Tag: Public health

  • COVID-19 in Ontario – A Focus on Diversity: Public Health Ontario Report

    On June 1, Public Health Ontario released Enhanced Epidemiological Summary COVID-19 in Ontario – A Focus on Diversity .

    Purpose

    This report aims to explore neighbourhood-level trends among laboratory-confirmed COVID-19 cases reported in Ontario who do not reside in long term care (LTC) from a health equity perspective. It combines individual case data with neighbourhood-level data on race and immigration as measured by the “ethnic concentration” dimension of the Ontario Marginalization Index (ON-Marg).

    The report findings improve our understanding of how COVID-19 impacts neighbourhoods differently in Ontario, particularly those with greater diversity that may already experience marginalization related to racism and discrimination. This information could be used to inform planning and equitable prioritization of public health and health system resources and interventions.

    Highlights

    • The most ethno-culturally diverse neighbourhoods in Ontario, primarily those concentrated in large urban areas, are experiencing disproportionately higher rates of COVID-19 and related deaths compared to neighbourhoods that are the less diverse.
    • After adjusting for differences in the age structure between neighbourhoods, the rate of COVID-19 infections in the most diverse neighbourhoods was three times higher than the rate in the least diverse neighbourhoods.
    • People living in the most diverse neighbourhoods were also more likely to experience severe outcomes (hospitalizations, ICU admissions and deaths) than people living in the least diverse neighbourhoods:
      • hospitalization rates were four times higher;
      • ICU admission rates were four times higher; and
      • death rates were twice as high.

    Read the full report here.

  • Hamilton and McMaster FHTs provide drive-thru COVID-19 testing for 60 people per day

    Y108 News article published April 23, 2020

    By Lisa Polewski

    Hamiltonians can now book a COVID-19 test at the city’s drive-thru site, based inside the Dave Andreychuk Mountain Arena.
    It’s not quite the same as a fast-food drive-thru, but the COVID-19 testing centre at the Dave Andreychuk Mountain Arena is as efficient as it gets.

    Since Hamilton’s third testing site opened its doors a week ago, they’ve been testing about 60 people per day.

    “We book every five minutes, and it takes about three and a half minutes for a client to come through,” said Laurel Turnbull, manager of nursing, complex care and quality improvement at the Hamilton Family Health Team.

    The arena is functioning as a COVID-19 testing centre between 10 a.m. and 3 p.m., seven days a week. The Hamilton Family Health Team and the McMaster Family Health Team are operating the site, which is staffed by primary care clinicians.

    Jill Berridge, co-executive director of the McMaster Family Health Team, said the response to the unique method of testing has been overwhelmingly positive, especially from those who are being tested.

    “They love the fact that they can stay in the comfort of their own car, and go through this process, and how quick it is,” said Berridge.

    The mountain site is also testing those who don’t have a car. Elderly residents or those who rely on mobility devices are able to get a ride through DARTS, and anyone who may get to the arena by public transit can also simply walk around the track to the different stations.

    It’s not as simple as turning up and getting tested, however. Appointments at the Hester Street location still need to be booked through a family doctor or Hamilton public health.

    Berridge said most people understand that process, although a handful of people are still showing up on a daily basis without an appointment.

    “But they’ve been very reasonable when we’ve asked them to go ahead and call public health and get an appointment to come back.”

    Although testing has ramped up across Hamilton — specifically in long-term care and retirement homes — Berridge said they are following the provincial guidelines on who qualifies for testing, which means you cannot simply request a test.

    “It would be hard to test everybody. The capacity for that type of testing just isn’t available right now. I think we do a good job of prioritizing people that really need to be tested.”

    During an update from the city last week, Dr. Elizabeth Richardson, Hamilton’s medical officer of health, said they’ve been getting requests from people who have had their employers ask them for a “clearance note” to go back to work.

    “That is not recommended at all, and in fact, it’s taking up resources that could be used for those who are symptomatic,” said Dr. Richardson.

