Parking Construction Summer 2012 to serve you better will be in process at the Medical Complex.  The upper deck need updating, and it is planned to be done in phases.  Most of the major work will take place on Fridays to Sundays weather permitting. During this time there may be some office cancellations and restricted parking.  There will be overflow parking available on Credit Valley Road and in the underground.  We thank you for your patience as this work is badly needed.

Stay at home order April 8, 2021

The province and some public health units have announced a stay at home order for 4 weeks. The GTA is the most populated region in the province, and makes sense that test numbers are up, and disease numbers are up.  Shelter in place applies to everyone including ESSENTIAL workers outside of regular work hours.  We will attempt to deal with your urgent problems in a remote fashion.   We hope to resume regular services in a few weeks and after our immunizations are complete.  Please keep the essence of this order in mind when you make a request.

It would be useful to recognize some of the costs that these measures bear on our health as a whole.  Wether it is the pandemic or measures to control covid there are no winners in this difficult situation.  We have seen suicides, overdoses, heart attacks, psychiatric illness, obesity, diabetes, addictions and other conditions increase significantly. 

All deaths are sad and many are tragic.  Perspective in really required.  In Ontario, the death rate has hovered with a slow increase over the years.

On average about 2300 persons die in Ontario each and every week.  About 900 are from cancer, heart disease and stroke.  About another 900 are from “other” causes which include suicide, accidents, overdoses, etc.  Lower respiratory diseases  account for about 150, and the average numbers dying from Covid or dying with a positive covid test varies from 60-100, the majority over age 60.  If we need to dwell on death numbers, than please also remember all those that are dying from all causes and the families they leave behind.

Of interest, I was surprised that I could not find a single case of a child or infant dying of covid in Ontario since the pandemic onset.  I hope this provides some assurance.  It certainly should provide us plenty of time to reflect and review the science before requiring any sort of mandatory vaccination in that group.

Another point of good news, is that we have learned more effective treatment algorithms with better outcomes in those few who progress to covid disease.

We still seem to be resistant to discuss solutions out of the box, and rely on cut and pasting policies from other parts of the world. 

We have become more obese as a society, more prone to turning to alcohol and drugs, enduring financial hardships and suffering from anxiety, depression and other illness. We have family units that have become estranged and numerous potential bonds broken and vital support networks lost.  Reach out remotely to someone.  It does not seem that things will ever be same as they were, but  a new balance of some sort will most likely emerg.

Covid vaccination April 5th,2021.   The lines are moving faster, and some confusion has been averted.  There are a lot more people who now qualify.

As of April 7, 2021, those 50 yo and above living in certain postal codes are able to get vaccinated. See the peel health website.

 Individuals 55 or older are eligible to receive their AstraZeneca Vaccine at the following pharmacies:

    Heritage Glen Pharmacy (Glen Erin/Battleford) – 6515 Glen Erin Dr
    Real Canadian Superstore Pharmacy (Argentia/Tenth Line) – 3050 Argentia Rd
    Shoppers Drug Mart (Thomas/Tenth Line) – 5602 Tenth Line W
    Shoppers Drug Mart (Creditview/Bristol) – 5425 Creditview Rd
    Shoppers Drug Mart (McLaughlin/Derry) – 7070 McLaughlin Rd
    Walmart (Erin Mills Town Centre) – 5100 Erin Mills Pkwy

For a full list of locations please visit ontario.ca/vaccinelocation.

A few primary care clinics have also been given Astra-Zeneca vaccine by the health department. Their names and locations have been withheld for some reason.

NEW: Starting April 2nd 60+ are now eligible to book appointments and receive their vaccine in Peel. To book, https://covid-19.ontario.ca/book-vaccine/These sites are using Pfeizzer or Moderna Vaccines.

Many frontline workers are eligible, see this link to see the vast list of who is included.
   front line workers.https://www.peelregion.ca/coronavirus/vaccine/getting-the-vaccine/#priority.

