Ultimate Blogging Championship

Tag: Public health

  • Update on COVID Resources and Vaccines

    Dear Members,

    Your Primary Care Collaborative* (PCC) would like to update you on a few resources and supports for members with the ongoing pandemic and vaccine rollout. However, before providing any updates, we want to start by expressing our grief and sorrow about the tragic and horrifying events of the last few weeks, recognizing that racism and hate has been part of Canada since its inception. We are committed to working with our partners and allies to listen, learn, grow, and do better at creating a more equitable and safer country for all. You can read AFHTO’s statement here.

    A Quick Update on Vaccination Efforts
    While COVID cases have decreased over the last few weeks, the briefing by the Ontario Science Table yesterday is clear that the only way to avoid a fourth wave is to ensure first and second doses are prioritized in high-risk communities, vaccine clinics are tailored to community needs, and that there is strong testing and case and contact tracing.

    We were pleased to see yesterday’s announcement that Ontario is accelerating second doses in Delta hot spots (Halton, Peel, Porcupine, Toronto, Waterloo, Wellington-Dufferin-Guelph and York public health units) and continue to seek clarity on the role primary care providers are to play with the vaccine efforts in their communities.

    Materials from Webinar with Dr. Daniel Warshafsky, AMOH and Nicole Blackman, IHPCC
    On June 9th Dr. Daniel Warshafsky, Associate Chief Medical Officer of Health within the Office of the Chief Medical Officer, provided updates on vaccine efficacy, breakthrough cases, Variants of Concern, vaccinations for youth, as well as a number of other questions raised by attendees. Nicole Blackman, Provincial Director at the Indigenous Primary Health Care Council also spoke about why it was crucial that Indigenous people are prioritized to receive vaccines. Here are some of the resources you may find helpful that were discussed during the webinar:

    Upcoming Education Sessions and Webinars

    • OCFP Community of Practice
      • Getting to herd immunity: addressing children, confidence and complacency with Dr. Jeff Kwong (Epidemiologist, Family Physician, Toronto Western Family Health Team) and Dr. Nisha Thampi (Pediatric Infectious Disease Physician, IPAC Medical Director, Children’s Hospital of Eastern Ontario). Register here.
    • Public Health Agency of Canada
      • NACI Recommendations on COVID-19 Vaccine Interchangeability – this moderated and live webinar includes a presentation and discussion on the NACI Recommendations on COVID-19 Vaccine Interchangeability with live Q&A to inform health care and vaccine providers. Register here for the June 16th (English) session or here for the June 18th (French) session.
    • COVID-19 Science Advisory Table
      • Medications for Outpatients with COVID-19 on Tuesday, June 15 from 7:00 to 8:00 p.m. Register here.
    • AFHTO, OCFP, Alliance for Healthier Communities, Nurse Practitioner-Led Clinics Association
      • Cancer Screening During the Pandemic and Onwards – a collaboration with our primary care partners and Ontario Health (Cancer Care Ontario) on Monday, June 21, 8:00 to 9:00 a.m. Register here.

     
    Oxygen Saturation Monitors continue to be available
    Oxygen saturation monitors are still available free of charge for primary care providers. Please be sure to order yours before the end of June! Every primary care provider can benefit from having these in their practice and for distribution to patients you may be monitoring with COVID, but also for other conditions (e.g., COPD).  These monitors will then belong to your practice – you do not need to return them to the Ministry of Health. Link to ordering survey HERE. Monitors usually arrive within 2-3 days after requesting. For questions, please contact OH_COVIDatHome@ontariohealth.ca. For a link to the one-pager with all the resource you need for monitoring COVID patients visit HERE.
     
    Additional Resources you may find helpful:  

    Updated PHAC and Ministry Guidance Documents:

    We look forward to continually updating you on the provincial vaccination strategy and hopefully a path forward to recovery. Please do not hesitate to contact us if you have any questions or ideas.

    Yours in good health,
    The AFHTO Team

    *Primary Care Collaborative partners

    • Alliance for Healthier Communities
    • Association of Family Health Teams of Ontario
    • Indigenous Primary Health Care Council
    • Nurse Practitioner-Led Clinic Association
    • Ontario College of Family Physicians
    • Ontario Medical Association Section on General and Family Practice
  • Bits & Pieces: cancer screening during the pandemic and more

    Bits & Pieces: cancer screening during the pandemic and more

    Your Weekly News & Updates

    In This Issue  
    • Cancer screening during the pandemic and onwards, June 21
    • Reminder- COVID-19 Education with Daniel Warshafsky, June 9
    • Reminder- Update on the Ontario Structured Psychotherapy Program, June 10
    • Member stories
    • AstraZeneca/COVISHIELD second dose Q&A, reports of myocarditis/pericarditis after vaccination and more
    • You could have over 22,619 pairs of eyes on your team’s initiative!
    • COVID@Home update
    • Upcoming events regarding geriatric clinical pharmacology and more

    Cancer screening during the pandemic and onwards, June 21

    In collaboration with our primary care partners and Ontario Health (Cancer Care Ontario), we will be hosting a webinar to further explore guidance for resuming breast, cervical and colorectal cancer screening and share stories from teams that have already resumed cancer screening.

    Objectives:

    • To understand the guidance for resuming breast, cervical and colorectal cancer screening resumption midst the many waves of the pandemic.
    • To explore how to use data to understand and address health inequities in screening/tailoring service delivery as well as tools to improve screening rates.
    • To learn from practices the creative approaches such as EMR queries, clinics and much more.

    Register here.