    “We want to really get the message out that that kind of testing, it’s not helpful. For somebody who’s well, the fact that they have a negative test today means nothing about tomorrow, or even five minutes after they’re tested.”

    There have been 3,238 tests administered at the city’s testing and assessment centres since the first two opened their doors on March 16.

    To view the full article, click here.

  • COVID-19 Outbreak Has Likely Peaked in Ontario

    Ontario News Release

    Modelling shows physical distancing still needed to prevent further spread

    TORONTO — The Ontario government today released updated COVID-19 modelling, which shows that the enhanced public health measures, including staying home and physically distancing from each other, are working to contain the spread of the virus and flatten the curve. However, the Chief Medical Officer of Health says emergency measures must remain in place to continue reducing the number of cases and deaths.

    “The modelling clearly demonstrates that we are making progress in our fight against this deadly virus. That’s due to the actions of all Ontarians, those who are staying home and practising physical distancing, and to the heroic efforts of our frontline health care workers,” said Premier Doug Ford. “But COVID-19 continues to be a clear and present danger, especially to our seniors and most vulnerable citizens. That is why we must continue to follow the advice of our Chief Medical Officer of Health and stay the course in order to keep people safe and healthy.”

    Key highlights from the modelling update include:

    • The wave of new community spread cases of COVID-19 in Ontario appears to have peaked.
    • Outbreaks in long-term care and congregate settings continue to be a major concern. Concerted actions are underway to protect vulnerable people in these settings.
    • Ontario is now trending toward a best case scenario rather than a worst case scenario and has significantly improved its standing as compared to March modelling.
    • The province has avoided a significant surge in cases. Total cumulative cases are forecast to be substantially lower than worst case or even moderate case scenarios projected by previous models.
    • While several hundred new cases are identified daily in Ontario, hospitals across the province have not been overwhelmed by the COVID-19 outbreak as a result of capacity planning and the public health measures currently in place. The rate of growth day-over-day is declining.
    • To further reduce the number of cases and deaths, it remains critical that Ontarians continue to adhere to public health measures, including staying home and practicing physical distancing if they must go out for essential reasons only.

    ADDITIONAL RESOURCES

  • How Lakelands FHT Handled a Positive COVID-19 Result At Their Clinic

    As told by Dr. Matt Dumas, Lead Physician, Lakelands FHT*

    In late March, Lakelands FHT discovered that there was a positive case at our Northbrook site. That resulted in the immediate closure of our building. We all had to go home and finish 14 day periods of self-isolation. To our surprise, this meant having to distance ourselves from our own families, which was very difficult.

    The day that we realized we would have to close our building, we decided to build a clinic without walls. We accomplished this by creating an email account for patients to contact us and posted this on our website and Facebook pages. Our 3 physicians and 2 NPs were able to remotely access the PSS EMR and fax prescriptions from our own homes. Our super RN/IT expert also had remote access and provided critical support. We were able to create schedules for ourselves and call patients from our homes by turning off the Caller ID’s on our phones. Our Mental Health Social Worker was able to call the patients in her schedule as well.

    The Lead Physician monitored the email daily and transferred the emails to the appropriate provider for action. Once the emails were completed, they were moved to a separate folder and our RN copy/pasted the emails into the patient’s chart before deleting them from the email entirely, limiting the amount of time that personal information was kept in cyberspace. With this system, we were able to respond to over 20 patient emails per day, as well as call the patients that were scheduled previously. This made for busy days, and it was a relief to sign out of the email every day at 4:30!

    We were discouraged that we couldn’t answer the phones at our clinic while we were shutdown, but we were able to respond to patient requests in ways that we had not done before: by answering emails to patients or calling them directly from our homes. This was an evolution from the days of paper charting.

    We also created call lists of all of our patients who are above the age of 70 and had our NPs call them to ask how they were doing, find out if they had any needs, and to remind them of the importance of physical distancing, which the vast majority of our patients were already following.