You will require an attestation form signed by your employer. 
https://peelregion.ca/health-professionals/covid-19/pdf/covid19-attestation-immunization-form.pdf

If you are 18 years or older and have high risk factors listed below, Dr Kujtan now will be able to refer you to the Trillium Health Partners to receive your vaccine. Trillium health partner  will contact you to arrange for an appointment to get vaccinated.

Highest-Risk Individuals:
• Organ transplant recipients; Hematopoietic stem cell transplant recipients; People with neurological diseases in which respiratory function may be compromised (e.g. motor neuron disease, myasthenia gravis, multiple sclerosis); Haematological malignancy diagnosed less than 1 year ago; Kidney disease eGFR< 30.

High-Risk Individuals:
• Obesity (Body Mass index greater than 40); other treatments causing immunosuppression (e.g., chemotherapy, immunity-weakening medications); intellectual or developmental disabilities (e.g. Down Syndrome).

Covid19 update Mar 30, 2020

The Employment Standards Act, 2000 was recently amended to include an unpaid, job-protected infectious disease emergency leave. This leave is available to employees who are not performing the duties of their position for certain reasons related to COVID-19, including:

SICK NOTES ARE NOT REQUIRED

· personal illness, quarantine or isolation in specified circumstances

· concern by the employer that the employee may expose other individuals in the workplace to COVID-19

· to provide care or support to certain family members for a reason related to COVID-19, including school or day care closures

· due to certain travel-related restrictions

The leave is retroactive to January 25, 2020. Employers cannot require employees to provide medical notes to prove they are eligible for the leave. Learn more.

In addition, Ontario declared an emergency due to COVID-19 on March 17, 2020. During a declared emergency, an employee may have the right to take an unpaid, job protected leave if the employee will not be performing the duties of his or her position because of the emergency and because certain circumstances apply. More information will be available soon in this guide.

Due to orders that have been issued under the Emergency Management and Civil Protection Act, the minimum standards under the ESA that are described in this Guide may apply differently to certain employees during the declared COVID-19 emergency. You can find the orders by visiting the Emergency Management and Civil Protection Act online and selecting the “Regulations Under This Act” tab.

  Premier Ford has extended the Emergency Order in Effect for Ontario till at least April 14, 2020.  This implies that everyone should stay at home and not venture out unless it is an emergency.  For those worried about coronavirus, please take the following assesment quiz,  https://covid-19.ontario.ca/.

We will continue to work in isolation, and provide services.  We will accomplish as much as possible by phone, fax and other remote means. Messages will be returned.  For urgent medical matters we will arrange specific assesment times.  Those with fever and infection will be triaged elsewhere until protection equiptment arrives.Please continue to practice social distancing and good hygiene. 

We continue to remain under an emergency order to remain at home, maintain proper hygiene and distancing.  I am very impressed with how our political and medical leadership have responded to the Covid19 situation when compared to our southern neighbours, who continue to bicker and fight amongst themselves, while the situation continues to peak and the economy suffers.  Seeing our prime minister on television daily, giving a calm and responsive approach, is helpful. The opposition support this effort. A similar approach is taken by the premier, and the head of my own OMA has been relentlessly mobilizing efforts and providing validated information. The medical community is mobilizing. Locally, we are preparing to bolster and support innitiatives and we will be redeployed to aid  hospital congestion. 

   I am dissappointed how the numbers are broadcast like a factual hockey score. Simply reporting how many positive swabs were processed in a day, and how many deaths occurred without context leads to fear.  The numbers are very complex and different. For numerous reasons, you cannot compare countries around the globe without considering complex variables. Much more context is needed around these numbers. This creates a fear, and overloads hospitals. It is drying up supplies needlessly that may be needed later.  There  is a fear based demand for testing and the results show that only about 3% are positive, and most of those are sent home.

Covid vaccine confusion. Mar25,2021.

