MARCH 20, 2020
COVID-19 Update for Elgin County Primary Care

Thanks for the great turnout on Dr. Joyce Lock's Health Care Provider Teleconference yesterday evening. You had great questions!

Dr. Chris Mackie (MHLU Medical Officer of Health) is offering a
Health Care Provider Webinar (click that link at time and join in)
Friday Mar 20 1200-1230

COVID-19 Status Update - ELGIN

  • 0 cases in Elgin or Oxford as of today
  • Under-reporting/under-identification due to shortage of swabs - only testing hospitalized patients and a few other groups previously identified (includes health care workers if you or your staff are symptomatic).
  • There is person-to-person transmission in Toronto confirmed Mar 15, we are estimated to be 7-10 days behind them.
  • Health Care Provider work recommendations:  As of Mar 13 – if returning from travel and SYMPTOMATIC as a health care provider. Do not return to work. self-isolate. If you are an ASYMPTOMATIC health care provider you are considered essential and you need to work and self-monitor and report symptoms immediately.
  • PH has added a call-centre and has increased staffing. Direct Line for Health Care Professionals: COMING TODAY IN Southwestern Public Health Update Email
  • Assessment Centre planning underway through STEGH for Elgin - goal to have people referred there after call or physician assessment, rather than a walk-in type clinic.

Thank you from our Elgin Community Pharmacists!
Thanks from our local community Pharmacists to all of our Elgin Family Physicians for accepting fax renewals during this time! This keeps people out of the office and the pharmacy that don’t need to be there.  It’s a good idea to at least do a phone call (which can be billed) with your patients on controlled substances to document according to CPSO.

Virtual First
Please provide as many visits as possible virtually (by phone or by e-visit). Please answer THIS SURVEY so I can get a sense of how many
Family Physicians in Elgin are able to provide virtual visits,
and who needs help at this point. If you need help text or email me with how far you've got and I will help you. Obviously many visits are still necessary in person (i.e. requiring a physical exam and we should still be providing these).

OntarioMD will be conducting two Live Webinars on Virtual Tools - Friday, March 20 th
OntarioMD will be conducting two live webinars TODAY at 12-1 pm and 5-6 pm on how to use virtual tools.  Physicians will demonstrate virtual tools and you can submit your questions during the webinar. Here is a link to our home page  https://www.ontariomd.ca/   and a link to access the webinars  Webinar Info page

PPE and Swabs
We recognize that you may have difficulty assessing URTI or other respiratory issues, including suspected COVID-19 without adequate PPE in your office and that you also have a responsibility to provide a safe workplace for your employees. It is expected that PPE will be coming soon. Please check out Dr. Mario Elia's video posted here yesterday (if you can't access message me and I'll add you) of how to set up to assess patients in your clinics. This will be necessary at some point as the number of cases escalates. Currently, if you identify someone who meets criteria for a swab, call ahead to the ER and send them there.

I would appreciate if you could appoint someone (staff) from each office to update this google doc (link fixed!) daily or at least weekly so we can keep track of the inventory in primary care offices. If you clinic gives or loans or borrows other clinics facilities or STEGH any swabs or PPE, please note this.


Cancellation of Non-Urgent Care
It is now recommended by OMA to cancel all non-urgent health care visits.  Many of these can be converted to online visits or telephone visits, which are now billable. Dr. Lock confirmed at this point baby immunizations are still considered essential. Please cluster visits for ARI symptoms at different times and minimize any waiting room time. Some offices are having patients wait in their car and you can call them or use iMessage on a Mac to text them when they can come in. How do you know what is considered non-urgent/non-essential?

Suggested message for phone/office:
“Please be advised that due to the current public health emergency underway, you may experience your scheduled appointments being postponed or cancelled. This will help us focus our work towards managing the pandemic. If you have any questions or concerns, please let us know. However, we may be delayed in getting back to you because of a high volume of patients seeking care.”


Assessment Centre Will Need
Physicians/Possibly Nurses Or Other Staff
If Hospital doctors are short-staffed due to illness or isolation, we may require help there at some point as well. Patty Aldrich at STEGH has this link to add your name/details in case you are needed. Adding your name here is just an expression of interest, not a commitment to specific work.