    With the advice of KFLA Public Health we have reopened the clinic. We have separated our staff at the Denbigh and Northbrook sites so that if there is another shutdown, the phone can be forwarded to the site that is still open, and the providers can work from home as before.

    *In the first version of this post, Janice Powell, Executive Director, was listed as the source. It has now been updated to reflect Dr. Matt Dumas’s contribution.

  • COVID-19 in Ontario- What Do the Models Show for Our Future?

    Ontario News Release

    Projected number of cases and deaths can be significantly reduced if people stay home

    TORONTO – Today, the Ontario government released extensive COVID-19 modelling, revealing several scenarios that project the potential number of cases and deaths. In doing so, the province is providing the public with full transparency about the consequences should everyone but non-essential workers fail to stay home and practise physical distancing.

    “The models show that the potential to spread COVID-19 is massive and deadly if we don’t act swiftly to stay home and practise physical distancing,” said Premier Ford. “We owe it to our frontline and essential workers, to our family, friends and neighbours to restrict our travel, and act responsibly. This is the only way we are going to minimize the risk to people, stop the spread and reduce the number of fatalities.”

    Key highlights from the modelling include:

    • While COVID-19 impacts Ontarians of all ages, those over the age of 60 face higher risk of severe disease leading to higher mortality rates. The data demonstrates the need to focus public health measures on protecting seniors.
    • Had Ontario taken no action, the impact of COVID-19 would have risen to an estimated 300,000 cases and an estimated death toll of 6,000 people.
    • Due to timely public health measures, Ontario has avoided much more dire impacts, preventing an estimated 220,000 cases and 4,400 deaths to date.
    • Over the course of the pandemic, between 3,000 and 15,000 deaths related to COVID-19 are predicted with current public health measures in place, compared to a total projected 100,000 deaths if no action were taken.
    • By taking further measures, Ontario can further reduce the number of cases and deaths related to COVID-19 down to projections as low as 12,500 additional cases and 200 additional deaths by the end of April.

    QUICK FACTS

    • Ontario has launched a new user-friendly online portal for the public to easily access their COVID-19 lab test results. By offering faster and secure access to test results on their computer or mobile device, this portal will help ease pressures on public health units and frontline workers to provide this information so that they can better focus on containing COVID-19.
    • On March 30, 2020, Dr. Williams issued a statement to strongly encourage Ontarians to stay home, limit the number of essential trips and adhere to physical distancing.
    • If you think you may have COVID-19 symptoms or have been in close contact with someone who has it, first self-isolate and then use Ontario’s Self-Assessment Tool to see if you need to seek further care.
    • Take these everyday steps to reduce exposure to COVID-19 and protect your health: Wash your hands often with soap and water or alcohol-based hand sanitizer; Sneeze and cough into your sleeve; Avoid touching your eyes, nose or mouth; Avoid contact with people who are sick; and stay home if you are sick.

    ADDITIONAL RESOURCES

     

  • Londoners and Thames Valley FHT organize to supply doctor’s offices, ‘love-bomb’ health-care workers

    The London Free Press article published Mar. 20, 2020

    By Randy Richmond

    A handful of Londoners have turned some casual conversations into a grassroots effort supplying thousands of gloves and masks to local medical clinics.

    And they want more people stuck at home, especially business leaders, to step up and help.

    “We all need to get out of this mindset of hurt. It’s really easy to focus on that, but I think the key right now is to band together and be a village,” said Diana House, a London real estate investor and developer.

    “Business people are sitting at home right now because their companies are closed. They are the people who need to rise up and say, ‘How can we help?’ “

    Help is needed to keep medical clinics and doctors’ offices in London operating, said Dr. Mario Elia, a family doctor and professor of family medicine at Western University.

    “If we do end up seeing big numbers over the next few weeks, we want to make sure that family docs can keep seeing patients, safely and timely, and that requires us to have adequate equipment,” he said.

    Besides masks and gloves, doctors need eye protection and gowns, he said.

    “Some docs are at kind of a critical time, if they do not get more, they may need to close in the near future. One of the issues that has come up in other countries is when health care workers start working in unsafe conditions, they start getting sick and the whole system just collapses.”

