employees are valued, communicate openly, and have work-life balance.


Since the beginning of the COVID-19 pandemic, the Simcoe Muskoka District Health Unit has been at the forefront of the ongoing pandemic response working on surveillance, case and contact management, monitoring and enforcing preventive measures, communicating information, and leading the local mass immunization campaign. This extraordinary work demonstrates the health unit’s agility to respond to the largest public health event of the century and highlights the role public health units play in ensuring the health and well-being of everyone in our society. It also underscores the need for greater investments in public health as routine programs and services mandated by the Ontario Public Health Standards were drastically scaled back due to the substantial redeployment of staff and reallocation of other resources to support the pandemic response. The programs most curtailed were those that address injury prevention, healthy eating, physical activity, chronic disease prevention, routine immunizations, dental health and substance use, amongst others.

According to the January 2022 Public Health Resilience in Ontario report by the Association of Local Public Health Agencies, the impacts of public health not being able to deliver its mandated programs and services during the pandemic has created a “health promotion and protection backlog…which is certain to have a significant and measurable effect on the health of Ontarians for years to come.” The SMDHU Board of Health will continue to advocate to the province to support provincial investment in ongoing coordinated pandemic response and greater financial investments in local public health agencies (such as SMDHU) to continue its mandate to protect and promote health; and to develop a vision for evaluation and renewal for a stronger public health sector to address population health needs.

While it will take time to resolve the deficits and backlogs resulting from the pandemic, the Board of Health supports Dr. Gardner and his staff to plan for recovery and the resumption of public health programs in 2022. The Board will also continue its work providing vision, creative thinking, and sound governance to support accessible and effective public health programs and services in Simcoe and Muskoka.

On behalf of the Board of Health, I thank Dr. Gardner, his Executive team and all health unit staff for their tireless work and dedication to the health and safety of everyone in our community. I also thank the volunteers who generously gave their time and energy to help with the smooth operation of our COVID-19 vaccination clinics. And last but not least I want to acknowledge and thank the many community partners, agencies and organizations that played a huge role in the overall COVID-19 response in Simcoe Muskoka.


Anita Dubeau
Chair, Board of Health

Message Header Dr. Gardner 

The past two years have been unlike any other for the Simcoe Muskoka District Health Unit (SMDHU), as we began a long and sustained response to the greatest public health challenge of our time. The COVID-19 pandemic has exacted a toll on the physical, social, emotional and financial well-being of our community while profoundly impacting our most vulnerable citizens.

The health unit’s response to COVID-19 began on Jan. 24, 2020, when we activated our Incident Management System (IMS) and began working with our many partners, including from the health and long-term care and municipal sectors to ensure readiness, capacity and contingency planning in preparation for the expected impact on the health of our residents. On March 11, the global COVID-19 pandemic was declared by the World Health Organization, followed soon after by Ontario’s declaration of a state of emergency on March 17. By April 2020, the health unit had paused most routine programming and had begun redeploying staff to support COVID-19-related work that included surveillance, communications, COVID-19 response phoneline, case and contact management, and eventually mass vaccination.

While the COVID-19 response dominated our work and forced the health unit to pause many non-COVID activities, the Substance Use and Injury Prevention, Healthy Growth and Development, Infectious Diseases and most Environmental Health programs continued to deliver crucial services to individuals, families, businesses and the broader community.

Our vital work would not have been possible without the tremendous efforts and collaborative work of all our partners from so many sectors, including health, emergency services, education, municipal, business and the Indigenous community. I am grateful for the dedication and resilience of SMDHU’s staff, the generosity of the volunteers who assisted with the successful operations of our COVID-19 vaccination clinics, and for the support of the Board of Health.

Looking to the future, we know that as a health unit and community we will continue to live with COVID-19. Simcoe Muskoka District Health Unit is well positioned to face new challenges that may emerge while we resume our mandated public health programs and services that promote and protect the health of all those who live, work and play in Simcoe Muskoka.


Dr. Charles Gardner
Medical Officer of Health

Board of Health Members

  • Anita Dubeau, Chair, County of Simcoe
  • Ralph Cipolla, Vice Chair, City of Orillia 
  • Sandy Cairns, District of Muskoka
  • Lynn Dollin, County of Simcoe
  • Gary Harvey, City of Barrie 
  • Stephen Kinsella, Provincial Appointee 
  • Peter Koetsier, District of Muskoka
  • Ann-Marie Kungl, City of Barrie
  • Rick Milne, County of Simcoe
  • Larry Oehm, Provincial Appointee
  • Floyd Pinto, County of Simcoe
  • Scott Warnock, Provincial Appointee
  • Peter Willmott, Provincial Appointee

Medical Officers of Health

  • Dr. Charles Gardner, Medical Officer of Health
  • Dr. Colin Lee, Associate Medical Officer of Health
  • Dr. Lisa Simon, Associate Medical Officer of Health

SMDHU COVID-19 Response

On March 11, 2020, the World Health Organization declared COVID-19 as a global pandemic. On the same day, SMDHU received confirmation of its first local positive COVID-19 case. This signaled a significant shift in our work away from delivering most of our mandated public health services and programs to a two-year agency focus on preventing the transmission of COVID-19 in our communities and protecting the health of our population through public health measures and COVID-19 vaccination. The following sections provide an overview of key COVID-19 events, data, and operational highlights of our work responding to the pandemic throughout 2020 and 2021.

