Dear Colleagues, 

I don’t have to tell any of you working on the frontlines of care what Ontario is facing. Given the extreme pressure on hospital ICUs and critical care beds, Ontario Health has issued a directive that all elective surgeries and non-emergent/non-urgent activities in most hospitals will be ramping down beginning April 12. 

In the midst of this current stay-at-home order, and our collective exhaustion, it can be difficult to imagine the relief we know will come as vaccination efforts continue to ramp up and roll out. Until then, it is critical that we continue our essential role in maintaining care for our patients, and do not stop or delay the provision of needed in-person care (see our OCFP guide to providing in-person care).  We know that mental health concerns, for instance, continue to be a predominant reason for patient visits; this OCFP patient resource can help you identify supports.

These efforts will help our patients stay well in the community and out of hospital. The College of Physicians and Surgeons (Providing Care section) summarizes it well:  Where physical contact is necessary to provide care (e.g., newborn care, prenatal care) or where physical assessments are necessary to make an appropriate diagnosis or treatment decision (e.g., infections conditions, post-operative care, chronic disease management), patients need to be seen in person.

The Ministry has reached out to primary care teams requesting additional support for the outpatient care of COVID positive patients. Provincial supports and resources through the COVID@Home program, including the provision of oxygen saturation monitors for use by patients at home, are available to eligible family physicians. See below for a webinar if interested in learning more.

Update and resources on vaccination, including in office

• We received this memo yesterday from Assistant Deputy Minister Patrick Dicerni regarding vaccination. It reinforces the key roles we as family doctors play, notably: vaccinating in our offices or participating in clinics run by others; counselling our patients to boost vaccine confidence; and communicating with our patients, especially those in the age and risk categories (pages 15 and 16), on how to access a COVID-19 vaccine and/or where to go for this information.  

• In the most recent AZ delivery to Ontario, about 20% (or 120K doses) were directed to primary care. All 34 Public Health Units are working to identify practices in their region who can support in-office vaccination, and currently 300 family practices across the province are being onboarded. Please reach out to PHU contact for primary care if you wish to participate. 

• This new OMA decision guide (gated) can help you assess your in-office capacity for vaccination and other ways to support the vaccination efforts. 

• This Centre for Effective Practice vaccination resource includes EMR tools to help identify eligible patients, and information on educating patients, links to OMA billing resources and COVaxON training supports from OntarioMD.   

• Ontario Health has expanded its Primary Care Vaccination Community of Practice to include any new practices that will be delivering vaccines. Next meeting is Tuesday April 13, 8 a.m. to 9 a.m. focused on sharing lessons learned and helping new practices. Registration is here and for subsequent sessions here.

• The UofT DFCM/OCFP free e-learning series on COVID-19 vaccination has been updated with new vaccine info and includes a module on building vaccine confidence. This series is updated continuously and certified for up to 1 Mainpro+® credit.
• Written proof of pre-existing health condition is NOT requiredto identify Phase 2 eligibility for COVID vaccination.
• Additional OCFP COVID related resources are available on our webpage: https://www.ontariofamilyphysicians.ca/tools-resources/covid-19-resources.

Other support from your peers 

• Our OCFP/UofT DFCM COVID-19 Community of Practice, sessions are all recorded and can be found here for certified self-learning, along with relevant resources. Mark your calendar for our next session on Friday, April 23, 8-9 a.m. to hear from Dr. Allison McGeer and Dr. Rosemarie Lall. 

• If you’re interested in learning more about using remote monitoring and best evidence to support your COVID+ patients in their home settings, register here for this Ontario Health COVID@Home Community of Practice, Tuesday April 13, 4 p.m. – 5 p.m..

***** 

I know that we were already feeling tired and are now being asked to continue to do what we always do – and more.  Our profession has stepped up time and time again for our patients – I see and value all the work that you do every day. At the OCFP we will continue to support you in your critical work, champion what you do and your role, and advocate for your needs.   

Liz