To: Family physicians and nurse practitioners
04-17-2020
Supply of Masks for Primary Care Providers

Last week we shared information regarding NSHA’s decision to supply all health care providers with a mask for in-person patient encounters.

For community-based providers in family practice, two masks per family physician / nurse practitioner per week will be supplied from a centralized location in your area.

Based on this, we are expecting that you limit in-person appointments to one day per week in your practice. You will have one mask to wear for that day and a second as a backup. Wearing the same mask throughout the day during in-person office appointments will help to protect your patients, and by pre-screening all patients by phone in order to refer patients with respiratory symptoms to your local primary assessment centre, this will limit exposure to the virus for yourself, your staff, and your other patients.

When you require a supply of masks, please send an email to the below address for your respective area. A Primary Health Care manager or lead will contact you to arrange distribution of masks for your practice. It is important that we responsibly manage our supply; we will share with you the anticipated length of time the supplied masks should last based on the recommended usage.

Request for Repatriation of STI Swabs

The Microbiology Laboratory would like to formally request any STI swabs or viral transport swabs in primary care clinics be repatriated. APTIMA swabs are required to support ongoing and increased volumes of COVID testing. Please return swabs to the closest hospital laboratory or courier to:

Dr. Todd Hatchette
Department of Pathology and Laboratory Medicine
Rm 315 MacKenzie Building
5788 University Avenue
Halifax NS B3H 1V8 

Testing for chlamydia (CT) and gonorrhea (GC) can still occur using urine samples in both men and women. Urine is an acceptable alternative for perinatal screening in women. The sensitivity of the testing methods is equivalent, so case detection should not change. Please collect the sample using a sterile container for urine cultures (at least 20 milliliters), and complete the standard requisition.

For more information, contact Todd.Hatchette@nshealth.ca .
COVID Community Virtual Care Team 

The COVID Community Virtual Care Team will provide 24/7 virtual care for patients with a known COVID-19 diagnosis, who do not have a current indication for hospital admission but who are at risk of clinical deterioration in the community. 
 
Patients will be referred through Public Health, emergency departments, secondary assessment centres, and inpatient COVID units. 
 
The intention of the team is to facilitate home-based care whenever possible and to provide safe and rapid access to acute care facilities when transfer is clinically indicated. This team will be available to patients across the province who meet all of the eligibility criteria. 
 
The following documents offer a preview. Please stay tuned for more information related to eligibility, referral processes, discharge criteria and more.
 
Recommendations for Office-based Practice: Suggestion Regarding More Vulnerable Patient Population

The following suggestion was adapted from information provided by Dr. Michele Saxon, Middleton Collaborative Practice.
 
Primary care providers should considering generating lists of potentially vulnerable patients (e.g. those over the age of 70, patients with anxiety disorders) to identify those who may benefit from a check-in during this time. A registered nurse or social worker with the practice can call the identified patients regarding prescriptions that may need to be renewed soon, to discuss social issues and status of their current supports, or to identify any health concerns that should be followed up by family physician or nurse practitioner.
 
Additionally, it may be prudent to consider discussing goals of care with patients who are elderly, and to consider completing the Expected Death at Home forms for anyone who meets criteria (e.g. very frail, multiple near end-stage illnesses), and whose goals of care do not involve aggressive hospital care, even if they contract Covid-19. 
Interim Primary Care Clinics in Northern Zone for Unattached People

Nova Scotia Health Authority has established three clinics for people who do not have a family doctor or nurse practitioner to receive care for their more immediate primary health care needs (those that are unrelated to respiratory infections). The clinics will be operational through June 30, 2020, as a temporary measure to provide primary care during the pandemic for people who are on the Need a Family Practice Registry.

The majority of appointments will be provided by phone. Unattached patients who live in the Northern Zone can be directed to make an appointment by calling:
  • Cumberland County (virtual clinic): 1-855-597-2420 Monday – Friday, 9 am – 12 pm
  • New Glasgow (serving Pictou County): 902-752-8643 Monday – Friday, 9 am – 12 pm
  • Truro (serving Colchester East Hants): 902-899-2273 Monday – Friday, 9 am – 12 pm
2SLGBTQIA+ COVID-19 Resource Guide

Many of Nova Scotia’s 2SLGBTQIA+ health services and community organizations have ceased operations temporarily, while some have transitioned to providing online services. prideHealth, a program of NSHA and IWK, along with other organizations that support the queer community in Nova Scotia, have created a resource guide that provides current information for the 2SLGBTQIA+ community about programs and services during the COVID-19 pandemic.
Virtual Care – Access to the Drug Information System

For primary care providers who work in private clinics or in community and who require access to the Drug Information System, please contact SHARE@novascotia.ca .

For health care professionals within NSHA and IWK, please use IT Self-Service to request access (paper forms are no longer accepted). When entering a request in IT Self Service, follow these steps:
  • Request product or service
  • Access
  • Application access
  • For new or to change access: SHARE DIS Add Change or Re-activate access
  • To remove access: SHARE DIS Deactivate access
Update on Public Health Early Years Services
            
The following list outlines the Early Years services that NSHA Public Health continues to provide to families in Nova Scotia:
  • All postpartum clients will continue to receive the Loving Care books, and infant feeding resources prior to discharge from hospital.
  • A Public Health nurse will continue to contact all families within 3-5 days of being discharged from hospital to home. The nurse will be available to provide support to families, however the services will be primarily through phone and virtual support.
  • Families who are currently being supported in the Enhanced Home Visiting Program will continue to be supported through phone and virtual support.
  •  Public Health will continue to provide childhood immunization services to infants and children who do not have access to a primary care provider.
  •  Public Health’s Pregnancy & Parenting Support webpage includes a variety of credible resources and information for families. This page is also available in French.

All other Public Health Early Years services are deferred until further notice.

If you have questions, please contact the Early Years manager in your area:
Northern Zone - Susanne.Landry@nshealth.ca