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COVID-19 Health Care Provider Briefing Middlesex and London Region October 6, 2020
Welcome Presenter: Dr. Alex Summers Associate Medical Officer of Health Middlesex-London Health Unit @alexsummers4
Surveillance Report As of October 5 th , 2020: • Over 35.5 million COVID-19 cases and over 1 million deaths have been reported worldwide. • 54,814 cases of this illness confirmed in Ontario, including 2,8980 deaths • Local:
Cases by Reported Date Data source : MLHU COVID-19 Case and Contact Management System, extracted 2020-10-06 at 08:30 EDT. Data current as of the end of day 2020-10-05
Cases by Onset Date Data source : MLHU COVID-19 Case and Contact Management System, extracted 2020-10-06 at 08:30 EDT. Data current as of the end of day 2020-10-05 Note : Illness that began in the period denoted by the grey bars may not yet be reported.
New Recommendations for LTCHs and RHs • New recommendations for LTCHs and RHs o In light of the rising incidence of COVID-19 in Ontario, MLHU strongly recommends the following for all long-term care homes and retirement homes: 1. All in-person group events should be postponed indefinitely. 2. All non-essential overnight short-stay absences should be discontinued; any absence that is overnight should require a 14- day quarantine upon return to the facility. 3. If a resident is off-site for a non-essential reason, they should have contact only with their essential caregivers. The caregivers and the resident should remain masked at all times while off-site. o If COVID-19 cases continue to rise in our community, further steps may be taken to ensure that outbreaks of COVID-19 are avoided.
Student Placements in LTCHs and RHs • Student placements in LTCHs and RHs o Student placement and activities in LTCHs and RHs must cease for the duration of an outbreak unless there is a critical need for staff such that students are necessary for ongoing operation. In this instance, students will then be treated as ‘employees’ and will not be permitted to train or work at any other health care facility .
Testing • HCP COVID-19 swab ordering and delivery • Primary care providers can order COVID-19 swabs from the Health Material Management System (HMMS) website. • Prior to transporting swabs to the Public Health Ontario (PHO) laboratory the following are required: • PHO lab requisition, • the specimen is to be placed in biohazard bag and sealed, • the specimen should be stored at 2 to 8°C and delivered to the PHO lab within 72 hours with ice packs. • The PHO laboratory is located on the 5 th Floor, at 850 Highbury Ave., in London. • Deliveries to the PHO lab can be done Monday to Friday from 8:00 a.m. to 5:00 p.m.
Testing at Pharmacies • Testing for high-priority, asymptomatic people only • Appointment only • Three locations in London – 395 Southdale Rd. E – 603 Fanshawe Park Rd. W – 3090 Colonel Talbot Rd.
County Testing Options • The Middlesex-London Paramedic Service (MLPS) are conducting mobile COVID-19 testing for those in the Middlesex County at the following sites: – Komoka Wellness Centre on Wednesday, October 7 th from 11:00 a.m. to 4:00 p.m. – Ilderton Arena Grounds on Friday, October 9 th from 11:00 a.m. to 4:00 p.m. – More dates and locations may be listed on the MLPS Twitter feed @ MLPS911 .
Assessment Centres • Oakridge Assessment Centre • Effective October 5 th , Oakridge Assessment Centre will shift to booked appointments only. • To book an appointment call 519-667-6886 • Hours of operation are seven days a week from 9:00 a.m. to 7:00 p.m. • Carling Heights Assessment Centre • All walk-in testing will be done at the Carling Heights Assessment Centre with the time-card system. • Hours of operation are Monday to Friday from 9:00 a.m. to 5:00 p.m.
Test Results • For Ontario healthcare providers to access their patient’s COVID -19 test results stored in the Ontario Laboratories Information System (OLIS), they will need to complete the online Practitioner Extract File Request form and have either: – access to one of the provincial viewers (ClinicalConnect, ConnectingOntario ClinicalViewer, and eHealth Portal), – an electronic medical record system (with OLIS to EMR), or – Hospital Information System (with OLIS integration).