    Reminder- COVID-19 Education with Daniel Warshafsky, Office of CMOH, June 9
    This session with Dr. Daniel Warshafsky, Associate Medical Officer of Health at the Office of the Chief Medical Officer of Health will cover key questions, including variants of concern, AstraZeneca and mixing of vaccines, breakthrough cases and emerging evidence around vaccination for children 12-17 years old. Nicole Blackman, Provincial Director at the Indigenous Primary Health Care Council will talk about why Indigenous people are prioritized to receive vaccines. Register here.

    Reminder- Update on the Ontario Structured Psychotherapy Program, June 10

    The Ministry of Health has recently approved six health service providers to serve as new lead organizations of regional psychotherapy networks for the Ontario Structured Psychotherapy (OSP) Program, one of which is AFHTO member CarePoint Health.

    The Mental Health and Addictions Centre of Excellence at Ontario Health would like to invite primary care organizations to a webinar on June 10 to learn more about the program’s background, the vision of OSP as a provincial program, and next steps with the expansion.

    Register here.

    Member stories

    Barrie and Community FHT- Barrie & Area launched their COVID@Home monitoring program

    East Wellington FHT– Lions Club donates $4,000 to East Wellington Family Health Team

    North Perth-North Huron FHT– North Perth Family Health Team, It Takes A Village start vaccine awareness partnership

    STAR and Stratford FHTs– Perth County primary care providers partnered together to offer about 500 COVID-19 vaccine doses

    AstraZeneca/COVISHIELD second dose Q&A, reports of myocarditis/pericarditis after vaccination and more

    Recent updates include:

    We continue to update several pages on our site with resources and news:

    You could have up to 22,619 pairs of eyes on your team’s initiative!

    This week we’re asking for your teams’ stories on:

    AFHTO wants to feature your stories!

    –    COVID Vaccine education (myth-busting, Q&As, etc)
    –    Providing COVID-19 vaccines or supporting vaccine rollout beyond your team
    Be sure to share before Tuesday, June 15th so we can feature it on AFHTO’s social media!

    @AFHTO | info@afhto.ca| Webform submission

    COVID@Home update

    Per Ontario Health:
    “If you monitored COVID+ patients in April and May please consider entering your data on that  specific timeframe in our new easy to use DATA FORM.  For those that have already done so thank you!  For questions on this e -mail OH_COVIDatHome@ontariohealth.ca.  We will use this information to show the value of primary care in such initiatives and for quality improvement purposes. Thank you for your continued participation in this initiative.”

    Geriatric Clinical Pharmacology and GeriMedRisk: drug safety for older adults beyond “Start Low, Go Slow”, June 24

    Co-hosted with GeriMedRisk, in this webinar, Dr. Ho will review the pharmacology of aging and its impact on adverse drug events among seniors. We’ll also explore tools and services for primary care providers to use to optimize drug safety. Register here.

    COVID@Home Community of Practice, June 9 & 23, 2021
    Learn how to monitor your COVID-19 patients in the community through this CoP.
    Learn more here.

    A Morning with the Lung Experts: What’s Trending in Primary Care? June 12, 2021

    Join Dr. Tony D’Urzo and the Lung Health Foundation Experts as they explore emerging respiratory care issues.
    Find out more here.

    Applying an Equity Lens when Caring for your Population, June 17, 2021

    This RISE OHT webinar will be based on a PHM approach, deep diving into co-designing care models for different priority populations.
    Learn more here.

    Primary Care Vaccination QI Support CoP, June 17 & July 8, 2021
    Join PCPs, EDs & clinical managers from AFHTO, AHC & NPLCA to share learnings, tools and strategies to deliver COVID-19 vaccines in Ontario.
    Find out more here.

  • Bits & Pieces: vaccine consent and information for youth, physiotherapy month and more

    Bits & Pieces: vaccine consent and information for youth, physiotherapy month and more

    Your Weekly News & Updates

    In This Issue  
    • Vaccine consent and information for youth and more updates
    • National Physiotherapy Month
    • Member stories
    • Ontario is creating a roadmap to eliminate hepatitis C by 2030
    • Important information about AstraZeneca second doses and more
    • MindWell for Healthcare Workers
    • Support reminder- BounceBack
    • Call for applications for FASD support groups-deadline May 26
    • Public Health 2021– call for submissions
    • DYK- board postings on AFHTO site
    • NPAO Patient Choice Award
    • Upcoming events including virtual wellness workshop series for patients and more

    Vaccine consent and information for youth and more updates

    There were so many updates in Friday’s situation report from the Ministry, this had to be separate from our COVID-19 section below. Documents include:

    Three COVID-19 vaccine documents have been developed for youth and/or parents/legal guardians:

    Two COVID-19 vaccine documents have been updated:

    The following documents have been updated and are available on the Ministry’s website:

    These documents and links will be updated on our site shortly.

    National Physiotherapy Month
    Primary care takes care of patients for a lifetime, which is why physiotherapists are an integral part of the team. For National Physiotherapy Month, we’d like to say THANK YOU to the amazing PTs in primary care teams.

    Member stories
    Northumberland FHT – radio interview on facilitating vaccinations

    Rideau FHT – Vaccines on wheels: organizing a drive-through vaccination clinic in your practice

    Text= We're building Ontario's roadmap to eliminate hepatitis C. Background= illustration of the profiles of people of different colours with different hairstyles and head coverings

     

    Ontario is creating a roadmap to eliminate hepatitis C by 2030

    Ontario is creating a roadmap to eliminate hepatitis C by 2030. Over 110,000 Ontarians are living with hepatitis C. With a diagnosis that is simple, an effective cure, and proven prevention strategies, eliminating hepatitis C is within our reach. Building upon a 2019 national strategy, multiple stakeholders are coming together to chart the path to elimination in Ontario.

    AFHTO is an advisor on this project. To find out more, visit the Ontario Hepatitis C Elimination Roadmap website.