    Family doctors should be the first place people go when they suspect they have some symptoms of coronavirus, but are not at an urgent stage, Elia said.

    The assessment centres should be for those who don’t have a family doctor and whose symptoms aren’t severe, he said.

    Elia and House are part of a loose network of medical and non-medical people who began putting their minds to the needs of doctors and medical staff in the coming weeks.

    “They are starting to prepare for the coming weeks and potentially months. The question was, ‘Who’s preparing to support them?’ ” House said.

    The conversations touched on child care and pet care for doctors and nurses under siege, and where medical professionals might live between shifts to avoid infecting their families.

    All those matters remain part of the discussion, but it became clear that getting supplies to medical clinics is the first challenge, House said.

    The network found a local supplier and bought, at cost 15,000 pairs of surgical gloves and 700 masks, and began tapping other sources.

    There are other places besides doctors’ offices that have masks and gloves, such as nail salons, dental offices, podiatrists, tattoo parlours, spas and veterinarian clinics.

    So, they’ve been contacting those businesses, other suppliers, Western University and Fanshawe College for help, House said.

    The Thames Valley Family Health Team has taken on the job of coordinating and collecting supplies, and medical students have helped distribute the first supplies to clinics.

    “It’s been a really beautiful thing to see the community get together,” House said. “It’s very grassroots, very much evolving. The goal is to keep the medical clinics open for as long as possible to divert as many people away from the hospital as we can.”

    The effort has worked so well, the clinics have enough gloves for now, Elia said.

    But surgical masks, gowns and eye protection are still needed, he said.

    Doctors’ offices are out of swabs, in short supply at the moment in London, but that’s because swabs are being directed to public health officials who are organizing the testing for the virus at emergency departments, Elia said.

    House knows dental clinics and other services will need gloves and masks when they re-open, but says the focus now has to be on medical clinics and hospitals.

    “I really think we’re in a triage situation and I think the resources need to go to medical first. We are trying to pull as many strings as we can to try to make sure the resources go to the right place,” she said.

    “They’re the ones who are going to get us through this. How can we just love-bomb them and shower them with support any way we can to make what’s going to be a very difficult season for them maybe a little bit easier?”

    There are going to be dozens of ways ordinary people can help, House said.

    “It doesn’t have to be this. It could be finding a health care worker and adopting them and saying, ‘Every time I go to the grocery store, I’m going to buy them groceries.’ “

    To view the full article, click here.

  • Ontario shifting to virtual-first model in bid to halt spread of COVID-19

    The Star article published Mar. 16, 2020

    By Megan Ogilvie

    Family doctors across Ontario are rapidly transitioning to a “virtual-first” care model as a way to halt the spread of COVID-19 in their offices and waiting rooms.

    Starting this week, most doctors will talk to patients on the phone, by video conference or through email as a first-step to determine who needs to come to the office for an in-person appointment.

    Patients who require face-to-face care, including pregnant women, babies requiring scheduled vaccines and some seniors with chronic health conditions, will have in-person appointments. But many patients will receive virtual advice on how to care for their condition at home.

    As well, some patients will be told upcoming, non-urgent appointments will be postponed for weeks or months. For example, Cancer Care Ontario on Monday advised physicians to postpone cervical cancer screening for low-risk women.

    For the most part, these province-wide measures are in place to protect family doctors, nurse practitioners, office staff and patients from getting infected with COVID-19.

    “We don’t want to bring healthy patients into an office where they could be potentially exposed to COVID-19 by mistake,” said Dr. David Kaplan, a family physician at North York General Hospital and the North York Family Health Team. “It’s part of social distancing. If you want to keep people out of communal spaces, it’s the same for keeping people out of waiting rooms. This is just another way that family doctors can help.”

    Dr. Thuy-Nga (Tia) Pham, physician lead for the South East Toronto Family Health Team, said her patients are welcoming virtual care, especially with so many having questions about COVID-19.