    There are many on the market and more coming.  Here is a link that compares them and takes out all the misinformation and misuse of various terms.  Please take 5 minutes to watch it.

We do recommend  taking any available vaccine at this time.  There is a lot of confusion  and terms used.  Please keep in mind that for large companies this is a business of immense profit, so there is a lot of leaked information to both support and demote each others studies.  Unfortunately, in todays world due to time constraints, we have to take the data provided by the “car salesman”(working for vaccine company) as the only one available and therefore requires  scrutiny.

Here are some certainties.  1. Any vaccine will prevent the severe form of covid, the disease, that can put people in the ICU.

2.  All vaccines will reduce the burden of covid in the world. Doubtful that it will eliminate it. 

3.  You can still acquire mild covid illness even though you have had vaccination.  You will recover.

4.  Highly unlikely that invisible carriers are a problem and even exist to any significant degree.

5.  Not recommended for infants and children at this time.

6.  Mild side effects are common,  temperature, site soreness, fatigue.

7.  Covid is capable of causing serious  blood clots.  Vaccines probably not, the scientific evidence is poor at this time. The Astra-Zeneca vaccine may rarely be associated with a clot at the back of the nose and base of the brain, but this is being monitored currently.  Headlines often originate from competitors indirectly pointing to low value information as clinical fact, to gain a better market share. 

8.  There are numerous people who are immune, or whose system can recognize and address it like any other virus and not create problems. We just dont have a good way of identifing them.

9.  We are lobbying government and health departments to involve us, and allow us to vaccinate you, but no indication that it will happen.  It took 4 mos, for our own staff to start  immunization, despite being both high risk front line workers and working in the Canada’s covid hotspot.   We will have to remain mostly virtual until the process is completed in a few months, and we obtain a suitable color designation that allows normal care to become more personal. We regret that we could not convince the gate keepers otherwise.  Please work with us in this very difficult time.  

Covid vaccine. Needles before bullets!  March 15,2021

We know you are hoping to get your COVID-19 vaccine as soon as possible and are seeking the latest information. Here is what we know now (March 12, 2021).

AstraZeneca Vaccine
We (have/have not) received the AstraZeneca COVID vaccine in our clinic.  The Astra Zeneca vaccine is being offered only to people ages 60-64 (if you are 60-64 as of the day of vaccination, or if you will be or have been 60-64 in 2021). It is available in pharmacies and some family doctors’ offices in certain health regions. We will let you know as soon as possible when the vaccine becomes available to us. Please do not call us to try to book an appointment. We need to keep our phone lines free for patients with immediate medical needs.

Vaccines for patients over 80 (born in 1941 or earlier):
If you are 80 or older and do not live in a care home, your local public health unit will have details about vaccinations in your area.  Also see local links in next artilcles.

Provincial online system
Eligible residents can now register for appointments starting on March 17.

For more information about COVID vaccines visit the Ministry of Health website: https://covid-19.ontario.ca/covid-19-vaccines-ontario

Please be assured that we will let you know if we have any vaccine and if you are eligible to receive it from us. Please take the first vaccine offered to you.

Covid19 shots, Needles before bullets! March10,2021

         It is hard to believe that a year and half later, Covid19 still dominates conversation.  Once again, our phone lines lit up when some well-intentioned  government employee announced that doctors offices are giving out covid vaccine.   The frontline doctors in Peel have heard nothing about it.  It would be a good idea, but there hasn’t been a shred of meeting or communication to pitch it to the local docs.  In fact several of my peers pitched the idea to politicians and health departments almost one year ago.  Nothing has happened to evolve this plan.  It would take quite some time to solve logistics, of supplies, storage, transportation, etc.   The front lines are quite overwhelmed and tired looking after all the non-covid sick that have emerged during the pandemic.  We will post updates here.

     To those caught up in current vaccine chaos, we apologize for the numbers and links provided, and turned out almost impossible to access.  Lets all take some refuge, and be glad that we are fighting this “war” with needles and not bullets. 