     

    Important information about AstraZeneca second doses and more

    Recent updates include:

    We continue to update several pages on our site with resources and news:

    MindWell for Healthcare Workers
    MindWell for Healthcare Workers is designed for healthcare workers by healthcare workers to give you the tools you need to feel confident and capable, remain calm amidst chaos and build overall resilience and well-being so you can perform at your best no matter what is happening around you.
     
    Short, simple, and effective lessons are provided in 4 weekly modules designed to give you maximum results in the least amount of time.  Sign up today to see positive change.
     
    MindWell for Healthcare Workers is a 4-week self-paced online learning experience accessible from any device. Each week includes approximately 10-15 minutes of learning content plus one 50-minute live session offered several times a week to fit most schedules.

    I miss my friends. I miss my social life. I'm lonely. Superimposed over a man's downcast face.

    Support reminder- BounceBack

    Bounceback’s latest campaign targets different demographic groups and highlights the struggles their coaches and clinicians have been hearing about from program participants during the pandemic. This includes concerns from middle-aged moms, men, parents of young children, people working from home, front-line workers, and students.

    If you’re interested, please feel free to share on your social channels and broadly with your networks.

    Call for applications for FASD support groups-deadline May 26
    Fetal Alcohol Spectrum Disorder is a neuro-developmental, permanent disability that affects 4% of the population in Ontario. Support groups for individuals with FASD or their parents/caregivers provide information, support, and reduce isolation and loneliness.

    Health Nexus has launched its application process for FASD Support Groups. Apply to receive up to $4,500 to run a virtual support group for individuals with FASD or their caregivers (and in person when COVID-19 permits). Candidates will be able to reapply for projects annually. To learn more, visit their site.

    Public Health 2021– call for submissions
    The Canadian Public Health Association is now accepting submissions for presentation at Public Health 2021. Submissions will be accepted for oral and poster abstracts, didactic symposiums or interactive workshops that are focused on one of their conference keywords. Deadline June 3, 2021.

    DYK- board postings on AFHTO site
    You know the AFHTO careers section as the best place to advertise job openings for staff, but did you know you can also post volunteer board positions there as well? Now you do. Feel free to post here.  And for any of your partners, as non-members they can post for a nominal fee.

    NPAO Patient Choice Award
    The NPAO NP Patient Choice Award is presented at the NPAO annual conference in September. Please share with your patients, colleagues and friends. How has your NP made a difference in your life or that of your family or friend? Deadline June 18, 2021.

    COVID-19 Education with Daniel Warshafsky, Office of CMOH, June 9

    This session with Dr. Daniel Warshafsky, Senior Medical Consultant at the Office of the Chief Medical Officer of Health will cover key questions, including variants of concern, AstraZeneca and potential mixing of vaccine, breakthrough cases and emerging evidence around vaccination for children 12-17 years old. Nicole Blackman, Provincial Director at the Indigenous Primary Health Care Council will talk about why Indigenous people are prioritized to receive vaccines. Register here.

    The Path to an Effective Vaccine – Lessons Learned in Real Time, June 2, 2021
    Free panel by Dalla Lana School of Public Health. Register here.

    Virtual wellness workshop series for patients, starting June 1, 2021
    New Vision FHT is opening their upcoming Anxiety during COVID and Emotional First Aid virtual workshop series to non-FHT patients and would like to invite you to share this with your team/patients to register. Registration is limited, so please encourage patients to register as soon as they can. Find out more.

    Child & Youth Eating Disorders: Information for Primary Care, June 1 – 15, 2021
    This special interest ECHO session series will cover:

    • Understanding Medical Implications and Monitoring for Children and Youth with Eating Disorders, June 1, 2021
    • Supporting a Young Person with an Eating Disorder in Primary Care – Tips and Tricks for the Primary Care Provider, June 15, 2021

    For more information, click here.

    Project ECHO: Ontario Bariatric Network, Starting June 2, 2021
    Join these OBN Project ECHO Series held by Guelph General Hospital BCOE & The Ottawa Hospital BCOE.
    Find out more here.

  • Important Information about AstraZeneca Second Doses

    Dear members,

    As you are aware the Ministry announced yesterday that they will make second dose administration of AstraZeneca COVID-19 vaccine available, beginning with those who received their first dose of the vaccine between March 10 and March 19, 2021. For primary care this impacts the primary care clinics that were part of the initial AZ pilot in 6 PHUs (Peterborough Country City Health Unit, City of Hamilton Health Unit, Wellington-Dufferin-Guelph Health Unit, Peel Regional Health Unit, Simcoe Muskoka District Health Unit, and City of Toronto Health Unit).

    For those sites that were part of the initial rollout of AZ vaccines, you have probably been contacted about next steps in getting the vaccines so that you can start booking the second doses to patients who want them through informed choice. This is a time limited rollout during the week of May 24 for individuals who opt for an earlier dose interval of 10 weeks with informed consent. If you are in one of those pilot areas and have not received any information about the second doses, please connect with your PHU contact or let us know so we can inform the Ministry.

    The Ministry has released two documents to help primary care providers with the administration of 2nd dose of AZ vaccines:

    In addition, take a moment and read the OCFP President’s Important Update about AstraZeneca Second Doses which also includes a script for your patients that you can adapt for your clinics.
     
    And take a moment and watch Dr. Allan Grill as he speaks to CTV News about the second dose AZ with informed choice, VOCs, safely enjoying the outdoors and getting more #NeedlesInArms.

    As always, we look forward to continually updating you on the provincial vaccination strategy. Please do not hesitate to contact us if you have any questions or ideas. We hope you get an opportunity to safely enjoy the outdoors this long weekend if you can.

