Dear Colleagues,

The first day of summer is almost upon us and I hope you are also enjoying the warmer and longer days.

I know the end of the provincial mask mandate tomorrow is on our minds and brings an added challenge as we make decisions about what to do in our individual practices. For now, though no longer mandatory in our practices, masking continues to be an important measure to reduce the risk of infection – especially for those who are vulnerable.

Please read below for further resources on masking and other updates. 

MASK MANDATES

With most Ontario mask requirements lifted on June 11, we have revised our screening form and summary of IPAC and PPE guidance to reflect the change. 

• The OMA has developed an adaptable template (log in to access) that includes a vaccination policy and a masking policy for clinic employees/staff. Here is OCFP signage reminding patients to wear a mask during their visit. Best to let patients know of your masking policy in advance of an in-person visit.
• The CPSO has affirmed that patients cannot be denied care based on their decision not to wear a mask – in that scenario, take appropriate precautions based on the patient’s health, such as continuing to strongly encourage mask use, scheduling them at the end of day or another dedicated time, or a virtual visit if the standard of care can be met.
• Universal masking for all staff and visitors remains a requirement in long-term care and retirement homes (Directive #3, point 4), and is recommended by CMOH in higher-risk congregate living settings, including shelters and group homes.

COVID-19 TREATMENTS | EVUSHELD

• A reminder that treatments, including Paxlovid, are available for people who are at higher risk of getting seriously ill. Many resources for Paxlovid prescribers in earlier message from me and here is summary information for patients about treatments.
• We’ll continue to provide the latest information on treatments in our COVID-19 Community of Practice. Stay tuned for more on the next session, June 24, 7:55 a.m.
• Resharing this list of COVID-19 assessment centres administering Paxlovid, and highlighting OntarioMD’s compilation of digital Paxlovid tools and supports to help identify your eligible patients, check drug interactions and more.
• The anti-viral remdesivir may be an option when Paxlovid is not appropriate. See the Science Advisory Table’s recommendations, and here is a list of clinical assessment centres dispensing remdesivir
• At the present, patients eligible for the COVID-19 prophylactic Evusheld include solid organ transplant recipients and hematologic cancer patients, with treatment administered by specialists. See this Ontario Health memo which lists prioritization for treatment with OH regional contacts to help answer questions from you or your patients. We understand that work is underway to expand delivery of Evusheld.

MONKEYPOX

• MOH has issued interim guidance (June 1) for the use of Imvamune as post-exposure prophylaxis for Monkeypox.
• Find links to testing information, IPAC recommendations and more on Monkeypox in my recent President’s Message, and in the OCFP/UofT DFCM Community of Practice session on May 27, with ID physician Dr. Gerald Evans and others.

OTHER UPDATES

• Updated MOH guidance on COVID-19 case and contact management (June 2) includes how to tell if a positive test from a previously cleared case is a persistent infection or a re-infection, and what to do about it.
• The Ministry of Health has just released a new version of COVaxON, with some changes to the tool. See OntarioMD’s upcoming training sessions for primary care practices.
• Nurses in community-based practices are eligible to apply for the temporary nursing retention initiative from MOH. The Ontario Nurses Association has posted the Ministry’s FAQs with more information on its website and nurses may use this form to apply.
• With funding available to support set up of online appointment booking, Ontario Health is hosting a webinar on the topic, June 21, 5 to 6 p.m. Learn more about the benefits of online booking in this terrific overview from nurse practitioner Beth Gerritsen.
• Open to all family physicians, New Horizons, Navigating Towards the Future of Family Medicine, a speaker series from at UofT Department of Family Medicine is exploring the potential of our profession in shaping health care.

*****

I hope everyone is looking ahead to some time this summer to be away from work and restore your energy and balance. It’s clearer than it’s ever been that we can’t do this work “running on fumes” – yet being a family doctor continues to be a joy and privilege and we remain as committed as ever to our patients and our communities. With a newly mandated provincial government, at the OCFP we will continue to pursue the support and resources needed to sustain our profession.

Liz