  Which Vaccine?   Take anyone available.  There will be at least 4 diff ones.  Drug companies spend a lot  of funds promoting the best statistics that their own studies show.  There have been no head to head trials to truly say which one is better, if any.  We are conducting the trial in real time, so that data will eventually emerg, and few will care, just as the various yearly flu vaccines arrive from multiple makers.

   Things for certain, are that all the vaccines have been shown to reduce or prevent the serious covid disease.  If you get covid illnes, you will recover, but disease sends you to hospital.

   If you have had the covid cold, dont panic about vaccination.  You are ahead of the pack and have proven that your system handles this virus normally.

  You can still take a vaccine if you wish.  Better science data will emerg.

   Pregnant women should not take the vaccine currently.

   Children were not part of any studies, so even the manufacturers suggest cut off at 16-18 year olds.   More, proper science will replace fake news.

   Problem with the older population is that these vaccines were developed and tested very fast.  Companies do this often, because a group of young, healthy 30-60 yo leads to favourable results in trials.   Despite that, the roll-out has decided that our eldest and sickest should get vaccine first.  Consider it a trial.  So far, the rumour has it that most did just fine.  I image, we will soon be giving vaccines to everyone.

   The point of vaccination is to prevent spread and lessen disease.  Our administrative elite on this planet have read the messages from front line commanders and agree, that vaccinated people should be considered as unlikely suspects to spread disease.  Consider your self a non spreader of any “hidden” or secret covid virus lerking in your body about two weeks after vaccination. 

   I do not believe or endorse a vaccine passport.

You could still get covid illnes,  (mild cold type), but this would not necessarily imply vaccine failure.

Covid Update Mar 8, 2021.  Fake news or simply unprepared once again.  If anyone can locate some reasonable accountability in our system, please forward to those around you.  We are in need of positive true news in the worst way. Despite  media announcements, we have found out first hand that a great deal of misinformation and misleading information has come forward with it.  Website and links, that never seem to be open or available, phone numbers given to patients that are never answered. I visited one immunization site while on hospital duty, and was surprised to see that most who had made appointments did not seem to fit into the first phase criteria?  Difficult to say why, perhaps embelishment  of information or inefficient screenig.  It seems to make the roll out appear quite chaotic.  What is worse is that physicians also have no ability to contact anyone of substance to obtain information and clarification.    Dr.Kujtan and staff, were bounced out of the January slots and still await word of immunization.  It will then take at least 5 weeks to be in a position to resume some form of face to face visits above that currently being done.  We think  June would be a likely time. 

Our  public health department announced last week, resumption and stepping up of vaccine priorities. Unfortunately, once again, their web site does not work and they dont seem to answer their phones.  Recorded messages give little information.    It has been difficult to contact other resources for help as well.      Anyway, there may be some guarded news for those patients OVER 80 years of age.

Another avenue to pursue is to follow this link.

https://trilliumhealthpartners.ca/covid-19/A/index.html

this link will take you to a place where you can pre-register at the trillium health center.  In our area, we are hoping to get vaccines into those over 80 starting March 8, 2021. 

Alexander Graham Bell, would be rolling in his grave, if he lived to see that his wonderful invention has become  a source of frustration and not the miracle it began to become.   We seem to spend hours of our lives on a regular basis, simple holding a communication device in limbo.  For this reason, we will not insult you with providing a phone number.  

COVID-19 ALERT VACCINE  Feb 22,2021

The provincial government announced last week that those aged 80 and above should contact their doctor to be vaccinated. We were unaware of this announcement before it occurred, and we do not have any further details regarding what information should be collected from your patients, to whom this information should be provided, how patients will be notified and where they will be vaccinated.

We have repeatedly emphasized with the government  and public health that doctors have a key role to play in prioritizing and advising their elderly patients. We will let you know when further reliable information is available.