Social Media 
People trust their doctors. Please consider making a shareable tweet or facebook post on your personal page or making a clinic/practice page where you can share information publicly.  Our clinic has done some if you want to copy, feel free to! https://www.facebook.com/elmwoodfamilyhealth/. Help amplify messages from each other, from southwestern public health and from the hospital. It is easy to make a clinic facebook page and you can turn off messaging so patients aren't sending you messages on facebook messenger.

Consult a Specialist on COVID-19
The COVID-19 BASE™ Managed Specialty Group is now available province-wide and is a ccessed through the BASE™ managed specialty option and listed under Infectious Disease and Public Health. This is a group of Infectious Disease specialists who can answer both patient-specific and general questions about COVID-19. This is not for patient screening questions.
For non-patient specific questions please enter the patient information as follows:
First Name: COVID19 Last Name: COVID19
Date of Birth: 1900-01-01
Select OHIP number not available
  Please note: Patient screening for COVID-19 must still be done through Public Health Services.
If you need a refresher on how to submit an eConsult, you can watch our training video HERE
Here is the first step for physicians to get set up with OTN for e-visits or e-consult if you do not have access yet.
STEP 1 – get a ONEID . This will allow you to gain access to many things, not just OTN for e-consult, and e-visits, so it is a good idea anyway.


Worried about Complaints?
CPSO has a Q&A for Patients and one for Physicians


Worried About Your Office?

Local Service Updates
(click on links below for up-to-date info)
March 23 - 8:30-5
March 24 - 8:30-4
March 25 - CLOSED
March 26 - 8:30-4
March 27 and 28 - CLOSED

If you have an OBSTETRICAL appointment booked for THIS WEEK, (March 16-21) your appointment is on schedule and we will be expecting you. 
Non-Obstetrical appointments for THIS WEEK (abdomen, pelvis, thyroid, shoulders etc) will be rebooked to a later date to ensure that we are are all heeding the advice of Public Health Ontario and the Ministry of Health in minimizing the spread of COVID-19.
We will be in touch with you if you an appointment booked after March 21. 

At this time, we continue to operate many of our clinics to provide in-person services to patients requiring essential or urgent care, while following strict screening and sanitization practices in accordance with public health agencies. For most of our patients, we’re moving to our existing Virtual Care Model, allowing us to continue offering care to patients across Canada.

After careful consideration, and closely monitoring COVID-19 related cancellations, closures, and current recommendations, the hydrotherapy pool at Talbot Trail Physiotherapy (STEGH location) will be closed until further notice.
We are following all best practice measures to ensure we minimize any chances of transmitting the virus in our clinic.
All surfaces in the waiting area, physio rooms, treatment beds and equipment are being cleaned and disinfected, and towels are being changed regularly throughout the clinic.
We have advised all patients to please be mindful of any cold and flu symptoms and to postpone treatment if any illness should be present.
We have provided hand santizer for your use. Please be sure to make use of this on arrival and departure of the clinic.
It is our priority to keep you safe and well during this time.

No updates
Contacts for YOU
( DO NOT provide  these contact details to your patients. )

STEGH
519-637-3266 is a direct line to STEGH that avoids the COVID-19 messaging which you cannot bypass on the regular public line.  Do not give this number to patients/caregivers/family.

Please consider calling switchboard or emailing  patty.aldrich@stegh.on.ca  and offering your cell phone number in case you need to be contacted about one of your patients or your assistance is required.   Also let her know if you are willing/able to work at the hospital or assessment centre if needed.  Our colleagues may need our assistance at some point and you have lots of transferable skills.

PUBLIC HEALTH
Some of you mentioned difficulty getting through. There is a call centre and physician calls are prioritized. Dedicated Line coming later today in PH Update.

MINISTRY OF HEALTH
Healthcare providers can call 1-866-212-2272 or email  eocoperations.moh@ontario.ca  during regular business hours to reach the Ministry’s Emergency Operations Centre. 
·       
Dr. Kellie Scott
Elgin Primary Care Alliance