Dear Colleagues,

My message today, fittingly, comes to you on World Family Doctor Day – a day to celebrate the vital role of family doctors and the contributions they make every day to their patients and communities. Now 20+ years in practice, I remain grateful to be part of this unique profession and to work alongside all of you.

I don’t have to tell any of you though that it’s getting harder and harder to be a family physician these days. As highlighted in our #LifeWithoutADoctor advocacy campaign currently underway, there is hope and there are solutions. We are determined to lift the barriers that impede our ability to excel and thrive in practice, and together with our members, we will succeed. Please be on the lookout for updates on our progress.

Updates since my last message below.  

EVUSHELD

Ontario’s rollout of the pre-exposure prophylactic Evusheld has started – with roughly 3,500 doses in the province (as of May 13) and additional doses accessible through a stockpile.

• Access to Evusheld will be to eligible patients through select clinics, including cancer centres and transplant sites. Evusheld supply will be received and managed by the hospitals where these clinics are located. Clinics may work with primary care providers or community infusion clinics, to support care delivery close to home.
• From Ontario Health: information for providers |patient handout |memo (includes list of regional contacts).
• Ontario is following CADTH guidance on eligibility and that may widen based on supply. Presently eligible: solid organ and stem cell transplant recipients, CAR-T therapy recipients, and patients being treated for other haematological cancers; must be age 12 or older and weigh more than 40 kilograms.
• Available at no cost to eligible patients in Ontario; Evusheld is an additional layer of protection for those patients – it should not be used if they had a known recent exposure to an individual infected with COVID-19.

PAXLOVID AND OTHER TREATMENTS

You have been doing an incredible job in prescribing Paxlovid. Some new (and some repeat) tips and resources:

• Continue to apply Ministry criteria to consider which of your patients to assess for possible treatment, then use the Science Advisory Table’s guidance to consider the evidence for whether they would benefit from treatment.
• A helpful new tool, Paxlovid for a Patient on a DOAC, from the Science Advisory Table and pharmacy department at UWaterloo.
• Resharing the downloadable Paxlovid prescription form from the eHealth Centre for Excellence.
• Our April 22 COVID-19 CoP session was “All about Paxlovid” – you can view the recording, resource list and curated Q&As for this and other sessions.
• For patients who do not qualify for Paxlovid, remember there are other treatment options.
• Resharing a link to referral information for remote COVID-19 monitoring programs and information for ordering O₂ saturation monitors for patient use.

VACCINES | BOOSTERS

Please continue to encourage your patients to receive all eligible vaccines as the best defence against severe COVID-19 illness. Many have not received third-dose boosters, and many children 5-11 have received one of two doses.

• The Ministry has updated guidance on vaccine administration (April 29), including timing of vaccines relative to infection (page 10) and eligibility for newer vaccines.
• No word yet on second boosters for healthcare workers. We understand that NACI will publish its next set of booster recommendations in mid-June.
• The OCFP/DFCM “Confused about COVID” resources have an excellent information table on boosters, including 4th and 5th dose eligibility.
• Moderna’s vaccine for children under age 5 is being reviewed by Health Canada and now expected to be available in Ontario in July. We will continue to advocate for our appropriate role in vaccination and will update you as we have more information.
• Novavax is available through local PHUs for patients who are unable or unwilling to receive mRNA vaccines.
• A new resource from the OMA on Indigenous patients and COVID-19 vaccine distrust (sign in to access), including practical steps to gain understanding and build cultural safety into your practice.

LONG COVID

• A new post COVID-19 condition EMR tool (for PS Suite and soon Oscar), from eHealth Centre of Excellence, that tracks symptoms and allows for a plan to be built. Also contains a printable patient handout with symptom-specific links to resources. Note you must sign up/log in to the community portal to access.
• Resharing OH’s Post COVID-19 Condition: Guidance for Primary Care, and how to access Post-COVID Condition Advice through eConsult.
• The Rehabilitative Care Alliance has a compilation of resources for post-COVID condition and a list of outpatient COVID-19 rehab programs, some limited to hospitals

OTHER UPDATES AND OPPORTUNITIES

• The Ministry has available 2022/2023 funding support for practices to set up online appointment booking. See criteria and make your submission.
• PHO is hosting a community of practice series focused on IPAC in Primary Care, intended for those responsible for oversight or implementation. First of four sessions is May 24. Contact [email protected]if you have any questions.
• CFPC’s Section of Teachers and Section of Researchers are jointly hosting a conversation – Quality Improvement in Family Medicine Education – Plan It, Do It, Teach It! No pre-registration is required, join via YouTube, May 24, 2022|12-1 p.m. (ET)
• Planning for the OCFP’s Family Medicine Summit (FMS) is going full steam, with two current opportunities: see our FMS 2023 Call for Abstracts and submit your idea to present by ; and help set the program for our flagship educational event – see how you might join the FMS Planning Committee. Deadline for both is June 12.
• Watch for details, coming soon, for our next COVID-19 Community of Practice session, May 27.

*****

I hope the sunshine and milder weather in much of province have been lifting your spirits.

With gratitude to all of you,

Liz