2020 COVID-19 TIMELINE Rev 5 

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2021 COVID-19 TIMELINE Rev 5 

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About Pandemic Waves

The COVID-19 pandemic has seen multiple periods of time when the number of new cases quickly increases, which are often referred to as waves. A new wave occurs when there is a surge or rapid rise in the number of new cases that is later followed by a decline in cases. Waves of the pandemic are influenced by changes in viral transmission in the community, changes to public health measures, and at times when laboratory testing criteria [i.e., decrease in when polymerase chain reaction (PCR) tests may be done] and case and contact investigation and management practices change and impact case counts.

COVID-19 Pandemic Timeline Overview

January 30, 2020: The World Health Organization (WHO) declares a public health emergency of international concern
March 11, 2020: WHO declares COVID-19 a pandemic
March 11, 2020: Simcoe Muskoka District Health Unit reports its first local case of COVID-19
March 11, 2020: Wave 1 of the pandemic starts in Simcoe Muskoka
March 17, 2020: Ontario declares a state of emergency (shown here with a vertical blue dashed line)
August 9, 2020: Wave 2 of the pandemic starts in Simcoe Muskoka
February 14, 2021: Wave 3 of the pandemic starts in Simcoe Muskoka
July 18, 2021: Wave 4 of the pandemic starts in Simcoe Muskoka
December 12, 2021: Wave 5 of the pandemic starts in Simcoe Muskoka

Other SMDHU Priority Activities

While managing the demands of the pandemic throughout 2020 and 2021, the health unit also maintained priority programming essential to protecting health and preventing disease and injury. Although this programming was sharply curtailed due to staff redeployment during the pandemic, the following section provides an overview of the non-COVID priority activities that continued in 2020 and 2021.

While managing the demands of the pandemic throughout 2020 and 2021, the health unit also provided programming essential to protecting health and preventing and reducing health hazards that arise from our built and natural environments.

  • Safe Water Program continued with efforts to prevent or reduce the burden of water-borne illnesses and injury related to drinking and recreational water through on-going response to adverse water conditions, and where required, issuing boil water and/or drinking water orders and public notices. Public health inspectors assessed risk and inspected small drinking water systems. Open designated public bathing beaches in Simcoe and Muskoka were surveyed and water samples taken, with beaches being posted when results indicated a potential for elevated level of bacteria in the water. Pools, spas, and wading pools were inspected prior to each re-opening ensuring they met regulatory requirements for safe operation.
  • Food Safety Program inspected many locations where food was served to the public, monitored food recalls, and educated the public on safety of food in food premises after extreme weather events such as the 2021 tornado in Barrie.
  • Healthy Environments Program provided ongoing information to the public about the health impacts of extreme temperature events and how individuals could stay safe and protect others. Public education to support the prevention of West Nile virus infection and Lyme disease transmission was also provided.
  • Rabies Program investigated rabies exposures and promoted the vaccination of domestic animals against rabies with the coordination of low-cost rabies clinics.
  • Tobacco enforcement officers assisted many residents, businesses and community partners with indoor and outdoor smoke and vape-free laws under the Smoke-Free Ontario Act.
  • Smoke-Free Program continued efforts to prevent youth starting to vape and supported residents to quit smoking.
Throughout the pandemic the health unit maintained essential supports for families and children across Simcoe Muskoka. Public health nurses and family home visitors from the Healthy Babies Healthy Children (HBHC) Program provided counselling, education and program referral for vulnerable parents and caregivers. Family visits were conducted virtually, outdoors, and when permitted, indoors with public health measures in place. The Healthy Growth and Development (HGD) Program continued to support critical public health interventions and services to help parents at all levels of need, including:
  • Phone support for parenting and infant feeding calls through Health Connection.
  • Telephone and home visit postpartum support to all new parents in Simcoe Muskoka.
  • Online prenatal and breastfeeding classes.
  • Breastfeeding support to new mothers in partnership with the Barrie and Community Family Health Team.
  • Support to the Canadian Prenatal Nutrition Program (CPNP) across Simcoe Muskoka, and local advisory committees that coordinate the programs.
  • Maintained accountability criteria for Baby Friendly Designation, including annual reporting and community working groups.
  • Coordinated the distribution of car seat vouchers, in partnership with Honda, for families that qualified across Simcoe Muskoka.
  • Maintained community partnerships with early years, prenatal and postnatal sectors.