    Yours in good health,
     The AFHTO Team

  • Pause of first doses of AstraZeneca/COVIDSHIELD Update

    Pause of first doses of AstraZeneca/COVIDSHIELD Update

    In This Issue:

    • Pause of first doses of AstraZeneca/COVIDSHIELD Update
    • mRNA Vaccines in Primary Care
    • Ontario Matching Portal
    • COVID-19 vaccination clinic workflow and mass upload tips & tricks
    • Community of Practice: Primary Care Participation
    • COVID@Home
    • A Big Thank You!

    Dear Members,

    You have probably already heard that the Ontario government announced on May 11th that primary care and pharmacy are to pause on the further use of the AstraZeneca (AZ)/COVISHIELD COVID-19 vaccines as first doses to eligible individuals. This announcement was made out of an abundance of caution and after carefully reviewing cases of vaccine-induced immune thrombotic thrombocytopenia (VITT), linked to the AZ vaccine. For the full Ministry announcement please click here.

    There are still so many unknowns around next steps, including if those who received first dose AZ will be eligible to receive a second dose of AZ at a shortened interval if they have certain health conditions or are nearing the mark when they are due for their second dose. We are awaiting direction from the Ministry of Health about what to do and will send information as soon as it is available.

    In the meantime, here are two immediate things you should do if you are administering AZ in your office:

    • Please keep any remaining AZ vaccines in your fridge and safe. More details are coming from the MOH about how these vaccines will be returned or if they can be used with certain populations.
    • Please ensure any patients booked to receive AZ are cancelled. They should be rescheduled to receive a mRNA vaccine when these are available.

    And for many of you who may be getting anxious calls from your patients, here are two documents you can adapt for your practice:

    • Clinic message developed by the Ontario College of Family Physicians that you can send by letter/email to your patients
    • Email developed by Dr. Noah Ivers at Women’s College Hospital that you can also send to patients that have received first dose AZ in your clinics

    Now more than ever, primary care has a critical role to play to strengthen confidence in vaccination. Here are some additional resources you may find helpful:

    mRNA Vaccines in Primary Care

    • Along with other primary care associations, we have been calling for the use of mRNA (Pfizer and Moderna) vaccines in primary care.
    • The province is receiving an increase of Moderna vaccines and by the end of May 60,000 doses of this mRNA vaccine are expected to be delivered across all 34 public health units which will then be provided to primary care settings.
    • The allocation to the public health units is based on per capita population and hot spot areas.
      Do you have any experience with mRNA vaccines in your clinics? We want to hear from you, especially if you have given the Pfizer vaccine so we can highlight the successes in primary care and advocate for more mRNA vaccines in primary care!
      Medical Officers of Health will continue to make decisions around which primary care sites will receive the vaccine to administer and we will provide you updates as they become available.  If you are having trouble connecting with your PHU please let us know and we can try to facilitate.
    • We hope this is a first step, and we will continue to advocate for an expanded role for more primary care practices to be included in the vaccination rollout. We know there are still many patients who need the vaccine who have yet to receive it. And we know we are in the best position in primary care to identify these patients.

    Ontario Matching Portal
    The Ontario Matching Portal (OMP) was created during Wave I to match employers with job seekers interested in supporting the pandemic response. Initially developed to support redeployment of volunteers and health care professionals to Long-Term Care facilities, the portal has now been extended to support the COVID-19 vaccine rollout. With an expansion of use, all health care organizations can now register to use OMP as part of a comprehensive health human resources (HHR) strategy for the COVID-19 vaccination effort. With over 6,023 people who have signed up to support vaccination across the province, your team can register as an organization and access volunteers to help with administration or health care providers to support vaccination within your teams. To learn more see:

    We are talking to the Ministry about hopefully hosting a webinar/didactic walk-through of the Portal for our teams but in the meantime, please let us know if you have any questions.  

    COVID-19 vaccination clinic workflow and mass upload tips & tricks
    As we had noted in this week’s Bits & Pieces newsletter, we are pleased to have launched two new resources for teams to help with workflow in their clinics. As teams move from pilot COVID-19 vaccination clinics to mass vaccination clinics, drive-thru vaccination clinics and in-clinic vaccinations, we have put together a document geared towards the Super User, with some tips and tricks. With a big thank you to Windsor FHT, Hamilton FHT, Upper Grand FHT, London FHT and many more this document summarizes some of the lessons learned. 

    We have also put together a Mass Client Upload Workflow document in collaboration with the QI in PC Council, with tips and tricks for data extraction, manipulation, and upload.You can also read more in last week’s eBulletin.

    Community of Practice: Primary Care Participation
    Just a reminder that you can join the Primary Care Vaccine Quality Improvement Support Group Webinar Series Community of Practice being led by Ontario Health in partnership with the Primary Care Collaborative and OMA. This CoP covers very practical tips and suggestions on how to set up your vaccination sites as we look at further primary care sites participating in vaccination.

    COVID@Home
    You would have received an email from the Ministry today with a reminder about the COVID@Home program. As we are still waiting for answers to some of our questions from our April 23rd COVID@Home webinar, just a reminder that Ontario Health is providing tools and resources for COVID@Home to interprofessional primary care teams.

    COVID@Home aims to help primary care providers and interprofessional teams to remotely monitor their patients with mild to moderate COVID-19 in the community safely. If you have an already existing remote monitoring program in your region, please continue to support those local efforts – this program is to help address any gaps that may be in existence.

    Information about COVID@Home, including clinical and escalation pathways, can be found here and the following link will enable you to order oxygen saturation monitors at no cost. Ontario Health is holding Community of Practice meetings Wednesday mornings from 8:00 am – 9:00 am if you would like to learn more, ask questions, and hear from teams doing this work. You can register for the meeting series and attend as able.