    Last week, the province’s Ministry of Health, after discussions with the Ontario Medical Association, announced new billing codes to allow family physicians and nurse practitioners to move to virtual care.

    Pushing more routine appointments to virtual visits will help family physicians more effectively deal with the surge in patients needing treatment or advice on COVID-19. And seeing more patients virtually will help preserve face masks, disposable gowns and other protective equipment which could be in short supply as the COVID-19 pandemic progresses.

    To view the full article, click here.

  • H+K Memo on Ontario Government COVID-19 Press Conference

    MEMO:

    To: H+K Clients

    From: Hill+Knowlton Strategies

    Subject: Ontario Government Press Conference on COVID-19

    Date: March 16, 2020

    Context
    On March 16, 2020, Ontario Premier Doug Ford held a press conference to update on the province’s response to the COVID-19 pandemic. Premier Ford was joined by Finance Minister, Rod Phillips; Minister of Labour, Training and Skills Development, Monte McNaughton; Minister of Health, Christine Elliott; and Ontario’s Chief Medical Officer of Health, Dr. David Williams. Primary topics addressed during the press conference included new legislation being tabled to protect workers and jobs, as well as an update on Ontario’s provincial budget, previously scheduled for March 25, 2020.

    It is worth noting that the legislature is currently on an already scheduled recess with a scheduled return of March 23. On March 12, MPPs voted to give the government the authority to extend the break, if necessary, to prevent the further spread of COVID-19.

    Read the full memo here.

  • Bits & Pieces: COVID-19 memo, changes to mental health system, AI fellowship & more

    Bits & Pieces: COVID-19 memo, changes to mental health system, AI fellowship & more

    Your Weekly News & Updates


    In This Issue  
    • COVID-19 updates including memo and tools
    • Members’ stories
    • Ontario Health Teams and privacy: a legal perspective
    • Ontario government announces changes to mental health and addictions system
    • Fellowship in compassion and artificial intelligence
    • Integrating mental health services in primary care- deadline March 23
    • Spring registration for ECHO Ontario mental health programming now open
    • Deadline to join Prenatal Screening Ontario Advisory Committee extended
    • Insomnia focus groups invitation
    • Upcoming events including The Art of Doing More with Less

    COVID-19 updates including memo and tools

    For EDs, Lead Clinicians and Board Chairs:
    We understand you have quite a lot on your plate; however, the Ministry of Health and Ontario Health (Shared Services) have emphasised the importance of completing this short survey, to assist in tracking provider preparedness. Please do so as soon as possible. This is a direct link to the spreadsheet, with no need to log in.

    Health care providers facing immediate challenges with their personal protective equipment supply levels can email the ministry at EOCLogistics.MOH@ontario.ca.

    We continue to update the relevant page on the Novel Coronavirus (COVID-19), including memos from the Deputy Minister dated Mar. 6 and Mar. 9. If you have any questions, you can also email EOCOperations.moh@ontario.ca.

    New resource page: we now also have a new infection control resource page, with screening tools and more, including educational resources and tools from Public Health Ontario A reminder to please share any resources you have developed by sending them to info@afhto.ca.

    Ministry updates now twice a day: Every weekday at 10:30 a.m. the Ministry has been updating its dedicated web page with the most up-to-date information on the status of cases in Ontario, including: the number of cases currently under investigation; and the number of confirmed positive, negative and resolved cases.

    They will now update this page twice daily (10:30 a.m. and 5:30 p.m. EST), seven days a week. It will also now include general information on each new confirmed case of COVID-19, including gender, age, public health unit, hospital (if applicable), where acquired and status.


    Members’ stories

    South East Toronto FHT: opening a COVID-19 screening and assessment centre


    Ontario Health Teams and privacy: a legal perspective
    On Feb. 28, BLG published their article Ontario Health Teams: Personal Health Information Sharing, Client Privacy and PHIPA Compliance. Read on to get their perspective.


