An Important Update    Sept 21, 2020

The COVID-19 situation is evolving. We are situated next to one of the Provinces largest COVID testing sites with long wait times, and little monitoring  which have had an impact on our operations (washrooms) .  Unfortunately, some individuals awaiting testing have been wandering through the medical building for various reasons.

Today we were notified that a staff member who works in the building has been confirmed with having the COVID-19 virus. This employee last worked on 15^th September 2020.

Please continue to follow covid-19 precautions and observe our evolving directives of how to best handle patient care.

Our medical center is still inundated on a daily basis with dozens of cars full of potential covid patients awaiting testing, which can take hours.  Our local hospital continues to operate their drive thru testing center out their back door, which happens to be our front door.  If you happen to find yourself waiting in this line, please do not park and roam the property or enter the building for whatever reason.  It is making stage 3 difficult to manage for the dozens of practitioners in our building.  We continue to use virtual and remote resources to help manage your health, but at times it is necessary to do in person examinations or procedures that cannot be deferred indefinitely.

Numbers broadcast with regards to covid can cause some concern, because they are often reported without context.  A happy child with sniffles seems to make National News with the same enthusiasm as does an elderly patient suffering dementia, diabetes  who test positive for Covid.  Severity or outcome dont seem to matter to news outlets.  Our ICU occupancy rate in the province remains little different than other years and has the built in buffer room to accomodate a lot more if needed at this time.   It would be so nice to know how many patients in a daily report are actually hospitalized or intubated, which would lend much ability for various agencies to plan instead of panic.  As long as I have been in practice, we have always taught residents, that the third week of september seems to produce a deluge of pediatric infections for numerous reasons.  

Here is some perspective. 

In 2016  the World Health Organization has statistics on 56.9 million people who died. 

The top cause of death for 15 million people was stroke and heart disease.

The top infectious cause of death on our planet is TUBERCULOSIS, followed by other infectious lung diseases, totalling about 3.5 million

Coronavirus has allegedly claimed just over 920K, but there has been confusion in classification and reporting. 

Influenza claims between 250-500k lives on an annual basis, despite everything we do.

Road injuries claim about 1.4 million people annually.

Chronic lung disease mostly with smoking, claims about 3.7 million people

You may be surprised to find that diarrheal illness claims 2.4 million people yearly.

Coronavirus and its other respiratory cousins are definitely a problem. No one is claiming that it can be erradicated.  The current strains, like dozens before them, will be incorporated into the fabric of human existence on our planet. The main reason for changing our entire way of life, is a fear that the slow creep can turn into a deluge, but it seems that in Canada,  we have been able to step up and control at every juncture.  Current models suggest that each infected person can infect one to two others during the course of their 3-14 day illness.  There is no scientific basis to assume that a supposedly invisible asymptomatic pupil will take down an entire classroom or school.  I urge everyone to demand better, more contextual reporting.  Covid or other virus, the one thing we know for sure is that every year, our hospitals get overwhelmed with respiratory illness around Christmas with patients taking up space everywhere.  I think a lot more people may finally notice this in the coming months.

Finally, flushots.  Health department is not accepting orders for a few weeks, and then we tend to be the last to get them so we hope by end of october to start vaccinating. Please remember, they do not provide any protection against covid.   Blood antibody testing is being made available to a small group of high risk patients.  It is of value only in severe clinical situations.  Private testing runs about $300 and is supposedly available.

We have uploaded a comparison tool for you to use under the latest editorial section.

In a hope to add some balance and comparison of viewpoints.  I have added an article by a canadian physician with 50 years experience.  His views on the current situation and how it evolved to this fear, mass bankrupcy and escalation of mental health problems is interesting. It can be found under ARTICLES on our website.  It originally appeared in the Medical Post on Sept 4, 2020.

Covid 19 Update

  It seems that new stages of reopening are emerging every day. We have no idea how many there will be in total. There are numerous requirements which must be met in order to provide personal care. For the time being and into the future, until full opening is achieved,  most urgent problems will be dealt with virtually and in person as a last resort. At this time we still do not have enough personal protective  equipment to allow full reopening.  Our waiting room is closed.  Under current guidelines  we would have to work anywhere from 12 to 18 hour days in order to meet the same level of service as was in place prior to Covid lockdown. We are attempting to provide urgent care in a minimal contact fashion. This may involve  attending in person to have specific testing along with a follow-up virtual visit. Our virtual counselling services are currently taxed to the limit and extensive wait times can be encountered. Different clinics and specialists are also handling things differently due to the confusion. We will all have to be patient and attempt to adapt.

Please do not call and ask for a referral that is non-urgent. There is no advantage to be placed on a waiting list since they do not exist. Each request is  handled on a case-by-case  basis with urgent  request taking precedent.  If you are looking for results from another physician or clinic, then it is best to call the practitioner who ordered the results or is monitoring that aspect of your care.  We will contact you  for any abnormalities ordered through our clinic.

It is mandatory to wear a mask in all public areas of our medical building.  This also includes inside of clinics. We asked that you do not  come to the medical centre without  a confirmed appointment. There are times specifically set aside  to follow-up  those that have  recovered from Covid and we would appreciate  that this be accomplished in isolation with minimal exposure to other patients.

We highly encourage you to keep track of things like blood pressure, weight, blood sugar  etc. at home and  either email or call in results to us if you have any concerns.

We  will continue to attempt to keep immunization and prenatal appointments on schedule.

It is important that you show up at the time given to you. Maintaining social distancing depends on this.  If you are late, please call ahead  so that we can rebook you into a better more appropriate  appointment time.