    A Big Thank You!
    We know how hard primary care worked to get as many #NeedlesInArms over the last few months and the tremendous amount of work that goes into counselling and educating your patients before vaccinating. Thank you for all that you do and please let us know what is going on in your team so we can highlight when we meet with government.

    We look forward to continually updating you on the provincial vaccination strategy. Please do not hesitate to contact us if you have any questions or ideas.

    Yours in good health,

    The AFHTO Team

  • April 27th Update on COVID-19 Vaccination Roll Out

    In This Issue:

    • Introduction including Ontario Science Table brief
    • Responding to Patient Concerns About the AstraZeneca Vaccine
    • Message from Ontario Health (Cancer Care) – Guidance for Primary Care & General Medical Imaging for Vaccine-related Adenopathy
    • COVaxON
    • Primary Care Community of Practice
    • New and Updated Resources

    Dear Members,
    We are writing to provide you with an update from our united Primary Care COVID-19 Vaccination Collaborative (PC-VAC*).  

    We know the last few weeks have been exceptionally challenging and you are all exhausted – we all share in your anger and frustration with how poor policy decisions have led us to this devastating third wave, but we are continually inspired with how much primary care continues to step up and support your patients, your community, your colleagues, and the health care system.

    Whether it’s pivoting to supporting vaccination or continuing with in-person care to prevent people going to hospitals, working in the assessment centres or, more recently, managing COVID@Home, primary care has been at the cornerstone of this pandemic.

    This brief from Ontario’s Science Table lays out very clearly the six things that will reduce transmission, protect our health care system, and allow us to re-open safely as soon as possible. As the Primary Care Collaborative we support these principles – specifically for fair, evidence-based measures that will limit the risk of illness for workers and their families, and to provide tools to help overcome other barriers to vaccination, such as hesitancy.

    While we also welcome the government walk back on the potential of introducing paid sick days, we still do not know any details on this. So, as we wait on details we are also requesting still further clarity on some of the additional measures that have been introduced. We will share more information as it becomes available.

    On April 23rd, the Ministry added Pregnant Individuals under the highest risk conditions in the Phase 2 prioritization guidance. While we wait for the updated Prioritization Guidance Document to reflect this change, you can read the memo that was sent to the PHUs from Dr. Dirk Huyer, Lead, Clinical Guidance and Surveillance Workstream. Additional updated information can be found below.

    Responding to Patient Concerns About the AstraZeneca Vaccine
    The OMA has developed key messages to help physicians address patient concerns about the AstraZeneca vaccine, including the rare occurrence of vaccine-induced prothrombotic immune thrombocytopenia (VIPIT).

    The Ontario COVID-19 Science Advisory Table has developed guidance for VIPIT for both Emergency Medicine/In-Patient Settings and Outpatient Settings, including a triage flowchart for diagnosis and recommendations for management. A lay summary is also available for physicians to refer to when speaking with their patients.

    Thrombosis Canada has put together this FAQ on COVID-19 vaccines and blood clots.

    OCFP has developed a message that can be used/adapted by your practice to update patients on use of the AZ vaccine, including questions about safety. The CEP also has tips for conversations  with your patients.

    NACI updated its recommendations on the use of authorized COVID-19 vaccines to incorporate its analysis of a rare but serious safety signal of vaccine-induced immune thrombotic thrombocytopenia (VITT), following vaccination with the AstraZeneca vaccine. Also released was a summary of the  vaccine statement and the CCMOH also followed-up with a statement.

    Message from Ontario Health (Cancer Care) – Guidance for Primary Care & General Medical Imaging for Vaccine-related Adenopathy
    Axillary adenopathy has been reported as a common side effect of the COVID-19 vaccine. Due to the mass vaccination underway, it is expected to be increasingly found in breast and other imaging. Ontario Health (Cancer Care Ontario) has developed guidance for primary care on COVID-19 vaccine-related adenopathy. The guidance provides recommendations on management of adenopathy detected during breast screening, general medical imaging, and patient detected adenopathy.

    COVaxON
    If you will be vaccinating in your clinic or would like to in the next phases of the rollout, we encourage you to sign up for COVaxON training on the OntarioMD website. Training will be scheduled on an ongoing basis. OntarioMD is suggesting that each practice have one or more (depending on the size of practice) member of their staff trained on the ‘End to End Training’ module.

    Primary Care Community of Practice
    Ontario Health (OH) and your primary care associations have collected resources and lessons learned through a series of Community of Practice meetings with the primary care pilot participants.

    Please join the Primary Care Vaccination CoP online forum for resources. If you have trouble signing up for Quorum, please message janine.theben@ontarioehealth.ca for assistance.

    If you’re participating in vaccination efforts and would like to learn from other primary care sites that are currently vaccinating please register for upcoming webinars. You can view the recording from the April 22 Community of Practice here.

    New and Updated Resources

    “Safer” vaccination site for those who are uninsured

    • Uninsured Network is developing a list of “safer” vaccination sites where migrants including undocumented residents can receive access to the vaccine in a safe, dignified way. Organizations and practices standing up vaccination sites can fill out their Declaration: Access Without Fear Access to Vaccines in Ontario form online if they are interested in implementing the recommended practices (as listed on the form), and be listed/promoted as a “safer” vaccination site.

    Multilingual resources

    • riomix.ca is a collaborative, centralized, and accessible repository of translated materials and multilingual websites relating to health and community care and support from Access Alliance. The resource library includes but is not limited to COVID-19 materials.

    Find resources from previous weeks here.

    We look forward to continually updating you on the provincial vaccination strategy. Please do not hesitate to contact us if you have any questions or ideas.