Test Results • Patients can access their COVID-19 test results online through the Ministry of Health’s Portal with a valid Ontario Health Card. Results may be available within 24 hours of being tested. • For those unable to access their COVID-19 test results on the Ministry of Health portal AND who were tested at an Assessment Centre in London, they can complete a form to request their COVID-19 test results from the Health Unit. – Note : results are available first on the Ministry of Health Portal. It can take approximately 2 to 3 days (or longer) for test results to be available through the Health Unit. If you have an urgent request, please call 519- 663-5317 .
Updated Symptom List • This is available on-line effective October 2
Question #1 – Major Symptoms • Does your child have any of the following new or worsening symptoms? Symptoms should not be chronic or related to other known causes or conditions.
Answers to Question #1 • Fever and/or chills, greater than 37.8 • Cough (not related to known condition) • Shortness of breath • Decrease or loss of smell or taste
Question #2 – Minor Symptoms • Does your child have any of the following new or worsening symptoms? Symptoms should not be chronic or related to other known causes or conditions.
Answers to Question #2 • Sore throat • Headache • Nausea, vomiting and/or diarrhea • Fatigue, lethargy, muscle aches or malaise • All of the above should not be related to other known causes or conditions.
Remaining questions • Question #3 – Has your child travelled outside of Canada in the past 14 days? • Question #4 – Has your child be identified as a close contact by public health or the COVID Alert App? • Question #5 – Has your child been directed by a health care provider or public health to isolate?
Interpretation • If you answer YES to any of the symptoms in question #1: – This is a FAILED COVID-19 screen – Self-isolate – Go to an assessment centre for a COVID-19 test, or visit HCP for alternative diagnosis
Interpretation • If you answer YES to only one of the symptoms in question #2: – Your child should stay home for 24 hours from when the symptom started – If the symptom is improving, your child may return to school/child care when they feel well enough to do so. – A negative COVID-19 test is NOT required – If symptoms worsen or change, reassessment required
Interpretation • If you answer YES to two or more of the symptoms included in question #2: – This is a FAILED COVID-19 screen – Go to an assessment centre for a COVID-19 test, or visit HCP for alternative diagnosis
Interpretation • If you answer YES to questions #3, #4 or #5 – This is a FAILED COVID-19 screen – Self-isolate – If symptoms develop, go to an assessment centre for a COVID-19 test, or visit HCP for alternative diagnosis
Updated period of communicability • The Ministry has updated the clearance period for case to 10-days from 14-days – 10-day clearance period for the majority of cases with mild to moderate illness – 20-day clearance period for cases with severe illness (ie. ICU support) or with severe immune compromise. • Contacts who have had a high-risk exposure to a case must continue to quarantine for 14 days from their last exposure
Updated Resources • Updated: Guidance on Swabs for Testing and Sample Collection Instructions for COVID-19 • Updated: Guidance for Paramedic Services
Education/Resources On October 20 th Queen’s University will be offering a webinar • entitled: COVID-19: Treatment and Management of COVID Patients. • The National Collaborating Centre for Methods and Tools has a COVID-19 Rapid Evidence Service and an email alert listserv. • The World Health Organization (WHO) has the following resources on its website: – WHO COVID-19 Dashboard – Interactive timeline on COVID-19 – WHO COVID-19 Weekly Epidemiological and Operational Update • updated COVID-19 resources from PHO: – Synopsis of Key Articles – Coronavirus Disease 2019 (COVID-19)
Wave 2 guidance • All Ontarians should only have close contact with people living in their own household and maintain two metres physical distancing from everyone else. Individuals who live alone may consider having close contact with another household.
What does this mean? • Whether you are at home or out and about, your close contacts should only be those in your immediate family. • For everybody else, stay 2 metres away and wear a mask, no matter where you are or what you are doing.
What does this mean? • In order for our kids to go school, we need to limit their close contacts as much as possible when not in the classroom. This means no play dates, no movie nights, and no sleep-overs. • In order to keep our workplaces open, we need to put in the work whether we’re in the office or not. This means no apps after work, no cakes in the break room, and no in-person retirement parties.
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