Although most Clinical Service Department staff were deployed to COVID-19 activities in 2020 and 2021, remaining staff continued to deliver essential public health clinical services throughout Simcoe and Muskoka.

  • The Infectious Diseases (ID) Program worked to prevent community transmission of urgent public health diseases such as tuberculosis, syphilis, listeriosis and legionellosis, and managed outbreaks of Hepatitis A, Influenza, Clostridium difficile, and Group A streptococcus. Public health inspectors conducted limited inspections of personal services and child care settings to ensure they were meeting public health requirements. ID staff also answered inquiries to the non-COVID phone line and provided 24/7 on-call response for infectious diseases emergencies and reporting of cases and outbreaks of COVID-19 and other diseases.
  • The Sexual Health Program supported healthcare providers and clients by coordinating the delivery of medication for sexually transmitted infections and harm reduction supplies. The team also provided anonymous HIV testing and treatment to cases referred by the Infectious Diseases Program and managed the assessment of potential exposure to bloodborne infections.
  • The Immunization Program implemented urgent large-scale non-COVID-related community immunization clinics such as Hepatitis and maintained the Universal Influenza Immunization Program. The team continued to onboard and support new facilities storing and administering vaccine on-site and completed vaccine storage and handling visits to ensure vaccine safety storage requirements were met. They also continued to support local providers for inquiries and responses to adverse events following immunization for all publicly funded vaccines.
  • The Oral Health Program launched the new Ontario Seniors Dental Care Program and completed over 2,500 seniors’ appointments. The program also reached contractual agreements with local denturists as part of a successful tendering process allowing denture services to be provided for low-income seniors. The team also managed the completion of the Gravenhurst dental clinic expansion and when possible, provided emergency-based oral health services for children and adults on publicly funded programs.


In 2020 and 2021, Simcoe Muskoka experienced a significant rise in opioid poisoning emergency department (ED) visits and related deaths because of an increasingly toxic and unregulated drug supply. In 2020, there were over 650 ED visits for opioid poisonings among Simcoe Muskoka residents and 135 related deaths. According to preliminary data for 2021, opioid poisoning ED visits were about 25 per cent higher than 2020 and there were 132 confirmed and probable opioid-related deaths in Simcoe Muskoka in the first nine months of 2021. This was more than 33 per cent higher than the 99 deaths in the first nine months of 2020.

SMDHU prioritized opioid-related activities during the pandemic through ongoing participation on the Simcoe Muskoka Opioid Strategy (SMOS) Steering Committee and at several of its Pillar tables with key partners. In support of harm reduction services, the health unit coordinated the distribution of Naloxone kits and needle exchange equipment to contracted community partners who provided low barrier access of these supplies to clients during the pandemic. Twelve additional distribution partners including hospital emergency departments, shelters, outreach organizations, withdrawal management programs, and fire departments, signed contracts with SMDHU to distribute Naloxone through the Ontario Naloxone Program. Five new partner agencies signed contracts with SMDHU to distribute safer use supplies through the Ontario Harm Reduction Distribution Program.

In partnership with the Canadian Mental Health Association Simcoe County Branch (CMHA SCB), the health unit provided leadership and support in the consultations, planning and application submissions for a Consumption and Treatment Services (CTS) site in Barrie. Applications were submitted by CMHA SCB on Oct 7, 2021, to Health Canada and the Ministry of Health. CTS sites help save lives and create safer communities. They provide a clean, safe and non-judgemental space for people to use their own drugs under the care of medical and non-medical staff. As relationships are developed with clients they are offered referrals to primary care, treatment, and other health and social services.


During the pandemic, with funding received from the County of Simcoe, SMDHU continued to implement county-wide public health strategies related to the legalization of cannabis. SMDHU epidemiologists analysed data gathered from the Rapid Risk Factor Surveillance System (RRFSS) and the Ontario Student Drug Use and Health Survey (OSDUHS) surveys and reported the results on HealthStats. They also monitored for unexpected increases in cannabis-related emergency visits from local hospitals and published quarterly situational awareness reports. A youth focused social media cannabis campaign was developed and implemented in 2021 to increase awareness about the health impacts of cannabis use. Over the course of 2020 and 2021, tobacco enforcement officers conducted 668 compliance/enforcement inspections which encompassed cannabis controls.

Financial Information

2020 Financials Horizontal

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2021 Financials Horizontal 

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