    Yours in good health,

    The AFHTO Team

    *Ontario Primary Care COVID-19 Vaccination Collaborative Partners 

    • Alliance for Healthier Communities
    • Association of Family Health Teams of Ontario
    • Indigenous Primary Health Care Council
    • Nurse Practitioner-Led Clinic Association
    • Ontario College of Family Physicians
    • Ontario Medical Association Section on General and Family Practice
    • Ontario’s Academic Chairs of Family Medicine

  • Mobilizing Primary Care to Support Hospitals with COVID@Home and Ramping up COVID-19 Vaccinations

    Dear triad members,

    Last night we received a memo from Matt Anderson, President and CEO of Ontario Health, that outlines the severity of the situation in hospitals due to the increase in COVID-19 cases.

    Ontario is facing a severe crisis with hospital capacity due to the surging number of cases. The positive COVID-19 cases announced today was over 4,200 – the second highest number since the pandemic began. The pressure on hospitals’ critical care capacity is extreme. As a result, Ontario Health has instructed hospitals to ramp down all elective surgeries and non-emergent/non-urgent activities to preserve critical care and human resource capacity as of Monday, April 12, at 12:01 AM. This does not currently apply to hospitals in the Northern Ontario Health Region or pediatric specialty hospitals.

    In the ADM memo we shared yesterday with the EDs and administrative leads, PHUs have been asked by the Ministry to utilise primary care to their full capacity in the mobile team vaccination efforts and in contacting eligible patients to encourage they vaccinate. This includes anyone aged 18 and older in high-risk communities, as announced on April 7.

    There will be pop-up and mobile clinics for those aged 18 and older in high-risk communities at essential workplaces, in community centres, and in public spaces. At this time, people aged 18 to 49 cannot book online; mass vaccination sites will be adhering to older age cut-offs and other eligibility criteria, as noted on the online booking page. Communication about this to patients will be critical.

    Teams are encouraged by the Ministry to work with their PHU to be clear on eligible patients and to optimise the use of primary care in delivering the vaccines.

    You will also soon receive a memo from the Ministry requesting that teams who are in identified hot spots (about 30+), where hospital capacity has reached its limits, help support the care of mild to moderate COVID-19 patients in their homes with the COVID@Home program. You may hear from your Senior Program Consultant, who will check to see what kind of capacity you have for this initiative, including extending support to patients of non-affiliated physicians in your community.

    As part of the COVID@Home initiative, the Ministry of Health has procured a stockpile of oxygen saturation monitors to be distributed to primary care professionals and teams to provide enhanced monitoring of their COVID-19 positive patients at home. To learn more, the Ontario College of Family Physicians has shared a webcast explaining COVID@Home with Dr. Dee Mangin from their most recent Family Medicine Summit.

    We have requested a meeting for teams early next week with the Ministry and/or Ontario Health to support teams who have questions. We will share that information as soon as we have it.

    For today, please reach out to your public health unit, if you have not already, to help support community-wide vaccination efforts. All needed care for your patients remains critical. However, as this is a dire situation that Ontario is facing, we encourage you assess your ability to support the vaccination efforts and to help relieve strain on the hospitals to the best of your capacity.

    We will continue to keep you posted as we learn more. These are incredibly challenging times, and primary care will be critical in ensuring we get through them.

    Thank you for the work you are doing. If you have any questions, please contact us at info@afhto.ca.

    Yours in good health,

    The AFHTO team

  • Ontario stay-at-home order and the Phase 2 COVID-19 vaccine distribution plan

    Dear Executive Directors and Administrative Leads,

    The third province-wide stay-at-home order took effect today at 12:01 AM.

    Under the stay-at-home order, primary care teams are encouraged to continue virtual care wherever possible but do not stop or delay in-person care. It remains at a clinician’s discretion to determine if a patient needs to be seen in person.
    While all teams have continued to deliver virtual care since the pandemic began, a reminder that the following are available as support tools in determining virtual vs. in-person care:

    In yesterday’s announcement, the provincial government did not address some of what we consider important to help control the spread, such as paid sick days. However, the pivot to go into high-risk communities and to vaccinate anyone there aged 18 and older is a step in the right direction.   

    These mobile teams – part of Phase Two in the COVID-19 vaccine distribution plan – are starting in the regions with the highest rates of transmission (ex. Toronto, Peel). This will expand to other hot spot regions based on established patterns of transmission, severe illness, and mortality. The news release can be read here.

    We received this memo today from ADM Patrick Dicerni regarding vaccination. On a related note, we encourage teams to work with public health regarding the mobile teams that will go to high-risk congregate settings, residential buildings, faith-based locations, and locations occupied by large employers in high-risk communities. Vaccinating is something primary care does best, and no one knows their communities better! If your team has the capacity, reach out to your public health unit as primary care can play a key role in getting these shots in arms.

    This is hopefully the final time we’ll see a stay-at-home order issued in Ontario for COVID-19.

    If you have any questions, please contact us at info@afhto.ca.

    Stay well,
    AFHTO

    Relevant Link:

  • April 5th Update on COVID-19 Vaccination Roll Out

    In This Issue:

    • Vaccinating in Primary Care
    • COVaxON
    • Primary Care Community of Practice
    • COVID@Home Monitoring for Primary Care
    • Provincial Antigen Screening Program
    • COVID-19 Vaccine Eligibility EMR Searches
    • COVID-19 Learning Opportunities
    • New Resources
    • Relevant Ministry Guidance Documents for Primary Care

    Dear Members,
    We are writing to provide you with an update from our united Primary Care COVID-19 Vaccination Collaborative (PC-VAC*). March 26th key messages we shared with vaccine decision-makers can be found here.  

