Dear Colleagues,

We are in a devastating phase of the pandemic in Ontario, particularly so in our hardest hit communities, and it comes at a time when we collectively are already weary. My focus in this message is to help make the evolving guidance clearer so you can continue making the best decisions for you and your patients, and to share updates I believe give us reasons for optimism. I will say again upfront, it is so important at this time that you look after yourselves and each other.

There is a way forward with decisive steps and clear policy, and we welcomed this brief from Ontario’s Science Table. We continue to speak out, along with our primary care partners, for 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.

We know that primary care is a cornerstone of an equitable vaccine rollout – especially when it comes to our patients who trust us most and may be vulnerable – and, after advocating hard for this, we are pleased to see more vaccines in the hands of family doctors across all Public Health Units.

Resources | News

• We know you are balancing many clinical requests – from acute care, preventive care, help with vaccination efforts, and supporting pressured hospitals. With the goal to help preserve your energy and time, and prioritize focus, we have compiled these guiding considerations. These align with Ontario Health requests to our sector along with the new MOH Directive, while taking into account your own practice needs right now. A reminder that PPE allocations are still available from the provincial pandemic stockpile – Q&A here.
  
  
  •  In Ontario, the age eligibility for the AstraZeneca (AZ) vaccine has just been expanded to those 40+. This is great news and the evidence continues to clearly show AZ efficacy outweighs the risks. NACI is expected to update current guidance this week.
  • This message 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
  • Ontario’s Science Advisory Table has published this guidance for VIPIT in an outpatient setting.
  • Thrombosis Canada has put together this FAQ on COVID-19 vaccines and blood clots.
  • More patient resources on AZ: Check out Dr. Mario Elia’s Facebook Live video, answering his patients’ common questions about AZ, and Science Sam has some great short Instagram videos that are good for sharing with patients.
• This guide from the OMA (gated) can help you determine capacity for in-office vaccination. Please reach out to your PHU contact for primary care if you wish to participate in vaccinating. You can also connect with others who are vaccinating through the Ontario Health CoP for vaccinating in primary care.
• An update on doctor’s notes – this recent Ministry of Health memo states a note from the hospital clinic/physicians IS now required for patients who are exempted from the 16-week interval between doses. Notes are NOT required to prove eligibility for vaccination based on the list of Phase 2 health conditions. Those with a history of severe allergy to a COVID-19 vaccine or to any of its components DO still require allergist/immunologist consultation and a signed allergy form.
• Updated statement on approach to unilateral axillary lymphadenopathy related to vaccination from the Canadian Association of Radiology.
• This SOGC statement, issued April 20^th, supports use of all available COVID-19 vaccines in any trimester of pregnancy and during breastfeeding.
• The next COVID-19 Community of Practice with UofT DCFM is Friday, April 23, 8 a.m., with infectious disease specialist Dr. Allison McGeer, as well as family doctor, Dr. Rosemarie Lall, who will share her experience of rolling out the vaccine in Scarborough
• Mental health remains a major reason for patient visits during COVID-19. New resources from Wellness Together Canada include grief and loss coaching, peer supports for people dealing with addictions, and the Breathing Room Other mental health resources here.
• The OCFP Practising Well Community of Practice session on Wed. April 28, 8-9 a.m. will focus on practical ways to support patient mental health issues. Register now to learn from your colleagues’ experiences and get practical tips, including for virtual care.
• A reminder for those who are affected, eligible healthcare and other frontline workers have access to free emergency child care.
• With the CPD credit cycle ending soon, check out the OCFP’s Family Medicine Summit, with dozens of sessions available until July 31 and up to 65 Mainpro+® credits, registration open until June 30th.

*****

I know that the situation continues to be incredibly concerning and that every day we are all being asked to do more. At this time, I am grateful to each of you for digging deep to continue to be there for your patients and communities. I have huge faith and pride in our profession and feel honoured to be representing you and supporting our collective work at every chance

Take care, 

Liz