Some patients are panicking  with paperwork that  demands medical deadlines.. These cannot be met or accomplished during a coronavirus lockdown. We suggest you contact the  institution or company which issued the paperwork or demand.  Accommodations are being made in most cases.

it is our hope that by early fall we may be in a position to tackle the large volume of  normal and preventative testing that has accumulated. We encourage everyone to follow the current provincial guidelines.

To:  The Right Honourable Justin Trudeau, P.C., M.P., Prime Minister of Canada

Date: July 6, 2020

RE: Dealing with COVID-19: A Balanced Response

The undersigned represent current and past leaders in public health, health care systems and academia.  We are writing to you to with our thoughts regarding a balanced approach to dealing with COVID-19  We strongly believe that population health and equity are important considerations that must be applied to future decisions regarding pandemic management. 

The current approach to dealing with COVID-19 carries significant risks to overall population health and threatens to increase inequities across the country.  Aiming to prevent or contain every case of COVID-19 is simply no longer sustainable at this stage in the pandemic.  We need to accept that COVID-19 will be with us for some time and to find ways to deal with it.  

The current and proposed measures for reopening will continue to disproportionately impact lower income groups, Black and other racialized groups, recent immigrants to Canada, Indigenous peoples and other populations.  And it risks significantly harming our children, particularly the very young, by affecting their development, with life-long consequences in terms of education, skills development, income and overall health. 

Canada must work to minimize the impact of COVID-19 by using measures that are practical, effective and compatible with our values and sense of social justice.  We need to focus on preventing deaths and serious illness by protecting the vulnerable while enabling society to function and thrive.

Elimination of COVID-19 is not a practical objective for Canada until we have a vaccine. While there is hope for a vaccine to be developed soon, we must be realistic about the time it will actually take to develop and evaluate it and then deliver an immunization campaign covering the entire population.  We cannot sustain universal control measures indefinitely. 

We need to accept that there will be cases and outbreaks of COVID-19.  We need localized control measures that are risk-based.  We should consistently reassess quarantine and isolation periods, recommendations for physical distancing and non-medical masks, and travel restrictions based on current best evidence and levels of risk.

At the same time we must improve infection prevention and control in long-term care and congregate living settings.  We should provide support for people living in the community who need to or choose to isolate when the disease is active, as well as those who have been adversely affected by COVID-19, or the consequences of the public health measures. 

Canadians have developed a fear of COVID-19.  Going forward, they have to be supported in understanding their true level of risk, and learning how to deal with this disease, while getting on with their lives – back to work, back to school, and back to healthy lives and vibrant, active communities across this country.

We acknowledge the heroic work that has been done in recent months by many across all levels of government and the public and private sector, and the sacrifices that Canadians have made to get to this stage.  As we look forward, Canada must balance its response to COVID-19.  

Sincerely yours,

Robert Bell, MDCM, MSc, FRCSC, FACS, Former Deputy Minister of Health, Province of Ontario
David Butler-Jones, MD, MHSc LLD(hc), DSc(hc), FRCPC, FACPM, FCFP, CCFP
Canada’s first Chief Public Health Officer and former Deputy Minister for the Public Health Agency of Canada
Jean Clinton, BMus, MD, FRCPC Former President and CEO, University Health Network, Toronto
Janet Davidson, OC, BScN, MHSA, LLD(Hon)Former Deputy Minister, Alberta Health,Former CEO, Trillium Health
Martha Fulford, MA, MD, FRCPC,Infectious Diseases Specialist, McMaster University
Brian Postl, MD, FRCPC,Dean, Rady Faculty of Health Sciences  Univ of Manitoba
Neil Rau, MD, FCPC,Infectious Disease Specialist
Richard Reznick, MD, FRCSC, )Dean Emeritus, Faculty of Health Sciences, Queen’s Univ
Susan Richardson, MDCM, FCRPC,Professor Emerita,  Toronto
Richard Schabas, MD, MHSC, FRCPC,Former Chief Medical Officer of Health,  Ontario
Gregory Taylor, MD, FRCPC, Former Chief Public Health Officer of Canada
David Walker, MD, FRCPC,Former Dean of Health Sciences, Queens Univ Expert Panel on SARS, 2003
Catharine Whiteside, CM, MD, PhD, FRCPS(C), FCAHS,  Former Dean of Medicine, Univ of Tor
Trevor Young, MD, PhD, FRCPC, FCAHS,Dean, Faculty of Medicine  Univ of Tor.  and others.

YOU TEST POSITIVE – Public Health will contact all positive cases

-Self isolate at home for 14 days from the onset of your symptoms

-You can come out of isolation 14 days after your symptoms began, if you’re feeling better, and don’t have a fever (your temperature remains lower than 37.8 degrees Celsius) and can return to work but must maintain physical distancing.  

-Clearance swabs are not required for individuals to return to work.  

YOU TESTED NEGATIVE

-If you tested negative for Covid-19 you will still need to stay in self-isolation for a period of time, as you could still be at risk of developing Covid-19 based on your exposure or you may have another illness.

If no known exposures to a Covid -19 case:

-You should remain in self-isolation for 24 hours after your symptoms resolve

If you recently travelled outside of Canada or have been in close contact (eg. in the household or workplace) with a case of Covid -19, you need to:

-Remain in self-isolation for 14 days after your last exposure.

Though you tested negative, if you develop new or worsening symptoms, you may need to get re-tested.

YOU ARE AWAITING RESULTS

–Self-isolate at home until your results are received.

-Members of your household should self-isolate with you until your results are received.

HOW CAN I OBTAIN MY TEST RESULTS

 -Follow guidance provided by the clinician who test you.

-Check the online portal

-Refer to the website of the institution where you were tested:

  Trillium Health Partner

  William Osler Health System

  Headwaters Health Care Centre