This fall, we have encountered an uptick in infections leading to hospital capacity becoming strained, especially at paediatric hospitals where cases of respiratory syncytial virus (RSV) have coincided with an increase in COVID transmission and an earlier-than-normal flu season. It’s expected that these pressures will continue until mid-January. Additionally, pharmacies across Canada are dealing with a shortage of cough syrup and cold medicine, particularly medication for children. Health Canada expects a shipment of ibuprofen from the U.S. and acetaminophen from Australia to arrive imminently and will be available for distribution to pharmacies soon. Please click here for an update on the Children’s Cold and Flu Medications and Amoxicillin Shortage from the Ministry of Health and Ontario Health.
Memo on an Important Ministry Request – Respiratory Illness Season
Yesterday you would have received a memo from the Primary Health Care Branch at the Ministry of Health (EN FR) in response to the rising respiratory illness and system capacity constraints. We know many of you have a lot of questions on how to interpret the memo, especially the line:
… I am writing to call on your support and requesting your organizations to offer clinical services 7 days a week, including evening availability, until further notice, to meet the needs of your patients. Please advise your patients of this availability so they may seek care in the appropriate place for their health concerns.
In discussions with the Ministry, this memo was not intended to be directive nor prescriptive but was a request to communicate to your patients about how to access care, especially for sick children, with a focus on receiving care through their primary care teams first so that your patients do not seek care in the hospital if not needed.
For many of you this likely doesn’t change the expanded services you already provide; however, this is an opportunity to remind your patients of these services including virtual care supports, after-hours clinics and promotion of Health Connect Ontario (formerly THAS). And if you aren’t open or accessible 7 days a week, please let your patients know where else they can seek care first before going to the hospital.
There are some great resources that you can also post on your website, send proactively to your patients, share via social media, and encourage your patients to use:
IF you can deploy your FHT resources (e.g., NPs/RNs/PAs and front line staff) to support additional after hours care (this could be in person or could be virtually, whatever works best for your team), funding support for teams that anticipate extraordinary costs associated with the expansion of availability is available.
If you have unspent funds in your budget, you can also reallocate funds to help support additional staff hours with the usual in-year reallocation approvals process. As well, pooling of resources among FHTs and other primary care teams is also an option and is highly encouraged, especially for weekend coverage. Please speak to your Senior Program Consultant about options available to you.
Note that overtime pay is at the discretion of the employer, however teams are required to follow the Employment Standards Act where the team is non-unionized. Where unionized, teams are required to comply with the Collective Agreement.
We know you may have more questions about the memo and the ask to alleviate the pressures currently being faced in the health care system, especially in paediatric hospitals. We’re in constant communication with the Ministry, the CMoH’s office and Ontario Health so please outreach and we’ll do our best to address your questions and concerns.
Clinical Assessment Centres
Another resource that can be promoted to patients are the Ontario Health Clinical Assessment Centres which will be expanding access and supporting primary care providers in diverting COVID, Flu and ILI assessments from the ED (ready for beginning of December). Ontario Health Regions and CACs have been encouraged to form partnerships with interprofessional primary care teams where feasible to enhance capacity and ensure broader access (i.e., evenings and weekends) to meet the increased needs of patients.
There are currently 107 assessment centres across the province—some of you may already be affiliated with your local CAC, or you may receive partnership opportunities in the coming weeks to support this request. Revised Clinical Guidance for CACs will be released shortly, encompassing the broader scope of work required of CACs during this time. This guidance will be shared with all primary care providers and organizations to support collaborations with CACs in managing ILIs.
Upcoming Changes to Process for Ordering Provincial PPE/Testing Supplies
Effective April 2023, Ontario Health will transfer the management of provincial PPE/ testing supplies stockpile to the Ontario Ministry of Health. As a result, the Ministry of Health is launching a platform that will enable providers to continue orders online. All primary care organizations/practices can register for a free account (1 per organization). In the meantime, you can still access PPE through the provincial stockpile if you need it.
- Members can expect a communique from Ontario Health with additional details (e.g., how to sign up for the new platform, Ministry contact information, etc.) closer to April 2023.
Resources and Supports
- Resources to support your patients (COVID-19 vaccines and Flu Vaccines):
Access the Ministry’s booster eligibility calculator here. This ensures your patients have a clear understanding of the COVID-19 booster dose recommendations and the importance of why and when they should receive a booster dose.
The OMA has developed Template letter: COVID-19 Fall booster doses for individuals aged 5+ that can be accessed. A reminder that the OMA has updated COVID resources that can be found behind their paywall here.
Access the COVID-19 Vaccines Information Sheet. This document reflects updates to high-risk groups and availability of the Pfizer bivalent vaccine EN FR
COVID-19, RSV and Flu Vaccine Posters (please continue to encourage COVID boosters and flu shots with every patient visit if possible):
Boost Your Protection Against COVID-19 poster EN FR
Respiratory Syncytial Virus (RSV) EN FR
Anyone can catch the flu. Protect yourself and others. EN FR
Flu shot social media graphics
Updated COVID-19 Guidance:
As you may be aware, the Ontario Ministry of Health has updated its COVID-19 Vaccine Guidance (November 7, 2022) which reflects the following changes (remember to clear your cache to see the updated guidance):
- Addition of NACI guidelines for monovalent Pfizer-BioNTech 6 months – 4 years.
- Revision of high-risk populations.
- Addition of out-of-Province vaccination chart.
- Reference table for mRNA vaccines: caps and labels.
We know how much teams have stepped up during these grueling almost three years of the pandemic without any additional supports or recognition and you are exhausted. We have expressed to the CMoH and others in the Ministry and Ontario Health that members are already working at capacity, dealing with vacancies and staff being off sick, working with partners in their OHTs, all while still facing greater and greater operating pressures and mounting wait lists on regular care, in addition to surge issues. We remain in continual awe when our teams respond to these calls to action as you continue to shine a light on how critical primary care is to the health care system – it is truly the foundation. A sincere thank you for everything that you do for your patients and your communities.
Yours in good health,
The AFHTO Team