    Roadmap to Wellness: A Plan to Build Ontario's Mental Health and Addictions System

    Ontario government announces changes to mental health and addictions system
    Last week the Ontario government launched their Roadmap to Wellness: A Plan to Build Ontario’s Mental Health and Addictions System. The new Mental Health and Addictions Centre of Excellence within Ontario Health will serve as the plan’s foundation. The plan’s four pillars include:

    1. Improving quality;
    2. Expanding existing services;
    3. Implementing innovative solutions; and
    4. Improving access.

    You can read the report here, visit the Ministry’s site to get the full plan in English or French, and you can also read H+K’s memo here.

    If you have questions or comments about the Roadmap, you can send an email to Roadmaptowellness@ontario.ca.


    Fellowship in compassion and artificial intelligence
    AMS Healthcare is offering up to eight (8) one-year fellowships of up to $75,000 to early and mid-career academic researchers and regulated health care professionals to study and develop expertise/ competence in the impact of DT/AI on compassionate care. An information call will be held on Monday, March 16. Find out more here.


    Integrating mental health services in primary care- deadline March 23

    Are you doing something innovative to integrate mental health services and supports in primary care delivery?

    The College of Family Physicians of Canada is partnering with the Canadian Psychiatric Association and the Canadian Psychological Association to highlight innovative practices among family physicians, psychiatrists, and psychologists that address common challenges and barriers to integrating mental health services in primary care across Canada and how best to influence patient, provider and system outcomes.

    They have extended the deadline for publication in the Innovation in Primary Care (IPC) series to Mar. 23. Find out more here.


    Project ECHO CAMH

    Spring registration for ECHO Ontario mental health programming now open

    ECHO Ontario Mental Health is a virtual training and capacity building model that supports primary and community care providers in delivering high quality, evidence-based mental health and addictions care in their local communities.

    It links expert interdisciplinary teams with front line care providers in order to share best practices, jointly discuss practical recommendations for complex client care, and build sustainable communities of practice. The program is offered at no cost, thanks to funding from the Ministry of Health. CME Credits are available for participants.


    BORN EOI Jan 2020

     

    Deadline to join Prenatal Screening Ontario Advisory Committee extended

    BORN Ontario is seeking family physicians with a special interest in prenatal care for the Prenatal Screening Ontario Advisory Committee.

    For more information email PSO@BORNOntario.ca. Deadline Mar.27, 2020. See poster pdf.

     

     


    Insomnia focus groups invitation
    Participate in a virtual focus group about system-level challenges and enablers to adopting the care outlined in Ontario Health’s Insomnia Disorder Quality Standard being developed by the Quality business unit at Ontario Health, formerly Health Quality Ontario. Your feedback will inform the recommendations for adoption to support the uptake of this quality standard.

    The Insomnia Disorder Quality Standard focus groups will be held on the following dates:

    1. Monday March 23, 2020 (12:00 – 1:00PM EST) – follow this link to register via Eventbrite  
    2. Friday March 27, 2020 (12:00 – 1:00PM EST) – follow this link to register via Eventbrite

    If you have any questions, please contact Mandy Lee, Quality Improvement Specialist at mandy.lee@hqontario.ca.


    The Art of Doing More with Less, March 18, 2020
    The final webinar in AFHTO and Grant Thornton’s Financial webinar series is next week! Join Christy McClelland and Sanjay Desai as we explore how non-profits can improve performance with financial sensibility. Register today!


    Electronic Asthma Management System (EAMS) – OSCAR Tool Demonstration, March 24, 2020
    Join this webinar for an hour-long demonstration to learn more about EAMS. Register here!


    Understanding Bronchiectasis Webinar, April 21, 2020
    Learn more about this neglected pulmonary disease. By the end of this webinar, you will be able to help patients self-manage the disease and avoid the acquisition of nontuberculosis mycobacteria. Find out more here


    RNAO Nurse Executive Leadership Academy, October 20-23, 2020
    Save the date for this 3-night knowledge exchange in Niagara Falls. Learn more today.