Dear Colleagues,

We know family doctors want to play a critical role in supporting the vaccine rollout. It’s clear our patients want us involved too, based on this public opinion survey we did. We are seeing growing family physician involvement and collaboration with the Ministry of Health and Public Health, which is welcome news.  At the same time, the rollout is a race against the variants that have now taken hold, creating issues for our hospitals, and in many communities across the province.

As family doctors, we have several important roles to play in helping curb the tide of this pandemic:

• Addressing vaccine hesitancy with patients – our data shows we are best able to move the needle and build vaccine confidence. We can do this with our patients at every encounter and be proactive about ensuring they get vaccinated.

• We can all play a role in reaching out to our eligible patients by phone/email/SMS to support vaccination According to the MOH data, close to one-third of elderly patients outside long-term care are not yet vaccinated. 

• The MOH is working to enable “push notifications” to family physicians about which patients have been vaccinated – right now, the timeline for this is the end of April; we are advocating for this to be accelerated.

• Learn from your colleagues on what COVID-19 vaccination might involve. The 90 primary care practices across six PHUs who were part of the initial AZ “pilot” are to be congratulated for getting their allotment of needles in arms by the deadline. There is a learning curve in the setup and an administrative intensity but immense satisfaction expressed by those who participated and their patients. Many lessons to be learned. 

• Check out the recording from our March 26th CoP where Dr. Sandra Khan and Dr. Sohal Goyal spoke about running pilots in Peterborough and Peel, respectively.

• Ontario Health has a collection of practical resources and lessons learned to support the current pilots on OH Quorum – you can register here and check out the resources, whether currently involved in a pilot or not. 

• Consider how best to support your local PHU with vaccine rollout. Just announced today is the next AZ allotment, of which about 20 per cent will go to primary care across all 34 PHUs. This vaccination effort is not like the flu clinics we are used to and won’t be for everyone. If we have capacity, we can consider in office, or join up with another practice or FHT/CHC, support mobile clinics or drive throughs. 

• PHUs are responsible to connect with and support practices who want to participate. If you are interested, reach out to your local PHU to hear what’s involved and determine your capacity to support.

This must be an “all hands on deck” with Public Heath Units, pharmacies, paramedics, hospitals, OHTs working with family doctors and primary care towards the common goal of an efficient and equitable rollout. 

In that spirit of partnership, the OCFP is part of a new table between the primary care sector and the Ontario Ministry of Health and the Ministry of the Solicitor General to support effective implementation of COVID-19 vaccination in primary care settings across the province. The OCFP, as part of the Primary Care Collaborative, is joined by the Association of Family Health Teams of Ontario (AFHTO), Indigenous Primary Health Care Council (IPHCC), Nurse Practitioner-Led Clinic Association (NPLCA), Ontario Medical Association (OMA), and OMA Section on General and Family Practice (SGFP). This is a welcome development, and we are grateful for this collaborative approach. 

Other New Tools and Updates

• For your patients concerned about NACI’s recommended pause of the AstraZeneca (AZ) vaccine in those under age 55, you may wish to share this new information from the Centre for Effective Practice.  The Ontario COVID-19 Science Advisory Table, which includes several family doctors, has produced this Science Brief on Vaccine-Induced Prothrombotic Immune Thrombocytopenia (VIPIT) from AZ vaccination. Other clinical resources on their site include this evidence-based tool to support your decision making about COVID-19 treatment.

• We’ve updated our COVID Vaccine FAQ for answers to the top questions from members and the public as well as our Vaccination for Special Populations
• The CEP has also developed this information on the maximum 16-week interval time between vaccine doses. Ontario just shortened the interval time between vaccine doses for transplant recipients and certain cancer patients. While the OCFP is not involved in the review of evidence like the vaccine advisory bodies, we have conveyed and will continue to reinforce with the Ministry of Health the importance of adjusting this strategy as needed based on emerging evidence.

• The Ministry of Health’s Phase 2 prioritization outlines the sequencing (page 9) and health conditions to be prioritized (pages 15-16). The highest-risk patients and their caregivers are expected to be offered a vaccine at the start of April, followed by the high-risk group in late April and the at-risk populations in mid-May. Check your local PHU as many are moving differently through the age categories.
• The eHealth Centre of Excellence’s EMR search tool can help you identify and prioritize your patients for Phase 2 of the rollout (searches are available for Telus PS Suite, with Oscar and Accuro EMRs coming soon). Registration on its community portal required.

• Reminder to also check out the UofT DFCM/OCFP free e-learning series on COVID-19 vaccination – it is updated continuously and certified for up to 1 Mainpro+® credit.

• As part of the [email protected] initiative, the Ministry of Health has procured a stockpile of oxygen saturation monitors for monitoring COVID-19 positive patients through primary care. Here is information on how to access an oximeter, a resource toolkit and information from Hamilton Family Medicine on assessment, diagnosis and management of COVID.

• Prolonged illness after infection with COVID-19 – known as long COVID – is an emerging issue and understanding is limited. Here are answers to some common questions about long COVID that arise for family doctors. 

• The Canadian Society of Breast Imaging and Canadian Association of Radiologists have issued this practical guide to help you with the Management of Axillary Adenopathy in Patients with Recent COVID-19 Vaccination. 

• The OCFP took a meaningful step in our work toward an equitable, inclusive healthcare system, with the signing of a Relationship Accord with Nishnawbe Aski Nation on March 24 as a part of their Health Care Transformation. Read my remarks on this important moment. 

• Finally, our OCFP survey of the public received media attention acknowledging the need for more family physician involvement in vaccination, including by The Canadian Press, Ottawa Citizen and Global News, among others.

Events and Opportunities

• Registration is open for our next COVID-19 Community of Practice session, Friday, April 9, 8 to 9 a.m., focused on building vaccine confidence in the Black community with Dr Onye Nnorom, President of the Black Physicians’ Association of Ontario, and will also include the latest updates on COVID vaccination with Dr Dan Warshafsky, Medical Consultant at Office of the Chief Medical Officer of Health.

• Submit your questions and register for a Q&A-based webinar with IPAC specialists, Friday, April 9, 12 to 1 p.m. The session, hosted by the OMA and Public Health Ontario, offers a great opportunity to ask your IPAC-related questions to the experts.
• Learn more here about how you can join our Board of Directors and help us deliver on our vision, “Family Physicians – Leaders for a Healthy Ontario.” Nominations are due April 5, 2021, for the term beginning September 2021.
• The end of the credit cycle will soon be here: Register by June 30 to access the excellent on-demand sessions from the OCFP’s Family Medicine Summit. You can access until July 31, 2021 and earn up to 65 Mainpro+® credits.
• Our inaugural Practising Well Community of Practice session, on March 5, focused on physician wellness. Access the full session and resources and stay tuned for details of the next session,  April 26, 8 to 9 a.m.

*****

I know there is a big push ahead for us with COVID cases rising, the need for all of us to support vaccination, and the ongoing day-to-day care of our patients. I know we are all feeling tired. Please continue to support each other – an antidote to one’s own distress can be found in offering a gesture of kindness to a colleague. And please take care of yourselves; so often we put ourselves last. Now is the time to be fiercely dedicated to taking care of yourself. We will get through this, together.

Liz