    The April 1st Update on COVID-19 Projections from the Science Table paints a very grim picture for the upcoming month. The third wave is here, and it is being driven by the Variants of Concern (VOC) where we are seeing younger Ontarians ending up in hospitals, with ICU beds at full capacity. The update also highlights that the vaccine rollout has not reached the highest risk communities where there are high rates of COVID-19.

    The Primary Care Collaborative had an opportunity to speak about the rollout challenges at the Associate Minister’s Collaboration Table with a deliberate ask – please employ an equity lens NOW and make sure vaccines are going to those who need it the most, in the communities where they live. Ensure primary care is front and center in that rollout to get more #NeedlesInArms.

    Vaccinating in Primary Care
    Ontario is expanding pharmacy and primary care locations for COVID-19 vaccinations. Approximately 120,000 doses of the AstraZeneca vaccine have been allocated to public health and primary care practices in the 34 regions. The clinics have already heard or will hear directly from their public health units about when to expect the vaccines in their practices.

    We are currently working with government to ensure that all thirty-four public health units also allocate Moderna and other vaccines to primary care settings soon, learning from regions like Kingston, Frontenac, Lenox & Addington (KFLA) and Lambton where utilization of Moderna is part of the norm.

    COVaxON
    If you will be vaccinating in your clinic or are involved in future rollouts, please sign up for COVaxON training on the OntarioMD website. Training will be scheduled on an ongoing basis. OntarioMD is suggesting that each practice have one or more (depending on the size of practice) member of their staff trained on the ‘End to End Training’ module.

    Primary Care Community of Practice
    Ontario Health (OH) and your primary care associations have collected resources and lessons learned through a series of Community of Practice meetings with the primary care pilot participants. Please join the Primary Care Vaccination Pilot CoP online forum for resources. If you have trouble signing up for Quorum, please message janine.theben@ontarioehealth.ca for assistance.

    COVID@Home Monitoring for Primary Care
    Ontario Health is providing tools and resources for COVID@Home to help primary care providers who wish to remotely monitor people who have mild to moderate COVID-19 in the community. For further guidance on the implementation of this initiative at a site level, please refer to the Ontario Health resource toolkit COVID@Home Monitoring for Primary Care, which includes clinical pathways as well as instructions for the use and proper handling in collecting and disinfecting the monitors for use by the next patient.

    To request oxygen saturation monitors for the COVID@Home initiative, please complete the Oxygen Saturation Monitor Eligibility and Intake Form. Requests will then be reviewed for eligibility purposes by Ontario Health, prior to fulfilling requests. Please note that the Ministry of Health reserves the right to limit quantities as needed.

    Provincial Antigen Screening Program
    The Provincial Antigen Screening Program allows employers in priority settings to add an additional safety measure in high-risk and essential workplaces, to help reduce the spread of COVID-19. Through the program, rapid antigen point-of-care tests (POCTs) can be distributed to primary care settings to enhance existing routine screening measures for asymptomatic employees and other identified groups.

    Rapid antigen POCTs may allow for workplaces to proactively identify cases of COVID-19 that may have otherwise been missed, supporting employee safety and business continuity in a variety of workplaces. In addition, primary care practices are also eligible to access the diagnostic point-of-care rapid testing with ID Now that can be used to diagnose COVID-19 in symptomatic patients. Please click here for more information or contact Heather Nichol if you have any questions.

    COVID-19 Vaccine Eligibility EMR Searches
    The eHealth Centre of Excellence has updated the COVID-19 Vaccine Eligibility EMR Searches for Telus PSS EMR. The COVID-19 Vaccine Eligibility EMR Searches version 2.0 was built to service Phase 2 in the Ontario COVID-19 vaccination plan. You can find more information on this phase here, and can download the latest tool version here.

    If you are interested in further training or a review of the upgraded version, you can schedule a Coaching Session to answer any questions. All Coaching Sessions are free of charge and are accredited by CFPC for Mainpro+ CPD credits.
    COVID-19 Learning Opportunities

    Updated COVID-19 vaccination e-learning series

    • The COVID-19 vaccination e-learning series has been updated with a new module called “Emerging Topics”. The new module includes information on the impact of variants on vaccination, transmission post-vaccination, the four-month dosing interval, and the latest information about AstraZeneca and VIPIT. It is free to access following a short registration here.

    The COVID-19 Vaccine: Building vaccine confidence in the Black community, evolving guidance, and more
    The next Ontario College of Family Physicians (OCFP) Community of Practice will be on Friday, April 9, 2021 at 8:00-9:00am (ET). They will be continuing our discussion on COVID-19 vaccines, this time focusing on building vaccine confidence in the Black community. As usual, the panelists will also be speaking about the latest changes in guidance and policy and answering the questions you have. Register here.

    New Resources:

    Relevant Ministry Guidance Documents for Primary Care:
    Below are the reference and guidance documents developed by the Ministry of Health that are relevant to primary care for your reference.

    Vaccine Prioritization Resources:

    1. Guidance for Prioritizing Health Care Workers for COVID-19 Vaccination
    2. Phase 2 Prioritization for COVID-19 Vaccination

     Health Care Provider Education Documents:

    1. COVID-19 Vaccine Approval Process and Safety
    2. About COVID-19 Vaccines
    3. COVID-19 Vaccine Availability and Rollout
    4. COVID-19 Vaccine Information Sheet
    5. Extension of the Second Dose Interval Memo

     General Immunization Documents for Patients:

    1. What you need to know about your COVID-19 vaccine appointment
    2. After Your COVID-19 Vaccine
    3. COVID-19 What you need to know V2.0

    General Immunization Documents for Immunizers and Vaccine Clinics:

    1. COVID-19 Vaccine Clinic Operations Planning Checklist
    2. Vaccine Storage and Handling Guidance- Pfizer-BioNTech and Moderna COVID-19 Vaccines
    3. Administration of Pfizer-BioNTech COVID-19 Vaccine
    4. Administration of Moderna COVID-19 Vaccine
    5. Administration of AstraZeneca COVID-19/COVISHIELD Vaccine
    6. COVID-19 Vaccination Recommendations for Special Populations
    7. COVID-19 Vaccination: Allergy Form

    Consent for COVID-19 Vaccination Documents:

    1. Pre-Screening Assessment Tool for Health Care Providers
    2. COVID-19 Vaccine Consent Form

    Find resources from previous weeks here.

