Dear Colleagues,

These last few weeks have been a time of national and personal grieving. We were deeply saddened by the discovery of the remains of 215 Indigenous children at a former residential school in Kamloops and our heart collectively broke as we considered the unfathomable loss to those families and communities of the Tk’emlúps te Secwépemc First Nation. This week, we were devastated by the death of a family in London who were targeted for their Muslim faith, and we join the community in their grief. At the same time, we have a need to speak about this openly and to face our country’s shameful history of colonialism and the ongoing reality of racism. Please read the OCFP’s statement about our commitment to action. 

Update on mixing and matching COVID-19 vaccines

• The Ministry of Health has updated information(June 8) for those who received a first dose of the AstraZeneca (AZ) vaccine. Your patients who received a first dose of AZ can choose to:
  • Receive the AZ vaccine for their second dose, 12 weeks following the first dose; OR
  • Receive an mRNA vaccine (Pfizer-BioNTech or Moderna) for their second dose, 12 weeks following their first dose. 
  • Bottom line: The most important thing is to get second doses in arms as evidence shows it significantly increases vaccine effectiveness, including against variants – see the June 10th Ontario Science Table Update on COVID-19 Projections (slide 10). 

• Check out these “I got AstraZeneca for my first dose. Which vaccine is best for my second?” decision aids – a one-pager and the long form document – for you and your patients, developed by a team of doctors, pharmacists, scientists, and patients. 
• For your patients whose first dose was either Pfizer-BioNTech or Moderna, Ontario has expanded accelerated second dose bookings:
  • as of June 7, eligible groups now include those 70+ and those who received their first dose on or before April 18;
  • on June 14, eligible groups will include those who received their first dose on or before May 9 and who live in Delta variant hot spots – more info & timelines here. 

Other vaccines-related info

• The CEP has developed a guide to support conversations with your patients who may be expressing some Moderna hesitancy (i.e., a preference for Pfizer).
• COVID-19 vaccination records are being pushed through Health Report Manager (HRM) – COVaxON. Notifications are now available for vaccinations done after May 18, 2021.
• More information in this overview of HRM COVaxON Vaccination. 
• EMR integration is underway with the support of OntarioMD. In the meantime, here is an HRM Workflow Guide, thanks to Dr. Scott Laing of Ottawa, and Guelph FHT has a comprehensive COVID-19 Vaccination Toolbar, created by Drs. Joan Chan and Gabriel Ting.
• COVID-19 vaccination data is now also available through the provincial clinical viewers, Connecting Ontario and Clinical Connect. Access to the viewers can be requested via Ontario Health’s Digital Health Service 
• We have updated our OCFP COVID-19 Vaccination for Special Populations with the latest recommendations. 
• Vaccination of youth and children – new resources: Children’s COVID-19 Vaccine Table and SickKids. For youth there is an MOH Vaccine information sheet and updated consent form (May 21).
• Updated MOH guidance for those vaccinated outside of Ontario/Canada – among the conditions: proof of immunization is required; the local PHU should be notified to update documentation; any second doses should follow Ontario intervals.

Transmission, variants, IPAC & PPE updates

• FAQs from our last COVID-19 Community of Practice (see "Past Sessions", June 4, 2021), with UofT Department of Family & Community Medicine, where Peter Juni and Allison McGeer covered questions on variants, transmission and latest evidence on vaccines.
• Most experts recognize both short- and long-range aerosol transmission with COVID-19, although there is some debate over its predominance and what this means for IPAC/PPE.
• Public Health Ontario's May 20 update (see pages 8 and 9) continues to recommend Droplet and Contact Precautions for the “routine care of patients with suspected or confirmed COVID-19.” PHO points to studies showing long-range transmission under certain conditions (e.g., prolonged exposure in crowded, poorly ventilated spaces), and the effectiveness of current IPAC practices and PPE when applied appropriately and consistently.

New national guidelines on self-isolation

• Fully vaccinated (i.e., at least 14 days after second dose) individuals who are identified as high-risk contacts do not need to isolate, unless specifically directed by their local PHU (Ministry of Health guidance). By early July, fully vaccinated Canadian and permanent resident travellers will no longer need to spend 14 days in quarantine upon return (Globe and Mail). 

COVID-related webinars and resources

• Our next CoP with UofT DFCM: Getting to herd immunity: addressing children, confidence, and complacency – Friday, June 18, 8-9 a.m. (ET). Register.
• Medications for Outpatients with COVID-19,from the COVID-19 Science Advisory Table: Tuesday, June 15, 7-8 p.m. (ET). Register.
• Cancer Screening During the Pandemic and Onwards, from the OCFP in collaboration with our primary care partners and Ontario Health (Cancer Care Ontario): Monday, June 21, 8-9 a.m. (EST). Register.
• NACI Recommendations on COVID-19 Vaccine Interchangeability, from the Public Health Agency of Canada: Wednesday, June 16, 1:30-2:30 p.m. (ET). Register.
• This newsletter, from Ontario Health East – Champlain Region, highlights the impact of COVID-19 on cancer screening and diagnosis and key measures to help alleviate some of the resultant bottlenecks in our system. Thanks to Dr. Anna Wilkinson.
• Summary of treatments and resources for Management of Youth and Young Adult Mood Disorders (Anxiety and Depression) During COVID-19, from Centre for Effective Practice/UofT DFCM.
• The OCFP is partnering on this 10-minute survey: Measuring Burnout in Canadian Family Physicians. Please consider completing it to help us better understand this important issue.

Upcoming CPD from the OCFP

• OCFP Practising Well Community of Practice – Self-management for Chronic Pain: Wednesday, June 23, 8-9 a.m. (ET). Register.
• Learn how you can become an OCFP Practising Well Peer Guide – join us for an upcoming information session, June 15 or August 31. Register | Learn more.
• Complete this expression of interest to be notified of upcoming sessions on: Mood Disorders; Child and Adolescent Health; and Practising Wisely.

*****

A note about our CEO, Leanne Clarke

The OCFP Board of Directors is recruiting the OCFP's next CEO following the resignation of Ms. Leanne Clarke, effective July 30, 2021. More details available here. 

For the many of us who have had the pleasure of working with Leanne these past eight years, we will miss her inspiring leadership and tireless commitment to family medicine and primary care, within a stronger health system for all Ontarians. On behalf of the OCFP Board and staff, we are grateful for her immense contributions as CEO, and the tremendous legacy she leaves for our organization – including our many strengthened partnerships, which will continue to guide the OCFP towards its vision of a healthier Ontario.

Liz