    We look forward to continually updating you on the provincial vaccination strategy. Please do not hesitate to contact us if you have any questions or ideas.

    Yours in good health,

    The AFHTO Team

    *Ontario Primary Care COVID-19 Vaccination Collaborative Partners 

    • Alliance for Healthier Communities
    • Association of Family Health Teams of Ontario
    • Indigenous Primary Health Care Council
    • Nurse Practitioner-Led Clinic Association/Nurse Practitioners’ Association of Ontario
    • Ontario College of Family Physicians
    • Ontario Medical Association Section on General and Family Practice
    • Ontario’s Academic Chairs of Family Medicine

  • March 19th Update on COVID-19 Vaccination Roll Out

    Dear Members,
    We are writing to provide you with an update from our united Primary Care COVID-19 Vaccination Collaborative (PC-VAC*). This week’s key messages that we shared with vaccine decision-makers can be found here.  

    The projections from the Ontario COVID-19 Science Advisory Table and Modelling Consensus update on COVID-19 Table on March 11 suggests that vaccination in long-term care has paid off but progress has otherwise stalled. There are increasing concerns about variants of concern (VOC) that are spreading across Ontario and our behaviour over the next few weeks will determine what our summer will look like.

    However, given that VOCs make up nearly half of the confirmed cases being reported and there has been an increase in ICU numbers trending up, the Ontario Hospital Association and the Science Advisory Table have indicated that Ontario has entered a third wave of the COVID-19 pandemic.     

    Key Updates:

    Primary Care Vaccination Pilot Community of Practice:
    Together with Ontario Health (OH), the primary care associations have formed a Community of Practice to support those involved in vaccinations in these regions. Initially the CoP will include those participating in the pilot and will scale as other PHUs are included. If you are currently participating in the pilot and would like to join the CoP, you can register for the upcoming series of connecting calls here weekly Thursdays from 8 am to 9 am.

    Resources are available on the Quorum Community Space Primary Care Vaccination Pilot CoP. If you have trouble signing up for Quorum, please message janine.theben@ontariohealth.ca for assistance.

    COVaxON:
    OntarioMD will be providing additional training and onboarding on COVaxON (the vaccine registration system) for clinical providers, initially focused on those who are directly involved in vaccine pilots, including support for technical questions that arise throughout the process. You can register for training directly. A Clinical Workflow Training recording is also available.

    If you are beginning to participate in vaccine administration with your PHU and are not yet connected, below are OMD contacts by existing pilot site:

    COVID-19 Vaccine Eligibility EMR Searches
    Version 1.0 of COVID-19 Vaccine Eligibility EMR Searches are now available, created by the eHealth Centre of Excellence. This work is based on the Vulnerable populations and COVID-19 resource published by the Public Health Agency of Canada (PHAC) and informed by the COVID-19: Vaccines Resource developed by the Centre for Effective Practice (CEP).

    It aims to equip Primary Care with resources for your EMR which will enable you to identify and prioritize ambulatory patients from within your roster who are in greatest need of the COVID-19 Vaccination to avoid negative healthcare outcomes. Version 1.0 of the searches are all available to download right now from our Community site for all three EMRs.

    IMPORTANT: The Province of Ontario has announced the focus for Phase Two of Ontario’s vaccination distribution plan. The list of eligible health conditions provided in this announcement does not align with the Version 1.0 searches currently released by the eHealth Centre of Excellence. Their team is hard at work putting together Version 2.0 of our COVID-19 Vaccine Eligibility EMR Searches which will align with the health conditions listed in the Province’s announcement.

    COVID-19 Vaccination in Canada: an educational series for primary care professionals
    “COVID-19 vaccination in Canada” is now certified for up to 1 Mainpro+® credits.  This self-learning series from DFCM and the Ontario College of Family Physicians is designed to provide primary care professionals with the knowledge and skills to support Canada’s COVID-19 vaccination effort. Added is a new module on viral vector vaccines that includes extensive information on the AstraZeneca vaccine and available information on the Janssen vaccine. There is also updated content throughout the series including on the vaccine rollout, dosing interval and more. To learn more and to register please click here.

    The next COVID-19 Community of Practice for Ontario Family Physicians is on Friday, March 26th from 8:00 a.m. to 9:00 a.m. and will include dialogue with some of the family physicians involved in the AZ pilot sites. Click here to register.  Previous COVID-19 Community of Practice sessions can be found here.

    New Resources:

    Find resources from previous weeks here.

    Finally, the OMA has relaunched its burnout survey to understand the impact of COVID-19 on physician burnout. Physicians are invited to complete this 5-7 minute survey.

    We look forward to continually updating you on the provincial vaccination strategy. Please do not hesitate to contact us if you have any questions or ideas.

    Yours in good health,

    The AFHTO Team

    *Ontario Primary Care COVID-19 Vaccination Collaborative:

    • Alliance for Healthier Communities
    • Association of Family Health Teams of Ontario
    • Indigenous Primary Health Care Council
    • Nurse Practitioner-Led Clinic Association/Nurse Practitioners’ Association of Ontario
    • Ontario College of Family Physicians
    • Ontario Medical Association Section on General and Family Practice
    • Ontario’s Academic Chairs of Family Medicine